AIDS Doctor Battles a Staggering Caseload in Trying to Care for the Littlest Victims

He is a champion of children, a gallant gladiator of medicine, a helper of the hopeless fighting their invisible, incurable killer.

James Oleske is a pediatric AIDS doctor, an advocate of hundreds of poor and chronically ill children. In trying to save their lives, he has given up much of his own.

As medical director of the AIDS program at Children’s Hospital in Newark, the 46-year-old immunologist has no fears of losing his job. “As I tell everyone, mine’s the most safe job in the world. No one’s looking to take my job away.”

No wonder. His caseload is staggering, morbid and tragic: 250 patients who are ill with acquired immune deficiency syndrome, 200 more who need to be evaluated each year because they are born to mothers infected with the disease.

Worse yet, it’s a family disease. “The mother is dying of the same disease the child is dying of,” he said. “If they don’t die before their parents, they may become orphans.”

An average day for Oleske and his associates is 8 a.m. to 8 p.m. Sometimes, it is 16 hours. His work never ends, stretching beyond the clinics, the hospital rooms and the laboratories.

Heartaches abound. “We’ve had a number today,” Oleske said during one particular day of setbacks. “They’re getting sicker, and I’m trying to deal with that. Right now, I’m a little depressed.”

He tends to the mental casualties of the disease--the families--as well as the physically wounded. And, with AIDS, there comes a time when he no longer can stall death.

“When you have to talk to a parent about not resuscitating their child, that becomes a very emotionally draining experience,” he said.

And how do you tell children they are dying of AIDS?

“You don’t say they’re dying of AIDS,” Oleske said. “You say they have an infection. You explain what the infection is as best you can. You try to answer their questions. I think it’s important that children over the age of 5 begin to be talked to about the disease because they pick up very quickly that they’re going to an AIDS clinic.”

Oleske has witnessed the deaths of more than 125 of his wards, too many for a pediatrician.