AIDS Shakes Trust Between Doctors and Patients : Health: More patients are learning that they were exposed to people infected with the HIV virus. Such disclosures have spawned anger, anxiety, frustration and fear.

That sunny Thursday in June had been one of those rare, perfect days for Kelly Wolgemuth. She had enjoyed the swimming pool with her year-old son, basking in the warmth of this “wonderful ball of joy” she had conceived via artificial insemination.

The sunshine of that day quickly faded, Wolgemuth recalled, not only for her, but also for more than 400 other women in central Pennsylvania.

Awaiting her when she returned home was notice of a certified letter. She and her husband knew what it was even before he picked it up. They had heard the news on television: A resident physician who had cared for her at the infertility clinic was infected with the AIDS virus.

“There was just a terrible, sinking feeling,” she remembered. “I was scared.”

“Oh my God! I’m going to die,” she thought. “Could this possibly be?”

More and more patients are learning that in seeking treatment, they also were exposing themselves to people infected with the AIDS virus. Sometimes they learn of the risk only after the carrier has died.

The revelations are widespread--in Harrisburg, Hershey and Pittsburgh, Pa.; from the Maryland Penitentiary to the college town of Morgantown, W. Va.; in California, Illinois, Michigan, Ohio, Wisconsin, New York, New Hampshire, Georgia, Florida and Texas.

Such disclosures have spawned anger and anxiety and frustration and fear among patients, even though medical authorities say the risk of getting AIDS this way is very low. Thousands of patients have dialed hospital hot lines and talked to counselors.

Is this an overreaction? The federal Centers for Disease Control says the only known cases of doctor-patient AIDS transmission are those of five people who got the disease from a Florida dentist.

Yet the sacred trust between patient and doctor has been shaken. There is nationwide debate as to whether medical and dental personnel should be screened for AIDS, and legislation and guidelines on such testing have been proposed.

The U.S. Senate in July approved a measure that would jail AIDS-infected professionals who perform invasive procedures without telling patients they carry the HIV virus. The U.S. House has yet to take up the bill.

At the same time, the CDC issued guidelines recommending that doctors and dentists who perform surgery or other invasive procedures voluntarily take AIDS tests and stop practicing if they are infected.

An emergency room physician in New York state who practiced for six years after he learn he had HIV was the first doctor known to quit as a result of the guidelines. Dr. Neal Rzepkowski of Dunkirk, N.Y., said none of the more than 4,000 patients he treated was infected.

The controversy has raised broader issues, such as privacy. Pennsylvania’s AIDS confidentiality law, which prohibits divulging names of people infected with the AIDS virus, was tested last month for the first time since it was enacted last year. In what could be a precedent-setting decision, an appeals court ruled that “the scales tip in favor of the public health, regardless of the small potential for transmittal of the fatal virus” from doctor to patient.

The appeals court upheld release of the clinic resident’s AIDS status, and of his name, on a limited basis, to other physicians. His attorney, Bruce E. Cooper of Harrisburg, characterized the disclosure as being made in a “climate of public hysteria which is totally unassociated with any medical or scientific fact.”

Even as lawmakers debate the issue, what is believed to be an unprecedented class action arising from the Pennsylvania case is taking a different tack: that of trying to force a hospital to require AIDS screening of everyone practicing there.

Wolgemuth’s AIDS test was negative, but she and her husband, Kirk, filed the class-action lawsuit on behalf of the 400 patients and their families against the two hospitals that employed the resident--Milton S. Hershey Medical Center and Harrisburg Hospital. The suit seeks more than $80,000 in damages from each hospital.

Deborah Saline of Hershey Medical Center said: “We believe both hospitals acted in a responsible and appropriate manner.”

Kelly Wolgemuth, 28, said there have been “Kelly-bashing” letters to the editor in the local newspaper accusing her of filing the suit for the money because her husband is an attorney.

“I’m not in it for the money,” she said. “It’s the minimum you can put down to get a jury trial. I want people to realize that I could be anybody. I just don’t want people to get those letters. My main thing is to wake up people, get them thinking. I didn’t think much about it and I’m sure a lot of people don’t either.

“If I could just say to them, ‘Do you know if your doctor’s OK?’ Most people don’t know, and there’s no way for them to find out because doctors do not have to tell you.”

The Wolgemuths’ attorney, William A. Atlee Jr. of Lancaster, said he hopes that the suit will force hospitals into mandatory screening instead of awaiting government action.

Atlee believes the suit is the first of its kind.

“It’s a very interesting case that’s right on the edge between the patient and the doctor, between the public and the medical profession,” he said.

“The public feels strongly and, I think, rightly, that doctors and health care providers who expose patients to a risk should be tested,” Atlee said. “The medical profession is unwilling to take that step. This disease is not a cold. It’s a death warrant.”

Kelly Wolgemuth said Hershey Medical Center informed her that the infected doctor participated in her surgery and treatment at the hospital’s infertility clinic. She does not know if he also was involved in the delivery of her son, Christian, on June 7, 1990.

“I was angry at the doctor,” she said. “I was angry at the hospitals for not requiring AIDS testing of their doctors. It’s very frightening because you think of the consequences. A lot of people could be at risk and not know it. Even if a doctor tests positive they are not required to tell anyone. They can continue surgical procedures.”

For some, the rhythm of their lives has changed. They and their children live in an uncertain time, hoping they are not that one person in 41,667 or one in 2.6 million, the range of odds on patient infection given by CDC statisticians.

Another patient, who asked not to be identified, said that such long odds and her initial negative test result do not ease all the concern. She will need three more tests in the next year. Her sex life has been disrupted. Her newborn baby, too small now for drawing blood, will have to be tested when she is a year old.

“You can always be that one person, and until I know for sure, it’s going to always be there,” said the woman, who is in her 20s, has been married almost seven years and has three children.

The counselor at Harrisburg Hospital wasn’t much help because she took things too lightly, the woman said. Rather than use condoms for six months, as the hospital suggested, the woman and her husband decided to abstain.

“I don’t know how we can get back to a normal sex life even after a year, because it’s always going to be in the back of your mind. It does a lot of psychological stuff to you,” she said.

The woman, who has hired an attorney and is planning to file her own lawsuit or join the Wolgemuths’ class action, said she cries a lot and has problems at work.

“I’m a wreck,” she said. “When I’m home, I can cry whenever I want. At work I don’t cry--but I shake. Unfortunately, I’m supposed to be able to enjoy this little bundle that I have. I do enjoy her, but it does take away some of the extra greatness.”

The doctor has not been publicly identified because of Pennsylvania’s confidentiality law, but a county court allowed Hershey Medical Center and Harrisburg Hospital to identify him to other doctors. Patients, however, were not given his name.

The physician, referred to in court papers as “Dr. Doe,” took a voluntary leave of absence in May. His patients were notified June 19.

He testified in a closed hearing that he had himself tested after an attending physician stuck him in a finger with a scalpel while he was assisting in surgery. His attorney said there was no evidence that any patient had been exposed to infectious fluids.

Kelly Wolgemuth said she tries not to think about it now.

“It’s terrible,” she says over and over, sobbing. “You trust your doctor. Some people, that’s all they may have. It may be the one person they trust to inform them.”

“There’s going to be an awful lot of people out there who are not going to have nice lives,” she added.