The quest that has consumed Mathilde Krim for 20 years began with a friend's phone call.
Joseph Sonnabend, who practiced medicine in New York's Greenwich Village, had started noticing strangely similar symptoms in some of his gay male patients: swollen lymph glands, enlarged spleens and stubbornly resistant infections. Their immune systems were seriously compromised.
In the ensuing months, the mysterious syndrome revealed its ominous power: It killed every one of Sonnabend's affected patients.
Krim, then a researcher at the Sloan-Kettering Institute for Cancer Research, helped Sonnabend analyze some of his patients' blood samples.
"It was totally mind-blowing for a scientist who thinks she knows something to realize that, here in the middle of New York in the 20th century, a new disease could occur," said the 74-year-old Krim. "I personally didn't believe for a minute that being gay could cause it. It was a scientific and medical puzzle that attracted my attention."
She wasn't sure what she was studying, but based on the disease's mounting incidence in the early 1980s and distribution in the population, she felt certain it was spreading. She feared a major epidemic and voiced her concerns to all who would listen.
But when Krim tried to rally scientists, corporate donors and government officials to help contain the disease, most turned away. Time and again she heard the words: The disease was striking "those who deserved it."
"In those early days, they were literally dying in the streets," Krim said. "[Gay men who had AIDS] lost their jobs, their apartments--their families turned away from them. It turned my stomach, it really impacted me and I decided this was something not to be tolerated."
Krim and a few fellow scientists strove to uncover the disease's cause, modes of transmission and possible treatments. But because they couldn't raise funding, their efforts were largely stymied.
She watched angrily, helplessly as AIDS started showing up in other populations: hemophiliacs, intravenous drug users, blood transfusion recipients and newborns.
Still, the public and many government officials seemed surprisingly unconcerned. In 1983, Krim took matters into her own hands. She established the AIDS Medical Foundation to serve as a "scientific venture capitalist." It would provide seed money to researchers with innovative AIDS-related theories and technologies--scientists who, in many cases, had been turned down for funding by government agencies. She also hoped her organization could educate the public about the disease and would effectively lobby for legal protection of the afflicted.
Krim's second husband, former United Artists Chairman Arthur Krim, tendered the organization's first capital--about $100,000. Within 90 days, Mathilde Krim raised $550,000 more.
Soon, a growing number of researchers turned to her organization for funding. Krim began putting in 16-to-18-hour workdays, seven days a week to oversee operations; visit hospices, clinics and adult day-care centers; keep current with scientific literature; and host fund-raisers.
She learned that a West Coast-based nonprofit group, the National AIDS Research Foundation, was performing similar functions. In 1985, the two organizations merged to form the American Foundation for AIDS Research (http://www.amfar.org). Krim became chairwoman of the new group's board. Then she embarked on a controversial public-awareness campaign.
She lectured about the dangers of unprotected sex and urged the closing of gay bathhouses, irritating many gay men. She angered heterosexuals by deeming some of them hypocrites: How, she asked, could they condemn gay men for being dangerously promiscuous when they actively thwarted homosexuals' efforts to have legitimate monogamous relationships? She riled government officials by advocating the distribution of disposable hypodermic needles to intravenous drug users.
As a scientist, Krim proved herself a bit of an anomaly. Though her profession prides itself on aloof objectivity, Krim has gained a reputation for being compassionate and empathetic. On occasion, colleagues criticized her for letting her heart overrule her head.
Mervyn Silverman, former president of AmfAR and now a San Francisco-based health consultant, recalled attending a New York City fund-raiser with Krim. During dinner, Krim suddenly excused herself and disappeared behind a curtain. Silverman followed her, and discovered her weeping.
"She had been talking to a man who had been telling her about what his partner had gone through from the ravages of AIDS," he said. "It affected her that much."
Krim's early years were spent in Italy and Switzerland.
In the 1930s, as Adolph Hitler rose to power in Germany, she became aware of rising anti-Semitism around her. She had little exposure to the people who were targets of the comments, but that changed after World War II when she saw Holocaust film footage. It terrified her and she wept.
She confronted her parents, who, she said, were "mildly anti-Semitic." She urged them to see evidence of what had been done to the Jewish populations of Europe. They refused.
"When I learned what happened to the Jews, I confronted the reality that racism is murderous," Krim said. "I learned a lesson there."
Rebellion followed. Krim enrolled in the University of Geneva, where she was one of two women studying science. Because the discipline was considered an "old maid's career," her parents had tried to dissuade her from it. They failed.
While at the university, she met many Jewish activists and fell in love with one: a Bulgarian medical student who was a member of a Zionist underground movement. She joined the organization, eventually smuggling guns across the Swiss-French border for its members. Somehow, she kept up with her studies, earning a bachelor's degree in genetics, then a doctorate. She graduated in 1953.
When she told her parents that she intended to marry her boyfriend and convert to Judaism, they took it badly.
"My father fainted on the dining room floor, it was such a shock," she said.
The newlyweds moved to Rehovot, Israel. Krim, who's fluent in five languages, became a research associate at the Weizmann Institute of Science, studying cytogenetics and cancer-causing viruses. She was part of a team that discovered how to use amniocentesis to determine a fetus' sex.
Her marriage ended in divorce, but in 1956, she was introduced to Arthur Krim, a Weizmann Institute trustee. Two years later, after a long-distance courtship, they married. She moved to New York, accepting a position at Cornell Medical School to study cancer viruses.
In the early 1970s, she became intrigued by interferon, a glycoprotein produced by cells to fight viral infection. Based on early research, she suspected it could prove effective against some viruses that caused tumors.
She focused almost single-mindedly on the substance, believing that it might lead to a more humane cancer treatment than the often brutal radiation, surgery and chemotherapy methods.
Some of her peers quickly dismissed it as valueless, however, nicknaming it "imaginon" and branding it a "lunatic cure." Due to Krim's zealousness, and perhaps because of her then-new position as director of Sloan-Kettering's Interferon Lab, some also began calling her "the Interferon Queen."
Interest in interferon as a therapy waned by 1983. Undeterred, Krim continued studying it, now hoping it might be effective against AIDS-related Kaposi's sarcoma.
Though her efforts have been slow to pay off, in recent years she's received some vindication. Interferon has proved effective in inducing remissions in hairy-cell leukemia, and now is used to treat a long list of serious maladies: bladder cancer, renal cell cancer, hepatitis C, malignant melanoma, multiple myeloma, non-Hodgkin's lymphoma and Kaposi's sarcoma.
Krim's next scientific-political skirmish occurred in the mid-1980s when the drug azidothymidine (AZT) was shown to stop the AIDS virus from multiplying in some patients. Its manufacturer, Burroughs Wellcome, planned to follow standard research procedure by conducting double-blind clinical trials to learn about the drug's efficacy and side effects. Some AIDS patients in the company's trials would receive placebos; others the AZT.
But Krim forcefully objected. She believed it to be immoral to withhold a potentially promising therapy from individuals who, if untreated, would certainly die. She testified before Congress; at first her efforts were to no avail. However, two years down the road, her vision was realized: In clinical trials for new AIDS therapies, AZT has replaced the placebo.
"It's part of her makeup to take up the cause of people who don't, at the time, have advocates," Silverman said.
Krim is quick to admit that the war against AIDS is far from over. In fact, she estimates that researchers are only "halfway down the road" to a cure. She ticks off the obstacles.
No vaccine is ready for field-testing, she said. No microbicide has proven effective in preventing HIV transmission. Antiviral agents used in HIV treatment have a 50% failure rate. And Krim worries about the growing complacency of the public about HIV transmission.
But AmfAR and Krim are continuing to have an impact. Since 1985, AmfAR has invested nearly $175 million in AIDS-related research, prevention campaigns, education and public-policy efforts. It has awarded grants to more than 1,850 research teams throughout the world.
Krim recently received the Presidential Medal of Freedom for her AIDS-related work.
"She's the perfect example of how one person really can make a difference," said Susie Zeegan, co-founder of the Elizabeth Glaser Pediatric AIDS Foundation, who has known Krim for 12 years.
At an age when many opt to play golf and travel the world, Krim said she has no plans to turn away from her 20-year quest to eradicate AIDS, or from those who need her help.
"I am determined to stay with this issue," she said. "I think science can solve the problem."