Dr. Kim S. Erlich is a board-certified internal medicine and infectious disease specialist in Burlingame, Calif. In our "Meet the Specialist" series, we highlight the unique perspectives of various medical specialists on the types of patients they see, and what they find rewarding and challenging in their daily practice. As an infectious disease specialist, I specialize in treating patients with difficult-to-diagnose and often serious infections. This has given me the opportunity to study a range of conditions that represent some of the most challenging medical dilemmas of our time. But my career took an unexpected and life-changing turn with the outbreak of HIV (human immunodeficiency virus) in the early 1980’s. An incurable virus that attacks the body’s immune system, HIV has taken a great toll on our nation and the world. As I’ve worked with patients over the years helping them battle what was once a death sentence, I’ve seen both the fragility and the resilience of the human spirit in stark relief. My specialization in infectious diseases has given me a deeper understanding of this disease and I encourage anyone battling HIV to seek a doctor who’s had significant experience treating this complex virus. Why Medicine? Growing up, I always loved math and science. These interests led me to majoring in chemistry in college, but I also found that I wanted to work closely with people. This eventually led me to a career in medicine, and a realization that there are many ways science can positively impact human health and human lives. As a medical student, my chemistry background fostered an interest in the relationship between medicine and the human immune system, which motivated me to specialize in infectious diseases. Each year and each decade, doctors and scientists make advances in the field of infectious diseases, but we remain in awe of and humbled by the mysteries that remain. One mystery we are understanding more over time is the immune system and all of its complexities. Our immune system is highly adapted to our environment and to the organisms we share space with, but at the same time, it can completely unravel if just one piece of the intricate immune system is disrupted or lost. Exploring this phenomenon has been at the core of my career as an infectious disease specialist, and continues to motivate me as I treat patients battling infectious diseases ranging from Lyme disease, an infection carried by ticks, to influenza (flu), a contagious viral respiratory condition. How the HIV/AIDs Outbreak Shaped Me While I was still in medical training, the HIV/AIDS outbreak took the world by storm. Epidemiologists, scientists who study diseases, quickly determined that the cause of the illness acted like a contagious virus, causing people to become ill and ultimately die—but there were many unanswered questions. Intrigued, I moved to San Francisco so I could work firsthand in the midst of this new and frightening epidemic. Over time, scientists and clinicians learned an enormous amount about the HIV virus itself, the risk factors for catching the disease, and how the virus attacks the immune system. It took time to develop effective drugs to inhibit the virus and ultimately treat and save our patients’ lives. This period of time was terribly difficult, as patients continued to die until effective medications were available. Many of my colleagues experienced burnout and depression, as we felt powerless to treat patients effectively without adequate medication. To make matters worse, in the early years of the HIV/AIDS epidemic, there was a great deal of shame associated with a diagnosis of HIV/AIDS. On many occasions I heard my patients say: “I wish it was cancer, then I could tell people.” As a physician, I had to watch patients cope with both the emotional burden of their diagnosis as well as the physical deterioration of the disease. But these experiences with so many brave and courageous patients made me a more compassionate doctor and taught me to value life that much more. A New Era However, I feel strongly that those who died did not die in vain. Many of those brave souls paved the way for the current era of HIV/AIDS management. Perseverance and medical advancements have made a diagnosis of HIV infection a very different disease today. I now tell my patients that they will likely live a normal or near normal lifespan despite being infected with the virus. The disease is still serious, but thanks to safe, effective drugs, increased knowledge, and the greater availability of support centers, the infection is manageable. That’s why I advise anyone with HIV to avoid resorting to denial, fear and shame, and to seek a doctor, such as an infectious disease specialist, with solid experience in treating this virus. With this relationship as a grounding point, patients can learn to navigate their disease and live full, happy lives. As a physician, I am thankful to be a part of this process.