SURVIVING THE FALL

A moving personal account of a doctor's discoveries about himself as he struggled to care for his dying AIDS patients. In 1981, when the AIDS epidemic was just beginning, Selwyn, newly graduated from Harvard Medical School, joined the Montefiore Medical Center in the Bronx as an intern in family medicine, later becoming medical director of its drug-abuse treatment program. For nearly ten years, his only patients were the HIV-infected, mostly intravenous drug users and their sexual partners and children. Surrounded by dying young men, widows, and orphaned children with whom he found himself making deep connections, Selwyn began to explore his own history and eventually to come to terms with it. His father had died in a mysterious fall from a window when Selwyn was an infant, his apparent suicide a family secret. Selwyn came to see parallels between the stigma of AIDS and the stigma of suicide, between the drug addiction of his patients and his own addiction to work. The stories of five patients had special resonance for him: Nelson, with his idealized family; pregnant Milagro, bent on a path of unalterable self-destruction; Delia, whose infant child would soon be orphaned; Javon, determined to leave his son a legacy; and Betty, with her irrepressible zest for life. Selwyn is led to explore his grief and sense of loss in Kubler-Ross workshops, press his family for information about his father, recover his father's ashes, and finally to visit the site of his death. Going through fear, pain, and darkness, says Selwyn, is a prerequisite to becoming an effective caregiver, as he comes to see the physician's primary role not as an all-powerful conqueror of illness but as a companion to those going though an illness and as a witness to their suffering. Poignant revelations from the heart of a physician.