In her oral history interview, former consultant haematologist Professor Christine Lee talks about her work during the AIDS epidemic of the 1980s. Professor Lee oversaw the care of haemophilic patients who had contracted the HIV virus through blood transfusions. These short extracts from her interview outline some of the ethical, medical and cultural challenges she faced.

Professor Lee was working in a research post at the Haemophilia Centre at the Royal Free Hospital, London when she first encountered patients with what would later be identified as AIDS:

It was at the end of 1982 [that] the first cases of this strange new immunodeficiency syndrome had appeared in people with haemophilia; it wasn’t really clear what was happening.  

They were presenting with strange infections.  I mean I can remember in particular the oldest patient we had, he was 85 at the time I was looking after him, and I was looking after this strange pneumonia and testing him for things like tuberculosis, glandular fever, all sorts, he had this mottled lung and I couldn’t find anything and eventually he died.

Other interviewees in the RCP oral history project who were working at this time echo the feelings of confusion and fear, both among medical professionals and the general public, which Christine describes:

I had my first patient with AIDS in 1982 – he came in with a cough, a cough like I’d never seen before … I remember seeing the Xray and we took it to the radiologist and said, “What’s this?”

Robin Scott, former consultant physician in East Berkshire 

We had this experience in the [Haemophilia] Centre of looking after these patients in a climate, nationally, of great fear, you know, people were afraid to touch them, people thought you were going to get AIDS from lavatory seats, there were all sorts of things going on.

Christine Lee

Once more was known about AIDS and how it spread, educating the public became a priority, both for the government, who launched their ‘Don’t Die of Ignorance’ campaign in 1987, and for the medical profession. Christine, now in a new role as consultant haematologist at Queen Mary’s Roehampton, was heavily involved in this education drive:

I went round every secondary school [in Richmond]… to give a lecture on HIV. And, you know, at that point it was really scary, what the government said at that time was what was understood and what was thought, that it was going to be exponential and everybody was going to die.  

And there were these sort of graphs that went up exponentially and so this was the message I had to take round to the schools and the other message that, you know, they really wanted propagating was the fact that you didn’t get it sitting on a lavatory seat and you weren't going to get it touching people.

Intensive research into the virus and how to treat patients was started, and Christine describes how the profession came together in the days before the internet to discuss developments. During her time at the Royal Free she attended these sessions regularly. The first effective antiretroviral therapy wasn’t approved for use until 1995. In light of this, these meetings and research efforts were important in giving physicians a sense of purpose and optimism during a very bleak period: 

Every month there was a meeting… and everybody who had any kind of involvement in this new condition went to that meeting because things were moving so fast that you couldn’t really wait until it got published.  It was just going really fast.  

And there were some extraordinary meetings… When the tests first became available they had a debate from somebody from the AIDS community, a patient, and… Ian Kennedy. And he had this debate to test or not to test because, you know; there was nothing you could do much.  

There were pathologists who talked about the various immunodeficiency disorders and early epidemiologists. So it was – it was a little community.

I have absolutely no doubt that the research over the years, from the 80s and early 90s until we had some treatment to offer, the research was a safety valve for the staff actually because you really were helpless. You had no specific treatment for these patients except giving them what was called prophylaxis so you put them on Septrin to stop them getting pneumonia, you put them on Acyclovir to stop them getting viral infections and Fluconazole to stop them getting thrush but you couldn’t do anything else. And they were young people. It was awful.

Sarah Lowry, oral history project officer

• 1 December 2016 is World AIDS Day. The British Association for Sexual Health and HIV (BASHH) is the specialist society for medical practitioners, nurses, health advisers, scientists in the field of medicine, and other healthcare workers in the specialty.
• You can find Professor Lee’s full interview and other interviews from the oral history project on the RCP library catalogue.
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