“Typhus is not dead. It will live on for centuries and it will continue to break into the open whenever human stupidity and brutality give it a chance, as most likely they occasionally will.” – Hans Zinsser. The lure of infectious disease began with books (science fiction, noir detectives, Arrowsmith), but the hook was sex and drugs. While debating a life in philosophy or neuroscience (but for the slaughter of mice), I stumbled into volunteering at the Berkeley Free Clinic.
Mentored by charismatics at the radical front of free health care and harm reduction with dignity, these teachers had weathered the Vietnam War, AIDS crisis and multiple injection-drug epidemics. To keep up and care for clients, I had to understand not only chlamydia, abscesses and hepatitis C, but also feminism, gay liberation, sex work, homelessness and criminal justice. The infections were a window into the vulnerabilities of our social immune system. At the University of California, San Francisco, my ID teachers varied widely in appearance and constitution, as well as where they would return after rounds: the laboratories, the clinics, phone meetings with WHO, the city’s public health department and the one attending who would stop by the freeway underpass to sit with one of her struggling patients. ID was the hopeful work of hopelessly tangled systems: global commerce and immunoglobulins; gender, power and negotiating condoms; heroin, the hospital venting systems and where the water flows. My ID mentors and colleagues continue to inspire and surprise me with endless curiosity, rigorous intellectual integrity and ferocious passion for doing the right thing. Typhus is not dead, nor are MRSA, HIV, or human brutality. I am grateful to be an ID physician who can draw on a rich history and community to push against these with vigor and compassion, immersed in the ambitious life’s work of sex, drugs and microbes.
– Dharushana Muthulingam, MD
Clinical infectious disease fellow
Yale School of Medicine