BOSTON — The telephone call from his physician, Dr. Robert T. (Chip) Schooley, reached Jeffrey Mullican, a 32-year-old trade association executive, in his office at 1:26 p.m. on Thursday, Sept. 18, and lasted only a few tremulous seconds. Later, after yet another of his seemingly endless struggles to keep his balance between fear and hope, Mullican called his parents.
"Mother, I have good news," he said, and repeated what Schooley had told him. "Oh my God," she said. "I'm so happy I could cry. Our prayers have been answered."
In fact, they had and they had not.
Hope is the oxygen of the spirit--the indispensable, life-sustaining possibility that the terrors of today may lift tomorrow. But, as Mullican has learned, hope has a dangerous tendency to surge out of control, to sweep away the best-built defenses and open the way to risks of unbearable disappointment. For almost six months, he has been a man on an emotional tightrope, teetering between euphoria and despair.
Mullican, who is gay, has AIDS. Four months ago, facing almost certain death in less than a year, he made a fateful leap by joining a nationwide clinical test of a potentially helpful new drug--a test in which half the patients would receive the drug for six months while half got medically worthless sugar pills as a control, with neither the patients nor their doctors knowing which was which.
Although necessary to assure scientific impartiality, the so-called double-blind test meant that, even if the drug proved beneficial, it might come too late for those who had received the placebo.
Use of Drug Expanded
Last week, scientists monitoring the overall progress of the test at 12 medical centers across the country decided that patients receiving the drug, called azidothymidine, or AZT, and manufactured by the Burroughs Wellcome Co., were doing so much better than those on the placebo that medical ethics demanded the experiment be halted and AZT be given to all patients.
For Mullican and thousands of other AIDS patients, that was potentially hopeful news--if it was not already too late. The call from Schooley, who headed part of the study at Massachusetts General Hospital, answered a crucial question for Mullican:
"I wanted you to know," Schooley told him, "Burroughs Wellcome just called and gave us the numbers (the identifying code numbers) of the people who have been on the drug. You're one of them."
Initially, Mullican remembers, he was very calm. "I won't let myself get too excited about this," he said. "It's only a first step--a very positive one, but it's certainly far from an answer. The unfortunate truth is that I still have AIDS.
"It's a little like sitting on Death Row and getting a reprieve, but not knowing how long that reprieve is going to last," Mullican said. "I would like to think it's going to last 50 years. But there's no way of knowing."
What Mullican understands is that researchers do not consider AZT a cure and that no one yet knows how long the drug will prolong life, or what its side effects might eventually prove to be.
"In that sense, individuals like Jeff are real pioneers," said Schooley. "They've been on the drug longer than almost anyone else."
Acquired immune deficiency syndrome, a viral disease that destroys the immune system, has primarily afflicted male homosexuals and male bisexuals, intravenous drug users and recipients of contaminated blood transfusions and blood products such as those given to hemophiliacs. AIDS is transmitted through intimate sexual contact--through the exchange of body fluids such as semen and blood--and through the sharing of hypodermic needles.
Thousands Have Died
The disease has already taken nearly 14,000 American lives and, without a medical breakthrough, is expected to claim hundreds of thousands more in the coming years.
It usually manifests itself in the form of one or more specific conditions: The patient suffers from certain rare cancers, from neurological disorders or from a rare and insidious respiratory infection called \o7 pneumocystis carinii pneumonia.\f7
Mullican had suffered one bout of \o7 pneumocystis\f7 last April, when he was diagnosed as having AIDS. He had been doing extremely well since his one episode of \o7 pneumocystis: \f7 He had regained the 20 pounds he lost during his illness; he had been able to work every day, and--most important--he had not had a recurrence of pneumonia.
Still, AIDS patients with \o7 pneumocystis \f7 typically survive no longer than 35 to 40 weeks. That is why Mullican was so anxious about the possibility that he could have been one of those receiving the placebo instead of AZT for the 14 weeks he had been taking the pills.
That is also why--encouraging as the early results are--Schooley was reluctant to predict the future--Mullican's or any other patient's.