BOSTON — "If I have seen further," Sir Isaac Newton, the great 17th-Century physicist, once said, "it is by standing upon the shoulders of giants."
When the history of the scourge known as AIDS is finally written, perhaps in the 21st Century, Dr. Robert T. Schooley does not expect his name to be numbered among the giants on whose shoulders the conquerors of the dread disease stood. At best, he says, his research may find a place among the footnotes.
Yet, in the collective world of late 20th-Century medical science, researchers such as Schooley play an indispensable role.
"I don't think that in the year 2055 someone will pull out an encyclopedia, look up AIDS and find the names of most of the people doing the work now," he said recently. "When you look at polio, you only see Jonas Salk and Albert Sabin. You don't see the several hundred others who were also doing research. Yet Salk and Sabin couldn't have done what they did without the work of those several hundred other people.
"I don't have any illusions about being remembered as the person who cured AIDS. I want to be remembered as one of the people who contributed."
'A Microcosm of Life'
Since 1982, Schooley, a specialist in infectious diseases at Massachusetts General Hospital, has been engaged in AIDS research. His work has taken place both in the laboratory, where he is studying the body's immune response to the AIDS virus, and in patients such as Jeff Mullican, an early participant in the national study of AZT, the only drug thus far licensed to treat the deadly disease.
"In a sense, research is just a microcosm of life," said the 37-year-old Schooley, known as Chip. "When people think about experiments in science, they think of them as being different from life--but everything you do is an experiment. It's really just the same activity being carried out a little bit more methodically, that's all."
Massachusetts General Hospital encountered its first AIDS patient in 1980, at least a year before the disease was identified as a new medical malady and given a name, acquired immune deficiency syndrome. The patient, a young homosexual, had Kaposi's sarcoma, a capillary cancer extremely rare in that age group. Since that time, AIDS--which destroys the body's immune system, leaving it vulnerable to otherwise rare infections and cancers--has struck more than 35,000 Americans, killing more than 20,000 of them.
The majority of cases in this country thus far have occurred among gay or bisexual men, intravenous drug users and their sexual partners--but AIDS can afflict men, women and children, regardless of their sexual orientation. It is commonly spread through anal and vaginal intercourse, through the sharing of unsterilized hypodermic needles, and by infected women to fetuses during pregnancy.
For Schooley, who chose to specialize in infectious diseases because "you can give people a drug, they get better and go home," the onset of this virulent new epidemic represented a major turning point in his own medical career.
"I'm in it for the long haul," he said. "I hope there is no long haul, but I wouldn't be a realist if I thought it was going to be over quickly. I think we will make progress in a wide variety of areas with increasing speed--but I think AIDS is going to be a big problem for a while."
A Grinding Struggle
As it plays out in his own life, the battle against AIDS has become a grinding, almost prosaic struggle to find enough hours--an ordeal all too common throughout American life. What sets Schooley apart, however, what interjects an undercurrent of urgency he can never quite escape, is the fact that his job lies at the front lines of a life-or-death campaign against a disease that threatens to kill literally every single person it infects.
Schooley is an assistant professor of medicine at Harvard University, for which Massachusetts General is a primary teaching hospital. Like any member of a large, inevitably bureaucratic organization, he must devote many hours each week at hospital committee meetings and similar institutional duties.
The bulk of Schooley's income comes from grants, most from the federal government, in support of his research. Drafting proposals, winning the grants and dealing with the red tape they entail are his responsibility too.
As a senior researcher, he frequently travels out of town to deliver talks and attend major scientific conferences. Such things are necessary if he is to cultivate professional contacts, stay current with what others in the field are doing and maintain his own stature within the AIDS scientific network.
Where AIDS is concerned, Schooley is also a public advocate. He works with a variety of public and private groups to provide accurate information about the disease and regularly speaks against misinformation, discriminatory attitudes and what he considers unnecessary public anxieties about AIDS patients.
Job vs. Family Needs