As a UCLA researcher, Dr. Michael S. Gottlieb headed a team that first reported a new disease, now known as AIDS, on June 5, 1981. Gottlieb, 58, is now in private practice in Los Angeles, primarily treating AIDS patients.
In a room overlooking palm trees and high-rise buildings on Wilshire Boulevard, Gottlieb flips open the medical file and starts reading aloud.
"Diagnosis of HIV infection ... finger-stick test ... high-risk sex ... T cells ... viral load ... "
Gottlieb looks up a few times at Gabriel, a 26-year-old man with soft brown eyes, who tested positive for HIV 2 1/2 years ago.
Some numbers charting Gabriel's infection are worrisome. Gottlieb, an avuncular man with thinning brown hair, wants Gabriel to know just how easy it is for the virus to get out of hand.
Gabriel, too young to remember the horrors of the early years of the AIDS epidemic, sits silently. Then Gottlieb gives him the good news. After six months of drug therapy, Gabriel has a virtually undetectable level of the virus in his blood.
Gabriel says he has been thinking a lot about the future -- a new job, the house he wanted to buy with his boyfriend, zooming around in their new Audi A3. "I just got back from Vegas this morning," he says. "Wow, could this day get any better?"
Frank Dagri, a salty 52-year-old from Canoga Park, is waiting in the next room.
Gottlieb knows Dagri is old enough to remember when people were dying all the time, and he doesn't have to be reminded of the perils. Instead, Gottlieb begins kidding around to lift his spirits.
Dagri thinks he was infected about 15 years ago by a girlfriend. He gave it to his ex-wife before he was diagnosed. She died in 1996.
Gottlieb knows that Dagri is up against a wall. Of the two dozen or so drugs on the market, he is resistant to all but two.
"I've always looked at AIDS therapy as a series of leaky lifeboats," Gottlieb says. "You stay in the first one until you're sinking, then you jump to another one. But you don't give up looking for others."
Lately, Dagri has been taking an experimental drug, maraviroc. For the first time in years, his T cell count -- a key measure of his immune system's strength -- has jumped into a passable range.
Gottlieb is encouraged, but Dagri worries the drugs will eventually fail like the others. "If they don't invent another one, I'm as good as dead," he says.
In the old days, Gottlieb says, he used to sign two or three death certificates a week. Lately, it's about six a year.
"He's doing OK," Gottlieb says, with a tilt of his head.