HIV and ID Observations

At the IDSA meeting in 2012, John Bartlett gave a lecture called, “Infectious Diseases Update for the HIV Provider” — what a great title — which was, as usual, information-packed, practical, well-referenced, and just plain fun. It also occurred to me at the time that there is probably no other person on the planet who could give this lecture, and made me vow to write something about what a treat it is chatting with John at ID meetings or other events.

For those of you who don’t keep up with the celebrities in Infectious Diseases, John was Chief of the Division of Infectious Diseases at Johns Hopkins for 26 years, stepping down in 2006. He was also the Co-Chair and one of the founding members of the Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents, a position that we’ve just learned he is leaving this year.

But John is much, much more than these titles. John is the true Renaissance Man of Infectious Diseases, the person in our field who somehow seems to know something — and usually a lot of something — about everything.

You want some examples? How many ID doctors are true experts in all of the following distinct topics?

• HIV
• Clostridium difficile
• Respiratory tract infections
• Antimicrobial resistance
• Anaerobic pulmonary infections

I’m fairly certain the answer is “Just one — John Bartlett”, and I’m no doubt doing him a disservice by leaving off several other areas of expertise that should be added to the list. Most of us ID doctors would make a career out of one of these topics.

The other impressive thing about John is that he’s a true visionary. Says his long-time former colleague Joel Gallant:

John is a man of incredible vision. He always knows what the next big thing will be, and embraces it long before it becomes the next big thing. There are many examples: managed care, bioterrorism, medical education on the internet (before he knew how to turn on his own computer), pandemic flu, and of course HIV/AIDS. Back when most hospitals, university medical centers, and ID divisions were running away from the AIDS epidemic, John took it on, both as a scientific priority and a moral imperative. With the help of Frank Polk and the Hopkins president, he established an outpatient AIDS clinic and an inpatient AIDS ward—both of which were way ahead of their time.

This last part is well worth reading again, which is why I bolded it. To start an HIV program at Hopkins in the 1980s was a truly brave move; many hospital administrators (possibly at Hopkins and definitely elsewhere — ahem, looking at you one particular Harvard hospital) strongly opposed opening HIV clinics or inpatient services, as they feared the stigma such a clinical and research focus would bring to their institutions. John discusses these early days in more detail here.

Finally, is there a person better at combining both the practical and the scholarly aspects of Infectious Diseases than John G. Bartlett?  And someone who does it with such excitement? Not a chance — think of his numerous guidebooks … his “Game Changers” or “Hot Topics in ID” lectures at IDSA … his end-of-the-year summaries (here’s a good one for 2013, didn’t know there was a Mimivirus!) … his “Awards”, such as this one for most important bacterium, of all things.

You can just sense how fascinating he finds each of these topics, and that enthusiasm inevitably makes us excited too — a key quality of a great teacher.

John will be missed on the Guidelines panel, but we will always know where to find him at our ID meetings — sitting toward the front at a major plenary session, taking careful notes in longhand on a large yellow pad.

Hey, he doesn’t want to miss anything!

(One in a very occasional series.)