Dr. Rudolph Almaraz, the Johns Hopkins breast cancer surgeon who died of AIDS last month, continued to operate on patients after he knew he had the disease, his widow said yesterday.
Speaking publicly for the first time, Betty Almaraz defended his decision in an interview with The Sun.
"He was a talented and gifted man. The risks [of his transmitting AIDS to his patients] are minimal. My husband saved many, many lives, weighed against the infinitesimal risk," said Mrs. Almaraz, whose husband, Rudolph, died Nov. 16. "If he had stuck anyone at all, he would have been the first to tell anyone.
"He was concerned about mass hysteria," Mrs. Almaraz said. "He was concerned about creating mountains out of molehills. There was no need to alarm these people."
Mrs. Almaraz also said her husband could not have contracted AIDS any way but from a patient. AIDS is most commonly transmitted through homosexual contact, the sharing of needles in intravenous drug use or in a blood transfusion.
"I know of no instance where my husband engaged in an extramarital affair with a man," said Mrs. Almaraz, who was interviewed yesterday in the office of her attorney, Marvin Ellin.
She said her husband had extramarital affairs with women in the 1970s, but she does not believe he contracted the disease that way. He was not a drug user and he had not had any blood transfusions until his recent illness, she added.
Mr. Ellin has said Dr. Almaraz contracted the disease while operating on an AIDS patient at Memorial Sloan-Kettering Cancer Center in 1983. The New York City hospital has said that Dr. Almaraz never reported a possible exposure during his six-month fellowship there.
Only 37 health care workers are believed to have contracted the AIDS virus from patients under their care. The possibility that any doctor could transmit AIDS to a patient is negligible, health experts say.
Nevertheless, Dr. Almaraz, a surgeon highly regarded for his skill and compassion, feared "his loss of dignity, his loss of practice" if he had revealed his AIDS status, Mrs. Almaraz said. She also said her husband consulted federal health officials and doctors who cared for him and followed their recommendations for continuing to practice safely.
The doctor's illness had been rumored for some months before his death at age 41, but he refused to confirm or deny the rumors to Hopkins hospital and others.
The hospital, where it is believed Dr. Almaraz operated on an estimated 1,800 patients, has since written to Dr. Almaraz's former patients, offering free AIDS testing and counseling should they fear they contracted the virus.
Still unknown, however, is exactly when Dr. Almaraz was diagnosed. Mr. Ellin instructed Mrs. Almaraz not to answer questions about specific dates because he believed lawsuits will be filed against her husband's estate.
Mrs. Almaraz, like her husband, is from San Antonio, Texas. The "high school sweethearts" married in 1971, the year he graduated from St. Mary's University in San Antonio. After he graduated from the University of Texas medical school in 1975, they moved to Baltimore for him to take a surgical residency at Hopkins.
They divorced in 1978, she said, after he engaged in extramarital affairs with other women.
"Back then, there were lots of women after him," she said, characterizing her husband as a young, attractive, up-and-coming surgeon. "There were affairs. Of course, there were affairs."
Even during the years they were divorced, however, the couple lived together at times, she said, such as when he was on the six-month fellowship at Sloan-Kettering in 1983.
They ultimately remarried in 1986, Mrs. Almaraz said. The couple then adopted a baby girl, Rachel, who is now 3 1/2 years old and "knows her daddy died." Mrs. Almaraz said she knew of no other extramarital affairs after their reunion.
Asked whether she thought her husband could have contracted AIDS from another woman, she responded: "Not in 1983."
Mrs. Almaraz, seemingly uncomfortable but composed during the interview, said her marriage was "typical."
"We had highs and lows. He loved me a great deal. I loved him a great deal. We were high school sweethearts. We were as much a part of each other as my left arm is to my right arm," she said. "We had a good relationship."
Mrs. Almaraz said she has been tested and found not to have the HIV virus.
"We were devastated," she said simply of their reaction to his diagnosis of AIDS.
Dr. Almaraz wrote his patients last spring to tell them he was moving back home to Texas and would sell his practice to Dr. Neil Friedman, who had worked with him since June 1989.
"Those were our plans," she said. "I was down there when he became violently ill. I was in San Antonio looking for a house."
That was in early spring, she said. Now, she added, "I don't know what I plan to do. It's a little too early to decide."
Mrs. Almaraz said her husband followed guidelines for health care practitioners who have tested positive for the AIDS virus.