Dr. Bernetha George has gone to war with the powers that be on behalf of her patients.
Dr. George's patients are poor, uneducated and unemployed. They are intravenous drug users who have been infected with HIV, the virus that causes acquired immune deficiency syndrome.
It doesn't matter whether Dr. George wins or loses her battle. Her patients will still be poor. They will still be uneducated; still doomed, some day, to die of AIDS.
At most, she has gone to war to buy her patients a little time, a little comfort, and possibly a little dignity.
The powers that be seem to think Dr. George is a mad woman to launch a war like this, for they can squash her like a bug.
I hope they don't. I hope she survives this war.
"What can they do to me? They can't do anything to me," protested Dr. George when I warned her that the powers that be might be moved to retaliate against her for going to the press.
"I'm concerned about my patients. We're not gods. We're not perfect. The best we can do with AIDS, is just that -- the best we can do. And to see ourselves doing less than that for our patients is just not acceptable."
"I know who you've been talking to, you've been talking to that Dr. George," growled Elias Dorsey, acting health commissioner and one of the powers, when I asked him about some of the issues raised.
"Well, I don't want to talk about it. I don't want to talk about her. I'll just tell you this. She's wrong. She's wrong about everything."
"They act like I'm crazy," said Dr. George. "I can't understand why they can't see that on an issue like this, I can't give up, I can't back down. Our patients are the totally disenfranchised. They have been kicked enough. They deserve nothing less than our best."
Dr. George is the medical director of the Daybreak Rehabilitation Center, a methadone maintenance program in Cherry Hill.
Last year, the federal government-- noting that AIDS is growing fastest now among intravenous drug users -- gave the clinic money to provide on-site treatment for clients who have tested positive for HIV. To date, 32 of the clinic's 225 clients have tested positive and are undergoing treatment.
Dr. George claims the physician treating the AIDS patients is inexperienced in the field. Over the past several months, she says, he has mishandled crucial blood tests, prescribed medicines inappropriately and failed to communicate effectively with his patients. Although he claimed to have had experience treating AIDS victims, the physician's training is in another field entirely.
After several attempts to rectify these problems, Dr. George and the clinic's administrator dismissed the physician.
However, the physician, who could not be reached for comment, appealed his dismissal to the health commissioner. He was reinstated last week after a review of his casework, but with the proviso that his work be closely monitored.
Dr. George claims politics, not quality of care, determined the health commissioner's ruling. She adds that the commissioner's office violated federal procedures regarding patient confidentiality when it conducted the review.
"She's wrong about that, too," said Dorsey angrily, repeating that he would not discuss the case further.
Dr. George refuses to let the matter rest, nor should she.
To date, the state has identified 1,997 diagnosed cases of AIDS in the city since Jan. 1, 1981. Two-thirds of those patients already have died.
The virus continues to spread, although there are things, such as changing their diet and lifestyle, that people with HIV can do to stave off the onset of AIDS. Certain treatments, primarily with the drug AZT, can prolong life.
But what if health administrators have gotten cavalier about the quality of care provided certain segments of the community?
Maybe they are so desperate for physicians willing to treat AIDS patients that they compromise on competence.
Or maybe officials have so little faith in the public's commitment to treating the poor that their impulse is to hide problems rather than deal with them openly.
Dr. George believes these attitudes contribute greatly to our inability to stem the spread of this disease.
She makes a lot of sense to me.