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AIDS: Pioneering dentist looks back on early hysteria around HIV and AIDS
by Tully Satre

In 1998, Mayor Richard M. Daley completed a multi-million dollar restoration on Halsted Street with nearly two-dozen rainbow-linked bronze pylons. One of the unique charms of the city in the past decade and a half has been its official nod towards the vibrant gay community.

Seeing a street lined with monuments that mark the city's official acceptance of the gay community, it is hard to imagine this was ever a place you could lose your job for being HIV-positive. A mere seven years prior to the city's official recognition of its own gay neighborhood, Chicago had a very different attitude towards the gay community, especially people infected with HIV—a virus associated with gay men. ( Although AIDS discrimination is no longer officially sanctioned, it does of course still occur. )

Prior to revealing his HIV status to his superiors in 1991, Dr. Larry Spang recalls how a fear-induced media began affecting his performance at work. "Even though we knew we were being very careful, we were still very nervous," Spang explained of HIV-positive doctors. "If somebody found out you were positive, [ it ] could end your career."

Spang was the chief dental officer at the Metropolitan Correctional Center ( MCC ) on the corner of Clark and Van Buren. MCC is a federal prison famous for its jagged triangular shape, mustard exterior and razor-thin windows. Spang recalled losing sleep as headlines rolled in daily with high tales of patients becoming infected by their doctors, "Every day I would open the newspaper and see another headline," he said.

In January 1991, following a statement released by the U.S. Centers for Disease Control that a Florida dentist may have transmitted the virus to three of his patients, the Chicago Tribune reported that the American Medical Association and the American Dental Association urged its HIV-positive members to avoid invasive procedures or otherwise reveal their HIV status to patients. "I felt threatened," Spang said, "not by anyone in particular but by the world in general."

As the months went by, stories began to surface about Dr. David Acer, the HIV-positive Florida dentist who was in trouble for passing on the virus to his patients, "knowingly," Spang said. One of Acer's patients, Kimberly Bergalis, became the poster child for implementing policies that would mandate HIV testing for all doctors.

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Bergalis exhibited signs of AIDS in 1989, two years after an invasive dental surgery performed by Dr. Acer. All signs of the otherwise healthy 22-year-old pointed towards her contracting the virus from her dentist. As the nation's media witnessed her health slowly failing to the disease, the American public fell victim to fear and Spang grew increasingly nervous about his job. With panic about HIV-positive doctors and dentists widespread in America, Spang decided it was best to reveal his status.

"I used an over-abundance of caution, because I had to," Spang said of his decision to reveal his status. "I was really getting into iffy situations." He made an appointment with the assistant surgeon general in Washington, D.C., one of the chief officers for the U.S. Public Health Service, which had given him the job at the prison.

"I went to Washington and walked into the assistant surgeon general's office and said, 'I'm HIV positive,'" Spang explained, "And he asked me if it had anything to do with IV drugs, and I said 'absolutely not' and so he told me, 'then you have nothing to worry about.'"

To this day Spang still is not sure how they found out, but it was not long before the same CDC team that had investigated Dr. Acer flew to Chicago. CDC put Spang up in a Gold Coast hotel room and performed an intensive investigation over the course of three days before returning to Atlanta. Within six weeks, the team produced a report. "It told me things about my medical history even I didn't know!" Spang said with surprise, " [ The report ] basically said that there was nothing to worry about: that I had good infection control, excellent technique, and [ my HIV status ] was no concern at all and should just be kept quiet."

Apparently, the Federal Bureau of Prisons felt differently. The bureau informed every prison in the U.S. that an HIV-positive dentist practiced at the MCC and any inmates that underwent dental work in Chicago should be tested. Additionally, the MCC ( likely with orders from Washington, Spang noted ) decided to hold a press conference in the city stating that one of their healthcare professionals was HIV-positive and that inmates that passed through the facility should take note.

It was the exact opposite of what the CDC recommended. Spang immediately sought out refuge with the ACLU, which promptly brought the case to court in an attempt to call off the press conference. The judge failed to rule in Spang's favor and in turn requested the Bureau change the terminology in their press release from "doctor" to "dentist."

It was early August 1991; Dr. Spang was looking forward to a weekend of peace and quiet in Saugatuck, Mich., free from the busy streets of Chicago. He and his partner, Richard Alegre, a retail professional, had just pulled out of the city when the news hit the wires: an HIV-positive dentist practiced at a federal prison in Chicago. It was not exactly the relaxing weekend he had anticipated.

The press conference yielded a national media frenzy clinging to the back of the horror stories of Dr. Acer, the Florida dentist who passed on the virus to seven of his patients.

The next morning Spang and his partner awoke in Michigan. Spang went to the front porch to get the newspaper and that is when he saw the Tribune's headline: "Prison Dentist Sues To Hide AIDS, Infected Health Aide Fears Inmate Reprisal." A headline for the Sun-Times stated "Jail Dentist Here Tests Positive For HIV."

Spang was the prison's only dentist; little detective work was required to figure out whom the mystery dentist was. MCC shut the door to Spang, who was no longer permitted access to the prison's facilities, "not even to get personal items from my office," Spang remembered, though he was eventually able to retrieve them.

Without work and burnt out from an undesirable claim to fame, Dr. Spang was given a desk job by the Public Health Service. As a highly trained dentist, it was hardly the career path he had imagined. ( "I'd rather jump out a window," he said. ) Luckily for Spang, his dedication and hard work with the Public Health Service over 12 years did not go unnoticed.

Spang explained that an anonymous individual ( whom he never met in person ) on the periphery of the Public Health Service in conjunction with Spang's Chicago supervisor, Heidi Nelson, the Chief Operating Office of Heartland Alliance, felt sympathetic towards his case. "They came up with an idea for dentistry for low-income individuals, especially HIV-positive patients, people diagnosed with tuberculosis, and persons of advanced age," he said. "Illinois did not have a dime for dentistry for people with low-income."

At the time, no such concept had been designed, but it was not something Spang was completely alien to. "Thirty years ago I was a dentist working for the Public Health Service in the Lower East Side of Manhattan, which used to be rough territory," he said. It was in New York where Dr. Spang began his work with lower-income patients, many who had AIDS-related symptoms. If anything, this was an opportunity for Spang to revive his reputation and career by helping those who needed it the most.

Spang spent the next several years developing the concept and finding funding by applying for grants. Spang explained that "a lot of patients with AIDS also had tuberculosis." With that in mind, part of Spang's design was a state-of-the-art system engineered to prevent the spread of TB through the air using specialized plumbing and "positive pressure ventilation," Spang said. In April 1994, the Spang Center for Oral Health opened its doors in the Uptown Neighborhood Health Center. The center still operates today and provides dental care all over Chicago.

Spang retired from the Public Health Service in July 1996, but continued to serve Chicago's HIV/AIDS community. He delivered meals once a week with Open Hand Chicago, an organization founded in 1988 and dedicated to providing in-home meals to persons living with AIDS. Spang was also the co-chair for the Chicago and Cook County HIV Services Planning Council, which was responsible for distributing $17 million annually from Washington to non-profits devoted to helping HIV/AIDS patients around the city. In 2003, Dr. Larry Spang was inducted into the Chicago Gay and Lesbian Hall of Fame for his efforts and involvement with a number of organizations to improve Chicago both as a city and as a community.

In January 2005, on the brink of their 22nd Chicago winter, Dr. Larry Spang and his partner Richard escaped to coastal city of Laguna Niguel, Calif., where Richard was offered a new job.

"I didn't know anybody," Spang said of the move to California, "so I got involved with my church." Spang found volunteering with the local Episcopal Church nostalgic, as his father had been an Episcopal minister.

Spang also began volunteering for a tiny non-profit in Laguna Beach called ACTION ( AIDS Care Team In Our Neighborhood. ) , a small network of volunteers that provided services to people with AIDS between the hospital and hospice. "It folded a year and a half ago because we were running out of customers," Spang said, "people [ with AIDS ] today are living longer and most are able to take care of themselves."

During his time with ACTION Spang grew close to two clients that he worked with. One passed recently, but the other is still alive. "Guadalupe," Spang said. "She's my girl. I spend more time with her than I do with Richard!"

The couple of 25 years sees an unpredictable future unsure of their next move. They live in a three-bedroom house minutes away from the ocean. "It's not a bad place to be stuck," Spang said. "We can see the mountains beyond Pasadena."

Spang said he misses the hospitality and warmth Chicagoans are famous for, which often made up for the city's brutal winters. Spang finds most people in California to be rather cold, despite the warm weather.

"I am so blessed, through this whole thing," Spang said in retrospect. "I am still here … healthy. My T-cells are higher than they've ever been." As for the future? "No idea. Not planning on moving."

Spang said that every so often he gets tired of the doctors, having been HIV-positive since 1980 and living with AIDS since 1989. "For the most part, I'm fine," he said. "I've never been hospitalized once for anything directly related to AIDS."

"I firmly believe," Spang added, "that when one volunteers in whatever capacity and is utilizing his talents, you truly do get back more than you give and all that love can only be beneficial."

Spang is also interviewed on http:// www.chicagogayhistory.com .

This story is part of the Local Reporting Initiative, supported in part by The Chicago Community Trust.

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