San Francisco Examiner - May 10, 2004
Justin Nyberg, Staff Writer

It's not easy. Israelski's enthusiasm for his work leads him to jump briskly from subject to subject, speaking forcefully and fast, and gesticulating as he traces his thoughts as they move in several directions at once.

His work is scattered by nature. He has dedicated his life to filling a patchwork of holes in the medical care provided to the poor by the private health care system.

His patients include the county's most destitute and complex patients, those struggling with combinations of disease, poverty, drug addiction or mental problems, often concurrently. They often don't speak English. Most have little or no insurance. They are the kind of patients profit-minded hospitals would rather see treated elsewhere, preferably at public hospitals like the San Mateo Medical Center, where Israelski is based.

"The patients I am honored to care for ... there is no competition. None of those other health care providers are competing for these populations," Israelski, 48, said. "My hope is to put San Mateo County on the map in terms of health service delivery for the under-insured."

Israelski is the chief of infectious diseases and AIDS medicine at the county hospital, as well as its director of research, where he conducts studies on everything from HIV rates among the county's migrant farm workers to how so-called "flesh-eating" bacterial infections spread through "special populations."

He is also a clinical associate professor at Stanford University, and the medical director of a nonprofit called AIDSETI, which is helping villages across Sub-Saharan Africa combat AIDS by helping them manage their own health care resources. At the county medical center, he also provides direct, primary care to patients suffering from AIDS, hepatitis and other infectious diseases, collects outside funding and attracts some of "the best and brightest minds in infectious research" from around the world as fellows to study and work in San Mateo County.

"We are doing things that are cutting-edge and we are not costing the county any money," he said. "Just because you are poor, you can still get outstanding care here in infectious disease."

However, after 15 years developing a research program focused on the county's underprivileged populations, his dreams hang in the balance.

The San Mateo Medical Center costs the county over $50 million each year, mostly because it focuses on those patients who are least able to pay. There is talk of closing the center down.

That would jeopardize the work Israelski and others like him, many of whom were drawn to the lower-paying jobs in public health care out of a deep sense of community service. They focus on patients who otherwise could not access top-of-the-line medical care. They consider themselves public servants.

"I look at public health care as something that is essential for our Community to come to terms with," Israelski said, speaking of "Community" with a capital C to invoke the greater sense of the word. "I think San Mateo County should be the beacon, the city on the hill, if you will, for other counties in America."

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