The Bay Area Reporter - November 2, 2000
Katie Szymanski

But little attention is currently paid to the people in between these two extremes, that is, people with HIV who dare to ask questions and raise concerns about their treatment.

Jonathan Romano is one such person who says the AIDS establishment's efforts to silence all opposition has gone too far. Romano, 43, spent his birthday in jail this week (without his HIV meds, of course) for allegedly violating restraining orders issued against him for the crime of angrily pursuing his complaints against Alta Bates Medical Center in Berkeley. He has received a total of six restraining orders against him for conduct that has been classified as "violent" at Alta Bates, and a seventh restraining order goes to court on November 1, as the Bay Area Reporter goes to press. Unlike the previous injunctions, this one threatens to ban Romano from both the emergency room and surgery at Alta Bates and Summit hospitals, the two facilities closest to his home.

"I don't know what I'm going to do," Romano told the Bay Area Reporter, noting that the stress of the restraining orders has taken a toll on both his emotional and physical well-being. Romano, HIV-positive since 1981, has 235 T-cells and a viral load of 11,500, but has avoided seeing a physician since June, only recently seeking care in San Francisco.

"I was just so freaked out," he said.

First three restraining orders

Granted, Romano is not every - or even any - doctor's dream patient. The first set of three restraining orders against him were issued in May and based on an incident where Romano repeatedly screamed at medical staff over the phone and in person for denying his participation in a clinical trial.

Romano said that he lost his temper because the clinical trial was presented to him as his only hope, and he was first informed that he was accepted, only to find out later that he had too many T-cells to qualify. "They knew about the T-cell requirement going into it, so I don't know why they would make me go through that," Romano said of his application process.

The restraining orders describe Romano entering the medical center after learning he was rejected and screaming at a doctor for being "uncaring, misleading, and wasting his time."

Although the "credible threat of violence" box was checked on the restraining order's form, the only possible statement that could be interpreted as such was Romano's "I'm going to get even with you," allegedly told to Alta Bates' Dr. Susan Jacobson as she stood in the hospital's entrance. In fact what Romano said and meant, he explained, was that he was going to file a complaint, which he did. The judge who issued the restraining order asserted Romano's right to follow through with the complaint despite the injunction, which he did as well.

Second set of restraining orders

Unfortunately, once a person is tagged for "violence," the reputation tends to stick. So it didn't take much for Romano to receive his second set of three restraining orders, after he attempted to pursue his complaint against Alta Bates.

According to the hospital's own statements, officials at the Alta Bates internal review board (IRB) intentionally kept information from Romano about the review board's decision not to take action against the hospital.

"I had delayed informing Mr. Romano of the IRB's decision because I was afraid that he would come to the office and threaten me," said one such statement in court transcripts.

But not getting an answer angered Romano as well, and transcripts reveal that he marched into the IRB offices, used profanity, and demanded to know the status of his complaint. When he was told it was denied for review, he apparently asked what state agency he could appeal to, then left. The second set of three restraining orders against Romano are based on this incident.

IRB officials cited hearsay - "I was told of Romano's previous incidents and am afraid," - and a "violent past," as described by the first set of restraining orders. These statements were then used as reasons for issuing the second set restraining orders.

Seventh restraining order

The seventh restraining order - by far the most comprehensive - also uses the previous restraining orders as a basis for further punishment, then cites a "publicity campaign" that Romano launched after the second set of orders was issued.

Romano admits to the publicity campaign, which consisted of his personally handing out fliers to doctors describing his situation and calling for the resignation of the hospital's patient relations manager.

But most troubling, perhaps, is that the seventh restraining order cites Romano's complaints to the state's medical review board as "harassment" and as further proof of the need to restrain him. Romano's complaints before the board target 1) an Alta Bates doctor who allegedly kept Romano on Thalidomide for six months in 1995, which caused irreversible neuropathy; and 2) Dr. Jacobson, who allegedly indirectly informed Romano during court proceedings that he had borderline personality disorder. And that's the kicker.

If Romano's allegations are true, then Alta Bates had known for years that they considered him to have BPD, a condition that can lend itself to impulsive anger. Yet he was never offered treatment for this diagnosis, and found out about it only in court when his condition was casually referred to during testimony. Also of interest is Romano's claim that he was prescribed a low dose of 10 mg of Paxil for HIV-related depression; when he asked for the dosage to be increased, he was denied. This history suggests that his outbursts - even if warranted - may have been prevented by the hospital itself.

Attorneys for Alta Bates Hospital had no comment on the previous or pending legal actions against Romano. But attorneys and community leaders consulted by the B.A.R. for this story seem to believe it is he who is the victim.

"People with HIV in this country have a justifiable reason to be angry," said Judy Greenspan of the HIV in Prison Committee of California Prison Focus. "There's no reason why anyone with HIV should be prosecuted for attempting to obtain medical care. The system is responsible for the anger and mental torment that people with HIV go through."

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