San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Saturday, August 16, 1997 - Page A13
Monique Fields, Chronicle Staff Writer

Scott knows of no other African American doctors in private practice in the East Bay who treat a significant number of patients with HIV and AIDS. That has helped make his Oakland medical office the center of an extended family of sorts. "You got to be able to do more than push pills," Scott says. "Anybody can push pills. You need to get to know the patients and they need to get to know you."

People grappling with the AIDS virus account for only a small portion of Scott's internal medicine practice -- about 340 patients out of 2,000. But as the numbers of AIDS cases rises in the African American community, the virus is demanding more of his time and attention. The only new patients he accepts these days are people with HIV and AIDS.

Few other black doctors provide the treatment, Scott says, and so he decided to make it a focus of his practice. He often works straight through lunch and rarely makes it out of the office, a two-story former residence, until long past his scheduled closing time of 6 p.m. On this particular day, patients wait in exam rooms while he feels for swollen lymph nodes, listens for abnormal breathing and checks throats for cancer.

Much of the time, his attention seems directed more at curing hopelessness than any physical ailment. "You're not going to go blind," Scott tells a 31-year-old man who has an AIDS-related eye infection. Johnny (not his real name) finally shows up. "I'm going to make you well,"

Scott tells the man, who earlier in the week underwent a lung biopsy for an AIDS-related condition. Many of Scott's AIDS patients are gay or are intravenous drug users. Most, like Jeannette Felder, 27, contracted the disease through unprotected sex.

The daughter of a doctor and a nurse, Felder knew something was wrong when she developed a persistent dry cough in 1994, but was too scared to be tested. She hoped she "had lupus or cancer, anything but HIV." But then the aspiring nurse also realized that if infected she could have passed on the virus to her 18-month-old daughter. When she finally took the test, she found out the virus had already progressed to full-blown AIDS, the No. 1 killer of African American women between the ages of 25 and 44, according to the federal Centers for Disease Control and Prevention in Atlanta.

When Felder told her then- boyfriend that she had tested positive, he denied she had the virus. "He was like, `You don't have that. The test was wrong.' And he wanted to have sex with me that night -- unprotected."

The boyfriend, Felder's ex- husband and her daughter have all tested negative for HIV.

Scott has heard many stories similar to Felder's. African Americans often do not seek treatment for the virus until they begin to experience symptoms, he says. "I have a number of patients who knew they were HIV positive and chose to do nothing because they were afraid of the treatment," he says. Scott says he does not believe in withholding treatment for HIV from his patients, even though protease inhibitors, regarded by many as wonder drugs for HIV and AIDS, require those taking them to follow a rigid schedule.

Although missed doses can allow the virus to become resistant to treatment, Scott does not prejudge patients as unreliable. If they want the drug, he will prescribe it. Dr. Scott says his patients want to live, therefore he believes they will take their medication properly.

To Felder, a patient for three years, Scott is a "blessing." Since she came under his care, her health has improved significantly. She has been taking protease inhibitors for six months. Her T-cells, one indication of the strength of her immune system, have risen from zero three years ago to 102 two months ago, Dr. Scott says. Her viral load -- or the amount of virus in her system -- has decreased from 166,000 to 8,000. Just three years ago, Felder wondered if she had another year left. "When I was 24 I never dreamed that I would possibly make it to 30," she said. "Now it looks like I might make it well into my 30s."
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