Dr. Michael Alkan brought a world of experience to Chicago when he gave his keynote speech at the 56th annual American Medical Student Association ( AMSA ) Convention, held at the Palmer House Hilton.
He talked at the AMSA event about medical stints in the Congo, India, Ecuador, Botswana, China and other Asian countries. He also addressed his numerous stints in Africa, usually Ethiopia and Kenya.
Most of his work has been AIDS-related. Truly an expert on the disease, Alkan has been dealing with AIDS patients since 1982, when he saw his first AIDS patient, an Israeli youngster with hemophilia. 'We had absolutely no [ effective ] treatment in 1982,' recalled Alkan.
'I will never forget that first [ AIDS ] patient, as well as another AIDS patient from, oh, about a year later. In both cases, the families moved away from our area because they were afraid of the stigma. One of the families even pleaded with me to tell everyone that their loved one died of cancer.'
Alkan, 64, is an internationally renowned expert in global health issues. He graduated from medical school in 1965 in Jerusalem and is now the chief of infectious diseases at the Soroka University Medical Center as well as a professor of medicine at Ben-Gurion University of the Negev, Beer Sheva, Israel.
Alkan has taught at Moi University in Kenya and at the Catholic University in Quito, Ecuador. He has participated in planning and teaching a curriculum in international medicine for students in a joint program involving Colombia University and Ben-Gurion University.
Alkan has also been involved in disaster relief in Cambodia, Congo, Kosovo, India and Louisiana.
But AIDS is his forte.
'From the time I saw my first AIDS patient in 1982 until, oh, about 1990, we had nothing,' for the patients, he said. 'Then AZT came along and we thought we were doing something. But it basically was like a deferred sentence. Instead of dying a year later, they'd die two years after the diagnosis.
'It was not until about 1995 that we started giving anything more meaningful. And it wasn't until about eight years ago that we had the combination that we give today. What we have, and what we do now [ regarding treatment ] , this transformed AIDS from a fatal disease into a chronic disease, sort of like diabetes; as long as you take your insulin, you're OK.'
But Alkan certainly remembers the early years of AIDS.
'In the early 1980s, I was thinking, 'Oy vay; I chose the wrong profession,' because I had so many patients who I couldn't do anything for other than be passionate and polite to their families,' Alkan said. 'We could treat some of the complications and prolong life a little with suffering, but it was nothing like how the disease is today. It was very depressing.
'At the time, I thought the patients were in dire straits. And, when we started giving the combination treatments, I was still skeptical. I thought it was just another stunt. It wasn't until I saw my patients, months into the treatment, gaining weight, going back to work, leading a normal life. That's when I said, 'Wow; this is better.''
'The older I get, the more direct my observations are to the family of the patient,' he said. 'Sometimes with the patient, I try to make things look at little prettier than they are. But, with the family, I tell them everything. There's no reason to prevent the family from knowing what [ lies ] ahead of them.
'When I was more insecure, I was more afraid of the truth. But now, as I gain more and more experience and have more interaction with patients and families, I am very confident. Even if the truth is horrific, like someone is about to die, there are ways to save this, so [ the remaining ] time is passable.'
Alkan said AIDS treatment over the past 20-plus years is simply 'unbelievable.' In fact, most medical conditions have received incredible advances over time. Take, for instance, SARS.
Dealing with AIDS patients has been 'taking and quite difficult,' over time, he said. But, over the last 10 years, it's also been rewarding, too.
And over the past couple of years, there really has been a big revolution, especially in Third World countries, he said. 'Nowadays, there are several countries in Africa that have very good AIDS treatment programs,' he said.
AIDS cases in Africa didn't really start spreading as a catastrophe until the mid-1990s,' said Alkan, who, in 1985, started working and treating the Jewish Ethiopian community.
'We know for a fact, through wide-spreading testing that, in 1985, all Ethiopian immigration to Israel was HIV-negative. The first cases of HIV-positive Ethiopian Jews came in 1989 or 1990. And the numbers went up from there,' said Alkan, who had a clinic at the time that gave consultations on infectious diseases to doctors in the community for Ethiopian patients who were very difficult to deal with because there was no proper form of communication.
Alkan had an Ethiopian woman at his clinic who volunteered to work with him. She started in 1985, and is still the backbone of his AIDS clinic today. Now, though, she's a paid worker.
About 70 percent of the patients he treats at his AIDS clinic in Israel are Jews from Ethiopia.
Alkan's family and job are in Israel, but he still goes to Africa for two- or three-month stints. Of his work, up to 60 percent is AIDS-related, mostly in Israel and Africa. He often teaches other medical professionals, including doctors.
For example, there was his trip to rural China right before coming to Chicago, where he was asked to train 10 Chinese doctors regarding the treatment of AIDS. However, when he arrived, with a budget for 10, there were 15 at his lecture. Alkan welcomed the five extras.
The material was translated into Chinese and, a week before the end of the course, Alkan was told that some of the doctors have friends who wanted to take the final examination as well. Surprised, Alkan questioned it because these friends had not even been to the course. Well, Alkan learned that the original 10 had copied the CDs and literature, and others just learned from the CDs. So, 20 took the exam—and all 20 passed.
'Hopefully I made a ripple in the water that will go further than I first expected. That's very gratifying,' he said.
Alkan said the future of AIDS treatment is either classified as realism and wishful thinking, with clear differences between the two.
'The wishful answer is that there will be a way to change the course of the disease dramatically so that the patient will not be a slave of the treatment for the rest of his or her life. That would be either a vaccine or some completely different way to kill the virus,' he said. 'But the realistic answer is: I don't see the AIDS vaccine within the next 10 years, at least.'
However, he added, 'The number of scientists working on the vaccine is so big. And the competition between all of these scientists is a good catalyst for better work, quicker results. So, from that standpoint, there's a lot of room for optimism. And the technology of the laboratory work has come a very long way.'