In 1979 when undergraduates applied in record numbers for admission to medical school, AIDS was not a clinical and diagnostic category. In 1990 when the applications to medical schools are plummeting, AIDS is unarguably with us, and not just as a clinical entity. AIDS has become what the French anthropologist Marcel Mauss called a “total social phenomenon — one whose transactions are at once economic, juridical, moral, aesthetic, religious and mythological, and whose meaning cannot, therefore, be adequately described from the point of view of any single discipline” (Hyde 1979). For cultural analysts, present and future, the 1980s and beyond are the AIDS years.
This chapter is about the impact of AIDS on the shop floor of the academic urban hospital, an attempt to understand the impact of AIDS on everyday practices of doctors providing inpatient care. Following Mauss, we wish to view AIDS as a total social phenomenon rather than as a mere disease. Procedurally, we shall concentrate on the house officer (someone who, after graduation from medical school, participates in medical specialty training) and the medical student to see how this new infectious disease changes the content of everyday work and the education of apprentice physicians learning how to doctor and to assume the social responsibilities of the role of the physician. We are going to look at professional and occupational culture as a set of shop-floor practices and beliefs about work.