Andi Giger, freelance journalist from St. Gallen

Pietro Vernazza was a fresh assistant doctor in Sursee when the chief physician rolled up his sleeves over his hands and carefully opened the door. In the single room lay a patient with lung problems and body sores. Although there were no tests for it yet in early 1984, the symptoms clearly indicated: The patient had AIDS. It was the first time Vernazza encountered an AIDS patient. The chief physician, who normally shook hands with everyone, avoided any contact with the patient. Vernazza was confused because, by that time, the knowledge was already that HIV is a sexually transmitted disease and could not be transmitted by shaking hands. And the single room: The patient was neither privately insured nor a danger to others in the room. He did not survive his illness. His next chief physician in St. Gallen supported Vernazza and encouraged him to learn how to care for dying people. Vernazza recalls, "I realized that the topic of death also has interesting aspects, and how valuable it is to approach these stories with curiosity." It helped not to make the problems your own.

Insect bites, hugs, or public toilet seats: For a time, it seemed that almost everything was an HIV risk. Fear was ubiquitous. Gradually, science made progress, but ignorance persisted for years. Amid all the misery, there were people who were not guided by fear. People who dared to touch AIDS patients, gave them courage, or at least allowed them to die with dignity. Often, it was nurses, lesbians, activists, family members, and people from the church.

Eating Corn Rolls in the Outpatient Clinic

Margit Bösch is a nun of the St. Anna community and had the knowledge of a trained nurse, which was extremely valuable during the epidemic. She had just started working at the outpatient clinic of the church's street work in Lucerne when she had her first encounter with someone living with AIDS. The man was about 1.90 meters tall, thin, with sweaty hair, and unkempt. He was called marginal, a "druggie." Every morning, he would stop by to eat his corn roll. He carefully picked the raisins out of the dough and – as he had always done – remained silent. Except for that morning. "Do you want some?" he asked, looking at Bösch. "Sure." He broke off a piece for her, and together they ate the roll. It marked the beginning of an extraordinary bond.

Vernazza and Bösch quickly learned what it meant to stand by people living with AIDS: They themselves became outcasts. Vernazza was even refused blood donation. The fear of getting infected was immense. "That was completely irrational. Even in the healthcare sector, societal ignorance persisted," says Vernazza today. When he became a father, a good acquaintance of his – who was living with HIV – visited the newborn family. When asked if she wanted to hold the baby, she was surprised and asked if that wasn’t dangerous. She had wished to become a mother herself. "Guilt and the belief that you are a danger to others accompanied many people with HIV. The fear of transmitting the virus to others was often greater for people with HIV than the fear of HIV in people without it," says Vernazza. The whole world made them a threat, even though science had already reassured people and even brought hope.

New Priorities

"It was the necessity of the times," recalls Bösch. The St. Anna sisters were founded 80 years earlier out of necessity when women needed midwives. It was a time when cloistered women worked in hospitals but were not allowed to be present at births. So, they went to families' homes and helped as midwives. Bösch also began her career in the operating room. But in the second half of the 20th century, surgeries became increasingly technical, births became safer, and the need was different. "I wanted out, reoriented myself, and realized that I was needed elsewhere."

Humanity, the dignity of all, and respectful interaction have disappeared in some streets and parks. "The police conducted interrogations of homeless people and those with addictions, sometimes even arrests that were not justified. The victims often didn’t know their rights; they were afraid." It was the time of open drug scenes at Platzspitz, Letten, and in Lucerne at Eisengasse. People stole, slept in forbidden places, and begged. "I never called the police. If they couldn't even catch the smallest fish, that wasn’t my problem."

Challenges as the Only Point of Contact

Vernazza institutionalized the AIDS consultation at the Cantonal Hospital in St. Gallen. It was located in a remote part of the campus – that too was a sign of separation. "I was the only person for many patients with whom they could talk about HIV." This required skills that weren’t taught in medical school: conversations about death or accepting that a cure wasn’t possible. "For many medical students, healing people is a main motivation." Many in medicine didn’t want to deal with the issue. "That changed when medication came along. Suddenly, we could do something about it, and that motivated us."

The big man from the Lucerne outpatient clinic knew that he wouldn't live much longer. His teeth were rotting, he had severe thrush in his mouth, and he could barely move. His two roommates also had AIDS. They had lost contact with their families. They wished to celebrate Christmas once again. Bösch spent Christmas Eve with them at their home, sharing a fondue and a joint. "Smoking a joint was something that connected the community." Bösch adapted in many areas, including language. "I had to learn what a flash, speed, or a horror trip was at first." She also swore sometimes, wanting to respond in her language, adapting.

The three AIDS patients passed away within the following six months. Even at the funeral, another joint was smoked. "We often did that; it was a shared ritual. Everyone who wanted took a drag," says Bösch. Sometimes, funerals were without any relatives; just she and Sepp Riedener, the founder of the Church Street Work in Lucerne, paid their respects to the deceased.

A Matter of Attitude

Sex workers, people with addiction issues, gay people: The fact that the AIDS epidemic mainly affected groups that were not particularly close to the church didn't matter to Bösch. "They were sick people. Treating them as equals and offering help was the most important thing." An important aspect of the story had always been that people were often not excluded primarily because of the fear of potential infection but out of rejection of a certain milieu. "For me, it was always important to know that nothing was in vain. The people had hope, ideas, and visions, they gave love, and left traces – and none of that was in vain."

In St. Gallen, Vernazza mainly dealt with patients from the drug-using milieu. The fact that a judgmental attitude – regardless of the prevailing societal norms and expectations – had no place in medicine was crucial in the fight against AIDS. It was also the foundation of Switzerland's Four Pillars Drug Policy, which became an international model. "Showing interest, listening, and developing understanding was an important task in medicine – and ultimately part of the medication."