The Epicenter of the Epidemic

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Dr. Rick Hecht '75 works to understand HIV infection and see if the mind can influence the body

From the fall 2009 Caller

By Nadine Fiedler

Sometimes you’re in just the right place at the right time for your life’s work to come clear to you. For Rick Hecht ’75, the place was New York City, where he was in his first year of medical school. The time was 1982, when people first recognized the grave scope and widespread nature of AIDS, and many New Yorkers were stricken by the virus. “I was at the epicenter of the epidemic,” says Rick. He found the growing problem of AIDS and HIV increasingly compelling as he moved through med school and residency and worked with patients who had been infected.
As a resident Rick worked in a clinic with patients who were treated for drug dependencies shortly after the HIV antibody test became available. For the first time, people were being diagnosed with HIV but not AIDS, and they felt comparatively well. “So one of these people asked me, ‘I’ve done my drug treatment. What can I do now to be healthy with HIV?’” says Rick. “I went to my preceptor, and she scratched her head and said, ‘I’m not sure what you can do.’” Discovering the answer to his patient’s simple question became the core of two decades of intensive research and clinical work for Rick.
He went on to work at the AIDS program for Montefiore Hospital in the Bronx, then worked at the University of California-San Francisco (UCSF) as a research fellow in clinical epidemiology. “I had done enough HIV work to want to do more research,” he says. “There were a lot of unanswered questions: what should we do for care and treatment? Why do some people infected with HIV get sick while others stay well for years?”
An important research breakthrough led Rick to focus on the extremely early stages of HIV infection. “It became more and more clear that the course of the disease is set in the first few months. If we understand that better, we may have important clues for treatment, or even vaccines for protective immunity,” he says.
Rick now oversees a research program on early HIV at UCSF. It has become one of the largest of such programs in the world, examining many aspects of early infection. Rick and his colleagues have enrolled, studied, and followed more than 600 people and are connected with similar programs worldwide. “You have to be patient with the slow course of research, but in the long run it moves pretty quickly,” says Rick. “Twelve years ago all my patients died. Now only the ones who don’t take medications die. It’s a huge shift. Over the years questions and issues of treatment have shifted more rapidly.”
Rick’s work has another, less conventional side. As director of research for UCSF’s Osher Center for Integrative Medicine, he studies whether mindfulnessbased practices such as yoga and meditation can influence the course of disease, a longtime interest of his—and one of the reasons he says he originally went into medicine. “In a study of the effects of meditation on HIV I’m working to answer the question that my patient asked me back in the Bronx—what can I do to stay healthy?
“I find satisfaction in seeing the ways in which I can make a difference, both in clinical care and research. In research, I find fascination in learning new things;” says Rick. “If the answer is not what I hoped for, it’s still worth doing work that hasn’t been done before.
“I feel blessed. Each day brings mundane tasks, but I also get to do things that I find interesting. I plan to stay and work in this field as long as I possibly can.” As for his roots, he says, “Catlin Gabel was formative for me intellectually. I write a lot of grants and reports, and my experience there was really important in developing those skills and critical reading skills. It was one of the best educational experiences I ever had.”
Nadine Fiedler is the Caller editor and CGS director of publications and public relations.