We had a ward full of young, almost all gay men, who were otherwise well, who had come in with the most devastating opportunistic infections. And it was that kind of involvement back then, with very little attention paid by the public or the government at the time, that was another triggering thing for me to make a career change. And the career change was, I had always been an in-the-trenches physician, an at-the-bench scientist. I looked down upon administration. “Oh my God, administration! What a bunch of stodgy people who don’t know what they’re doing!”
And then the directorship of the National Institute of Allergy and Infectious Diseases opened up, in 1984, because the current director went down to become dean of the medical school at Emory. So they asked me if I wanted to do that. Traditionally, before then, directors never saw patients, and they never had any labs, so I figured I had nothing left to lose. So I said, “I’ll be happy to do this.” But what I had in mind was, if I did it, I was going to take this sleepy field of infectious diseases, which was like the sixth or seventh largest institute at NIH — with a budget that was about 300 million dollars at the time — and I was going to make it something bigger because — and particularly, I was going to use it as the bully pulpit to get attention to HIV-AIDS.
So I told the appropriate people who were picking that I would be happy to take the job, but: “a) I have to still be able to see patients, and b) I have to continue to run my lab.” And they said, “My God, you can’t do all three! Nobody’s ever done all three.” I said, “Fine, then I won’t do the job.” I said, “But I promise you, I would make sure that my primary interest would be running the institute in a broad way and not just focus on what I’m doing.” So the rather insightful director of the NIH, at the time, a man named James Wyngaarden, said, “Okay, give it a shot. I think you could do it.” And that’s when I had multiple hats. I came in, I became a director, I did things that had to do with broad global health issues, at the same time as I continued to work very, very intensively on trying to delineate the nature of the defect in HIV-AIDS. And that’s really what I’ve been doing since.