San Francisco, CA
United States
SF History Center, SF Public Library, 100 Larkin St San Francisco General Hospital AIDS Ward 5B/5A Scrapbooks since 25 July 1983
San Francisco General Hospital AIDS Ward 5B/5A Archives 1983-2003, Series 1: Scrapbooks (11 Volumes)

5B The First AIDS Ward
Ward 5B at San Francisco General Hospital opened on July 25, 1983, as the new staff moved equipment into an area that had previously been used as residents' sleeping quarters. The next day, the first few patients were transferred from other units. They included both AIDS and hospice patients. Prior to the opening of 5B, most AIDS patients were treated on wards 5C and 5D, which were general medical units. Throughout 1982, as the numbers of patients began to rise and the level of fear about the contagiousness of this new disease began to rise-- both in the general public and in hospital staff-- a decision was made by the Nursing Department, the Department of Medicine, and hospital administration to open a separate, special-care unit for the treatment of AIDS and hospice patients. Notices were posted throughout the hospital in early 1983 soliciting interested staff. Interviews were held in the spring. Eleven nurses and two unit clerks were selected by Cliff Morrison, a former Clinical Nurse Specialist in psychiatry, who was the first nurse manager. From the beginning, psychological support of patients, friends, and families was included in the treatment plan with the help of three counselors on staff through a grant to the Shanti organization. A hospital psychiatrist facilitated regular staff support groups. Social workers, dieticians, physical and occupational therapists, and chaplains were included in the interdisciplinary team that provided care.

With the number of AIDS cases in San Francisco rising dramatically, 5B (with only 12 beds) was deemed inadequate and, on January 17, 1986, the hospital moved its AIDS ward to the 20-bed 5A. At the height of the epidemic (late 1980s - early1990s), there were often as many patients with AIDS off of 5A as there were patients on the ward, all waiting for available beds. Throughout this period, 5A remained the preeminent center of excellence in AIDS care in the country, recognized in the U.S. News and World Report "Best Hospitals" issues 1991-1997. Visitors, students, and the media were welcomed as others tried to implement the "San Francisco model" in their areas.
5B/5A was self-labeled a "ward without walls," inviting community groups to help furnish a more comfortable space. A large group of loving volunteers provided weekly assistance for the staff and patients. Actors and politicians came by to show their concern. Mother Theresa’s signature is probably the most cherished in the ward's guestbook. In the mid-1990s, with protease inhibitors reducing the numbers of AIDS inpatients, 5A had empty beds. Because the staff had already been treating AIDS-related cancers, a decision was made to open the ward to the treatment of other oncology patients. By 2002, the number of AIDS inpatients had dropped to the point where the average census of 5A was one-third AIDS patients, one-third oncology patients, and one-third general medical patients from the emergency room. On the day of the ward's twentieth anniversary, there were four patients with HIV on 5A.

Scope and Contents
This collection documents memorabilia collected by the nursing staff of AIDS wards 5B/5A at San Francisco General Hospital from 1983 to 2003. Current materials continue to be collected by staff and are periodically added to this collection. This archive reflects the evolution of thought that the nurses put into the saving of their history. It starts with what quickly became a tattered old, red scrapbook and became the collection that is documented in these pages. Because the culture of 5B/5A was created by the nurses, this archive reflects what was primarily of interest to them. Therefore, the contributions of the Shanti counselors, social workers, chaplains, and others get brief mention. Their archives are yet to be collected. The contributions of the many volunteers over the years are documented well because their program was created and overseen by the nursing staff. Strongly represented in the photo collection are the public events and celebrations that staff and volunteers were part of --parades, union demonstrations, holiday parties, nursing awards dinners, etc. There are several photo groups by professionals who came to the ward and photographed staff and patients .The written records are strongest in the day-to-day details of communication books and the monthly concerns of staff meetings. Extensive Head Nurse files were primarily saved by the first three nurse managers. George Jalbert, Bill Walker, and Steve Keith organized the early 5B/5A archives. After Walker's departure, Steve Keith and Adrienne Kernan were primary contributors to the photo archive and Steve became Nurse/Archivist for the ward.

Photos © San Francisco History Center, San Francisco Public Library

28 October 2020
Susan Goldstein, San Francisco