The Story of an Influential AIDS Doctor Working in the Deep South

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arts_books1-1_42.jpgIt was a typical day in late May 1982. The last blooms still hung onto the azaleas. In Charleston, tourists, like fireflies at night, has descended on the Holy City for the start of the sixth annual Spoleto Festival of the Arts. But Dr. Robert Ball Jr. had more on his mind than symphony orchestras and classical music performances. As he prepared to see patients at his infectious disease clinic in Charleston's West Ashley neighborhood, his phone rang. A family practice physician called seeking an infectious disease consultation for a desperately ill patient.

As an infectious disease specialist, Dr. Ball had grown accustomed to such pleas for help, doctors referring strange cases of tropical diseases to him for care. In less than a decade of medical practice he had developed the reputation of being something of a storm chaser of the infectious diseases that surfaced in the Low Country of South Carolina, an area characterized by viciously hot and humid summers, extensive marshes, and, of course, mosquitoes.

The physician on the other end of the phone line had admitted his patient to St. Francis Xavier Hospital for observation. He was at a loss to determine what ailed the young white man. Without hesitation, Dr. Ball promised to see the patient that day. It was a short drive from his office to the hospital, which had been founded by the Sisters of Charity of Our Lady of Mercy in 1882. When Dr. Ball walked into the private hospital room, he saw a patient who looked to be in his late teens or early twenties. He quickly learned that for several weeks the patient had been suffering from high fevers and swollen lymph nodes. A chicken pox-like rash covered his entire body. Lesions pockmarked his frame, with open, raw sores draining clear fluid. Herpes-like lesions covered his genitals and perineum, the area between his scrotum and anus. On close examination, Ball also noticed that the man had thrush, a yeast infection of the mouth that doctors would later associate closely with being HIV positive.

The young man's swollen lymph nodes signaled trouble. His herpes clearly had been contracted sexually; another disease might have been lurking inside him for several years before trashing his immune system. The symptoms had become too obvious to ignore. Whatever the reason, his health was deteriorating rapidly. "It was the worst case of genital herpes I had ever seen," Dr. Ball says. "Normally, genital herpes doesn't spread throughout your body. In his case, it did."

Thankfully, Dr. Ball determined, the patient didn't have the pneumocystis carinii pneumonia (PCP) or the cancers that physicians had quickly discovered were common among people with AIDS. Of more immediate concern was his extremely low white blood cell count. "There were a number of other lab abnormalities that indicated a systemic infection that was probably viral," Dr. Ball recalls, speaking with an even, genteel southern inflection that could have come straight out of a Pat Conroy novel.

In addition to his private practice, Dr. Ball also taught at the Medical University of South Carolina (MUSC), his alma mater, and knew the lab staff of the huge facility. After he examined the patient, he immediately ordered additional blood tests and further analysis of the man's white blood cells. When the patient's MUSC lab tests came back a week later, they showed an extremely low number of what are now called CD4 lymphocytes. Back then they were called OKT3 lymphocytes. Having low CD4 cell numbers increases the risk of opportunistic infections, leaving an individual as vulnerable as a battleship floating on the high seas without guns. Simple pneumonia could be as lethal as the bubonic plague. Troubled by the initial test results, Dr. Ball ordered more tests. As he awaited the results, he ran through all the possibilities. Little did he know that fateful doctor-patient encounter in St. Francis Hospital on that spring day would turn his comfortable, white, middle-class world upside down, change the course of his professional and personal life, and shake long-held political and spiritual beliefs, transforming him from a white southern Barry Goldwater conservative to that rarest of species, a white southern progressive.

* * *

Robert Ball's links to Charleston and the Low Country are as deep and as storied as the region itself. His ancestors first settled on the land when South Carolina was still a colony, more than 320 years ago. The pages of the telephone book are peppered with Balls. He served as president of the Society of First Families of South Carolina, a genealogical organization that documents and celebrates the history of the earliest colonial settlers.

Young Robert grew up in the West Ashley section of Charleston. He played football in high school but was never great at it. His passion was books. He spent hours locked away in his bedroom devouring science books. After high school, unlike many South Carolina blue bloods, he didn't head west for the University of South Carolina in Columbia or even Clemson upstate. Robert remained closer to home. He drove less than half an hour to the College of Charleston, where he studied biology and chemistry. To no one's surprise, he wanted to be a doctor.

Little did he know that fateful doctor-patient encounter in St. Francis Hospital on that spring day would turn his comfortable, white, middle-class world upside down.

In college, Robert, an avid boater, helped form the school's first sailing team. He dabbled in Republican politics and a lot of campus life. His old college yearbooks showed that Robert also was involved with at least four campus organizations each year. He led a Charleston chapter of the John Birch Society, a group that was founded in 1958 by former candy industry executive Robert Welsh, who spouted an ultraconservative brand of pseudo-Christian anticommunism, nationalism, and antiglobalism. John Birch Society members called for the repeal of the federal income tax on constitutional grounds, sought the abolition of the Federal Reserve and the United Nations, and viewed the civil rights movement as the vanguard of a communist plot. In 1964, like most other John Birch Society members, Ball supported Barry Goldwater. The conservative Arizona senator had lost to Nixon in the 1960 Republican primaries but prevailed against moderates Governor Nelson A. Rockefeller of New York and Governor William Scranton of Pennsylvania before being trounced by the incumbent president, Lyndon Johnson, in 1964.

Two years later, after he graduated from the College of Charleston, Ball followed a path he seemed genetically bred to pursue. He drove across town and enrolled at what was then the Medical College of South Carolina, an institution whose desks, chairs, and labs were stained with the sweat of his forebears. Ball is descended from a line of physicians seven generations deep. His great-grandfather was a doctor; a number of great-uncles were too. One uncle was a physician; another, Benjamin M. Martin, was chief radiology technician at MUSC for over two decades. Both grandfathers were doctors, and his paternal grandfather, Dr. James Austin Ball, was the medical school's first professor of infectious diseases, then called tropical medicine, at the turn of the century. His maternal grandfather, Dr. Thomas Hutson Martin, graduated from the College of Medicine in 1919 at age 19 before launching a long and distinguished career as a physician and surgeon in Charleston. Dr. Martin was a longtime member of the Charleston County Board of Health and an assistant professor of surgery at the medical school. He retired from practicing medicine in 1951. Later, Ball would donate Dr. Martin's class ring to the medical school's Waring Historical Library.

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Andrew J. Skerritt is a longtime journalist who has contributed to publications including the St. Petersburg Times, the Rock Hill (SC) Herald, the Tallahassee Democrat, and the Root. He teaches journalism at Florida A&M University.

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