Michael Gottlieb was born in 1947 and grew up in Highland Park, New Jersey, across the Raritan River from New Brunswick, home of Rutgers University. The swift flowing Raritan drains into nearby Raritan Bay, which became infamous in the summer of 1916 when a man-eating Bull Shark went on a rampage, killing 5 people and terrorizing the Jersey Shore, with three of the deaths occurring in a tidal inlet of Raritan Bay called Matawan Creek.

Gottlieb’s father was born in Brooklyn, New York, and went on to be a football star at Rutgers and was indoctrinated into the Rutgers Football Hall of Fame. Rutgers football has a long, but unglorified history, and is best known for participating in the first collegiate football game, against Princeton, in 1869. His father’s life was cut short prematurely when he noticed blood in his urine one day and was diagnosed with bladder cancer. He was 47 years old. This was just one of many family tragedies that included Michael’s brother, Paul, a molecular biologist who graduated from Princeton, who died at age 59 from liver cancer secondary to the chronic inflammation caused by Hepatitis C Virus, which he unknowingly contracted during one of his many transfusions in the course of treatment for Ulcerative Colitis. He also had a younger brother, a lawyer, who died of brain cancer aged 38.

Gottlieb’s wife died of Common Variable Immune Deficiency, ironically a subject he had written a chapter for in a textbook.“I met her on TV, said Gottlieb, “She was a television news anchor here in LA. We did a telethon during the early days of HIV. Anthony Fauci was in Bethesda. I was here. Somebody was in Seattle, somebody else in Boston. It was 1987. So we met then.”

“Highland Park was a small town. You could walk to the main street and go to the candy store or soda fountain. It was a different America. Comic books, baseball cards, soda fountain. I grew up with the Irish, the Italians, the blacks to some extent, the Jews. And then the Hungarians started pouring in in ’56. In the exodus, after the revolution,” he said, alluding to the uprising against the Soviet controlled Hungarian government that was brutally squashed by Russian tanks and troops over a 12-day period in 1956.

Gottlieb states he may have been influenced toward medicine by the book Eleven Blue Men, by Berton Roucche, a case history of medical mysteries from an epidemiological perspective. “You know, every Jewish mother wants at least one doctor. And my brother rebelled and studied physics and then biochemistry. So I guess I was next in line.”

“After Rutgers prep, I went to Rutgers university, which was very small back then. I was interested in history back then, but I had a friend who graduated second in his class and he had gotten into University of Rochester Medical School. He had a photographic memory. Became a heart surgeon.”

Gottlieb remembers having an epiphany one night in the Rutgers library. “I remember writing a history paper on the Bland-Allison-Silver Act of 1898. And I was up in the stacks going through the congressional record. And I said, is this what you want to be doing the rest of your life? Going through a dusty old congressional record that nobody’s looked at for 50 years? So I said if Jim was going to medical school, and he’s a smart guy, maybe I’ll go too. “I did surgery at first and I loved it. I scrubbed in on a lot of heart surgery in the first 6 months.

Then I did medicine, and I loved it more. I told the Chief of Medicine I wanted to move into medicine instead and he said, We don’t have a slot. Do another year of surgery and then we’ll think about it if you still want to make the switch. And I did.” Gottlieb excelled in medicine and decided on a fellowship in Allergy-Immunology at Stanford in 1977, where he worked mostly on transplant immunology, a fast-growing field focused on suppressing the body’s T-cell immune response to prevent rejection of a transplanted organ.

“I was working with mice and monkey’s and some dog work, which I very much regret,” stated Gottlieb, an animal lover. “We were doing heart transplants on dogs, with Dr. Shumway and his staff, at Stanford.” Dr. Norman Shumway MD PhD is considered the father of heart transplantation and performed the first successful heart transplant in 1968 on 54-year-old steel worker Michael Kasperak, who lived for 14 days afterwards.

In 1959, working with surgical resident Richard Lower MD, Shumway transplanted the heart of one dog into another dog. The dog survived for eight days, proving the technique was possible.

Shumway spent the next decade perfecting the technique until he had enough knowledge, data and gumption to perform the surgery on Mr. Kasperak. “The first time I met Shumway I walked into a seminar unshaven and in my jeans. Shumway asked my boss, “Is he really a doctor?””

Gottlieb was also instrumental in participating in the first bone marrow transplant at Stanford. He worked with radiation oncologists using radiation as an immunosuppressant for the treatment of Hodgkin’s Lymphoma. “We had done it in dogs and were ready to do it in humans. So they sent me to UCLA to learn how to harvest marrow on the UCLA transplant unit. I worked with Bob Gale MD, who eventually was sent to Chernobyl by Armand Hammar to help with radiation victims” after the meltdown. “When I came back to Stanford, we tried the bone marrow transplant on a woman named Rosa from Ohio, who had aplastic anemia,” which is a rare disorder involving the catastrophic failure of the bone marrow to produce any cells, including white cells to ward off infection and guard against cancer cells, red cells to carry oxygen to tissues, and platelets to clot the blood. “I harvested marrow from the posterior iliac crest (part of the pelvic bone) under anesthesia. The donor was her brother. Her marrow wasn’t working, so we gave her the brother’s marrow. You know, stem cells. A partial match. We irradiated her, made space for a nest in her marrow, but it didn’t work, and she died.”

“I almost switched to Oncology, but I just couldn’t. I had a deep interest in Lymphoma. The easier to treat malignancies I could deal with but the solid tumors, you know, pancreatic…you must have a stern constitution to last in that kind of work.” Ironically, Gottlieb must have had more of the constitution than he realized given his later work with AIDS patients, especially the long period of time before it could be effectively treated. In Oncology, sometimes you can make people better, but from 1981 to 1991, AIDS was universally fatal.

Now that Gottlieb had a foothold in UCLA, he was able to apply for a post-fellowship job in the Department of Allergy and immunology complete with a 10-year track to tenure. At the time, the division was a one-man show. Dr. Gale was able to recommend Dr. Gottlieb to the current chief. It was almost too good to be true. A paid position in a small, yet prestigious academic center and coincidentally just as immunology was starting to take off. Unknowingly, Dr. Gottlieb was about to be catapulted into the forefront of a global catastrophe called The Acquired Immune Deficiency Syndrome, or AIDS. The term gay, or “joyful or carefree,” is thought to date back to Old French and ultimately to a

German derivative from the 12th century. Over the next few centuries, it also began to take on a sexual connotation. Per the Oxford English Dictionary, 3rd edition, the word also described “addicted to pleasures and dissipations.” The foundational essence of the word comes with it a certain devil- may-care adventurous and reckless attitude, describing, for instance, the end of the Victorian Era as the “Gay (18)90’s,” and the phrase “Gay Paris.” The word gay did not always exclusively refer to homosexual men either but could describe a brothel or a female prostitute. Toward the 1920’s, it began to more firmly take on the depiction of a male homosexual. The central cities of gay life have long been the Marais district in Paris, New York City, especially Greenwich Village and elements of Harlem, and Berlin. Large cities invited a staggering cultural, ethnic, and sexual diversity where everything and anything was possible. Hidden in these huge population centers, like could often find like, without standing out. One could blend in by day and disappear or roam freely by night, creating opportunities for subcultures to grow and flourish without the inhibition of social and sexual mores. By the mid-50’s, the term gay became mainstream among gays themselves, possibly because the term homosexual resonated in such a clinical sense to the ear. Indeed, the Diagnostic and Statistical Manual of Psychiatric Disease did classify homosexuality as a disease until 1973 when this misdiagnosis was removed. Homosexuality was even considered a crime in England and was readily prosecuted until The Sexual Offenses Act of 1973 removed it if the act was between two consenting adults at least 21 years of age. Likewise, it was illegal in New York until the 1980’s.

In 1960, the FDA approved the birth control pill, setting in motion the sexual revolution. “Free Love” became more acceptable, and with it, women’s rights, divorce, and same-sex relationships. In addition, the protests of the Vietnam War, the Civil Rights movement, and the Hippie movement, ushered in a new radical era from the obedient 1950’s. The 60’s was an era of both experimentation and rebirth and a call for a new order. The gay rights movement went through its own transformative event in the last year of the decade. On June 28, 1969, police raided Stonewall Inn, an openly gay bar in the heart of the gay scene on Christopher Street in Greenwich village. Violence ensued, arrests were made, and patrons and neighborhood residents began a series of open protests or gay rights over the next few days. A year later, on the anniversary, a gay pride march commemorated the event, and the gay rights movement had begun in earnest. Ironically, the club was owned by the mafia and used to launder money, knowing full well the gay community would not report them to the authorities given it became their hangout and with the stigma of being homosexual, which was still theoretically illegal in the city.

For decades, the YMCA and New York City bathhouses became an accepted place to congregate, socialize, and have sexual encounters outside the public view. The city developed bathhouses a century before for those without proper facilities in tenements to keep up their ablutions and prevent the spread of disease. In the 70’s, with the shackles having been released on homosexual gatherings and casual sex with multiple partners, the bathhouses became dens of the reckless side of unrestrained promiscuous behavior and became a silent breeding ground for the Human Immunodeficiency Virus, or HIV, to incubate and clandestinely flourish. Likewise, in Los Angeles, bars and dancing clubs were emerging from the underground and planting their roots in West Hollywood, among other area’s.

In the straight community, transmission was of HIV was made facile by the sharing of needles in drug dens and back alleys. Heroin was a relatively cheap and an increasingly popular drug of choice among the indigent and hippie community, thanks to mafia influences in making it readily available on the streets. In addition, Vietnam Veterans were becoming addicted overseas in Southeast Asia and continued to quench their habit back on their return to the Homefront. It was an era best summarized by the motto of Turn on, tune in, and drop out made popular by the psychedelic psychologist from Harvard, Timothy Leary.

In 1976, Henry L Kazal MD, a physician practicing out of St. Vincent’s Hospital near Greenwich Village, first reported an association between gay men and gastrointestinal or proctologic disease that became known as Gay Men’s Bowel Disease, in the pre-HIV era. It consisted of a rash of diseases of the intestines and anus, such as syphilis, gonorrhea, venereal warts, diarrhea caused by parasites and sometimes a low platelet count, the cause of which was curious and unknown, but clearly favored the homosexual community, where men were having anal sex with other men.

Catapult forward to 1981. “I started doing research on mice at UCLA,” said Gottlieb, “a continuation of the work I had done at Stanford, but that didn’t work out too well. So I said, “Ok, I’ll do some teaching.” The chief was a really smart guy, but his interest was in the lab. He was not a real clinician. We had fellows (In allergy and immunology). But the residents didn’t call very often for immunology and allergy consults. So I said to the fellow, go up on the wards and talk to the residents, you know, drum up some business, cases that you and I and the medical student can discuss.”

“So, I’m sitting in my office in the basement, a very small space, cinderblock, no windows, when the fellow comes back with a quizzical expression on his face, and he says, you know, up on the fifth floor, there’s this guy and he has candida (a fungus) on his scalp. He’s skinny, and he’s got some fevers. Okay, I said, let’s go see him.”