Carpe Diem

You face annihilation, and then go on from there."

"So Many Men, So Little Time" was the grim motto of a party held seven years ago in Provincetown, Mass., a resort community on Cape Cod that once bore the sad distinction of being a place, it was said, where gay men with AIDS went to die.

"When I first came to Provincetown, the men got sick, went into the hospital and never came out," recalls Scott Penn MA '81, who served as executive director of Outer Cape Health Services, a private non-profit clinic, from 1986 to 2000.

In a community that was then a critical area for the AIDS pandemic, Penn saw co-workers dying around him. Every month, he recalls, there was another memorial service for a young victim: "In a small town, you notice those kinds of losses. It was all very discouraging, as if we were walking through a minefield and didn't know who would blow up first."

Today, the disease is no longer an automatic death sentence. During the 14 years that Penn—an alumnus of SLC's graduate program in Health Advocacy—served as executive director of the health clinic, which treated patients with all kinds of diseases and health problems, he witnessed a profound improvement in the prognoses of men afflicted with AIDS, in large part the result of a new class of drugs—protease inhibitors, used in combination with a set of older antiviral medicines.

The change began in the mid-1990s, when many who were diagnosed as HIV-positive or who suffered with full-blown AIDS began responding to the new drugs. Indeed, many who contracted AIDS then are still alive—albeit with limitations. There are sometimes harsh side effects to the powerful medications, and the formulas often must be changed during the course of a victim's life. And now, new studies are suggesting that some patients can build a tolerance to the drugs, which can thus lose their effectiveness in fighting the disease.

Those limitations notwithstanding, the new lease on life has brought with it many positive changes among the gay population. "Once the terrible, bottomless fear of death was gone, the question became, 'how do we dig in for the long haul,'" says Penn, who is gay but has not contracted AIDS. "Also, for many gay professionals, especially health professionals, there's been the decision not to try to 'pass' anymore—but to work openly to save the people who are positive and help protect those who are negative." Under his watch, Outer Cape Health Services opened a second and third clinic and increased its number of employees from 20 to 100. Its annual budget grew from $750,000 to $5.5 million.

Looking back at the gains made and the lives of gay people today, Penn—who is now a manager of development for Mount Sinai Hospital in New York City —mixes pragmatism with hope: "These days, the philosophy is to live for the moment, but also not to take anything for granted. That same kind of thinking occurred in the minds of many other Americans after 9/11. You face annihilation, and then go on from there."