Today, on World AIDS Day, I remember Glenn Walker.  That's his real name.  It's important.

I met Glen when I was an intern on the HIV ward at University Hospitals in Cleveland in 1993.  It wasn't called the HIV ward - it was called the SIU - the Special Immunology Unit.  Which didn't fool any of us, of course.   I have very distinct memories of this space, because it was where I made my bones as a doctor.

Glen had no T cells, and was frequently in the hospital.  He was pleasant enough, but he had terrible AIDS related dementia.  He wandered around, getting into other patient's beds and eating other patient's food and sauntering onto the elevator and winding up 3 blocks away, barefoot and panhandling for smokes.  You had to keep your eye on Glen.  And of course he was seriously sick quite a bit of the time, as well, which sent his dementia into the fog of war, where he hit us and fought us and there was real anger in his usually placid eyes.

At first you thought Glen was sweet and tragic, but after a few middle of the night tussles where you had to call security and affix him to his bed with leather restraints, his continuous efforts to be up to something got irritating.  Glen was a pest.  No nursing home could deal with him and even if we could dupe one into taking him, he'd be back with a fever in no time.  He was ours, always, like a permanent 3 year old who was never going to grow up and go to school.  With Glen around, there was never going to be any peace.  We smiled at him, and he smiled back - but we cursed him underneath our breath.

One day during morning report when I was a senior resident, we saw something big fall past the 3rd floor window of the conference room.  Rick Bailey went to the window and looked down.  "It's Glen Walker," he said, only slightly surprised.

Of course it wasn't Glen Walker is what we all thought.  Rick was a prankster.  But of course it was Glen Walker - of course it was.  He'd snuck into a bathroom and stood on a toilet and climbed out a window and fallen 4 stories.  He landed on his feet, shattering his ankles.

The first thought we had:  Glen in a wheelchair with two huge casts will be easier to manage.  Which he was.  The second thought we had:  "Glen No-Walker."

I knew it was wrong, but I sort of forgave all of us for calling him that, because black humor is about the only way you make it through a month on the Special Immunology Unit.   Until Glen Walker died, and his family sent us the program from his memorial service.  On the cover was Glen in full health, looking nothing like the 90 pound wasted man I knew.  And inside was a paragraph about how he had gone to Julliard, where he'd gotten a degree in piano performance.

What a rare and precious thing it is to have that kind of talent.  The ignominy of how we treated him at the end of his life still causes me to feel intense shame.  How could we not have known?  How could we not have asked?  How could we not have reminded ourselves that Glen used to be different - a whole man, same as us?

Well, its a thing.  He was alone, with family in a far away city.  His disease took away his mind and so you could argue there was a good reason we didn't feel his humanity the way we should have.  I'm not sure he noticed.  Nevertheless, I today I remember, as I frequently do, standing at the nurse's station where someone had taped up the program and being startled when I realized whose picture I was looking at.  I remember how sorry I was when I read about who he really was and realized he hadn't been a real person to me.

I really am sorry, Glen.  I'm sorry about everything - but mostly that I never got the chance to hear you play.