Hooked on ID with Cornelius (Neil) J. Clancy, MD
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I completed medical school and internal medicine residency in the years immediately before protease inhibitors against HIV reached the clinic.
During residency, more than half the medicine beds in my hospital were occupied by persons with AIDS. A good outcome was having one of these patients improve symptomatically, make it home and stay out of hospital for a few weeks or months. It was physically and emotionally draining work, which dissuaded many of my friends and colleagues from careers in internal medicine and infectious diseases. I had planned on applying to pulmonary or cardiology fellowships, and never really thought about infectious diseases. In my final year of residency, however, I rather suddenly had the great revelations of my professional life: infectious diseases shape the course of history; when the history of our times is written, AIDS and, inevitably, other infectious diseases would occupy central places. When I looked back on my life, I wanted to be able to say that I played some small part in seminal events of the day.
Saquinavir, the first FDA-approved protease inhibitor, arrived in my first year of fellowship. To this day, the most remarkable thing in my career was seeing so many people with AIDS rise from the dead after starting the new cocktails. Since then, I’ve made an academic research career largely in medical mycology and antimicrobial resistance. Yet, when I reflect, what gives me most satisfaction is having been a foot soldier in activities outside my primary areas of interest, such as treating AIDS, working on Legionella and mold outbreak investigations, and engaging in Ebola and COVID-19 preparedness. The greatest appeal of infectious diseases is the opportunity it affords to work on so many different things crucial to the public health, and to be able to do so in so many different capacities — patient care, prevention, research, teaching, administration and management, policy, international health, serving underserved populations, addressing inequity, etc.
This is without a doubt the best time to enter our field. Even as a student or trainee, you can do work now that makes an immediate impact, improves peoples’ lives and changes practice or health care delivery in ways that could not be imagined even 10 years ago. My only regret is I cannot do it again.
— Cornelius (Neil) J. Clancy, MD
Associate professor of medicine
Director of extensively drug-resistant pathogen lab and mycology program
University of Pittsburgh