Activist nurse Michael Harank remembers Oakland’s Bethany House during AIDS epidemic

“Hello, Michael speaking.”

Registered nurse Michael Harank picks up the phone from his desk at the Lifelong Medical Care clinic in Berkeley. It’s an ordinary Friday afternoon.

The call is from a pharmacist. A patient wants to get her medication a few days earlier because she’s going out of town. Harank looks around—the doctor isn’t there. Instead of asking the pharmacist to call back later, Harank tells her that he will investigate and call her back. He pulls out the patient’s charts and starts calling around, voluntarily adding this extra task to his workload.

“It’s just easier for everybody,” says Harank. “It’s not a ‘But it’s not my job’ kind of attitude.”

Now in his 60s with grey hair, a pierced left ear, and a face with a smile always buried somewhere, Oakland resident Harank is a lifelong activist who has spent his life advocating for people with HIV/AIDS. He believes nursing is a door that opens other doors into people’s lives, because people trust doctors and nurses—especially nurses. “Activism comes from the word ‘action.’ If you’re just a person of words and don’t put it into action, then your life lacks integrity,” he says.

Harank, originally from Boston, was raised Roman Catholic. He obtained a bachelor’s degree in religious studies from the College of the Holy Cross in Worcester, Massachusetts, in 1976. He moved to New York in 1978 to join the Catholic Worker Movement, which was co-founded by Dorothy Day, the American journalist and social activist who Pope Francis praised in his 2015 speech in front of the Congress as one of the “four representatives of the American people.” (The other three were Abraham Lincoln, Martin Luther King, Jr. and Thomas Merton.) The movement’s aim was to provide social services to those on the margin of society. They published newspapers, opened up houses of hospitality and farming communes, and operated a soup kitchen in New York on a “no questions asked” basis.

Harank said he joined the Catholic Worker movement “because that was my understanding of Christianity and Christian faith, which was to align or be in solidarity with the poor and the outcast and the marginal.” Working for the group, Harank lived with Day for the last three years of her life at the Mary House in New York.

While living with Day, Harank started working at St. Rose’s Free Home for Incurable Cancer, a Manhattan hospice founded by Rose Hawthorne, the writer Nathaniel Hawthorne’s daughter. One day, the director of nursing at St. Rose’s took him aside and said, “Michael, you should think about becoming a doctor or nurse, because you have some gifts to share with people who are suffering,” Harank recalled. “There was a certain sadness working with the dying. But there’s also the joy of compassion being a listening presence and active presence to people who were suffering from cancer and dying. Death is part of life. And to be a presence of love in the midst of death is a great gift.”

He decided to get a nursing degree.

When he graduated in 1987, the first job he chose out of school was to work at a dedicated unit at a hospital in Boston for prisoners and people dying with AIDS. During this era, scientists were still trying to understand the disease that had turned into an epidemic killing hundreds of thousands of people. The first anti-HIV drug had just been approved by the Federal Drug Administration earlier that year. The fear of the unknown made people panic and many medical personnel were reluctant to care for AIDS patients. “They needed nurses because people were so afraid. It was hard to find nurses who would work with people dying of AIDS,” he says.

In 1988, Harank moved to California, continuing to work with organizations that treated people with AIDS. A year and a half later, he started to realize there was no residential hospice center in the East Bay. On his own, Harank started a small Catholic Worker House for homeless people living with AIDS in Oakland. It became known as the Bethany House, which he ran for almost a decade throughout the 1990s, giving free care and shelter to those in need during the last moments of their lives.

“It’s easy to provide food and shelter, but it’s not easy to provide a safe and clean sanctuary for people who have been rejected and stigmatized,” says Harank. “You’re not alone when you were born. You shouldn’t be alone when you die.”

Located on Golf Links Road, the house was owned by the Oakland branch of a Roman Catholic order called the Redemptorists. They gave Harank the use of the house, rent-free. It was a 3-bedroom, 2-bathroom house with a deck and a creek running through the backyard. “You can hear the sounds of the water at night during the rainy season,” Harank remembers.

During the 10 years he ran it, the house served over 30 people, relying on donated money. For the residents, Harank was their advocate, nurse, listener, companion and taxi, driving them to medical appointments. Later, it grew into a community of residents and volunteers, who would spend time in the garden or take residents out for movies.

“One of the joys was watching people getting off the track of survival and start walking down the path of truly living before they died,” Harank says. ”The challenges were about living in community with people who were sick and all the needs that they had—physical, psychological and spiritual.”

The residents at Bethany House got medication through the state of California. These drugs wouldn’t save their lives, but did slow the process of the disease. They came to Bethany House for care because they had been rejected by their family—often for being gay, being drug users, or other reasons—on top of being infected with HIV. Harank would try to reunite them with their families, but that didn’t always work out.

In 1995, the number of Americans who died from AIDS peaked. In 1997, the death rate from AIDS fell to almost half of what it was in 1996, and reached its lowest since 1987, according to Centers for Disease Control and Prevention figures. The increased use of a combination of antiretroviral drugs—sometimes known as a “cocktail”—hadn’t stopped the rise of the HIV infection rate, but it had enabled people with AIDS to live longer.

By the late 1990s, the epidemic had changed dramatically—the focus was less on hospice and more on helping people live healthier lives for longer. And the Redemptorists needed the house back for other uses. So Harank discontinued the Bethany House and went to rural New Hampshire in 1999 for a sabbatical. After 12 years of intense AIDS work, he needed a rest and he wanted to write about his experiences with Bethany House.

When he returned to Oakland in 2001, he read that disease that was now killing people with HIV was Hepatitis C. It’s a liver infection caused by a virus, which is spread in a similar way to HIV: through blood or body fluids. It can cause liver failure and eventually death. A doctor Harank used to know asked if he would want to start an HIV/Hepatitis C co-infection program at Highland Hospital in Oakland, which would serve people who had both diseases.

The new program educated HIV clinicians about Hepatitis C treatment, set up the co-infection clinic in the HIV clinic, and assigned Harank full-time to monitor and support HIV patients getting Hepatitis C treatment. There was also a weekly support group for the patients. The program turned into a paper called Integrating Treatment for Hepatitis C Virus Infection into an HIV Clinic, published on Clinical Infectious Diseases in 2005. The team went to the National Institute of Health for a presentation to explain their cure rate, which was 10 percent higher than the national average. “I think it was the support that kept people in treatment, which resulted in their higher percentage of cure,” says Harank.

New requests keep on popping up on Harank’s computer screen. He clicks it open, pulls out the charts to read patient history, and starts calling.

One down. Clicks it close. Two more pops up. And the phone rings again.

“Hello, Michael speaking.” A patient wants to have a refill without making an appointment with the doctor.

Three new requests come through.

“Oh, I actually have to make sure I get this death certificate done,” Harank reminds himself. He needs the funeral home to fax him a form so a doctor can sign the certificate. Without it, the family can’t bury their loved one, so he wants the family to have that certificate as soon as possible.

The phone rings again.

“Hello, Michael speaking.” Immediately, he switches into Spanish, smiling.

The call isn’t from a patient, but from his friend Bacilio, whom Harank calls an “adopted son.” The young man was an immigrant who collapsed at work one day in the early 2000s and was sent to Highland Hospital, where Harank worked. It turned out he had been infected with HIV, but he didn’t know. Social workers called Harank and told him that the young man didn’t have anybody to support him. Harank brought him food, helped him find a job, a place to stay, and continued his medical care.

Gradually, Bacilio became an activist in Oakland’s Latino community, sharing his story and telling people that he was living with HIV. He invited Harank to appear with him in a poster and billboard campaign to raise awareness of the disease and to decrease the stigma against it. Harank happily agreed, even though his friend warned him that if people saw him on the poster, they might think that he, too, had HIV.

”I don’t care,” Harank told him.

Today there’s a poster on the wall behind him with a picture of the two men standing together. It reads: “TOGETHER HIV STOPS WITH US.ORG”. There’s also a quote from Bacilio: “This man is like a brother to me. When I came here I didn’t know anyone and I didn’t know much about HIV. I almost died, but Michael helped me believe that I could live and be healthy.”

Now there are new messages on Harank’s computer screen again. ”Patient very rude and confusing…” Harank reads. He starts to laugh. ”I love it!” he says.

“Before we deal with this, I need to have something sweet,” he decides. Harank walks over to the pantry and finds some cake, then carries the cake back to his desk. “Let’s see what’s up with the rude patient. You turn into a Zen monk, right?”

It’s almost 5 o’clock now. Harank is working on the last request of the day. After that he’ll go pick up Bacilio for dinner, their Friday routine.

Next May, Harank will retire from the clinic. He plans to go travel and write. But he’s not sure what the activist in him will do. That part of him will probably never stop working. “I don’t know,” he says. “When I ‘retire’—quote unquote—in May, I’ll have a lot more time available to dedicate to some of the issues that I think are really fundamental and vital. So, we’ll see.”

For the music used in the audio piece.
“Bittersweet” Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/