Tinsley Harrison Internal Medicine Residency Program                        Excellence Without Ego

An Interview with an Alumnus: Michael Saag, M.D.

By Josh Stripling, M.D.

SaagIf you know anything about HIV, the 1917 Clinic, or the importance of HIV research at UAB, there is probably a good chance that you know the name of Dr. Michael Saag.  For those of you who have ever been on his service there is another thing you know: It’s important for him to know who you are, and for you to know him!  

Dr. Saag is a wonderful teacher, ID physician, and world-renowned researcher, contributing as one of the top funded NIH investigators at UAB.  But maybe not so well known is that he is an amateur barber, cinematographer, father of three, and now a published author. Recently released was Dr. Saag’s personal manifesto entitled “Positive: One Doctor’s Encounters with Death, Life and the US Healthcare System.”  

By definition the book is a memoir, tracing Dr. Saag from his roots in Louisville, KY to his training at UAB’s Internal Medicine Program.  Dr. Saag started at UAB in June 1981, precisely the same time that the first cases of what would later become known as AIDS were reported in the CDC’s MMWR.  Through his residency and fellowship in Infectious Diseases at UAB, he serendipitously bumps into HIV over and over until he and the virus become intertwined:  The virus doing its damage to countless patients he grew to know and love; Saag’s taking the fervor derived from loss of patients into the lab and clinic.  Ultimately science trumps the evil virus, and the book tells many ‘behind-the-scenes’ stories of how the battle was waged through a massive collaborative effort of numerous talented investigators, activists, clinicians, as well as academic administrators, industry, and government.

But more than a memoir, the book is a manifesto. From his experiences during training, those as an attending and as a confidant to his many patients, Saag voices his frustration at the dysfunctional healthcare system that seems to serve greed much more than patient need.  By drawing a parallel to the battles won against HIV, he asks, “Why can’t we pull together to create a healthcare system that serves all of us, not just a few?”  HIV was brought under control through remarkable collaboration and if we can do that with a viral disease totally unknown prior to the 1980s, surely we can have similar outcomes with our healthcare system. 

The book is Saag’s statement of hope:  “It’s not all about me, it’s all about us. By pulling together, we can and will create a better healthcare system that serves all of us.”

In his book, he calls UAB “a magical place to work. There is a can-do, entrepreneurial spirit there that I have not seen at other academic institutions. As is evident throughout this book, I was afforded opportunities very early in my career that would not have happened elsewhere solely because UAB and it leaders focus on the ideas, not on the age of the person who brings the idea forward.”

Q: Why write a book?

A: Anger! The most powerful motivating force in life is fear and second is anger. I wrote this book because I was fed up with putting up with the inefficiencies and injustices with our healthcare system and I point out many of these in this book. I was tired of seeing a system where we do things based on insurance and payer status. I mean we do it everyday! The answers and changes to healthcare delivery currently are uncertain, but the most important question is: “What if we did nothing?”

Q: What led you to HIV in the first place?

A: Serendipity.  As happens with most things in life.  I didn’t plan to work in HIV; heck, I initially thought I’d be a surgeon, and then a cardiologist.  Even when I decided I wanted to specialize in ID, I wasn’t thinking HIV nor academics but simply working in private practice ID back home in Louisville.  The take home point:  No one can (or should) plan his or her future too carefully.  Follow your gut, find your passion, and be open to opportunities as they arise. 

Q: Who were the people that most influenced you during you training at UAB?

A: I would have to say that I had many mentors, Dr. Bill Dismukes and Dr. Glenn Cobbs, chief among them.  And I really learned a lot from Dr. Claude Bennett.  As a Chief Medical Resident, every Tuesday morning he would have chief rounds.  They were special moments when we were able to talk about medicine as an art, the importance of being a mentor, and how important closeness and intimacy were to that role. He was exceptionally honest and was not afraid to voice his feelings and challenges, even when his expressed opinion may not have been in his best personal interest while giving me advice.  I especially respect that aspect of our relationship.

Q: What is one story from residency that you don’t mind sharing?

A: One of my favorite experiences was making the short film titled, “The Hospital Zone”. It was the first time videos were shown at the end-of-the-year Housestaff Party (I am proud we started that tradition at UAB).  The movie was a spoof using the concept of Rod Serling’s hit TV show, The Twilight Zone.  Our movie highlighted what it was like to be a 1st year (PGY1) resident at UAB and starred Scott Buchalter as ‘J. Claude Brown,’ following him through a very unusual day and night on call when, “ J. Claude got beeped into . . . The Hospital Zone.” You can imagine the rest.   Bob Bourge was the cameraman and director.  Bob, Scott, and I wrote the script. It was a huge hit!

If you would like to learn more about the amazing patient experiences of Dr. Saag’s, the development of antiretrovirals and amazing insight into our current healthcare system please read Dr. Saag’s book.  You can get a copy via the book’s website:  http://www.positivethebook.com

 or on Amazon, http://www.amazon.com/Positive-Doctors-Personal-Encounters-Healthcare/dp/1626340641/ref=sr_1_2?ie=UTF8&qid=1395173005&sr=8-2&keywords=positive, or other websites for a Kindle version. 

On May 8th, Collat Jewish Family Services honored Dr. Michael Saag at the 6th annual Hands Up Together event held at the Dorothy Jemison Day Theatre at the Alabama School of Fine Arts.  Dr. Saag was recognized for his life’s work of service dedicated to selflessly serving HIV/AIDS patients and their families as well as the development of an innovative, comprehensive HIV outpatient clinic focused on outstanding patient care and clinical outcomes research.