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Compassion in Action: Pike Market Clinic’s Response to the HIV/AIDS Crisis

Posted December 1, 2023

The Clinic was ground zero for the AIDS epidemic in Seattle. Gay people were our colleagues at the Clinic, our comrades…. We were reeling from the madness, but we had to do something.

-Joe Martin, Pike Market Medical Clinic social worker and advocate


December 1st is World AIDS Day, an international day dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection. 

As HIV/AIDS emerged in Seattle during the 1980s, Pike Market Medical Clinic (now Neighborcare Health at Pike Place Market) played a uniquely critical role in offering care at a time when the virus was being ignored and misrepresented.

“The Clinic in the Market was really well positioned to respond to HIV, in a way that a lot of other health centers could not,” explains Chris Hurley, community health advocate and former Executive Director of the Pike Market Medical Clinic. “Community health clinics often have very niche populations based on the needs of the community, and the needs in the Market made the Clinic uniquely qualified to care for people who had what came to be known as AIDS.”

“What also set the Clinic apart was our non-judgmental attitude,” said Carol Glenn, who was a nurse at the Market Clinic when HIV came to Seattle. “The Clinic didn’t pass judgment. The Clinic had heart.” 

In the face of an unknown virus, Seattle’s network of healthcare staff, activists, and organizers mobilized with a fierceness that would set a nationwide standard for prevention and treatment. Today as we remember the thousands of people in Seattle who have lost their lives to AIDS-related complications or are still living with HIV, we also honor the Pike Market Medical Clinic staff who provided critical care in the early days of the crisis.

The early days of the virus in Seattle
Lesbian, gay, bisexual, transgender, and queer people have long been part of the social fabric of Seattle. Already incredibly politically active and organized in the late 20th century after a number of civil rights victories, gay Seattleites and allies prepared for the worst as they heard horror stories of a mystery illness creeping through San Francisco and New York City. 

“It came right after Initiative 13 was defeated, which would have limited housing and employment rights for gays,” recalls Joe Martin. “It was a huge win… and then this phenomenon started happening amongst gay men.” 

A crowd gathered to celebrate the defeat of Initiative 13 at the Eagles Auditorium Building in Seattle, November 7, 1978 

As the first Seattle cases were diagnosed in 1982 and the health department characterized it as merely “a gay disease”, LGBTQ+ organizers mobilized to start providing counseling, grow funding, and dedicate resources towards the impending pandemic. The Seattle AIDS Support Group, Chicken Soup Brigade, the Northwest AIDS Foundation, People of Color Against AIDS Network, and Shanti/Seattle were all essential organizations primarily shaped by the dedication and ingenuity of these community networks. Lesbian groups mobilized, becoming became highly involved in activism, caregiving, and opening community spaces. The all-volunteer-run Seattle Gay Clinic in Capitol Hill became an essential hub for information exchange and an alternative to the public STD clinic housed in the same building as the police department.  

“Stan Henry was a key volunteer at the Seattle Gay Clinic, and he was also the receptionist at the Market Clinic,” said Chris Hurley. “Stan began referring patients to us, and was a key part of how people were directed to the Clinic. That connection really facilitated a lot of our internists becoming embedded as a key resource in the world of HIV care.

But it wasn’t just referrals from other gay neighborhoods –  LGBTQ+ people in the Market community would also be affected by the virus, and turn to their Clinic for support. 

“Market bartenders and servers, people who worked on the craftline, artists, they all used the Clinic as a primary care provider,” said Carol. “Eventually, most restaurants and small businesses in the Market had workers suffering with HIV, and the Clinic was there to support them. We always took care of our people.”

A clinic for Pike Place Market and downtown neighbors
Founded in the late 1970s by a group of community health activists, the Pike Market Medical Clinic was created to serve downtown neighbors and residents in the Market, many of whom are seniors and living on low incomes. Staff began providing limited nursing services in June of 1978 in the old Motherlode Tavern at 1607 1st Avenue, before expanding to their present-day location in Post Alley. “We had recently moved to our new location at 1930 Post Alley, and weren’t there long before the situation really hit,” recalls Joe. 

Pike Market Medical Clinic staff pose with medical equipment. Chris Hurley is pictured far left, and Joe Martin front row second from right.  

Since many of the Clinic’s patients were seniors living with complex health issues, Pike Place Market was uniquely suited to provide care for the emerging virus.  

“There was a reason the Clinic ended up being a key source of primary care for people with what became known as AIDS,” said Chris. “One is that we had the right internal medicine doctors with the right skills to match the complex needs of people with AIDS. In the early days of the epidemic, AIDS was a specialty service frequently requiring inpatient care.  Our docs routinely attended to their patients in the hospital, unlike family practice physicians at other clinics. Also, Clinic physicians were internists who really specialized in care for people with chronic illnesses, complex and compound problems. They really matched the need – and then some. ” 

Chris Hurley, pictured outside the Pike Market Medical Clinic where she served as Executive Director. Chris would also go on to be the founding director of Bailey-Boushay House, a specialized care facility for people living with AIDS. 

As symptoms of the HIV virus were published in Seattle Gay News and the resulting clinical syndrome was named (Acquired Immunodeficiency Syndrome), more people began to suspect they were sick. “All of a sudden, we had men come in with nasty rashes, diarrhea, pneumonia,” said Carol. “Nobody knew what was going on. We had no idea how it was transmitted, we had no tests. We knew nothing.” 

Pike Market Clinic doctors Tom Heller and Lester Pittle, nurse practitioner Patricia Richert, nurses Cecil Frank, Carol Glenn, Jacqueline Meyers, Janna Pekaar, Gayle Reed, Marta Richardson, and other staff continued to tend to their patients despite the perceived risks. Their team was instrumental in providing initial care when so much about the virus was unknown, and hysteria about potential exposure ran rampant in Seattle.  

“There was a misguided sensibility that this could somehow be caught, or was transmitted in the air,” says Joe. “Not to mention the anti-gay rhetoric. But the Clinic was caring for them regardless. People on staff were being affected, their community was being affected. Stan Henry, who is now deceased, God bless him. Scott Glasscock, God bless him. They were saints, the doctors.” 

Activists described it as three pandemics: HIV itself, the fear of HIV, and underlying it all, a fear of LGBTQ+ existence as a whole. Some people had no place to turn to, but their community and the Clinic at Pike Place Market.

“We had 18, 19, 20-year-old men coming into the Clinic, whose parents had said ‘change your name or die’,” remembered Carol. “Middle-aged men were turned away at other clinics and sent to the Market Clinic. Women were left out completely. It was horrifying.” 

Carol recalls one patient dying of complications from AIDS, and she comforted his grief-stricken partner at the Clinic. “He fell into my arms, his shirt was drenched with sweat and soaked mine as he hugged me, his hair was plastered to his head…” In his heaving sobs, droplets of his saliva tinged with blood landed on Carol’s face and mouth – a death sentence based on the limited knowledge of the virus at the time. “After he left, I went to the bathroom and threw up. I washed my mouth with soap. I threw up again. And I went back to work. We just didn’t think of ourselves at the time, all we could think was ‘how can we help’?”

A Foundation to sustain this vital work
It’s no coincidence that the Pike Place Market Foundation was created the same year that the first case of HIV was diagnosed in Seattle. In the early 1980s, Reagan-era policies to ignore the HIV/AIDS crisis as well as gut welfare programs both created critical gaps in Seattle that the Market’s social services were left to fill on their own.  

In 1981, federal budget cuts slashed social service funding and decimated social service infrastructure nationwide, just as needs were skyrocketing. Overnight, the Pike Market Medical Clinic lost a $150,000 federal grant representing half their operating budget. To preserve Market agencies like the Clinic, the Pike Place Market Foundation was founded to fundraise the difference and help fulfill the Market’s historic charter of providing services in the Pike Place Market neighborhood. To this day, the Market Foundation continues to act as the Clinic’s largest private donor to ensure that they can invest in operations year after year.

Pike Market Clinic nurse, Cecil Frank.

“The difference is that the Foundation’s support is consistent, and specifically for operations, instead of being contingent on a new project,” says Chris. “Nowadays, this is where philanthropy is going more and more, but it’s where the Market Foundation has always been.” Not only did this funding keep the Pike Market Clinic stable after the loss of federal funding, it also allowed Clinic staff the flexibility to pivot and offer community health resources based on emerging needs in the community, like HIV/AIDS.  

“That’s the beauty of designing services based on a specific population, is that you can focus on very specific needs and dynamics of patient care as they change in the community,” says Chris. 

Since its inception, community health clinics like the one in Pike Place Market have battled increasingly complex health issues like HIV/AIDS and COVID-19, which both revealed critical gaps in our medical and community support systems. As healthcare continues to become increasingly inaccessible to our neighbors living on low incomes downtown, the Market Foundation is committed to supporting the vital work of Neighborcare Health at Pike Place Market through annual support and partnership.

The Deadly Collision of Virus and Inequality

 “By magnifying the divisions already present in our world, viruses may not consciously discriminate because viruses have no consciousness… Yet their effects do discriminate against the bodies of the underclass, because those bodies have been placed in proximity to danger by the structural design of powerful humans.”
– Jonathan M Metzl 

By the time President Reagan finally publicly mentioned AIDS four years after the epidemic began, over 12,000 Americans had died. The federal government’s lack of action revealed the deadly consequences of politicizing a public health crisis, and the fallout would continue for years across multiple presidential administrations. Seattle ACT UP activist Steven Michael was still fighting for action 14 years and two administrations later, as his community pleaded that President Clinton deliver on his promises. 

“It is not acceptable in 1996 that we have to once again disrupt Clinton’s speeches on the campaign trail in order to get him to even mention the word AIDS,” said Steven. “If I die, take my body to the White House. Show the world that Bill Clinton has lied to and betrayed people with AIDS.” When Steven died of AIDS-related complications in 1998, his partner Wayne Turner (also a member of ACT UP Seattle) did just that, and held a political funeral for Steven in front of the White House.Wayne Turner and Steven Michael met at ACT UP Seattle, and later took their activism cross-country to hold President Clinton accountable on the campaign trail and secure AIDS policy promises. Steve ran for President in 1996, as the AIDS Cure Party candidate in order to secure media coverage and mobilize the LGBTQ+ voting bloc.

Echos of the initial HIV response were seen once again during the outbreak of COVID-19, which, in similar ways to HIV/AIDS, exposed deep gaps in our healthcare system and made our most vulnerable neighbors more susceptible to the virus. 

There are vast inequalities in who can survive viruses: how viruses spread and take their toll is often much more dependent on social structures than on biology. Compounded by racism, ableism, homophobia, and capitalism, these systems affect people’s access to healthcare, housing, safe jobs, and other factors that determine their proximity to a virus. 

Ultimately, when a pandemic like HIV/AIDS or COVID occurs, it is the most marginalized in our community who experience the most harm: people of color, LGBTQ+ communities, disabled people, those experiencing poverty, and incarcerated people. While social stigma often places the responsibility for contracting a virus on an individual, this obscures the systemic failures that make an individual vulnerable to viruses in the first place.  

ACT UP marching in Seattle, 1994. 

An anonymous patient in Seattle Gay News reflected: “The deepest despair was this: ‘I don’t matter… I don’t matter.’ Would it be too mystical to suggest that acquired immuno-deficiency syndrome is the perfect physical metaphor for ‘I don’t matter’? After all, why defend a body that doesn’t matter?” 

When a person is at an increased risk of contracting a virus, it is not due to personal failure or irresponsibility; rather, larger systemic factors have limited their access to the support and care they need to maintain a healthy life.  

The Pike Place Market Foundation’s model for a healthy community reflects this very principle, and focuses on the Social Determinants of Health: non-medical factors that affect a person’s well-being. 

Community health is not just determined by the care individuals receive from a doctor, but also by economic stability, education, access to nutritious food, a safe neighborhood, and community support. Within this model, the Market Foundation works with service partners like the Clinic to reduce or eliminate barriers to these determinants so that our neighbors can find stability and have an opportunity to attain their full health potential.

Betsy Lieberman (right), co-founder of Bailey-Boushay House. 

Forty years since the Pike Market Medical Clinic first started treating people living with HIV/AIDS, tremendous strides have been made to treat and manage the disease. In 1985, the Department of Public Health’s AIDS Prevention Project was the second unit dedicated to HIV/AIDS in the country. In 1987, Seattle’s HIV Vaccine Trial Unit became the first of its kind in the U.S., and King County prohibited discrimination against county employees with HIV/AIDS. In 1994, effective antiretroviral treatments became available, and AIDS-related deaths finally began to decline.  

Many of those Pike Market Clinic staff who saw the devastating early impacts of the virus continued to devote their lives to improving care for people living with HIV and developing long-term care services. Clinic Executive Director Chris Hurley and Clinic Coordinator Betsy Lieberman went on to establish Bailey-Boushay House in Seattle: the country’s first inpatient hospice facility where people living with AIDS could get the best possible treatment and end their lives in dignity. 

After nurse Carol Glenn left the Pike Market Clinic and began working at a large Seattle hospital, she helped build a network of patients, their friends and families, along with many HIV care providers and agencies. Together, they worked to distribute leftover or no longer-needed HIV medications and supplies across the country and abroad at a time when the medication was inaccessible.

“It didn’t matter whether you were in Kenya or Kentucky, people couldn’t get the treatment they needed,” she said. Carol’s secret activism ultimately cost her the job and ended her 44 year nursing career, but helped countless people prolong their lives. “I loved being an HIV and AIDS nurse, I would have done it forever,” she reflects.

Health officials now agree that the city’s quick initial response continues to have a lasting impact and lower infection rates to this day. King County was among the first communities nationwide to achieve the World Health Organization’s target that 90% of people with HIV know their status, get treatment, and prevent transmission. Now dubbed the “Seattle model,” this wraparound approach to addressing HIV/AIDS through grassroots activism, political engagement, and accessible, community-specific healthcare proved instrumental in managing the epidemic.  

However, hundreds of people in King County still get diagnosed with HIV each year, a disproportionately high number of them Black men, people who are homeless, and those who use IV drugs. “HIV is still here. AIDS is still here,” says Joe. “There are ways to prevent and treat it. But it is still a very, very highly charged issue.” 

When viruses serve as magnifiers of the divisions already present in our world, we must pay close attention to which communities are most affected, and what systemic barriers prevent them from getting the care they need. The lessons learned from Seattle’s initial HIV outbreak and the subsequent response continue to underscore the importance of community-focused healthcare, and remind us that our neighborhood’s health is intricately connected to our ability to address the systemic barriers that exist in our city.

In commemorating World AIDS Day and the vital work of the Market’s Clinic, the Pike Place Market Foundation is committed to supporting our service partners as they navigate the increasingly complex health challenges facing our neighborhood. Together, we can invest in comprehensive, accessible, and equitable care for everyone in our community.

We need your help to ensure that the Market’s social services have the funding, staff, and resources to meet emerging needs in Seattle for years to come.

 Give today and join us in supporting a thriving Market where everyone can live their best life possible!