“Don’t use too many adjectives,” Dr. Kiran Belani warns at the end of our interview. “Thousands of people are doing great work. I don’t want this to be a hero story.” Belani cared for Minnesota’s first HIV-infected child in 1985, and for 10 years was the only pediatrician in the state working with HIV positive children.
Her childhood dream
By the age of 4, Belani knew she wanted to be a doctor. Her uncle was in medical school, and she noticed how popular he was. She wanted to be popular too. And like her uncle, Belani always liked helping people. In Bangalore, India in the 1950s, a lot of people were getting shots to prevent rheumatic fever and other illness, and Belani assisted her uncle in giving them. She also cleaned wounds and tended to people with whooping cough. Luckily, she wasn’t the slightest bit squeamish. She dissected frogs and wasn’t afraid to hold a cockroach in her bare hand in order to study it. Her family was an educated one that supported her career aspirations. “Everybody just assumed I would be a doctor,” Belani said.
“Everybody” included a large extended family. As is common in India, Belani lived with her parents and uncles. In some ways, becoming a doctor was a practical decision: Many women in India were physicians. If a woman wanted a career she could continue practicing after she married, she had to be a physician. If she chose any other occupation-even if she were a teacher or chemistry professor-she was expected to give up her career in order to become a wife and mother. Due to the large Muslim population and the Muslim influence on many Hindus, in India there are a lot of women who will only go to women doctors, so women physicians are in demand.
It takes a village
Belani and her husband moved to the U.S. when she was 23. “Before I came here I didn’t know that not many women were doctors in the U.S. (in 1985, only 14 percent of U.S. doctors were female) and I was shocked at the discrimination, and even at the small amount of poverty I saw. I thought everything would be perfect here. I was surprised by what I found. This place is just like every other place in the world.”
Belani is a strong-minded woman who likes to set the agenda, and she doesn’t like talking about topics like discrimination and hardship. She feels she’s been very fortunate. When she had her first child she didn’t even consider giving up her career. “I’ve never been afraid to ask for help. I’m no superwoman,” she said matter-of-factly. Belani was lucky enough to have family members who were willing to help. “For the first six months of each of my children’s lives my mother-in-law came from India to live with us. When I was studying for my medical board exams, my sister cared for my 3-year-old daughter for four months.”
She wasn’t afraid to depend on people in her career either. When she first started working with HIV-infected children in 1985, it was often sad and frustrating, but also exciting. Not much was known about HIV. “With HIV we had no script-we built it along the way. I wouldn’t have had that opportunity with other diseases,” Belani said. But nine years later, when good medicines still weren’t available and she went to 12 of her patients’ funerals in one year, she began to feel burned out. “My colleagues and I all wondered: What are we going to do? There were no miracle drugs-everybody with HIV got AIDS. It’s a horrifying death. The kids were getting diseases we’d never seen before-cryptococcal disease, pneumocystitis. ... It’s horrifying, and it’s slow.”
Though she didn’t go it alone, “I had a support network,” she said. It was the patients who really kept her going, despite the stress. “I had to be optimistic, or I couldn’t have kept my patients alive,” Belani said.
Beyond her control
Her cultural background-she was raised in the Hindu tradition-has helped Belani put things in perspective. “The Hindu religion teaches you to let things be, and everything will work out,” she explained. “I’m not an emotional person-and I don’t think of myself as a spiritual person. But I believe in a higher force, in destiny. If you think things are under your control you get upset-you get more disappointed when something bad happens. Of course I was sad when a child would die, but I took solace in knowing I did my best and everything else was beyond my control.”
As a child she was in constant contact with people who had encephalitis, malaria, tuberculosis. It was then that she learned to do the best she could to help people, knowing that she couldn’t control the outcome of any situation. Her even temperament was formed early on. She rarely considered the possibility that she might contract one of the diseases that were all around her. There has only been one time when she thought she might be infected. She was working in a medical ward in India when a patient with tuberculosis coughed some blood onto her lab coat. When Belani wasn’t infected, she decided her immune system was strong. She didn’t worry about contracting a disease after that incident. She was never afraid to hug her patients.
Belani’s perseverance and optimism paid off. In 1995, highly active retroviral drugs became available. These drugs changed everything. “Today having HIV is often less work [for a patient] than being diabetic. You just take pills,” she said.
A role model, not a hand-holder
In addition to perseverance and optimism, Belani was also gifted with the ability to make hard choices-especially as a mother. Her husband is an anesthesiologist, and they both work long hours. She often put work ahead of family, and was honest with her children about that. “I didn’t go to every school function. I couldn’t,” she said. “But I did take my kids to the hospital. Both volunteered to read to sick children at the age of 13. They met sick kids-kids with diseases, kids with birth defects. They realized how lucky they were.” Going to the hospital, Belani said, helped her children appreciate their mother’s work, and accept the fact that she had to be away a lot. A babysitter met them at the bus at 3 p.m., gave them dinner, and got them started on their homework. Belani came home by 7 p.m. She was there to tuck them in, and after she did, she and her husband made the kids’ dinner for the next day.
She was a role model, rather than a hand-holder. Belani encouraged her daughter’s humanitarian pursuits, and warned both children of the dangers of too-early romantic involvement. “I was conscious of gender equality, and treated my children the same,” Belani said. She herself had not been raised to be a boy’s equal. “Things have changed a lot in the last 30 years, but when I was in India girls were raised more strictly-they weren’t allowed to go out as much as boys, and they weren’t involved in sports. I didn’t want my daughter to feel restricted just because of her gender,” Belani said.
“I told my children I was telling them as a professional, rather than a mother. I said: You must figure out yourself first, before you have a boyfriend or girlfriend.”
The helping gene
“Women are specially equipped to help people-our status as underprivileged citizens makes us more compassionate,” Belani said. “Also, men are less likely to go into public health and HIV, because these areas are lower-paying than many other medical fields. I’m not sure if it’s because I’m a woman or a person of color that I’m able to relate to my patients. But I have found-as a patient-that women make wonderful doctors.” She is especially passionate about the discrimination HIV-positive African American people face. “African Americans are the population most affected by discrimination,” she said. “They’re the least likely to have health insurance … often they’re isolated, and afraid to tell anybody they have HIV.” Belani herself feels that despite the stigma people with HIV still face, there is also a lot of compassion for them here in the U.S. She is especially moved by the couples who are adopting children with HIV. “They are the real heroes,” she said.