As I write this, I am flying en route to Washington, D.C. for the XIX International AIDS Conference . Gazing out over the hazy quiltwork of heartland, I am reminded of the old expression of taking the 30,000-foot view on a problem and how that brings the big picture into focus.

It strikes me that there was no 30,000-foot view at the beginning of the HIV/AIDS epidemic in 1981 when the first reported cases of AIDS appeared. The only people who seemed to be focused squarely on the disease were seeing it at eye-level: those who were sick and dying from infections, their friends, their doctors, their loved ones, and the activists who took to the streets.

Nothing better captures the immediate reality of those early days than this story by former UCSF professor Art Ammann of the frustration he faced as he tried to call attention to several patients with AIDS.

Ammann was part of a vanguard of doctors at UCSF who began meeting after they started seeing the first cases of AIDS. It’s hard to imagine today, but Ammann’s discovery and characterization of the first two pediatric cases was ignored and refuted—and not by the denialists. It from within the medical establishment itself, he said, where the resistance came.

“New England Journal of Medicine wouldn’t accept the article,” he said. People said we were just trying to jump on the bandwagon.”