santa clara county public health department

You might have heard about Dr. Marty Fenstersheib, Santa Clara County’s testing and vaccine officer who came out of retirement in 2020 to help in the fight against COVID-19. However, you may not know he worked for the county since 1984 and was instrumental in the fight against HIV/AIDS.

Born in Pittsburg, Pennsylvania, Dr. Marty Fenstersheib received his B.S. at Tulane University, M.D. at Universidad Autonoma de Guadalajara, and M.P.H at U.C. Berkeley. He is Board Certified in Pediatrics and Preventive Medicine. He always craved big challenges. He left his first job in private practice because he found it too easy. He entered U.C. Berkeley’s Public Health program and, as a fluent Spanish speaker, was soon working in a Spanish-language clinic in San Francisco’s
Mission District.

In 1984, he joined Santa Clara County’s Public Health Department as director of the immunization program. This was in the early days of the epidemic. “I actually was the first person in the health department that gave results to people that they were HIV positive. The test came out in 1985 and nobody knew what to do, so no one wanted to give the results. So, I did,” Fenstersheib said. “It soon became known that if you got the test and I came in the room—it wasn’t good news. After
that, there was nothing else to tell them.”

Fenstersheib achieved national prominence when he pioneered a then-revolutionary AIDS treatment that meshed medical care with education to keep infected patients from spreading the virus. He helped open a County clinic to provide education, referrals, and support. The approach was profiled in the Journal of the American Medical Association.

The HIV Early Intervention Clinical Program he started in 1987 became the model for the State of California. More than two dozen similar clinics were subsequently established and funded across the state. When Congress significantly expanded
the federal funding for AIDS care in 1990 with the passage of the Ryan White CARE Act, Fenstersheib’s program became the national model for AIDS treatment clinics.

Throughout the epidemic, Fenstersheib continued to serve as a hands-on clinician, caring for HIV patients for more than 27 years, even after becoming the County’s Public Health Officer and later, after adding the role of the Public Health Department Director.

The epidemic had a profound impact on Fenstersheib personally. His partner was diagnosed as HIV positive in 1984 and died in 1992. In addition, Fenstersheib has sung with the San Francisco Gay Men’s Chorus since 1983, and he reflects on the loss of more than 300 members of the chorus who have died of AIDS since the epidemic began.

Fenstersheib retired from the county in Sept. 2013. In 2020, due to his knowledge of public health and infectious diseases, he was hired back to be the COVID-19 testing and vaccine officer at the county’s Emergency Operation Center.

In 1981, Dr. Ira Greene was already a well-respected and beloved doctor. As the Chief of Dermatology at Santa Clara Valley Medical Center (VMC), he began seeing an increasing number of patients with Kaposi’s sarcoma (KS). At the time, he didn’t know that he was treating an illness that would soon grow into an epidemic.

Greene attended medical school at the University of North Carolina, and after initial training as an internist in Arizona, he made his way to Stanford for a residency in dermatology. He eventually became a clinical professor there, in addition to his role at VMC.

The KS cases Greene saw in the early 1980s caught his attention because they began appearing in relatively young men. Until that time, KS was an extremely rare condition that mostly afflicted elderly patients. Because Greene had experience in internal medicine, he also took note of the strange mix of skin lesions, swollen glands, lethargy, pneumonia, and other symptoms affecting these patients.

That laundry list of symptoms soon became associated with the syndrome doctors would come to call AIDS. Greene’s knowledge and background as a gay health care professional made him a logical choice for leading the effort to combat the emerging disease. Alongside Dr. David Stevens, Greene established a specialty treatment center at VMC that eventually became known as the Partners in AIDS Care and Education (PACE) Clinic. However, it was his empathy and connection to his patients that truly made him the right person for the job.

By 1988, Greene became associate director of Santa Clara County’s AIDS program. Even though that leadership role took much of his time, Greene never stopped seeing people with AIDS one-on-one as a primary care physician. His compassion during these often bleak years was steadfast. He did all that he could for his patients, often securing experimental treatments in a last-ditch effort to save the dying.

Friends who knew Greene saw the emotional toll that this work exacted. He developed many close personal ties to patients who ultimately succumbed to the epidemic. Still, he continued to make visits to AIDS patients through the 1990s.

“When you work with dying people, you learn a lot about yourself. You are forced to confront your own feelings about death. You feel very mortal,” Greene said in an interview with the San Jose Mercury News in the late 1980s.

Tragically, Greene died in 1998 when his Palo Alto home caught fire. It was a shocking loss for the community.