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A Goodbye to Dr. Tulika Singh

A Goodbye to Dr. Tulika Singh

Singh hopes to create a fusion practice for people with HIV and non-HIV patients

Dr. Tulika Singh is leaving DAP Health, after serving as Director of Research and Associate-Chief Medical Officer for five years. She is beginning a fellowship program at The Andrew Weil Center for Integrative Medicine at the University of Arizona, Tucson. She plans to become Board Certified in Integrative Medicine before returning to patient care.  

“I hope to create a fusion practice for people with HIV and non-HIV patients,” she says, “Incorporating alternative and conventional medicine to offer them the best care possible.” 

 While at DAP Health, she received FACP & FIDSA honors, given to Internist and Infectious Disease MDs for exceptional work. She also led groundbreaking research in new antiretroviral long-term use injectables. And she helped update HIV Primary Care guidelines for IDSA/HIVMA, used by thousands of clinicians in the U.S. 

 Dr. Singh is certainly not leaving conventional medicine behind. This Board-Certified HIV Specialist and Infectious Disease and Internal Medicine Physician says she wants to go even further to help make people well.  

“It is important that I finally pay attention to the other side of medicine,” she says.  “If conventional medicine was the only answer, then why are we so unhealthy in our country?” 

Integrative medicine uses conventional science-based approaches, such as drugs, surgery, and lifestyle changes. But it also utilizes wellness practices and non-Western medicines. It calls for including behavioral and emotional health in treatment, and for looking at non-medical factors affecting a patient’s health.     

“It is a completely different ballgame,” than traditional medicine, says Dr. Singh. “It includes taking time to get to the ‘why’ of a patient’s illness and addressing it.” 

DAP Health patients utilize wellness and social services in a dedicated wing on the campus, a practice developed when alternative and holistic therapies were the only options for people with HIV in the 1980s.  

“Long-term HIV survivors are so resilient and strong,” she says.  “I have utmost respect and admiration for their journey.” 

Dr. Singh has been practicing HIV specialty care since 2009.  

Although antiretroviral therapy is a modern miracle, many patients need help managing pain, decreasing stress, and maintaining life balance. 

“I really appreciate the multiple alternative medicine options that DAP Health patients have access to, like acupuncture, massage, yoga, reiki, and physical therapy all under one roof,” says Dr. Singh. “I see how much that has helped them.” 

Understanding the value of non-Western and alternative healing methods comes naturally to her, given her Indian parents both were specialists. She still remembers the advice her father gave her when she sought his blessing for her attending medical school.   

“Go and learn your modern medicine,” he said, “But you’ll learn Ayurveda, homeopathy, and naturopathy have their place.” 

25 years later,  says Dr. Singh, “and he’s right!”  

Inspired by Patients and Coworkers During Pandemic 

“The resilience and adaptability in our patients throughout this have been so inspiring,” she says. 

 Dr. Singh worked to keep her patients engaged in their health during COVID lockdowns, ushering in telehealth and Virtual Visits when coming to the medical offices was impossible. During the worst days of the pandemic, DAP Health patients received uninterrupted and ongoing care because Dr. Singh and her team made connecting with technology painless for patients.  

“COVID slowed us down, but it didn’t stop us,” she says. “We got on the phones and computer monitors and we took care of patients.”   

Finding a way to keep medical care going during COVID, she says, is credited to the flexibility shown by patients, DAP Health leadership and her fellow medical staff.  

“We came together, and we became more resilient and caring, more than we were ever before,” she says. “It was an exciting as well as a humbling experience.” 

Coming Out All Over Again

Coming Out All Over Again

For the first time, Desert AIDS Project CEO David Brinkman speaks publicly about his very personal struggle with COVID-19

By Daniel Vaillancourt

Making good on its mission to provide holistic healthcare to every resident of the Coachella Valley, regardless of serostatus or ability to pay, Desert AIDS Project unveiled its new COVID-19 Triage Clinic on Monday, March 16. This, by the by, despite the fact that the pandemic will ultimately have a negative economic impact of some $2.5 million on DAP due to revenue lost from the cessation of routine visits and reduction of select services, the closure of all Revivals thrift stores, and the cancellation of annual fundraiser Dining Out For Life.

Among those so far tested for the novel coronavirus at DAP is the non-profit’s CEO, David Brinkman, whose result was positive. What follows is an edited transcript of our telephone conversation of Tuesday, April 7—nine days after his diagnosis. I was sequestered in my home office; he was quarantined in his.

(Full disclosure: For the last decade, I have scripted DAP’s annual benefit, February’s Steve Chase Humanitarian Awards. Following known exposure to multiple friends currently suffering from COVID-19, I, too was tested for the coronavirus at DAP. My result was negative.)

DAP CEO David Brinkman at the Steve Chase Humanitarian Awards
David Brinkman at the February 2020 Steve Chase Humanitarian Awards Photo: Lani Garfield

Daniel Vaillancourt: First things first. How are you feeling?

David Brinkman: I’m fine. Each morning my energy increases a little bit over the day before. That’s the sign you’re on the mend, right? I’m much more concerned about DAP’s well-being.  

To my knowledge, you’re the first leader or public figure in the desert to come out about testing positive for the coronavirus. Why are you going on the record?

That’s probably the hardest question to answer. I initially thought I wouldn’t share this publicly. Our focus needs to be solely on supporting our healthcare workers on our front line, educating the community, and supporting its members. I first spoke to my physician husband, Will Grimm, then to my board chair and co-chair, Steve Kaufer and Patrick Jordan. It quickly became clear that by sharing my story, I could help our community and DAP win the war against this virus. So here I am, using this platform to educate, decrease fear, and inspire hope.

What led to your wanting to be tested?

Ever since the start of this crisis, all of us at DAP have been working a minimum of 12 hours a day. By Thursday, March 26, I couldn’t tell what was going on with my immune system, but I could tell it was being impacted. Was I manifesting symptoms of a cold because of exhaustion, or was it something else? On the morning of Friday, March 27, I called DAP’s COVID-19 hotline and was assessed over the phone. I didn’t want a test kit to be used on me unless it was absolutely necessary. After voicing my symptoms—especially my dry cough, the telltale sign of coronavirus infection—I was instructed to come in and be tested. I was administered nasopharyngeal and throat swabs, then told to quarantine. I headed straight back to my home office. DAP has been my focus every waking hour of the day since the pandemic began, so I had plenty of work to keep me busy.

No anxiety as you awaited the test result?

I was fortunate that by the time I was tested, the labs had caught up and increased productivity. I was told I’d have news within 48 hours to three days. Five days at the very worst. I got the call on the evening of Sunday, March 29—just a little more than 48 hours later. Honestly, from all the years of being tested for HIV and the memories of having to wait two weeks for those results back in the ’90s, this was nothing. So no, I wasn’t anxious at all. That said, in times of crisis, one of my roles at DAP is to be very visible, demonstrating a tone of leadership, certainty, calmness, and focus. I knew that if I tested positive, there was no way I could do that. It would change how I communicate with our employees.

Did you not have qualms about being tested at your place of employment?

That’s a legitimate question, but at DAP we’re so well-trained around issues of confidentiality and HIPAA laws to protect patient privacy. I knew the same standard would apply to me. Following my positive test result, per DAP’s policy, I notified our head of human resources. Had I been in close physical contact with another staff member while contagious, HR would have notified that person. But in my case, since we’d already been social distancing at work—or working remotely from home—for weeks, there was nobody to notify.

How did the disease progress post-diagnosis?

Interestingly, I never experienced fever. After I got my results back, the next phase of the virus was loss of taste and smell. Those symptoms lasted nine days. Just two days ago, I tasted sweetness again. Yesterday, I started to taste salt. By the middle of last week, the fatigue was getting more significant and problematic, because my average day—filled with phone calls, emails, and meetings via Zoom—is 12 hours long, at minimum. I’m someone who can usually function perfectly on two and a half to five hours of sleep a night. Since becoming sick, I’ve been sleeping nine hours a night solid, without opening an eye once, which I haven’t done since I was a teenager. Finally, there was a period where my lungs started to tighten. I never felt like I couldn’t breathe, but a week ago, each evening as the sun was setting, my breaths became belabored. It started low in my lungs and stayed there for five or six days. Thank goodness, last weekend it came to the top of my lungs and has started moving. Today, it’s loosened. I finally feel like I’m getting over it.

Being the leader of a healthcare organization providing services to the community during this pandemic, how has it been for you to access said services personally?

What comes to mind is not about my being tested and proving positive. It’s about reflecting upon all of us going through this pandemic together. I also reflect upon how our DAP founders were feeling when hundreds of thousands of young people were dying of AIDS in the early eighties. We all know that when fear grabs hold of you, it paralyzes you from finding creativity, power, and resourcefulness. This pandemic makes me think about our founders with a heightened level of respect, but also inquisitiveness about what moved them through their fear to a place that created the response Desert AIDS Project became. They were losing the loves of their lives, their very best friends. From talking to our surviving founders over the years—and seeing how quickly their eyes well up with tears—I know it was unconditional love for humanity that propelled them.

What would you like to leave our readers with?

I want to remind them that DAP has previously honored the great physicians Anthony Fauci and Deborah Birx on our Steve Chase stage. Both of them said that DAP is a global model on how to respond to the AIDS crisis—our organization, in our small town. Given where these two experts are today—and what important roles they play in this current pandemic—I hope their great esteem of DAP and of our community encourages all of us to know that, together, we can prevent the spread of this pandemic here in the desert. We can prevent further loss of life. We have an amazing team of infectious disease specialists and heroic nurses providing stellar services. The uninsured are never turned away. That’s so special. We’re soon launching our first coronavirus-positive support group via Zoom. That’s so unique. Imagine the impact those first support groups for HIV-positive people had in 1983. We can show the world what a community of committed neighbors can do. Why? Because we’ve done it so successfully in the past.

Long-Term Behavioral Health Advocate Dr. …

Contact: Jack Bunting

[email protected]

(760) 656-8472

Palm Springs, CA – (September 18, 2019) — Desert AIDS Project (DAP) is proud to welcome Dr. Jill Gover as Behavioral Health Manager. In this role, she will enrich the department and the agency with her expertise and proven commitment to putting clients first. Affectionately known in the community as “Dr. G”, she brings decades of expertise and compassion in helping people living with HIV / AIDS (PLWHA).

At DAP, she will steer operations of the department and the Behavioral Health clinic, supervise staff, and see clients in a therapeutic capacity.

Most recently, Dr. Gover served as a clinical psychologist and director of the Scott Hines Mental Health Clinic @ The Center in Palm Springs, providing eight years of tireless service to clients.

She has emerged in the Coachella Valley as a steady voice calling for more resources and vigilance around mental health issues facing the LGBTQ community, especially PLWHA.

“We feel immense gratitude to have Dr. Gover join the Behavioral Health staff at DAP,” said David Brinkman, CEO. “Living with HIV is overwhelming for many of our clients, but she has mastered the understanding required to give them the vigilance and support they deserve.”

In particular, Dr. Gover is one of this community’s loudest voices calling for heightened awareness around suicide prevention, and there is a compelling reason.

  • In the 2014 Riverside County Public Health LGBT Health and Wellness Profile study, LGBTQ+ adults reported having two-to-four times as many suicidal thoughts as heterosexual peers, with bisexuals at highest risk. 
  • In the 2015 Inland Empire Transgender Health and Wellness Profile Report, transgender adults were asked, “Have you ever seriously considered committing suicide?”  Seventy-five percent of the participants responded, “Yes” compared to six percent of the general population. 

These are truly shocking statistics, according to Dr. Gover. But by choosing to join DAP, she plans to continue her lifelong work to help humankind.

“I have been assisting people living with HIV / AIDS, both personally and professionally, since the early days of the epidemic as a gay rights and AIDS activist,” said Dr. Gover.  “This is my community and I cannot think of an agency that is a better fit for the work I love to do.”

Experience From Decades Of Treating People Living With HIV / AIDS

Dr. Gover completed schooling and started her psychology practice in the earliest years of the AIDS crisis in California. She has practiced in the Bay Area, Northern California, and the Inland Empire. 

By spending decades treating her clients living with HIV / AIDS, she understands their suffering, and offers approaches for them to find hope and wellness.

As she explains, for PLWHA, the AIDS epidemic has been a series of traumatic events. Sustained trauma can present as a myriad of symptoms, such as anger, hypervigilance and anxiety, depression, insomnia and nightmares, survivors’ guilt, substance abuse, sexual risk-taking, low self-esteem, hopelessness, emotional numbness and social withdrawal. 

According to Dr. Gover, behavioral health strategies that develop a new, positive “internal narrative” of self-talk are crucial to combating the challenges and fears that overwhelm so many people living with HIV.

“I want to establish a safe environment in therapy where patients can learn and practice the tools and skills needed to make the changes they want to make in their life.” 

Her Therapeutic Approach

Dr. Gover believes that the story we tell ourselves can often be distorted, and because of that, we experience unnecessary emotional distress.  As a cognitive behavioral therapist, she is interested in exploring the mistaken beliefs, unhelpful schemas (rules we live by), and faulty thinking that causes problems in our lives. 

With curiosity and without judgment, she invites the patient into a collaborative approach to investigate the evidence and efficacy of particular thought patterns, and helps patients reconstruct a “new narrative” of self-talk that improves quality of life.

More about Dr. Gover

Jill Gover, Ph.D., is a clinical psychologist, specializing in addiction, anxiety, depression, aging, chronic pain, HIV, and LGBT+ issues. For 15 years she was the Coordinator of Student Assistance Programs for the Vallejo USD, responsible for developing a large internship program and bringing mental health services into the schools. For the next 13 years, she was the Director of Mental Health Services for an FQHC community health center, responsible for integrating behavioral health into a primary care setting. In 2011 she joined the staff at The LGBT Community Center of the Desert, where she created a clinical internship program for mental health professionals and established The Scott Hines Mental Health Clinic to provide low cost mental health services to the community. Dr. Gover oversaw clinical internship training and several treatment programs for the LGBT community, including a Long-term Survivors (LTS) therapy group for gay men living with HIV. She has been an active member of HARP-PS (HIV and Aging Research Project) for the past five years. 

Dr. Gover has published numerous articles and developed psycho-educational curricula on anger management, suicide prevention, adult children of alcoholics, HIV, and healthy aging. She is a well-respected presenter on various issues related to mental health, and has delivered numerous workshops and trainings throughout California.

About Desert AIDS Project

Desert AIDS Project (DAP) is a Federally Qualified Health Center in Palm Springs, CA offering DAP Total Care – a combination of medical, dental, counseling, social services, support groups, alternative therapies, in-house pharmacy and lab, and other health and wellness services.  DAP’s sexual health clinic, The DOCK, offers STD testing and treatment, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and HIV and HCV testing. DAP’s Get Tested Coachella Valley campaign, the nation’s first region-wide free HIV testing and access to care initiative, was recognized by the White House for helping to bring about an AIDS-free future.  DAP has earned a “Four Star” rating from Charity Navigator for the sixth consecutive year – landing DAP in the top 6% of nonprofits rated. The distinction recognizes that we exceed industry standards in terms of our financial health, accountability, and transparency.

Visit www.desertaidsproject.orgwww.thedockclinic.org, and www.gettestedcoachellavalley.org to learn more.