For Dr. David McEwan, caring for others was a calling long before he became a physician.

He first discovered Father Damien and the extraordinary care he provided on Molokaʻi when he was 13.

This young boy from the snow belt of Rochester, New York, declared, “I’m going to be a doctor in Hawaiʻi… I’m going to make the next generation healthy. Then it really will be paradise!”

Years later, David would become a family practice physician in Hawaiʻi, where he diagnosed the state’s first case of HIV in the early 1980s. His practice of medicine placed him at the center of the most devastating health crises of a generation.

As a co-founder of Life Foundation, now known as the Hawaiʻi Health & Harm Reduction Center (HHHRC), he helped build a community response to HIV/AIDS and supported the people most affected by it.

When Hope Was Hard to Find

During the 1980s, HIV and AIDS were a devastating and largely misunderstood epidemic in Hawaiʻi. While practicing medicine full time, his work with the LGBTQIA+ community grew quickly. Painfully, he watched a poorly understood illness become a source of fear, trauma, devastation, homophobia, and death.

“During the first 10 years, it was a death sentence,” David said.

For the sake of his patients, he needed to have hope. People needed support, and they needed someone who would never give up on them.

So, he kept showing up. He kept learning. He kept answering questions. And above all, he kept believing that science would eventually find new treatments.

A List That Became a Promise

At the time, there was no official reporting of cases, so David kept his own list. He wanted to believe that one day there would be a cure and that, when that day came, he would be able to immediately pick up the phone and call his patients.

“I hoped that medications would come,” he said, “and if there’s no master list, I was sure as heck going to have my list.”

As the list approached 1,000 names, recording the magnitude of the pandemic’s spread became difficult to bear. He stopped adding names but kept the list. It represented hope.

“There are patients that were on my list that are still alive,” he said, “and I’m very proud to have witnessed that.”

When Care Meant Everything

Tragically, the hoped-for treatments did not come soon enough for many of those patients.

David was called upon to care for the terminally ill, admitting many to Hospice Hawaii, now Navian Hawaii. His days regularly included visits to the dying.

Hospice and hospitals were a “crucial” and “incredible humanitarian undertaking” for patients and families. He saw firsthand what hospice could provide when medicine could no longer change the outcome: care for the person and their partner, support for the family, and a way to face the end of life with dignity.

“I’m very grateful for everything that they did and continue to do,” David said.

Hospice was more than a part of healthcare. It was part of the larger promise of caring for people through every stage of their lives.

The Family That Shows Up

While caring for his hospice patients, David witnessed relationships that would forever shape his understanding of family.

Sometimes, a biological family would embrace their loved one. Sometimes, they walked away. Often, it was partners, friends, and the LGBTQIA+ community who stepped forward.

“I saw the gay community play a huge role,” he recalled.

He saw people create meaningful lives together and stand beside one another when traditional family structures failed.

Families were not defined by biology. Family was those who simply showed up.

Don’t Be Afraid, Be Real

After decades of caring for LGBTQIA+ people, David’s message to healthcare providers is simple:

“Don’t be afraid. The LGBTQIA+ community is amazing.”

Ask. Listen. Learn.

He encourages providers to create space for patients to talk openly about who they really are, their relationships, and the lives they are living.

“You got to break the ice and get real,” he said. “When you’re dealing with medical care, it’s time to be totally open about everything.”

When someone feels safe enough to tell you their whole story, care changes. It becomes more honest. More compassionate. More humane.

And perhaps that is the thread running through David’s life’s work, from the young boy who simply wanted to take care of people, to the physician who cared for thousands during the AIDS crisis, to the advocate who continues to believe that being seen, heard, and cared for can make all the difference.

Caring means more than treating an illness. It means seeing the person, making room for their whole story, and creating meaningful change.