Mitchell -- who legally changed her last name in 1975 in homage to Martha Mitchell, the outspoken wife of Attorney General John N. Mitchell in the Nixon administration -- made some 1,000 sex movies over 20 years, including 38 that she directed.
She fondly recalled starring roles in Captain Lust and the Pirate Women and Sexcapades, among others. She also had bit parts in mainstream films like Tootsie and The Deer Hunter, and played a nurse on the soap opera The Edge of Night.
By all accounts, Mitchell's transformation from sex-film star to doctor could not be more profound. On her office door, a sign says, "Well-behaved women rarely make history."
Though many sex-film performers were casual, at best, about getting checked for HIV years ago, the situation seems markedly improved under the monthly checkups instituted by Mitchell, who has recorded just 11 HIV infections in the pornography industry between the clinic's founding in January 1998 and the outbreak last month. By contrast, about 40,000 new cases of HIV are reported annually in the US, she said.
Health officials appear to have left Mitchell largely to her own devices, though the latest outbreak is giving them reason to reconsider.
Jonathan E. Fielding, director of public health for Los Angeles County, said his office was investigating whether the clinic was following proper procedures and whether the virus had spread from workers in the industry to people outside it.
The industry employs about 6,000 people and churns out about 4,000 videos a year. Economists here estimate that it brings in as much as US$9 billion a year.
As the industry watchdog of well-being, Mitchell also acts as something of a detective, investigating the origin of each infection and badgering performers who were exposed to come in for testing. Since the outbreak, dozens of names -- the performers almost invariably use stage names -- have been posted on the clinic's Web site, along with their date of exposure and whether they have tested positive.
Not everyone cooperates. One of 12 actresses who had sex with the first performer to test positive in the outbreak ignored requests to be tested, Mitchell said. Last week, Mitchell and her assistants tracked the actress down in Las Vegas.
Mitchell offered her US$500 in cash to be tested and the actress accepted. "Whatever works, right?" Mitchell said.
She was also looking into rumors that some performers on the quarantine list had gone back to work before learning whether they had been cleared.
"This is a very difficult population to deal with," Mitchell said. "I've had to battle more within the industry than without."
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