Saturday, March 22, 2014
Patient 2, Internal Medicine rotation
The second patient I saw on IM rounds was a 45 year old Black man who was HIV positive. I can't exactly recall what led to his ER visit, but I remember quite well that his T-cell count was near 0 upon admission. I also remember that the others on the team wouldn't go into his room and while I gathered that he was a difficult patient, it seems VERY strange to me a group of current/future doctors would be "afraid" to go into the room of an HIV positive patient. At least that's how I read it, as fear. I mean if Mr. Jackson was throwing poop at folks when they walked in the room, I could understand "the fear" to some extent. But to me, their fear was just ignorant. You see I was a volunteer AIDS counselor for many years and used to do blood draws for HIV test at a rural public health clinic. So, I figured that since I wasn't planning on having sex with Mr. Jackson, I didn't have anything to worry about.
So I put on the disposable gown and went to visit Mr. Jackson with Dr. B.
The room was very dimly lit and the only other person in the room was Mr. Jackson's daughter. And she was beyond pleasant and thankful to Dr. B for essentially saving her Dad's life. Turns out, Mr. Jackson had a BIG problem with taking pills and I surmised that after almost 20 years of being HIV positive, he had grown weary of taking lots of pills everyday. So Dr. B had ordered a Hospice consult for Mr. Jackson not out of need per se, but to "encourage" Mr. Jackson to take his medication. And immediately after the hospice folks left, Mr. Jackson started taking his HIV meds. The day of our visit, his T-cell count was almost back to normal and Dr. B was checking in on how he was doing.
What I learned that day was that despite CLEAR evidence for how HIV is likely transmitted, people are STILL ignorant about it. And to see medical folks behave out of fear was mind boggling. I mean, all one student did was touch the door handle of Mr. Jackson's room and he disinfected his hands immediately after he let it go. And no, I didn't see him do the same with ANY other patient we saw that day.
Again, ALL I could think about was how what I saw that day rounding emphasizes the need for both more compassionate and minority Doctors. I also thought that my personal argument for why no one under age 25 should be admitted to med school was substantiated as well.