Pat was first found to be positive 18 years ago when patients expected only to live a few years. Now 18 years later Pat hardly believes they are still alive. I find it remarkable how far medicine has come in such a short time. For some the discovery of effective HIV medication wasn’t soon enough but for many it has given them the chance to see their children grow up and to see their children’s children. Pat never expected to see his/her own children reach adolescence and now Pat is watching his/her grandson approach adolescence.
There was and still is a stigma attached to HIV. It is perhaps not as negative as it once was but it is there. I think the natural reaction is to be scared or precautious around someone who is infected. I found my first reaction to the patient surprising. The patient was being seen for an illness unrelated to HIV, HIV was simply another chronic illness such as diabetes the previous patient had. When taking the history Pat simply mentioned he/she was positive and unconsciously I had a moment where I was apprehensive about seeing this patient.
The feeling was a mix of feeling fearful and cautious around this patient. However, it only took a split second before my rational brain took over. You can’t contract HIV from talking to the patient, being in the room with them, or even doing a physical exam. There needs to be direct contact with body fluids in order for transmission to occur. It then dawned on me how I was probably a bigger threat to her since she was immunocompromised. This means that a simple infection a normal person’s immune system can fight off an immunocompromised person can’t. This patient’s CD4 count was about 250 and was on a corticosteroid further increasing the risk of infection. Pat should have been apprehensive about me touching him/her.
Pat showed me how wrong first impressions can be and how fear can really obstruct your thoughts if you let it. This patient also excites me for what the future of medicine may brings and I look forward to being a part of it.