Hasty 

 filtered tiny pink flowers 

There it was.

I stared at the screen again, not wanting to believe it.

She was positive for HIV?!?!??!

Do you make someone take time off of work and pay another copay to come in and see you so you can deliver this kind of news in person? Or do you call and let them know by phone ASAP so they can protect their sexual partners? 

Some patients want the face to face. 

Some patients do not. 

She was brand new to the clinic. I didn’t preface her visit with the, “If we get something bad, how do you prefer to get those results?” conversation. Neither of us was expecting it to come back positive. She was married. By all accounts she was low risk, but still I ask everyone if they want STD testing even if they are married. She had shrugged and said, “Sure, why not?” It was just a routine physical for crying out loud. 

What would YOU do if you were the physician?

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151 thoughts on “Hasty 

  1. That’s a bummer. I’m a rip the band aid off kind of person…and think bad news is best received in my own environment …hence a phone call I would prefer.
    I don’t envy your position. I think you probably have to shield yourself…and not take anything personally. What’s the saying…”It’s a nasty job…but someone’s got to do it.”

    Liked by 2 people

  2. This was an incredible powerful piece!

    Makes me think of so many that in the 1980’s and 1990’s knew this meant a death sentence or near to it.

    Feel so blessed that we live at a time where treatment has come so far. A lot of lives don’t have to be lost to this terrible virus/disease but I think what shocks people and causes some of the worst pain is the stigma.

    That is what people I think react to that are even knowledgeable about the great treatment around and upcoming.

    It’s the stigma that they know they have no entered into that provides the big hit and the tears upon tears.

    Time to help people come out of the shadows and help them know that they don’t need to live in loneliness and isolation.

    Liked by 3 people

      • It will get better.

        The first generation of activists that went out there and received scourge and condemnation as ideas where associated with them fought for treatment and the ability to live and laugh and pursue happiness and memories.

        Now it’s time for the second generation of activists to get out there and make themselves public and help get the discussion going on the realities of the situation and how to get to 90/90/90 and stop this situation and the stigma/silence once and for all.

        More celebrities need to come out as there is a lot more than Charley Sheen living with this at the high level of fame and politics.

        Liked by 1 person

  3. Wow, what an incredibly hard decision to make.
    In such a position, I feel inclined to call the patient in to deliver the news. Like I mean, what if you call her, and she’s at work and finds out the news, then ends up making a mistake at work?

    On the other hand, I find it interesting that where you practice, an HIV test is routine? In Australia, there are no real “routine” physical checks. Most lab tests are based on need, so in a patient who was married, who had no symptoms of STI’s or immunocompromise, or multiple sexual partners and unprotected sex etc, we would not test for HIV, as it would just be seen as waste of money, plus the ethical challenges too.

    So I find that really interesting that something like this was offered. Also, what are the chances of a false positive as well? Unnecessary tests also come with the risk of false positives.

    Liked by 1 person

    • I find that patients are not always upfront about their extramarital affairs or drug use but they are less afraid to agree to an HIV test. I do tell them that if they are low risk, it is not necessary. In this case, it was a good thing it got done. In the US we probably do over test a lot. Like yearly cholesterol checks in 20 year olds because the employer requires biometric screening….

      Liked by 1 person

  4. I would have to say in the office..she may need guidance and you may not see that over the phone…its not a diagnosis one is expecting when your married and thinking its a faithful relationship….unless she’s the one stepping out, regardless, its a pretty devastating diagnosis…even though it doesn’t have to be a death sentence…..I feel for this couple…their lives have changed forever…and I feel for you….can’t be easy……….welcome to summer…..kat

    Liked by 1 person

  5. I would definitely tell them face to face. My sister is HIV positive and when she found out back in 2004,she was in shock for so long and could barely function. A bit of counselling would go a long way,I think.

    Liked by 1 person

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