Emergency Room Series: Dont Discriminate.....

Oh Dear!!!.....

I would like to maintain the fact that this series is strictly anonymous. The name, age, and other bio data of each patient's case discussed is kept highly confidential. 

 This series mainly involves the writer sharing experiences and stories in the ER for the readers to learn a few things from and I'm glad a lot of people are positive and doing just that. I would try not to use medical terms so that everyone would understand

The ER today was unusually calm and we had few cases to handle. A man in his forties was brought in today. He was accompanied by a lady who we later learnt was his wife. She claimed he felt very dizzy at home and fell and that was all she knew.

 On physical assessment, he looked pale and lethargic. He looked like he had lost some weight and his eyes were yellow. His skin was dry and slightly wrinkled and his lips were cracked and he was extremely weak. He was coughing a lot too. We took it as a severe dehydration case and queried tuberculosis.

We tried to get a history from the wife but she didn't know much. She later said he had been stooling for two days and she had gotten him some drugs from the local pharmacy but that didn't work. 

We set up an IV access and put up fluids to rehydrate him. We also took blood samples for electrolyte test as well as for several other tests. His bp was low and his breathing and pulse were quite high. After an hour, he gradually came around. The doctor on call asked him how it all started and the first thing he did was to tell his wife to get him a soft drink. We told him that he isn't allowed to drink anything so he said she should get him tissue paper. I told him we had some if he needs. He then asked her to get their holy water at home, then it became obvious to me that he wasn't comfortable around her so I asked her to excuse us which she did.

He also asked me to leave but the doctor insisted that a nurse had to be with him and that nurses take their own history from patients in the ER for their own record. He reluctantly told the doctor that he had HIV and was diagnosed 6 years ago. 

He said he has been on anti-retroviral drugs but stopped 7 months ago because his private supplier travelled. "Well, that explains some of the symptoms" I thought to myself. He said he had been stooling for about a week and only told his wife two days ago because he got very weak and couldn't go to work.

The doctor asked him the names of the anti-retroviral drugs he uses so we could supply them because we wanted him to use the drugs his body was accustomed to but he didn't know them all so he was asked to tell his wife to get the empty bottles at home. He kept quiet. 

I asked if the wife was aware of his status, he said no. I was shocked. 

He said he met her about X years ago and got married shortly after but didn't disclose his status and has been using his drugs. He claimed she wouldn't have married him if she knew. My guess is that she also hasn't been pregnant because she would have found out during routine antenatal screening tests.

Well its not our duty as a nurse or doctor to disclose such information to the wife unless he approves. We made him know that he's killing the woman slowly while he treats himself. He simply looked away. He talked about how the wife talks negatively about a certain person they know who has HIV. He said it discouraged him from telling her while they were courting.

 I asked if he ran pre-wedding tests ( those tests to know if couples blood groups are compatible which includes HIV test) he said no.. I wasn't feeling concerned for him anymore but for the innocent wife who didn't know what was going on

Although I understand that HIV is a topic people dread to talk about in this part of the world. I just want you all to know that it doesn't kill. I repeat, HIV doesn't kill. The fear is what kills. The discrimination is what kills. The neglect is what kills. 

The discrimination is just so bad that no one wants to open up to having the infection. Its just plain ignorance. HIV is not so easy to contract unless by unprotected contact with blood and seminal fluid. Not by sweat, tears, urine, faeces, or saliva. 

Sometimes I wonder why people with hepatitis which is far more deadly, has no direct drug or cure and is easy to contract feel that its better than having HIV. 

About 130million people live with hepatitis worldwide and I wonder why all the negativity is on HIV victims.
Most people will blame the man for not telling his wife, that he's wicked or maybe he's the devil himself but really, I'm just neutral. I don't blame the wife for discriminating neither do I blame the man for not being sincere in his marriage. 

We need to change our mindset and realise that people living with HIV need love, care, attention and support. HIV simply means the body can't defend it'self effectively against infections and need the help of drugs. Its that simple. They can live normal lives and have children who won't have the infection. 

I really hope the man tells her his status soon enough.
Thanks for reading.