My gentleman who decided not to show up to any of his appointments was finally brought into the clinic. So how do you tell a person that HIV is winning and that his body is losing? How do you tell someone this information when you have never met them before?
I decided to go through a quick history physical exam looking for any signs of opportunistic infections and to try and build a rapport before breaking the bad news to him. Note to self: don’t ever try this method again!
The patient began to become very suspicious of me and frustrated that he did not know why he was here and why he was not seeing the doctor he normally does. I had to start from ground zero and explain my training, my role here at the prison as a student, and why the doctor was not seeing him today. He relaxed, ever so slightly. I broke the news.
I discussed his CD-4 count and viral load and talked about what this meant.
He looked caught off guard.
I offered the pros and cons of starting the anti-retrovirals for HIV.
He was hanging on my every word.
We talked about his health and what he can do to help his body fight off the HIV.
He was completely invested in doing the right thing
At the end of the visit I said, “thank you for being willing to work through this with me.”
“That’s all right Doc. I am just nervous about my health, and I didn’t know what your experience was. You’re all right”
As we were walking out he is joking around with me; his face has completely softened and I can see the smile lines shine through his weathered face. I feel like he and I just ran a marathon together and we have made it to the finish line, but for him the race is only beginning.
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