Saturday, June 17, 2017

HIV Tales from my diary-Tale 15

http://aidssupport.aarogya.com/index.php
 Tale 3 of healers suffering themselves )
Ram Prasad was successful BAMS ( Bachelors in Ayurvedic Medicne and Surgery) doctor practicing as an allopath ( as usual) in a midsize ,peaceful town ,of one of the most picturesque state of India, Himachal Pradesh. He was married to Nirmala and was blessed with a son and a daughter. The famous doctor came into my contact in 2006, when he was 44 years of age and in fourteenth year (7×2) of marriage. He was brought to me in a serous condition by his sister – a staff nurse of civil Hospital , Gurdaspur, a neighboring town. He was having Varicella infection ( chicken pox ) along with Erythema Multiforme, type of a drug rash ,which was, caused by illogical self medication by doctor himself. He needed admission. My advise for the same led to a request ,which was ,sort of ,unusual. The doctor wanted himself to be admitted in a hospital with altered name ( that too of my choice ) and that too ,in a hospital ,where secrecy of disease can be kept. ” what name ?? What disease ??”, I simply asked. The doctor already knew his HIV status and wanted me to hide . Instantly, I gave him a new name ” Champak Lal” and he and the family happily accepted too. My query of mode of transmission of virus in him got the usual answer which is given by erring medicos. ” Occupational hazard , Sir. I must have got a prick of needle from some patient”, he said. Believer in others , as I am, I believed him too ,despite his revealing no specificities. The admission to hospital was uneventful and he was discharged in about a week’s time after full recovery from EM and Varicella both , leaving some scars although. For his HIV , I prescribed Zidovudine , Lamivudine and Efavirenz treatment. Things were all getting back to rails of normalcy and he started coming on his own , alone for follow ups. It was his third or fourth visit to me , when he removed the veil, of occupation hazard ,he was wearing so far. He talked about his lust for sex and the seven year itch.
The seven-year itch is a psychological term that suggests that happiness in a relationship declines after around year seven of a marriage. Wikipedia suggests that the phrase originated as a name for irritating and contagious skin complaints of a long duration. Examples of reference may have included STD outbreaks that are known to significantly decrease in frequency after seven years. Later on in the 19th and early 20th centuries it was viewed as an expression of imagined appropriate punishment for antisocial behavior, or as a simile for a situation with little hope in relief.
The phrase was first used to describe an inclination to become unfaithful after seven years of marriage in the play The Seven Year Itch by George Axelrod, and gained popularity following the 1955 film adaptation starring Marilyn Monroe and Tom Ewell.
The doctor accepted that it was not the occupation, but his extramarital sex and his lust for sex , which has caused his ailment. He suffered from the proverbial 7 year itch. He wanted my help. He wanted me to tell his wife that she still can have sex with him , although protected one. Nirmala, his HIV negative wife had gone into a ” No Sex” mode after discovering his ailment. I counseled her about barrier protection while having sex with her HIV partner so as to protect herself from the virus. I also told her to report to me immediately, if the barrier protection , someday , sometime , gets broken/ forgotten.
The couple must have resumed their sexual self till that day when Nirmala called me at an odd hour. She was calling from a public booth.
” Hello , Doctor Sahib, I am Nirmala , wife of Champak Lal calling from —–, do you recognize me ?” She opened the conversation.
” Yes Madam I can recognize you but please don’t say wife of Champak Lal ,from a public booth , where there might be more ears to listen to. Those ears may draw wrong conclusions and one day you may find yourself surrounded by fingers pointing to your character. For them , you are Mrs. Dr. Ram Prasad only ”
She laughed at her folly but could not forget the folly for which she called me. She reported broken barriers. Post exposure Prophylaxis was ordered on phone itself. I told her to take the same tablets as her husband , sensing non availability of other more appropriate ARV. She did comply.
Doctor’s wife , however , could not give company to him for long , in the year 2008 she died in an accident. His son and daughter were away to a medical school to pursue MBBS. Ram Prasad felt lonely. Not only that his itch and lust persisted. His resistance and societal shame gave way to his lust and he ,despite having a doctor son and a daughter of marriageable age , married himself. The newly wed girl, however, could not digest the so far hidden reality of HIV in her husband. Once she was upfront with the reality she deserted him in no time , two months to be precise. Loneliness became killing. Ram Prasad took an asylum in the lap of drugs. He got hooked to drugs. The drugs , which he started in the garb of cure of his insomnia , became his home. He became irregular in treatment. First , it was lipodystrophy disfiguring the renowned doc which led to change of ARV from Zidovudine to Tenofovir and then his sleeping pills and irregularity became the cause of resistance of HIV to drugs leadingbon to second change of drugs. He was switched this time to Atazanavir, Ritonavir and Tenofovir , Emtricitabine combination.
The change , however ,could not change his fortunes.
Seven years later , in 2013 , his seven year itch proved lethal and he succumbed to the virus.
His son , who is now himself a qualified doctor might have taken over his roaring practice but I sincerely wish that he doesn’t follow his father’s seven year itch steps.
Rakesh Bharti

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