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HIV Tales from my diary – Tale 18.
( Tale 5 of of healers suffering themselves )
Balwinder was a FEMALE ( in my state names can be differentiated with suffix of Kaur or Singh only ).
She was FORTY.
She had two children , proving her FERTILITY.
Denying the zero mania she was little FAT too.
To complete the The 5-F rule referring to risk factors for the development of cholelithiasis, she even was FAIR.
The only unfair thing to happen to her was her widowhood to HIV and now this pain abdomen. The pain turned out to be sticking to the rule and gall stones were found. Surgery was on the cards but surgeons were reluctant. She started running helter skelter, did not loose even a gram of weight , but did loose her patience. Impatient patients often land into my territory ; don’t know why. She also came to me , not for treatment of HIV but seeking help in getting a surgeon to operate upon her. As per my habit, I started searching for right guy. Right, because , majority of surgeon won’t take up a patient , who has been wronged by the society ( rightly or wrongly). My search took a pause ,when a visiting surgeon to a big private hospital acceded to my request. Feeling victorious , I asked Balwinder to see the surgeon and assured that her work will be done. Hospital did admit her same day but the owner’s brother , a surgeon was perturbed. He called me instantly to lodge his protest. ” Bharti, it is not fair yaar. You are now referring surgical cases to other doctors rather than me “, he grudgingly asked for an explanation.
Reassuring and reconfirming my friendship to him, I said,” don’t you worry dear. If you are ready to operate on HIV patients , there is no dearth of needy and I can always compensate for this folly”. My words , I could sense through the phone , made him look here and there and when he could not find any escape route than he came straight to the point,” No, please don’t send seropositive patients, I don’t operate on them for various reasons including professional hazards”. The banging of phone was loud and clear.
It was just a coincidence that same night , I got a frantic call from a classmate , a surgeon from a nearby town ,Batala. He was operating upon an old man suffering from intestinal obstruction due to intussusception. He did not wait for test results because of the age of the person and the emergency. The report after the surgery , however, led to a situation, in which ,the surgeon himself landed in emergency.
He was desperate to know the post exposure Prophylaxis. The incident made him brush up his knowledge on HIV. Besides the books ,he even took the help of his brilliant son studying in first year of MBBS, at the premier most institute of medical sciences in the country, AIIMS, New Delhi.
Balwinder Kaur , in the meantime was once again out of the hospital ,as despite surgeons wish , the whole staff including the anesthesiologist refused to operate fearing contracting HIV through her surgery.
The ball was back in my court. But this time , the ball was served as an ace. Balwinder asked me ,” what if I get a forged HIV negative report by paying double the amount to the labs???!!!!!!”. The sarcasm ,showed me the mirror of our medical world. I could not return her ace and she did score a point. I needed a breather ,after this match point. I bought some time.
The time bought was sufficient to convince the Batala Surgeon ,classmate of mine ,to operate on a HIV patient , this time by design and not by default. He too ,by now was armed with refreshed knowledge about HIV.
The match was fixed again with same vigor , the only difference being , this time coals were to be carried to Newcastle. All these years people from Batala used to be referred to Amritsar ( being a better equipped city as far as health services were concerned) but this time an Amritsar resident was to be referred to Batala and that too for a left hand game for surgeons. Cholecystectomy, after all ,is never a big deal for surgeons ,since the time I graduated ,at least.
The operation day once again met the same fate. Batala doctors whole staff went on a ” leave” leaving the patient in lurch once again. I asked my friend ,” what next ”
He assured ,” don’t worry, they can’t remain on leave forever , I am certain we shall do this elective surgery soon”.
The “D” day finally arrived. Patient was given the premeditation, and shifted to the OT. Surgeon was busy scrubbing and came the nose of his wife , a Gynaecologist herself. She could not resist poking it ,smelling a fish ” HIV”.
I could , however , telephonically convince her that it is better to operate electively taking effective precautions rather than operating in ignorance , throwing precautions to wind and end up taking PEP. I also told her that someday ,someone has to put his foot first , on Moon, then why not her husband should be the one.
Surgery ultimately was done and Balwinder discharged in due course of time after an uneventful post op period.
I am no more in touch with the patient, but her tale touched many aspects of dealing with such victims ,in the earlier days of the epidemic called ” AIDS”.
How far things have changed after three and a half decades can be anyone’s guess. Specially for those are suffering and those who treat them. My assessment,”we have miles to go before we sleep, woods are dark and deep”.
Rakesh Bharti
Balwinder was a FEMALE ( in my state names can be differentiated with suffix of Kaur or Singh only ).
She was FORTY.
She had two children , proving her FERTILITY.
Denying the zero mania she was little FAT too.
To complete the The 5-F rule referring to risk factors for the development of cholelithiasis, she even was FAIR.
The only unfair thing to happen to her was her widowhood to HIV and now this pain abdomen. The pain turned out to be sticking to the rule and gall stones were found. Surgery was on the cards but surgeons were reluctant. She started running helter skelter, did not loose even a gram of weight , but did loose her patience. Impatient patients often land into my territory ; don’t know why. She also came to me , not for treatment of HIV but seeking help in getting a surgeon to operate upon her. As per my habit, I started searching for right guy. Right, because , majority of surgeon won’t take up a patient , who has been wronged by the society ( rightly or wrongly). My search took a pause ,when a visiting surgeon to a big private hospital acceded to my request. Feeling victorious , I asked Balwinder to see the surgeon and assured that her work will be done. Hospital did admit her same day but the owner’s brother , a surgeon was perturbed. He called me instantly to lodge his protest. ” Bharti, it is not fair yaar. You are now referring surgical cases to other doctors rather than me “, he grudgingly asked for an explanation.
Reassuring and reconfirming my friendship to him, I said,” don’t you worry dear. If you are ready to operate on HIV patients , there is no dearth of needy and I can always compensate for this folly”. My words , I could sense through the phone , made him look here and there and when he could not find any escape route than he came straight to the point,” No, please don’t send seropositive patients, I don’t operate on them for various reasons including professional hazards”. The banging of phone was loud and clear.
It was just a coincidence that same night , I got a frantic call from a classmate , a surgeon from a nearby town ,Batala. He was operating upon an old man suffering from intestinal obstruction due to intussusception. He did not wait for test results because of the age of the person and the emergency. The report after the surgery , however, led to a situation, in which ,the surgeon himself landed in emergency.
He was desperate to know the post exposure Prophylaxis. The incident made him brush up his knowledge on HIV. Besides the books ,he even took the help of his brilliant son studying in first year of MBBS, at the premier most institute of medical sciences in the country, AIIMS, New Delhi.
Balwinder Kaur , in the meantime was once again out of the hospital ,as despite surgeons wish , the whole staff including the anesthesiologist refused to operate fearing contracting HIV through her surgery.
The ball was back in my court. But this time , the ball was served as an ace. Balwinder asked me ,” what if I get a forged HIV negative report by paying double the amount to the labs???!!!!!!”. The sarcasm ,showed me the mirror of our medical world. I could not return her ace and she did score a point. I needed a breather ,after this match point. I bought some time.
The time bought was sufficient to convince the Batala Surgeon ,classmate of mine ,to operate on a HIV patient , this time by design and not by default. He too ,by now was armed with refreshed knowledge about HIV.
The match was fixed again with same vigor , the only difference being , this time coals were to be carried to Newcastle. All these years people from Batala used to be referred to Amritsar ( being a better equipped city as far as health services were concerned) but this time an Amritsar resident was to be referred to Batala and that too for a left hand game for surgeons. Cholecystectomy, after all ,is never a big deal for surgeons ,since the time I graduated ,at least.
The operation day once again met the same fate. Batala doctors whole staff went on a ” leave” leaving the patient in lurch once again. I asked my friend ,” what next ”
He assured ,” don’t worry, they can’t remain on leave forever , I am certain we shall do this elective surgery soon”.
The “D” day finally arrived. Patient was given the premeditation, and shifted to the OT. Surgeon was busy scrubbing and came the nose of his wife , a Gynaecologist herself. She could not resist poking it ,smelling a fish ” HIV”.
I could , however , telephonically convince her that it is better to operate electively taking effective precautions rather than operating in ignorance , throwing precautions to wind and end up taking PEP. I also told her that someday ,someone has to put his foot first , on Moon, then why not her husband should be the one.
Surgery ultimately was done and Balwinder discharged in due course of time after an uneventful post op period.
I am no more in touch with the patient, but her tale touched many aspects of dealing with such victims ,in the earlier days of the epidemic called ” AIDS”.
How far things have changed after three and a half decades can be anyone’s guess. Specially for those are suffering and those who treat them. My assessment,”we have miles to go before we sleep, woods are dark and deep”.
Rakesh Bharti
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