Tuesday, March 15, 2011

Reflection on the Ides of March: Three minutes.

*names, minor details changed to protect anonymity.

Ready in three minutes.

This whole exchange took place yesterday while I was (very busy) typing my notes at the nurses' station in the afternoon. The daycare pickup clock was ticking. . . .

The entire incident happened over a three minute period.

_______________________________

"Excuse me, ma'am?"

I looked up and saw a woman in front of me. Her face was smooth and youthful, but troubled. And not troubled in that "do you know where the women's clinic is?" kind of way, but more of a troubled in that "I'm getting evicted" kind of way. I removed my hands from the keyboard to show her she had my attention.

"Could I ask you a quick question?" she asked. I immediately noticed that she was wearing what looked like a Grady employee badge, so I now knew for certain that she wasn't lost.

"Sure," I replied, now curious about her furrowed brow and searching eyes.

She let out a big sigh and then said, "Okay, so like. . . .if somebody got the AIDS, right? Well, not the AIDS where you real sick, but the AIDS where you just got it in you and then you wear a necklace on your neck and put it in they mouth. . .you know, like a cross on a necklace. . . and nen somebody else put it in they mouth, do that mean they can get the AIDS, too?"

Wait, huh?

I decided to say that out loud. "Wait, huh? I'm a little confused. How about you tell me exactly what happened so that I can help figure it out with you."

I noticed that she was panting a little bit while she was talking to me. Her right hand was tremulous and her eyes had become glassy while giving the first explanation. She was worried. Like, real, real worried.

"Okay, so explain what happened to me--" I reached my hand over the counter and grabbed her wrist, "--and take a deep breath. So far, this doesn't sound like it is much of a problem, okay?"

She took a deep breath, but it didn't seem to help. "Okay, so. . . . like my close friend. . . he. . . . he got the AIDS. . .but he go to the doctor and he don't be sick or na'n. . .like he say he don't even have it to that point like thet or na'an."

"So, he is HIV positive is what you're saying?"

"Yeah, ma'am. Tha's what he always be correcting me saying. That it ain't the AIDS but iss really the HIV in his body that they keeping from being the AIDS."

"Your friend sounds pretty smart."

"Yeah, ma'am. We grew up together. He, you know what I'm sayin', be with dudes and stuff but we been friends since we was real, real little. So he like a brother to me. And, you know what I'm sayin', he trust me and told me about thet."

I leaned my chin into my hand and just listened to her.

"Okay, so wha' had happened is that he was at my house and he was playing with my baby daughter. Well, she really like two, but you know she like my baby, you know what I mean. So he was holding her and stuff and I went in the kitchen and nen when I came out she had his cross on his necklace in her mouth."

I turned my mouth sideways and squinted my eyes. "Okay."

"And nen I was like, 'Oh my God! Get that out her mouth!' And he was like, 'What you trippin' for?' And I was like, 'I seen you with that in your mouth when you was texting when you first got here!' And then I start screaming at him why he let her put thet thang in her mouth when he know he jest had it in his mouth." She was shaking again. And now she was sweeping away thin tears that were sneaking down her cheeks.

"Oh my goodness. What did your friend say?"

"He got all mad and left. Like he said, 'What kind a friend are you?' And I said, 'Eff that, tha's my babygirl.' So for two weeks I been reading up tryin' to find out whether my baby got the AIDS now."

Two weeks? Damn.

"What's your friend's name?"

"Justin."

"And what's your name?"

"Nika."

"Okay, Nika. I'm Dr. Manning." I squeezed her wrist again. "Listen to me, okay? Even if Justin had the cross in his mouth two seconds before your baby did, that isn't something that you need to be worried about."

She didn't look convinced.

"Nika, the way you get HIV is if it's in some blood you get, which almost never happens now. If you shoot up with somebody's needle, you can get infected." She gave an exaggerated shudder--the kind people often give when they want you to know that they'd never voluntarily inject themselves with a needle. "You can get it from having sex with somebody who has HIV if you aren't using a condom. That's if you are a girl or a boy, it doesn't matter. If you get stuck with a needle or come in close contact with like blood or something. But not spit or saliva."

"For real?"

"For real. Like there's a lot of happy couples that kiss and make love and everything where one person is HIV positive and the other one is negative. And they stay that way. Kissing is fine. Even really, really kissing--as long as the person doesn't have like an open bleeding sore or something. It would take a lot to get HIV through the mouth. Now a cold? You can get a cold. Did Justin have a cold?"

"No, ma'am. He stay healthy."

"That's great."

"I had made my baby an appointment. I was gon' see if they could test her for the AIDS."

"Nika, cancel that appointment. I would use that time to go and find Justin and tell him you're sorry and that you didn't know. Tell him you didn't mean to hurt his feelings. You know? Because you probably did, you know. . .hurt his feelings."

She looked down. And finally she had stopped shaking.

"Nika?" She raised her eyebrows. "I wanted to mention something Justin said. So if you come in contact with the virus that causes AIDS, and it gets in your body, that's called HIV positive. HIV can hurt the blood cells that fight infections and then when they get low, you are prone to getting sick. There's a lot of medicines that keep people from that point, and doctors who help them. But if the blood cells get low, that's called AIDS. And it's okay to just refer to what Justin has as HIV, if you must, instead of 'the AIDS' or 'the HIV.' That's if you must."

"He prob'ly was hurt. He lookeded real hurt," she said in a tiny voice.

"Well, it sounds like he trusts you with a lot of personal information. I'm pretty sure he'd be cool if you told him about our conversation. I say the wrong thing all the time when I don't know that much about something. If you are really sorry in your heart, then somebody who loves you will accept your apology."

She gave me a bright smile, and for the first time, I noticed the gleaming gold tooth on the side of her mouth. "I sure 'preciate you for taking the time to talk to me. For real."

"I just wish I'd seen you two weeks ago," I replied with a wink.

"So cancel the appointment?" she confirmed before leaving.

"Yep. Cancel the appointment, but not the friendship."

She nodded slowly and pointed in my direction. "Right. . ."

And just like that she departed and headed for the elevator. But not before I heard the beginning of the call she placed on her cell phone. . . .

"Hey, J. . . .wha's up? It's me. . . ."

All in three minutes. Wow.

I went back to finishing my notes and made it to daycare with time to spare.

6 comments:

  1. It always amazes me how relative time can be.

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  2. These stories from the front lines reaffirm my belief that doctoring is truly a calling. Thank you for being a great role model and helping me keep things in perspective as I am going crazy memorizing the cephalosporins today. :D

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  3. Myth and stigma are powerful forces. It would have been so easy to brush that woman off but that would have been a missed opportunity to educate, sensitize, and...most importantly...reassure. Thanks for your spoken - and written - words.

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  4. Wow what a powerful three minutes.

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  5. Patient education + on-time daycare pick up = Great day! Thank you for sharing!

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  6. Only at grady... isn't it moments like that where you sit back and think "Yes Lord, I am in the right spot."
    :) What a successful ending to a day.

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