My posting in the Medicine department during my internship was both tough and rewarding.In a span of one and a half months,I had matured from a happy-go-lucky intern to a responsible,thoughtful doctor. An incident midway during my posting really had a lasting impact on me.....
I had mastered most of the procedures in Medicine including Lumbar puncture,Ascitic and pleural tap,collecting arterial(radial and femoral) blood for ABG(arterial blood gas)analysis.
But the one procedure which every intern covets is the 'Central venous Line'.There are 3 ways of doing it:-
1.Peripheral(easy)
2.Subclavian(toughest)
3.Jugular.
I had the misfortune of witnessing a failed attempt by one of my friends in the HIV ward.The boy ,instead of entering the subclavian vein entered the subclavian artery.(Both are close by and this is a blind procedure)The massive internal bleeding led to a hemothorax and the patient died within the hour.No significant emergency measures were taken to save him.Why?
"Are,HIV patient waise bhi marnewala hai.Ispe sab karke seekh lo".(The HIV patient is going to die anyway.Do all procedures on him and learn).
This was what the residents used to tell us.
Shattered ,I went into depression for 3 days.I did my usual work efficiently but my mind was preoccupied.
Why should HIV patients be treated as guinea pigs?Are they not human beings?Agreed that many of them wronged by not using protection,but they are paying for it with their lives!The social ostracism is expected as not many are mature enough to understand their situation.But we are doctors.If we also ill-treat them and use them for experiments,where will they go?
Relegated to balconies,these people are kept in the filthiest of surroundings.No one sweeps or mops that area for fear of contracting disease.The bedsheets are ancient and laden with dirt.No resident doctor or staff nurse bothers to venture near them.Only interns or student nurses are coaxed to go near -that too with the dangling carrot of a procedure.But most interns also refuse.After sometime even their relatives forsake them.
What happens is that sooner rather than later,the patient breathes his last.All are relieved.Good riddence!
But for me,its another battle given up without a fight.Another setback to the basic principles of humanity.This callousness on part of the so called 'Life saviours' borders on frank cruelty.This must stop.
Who are we to judge these people as good or bad?We are not Gods to play with their bodies to satisfy our academic aspirations and then allow them to die.Every patient (whether HIV positive or not) is valuable and must be given full care and treatment.Such patients need more care-medical,sanitary and emotional compared to others.They need to have exclusive wards with specialist doctors and trained staff.
Yes.AIDS at the moment,is an incurable disease.But it is possible to give these people a decent quality of life by alleviating their pain and controlling opportunistic infections.We can help them to be self-sufficient and live their last few days with self-respect.Compassion and understanding are equally important as the anti-retroviral medication as the psychological effects of the disease are equally crippling.
Come on all members of this noble fraternity.Let us show our solidarity and support to fight this deadly disease whose cure may just be round the corner.Till then we must hold on remembering these words,
"Hate the disease and not the diseased".
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