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Sunday, December 11th 2005


I was trying to put studying for my last round of tests this semester (or not) into perspective. Maybe I was just trying to kill time from the biochem study guide by starring off into space.

The first two months here I had a medical ethics and humanities class. It was kind of a disorganized hodge-podge, addressing both the history of medical ethics and basic ethical reasoning as well as how you could approach patients empathetically as stories. Pretty new age, at least down here in Texas.

A physician came in and told us one of the most incredible stories I had ever heard, and I’m not really sure what brought it back to me today, although I had certainly forgotten about it for a while.

I changed it some, hopefully enough. I wonder if the ethical implications of posting identifiable info are changed by the fact I have a readership of right around zero. Probably not…

The doctor was a family physician who had finished his residency at the beginning of the AIDS epidemic, and so when he went out into practice he took up a position, really apparently actually built it from nothing, at an AIDS clinic.

A few years into his practice a patient who he’s close with is in the hospital and in bad shape, and the patient decides his time has come and he wants to go home with a hospice nurse. Probably the right thing, but the physician feels close to the patient and kind of wishes he would keep fighting.

A couple days after the patient goes home the physician decides to go see him. He hassles with the patient and finally gets him to agree to let him draw some blood to take back to the lab and see what the T cell count is. The physician is hoping for good news.

He draws the blood, something he’s done a thousand times, but there’s no sharp container to dump the needle in, so the physician wraps it in a paper towel and sticks it in a bag with the blood. He forgets about it on the way back to the clinic.

Back in his office he reaches into the bag and something sticks him and he immediately realizes what has happened.

The first test comes back negative. The second test comes back negative. All the while he’s on anti-retroviral meds. It’s nearly eight weeks, two months, after the stick, that the third test comes back positive. From a needle stick.

There’s something humbling about being the patient, as this doc became. You realize there’s great power and there should be great responsibility in what physician’s are allowed to do.

Sometimes there seems to be a lot of professionalism rhetoric and a pedestal that physicians seem to place themselves on. There are doctors with egos. All the while however the public respect for the medical professional seems to be dropping. In that environment the talk about humanism and how noble this profession is can seem kind of like fluff; like old windbags talking up their choice of profession.

Stories like the one above actually kind of restore my pride in the path I’m on. Not to say that that pride was ever completely gone, just that it takes a dip every now and then.