Sorry for the recurrently late posts. The Diamond Jubilee has meant lots of fun things to distract myself from and make the most of this 4 day weekend, though also meant that I haven't been with a computer to post until today... Despite my poor posting, I do have things to talk about. Last week was pretty interesting, mainly spending time in outpatients, in both an HIV clinic, and a general infectious disease clinic.
I have noticed that a larger proportion of HIV doctors are (outwardly) gay compared to other medical specialities. Perhaps this is linked to the fact that when they were training this disease was ravaging some of those in the gay community, and they were determined they wanted to help stop it. Perhaps it is related to the fact that there are more gay patients in this speciality, which attracts gay doctors. Perhaps it is just a more accepting patient group, and doctors who are HIV specialists feel happier to be open about their sexuality... Whatever the reason, this is a trend I noticed, and when going into the clinic with the HIV consultant I was secretly trying to work out whether he was gay or not. By some coincidence (small world and all that) one of my friends who I knew outside of hospital life walked into the room, and after the exclamations of surprise at meeting each other here, he introduced me to his husband. I knew he was married, just not to who! It definitely solved the question over whether the consultant was gay though!
In the infectious disease clinic, the most interesting case that I saw was a man who had been travelling through Africa and had been bitten by a dog. He had come in with a walking stick, wrapped in a shawl, very 'new age' style, and talked about how he had been travelling by foot through the birthplace of man. This had been about a month ago, and he had been bitten by a dog, who was one of a pack belonging to a witch doctor. The witch doctor had assured him that there was no rabies in his dogs, because of his medicines, and so this man had travelled home without having any preventative treatment. Recently, with all the media coverage of rabies in the UK, this man's friends and family had urged him to get it checked by the doctors. Unable to diagnose rabies, the only thing that could be offered would be to treat him as though he had been infected, to reduce his risk of contracting rabies. He was not keen on this idea, talking about how he never had any vaccines as they harmed your body, and told us that he could probably get a natural cure in crystals. I am unsure as to why he came into the hospital in the first place, if he wasn't going to accept any treatment. To reassure his friends and family, I guess... After a lot of discussion, and calling the HPA, the man was still sure he didn't want the recommended treatment because it was not guaranteed to work. The recommended treatment consists of immunoglobulin and a vaccine as soon after exposure as possible. This lead to a long discussion about medicine, and how very little is guaranteed. He demanded proof that it would help him, which we then emailed to him to read. He decided he may come back in after reading it if he and his 'healer' decided it was 'appropriate'. Its very strange how someone who is so obsessed over proving things work practices types of medicine that many feel do not have any proof. Perhaps he is more used to the 'definites' that some alternative medicine practitioners work with. This homoeopathic diamond will definitely cure your breast cancer... Perhaps that helps the placebo effect...
I hope he does come back in for the treatment, but it seems that he won't. The odds are that he hasn't got rabies, he will chose crystal therapy, and feel that it has protected him. I hope that's the case, as the alternatives are pretty bad. it seems silly, but all these lectures about 'autonomy' are all about letting patients make decisions that we feel are misguided, and I just need to remember that it is his life, and my beliefs. He should be allowed to follow his own beliefs.