“The love of one person can heal. It heals the scars left by a larger society. A massive, powerful society.” Dr. Maya Angelou
She was a young 18-year-old African American woman from the South Bronx, and I had been dating a guy from her neighborhood—maybe that’s where our kinship began. Recently diagnosed with Cryptococcal Meningitis (CM), an opportunistic yeast infection, she had faced delays in seeking and receiving care for her HIV diagnosis in 2004. Here it was, late spring 2006, and we were meeting for the first time.
As a Physician Assistant student two weeks away from completing my clinical rotation year, my team of internal medicine residents and I were reviewing her chart and deciding what personal protective measures we should take before entering her room. CM is acquired by inhalation, so we donned long plastic gowns over our white coats and accessorized with paper-thin masks attached to clear plastic facial guards to shield against yeast spores.
Three of us entered her room, and in less than five minutes, we informed her that her most recent diagnosis would qualify her for full government-assisted medical coverage, having now met the criteria for AIDS. This would allow us to begin a wider range of treatment options. She seemed pleased, a half-smile stretching across her face as we delivered the news.
As we turned to leave, I had almost crossed the threshold when she asked, “Can someone, maybe one of you, come and sit with me today? I think I’m spending too much time alone.” I paused. It was an odd request—we were at work, there were other patients to see, and she had a contagious virus. But she was also human, alone, forced into vulnerability by circumstance, and living in an environment unwilling to see beyond her diagnosis and demographics. Stumped, I replied, “Sure, I’ll stop by before I leave for the day.”
According to the nurses on the floor, she was “often argumentative, angry, verbally aggressive, and at times could become physically confrontational.”
She had been living with HIV for two years, the unfortunate outcome of her first sexual encounter. After a six-week stay in the pediatric unit, she was now being moved to the adult internal medicine floor, a less friendly area in the hospital. Her most recent diagnosis required more resources and a higher level of nursing care than what was available in pediatrics at the time.
She was the floor’s youngest patient, a teenager confined to a room twice the size of a prison cell, without windows or visitors. Her only entertainment was a television mounted to the wall, which was now becoming hard to see as her vision was also fading. She hadn’t had visitors in more than four weeks, and during that time she was mentally and socially unraveling in a place where she should have been receiving thorough and quality care.
Her diagnosis was kind of a big deal. She was a big deal.
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