here in Mukinge. This is very much a person-by-person struggle, as all
of the posters and advertisements in the world seem to do little to
convince the village wife that she could conceivably be HIV positive,
much less need treatment for it. We have mandatory offered HIV testing
for all of our TB patients because the co-infection rate is around 70%;
one of my patients today became very angry because we were drawing blood
from her on the ward. This was a blood draw to determine if she would
be healthy enough to start on anti-HIV meds; she'd already had her HIV
test last week. To our surprise, however, she got very angry, claiming
that she'd never given consent for an HIV test and had never been told
her test results. Now, we pretty clearly document our counseling
process, and there were notes from our HIV counsellor on the chart, so I
was pretty sure that she'd been told both about the first blood test and
the results. But she was very adamant, spitting out Kikaonde far too
rapidly for me to follow, so I brought in the HIV counselors to come
talk with her again. After some further questioning, it was pretty
clear that she had gone through the whole counseling process as usual,
but was in such denial about her positive test that she couldn't even
admit that she'd been told the results.
As I was standing there in the nursing station with her and our
counselor, I keep thinking about how I could 'force' her to hear her
test results simply by repeating them again there until I was sure she'd
heard. I really wanted to, to a certain extent. I mean, shouldn't her
husband and children have the option of being tested, even if she was in
denial? Plus, it just seemed like cowardice to run away from the truth
like that. But for her, the truth was really a weapon in the truest
sense of the word, and to wield it like that against her would probably
do irreparable damage to her, as well as to our doctor-patient-hospital
relationship. So we left it alone, with her in her denial.
No comments:
Post a Comment