Does anyone know the disease? Has anyone seen such a patient? It is not a rare disease, but it is one of the most terrifying. It is commonly
Does anyone know the disease? Has anyone seen such a patient? It is not a rare disease, but it is one of the most terrifying. It is commonly known as AIDS, is a kind of human morality, and desire, perhaps love is closely related to the disease, is a kind of let the patient embarrassment, fear, let the family make social alienation, let the human feel sick. God is the most cruel human disease.
There is news that AIDS in China is on the rise. There's no need to listen to the media. As the biggest southwest of a comprehensive hospital doctors, we gradually exposed to the disease, in a variety of ways happen unexpectedly.
AIDS as an immune deficiency disease, the first symptoms are often a variety of infections, so patients are often due to a variety of symptoms in different specialties. What impressed me most was a 36 year old patient who refused to disclose his illness to his family.
I was in the digestive tract tube at that time, lower gastrointestinal digestive medicine group is Difficult miscellaneous diseases group, what to be patient, abdominal pain abdominal mass and intestinal ulcers, diarrhea, fever and so on diagnosis is not clear, not clear the disease from my group. There are days of receipt of the director of a telephone, said there is a colonoscopy in patients outside the hospital found a huge ulcer in the terminal ileum, suspected Crohn's disease, ready to go to the hospital to let me leave a bed. I'm glad that Crohn's disease, a rare disease, is exactly what we're looking for.
Patients come, young, stout, although some sick, but still have the spirit. A large family, show the utmost solicitude. Inquiry, in addition to abdominal pain, fever, no other positive signs (as if no lymph node enlargement). View of the hospital outside the colonoscopy report, report on some surprise: description of the ileal ulcer 3X4 cm in size, a copy of the picture is not very clear to see form. So to the family account: the course is so short, so large intestinal ulcers, but also accompanied by high fever, is not consistent with the diagnosis of Crohn's disease in our hospital, must review colonoscopy and biopsy to exclude the possibility of lymphoma. Patients and their families are very cooperative, understanding. But due to heat up to 40 degrees Celsius, as a routine, we checked the blood transfusion set (hepatitis B, hepatitis C, HIV, Mei Du).
The second day colonoscopy report came out, there was indeed a huge ulcer in the terminal ileum; blood transfusion before the full report came out: HIV positive screening, recommended diagnostic tests. Look at these two reports, we are surprised, did not expect such a result. My first reaction was to explain the illness to the family members, and to inform the nurse of isolation.
Holding a report into the ward, see the patient lying quietly in bed, no family. I asked, "where's the family?" Answer: "come back for a while". I looked at him in silence, I found it difficult to speak, turned away from the ward. Some doctors are discussing in the office. A doctor said: " heard that the country has recently provided that the disease can only tell the patient himself, not to tell the family, because it belongs to the patient's privacy ". I was shocked, usually confessed to the family to account for illness, did not expect this to be. Almost accidentally took a lawsuit in the body, the state this is really endless ah. Immediately call the infection department colleagues to confirm the matter. As the group's medical team leader, I only responsible person to person account of illness.
Once again into the ward, found that accompanied by the patient around. I said to the patient: come to my office. I have something to tell you. Listen to the patients get up, wearing a hospital gown, holding a transfusion rod for companionship, slightly slowly came to my office. To accompany to the door, close the door, I took out the report, told the patient directly: "the report came out, we suspect that you have AIDS, but also need to do a further confirmation test". Listen to this, the patient's face was very calm. I involuntarily added: "know this disease?" He said quietly, "I know". We are speechless for a moment. At this time the patient's wife rushed to the ward, perhaps listen to accompany the patient said in my office, the door was worried about shouting! I said to the patient, "go back"! The patient asked, "what is the likelihood of a diagnosis of this disease?" I said: "in my experience, should be affirmed"! He walked silently, his wife kept asking him, "what did the doctor say to you?" He did not answer. His wife began to ask me, "what is my husband? What the hell did you say to him? I said, "you ask your husband!"
After a while, a large group of family members rushed to my office, surrounded me, emotionally let me tell them what the patient is sick. Also threatened that I never heard that the patient is not only to explain the patient's account. If their patients have heart what unexpected misfortune that must have a good, i. Well, I can't stand it anymore!
Those days are not peaceful. We examined the picture found in return: pulmonary miliary tuberculosis, intestinal ulcers of intestinal tuberculosis is also considered, a full set of immune CD4 cells may decrease, diagnostic tests were also positive. Don't stop the family I asked to find the disease, clinical rounds of the patient's family also asked me in the end is what disease. I can only say: "you ask the patient himself, this is his right". But in any case, patients are quietly not to utter a single word. I had to call the patient to the hospital to call the director, to report to the leadership is not illegal. I said: "director, ah, you have to get acquaintance with the spread of AIDS Tuberculosis, intestinal tuberculosis, do you want to give his family that is your thing, I can not stand fast"! Then another officer is asked to call the patient (see their families really is wide, I also ah Yue) truthfully report. By reason, the patient's family should also have the right to know, because these two diseases are isolated.
I do not know whether the family slowly know, or guess what, to the people very little. Only his wife, a small and exquisite woman, quietly to take care of him. Don't ask what we see, but also did not wear masks in isolation, I was not good to remind her to check the HIV, just sympathize with her. With the Department of infection: the infection department contact, reply: this patient is now too much, they can not receive the proposal back to the local epidemic prevention station for treatment. Given the anti TB drugs, the body temperature slowly controlled, we remind them to be discharged.
The day prior to discharge patients alone to come to my office, I can not write to ask the discharge diagnosis of AIDS, he needed to hold the discharge certificate to the unit for reimbursement. I said I had to give a diagnosis, and I would write acquired immunodeficiency syndrome. He sighed and said, "it's not the same. I have to go back and do a lot of things about myself". I told him: "according to our medical practice, infectious diseases, we should ask the source of infection, which is conducive to national unity to take control measures. But if you don't want to talk to me." I'm sure he'll think about it this time. He said, "about 3 years ago, when I was on a business trip to Yunnan, I was playing at the Burma border."
The discharge was his own. I don't know if his wife knows in the hospital, or just do not want to say. But he is so fast, so serious pathogenesis, prognosis is very poor. Even if the tuberculosis control, other infectious diseases will also take advantage of a weak point. The apparent decline of CD4 cells indicates that his "immune deficiency" is in a very dangerous situation. But he and his family opposition, will make him more isolated and helpless. I don't know what else he did not deal with, there is nothing to do with his family to do, he should be no more, and later have to rely on others.
As a doctor, I kept my secret for the first time so hard for a patient. Although he did not say to me until discharged a thank you, seems to think that this is behoove thing, but I know that if I had not told him but directly told his family, in his present this hard to let others know attitude, he will tell me the violation is easy thing.
The disease is embarrassing for all people, and even the whole of humanity, because it is closely related to human desire, and close contact with people, it challenges the basic trust between people. Those who have this disease can not be called in the eyes of the patient, family and society, he should be a sinner, finally may be terrible. But we know that in the bright sunshine, in the surface of the bustling, the disease is still quietly spread around us. What should I do? One can be austere without selfish desires? No time for humanity? What a cruel future for mankind!