Thursday, November 10, 2011

This post is at least PG-13. R if you live in the midwest.



This week we've had some really good lectures on HIV/AIDS. I'm old enough that I can remember the late 1980's which saw the near panic crescendo from all of this. Perhaps, the climax was Magic Johnson's diagnosis and retirement from the NBA. It is a little hard to believe that that was 20 years ago, as the anniversary was just a few days ago. I can actually remember thinking that this was good for the Portland Trail Blazers, since Magic's retirement left the Lakers in a bind. Of course, this was the thoughts of a young boy insulated from most harsh realities of the real world. All that surrounds the AIDS epidemic is so crazy and dramatic compared to most other areas of medicine. A friend whom I worked with a few years ago was getting a master's degree and in one of the classes she was taking the professor espoused the idea that the CIA had created HIV on purpose and distributed it to people in Africa, and this is where it came from. I really don't know much about that, I haven't read or talked to anyone who holds that position, but even for a person like me with a penchant for obscure conspiracy theories has considerable doubt concerning that one.

I grew up in a very conservative Christian community and I can remember in various youth groups we had some people holding the opinion that HIV/AIDS was a punishment from God, meant for homosexuals. In this same exact logic, one can conclude that diabetes, heart disease and any other random obesity associated disease is punishment for the fat people. Polio is punishment for people who liked to swim in public pools. I won't go off on this for long, but for those who want to prioritize sin (or what they perceive as a sin) had better reread what the good book says about that, as one is just as bad as another. I attended church in Benicia a few weeks ago and the pastor said something that really struck me. He talked about how, in the gospels, Jesus never once mentions homosexuality. However, greed and pride are discussed in a manner that leaves no doubt as to how he views them. How is that the many churches have nothing to say about the greed and pride that are abundant in our economic system but rail against homosexuality as if eradication of it was the prime-directive? Okay, sorry, I'm off the soap box now.

Back to a lighter topic, AIDS.

I remember an afternoon when I was working in the ER when we had a patient come in complaining of priapism, which is an erection that won't go away. He had this erection since the night before when he took a handful of viagra and another handful of various club drugs. This was literally how he was describing his prior night, he was at a dance club and he and his friends just kind of mixed whatever kind of drugs they had together and just ate 'em up. Ecstacy, MDMA, LSD, GHB, Ketamine -- you name it. Oh, and someone had a big bottle of Viagra, so they split those up as well. Let the party begin! This guy did this on a regular basis, but not with the Viagra so now, 15 hours after his weewee came to attention he was in considerable pain and came to see us.

Once the nurse found out it had been 15 hours she rushed him back to one of the rooms. One of the things I liked to do when I worked in the ER was kind of listen in or watch from a distance what the doctor was saying or doing. I think I learned a lot by doing this. If anyone out there is reading this and is thinking about applying to med school I can tell you that working in a clinical setting will provide so much more than an official "shadowing" afternoon will. Anyway, unfortunately the door to this patient's room was shut for the next few hours. But, thankfully some of the nurses were more than willing to give me the play-by-play. At first they tried to get the erection to go down with various drugs. I'm guessing NO was probably one of them (as it relaxes smooth muscle) but I really don't know what else, except that none of them worked. The rooster was still on the roof of the barn cock-a-doodle-a-dooing-away, and he wouldn't come down. Then the nurse told me, as he was gowning up and donning eye protection that the doctor was going to try and take the blood out with a needle, and that the patient was HIV positive, and that he was going to have to be in there as well to assist. I'm not sure what happened next except that when the doctor and nurse came out they were covered in blood. The bed and the floor in the room was soaked as well. I once had a friend that had another friend who worked as a photographer and as such, was in the visiting team's locker room at the Pepsi Center, where the Nuggets play. Supposedly when Shaq walked out of the shower, sans towel, the first thought that came to his mind was no way, a 2 liter bottle!? and, I'll just leave it at that. The reason I even bring this up is I have a feeling that this poor man might have been packing a RedBull can, at best, but you wouldn't know it from the blood that was everywhere. The room had to be thoroughly cleaned and sanitized, as is appropriate, after that.



So, that's what we're studying yesterday and today. And then on into other viral and bacterial infections.

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