The future face of pediatric HIV – A patient encounter

As I was typing up my clinic note, the two were singing. I didn’t understand the words, as they were in SiSwati, but they delighted the 4 year old child, who made up for her lack of pitch by maximizing the volume of her singing voice.

This was a well-cared for child, a well-nourished child…an HIV positive child. Her pink and white striped shirt, her white blouse, and her off-white and off-pink sweater went well together, so much that I was reminded of those clothing combinations one often sees in a department store catalog.

Haven’t seen one of those in a while.

“What is your relationship to the Yenzokuhle?” I asked the woman singing beside her.

“She is my daughter,” she said, smiling.

“She is lucky to have you,” I told her.

It is a lucky child indeed who has a mother to sing happily and heartily along. (When I was Yenzokuhle’s age, my mother and I frequently sang “Puff the Magic Dragon” and “One-eyed, One-horned, Flying Purple People Eater”. Occasionally my mom would even strum along on her guitar.)

This was a happy, beloved child. I envied her energy, her zest, her style. I was even jealous that she was able to sing loudly and poorly and not wonder if I cared.

As I typed in her prescription for antiretrovirals, I wondered to myself if Yenzokuhle might be the future face of pediatric HIV, rather than the several patients I had seen before her: frail, frightened, crestfallen, understated.

As I wondered this, the child’s voice climbed to even loftier decibels, and squeaked such that my head cocked automatically fifteen degrees to the side. With a final shout, the song and the culminating crescendo was replaced by a brief silence, then the simultaneous giggling of a mother and child.