Tuesday, September 11, 2007

Pathologic pick-a-boo - A patient encounter, Part 1

I first met Monde in the hospital. Well, we did not meet.

Let me start again.

I first saw Monde in the hospital. He did not see me.

As I approached the foot of his bed, his head was turned to the left as if he needed desperately to peer deep into the stained, foam mattress beneath him. The dark brown of his eyes had disappeared into his sockets, where they fluttered in and out of view.

His eyelids were quivering as well.

These were not the rhythms of healthy eyes. Monde had tuberculosis living in and around his brain and spine.

His twitchy-eyed face was covered with flat warts and his weight was 60% of what it should have been.

He wore a hospital gown, though there was little flesh to cover, little dignity to preserve.

His mother sat at the bedside, looking at him with what I would describe as bewilderment and intrigue. Wonderment, even.

The expression on her face asked, “Is this skeletal, distorted, jerking child actually Monde?”

I was not optimistic that he would survive. His CD4 count at the time was 3%, making his immune protection analogous to sky-diving with a cocktail umbrella or, perhaps, Nascar racing with whoopee cushions for airbags.

While the TB and HIV thrived behind his unseeing, darting eyes, Monde was dying.

(Gotta go study. To be continued tomorrow. Don't worry, the story is a happy one.)


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