Wednesday, September 12, 2007

Pathologic pick-a-boo - A patient encounter, Part 2

Do read Part 1 first. (See below.)

“Will he understand?”

“Probably so,” I answered. “If not, we can review it each time he is here so that he knows more about why he is taking the medicines."

I turned to the young child. He was seated on a black plastic and metal chair. I envied his posture. Looking at him, I began to also envy his style. He wore a pressed, red and white, short-sleeved, plaid, button-down shirt and baggy khaki pants, the kind with plenty of extra pockets.

“Monde, how are you today?”

“I am fine,” he said.

I gave a hyperbolic fist pump in the air, the celebratory and mildly obnoxious kind.

Monde smiled. It was an ungnarled smile. His brown irises were centered perfectly and still within paper-white eyes. His cheeks were full and wartless.

The TB soup around his brain was gone, and he had the face of a child again.

I talked to him about his soldier cells and how they were getting stronger on ARVs.

“The soldier cells were three [percent] before, and they are now six! Imagine when they get to ten, or even twenty! You are going to be very strong.”

I dramatically flexed my arms to show him how strong he was going to be. (Don’t roll your eyes, dear reader; kids like that kind of stuff.)

When I finished 'HIV-for-seven-year-olds 101', I asked Monde's mother if there was anything else.

“I told Monde that he would be on the medicines for life,” she responded.

I extended my arm, holding out my clenched fist; Monde did the same, hitting his knuckles softly against mine.

“Well, that is going to be a long time."

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