Wednesday, November 07, 2007

Important numbers - A patient encounter


Mthobisi’s fleece sweatshirt had the number ‘14’ on it. I remember this value because it matched Mthobisi’s CD4 count on 31 January, 2007, just before he started ARVs.

Clothes with two digit numbers on them are popular these days. In addition to my patient’s #14, there was a #23, a #42, and a #00 in clinic yesterday.

While I have no problem with numbered apparel, I would prefer that the numbers have some significance. Perhaps they could even be accompanied by an explanation. Imagine, for example, a fleece sweatshit that says:

299, 792, 458 m/s – the speed of light
6.022 x 1023 – 'Avogadro’s constant', or the number of protons in a gram of pure protons
3.14159265 – 'pi', the circumference-to-diameter ratio for any circle in a plane
i – the 'imaginary unit', or the square root of -1.

As I am not a mathematician, I put together my own list of significant numbers, sticking to the more marketable, two-digit fashion:

01 – the number of dollars that 80% of Swazi’s survive on each day
33 – the healthy life expectancy of the Swazi male, in years
50 – the percentage of HIV+ children that die before their second birthday without treatment
02 – number of pills required each day to keep an HIV+ human being alive
44 – how many cents each of those pills costs, according to Clinton Foundation 2006 ARV price list

And my favorite number of all:

510 – Mthobisi’s CD4 count after 10 months of ARVs


As Mthobisi left the exam room, I held out my hand to shake his. He shook my hand firmly with his left hand, realized that he should have offered his right (as is the custom), and quickly corrected himself. He smiled as I complimented him on his strong handshakes.

As I typed up a summary of his visit, I wondered if I might some day read a story in the sports section of the paper about an ambidextrous athlete from Swaziland that pitched (or in the case of cricket, “bowled”) the perfect game. Or, even better, maybe there will some day be a "Mthobisi’s constant".

Five-year-old Mthobisi could grow up and destigmatize the virus he was born with, or perhaps even cure it.

Yes, the number 510 is a beautiful and important number.

It is the number of CD4 cells per uL of blood that is allowing Mthobisi to become whatever he is going to be when he grows up.



At 11:26 PM, Blogger Hisviolin said...

I really like this post. It's important to me.

I have enjoyed reading about your experiences in Swaziland. Best wishes.

At 1:36 AM, Anonymous Anonymous said...

I found this very touching. I really didn't realize how hard it was living in Swaziland. I hope he does grow up to cure his disease.


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