The Pumpkin Man

2003-02-07 - 7:24 a.m.

Last night, as usual, I had a strange dream. I dreamt that I was in an army. I was Scottish and we were fighting the British. We only had one small platoon of soldiers while they had several battalions. We were all huddled together hiding from them while they were lining up in perfect formations all around us. But they didn't know we had a secret weapon. We had something like a cannon only instead of shooting cannon balls, it shot hollow spherical cages as big as a man that were red hot. When these hit them they were heavy enough to knock them down and break bones and hot enough to burn. But more importantly, if they hit just right, the enemy would be trapped inside a cage of rolling, red hot metal. The battlefield was also dotted here and there by skyrocket junipers. If a man was caught inside one of these cages and then the cage rolled onto a juniper, the cage would get stuck, the juniper would burst into flames and the man would burn to death. It was really quite an effective weapon. We quickly won the battle as the British surrendered. We were securing the British troops when I overheard one of my fellow Scots bragging about his accomplishments to a pretty woman. I thought to myself, "He's so full of shit," and then, before I even thought about it I yelled over to him, complete with my Scottish accent, "When are you going to say something true, Scot?" I was immediately embarrassed and ducked down behind something to hide. He was amused and was coming over to talk to me when a commanding officer barked an order at us. I was ordered to prevent the British troops from running away by taking their shoes and chucking them as far as I could. It was rather interesting because although the troops were dressed in camouflage uniforms, they weren't wearing combat boots. They were wearing everything from cross-trainers to high heels and sandals. I had just chucked the last pair of shoes when the same Scotsman came over to talk to me. He started flirting mercilessly and although I knew he was telling lies because he kept talking about how pretty I was, he was very handsome and I felt myself giving in to his charm. He started to lean in to kiss me when, of course, my alarm went off.

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I'm going to get on my soap box and talk about something which may piss some of my readers off or lower their opinions of me. I'm sorry for that, but this journal is for me, really, and I want to get this off my chest. I've recently started an infectious disease rotation and I've been focusing on HIV and AIDS. While learning about all the efforts healthcare providers must go through to treat these patients and how difficult it is, relatively speaking, to contract this virus, I started forming some pretty negative opinions. Most people get HIV by engaging in activities which they know will put them at risk for getting it. So, very ungraciously, I was thinking it would be much easier just to stop trying so hard to help these people who brought this on themselves knowing the consequences. Just stop. Tell them there's nothing we can do. Let everyone who doesn't have a brain enough to protect themselves from this entirely preventable yet utterly incurable disease die, leaving the human race better off. Obviously, even if this plan was implemented, it wouldn't eradicate the disease nor would it in any way make the human race better, but I was still having these very negative thoughts towards these people.

Then, yesterday, I came face to face with my first case of end stage AIDS. Excuse me for saying this, but holy fuck. I'm tearing up again just thinking about it. My ID team went into his room to talk to him. When we came out, Bill, one of our med students, told us that his previous rotation was in the burn unit and that was nothing compared to this. I've only been down to burn once and I didn't actually see any patients while I was there so I can't make any comparisons, but I've heard working with burn victims is gruesome, heart-rending work.

When I walked into this patient's room, I saw a skeleton propped up on pillows. If I didn't already know his age and had I been asked to guess, I would've said this guy was in his late 70's to mid 80's. He was actually 37. His skin was beefy red and peeling off in great sheets. The hair on his head and legs grew in weak tufts. Every bone was visible. His hands and feet were so severely contorted by contractures that they were about as useful as clubs. He had trouble focusing his eyes on anything for more than a few seconds. He couldn't breathe well enough to get out more than two or three words at a time. He was so itchy the whole time he was talking to us he was scratching himself with his stiff, twisted fingers. He was bed-bound with severe decubitus ulcers on his back and butt. And perhaps the worst part of it all is that he was still almost completely lucid. He was very aware of his condition, his treatment, and his prognosis. This man actually didn't have any role in his acquisition of the virus. He is a hemophiliac who got this from medically necessary blood transfusions.

Nobody deserves this. Nobody. I don't care if they bring it on themselves or not. This is a disease that needs a cure. We have to do something about this. And believe me, there is a ton of research going into this and new treatments are always coming out. But there is no cure on the horizon. While we're waiting for those research types to do their thing, we have to do what we can do. But whatcan we do? I think the best thing we can do is educate people. Make sure everyone knows how to prevent this. Make sure all patients know what they can do to prolong their asymptomatic years. Arm them with knowledge. We can fight this. We must fight this.

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OK, the soap box is safely tucked away. I'm now going to tell you about my first car accident. Actually, I'm not sure it really counts as a car accident considering the minimal amount of damage that was done. I was driving home from work. I was going to call the owner of Quincy Drug to tell him I was coming, but I hadn't yet worked up the nerve. I was still practicing what I was going to say trying to come up with the least dorky way to get my point across. Traffic was stop and go. I was at a stop, talking to myself, when I heard a short screech and my car lurched forward. My initial reaction was annoyance. I put on my blinker and pulled across a lane of traffic to the side of the road. So did the car behind me. It was an old black Escort with a bumper sticker from my high school in the lower left-hand corner of the back window. The man who got out of the car was in his forties and wearing dirty jeans and a long-sleeved shirt. He was short and balding with light-brown hair and bluish eyes. He had grass or a leaf or something stuck to his face below his left eye and he had a small diamond stud in his left ear. The first thing he did was apologize and ask if I was OK. I said I thought I was. He said he had just recently bought the car and that he barely tapped me and, indeed, as we examined my bumper we could only find small scratches and dents. I didn't know what I should do so I asked him for his insurance information. He told me he didn't have insurance. This of course sent up red flags because there's a law in California mandating car insurance. You have to have it to drive, you have to have it to get your license, and you have to have it to buy a car. I said, "Can you wait a minute?" and I called home on my cell. My mom picked up, I briefly explained the situation, and she told me to just get as much information from him as I could. I got his name, address,and phone numbers, then asked for his drivers license number. That's when he told me he didn't have a license. Believe it or not, there's a law in California mandating drivers licenses as well. He gave me his state ID number and I'd basically run out of questions to ask him. So I let him go. He didn't get any information from me. The scratches on my bumper I think are not worth the trouble of calling my insurance company. The lack of license and insurance are worrisome, though. I've been advised by one person that I should notify the proper authorities about him. The thing is, I spent three months last year working with indigent patients. It's possible that this man is working as hard as he can to get back on his feet. Maybe he can't afford insurance and the only way he can get to work is with this car. Am I going to let a little bump and a few scratches knock him back down and put him on welfare or even on the street? I don't think so. The only thing that bothers me is the statement that he recently bought that car without insurance. Did he steal it? Is that why he was trying to explain about it when I hadn't asked and it wasn't even particularly pertinent? Now I don't know what I should do. I don't want to knock him down if he's honestly trying to work his way up, but if he's a car thief, that's another matter entirely.