Due to the fact that last time I checked you don’t need to update your credentials to be a Certified HIV Counselor, I think the test I passed in the early 90′s at the Rhode Island Department of Health still covers me.
I haven’t done HIV counseling in years, and I would absolutely get an update if I expected to counsel anyone now. A lot has changed.
In the 90′s, they were just finding the meds that are keeping a lot of people alive today. I did counseling with patients prior to the HIV test, and counseling when giving results. After all, this might be dire news, and you didn’t want your patient to lose all hope. You also wanted to educate them for prevention.
Today, we can light a candle, and the AIDS quilt with its acres of squares dedicated to all the people we lost has not come to Rhode Island for a long time. Sorrow fades, we survive.
When I was actively counseling, I had a guy come in for his results–negative. Good news, absolutely. However, I read his chart for primary medical care, and there was bad news of another health threat in it. He had uncontrolled diabetes.
So the conversation went something like this–
“Good news, your HIV test was negative.”
“Oh, thank God!”
“Yes, but I have to tell you that your chart shows that your blood sugar was 356 last time you came in to see the doctor. You really need to schedule an appointment to talk about your diabetes.”
“Yeah, I know I have a little bit’a sugar, but I don’t have AIDS.”
“As far as the test can tell, you are HIV negative [explanation of the limits of testing, plus safe sex advice], but I’m concerned about your blood sugar.”
“Whatever. I’m just relieved I don’t have AIDS.”
“But diabetes could kill you!”
“Yeah, but I don’t have AIDS.”
What counsel can we give the American public today? We are being destroyed from within by a commonplace malady– one that kills our relatives, neighbors, and nameless people who show up in the statistics. But we’re used to it. A terror like AIDS will mobilize us. A terrorist who killed tens of thousands of Americans yearly would generate outrage.
But death by incompetence, greed, blind stupidity and cowardice? We’re used to it.
I wish we were able to reach a consensus that every American should be able to get health care. Other countries have done it. It’s not easy, and it is expensive, but the alternative is paying more for less, as we are doing today.
In the older population, which is my patient base, diabetes affects over 10%. The consequences are horrific. I think that if we could step back, and see how the number of Americans suffering and dying from lack of health care outnumbers the Americans dying of HIV we would have more sense of crisis.
Part of the fear of HIV was the possibility that we might be next. But if you are average, you certainly know someone who is afraid of losing their health insurance. Who is on COBRA. Who is running up their credit card with medical expenses. Can you catch unemployment? It does seem to be spreading.
Universal Health Care, like peace, has to come eventually. Let’s skip the rest of the war and just do it now.