Monday, August 18, 2014

new job, new pager

I started being on-call for the emergency department this weekend. LA County Hospital(LAC+USC) has a HUGE emergency department. I am told they see 180,000 patients each year (compare to Allegheny General Hospital ED which sees 38,000 patients per year, and Temple that sees 130,000 per year). The wait to be seen ranges from 12-36 hours.
Every patient who comes into the ED receives HIV testing (unless they opt out). When someone is newly found to have HIV, I get called to go talk with the person. Sometimes this involves telling them their diagnosis if no one has told them already; mostly it involves talking about what that diagnosis means and connecting them with our clinic. I think I am a bad luck charm becaues I was called about 4 new patients in the first 24 hours.

Not everyone comes in suspecting that they have HIV; in fact, most don't. They come in with coughs and headaches that have gone on too long, only to find the underlying thing causing their symptoms is not only HIV but AIDS.

My first patient (details changed to protect privacy) was younger than me, but life had been unfair. He'd been living on the streets, earning money however he could - even if that meant doing things he didn't want to do. Drugs made doing these things easier. He suspected for a while that he might have HIV, but couldn't find the courage to be tested until now. After 20 hours of waiting, he had his answer. So at 5am, we sat and talked in a quiet corner of the chronically-overcrowded ED. He spilled out stories of his life; of trauma; of how he wants to live now. We scheduled an appointment at our clinic. He'll start treatment. He'll probably be fine. Or at least his HIV will. Most of what he carries, I can't fix. But I can keep hoping for him.  
(view of downtown LA from LAC+USC)

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