Crushing

A few weeks ago, I was in clinic and I met a man with AIDS. This is not unusual, since a meet a lot of people in clinic with AIDS.

The difference was this man was dying. Right before my eyes.

He was in his mid-30s, very pleasant, very grounded. He had been through a lot in his life. He was diagnosed several years earlier, and he had actually started treatment. Then, as he explained to me, he got very angry. "Angry at God," were his words. He stopped seeing his doctors. He stopped taking his medications. He just stopped trying to live. He went back to using drugs. He was transiently homeless.

Then, about a year ago, something inside him woke up. I'm not sure what, and he wasn't really able to explain it all that well. He worked through his anger, and he was ready to really live.

He was admitted to one of our hospitals with pancreatitis and fulmanent liver failure. Our best guess is that it was an extremely rare reaction to one of his HIV medications. He nearly died. For the doctors out there: his Ranson score was through the roof.

He made it through and was discharge, but when I saw him in clinic he was pale and wasted. He started crying as he told me about what he'd been through in his life. He had a glimmer of life in his crystal blue eyes, but it was faint. He had a firm resolve to make it through, but his physical body seemed to say otherwise.

I admitted him for anemia and failure to thrive, a diagnosis usually given to neonates. His housing situation was still tenuous, and he really needed close to 24-hour nursing care. He was barely strong enough to get to the bathroom, let alone stand in a shower and wash. However, with no income and no insurance, finding a place to accept him was going to be a nightmare for the social worker.

The hardest thing was the complete faith he put in us to make him well. His chances of survival are so small. If he does make it, it's purely because of his will to live and his faith in God. Medicine can only do so much for him now. The best thing was the sense of peace he had about his situation. The paradox of his physical condition and his spiritual one still strike me now, all these weeks later.