Thursday, February 17, 2011

Is 'honor' more important than your wife's health?

Few days ago a doctor who is well known to me called to ask the diagnosis of one of his distant relative who is under my treatment.
 I hesitated.
 I asked him why you were asking that question.
He said that the guy was admitted in a critical condition in another hospital.I asked further details and realised that the patient is in deep coma and not in a position to give consent  to reveal his diagnosis.
Then I told the doctor that his relative was under my treatment for last 5 years for HIV related illnesses. He was very surprised.Nobody in the family it seems know about it. But I was not surprised.

Let us call this guy Mr K.
He was referred to me 5 years ago by another doctor after he was found to be HIV positive while he was being investigated for recurrent fever. He came alone to me and was mentally a wreck. I could make out that he was thinking about taking his life.
It was very difficult for me to convince him that there is treatment for this and everything is not lost. I told him you can live as near normal life as others if you take proper care and regular medicines. Then I told him that his wife has to be tested.
 He said he cannot tell this to his wife as she will be shattered and the family life will be doomed.
" It is better for me to take my life than to tell this to my wife".
"OK you should tell this after some time.But meanwhile do not have any sexual contact,I warned".
He agreed.
Every time he come to me I used to ask him about informing his wife and he was adamant that he cannot.
I continued to prescribe medicines and monitor him. He was doing fairly well continuing his job and doing everything he need to do as the head of the family.
He did not attend my OPD for last few months and I was wondering what happened to him. I was afraid he was not taking medicines properly and his illness must have exacerbated.
What I was afraid of happened.
Just now I received a more dreaded news. His wife was also tested positive for HIV, though she appears relatively healthy at present.
Was she positive at the time of her husband's diagnosis? Or did Mr K broke the promise he gave to me and had sexual contact with her even after knowing he is positive.I hope it was the former.
 If she was already positive and I knew it I would have been able to manage her health better.Should I have insisted on bringing the wife and telling the truth before prescribing medicines for Mr K?
Why Mr K refused to tell the truth and test his wife?

Is 'honor' more important than your wife's health?