Island Med Student

Monday was a very enlightening day for me. It was supposed to be my first day in pediatrics at PMH, but my doctor was assigned to the HIV clinic. So, instead of seeing little kids, we saw around 10 HIV positive patients. It was absolutely fascinating.

First of all, the patient population was not what I would have expected. It was mostly older men. Please keep in mind that with an N of 10, I’m not about to make any statements about the epidemiology of HIV in Dominica. But I was interested to see what kind of patients came in.

I learned a lot about the HAART regimen, and what kind of problems to expect based on CD4+ counts and viral loads. What was particularly surprising was that we saw a few patients who currently, or in the past, had very low CD4+ counts, and very high viral loads, yet remained virtually asymptomatic. This is the kind of stuff you don’t learn in the books.

The day ended very solemnly. I met a man who has a huge growth on his parotid gland. His tumor is benign, but it’s almost twice as large as his head. I could smell the necrotic tissue from two rooms away. He was incredibly emaciated, which I’m sure was related to the fact that he can barely eat. I plan on writing a more lengthy post about this man, so I won’t say much more for now. But what is the most important thing I learned that day? Take nothing for granted, especially your health.

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