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HIV Lessons
- University of Arizona College of Medicine, Tucson, AZ 85719. Requests for Reprints: J. Kevin Carmichael, MD, Department of Internal Medicine, Section of Infectious Disease, University of Arizona College of Medicine, 1501 North Campbell Avenue, Tucson, AZ 85719.
As I walked into work one morning, I noticed the headlines on the newspapers in the machines outside the hospital. It was the Tenth Anniversary of AIDSby that they meant 10 years since the first reports appeared in the Morbidity and Mortality Weekly Report.
Mr. Garcia was going to die. His family gathered from all over the Southwest: dark, tanned men in working jeans, cowboy boots, and hats; women in jeans as well; and lots of children. Everyone was uncomfortable in the cool sterility of the hospital, and as I approached, their acute awareness of my presence made them even more uncomfortable. To many people, doctors represent hope and health, but I had to tell this family that this young mantheir son, brother, nephew, cousinwas going to die.
I met Mr. Garcia in the hospital; he had Pneumocystis carinii pneumonia complicated by a pneumothorax. After discharge he developed cytomegalovirus esophagitis with superimposed retinitis. His mother cared for him well. She learned to flush and dress his Hickman catheter and to administer ganciclovir every day. Mr. Garcia …
