One of the most difficult challenges of this job is the hazards associated with it; the fact that each encounter with a patient is saddled with the potential risk of contracting one deadly virus, or that recalcitrant mycobacterium.

The fact that you are all too aware of this doesn't make it any better, especially when you work in a HIV/TB centre, in a resource-poor setting, where even hand gloves is a luxury . Sometimes, it's as if you're working with the Sword of Damocles dangling over your head, threatening to drop any minute.

When you're exposed, what kills you most isn't the physical effects of the exposure, but the psychological impact, the trauma of it. The what ifs. The fact that you get to die many times before the actual death comes. The moral burden, of feeling guilty that you may have unknowingly exposed others, including the people you love!

I remember last year, when a case of febrile illness I was managing suddenly deteriorated into vomiting, and stooling, of blood. It was at the wake of a Lassa fever scare in Benue, and history had revealed that the patient hunts, and eats rats! The fear, the anxiety, was like nothing I had felt before. (will talk about this in subsequent posts)

Unlike the time I had a pin prick from a HIV positive woman, where I was, to a large extent, a risk only to myself; I was also a potential risk to others. So, even as I isolated myself from others, I kept on making a mental list of the people I had come in contact with, before the case took a different turn. Of course I didn't tell my family; I couldn't bear the thought of having worry kill them.

Finally, it turned out it was just Upper GI Bleeding from an NSAID-induced gastritis. And I heaved a huge sigh of relief.

Don't ask, don't tell.

Doc. Joe