All I Ever Did Was Love a Man I met Sabrena* during my internship in internal medicine and many years later I still hear her words echoing in my ears. Sabrena was a patient that had a huge impact on the physician that I am today and the human that I am striving to become. She taught me more than I ever could have learned from a textbook. Sabrena taught me lessons in love, life and in death. I see a frail, ill-appearing face with young, huge brown eyes. She is a single mother of three and only 36 years old but remnants of a strong black mother linger with her. She lies on the hospital bed weakened and confused. She tells me that she's been dizzy and falling a lot lately, unable to keep the room from spinning. She's also been vomiting and can't keep any food in her stomach. Her name is Sabrena* and she has the most beautiful smile. As I begin to ask questions about her medical history she tells me about her children, how important they are to her and how she must take care of them. I attempt to get her back to the point, after all, I have other patients to see and need to complete her evaluation. Sabrena continues to smile and she tells me about her "friend" that sometimes holds her at night. I politely smile but quickly begin asking the "important" questions for I must know about her disease. She has no idea of the names or dosages of her medicines, doesn't know the dates of her previous hospitalizations. She does know that she is HIV positive and that her CD4 count is "real low." She tells me that I must talk to her sister, for * Name changed to protect privacy JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION
she knows everything. She quickly changes the subject and asks me if I were married, did I have kids, did I like being a doctor and tells me that I am her first black female doctor. Her words often slur and her eyes droop but she continues to smile. As I finish my exam and review her old records, I feel her watching my every expression and move. Sabrena looks at me searching my face, wondering if I could just tell her she'll be okay this time. She needs me to tell her that this is not the end-not yet. I ask her about her Code Status-you know-if her heart stopped beating or if she stops breathing if she wants to be resuscitated, did she want us to try to "bring her back?" She looks at me with those big beautiful brown eyes and says-"Doc, I've gotta go home and take care of my kids, do everything possible to keep me alive." I couldn't find the words to tell her that her prognosis was dismal. In my busy rush to complete my day, I was abruptly stopped in my tracks as I attempted to treat her and get her home to her children. My days and the weeks to come took on new meaning. She became the first patient that I saw in the morning and the last patient at night. During my days of overnight call, I would often feed her broth and listen to her talk about her children and her "friend." I called her sister, arranged social work, and wrote orders for her children to visit her. Sabrena's CD4 count was zero and she had fungus growing in her brain. Yes, I ordered all of the medications, 14 in all, knowing that none would save her life, but maybe-just maybe-I could prolong the inevitable. VOL. 94, NO. 11, NOVEMBER 2002
ART IN MEDICINE
One night as I was leaving the hospital, I stopped for a brief glance at her chart and went in to say goodnight. Sabrena had no smile, only tears and visible fright. I quietly touched her hand and asked what was bothering her. She turned her head to the wall and continued to cry, often sobbing while quickly trying to wipe her tears. Finally, she turned to me and said, "All I ever did was love a man." Sharon D. Allison-OQtey, MD COSHAR Medical Inc.
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VOL. 94, NO. 11, NOVEMBER 2002