Crossed path on doomsday

He was one of my childhood playmates, his house just a few blocks away from mine. However, I lost contact with him after I left the village to study medicine. In due course, I graduated from the Institute of Medicine, Kathmandu, and joined Green Pastures Hospital and Rehabilitation Centre (GPH), Pokhara, as a medical officer. Run by the International Nepal Fellowship, this missionary hospital provides refuge, at it own cost, to the many socially ostracised victims of leprosy.

One day a young but cachectic man entered the outpatient department in a wheelchair. To my utter surprise, he was none other than my childhood friend. With him were his wife, their 7 year old daughter, and a maternal uncle. It was eight long years since I had last seen him, and I was deeply grieved to see his pathetic condition. He could not take a single step on his own. His wife was always beside him to attend to his every need.

I learnt that six years previously he had been found to be infected with HIV. Over time, he became increasingly weak, and, fearing social ostracism, for the past six months he had incarcerated himself inside his home. Somehow his maternal uncle learnt about the situation and persuaded him to seek treatment. The government hospital refused to take him, telling him that he was a threat to everyone and that the disease was incurable. Someone suggested that he come to GPH.

With leprosy in decline and HIV infection becoming more common, the hospital had started taking terminally ill AIDS patients to help them achieve a dignified death and to counsel their family members. My old friend asked me how long he would live. He sounded as if he already knew the answer and had come to terms with the truth.

The next day he ran a fever of 40.5°C; he looked very toxic. Obviously, his crippled immune system was overwhelmed by nosocomial microbes. He died peacefully the same day. We counselled his wife, and, after she gave consent, we tested her and her daughter. Fortunately, the child turned out to be HIV negative, but her mother tested positive. Now, the child is living with her grandparents. My old friend's wife has married a man with similar infection. Such a union is highly commendable in my opinion. They can provide physical and psychological support to each other, which, I hope, will make them stronger to tackle the difficult days that lie ahead.