Kushalin blog

First Person: On World AIDS Day, Recalling the Courtly 'Mr. B'

Dec. 1 is World AIDS Day. Yahoo! News asked members of our Yahoo! Contributor Network to tell us about their experiences dealing with HIV and AIDS. Submissions have been touching, heartfelt, hopeful, encouraging — and most of all, personal.

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Mr. B was two days removed from a possible cardiovascular incident -- still undetermined -- that resulted in a loss of consciousness (more commonly known as "passing out) and a laceration to the scalp from when he fell and hit a coffee table.

The head wound was fixed with 12 stitches, and he'd undergone all necessary tests to rule out any head or brain injury from the fall. His medical history included a three-vessel open-heart surgery from the 1980s, a redo 12 years later, advanced Parkinson's disease, legal blindness from macular degeneration, and almost total deafness.

Mr. B -- himself a courtly, old-fashioned and kindly person -- had a wonderful family situation to be discharged to: a stay-at-home retired nursing assistant daughter supplemented by a granddaughter and a grandson in nursing school. Family dynamics appeared warm and stable. The oddity that set Mr. B apart from other patients on our cardiac step-down unit was his age, 93.

Oh, and he was HIV-positive.

By 2005, when I cared for Mr. B in metropolitan Portland, Ore., we followed all necessary and standard operating procedures, so to speak, for everysingle patient -- not just those with HIV-positive or AIDS diagnoses. This included: blood and body fluid-borne pathogen biohazard precautions, "needle-less" intravenous systems, gloves for almost any skin-so-skin contact, eye splash guards, and double-gloving.

Certainly, the diagnosis reminded one to be just a little bit more careful, but we nurses entered and exited Mr. B's room blithely, unlike like how we donned gowns, masks, hats and gloves in a separate biohazard foyer before entering the room of a MRSA-resistant patient. ( "MRSA" or "methcillin-resistant Staphylococcus aureas," refers to infections caused by staph bacterial that are highly resistant to some antibiotics.)

Mr. B was a very elderly heterosexual man who had contracted the HIV virus during blood transfusions required during his early 1980s cardiac bypass surgery. He had been "lucky," he related, learning quickly of his status and having the insurance and financial resources to treat his status with the newest and state-of-the-art treatment protocols. In fact, his viral load remained minimal and his T-cell, or CD4+ count -- a measure of his immune strength -- had never dropped to levels that would indicate even a slide toward the development of an active AIDS infection.

Communication, particularly such potentially soul-bearing ones with so many privacy issues, were difficult with Mr. B. You had to speak very loudly, slowly and very closely to his face, yet in his peripheral vision to allow him to speech-read as much as possible. He was more embarrassed, he admitted, to the difficulties inherent in holding a conversation with him than in actually discussing the details of his diagnosis. But his family shared freely about his history and the grace with which he greeted his diagnosis back in the day when HIV patients were shunned, avoided or even reviled.

His daughter, Nina, related how her mother, who was still living then, and her father greeted the news of his diagnosis. They were both shocked, she admitted, and spoke at length with their priest for many weeks. Both of her parents learned as much as they could of the condition, the disease, the difference between the two, and then began to slowly share the news of her father's diagnosis with family and close friends. At some point, Nina continued, Mr. B even spoke at his employer's conferences of the disease and the phobia surrounding it. Even though he was a higher-level manager near retirement, he was still taking a risk in revealing this information back in the day when Ryan White was ostracized from attending school with his peers. Her father's diagnosis led her to become a nursing assistant and both of her children to go into nursing school. Unknown to me, I was nursing a hero.

I'll never forget Mr. B. Not because of his diagnosis. Because of his courtly, old-fashioned manners, the gratitude he expressed over the smallest of courtesies and the patience he demonstrated in sharing his history with me. Oh, and the kiss on my cheek he gave me upon his discharge home.