BASHH

Welcome back to those of you who survived both the worst winter for 20 years and also my first blog. Fear not, for a respite is coming, at least as far as the weather is concerned...

Now I don't believe in New Year Resolutions, principally because in a previous life I am convinced that I was a small, furry, hibernating creature who eventually and reluctantly emerges from their winter coma and gets on with their life sometime in March. I can barely get out of bed without weeping in January, let alone (try, and inevitably fail to...) restructure the core of my being. But there is something about the arrival of Spring that lifts the mood and squeezes the smallest drop of serotonin from even my dark brain, spurring me to action. With this in mind I decided this month that the time was right to do something positive- in my case tackle HIV disclosure, at least on my small and local level.

Let me explain. I have a cohort of HIV patients who steadfastly decline to disclose their status to anyone. Not their GP, nor their friends or families. Not a soul. It has always seemed like a lonely position to me and somewhat unnecessary in this so-called enlightened age of tolerance and human understanding, so I thought that maybe if I applied some gentle encouragement I could change some minds. I was half way through my first attempted 'conversion' (that should get all the rugby fans accidentally reading this after a misdirected google search...) when the patient replied to me... 'Life won't be the same. I just don't want to tell anyone. Haven't you ever felt that way about something...?'

And then I remembered. It's hard to see how I could have forgotten really. A few years ago I had a fresh needlestick injury from an HIV patient during blood letting. To cut a long and anxious story short I took the gallon of PEP advised and waited the long months out before subsequently testing in the clear. It's odd that after a traumatic event we, as humans, have a way of blocking it out and ignoring something that at one point in our lives we thought we would never forget. But what I do remember is this. I told very few people about what I was going through during that endless six months. For some reason I just didn't want anyone to know. Maybe it's because I feared how life would change, or that I would be seen differently by others, or perhaps it simply that I didn't want to believe that it was actually happening, fearing that my speaking its name would make it real.

We often ask and expect our patients to undertake personal and difficult disclosures; to face up to stigma... or worse, we reassure them that stigma doesn't exist any more. But the view is decidedly different from the other side of the medical fence as I can still remember.

So I've changed my 'Spring Resolution'. Instead of trying to 'help' my patients to do what I think is right for them I'm going to attempt something much harder for me - to do more listening and less talking; to consider feelings as valid as logic, and finally not to delude myself that I would behave any differently in the same position.

And feel free to remind me of this when you undoubtedly come across me somewhere yet again telling someone else what to do... :)

Gosh, that was serious... Twittering must be easier than this...

More soon...