How things have changed- the story of how I faced HIV as a medical student.
I was humbled to see Welsh Rugby hero admit online that he is HIV positive. (1.)
He has had no end of support from the public. Even HRH Prince Harry has called him a legend. (2.)
Prince Harry thanks 'legend' Gareth Thomas for helping to break the stigma of HIV
Speaking to the Telegraph five hours into a 12-hour Iron Man event in Tenby, South Wales, in which Mr Thomas was a…
HRH Prince Harry is no doubt carrying on the good work his late mother- the late Princess Diana — did for such people (3.)
How Princess Diana changed attitudes to Aids
In April 1987, Princess Diana opened the UK's first purpose built HIV/Aids unit. John O'Reilly was a nurse on the ward…
When I saw the coverage I broke down. How attitudes had changed! I was flooded with pent up emotions of how I faced the threat of HIV when I was a medical student. Gareth Thomas has come out as being HIV positive. Had I been found HIV positive I would have been ruined in every way imaginable. I had nowhere to go
Let me tell you my story.
I was a medical student at the University of Sheffield. I was doing junior surgery.
I was on call one night and there was this registrar surgeon who was bullying me throughout the whole attachment. He even had the audacity to tell me that no matter what I did on that attachment he would have me failed. He once openly said in theatre to the other staff that I was going to fail the attachment. What he didn’t realise that I was recording every word he said.
(Just as an aside if you are a student in a profession allied to medicine then NEVER speak to a senior colleague without a recording device. I would advise a body camera. If only today’s technology was available then!)
That night when I was on call this guy was hounding me like mad. He was fault finding at every possible opportunity. Now I was always told that you should implement safe practice. If you take blood from a patient then you should get a sharps bin, take it to the patient, and dispose of the needle instantly and safely. That eliminates the risk of a needle stick injury.
This guy was having a go at me for doing this and shouted at me as I withdrew the needle. However in doing so I got a needle stick injury. He then rushed off because he had to operate in an emergency.
The fear of God went through me. I went home and to make matters worse some thug tried to assault me in the car park-bad move- I thumped him and ran off.
I then rang up the Occupational health on call service who told me to phone student health in the morning. They told me to phone Occupational health! In a frantic state I rang my Dad who is a family doctor who told me to phone up Genito-Urinary medicine urgently. They got me in very quickly.
Although they said the risk was low that doesn’t make it any easier.
In those days the delay between testing and the result was some 3 months. Worse still the treatment in those days is nowhere near as advanced as it is now.
With regards that registrar my Dad rang up the consultant who said that if that registar did anything the tape would be given to the police. The consultant himself was furious with that registrar. He told my Dad that they pride themselves on good relations with students and in any event without the university money coming into their department they wouldn’t have jobs to go to.
I just couldn’t face anyone. I was petrified beyond belief. I couldn’t eat or sleep nor could I face people. Luckily I had a lecture block before the Christmas vacation and I wasn’t on attachment. It’s very easy to skip a lecture block. However, during those lecture blocks, you have to attend two one hour tutorials but that is easy.
Every night I went to bed I was worried that I wouldn’t be alive the following morning. If I were to be HIV positive then I would no doubt be kicked off the medical course. I had huge undergraduate debts, how would I pay them off? (Hint don’t go to university. From a financial point of view there is no benefit to a university education no matter what anyone tells you.)
I lost weight as I couldn’t face eating but was it the disease kicking in? I had seen people with HIV as a medical student and I saw how they wasted away.
Then it was Christmas which was joyous for everyone else but like Rose in Titanic (4) inside I was screaming my lungs out but my cries were silent and everybody had deaf ears.
In medical school, you are taught to be seen but not heard.
Worse still in 3rd, 4th and 5th of January in a few weeks year I had the integrated exam in pathology, pharmacology and medical microbiology. Even the professor said that was a very anti-social time of year to have exams.
Think how stressed you feel during exam weeks. Add to that the fear of death and you will understand what I went through. It was no surprise that I found myself on the pass/fail viva list. A pass fail viva is an oral examination where they ask you a bunch of questions in order to try and redeem your fail to a pass- assuming of course that they want you to. Sometime later the University of Sheffield came under intense scrutiny for its failure rates of non-white students in medicine. (5)
With regards being seen but not heard. I never forget the case of the female medical student at the University of Sheffield who was sexually harassed by a consultant. She complained-guess who was one of the examiners in her pass-fail viva? That’s the University of Sheffield for you!
I knew I was going to fail which I did.
Worse still they put the fail list up on a notice board for anyone to see. However, that led to them getting into trouble. As time went on I took down those lists and those lists were responsible for me giving sufficient evidence for the Commission for Racial Equality investigation into the University of Sheffield. (5.)
The Commission for Racial Equality investigation into the University of Sheffield.
“In the case of Obstetrics and Gynaecology exams and the Paediatrics results the disproportionate impact of the failure…
To make matters worse I was back on attachment. To make things even worse one of the consultants was the undergraduate dean of the medical school! Little did I know that sometime later he was going to lie on oath against me years later. This is something I can prove very easily.
To make matters even worse than that at the end of the month there was another exam- the clinical exam where you had to demonstrate before two consultants that you could competently examine patients.
However, to round it all off my girlfriend at the time left me for a *very wealthy* man.
With all that going on I broke down one day. I couldn’t see my own doctor- one mention of HIV infection and you can kiss goodbye to any form of life insurance. My own doctor would have informed the medical school within seconds and I’d have been barred from future study on health grounds. My own doctor would have been legally required to do so. There was nowhere I could go, nobody I could get help from.
Again like Rose in Titanic I was screaming my lungs out but every body had deaf ears.
One day I went to the Royal Hallamshire Hospital which is some 200 feet high. I had planned to just jump off the roof. I couldn’t find the way to the roof but then something stopped me- a flashback- my beloved childhood sweetheart.
I turned around and went to the elevator and made my way downstairs and walked to the medical school. I went to hand in my notice. The lady I spoke to knew me- she was in bewilderment. She asked why. I asked her if she could keep it quiet. I told her. She kept it quiet. She was cheating on her husband and I knew about it and she knew that I knew!
I gave her consent to speak to GU medicine. She asked them, “Is he safe to take the clinical exam at the end of the month? Is he a risk to patients?” The answer was an unequivocal “Yes he can take the exam. He is a very low risk. He is no more a risk to patients than any other medical student. If he was a risk to patients we would have informed you ourselves.”
Despite gaps in my knowledge in pathology, pharmacology and microbiology I was brilliant at examining patients. I remember once on one attachment this internationally renowned physician did a ward round. He then said to his registrar “You’ve just passed MRCP (a postgraduate exam with at best a 20% pass rate) this is at your level. What is so striking about this patient?” The registrar looked stumped. The senior house officer looked bewildered. I then said, “Can I say something?” The physician said “Yes.”
I told him what I thought. He said “Correct (in amazement.) How did you know?” I told him “My Dad is a GP and he has taught me how to examine patients.” He then said “If you want to apply for my house job please do so now. How does a medical student spot something so quickly that a registrar could not?”
I passed the clinical exam. I remember the examiner asking me to do a neurological examination and I did a few unusual things. He asked, “Who taught you to do that?” I said, “My Dad, he’s a GP.”
He said “I am an examiner for the Royal College. I have never seen a postgraduate doctor do that, never mind a medical student.” Had I been white Caucasian I would have got a much higher mark.
I then proceeded to a peripheral attachment. The resists were some 6 weeks away.
I asked one of the middle-grade doctors on the attachment what could I miss given the resists. Quite frankly I didn’t to be doing clinics, ward rounds and other things when I could be revising. He said that the consultant pays no attention to students and told me to spend time in the library and pop my head around the door when required.
The following morning the consultant did a ward round and I think I saw the back of his head once. He shouted out “I don’t want the students here or in theatre today.”
I went home and in my mail, there was a letter from the medical school. Needless to say, I was scared.
It was a letter detailing the resist tutorials and we were told to attend them. There was literally one every day and so travelling from Sheffield to this peripheral attachment and back and attending the tutorials would be impractical. I bit the bullet and wrote to the student liaison officer of the hospital enclosing the medical school letter and said that these tutorials had to take priority and so I couldn’t attend.
Let’s face it I could have been dead within weeks so what did it matter?
So then two weeks later I had my follow up appointment to tell me the result of my HIV test.
I was scared before but the closer I got to my appointment the more scared I got. The night before the appointment I couldn’t sleep. Every emotion possible went through me.
I went to GU medicine. As I went in I felt as if everybody was looking at me.
I was called into the doctor’s office. However, as I went in there was no doctor there. I was half expecting the dean to come in saying “you are HIV positive. You are excluded from the course.”
However, it was a nurse. I was so scared I could not sit down. She then opened up the result and said “A negative result.”
The words “A negative result” took an age to register.
I then said, “Say that again.”
She said, “It’s negative.”
I can honestly say that up until that point in my life I had never cried so much. I broke down. I fell to my knees. The nurse had to help me up; in fact, she got me on the patient’s couch!
I was free! I was alive! I was not HIV positive!
I went to a local pub to get a slap-up meal to celebrate. I didn’t drink-I couldn’t afford a hangover with just weeks to go before my exams.
Finally, I could get back to work on my exams. Let me assure you that in the next few weeks I went through those textbooks like nobody’s business!
I remember we had one tutorial where the lecturer taught meningitis, urinary tract infections and tuberculosis.
This is what happened in the exams.
Essay papers: — There were 4 questions of which you had to choose 3. One was on meningitis, one on urinary tract infections and one on tuberculosis. It was easy!
Then there was the practical- that was easy I had attended loads of autopsies so that wasn’t a problem.
It was the binary choice that let me down.
Get it right +1 mark.
Get it wrong (–) 1mark.
Abstain 0 marks.
I proceeded to a pass-fail viva and there were 8 candidates that day. I was the only one who passed.
When I saw my name on the pass list my HIV hell was over.
However I do recall two staff at the University of Sheffield medical school, Dr Steve Peters (in a private meeting) and Professor Weetman (at review panels) saying to me some years later “If you had done enough work how would the threat of HIV infection affect your exams?”
These are doctors by the way!
Needless to say I got no support from my student colleagues either. Little did I know of the horror that was about to follow. A man called Steve Peters was about to play God with my medical career. He had the full backing of all the medical school but more of that later.
This is why I do my utmost to avoid putting myself at risk of HIV. Even during my doctor days, I used to take enormous care to avoid needle stick injuries. It never ceases to amaze me how complacent hospital staff are about this. If I had to do an invasive procedure I would always take a sharps bin to the patient and dispose of the needle on the spot.
However, two incidents come to mind.
There was one patient on my ward (now deceased) who had a low iron level in his blood. It was a chance finding, the patient had learned to live with it. I suggested vitamin B12, folic acid and iron and it would pick up normally. Sadly I was overruled and he was transfused blood. In a rare occurrence, he developed HIV infection.
A few weeks later I was doing nights 8 pm to 9 am and one morning my consultant came up to me and asked me how much contact I had with this man. I asked why. He said he was HIV positive. I joked “Trust me, I know all there is to know about HIV transmission.”
I then had a week’s leave and then I came back to my ward.
I was asked to take a blood sample from this patient. I used universal precautions and put a yellow danger of infection label on the form and bottle.
Within minutes this jobsworth technician came on the ward and shouted out “This man is HIV positive and I am not risking MY staff by doing this sample.” If he had shouted any louder they may have heard him in Australia! This is the same hospital that accused me of a breach of confidence for passing on the email address of a patient to a friend. I had his permission, he’d put it on the stroke association website, he never complained. When they said he’d made a complaint he sent in a lawyer’s letter saying he hadn’t.
What you can do
Follow me on medium.com, subscribe to my newsletter because soon I’ll be doing a blog on how to avoid HIV which is a blog in itself.
If you ever go to hospital, and see a doctor bullying a student please take action and report the doctor. They cannot ignore a complaint from a patient.
If you are a family doctor and you know of hospital doctors who bully junior doctors and medical students please write on your referral letters “I do not want my patients to be seen by this doctor.” Also please do not give such doctors private referrals.
We’ve come a long way since my HIV hell. I am pleased that Gareth Thomas has got more support in a few days than I did in three months.
Terrence Higgins Trust https://www.tht.org.uk/