Positive

Positive Danielle Ofri She was a tiny woman, but she had me cornered near the 16-West nurses' station, practicaUy grabbing the lapels of my white coat. "Are you accusing my niece of having AIDS?" she hissed, her face only inches from mine. "My niece doesn't do drugs, she doesn't hang around nasty people, she's never had any bad diseases. She's a good girl!" Her voice began to rise as she pressed closer into me and the singsong of her Jamaican accent became more dissonant. "You doctors think every Black or Hispanic kid who comes in here has AIDS. I've been at BeUevue for 25 years and I've seen how you doctors are." By now she was nearly screaming. The gray strands in her dark hair shimmered with rage. "Don't you ever talk to my niece like that again. And you're only an intern! I want her transferred to a real doctor." I tried to edge backward, but she locked her glare on me. I could feel her angry breath hot on my face. She plunged one firm finger into my chest. "I don't trust you. Stay away from my niece!" A few people stuck their heads out of offices to see what aU the commotion was. I tried to use my most diplomatic voice. "Mrs. Stanton, I'm not saying thatYvette has HIV It's just that the type ofpneumonia she has can sometimes possibly be associated with HIV" "Don't give me no a-sso-ci-a-tions." She sputtered each syUable at me. "I know my niece and she does not have AIDS." "I'm not saying that she has AIDS." I tried to take a breath, but there wasn't much air. "Could we sit down in the lounge and talk about this?" "There ain't nothing to talk about and we can do it right here." Mrs. Stanton crossed her arms in front ofher chest and drew her cheeks in tighdy I lowered my voice. "I'm not trying to say anything bad aboutYvette. It's just that in the remote chance she has HIV we should know now so she can get the most effective and appropriate treatments." 87 88Fourth Genre "The 'appropriate treatment' is for you to stop harassing her about taking that AIDS test. My niece does not have AIDS. Period." She paused and shifted her posture so that her head was cocked even closer to me. I could see right down the part in the middle of her head. "Do you hear me? Period!" It was only last week when I was scrutinizing Yvettes chest X-ray in the cramped radiology room in the ER. AU the normal lung markings were scrunched up, like she hadn't taken a deep enough breath. Yvette was short of breath, true, but she didn't strike me as sick enough to explain these dense markings on the X-ray. Not in a 23-year-old. It was only midway into my internship year, but I'd already admitted enough patients to BeUevue Hospital to have acquired some amount ofclinical intuition. I marched over to her stretcher. "This X-ray isn't good enough," I announced. "We're doing it again, but this time take a real breath!" The second X-ray was essentiaUy unchanged. The crowded lung markings could have been ordinary pneumonia or might have been consistent with PCP (Pneumocystis) pneumonia. Yvette just didn't seem like AIDS to me. Something didn't fit. I waded back through the noise and general chaos of the ER to Yvette to interview her. With her silky brown complexion, large rounded eyes, and generous supply of baby fat, she barely looked 16. But she was panting. I could see her gulping for air between sentences and there was a fine line of moisture on her forehead. The muscles of her neck and chest weren't straining , though, so I wasn't worried that she was going to "crap out" and need a breathing tube. "It's only recently, doctor. Maybe a few weeks ago that I started having trouble breathing. I've never been sick . . . ever."Yvette...