Indian Journal of Medical Ethics

VIEWPOINT

Reflections of an HIV-positive doctor

Deodatta Gore

DOI: https://doi.org/10.20529/IJME.2004.049


In 1991, I was a consultant general surgeon practising in Ratnagiri. The events that followed turned our lives upside down. Patience, faith, determination, devotion—every possible human quality in my family—was tested. I am glad to say that they met this challenge.

It began on 17 October 1994 in Ratnagiri. I had high-grade fever, which I thought was flu. The fever disappeared with a single dose of ciprofloxacin and I resumed work the next day. However, in the following weeks, I started feeling extremely weak and began to lose weight. A few months later, I started getting fever in the evenings but I ignored this and took symptomatic treatment. By June 1995, I started getting a dry, hacking cough and painful deglutition. But no alarm bells rang and I continued to work. Then I came down with an acute sore throat and fever. A tablet of crocin produced severe sweating that drenched my clothes and bed sheets. Finally, I realised that something was seriously wrong with my health, and consulted a local physician. By then, I had become severely dehydrated and had to be admitted to a nursing home. I had high-grade fever, I was not responding to antipyretics, and I could not sleep. It was at this stage that the consultant physician advised a test for HIV infection. Shockingly, the result was positive.

Forget counselling, the physician had no time to talk to me. The diagnosis devastated my life. In one moment, whatever I had achieved in the past 30 years fell apart. I was transferred to Pune where another physician confirmed the diagnosis. Even today I am unnerved by the memories. When I asked about my prognosis, the consultant just shrugged his shoulders and walked off.

After some days, I was discharged against medical advice and came home to Ratnagiri. I was treated for pulmonary tuberculosis and candidiasis, and also started on zidovudine. However, I suffered from severe diarrhoea that did not respond to any medication. I could not tolerate zidovudine and it had to be stopped eventually.

I had lost my will to survive. But my wife and family members encouraged me to fight the disease. Their daily encouragement boosted my confidence.

The medical community was shocked to hear the news but knew my family for years and that helped me a lot. People were considerate and helpful. Some offered me a job. Others offered a place for my wife to start her general practice. They did not even charge any rent for the first three years.

I recovered gradually, and began working as a lecturer in medical laboratory technology. I could no longer practise medicine since Ratnagiri is a small place and everybody knew my HIV status. I accepted my fate.

I did not even try to trace the possible route of infection, forget blaming someone else for my misery. I simply accepted it as my destiny. My wife, parents and in-laws were also supportive and that helped me calm down.

The disease resurfaced a year later, on 30 April 1996 to be exact. The first indication was pain in the epigastric region, which radiated to the thoracic vertebrae. Then I started getting severe herpetic ulcers in my mouth. The pain was unbearable. As my condition worsened I became unable to eat even semi-solid food. I was losing weight rapidly. My brain had become affected. A few months later, I was transferred to Pune once more. At this point my CD4 count was 39. I was treated for herpesvirus infection and put back on anti-retroviral therapy (ART).

The dementia associated with this disease made our lives horrible. My wife and family made a huge effort to see me through. They ensured that I took medicines and food regularly as I had lost orientation in time and space. This time my recovery took more than six months. My abnormal behaviour continued for almost a year. Fortunately I survived.

In July 1997, my father passed away. This was another setback in my life. My life was in shambles. I lost the will to live.

In August that year I met my spiritual guru who has transformed my life since then. There are no words to explain what I got from him. I was at peace with myself, my HIV status and health. I gained the confidence to fight back, live with it and maybe one day overcome it. I changed my lifestyle after this meeting. I started praying regularly. I do yogasans and pranayama daily. I have developed my own diet, which is quite different from what is usually prescribed.

In 1998, I developed resistance to the ART regimen and had to be put on a new regimen, which I have been following for the past six years. ‘Touch wood’, I have not encountered any resistance or side-effects so far. I owe this to the lifestyle and diet that I follow, and the spiritual guidance of my guru.

All these years I had not practised medicine. Initially my poor physical health prevented me from doing so. Later it was the fear of exposure to communicable diseases. On 4 May, 2002, I started running an outpatient department (OPD) exclusively for HIV-positive people. It was a quantum leap for me, considering what I had been through. For the past two years I have run the OPD without interruption. I have also brought together HIV-positive people in my district and formed a group of people living with HIV/AIDS, the Guruprasad Trust. Today HIV-positive people from all over Ratnagiri are referred here. We offer them counselling services, treatment of opportunistic infections and ART. We also accept donations to help HIV-positive people.

It has taken a long time and massive efforts for our group to reach this stage. People in the medical/paramedical fraternity affected by this disease face serious professional, economic and social setbacks. I appeal to those affected to come together. The idea is to form a group of affected healthcare providers to help themselves as well as other HIV-positive patients.

I have now lived with HIV for nine years. The local medical fraternity has seen me suffer. They have seen me with dementia and cerebral atrophy. They have seen me fight it out every day. Today they are seeing me as a consultant in HIV medicine. They respect my fight back and support me by referring HIV-positive patients to me.