Monday, January 25, 2010

Awkward...and Inappropriate

So last week we had a large research forum at school where local scientists came to discuss their work and the applications it would have to medicine.

For the most part it was a 'how to get yourself published in 8 weeks if you apply for this research funding and work with one of these dudes/dudettes'. So for the Canadians who are going home over the summer and don't qualify for the grants/opportunities it was just a chance to hear some of the exciting things going on in Irish research.

The keynote of the day came late, an address by Dr. Robert Gallo, a world famous MD/researcher who is (arguably) credited for co-discovering the HIV virus and it's link to AIDS. The man is also the most cited living researcher and has been published in over 1500 scientific journals. He gave a very funny, insightful, informative, and humble presentation on his work and where HIV research is heading in the 21st century.

I was so pleased to have the opportunity to hear him speak.

Then they opened up the floor to questions.

I noticed in the crowd many of the researchers from the day, fellow med students, medical school faculty. Actually was looking forward to hearing what some folks might put to him for questions...I mean he is one of the great living minds in the area of medical research.

Question 1 (clean-cut dude with GAP sweater and jeans stands up):


It is in caps for a reason. He wasn't yelling at the TOP of his lungs but he was speaking so loudly and forcefully that his JVP was measurable from across the lecture theater.

(Heads in crowd shaking...looks of disbelief...I see blood drain from Dean of Medicine's face).

Now if I wasn't completely won over by Dr. Gallo before this part, he got me with his answer. His response was gracious, and even incorporated some light humor into the tense setting that overtook the room. He talked about the restrictions of human drug testing, the FDA, the expense of using animal subjects...etc. And how, if dood knew any ways around it and could present him with a feasible alternative, he'd gladly and willingly give up animal testing. Class act.

Pale and shaken Dean takes mic and asks for another question...

Question 2 (Older dude, with long skull and crossbone headband, heavy peri-orbital edema, white t-shirt):

"So I have this friend who has a CD4 count of 700 and an undetectable viral load....and he's having unprotected sex...with a woman...and he hasn't told her that he's HIV positive...what do you think about that? Is she at risk for getting AIDS?......oh and I should probably mention that she is pregnant with his the baby at risk of catching AIDS? And should she breastfeed? Did I mention, his CD4 count is 700 and viral load is undetectable? What would be your advice?"

Just when you thought question period couldn't get any worse. It clearly had.

Dean of Medicine now looks like he's on verge of collapse as all blood has completely left the upper half of his body. Eyes are darting for burning fireplace or woodchipper to toss microphone into.

Again Dr. Gallo took the time to respond thoroughly to the question, as if he had been the guys doctor for the past 10 years. Oh sorry, the guys "friends'" doctor.  Riiiiiighhhhhhhht.

Listen up people.

If you're having some questions to do with your HIV status, your lowly moral reasoning at not informing your partner that you *may* be exposing him/her to a deadly disease, and your unborn childs'  future----please talk to your GP, call the nurses line, go to a STI clinic, but don't come and ask Dr. Gallo if your 'friend' should tell his girlfriend/mother-of-his-unborn-child that he's HIV positive.

Not appropriate.

It's like asking Marie Curie if you should have a follow-up x-ray on your scaphoid fracture or James Shapiro how many units of NPH you should take if your blood glucose is running a little higher than usual. 

Which brings me to another thing that gives me a rash...medical people are many things, but one thing that we are not--is naive.

If you start citing your "friends" lab values the gig is up. We know who you are talking about.

If you tell the triage nurse that you were walking down the street, minding your own business and a shotgun went off on your kneecap--oh and that it was not a gang related incident---we are still going to have to notify police.

If you say you slipped in the shower and your hand landed against the wall (which happened to be cement) clenched in a fist to "catch yourself" we are going to know you got in a fight. That's why it's called a "boxers fracture".

We know that the reason your tox screen came back positive for cocaine wasn't because the taxi driver sprinkled cocaine in the cigarette he gave you, even though you're *sure* that is the only way it could have gotten in your bloodstream.

Don't treat us like naive fools, because most of us aren't.

Thank you. (Steps off soapbox).


Beach Bum said...

Sometimes you just have to shake your head.

Albinoblackbear said...

Or hit it repeatedly against a wall.

OMDG said...

Were these classmates of yours? Yikes!

Albinoblackbear said...

Hahah, um NO they most certainly weren't.

Dragonfly said...

You know how there is the saying "there is always one"? Well...sometimes there is more than one.
I read Virus Hunting by Doc Gallo in my last year of high school. I was really inspired by it...then i read "And the Band Played On" the next year which was also really good (though with a different focus).

K said...

Hi, I'm new here. Great post! And it's so true. Some people just don't have any insight.

Albinoblackbear said...

DF--I want to read both of those books when I get though the current Adrian Mole (I needed something light after Shantaram).

I was just so embarrassed over the impression Dr. G got from our university.

K--Welcome! Thank you. Yes and when you combine lack of insight with lack of boundaries in a public forum, it gets ugly (case in point).

Dragonfly said...

I know the feeling. I read a few too many books about genocide, massacre etc last year (even books by MSF type people had a lot of it) so spent a month or so reading books that were as frivolous as I could find...:-) I must read Shantaram when I get a chance, but have quite a few good ones waiting at the mo..

Maha said...

I'm completely aghast at the questions, especially the one posed by the gentleman on behalf of his 'friend'! On the other hand, its pretty cool that you got to hear such a prominent researcher speak.

People shitting the triage nurses are not cool. People who change their stories with each new provider are even less cool.

Albinoblackbear said...

Maha--Yes and Yes. I forgot about the people who have a new story for evey HCW. Grrrrr....