The Knife's Edge by Stephen Westaby

Author:Stephen Westaby
Language: eng
Format: epub
Publisher: HarperCollins Publishers
Published: 2019-03-08T11:16:23+00:00

Unless already known, the infectious state of the source should be determined. Unless known to be negative for hepatitis B and C viruses, post-exposure prophylaxis should be initiated within one hour of the injury. Prescribe a booster dose of hepatitis B vaccine together with hepatitis B immunoglobulin for added protection. There is no vaccine for hepatitis C so treatment consists of monitoring for seroconversion.

In other words, you just wait and see if you get it. That’s why Julie was so pissed off. She had gone through all this before back home in Australia after a needle-stick during a heart transplant when the donor was discovered quite by chance to be a hepatitis carrier.

I went back to theatre and asked the anaesthetist to draw some blood from the child for serology testing, but he told me that this couldn’t be done in Saudi Arabia without the mother’s permission. My blood pressure was already too high, but it immediately shot through the roof.

‘Just take the fucking blood,’ I yelled. ‘I’ll write the forms and take it to the lab myself.’

On the request form I wrote: ‘Desperately sick haemophiliac child after cardiac surgery. Need to know what we are treating. HIV and hepatitis status please.’ The boy was still on the operating table, so right now I was his guardian. I just needed to convince the lab that the tests were in the boy’s interest, which they were. But my motives were dishonest. Philippe was doing fine. It was Julie I was concerned about. Hepatitis was bad enough, but AIDS was a death sentence in the 1980s. So I left Julie with her bleeding hand under a tap and set off to find the laboratories.

I was expecting a confrontation about permission to test for HIV, but it never materialised. AIDS was rare in Saudi Arabia and the assays were new, so I guess that they were eager to try them out. It was not the virus itself that the assays measured but the antibodies produced by the patient in response to the infection. Then the obvious question – how soon could they let me know if the patient was HIV positive? They said they’d call in a couple of hours, but if the boy did have AIDS what should I do? I felt a deep responsibility for Julie, not to mention genuine affection. Her cheerful disposition had made my life much happier than it might have been in a difficult environment. One expression I often heard from my beloved elderly mother was, ‘Put yourself in their shoes. Try to understand what it’s like to be them.’ She would apply that principle to the sick, the disabled, the mentally ill and the poor. Or should I say poorer. ‘They all have feelings,’ she used to say. Those few phrases defined empathy.

By the time I returned to the operating theatres some shit for brains had terrified Julie by warning her that Philippe could be an HIV carrier. Her sore hand now bandaged, she was pleading for someone to do something, anything, to dampen down her fear.

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