Judge not....

A 30 plus year old man was brought to us in a moribund stage. Examination in the emergency revealed a semi-conscious man with signs of multiple infections in his lungs and brain. The disease was quite evident – HIV infection (Late stage AIDS) with multiple infections. His CD4 count was just 6. The relatives (2 brothers – one elder and the other younger) seemed to be surprised at the diagnosis and wanted this diagnosis to be kept confidential. Being from a reasonably well off family, they were talking about keeping confidentiality by moving patient from the ICU to a private room once he was stable. Some of us spend quite a bit of time, explaining the illness, the potential of full recovery etc. and they seemed to be convinced. But after 48 hours as time came to move the patient out of ICU they seemed to be confused, and wanted to shift to a general ward. Finances which was not an issue prior to this was highlighted as the issue at hand. Though not convinced, we agreed that he could be in the general ward. The next day after the rounds, we explained how he was improving and it would be a matter of few days, he should slowly recover. A few hours later both of them came to meet us. They wanted discharge immediately. Again money was highlighted as the issue. But we were clear, that there was something else. An uncle who appeared in the scene, told a staff that he knew the status for 10 years or more, but the rest of the family were not told. The parents and other relatives did not appear in the scene though we were told the father will come to see. The issue was pretty clear for us. It was not money. They wanted him to die, with the diagnosis kept as a secret from the extended family. TB is what they wanted to communicate to others. The honour of the family was more important than the life of their brother….

We were angry and upset, and tried to communicate – but their decision was clear – sorry, we have no money and so we are taking him home.  We send him off “LAMA” – for a sure death at home. We, in our minds wrote the family off, as those who have no compassion or care for their own brother. Judged by us as sinners who are willing to even murder their own brother….

Two days back another young man came to us in OPD. Found to be HIV positive, with 410 CD4, but with severe anaemia, 2.7 gm/dl Hb. I sat him down and started talking to him about his illness and what needs to be done etc. Generally, I do not ask HIV patients about their “contact source” since most of the would be migrant labourers and coming from context where high risk contacts are part of their life. But one of my colleagues asked me, how did he catch the infection? That initiated the “curiosity” in me. I went back and asked him about his history and past, and came to know that he had been a manual labourer in Bengaluru and had been used to drinking alcohol almost on a daily basis.  Though he refused to give any clue of his behaviour, other than the alcoholism, I was sure that he would have had definite unsafe contacts. And this encounter left me with a disturbed heart.

On one hand, anger and irritation at his behaviour, disturbed about the unwillingness to openly “confess” his “sin” to us….On the other hand, a realization that, though I have for years taught on “unconditional acceptance” the heart still easily “judges” people based on the standards I have set for myself….

I was left wondering – who was at a greater fault – the family who allows their brother to die to protect their family honour, a man whose context pushed him into unsafe behaviour, or the well-educated professional like me, who declares judgement on people easily….

What will it take for me, to see their situation through their eyes, and through the eyes of the creator who created each of them in His image…..and love them unconditionally?