Words and Thoughts

Background:

During a patient encounter, I spoke to an elderly gentleman who presented to the HIV clinic for his medication injections. He was started on injections because his gag reflex made swallowing pills difficult. However, the patient admitted that while he preferred the injections to oral tablets, he typically found the experience daunting due to his fear of needles. I decided to chat with him with the hopes of distracting him from the injection. The patient and I talked about his past job and his life in America. He also told me about how he found out he had HIV and how it affected his health beliefs as a young, gay man. He informed me that his diagnosis was shocking because he had not explicitly consented to an HIV test and he described the delivery of the diagnosis as callous and insensitive. He also admitted that after the disclosure of his diagnosis, he partook in potentially dangerous activities because he ‘simply didn’t care anymore’. The nurse announced that she was finished with the procedure and the patient remarked that he barely felt it. He thanked me for distracting him and said our conversation was much appreciated.  

In order to understand the effect of words on a patient, it is essential to consider the encounter from their perspective. I’ve therefore written a poem to explore how the patient may have felt during his appointment.  

Poem: Words and Thoughts 

Lying on the medical couch, face down 

I can’t help but notice the voices around 

I suppose this injection is a lesser evil of sorts 

But my anxiety has taken over my thoughts 

Nowhere to run, nowhere to hide 

Apparently my consent was implied 

Will this be another medical scar? 

“What is it that you used to do for work?” 

A voice cuts through my mental lurk  

The needle whispers on my skin 

“I used to oversee the gambling” 

“I lived in Las Vegas for many years” 

The needle appears? Disappears? 

I can’t tell 

I keep talking, scared of that impending pain 

Distractions will help somehow but I can’t explain 

Why does knowledge hurt so much? 

And why are some doctors out of touch? 

“You’ve done so well, it’s over with” 

False words, was the pain a myth? 

Words can cut, words can heal 

I hope they think of the power they wield” 

Kesri Gajadhar

F1, West Midlands North Foundation School