What a relief

He was cachexic. I thought he was having some sort of malignancy.

The veins in his antecubital fossa were big and fat and looked as if they would burst at any time. I held the syringe with great confidence and as the needle sank into one of the veins, my course-mate, Lady Yong, shrieked," Darren, be careful! RVD (retroviral disease) positive!"

I panicked. My hands trembled a little and blood was oozing out from the puncture site. And the horrifying thing was, I could see blood on my left hand and I wasn't wearing gloves.

I finished the blood-taking within the next 10 seconds and rushed to wash my hands thoroughly and checked every inch of my hands for any minute wound through which the human immunodeficiency virus could have gained entry into my bloodstream.

I flipped thorough his case notes and was extremely petrified to discover he's immunocompromised. I took a detailed history from him after washing my hands for like 10 times. On physical examination, he had oral thrush (a common opportunistic infection in the immunocrompromized) and enlarged liver and spleen. His lungs were bad, with crepitations all over. They thought he was having miliary tuberculosis or Pneumocystis jiroveci pneumonia. I prayed hard that the doctors were all wrong. Nevertheless, to my horror, his HIV test result came back positive a few days later.

There was no needle-stick injury. Even if there was, the chances of my getting infected would not exceed 1 % as the viral load was too low. Yet, for the past 1 year, I couldn't help feeling anxious and having the hypochondriatic delusion that I was HIV-positive despite the evidence to the contrary. Every time someone talked about AIDS or HIV, I became restless and catastrophized whatever thoughts that came to my mind. Isn't it devastating to know that you might be HIV-positive before you really get the chance to have sex in your life?

However, now, I can proudly announce my HIV status as the test result came back negative a few days back. It's part of the medical check-up required by the university in which I'll spend one month doing my elective posting in May.

Lessons learnt: Never take blood without wearing gloves. And never fuck without a condom.

Fact: Hepatitis B virus is 100 times more infective than HIV.

The kids

Medicine has always been thrilling to me, be it internal medicine or paediatrics.

However, in internal medicine, almost half of the patients in the ward are there due to self-inflicted damages. You see people with chronic obstructive pulmonary disease due to chronic smoking. Chronic liver disease due to alcoholism. Uncontrolled type 2 diabetes mellitus. Sexually transmitted infections. AIDS.

However, in paediatrics, the picture is rather different. Stanley had biliary atresia and his liver is now cirrhotic although surgery had been done. For some reason, his mother refused to let Stanley undergo liver transplant though she knew that's the only option available to increase the lifespan of Stanley and without which his liver would definitely fail. She spoke to me so nonchalantly which reflected her courage and readiness for whatever that might come. I turned to look at Stanley. He shot a handsome smile as if he had lived his life to its fullest and didn't seem to be afraid of death.

There's another adorable girl with end-stage renal failure secondary to late cresenteric glomerulonephritis. The puffy girl with lupus nephritis who looked so depressed as a result of long-term steroid therapy. The constantly centrally cyanotic girl with pulmonary atresia whose mother declined to have her heart lesions surgically corrected.

The children are deprived of so many things in life that I've taken for granted. I don't know how they cope with their illnesses as such a tender age. It's sorta saddening to look at their angelical faces under which lie the suffering and torment only their mothers can understand.

Paeds

" So, you've come to the final rotation. I want you guys to make every endeavour to pass. For your information, it's the posting with the highest failure rate. In case you fail, you might not have the opportunity to resit the exam and this means you'll be be retained for a year."

That's what the posting coordinator said when we met her on the first day of Paediatrics Posting. And since then, I've been under tremendous stress.

The consultants really do expect a lot from us. Besides, the medical officers in the ward are ferocious. They may look very kind when playing peekaboo with the kids. But, you don't know when they're going to snarl and bark at you and ask you questions that make you feel as if you've not learnt anything in the past 4 years. I guess I have to thank them for showing us the discrepancy between the level we're at and the level which we should achieve.

Now, I realize I shouldn't have sniggered at my roommate when he was studying day and night like a bookworm when he's in Paeds.

I'm tense. And I still miss Caleb once in a while.