It's tough being a teenager anywhere

I spent a long time in clinic today with a patient who I will call Becky.  She is 15 living with HIV.  I asked if her if there was anything that she was concerned about today.  She told me no not with her health, but somedays with her head.  I gave her a puzzled look.  She then mumbled, "You know with HIV and my head.  It's difficult." She went on to elaborate how some days she sits and cries because she becomes so saddened by her illness.  Most of her friends do not know her status - there is still stigma here in a country where around 25 percent of the population is infected.  She only feels she can talk to her sister who is away at college.  This relationship appears to have become a little rocky recently as her sister, concerned about Becky, told their mother about Becky's sadness.  Becky was then yelled at by her mother.

I have worked with enough teenagers to know that this is just part of the story, Becky's side.  I know the relationships and situations are much more difficult, but my heart breaks for her just the same.  I know that teenagers with all sorts of illness feel as isolated as Becky - like the only one and that the illness is overtaking their lives, limiting their futures.  Even if this is not the case.  HIV is not the death sentence that it use to be.  Medications keep the infection silent when taken properly and the regimes are not as complicated as they once were.  (And Becky after defaulting in 2005 has been doing well now that she is back on treatment).  But how does a young person necessary believe in hope of the future, especially in a country that has so many orphans from the illness and where most people know someone who has died from its complications.

I think this visit elaborates the most difficult thing for me here.  For those of you who have had the conversation with me about why I chose to do this silly thing called Triple Board know that I cannot ignore a sad child.  And there have been many sad children here.  I have watched them break down in tears because of a sick sibling in the hospital, because of being teased at school, because of remembering a mother who was lost to the illness that they now struggle with... this has been the hard part. Made more by the fact that many of the children do not speak my language to understand comforting words.  I feel hopeless to help in this realm, and the core of my being just wants to make those tears go away.