During the night, he wandered the halls, yelling, hallucinating.  Not too unusual in a hospital, except he was in his twenties.  So he's an early starter.  Then again, when you've got a virus in your brain, and you're in a strange place, and loaded with dilaudid, you're allowed a little mental leeway.

Viral encephalitis.  The tests told us there was a 99.9% chance it wasn't herpes.  So that basically left: harmless flu-like virus or HIV.  Thanks, modern technology.

"His family's on the phone now," the nurse misinformed me. 

"Hi, this is Dr. Scott.  I'm taking care of Mr. Ivy."

"Hello ... um," a young nervous male answered.

"Who is this again?"

"... I'm ... his partner."

"Oh," I switched to a kinder tone, "Did you have questions?"

"Do you know what's wrong?"

"It looks like a viral encephalitis.  Right now, we're waiting for the ... some other tests." 

"... Oh ... I should probably tell you ... I haven't been using protection.  Should I get tested too?"

It's still a little disarming to get such personal information over the phone from someone you've never met like that.  At least when it comes to anal sex. 

"Yeah, I think that's a good idea." 

"Okay.  When do you think the test results will come back?"

"Tomorrow.  I'll call you then with the results, okay?"

"Thanks.  .... um ....  I guess I don't have any other questions." 

He sounded like a scared college kid.  I felt his fear, the fear that your life is about to drastically change for the worse through something you caused or neglected.  It makes you feel very small.  It makes you an adult. 

The next day, the lights were out in the patient's room when I walked in.  I could see his partner standing by the window.  Even if I hadn't talked to him on the phone earlier, even in the dark, I could see that he was the gentler one.  I didn't turn the lights on.  Partly because the light might exacerbate my patient's headache.  Partly because they were talking with the lights off anyway.  Partly because there's a certain comfort in the darkness.  Sometimes the world doesn't seem quite so harsh when it can't see you either. 

"Well, the good news is the HIV antibody test was negative," I start like this because I like giving good news.  "The not so good news is that the antibody test can be negative for the first six months if you contracted HIV.  The RNA test was what I really wanted but that won't be back until Wednesday (a fact they fucking conveniently neglected to tell me yesterday)."

"So he's all right then?" the partner asks to my amazement.  Medicine rule number 38 - patients and families hear what they want to hear. 

"We don't know.  We won't know for sure until the other test comes back.  Sorry." 

"Well, I feel great.  I am ready to get out of here," the patient himself said as bright as sunshine. 

So he went home to wait for his HIV test results.  In a few days, this couple will either be drafted into the war of their lives against every opportunistic bacteria, fungus, and virus that exists, or they'll get to party like rock stars (with protection this time I hope). 

As a hospitalist, I don't like being in the dark, not having the answers by the end of the story.  As a person, sometimes there's a certain comfort in the darkness. 

Amy took the kids to a petting zoo.  Surprisingly, our little ones weren't scared to death of the animals up close this time.