Reflecting on needlesticks

Needlestick injuries are a professional hazard for any doctor. Some are more at risk than others, but it can happen to anyone. A needlestick from a person with HIV or Hep C could change our lives forever. Would we want to have children? If so, how would go about it? Could we still work?

Before choosing to do medicine I never thought about this issue. The abstract thought that doctors work with sick people and could catch something is quite different from the reality of a life-threatening illness. I guess when I was high school I was vaguely thinking about getting a lot of colds and the occasional bout of gastro.

As a medical student, in particular after my own needlestick experience, this issue became more of a reality. The impact it has on your life to wait for blood tests (and I was lucky and got mine from a low-risk patient) and potential implications for the rest of my life became more obvious. I resolved to be more careful.

The advent of SARS brought the issue out in a new way. SARS was frightening because being careful didn't seem to be enough. Health care workers were being struck down despite precautions, and for the first time I wondered: should I say no? Should I refuse to risk myself to see these patients? Fortunately, the decision was never seriously asked of me. The SARS patients I was asked to see I judged to be low-risk, and in fact they didn't have it.

Yesterday I realized that no matter how careful, how the risks are reduced, living with potentially infectious illnesses is a lifestyle choice for a doctor. Did we all realize this when we chose medicine? Not at all. Does that absolve us of the responsibility of taking this risk? Not at all. Choosing to be a doctor means taking a small calculated risk. We know how to reduce risk, and how to protect ourselves. We know what the risks are and shouldn't let media "scare tactics" influence our practice.

Doctors (all health care workers really) are privileged to work in a field which gives us the chance to see people's lives changed, and to be a part of that. We get enormous satisfaction from being able to help people (along with all the other stuff that goes with the job). We are supported, trained and educated by infrastructure provided by society and (generally) are held in respect as one of the "learned professions". Sometimes people even say thank you.

I love being a doctor, and if that means living with a small risk of catching a fatal illness, even after my best efforts to protect myself, I have always been ready to take that risk. I guess I never previously thought about how it could impact my family; Dean and our marriage, my (potential) children. How would I feel if Dean was the one to contract a fatal illness? He is actually at higher professional risk than I am.

It doesn't change the basic equation - this is what it is to be a doctor. I know that, and I still choose my profession. The rewards are worth the risk.