Wednesday, April 30, 2014
Life at Grady: Hepatitis, See?
My dear, dear friend and (award-winning) Grady doctor, LM, focuses her practice on patients with Hepatitis C. And let me just share a few things about Hepatitis C.
• Hepatitis C is a smooth criminal. It does its damage slowly . . .kind of like the way termites do. And the same way folks don’t realize they have termites until all hell is breaking loose or they get swarmed is the same way Hep C sneaks up. Stealthy, I tell you.
• Some crazy number of people in the U.S. has Hepatitis C. Crazy meaning nearly 3.2 million according to the CDC. And because it’s such a ninja, people don’t feel sick so they don’t know they even have it. In fact, most are shocked to hear they have it.
• African-Americans are disproportionately affected by Hepatitis C, and also are more likely to have the genotype that is harder to treat.
Here’s what’s cool about what Lesley and others do in the Liver Clinic: First of all, Lesley isn’t a hepatologist or to put it in layman’s terms, a “liver specialist.” Quite the contrary, actually. Lesley is a general internist (like me) who saw a need for patients that wasn’t being met. She has since devoted her time and career to assisting patients with learning about Hepatitis C and especially navigating the often tricky task of getting the expensive treatment. Lesley gets with all sorts of people with resources and helps make these available to our patients. She then manages and directs all aspects of their care surrounding Hepatitis C, which takes a tremendous amount of effort, work, and attention to detail.
When you think about the ways that people get Hepatitis C, you realize how awesome it is for our patients to have her there. A lot of people with Hep C have led some hard lives. Some acquired it through injecting IV drugs or getting crude tattoos in jail. Others may have been transfused or come in contact with bodily fluids at some point. And, sure, there are a significant number of people who did none of those things and have no idea how they got it. But where we work, lots of people who are seen for this have some kind of story. I like knowing that they can get the treatment they need and deserve without having to get judged at the same time.
The Liver Lady also teaches the residents, faculty and students about Hep C. I’d go so far as to say that, thanks to her, we are ALL more aware of the need to test patients for Hepatitis C at Grady—and even better, we get them treatment. It’s so different than it was when I first started here. We’d try to send our patients with Hep C to our gastroenterologists who were already overwhelmed with multiple other GI issues in our patient population. That, combined with the expense of getting folks treated, meant that people fell between the cracks if they had no insurance (which our patients rarely have.) This woman has, literally, changed the lives of countless people by watching the blind side for folks who don’t see cirrhosis coming to tackle them head on. That’s what I’m talking about.
So recently, the CDC put out these videos on the “Faces of Hepatitis.” Dr. M. was featured in this video that just saw for the first time Thursday. My friend and fellow Grady doctor, LM, talking about treating patients with Hepatitis C. Oh, and if she looks like an amazingly kind and sweet human being? It’s only because she is. I kind of teared up when I watched this—and refuse to watch it again because I’m certain I will full-on cry if I do.
You know why?
First of all, because she is my friend and I respect, love and am proud of her. And second of all because she shows a side of Grady hospital that people don’t often see. Many think of what we aren’t doing right or feel skeeved out by some of our patients or even imagine it as only a place for trauma. But see, it isn’t. It’s a place that has people like Dr. M, a woman so accomplished that upon graduating from residency she was awarded the “Best Resident” title. This means she could be anywhere in the world—including a marble building with slick floors and insured patients—but she has chosen to be here. Yes, she has.
This is the Grady I know. And I’m proud to be working shoulder-to-shoulder with people like the Liver Lady.
Damn, I love this place.
Kimberly Manning, MD, FACP, FAAP is an associate professor of medicine at Emory University School of Medicine in Atlanta, Georgia where she teaches medical students and residents at Grady Hospital. This post is adapted from Reflections of a Grady Doctor, Dr. Manning’s blog about teaching, learning, caring and growing in medicine and life. It has been adapted and reprinted with permission. Identifying information has been changed to protect individuals’ privacy.
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