I Would Rather Have Syphilis

His hands were shaking. He was obviously embarrassed. He went on to reveal the painful rash on his abdomen, thighs and other parts. I had to hide my genuine feelings, which were disgust, fear and pain. I could only hope he felt the same. So I moved forward in my conversation with this 20 year old man.

The best way is a mechanically, emotionless approach to what I know is an ever growing nationwide epidemic, by addressing the person before me as I would tell the weather. That is very factual, accurate and will have an effect on the choices for the day.

‘It looks like Herpes ‘I told him.

‘Well how do you know? he asked.’

‘Well, before we go further, I continued, are you in a monogamous relationship?’

‘Of course, he responded. I have been with the same girl for the last two months.’

‘I understand, I went on, but what about before those two months. Have you had other sexual partners? ‘

‘Just a handful of others in the past. Why do you ask?’

I could appreciate his innocent question, as he gathered his garments about him. He was obviously numb to his past exploits, and dumb about the dangers he presented to himself and his community. I had over 5 other patients waiting in other rooms. There was no time to have a prolonged discussion of illnesses and the rights and wrongs (that ugly word morality) with someone who still had facial pimples and lower body rashes.

I hurried on. ‘These are lesions that resemble Herpes. The consequences of this are that you will never be rid of this illness and anyone with whom you have any intimate contact is at risk of developing this. You have to decide if having sexual contact in the future with anyone is worth risking their health and yours, as well as the health of anyone they have as sexual partners. ‘

He hung his head, not so much in shame but in heaviness of the burden this illness would carry on his later sexual exploits. ‘Why can’t it be syphilis? I would rather have syphilis. Can’t you test for syphilis?’

I knew immediately that I must move on to people who had serious intent on getting and staying well.

‘Well I could test you for syphilis or any of the other more than dozen diseases you might have. The problem is that even if you test negative now, it does not mean you are not harboring one of these other lifelong infections. So testing for syphilis is possible, but it will not tell me the whole risk you face for the rest of your life.’

He looked up at me and smirked. It was the sly smile saying, you really don’t know everything doctor. A quick nod of his head, and he was out the door, probably hoping I was wrong and he only had syphilis.