Share this page!

David Malebranche, MD, MPH Profile picture
Twitter logo
25 Mar, 5 tweets, 2 min read
Did a follow up call with a patient this morning. Gave her her #HIV lab results:

- T cell count over 1000
- Viral load undetectable

No reaction. It was expected. We spoke about other referrals before concluding .

"Anything else I can help you with?" I asked.

She paused.
1/
"Doc, I have a question, but it's more personal."

"Shoot," I responded, unsure where this was going.

"Do you know anyone in the medical field who is living with HIV? Before my diagnosis I wanted to go into the field but I didn't think I could after that."

My turn to pause.
2/
"You're speaking to one," I said.

I could feel the weight lift from her shoulders through the phone.

"Living with HIV doesn't mean you can't work in the medical field," I continued. "There are many people who are HIV positive and work as doctors, nurses, every position."
3/
"Wow," she said. "I was over here wasting all this time when I could've been applying to schools and following my dreams."

"You didn't waste any time," I told her. "You just went on a different journey. You can do whatever you want to. Now you know."
4/
"You should see me smiling right now - you just made my day!" she exclaimed, voice soaring. "If I can pursue medicine, that's gonna help my depression."

"I know it will. Let me know what you decide to do," I said, hanging up.

I was grinning as hard as she was.
5/

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with David Malebranche, MD, MPH

David Malebranche, MD, MPH Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @DMalebranche

David Malebranche, MD, MPH Profile picture
6 Mar
A young Black man has been living with #HIV for 4 years.

He is adherent with his meds. The lab report shows he has been undetectable since he started treatment.

He works 16-hour days in a factory and is seen at a busy urban HIV clinic.

He has private insurance.
1/
His last in-person visit with the clinic was in January 2020, right before the #COVID19 pandemic shut the world down.

All was well during that appointment.

His doctor continued his prescription with a year's supply of refills.
2/
He is scheduled a 3 month follow-up telemedicine appointment during the #COVID19 pandemic.

All continues to be well at that visit.

It's April. Flowers are beginning to bloom.

He is given another telemedicine appointment 3 months later.

He misses that one.
3/
Read 10 tweets
David Malebranche, MD, MPH Profile picture
21 Nov 20
1/
 I went to a local @cvspharmacy today to get my second shot of the Shingrix vaccination.

This is the vaccine that helps protect people over 50 years old from getting the painful reactivation of the childhood chickenpox virus.

Also known as shingles.
2/
 The pharmacist was kind. Applied a discount to offset the cost. Gave me the obligatory medical information and consent form to sign.

I did.

He "gently agitated" the vaccine mix in front of me.

To my surprise he came around the counter to give me the shot.
3/
 "Which arm?" he asked.

I took my left out of my jacket.

As I turned away from him, I noticed a Black woman staring at me.

Her eyes wide in a mix of horror and surprise.

She was picking up her medications, but got distracted.

I knew exactly what she was thinking.
Read 8 tweets
David Malebranche, MD, MPH Profile picture
29 Aug 20
1/
 Chadwick Boseman died from colon cancer at 43.

I am sad that this talented brother lost his earthly life to this disease at such a young age.

Most of us don't know the details of the screening, diagnosis, and treatment journey he endured.
#ColonCancer
#SaturdayThoughts
2/
 What I do know is that according to the @AmericanCancer, colon cancer screening is recommended starting at age 45.

I also know that Black people suffer disproportionate health inequities related to colon cancer compared to other races/ethnicities.
3/
 We suffer these inequities not just because "we don't screen as much," but due to issues with access to care, insurance, public health outreach, and provider bias.

The same factors that drive racial health inequities from #COVID19, #HIV, and numerous other health conditions.
Read 11 tweets
David Malebranche, MD, MPH Profile picture
29 Jul 20
1/
 I am leaving academic medicine for the 2nd time in my life.

I am walking away from the combination of job duties I love most:

Service
Teaching
Research

I didn’t leave because I felt disrespected or unacknowledged as a Black faculty member.

That was the 1st time.
2/
 I left this time because I had to.

I had to stop putting everyone else first while throwing myself under the bus.

I had to refrain from running into brick walls that I knew were not moving or capable of being toppled over.

I had to accept that my healing is important too.
3/
 I had to acknowledge that I have yet to truly grieve over my deceased father.

I had to admit that #COVID19 has changed me.

I had to stop to catch my own breath instead of only helping everyone else catch theirs.

I had to realize I was exhausted and needed a break.
Read 5 tweets
David Malebranche, MD, MPH Profile picture
31 Mar 20
1/
 I know a lot of folks living with HIV are worried about coronavirus.

It's understandable. Everything is crazy right now.

We are learning more about it daily.

We are hearing stories about people getting sick and dying.

It's ok to be anxious and nervous about it.
2/
 It's already enough living with HIV. Any fever, sniffle, or rash can cause panic and concern.

It's scary. All of it.

But you know what?

We know a good amount about COVID-19. There are good resources where you can empower yourself.

cdc.gov/coronavirus/20…
3/
 @CDCgov has great information that is updated every day.

@TheBodyDotCom presents facts that are easy to read and gives great tips on how you can navigate this pandemic AND thrive with HIV.

thebody.com/health/hiv-cor…
Read 7 tweets
David Malebranche, MD, MPH Profile picture
8 Jan 20
1/What bothers me the most about medical providers today is not that they aren't intelligent. They most certainly are.

It's that they lack a sense of urgency with patients even when the facts are RIGHT IN FRONT OF THEM. Here are some examples:
2/
 An 87 year old man with high blood pressure and heart disease has leg pain and non-healing leg ulcers.

Tests show 2 of 3 leg arteries are 100% blocked. The pain is so bad he sleeps sitting up.

He is told to follow up as an outpatient to get ultrasound and cardiac clearance.
3/
 A 28 year old man with HIV has a new diagnosis of syphilis, headaches, and blurry vision.

STI guidelines state a new syphilis diagnosis with neurologic/visual symptoms should get spinal tap/eye exam.

He is told he doesn't need that, gets 1 shot penicillin and sent home.
Read 7 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!

Like this author's thread?

Get emails when @DMalebranche has new unrolls!

Check out other threads from @DMalebranche!

Read all threads by @DMalebranche