We are raised to think of death not as a necessity but as an enemy. When people who are still healthy are confronted with someone who is dying, they are intensely uncomfortable. They are frightened of losing the dying person, of their own deaths, and of death’s finality. “Death isn’t like breaking up with someone and time heals it,” said Helen. “Death is death, period, and no one wants to deal.” Sometimes their discomfort, their not wanting to “deal,” makes people appear insensitive. Alan was in a mall, shopping, and someone he knew came up and asked, “Why have you got all those shopping bags? Aren’t you dying soon?” Alan snapped back, “How soon are you dying?” but he was surprised and confused and hurt by his friend’s question. Dean had a friend who habitually made a joke of looking around at Dean’s furnishings and saying, “Oh, that’s new. Leave it to me in your will.” Dean finally replied, “Okay, that’s fine. Do you want the kitchen chairs too?” After that, the friend dropped the joke. Such remarks sound insensitive, as though as though the person is taunting you with life and health. But they are not; no one is this callous. Insensitivity is the method some people use to deal with their own pain and fear. The method is certainly inappropriate. Both Alan and Dean let their friends understand how inappropriate their remarks were and that they should be more careful in the future. Sometimes people’s discomfort with the reality of death isolates those who are dying. People facing death often find that other people are friendly and sympathetic but want to talk only about easy, comfortable subjects. When the subject of death comes up, they talk instead about what they’ve done recently, or about the future: “I can’t wait until we get you to a ballgame.” They also sugar-coat the subject: “Remember how sick you thought you were before, and a month later you were off on a trip.” This is hard on the person facing death. He or she may be happy enough to talk about the weather, the news, or sports, or to gossip about mutual friends. But being prohibited from talking about the things that are of most concern makes a person isolated and sad. On the other hand, everyone facing death knows some people who will “deal.” Perhaps it is someone who also faces death or someone who has lost a person they loved, or a professional who has had training in helping people handle the emotions and problems of dying. Often it is someone who loves the dying person and is less afraid than other people of the reality of death. These people tell the person who is dying that they will not leave, they will stay as long as they can. With Alan’s young nephew, that message is reversed. Alan’s nephew worries about Alan’s death, and Alan tries to help by telling him he won’t be abandoned: “My nephew cries when he thinks about it,” Alan said. “I tell him, ‘I’m not going to give up easily and I’m going to try to be there for your graduation. Don’t be disappointed if I can’t, but I’ll try.’”*224\191\2*
Archive for HIV
Oral hairy leukoplakia is an infection of the mouth which resembles thrush. Its cause is unknown, but it appears to be associated with the virus that causes infectious mononucleosis. Most infections by the infectious mononucleosis virus produce only trivial symptoms or no symptoms, but once the infection with mononucleosis virus occurs, the virus remains in the mouth for the duration of life. The person with oral hairy leukoplakia does not have the usual symptoms of infectious mononucleosis and does not transmit infectious mononucleosis to others. Oral hairy leukoplakia appears to be an unusual reaction to the common presence of this virus in the mouth.
As noted earlier, most of the conditions that occur in people with HIV infections also occur in the rest of the population. Oral hairy leukoplakia appears to be an exception: it occurs exclusively in people with HIV infection.
Unless the person is in pain, treatment is not warranted. Oral hairy leukoplakia does seem to indicate that the immune system is increasingly suppressed, and that the development of AIDS is probable within the next few years.
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