In today’s world there seem to be many instances where doctors and sound medical judgement based on scientific evidence are being overridden by the moral judgement of those who should not be making the decisions. One very poignant example of this is what is going on in Texas with Governor Abbot requiring Child Protective Services to investigate doctors and parents for providing gender affirming care to children. By doing this he is effectively putting “The State” in between a doctor and his patient in a way that is unconscionable, and causing mass resignations. But that story is not this story. This one is about another group of people that are just as vulnerable to others Moral Judgement.
Before I begin I have to tell you that because I have written several diaries for this site I have created a new account in the hopes that my previous posts will not lead to my identity because this story is of a very sensitive nature.
My husband and I are both Veterans, we are both HIV positive, but we have different insurance. He is covered under the Veterans Administration and receives all his care from them. I have private health care and get all my needs met by a doctor of my choice. We don’t make a lot of money and both receive help from the Aids Drug Assistance Program (ADAP). We are so grateful for the help and without it would be paying more than you could imagine for medications.
My husband also works for the VA, the same VA that he receives his medical care from. Several years ago he was required to attend a policy meeting. Why he was required to attend is unclear, the meeting did not provide him with anything of use for his job related duties. However, during the meeting a policy was disclosed. That policy was in regards to the prescribing of Testosterone therapy to veterans that were HIV positive. The policy was verbally stated and stated clearly. Giving Testosterone to an HIV positive veteran in their opinion was the equivalent to giving a loaded gun to a person who was likely to be violent. They openly said that HIV positive vets were likely gay, likely promiscuous, and were likely to infect others with HIV if they engaged in sexual activity. Therefore, the policy was going to be to deny testosterone therapy whenever possible to prevent them from being able to engaging in promiscuous sexual activity. A moral judgement, a prejudice one, and a one that is discriminatory at best and illegal in some way I am sure.
My husband’s testosterone levels have been tested many time and without testosterone therapy have consistently come back well below 30 ng/dl. The normal for a male is around 300 ng/dl or above. Without testosterone his mood changes. His mind goes to a dark place. He gets depressed, overcome with a sense of doom and pessimistic thinking that everything that can go wrong is going to go wrong. His energy levels tank, he gets angry, he says things that he would never say when in a normal condition. He is easily annoyed, and more confrontational. He stops smiling, and can’t stop thinking about the worst things. It changes him from the loving and most compassionate man to something that is unrecognizable and honestly, very worrisome. It causes me to have panic attacks when he sinks to that level.
Ever since that policy meeting getting his testosterone has been like pulling teeth. Every time his prescription has to be renewed we go thru the same thing, delays, sometimes for months. Arguments about the need, the dosage, the frequency. More testing, as if hypogonadism is just going to cure itself. Sorry a bit of sarcasm there. Then they intentionally tell him to take his shot, then get tested for testosterone levels three days later and when they come back at an almost normal level they say he does not need the testosterone. Then he has to fight with them because he just received the shot, and has to explain that is why it was close to normal. Then they say they will send the prescription but conveniently forget. Then there is the next round of secure emails, and the calls and the complaining, and then after having gone about 8 weeks without treatment he finally gets his medication. Then the cycle starts all over again. Worse, because the doctors change so often and they never actually read the patient’s records to see what the history is and what has been done previously.
In contrast my story is so different. I have a doctor that tests my hematocrit regularly keeps an eye out for any changes and responds within 24 hours when I need a refill. When I have a problem we work in collaboration coming to an agreement that we are both happy with and satisfied with a plan that we both feel is appropriate. I never have a problem but my husband, a veteran that served in a foreign war, and has distinguished himself with exemplary service, (and has the awards and ribbons to prove it), is subject to the whims of doctors and policies that are discriminatory and unforgivable.
Maybe in the next diary I will tell you about one of their doctors that prescribes green vegetables three times per day to treat severe pain to wounded warriors that suffered unimaginable injuries. This doctor had vowed to never prescribe a patient any pain medication under any circumstances. Yes, that is happening. Our Veterans deserve better. Why is it so hard to make sure they are getting the care they so rightly deserve? I mean competent care without judgement, without having to be served by people that are literally deathly afraid of them, and yes, that is another story.
Our VA system has problems, but every veteran will tell you that they do not want it privatized. They do get good care when they get it. Yes there are delays and some polices that need changing, they need to talk to veterans and more importantly veterans that work for the VA because they are the only ones that know the truth and are willing to tell it like it is. Veterans taking care of veterans is the absolute best thing we could hope for. Because vets understand vets, we care, we empathize and we feel that is more than an obligation, or a job, it is an honor to take care of our own. Civilians just don’t get it. I know because I served in the Army Medical Corps, and my husband was a Navy Corpsman stationed with the Marines.