GWEN HAD A HANGOVER the next morning. The headache lingered into her mid-afternoon meeting in a hospital conference room. Thirty nurses, medical assistants, and laboratory technicians sat around the perimeter. They looked tired after finishing their eight hour shift and uneasy about the subject to be discussed. Gwen introduced herself and explained the specifics of what had been advertised in flyers posted throughout the City Hospital corridors. They could sign up here to get a blood test that would determine if they had been infected with the AIDS virus. In addition, they could opt to have the test repeated every six months.
“It’s voluntary screening,” Gwen said. “I want you to be clear about three things. First, all results will be kept strictly confidential. Second, screening is being implemented for our protection, to learn how to make our jobs safer. Third—this hopefully is just hypothetical—if someone were to be infected from a needle stick or scalpel wound, the antibody results could be used to document it was due to the occupational exposure rather than…some other behavior.”
Lilly, a Filipina nursing supervisor, exactly Gwen’s age, raised her hand.
“Yes?” said Gwen, recalling a framed photograph of three children she had seen on Lilly’s desk.
“How long before we know the result?”
“We only have enough lab tech support to run the assay once a week, and we have to schedule a counseling session to give you the result. So right now it’s taking about two weeks from the time your blood is drawn until you can get the result.”
“That’s a long wait,” objected a middle-aged black ICU nurse.
“I couldn’t agree more, but regulations require a counselor to be present when you get the result, whether it’s negative or positive. Most employees at City Hospital want to participate, and there aren’t enough counselors to schedule it any sooner. Once we’ve completed this round of screening, we can spread out the follow-up testing. Then the waiting time will get shorter.”
A young, blond woman with a Swedish accent said, “I have a friend who was tested in a research study. He says it’s very frightening, waiting to find out.”
“Honey,” said an older gay man, “The folks I know who’ve been through it say the waiting is ice-cold terror.”
There was a collective, introspective lull. Gwen looked around the room to see if anyone had an question. She saw doubt and vacillation, though no one appeared ready to articulate it. She invited comments and was met with silence.
A few people walked out. The rest got in line to sign a consent form and choose a date for their blood draw. As the last staff somberly exited, a public health nurse hurried in. The woman was assisting Gwen in this project and held one of the manila folders they were using to keep each participant’s records.
“Can we talk?” she whispered urgently to Gwen.
“Sure, what’s up?”
She didn’t speak until the room was empty and she had shut the door.
“One of the stored samples is positive. It’s a woman. Her only risk factor is a needle-stick three years ago.”
Gwen felt her chest pound. The pace of her breathing involuntarily sped up. She couldn’t remember the drill for dealing with an infected health care worker. After her own close call, she had never really believed it could happen to anyone else here. What was she supposed to do now?
“Who is it?” Gwen asked.
“You sure you want to know? Her post-test counseling visit is next week. We can’t tell her before then, can we?”
“No!”
Gwen considered the implications. If she knew who it was, that could help her prepare to handle the woman’s reaction. But what if it was someone she worked with in clinic? What if they interacted before the disclosure meeting? How could she not be tense and artificial? And afterwards, wouldn’t that be seen as a betrayal?
“When’s the appointment?”
“Monday, three o’clock. Can you be there?”
“Of course I’ll be there.”
Gwen deliberated, eyes fixed on the manila folder. She held out her hand.
As soon as Gwen was alone in her office, she opened the folder. It slipped from her moist, shaking fingers onto the floor. She wiped her palms on her skirt, clenched and unclenched her fists, and tried again.
It was a name she didn’t recognize—one small mercy—Laurie Hampton, an ICU nurse. Another was her age, forty-seven. Future pregnancies wouldn’t be an issue. Gwen read the account of a needle-stick exposure. The source patient had later been diagnosed with Pneumocystis pneumonia. The file was small, just the incident report, a behavioral questionnaire that had every box checked ‘No,’ a signed consent form, a phone number and address in Daly City, and a woman named Tanya listed as an emergency contact.
Gwen noticed a page stapled behind the report. It was a photocopy of a letter dated a month after the incident. Herb Wu had written to City Hospital’s head administrator demanding the hospital refer Ms. Hampton to a psychotherapist and pay all costs.
She closed the folder and chewed on her ballpoint pen. Suddenly, the pen snapped. She watched in horror as a drop of black ink fell from her lip onto the file’s cover, obliterating Laurie Hampton’s identification number.