2002

Introduction

In November 2000 a group of provincial experts, including representatives from the BC Centre for Disease Control, doctors who provide abortions, and staff from the three major abortion clinics in Vancouver, met to define the standards for antibiotic prophylaxis at the time of induced abortion.

Background

Case presentation

A 43-year-old man who has sex with men and who has advanced HIV disease, a CD4 count of 360 cells/µl, and a viral load of 3320 copies/ml presented with a 5-month history of anal pain and rectal discharge. The patient had a long history of anal symptoms, and initially thought his rectal bleeding was indicative of worsening hemorrhoids. The anal pain increased to the point where he sought medical attention for pain control.

Introduction

I appreciate all the hard work done by the BCMA on behalf of all BC physicians, especially during these challenging times. What I don’t appreciate is the seeming unwillingness or inability of some physicians to recognize that medicine has an ever-changing face. Why did the editor MHG, in the opening lines of his recent editorial (BCMJ 2002;44[3]:115) recognize only male physicians, “gentlemen physicians of the BCMA,” as coming to our defence? Is Dr Heidi Oetter not a woman?

Recently, within 24 hours, two disturbing incidents concerning senior citizens and their family physicians came to the attention of this fellow septuagenarian.

One older patient who is the ongoing provider for a family with a mentally handicapped dependant, and who has been affected with ongoing renal failure, told his wife that he had been declared by his ($400 000 + $50 000) GP that he was too old to qualify for dialysis. The anguished wife was later reassured on good authority that age plays no part in the criteria for dialysis.