Please help out a fellow physician
Nov 2, 2010
Hi dr bob. Please help me get out of a rut. I've been on a low lately. I'm a surgery resident and I have written you before about a similar problem. There was a recent scenario that happened an I really would appreciate your opinion on the matter. I know that I should consult occupational health for all potential incidents but I don't think that an average person would consider this a true incident which is why I want your opinion. I do have a OCD and have gotten psychological help for this problem. I have actually been much better until this most recent incident. I was in surgery and everything went well. While I was examining the next patient I noticed a cut on my dorsal hand. It was relatively fresh and I didn't know how I cut myself. When I cleaned with alcohol it really burned and right before my last patient when I alcoholed my hands I did not have any burning so I know that it was fresh. Now I'm nervous that maybe I cut my hand without noticing during the surgery and I am worried about HIV or hepatitis. I do not know the patient it was since this happened a while ago and I figured that my anxiety would lessen over time but it has not. I'm still quite anxious about the whole scenario.
What do you think. Do you think that I could have cut myself with a bloody scalpel or needle during surgery and not have noticed?? Am I being irrational. As I said I didn't consult occupational health because I think that they will shrug it off since they know me already and I have had other incidences on the past. But as I said I have been much better recently. So please what do you think. Please help a fellow physician out. I know that you are an expert in this field and your opinion would really mean a lot to me. I will donate to your charity for your help and time. Thank you.
Response from Dr. Frascino
"I know that I should consult occupational health for all potential incidents. . . ." I absolutely agree. Even if you are concerned that "an average person would not consider (your potential exposure) a true incident. . . ." If that were indeed true, occupational health would simply document the incident and offer you reassurance. Had you done this at the time of the potential exposure, you wouldn't be writing to me now and your OCD wouldn't be flaring OOC (out of control)! Hopefully this is one lesson you have now learned.
To answer your question, no, I doubt you could have cut yourself with a bloody scalpel or needle during surgery and not noticed. However, I wasn't there, nor did I have the opportunity to evaluate you immediately after the incident; consequently, I cannot give you complete reassurance. If you remain concerned, get an HIV-antibody test at the three-month mark. This can be done through occupational health if you are willing to have the incident documented, even after the fact.
Thanks for your tax-deductible donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. Continue to work closely with your therapist to control your OCD.
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