WHY CLEAN NEEDLES TO SAVE INNOCENTS

The debate over needle sales in Sacramento County has generated much
heat - and fear. On Tuesday, the Board of Supervisors is scheduled to
vote on whether to allow the nonprescription sale of hypodermic needles.

IV drug users rouse little sympathy. Most of us find it hard to care
about those who made such terrible choices. As any physician can tell
you, most of these users are probably lost. Without tremendous
efforts by the user and society, in rehab and support, most will
destroy their lives and die before their time. Our society seems far
short of the compassion and cash it would take to rescue most of
these lost souls, but we could save some of them, and perhaps more
important, many of their innocent victims.

In the mid-1990s, I began caring for a family in my practice who
seemed much like any other. I'll call them Frank and Susan, and they
had a son, about 9 years old when we met. Their early visits were
typical problems for any family doctor: colds, scrapes and sprains,
perhaps the first signs of high blood pressure. I soon realized this
was not the world's best marriage, and Frank certainly not the best husband.

This was nothing unusual - marital strains are as common as low back
strains for any doctor, and more stubborn. Frank would rarely come to
the office with his son or his wife, and rarely see me himself except
for minor injuries. If he had any concerns about his life or health,
he denied them to me, and probably to himself.

Through Susan, I learned about his drinking, and that he sometimes
didn't come home, for one night or several. The separations were no
surprise, nor were her later attempts to take him back. We all share
the urge for a pair of warm arms - sometimes, any arms - to comfort
us after a hard day, or week or life. There are few human desires
stronger than the hope to keep together a family to nurture and love us.

When Frank came to the hospital after a car accident, his surgeons
learned what Susan may or may not have suspected: He was not only
drinking, but also using drugs, and he was HIV positive.

When he left the hospital he was no more reliable than before about
making or keeping appointments, or taking the complicated regimen of
medicines needed to slow down HIV. In two years he was dead of AIDS.
His wife also had a hard time accepting the reality of what had
happened to her family.

When she tested positive, she hesitated for months before even
agreeing to see a specialist about her HIV. She started treatment
almost a year later, but her life continued to fall apart. She may or
may not have taken her medicines correctly, but her blood counts
worsened, and she began missing appointments. She became unable to
work, and soon after neither her specialist nor my office could find her.

Their son, now about 20, will soon stand over the graves of both his
parents, if he hasn't already stood there. I pray he will be able to
put together a better life for himself, without the support and
guidance of a family to help when things get tough. Will he wonder
how his life might have been different if his father had gotten clean
needles and not infected his mother? Will we wonder, if our Board of
Supervisors fails to implement needle sales already approved by the
governor and Legislature, why we failed to try to save even one
family like his?

About the writer: Francisco J. Prieto, M.D., is a family physician
practicing in Elk Grove, and a Patient Advocate for Diabetes on the
Independent Citizens Oversight Committee. The committee oversees the
California stem cell initiative.