Forget Punishment: God Had Nothing to Do with My HIV-Positive Patient

It didn’t seem like my college-age patient Quincy had any idea what was in store when I entered the exam room.

“Hi Dr. Rifkin,” he said with a warm smile as I sat next to him. Quincy (not his real name) had been my pediatric patient for years.

I didn’t delay. “Hi Quincy. I’m afraid I have some terrible news. Your lab work came back—you’re HIV-positive.”

His head went back slightly. His eyes opened wide for a moment. And then he started to cry.

I sat with him as he cried, for minutes. Quincy made no attempt to hide his tears. At one point I asked him if he preferred to be alone for a while. He shook his head no. So I stayed as he continued to weep.

There were so many questions I imagined were spiraling through his head: Am I going to die? How could my partner have given me this? Do I have to “out” myself as gay now? Will my parents reject me? Will everyone reject me?

“What’s going through your mind right now?” I asked gently.

His answer—the source of his anguish that arose with immediacy above all the other issues—set me aback with a force I will never forget.

“I feel God is punishing me for the lifestyle I chose,” Quincy said.

I sat up tall in my chair and responded immediately and spontaneously: “That is not true.” I paused for a moment and then continued. “This news is horrible. But it is not a punishment. This is not about who you are as a person.”

I felt for his anguish. It was difficult to believe that at what was possibly the worst moment of his life, in addition to the sudden emotional enormity of being HIV-positive, having to live with that always, being on chronic medicines, dying if he developed severe AIDS, notifying partners, telling his family, dealing with anger toward the person who gave him the virus, dealing with the knowledge that the infection was preventable, deciding whether he was going to out himself, thinking “my life will never be the same”—in addition to all that, Quincy felt that an omniscient supernatural being was punishing him for being gay. No, worse than that. For choosing to be gay.

That is a cross too heavy for any human to bear, especially with an avalanche of other feelings weighing down from all sides. For Quincy to feel that he was being intentionally punished for decisions he made because of who he is—it was crushing.

Before this experience with Quincy, I had felt that the strongest moral justification for faith without evidence could be made based on consequences. That is, if faith provided enough comfort and well-being, it might be justified, even taking the value of truth into consideration.

That argument crashed when Quincy spoke. I viscerally felt the negative pain and the consequences of unsupported beliefs. The enormity of his emotional burden was overwhelming enough without the weight of the supernatural compounding his misery.

The infection is a horror, but it’s a natural horror.  At the same time, his treatment in the form of scientific medicine and his emotional support in the form of human love are natural too.

I educated Quincy about the infection, about notifying past partners, and about protecting others in the future. We set up an appointment with a specialist, discussed support systems, and discussed whether Quincy was okay to drive home.

Before he left I asked, “Is it okay if I give you a hug?”

He said yes.