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My Apology and a Call to Action on MDR-TB

After a career as a physician in public health I find myself impelled to offer a public apology to quite a few patients, only a fraction of whom I have treated. I have been offering up my apologies to individual patients for a few years, but somehow it doesn’t seem to be enough. The situation starts with my description of a particular diagnosis and treatment plan, “Your TB is unfortunately due to a TB germ resistant to the two most powerful drugs for treating TB (INH and rifampin). We call it multi-drug resistant, or MDR-TB. I am confident, with the help of the nurses and other TB clinic staff, that we can cure your TB, but we will need to start you out on a 2-year course of treatment with daily injections plus oral medications. This treatment will almost certainly save your life and within a few months allow you to spend time with your family and friends without putting their health at risk. Because TB spreads through the air if not cured, we have no choice as public health providers - we must cure your TB or restrict your activities to prevent others from catching this disease. I will stop talking now and want you to ask any questions you have about the diagnosis or treatment.”

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