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By Stanley T. Lewis, MD, MPH, AAHIVS

St. Hope Foundation

Patience and tolerance are very similar as they both require you to yield. Patience requires you to yield to Father Time; be patient and things will eventually change. Tolerance requires you to yield to Mother Nature; it is what it is – accept it.

If you are a parent, you can relate to the never ending need for patience in child rearing. Patience is applied when you know there’s a change coming. You know that little Sam will eventually learn how to use the potty; apply patience. You know that little Suzie will learn how to ride that bike; apply patience. Tolerance, on the other hand, is different. Tolerance is what you apply when there’s not a change coming. Johnny is gay; apply tolerance. You must accept him and love him as he is. He’s not going to (nor should he) change. Make your circle of love big enough to welcome your gay son. If you are unable to apply tolerance, everyone loses. Conversely, you may not tolerate your teenager sneaking out at night. That behavior should not be tolerated and if it continues, there will be consequences.

I think about patience and tolerance when it comes to HIV. I remain patient as we wait for a cure to reveal itself. We have made tremendous strides toward curbing the immediate threat. But HIV is no chump. You can still get it if you’re not careful and smart. You can still die from it if you’re not committed to taking care of yourself. Conversely, I am not tolerant of HIV. I don’t accept it as a constant, unmodifiable fact of life. However, when I see beautiful, young, informed people coming into the clinic newly diagnosed with HIV, I wonder have we become tolerant? Do we believe that HIV is an unmodifiable reality? Have we become complacent and accepting while we simply wait until high risk behaviors finally catch up to us? It’s okay to be patient as science races to find a cure. It’s not okay to become tolerant of this disease in our society.

I also think about patience and tolerance when it comes to HCV. Hallelujah! I no longer have to patiently wait for a cure. The wait is over; the cure is here. I don’t have to stand by helplessly and watch patients succumb to liver disease caused by this virus. I don’t have to be patient nor do I have to tolerate HCV anymore. So now, the next battle begins. We have to mobilize the healthcare apparatus to take the fight to HCV. With an estimated 170 million infected worldwide and 350,000 deaths annually from this disease, the mobilization is monumental, but it must be done. However, I’m afraid the biggest threat to prompt eradication may be access. We don’t have to tolerate HCV anymore but we will if we don’t hurry and find the political will to overcome the costs applied to the cure. In the face of a cure, it is even more painfully tragic to watch hundreds of thousands continue to suffer and die from this disease unnecessarily. This must change; this cannot be tolerated.

I implore the insurers, manufacturers, governing agencies, and all stakeholders in this human struggle to we rise above whatever self-imposed obstacles we have constructed and win this fight against HCV. The fruit of the scientific labor has been harvested. We need only to bring this balm to Gilead. Patience and tolerance are the same in that they require us to yield. With HIV, we’ll continue to be patient but we should not allow ourselves to become tolerant of this disease. With HCV, we don’t need to yield to the virus any longer. The only yield signs are the ones we’ve constructed. And with our children, we continue to pray for tolerance as appropriate and patience always.

About Dr. Lewis

Dr. Lewis is an Internal Medicine physician with more than 20 years of clinical and research expertise treating patients diagnosed with Hepatitis C, HIV, high blood pressure, diabetes, obesity, gout, fatigue, depression, headaches, hypothyroidism, osteoporosis, sleep apnea, chronic obstructive pulmonary disease, antibiotic resistance, end of life issues, women’s health, etc. Dr. Lewis believes in taking care of the whole patient. Dr. Lewis is the chief medical officer of St. Hope Foundation and has served for several years as the Assistant Professor of Medicine in the Department of Internal Medicine at the University of Texas Medical School in Houston. Dr. Lewis is a nationally recognized researcher and HIV specialist by the American Academy of HIV Medicine. Dr. Lewis’ motto is “I am here to care for the patient.”