“Bruce, can I talk with you for a minute?” Dr. Burnstock spoke quietly to his neighbor.
“Sure, Doc. What’s up?” Bruce followed the doctor away from the neighborhood group.
“Do you mind if I ask you a personal question?”
“Sure,” Bruce responded, though his face registered surprise. “What’s this all about?”
“How long have you had those small blistered areas on your neck?”
“What?” Bruce slapped his hand on the back of his neck, trying to hide the most recent lesions. “Oh, those. I don’t know. Just a few weeks I guess.”
“You have scars from other lesions that are older than a few weeks. How long, Bruce?”
“I guess maybe six months. Actually, it’s come and gone for a year or two — or three. I don’t know really,” Bruce’s face changed from deception to worry. “Why? What’s wrong?”
“It’s called porphyria cutanea tarda,” the doctor explained. “It means your body is not processing a particular chemical in your blood. There are several possible causes.” The doctor paused. “I was reading today about a particular disease that sneaks up on you.” He paused again, considering. “You’re about 59 or 60, yes?”
“Sixty-one next April. Why?” Bruce was now paying close attention.
“Three-fourths of all Hepatitis C is found in those born between 1945 and 1965.” Dr. Burnstock smiled wryly. “Remember those years? The 1970’s?”
“Yeah, some years, huh?” Bruce laughed softly. “I was kinda wild back then.”
“How wild, Bruce?” The doctor was now very serious. “ Drugs? Shooting up?”
“Yeah, pretty wild.”
“You might have Hepatitis C, Bruce. It’s a serious disease. Most of the liver transplants are done for people who have had liver failure because of Hepatitis C. We also get a lot of liver cancer from this disease. In fact, a recent idea is to test everyone in your age group.”
“Wow, I had no idea,” Bruce whispered. “I thought that came from blood transfusions.”
“It did — some — before 1992 when we started testing for it in all blood transfusions. But the largest source is IV drug use, sharing needles, getting tats with unclean instruments — that sort of thing. In about 15% of the cases, the body heals itself. In 85% of cases the infection quietly persists over the years, eventually 30-40% getting cirrhosis — with liver failure, maybe 10% developing cancer.”
“Can it be treated? How do I know if I have it? What can we do, doc?”
“Whoa, slow down.” The doctor patted his friend. “We don’t know for sure if it’s Hepatitis C. And yes, we can test for it. And yes, there are some excellent new treatments for it that are 95% effective. But first, let’s find out if that’s what you have. Can you come in tomorrow?”