It had been crazy busy all night in the emergency department and I had been running from room to room patching holes and trying to get patients seen.

I felt behind all night.  Finally, I had a moment to collect my thoughts and turned my attention to a patient who had been waiting for quite a while.

This patient had multiple large and deep lacerations to his forearm, self-inflicted wounds caused during a moment of alcohol induced despondency.  I walked into the room, apologized for the delay, washed out the wounds and began to sew them closed.

The patient seemed nice enough.

He had sobered up some, and he had the mental clarity to recognize that he had made a mistake.  We had a great conversation — everything ranging from sports, to handling relationships, to how he was doing managing his HIV infection.  You see, in addition to a series of volatile relationships and a problem with alcohol and other substances, this patient also carried a diagnosis of HIV, and he’d been noncompliant with his HIV medications.

I was putting the finishing touches on the wound repair, nodding and listening to this gentleman as he told me stories about his situation, when I felt a sudden prick to one of my fingers.  I looked down, and to my dismay noticed a small bead of my own blood growing underneath one of my gloves.

Quickly, I finished the repair, excused myself from the patient’s room, and rushed to a nearby sink to pull off my gloves.  As I washed my finger off under the facet head I had the sickening realization that I had stuck myself with a needle that had been covered with the blood of a noncompliant HIV patient.

My head began to swirl.

I called our hospital’s infectious disease contact, and reported the event to the necessary departments per protocol.  I had my own blood drawn for testing and was begun immediately on a month-long regimen of medications used to diminish the possibility of HIV transmission.  At the end of the month, I was told, my blood would be redrawn to confirm that I was still HIV negative, and then drawn again for follow up testing months later.

As a rather experienced clinician, I knew the scientific literature on occupational exposures to needlestick injuries.

In my calm, scientifically trained intellect, I knew that the chance of transmission of HIV with a solid bore needle through a glove — even a needle covered with HIV blood — was infinitesimally low.  Yet, on my drive home my mind was reeling — what if I was that one incredibly unlucky individual who actually contracts HIV through a stick?  How would all this affect my relationship with my wife?  If I do get HIV, how would this change my relationship with my kids?  What about work and finances and retirement?

Over the course of the next thirty days, I took the medicine I’d been prescribed, pushed back all the anxieties and concerns, and continued about my business.  I must confess, however, that there were still some nagging doubts that entered my mind during quiet moments.

At the end of the month I again tested negative, and have tested negative, thankfully, to all subsequent tests.  It was then — as the relief washed over me after learning of my post-month results — that I began to realize that in spite of my continuing in my daily routine, I had carried some significant concerns about the entire episode.  Even though I knew the data, I was anxious to get that final clearance and close the chapter on that episode.

The entire experience was interesting, in retrospect.

For a brief period of thirty days, I had walked — ever so tenuously — in the shoes of my patient that early morning in the emergency department.  I am sure that when he received his diagnosis, he had had many of the same fears and concerns that I had after my stick, the only difference was that his test had turned out positive, and he had far fewer resources to deal with his burden.  I had a loving family, a good income, disability and life insurance, educated peers who hopefully would have been understanding had my test turned positive — my patient had none of these advantages.

As I have continued to reflect on this experience, what shocked me is not how different I was to my patient, but how easily I attributed the difference to my own innate goodness.  Why was I the physician of privilege, and he the patient from among the downtrodden?  Well, I had reasoned, I had studied hard, and made wise decisions, and denied myself, and risen through the ranks to become the individual I was … or so my thinking had been, once I pulled it out into the sunlight to examine it.

But in reality, when objectively examined, so much of who I had become was due to circumstances far beyond my control.  I did not choose my parents.  My innate abilities that allowed me to study and comprehend information were in many ways the outcome of a genetic lottery over which I had no control.

In fact, merely the period of history in which I had been born was a huge factor in my successful trajectory.  Had I been born among the Mongols during the time of Ghengis Kahn, or among the Zulu warriors during their epic battles with the British, or during any of the turbulent times of warlords and men of brute strength, it is likely my slight frame and lack of athletic talent would have been a much larger impediment than it is today in the information age.

In other words, so much of what I attributed to myself as evidence of my impressive “goodness,” had absolutely nothing to do with me.

The difference between succeeding as I had — or failing with the same amount of effort — was simply having different parents, or being the recipient of a different shuffling of nucleotides, or being born in the era of feudal lords instead of the Internet and computer nerds.

It was the thinnest of margins — as thin as a whisper, or a stretched latex glove over a finger.

Gregory Bledsoe is an emergency physician who blogs at GH Bledsoe.