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December 3, 1997

Crossing Over

Author Affiliations

El Paso, Tex

JAMA. 1997;278(21):1721. doi:10.1001/jama.1997.03550210015006

Mr Luis Gomez in ICU bed 6 had hemophilia. As I put in the central line, I was thinking of the fact that despite all the new treatments for HIV, he was still losing the battle. He had once told me that he believed he and his twin brother, Jose, were lucky because they did not have to bleed to death like countless other persons with hemophilia before them. Though the factor VIII that had kept them from bleeding had also infected both twins with HIV, they did not seem to dwell on it anymore, almost as if this were their destiny, their fate. Now, here he was, Luis, the frailer twin, in the ICU with pneumococcal sepsis and multiorgan failure, tubes with bloody collars entering and leaving his body, machines beeping all around him.

I often wondered what Jose thought as he stood by the bed in this technological