This three-sentence summary provides the key details and events from the document: Dr. Foster meets with Barbara Dunham, an elderly woman suffering from declining health, and her daughter Catherine to discuss Barbara's condition. During the meeting, Dr. Foster reveals to Catherine that despite previous diagnoses, Barbara has actually been HIV-positive for years and her symptoms are effects of the virus going untreated. Catherine is shocked by this news and unsure how to process it or what steps to take regarding her mother's care and treatment going forward.

1. 1
Three Letters
A Short Play
By
Kristin W. Untiedt-Barnett
Characters:
Nurse – sincere, a friend to Barbara
Barbara Dunham – 79, lives in a retirement community, suffering from health problems
Catherine Rosenberg – 45, Barbara’s daughter, concerned about her mother’s health
Dr. Foster – 34, physician, new to the retirement community’s medical center, kind
(SCENE: Dr. Foster’s formal office at The Oasis
Medical Center in Florida.
TIME: The present.
AT RISE: NURSE is escorting BARBARA and
CATHERINE into the doctor’s office.
CATHERINE has to guide BARBARA who is
confused and somewhat disoriented.)
NURSE
Right this way, ladies. Just have a seat and Dr. Foster will be right in for your appointment.
CATHERINE
Thank you.
NURSE
It’s good to see you again Mrs. Dunham. You do look like you’re feeling better since last time
we saw you.
CATHERINE
I hope her health is on an upswing now. It’s been a long time since she’s felt really…good, you
know.
(BARBARA has wandered to a painting on the wall. She reaches out to
touch it.)
CATHERINE
Mother? Mother?
BARBARA
Yes, dear?

2. 2
CATHERINE
Come in to the office. We have to visit with Dr. Foster.
BARBARA
Oh, yes. He’s so handsome, Dr. Foster.
NURSE
Well, he’ll be here shortly so you can have a nice visit.
(NURSE helps CATHERINE guide BARBARA to a seat in the office.)
CATHERINE
Thank you. I think I can take it from here.
(NURSE begins to exit)
BARBARA
Good bye, dear.
NURSE
Now, don’t forget to stop and say goodbye on your way out, too.
CATHERINE
We won’t, will we, Mother?
BARBARA
Oh yes. We can’t forget to say goodbye.
(NURSE exits)
BARBARA
Those OMC girls are just so nice to me…every time I come for a visit.
CATHERINE
OMC girls?
(DOCTOR FOSTER enters)
FOSTER
Oasis Medical Center. (to BARBARA) You just love all my girls, don’t you Barb.
BARBARA
Oh, hello Dr. Foster.

3. 3
FOSTER
And I see you’ve brought a gal of your own with you today. Well, Barb, aren’t you going to
introduce me?
BARBARA
Doctor, this is my daughter…(forgets her name)
FOSTER
Catherine?
CATHERINE
Yes, but you can call me Cathy.
FOSTER
Well, it’s nice to finally meet you. I’m glad that you could come down so that we can discuss
your mother’s health on a more personal level.
BARBARA
Cathy came all the way from Pennsylvania to see me.
FOSTER
You are one lucky lady, to have a daughter that loves you so much that she will travel so far just
to see you.
BARBARA
Indeed.
FOSTER
Before we get started, I’d like to hear your feedback, Cathy. What do you think of your mother’s
progression?
CATHERINE
I don’t know if I’d call it progression. It’s more like regression. Her Alzheimer’s seems to be
worse than ever. And I’m also really concerned about her weight. I think she’s losing again.
(FOSTER approaches BARBARA)
FOSTER
I’m going to have to listen to your heart again. (to CATHERINE) I’ll have the nurse weigh her
and we’ll look at the charts for comparison. (listening to BARBARA’s heart) Take a deep breath.
And another. Good. Sounds like your ticker is in good shape.
(FOSTER pages the NURSE)

4. 4
FOSTER
Now, Barb, the girls are going to take you for some quick tests; weigh you, check your blood
pressure –
BARBARA
They won’t take my blood again, will they?
FOSTER
Actually, they will need to take some blood today. But it’s just a little for some very important
tests. We have to make sure we’re keeping you in tip top shape.
BARBARA
Yes, I do need to be in my best shape for the bridge club on Thursday.
(NURSE enters)
NURSE
Bridge club is on Thursday? Well, we don’t have much time to get you ready.
FOSTER
(to NURSE) We’ll need some time here.
NURSE
Alright. Let’s go Mrs. Dunham, and after we get you all fixed up we’ll have a nice cup of tea.
(NURSE nods at FOSTER and escorts BARBARA out. FOSTER’s
demeanor becomes more solemn)
FOSTER
I really am glad that you were able to make the trip. It’s very important that you are well
informed.
CATHERINE
You don’t sound enthusiastic.
FOSTER
Well, you should be taking your mother’s health very seriously. When a person is nearly 80
years old their family should be actively involved to assist in making decisions regarding
medical care, particularly when one is suffering from memory loss and dementia. First, I’d like
to ask you a few questions regarding your mother’s history.
CATHERINE
Ok. Sure.

5. 5
FOSTER
When I came to OMC last year to take over for Dr. Jones I found that the files on several of our
patients did not include important personal information. Considering your mother’s condition, I
thought it would be best to ask you.
CATHERINE
What kind of information do you need?
FOSTER
Well, how long has she lived in the Oasis Retirement Community?
CATHERINE
She moved here about 11 years ago, just after Dad died. Stroke.
FOSTER
Alright. When did you mother first move into assisted living?
CATHERINE
About three years ago, she had congestive heart failure. It was really hard on her. She just
couldn’t seem to shake it, you know. She spent 4 weeks in the hospital. After that, she was just
so weak. Do you think the assisted living program is the best option for her?
FOSTER
Assisted Living at Oasis is one of the best in Florida. At this point, her situation requires extra
care, but not permanent hospitalization.
CATHERINE
What do you mean, “at this point?” Do you expect the Alzheimer’s to get worse so quickly?
FOSTER
Mrs. Rosenberg –
CATHERINE
Cathy.
FOSTER
Cathy. After reviewing your mother’s file, I decided that I needed to do some more tests to get
to the root of the problem.
CATHERINE
What kind of testing? She has Alzheimer’s. We know that already.
FOSTER
Well, with her dementia, history of heart problems, weight loss and other symptoms, I thought it
deserved further scrutiny.

6. 6
CATHERINE
You mean, it might not be Alzheimer’s?
FOSTER
The tests results revealed that Alzheimer’s is not the cause –
CATHERINE
What? All this time we thought… If it’s not Alzheimer’s – Oh my God…cancer! That
explains…
FOSTER
It’s not cancer –
CATHERINE
No? But the symptoms?
FOSTER
It isn’t cancer.
CATHERINE
Thank God! What about the dementia? Her heart?
FOSTER
I have reason to believe that your mother never had congestive heart failure. Sometimes
pneumocystis pneumonia can present itself as heart failure. The symptoms are very similar.
CATHERINE
Well, that’s a relief. No wonder it took so long for her to recuperate. She was misdiagnosed. So
this…pneumocystis pneumonia…how did she get that? Does it have long-term effects? And
how does this explain the dementia?
FOSTER
Mrs. Rosenberg. (deep breath) Mrs. Rosenberg…you mother’s test results showed that she is
HIV positive… Her symptoms – the pneumonia, weight loss, and dementia – are effects of the
virus going untreated…
(Silence)
FOSTER
Mrs. Rosen –
CATHERINE
I’m sorry. (uncomfortable laugh) I don’t think I heard you correctly. HIV positive?
FOSTER
Yes. The test results showed –

7. 7
CATHERINE
Test results? Well, your test results are wrong!
FOSTER
We tested four times, just to be posi…sure. All results came back the same.
CATHERINE
She’s 79 years old! She can’t have...
FOSTER
HIV is does not discriminate.
CATHERINE
But how could she have gotten… (gasp) The blood work…in the hospital…when she had the,
the…pneumonia.
FOSTER
Medical facilities and processes are very sterile and no longer considered a high risk for HIV.
CATHERINE
Dr. Foster! What are you suggesting? That my mother…I can’t even think about it!
FOSTER
Mrs. Rosen…Cathy, recent studies have shown that the number HIV cases in the elderly
population is on the rise. With advances in medical technology, people with HIV and AIDS are
living longer, but they are also passing it on to their partners.
CATHERINE
(quietly) This can’t be happening…
FOSTER
Most patients over 65 aren’t tested for HIV as a part of their regular health exams. And the
symptoms are often misdiagnosed – as I believe was the case with your mother’s diagnosis of
congestive heart failure, and Alzheimer’s.
CATHERINE
Alzheimer’s? (almost laughs) That would be better than…this.
FOSTER
Many elderly patients don’t know they have HIV because they are uninformed and don’t
consider themselves to be at risk.
CATHERINE
I thought you said that…it doesn’t discriminate.

8. 8
FOSTER
It doesn’t. The elderly are at just as much risk as anyone else. However, so many of them stop
taking precautions against STDs that they have become one of the fastest growing HIV positive
populations.
(CATHERINE has become quiet, confused and disoriented, like
BARBARA)
CATHERINE
I don’t know…
FOSTER
What?
CATHERINE
I don’t know…what…to do.
FOSTER
You have some decisions to make.
CATHERINE
Yes.
FOSTER
The first is treatment.
CATHERINE
Ok.
FOSTER
I would like to start her on an aggressive ATN combination therapy to combine the effectiveness
of several ARVs.
CATHERINE
Yes.
FOSTER
She can take an AZT, ddI, and ddC cocktail to start…
CATHERINE
Ok.
FOSTER
Cathy, are you alright?
(CATHERINE does not seem to respond. Her eyes well up with tears.)

9. 9
FOSTER
I know this is a lot to take in. But the sooner we start her treatments, the sooner we can get her
T-cell count up. And with continued treatment and proper diagnosis of any other conditions –
(CATHERINE is crying. She is upset, but not angry.)
CATHERINE
You know? You know? How can you know what this is like? My mother has…I can’t even say
it! (collects herself) My mother has…H-I-V. My 79-year-old mother has HIV.
FOSTER
Cathy…
CATHERINE
What am I going to tell my sister? What do I tell my children? Oh God! What do I tell her?
FOSTER
That is a decision that we should definitely discuss. Considering the progression of her dementia
I’m not sure she would –
CATHERINE
(calmly) No. She won’t understand. If I don’t even understand – ATN, ddI, AZT…all of this –
how can she?
FOSTER
I don’t suggest that you conceal the fact that she is sick, nor should you lie to her. But there are
so many unfamiliar terms, I fear that going into detail would only add to her confusion.
CATHERINE
How could I not tell her? She’s not so confused that she won’t know something’s wrong. And
what about all of these treatments?
FOSTER
The new medications can be added to her established routine without much trouble. But her
progress will need to be closely monitored. She may have to be hospitalized or even move into a
permanent facility.
CATHERINE
But I can’t do that…
FOSTER
Individualized care may be necessary.
(CATHERINE collects her emotions and dries her eyes.)

10. 10
CATHERINE
Yes. (quietly) I understand.
(NURSE brings BARBARA into the office.)
NURSE
We’re back, now. We had some lovely tea, didn’t we Mrs. Dunham?
BARBARA
Yes. It was lovely tea.
(NURSE notices CATHERINE’s tears and gives FOSTER a knowing
look.)
FOSTER
I’ll give you a moment.
(FOSTER and NURSE exit. Ad lib about paperwork and pamphlets.
CATHERINE tries to hide her tears.)
CATHERINE
You enjoyed your tea, mother?
BARBARA
Oh yes, dear. I always have such a lovely time here with the girls. Cathy is something the
matter? Are you sick?
CATHERINE
Oh. No. I’m not sick…Come, hold my hand?
(BARBARA crosses to CATHERINE and takes her hands.)
BARBARA
I love you, Cathy.
CATHERINE
I love you, too, mom…Mom? What would you think about…coming home with me; to
Pennsylvania?
BARBARA
It’s so much warmer here…Oh. Cathy, dear, do you need me to come home and take care of
you?
CATHERINE
Yes, mom. I need you…to take care of me.

11. 11
(LIGHTS FADE OUT)
END