90 Becoming a Patient
third-party payers or HMOs, for which these physicians often served as
providers as well. Yet the high cost of HIV medications (up to $20,000 per
year) forced many infected physicians to submit insurance claims, and
therefore divulge their diagnosis. The steep price of these drugs left them
little choice.
Medical Errors
In their individual care, many ill physicians became more aware, too, of
‘‘screw-ups’’ in care. Generally, they were far more cognizant of these
errors—at times potentially lethal—than lay patients would be. For ex-
ample, some of these doctors were dispensed the wrong kind or dose of
medications. Nancy, the endocrinologist with metastatic breast cancer,
was given the incorrect amount of blood thinner.
The nurse made a mistake and gave me a ten- or a hundred times
concentrate of heparin, so I started bleeding uncontrollably. They
couldn’t figure out why. So I had to go back and have a proce-
dure repeated the next day!
Their medical training made these physician-patients more conscious
of medical mistakes than they might have been otherwise, and reveals
the kinds of errors that can occur. Deborah reported, ‘‘When I was
hospitalized, the aide wrote down my temp as 104, instead of 100.4, and
a fever workup was ordered. Luckily, I realized what was going on.’’ No
harm occurred, though extra blood was drawn, and unneeded tests were
run.
Many physicians also became more acutely aware of the extent of
differences in the quality of care between hospitals. Some institutions
may have less experience, particularly with complicated procedures. Jim,
the drug company researcher with leukemia, sought to transfer from his
nearby ‘‘St. Suburbia Hospital,’’ where he received no workup, to an ac-
ademic medical center in a major city.
At my local hospital, very little was done for me. I had a fever and
didn’t get any X-rays. They didn’t know any genetics, or do
a bone marrow biopsy. Over the loudspeaker, I kept hearing re-
quests for people to come in to donate platelets. Then they said to
me, ‘‘We can’t do this procedure right now because we don’t
have enough platelets.’’ That clinched it! I transferred to the city.