104 Becoming a Patient
processes emerge: biological processes can play roles as well. Inner and
outer selves shaped each other.
Often, physicians-of-record did not comprehend the difficulties caused
by scars remaining from procedures. Jessica, the pediatrician with Hodg-
kin’s lymphoma, said that every doctor should have her procedure done to
know the extent to which needles hurt and can cause permanent psychic
wounds. The psychological impact may be subtle, and therefore ignored by
doctors. But for the patient, these marks can evoke disturbing memories
and lasting emotional pain. Jessica said:
Every doctor should have a bone marrow biopsy done just to see
how it feels! People say, ‘‘I know how you feel,’’ or ‘‘I know you’re
worried about. . . .’’ But I can say, ‘‘It hurts a little when they put
the needle in. You’ll have the scar.’’ Sometimes I add, ‘‘Because
I’ve had one of these.’’ With older patients or parents I’ve had
trouble convincing, I’ve actually shown them the scar: ‘‘This is
where it is. It’s not bad’’—not with a patient I was first seeing, but
with a kid I’ve known for a while who has gotten sicker.
Jessica raised the question of whether it is appropriate for doctors to
display their scars to patients. It seemed overly intimate, but could aid
patients. She felt this trade-off made sense, though other ill physicians felt
the need to balance it with greater professional distance.
Ill doctors became more sensitive, too, to the dependency, uncer-
tainty, and humiliation patients faced. Being left on a stretcher in a
hallway for hours felt disrespectful and humiliating. Yet to striking de-
grees, professional training inhibited earlier realization of the impact of
these deprivations and indignities on patients.
The uncertainties of patienthood took their tolls as well. Harry said:
The patient has no idea what anything is, what’s about to happen,
what to be scared of—infantilized in an environment that puts
you in a johnny gown, and doesn’t even let you wear your own
slippers, or ones that stay on your feet!
Physicians come at 6 A.M ., when the patient is fast asleep, and
say, ‘‘How are you doing?’’ And before the patient has time to
collect him or herself, the doctor is off and running. Patients want
someone who can sit, listen, and empathize a little, and say,
‘‘Mmmhmm. Mmmhmm.’’ It doesn’t have to be very long—five or