110 Becoming a Patient
medications have a lot of side effects that oncologists never explain.
It pisses me off when I see them talking themselves up for some-
thing that is ridiculously minuscule.
Admitting negative outcomes, despite the promise of modern scientific
triumphs, is to confess and confront medicine’s limitations. Hence, doc-
tors may frame prognoses and treatments in unrealistic and self-serving
ways. Anne continued:
Doctors lie to themselves and their patients, because of the limi-
tations of what they’re doing. Medicine has made immense prog-
ress, but there’s a whole lot more to do, and a lot of doctors,
especially oncologists, just mislead patients.
Anne’s feelings grew from both her patients’ and her own experiences,
each set sharpening her critique.
At the extreme, especially early in their careers, doctors may insist on
upholding their power, even if patients receive poorer care as a result. The
fact that doctors think they are more important than their patients may be
a necessary conceit: this bravura and sense of confidence can maintain a
distance that bolsters objectivity and, as we will see later, generates a pla-
cebo effect. Dan, the oncologist with chest metastases, said, ‘‘Everyone
wants to be important. But getting away from your own God complex is
important, but difficult: you need to prove how important you are.’’
Arrogance can hamper the quality of care provided. Deborah de-
scribed physicians ‘‘playing the game of the doctor. It’s really arrogance:
‘I am the doctor, three steps above you.’ ’’ Indeed, such hubris almost
killed her. When she needed oxygen, a resident neither gave it to her nor
called a superior.
I was suffocating, coughing and losing my breath, and needed
oxygen. I wanted to die. The resident walked in, and didn’t know
what to do. I said, ‘‘Go call somebody!’’ She refused: ‘‘I am the
doctor. I’m not going to call anybody.’’ I happened to know nurses
on the floor. One walked in just to say good morning, and said
to the physician, ‘‘You’re out of your mind! She needs oxygen!’’
The nurse grabbed the mask and gave me the oxygen, and told the
resident to leave. That nurse saved my life.
Physicians get trained to interpret patients’ complaints, seeking un-
derlying, known medical problems; but in so doing, they may discount