‘‘Screw-ups’’ 119
As mentioned, waiting can be one of the most difficult parts of being
a patient. As fellow physicians, these doctors received more ‘‘call backs’’
than lay patients. Still, this special treatment did not fully alleviate the
problem. Steven, the suburban endocrinologist with HIV, recognized that
he faced fewer delays because he was ‘‘halfway’’ between a patient and a
doctor. But he remained perturbed.
I hate waiting for things that I know don’t take this long—calling
doctors and not being put through immediately. I struggle with
being a patient and being a doctor at the same time. If I called just
as another doctor to a doctor, to discuss a case, he’d come right to
the phone. If you’re just a patient, he won’t. Doctors will call you
back at their leisure. You play phone tag.
As alluded to earlier, these frustrations stemmed partly from the sym-
bolic meanings of these delays: the diminution of status.
A few doctors admitted, ‘‘I know I’ve kept patients waiting, too,’’ but
most had difficulty resolving this discrepancy between having kept pa-
tients waiting and now having to wait themselves. Medical socialization
impedes awareness of these concerns, distancing and disconnecting doc-
tors, who then see and construct patients as the ‘‘other.’’ Grueling hours of
premed courses, med school, internship, and residency instill separation
that helps physicians maintain professional distance. This distance aids
doctors in assisting many patients over time, minimizing burnout, yet can
diminish patient satisfaction and care.
At the same time, many of these physicians simply accepted that de-
layed timetables are ‘‘just how things are done.’’ Pascal, the Lebanese
internist, now understood these issues more clearly, but had trouble acting
more swiftly for patients.
I now understand a lot more how long things take to happen when
you call my office and ask for something. But that’s just the system,
and how people are used to doing things. It’s unfortunate, but
there’s only so much I can change what I do.
Pascal saw even his own office as part of this intractable ‘‘system’’—
seemingly beyond remediation. Yet his feeling of being unable to alter
his own practice—his sense of helplessness—highlighted barriers, both
real and perceived, beyond these individual providers. Some of these
tensions may be inevitable, since the experience of being a patient may
invariably involve both waiting and suffering. Indeed, the words ‘‘patient’’