Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 137

126 Becoming a Patient individuality, and identity devastated them, and illness taught many the costs of dependency, uncertainty, and humiliation. They learned how patient time, doctor time, and hospital time conflicted; how ‘‘a person waiting is a person suffering’’; and how poor access to a doctor can rein- force disturbing feelings of dependency and loss. They complained, too, of indirect or nonexistent communication, particularly about taboo topics such as mental health and sexual problems or side effects, as well as of verbal or nonverbal insensitivity and trivialization of problems. Physician hubris facilitated poor communication, and precluded self-awareness. Yet these doctors had trouble reconciling their new experiences as patients with the fact that in the past they, too, had sometimes kept patients waiting and had not promptly phoned patients back. The pro- fession hampered awareness of many of these concerns, further high- lighting the degree to which it viewed and constructed patients as unequal, distant ‘‘others.’’ These doctors became more aware, too, of how definitions concerning time varied widely (e.g., what it meant for disease to progress ‘‘slowly’’ or ‘‘rapidly’’). Moreover, as a result of competing time demands, test results and treatments fell ‘‘between the cracks.’’ Doctors structured time in ways that patients had to follow (e.g., in the waiting room), reflecting and reinforcing authority relationships within these settings. What happens when disagreements resulted? Sally felt compelled to go ‘‘on strike,’’ exercising what she felt was her only option. As a doctor, she felt empowered to refuse her doctor’s orders. Presumably, lay patients would not feel as empowered to do so. Within a culture, time is socially constructed, but clearly may be ex- perienced differently by various groups (i.e., doctors and patients). Sur- prisingly, heretofore these doctors were not aware of how much their patients’ experiences clashed with their own. One’s experience of time helps shape, but can also limit, one’s point of view. Though questions emerged of whether these ill physicians’ complaints and expectations were reasonable, these doctors felt their standards were fair. Still, it remains unclear how to reconcile their expectations with the ‘‘reality’’ that the profession has difficulty meeting these standards. Pro- fessional and public education needs to find more effective solutions to address these discrepancies, obstacles, and dilemmas. As we shall see, increased awareness of these barriers can help.