128 Becoming a Patient
annoyed them. Did I have fewer referrals afterward because people
said, ‘‘He has heart disease, we shouldn’t stress him so much,’’ or
‘‘Is it safe to send him a patient when he might get sick next week?’’ I
wasn’t aware of that, but it might have entered someone’s thinking.
In fluid, complex work settings, Harry illustrated the difficulties of
pinpointing discrimination per se, separating it from colleagues’ other po-
tential motivations. Yet these ill doctors reported and feared very real
loss of employment and job offers, failures of empathy, and subtler per-
ipheralization or marginalization. Trainees and those with new jobs or
particular stigmatized diseases—psychiatric diagnoses, cancer, or HIV—
confronted particularly negative reactions.
At times, outright discrimination, such as retraction of job offers,
occurred. HIV-infected physicians encountered these concerns starkly, in
bold relief. As a result of his HIV infection, Paul lost a job offer—it
‘‘disappeared.’’
I worked for an HMO, and chose to have health care outside of the
system, through Blue Cross. When I called the HMO to find out if
there was a preexisting waiting period, they said no. But it turns
out that they meant no for their insurance, not for Blue Cross. So I
was out of insurance for a year! When I talked to the person that
told me there was no preexisting waiting period, he kind of un-
derstood that I was HIV-positive. They hired me, but then I got an
offer to work for the Public Health Service. The HMO continued to
recruit me to come back. So I reapplied. I didn’t get reimbursed
for my travel, so I had to turn in