136 Becoming a Patient
transmission from physicians to patients has occurred only twice in the
world.
Colleagues’ perceptions that a physician is not merely sick, but dying,
prompted added obstacles. Some doctor-patients were implicitly written
off entirely—as ‘‘dead’’—and had their patients reassigned. Thus, the state
of dying itself can be a stigmatized condition, causing awkwardness and
discomfort among colleagues, and in turn abetting stigma. When Deborah
had metastases, everybody gave her the ‘‘signature of death. . . . Colleagues
didn’t think I was going to make it. They treated me as if I were dead.’’
When she later returned to work, coworkers ignored her, unsure how to
approach her.
It took me a while to put together my patients’ charts. People
put them in a box, and didn’t tell me where it was. We
keep dummy charts—the real charts go to the chart room. Some-
body had taken all my dummy charts, after they distributed
all my patients, and put the box somewhere and never told me.
I found out just two months ago. Somebody said, ‘‘This box
belongs to you.’’ I said, ‘‘What are you talking about?’’ So here
came this box.
Physicians felt stigmatized by institutions in symbolic but painful ways.
For example, Deborah’s voice mail was taken away.
When I came back, I had no voice mail. There is a list of every-
body’s phone number, and my name doesn’t appear on it—things
that may seem unimportant. It took me three months to get my
voice mail back. I had to fight, so people thought I was very rude. I
applied for it, and nothing happened for three months. I went
back, and said, ‘‘It’s not fair. I’m seeing patients. I need voice mail.’’
They still haven’t come up with a new list, even though I’m seeing
patients again in the clinic. I don’t understand.
Indeed, a ‘‘death role’’ or ‘‘dying role’’ appeared as a specific subtype of
the ‘‘sick role.’’ At a certain point, ill physicians realized that they were
treated not merely as ‘‘patients,’’ but as ‘‘dying patients.’’ Colleagues may
simply not know what to say. Medicine, the profession most affiliated
with death, in certain regards maintains an aversion against it. As Jessica
Mitford wrote in The American Way of Death in 1963, the U.S. health
care system, too, attempts to avoid, rather than confront, death (6). As a
result, Americans tend to view death as a taboo subject. Only when these