Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 15

4 Introduction I thought my training as a psychiatrist would help, but it was quite the opposite. The experience forced me to cross the border from provider to patient, and taught me how much I did not know. I realized that I, as a doctor, would never be the same, or look in the same way at the problems that patients and their families faced concerning depression or grief. The difficulties were far more complicated and long- lasting than I had ever imagined; closure was far more elusive. I wondered, too, how the experience of becoming a patient affected other physicians. The psychoanalyst Carl Jung described a paradigm of the ‘‘wounded healer,’’ who, through awareness of his or her own injuries, is able to heal others (1). Through personal suffering alone, he or she acquires deep wisdom. Observed by Jung in psychoanalysis, this phenomenon has since been delineated in pastoral care, Alcoholics Anonymous, and other forms of psychotherapy. Jung traced this concept back to the ancient Greeks. They believed that Asclepius had founded the sanctuary for healing in Epidaurus, based on self-treatment of his wounds. In various cultures, shamans have been said to undergo such transformations, drawing on their own pain to benefit others. But Jung was keenly aware of the po- tential dangers here as well—a healer may overidentify with patients, feeling their wounds too acutely, reawakening his or her own. Do these processes operate among physicians today, and if so, how? Doctors who get sick have uniquely been on both sides of the stetho- scope, and possess unique double lenses. Their dual, contrasting sets of experiences as both physicians and patients can provide rare insiders’ per- spectives on the increasingly complicated contemporary medical system, but also can pose problems for these physicians as they try to treat others. To understand these issues, I set out to interview doctors who became sick with serious disease. Through this journey, I soon saw how as pa- tients, they drew on their knowledge as doctors; and as doctors, many came to incorporate the often painful lessons they had learned from being on ‘‘the other side’’ as patients. They observed how their own doctors treated them, assessing this treatment with more knowledge and higher standards of comparison than do other patients. Hence, they could be more critical. They learned to speak two different languages, talk both tongues, and could thus translate from one to the other. In doing so they offered insights and epiphanies that could help both other patients and providers.