‘‘They Treated Me as if I Were Dead’’ 139
about a colleague’s illness could hold it against him or her professionally.
Deborah, the psychiatrist with breast cancer, said:
I was going to do a one-month cancer ward rotation. But after he
had accepted me, the head of the ward said I could not do the
rotation. I was very angry. He was very nasty, cruel, and inhumane.
He said, ‘‘I don’t think you’re capable.’’ He thought my judg-
ment was poor if I wanted to come and work there: I couldn’t work
with cancer patients because I myself had cancer. I really felt dis-
criminated against, and pleaded with him: ‘‘I don’t think my
judgment is poor. I think I could manage it. I’m stable.’’ He said,
‘‘No way. You’re not a survivor. You’re still being treated.’’
Though she might lack objectivity on the ward, Deborah felt that he did
not handle this situation well.
Moreover, when she was a patient and this ward chief attempted to
consult with Deborah in the hospital, she declined. She felt he had a
conflict of interest:
He tried to see me in the hospital, because he sees many of the
patients on the breast cancer floor. I refused. I didn’t want
to see anybody. Three times, he sent his fellows to see me. But
I didn’t request to be seen by a psychiatrist. I didn’t want
one.
Still, he perused her medical record, raising profound questions of in-
vasion of privacy. ‘‘I know that he read my chart, because I saw him on the
floor a couple of times, and avoided him.’’ She tried to fight, but in the
end, felt she couldn’t ‘‘be a martyr.’’
Types and settings of medical practice could affect vulnerability as well.
For example, with regard to HIV, some practices and practice settings
were felt to be more HIV-friendly than others. Specifically, physicians
in academic and administrative jobs felt more comfortable disclosing at
work, and feared repercussions less than physicians in private practice
who saw predominantly heterosexual patients. Certain geographic areas
appeared more HIV-friendly than others—in particular, urban more than
rural environments, and certain cities (those with large, visible gay com-
munities). A few doctors felt confident that disclosure would not pre-
cipitate discrimination; some selected specialties and posts where that was
the case. Pascal said, ‘‘I chose this job because if I work with HIV-positive
patients, there would be no question of who got what from whom.’’