142 Becoming a Patient
Often, these doctor-patients disagreed with coworkers as to whether to
work or not, and if so, to what degree—from part-time to full-time—and
who should decide. Overall, four scenarios arose (conceptualizable as a
2 2 table), based on whether the ill physician did or did not want to
work, and whether colleagues felt he or she was or was not ready. Oc-
casionally, an ill physician and his or her colleagues concurred as to when
and to what degree to reduce (and later increase) his or her workload.
Other times, conflict ensued.
For both work and personal reasons, many tried to exit the sick role as
quickly as possible, and return to healthy or ‘‘normal’’ functioning. Yet
some did so too hastily. Innocently, peripheralization may start with the
doctor-patient willingly entering the illness role. Later, problems can arise
of how quickly to leave it.
Conversely, other ill physicians may feel physically unable to work at
full capacity, even though institutions may be unable to function opti-
mally without personnel (especially leaders) working full-time. Initially,
colleagues may want to ‘‘spare’’ a sick doctor the burden of work. Yet the
sick role could be a double-edged sword, relieving some duties but taking
away others that one may in fact want. Frank, the surgeon, had an MI in
the OR after he rushed a patient down on a stretcher when he felt hos-
pital transport personnel were taking too long to arrive. Once in the OR,
he experienced chest pain, and within an hour or two received an emer-
gency coronary artery bypass graft. He reported:
Afterward, I started delegating more, because I found it conve-
nient. But in the first year or two, I lost some of my influence. I was
treated as very fragile, which had both advantages and disadvan-
tages. They wanted to see whether I was going to stay alive. When I
was out of commission, they started a new program that was my
idea, but it didn’t work. So I was left cleaning it up. They wanted to
spare me a lot of work. They were afraid I would overwork.
Colleagues—as friends and as health care providers—may be concerned
about and monitor an ill physician, whether or not he or she wants this
extra attention. Being closely observed can feel overbearing. The nurses
now watched Frank carefully, concerned about the possibility of another
heart attack. ‘‘When I get really temperamental in the OR, the older nurses
say, ‘You’d better take it easy. You don’t want to have another one!’ ’’
Over time, problems arose over exactly how much leeway to provide
physicians who are or have been seriously ill. Many doctors at first