Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 154

‘‘They Treated Me as if I Were Dead’’ 143 wanted some allowances made, but then desired to resume their former duties. Some wished to proceed too swiftly. Others wanted to reenter at what they considered an appropriate pace, while staff and colleagues were wary or not considerate enough. Questions arose of how these decisions should be made, who should make such determinations, and when such allowances should end. Tensions emerged between being placed in the sick role and wanting to see oneself as healthy. In sum, ill doctors faced a range of forms of discrimination and subtler peripheralization: losses of job offers, referrals, fellows, and requests to consult on papers and grants. Discrimination can be verbal or nonverbal. When they were becoming ill, doctors often wanted colleagues to give them some slack, but conflicts then surfaced over how much, and for how long. Over time, some doctors wanted less, and others, more. Certain diagnoses—psychiatric ones and those perceived to be the doctor’s own fault—attracted particular discrimination. Types of settings influenced degrees of discrimination, too, and trainees were particularly vulnerable. Some sought jobs in which they might face less bias. These physicians’ own shame could also aggravate perceptions of such negative reactions from others. The narratives here move beyond much of the current literature on stigma, to issues of how it is mutually negotiated in dual directions over time. Sadly, many doctors felt laws would at best only partially alleviate these problems. As we shall see, against this vivid backdrop of forms of discrimination, these doctors had to make critical decisions about disclosing their illness and treating their own patients.