Introduction 5
Doctoring Today
‘‘ What do you do ?’’
In the United States , strangers commonly ask each other this question when initially meeting — on a plane , or at a dinner party . Often posed within seconds of the introduction , this query offends many Europeans , but suggests an essential element of American identity and culture . In many ways , Americans define themselves by their work . We are a ‘‘ can do ’’ nation . Here , success , ‘‘ working one ’ s way up from the bottom ’’ and ‘‘ pulling oneself up by one ’ s bootstraps ,’’ motivate many as vital ideals . Yet in an age of corporate downsizing and outsourcing , changing and unstable economies , what does it mean to acquire and maintain a professional identity for an extended period of one ’ s life — to put it on at the dawn of one ’ s career and of each day — and then to be forced to remove it ? Concepts of professional identity have profound implications for understanding who we are ; how we find meaning , satisfaction , and support ; and how we cope .
At the end of my medical training , I was surprised to see how much the experience had molded me : my allegiances , and cognitive and emotional responses to patients and everyday life . I wrote two books — A Year Long Night : Tales of a Medical Internship ( 2 ) and In a House of Dreams and Glass : Becoming a Psychiatrist ( 3 )— exploring how other students and I became doctors and psychiatrists , respectively , acquiring ‘‘ special knowledge .’’ But I began to wonder what happened later on in doctors ’ careers , especially when they , too , got sick .
Increasingly , millions of viewers watch TV programs such as ER , Scrubs , Grey ’ s Anatomy , and House that depict physicians in dramas , soap operas , sitcoms , and so-called reality shows . But what are doctors ’ inner lives and struggles really like today ? Many key questions remain about how they view themselves , their work , their patients , and their power , and how they integrate their professional selves with other aspects of their lives .
Since Hippocrates in antiquity , various writers have probed the complex and unique roles and lives of physicians . Part artist , part scientist , a healer possesses special scientific understanding as well as patients ’ deep secrets . Every culture has ‘‘ medicine men ’’ and treatments that operate through what we in the West term ‘‘ placebo effects .’’ In the West , the Hippocratic Oath guides how physicians should behave — their roles and