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