‘‘ Coming Out’’ as Patients 151
realistic. It takes too much energy. It just happened so fast: rumors were building.
These doctors also observed hospital coworkers overtly violate each other’ s confidentiality. Brian, who had hepatitis C, saw colleagues searching for each other’ s medical information for gossip. As a result, he and others sought treatment at other institutions.
I see doctors and nurses go into the charts and electronic system and look up other employees. They’ ll say,‘‘ I heard so-and-so was sick. They’ ve been admitted to the hospital.’’ They’ re looking to see what’ s wrong— because they don’ t know— and so they can gossip. I’ ll say,‘‘ You shouldn’ t be doing that.’’ They’ ll look at me and say,‘‘ Oh, it’ s nothing. I was just checking up on them, making sure they’ re ok.’’
These employees rationalized these violations of privacy as altruistic— out of concern for the patient on whose privacy they were infringing.
Conflicts surfaced because, within the culture of a medical institution, staff may commonly discuss milder medical problems among themselves. These social bonds among coworkers can clash with the need for privacy. Whether to see ill coworkers as colleagues or as patients can then compete. Harry, the refugee, said:
For better or worse, physicians talk about their colleagues in the lunchroom— not maliciously, but because everybody’ s interested. You want to know who’ s in the hospital, and go visit them.
Such curiosity may be an instinctual human trait. Some scholars have argued that gossip confers evolutionary adaptive advantages, teaching one about dangers already experienced by others( 8). But in civil democratic society, privacy remains an important right.
Often, these doctors’ friends were fellow health care professionals, a situation prompting particular difficulties, and disclosures to very few, if any, friends. Tina, an HIV-positive pulmonologist, for example, informed none of her friends, as most were other physicians, and she feared that word about her infection would leak back to the hospital where she worked, and that she could lose her job. She contracted HIV after sleeping with a gambler who often went to Atlantic City. She feared that disclosure would increase her shame at having been sexually involved with‘‘ someone like that.’’