‘‘Coming Out’’ as Patients 155
It’s a dirty little secret. This is the first week I’ve been in my office,
having to take pills. I do it secretly, and those secrets hold power.
When you have a secret, it means something: there’s unpleasant-
ness to it. I had a little pillbox with me this morning, and as I
went down the hall, my pills rattled. I wondered if anybody else
heard. At 4 P.M ., I’m ready for my second dose, and go back to my
office. I don’t shut the door because that will raise even more
problems. I turn my back. Yet the staff is notorious for creeping up
on me. So that’s stressful: wondering if I turn around, are they
going to see me pop these pills, and want to know why. I almost
never shut the door because I haven’t really had any secrets—even
if I get a personal phone call. If I shut the door every day at 4,
they’re going to wonder. So I just look around, make sure nobody’s
coming down the hall, open the box, and pop in the pills.
Steven illustrated here how much difficulty and psychic energy clan-
destinity involves. Such furtiveness burdened him far more than he an-
ticipated. He added:
I didn’t think it’d be this hard, interviewing patients, thinking,
‘‘When’s my next dose? What do folks in the office think about
this?’’ Constantly worrying someone’s going to find out.
At night, these fears awakened Steven.
Use of insurance or lab tests could also permanently expose. The need
for insurance potentially sacrificed privacy—most painfully with stigma-
tized conditions, including mental illness. Still, many felt they had no other
options. Suzanne and others used labs outside, rather than inside their
medical centers. Here, as elsewhere, in the complexities of medical
institutions, violations of privacy and confidentiality occurred due to
blurring of roles—as employee, patient, and even at times family member.
Lying About One’s Illness
Other ill physicians felt unable to disclose their illness, and rather than
remain silent, felt compelled to lie. They dissembled in particular set-
tings when the risks of divulgence appeared to outweigh the benefits
of disclosure. Though society views lies as morally reprehensible, stud-
ies have shown that college students in fact admit to lying, on average,