Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 17

6 Introduction responsibilities toward their teachers, the healing arts, and their patients. Yet over time, doctor-patient relationships have shifted, shaped by a range of social, economic, medical, and scientific factors. In the 1950s, sociol- ogists further advanced understandings of the roles and relationships of doctors and patients. The sociologist Talcott Parsons described the ‘‘sick role,’’ in theoretical terms, as entailing rights and responsibilities, exemp- tions from certain duties, and obligations to get well, and as involving a power differential between physician and patient (4, 5). Parsons explored, too, the ‘‘situation of the physician’’—to ‘‘do everything possible’’ for the patient’s recovery, which requires probing patients’ bodies and ‘‘private affairs’’ (4). To achieve these goals, many physicians find it easiest to maintain a paternalistic stance and rigid boundaries between the roles of doctor and patient. Long years of grueling training and professional so- cialization help enforce an ethos of authoritarianism. The French post- modern critic Michel Foucault has argued that physicians and medical institutions reinforce power differentials in ways that mold patients’ ex- periences of illness (6). But doctors also face difficulties and tensions of their own. They fear not being able to save all their patients (5). Though illness may exempt doctors from responsibilities, I soon found that when they got sick, doc- tors faced troubling conflicts. The New Testament admonishes, ‘‘Physi- cian, heal thyself’’ (Luke 4:23), and many of these doctors felt they should not get sick—a situation creating dilemmas for them when they did (7). Though the early stages of doctors’ careers have been examined—how they transition from the lay world to that of medicine (2, 6)—much less attention has been given to the later stages of medical careers and the exact boundaries of the ‘‘doctor role.’’ Little is known about how they travel back to the lay world from that of being a doctor, what stages comprise their journeys, and whether their two roles change, blur, or conflict, and if so, how. Medical Metamorphoses ‘‘I always thought I was Ms. Compassionate and listened,’’ Jennifer, one of the first physicians I interviewed about these issues, sighed. She glanced down sadly as she reflected on her illness. ‘‘It was just so very different to go from one role to the other. I was really much more cavalier and un- caring than I ever would have thought! My eyes were completely opened.’’