164 Becoming a Patient
anything to do with her, so I didn’ t feel I could confide in her. She was insulted. To this day, I haven’ t had a good relationship with her. I felt that she was doing it more to feel good about the fact that she is concerned about the residents. But I didn’ t appreciate the way it was done— that it was really true. Maybe I’ m wrong. I felt I was very brusque. I wrote her a note:‘‘ I really appreciate that you called, but I really don’ t feel I’ d like to speak to you about my personal problem. I have a support system already.’’ If she had called me in the hospital and just said,‘‘ How are you?’’ that would have bridged the distance. She just ignored the note.
Prior closeness can facilitate disclosure, and disclosure can promulgate further closeness. Previous literature has mentioned professional silence, but it emerges here in part as a dynamic process. At times, these individuals pushed and pulled against explicit and implicit workplace boundaries and norms.
Physician-patients may want colleagues to know, but to respond to the news only in particular ways. Nancy wanted people to ask, but she desired that they see the information she gave only as positive. She also hesitated bringing her illness up,‘‘ afraid I might upset them.’’ She wanted people to ask how she was doing, but only‘‘ in the right way,’’ further underscoring the dynamic nature of such interactions— responding to others’ responses to oneself. Lou thought that colleagues‘‘ should say,‘ I heard you were sick, how are you feeling?’ When people do that, I usually say,‘ Thank you for asking. I’ m not doing that well, but I’ m sort of hanging in there.’’’ He did not answer their question directly, yet stymied further discussion, closing off openings for additional queries.
Efforts by ill physicians to be upbeat about their illness could encounter resistance from colleagues. Lou felt colleagues responded to illness in a professional rather than a personal way.
Colleagues put an arm around me and said,‘‘ Isn’ t that terrible? I feel so sorry for you.’’ They have a funereal affect, which is not helpful. Better are those who react more naturally:‘‘ How are you doing?’’ We don’ t teach doctors really how to respond to sick people on a personal level!
Doctors learned how to respond to illness as professionals( based on medical science), but not as human beings( based on genuine empathy). The two approaches differed in whether and what emotion was