170 Becoming a Patient
With 450 T-cells, he was totally well, but wanted disability. I
said, ‘‘You’ve got more T-cells than I do! There’s no reason
you can’t work.’’ He said, ‘‘You don’t have HIV.’’ I said, ‘‘Yes,
I do.’’
In addition, as Nancy and Mark both indicate here, and as will be dis-
cussed later, physicians with serious illness can feel frustrated, angry, and
even envious when treating relatively healthy patients who nonetheless
complain and don’t comply with proven treatments.
Physicians who did disclose to patients encountered a variety of reac-
tions. On the one hand, the revelation could foster trust and closeness. For
example, Walter, the activist, divulged his Hodgkin’s lymphoma to help a
patient make a treatment decision.
His life came out better. I was a human being with him. He feels
privileged to be privy to my secret, which says something about
his value: that I trusted him to know.
Physicians and patients can reinforce their trust of each other (e.g.,
through a positive feedback loop). A sense of camaraderie can develop.
Jacob, the radiologist, added, ‘‘I deal with cancer patients a lot, so it’s been
a big plus rather than a negative to have cancer. I show them my big scar.’’
Illness itself can increase intimacy.
Yet such closeness has potential problems. Patients’ knowledge of a
physician’s illness can skew the relationship. With patients, Paul thought
it was best not to have his own health be a major topic in interactions.
‘‘The patients that do know. . . are very concerned. It’s good, but seems to
take the focus away from why they’re here.’’
Half-truths, half-lies, and misrepresentations can occur. Alex, the den-
tist with HIV, worked in a small town, and many of his patients attended
the same fundamentalist church as he and his family. When queried, he
responded that he stopped work because of an auto accident—a misrep-
resentation.
When they’re talking around the issue, and you’re talking around
the issue, and obviously by their questions, they know: Well,
just be honest and tell them. I’ve only done the dance a couple of
times and I realized how stupid it was. ‘‘You haven’t been looking
very healthy lately. How come you really did quit practice?’’ I said,
‘‘Well, I had an automobile accident. . . .’’ I do have back problems
and allergy problems, and would use both those excuses. All of