176 Becoming a Patient
to disclose more than I do now. I thought disclosure was great: Get this off your chest. But it’ s not always that way.’’
Nevertheless, coming out can serve political, institutional or social functions. John, the public health official, announced his infection for political reasons. He was more readily able to do so than Jennifer because he did not treat patients. During a controversy:
Activists decried named-HIV reporting. They were not HIVinfected, but purporting to speak for the HIV-infected community. I said,‘‘ I am HIV-infected, and am offended by this.’’ I decided to call a spade a spade. But the media decided that the story was not whether AIDS should be reported or not, but that I had HIV. That became the main news. Most people said:‘‘ I’ m glad you came out about this issue.’’ But going public made me more of a jeopardy to the political leadership.
Not surprisingly, many ill physicians immediately knew that they would never go public; they were too‘‘ private.’’ Still others ranged between these two extremes, and drew lines as to how‘‘ out’’ they felt comfortable being. Pascal, for example, had been able to tell staff, but not the media.‘‘ I’ m shy,’’ he said,‘‘ not a public person.’’
Others wished to go public, but felt that for political or economic reasons, they simply could not. Tom disclosed that he was gay. He wanted to be public about his illness, but wasn’ t, because of the potential effects on his clinical practice.(‘‘ That would be a service to colleagues. But I feared my practice would dissipate.’’) He concluded that the risk was not worth it.
Telling Family Members
These ill physicians, particularly those with HIV, also had to decide whether, when, and what to tell their families of origin. They feared their identity would change, even in their family, from doctor to patient, and they often sought to avoid this alteration. These familial dilemmas both resembled, and at times differed from, those in other social contexts.
Often, physicians delayed disclosing their illness to their parents. Though they were successful professionals, many doctors now lived in large cities, far from their families of origin. At times, even these physicians felt shame about their disease. They wanted to maintain the image of the successful, healthy doctor, a source of parental pride.