182 Being a Doctor After Being a Patient
treating themselves aggressively, as described earlier, to inflating or de-
flating risk, trying to view dangers in black-and-white terms.
In the positivistic biomedical model of medicine, uncertainty poses
fundamental problems. The sociologist Renée Fox and others have de-
scribed how medical students learn to handle the uncertainty inherent in
much of medicine (1), but little if any attention has been paid to how
physicians deal with these ambiguities later in their careers. The ways
physicians cope with lack of predictability in their own lives as patients
have not been examined.
Among these doctor-patients, three kinds of uncertainty arose: con-
cerning medical prognoses, personal lives, and professional lives. Coping
with these three kinds of unpredictability often constituted the most
difficult part of being ill.
Uncertainties in prognoses and treatment responses threatened one’s
career and personal life. For example, John, the public health official,
described this ambiguity about the future as the hardest aspect of his
illness, due to his inability to plan appropriately.
The most difficult thing has been the uncertainty: this total unpre-
dictability. What’s going to happen? Three years ago, I stopped my prac-
tice because my count had gotten low. Now, I’m thinking about going
back to practicing full-time. That would never have crossed my mind.
Doubts about one’s professional future—the inability to anticipate or
imagine having a future at all—proved extraordinarily unsettling. Jerry,
the surgeon-lawyer, felt that after his partner’s death, this murkiness
troubled him most.
The most stressful thing, after getting over the initial shock, was
the uncertainty of the future—the doubt. I look more toward the
future than I used to. I just joined a national committee, a three-
year commitment. Three years ago, I didn’t have the optimism that
I’d be able to do that.
These professional quandaries illustrated how important stable profes-
sional and personal expectations were to daily life. These doctors had to
differentiate between short- and long-term plans, and decide on the exact
length of appropriate time frames: just how long or short a period to an-
ticipate.
Many physicians on disability due to HIV fantasized about retraining
in another subspecialty or field, such as law. But such switches required