Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Seite 194

Double Lens 183
high investments of time and energy, without clear returns. Jerry, the
surgeon, became a lawyer, but wondered if all the effort was worth it.
Now, he concentrated on shorter-term endeavors—immediate tasks and
gratification on a day-to-day basis, tangible results—rather than any long-
term projects.
The fact that medicine preselects for individuals who desire and seek
certainty over unpredictable processes can compound these difficulties.
Dilemmas emerged, too, of how to alter one’s time frame and ex-
pectations—not only at initial diagnosis but also later, as an illness became
more chronic. With improved HIV treatment, for example, many phy-
sician-patients who faced changing prognoses were not sure whether to
readjust the ultimate time frame for their lives—whether to plan to live
or die. Jeff, the adolescent specialist, said, ‘‘The biggest issue is: Am I
living like I’m going to be living, or like I’m dying soon? I’ve never been
able to figure it out.’’
Grappling with uncertainty was hard because ill doctors and others
often had trouble handling it, and readily dismissed it. Deborah, the
psychiatrist with breast cancer, said that one of the hardest aspects of her
illness was that others saw uncertainty as shadowing her life. ‘‘My program
director keeps saying, ‘If you finish your residency, I’ll be very happy. . . . If
you survive the rest of it . . . . If you’re alive . . . .’ ’’ His pessimism may have
proved justified—she died 9 months after this interview—but she per-
ceived insensitivity that deeply disturbed her.
For years, these doctors had vigorously followed a rigorous career path,
and now, with the possible end of their life in sight, they had to decide
whether to detour or deviate, and if so, how. Physicians who had gained
personal rewards from their professional work now struggled with whe-
ther and how much to surrender these ambitions, and focus more on their
personal lives. Many now placed personal goals over professional ones far
more than before.
Though many strove to focus on simply living day-to-day, others went
even further, and tried to ‘‘seize the day’’ to the maximum. Yet such
‘‘accelerated living’’—traveling, and living as fully in the moment as one
could—incurred many costs. Jeff, the adolescent specialist, said:
Accelerated living is very expensive. If you try to see all your
friends around the world, and new countries, you go into debt.
Debt is ok if you’re going to die in six months. But if you’re not,
you have these credit card bills!