Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 200

Double Lens 189 Doctors are aware of not only bad prognoses, but also possible medical errors. Nancy said, ‘‘I know more about the bad mistakes that can happen. That’s scary.’’ Some of these physicians ‘‘worry about every little thing,’’ tending toward ‘‘medical student’s disease,’’ in which no ‘‘real’’ medical condi- tion exists (11). Pascal, the internist, found it more difficult being a doctor, knowing the possible meanings and interpretations of minor symptoms. (‘‘The littlest things set off alarms: ‘Maybe this is going on.’ ’’) Though they commonly also ‘‘fear the worst,’’ lay patients have fewer established categories for handling medical information. Doctors have themselves witnessed ‘‘the worst’’ cases. As suggested earlier, spectrums emerged of how much information individuals wanted. As patients, most physicians desired more informa- tion, and some ordered a surfeit of tests for themselves, thereby com- plicating treatment decisions. Tom, whose lover died of AIDS, felt that being an MD made it both more and less difficult to be a patient, because of the amount of medical knowledge. The more information, the more confusing it is. The more data I read, the more conflicted I am. It would be easier to be a non- physician, go to a doctor, and have them make the decision for me. Yet what, exactly, constitutes ‘‘too much’’ information? At what point does ‘‘enough’’ become ‘‘too much’’? Why, exactly, is some information too much or too confusing? How can these points best be ascertained for each individual? Clearly, in the real world, one weighs not a single set of probabilities, but complex sets of multiple statistics—the effects of drug A versus drug B versus drug C versus drugs A and B versus A, B, and C versus no drugs, and so on, with side effects and benefits of each. At a certain point, such determinations become too complex to make for oneself, be- cause they involve too many competing variables and factors. Yet the points at which different individuals become ‘‘overwhelmed’’ vary. At times, physicians used their ‘‘understanding of what the statistics mean’’ to deny the likelihood of rare, dangerous events occurring, and to counter their own best interests. Their training could facilitate their minimization of the severity of certain risks. When they did not want or like the possibility of an outcome, they could negate risks that may in fact transpire, using their professional training to support their psycho- logical desires. For example, Jeff, the adolescent specialist with HIV,