Double Lens 195
physicians overvalued medical knowledge as almost ‘‘magically’’ thera-
peutic in and of itself.
Once ill, these doctors often made decisions about their medical care,
not as doctors, but as emotional human beings—based not on ‘‘science,’’
but on subjectivity. From different experts, Walter received conflicting
recommendations about treatment. In the end, he based his final decision
on his own sense that he just was not emotionally prepared to undergo a
bone marrow transplant.
From three very bright doctors, I had three different opinions
about what to do. One said his instinct would be to monitor care-
fully, and not do a bone marrow transplant. I was going to be
scientific, think it through. Then, I realized I just wasn’t emotion-
ally ready to do the bone marrow transplant: I was convinced I
would die, because I had been so sick. It may not have been very
rational, but it wasn’t science for me. All that science later, I realized
I was scared to do the transplant.
Walter was surprised that he adopted a nonscientific approach and that
his doctors, too, made recommendations based in part on their ‘‘instinct’’
(i.e., not wholly rational logic). Medical training had schooled him that
doctors proceeded otherwise.
Recommendations based on quantitative medical tests might in fact
conflict with patients’ physical and emotional states. Despite his work as a
drug company researcher, Jim came to recognize the importance of
weighing not only ‘‘the numbers,’’ but patients’ affective states. ‘‘If I was
feeling really tired and knocked out, a lot of times the doctors would have
transfused me. But I said, ‘I don’t want to be bothered with it now. I’m ok.’
Sometimes I don’t know how I felt those things. I just did.’’ Jim implicitly
weighed the risks and benefits, including the affective costs that he valued
more than his doctors did. As a patient, he acted much less like a scientist
than he thought he would. He now experienced these decisions far dif-
ferently than heretofore.
Many of these doctors became more aware not only of the critical role
of psychological factors in the desire for and receipt of information, but
also of the disparity and dissonance between information and needs for
support and reassurance. These physicians now perceived, as they had not
before, how emotional needs overlapped with, but were distinct from,
‘‘technical’’ information. Jeff, the adolescent medicine specialist, added: