196 Being a Doctor After Being a Patient
I think about a friend who’ s a pediatrician and a single mom and had a baby, and her perception of what it’ s like to be a mom with the baby crying at 2 A. M., calling her physician with basically what she, as a physician, would think is a stupid call, but she’ s living it. Being a patient, you’ re able to relate so much better to what people go through.
At the same time, despite increased awareness of the degree to which fears shaped patients, these physicians described the competing pressures they nonetheless faced to provide their own patients with quantitative data rather than emotional reassurance. As mentioned earlier, doctors may be becoming more procedure-oriented partly because of decreasing amounts of time they have with patients, and higher rates of reimbursement for high-tech procedures than for low-tech physical exams. In many situations, tests provide ready answers. Harry, the internist and war refugee, said,‘‘ Nowadays, when you have ten minutes per patient, you send patients for complicated technical tests that tend to solve your problem much more rapidly.’’ Dan, the oncologist with chest mets, described interns as very‘‘ procedure-oriented,’’ because they had less clinical experience, and hence less confidence in their clinical observations and interpretations. Yet these hi-tech tests were inherently limited, too.
Ill physicians also received‘‘ cold’’ presentations of data as a result of dynamic interactions and collusion with their treating physicians. Specifically, their own doctors often did not frame prognoses as optimistically as possible because of assumptions that these physicians-patients wanted only‘‘ the cold, hard facts.’’ These ill doctors were commonly presumed to know more than they did about their own disease by their physicians-of-record.
Yet at times, ill physicians themselves actively contributed to such assumptions by wanting to be perceived as fellow physicians rather than as patients. For example, as a patient, Jennifer found that her physicians treated her as a colleague, not as a patient, and presented‘‘ the facts’’ to her unadorned, rather than with emotional sensitivity. Yet she recognized that she fueled their impressions.
I wanted somebody to be warm and fuzzy with me. But I wasn’ t saying,‘‘ Hi, be warm and fuzzy with me.’’ I just assumed they would know that’ s what I wanted— somebody to hold my hand, and say it was really going to be ok. But nobody was doing that. In fact, my doctors had a very pessimistic outlook for me. They said,