Introduction 11
to conceptualize and manage ‘‘spoiled’’ aspects of their social or personal
identities (19). Those with a particular stigma often alter their concep-
tion of self, resulting in a ‘‘moral career,’’ sometimes attempting to con-
ceal its symbols and to ‘‘pass.’’ Others become fully involved in groups of
similarly stigmatized individuals and become ‘‘professionals.’’ Gaps may
widen between their pre- and post-stigma acquaintances. Sick doctors
face dilemmas: whether they should try to ‘‘pass’’ (i.e., as healthy) or
are morally obligated to disclose their illness to patients and colleagues.
Sissela Bok and Immanuel Kant have argued that individuals should
rarely, if ever, lie or deceive (20, 21). But how, then, should ill physicians
navigate between these poles of honesty and professional transparency
on the one hand, and secrecy and silence on the other? Indeed, in his
earlier work, The Presentation of Self in Everyday Life, Goffman described
how all individuals in fact act as if they strut upon a stage, trying to
manage how others see them (22).
I wondered how these doctors negotiated these difficult transforma-
tions—what, exactly, changed versus stayed the same, and why. As we
shall see, some resisted such change, grasping onto the status quo—and
demonstrating what I term a ‘‘will to wholeness.’’ Others proved far more
protean. These doctors drew differently upon their own experiences with
disease, from profoundly metamorphosing to modifying only smaller or
subtler aspects of their outward behaviors with patients. Not all wounds
affect one equally; and no particular wound moves all individuals in the
same way.
Postmodern critical theories of Foucault and others focus on broad
categories of gender, race, and class. Yet individuals of the same gender,
race, or social class may vary significantly. But in what ways do they?
These doctors can help elucidate how critical theory intersects with in-
dividual psychological responses, with differences between individuals
within only one broad social category.
Making Better Doctors
Increasingly, these topics have become important, as both health care
providers and their patients face mounting challenges. The health care
system continues to grow as a portion of the U.S. economy and to
alter rapidly. In one way or another, we are all patients: growing up seeing
doctors, stripping before them, divulging our secrets and souls. Yet
as biotechnologies quickly advance, geneticists further crack the human