Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 221

210 Being a Doctor After Being a Patient will try anything. I draw my own limits: ‘This is what I’m willing to try, and why.’ I just don’t have the time and energy to do everything you can do.’’ Though lumped together as a single category, CAM appeared not to be monolithic, but a broad, diverse label that covered treatments with varying degrees of supportive or suggestive evidence. Among nonscien- tific approaches, these doctors tried to establish criteria for evaluating CAM claims. Charles, the HIV-infected underground researcher, de- veloped several gauges. There is a lot of baloney out there. I can separate better than a layman what was real from unreal, legitimate from illegitimate. It had to meet three criteria: have some scientific or clinical experi- ence behind it, be relatively nontoxic, and be available. If it met all three of those, there was a good possibility I would try it. Overall, two critical factors interacted here to affect openness to CAM: the risk involved in the modality and the availability of Western treat- ment options. Jacob pursued what he saw as ‘‘Jewish’’ alternative healing, and deni- grated other CAM. ‘‘The only nonproven stuff that we are allowed to do is Jewish stuff. We do it because the Jewish tradition says it. I consider the other stuff idol worship.’’ Still, in the end, CAM decisions frequently necessitated difficult judg- ments. As Nancy said, ‘‘It was kind of a call’’ (i.e., not a fact). Critics may see these beliefs in CAM and spirituality as unscientific, but these doctors wrestled with these issues, varying in skepticism and faith, and generally leaning strongly one way or the other. No doubt, readers of these pages will be split, too, as to the legitimacy of these unproven beliefs. Indeed, conflicts between science and religion, and reason and emotion, have occupied Plato, Pascal, Voltaire, Diderot, and countless others for centuries. In their beliefs, these sick doctors fell across a wide spectrum, reflecting in part the tensions they faced in their roles as physicians and as patients. In all, patienthood challenged these doctors’ assumptions about medical knowledge, and compelled them to reflect on and alter their perspectives. They confronted uncertainties in both their personal and their profes- sional lives. They felt they knew how to interpret statistics, and did not get hung up on the possibility of unlikely side effects. Yet medical