214 Being a Doctor After Being a Patient
value such commitment. Jessica, the pediatrician with cancer, said she
was ‘‘the sort of person who never calls in sick’’—indeed, a dedicated and
compulsive type. She didn’t want her life disrupted because of her illness,
but consequently received suboptimal care. From this trait, she derived
pride, self-esteem, and structure. Single, her life focused on her work.
Workaholism resulted from financial motives as well. Some physicians
tried to treat more patients, so that if they were forced to go on disabil-
ity, their income would be higher. Steven, the suburban endocrinologist,
confessed:
I need to see as many patients as possible, in case I get sick. The
more income you make, the more disability you get. Patients want
me now. If I get sick, they won’t.
Poor self-esteem perpetuated workaholism, too. Kurt, the internist
with HIV who had spiraled downward after using crack, had previously
tried to compensate for his past by earning professional kudos.
I was gay, and never felt good enough in anything I did: athlet-
ics, pretty girlfriends. I could only get affirmation by academic
achievements. I wanted it to go on.
Indeed, many of these physicians were heavily influenced by how others
saw them.
Workaholism resulted as well from other psychological motives, such
as past traumas. Despite his illness, Frank, the surgeon who had an MI in
the OR, continued to work long days. A refugee, his current ambition
arose in part from his precarious history. ‘‘When I was younger, for me
to work fourteen to eighteen hours a day was not unusual. It’s not that
unusual even now.’’
By comparison, other rewards paled. Only work—not materialism or
conspicuous consumption—bolstered Neil’s self-esteem. ‘‘If I worked re-
ally hard, people would love me. I bought a Jaguar convertible, and did
very materialistic things, but they did not make me happy.’’
Workaholism also justified spending less time with others in one’s
personal life. David, the psychiatrist with HIV, said, ‘‘If I am working all
the time, then I have an excuse for not having a social life.’’ Stuart added
about friends:
They’d let you tell them anything, and they’d believe it. But
then I came to realize that it was important to remember birth-
days, stay in touch with friends. . . .