222 Being a Doctor After Being a Patient
support group, but heard too much negativity and complaining. ‘‘Two
people whining for two hours. I felt, ‘This isn’t good for me . . . or where
I want to be.’ ’’
The Medical Expertise Retention Program of the Gay and Lesbian
Medical Association has helped many HIV-infected physicians, but the
fact that it is run by a gay and lesbian organization deterred some het-
erosexual doctors.
For physicians from other countries, cultural differences can prove to
be obstacles, too, in accessing psychosocial support. Mathilde and her
husband were both born in South America. She said, ‘‘We belong to
another culture and don’t believe in support groups.’’ Indeed, the notion
of individuals opening up freely to one another in a support group may
be somewhat peculiarly American.
Others with HIV also recommended a ‘‘buddy system,’’ a national
meeting, an anonymous 800 number, or a Web site. Jennifer said:
Some kind of a network, so people could hook up with at least
one other person . . . for prophylactic treatment and for occupa-
tional needle sticks—to provide information, give support.
These mechanisms have yet to be established. However, for many, lo-
gistics and confidentiality might pose problems with these approaches as
well. Still, these strategies may hold promise, and should be considered
by local and national professional organizations.
Self-medication and Self-destruction
Several physicians resorted to various kinds of psychological self-
medication—from anti-depressants such as Prozac, to drug and alcohol
use, and, in a few cases, even abuse. In the latter cases, downhill spirals
could ensue. Kurt lost his job at a large group practice due not to his HIV,
but to his lateness and absenteeism because of drug use. Once infected,
he resorted to drugs, which furthered his decompensation.
A few doctors, trained to believe they could ‘‘control’’ disease, now
could not cope, and medicated these conflicts, or contemplated or at-
tempted to wrest ultimate control over their fatal disease through suicide.
These approaches varied from suicidal thoughts to near-fatal actions. Dan,
with chest mets, who had been very assertive throughout his life, said: