‘‘Being ‘Strong’’’ 225
I’ve seen patients suffer much worse than I have. A patient
with cystic fibrosis had lung transplants, was not going to get an-
other one, and knew he was going to die—never able to marry
or have a life. At least I’ve had a life and a child! When I com-
pare myself to people like that, it’s hard to feel so bad.
In short, workaholism and potential burnout posed problems to phy-
sicians before they became ill themselves, but even more so afterward.
Overidentification with patients, and feeling unappreciated, and over-
whelmed by the physical, professional, and psychological tolls of their
disease and that of their patients could aggravate feelings of burden. Such
frustration can ensue particularly after being diagnosed, and continuing
to treat patients with one’s same or similar symptoms or disease.
Many sick physicians found it hard to counter feelings of burnout and
seek psychological support, sensing that physicians had to ‘‘be strong.’’
But some managed to set limits on their type of practice, its hours, and
the demands it posed on their outside life. Others changed their attitudes
or were inspired by patients who persevered. A third group tried to self-
medicate with antidepressants, drugs, or alcohol, and even contemplated
or attempted suicide.
Ironically, professionalism emerged here as a potential double-edged
sword—selecting for, demanding, and rewarding high levels of dedication.
This intense dedication also generated workaholism and lack of balance
in one’s life. The profession enabled one to avoid ‘‘having a life,’’ which
permitted longer work hours. The field demanded intense commitment
to help patients, but precipitated burnout. Thus, these physicians con-
tinually had to titrate their commitments appropriately. Their narratives
highlighted unique characteristics of physicians: the ways their author-
ity can interfere with accessing appropriate care, and reduce both family
members’ ability to help, and potential comfort from support groups. As
described below, for some doctors, the only solution was to leave the
field altogether.