228 Being a Doctor After Being a Patient
I’ve been having a miraculous recovery, but it’s incredibly painful.
I’ve been out of work since. . . . Six months before this happened,
I got a new lab here, which burnt down. I’m a new researcher, and
it’s a new collaboration. . . .
Repeatedly, Scott stopped, unable to complete his sentences, as he tried
to articulate the waning of his hopes and opportunities.
Quitting work could pose additional difficulties—for example, forcing
one to disclose fully to family, friends, coworkers, employers, patients,
and others that one has a serious disease and may die. Jeff, the adolescent
specialist, for example, would now have to disclose to others that he had
AIDS, not another diagnosis. As described earlier, disclosure posed added
difficulties because it forced one to confront the disease more. These is-
sues arose with many diagnoses, not just HIV.
Retirement was hard, too, when physicians had established strong
bonds with patients that could be mutually difficult to dissolve. When
Steven, the suburban endocrinologist, moved to another city, many pa-
tients shed tears.
They said, ‘‘How can you do this to us?’’ I’m not ready to go
through that again. I know some of them will cry, and I will, too.
For both sides, breaking the physician-patient bond felt like a betrayal.
Doctors wondered, too, whether they had a moral obligation to work.
The profession may implicitly pressure members not to retire as soon as
possible. Albert, the sixty-two-year-old doctor who had an MI on the
highway, commented that people had told him he was ‘‘not old enough’’
to leave work.
These strong motivations to work, and difficulties of making the deci-
sion to leave the field, led some simply to avoid the choice. Consequently,
at times physicians continued to practice too long, and their work suf-
fered. Stuart said:
How does one take an infected doctor aside and say, ‘‘It looks
like you didn’t make rounds on Sunday. You shouldn’t be do-
ing that.’’ If someone was so tired that they couldn’t keep doing all
the tasks, or returning phone calls, and you knew why, you’d have
to tell him, ‘‘I don’t think I want you covering my patients any-
more.’’ It usually didn’t come as a shock to them. But there were
some tough conversations. They rationalized that they didn’t
know what to do to shut the practice down. They wouldn’t get