Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 24

Introduction 13 psychological difficulties (41, 42), yet such problems can potentially affect patients adversely (43). Educational efforts to help improve physician communication have been attempted, but many physicians still clearly have trouble inter- acting with their patients (44). Recent efforts to increase students’ em- pathy through reading and discussing literature (45) to improve commu- nication skills may help in the short term, though results have not been entirely consistent (46, 47) and the long-term impacts remain underassessed. Questions of how doctors and patients can best interact are of rising consequence. For their colleagues, these doctors’ experiences can be more poignant and compelling than those of lay patients. They can help other trainees and practitioners in medicine, nursing, psychology, social work, and other health fields to see more clearly how patients perceive them. These stories of sick physicians can encourage fellow providers to be more open and sensitive to problems in communication, and to see what specifically needs to be improved. Frequently, physicians dismiss patients’ criticisms: ‘‘Oh, it’s just the patient complaining.’’ But these sick doctors can say, ‘‘No, I am one of you, and these are legitimate gripes that I, as a patient, know.’’ Other providers may come to recognize more fully that they, too, will one day be patients, that the boundary between physicians and patients is, in the end, nonexistent. Prior Writings About Ill Physicians Physicians such as Oliver Sacks, Fitzhugh Mullan, and Jody Heymann have described their own personal experiences with particular disorders (48, 49, 50). The Doctor, a film starring William Hurt, depicted one ex- treme case: a cold, chauvinistic surgeon whose illness made him more humane (51). Two books, by Pinner and Miller in 1952, and by Mandell and Spiro in 1987, compiled single accounts by physicians, each describing his or her particular experience with an illness (52, 53). But these two compilations of individual stories, while valuable, were not organized the- matically, to analyze issues systematically, investigating the same set of concerns and questions with each physician to detect and examine pat- terns, similarities and differences, and areas (e.g., death and dying) about which individual physicians may be reluctant to comment, or do not mention at all. These two books organized individual doctors’ reports by disorders, like a medical textbook, with each report standing by itself.