Introduction 15
ship have also been recommended, given that ill doctors are similar to, yet
different from, other patients (60). Some systematic research has been
done on managing physicians with substance abuse (61), but not on phy-
sicians with serious, life-threatening medical problems per se.
In short, many crucial questions have received little, if any, attention. It
is not clear how ill doctors treat their own patients differently, view health
care communication, and deal with stigma, disclosure of illness, spiritu-
ality, retirement, or multiple other topics. How thick or thin are the white
coats that doctors wear—the armor that protects them from disease? Prior
work also tends to view self-doctoring as a single entity, focusing on self-
prescribing rather than distinguishing between types of self-doctoring
(e.g., self-prognosing). Prognostication of other patients has recently re-
ceived discussion (62), but self-prognostication—gauging one’s own
future—has received little, if any, attention.
Are Doctors Different from Everyone Else?
My own experiences as a doctor and as a patient, and what I learned from
prior research and the interviews presented here, indicated to me how
doctors, in confronting illness, differed from, and in some ways resem-
bled, lay patients. In Being Positive: The Lives of Men and Women with HIV
and Mortal Secrets (63), I examined the experiences of patients wrestling
with one of the great crises of our age, HIV. The Trembling Mountain: A
Personal Account of Kuru, Cannibalism, and Mad Cow Disease drew on
fieldwork I conducted while living with the Stone Age Fore group in
Papua New Guinea, studying the kuru epidemic (spread by a prion similar
to that responsible for bovine spongiform encephalopathy [‘‘mad cow
disease’’]). This book explored fears of patients and providers in con-
fronting one of the great unknowns of science today, prion diseases (64).
Recently, I have been examining, too, the experiences of patients facing
genetically-associated diseases, from breast cancer to Huntington’s disease
(65, 66, 67).
When sick, both doctors and patients fear bad outcomes and engage in
denial. But only physicians can order themselves medications, and have
trained for years to approach and treat disease in others, probing all parts
of strangers’ bodies. Doctors possess unique knowledge, rights, respon-
sibilities, moral commitments, and placebo effects. I saw how patients
taught and inspired them. Many physicians felt they did not have the