11
‘‘Us versus Them’’
Treating Patients Differently
‘‘I do more for patients now than I used to,’’ Deborah, the psychiatrist with
cancer, confessed. The experience of illness changed how most of these
physicians treated their patients. Frequently, personal experiences of illness
reversed years of professional medical training. In facing the darkness of
their own disease, these doctors often came to treat patients and to teach
trainees better. Nonetheless, ‘‘enlightenment’’ did not always occur. Treat-
ing those under their care more humanely was not always easy or success-
ful. Psychological, social, and economic barriers could hamper doctors’
improving the care they offered. Other physicians veered too far in this
new direction—doing too much for patients, raising questions of how
much of an advocate or friend to be. As providers, they often found it hard
to arrive at the appropriate balance between being too concerned or too
detached. They wrestled to achieve what the sociologist Renée Fox terms
‘‘detached concern’’ (1)—to be simultaneously concerned and, in order to
be objective, somewhat detached. Over time, they struggled with this
balance, seeking equilibrium—sometimes voyaging too far one way or the
other, becoming too close or too removed, and then having to adjust, based
on their perceptions of patients’ responses.
‘‘We’re All in This Together’’: Reducing the Hierarchy
The experience of being ill inspired many physicians to strive to reduce
the barriers between themselves and their patients. Often, doctors now
reassessed the doctor-patient relationship, seeing it less as ‘‘us versus
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