16 Introduction
right to give up the profession, to let people suffer. Even when they became ill, some continued to place their patients’ health above their own. Doctors can access care more knowingly and effectively than lay patients, but do not always do so when facing life-threatening disease.
Methods
To address these questions, I interviewed seventy individuals in depth. I first conducted twenty sets of pilot interviews to focus the range of topics, and then conducted the remainder of the interviews for the full study, doing so in two phases. I initially studied HIV-infected doctors— who raise many of these issues in bold relief— and then, in order to broaden understandings of these issues, expanded the study to include physicians with other kinds of medical problems. I recruited participants through the Internet, through e-mailed announcements and Web sites( e. g.,‘‘ Are you or do you know a physician with a serious illness?’’), word of mouth, and ads in newsletters. For the full study, I was contacted by 48 doctors, a medical student, and a dentist. These individuals( referred to below as‘‘ doctors’’) had HIV, cancer, heart disease, hepatitis C, Huntington’ s disease( HD), infection, bipolar disorder, and other diagnoses. They ranged from twenty-five to eighty-seven in age; one was Latino, the rest were Caucasian. They lived in several cities; and included surgeons, internists, pediatricians, radiologists, neonatologists, endocrinologists, infectious diseases specialists, anesthesiologists, neurologists, psychiatrists, and trainees. Many had observed and treated other ill colleagues, and had family members( parents, siblings, spouses and children) who were physicians who had been sick as well. These participants observed and commented on these others, too.
I could have summarized these participants’ stories and spoken for them, but that would fail to capture the power and poignancy of their own words. Their voices best convey the struggles and conflicting identities, poetry and pain they described. Sick, contemplating the ends of their lives, they divulged things they had sometimes told no one else— at points embarrassed, but searching. Through suffering, many found sagacity about doctors, patients, death, and life.
One of my former teachers, the late anthropologist Clifford Geertz, and others have advocated understanding social phenomena from the experiences of those in a particular situation to provide a‘‘ thick description,’’ rather than imposing explanatory frameworks from outside( 68).