Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Seite 273

262 Interacting with Their Patients
Yet in doctor-patient relationships, this differential in roles, and dis-
ease vulnerability had critical implications, as it corresponded to, if not
legitimated, a differential in power. Another physician, for example,
sensed that patients needed him to be ‘‘stronger’’ than they were.
A lot of time what you’re really dealing with—especially with
death and dying—is ‘‘Yes, I’ll be here longer than you will be. I’m
stronger than you are. You can lean on me.’’
Physicians’ power can therefore aid patients.
Doctors’ powers arose in part from beliefs that they were healthier
than their patients. Though feeling more aligned with patients than
before, Suzanne said, ‘‘I still think: I’m the all-powerful resident who
knows everything, and these are mental patients.’’
Differences in function further this power differential. Physicians per-
form duties that patients cannot. Doctors not only possess technical knowl-
edge, but they also address emotional and psychological issues, and alleviate
uncertainty. Harry spoke of doctors’ anxiolytic properties: Physicians had
to tolerate worry. Yet he was surprised at the importance of this function.
Nobody told me in medical school, but the toleration of anxiety is
our stock in trade. You spend a great deal of your time dealing with
others’ anxiety. You can’t get angry at the patient. You have to be
aware of what you feel, and remain calm: sit and let people be anx-
ious, and not be impatient or annoyed by their irrationality and non-
sense.
Medically, this anxiety-reducing function of the doctor-patient hier-
archy is critical. Anxious patients do not do as well.
Doctors can also use this hegemony to make patients feel valued.
Walter, the political activist with lymphoma, saw other psychological
benefits to physicians’ use of their status.
When patients from poor communities have a doctor with status
look them in the eye, and talk to them with respect, as another human
being, it gives them a sense of their own humanity—that they . . .
matter. Particularly when you’re sick, that’s incredibly important. I go
out of my way to listen to people’s hearts. Every physical, I examine
people. It fulfills their vision of being taken care of. If you lay hands
on people, they feel you are thorough, and cared enough to do that.
Hence, the doctor-patient hierarchy can be employed to good ends.