Introduction 17
‘‘Illness narratives’’ can shed light on approaches toward, and ways of
coping with, disease (69). Studs Terkel and others have shown the value of
oral histories in conveying the grit and detail of individuals’ lives (70, 71).
Here, for example, stories can communicate not just the fact that dis-
crimination or denial exists, but also how individuals experience it—how
even well-meaning colleagues discriminate, and well-adjusted doctors
deny their problems, unaware.
Due to space limitations, I cannot present all their stories. To illustrate
key points, in the pages that follow, some individuals appear more than
others, and in the background or foreground. The pilot interviews very
much informed the project, and at times I have drawn on these as well.
To give an overview and help orient the reader, these individuals’ names
(all pseudonyms) and brief descriptors are given on the next page. To
further protect confidentiality, I have changed certain identifying details.
I conducted all the interviews myself at the subjects’ offices or homes
or in my office—whatever was most convenient for them. The Columbia
University Department of Psychiatry Institutional Review Board ap-
proved the study; and all of the interviewees provided informed consent.
All informants spoke to me twice, for two hours each time, about their
experiences as patients and as providers, and about other aspects of their
lives. As I was a fellow doctor, they opened up to me. Many felt that these
interviews—having a trained psychiatrist listen to them—were therapeu-
tic. Though the interviews clearly did not constitute psychotherapy, many
of their stories were wrenching, and they found the opportunity of re-
viewing, organizing, and synthesizing what they had learned to be helpful.
They also valued entrusting me with their stories to convey to others. By
nature, a few were not very introspective. But almost all were forth-
coming, and some called me later to follow up, a few of them shortly
before they died. Their openness enriched these interviews, elucidating
many issues that the literature on doctoring has wholly or largely ignored.
I audiotaped, transcribed, and content-analyzed the interviews, in-
formed by grounded theory (72), developing hypotheses during the
process of conducting the interviews. An assistant and I examined all the
narratives to assess factors that shaped experiences, identifying categories
of recurrent themes and issues. I drew on my past ethnographic expe-
rience, and consulted with an eminent senior sociologist.
The experience of becoming patients prompted these doctors to re-
flect on numerous aspects of their lives at the most fundamental levels.
Invariably, these interviewees discussed, too, the illness experiences of