Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 31

20 Introduction I have pointed out where contrasts emerge, but I was most struck by the similar problems, crises, and types of insights. Doctors with HIV shared much in common with those who faced cancer and other kinds of serious medical problems: dilemmas of whether and how to tell col- leagues, treat their own patients differently, be more spiritual, and con- tinue to work, or retire and lose their career. Uncertainties loomed as to how long the benefits of treatments would last before disease reasserted itself. At times, experiences with HIV presented many of these issues writ large, yet physicians with cancer also often confronted risky and invasive treatments (e.g., toxic chemotherapies and radical surgeries), and uncer- tain prognoses—given the possibility of disease recurrence and increased risk of other types of primary cancers. Opportunistic infections arise among both immunocompromised doctors on chemotherapy and those infected with HIV. Doctors with HIV who had retired on disability, and now felt better on new medications, faced dilemmas of whether and how to restructure their professional and personal lives. Physicians recovering from cancer also encountered the possibility of recurrence, and hence the same issue, even if at times less starkly. Many ill doctors now came to identify more with their patients (e.g., getting results to patients faster); gay doctors with HIV who treated members of the gay community often encountered this issue with added urgency. Some doctors with HIV con- fronted particular stigma or discrimination due to fears that they might infect patients, and to aspects of a physician’s background, such as sexual orientation. Gay men—the group most affected among doctors—may face added stigma. Yet fundamental issues of stigma and discrimination arose for other physicians, too. Whatever these doctors who courageously talked to me experienced, others whom I did not interview surely feel, too. I have tried to illustrate these themes and the variations within them, rather than merely presenting a sequential series of isolated doctors speaking one after another. The material itself strongly dictated that I not simply offer a series of short, distinct tales of each physician’s life. Therefore, to highlight commonalities as well as differences, I have chosen to present a group portrait, a montage, a collage, similar to a documentary, in which interviews with different people are intercut, with each person commenting on a specific issue in turn, and then reappearing. I have tried to present these areas in the order and arc through which they occur in these physicians’ lives. Granted, film documentaries have an advantage over written text—the viewer can see the person speaking, and does not have to be reminded each time that Mr. X is a spry, gray-haired, elderly