Forms of Denial and Other Internal Obstacles to Becoming a Patient
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‘‘ Magic White Coats’’
Forms of Denial and Other Internal Obstacles to Becoming a Patient
‘‘ We doctors wear magic white coats,’’ Dan said. A middle-aged oncologist, he had metastases( spread of cancer from one place in the body to another) in his chest.‘‘ We destroy disease all the time,’’ he explained.‘‘ How could it ever attack us?’’ His comment amazed me, but was hardly unique.
When confronting disease, the physicians I interviewed faced a wide variety of both internal and external challenges: medical, logistical, social, psychological, and existential. Physicianhood proved to be a doubleedged sword, both aiding and impeding response to disease.
Repeatedly, I was struck by the levels of denial these doctors evidenced when they were facing the horror of illness— how their fears as patients overcame their objective knowledge as physicians. The profession abetted this psychological response to diagnoses.
MD as ID
‘‘ Who are you, compared with what you do?’’ one doctor asked me. In becoming patients, these physicians felt threatened in their roles and identities as doctors, and reflected on what their profession had meant to them, and why they had entered it in the first place. Their past relationships with the profession molded their current views. They described trajectories through which they had passed, integrating their professional roles into their lives before becoming ill. They had become physicians for a variety of reasons that in turn shaped how they viewed medicine, what they expected, and how they now reacted to their condition.
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