26 Becoming a Patient
Regardless of why they entered the field, these individuals had soon
come to define themselves by their professional identity. Juan, an in-
ternist, struggled to become a physician in part to overcome affronts to
his self-esteem that he had felt as a sickly gay Latino child. ‘‘A doctor’s a
doctor’s a doctor,’’ he said. Nothing, he felt, could take away what his
sweat had earned him. Similarly, after being diagnosed with AIDS, Jerry,
a Pennsylvania surgeon, went on disability and attended law school, but
his identity remained that of a surgeon, not a lawyer. Having lost his
surgical practice, he tried to keep busy. Yet for a long time, he did not
know what to say to people who asked him what he did.
The first thing people always ask you is ‘‘What do you do?’’ That
defines 90 percent of who you are, it seems. I get tired of telling
people, ‘‘I’m retired.’’ Their next line is ‘‘You’re so lucky!’’ Some-
times I say, ‘‘It’s not quite like that,’’ and I’ll tell them the story.
I have to stay very active. I got a law degree, but it didn’t give me
the sense of identity I had as a practicing physician.
Such identification with one’s job is particularly strong in medicine, but
as we shall see, it can reinforce a rigid hierarchy and authority.
For many, medicine offered enormous personal gratification beyond
financial rewards, providing the major, or main, sense of purpose in life.
Roxanne, a gastroenterologist, was diagnosed with abdominal cancer. Even
before that, she derived deep moral meaning from her work. After her
diagnosis, she continued to see patients because she liked to, and because
being a physician was a ‘‘calling’’ that sustained her. ‘‘An MD degree is a
privilege. You use all that knowledge to help others.’’ As we will see, for
her, her work carried a sense of religious vocation.
The medical profession also provided structure that organized and
directed lives. Mathilde, a Pennsylvania physician, talked about her
husband—a fellow doctor who had recently died of AIDS that he had
acquired from a blood transfusion. She felt that their daily work with
patients provided connection and fulfillment. ‘‘I enjoy my job, and love
my patients and they love me. That helps a lot.’’ Indeed, physicians can
develop deep relationships with the field as a whole. About her husband,
Mathilde said:
The most stressful thing for him was that he was in love with
medicine, and it had failed him. He could deal with tragedy and
adversity, but not with losing his love.