‘‘Magic White Coats’’ 27
Becoming Patients
Ill physicians faced not only loss of their role, but also burdens in en-
tering a new one, that of the patient. The difficulties of this new identity
surprised them all, especially since they had assumed beforehand that they
knew what to expect. Their prior and present senses of self now began to
separate radically.
They struggled to articulate and describe this profound disruption in
their self-conceptions and sense of the future. Lou, an elderly pediatri-
cian in remission from cancer, said, ‘‘I can taste these things about being a
patient differently now,’’ grasping for a metaphor. ‘‘I knew them before.
But it is very different now.’’
Many of these doctors said they knew intellectually what patienthood
would be like, but still hadn’t always ‘‘believed’’ it. Even when they were
aware of this discrepancy, and tried to prepare themselves for it, the
reality still shocked and overwhelmed them. Jim, a physician who worked
as a drug company researcher, developed leukemia. ‘‘You can’t be com-
pletely prepared for it,’’ he said. ‘‘Even though people told me, ‘You’re
not going to feel well for thirty-six months, or feel like yourself, or want
to go back.’ Still, I was surprised.’’ He strove to keep working. While he
was in the hospital for the first time, he bought a laptop. He was dis-
appointed that he could not bring himself to open it.
Firsthand knowledge of illness differed from book knowledge in sev-
eral significant ways. Epistemologically, these physicians gained deeper
personal comprehension that led them to perceive their work differently.
Heretofore, they had education about treating disease, but not about be-
ing sick. The philosopher John Dewey wrote of different forms of learn-
ing, and of the importance and benefits of active and experiential, not
simply passive, education (1). These doctors revealed the limitations of
their prior education, only now becoming aware of former barriers to
heightened