32 Becoming a Patient
over my head. The second month of residency, I finally got tested,
and found out I was positive. That was really hard. Here I was
at the beginning of my residency, concerned about whether I could
even finish.
Not until the symptoms or evidence became irrefutable did many of
the physicians I interviewed begin to accept their illness. Eleanor’s
husband, a physician, had hypertension and diabetes, but never sought
medical assistance. He minimized his cancer and stroke until forced to
confront his own X-rays depicting metastases. Eleanor said:
He was diabetic, but never sought care. He managed his own case.
Then, he was diagnosed with cancer, had two strokes, and was
forced to leave medical practice. He was diagnosed with metastatic
cancer, and had a third stroke. . . . He had hospitalizations. But his
response to all of his illnesses was to deny them. For years, he still
didn’t go for checkups!
Such minimization could take substantial effort. Some physicians
constructed their world, citing or ignoring evidence to support their
beliefs. Denial could verge, too, on magical thinking. Eleanor, a fellow
health care professional, observed about her husband:
He just did not see himself as a patient. There was an element of
magical thinking: If he didn’t stick to his diet, he wasn’t diabetic. If
he didn’t have a biopsy, he didn’t have cancer. If he didn’t ac-
knowledge the cardiac arrhythmia, there was no cardiac problem.
If he didn’t acknowledge the aphasia, there was no stroke. There
were two separate compartments: the magical thinking (‘‘this can’t
possibly happen to me’’) and the physician-scientist, trained ob-
server and diagnostician. There wasn’t any connection between the
two. Only when he got really backed up against the wall—when
he saw the bone scan, and when I called ambulances to take him to
the ER—did he feel sheer terror.
He had his second stroke at work and then drove home. I took
him back to the ER.