‘‘ Magic White Coats’’ 35
rationalizations. Now sick, they strongly resist giving up their role as doctor. Jacob, a devout Jewish radiologist with skin cancer, said:
A dent in the armor of invulnerability was a surprise, a startling change. I wasn’ t expecting it. It changed the whole focus of my life. I always assumed I would live longer than anybody else— because my pulse is low, my blood pressure is low, I don’ t get upset....
Jacob sought varying reasons to bolster his belief in his immunity.
These myths can be ingrained in doctors to such a degree that confronting disease can precipitate deep depression. Dan, the middle-aged oncologist with chest metastases( or‘‘ mets’’), had been very assertive throughout his life. He had a busy and successful practice in a major hospital. Yet now he had changed.‘‘ Knowing I have a disease that could kill me produced a mild depression which I did not have before. We’ re not invulnerable, immortal, perfect.’’
Other physicians did not sufficiently plan for the possibility of disease or death in their lives, not yet writing or sufficiently updating wills. Mark, an internist, was very open about being HIV-positive, suggesting that I interview him over lunch at a diner near his office. As will be discussed later, as a result of being a patient himself, he felt that he had improved at dealing with end-of-life decisions for patients. But, surprisingly, he had not been able to bring himself to write a will.‘‘ I don’ t think it means anything Freudian. Maybe it does. I really should do a will— that’ s my intention.’’ Yet he still could not bring himself to do so.
These physicians’ surprise was itself surprising, indicating the extent to which they had previously been socialized to feel otherwise. These beliefs persisted to such a degree that physicians may not only distance themselves from patients, but also look down at, and stigmatize, them. Some doctors thought that being a patient was‘‘ the worst possible thing’’ that could happen to them. Eleanor, whose physician-husband had recently died from complications of diabetes, said about him:
He thought that the world was divided into two groups— us and them— us being the physicians, and them being the patients. If you have an illness, you become one of them. Doctors think,‘‘ We’ re not patients.’’
These doctors revealed the degree of stigmatization of patients that can exist within the medical profession. Charles, who had become an