Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 56

‘‘The Medical Self’’ 45 of-record—assessed, monitored, and limited these behaviors. Self- prescribers approached these tensions in a variety of ways. Scott, who had an infected foot, treated his own hypertension, since, he claimed, he couldn’t get his MD to do so. I’ve been treating myself because I can’t get a doctor to. My doctor takes my blood pressure every once in a while, and it’s pretty normal. But I can take my blood pressure all the time. So I’ll futz with my doses—add this, that, adjust, etc.—and I’ve gotten the readings I like. When undergoing surgery, Scott even brought his own addictive opiates as pain meds with him to the hospital ‘‘because the nurses made dosing errors.’’ Other doctors drew limits on how much self-dosing they permitted themselves. After all, not all self-prescription was equally dangerous or worrisome. Yet explanations they offered could at times constitute ratio- nalizations. Dan, the oncologist with chest mets, said about his operation: I’m playing my own doctor, which is probably not the most bril- liant thing. But as long as I’m playing my own doctor, being conservative rather than radical, I tend not to be concerned. Even these doctors had difficulty revealing their self-doctoring to their physicians—not always disclosing fully. Scott, who self-prescribed ex- perimentally, did not tell his doctor until afterward. Some never divulged their self-prescribing to anyone. For example, Jessica, a pediatrician with Hodgkin’s, secretly gave herself antidepressants. From time to time I have medicated myself with Paxil. But I stop because of fear of long-term side effects. I don’t go see a psychia- trist, for multiple reasons: time and money, and I would probably find it difficult to talk about very private, intimate things. My nature is to be very private. So I medicate. I can write prescriptions for myself. I usually use low doses. My sister was taking Paxil, and it helped her, so I said, ‘‘I’ll try that.’’ I never really wanted to be on it, but I needed it. I stopped after a while, but then needed to start it again. Obviously, it’s altering my brain chemistry, and nobody really knows how in the long term. So it makes me a little nervous. Still, Jessica never told her doctor, even though variations in her symp- toms implied that consistent treatment by a professional might benefit