‘‘ The Medical Self’’ 53
lighting again how doctoring does not overcome certain preexisting human traits, but gets grafted onto them. Unhealthy behaviors continued even in the face of pressures from colleagues. Coworkers may remind doctors of dietary restrictions, but to no avail. Herb, the neonatologist with an MI, found, for instance, that nurses with whom he worked reprimanded him for eating junk food when they saw him doing so in the staff lounge, warning him of‘‘ the evil temptation of pizza.’’ He suggested that we live in a new era of morality, employing moral terms of‘‘ good’’ and‘‘ evil,’’ focused on diet and health. Albert, a white-haired internist in his mid-sixties, looked like a small town doctor from an earlier era. He had had an MI while driving on a highway, and said that afterward, he suddenly became‘‘ religious’’ about his diet, alluding to the high sense of obligation entailed— as if such health behaviors were special, sacred, and subject to laws.
I had never cared how much fat was in my diet. As soon as I became aware of it, I realized that everybody in the room but me would know the fat content of a bag of potato chips. Then, for a while, I could quote the fat content of every food I ate. I got a certain amount of satisfaction from being religious about that.
Individuals may try to act on medical findings in their everyday lives, yet doing so requires vigilance and energy. It took his own unexpected illness to prompt Albert to alter his outlook and activity.
Many doctors failed to practice what they preached with regard not only to diet, but also to safer sex, which may affect others as well. For example, David, the psychiatrist with HIV, had unprotected sex though he knew he shouldn’ t:‘‘ I had unsafe sex after I knew better... with a guy at a gay physicians conference, even as we were sitting there talking about this stuff.’’ Physicians are not alone in engaging in risky behavior despite knowledge that they shouldn’ t, but they are unique in simultaneously urging patients to engage only in healthy behaviors.
At times, magical thinking— that MDs were somehow invulnerable to disease— abetted unhealthy behaviors. David felt that his unprotected sex was somehow safe.
One of my dead boyfriends was a doctor. I rationalized that because he was a doctor, his unsafe sexual practices were somehow safe. Because he was a doctor, he couldn’ t be positive. It made no sense. I was just avoiding the subject.