70 Becoming a Patient
do it out of principle. It’s low-class to be your own lawyer. My father used
to say, ‘A man who is his own lawyer has a fool for a client.’ ’’
Feelings arose as well that criticizing fellow physicians was taboo. Re-
specting authority fully was important. Yet, as we shall see, this taboo
could potentially impede professional mandates to help patients as
much as possible. At times, these physicians made nuanced decisions
whether to obtain second opinions or not that were based on the magni-
tude of the problem, doing so only for ‘‘major things.’’
Yet even if an ill physician avoided pursuing a second opinion, his or her
family members and friends could urge such a consult, precipitating con-
flict. Eleanor said about her physician-husband, ‘‘My daughter and I both
tried talking him into getting a second opinion after his surgery. He refused.’’
Yet these doctors also had to decide whether to provide second opinions
for friends, family members, and others. Jacob did so, though questioning
the practice. Nonmedical acquaintances routinely asked him to read their
radiologic images. ‘‘People in synagogue give me scans to look at. I seem
like such an empathetic guy, so therefore I am the greatest MRI reader, the
greatest doc.’’ He criticized these common assumptions, yet obliged the
requests. He felt that he wouldn’t pursue second opinions himself, but
that others had a right to do so.
Doctor-Patient–Doctor Relationships
‘‘What is a doctor’s role to a doctor?’’ one physician asked. How should a
provider approach and treat a patient who is also a colleague? The rela-
tionships of ill physicians to their own doctors differed from those be-
tween doctors and nonphysician patients. Relationships between doctors
and lay patients have been explored, largely in attempts to learn how
to increase empathy and the quality of decis ion-making (2, 3). Yet how
doctors treat fellow physicians has not been systematically examined.
Boundaries can muddle with lay patients, too, but here do so at times in
wider and far more complex ways.
Frequently, colleagues were not only physicians, but friends as well,
thus occupying three roles that could conflict or shape one another. Given
the increased risk of identification, ill doctors challenged their own phy-
sicians’ defenses. Physicians-of-record had to decide how much leeway to
give an ill physician—whether to modify standard practices, and if so, how
much. Doctor-patients in turn often expected special, VIP treatment, or