76 Becoming a Patient
illness clearly lay outside their area of expertise. Brian, the pediatrician
with hepatitis C, said his doctor felt hesitant and awkward treating him as
a patient. ‘‘The first time I went to my doctor, he said, ‘All right, I’m going
to test your prostate. Drop your pants. That doesn’t bother you, because
you’re a doctor, does it?’ I said it would bother me if he didn’t!’’
Collusion commonly occurred. Eleanor said about her husband:
Part of the problem was that colleagues were willing to be cornered
in the hallway for quickie consults. Colleagues would say, ‘‘You
really ought to come in and be checked.’’ But that’s where it began
and ended. That facilitates more denying: if it’s a quickie consult
in the corridor, it’s not really serious. Both sides were willing to do
that.
Many physicians-of-record gave ill doctors more latitude, seeing them
less often if these patients wanted. Scott, the internist with the infected
foot, said about caring for fellow physicians:
I yielded a lot more to docs than to other patients. If I would
normally see patients at three-to-four-month intervals, I’d proba-
bly hold docs to half that. They could talk me out of it. I tried
not to buckle under. If I hadn’t seen them in a year, I’d say, ‘‘Am I
still your doctor?’’ To try to avoid this confusion, I’d say, ‘‘Let’s
try not to let this happen again,’’ without sounding rude. I wanted
to say, ‘‘Be nice to me. Respect me!’’
In a small city or town, finding a physician whom one does not in some
way already know can be difficult. Awkwardness may be inevitable. As
mentioned earlier, Pascal, the Lebanese internist with HIV, concluded he
simply couldn’t have a doctor in his small town. ‘‘If I were in a larger city,
it’d be easier. I wouldn’t know anyone.’’
Doctor-colleague-friends may shirk roles or functions of a physician.
They may not only fail to perform full or partial physical exams, but
also defer treatment decisions to these ill physicians. Jerry, the surgeon-
lawyer, said, ‘‘My physicians definitely treat me differently than they do
their other patients. They pretty much leave my care up to myself.’’
Colleagues may have trouble treating a sick peer. Paul, for example,
decided he did not want to care for friends, since objectivity would be
difficult and their illness would distress him. It would be hard if and when
they got seriously sick.