78 Becoming a Patient
their doctors, and then had to decide what to do: whether to speak out,
and if so, how much and in what way. These two parties then fought
over hierarchy and authority.
Some questioned, but did not disobey, their physicians’ advice. Nancy
said that despite her qualms, she tended to follow her physician’s sug-
gestions because otherwise, ‘‘I would be pulling rank and I would rather
not do that.’’ Respect for the system could then clash with feelings of
entitlement. With more seniority, Lou, who had a p laque on his office
wall, went further, challenging his physician. ‘‘I wouldn’t sign myself out
against medical advice, but I asked, ‘Is there anything that we’re doing
here that I can’t just do at home?’ ’’
Others felt no hesitation about confronting their providers more force-
fully or fully. As patients, some doctors were sometimes very demanding.
Simon, a radiologist with HIV, refused to be audiotaped because he was
terrified of losing his disability insurance. He said he was a ‘‘better’’ doctor
than patient. In the first role, he had to act ‘‘professional,’’ but in the sec-
ond, he could be ‘‘bitchy.’’ ‘‘I can be very nasty as a patient, demanding
that I want something done stat!’’(immediately).
The awkwardness of consulting physician-colleagues could lead to
doctor-shopping. Some sick physicians visited multiple doctors, previ-
ously known or unknown, before finding a ‘‘good match.’’ Jennifer, who
had become infected with HIV through a needle stick while treating
a patient, illustrated the lengths to which one could have to go to find a
physician.
I was a colleague of everybody in the area that treats HIV. I had
become friendly with all of them on a professional basis, and we
did a lot of social things. Then, I needed somebody to take care
of me. It works better if the patient is anonymous. Otherwise,
there is awkwardness, not really knowing who is in what role.
My first doctor was the most knowledgeable. We had been
friends. I went to him, but didn’t get examined. It just felt wrong.
Then I thought I’d really rather have a woman physician, and one
who doesn’t know me. I heard wonderful things about a new in-
fectious disease woman on the other side of town. I went, but
then got really sick, and she was not very accessible. I ended up at
my local county hospital ER, miserable. No doctor could take
care of me there. The only doctor I would even consider in my area
was a good friend. He didn’t think it was a good idea, but finally