‘‘The Medical Self’’ 79
said, ‘‘Ok, I’ll try it.’’ It didn’t work. He never once examined
me, except doing cranial nerves. The first time I had any problem,
he just freaked, basically saying, ‘‘You could just go home now
and die.’’ He gave me this huge prescription for Seconal—for anx-
iety or to kill myself. I said, ‘‘I don’t need Seconal. I need a head
scan and a lumbar puncture!’’
To find an appropriate provider, others, too, meandered far. Jennifer also
presented an important category here: ‘‘friendly . . . on a professional
basis,’’ that is, ‘‘professional friends’’—more than co-professionals but not
entirely friends. Such friendships ranged widely in strength, length, and
trust.
Questions arose of what to call such colleagues who offered some as-
pects of treatment, but were not formally or officially one’s doctor. Pascal,
the Lebanese internist, for example, referred to ‘‘the person’’ that writes
his prescriptions for him—as distinguished from ‘‘his doctor.’’ Pascal
made his own medical decisions, but did not order his own drugs.
I’m sort of my own physician. I make the decisions, and discuss
them with the person that writes my scripts. I haven’t been to phy-
sicians for a physical exam for years.
Pascal saw problems with this arrangement, but no alternative.
I wish I had someone to go to, and be a patient. But there’s no one
here. I don’t feel uncomfortable making these decisions. I think
they’re good decisions, but that’s probably not a good thing to do. I
don’t think of it as an ethical problem, but I just would like it to be
different. I want someone to be objective.
Pascal felt awkward with this situation, but not strongly enough to prompt
him to change it.
Such collusion and denial could have several implications. Eleanor’s
husband chose staff who colluded with his minimization of his illness, and
did not, for example, discuss end-of-life care much. She quoted a dis-
cussion between her husband and his doctor:
‘‘How are you feeling?’’ ‘‘Fine, thank you.’’ ‘‘Are you interested in
radiotherapy?’’ ‘‘No.’’ ‘‘Do you have a living will?’’ ‘‘Yes.’’ ‘‘Any
interest in hospice care?’’ ‘‘No.’’ That was the end-of-life conver-
sation. Everybody was very complicit with his denial, and did
not address the outstanding issues.