What Doctors Fear Most

Medical training teaches all would-be doctors that the human body—though incredibly sophisticated—can also wind down easily, like a fine watch with cheap batteries. We carry this knowledge with us into practice, and most of us are able to cope with our patients' illnesses only by not connecting them directly to our own vulnerabilities. We survive our awareness of what can go wrong by acting as if we are beyond harm ourselves.

But all this changes when a doctor gets sick. Doctors, notorious for being the worst patients, are often unable to cope with their intricate knowledge—once something goes wrong—of exactly what can go wrong next.

Chez, a close friend of mine from medical school, loved rich food and rarely exercised. But he was only thirty-three, so when he called me complaining of sudden chest pressure and the numbing of his left arm, I found it hard to believe it was his heart. "Do you think it's my heart?" he asked.

"We both know it could be a lot of things," I told him. But my voice conveyed my nervousness. Once the topic had been broached, we were both thinking ahead to angioplasty or surgery and the restricted lifestyle that could follow.

I was also thinking of the trust he had to call me at such a moment—I wasn't his doctor, but I became so instantly, calling the ambulance, meeting him at the ER, arranging the aspirin, nitroglycerin, and heparin, and calling the cardiologist who relieved me of the reins.

It was his heart—the EKG in the ER showed ongoing changes to its front wall. The cardiologist gave him a statin drug and rushed him off to the cardiac catheterization laboratory. There, a stent was slid from his groin up into his heart's left anterior descending artery. The procedure was successful, and the prognosis was excellent.

It had all happened too fast for me to be able to gauge the emotional impact on a young doctor suddenly turned patient, though I suspected that the shock of it kept him from instant appreciation or fear. But days afterward, he was depressed: the first in our group to have to live with the knowledge that the limitations we saw in our patients existed in ourselves.

"I'll be back to work in a week," he said, not quite meaning it.

"You're as good as new with the stent," I responded, telling a smart internist what no doctor ever fully believes.

He did rally somewhat, afterward returning to his position at a Bronx hospital. But I could tell that he could no longer focus on his job. He quit soon after and took a part-time job in an HIV clinic, deliberately treating patients who had a worse illness than he did.

We drifted apart after that. I sensed that he believed I could never again accept him as being healthy because of what he'd revealed to me, and that this embarrassed him. I couldn't overcome his feeling, much as I wanted to. Still, I managed to keep track of him. The cardiologist who had taken over Chez's care at the hospital saw him regularly, and he appeared to be free of symptoms.

Chez left the HIV clinic after a few months. The last I heard he was working for a hormone-dispensing clinic downtown. After he quit that job, he disappeared. A Google search on him draws a blank. I hope that we will become reacquainted at a medical school reunion, and that the passing of years will have helped him overcome his embarrassment at having his mortality so prematurely exposed to a close friend.

Though I no longer see Chez, the experience placed a sturdy marker in my mind. Ever since his sudden chest pain and associated dread, I feel mortal. One of the ways I am able to function in the clinical trenches is by pretending I'm beyond harm; yet it becomes harder to pretend when a contemporary is stricken.

Since then, I have taken care of several other doctors in my private practice without experiencing the apprehension...