Psychiatrist explores minds of ill doctors

January 14, 2008 12:35:15 PM PST
At 8:30 a.m. on Sept. 11, 2001, Robert Klitzman's sister, Karen, called her best friend from her office on the 105th floor of the World Trade Center. No one ever heard from her again. Grief-stricken, Klitzman became depressed, but he didn't realize it for a while. He is a psychiatrist. He couldn't become mentally ill, could he?

Once he realized that he indeed could, the award-winning researcher-author and associate professor of psychiatry at the Columbia College of Physicians and Surgeons decided to find out how physicians react when they fall ill.

He interviewed over 50 doctors who suffered from such diseases as HIV, Hodgkin's lymphoma, breast cancer, bipolar disorder and leukemia. Identified only by pseudonyms, they bared their souls to Klitzman. The result is a remarkable book, "When Doctors Become Patients," which helps illuminate the medical profession's mind-set under duress.

Physicians, his study reveals, tend to think the world is divided into two groups, doctors and patients, and that doctors will never get sick and morph into lowly patients.

"It's arrogance," a psychiatrist-in-training with breast cancer explains. "Doctors think it will never happen to them. But that is such a mistake. Because it can and probably will happen."

So what do they do when it happens?

After the initial shock and denial, they have to make several decisions. Should the sick doctor be his own doctor? If he wants a colleague to be his doctor, which one should he choose and how much control should he give him? "Doctor-patients" also struggle with the thorny question of whether to tell their superiors, colleagues and patients about their illnesses, for going public could affect their practice, employment or promotion.

Some doctors emerge from their ordeal with newly found sensitivity and empathy for patients. A radiologist with cancer says he now "pretty much drops everything" to tell his patients about their test results. "When patients say, 'It's nice you did that,' I say, 'I've been there, and know what it feels like,"' he is quoted as saying.

There have been a couple of books in the past that presented first-person, stand-alone accounts of sick physicians, but Klitzman's is the first ever to weave together those individual experiences and paint a comprehensive portrayal of wounded healers.

The author is uniquely qualified to tackle this intriguing subject. Not only does he have personal experiences as a doctor and a patient, but he has researched disease-ravaged people before. He explored the world of HIV-infected individuals and wrote "Being Positive: The Lives of Men and Women with HIV." As a 21-year-old college graduate, he traveled to Papua New Guinea to study an epidemic of kuru, a disease spread through cannibalism, for Nobel Prize in Medicine co-winner D. Carleton Gajdusek. He wrote about this extraordinary experience in "The Trembling Mountain: A Personal Account of Kuru, Cannibals, and Mad Cow Disease."

Klitzman, who has received several fellowships, including one from the Rockefeller Foundation, published his first book, "A Year-long Night: Tales of a Medical Internship," in 1989. His forte as a researcher-author is that he always takes a multidisciplinary approach to his subject, and gives it a very personal touch by sharing his own feelings with readers. That makes all his books emotionally appealing as well as academically valuable.

The material contained in "When Doctors Become Patients" should provoke deep thoughts in all potential patients - in other words, everybody.