The sick doctor

It’s difficult to receive a serious diagnosis. Sometimes, it’s even harder to tell the world about it. This is challenging for the patient, and the doctor.

How does the clinician decide to reveal a diagnosis like Parkinson’s Disease or Bipolar Disorder? When should the doctor stop practicing?

Doctor ethics
Is it ever acceptable, or possibly even necessary, for the clinician to deceive the patient?

Sometimes it takes the doctor years to accept and admit what’s going on inside her body. There’s an additional, unique level of complexity for the clinician—her diagnosis can compromise the patient’s care.

The sick doctor feels weak, wounded and unable to carry out her tasks. Being the subject of conversation feels unnatural for the clinician who is used to the patient fulfilling this role. 

The doctor’s colleague is often too polite to say anything even though she knows there’s something wrong. In fact, it’s often the patient who offers the clinician advice: ‘You look like my grandfather who had...’

What does this say about the culture of medicine? Does the patient feel empowered to say these things while the doctor does not?

The clinician may be reluctant to look at the faults of her colleague because this could unveil something about her own faults as well. The doctor may wish to share her diagnosis with the patient but choose not to since this would expose her weakness, and that seems unacceptable.

There’s an ongoing, ethical debate about the extent to which the clinician should admit her day-to-day frailties when she’s about to do something really important that affects the life of the patient. This is a factor for the doctor who is sick as well as the tired, sleep-deprived surgeon who was up all night on-call and is now operating on her patient the next morning.

The regulatory College requires the doctor to disclose conditions that may affect her ability to practice medicine safely. As painful as this is, it’s something every clinician needs to think about.

When does the doctor cross this line? How does the clinician know when she has reached the point where she’s possibly doing harm to the patient, or needs to ask for help?

The doctor may be afraid to ask for this help. Yet, she needs to be aware of this deficiency and willing to admit it to her colleague. In turn, the colleague needs to support her emotionally, and help the clinician make sure she’s practicing safely.