Us versus Them: A False Dichotomy?

My friend Jordan Grumet MD wrote a piece in his blog on January 20, 2017 entitled “Us and Them”. In it, he described how a coworker had been diagnosed with a deadly brain tumor, a glioblastoma multiforme, which is normally thought to be a  “uniformly fatal brain cancer”. When he and other residents learned of her diagnosis, “that day in the ER, she ceased being one of us, and became one of them. The sick people.”

Although Jordan and I usually see eye-to-eye on most things, in his case I must disagree.

Doctors are a pretty tight group. We stick together most of the time, no matter the issues, and we have each other’s back. We never really expect to get sick, much less contract a potentially fatal illness ourselves, but of course being human just like our patients, we do. I believe that when a doctor gets sick, he or she is still very much one of us, just ill and in need of help.

Much like when a doctor gets addicted to pain killers or drinks too much and becomes impaired, he is still a doctor, still one of us, although a demonstrably flawed member of our group who may face sanctions due to his ongoing behavior. He does not suddenly become an alcoholic or an addict only, but is simply a doctor with an addiction problem.

I think that using the false dichotomy of Us and Them, or Us versus Them in the current politicalspeak, is not helpful or accurate.

We should not, as professionals, distance ourselves from trouble or heartache by putting patients in the “them/sick people” box. It insulates us from the pain, that is indeed true. It also takes away our ability to be more real, present and human with our patients. Even if, especially if, the patient is one of us.

If I am sick, I still want to be treated as a person who also happens to be a doctor. I am well-trained in some aspects of medicine, but my training may be all together inadequate to face my own illness without the help of my doctors, who also may happen to be my peer group and perhaps even my friends.

I would never want to be involuntarily removed from my peer group due to circumstances beyond my control.

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