“I did my training in medical school but worked temporarily during the summer as an assistant nurse at the oncology clinic in Lund. The doctor patient, who I choose to call “M” in my thesis, had himself until just recently worked in the same hospital. Now his cancer had spread and he was beyond any known possibility of finding a cure”, says Jonatan Wistrand.
They established a good connection and M’s situation made Jonatan think about what it must be like to go from being the doctor to becoming the patient. He would eventually also need to go through this experience, just as every other doctor does. In addition, Jonatan Wistrand would in his role as doctor meet several patients who were also colleagues.
However, his curiosity in this subject had already been piqued even before he even met “M”.
“A year or so before this I developed testicular cancer and was admitted to the same cancer ward. It was an odd experience. I was studying medicine and was trying to find my identity as a future doctor but instead I ended up taking on the role of patient. Even at this early stage I became curious about what happens to the sick doctor. But it was during my meetings with “M” at the oncology clinic and in the narratives that developed during our talks that I really began to have questions.”
Today, Jonatan Wistrand has been given a clean bill of health and in his thesis he presents his impressions from the variety of literature that he has read on the subject, where doctor patients from two centuries convey in their own words how they experienced being in this dual role.
“A lot of research has been conducted into the subject, primarily with the use of questionnaires and interview studies, but I have used a textual analysis and historically comparative approach which is more commonly used in the Faculty of Humanities than in the Faculty of Medicine. In the autobiographical narratives that I have read there is often a noticeable harmony between statements that are written during the same time period. Doctor who became sick in the early 20th century did not become patients in a strict sense, but instead maintained their identities as doctors.
“But during the second half of the 20th century something happened. The medical profession is no longer regarded as such a strong calling in the same sense. We hang up our stethoscopes before we go home. It therefore becomes possible to integrate the role of patient with the role of doctor. Although this is still not a smooth process.”
Previous scientific studies that Jonatan Wistrand has read suggest that doctors who become sick face difficult challenges; they often seek medical help at a later stage, use drugs classified as narcotics to a higher extent and are more unwilling to go on sick leave when they themselves are sick compared to the general population.
“As a doctor, it may feel like it is smoother to choose informal ways, such as prescribing medication for yourself or consulting a colleague in passing. However, deviating from the established channels into healthcare might also entail risks. The distribution of responsibility becomes more blurred, as well as the process of the investigation and follow-up”, Jonatan Wistrand explains.
“In my meeting with “M” I realized that it was impossible to ignore his identity as a doctor, and I think it will always be this way, that as doctor patients we have two identities, and we need to find ways to cope with both of them. Which is not always that easy, not for the doctor who gets sick or the surrounding healthcare staff.”
Contact: Jonatan Wistrand, doctorate at the Department of Clinical Sciences in Lund, Lund University, Resident Physician in general practice at the healthcare centre in Löberöd: 0703-187239 or jonatan [dot] wistrand [at] med [dot] lu (jonatan[dot]wistrand[at]med[dot]lu)