The doctor as patient—what doctors have learned from their own illnesses

Robert Klitzman, M.D. ’85, learned to be a doctor at Yale. Learning to be a patient was his subject, however, when he spoke to alumni in Harkness Auditorium on June 4 at the start of the annual alumni reunion. After his sister was killed in the World Trade Center on 9/11, Klitzman became deeply depressed. “I thought my training as a psychiatrist would help,” he said, “but it was quite the opposite.”

Klitzman, co-founder of the Center for Bioethics, and director of the Masters of Bioethics Program at Columbia, and a professor of psychiatry there, found that a physician’s knowledge can lead to self-treatment and denial. He also gained insight into the ways in which doctors can unwittingly make a suffering patient’s life even harder. He was inspired to interview physicians nationwide who had suffered serious illness and to record their experiences in a book published in 2008, When Doctors Become Patients.

The doctors he interviewed realized they’d been minimizing the severity of many of their patients’ symptoms. One gastroenterologist described her own abdominal pain as “so much worse than anything I could have possibly imagined.” They were much more aware of long waits for appointments and the indignity of hospital gowns. But mostly they talked about issues of communication: how uncomfortable it is to bring up such embarrassing problems as impotence or the tortuously slow pace of time for a cancer patient awaiting test results.

A lively discussion followed in which people in the audience wondered whether empathy can be taught. “The jury is out,” said Klitzman, adding that medical students can be instructed to apologize for long waits and call promptly with test results. “Specific, concrete kinds of behavior can be modeled and taught,” he said.