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Cycles of interest on how professionals cope with major illness run through the social fabric. Forty years ago, When Doctors Are Patients (1952) edited by Pinner and Miller, was published. Each chapter was a study of a physician coping with a major illness. Recently (1987) a follow up book, When Doctors Get Sick edited by Mandell and Spiro, was published, and now a book on how 14 analysts—both medical and nonmedical—cope with the onset of major medical problems appears. These problems range from conditions so vivid the patients inevitably become aware (e.g., pregnancy), to obscure situations that force absence from the office in such a way as to leave the patient free to conjecture the illness in the transference neurosis, as the analyst gives minimal information of the etiology of the disruption. Eleven of the contributors are physicians, two are Ph.Ds, and one is an M.S.S.W.
The ailments range from silent heart attack with cardiac arrest and revival to several discussions of termination by death of the analyst by his or her colleagues and by candidates in active analysis at or near the time of death. In some of the chapters the nature of the illness unavoidably causes open disclosure to the patient. In others forthrightness can be avoided in the service of the transference neurosis. This dilemma obviously operated with the author of each chapter. Some chapters are more dramatic than others. Some of the conditions examined are:
Silent heart attack in the analyst's office with subsequent cardiac arrest (at hospital) with survival.
Rupture of the esphargus during surgical dilation.
Meningo-encephalitis with thrombosis of the cavernous sinus.
Breast cancer with prognosis over 6 years from optimistic, to grim, to hopeful.
Death of an analyst as seen by a co-therapist.
Post termination death of the analyst.
Death of the analyst as seen by the analysand during analysis.
It is the theory of this reviewer that most surviving humans sooner or later confront catastrophic personal il