Healer or Dealer – a doctor shares his own story to illustrate the challenges of treating addiction
“A disturbing dance of deception with an opioid-addicted patient”, an intriguing title for an article written by Siddhartha Mukherjee in 1/4/2018 issue of The New York Times Magazine. The author uses his own experience with the insistent demands of a patient in what he calls the “opioid pre-epidemic” to highlight the challenges faced by doctors in the early wave of addiction: not only a lack of adequate training and false information but also a dramatic change in the traditional doctor-patient role.
As Dr. Mukherjee so skillfully expresses it: “The doctor shifts from healer to dealer…. The doctor is, at first, the enabler and the supplier, and then the tormentor, the withholder, the liar, the enemy.” Rather than “fix” the patient, a doctor is urged to provide “a fix”. The result is a doctor-patient relationship characterized by suspicion. Doctors today have increased knowledge and understanding of opioid addiction, but is this enough to establish a relationship with a client based on trust or are they doomed to persist in the role of drug dealer?
Though Dr. Mukherjee does not answer that question, he provides the reader with a new understanding of the predicaments doctors face and challenges the ideas that doctors are the enemies in the opioid crisis; in some case they are the victims too.