A few weeks ago, at a business meeting, I was introduced to a young woman lobbyist. For some reason, her name sounded familiar. But, it was not until well into the session that I remembered why.
Her doctor, who was also a social acquaintance of mine, had recently told me her story, complete with patient identification. Because of a physical anomaly, she could use almost no conventional contraceptive methods -- and therefore was prone to unwanted pregnancies.
I had been horrified to hear this woman's medical history so casually discussed by her doctor -- but was doubly horrified to realize that I was now getting to know her while in possession of her most intimate secrets.
My secret embarrasment during the course of the meeting was compounded when I mentally reviewed other occasions when local physicians had related privileged matters -- and in the most offhand manner.
Among the list of patients whose histories had been shared with me:
* George Balanchine's battle with the fatal degenerative brain disease Creutzfeldt-Jakob syndrome when he was admitted to George Washington University Hospital during his last visit to Washington.
* A top Reagan official who suffered from acute hypochodria and was constantly "harassing" physicians with what were termed imaginary indispositions. Among the complaints were suspicions of coronary problems, ulcers and pneumonia -- all of which, apparently, proved groundless.
* A leading Washington journalist whose amorous adventures led him to a series of uncomfortable bouts with notorious romantic illnesses.
* A well-known Washington socialite whose high-pressured existence keeps her in chronic dependence on a phalanx of District psychiatrists.
It occurred to me that almost every time I was exposed to "doctor talk" it had been "loose talk." And it also occurred to me that the practice of trading on patient names (as well as illnesses) has become well-nigh epidemic.
In a town where information is supreme, and access to power the next best thing to wielding it, local physicians have fallen prey to a devastating sickness of their own. The sickness manifests itself as a kind of professional one-upsmanship in which the winner can either claim the most glittery patient roster or stewardship over the most unusual (and sometimes tragic) diseases.
In an age of rapidly diminishing privacy, Washingtonians must now beware of the formerly sacrosanct physician-patient contract. It is clear that there are few secrets kept even in your doctor's office.
How can this be destructive? One glaring example reflects the potential liabilities of careless doctor talk: A well-known local bachelor physician was dating a single career woman, also a Washingtonian. As he became more interested, he detected increasing aloofness on the part of this woman.
Finally, there was a confrontation. She informed him that her physician had told her that she should not encourage her suitor because he was involved with "another woman."
He was shocked. His first move was to call the physician whose counsel his "date" was heeding. Having done this, the love-lost physician learned that the advice-giving doctor's partner was treating a patient whom both partners believed was involved with the hapless doctor suitor. Although the gossips were wrong, a potentially serious romance was on the rocks. This time, loose doctor talk had, ironically, damaged another doctor.
And this experience, I know, is hardly unique. A good friend and local resident regularly jogs with two physicians -- one an internist and the other a psychiatrist. My friend, who is presumably accorded "honorary physician" status on these runs, has often told me in the most complete detail of various case histories discussed on the trail.
Certainly, we have all been made aware of highly notorious cases of physician indiscretion -- the doctor who talks to the press about Hollywood patients or espionage figures (as in the yet-unresolved mystery death of former CIA agent John Paisley), but until recently we had little reason to suspect that our rather anonymous lives and ailments should be of interest.
Even more important than the question of whether we are the latest topic for doctor gossip is what can we do to stop it? If there were easy answers, I am sure that victims of doctor gossip would long since have put an end to the practice.
Is there a cure? Washington patients need to discuss the issue of confidentiality candidly with their physicians. It is important that family doctors -- or internists -- as well as specialists hear directly from their patients how concerned they are with privacy. No matter the nature of the complaint that brought them to the doctor's office in the first place, it is critical that patients make clear that they never expect to hear that the physician has discussed the nature of the problem reviewed or the fact that the particular individual is even a subscriber to the practice.
Sadly, the nature of the times and the pressure of competition demand a new level of involvement on the part of the patient if confidentiality is to be observed. It is critical for Washington patients to understand that their doctors must be put on notice. Without these precautions, their names and their maladies may well become exploited in the baldest fashion.
Finally, no matter how entertaining the news may be, inform physicians that gossip about patients is unsavory. Indeed, in the final analysis, "loose talk" among physicians may be more than damaging; it may well be actionable.