Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Immunity illusions


When my classmate in medical school died of chronic illness, I was finally able to imagine myself as a patient. I now treat patients with the compassion that I would want to receive in the hospital.  

“You know that white coats aren’t immunity cloaks, right?” my friend asked me. “Why is every book written by a physician about the realization that even they can become a patient? What is it about medical training that leaves you believing that you’re immune to disease?”  


I laughed with her about the hubris of doctors. After the laughter, I told her that my own training was changed by a classmate who had cystic fibrosis. He was a year ahead of me in medical school and decades ahead of me in character. 


Brett Pearce’s childhood was spent in hospitals. He lost a lung. And he lost his freedom, which was replaced by a lifetime of immunosuppressants. His physicians warned him about the threat of infectious diseases. Brett decided to become a doctor despite his illness because he wanted to find a cure for himself and others. He conducted student research on the quantitative morphology of cystic fibrosis and then advanced into clinical training. 


During Brett’s pediatric rotation he contracted a viral infection. He fought back, but eventually succumbed to illness. A faculty member recalled Brett saying, “My illness has been a learning experience. The lessons at times have been costly but made me who I am.” He learned the lesson that takes most physicians decades: white coats are not immunity cloaks.  


At his funeral, Brett wore his white coat in the casket, and we wore ours in the pews. One of the deans told the student newspaper that Brett’s spirit would live on in his classmates. We would become more compassionate physicians because of his example.


I now tell patients that it is much harder to have an illness than to treat it. I tell my medical students the story of Brett, and how after the funeral, I worked to increase my compassion and time that I spent with patients and their families. I started asking patients what they hoped for and what they feared. 


Three months after Brett’s funeral, I married my wife at the same altar where his coffin had laid. A year later, our son was baptized at that altar too. I thought of Brett on each occasion—his story was of a patient who became a physician, rather than of a physician who realized they could become a patient. He never suffered illusions of immunity and chose to become a doctor anyway. 


After Brett’s death, I started spending much more time with patients. I was finally able to imagine myself as a patient, and to treat patients with the compassion I would want to receive in the hospital. 









This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.