March 2, 2010
Recently, while preparing to be part of a patient panel of an AIDS Forum for second-year medical students, I struggled to find a way to describe the unique, relatively new relationship between myself and my doctor, since testing HIV positive.
I remember how nervous I was before my first appointment with him. I knew I needed to share some deeply personal things; things I had never said out loud to another human being. I felt a great deal of shame about some of them but I also knew that he could really only help me if I was completely up front with him. Because he spoke to me with such respect and had such a truly caring sense about him, my gut told me it was OK to divulge my secrets. I'm glad I did. It helped him understand why my numbers were as low as they were and therefore changed the start of my treatment. That meeting, a team was formed and I left that office with a newfound confidence that has been instrumental in my fight with HIV. Wars are never won by individuals, they are won by teams.
After tossing out countless metaphors, I stumbled upon the term, "wingman". Perfect, I thought. Although often used to describe the supportive role a straight man plays in getting his buddy laid, I used Google to dig a bit deeper, and found that within the United States Air Force, there is a real effort to develop an entire wingman culture.
Simply stated, wingman culture emphasizes the importance of each one of us looking out for one another. In an article for the U.S. Air Force Medical Service monthly newswire, Lt. Col. John Stea and Maj. Nicole Frazer explain the role and responsibilities of being a wingman as it applies to aviation and the military. I think it also rings true for the man (my doctor) who helps me manage my disease.
"A wingman has specific duties and his perspective is clearly different. As in flight, no one person can be aware of all the obstacles and dangers in the environment. Therefore, the wingman complements the lead and can see the 'big picture'. The wingman can see how the stress in a person's life relates to his or her functioning. A wingman might be able to help that person change the impact of the stressor, or change the source of the stress. The wingman culture is built on guiding principles, such as personal responsibility and community involvement, which reinforce and uphold the Air Force core values.
Integrity encompasses the responsibility to assist others in times of need. It can be as simple as talking to someone or giving them a list of community resources. A person of integrity possesses courage and does what is right even if the personal cost is high.
Service before self means respect for others and acknowledging the impact of our actions on their lives. Principles of this core value of being a good wingman include deference to others' needs, respect for others and a spirit of collaboration; in essence, working together to help others. A commitment to personal excellence requires learning about resources where others can receive assistance. Guiding someone to the chaplain or to a therapist can make a difference in that person's life, perhaps even saving it. All this guides us along the path to community excellence, where all members gain by our individual actions of excellence."
After reading those words, I couldn't help but wonder, "Is that why he's such a good doctor?" I chose him mostly because of his reputation and education but the fact that he spent years as an AIDS activist, that he regularly speaks at classes teaching men how to thrive with HIV and that he went to public Street Fairs to administer Hepatitis A & B vaccines demonstrated to me that this guy was an active part of my community. That means a great deal to someone that's about to embark on a medical partnership that will hopefully last for years.
Like any relationship, it grows more solid as time goes by. You see the other in various situations and watch how they deal with you. I guess that's how trust begins. One of the first big challenges I faced after receiving my diagnosis was finding a physician I not only trusted but one that I connected with, to head up my new "team". I spent weeks contacting everyone I could think of, asking if they knew any doctors, exceptional in the field of HIV with a strong holistic approach. Granted, I live in San Francisco, but burn out is a genuine reality and great doctors are scarce, even here. Let's face it, how many MD's call their patients on a Sunday evening, after the start of antiretrovirals, to make sure that they're doing alright or provide the ability to email them with questions or concerns that may seem trivial to some but not when you're so new at all of this.
In my closing comments to the students, I got a bit choked up when I spoke how much I have grown to trust and value the wingman that has had my back the past two years. I hoped one day each of them might do the same for their own "lead pilot".
Who's got your back?