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the moralizing tone and disapproval that she felt were
inevitable. It was easier to ignore the whole thing.
Needless to say, I sent back an immediate e-mail
strongly advising that they see a physician quickly. They
lived on another coast and could not see me. After some
cajoling, she went to a medical doctor. A mammogram
and subsequent biopsy revealed a cancer in the affected
breast.
John and Tara found themselves plunged into a
nightmare. She had no physician to advocate for her
interests. The specialists did not understand or respect the
relationship between John and Tara, and wanted to deal
only with Tara's legal husband. John felt miserably guilty:
he thought that he had caused Tara's cancer by his caning
of her breasts over the months of their relationship ­
despite my assurance that the cancer had taken root long
before he and Tara had begun playing. He also felt cut
off from Tara, excluded by her physicians from the frank
discussions and treatment decisions. Most of this would
not have happened if Tara had established a relationship
with a nonjudgmental primary care physician before she
started having problems.
How to do it. Coming out ­ forthrightly sharing
information about your sexual orientation and/or practices
­ to your doctor, chiropractor, physician's assistant, nurse
practitioner or other health-care provider probably won't
be quite as tough as coming out to your mother. But it
won't be easy either.
While I (obviously) think of myself as a sex-positive
physician, there are patients I've taken care of for many
years who were not able to confide that they were gay,