He was really bright and got into medical school, but he didn’t like working with patients — perhaps because of his parents’ situation. In the end, he decided to go into public health and not be a clinician. That kind of shift c an work for some.

Similarly, I had a young woman come to me. She was training to become an oncologist and she had crashed her car twice. What was going on? When we talked, it turned out that her father had died of cancer when she was 7.

Her unresolved grief was coming to the fore in the clinic. She decided that being around cancer was like reopening an old wound. Eventually, she moved over to family medicine.

You write about counseling physicians who are disabled or ill. What are their special issues?

Well, doctors are not supposed to get sick. When it happens, healthy colleagues will sometimes try to push them out, because they don’t want to be reminded of their own vulnerabilities.

I had a client with a physical disability, and he was very good at his job. But a couple of his colleagues bullied him and made his work life intolerable. For him, the solution was to find another hospital to practice in.

I had another client, an obstetrician, who wanted children and was infertile. When fertility treatments failed, her colleagues minimized her distress and acted like she should “get over it,” an attitude they wouldn’t have with their patients. For a time, she considered leaving obstetrics.

As we talked, she realized that she liked the drama of childbirth and wanted to continue in her specialty. I encouraged her to speak to her colleagues. Together we developed a backup strategy: she could move over to emergency medicine. Just knowing that there was a Plan B made it possible to stay.