Medical commentary: 'I’m coming out' has a different meaning these days

I was walking through the hospital waiting room when Diana Ross’s “I’m Coming Out” floated through the speakers — that soft Muzak version that somehow turns rebellion into elevator music. The irony almost made me laugh out loud. That anthem of liberation, playing in one of America’s most closeted institutions.

Because in medicine, coming out isn’t just about identity. It’s about diagnosis.

And the question isn’t if you’ll hide it — it’s how long you can get away with it.

Take Dr. Sue Goldie. A Harvard physician. A MacArthur “genius” grant winner for developing computer-based models linking the basic biology of a disease and its epidemiology to outcomes in large populations.

She hid her Parkinson’s for four years. She told strangers at triathlons before she told colleagues. Why? Because strangers can’t fire you. Strangers can’t whisper at conferences that maybe you shouldn’t be treating patients anymore.

Here’s what keeps me up at night: I’m a neurologist. And when patients ask me, “When should I tell people?” I don’t always say, “Right away.” Sometimes I can’t.

Because for patients who are pilots, surgeons, CEOs — disclosure can sound a lot like a resignation letter. We’ve built a system where honesty about your brain is a luxury most people can’t afford.

Not everyone has the same safety net. Some people stay quiet not because they’re ashamed, but because they’re protecting their livelihoods, their licenses, their families. That silence isn’t weakness. It’s survival.

One million Americans live with Parkinson’s. Add Alzheimer’s, multiple sclerosis, early cognitive decline — now we’re talking about tens of millions living double lives.

Your surgeon may be timing his tremor medication before your procedure.

Your pilot may be calculating how many more months she can pass cognitive screening.

Your financial advisor may be forgetting why she walked into the meeting room.

And here’s the paradox: early honesty makes everyone safer. It allows people to get help, adapt their roles, and step down with dignity — not disaster. But we’ve built a culture where people wait until they can’t hide it anymore. Until the mistake happens. Until the secret becomes the scandal.

We celebrate radical honesty on social media about everything from anxiety to colonoscopies. But brain disease? That’s still the last closet.

Maybe it’s time to build a world where coming out with disease doesn’t mean losing everything. Because the choice to share should come with support, not consequences.

The music’s already playing. The question is: will anyone feel safe enough to dance?