“Dr. J., me and my boyfriend were wondering: Are you married?” said Marcos, or Mr. Cruz, as I call him in the office. As a rule, I use patients’ surnames. Many feel more comfortable calling me “Doctor,” so it seems only fair to say “Mr.” in return. Mr. Cruz discovered I have a daughter. Much as he’s been in the office lately—between an unusual HIV-related blood disorder and a torrent of gallstones—he’s caught me answering cell-phone calls from an angst-ridden adolescent. Between clinic visits and hospitalizations, we’ve gotten to know each other.

“Married? That’s kinda personal, right?” I said.

There it was—that imbalance. I probe a patient’s most intimate bodily functions and sexual practices. Is there a problem with them knowing more about me?

Bending boundaries is risky. If doctors get too close to the person, our emotions may disrupt the clear thinking and action we’re trained for. Then there’s self-preservation: We must maintain enough distance to leave room for our families—and to have lives of our own. Plus, patients need to be able to bring up anything from cranky bowels to a sore in a sensitive site. If I’m a friend, that’s harder.

But relationships with HIV patients are special. Few other conditions involve such a long-term, sustained partnership, facing a life-threatening virus that requires all our concentration. Over the long haul, we need to be able to laugh together, celebrate victories, even open a few doors.

So I smile and say, “No, I’m not married” and go on to check his blood pressure.