James D. Wade

A nice man, James D., taught me a lifelong lesson when I was a medical intern.He had come to the hospital for a third opinion regarding a rapidly progressive neurologic illness that had turned him into an emaciated, wheelchair-bound, helpless soul.Because all the consultants had given no hope for cure or improvement, because of the multiple complications of his illness required frequent attention, and because of my endlessly busy days as an intern, his care became a bit of a burden.Mr. D. Had become one more case. One day his girlfriend gave me a picture of one of his beautiful paintings of wildlife.Later she showed me a picture of Mr. D. Posing in front of his paintings.Taken only three months earlier, it bore no resemblance to the man now lying so ill in bed.He looked so happy, proud, and healthy, like the real person he was.It hit me violently that I had lost sight of my patients as human beings and had begun to see them as a different species : the patient species.I had begun to detach myself from the most important aspect of medicine, and the picture of the recently healthy Mr. D. Set me back on the right course.I believe that both my patients and I benefited tremendously from the wake-up call.

The process of becoming a doctor is so protracted and arduous that it is easy to forget along the way the initial reasons and ideals for wanting to become doctor, especially because the current medical curriculum is disease-oriented, not patient-oriented.We need to devote more time and attention to teaching attitudes, skills, and behaviors at the expense of the present pre-occupation and fascination with technical knowledge.
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Aoun's physician, James Wade, MD, MPH, currently Medical Director of the Fred Hutchinson Cancer Center in Seattle, has written on the subject of patient participation in medical decision making.In The Physician/Patient Relationship : One Doctor's View, (Health Affairs 1995 ; 14 (4) : 209-212), Wade describes his model of the ideal relationship, in which the doctor encourages patients to express their needs and preferences, allows them to maintain personal control, and offers them unfaltering support. Wade argues against a strict informative approach, however, in which the doctor is little more than an information resource and technician, recommending instead that physicians provide patients with guidance on the best course of action.