Medical school course seeks to train 'doctors who heal'
Spending several months with a man dying from colon cancer taught doctor-in-training Charles Wykoff more than just the mechanics of treating illness. It taught him what cancer patients — and just about all human beings — crave.
"We all want to live," he says, "and if we can't live forever, we want as much quality time as possible before we die."
"Being a teacher is a way to contribute, express your gratitude to the health-care system that has helped you, and leave a legacy to the next generation of doctors."
— Susan Block, MD
Wykoff gained this insight as part of a Harvard Medical School course for first-year students called "Living with a Life-Threatening Illness."
Now in its ninth year and once featured on "Nightline," the emotionally intense course includes a weekly class on such topics as pain relief, healthcare proxies, and religious beliefs about death. Faculty are drawn from surgery, oncology, anesthesiology, and various other disciplines, notes Dana-Farber's Susan Block, MD, who directs the course with her husband, Andrew Billings, MD, of Massachusetts General Hospital.
The real instructors, however, are the patients of many ages who volunteer to be "shadowed" for a semester in various settings. Many of the patient-teachers die during the session, and the students often follow up with grieving families.
"Many patients want to do this," Block reflects. "When you're sick, dependent, and vulnerable, you often feel diminished as a person. Being a teacher is a way to contribute, express your gratitude to the healthcare system that has helped you, and leave a legacy to the next generation of doctors."
Samantha Goldstein and Charles Wykoff
Among the thankful students is Samantha Goldstein, who was paired last year with a man in his 50s diagnosed with colon cancer and receiving hospice care at home.
"He taught me that death can be a joyous time in addition to being devastating," recalls Goldstein. "My patient was finally confronting issues and reconnecting with people from his past. And when he died, he was no longer in pain — and that was comforting to those around him."
Wykoff often accompanied his patient, a man in his mid-40s, to weekly appointments at DFCI followed by lunch. The patient shared his fears and anger about dying too soon, his desire to "build memories" for his 10-year-old son, and his hopes for a miracle cure.
Although he witnessed only one example of those claimed by cancer each year, Wykoff believes his patient's longing to live as long and fully as possible is universal, and that doctors who understand this make better caregivers.
"Possibly," he wrote in a class paper, "an appreciation for these desires, and an ability to address them, distinguishes doctors who treat from doctors who heal."
