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The Patient as Physician
- American College of Physicians, Philadelphia, PA 19106 Requests for Reprints: Herbert S. Waxman, MD, American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106. Requests for Reprints: Herbert S. Waxman, MD, American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106.
The physician who becomes a patient has a chance to become a better doctor. In 1985, I developed sudden chest pain, which led to cardiac catheterization. My physicians found a type I acute aortic dissection, and emergency surgery quickly followed. The cardiopulmonary bypass time was very long, and I received hundreds of units of blood products to maintain hemostasis. After surgery, I sustained extensive lower-extremity necrosis of muscle and nerve, probable deep venous thrombosis, cardiac arrhythmias, total global amnesia, painful peripheral neuropathy, and severe depression. It took me 3 months after the surgery to begin the transition back to my responsibilities as a department chairman and clinician-educator. And I still worry about the longer-term consequences.
Dedicated physicians from many specialities saved my life, for which I have the most profound gratitude. Yet, I learned hard lessons from my experience. Three aspects of my own care are particularly instructive.
Time
After the first 10 days or so, it seemed that my short-term survival was no longer in doubt. As a consequence, my physicians did not have to spend …
