Hospice and Palliative Medicine Visionary Warren Wheeler Shares His Insights on the Field

In celebration of 25 years serving the profession, the American Academy of Hospice and Palliative Medicine (AAHPM) asked its 5,000 members to nominate who they think are the leaders – or Visionaries – in the field. They then asked members to vote for the top 10 among the 111 nominated.

“This program recognizes key individuals who have been critical in building and shaping our field over the past 25 years,” noted Steve R. Smith, AAHPM executive director and CEO. “These individuals represent thousands of other healthcare professionals in this country that provide quality medical care and support for those living with serious illness — each and every day.”

The Visionaries – 14 women and 16 men – are physicians, nurses and hospice pioneers such as British physician, nurse and social worker Cicely Saunders, credited with starting the modern hospice movement, and Elisabeth Kübler Ross, author of numerous books including the groundbreaking “On Death and Dying.” Five elected officials were nominated and one of them, former President Ronald Reagan, was named a Visionary for signing into law the Medicare hospice benefit in 1982.

Many of the visionaries will be sharing their thoughts about the field and who inspired their work. We’ll be posting them over the next several months. Today’s post is from Warren Wheeler, MD, Senior Director of Palliative Medicine, Nathan Adelson Hospice in Las Vegas, NV.

Who has most influenced your work and what impact has he or she had?
As a medical oncologist in 1977, my patient Mrs. W. had gangrene of her lower extremities, a complication from metastatic breast cancer. She had horrific and uncontrolled malignant pain. I had been trained in medical school, internship, residency, and fellowship to treat the disease, not the person with the disease. As I and my house staff entered her room she was delirious and screaming from pain. Her two daughters stood at the foot of the bed and asked, “How can you let our mother suffer like this?” I was belittled in the presence of house staff, felt vulnerable, and inadequate as a physician. I owe it to this patient for changing my direction for caring of patients.

The first article I read on management of pain and symptoms in terminal illness was by Dr. Balfour Mount in his address to the Royal College of Surgeons of Canada. This opened my mind to a whole new area of learning. My next encounter was with Dr. William Lamers, Jr., medical director of Hospice of Marin. I completed his training seminar on ‘Developing a Hospice Care Team’.

Many pioneers of hospice have had a professional influence on my philosophy and knowledge on how to care for the chronically and terminally ill patients. Those physicians with major impact have been Drs. Eric Cassell (personhood), Ronald Fisher (day-care hospice of the NHS), Kathleen Foley (“The dose that works is the dose that works”), Cicely Saunders (principles of hospice philosophy), and Robert Twycross (whole person care).

What does it mean to you to be named a “Visionary” in Hospice and Palliative Medicine?
To paraphrase poet Robert Frost, this is a lifetime affirmation that the hospice and palliative care road I chose has made all the difference in me as a person and in the care I give to patients. I have often thought how privileged it would be to have met Sir William Osler or Florence Nightingale. Well, I have the honor of living at the same time as their hospice counterparts, knowing and learning from them. This is truly an experience of a lifetime.

What is your vision for the future of hospice and Palliative Medicine?
My vision is that hospice philosophy and the principles of palliative care will be mandatory curriculum in all the professional schools of pharmacy, nursing, and medicine. The hope is that this will have a major influence on the minds of Americans who presently feel that they never die, but just underachieve!

More information on the Visionaries project, including the list of 30 Visionaries is on the Academy’s website www.aahpm.org.

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