Retired physician teaching about Alzheimer’s – his own

Chicago TribuneFebruary 5, 2014 

— Dr. Daniel Winship and Jared Worthington wandered through the stacks at the Pritzker Military Library, pausing whenever curiosity called.

“ ‘Memoirs of an Army Surgeon – 1948,’ ” Worthington read from a book he pulled from the shelf. “Can you imagine?”

Their interest in medicine is mutual. Worthington, 25, is a first-year medical student at Northwestern University’s Feinberg School of Medicine. Winship, 80, is a retired physician with a particular interest in medical education, including a stint as dean of Loyola University Chicago Stritch School of Medicine.

Now Winship has returned to that field, but in a way he never could have predicted.

He is teaching a medical student about Alzheimer’s disease – his own.

Winship and Worthington have been paired up in the Buddy Program at the Feinberg School. The program matches medical students with people who have early-stage Alzheimer’s disease for a year of visits, outings and, possibly, friendship.

The purpose is twofold: to give the still-active patients an enjoyable and productive activity and to let medical students develop a deeper understanding of Alzheimer’s by getting to know someone who has it.

It is crucial that they gain such insight, said Darby Morhardt, education director of the Cognitive Neurology and Alzheimer’s Disease Center at Feinberg, who created and runs the Buddy Program.

The number of people with Alzheimer’s is steadily growing as the population ages and more people are in the years of prime risk of the disease. By 2025, according to the Alzheimer’s Association, the number of people age 65 and older with the illness could be up by 40 percent. By 2050, the number could nearly triple, from 5 million today to a projected 13.8 million.

“It’s inevitable that primary care physicians are going to be seeing people with cognitive impairments,” Morhardt said.

In the Buddy Program, she said, the medical students learn how to communicate with someone who has those impairments. They also see that early-stage Alzheimer’s patients can still function in many ways and lead meaningful lives.

“It changes them as doctors,” she said.

It shaped how Dr. Jeffrey Craft, a St. Louis oncologist, interacts with his cancer patients who also have dementia.

When he went through the Buddy Program in 2000, he was paired with an assistant professor at Loyola University Chicago who was well-traveled, well-read and understood exactly what was happening to him, Craft said. They kept in touch for three years; the man later died.

He still keeps in mind his onetime buddy’s awareness of his handicaps and his fate.

“There is still an individual there,” he said. “These people know there is something that’s going on. They deserve respect for that.”

Winship certainly knows what is happening to him. A dapper and genial man who wore a pinstriped suit to the luncheon where the medical students and mentors met, he minced no words about Alzheimer’s, with which he was diagnosed in January.

“It’s a devilish thing,” he said.

But the chance to help guide a medical student again was a wonderful prospect for Winship, who was secretary of the American Medical Association’s Council on Medical Education when he retired in 2011.

“I’ve been a physician all my life,” he said. “I just want to do some of the things I did as a physician – to continue teaching and enjoying the students.”

Worthington was equally eager to learn. A soft-spoken student who grew up in Michigan, he has seen the disease’s toll up close.

His grandmother is in the later stages of Alzheimer’s at a long-term care facility near her home in Newfoundland, where Worthington spent his childhood summers. “My extended family has taken on the role of caregivers,” he said. “It’s pretty difficult.”

He hopes to specialize in neurology or psychology. And he was delighted to be paired with Winship. “It’s cool that he’s had this amazing medical career and he’s still willing to teach and give back,” Worthington said.

Winship will be doing so despite occasional struggles to find a word or a thought, a symptom of Alzheimer’s that started worrying him in 2010.

Other symptoms followed. “He couldn’t remember how to use the BlackBerry. He couldn’t remember how to use the remote for the TV,” said his wife, Jean Schmidt Winship, who is program manager of the Physician Assistant Program at Feinberg.

They hoped for any diagnosis other than Alzheimer’s. But when Daniel Winship underwent a battery of cognitive skills tests, the man who oversaw a $900 million annual budget at Cook County couldn’t draw the numbers and hands on a clock face.

He knew how badly he had done and nearly wept. “It just about did me in,” he said.

“I didn’t think I’d ever seen Dan that defeated,” Jean said.

The diagnosis was the one they dreaded. “I think we cried for two months,” she said.

But then they began searching online for programs for people with early Alzheimer’s. And when they happened on the Buddy Program, it seemed a perfect fit.

Daniel Winship, who ran the Cook County health system from 2004 to 2006, always thought it was essential to teach the human side of medicine along with the clinical side, Jean said. And to be able to do so now has been profoundly meaningful.

“It gives him a purpose again in his life,” she said. There have been 174 pairs of buddies in the program since it began in 1997, including seven this year. The program has been replicated at medical schools across the country, including Boston University School of Medicine; the Geisel School of Medicine at Dartmouth College and the Washington University School of Medicine.

On their visit to Pritzker library, the day’s lesson looked more like friendship. Daniel Winship and Worthington sauntered through the exhibits, chatting about books and history.

Indeed, since their first meeting, Worthington had been struck with his mentor’s fluent conversation.

“It really doesn’t seem like he has Alzheimer’s,” he said.

Except at certain times, like when Winship tries to tell Worthington about something from the past, like his work for the Department of Veterans Affairs, and falters.

“The VA was honored for doing a lot of work on the – um –”

He paused.

“I just don’t know what I’m trying to say here,” he said.

But he knew what to say when Worthington took a longing look around the shelves of books and asked, “How did you find time to read when you were a resident and an intern?”

Winship laughed. “Well, you’ve just got to squeeze it in,” he said before turning more serious.

“You’ve got to learn about medicine, and that takes time,” he said. “But I have a theory about it – that you’ll be better off learning (about medicine) if you learn other things, too.”

Worthington nodded. “It makes you a better doctor,” he said.

“I agree,” his mentor said.

Worthington and Winship will continue to meet over the next year. The Winships plan to invite Worthington to appointments with the neurologist; to show him Winship’s medical records; and to share Winship’s fears of the future – of losing his ability to communicate or recognize his wife and children.

The former medical school dean wants Worthington and the other medical students to someday put the lessons to good use.

“What’s happening to me is what’s coming to millions of people,” he said. “I hope they all want to do more to improve the care of the patient.

“That is, me.”

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