Fildes 3.0 How mixed-reality will make more attentive doctors

The Doctor. By Sir Luke Fildes, 1891  (

I love this painting by Fildes because it captures the essence of what it means to care for another person.  The doctor patient relationship is front and center.  And more than anything else, it is the laser focus of the doctor’s gaze.  He is not going to look away no matter what happens.  He is literally ”leaning in” toward his patient.  At the hospital, the most senior doctors are venerated as “attending physicians” or sometimes just “attendings” and Fildes shows us why.   Attention to the patient is paramount.  In our current medical era (Fildes 2.0) getting medical care means going to a sterile office where the doctor probably spends more time looking at his computer than looking at us.  Fildes reminds us what really matters: vigilance.

And yet there is despair.  Fildes’ doctor seems so primitive.  His tools are an an oil lamp, a bottle of tonic, and a cup of tea and they don’t seem to be helping.  And while his principle thought may be empathy, his pondering pose makes it clear that he is also wondering “what is wrong with my patient?” and “how can I help her?”

As we craft our mixed-reality tools, we have the opportunity to bend the doctor-patient relationship a little back toward Fildes.  Doctors will spend more time gazing at their patients than at a computer monitor.  And they will glean even more than they would from the computer monitor.    But Fildes cautions us too.  Even a pair of sunglasses, much less a head-mounted display, risks lessening the attention, intimacy and care that the patient feels.   There is still much work to be done.

--Bruce Daniel, March 2018

Bruce Daniel MD  (Director)
Professor, Radiology
and Bioengineering

Brian Hargreaves PhD  
Professor, Radiology,
Electrical Engineering 
and Bioengineering

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