To paraphrase one master in praise of another: Mediocre teachers are all alike; every inspiring teacher is inspiring in his own way. Clayton Wheeler inspired through his comprehensive knowledge, painstaking attention to detail, and unparalleled clinical skills. Those who knew him believed he never missed a diagnosis. No matter how obscure the disease or how minimal the symptoms, Dr. Wheeler was correct. It was the breadth of his knowledge that challenged his students to absorb more than we previously believed possible.
I was one of Dr. Wheeler's residents at the University of North Carolina (UNC) at Chapel Hill from 1979 to 1982. My fellow residents included Tim Kelly, Gabe Castillo, Alan Olansky, Victor Marks, and Jim Patterson. I think I can safely say we all were in awe of Dr. Wheeler's clinical skills and fund of knowledge. Every Monday morning all the residents sat together in Kodachrome rounds. Dr. Wheeler would bring a carousel of unknown slides and ask each of the residents for the description, diagnosis, and, of course, the differential diagnosis. No stone was left unturned. For example, if someone commented that a lesion was "erythematous," he would reply, "Be specific," meaning, for example, whether the salmon-colored or simply pink. Stating that the eruption was papular would lead to further interrogation by Dr. Wheeler. Pearly papules? Monomorphous papules? The clinical description had to be perfect before we could move forward to the differential diagnosis. When I was a first-year resident, I was amazed by the ability of the seniors, who were able to quickly describe the clinical presentation, then recite a list of differential diagnoses, and finally arrive at the correct answer. How could they possibly know all this? Could I ever possess these skills? The advice from one of the sage seniors was "memorize everything Dr. Wheeler says and you will be able to pass the boards." I quickly made this my mantra.
Working with Dr. Wheeler in clinic was a pleasure. He was patient, kind, and sympathetic, and of course he knew everything. I remember his attention to all details. A patient would have one symptom on the face, yet Dr. Wheeler would arrive at the correct diagnosis by looking at the nails. His detective work with each patient was inspiring. For example, he would make a diagnosis of psoriasis by examining the gluteal cleft or a diagnosis of lichen planus by studying the mouth. No self-respecting resident would have dreamed of presenting a patient to Dr. Wheeler without a thorough physical exam complete with an inspection of the nails, eyes, mouth, hair, and, occasionally, the anogenital area. The rumor was that Dr. Wheeler would show a carousel of ocular slides on the dermatology oral board exam and expect the candidate to make the correct diagnosis by knowing the link with the ocular presentation. This was his attention to all details.
Dr. Wheeler inspired the residents to be the best clinicians they could possibly be. He would never accept anything less than a complete dermatologic exam followed by a thorough differential diagnosis. We worked harder and were inspired to read more dermatology to make him proud of us. He had a unique ability to demonstrate his emotions in his eyes—you could know in your heart if he was disappointed or if he was proud of you. No words were necessary. No resident wanted to see disappointment on his face.
Our weekly journal club was another opportunity to observe the skills of Dr. Wheeler. Each resident reported on an article in the journals required for the week. Dr. Wheeler's quizzing on the subtleties of each paper inspired residents to read the journals cover to cover and in depth. Reading numerous periodicals each month certainly improved our fund of knowledge. Dr. Wheeler had the unique ability to ignite a flame of passion for learning dermatology in each of his students.
Dr. Wheeler also inspired us through his evident dedication to dermatology and to the Department of Dermatology at UNC. He worked long hours, 7 days a week. He even inspired the residents to come each Saturday morning for a basic science lecture and a pathology conference. Actually, if the truth be told, the Saturday-morning conferences were mandatory, but I like to think we would have shown up every Saturday morning even if they hadn't been. No resident wanted to disappoint Dr. Wheeler.
Dr. Wheeler was president of just about every dermatology organization, including the AAD, the SID, and the Board of Dermatology. The proof of his inspiration lies in the number of students who followed his path. Numerous former residents at UNC followed in the footsteps of Dr. Wheeler and became teachers themselves. Dr. Robert A. Briggaman, for example, was a former resident under Dr. Wheeler and went on to chair the Department of Dermatology at UNC; he also became vice president of the SID. In turn, he trained and inspired other residents. Numerous other former residents became leaders in dermatology under his inspiration. W. Ray Gammon, Joseph Jorizzo, Robert Tomsick, David Woodley, Marta Peterson, and Alan Fleisher are among the numerous residents trained under Dr. Wheeler.
Even 25 years after leaving his tutelage, I continue to recognize Dr. Wheeler's imprint on my practice. I frequently call on his wisdom when I encounter challenging patients, wondering what he would do. I still remember to examine the nails, eyes, hair, and mouth for subtle clues that might point to the diagnosis. The differential-diagnosis skills attained from the weekly Kodachrome sessions have been invaluable to my ability to practice dermatology. The habits learned from journal club have taught me to continue to keep abreast of the literature.
Dr. Clayton Wheeler made a difference in my life and in the lives of all of his former residents. In turn, he made a difference in the patients we all care for. He will be remembered by all of us as an educator, mentor, leader, and colleague. As Albert Einstein said, only when one lives a life for others does it become worthwhile. Dr. Wheeler's life enriched all of ours. We will miss him.
