Massachusetts General Hospital Cancer Center | Ellen Cohen | Tom Lynch | vice chair of the Schwartz Center board

He easily connected with people - at least 1,000 attended his funeral - and his journey through the health-care system was no different, says his wife, Ellen Cohen. She recalls how her husband became acutely aware of the power of human interaction as he underwent tests and procedures. "He realized that someone looking at him wrong or taking time to pat his shoulder - those things meant a lot," she says. "They could make or break his day."

Schwartz's plans to create a center were unknown, even to his closest family, until he asked attorneys to gather in his hospital room. Despite having difficulty breathing, Schwartz made his vision clear, expressing his desire to launch an initiative focused on the patient-caregiver relationship, Cohen says.

For years, the rounds were largely a Northeast effort, piloted first in 1997 at Massachusetts General Hospital Cancer Center in Boston, where the Schwartz Center is still located. But the concept continues to gain traction. By this fall, 100 health-care facilities in 25 states were hosting the rounds, involving some 25,000 clinicians annually, nearly all of whom work in hospitals. M.D. Anderson, which joined in early 2005, was the first site west of the Mississippi, according to Schwartz Center officials.

Beyond employee assistance programs and conversations in the hallway, few outlets for reflection are available to most hospital clinicians, says Tom Lynch, MD, chief of oncology at Massachusetts General Hospital Cancer Center and a physician who treated Schwartz. In today's fast-paced environment, even pausing for lunch in the doctor's lounge is usually infeasible - if such a lounge exists at all, says Dr. Lynch, also vice chair of the Schwartz Center board. "We don't have a place to put the emotional and cultural and other nonclinical parts of our interactions with patients," he says.