A patient who changed my practice: The case for patient-based evidence versus trial-based evidence

A patient who has an unequivocal psychotic illness within the schizo-affective spectrum is described. Over the course of the past 10 years she has convinced me that her way of looking at her own illness, particularly her refusal to take medication, has merits that cannot he dismissed as the overwrought workings of a disturbed mind. Her experience has helped me to understand that it is still possible to he all advocate of evidence-based medicine and yet accommodate the wishes of patients in a way that sometimes elevates personal patient-based evidence above that of external criteria.