Graduation speech

May 23, 2009 at 4:00 am (Uncategorized)

The following is the graduation speech I wrote for my university:

Dear fellow students, parents, brothers and sisters, children, faculty and staff: welcome to the graduation ceremony for the class of 2009. It is one of the four great days of medical school and I am honored to be given the chance to speak with you about the achievements of the 152 people who are graduating today. As a group we have published papers, presented at conferences, nailed a one-in-a-million diagnosis, gotten married, had children, and won the coed intramural volleyball championship.

These past four years will certainly be memorable to me for a very long time. Although it has taken us only four years to complete medical school, some of us have aged much more than that. Whenever I am at a bar and ordering a drink, I pull out my driver’s license to show my age only to have the bartender say, “Don’t bother.”

People talk about medicine as if it’s a calling. I don’t know if that’s true, but I do know that this is the field for me. Nothing else gets me up in the morning so early and so eager as medicine does. Every day is a chance to learn something new.

With all that learning and training comes an awesome responsibility. As doctors we will have great authority and power in which we can literally decide the fate of other people. With this role comes respect, prestige, and yes, even money. We have made many sacrifices to get to this point. We have given up the best years of our lives to sit in classrooms learning the nuances of the human body. Some of us have given up on relationships. We’ve held off on having children. We’ve suspended other careers. And yet the greatest example of self-sacrifice as a physician is to give away all of that talent for free.

A month ago I took my fourth trip overseas as part of a medical mission. Some of you here have gone on international trips as well. You’ve seen the worst hand that humanity can deal. You’ve gone to an impoverished region where poor people who cannot speak English receive your services at no cost to them. You then returned to this city where you worked with poor people who cannot speak English and received your services at no cost to them. And yet, somehow that trip was more meaningful. And you’ve realized that’s what gets you up in the morning. You can have an impact on the lives of others. Whether you decide to ultimately practice here, elsewhere in the country, or abroad, your decision to become a physician should be one of your guiding purposes in life.

Unfortunately, not everyone feels the same. So many of my classmates have gotten this far only to realize that they have made a very expensive mistake. They entered medical school in search of prestige, money, or the approving of their parents. Nothing is worse than a person who says, “My mother’s son is a doctor.”

I know of several people who now openly admit that they dislike medicine. Unfortunately, they are now more than $200,000 in debt and cannot leave the profession. They are now stuck in this job field for no other reason than economics. I think that many physicians are similarly trapped because so few other careers have a high enough payout to clear the necessary debt that comes with this training. So to all of our younger brothers and sisters who are here tonight and thinking of becoming doctors: know what you’re getting into. This is an 80-hour-a-week job that comes with high emotional strain, abuse from those higher up, abuse from patients, threats of litigation, inability to predict whether or not you will be paid, and a constant worry that maybe you didn’t make the right decision with that last patient. But if you like science, are good with people, and enjoy solving puzzles, then maybe you should consider a career in medicine.

I’ve brought something today. Here is my old white coat. I’ve worn this jacket almost every day over the past year. It is covered with stains from various bodily fluids, food from the cafeteria, and a mysterious orange color that I have yet to identify. Although I wash it regularly it will continue to be synonymous in my mind with transference of infections from one patient to another. It’s a reminder of the power and trust that physicians instantly hold with all patients. It’s the universal symbol of healing and knowledge. And yet when it comes right down to it, it is barely more than a glorified bed sheet with buttons and pockets.

Sociologists tell us that whenever there is a life-altering event, a ceremony is used to celebrate that change. Whether it be the birth of a child, a wedding, or a funeral, we use ceremonies to signify that something important has just happened. In a few moments we’re about to have a ceremony to signify our graduation. But it should be something much more than a party. Once we walk across this stage our lives will be forever changed, for better for worse, with all the rights and responsibilities of someone with the title M.D.

There will deservedly be fear as we enter the next phase of our training. We will constantly question ourselves: did I study this disease enough? Did I get all the information that I needed from the patient? Am I the right person for the job? Am I doing the right thing? As Dr. B______ once told us, every time you start to write a prescription, your hand should tremble.

Fear does not need to be limiting. A mystic once told the story of a group of lions who decided to attack a herd of zebras. The older, weaker lions went to the far side of the zebras and began roaring. The zebras, upon hearing the roars, became frightened and ran away from the sounds—right into an ambush of the younger, stronger lions. The moral of the story is that whenever you become scared, run towards the roars.

We can use that fear for good. We can say: I did study this disease enough. I am confident I got enough information from the patient. I am indeed the right person for the job. I know that I am doing the right thing. Medicine then becomes a focus on lifelong learning and purpose rears its head once again. And once we realize that what we do has a greater effect on our patients then on ourselves, I think we have learned the greatest lesson that medical school can teach. Kicking and screaming along the way, the University has taught us how to be doctors.

I look at this old white coat and realize that I have finished some of the hardest years of my life. I can smile knowing that I don’t have to take a shelf exam ever again. I also frown knowing that one day my signature will be on the prescription pad or the order form and that I’ll be the one who’s held accountable. I look at it and wonder where the last few years have gone.

I look at this old white coat knowing that one stage of my training is almost finished and know that I am about to embark upon the next journey. And whether medicine is a calling or simply an interesting job, I look at this old white coat knowing that soon we’re all going to be doctors.