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The Medical Commencement Archive

“Creating Your Legacy”: Dr. Carol Nadelson, 2017 Commencement Address of the University of Rochester School of Medicine and Dentistry

This week we have the pleasure of hearing from Dr. Carol Nadelson, who delivered her speech titled “Creating Your Legacy” at the University of Rochester School of Medicine and Dentistry 2017 commencement.

In 1985, Dr. Nadelson became the first female president of the American Psychiatric Association. She was also the first female editor-in-chief of the APA Press, and the first director of Partners Office for Women’s Careers at Brigham and Women’s Hospital, where she continues as the director today. As a Harvard Medical School psychiatrist and Brigham and Women’s Hospital expert on promoting academic medical careers for women, she has had a major influence on the lives of women in medicine by advocating for mental health resources and by leading the office for the professional development, career planning, and mentoring of female hospital staff.

Dr. Nadelson was elected to the Alpha Omega Alpha medical honor society at the University of Rochester Medical School in 1961. From 1979 to 1993, she served as vice chair of the Department of Psychiatry at the New England Medical Center in Boston. She became a clinical professor of psychiatry at Harvard Medical School in 1995. In 1985, Dr. Nadelson received the Elizabeth Blackwell Award for “contributions to the cause of women in the field of medicine” and in 2002, she was honored with the Alexandra Symonds Award for sustained high-level contributions to the field of psychiatry and leadership in advancing women’s health. She currently serves as president and CEO of the American Psychiatric Association Press, president of the Association for Academic Psychiatry, and president of the Group for Advancement of Psychiatry.

 

The road to practicing medicine is arduous, and few will deny this fact.  For Dr. Carol Nadelson—a female in the 1950’s—the dream of a career in medicine seemed unachievable.  Giving up on this dream, however, was not an option for Dr. Nadelson.

“Most people, including my parents, thought that there were other, more reasonable careers for women. But I was determined……What did I learn from it? To accept challenges, find role models and support, and persist in pursuing my dream. While the threat of imminent failure was always on my mind, I had to learn to believe in myself. “

Throughout medical school we are required to memorize an infinite amount of information. We are exposed to brilliant professors who are capable of helping us with this task, and simultaneously inspiring us. For Dr. Nadelson, however, the most informative and inspiring teachers were her patients.

“Most important was what I learned from my patients. They taught me to listen and to care for them. It wasn’t only a physical exam, a procedure or a new medication; they needed me to understand them, be honest with them, and help them come to terms with their pain, loneliness and fear. They needed to trust that I would commit myself to helping them; they needed caring and hope. Their needs could not be met in short, hurried and impersonal exchanges, nor if I were absorbed with filling out forms, more recently looking away from them to a computer screen.“

Dr. Nadelson closes with a reminder that we are entering the most noble of careers, a career without bounds, and with unlimited opportunities to apply the skills and knowledge base we have developed.

“As I welcome you into this compassionate and honorable profession, always remember that it is a privilege to be accepted into the lives of your patients and to serve them. At every age in our history, being a physician has been demanding, but at this time you face unique obstacles and challenges. You have the opportunity, indeed the mandate, to create a legacy that builds from the past and leads to a better future for medicine, for yourselves and for your patients. Congratulations!”

Read the full speech in the Commencement Archive: https://www.themspress.org/journal/index.php/commencement/article/view/293/310

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Thoughts After Your Long Hike

Congratulations, graduates and guests. I realize that we’re in New England, where unbridled pride is often an unwelcome party guest, but today is one of those times to celebrate proudly, loudly, and without a hint of ambivalence, whether you or your graduate are the first or the fiftieth physician in your family.

Guests: I’m sure that you have attended many commencement ceremonies before, from preschool through baccalaureate. Let me assure you that this day is different. To use an SAT-style analogy, four years of medical school is to eight semesters of college the way that a 20-mile hike in the Mojave Desert dragging a steamer trunk filled with lead bricks is to a stroll on the beach at Malibu with a cooler of Coronas. They share nothing but sand. To put it mildly, acceptance at and completion of, medical school is an achievement sui generis—one of a kind.

Congratulations to all of you. And if the pride thing is tough for you, how about gratitude? Graduates: if you haven’t already done so, it’s not too late to thank your family, loved ones, friends, and teachers for their support along the way. You each have elementary and high school teachers, and college and medical school professors who would cherish learning how they affected your life. So you are hereby encouraged to message them right now and for the remainder of these remarks. Really.

In that spirit of gratitude, thanks to Dean Compton for the invitation to speak today. Perhaps many of you are wondering why he did so, as am I. Seriously, I believe this invitation originated more than 9 years—and a few Deans—ago, when I called Steve Spielberg and David Nierenberg to see if Dartmouth might be interested in sending a few students to do clerkships at California Pacific Medical Center (CPMC) in San Francisco.

Little did I expect how quickly we would proceed and how strongly the relationship would grow, to the point that several hundred women and men of DMS have chosen—for reasons that remain a bit obscure—to forsake New Hampshire’s lovely winters and delightful mud seasons to spend a few months training with us.

Faculty: thank you for sharing your wonderful students with us. We enjoy seeing their greenpatched white coats roaming our halls and being challenged by their inquisitive minds and their upto-date knowledge. And, yes, that was a bad pun.

Graduates—fellow doctors: You have passed through intellectual, physical, emotional, and often financial challenges to get to this day. Now what? I have no idea. I never imagined that someday I would be delivering a commencement address as the CEO of a hospital. When I graduated from medical school, the thought of wearing a suit and tie gave me the heebie-jeebies.

Then again, I never imagined when I moved to San Francisco 40 years ago to go to medical school, that I’d spend the rest of my life there. Like the man says, “Stuff happens, most of which has now faded pleasantly into a soft, fragrant breeze on a warm June day.”

For example, as an internist, I’m pretty sure I made some difficult diagnoses in my career. Like all of you, I answered—I hope correctly—thousands of questions on hundreds of exams. I’ve written elaborate histories and physicals, formulated complex differential diagnoses, and dictated detailed procedure notes. Honestly, I cannot remember much about any of these.

But I do clearly remember a patient I sent home from the ED—to “protect” my friends on the admitting team upstairs and to cement my reputation as a “wall”—who should have been admitted. I remember a colleague pointing out gently that I had missed a grossly enlarged bladder in a man with incontinence.

I recall the day that a chief resident showed me a medical record in which I had pretentiously written that the EKG had no Osborn waves—so when the patient returned a few days later, having swallowed yet another tricyclic overdose, his paper chart still in the limbo of medical records, there was no comparison for his now-abnormal QT interval. But as far as I know, these—and countless other— mistakes that I made have remained secrets, so no one but me learned from them.

I remember the first time a manuscript that I had written was accepted for publication—albeit in an obscure journal that is long out of print. Of course there have also been rejections TNTC (too numerous to count). As well as a stern letter from the editors of the Annals of Internal Medicine warning me about salami science. And tersely dismissive grant reviews from study sections that led me to question whether academics and I were meant for each other. I surely didn’t realize that all of this lied ahead.

Most of all, I never expected to perform chest compressions on my dad on the airport floor in baggage claim in San Francisco, after he collapsed in front of me as if his bones had liquefied. So a welcoming son became an ER doc: I got down on my knees and pumped and breathed for 20 eternal minutes while waiting for the paramedics.

For sure, I didn’t expect that he would live happily for another 9 years, my first and thus far only successful out-of-hospital cardiac resuscitation. Those skills you have been taught will someday come in handy.

What have I learned from all of this? More importantly, what have I learned that might be worth sharing with you?

Be transparent. Admit and learn from your mistakes. Help keep others from making the same ones. Become the first generation of doctors to understand that an error disclosed once can become an error prevented forever.

Keep calm and carry on. Winter is coming. This next one may be the longest winter of your life, oh interns-to-be. During those shorter and darker days, when you may question why you chose medicine over law or business or who-knowswhat, try to fall back on your hard-earned and privileged place: that as a result of the choices you have made and the work you have done, you understand how we humans function. What happens to the food we eat, how we process the sounds we hear and the sights we see, how we extract oxygen from the air we breathe and pulse it to our fingers and toes…even what love might be. This knowledge is yours forever, and I promise that it can sustain you during long dark nights if you let it.

OK. This has been a lot, especially for those of you who accepted permission to text your gratitude. So if you haven’t been following closely, please remember one piece of advice from a guy with grey hair: Become better at paying attention. Our biggest enemy is going on auto-pilot. Pay more attention to your patient’s eyes than to the iPatient—you know, the one who lives in the electric health record and who now receives all too much of our consideration. Real patients have beating hearts and minds filled with doubts and concerns.

Peel back the dressing to examine the wound—that advice applies whether you’re going into surgery or psychiatry. As clinicians, people— strangers—will open their hearts to you, especially if you ask them to. And sometimes, all you need to say are those three magical words, “Hi. I’m Dr. Geisel.”

Be open to your patient’s vulnerability. Ask if something worries them. What you know to be a benign sebaceous cyst a patient might see as an incipient melanoma. Your reflux might be their heart attack.

Take the time to sit down. In a chair. Or on the side of the bed. I guarantee that the few extra seconds that it takes will improve your interactions with patients and enrich your experience.

Use your stethoscope to listen for the Rice Krispies Kids. You know, the ones that go snap, crackle, and pop. They can be found in the thorax and abdomen—but only if you are paying attention.

This same recommendation about paying attention applies to your loved ones. As physicians, we often rush around like acephalic poultry, and we too easily come to believe that our free time is too rare to share. Rather, it’s too precious not to.

And perhaps you too will have an experience like mine. When my dad—remember him?— was finally able to talk the day after his cardiac arrest, he was told what had happened on the airport floor. He smiled at me and made the inevitable parental joke: “Son, I’m sure glad you didn’t listen to me and go to law school.” So am I, and doctors, so are all of you, I hope.

Congratulations again! Go forth to breathe deeply and knowledgeably from the air we share with all of humanity, past, present, and future.

 

Warren S. Browner, MD, MPH

Dartmouth’s Geisel School of Medicine Commencement Address

Warren S. Browner, MD, MPH is Chief Executive Officer of California Pacific Medical Center. A board-certified internist, Dr. Browner is a Senior Scientist in the CPMC Research Institute; Clinical Professor of Medicine, Geisel School of Medicine at Dartmouth College; and Professor (adjunct) of Epidemiology & Biostatistics at University of California, San Francisco. Prior to joining CPMC in 2000, Dr. Browner was on the full-time faculty at UCSF for 15 years, serving as Chief of General Internal Medicine and Acting Chief of the Medical Service at the San Francisco VA Medical Center.  He has served as Executive Editor of the American Journal of Medicine for seven years. He has been a member of Federal panels for the National Institutes of Health, the Department of Veterans Affairs, and the Food and Drug Administration. Dr. Browner received a B.A. from Harvard College in 1975; an M.D. from UCSF in 1979; a Master’s degree in Public Health (M.P.H.) in Epidemiology from UC Berkeley in 1983; and completed a residency in internal medicine and a fellowship in clinical epidemiology at UCSF.

The Medical Commencement Archive Volume 3, 2016

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Lecture The Medical Commencement Archive

Humanism in Medicine and Healthcare in the Community

Good afternoon, and thank you for inviting me to be your speaker today. My name is Paul Rothman, and I am the dean of the Johns Hopkins University School of Medicine and the CEO of Johns Hopkins Medicine. It’s my privilege to be here on this memorable occasion to celebrate you, the esteemed graduates of the Northwestern University Feinberg School of Medicine Class of 2016.

First, I want to say congratulations. You should be incredibly proud of yourselves. You have succeeded in one of the country’s most prestigious and rigorous programs, which is a testament to your immense talent, intelligence and drive.

Whether you are moving on to a residency, a postdoc, a job in industry or another professional stepping stone, today opens up great possibilities for you. You are forging ahead in an era of unprecedented opportunities in science and medicine.

In 2016, we are on the verge of some astounding breakthroughs, thanks to increasingly sophisticated medical imaging tools, next-generation gene sequencing, computational modeling, and other technologies that allow us to obtain and analyze complex data sets.

I started my career in 1984, when our work as medical professionals was far different than it is today. Over the past 30 years, I have had the pleasure of witnessing stupefying advances in medicine—progress that has had enormous impact on how we diagnose disease, deliver health care and conduct health-related research.

The rate of progress should be even more stunning during your careers. Soon, your whole genome is going to be accessible on your iPhone. An EKG will be self-administered at home with a hand-held device, and an iWatch will monitor seizure activity. Highly accurate autonomous robots will assist surgeons in the OR. And health behaviors will be tracked so closely that we will know in real time whether patients are adhering to their treatment regimens. There’s no doubt that technological innovation will save many, many lives.

Which raises the question, as I look out at all of you newly minted doctors: What is the role of the human doctor in this brave new world of medicine, which threatens to reduce the patient to a data set and “doctoring” to an algorithm? How can we harness the power of technology without undermining the doctor-patient relationship?

I recently read a striking study by an assistant professor of medicine here at Northwestern named Enid Montague. She used videos to analyze eye-gaze patterns in the exam room and found that doctors who use electronic health records spend roughly onethird of each visit staring at the computer. Not only is that alienating, but it can mean that we doctors aren’t picking up on important non-verbal cues from our patients.

And the more sophisticated our medical technologies get, the more potential there is for this distancing effect. For example, a hand-held ultrasound is more precise than a traditional physical exam—be it percussing a patient’s abdomen to determine the size of the liver or putting a stethoscope to someone’s chest to listen for abnormal heart rhythms.

But the human touch is an important part of building trust between doctor and patient. Can you imagine a scenario in which a doctor did a physical exam without once actually laying hands on the patient?

I like to argue that technology serves to get the unneeded variation out while the physician is there to keep the needed variation in health care.

The computer can ensure that the diagnostic process is efficient and thorough, with all potential diagnoses considered. But the physician must be there to help interpret findings or to say, maybe that patient can’t afford that drug, or that treatment regimen is too complex for that patient to manage. We as human doctors can factor in so many subtle observations and make an appropriate judgment call.

In order to do that, we need to listen. William Osler, one of Johns Hopkins’ founding fathers, is famous for saying: “Listen to your patient. He is telling you the diagnosis.” And I would take this opportunity today to echo that advice to all of you.

Here’s the thing: I believe that most of us who go into this field start out compassionate— motivated to help our fellow humans and relieve suffering. I can tell you that’s what drew me to medicine, and I’m sure the same is true for you.

It used to be we would train residents out of this inclination to be humanistic—through impossibly grueling hours and a culture of browbeating. When my wife and I trained, we worked more than 100 hours a week, and it took us years to start feeling human again after that.

Fortunately, I believe medical schools have made great strides over the past decade in nurturing empathy. We’ve changed our selection criteria to attract more caring, well-rounded people, and our residents are now limited to a somewhat more humane 80-hour workweek.

The problem is that in trying to teach our trainees to be more humanistic, we’re going against the grain of society. In 2016, efficiency is the name of the game, so doctors’ visits and hospital stays are growing shorter, making it harder to form meaningful relationships with our patients. Furthermore, so much of our communication today is now mediated through technology. Think about it: People vet potential mates through online dating sites. Friends stay in touch over Facebook. We communicate with our officemates via email.

Health care is a service industry, so look at other service industries and you’ll see a trend of dramatic depersonalization over the past couple of decades. When was the last time you spoke to a human while making a travel reservation or depositing a check? I just read that Wendy’s is adding self-service ordering kiosks to all its restaurants this year. For better or worse, DIY gene testing is already on the scene. As younger generations enter the workforce, this trend will only intensify.

But here is the really good news about your generation, and this gives me a lot of hope. Even though millennials have been raised on technology, study after study shows that your generation is more community-minded than the Gen Xers and baby boomers who preceded you.

You’re more likely than previous generations to state that you want to be leaders in your communities and make a contribution to society, and roughly 70 percent of people your age spend time volunteering in a given year. Not only do you all have the idealism of youth, but you’re also matching that idealism with action. And it’s inspiring.

At Johns Hopkins, all our trainees participate in service projects, and I suspect that’s true for most of you as well—whether it’s providing free hepatitis B screenings for community members in Chicago’s Chinatown or donating your time to CLOCC, Northwestern’s Consortium to Lower Obesity in Chicago Children. In my view, the very best physicians are those who possess a service ethos—who are not just humanists, but humanitarians.

Recently, I was helping my daughter with her medical school applications, and one of the essay prompts included this quote from the late Nobel Laureate George Wald: “The trouble with living with contradictions is that one gets used to them. The time has come when physicians must think not only of treating patients but also of trying to help heal society, if only so that their work is not incompatible with … surrounding circumstances, partly of their own making.”

Let’s unpack that quote.

In American cities, long-standing systemic inequities mean that many members of our communities lack access to adequate health care, decent schools and other advantages that many of us here today take for granted. What Wald is saying is that we can’t be content to cure sick people and lecture them on how to stay well without also addressing these underlying social conditions that contribute to poor health and the glaring health disparities we see in our cities.

We cannot satisfy ourselves with doing one and not the other—particularly in light of the social unrest that has been happening here in Chicago and in my city, Baltimore, over the last year and a half following the deaths of Laquan McDonald and Freddie Gray. These and other events have provoked Americans to confront some difficult truths. Wherever your career takes you next, I ask that you try to channel those feelings into positive action.

After all, why put such herculean efforts into healing people and finding cures if we will stand for an environment that contributes to shortening their lives?

When we do make scientific advances, we have to ensure that everyone in our society—regardless of race or income—has equal access to the latest and greatest medicine has to offer.

In January, the director of our gynecologic oncology service at Johns Hopkins published an article looking at trends in the way we treat cancer of the uterus.

It used to be when you operated on a patient with early-stage uterine cancer, you did a hysterectomy by slicing open the abdomen. The incisions were large and sometimes could lead to infection, blood clots, major blood loss, etc. These days, minimally invasive surgery (laparoscopic or robotic) has become the standard of care, curing roughly two-thirds of these patients with far fewer complications than the old method.

At Johns Hopkins, we choose this method more than 90 percent of the time, unless there’s a complicating factor. Yet when our scientists looked at the national data, they found a troubling trend: African-American and Hispanic women are less likely to get the better, minimally invasive brand of surgery, as are patients who are on Medicaid or are uninsured.

  • I wish I could say this was a shocking finding, but unfortunately, it’s all too common. Here are a few startling facts on health inequity in the U.S. today:
    African-American adults are at least 50 percent more likely to die prematurely of heart disease or stroke than their white counterparts.
  • The prevalence of adult diabetes is higher among low-income adults and those without college degrees.
  • The infant mortality rate for non-Hispanic blacks is more than double the rate for non-Hispanic whites.
  • In Chicago, predominately white communities have much lower rates of overweight/obese children than communities that are predominantly African-American and Hispanic.
  • In the area surrounding The Johns Hopkins Hospital in Baltimore, the life expectancy changes dramatically from neighborhood to neighborhood— by as much as 20 years!

In 1966, Martin Luther King Jr. said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” So what can we—or, more specifically, you—do about it?

Any strategy health care professionals develop to address population health must address the root causes of poor health, including poverty. Of course, the problems associated with poverty are incredibly complex, and breaking the poverty cycle requires an approach with many prongs, beginning with education.

I don’t expect you all to have the answers right out of medical school. All I ask, as you set off on your quest to eradicate disease, is that you take seriously your role as leaders in the community. The degree you are earning today confers a measure of responsibility, and I have total faith that your generation will get us closer to solutions to these pressing problems.

As busy as we are, trying to make our mark on the profession and, by extension, “human health,” we can’t lose sight of the people in the very neighborhoods our institutions exist to serve. I believe the medical community has a real opportunity to lead in helping to heal our cities, conquer inequality and create better opportunities for all. That work starts with the humanity and compassion in each of you.

Again, I want to congratulate you for this terrific accomplishment. We know you are going to achieve great things. Thank you.

Paul B. Rothman is the Frances Watt Baker, M.D., and Lenox D. Baker Jr., M.D., Dean of the Medical Faculty, vice president for medicine of The Johns Hopkins University, and CEO of Johns Hopkins Medicine. As dean/CEO, Rothman oversees both the School of Medicine and the Johns Hopkins Health System, which encompasses six hospitals, hundreds of community physicians and a self-funded health plan.

Paul B. Rothman, MD
Northwestern University Feinberg School of Medicine Commencement Address

The Medical Commencement Archive
Volume 3, 2016

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MSPress Announcements

“Declaring an Affirmation of Commitment” Dr. Robert Folberg, 2015 Commencement Address of the Oakland University Beaumont School of Medicine

Screen Shot 2015-08-01 at 11.01.57 AMVolume 2 of the Medical Commencement Archive comes from Dr. Robert Folberg at Oakland University Beaumont School of Medicine’s charter class’ commencement. Dr. Folberg’s address, Declaring an Affirmation of Commitment, reflects not on the definition of being a good physician, but on being a good human being. Dr. Folberg is the Founding Dean of OUWB, as well as the Chief Academic Officer at William Beaumont Hospital. As a proud student of OUWB myself, I couldn’t help but debut this year’s Archive with my university’s Dean – a man who has never failed to give mini-motivational speeches in the hallway before exams and is always happy to attend and support student organization events.

Dr. Folberg revolves his speech around two questions: what do I want to do, and who do I want to be? Although to some, those two questions may inspire the same answer, Dr. Folberg stresses that the second question embodies a commitment beyond profession.

To answer the second question – who do I want to be – requires training, practice, and commitment. You were invited to come to OUWB because you excelled academically and because you provided evidence to us of experiences and attributes that predicted you would become physicians who are empathetic, compassionate, and engaged.

He continues by emphasizing the Declaration of Geneva, an oath that each study took upon receiving their first white coat. Each class at OUWB has the opportunity to make unique additions to the Declaraton of Geneva, reflecting upon the promises they hope to fulfill throughout their careers.

You recognize that we all have conscious and even unconscious biases that, if unchecked, could compromise our ability to practice medicine. How could we allow our biases to interfere with the practice of medicine if everyone has infinite value?

At the end of his speech, Dr. Folberg quotes an original line from the Declaration of Geneva: “I will give to my teachers the respect and gratitude that is their due,” and humbly titled each student as his new teachers in the profession of medicine.

Frequently, stymied by a case that challenges my abilities, I turn to my younger colleagues for help, and often, these are the very individuals who were my students. In a very real sense, I owe to them, my students, the respect and gratitude that is their due.

Volume 2 of the Medical Commencement Archive has a fantastic line-up this year! A new speech will be published each Friday.

Visit the Medical Commencement Archive

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Clinical General Lifestyle MSPress Announcements Reflection

Medical Commencement Archive Debut with Dr. Timothy E. Quill, University of Rochester School of Medicine

Today the Medical Student Press kicks off Volume 1 of the Medical Commencement Archive. The Archive will now release a new speech each Friday. Stay tuned for spectacular reads which speak directly to the future of medicine with wise reflections from the past. The inaugural speech entitled, Who is Your Doctor?, comes from Dr. Timothy E. Quill, M.D., at the University of Rochester School of Medicine and Dentistry. Read Dr. Quill’s full speech and bookmark the Medical Commencement Archive here.

dr quill copy 2Dr. Quill is an accomplished physician and author in the field of Palliative Care. He earned his undergraduate degree at Amherst College, and received his M.D. at the University of Rochester. He completed his residency in Internal Medicine and a Fellowship in Medicine/Psychiatry Liaison at the University of Rochester. Dr.Quill is now Professor of Medicine, Psychiatry, and Medical Humanities at the University of Rochester School of Medicine and Dentistry. He is also the Director of the URMC Palliative Care Program. Dr. Quill has published extensively on the doctor-patient relationship, with an emphasis on the difficult decision-making processes toward the end of life. He was the lead physician plaintiff in the 1997 Supreme Court case Quill v. Vacco challenging the law prohibiting physician-assisted death.

In his speech, Dr. Quill spoke to the class about the need for competent and personal medical care in this complex and fast-paced world of biomedicine with all its specialties and subspecialties. He drew upon his extensive clinical experience in palliative care to illustrate how a deep understanding of the patient and their family can help physicians not only guide patients through the plethora of medical options, but also make,

“…clear recommendations among those options based on their medical knowledge and their knowledge of the patient as a person.” Dr. Quill believes, “that kind of guidance and engagement, which is both medically competent but also very person, is what will make [one] a really exemplary doctor.”

Dr. Quill’s speech is indeed very touching and inspirational. His personal clinical anecdotes are moving, as  they illustrate how competent and personal medicine improves patient care. His focus and dedication to understanding and treating patients as opposed to diseases is evident and serves as a role model to all, including medical students. His words inspire medical student to,

“become one of those doctors who is not only technically very competent, but also very willing to engage with patients and families in difficult decision-making.

The MSPress encourages you to read his commencement speech to not only gain insight into Dr. Quill’s wisdom, filled with powerful anecdotes, but to learn from an accomplished and very thoughtful physician. Read Dr. Quill’s full speech and bookmark the Medical Commencement Archive here.

Thanks to Stephen Kwak, MSPress Editor, for his contribution to this blog post.