The Medical Commencement Archive

“An Invitation To Learn” – Dr. Jeremy Sugarman, NY Medical College 2018 Commencement

Dr. Sugarman gives a speech rich with advice by sharing three life experience stories. These are very unique ethical situations that can serve to provide helpful guidance to freshly anointed doctors when they face similar dilemmas or challenges down the line.

In his first story, Dr. Sugarman discusses the 1993 revelation that the US government had supported a series of radiation studies on its citizens without consent during the Cold War era in order to determine possible after effects from potential nuclear fallout. Physicians and scientists helped conduct over 400 radiation experiments on unaware subjects. Dr. Sugarman served on President Clinton’s Advisory Committee on Human Radiation Experiments to investigate wrongdoings and who may have been harmed. From this first story, he provides the following advice: “It is far too easy to be caught up in the rush to uncover the latest scientific truths. All of us, regardless of our professional careers, need to be alert to the interests of those who are subjected to science. Similarly, we all need to be vigilant regarding the temptations of big data due to the potential tradeoffs between enhanced knowledge and individual harms and wrongs, such as violating privacy. In addition, we need to be alert to what is driving the science that we do. Scientists and policy makers in particular must ask who is funding or supporting our work and for what purposes?”

In his second story, Dr. Sugarman speaks about his time on the Maryland Stem Cell Research Commission. There was a fellow commissioner named John Kellermann who was determined that stem cells were the solution to completely curing his Parkinson disease. This intense hope for a cure took priority over John’s personal, political, and ideological beliefs. Dr. Sugarman reminds graduating medical students “to not inflate the very natural hopes of people who are sick. An experimental approach that helps cure a mouse and be scientifically fascinating may never help cure a human…recognize the distinctions between treatment and cure. These differences matter. Anyone who is in anyway involved with the care of patients needs to be sensitive to them. Finally, the contemporary practice of delivering untested and unproven interventions that exploit this hope for cure are unethical and don’t in any way comport with the ethical obligations of beneficence inherent to the health professions.”

The final story that Dr. Sugarman shares is about his time serving abroad in Tanzania, which had widespread TB and HIV at the time. He also recounts a case when he suspected pericardial effusion in a patient. However, limited resources prevented diagnosis through imaging, and in the end, Dr. Sugarman performed a gutsy, blind pericardiocentesis that succeeded. “Working in Tanzania taught me many things that are of importance for your careers, regardless of whether you will be engaged with public health practice, a clinical role, or policy making. First, we respect one another by honoring appropriate cultural norms. For example, in the US we shake hands firmly and quickly; in Tanzania we hold hands gently and for long periods of time; in other cultures we kiss or bow or wai. Second, it is possible to engage patients in their care, even in desperate circumstances. Third, for clinicians, medicine is not only about knowledge but also about laboring. Aristotle considered medicine a techne, a skill or an art. And a skill needs to be practiced to be perfected.

…Please realize your degree is an invitation to learn. Stay alert for the lessons that will accompany your work. Welcome unlikely experiences. Welcome unlikely teachers. And welcome the ethical challenges in your work. Congratulations and all the best in the future.”

Read the full speech in the Commencement Archive:

About Dr. Sugarman:

Jeremy Sugarman, MD, MPH, MA is the Harvey M. Meyerhoff Professor of Bioethics and Medicine, professor of medicine, professor of Health Policy and Management, and deputy director
for medicine of the Berman Institute of Bioethics at the Johns Hopkins University. He is an internationally recognized leader in the field of biomedical ethics with particular expertise in
applying empirical methods and evidence-based standards for evaluating and analyzing bioethical issues. His contributions to both medical ethics and policy include his work on the ethics of
informed consent, umbilical cord blood banking, stem cell research, international HIV prevention research, global health and research oversight.

The Medical Commencement Archive

“Collaboration and Curiosity” – Dr. Huda Zoghbi, University of Massachusetts 2018 Commencement

Dr. Zoghbi delves into her speech by stating “regardless of your individual path to this day, there is one thing I can predict about your future: it won’t be what you expect.” Then, she proceeds to share a moving account of her journey through life and medicine interweaved with four main points of advice on how to handle the unexpected. A major encompassing theme is to be open to and appreciative of the human relationships formed during one’s path in the medical field, especially during times of hardship.

First, have a plan, but be flexible within that plan. There will be storms in the ocean that is your life and you have to learn to surf each wave as it comes. My drive to be a physician was strong, and that kept me going to medical school through four years, two countries, and one war. But the people close to me—my mentors Ralph, Marv, and Art, and my husband William—helped me see more clearly what it was that I really wanted to do. They taught me and they helped me to listen to that little voice inside that so often gets drowned out by the noise of obligations and the fear of leaving a well-trodden path. Listen to that inner voice.

Second, listen to other people, too. Listen to your patients and their families. The single biggest complaint I hear from people about healthcare nowadays is that their physician or nurse is looking at a screen instead of at them. We all want to make a difference in peoples’ lives, but sometimes the best thing we can offer our patients is our respectful attention. Thinking back to the first girls I saw with Rett, why were so many diagnosed with cerebral palsy, a diagnosis that would have been apparent at birth, when the girls were perfectly healthy the first year of life? The diagnosis didn’t fit; only a physician who didn’t trust the parents and didn’t trust their own eyes would try to make it fit. Or, thinking back to SCA1, why would each generation of a family develop more severe disease at an earlier age than their parents’ generation? Now we know the answer is a dynamic mutation, but at the time it was a puzzle. Pay attention to the reality in front of you, not the rules and models you learned in school. In 20 years, much of what you learned here will no longer be valid—so keep an open mind, and you might be one of the people who brings forth new knowledge to share with others.

Third, develop resilience. We are not born with patience, and perseverance doesn’t come into play until we meet circumstances in which it is possible to give up. Resilience is like a muscle. Hard times are never fun, but they’re the way we develop character.

Fourth and most important, cherish your relationships. You will have noticed that at each crucial juncture in my life there have been people who gave me opportunities. Meharry Medical College was willing to break the rules to let me transfer in mid-stream. My mentors and my patients opened my eyes and then opened their hearts to me. My collaborators and my trainees have made my career a joy. My husband William, who is a cardiologist with his own demanding career, has made our home a stress-free zone and helped me raise two beautiful children. Many other people have had a profound influence on me, and I have tried to honor their gifts by being generous in turn. I believe with all my heart that my strong relationships have enabled me to achieve the success and the happiness I’ve reached in my life.

As you reflect on your own paths, I am sure you can identify those who helped you get to this point. If there are fewer such people than you would like, then make it a goal to strengthen your relationships. Choose friends and loved ones who will help you become more resilient, pay closer attention, and listen to your own best self.”

Read the full speech in the Commencement Archive:

About Dr. Huda Zoghbi

Huda Zoghbi is the Ralph D. Feigin Professor of Pediatrics at Baylor College of Medicine, where she is also professor of Neuroscience and Molecular and Human Genetics. She has been an Investigator with the Howard Hughes Medical Institute since 1996. She is also the founding Director of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital. Zoghbi’s interest is in understanding healthy brain development as well as what goes awry in specific neurological conditions. She has published seminal work on the cause and pathogenesis of Rett syndrome and late-onset neurodegenerative diseases, and has trained many scientists and physician-scientists and is a member of several professional organizations and boards. She has been elected to the National Academy of Medicine, the National Academy of Sciences, and the American Academy of Arts and Sciences. Among Dr. Zoghbi’s recent honors are the Pearl Meister Greengard Prize from Rockefeller University, the March of Dimes Prize in Developmental Biology, the Shaw Prize in Life Science and Medicine, the Breakthrough Prize in Life Sciences, Canada Gairdner International Prize, and Honorary Doctor of Science degrees from Harvard University and from the University of Massachusetts Medical School.

The Medical Commencement Archive

“The Chapters to Come” – Dr. Carl Nathan, Weill Cornell Graduate School of Medical Sciences 2018 Commencement

Dr. Carl Nathan kept his speech short and sweet during the 2018 Weill Cornell Graduate School of Medical Sciences Commencement. Dr. Nathan was trained in internal medicine and oncology at Mass General Hospital, the National Cancer Institute and Yale before becoming a staff member at the Weill Cornell Graduate School of Medical Sciences. He has been a distinguished professor at Cornell University for over 3 decades, and current R.A. Rees Pritchett Professor and chairman of the Department of Microbiology and Immunology.

Dr. Carl Nathan makes his speech all about the impact the MD graduates have had on the people around them, including their parents, friends, and professors, and the impact they will have on the future of the medical field:

“You have given us new knowledge from your own minds and hands. You have given us fresh evidence that the prospects for scientific discovery are limitless. You’ve shown us that being the first to see something reproducible or to explain something mysterious brings as much joy and fulfilment as when van Leeuwenhoek first saw “wee beasties” through a microscope and Marie Curie discovered radium and thought of using it to treat cancer.

You’ve given us reassurance that no matter our inadequacies as teachers, your brilliance and resourcefulness let you absorb exponentially growing amounts of information with no sign of a limit to what the prepared mind can master.

Finally, in a troubled time, you’ve proven again that science is a form of communication that sifts fake from real and connects rather than divides, that creates a community transcending region, religion and origin. Many of you took precious hours from your pressured lives to share that message with children in the city around you.

What will you go on to give the world from your coming positions in colleges, universities, biotech, pharma, other businesses, foundations or public service?

You will help shed light on the unknown. Help cure disease. Help make cures accessible to those in need. Some of you will help create wealth. Help see that wealth distributed fairly. Help teach those who come up after you.

All of you can help defend the role of apolitical reason and scientific evidence in civic life and public policy. Help save this earth, its peoples and the diverse forms of life with which we share our climate, oceans, forests and fields.

The diploma you are about to receive is a symbol of the power you’ve proved that you have. Go use your power wisely. Then come back and tell us what you’ve done. Like your parents, partners, family and friends, your teachers and advisors are proud of the stories you are writing with your lives. All of us are eager to hear the chapters to come. ”

Read the full speech in the Commencement Archive:

About Dr. Nathan

Carl Nathan, MD is R.A. Rees Pritchett Professor and chairman of the Department of Microbiology and Immunology at Weill Cornell Medical College. After graduation from Harvard College and Harvard Medical School, he trained in internal medicine and oncology at Massachusetts General Hospital, the National Cancer Institute and Yale before joining the faculty of The Rockefeller University from 1977-1986. At Cornell since 1986, he has served as Stanton Griffis Distinguished Professor of Medicine, founding director of the Tri-Institutional MD-PhD Program, senior associate dean for research and acting dean. For eighteen years he co-chaired the Program in Immunology and Microbial Pathogenesis at Weill Graduate School of Medical Sciences of Cornell University, where he is now the dean. Nathan led the planning team for the Tri-Institutional Therapeutics Discovery Institute and is a now a member of its Board of Directors. Tri-I TDI is a not-for-profit corporation owned by Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center and The Rockefeller University. Nathan is a member of the National Academy of Sciences, the National Academy of Medicine and the American Academy of Arts and Sciences, a Fellow of the American Academy of Microbiology, associate scientific director of the Cancer Research Institute, a governor of the Tres Cantos Open Lab Foundation and on the scientific advisory boards of the Global Alliance for TB Drug Development, the American Asthma Foundation and the Rita Allen Foundation. He is a member of the national Pfizer Therapeutic Areas Scientific Advisory Panel and the Lurie Prize jury. He served for ten years on the scientific advisory board of the Cambridge Institute for Medical Research and the Board of Trustees of the Hospital for Special Surgery, where he chaired the Research Committee. He has been an editor of the Journal of Experimental Medicine since 1981 and presently serves as co-chair of its editorial board as well as on the editorial boards of the Proceedings of the National Academy of Sciences and Science Translational Medicine. He was awarded the Robert Koch Prize in 2009 for his work on tuberculosis, the Anthony Cerami Award in Translational Medicine in 2013 and the Milstein Award of the International Interferon and Cytokine Society in 2016.

Nathan is a member of the Bill and Melinda Gates Foundation’s TB Drug Accelerator and Principal Investigator of the NIH-funded Tri-Institutional TB Research Unit. His research deals with the immunological and biochemical basis of host defense. He established that lymphocyte products activate macrophages, that interferon-gamma is a major macrophage activating factor, and that mechanisms of macrophage antimicrobial activity include induction of the respiratory burst and inducible nitric oxide synthase (iNOS). He and his colleagues purified, cloned, knocked out and characterized iNOS biochemically and functionally, discovered the cofactor role of tetrahydrobiopterin in NOS’s and introduced iNOS as a therapeutic target. Although iNOS helps the host control Mycobacterium tuberculosis (Mtb), the leading cause of death from bacterial infection, Mtb resists sterilization by host immunity. Nathan’s lab now focuses on the biochemical basis of this resistance. Genetic and chemical screens have identified enzymes that Mtb requires to survive during non-replicative states, including the mycobacterial proteasome. His group is identifying compounds that kill non-replicating bacteria while exploring new collaborative models between academia and industry to help invigorate antibiotic research and development.

The Medical Commencement Archive

“A Moral Compass” – Dr. Howard Bauchner, University of Texas Health Science Center McGovern School of Medicine at Houston 2018 Commencement

This week’s commencement speech is by Dr. Howard Bauchner, who spoke at the University of Texas McGovern School of Medicine in Houston, TX. Howard Bauchner, MD was appointed the 16th Editor in Chief of JAMA® and The JAMA Network® in 2011. Prior to coming to JAMA, Howard was a Professor of Pediatrics and Public Health at Boston University School of Medicine and Editor in Chief of Archives of Disease in Childhood (2003-2011).

Dr. Bauchner focuses his speech on the morality of being a physician and ethical challenges one must face. He starts by emphasizing the trust patients will place on the graduating medical students: “What I want to focus on is the need to find a moral compass in your life as a physician. I cherish being a physician. Many patients trust us with their lives – thankfully we are no longer seen as a gods – and that is a good thing – but many many patients want us to help them with some of the most difficult and emotional decisions in their lives – how to care for a sick child, how to help a failing parent, what test or procedure should they have for themselves, and of course among the most difficult decisions – care at the end of life. This is your future as a physician, embrace it – and feel the privilege that it is to be so intimately involved in the life of another individual.”

He discusses the ongoing ethical issues facing the medical community such as high healthcare and drug costs, special interest groups that place the wellbeing of patients second, and difficulty of decision-making at the individual level vs the population level. He tells the graduates that they will have to face new ethical challenges with the advancement of technology, and must play the role of patient advocate.

To demonstrate the difficulty of managing such ethical issues, Dr. Bauchner shares a personal story of struggle: “I want to tell you a story of my own ethical failing – one that has haunted to me to this day.  I was attending on the wards at BMC – the old Boston City Hospital – and after days of caring for a child with pneumonia who was not getting better, and me resisting the idea of a repeat CxR, the child developed sepsis.  I was notified in the early morning hours at home, his temperature was 104, his WBC had increased to 35K, and a repeat chest CxR showed a large pleural effusion – likely an empyema.  He was whisked off to surgery, the effusion was drained, he was intubated, started on pressors for hypotension, and broad-spectrum antibiotics to cover the suspected bacteria.  I arrived the next morning – immediately went to the ICU – by this time his BP had stabilized, he had responded to the antibiotics, and was about to be extubated.  His parents came up to me and profusely thanked me for saving their child’s life – I stumbled – mentally and vocally – what should I say.  And to this day I feel ashamed, ashamed that I did not say what I should have, but you do not understand – it was my decisions that made your child so sick.

You will face many decisions – perhaps not quite as dramatic as this – that will affect your lives and the lives of your patients.  When do you speak up and when do you remain silent.  The colleague who does too many tests; the health care system that purchases practices so they can charge higher prices for care; the insurance company that blocks appropriate care; the pharmaceutical and device industries that charge prices in the US that are 5 and sometimes 10 times more than anywhere else in the world; and most importantly end of life decisions that you will make with patients and will be influenced by your own religious, cultural, and personal experiences.  You are likely to confront some but not all of these issue next year as a first year resident, but most will find their way into your professional life at some time.  There is no need to wrestle with all of them, since that can be overwhelming, but it is important to understand that these are ethical issues that demand and require much thought and reflection.”

Read the full speech in the Commencement Archive:

About Dr. Bauchner

Howard Bauchner, MD was appointed the 16th Editor in Chief of JAMA® and The JAMA Network® in 2011. Prior to coming to JAMA, Howard was a Professor of Pediatrics and Public Health at Boston University School of Medicine and Editor in Chief of Archives of Disease in Childhood (2003-2011). At BUSM he was Vice-Chair of Research for the  Department of Pediatrics and Chief, Division of General Pediatrics. He is a member of the National Academy of Medicine (formerly the Institute of Medicine) and an honorary fellow of the Royal College of Paediatrics and Child Health, United Kingdom.

The Medical Commencement Archive

“Looking Back and Looking Forward” – Dr. Robert Witzburg, Boston University School of Medicine 2018 Commencement

As a faculty member of the Boston University School of Medicine for over 30 years and current Associate Dean and Director of Admissions, Dr. Witzburg had heard his share of commencement speeches. However, most of those speeches were less-than-memorable. Even when Senator John Kerry came to speak, Dr. Witzburg could hardly recollect the content of his address. Thus, rather than telling the graduating BA-MD class of the BUSM, Dr. Witzburg posed a riddle for them to ponder: “Why am I here today?”

He goes on to ask each new MD to seek out the answer from within – not to look for help from teachers, mentors, or classmates. “Only you can discover your own uniquely personal answer to this riddle. Only you can dig down deep inside, where you keep your most treasured dreams, where you nurture your most lofty goals, where you drop your guard, look in your internal mirror, and face unafraid who you are and who you hope to be.”

Dr. Witzburg ends his speech with what it means to be a BUSM trained physician: “we advance our science with integrity and that we care for our patients with dignity, with compassion, and with respect simply because it is the right thing to do”.

“If you carry this with you into your future as physicians I am quite certain, that you will end your careers as I end mine – believing that you have done well by doing good, taking delight in the fact that you have never had an uninteresting day, nor gone home without having learned something new, and that your work has been, not a burden, but one of the greatest gifts of your life.”

Read the full speech in the Commencement Archive:


About Dr. Robert Witzburg

Dr. Witzburg is Professor of Medicine as well as Associate Dean and Director of Admissions at Boston University School of Medicine (BUSM)—a position he has held since 2002. A 1973 graduate of Tufts University, Dr Witzburg received his M.D. from Boston University School of Medicine in 1977. He completed his internship, residency and chief residency in Medicine at Boston City Hospital, and is board certified in Internal Medicine and Geriatrics. Dr. Witzburg has served the Boston community as Training Program Director and Associate Chief of Medicine at Boston City Hospital for 12 years and then as Associate Chief Medical Officer at Boston Medical Center and as the first Medical Director of the Boston Medical Center HealthNet Plan. He was the first Chief of the Section of Community Medicine at Boston Medical Center and Boston University School of Medicine, serving in that capacity and as Vice Chair of the Department of Medicine from 1997-2002. Dr. Witzburg was also a founder, President, and Medical Director of the Neighborhood Health Plan, a community health center-based HMO focused on enhancing the quality and scope of health care services available to vulnerable populations.


The Medical Commencement Archive

“Dallas Needs You”: Mayor Mike Rawlings, UT Southwestern Medical School 2018 Commencement

This week’s commencement speech is by Mayor Mike Rawlings, who spoke to the UT Southwestern Medical School 2018 Commencement. Mike Rawlings is the 61st mayor of Dallas and the longest-serving mayor in more than 45 years. During his time in office, he has focused on spurring economic development in the long-overlooked southern portion of Dallas through his GrowSouth initiative, improving public education, combating poverty and domestic violence, developing parks, elevating the city’s international profile and turning Dallas into a top destination for artists, young professionals, families and corporations.

Mayor Mike Rawlings starts off his speech by talking about UT Southwestern’s importance to the city of Dallas and his personal interactions with the physician leaders of UTSW. He makes a plea to the graduates to stay in the Dallas metroplex to help the growing community continue to flourish.

Mr. Rawlings then talks about the recent events that shattered the Dallas community such as the police shootings during the Black Lives Matter protest in 2016 and the Ebola scare in 2014, and how it took the strength of heroic medical professions to get through these events. One such hero was UTSW’s very own trauma surgeon, Dr. Brain Williams: “…5 of our officers were ambushed and killed during a Black Lives Matter protest. I saw the best of medicine that night. One of the lead trauma surgeons treating our officers at Parkland was Dr. Brian Williams, a black man who lives in Dallas and in the wake of that awful day spoke powerfully about the fear that he has experienced as a black man interacting with police officers – but he added that he of course would never have allowed his personal feelings to in any way impact the way that he cared for those officers. That night he was a doctor first, an advocate second. But he used his platform as a trauma surgeon who had worked to save our officers as an opportunity to speak in a raw and honest way about social justice… and that has continued in the years since the July 7 shootings.”

Mayor Rawlings then goes into a conversation about the importance of the personal interactions the graduating students will encounter throughout their professional medical careers, and draws from the work and thoughts of Martin Buber, a Jewish Theologian. He encourages the graduates to change their personal interactions from an “I – IT relationship” to an” I – THOU relationship” to recognize the divinity within ourselves and the divinity of others so that deeper relationships can be formed.

Mike Rawlings concludes his speech with a call to action for the graduates to realize their higher calling in life: “These are all personal choices each of you will have to make. Will you fulfill your calling? If so, what will it be? And how will you interact with your patients? Can you be conveyors of science and hope at the same time? I know you will make the right decisions. You are smart enough, you’ve been taught by the best, and you are lucky. I’m betting on you. And so is our city. Thank you for allowing me to celebrate this day with you.”

Read the full speech in the Commencement Archive:

The Medical Commencement Archive

“The Social Mission of Medical Education” – Dr. Fitzhugh Mullan, Yale School of Medicine 2018 Commencement

To start this year’s commencement archive, we have Dr. Fitzhugh Mullan’s 2018 commencement speech at Yale School of Medicine titled “The Social Mission of Medical Education”.

Dr. Fitzhugh Mullan is Professor of Health Policy at the Milken Institute School of Public Health at George Washington and Professor of Pediatrics at the George Washington University School of Medicine. He served 23 years in the United States Public Health Service, starting as a physician in the National Health Service Corps and later as director of the program. He subsequently, directed the Bureau of Health Professions, and attained the rank of Assistant Surgeon General. In 1996, he retired from the Public Health Service and joined the staff of the journal Health Affairs as a Contributing Editor and the Founding Editor of the Narrative Matters section. He joined the faculty at George Washington University on a part time basis in 1997 and full time in 2005. In recent years, his research and policy work have focused on US and international health workforce issues, especially equity in health professions education.

In his address to the Yale School of Medicine graduating class, Dr. Mullan tells a story about his experiences as a medical civil rights worker in the mid 1960’s right after his first year of medical school. He lived with the locals to help sort out local health problems and promote civil rights work by going door-to-door to encourage people to register to vote and sign their kids up to attend the white school that was going to be integrated for the upcoming year. His experiences along with the Civil Rights Movement sweeping the nation inspired him to become a Civil Rights doctor, a doctor for those who were underrepresented. He went back to the University of Chicago for medical school and helped organize student clubs and events focused on Civil Rights. The work of his peers and him was both on a local and national scale.

Dr. Mullan then asks the students of the graduating class to think about why they chose medicine as a career. In his works “Medicine, we know, will guarantee us a good living. But, for many of us, the selection of medicine goes way beyond that. Idealism draws many of us into medicine – the opportunity of helping others, alleviating pain, extending life, and perhaps contributing new knowledge to the healing arts. For others there is something more – a sense of what I will call social mission that is more than the desire to heal. Social mission recognizes that there are inequities in the world and, more to the point, in access to health and health care. In ways articulate and inarticulate, many young men and women entering medicine hope to help in this regard. They hope to make the world not only a better place, but also a fairer place. This is social mission.”

Dr. Mullan details the need for medical schools to have social missions in order to shape the doctors of the future. Dr. Mullan exclaims that “We need doctors who understand these problems and are committed to fixing them. The call for social mission is by no means limited to primary care or for those who see themselves as activists. We need physicians of all specialties to work in rural areas and to treat poor and low-income populations. We need physician research scientists and policy leaders equipped to tackle these equity problems”.

Dr. Mullan concludes with a statement that the whole medical system – medical schools and teaching hospitals – needs to be rebuilt to not only be better but fairer.


Read the full speech in the Commencement Archive:

The Medical Commencement Archive

“A Good Job”: Dr. Elizabeth Dreesen, 2017 Commencement Address of the University of North Carolina School of Medicine

I am pleased to present this week’s Commencement Archive piece: Dr. Elizabeth Dreesen’s keynote address at the 2017 University of North Carolina School of Medicine Commencement.

Dr. Dreesen grew up in a Navy family. Before earning her M.D. at Harvard Medical School, she completed a B.A. in History and African Studies from Boston University after spending a year at the University of Nairobi. After a year as an Obstetrics and Gynecology intern, she elected to train in General Surgery and graduated from the New England Deaconess residency program in 1994. She pursued further training in Surgical Critical Care at the University of Maryland Shock Trauma Center. After training, Dr. Dreesen and her husband started a rural General Surgery practice in western North Carolina. Dr. Dreesen has been at the University of North Carolina since 2006 and currently serves as the Chief of the Division of General and Acute Care Surgery there. She is known for her many years as a column writer for the Raleigh News and Observer, exploring experiences and issues in the world of medicine.


“Medicine isn’t just a good job, it’s a great job. It’s a complicated, bloody, hilarious, exhausting, inspiring job that will challenge you every day for the rest of your life. And jobs don’t get any better than that!”

What a unique set of adjectives to describe a job! When you think about it, few professions accommodate such diversity. We are truly blessed and privileged. Dr. Dreesen continues, discussing the features of this amazing career:

  • Dress comfortably—“At any given moment in medicine, somebody could throw up on you. So, as a group we dress respectably, but nothing too fancy.”
  • Excellent coworkers—“You’ll have coworkers who will amaze you.”
  • Enormous variety—“Every day is different in medicine, because every day you will meet a patient who surprises you… The breadth and variety of human experience will enrich you every day.”

Dr. Dreesen provides a unique perspective. We often view physicians as patient advocates and leaders in their field, however we may not fully appreciate the role they can play in their communities.

“In my own case, medicine made me a pillar of the community, a leader in my town. I’d been kind of an outsider through college and medical school – the protestor demographic. I was picketing the Dean’s office over my school’s labor policies, arguing with the administration about curriculum.”

As physicians we are privileged with a voice and a podium to make meaningful change. We should not shy away from these opportunities.

Finally, Dr. Dreesen echoes what I believe to be the most fulfilling reason that medicine is a “good” job.

““[Good jobs] change who you are, how you see yourself, and how others see you…In fact, a good job, a really good job, your new good job is one in which you have the opportunity to do moral good. And that is not an opportunity that every job affords.”

Photo Credit: Hamza Butt

Read the full speech in the Commencement Archive:

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“Becoming Healers”: Dr. Jonathan LaPook, 2017 Commencement Address of Quinnipiac University School of Medicine

I am pleased to present this week’s Commencement Archive piece: Dr. Jonathan LaPook’s keynote address at the 2017 Quinnipiac University School of Medicine Commencement.

Dr. Jonathan LaPook is the Chief Medical Correspondent for CBS news and has served in this role since 2006. A board-certified physician in internal medicine and gastroenterology, he is also a Professor of Medicine at NYU Langone Medical Center. He attended medical school at Columbia College of Physicians and Surgeons, and completed an internal medicine residency and a gastroenterology fellowship at the New York-Presbyterian Hospital/Columbia University Medical Center. Dr. LaPook has received two Emmy awards for his work in 2012 and 2013 covering the national drug shortage and Boston Marathon bombings, respectively.


While Dr. LaPook is accustomed to speaking in front of crowds and cameras, this particular speech was a first for him.   With great pride and humility, he addressed the very first graduating class of Quinnipiac University School of Medicine. While the event was new to everyone involved, the message Dr. LaPook delivered stems from his diverse experiences as both a physician and journalist.

Dr. LaPook discusses the semipermeable membrane—or as he puts it, an emotional wall—that lies between us (as physicians) and the patient. One must be mindful of the emotional balance that exists, and this, according to Dr. LaPook, is the first and last challenge of the art of healing.

“It starts with a decision about the emotional wall we all build between ourselves and our patients. Constructing it is tricky. You don’t want to make it too thin and porous, because that can be emotionally devastating. But you don’t want to make it too thick and impervious, because then you miss out on all the good stuff, the precious moments when you connect with a patient as a person. I treasure the time an elderly patient showed up for an office visit on a beautiful spring day, and I wheeled her over to the Central Park Zoo to watch the sea lions. No medicine I have ever prescribed has had a more powerful therapeutic response. Everybody has to find a comfort level. For me, erring on the side of “too empathetic” is the way to go. Patients pick up on it, and if they feel you really care, they’re more likely to open up to you.”


“When we’re watching a movie and an important moment is about to happen, how do we know?”

Unfortunately, when caring for sick patients, other than a few beeps on the monitor, important moments don’t come with dramatic music or close-ups. There is no camera-pan to direct our attention to informative, meaningful information. We are both privileged and burdened with this responsibility of seeking out and interpreting information in order to make informed decisions.

“Well, in life, there’s no close-up and there’s no change of music. You have to play the soundtrack in your own head. You have to control the zoom button yourself. You must catch that moment when the patient—consciously or unconsciously—tells you what’s the matter. You need to get them to open up to you as one human being to another. And they will not do that unless they know they are talking to a human being!”

As Dr. LaPook continues, he begins to discuss his career in journalism and its implications on his medical practice. In particular, covering global health crises has shaped his ability to communicate oftentimes complex medical information to a broad audience.

“The key is taking complex topics and presenting them in simple, accessible terms. Communicating clearly—and succinctly—is an important skill. Work on it.”

Dr. LaPook summarizes with a single piece of advice.

“Be comfortable with uncertainty. If you’ve been practicing medicine for five years and you think you have all the answers, you’re in the wrong profession.”

Although patients may expect us to have all the answers, we must not burden ourselves with this expectation. Medicine is an art, not a calculation. Physicians consume diverse clinical data not necessarily to find an answer but rather to justify a decision.

Dr. LaPook sends the graduating class out with a final message.

“What’s going to distinguish you as true healers is the way you embrace humility, compassion, and empathy. Turn away from the computer screen and look your patient straight in the eyes. Understand the extraordinary importance of listening. And realize that even when you don’t have the answer for a patient in need, you can still help—with a sympathetic ear, a reassuring touch of the hand, and by sticking by them, through sickness and health.”

Read the full speech in the Commencement Archive:

General The Medical Commencement Archive

“Cat’s Feet”: Dr. Donald Berwick, 2017 Commencement Address of the Dartmouth School of Medicine

This week, the Commencement Archive is pleased to publish Dr. Donald Berwick’s address to the Dartmouth School of Medicine Class of 2017, titled Cat’s Feet.

Donald M. Berwick, MD, MPP, FRCP, is President Emeritus and Senior Fellow of the Institute for Healthcare Improvement. A pediatrician by background, Dr. Berwick has served on the faculty of the Harvard Medical School and Harvard School of Public Health, and on the staffs of Boston’s Children’s Hospital Medical Center, Massachusetts General Hospital, and the Brigham and Women’s Hospital. He has also served as Vice Chair of the US Preventive Services Task Force, the first “Independent Member” of the American Hospital Association Board of Trustees, and Chair of the National Advisory Council of the Agency for Healthcare Research and Quality. He additionally served two terms on the Institute of Medicine’s (IOM’s) Governing Council, was a member of the IOM’s Global Health Board, and served on President Clinton’s Advisory Commission on Consumer Protection and Quality in the Healthcare Industry.

Recognized as a leading authority on health care quality and improvement, Dr. Berwick has received numerous awards for his contributions. In 2005, he was appointed “Honorary Knight Commander of the British Empire” by Her Majesty, Queen Elizabeth II, in recognition of his work with the British National Health Service. Dr. Berwick is the author of over 160 scientific articles and six books. He currently serves as Lecturer in the Department of Health Care Policy at Harvard Medical School.


Dr. Berwick delivers a powerful speech covering historic writings, poetry, and personal anecdotes. The ultimate message he conveys is choice, and our preparedness to make a decision.

The title of Dr. Berwick’s speech is Cat’s Feet, a phrase which he introduces in a poem by Carl Sandburg:


The fog comes

on little cat’s feet.


It sits looking

over harbor and city

on silent haunches

and then moves on.


He continues to discuss the poem and its portrayal of the unexpected choices we are faced with throughout our careers.

“The fog comes on little cat’s feet. Maybe you think of ethical choices as arriving with a brass band: Carton at the guillotine, Joan of Arc at the stake, or Martin Luther King and John Lewis on the Edmond Pettis Bridge. Moments of fame and drama “Here I am: Ethics.” Forget that. For you, me, most of us, the choices that matter come in unannounced, on little cat’s feet, silent in arrival and gone almost before we notice. You will have the same choice…Whether it will come tomorrow or next week or next year, I cannot say; but it will come. And it won’t come once. It will come again, and again, and again, always on cat’s feet, suddenly, too suddenly for you wing it. So, don’t wing it. Get prepared. Decide in advance.

As Dr. Berwick continues, he addresses an important question: what will be your self-identity as a doctor? Physicians must balance personal heroism with interdependency. In other words, we will have opportunities to be heroic, to act, and to take matters into our own hands. Dr. Berwick argues that we cannot and should not act alone. Rather, there is a greater “need for teamwork, generosity, and deference to others.” Dr. Berwick recommends to “not ask what you do; ask what you are part of. Ask, “Who depends on me, and how am I doing in their eyes?”

Dr. Berwick reflects on the evolution of ethical values appreciated in healthcare. Now more than ever, physicians have an immense ethical duty.

“If we be healers, then the time has ended when the tasks we shoulder stop at the door of an office, the threshold of an operating room, or the front gate of a hospital. We must engage in the rescue of a society, and of a political context, that has forgotten to heal. That has become our job too. Professional silence in the face of social injustice is wrong.”

Unlike some of the other pieces in this commencement archive issue, Dr. Berwick’s is marked with a tone of gravity and weightiness. He goes beyond our duty as physicians and calls on our responsibilities as individuals in society. The message is serious, sincere, and thought-provoking. I encourage all to consider his words closely.

Read the full speech in the Commencement Archive: