“I want to welcome everyone to the 2018 Indiana University School of Medicine Commencement Ceremony. This is truly a time for celebration as we acknowledge our 300+ medical students and 100+ Masters- and- PhD-level graduates. Our students might take this all in stride, with appropriate humility, if not outright nonchalance. However, I can assure them that their spouses, significant others and parents are beaming with pride.
I had the distinct privilege of meeting with the 2018 class officers. I sought a common thread in this class, but instead, was confronted with a very diverse group as to background and future career aspirations. I was impressed with their individuality, inquisitive nature, and mainly their collective camaraderie. You worked together for the improvement of your classmates during trying times while achieving your own brand of personal satisfaction and individual accomplishment. You will exit the stage with an MD degree, and the school will have benefitted from your passion and commitment to excellence. You have left an indelible imprint upon future classes as they too will be challenged by the emotional, physical and mental strain of becoming a physician.
Career changes within the field of medicine are not uncommon during residency. On a personal note, I did my residency here at Indiana University with the goal of joining my father in the practice of general internal medicine in Dayton, Ohio. However, due to an illness, he retired during the first year of my residency. I then did an elective in hematology-oncology and was seduced by the science of the field, the courage of patients battling cancer, and the personal relationships oncologists had with their patients.
As I was preparing these remarks, I pondered what a commencement address would have sounded like 100, 50, or even a mere 25 years ago? Over a century ago, Dr. Roentgen introduced the concept of diagnostic imaging with x-rays. Half a century later, the level of sophistication of imaging took a quantum leap forward with CT scans, MRIs, and PET scans, depicting internal structures with seemingly artistic perfection. An earlier speaker might have asked, “Will wonders never cease?” Our current generation of new graduates will no longer be limited to what can be visualized with the naked eye, thanks to byproducts from Human Genome Project. The current era of molecular medicine and precision genomics allows us to discern germ line mutations to predict future problems, both for patients as well as family members, discover oncogenes associated with cancer that can be therapeutically exploited and solve problems that defied resolution a mere decade ago. And no, wonders will never cease.
These advances are exciting and transformational, but do not alter the immutable doctor-patient relationship at the bedside and in the clinic. As you face your future patients, remember that the human condition is every bit as complex as any genomic report. Do not lose the humanity of being a physician while concentrating on information in the computer and ignoring the patient who desires human interaction. A computer can read complex genomic data, but is never a substitute for empathy and compassion. Knowledge and later wisdom produces the blueprint for a good doctor, but our patients deserve better from us. We are healers, and what makes a great doctor is compassion as well as passion. A great doctor cares about his or her patients, not merely caring for them.
You will be challenged with future patients with difficult-to-diagnose symptoms and be confronted by illnesses that are incurable despite the tools you have been provided. You can’t properly diagnose all medical problems nor cure all disease. It is hubris to think otherwise. It will perhaps be the task of one of you in the future to move the field of medicine forward by scientific inquiry.
Medicine can be a cruel mistress. You need to find a proper balance between work and family that must be individualized. We all too often decide not to cheat upon that mistress to the detriment of our home and family life. This is all too pervasive challenge in the era of patients seeking help via email on weekends and evenings and expecting immediate replies. This type of emotional workload is not sustainable nor should it be expected. This might prove to be the most difficult challenge you will face in the future.
All of our graduates should pat themselves on the back for choosing this noble profession. Never lose your spirit of innovation, passion and thirst for knowledge. You will become good doctors and will make your school proud to call you a graduate. Several of you will become great physicians and scientists and be responsible for future medical breakthroughs. Science will always remain the pursuit of truth without ideology.
The number one movie currently is yet another Marvel Comic Avengers film, Infinity Wars, which ran so long it just seemed like it stretched into infinity. When you were younger, you probably dreamt of having a superpower – perhaps the ability to fly. In medicine, you have the power to heal and save lives. You can be a superhero to your future patients. However, medicine can be a humbling profession and you need to remember to stay grounded in reality while spreading your wings.
I harbor no illusions that you will either remember or follow any of these recommendations. However, I do want to give you one final directive. Join your family and friends later today, celebrate and have a good time. You earned it.”