Thank you Dr. Davis.
Dean Charney, Professors, special guests, friends, siblings, parents, stepparents, and -- above all -- members of the class of 2014. Good Morning. It’s a great honor to be with you.
I am extremely grateful to receive an honorary degree along with three truly incredible people – Dr. Gupta, Dr. Hopkins, and Dr. Ignarro. Given the long years and late nights all of our graduates put into earning their degrees, I will not dwell on what it feels like to receive one just for heading uptown for the morning. But I am especially pleased to be with you, because – like many of you – I get to receive my degree today in front of my beaming mother who’s behind me somewhere –yes- Dr. Vera Delaney [applause]. She is a nephrologist here at Mt. Sinai Medical Center. And given her own love of medicine, she fantasized that her little girl would one day find that same passion and someday walk down the aisle to pick up a medical degree. But this was definitely not what she had in mind – and I’m not sure what she would have deemed less likely -- her Irish immigrant daughter accepting an honorary degree in her capacity as the U.S. Ambassador to the United Nations – or her doing so alongside the father of Viagra [laughter]. You’ll hear about that later [laughter]. Where is he [laughter]? Yeah.
It was clear to me from very early on that I was not, sadly, destined to follow in my mother’s footsteps. After scraping her knee on the sports fields as a child, I’m told, she would stare with fascination as the doctor pulled out a needle and stitched her up, firing questions at him. By contrast, when I bloodied my knee, I’d put on long pants in the hope of avoiding both the doctor and the needle. The sight of blood turned my tummy – a nausea that, now that I think about it, might well be the foundation for my later efforts to combat genocide.
There are profound differences between the world I now inhabit – the world of diplomacy - and that of medicine and science. For the doctors among you, you wear white coats. We diplomats - we are known for wearing dark suits. You are scientists. You can navigate statistics and draw on precise and ever-evolving empirical work to decide on the right treatment regimens. Knowledge – for you – provides healing power and knowledge increases steadily over time. In my world, by contrast, sometimes it feels as though, while nothing is forgotten, nothing is learned. Indeed, if we take today’s crisis in Ukraine -- the Russian seizure of territory, the onslaught of old-school propaganda, and the nostalgia for Soviet glory -- sometimes it can feel we are heading backwards. The same is true in Syria, where we see the painstakingly developed, century-old doctrine of medical neutrality in tatters, as the Assad regime executes patients they have pulled out of hospital beds, steals medicine out of humanitarian convoys, and drops barrel bombs on medical facilities as if they are military encampments. Sometimes, as I see my mother delightedly lapping up the latest discovery in JAMA or the New England Journal of Medicine, I envy her – and you – your sense of forward motion.
However, scientists and doctors are like diplomats in one critical respect: they -- we -- have to find and pursue pragmatic solutions. We do not take comfort in admiring problems; we are charged with solving them. And on this mother’s day weekend, I would like to share with you a few things I have learned from the doctor that I know best that have application to your future careers in medicine, public health, or research, but also to the world beyond.
First, empathy is everything. I don’t have many early memories of my mother in the physical presence of her patients. Like all doctors’ children, I spent my childhood weekends loitering in my mother’s office waiting for her to finish rounding. But my earliest memories are of my mother’s patients because she told such vivid stories about them. When she worked in the emergency room, she told tales of patients who survived car crashes and gunshot wounds, fueling my imagination. When she was working as a nephrologist, it wasn’t just kidneys she brought home. There was my mother’s deep melancholy over one patient’s latest miscarriage – only to be followed by her happiness over this woman’s subsequent pregnancy, her stress over the patient’s complications in that pregnancy, and her eventual joy at the birth of this woman’s magical baby boy. Each of these patients – the ones that drew my mother’s curiosity or her affection – became virtual guests at our dinner table as I grew up. Sometimes she couldn’t even finish a story about a patient because some line of theirs cracked her up so much and she couldn’t stop laughing. Sometimes she couldn’t mask her sadness when her treatment and her care proved not enough: “he was one of my favorites” she would say getting up quickly from the table. I never met these nameless patients, but, because of the way my mother engaged with them, I followed their ups and downs as if they were family.
And I learned the importance of looking at patients and seeing, not only symptoms and diseases, but seeing individuals. I never really paused to marvel at just how many patient details my mother retained right alongside drug regimens, patient histories, and the latest science discoveries. But now that I think about it, it isn’t just that encyclopedic retention that is worth pausing over; it is how much patience – and presence – it took for her to glean all of those details.
As a diplomat, I firmly believe that we are better at advancing U.S. interests when we understand where people around the world are coming from, what motivates them, what saddens them, what inspires them, how they got where they are. In medicine and public health these questions are equally important, even if asking these questions are not yet the norm in the world you are entering. Indeed, a recent Johns Hopkins study found that medical interns sat at the bedside to talk to their patients only 9% of the time. Also underutilized it seems – I’ve been reading up – are introducing yourself to the patient, explaining your role in the patient’s care, touching the patient via a handshake or some other kind of comforting gesture, and even engaging in basic conversation, asking such exotic questions as, “How are you feeling today?”
Now don’t get me wrong -- I know almost nothing about medicine and science. I couldn’t have passed Organic Chemistry if my life depended on it. But if you ask me what makes a successful doctor, it is the same thing that makes a successful diplomat: listening and seeing what’s in front of you, respecting and cherishing the inherent – inviolable -- dignity of each individual, meeting people not where you’re at, but – at least at the start – where they’re at.
My second message today is, no matter how long you end up practicing – or how respected a doctor or scientist or public health professional you become -- never be afraid to question those around you, or, more importantly, yourself.
Valuing uncertainty is the defining symptom of an open mind; it invites critical thinking, encourages lifelong learning, and respects the knowledge and wisdom of others. It is at once a sign of humility and a sign of tremendous confidence.
We all have our convictions, our principles, our beliefs. But we owe it to ourselves and to others never to assume that we are infallible, or that truth has only one side. We have to be honest in inquiring whether the views we advocate are based on facts and objective research or instead by what social scientists call “motivated reasoning.”
I have long tried to apply my mother’s commitment to scientific inquiry to my own field – challenging myself and others to think harder: to learn more facts, to develop stronger arguments, to abandon those that are not supported, and to constantly strive to learn about whether the decisions we make – and the actions we take – actually help to improve the human condition. And to never be ashamed to admit to oneself that the ideas one pushed didn’t have the effects intended. I pass this recommendation on with great humility because I know personally how hard it is to remain open-minded once one gets going.
In your world science places its own premium on uncertainty, so I know in one sense I’m preaching to the converted. The profession you are entering is predicated on documenting facts, identifying patterns, testing explanations, and designing new interventions. But how about bringing the same spirit and the same scrutiny to hospital rules and administrative policies? After all just because things are always done a certain way, doesn’t mean it is the right way. What about asking about the human consequences of a policy or regulation? Maybe you will land exactly where you start, but maybe you will be the person making change nobody ever thought was possible.
This brings me to my third and final piece of advice: never forget that you are extremely privileged to get to practice your profession. People ask me, particularly as one juggling the parenting of a one year old and five year old along with my job, “What’s it like to be working on Syria, Ukraine, South Sudan, and the Central African Republic?” They ask this with a kind of pained expression a little bit like I’m an oncologist working only on terminal cases. And they seem surprised when I say with a wide smile, “it’s the greatest privilege of my life.” I go into work in the morning and I sit behind the placard that says “the United States of America,” defending human rights and standing up for American interests. I get to bring U.S. foreign policy tools to bear to try to help people in desperate need. Other people read about the sad events in the world and it breaks their heart, doubly so, because they aren’t sure what they personally can do to help anybody. The government I work for sends food assistance to stave off famine and sends diplomats into conflict arenas to try to broker peace. Every single day, we get to work to try to stop violence, end hunger, and prevent disease. Sure, as you know, we don’t achieve all we set out to achieve – no more than you can cure every patient you treat or solve every scientific mystery that presents itself -- but we should never forget how blessed we are to be in the arena. I will also say how proud I am to work for a government who cares about the health of its citizens and a president who worked tirelessly to ensure that now, more than 8 million Americans enrolled in private health insurance coverage through the Affordable Care Act Marketplace.
Now you have a different calling, to be sure, but you have an even more profound privilege – you get to help people, you get to heal people directly. You get to save and give and improve life. How awesome is that? You get to keep trying to find that cure that might have eluded your predecessors but that could be around the corner that you could be the one to find. You get to engage with people who need you, who hang on your every word. Your work is tangible. Your service, and it is above all public service, is invaluable. And what’s remarkable is that you will acquire ever-more potent weapons in your healing arsenal with the passage of time. That is downright thrilling. Five years from now, ten years from now, thirty years from now -- when you attend your kids’ graduations -- your fields will have progressed in ways that are literally unimaginable to you or to your professors here today.
So from here on out, after you leave Mt. Sinai and people ask you what you do, don’t just say, “I’m a doctor” or “I’m a scientist” or “I’m a public health professional”. Say, “I get to be a doctor”, “I get to be a scientist”, “I get to advise on public health”. That is more than a line. It’s a spirit. It’s a grateful healing spirit.
Albert Einstein once said, “There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” My advice is go with Einstein. That’s always a good rule I think. Our very presence here on earth is a miracle. Medicine is a miracle. For many of you and your anxious parents your getting this degree, feels like a miracle [laughter]. But above all – and never forget this - being handed the power to heal is a miracle. You will be a better doctor and a better scientist if you try never to forget that.
Thank you so much for letting me share the day when that power was given to you. Thank you!
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