Author: Jonathan Cohen

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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: https://www.themspress.org/journal/index.php/commencement/article/view/299/315

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General Patient-Centered Care The Medical Commencement Archive

“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: https://www.themspress.org/journal/index.php/commencement/article/view/297/314

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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: https://www.themspress.org/journal/index.php/commencement/article/view/294/311

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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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Public Health The Medical Commencement Archive

“Circles of Compassion”: Dr. Kinari Webb, 2017 Commencement Address of Yale School of Medicine

This week, the Commencement Archive features Dr. Kinari Webb’s speech titled “Circles of Compassion.” She delivered the keynote address at the 2017 Yale School of Medicine Commencement.

Kinari Webb, M.D. is the founder of Health In Harmony, an organization that establishes links between the health of humans, ecosystems, and the planet in order to solve problems of poverty, poor health, and environmental destruction. During a life-changing experience in Indonesia studying orangutans, Dr. Webb encountered not only a beautiful and threatened natural environment, but also the dire health needs of the people surrounding the National Park. After her experience in Indonesia, Dr. Webb decided to become a physician and return to Indonesia to work together with local communities to improve their health and preserve their natural environment.

After graduating from Yale University School of Medicine with honors, Dr. Webb completed her residency in Family Medicine at Contra Costa Regional Medical Center in Martinez, California. Dr. Webb founded Health In Harmony in 2005 to support the combined human and environmental work that she planned in Indonesia. After a year of traveling around Indonesia looking for the best site for this program, Dr. Webb co-founded the ASRI program in West Kalimantan Indonesia with Hotlin Ompusunggu and Antonia Gorog. Dr. Webb currently splits her time between Indonesia and the U.S.

 

Dr. Webb did not take the typical path towards a career in medicine. She went—as she simply puts it—“against the grain.” Despite excelling as a top student at a top-tier medical school, she was drawn back to Indonesia, where she previously studied orangutans as an undergraduate. This time, however, she returned with a much greater vision: using medical approaches to improve the health of humans and the planet.

Dr. Webb argues that our medical knowledge base and clinical skills are applicable to all species:

“I first came to know just how profoundly lucky I was during the year that I spent deep in the rain forest of Borneo when I was 21. I discovered there that people were often forced to cut down rain forest trees in order to pay for health care. I found myself feeling angry and deeply sad that such an injustice was occurring in the world. After residency I founded a non-profit called Health In Harmony and I have spent the last twelve years working on this issue. You may not have thought of your stethoscope as a tool to help heal the lungs of the earth – otherwise known as the rain forest – but it turns out it can be.

Your medical skills have all kinds of unexpected powers and I want to argue that we actually all need to become planet doctors. We are at an unprecedented time in the 4.6 billion year history of the planet: this is the time when a species that actually has the capacity to understand what it is doing is dramatically altering life on earth. And the health of our planet is the greatest threat to your patients’ health that they are likely to face over your career. Without a stable climate, enough drinkable water, food to eat, and healthy air you will have a very hard time keeping your patients well.”

Before I finished reading Dr. Webb’s speech, I found myself on her organization’s website, out of sheer curiosity. Health In Harmony is unique because of its dual efforts to promote environmental and healthcare reform in rural, impoverished communities across the globe. From training organic farmers to establishing tuberculosis treatment programs, the organization substantiates the role of “planet doctors”, one of whom Dr. Webb considers herself.

As Dr. Webb continues in her speech, she discusses the steps necessary to further a career as a physician, which she refers to as “Circles of Compassion.” The first circle emphasizes self-care. Regardless of the direction a career takes you, Dr. Webb argues that you are the most important patient.

“The first circle is caring for yourself. Most of you are about to go into indentured servitude, so this isn’t going to be easy. I remember massive sleep deprivation, feeling pushed beyond the limits of my skills, terrified I’d make a mistake, and being right in the middle of profoundly traumatic experiences. I encourage you to prioritize taking time to soothe and care for your body and soul even in the midst of all that. In my own journey of personal and spiritual growth, I have found help in faith communities, meditation, time with loved ones, therapy, and maybe most especially, being in nature. There might be nothing better for healing the soul.”

Dr. Webb’s next circle of compassion underscores the care we provide to patients:

“As a doctor, the second circle of compassion beyond you and your family is caring for your patients – both their physical well-being and their capacity to be their fullest selves. In Borneo, when we hire medical staff, we are looking for people who know they don’t know everything, who will be life-long learners, and most especially we want providers who will care for their patients as though they were their own family.”

Dr. Webb leaves the audience with the following concluding remarks:

“I wish to leave you with three key points:

First, don’t be afraid to take the road less traveled – or as my classmate Margaret Bourdeaux used to say: the deer path less traveled. The expectation superhighway is hard to resist but if you can see it all laid out in front of you, it likely isn’t your path. And this earth needs all of us to do whatever we are most passionate about – even if your deer path leads you to beautiful North Dakota.

Second, compassion matters. It starts with you, it spreads to those around you, and then to the whole planet.

Third, I encourage you to ask yourself: “Am I willing to be one of the sacred planetary healers that the earth so greatly needs?”

Congratulations again on this amazing accomplishment. May you go forth and heal!”

Read the full speech in the Commencement Archive: https://www.themspress.org/journal/index.php/commencement/article/view/291/308

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Technology The Medical Commencement Archive

“Talk to the Radiologist”: Dr. Robert Wachter, 2017 Commencement Address of the University of Pennsylvania School of Medicine.

This week we have the pleasure of hearing Dr. Robert Wachter’s speech at the 2017 University of Pennsylvania School of Medicine Commencement, titled “Talk to the Radiologist.”

Robert M. Wachter, M.D. is Professor and current Chair of the Department of Medicine at the University of California, San Francisco. He is also former President of the Society of Hospital Medicine and former Chair of the American Board of Internal Medicine. Having coined the term “hospitalist” in 1996, he is often considered the “father” of the hospitalist field, the fastest growing specialty in the history of modern medicine. Dr. Wachter is the author of 250 articles and 6 books.

In the safety and quality arenas, he edits the U.S. government’s leading website on patient safety and has written two books on the subject, including Internal Bleeding and Understanding Patient Safety, the world’s best selling safety primer. In 2004, he received the nation’s top honor in patient safety the John M. Eisenberg Award. In 2016, Modern Healthcare magazine ranked him as the fourth most influential physician-executive in the U.S., his ninth consecutive year in the top 50 (he was #1 on the list in 2015). He has additionally served on the healthcare advisory boards of several companies, including Google. His 2015 book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age, is a New York Times science bestseller. He recently chaired a blue ribbon commission advising England’s National Health Service on its digital strategy.

We all have people in our lives that we credit with influencing our decision to become physicians. For Dr. Wachter, it was his father who played a significant role in this decision-making.  His father held a fascination with the medical profession. He went so far as to wear a garage door opener on his belt in imitation of a physician’s pager. Altogether, his father’s intrigue with medicine, as well as his unexpected and emergent cancer diagnosis, guided Dr. Wachter toward a career in medicine. He states:

“The experience taught me many things. How terrifying illness is for patients and family members. How doctors aren’t necessarily too great at prognosticating. And how important human-to-human contact is in medicine – not just between doctors and patients, but also among members of the care team.”

“Medicine is changing.”  Dr. Wachter conveys this message throughout the speech.  In particular, he focuses on the technological surge that is making its way through medicine.  He calls it “widespread digitization.” Is this change for better or for worse?  He does not explicitly answer this question.  Instead, he encourages us to take these technologies and apply them creatively, namely in a manner that will improve our ability to care for patients.  He implores caution, however, as he reminds us that we signed up for this career to treat patients, not diseases.

“As the work becomes digitized and the software gets better, we will spend more of our time interacting with our digital tools, and less interacting with each other, and with our patients. This is natural, and –assuming the tools are any good – it might even be OK. After all, computers will hold much of the information, and they will be where we develop and implement many of our diagnostic and treatment plans.

But, there is a huge danger from hunkering down in our digital caves. You can never fully understand a consultant’s thinking by reading her note. You can never place a complex radiology finding in context without speaking to the radiologist. You can never allay the anxiety of a sick patient’s spouse by sending a text message. And you can never comfort a dying patient without             sitting at the bedside and holding his hand.”

Indeed, technology will allow us to push the bounds of diagnostic and treatment capabilities.  In this regard I remain optimistic, though Dr. Wachter’s words have reminded me that at the end of the day, technology is a tool.  Tools supplement –not replace— our creativity, compassion, and ability to connect with others.

Dr. Wachter concludes with a call to action:

“We have the opportunity today to do more for our patients than ever before. And you have the knowledge, skills, values, and habits of mind to thrive in this changing world. You are the ones who will reinvent the work to deliver for our patients. And you will figure out how to balance our new digital capabilities with the enduring truth that medicine is, and must remain, the most human of professions.

Thank you for the honor of speaking to you today. Congratulations to each and every one of you.”

 

Read the full speech in the Commencement Archive: https://www.themspress.org/journal/index.php/commencement/article/view/289/307

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General

“Your Gift (and Obligation)”: Dr. Claire Pomeroy, 2017 Commencement Address of Northeast Ohio Medical University

We kick off the Commencement Archive with Dr. Claire Pomeroy’s 2017 commencement speech at Northeast Ohio Medical University titled “Your Gift (and Obligation)”.

Claire Pomeroy, M.D., M.B.A. is current president and CEO of the Albert and Mary Lasker Foundation. Under her leadership, the Foundation’s mission advanced to: “improve health by accelerating support for medical research through recognition of research excellence, public education and advocacy.” As an expert in infectious diseases, she passionately supports ongoing investment in a full range of research with special interest in health care policy and a focus on the importance of the social determinants of health.

Dr. Pomeroy has published more than 100 articles and book chapters. As a leader in her field, Dr. Pomeroy serves on the board of trustees for the Morehouse School of Medicine and the board of directors for the Sierra Health Foundation, the Foundation for Biomedical Research, iBiology, Inc. and New York Academy of Medicine. She is also a member of the board of directors for Expanesthetics, Inc. and for Becton Dickinson & Company. In 2011, Dr. Pomeroy was inducted into the National Academy of Medicine.

Dr. Pomeroy earned both her Bachelor’s and Doctor of Medicine degrees at the University of Michigan. She completed her residency and fellowship training in internal medicine and infectious diseases at the University of Minnesota. She has also earned an M.B.A. from the University of Kentucky. In 2016, Dr. Pomeroy received an honorary Doctor of Science degree from the University of Massachusetts Medical School. Dr. Pomeroy has held faculty positions at the University of Minnesota, the University of Kentucky and the University of California- Davis. At the University of Kentucky, she served as the chief of infectious diseases and associate dean for research and informatics. In 2003, Dr. Pomeroy joined University of California-Davis as executive associate dean and served as vice chancellor and dean of the School of Medicine from 2005 through 2013. She became president of the Lasker Foundation in June 2013.

In her address to the graduating class, Dr. Pomeroy is forthright. She does not embellish the career of a physician but rather illuminates the very real truths and what is expected of us as we take the lives of others into our hands. She states:

“By virtue of the credentials you now hold, people will now turn to you at their most vulnerable moments…..They will literally trust you with their lives. This trust is a gift and an honor. “

The use of the word “gift” is interesting. We often perceive physicians as the one “giving the gift”, namely providing care to the patient, but Dr. Pomeroy reframes this suggesting that it is the patient who offers trust and allows a physician to enter into a very personal domain.

Dr. Pomeroy continues on, urging the new physicians not to be content with the state of the medical field but rather to push its bounds.

“It has been said that change does not roll in on the wheels of inevitability; it comes through bold vision, continuous work, and unflagging dedication. This is what you are called upon to do. So as you accept your diploma today, you are also accepting the charge to lead us in the change our country needs.”

What was most compelling about Dr. Pomeroy’s speech was the discussion of her path to this career. After leaving a troubled childhood, only to be placed in four foster homes, Dr. Pomeroy faced the very issues physicians strive to improve in health care, issues such as “trusting the system,” and racial and social inequality. She so poignantly states:

“My first foster home was an “emergency placement” and just as I was thinking maybe I could trust them, it was time to go. From this, I learned about how hard it can be for the vulnerable and abused to trust the system, to trust even those dedicated to caring. My second placement was with an African-American family, who though not quite knowing what to do with this blond, blue-eyed white girl, opened their home with kind- ness. From them, I learned about race, equality and social justice…My final placement was with a couple who became foster parents just to take care of me and to them I will always be grateful. They saved my life. I learned that by giving ourselves, we can give life to others.”

She concludes with the following:

“In closing, I ask only that you heed Harriet Tubman’s call to action as she said, “Every great dream begins with a dreamer. Always remember you have within you the strength, the patience, and the passion to reach for the stars to change the world.”

Read the full speech in the Commencement Archive: https://www.themspress.org/journal/index.php/commencement/article/view/286/306