This week, Dr. Georgette A. Dent, Associate Dean for Student Affairs at the University of North Carolina School of Medicine joins the list of spectacular commencement speeches in the Medical Commencement Archive.
Dr. Dent is an esteemed educator, writer, and innovator in the medical field. She received her Bachelor’s of Sciences from Duke University where she graduated magna cum laude. Dr. Dent went on to earn her M.D. from Duke University School of Medicine, where she also completed her residency in Anatomic and Clinical Pathology. Dr. Dent completed a fellowship in Hematopathology at the University of North Carolina School of Medicine, where she now serves and inspires students as the Associate Dean for Student Affairs. Among Dr. Dent’s many accomplishments, she has served as a member of the AAMC Electronic Residency Application System Advisory Committee, the Liaison Committee on Medical Education (LCME), and the American Society of Hematology Committee on Promoting Diversity.
“Going forward, when you have an “on” weekend, it will not mean you have a Monday exam, it will mean that you are on call.”
“The Five C’s”, provides a succinct and intimate view of the UNC SOM Class of 2014. Dr. Dent encourages her students to go forward as physicians while staying true to their caring natures, abilities to connect with others, competence, character, and engagement with cutting edge technology. Read Dr. Dent’s 2014 Commencement Speech at the University of North Carolina School of Medicine.
Dr. Abraham Verghese, critically acclaimed author and widely respected clinician, is now featured in the Medical Commencement Archive. Dr. Verghese’s commitment to medical humanities, teaching, and the art of medicine is one that students have the pleasure and honor of learning from through various platforms.
In his speech, Timelessness in the Ever-Changing Medical Field, Dr. Verghese calls upon the Stanford University School of Medicine graduates to find the connection between their technology-laden careers and the careers of their predecessors.
“I hope that sense of history will make you conscious that when you are there with the patient, you are also participating in a timeless ritual. Rituals, like this one today, with all its ceremony and tradition are about transformation, about crossing a threshold — indeed the ritual of our graduation ceremony is self-evident. When you examine a patient, if you think about it, it is also a timeless ritual, a crossing of a threshold.”
In his speech, Dr. Verghese discusses the graduation speech boycotts of 2014, patients from his past, memories of medical school examinations, and opinions about medical licensing techniques. Dr. Verghese currently serves as Vice Chair for the Theory and Practice of Medicine at Stanford University, among many other appointments. Ending his speech, Dr. Verghese leaves the graduates with words that resemble a blessing:
“May you celebrate the rituals of medicine, recognizing their importance to both you and the patient. May you find courage to face your own personal trials by learning from your patients’ courage. May you minister to your patients even as they minister to you. When there is nothing more medically you can do for patients, remember it is just the beginning of everything you can do for your patients; you can still give them the best of you, which is your presence at their bedside. You can heal even when you cannot cure by that simple human act of being at the bedside — your presence. May you discover as generations before you have, the great happiness and satisfaction inherent in the practice of medicine, despite everything”
Interested in reading about Dr. Verghese’s work with infectious diseases? Check out My Own Country which features stories of the rise of AIDs in rural Tennessee. Interested in reading about mental health and creating balance within the medical field? Check out The Tennis Partner which explores the drug addiction and familial struggles of medical professionals. Fancy yourself a great fiction read in medical drama? Take a look through Cutting for Stone.
Further, Dr. Verghese writes on a variety of other interesting topics through New York Times, Newsweek, and Washington Post articles. Expounding upon the importance of the patient-physician relationship, Dr. Verghese has had a number of talks and interviews including TED talks.
Today the Medical Student Press kicks off Volume 1 of the Medical Commencement Archive. The Archive will now release a new speech each Friday. Stay tuned for spectacular reads which speak directly to the future of medicine with wise reflections from the past. The inaugural speech entitled, Who is Your Doctor?, comes from Dr. Timothy E. Quill, M.D., at the University of Rochester School of Medicine and Dentistry. Read Dr. Quill’s full speech and bookmark the Medical Commencement Archive here.
Dr. Quill is an accomplished physician and author in the field of Palliative Care. He earned his undergraduate degree at Amherst College, and received his M.D. at the University of Rochester. He completed his residency in Internal Medicine and a Fellowship in Medicine/Psychiatry Liaison at the University of Rochester. Dr.Quill is now Professor of Medicine, Psychiatry, and Medical Humanities at the University of Rochester School of Medicine and Dentistry. He is also the Director of the URMC Palliative Care Program. Dr. Quill has published extensively on the doctor-patient relationship, with an emphasis on the difficult decision-making processes toward the end of life. He was the lead physician plaintiff in the 1997 Supreme Court case Quill v. Vacco challenging the law prohibiting physician-assisted death.
In his speech, Dr. Quill spoke to the class about the need for competent and personal medical care in this complex and fast-paced world of biomedicine with all its specialties and subspecialties. He drew upon his extensive clinical experience in palliative care to illustrate how a deep understanding of the patient and their family can help physicians not only guide patients through the plethora of medical options, but also make,
“…clear recommendations among those options based on their medical knowledge and their knowledge of the patient as a person.” Dr. Quill believes, “that kind of guidance and engagement, which is both medically competent but also very person, is what will make [one] a really exemplary doctor.”
Dr. Quill’s speech is indeed very touching and inspirational. His personal clinical anecdotes are moving, as they illustrate how competent and personal medicine improves patient care. His focus and dedication to understanding and treating patients as opposed to diseases is evident and serves as a role model to all, including medical students. His words inspire medical student to,
“become one of those doctors who is not only technically very competent, but also very willing to engage with patients and families in difficult decision-making.”
The MSPress encourages you to read his commencement speech to not only gain insight into Dr. Quill’s wisdom, filled with powerful anecdotes, but to learn from an accomplished and very thoughtful physician. Read Dr. Quill’s full speech and bookmark the Medical Commencement Archive here.
Thanks to Stephen Kwak, MSPress Editor, for his contribution to this blog post.
Medicine is often a field at the forefront of technology. The importance of the field itself combined with the lucrative payouts seen for successful medical devices attracts many entrepreneurs and companies to the field. One of the most intriguing new technological advances is Google Glass – the augmented-reality glasses developed by tech powerhouse Google. There has been much speculation about the use of Google Glass in medicine. The possible implementation of Google Glass within the medical field raises important questions about how Google Glass may change medical education and practice.
What is Google Glass?
Google Glass is an augmented-reality system developed by Google. It is a voice-controlled, hands-free computing system that is housed in a “glasses” interface that users can wear much like spectacles. It contains an HD capable screen, 5 megapixel camera, and is Bluetooth, WiFi, and GPS enabled. The interface can sync with both Android and iOS phones for integration of information across platforms. Google Glass is currently in its “Explorer” beta phase, with a retail price of $1500. Speculation is that the upcoming retail version will be greatly reduced in cost.
What are the uses for Google Glass in Medicine?
The combination of features present in the Glass package makes it an enticing future medical tool. The main hypothesized role for Glass is in information sharing and transfer. Glass may prove useful in allowing physicians access to patient medical records, imaging studies, and pharmaceutical information in real time via the integrated HD screen. Glass may also be useful for physicians on home-call, as information about patient’s vitals and status can be relayed while the physician is en-route to the care facility. In the surgical field, Glass may help with surgical procedures by providing instant access to reference materials and real-time consults in the operating room. Finally, Glass may provide a more integrated and unique experience for medical students. Students will be able to view patient interactions and procedures with the same point of view (POV) as the physician, providing an unparalleled immersive educational experience. Furthermore, use of Glass by patients will allow students to view patient encounters from the patient’s POV, providing a perspective that many students may never have otherwise experienced.
While Google Glass is still in its infant stages, there has been some limited implementation in the medical field. Dr. Christopher Kaeding, an orthopedic surgeon at the Ohio State University, was the first physician to use Glass during a surgical procedure. The procedure was broadcast via Glass to both medical students and faculty at the university.
In terms of education, the University of California – Irvine Medical School has implemented Glass in its innovative iMedEd program. Established in 2010, iMedEd provides medical students at UC Irvine with specialized technological access and training. It started with school-issued iPads for every medical student, and later expanded to point-of-care ultrasound training and use. In 2014, the iMedEd program began utilizing 10 pairs of Glass to be distributed amongst the 3rd and 4th year medical students on the wards. It will be an interesting development to see how Glass is received amongst the students, and how they rate its effectiveness at enriching their educational experience.
What needs to happen for Glass to have widespread adoption in the medical field?
While Glass does have intriguing possibilities, it is by no means a proven entity in the medical field. I believe that for Glass to become an influential medical product two things have to happen. The first thing that must happen is that Glass must be utilized extensively in the consumer market. Many of the questions about Glass revolve around public uncertainty about privacy issues. If Glass gains a large foothold in the consumer marker, patients will become accustomed to interacting with Glass users and will feel less hesitant in a Glass-using setting. The second thing that must happen is that app developers must create useful medical apps for Glass. These apps must both provide utility to physicians and be compliant with HIPAA regulations. Much like EPIC was to electronic medical records, Glass needs companies who are willing to take on the intense regulatory scrutiny of the medical field in app development.
I recently had the privilege of visiting The Seedfolk Store in Rochester, New York. The store is run by the non-profit ProperRochester, Inc. which focuses on community engagement through urban agriculture with a focus on healthy food availability, youth empowerment, and entrepreneurship. The shop takes some inspiration from the book “Seedfolks”, a children’s novel by Paul Fleishman, in which an ethnically diverse community in Ohio works together to transform a vacant lot into a garden. I visited the shop as part of an activity for a medical humanities course I am currently taking, entitled “Death by Zip Code”, taught by Katrina Korfmacher, Ph. D. This course explores the importance of the environment on population health, focusing on epidemiology. The Seedfolk Store provides some vegetation in an area that is otherwise a “food desert”. These areas usually have fast food restaurants and convenience stores/corner shops. The Seedfolk Store has a refrigerator full of vegetables that are often requested in the area by neighbors. As a new organization, they are working on spreading the word about their efforts and services. While a full-fledged vegetable market would be unsustainable and unprofitable, this hybrid-shop is a great compromise and is catered to current demand. The shop gains some profits by selling granola from Small World Bakery, selling coffee for Coffee Connection, and selling potted plants and green tea bags that they make.
The staff’s experiences with ProsperRochester, Inc. is inspiring−it is clear to me that this team is daring and ambitious. They are dedicated to teaching youth about the specifics of food planning, processing, and distribution (selling and educating). These youth are employees and volunteers who work at the Seedfolk Store, green house, and in community gardens. They are actively involved with cooking education, small-scale food production, urban farming and learning about the local food system. The Seedfolk Store provides nutrition workshops, cooking classes, soup for the general public on Tuesdays, potted plant sales at the Rochester Public Market, and a rentable kitchen space for cooks. On April 12th, the team began planting at the M.K. Gandhi Institute for Nonviolence, a community partner which provides ProsperRochester, Inc. with space to widen in-ground gardening. In many locations, ProsperRochester, Inc.’s concerns about lead in soil has led to their use of raised bed gardening. ProsperRochester, Inc. also works closely with In the City Off the Grid, with which they are creating an aquaponics agriculture system at the Gandhi Institute and expanding a hydroponic greenhouse on Rochester’s East Main Street.
Most inspiring is that The SeedFolk Store’s team truly lives the message of health that they promote. Three members lost large amounts of weight and they told us their secret−namely they changed their diet, eliminating refined grains and processed sugars while increasing their intake of fruits and vegetables. One of the cooks renting the kitchen is a cheerful immigrant from Africa who wrote a children’s book about nutrition. She brought her own cooking supplies to The Seedfolk Store’s kitchen and waited in the rain for her ride home. This determination to further the health of one’s community through nutrition, no matter the obstacles, is very much necessary in all urban areas in the United States. I hope to help spread the word about this initiative and soon see similar projects pop up across the country to empower youth with the ability to make healthy life choices.
To visit The Seedfolk Store online or in person: The Seedfolk Store 540 West Main Street, Rochester, NY, 14611 (585) 279-9943
Not too long ago, I was rushing from one informational meeting to the next, trying to gather the scoop on medicine, medical school, and what exactly it meant to be a pre-med (I found it strange that these three rungs on the medical ladder were not necessarily complementary with each other… Did acing a nit-picky orgo exam really hold any bearing on my future abilities as a physician?). During my data-gathering in college, I soon saw a common theme emerging from all of the advice I accumulated.
Regarding the medical school experience: Medical school is tough.
Courtesy of Dalya Munves: http://thehealthscout.blogspot.com/
I was told that the material would be overwhelmingly vast, that I would spend most of my spare time with my nose in the books, memorizing, and that I should not even think about third year yet, because that was a whole ‘nother story. I was not deterred—I had found medicine (or rather, medicine had found me) and I could not imagine myself pursuing any other field. I was a little afraid because I knew I was not much of a memorizer. But, I would try my best. This all happened after my sophomore year of college, when I finally decided to “go pre-med.” (My path to choosing medicine will have to wait for a future blog post… stay tuned!).
I couldn’t imagine being busier than I already was. I was already heavily involved with three extracurricular activities, was starting to go into a lab to do research, and had a full course load. Yes, medical school was probably going to be busy—everyone said it would be—but somehow, I couldn’t wrap my mind around a life busier than what I was experiencing in undergrad. If I had been a more pro-active of a pre-med, I might have planned for the time-suck that I heard medical school was going to be. Maybe I would have started studying anatomy on my own, flipping through an atlas over the summer and starting to put down to memory muscles and nerves. Maybe I would have freshened up on my biochemistry or genetics.
Either way, I don’t think it would have prepared me at all for the balancing act that attending medical school has been. (In any case, I’m glad I didn’t fritter away my summer with a Grant’s Dissector.) It’s true that I’ve never been expected to memorize so much material in such a short period of time ever before. And that my attending lecture, small groups, and mandatory clinic sessions have resulted in much more class time (and hence, less free time) than in undergrad. Yet, these challenges are singular, and I have come to accept them as essential parts of the path I have chosen to take. The real challenge arches over other aspects of my life. It is the challenge of prioritization.
Most, if not all, doctors would agree that in order to keep sane, they’ve had to prioritize activities other than studying during their medical career. Often, it’s working out, cooking, sleeping, watching TV, or spending time with friends and family. It’s ultimately all about balance.
Being a medical student is like this: a teetering balancing act that may lean or sway more towards one activity or another on a day-to-day basis, but ultimately, in the big scope of things, stays firmly upright. This dynamic, rocking state of being is what balance truly is. I’m still awful at memorizing, and binder-loads of lecture material still catch me off guard. Yet, the biggest challenge of medical school has been learning how to best use the limited time I have in the most fulfilling way for me. It’s about learning to promote balance in my life.
In C. Dale Young’s poem, “Gross Anatomy: The First Day,” he begins the poem with an anatomy dissection instructor telling his students to:
“Begin with bone and muscle to discern exactly what you need to memorize. Each region has so many things to learn.”
He ends the poem with a snapshot of a sentiment too often felt by medical students:
“…You have many things to learn:
procedures, facts, new words at every turn.”
His introductory words elicit sighs.
Begin with bone and muscle to discern?
There is no time—too many things to learn.”
If I were to give advice to my naïve, pre-med self, I would sit her down and look her in the eye. I would tell her with confidence that she will be able to handle the course load of medical school just fine, that she will one day wield a stethoscope and call herself student-doctor without a second thought. But I would add, after motioning her to listen carefully, that she should make sure to pay particular attention to what is important to her. I would urge her to not let those things wither and to make finding balance a priority during medical school. Then I would share some sage advice I have gotten from fourth years past, “The extra hour you spend studying may not help you become that much of a better doctor in the long-run, but the extra hour you spend with your friends/your significant other/your family/your hobbies can make all the difference for your current and future happiness. Either way, you are going to get that MD. How you get there is yours to choose.”
From David Steindl-Rast’s TED talk, “Want to be happy? Be grateful”
Medical school is not what I expected. I’m neither saving lives day in and day out, nor am I the most knowledgeable person in my class. I’m not performing medical miracles and I’m not revolutionizing medicine as I envisioned I would be (yes, with just my twenty odd years of “life experience”). Instead, I feel as though I am trying to drink from a full powered water hose that won’t shut off. I am continuously faced with my own idiocy, ineptitude, and more importantly, fear. I see these super-human, overly capable figures who bear the name of doctor and wonder if I’ll ever be able to stand beside them. And then I stop, look and go.
“Stop, Look and Go” is a theory discussed by a monk who goes by the name of David Steindl Rast. He believes that the key to happiness is to be grateful for every moment that one has in life. However, he stipulates that this can only come about once one realizes that in every moment there lie an infinite number of opportunities at ones disposal. Now, keep in mind that this is, of course, easier said than done. I am far more comfortable wallowing in my self-loathing guilt-infested thoughts about all the opportunities I’ve missed, than focusing on the promise of the moment at hand. Rast’s ideas challenge human beings to do more−all by employing a simple rule we learned to follow as children before crossing roads.
So, what do I gain from the application of said rule? Here is an example of my utilization of this theory, albeit on a rather small scale:
When I Stop, I allow myself to be in the here and now. I am not thinking about the amount of material I have to learn over the next few days, or what I neglected to go over the night before. I am simply absorbing what is provided to me in this moment in time.
Then I Look. Of course, this requires so much more than simply looking. It requires the utilization of every sense to, as Rast puts it, take in the enormous amount of richness provided to us. Looking is the process of making associations and enjoying the present. It requires full awareness. For example, I happen to encounter a patient with inguinal hernias in a clinical setting, after just learning about the condition in the classroom setting. This is a highly enriching experience−an invaluable experience.
Finally, I Go. Now that I have grounded myself in the present and made associations about the overlap of opportunities of that present, I move to motivate myself to do something with this newfound peace and knowledge. This ranges from sharing my thoughts with a colleague who might appreciate them; to renewing my interest in a subject matter I am studying thereby incentivizing myself to continue studying when weary.
For some, all of the above may very well prove to be an exercise in futility and I certainly do not know if everyone will take from this theory what I have−wise monk or not. What I will say is that this has very much widened my perspective on the power of purposeful action and, in my opinion, enhanced my ability to learn and absorb the waterfall that is medical knowledge. To me, medical school is a lot of things. Some days it’s a nightmare, other day the bees knees. Some days it’s taking over my life, other days it is my life. It is difficult but awe-inspiring; fun but tiring. If it were a drug, I’d be an addict and if it were a person we’d be in a torrid love affair. Overall, medical school and being part of the medical profession is surely an invaluable opportunity and I strive to remind myself of my fortunate position as often as necessary, fueling my daily work and propelling me into the future. Thank you brother Rast.
This week, Dr. Georgette A. Dent, Associate Dean for Student Affairs at the University of North Carolina School of Medicine joins the list of spectacular commencement speeches in the Medical Commencement Archive.
