Thank you so much for that warm introduction.
It is really an honor to be here.
Dean Fire, Dean Donna, faculty, families, friends, and most
importantly, physicians and dentists of the class of 2014.
I'm truly honored to be here with you
on this special day when you join
the sacred lineage of healers.
It's a particular honor to be here because Harvard Medical
School is where I did several years of a vaccine research
just across the street.
It's also where I learned to take care of patients
during my residency at Brigham and Women's Hospital.
And it's where I've had the great pleasure
to work with so many capable and proud and intelligent students,
including many in this graduating class.
So it is good to be home.
And given recent controversies over commencement speakers
at other schools, I suppose I should thank you
for not protesting my speech.
Frankly, I would have come anyway.
But still it's, nice to be out of the line of fire
for a change.
I begin with the people to whom I owe everything, my parents.
They're seated here today, right over there among your parents
and among your family members.
It seems my parents just can't get enough
of graduation ceremonies.
It wasn't enough for them to come to mine,
now they have come to celebrate yours, as well.
But it makes sense because this was their American dream.
My parents came to the United States
as immigrants from India.
There were many reasons why they left everything
to travel halfway across the world,
but there was no catalyst in their journey
that was more important than education.
They crossed continents and oceans,
and endured countless moments of discrimination
because they hoped for a life in which
their children-- my sister and I-- would
have limitless opportunities.
They always raised us to believe that our reach should always
be greater than our grasp.
And they believe that the gap between those two things
would be bridged by education.
My parents are probably not so different from the people
in your lives.
Your families and friends, your mentors and champions,
who have made today possible.
So I ask you now to take a moment
and thank the people who taught you
how to reach for your dreams.
Today I'd like to talk to you about standing up
for your values and your vision as you build lives
as physicians and dentists.
I'd like to talk to you about why doing so
is hard, but important.
Not just for you, but also for the world.
You have now joined a long legacy
of healers who stood up for their values and their vision
when it counted the most, and who
changed the world around them as a result.
Doctors like Elizabeth Blackwell,
who believe that women have the same right as men to be
physicians.
And who overcame opposition and ridicule
to become the first woman to earn
a medical degree in America.
Doctors like former Surgeon General, C Everett Koop,
who spoke the truth about HIV prevention,
despite fierce political opposition.
Because he believed that science and public health
should not be compromised by politics.
As doctors and dentists, we share as singular a core value.
One that binds us together.
An unflinching commitment to improve
the lives of our patients.
This is our true north.
But how this value is reflected in your work,
your unique vision, that will be particular and specific to you.
Your vision include providing the best possible care
to individual patients, pioneering research,
advancing medical education, shaping health policy,
developing new health technologies,
or a host of other paths.
Your vision may also change over time, and that's OK.
Frankly, it's also OK if you don't have clarity
in what your vision is today.
Figuring this out can take time.
It will require exploring new ideas throughout your career,
especially when that voice within tells you softly,
but insistently, that you are not fulfilled.
And it will require never, ever settling for someone else's
path just because it is easier.
Now why is this important?
It's important because when you are working
toward a vision that's firmly grounded in your values,
you will be capable of astounding creativity
and massive impact.
Staying true to your values and your vision
is how you can change the world.
And we need you to.
Because you enter the world of medicine
at a time where we face crises with cost,
with coverage, and with quality.
You enter at a time where we are grappling
with critical public health issues,
such as an epidemic of obesity and chronic disease.
Widespread tobacco related disease
that will claim over 400,000 lives a year.
A resurgence in vaccine related illness, and unacceptable
disparities in health.
But you have the power to change this.
You can help us to build a 21st century model of health, where
our exceptional power to cure illness and deliver care
to patients is exceeded only by our ability
to prevent illness in the first place and promote wellness.
You can help us create a culture of health in America
in which all institutions, not just
our hospitals and our clinics, but our schools,
our businesses, and our houses of worship
embrace their roles as stewards of health in our communities.
Now to build a life guided by values and vision
is not always easy.
There are risks of disappointment and failure.
To walk this path requires people
who remind us of what really matters,
and who will help us find the courage to pursue it.
Our family and friends are some of our best anchors
in this regard.
But perhaps the most powerful force
in keeping us grounded in our values
is our patients themselves.
I learned this during my third year in medical school
when I met a middle aged woman named Ann,
who had been diagnosed recently with throat cancer.
Ann's condition had unfortunately
progressed to the point where she
needed surgery and a tracheostomy
so she could breathe.
I was assigned to follow Ann right after her procedure.
As I took the elevator down to meet her
in the post-operative care unit, I
remember reviewing the questions I
was supposed to ask her to look for evidence
of the airway compromise, excessive bleeding,
and other potential complications from the surgery.
By the time I arrived at the bottom floor,
I felt that I had mastered the facts.
But when I got to Ann's bedside I
realized that she was awake and alert, but she could not talk.
She was shivering even though the room did not feel cold.
And I will never forget the look of fear
in her eyes, which were red and moist as she cried quietly
in her bed.
My quiet and carefully chosen questions
suddenly felt less relevant.
I tried asking if she was in pain,
or having trouble breathing.
She shook her head no, seeming frustrated
that she couldn't speak.
I asked a few more questions, and she
shook her head a few more times, continuing
to shiver and to cry.
Finally, I put away my list of questions
and pulled out a spiral pad that I kept in my pocket
for personal reflections.
I positioned it carefully under her hand with a pen.
"Can you tell me how you were feeling," I asked.
She took the pen and slowly wrote
three simple words that have stayed with me ever
since, I am scared.
On the frayed pages of my spiral pad
she began to write about her fears of never speaking again,
and of what might happen if her cancer progress.
After I went home that night, I reread her scrawled notes.
And after all the procedures I had seen,
after all the knowledge I had absorbed that day,
it was that conversation with Ann
that felt the most important.
I kept that piece of paper in my white coat
to remind myself of this simple but powerful lesson.
That Ann, and the thousands of patients
I have been blessed to care for since then,
continue to teach me.
That the humanity of our patients
lies at the core of everything we do as doctors.
It is bigger and more important than everything else.
Many of you have had patients like Ann
who have touched your lives.
And all of you will in the years ahead.
I hope you draw on these patients
to remind you of the values that you want to define your lives.
Now even when we remember our vision and values,
to translate them into reality takes courage.
As the gifted poet Maya Angelou once said,
may she rest in peace, "without courage,
we cannot practice any other virtue with consistency.
We can't be kind, true, merciful, generous, or honest."
Now I believe that courage lies within all of us.
But it can be buried in fear and in self-doubt.
You may not realize it's there until you're actually tested.
One of my first tests when I was nearly 20 years ago,
when my sister and I were building
our first nonprofit organization, Visions.
We had trained a team of college students
from around the country to travel to India to conduct
the HIV/AIDS education workshops in schools and in colleges.
But five days before our departure
we lost all our funding.
Our choice was to return home and get jobs, or find a way
to raise $15,000 in five days.
A small fortune to college kids with shallow pockets.
But we believed in our vision, and we believed in each other.
So we took the plunge and started calling
everyone we knew for support.
And when we were done calling them,
we started calling people we didn't know.
We worked day and night, held events, wrote letters,
went to the local media.
And amazingly, people started giving.
Initially just a few dollars at a time, then a little bit more.
Ultimately we raised the $15,000 just in time to get to India.
And that summer we reach thousands of students
through our workshops, and laid the groundwork
for an organization that would expand our efforts
over the coming years.
This experience taught me something very important.
It taught me that we are capable of far more than we
can imagine, especially when we are fighting for a vision
and for values that we deeply believe in.
I've drawn on those moments many times in my life.
When fear and the noise of day to day life have made
me doubt myself, and wonder if I should settle for safer paths,
even if they weren't my own.
When I first became an attending physician
I decided to set aside time between weeks of patient care
to work on ideas for new technologies
that would improve patients' lives.
And it was my experience in Visions
that made me keep trying even as my pile of failed ideas
continue to grow.
Eventually one of my ideas took root,
that of using social networking and information
technology to improve collaboration and research.
And this became the basis for building a company, Trial
Networks, which is now improving clinical trials
around the world.
These experiences also gave me the courage
to build Doctors for America a few years later,
I was inspired by a simple believe
that doctor should be leaders in fixing our health care system.
I didn't know much about policy or grassroots organizing,
and I was warned often by veterans
that doctors were too busy, too cautious, and too cynical
to want to get involved in fixing our health care system.
But I also knew that many of my colleagues
came to medicine inspired by high ideals, like many of you.
And they were also inspired by patients like Ann
who had touched their lives.
They wanted to practice in a system that
served those ideals, and so did I. Found myself
up late at night wondering how much we could actually
do if doctors chose to speak up, and I
was blessed to find a few good friends who felt the same way
and they inspired me to act.
When we eventually started Doctors for America,
we found thousands of doctors and medical students,
in all 50 states, of all specialties and ages, who
were hungry to have a voice in creating a better health care
system.
One of these physicians was Mona, a private practice
allergist in Florida with a husband and four children
all under the age of 10.
Who had lots of ideas for improving their health care
system, but wasn't sure anyone would want to hear them.
She began painstakingly writing her first letter to the editor,
and to her surprise it was published.
Now just a few years later, Mona has
published many more pieces, spoken to dozens of events,
lead a prevention and education bus tour for her community,
and helped countless fellow physicians in Florida
find their voice and speak up for their patients.
Colleagues like Mona not only give me courage,
but they remind me that we-- all of us--
can no longer remain within our exam rooms
and ignore what is happening in our communities.
As physicians and dentists, we must
have a presence in both places.
Our sacred responsibility is both to the patient in front
of us, and also to safeguard the health of the nation.
It is a big responsibility, but one that we are called to meet.
Class of 2014, as you go forth to begin your lives,
as physicians and dentists.
As you ponder the great challenges
that loom before our patients and our country.
As you consider how you will respond to these
calls for action.
Remember this, the world needs dreamers and doers.
It needs doctors and dentists who
can imagine the world as it should be,
and who have the courage to step forward
with open minds, clear eyes, and full hearts
to translate these dreams into reality.
More than ever the world needs you.
There are those who might tell you
that you are too young and inexperienced to solve
the problems that we face.
But when I hear such views, I think of the medical students
and residents on this campus who launched a movement
to revitalize primary care that is reverberating
throughout the country.
I think about the young entrepreneurs
who are employing big data analytics
to improve quality of care.
And I think of the many students who
have served in free clinics-- in some of the poorest
parts of America and around the world-- because you believed
that it was not enough just to talk about disparities,
but to be part of the solution.
So I challenge you to find your vision
and stand firmly, resolutely, by your values
as you build your career.
Standing up for your vision and your values
means you have to remain standing,
even in the face of hardship.
It won't be easy, but it's your job.
It is who you are now.
If you build a life on your values and your unique vision,
you will change the world.
And you will inspire others to do the same.
Don't ever let anyone tell you otherwise.
Here is my prediction.
30 years from now, when commencement speeches
are given and medicals and dental schools
around the country.
When praise is heaped upon those pioneers
who lead our country forward during a time of great change.
They will speak of the bold, courageous men and women who
became healers on this day, .
They will speak of the historic era of uncertainty
into which you stepped.
They will describe how your courage and your conviction
overcame your fear and doubt.
As you built the foundation for help, for a nation
that was badly in need of healing.
They will observe that at a time of great division
and polarization in our country, you built partnerships
with the people and institutions you.
And restored faith in what we can do as a people
when we came together.
And they will declare that this was
a generation of whom much was demanded, but one
that stepped up and delivered.
Leading our nation from a place of peril to a place of promise.
Class of 2014, this is your generation.
This is your moment.
This is the future that you can create.
Your job is, as it has been for healers
throughout the generations, to fill darkness with light.
To face down ignorance with knowledge.
To replace despair with hope.
Rise to this challenge.
I believe in you.
Your families and teachers, they believe in you.
All that is left-- All that is left,
is for you to believe in yourself.
I wish you a lifetime of happiness,
of deep fulfillment, and of much, much inspiration.
Congratulations.