Baylor University Medical Center Proceedings January 2014, Volume 27, Number 1

by laparoscopic techniques, and even now they are replacing us with robots. Despite it all, it was exciting and enjoyable and we loved it. Fifty years after graduation, we met at our reunion and all agreed we made a great choice of a profession. We commented that “we practiced during the golden era of medicine.” Actually, I hear that from every generation of physicians and so it will be with this group! In recent years, I have become aware of the concerns of many students and parents. They wonder: Is medicine a good choice for a career? They sense the frustrations of their family physicians. Periodically in Washington, they round up the “usual suspects”—the politicians, lobbyists, insurance and pharmaceutical executives—to restructure our health care system with their ideas and self-interests. One can but recall the words of the great 19th-century American orator, Edward Everett Hale, after a visit to Washington. He was asked: “Do you pray for Congress, Mr. Hale?” He responded, “Frankly, after meeting them, I pray for the country.” Little has changed. We are still praying. But fear not, my friends. What you are hearing about is only the superﬁcial layer, the outer shell, of a great profession. Deep inside are many more layers, with unlimited opportunity. But what can you, the class of 2017, expect? In a recent thought-provoking book, The Creative Destruction of Medicine, the brilliant Dr. Eric Topol attempted to anticipate future changes in the health care delivery system. He commented on changes such as use of smartphones for complex diagnostic challenges and personalized medicine with use of genetic information. He even suggested that the stethoscope, so revered here at Georgetown, will be replaced by a handheld ultrasound device. He admitted to not using his own stethoscope for over 2 years, which suggests to me he never learned to use it properly and appreciate its value. Despite all these future advances, he probably hardly scratches the surface. Today, you will do two things that mark your oﬃcial entry into the profession of medicine. First, you will be robed with the white coat, the sacred symbol of healing, of compassion, of hope. Second, you will recite the ancient oath of Hippocrates, the oath that unites physicians worldwide and throughout the ages in the art of healing. In taking the oath you will commit to the highest standards of the profession. You will become a professional—today, now. What is a professional, you may ask? A professional is someone who accepts the responsibilities, the obligations, and the sacriﬁces that go with the privilege— and, indeed, it is a privilege to study and practice medicine. But above all, a professional is someone who always places the interest of the patient above his own. How can you do this in the early years of medical school? You face lectures, laboratories, constant study, with frequent moments of frustration, confusion, loneliness, and a feeling of there being no end in sight. It is “the dark night of medical training.” But, remember, the making of a physician is a long process, lifelong even. We are naturally impatient to reach the end. We would like to skip the intermediate stage that is so necessary. But we know that true progress is made by passing through 64 periods of discouragement, uncertainty, and even high anxiety. So we need to be patient, patient with what is forming within ourselves. Be patient—especially with ourselves. Francis de Sales called patience the greatest and most diﬃcult of virtues. Recall that it was the ﬁrst- and second-year students who thought of and designed the wonderful Hoya Clinic, which has exceeded all expectations. And it began with a simple idea: “Doctors for the street people.” Soon, you will meet your ﬁrst patient, the cadaver. He will not speak to you, but will teach you much. Remember, you will be dissecting the remains of a very special human being— someone whose last thoughts before dying were to help others, by instructing you. What a gift! The cadaver is the beginning of your patient-focused professional life. And, before you know it, the clinical years arrive, and the patient now becomes the full focus of your learning! Let us further consider the patient. Who is the patient? The patient is a fellow human being who has become sick. To become a patient is to be uncertain, anxious, frightened, no longer in control. To become a patient is to imagine the worst and, at the same time, deny being sick. To become a patient is to be angry, demanding, sensitive, suspicious. To become a patient is to be sad, to be lonely, to cry. You who focus on the patient will learn much. From the patients’ anxieties, you will learn equanimity. As you observe the futilities of their hostilities, you will learn love. As you deal with their despair, you will instill conﬁdence and optimism. As you share their suﬀering, you will admire their patience, their courage, their strength, and the power of their faith. As you experience their death, you will see life. You will recognize the limitations of materialism, the narrowness of self-seeking all the vanities of the world. You will ask: What is imp

Baylor University Medical Center Proceedings January 2014, Volume 27, Number 1 | Page 66