Random Thoughts from a Restless Mind

A couple of weeks ago Beth and I were invited to spend a little time with the VP of Development for the health sciences departments at the university where Beth got a BsRN and I got my MD. “Development” is a coy term that non-profits of all types use to describe asking people to donate money to whatever the cause may be. Mark, the VP who invited us out, is a delightful guy only slightly younger than we are. We danced around his core purpose for “discovering” that the unofficial class agent for the Class of ’86 lived 40 minutes from where he and his partner were visiting friends, and enjoyed a very nice couple of hours sitting at the bar of one of our favorite restaurants.

After a short time exchanging standard issue “elevator” origin stories Mark asked if I’d been the student speaker at my graduation ceremony. Mind you, my graduation from med school was 40 years ago, but I’m pretty sure that no one from my class spoke, and that we weren’t addressed by anyone other than a dean or two at graduation. No invited speaker, no University or department luminary, and certainly neither I nor any of my classmates were handed a microphone and a spot on stage. At some time over the years graduation has come to include not only speakers at the university-wide ceremony, but also at the smaller ceremonies for specialty programs such as medicine. Those invited typically have a connection to the school, and are often alums.

I am in love with the sound of my own voice, and so I immediately told Mark that I would jump at the chance to give the graduation speech at the University of Vermont Lerner College of Medicine.

To be sure, this is an entirely fanciful proposition. Not that I don’t have anything worth saying, or worth hearing by any college or grad school graduating class, it’s just that in the big old world in which we all live I am honestly and truly exactly who and how I have long described myself, a C-list celebrity with B-list aspirations. There are literally thousands of “known” entities higher on every university’s list of potential speakers, hundreds and hundreds on whatever list UVM might have, of folks with even the most tenuous thread of a connection than yours truly. I’m kinda like the guy in “Spill the Wine” by War singing about his unlikely casting in a movie, overfed long-haired leaping gnome, now skinny-fat and earthbound. Calling this a long-shot is exaggerating the possibility.

And yet, I really have something to say to a class of graduating doctors, or for that matter a class of graduating college seniors. I am, after all, a doctor; we are in many ways little more than paid observers (HT: WJP). I have willed myself to be a writer, an interpreter of what it is that I have observed. Now and again it all spontaneously distills itself into a package that occupies a little corner of the “restless mind” and like the rest of my random thoughts, seeks a way out into the world.

Herewith, then, is my graduation speech, this version tailored to my med school alma mater, that I will likely never give there, or anywhere else:

Dean Page, esteemed faculty, friends and family members, and my newest colleagues and fellow alums of the Lerner College of Medicine, thank you for this wonderful invitation. It’s been 40 years since I last graced this stage. A short walk that begin a long and wonderful journey. You know, I honestly don’t remember any speakers at our graduation ceremony in 1986. Certainly none from our class. What a cool thing, to be elected to speak to your classmates, the 140 or so folks who’ve walked the same walk and talked the same talk as you have. Maybe Dean Luginbuhl spoke. Honestly, I can’t really remember. The highlight was seeing my classmate Mike Philips receive his diploma from his Mom, the chairperson of pediatrics, while his Dad sat on stage with the rest of the faculty.

That was cool.

So what have I done to merit this invitation? What’s so interesting, unique, or special about my career or my life that makes me someone who would show up on a list of characters who get invited to address a graduating class of doctors? Honestly? Nothing, really. I grew up, went to school and made my childhood dream of becoming a doctor a reality. Like the majority of my classmates I have been a clinician in the community, in my case as an ophthalmologist in private practice just outside a mid-sized city in middle America. Back in the day UVM was known as a school that created the doctors who left school and training and headed off to a lifetime of taking care of patients. Again, nothing unique or special.

If anything has brought me here today it’s probably the stuff that doesn’t necessarily have anything to do with medicine, but rather what I’ve learned from the other thing that I’ve become over my lifetime, a writer. I have willed myself to become a writer, albeit one with only the tiniest of followings, none of which are likely represented here today. My classmate and close friend Bill Petraiuolo describes doctors as paid observers. Writers take this one step further and seek to find the larger themes that tie together those things we have observed. Sometimes, if we’re lucky, those observations and the interpretations we make crystalize into little nuggets of useful, actionable advice. One could think of them as wisdom I suppose.

Could be that I’m just getting old though!

Ah well; old or wise, in the end I’ve come up with three nuggets. The first: Talk to strangers. I know, your Mom always told you never to talk to strangers, and that’s really good advice when you’re a kid and just starting out. But as you grow up, go to school and start a career in pretty much anything, NOT talking to strangers handicaps in ways you might not realize. I mean, unless you’re a pathologist or radiologist, every day at work means talking to strangers, right? Patients and their families mostly. You can’t escape them. With all that practice at the office or in the hospital, why not take advantage of this necessary skill and bring it out into the “civilian” world?

Contrary to what your Mom was trying to protect you from, the overwhelming majority of our fellow travelers are really quite friendly and nice. Most are interesting, and many have stories they are happy to share. If I never talked to strangers I never would have met that really smart business consultant who designed partnerships for small, boutique service companies like specialty law and accounting firms. There was the marketing consultant I stood in line with at a Chipotle who described how the culture behind the counter was what really set the brand apart. Or the genius engineer I sat next to on a flight who described micro-marketing targeted to an individual identified by armchair-mounted screens with iris scanning to ID a patient so that you could show them educational information about the very reason they had come to the office.

All of those chats occurred in the early 2000’s; parts of all three became part of the DNA of my practice, SkyVision. I would have missed all of it if I didn’t go out of my way to talk to strangers.

Always ask for the job. Wayne Gretzky once said something to the effect that you never score on the shots you didn’t take. One of my sons, all full of himself after making Dean’s list first semester in law school, marched into the business school’s office at the university where he was studying law and declared something to the effect that they should accept him into their next class. Tickled and intrigued that he simply asked for the gig the dean told him to take the GMATs, that she would see if he was serious when she saw his results. The kid’s a pretty good test taker; she gave him the job. My other son traveled the world after asking for an internship in what was then known as CrossFit Kids. At age 18 he was teaching full-grown adults how to safely and effectively teach fitness to kids. My daughter, a behavioral therapist, built and ran two ABA clinics from scratch. When she learned that her company needed someone to do it, she asked for the jog.

Last, but definitely not least, don’t forget to sing when you win. Friendly strangers and the perfect next job both out there for the asking notwithstanding, this can be a hard world. Victories are there to be had but they don’t come easily. You can go a very long time between even the tiniest wins, so you need to rejoice each time you get one. You are all doctors, and I’m sorry to say that the hardest days of your medical career lie in front of you, not behind in the classroom or the lab or the clinics through which you rotated.

And so I ask you to be sure to celebrate every win. This might be the most important of my three little nuggets. Big or small, sing your victory song. You get that kid off the ward in time to graduate from kindergarten? Don’t forget to sing. That guy who showed up asystolic in the ER who you stayed with all night in the CICU? Yah, he just walked his daughter down the aisle. Don’t forget to sing. You went into psych and a desperate and depressed high school student came to your clinic, battered and beaten by what our modern world can do to us. Ready to be done with all of it, forever, but you saw them every day for a month. Gave them your phone number. A last desperate call before giving up and you took them to the ER. Now married, almost finished their Ph.D. You won! Don’t forget to sing.

Me? Well, talking to strangers helped me to create a culture-driven practice that rests upon a foundation that places caring for each other in the office and the OR first. We give better care for those who come to us because we care about each other. I am here today mostly because I asked Mark for the job! The last thing he heard from me as my wife Beth and I were turning to leave was to remember me for the gig. What a win! I’ll be singing as soon as I step off the stage.

And you? You’re about to be handed a fancy bit of paper that says you are officially a doctor!

Don’t forget to sing!

I’m back from the graduation I will never attend and the speech I will never give, and I’ll see the rest of you next week…

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