And the text:

Good Afternoon Dean Pizzo, family and friends, colleagues, The Guy Who’s Totally Uploading This To YouTube Right Now, The Undergrads Who Heard There’s Free Alcohol Afterwards, and of course, my fellow classmates, the Graduating Class of 2008,

Britney Spears once famously said, “Hit me baby—.” That was my ORIGINAL version of the speech. You weren’t supposed to hear that. Awk! Ward! Blarg. Wow. Uhm, okay. Let’s just pretend that didn’t happen.

Hannah Montana once famously said, “We. Need. Single-payer national health insuran—.” Okay fine, she didn’t. But, I’m kind of known for ranting about health care reform, so everyone probably thinks that’s what I’ll talk about today. But don’t worry. I won’t. Today, I would like to talk about something that’s been bothering me: name-calling.

During medical school (and my entire life) I’ve answered to just about any variation on the theme: Graham, Graham Cracker, Grahamazon, Grahambo, Grahamakin Skywalker, “Hey you,” Kilo, Graham Stain, Graham Positive, Graham Negative, and even, as one attending who didn’t care to learn the names of her students called me, “a medical student,” with the same tone one might use to ask, “Could you hand me a pen?” Man, I’m really going to miss medical school!

But lately, most people have been calling me doctor, and I’m not sure if I like it. Sure, people have said it all throughout medical school, but I always had sufficient grounds to correct them: “No no, not yet, I’ve still got 6 more months to go,” or “Gosh, I wish, but I still have to pass my boards!” But lately, I haven’t had a leg to stand on.

It’s almost as if I don’t want Graduation Day to be here. But too late now. Change happens. Today, we’re becoming doctors.

I remember at orientation an upper-classman saying that we probably thought becoming a doctor was a noble, selfless act—but any of you in the audience can easily vouch for how selfish it can be. We have demanded your patience, love, understanding, compromises, and support for all these years. So up front, I want to say to each of you, from all of us up here, I am sorry. But I promise to do better next time. Not to forget slash have to reschedule: your birthday, our anniversary, the dinner reservations we had, or that trip to Mexico.

But truly, we could not have made it this far without you. Not to get all Mr. Rogers on you, but to us, you are special. You are why we are dedicated to this: because our patients have their own families and friends like you. You are the selfless ones…not us. So from the deepest reaches of our hearts and souls, thank you so very, very much. Today, we celebrate becoming doctors as much as we celebrate you.

I guess I really worry about how the title of Doctor defines you. How it changes you. That I’m becoming a little bit more Doctor Walker, and a little bit less Graham. Sure, the title affords me some prestige and privilege—for example, complete strangers will now feel totally comfortable whipping out their strange moles at dinner parties—but at the same time, it makes people see me as primarily—or only—a doctor, not as a son, brother, partner, computer nerd, or Trader Joe’s enthusiast.

Maybe this is how it’s supposed to be. Maybe that’s the purpose of the title. To remind us and others of the Oath we take, or that patients’ needs are to come before our own.

But if becoming a doctor will change how people view me, there are several values I’ve learned here at Stanford that should get to represent me, too. And I have numbered these values, as I am going into Emergency Medicine, and have a short attention span. Oh, and just a sidebar: The next time you want to complain about your hospital’s Emergency Department, please remember that we’re probably getting distracted by… oh, I don’t know, coding patients, big traumas, (mumbling) bodily fluids being flung… at… us, or… … shiny… things.

Sorry. Back to my values:

Number one: I will continue to use objectivity, without forgetting the subjective.

Medicine is an art grounded in science. I’ll do my best to know the studies, the data, and the pathophysiology, and try to apply them objectively.
But I won’t forget the patient. I’ll listen. I’ll be compassionate. I’ll try to keep social context, “chief concern,” and patient perspective in mind.

And number two: I promise to ask questions, and on occasion dare to admit: “I don’t know.” And thank you to Stanford for encouraging this—in Gil Chu’s class, where we weren’t allowed to leave until we had collectively asked him 10 questions; with Dr. Wolfe, who teaches students to admit their own “Areas of Ignorance.” We are a generation of physicians who are unfortunately (or fortunately) still human. We are not gods. We still make mistakes, and we still don’t have all the answers. But, hopefully, we’ll know where to find them.

Number three: Don’t mess with the pancreas. Or, in the famous words of master pancreatic surgeon Dr. Norton, “I’m tellin’ you, don’t mess with the pancreas! You gotta believe me!”

And number four: I promise to be involved. Whether it’s researching, teaching, advocating, or volunteering, I will remember that health and medicine are often advanced and affected more by time spent outside a hospital than within one.

While passing clerkships and boards and memorizing facts may make us doctors today, it’s our values that will drive us to become great doctors, like the many we have met here at Stanford. Because the great physician is dedicated to the truth, but also to patient. She is a scientist, but also a healer. He tempers prognosis with hope. I think Kurt Vonnegut sums up medicine’s curiosity and compassion better than I ever could: “We are here to help each other get through this thing, whatever it is.”

So, today, fellow classmates, this is it, for better or worse. When our patients call us doctor, they’ll finally be right. (How scary is that?) While our profession may change how we see the world, or even how the world sees us, we must keep a part of ourselves the same. That part—our goals and our values—is what has gotten us to this point, up on this stage. You can call me Dr. Walker now, but I promise to remain just Graham. I’m too proud of each title to be dropping either anytime soon. Thank you.

20 Comments »