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KEYNOTE SPEECH BY BENNETT LORBER, MD, MACP

TUSM CLASS OF 2015 WHITE COAT CEREMONY

 

Bennett Lorber, MD, MACP.  Photo courtesy of Conrad Erb Photography.

On Friday, August 5, 2011, Temple University School of Medicine welcomed the MD candidates of the Class of 2015 to the medical profession and the Temple family. Larry Kaiser, MD, FACS, Dean of the School of Medicine, Sr. Executive Vice President of Temple University, and CEO, Temple University Health System, addressed the 211 class members and their families. Bennett Lorber MD, MACP, Thomas Durant Professor of Medicine at Temple, delivered the keynote address. Dr. Lorber's remarks appear below. (Photo courtesy of Conrad Erb Photography.)

 

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Good morning, Class of 2015. Welcome to medicine and to Temple.

 

You have made two great choices: Medicine and Temple. Medicine is a wonderful profession. Temple will give you the tools to join its ranks – ranks filled with dedicated, devoted, and decent women and men who care for patients and advance science.

 

Today, as you think about the next few years, most of you are feeling anxious and apprehensive, but also excited and filled with anticipation. In less than four years, when you leave Temple to begin residencies, you will feel anxious and apprehensive, but also excited and filled with anticipation. But then, unlike now, you will be medically knowledgeable, competent, artful, professional, and ready and well-equipped to take on the next part of your career.

 

One of the most renowned and revered members of our profession was Sir William Osler. We are all in his debt. Before Osler, the way one learned to be a doctor was to go to lectures and study specimens in jars for a few years, and then, after graduating, you apprenticed yourself to a practicing physician and followed him around to learn what to do. Osler said medical students needed to learn medicine at bedside, and put students in hospital wards; he started what we now know as residency training.

 

Osler said: “The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.”

 

As physicians we have a social contract. We bring society our good will, our accumulated knowledge and science, and the gifts of our professional skills. Society gives us trust, treats us well, lets us delve into intimate and secret details of peoples’ lives, and it even, as you yourselves will soon experience, lets us cut open bodies.

 

Doctors take care of patients. Patients are people who suffer. We relieve suffering
We don’t have customers, people who pay for a service.

 

Today we sometimes hear from some older physicians, “It’s not like it used to be.”
To this I say thank goodness. Does anyone want to go back to epidemics of polio or the time before we could fix blocked arteries in the heart? Complaints about the profession typically have to do with regulatory issues. As usual, Osler said it best: “I have heard the fear expressed that the sphere of the physician proper is becoming more and more restricted, but I maintain that the opportunities are still great, that the harvest truly is plenteous, and the labor scarcely sufficient to meet the demand.”

 

Medical school, and your career, will, to a large degree, be what you make it.

 

Again, to quote Osler: “To each one of you the practice of medicine will be very much as you make it–to one a worry, a perpetual annoyance; to another, a daily joy and a life of as much happiness and usefulness as can well fall to the lot of man.” -- and I’ll add woman.


We are fortunate people: It is a privilege to be a physician. In my professional life I have been tired, aggravated, frustrated, sad and even disheartened; but I have never been bored, and I have experienced moments of profound intellectual stimulation, deep satisfaction and gratification, even exhilaration. And, I have looked forward to going to work every day. I have learned something new each day; and, often, I have been useful.

 

Take your work in medical school seriously, very seriously. We are not supermarket clerks. There’s nothing wrong with being a supermarket clerk. In fact, for a short time, I was one. However, if a clerk puts the grape jelly where the spaghetti sauce is supposed to go, nothing serious will happen. What physicians do, on the other hand, impacts people’s lives in the most direct way. What we do–what you will do--really matters.

 

You are entering an extremely dynamic profession, the basis of which is in science.
Smallpox is gone thanks to medical science. During the 20th century, smallpox killed more than 500 million people, and now it is gone. Think of that! You will be part of the profession that did that.

 

But, although we got rid of smallpox, I can list for you more than 60 infectious diseases that were completely unknown when I graduated from medical school. AIDS is the most obvious example. You will have plenty to keep you busy.

 

The practice of medicine is based in science--and the science is spectacular! As the embryologist Jean Rostand said, “What a profession this is–this daily inhalation of wonder.” The Nobel laureate Rosalyn Yalow told us that “New truths become evident when new tools become available.” The invention of the microscope revealed the cellular basis of life. The tools of molecular biology have enabled us to identify organisms without seeing or growing them, creating a true revolution in medical science.

 

Did you know, for example, that there are tenfold more individual bacteria in the human gut than there are total cells in the human body, and that the microbiome in the gut contains roughly 3.3 million genes, far more than the 23,000 genes in the human part of us?

 

Did you know that our gut bacteria communicate not only with one another, but also with our bodies, and are necessary for the normal development of our immune systems and the maintenance of the integrity of our intestines?

 

Obesity is a big problem. Since 1876, when Robert Koch showed that anthrax was caused by a bacterium, we have had the idea that one bacterial disease has one organism causing it. But, it may not be just one. It may be populations of bacteria, or relative proportions of populations. Recently we learned that thin and obese people have different bacterial populations in their gut flora. Obese individuals have bacterial populations that are more efficient at harvesting calories from the food we eat.

 

This year marks the 30th anniversary of the start of the AIDS epidemic. An unexpected occurrence happened to me early in the AIDS epidemic (years before the effective treatments we have today): I became the kind of doctor I thought I wanted to be when I started medical school. I took care of people over time and learned the most intimate details of their lives. I met their families and life partners. And I learned an extremely important lesson: You can really be helpful even when you “can’t do anything.” Listening, or just being there, can be a great gift. Never forget as you study diseases, it is people who have them. Don’t forget to listen.

 

Here is another important thing to think about: We all need other aspects to our lives, things that are distracting, fulfilling, restorative, enriching, energizing, and fun. I make paintings, and am very pleased to tell you that the paintings hanging in all the student study rooms on the second and third floors of your beautiful new medical school building are by me.

 

I often ask students what they do for fun, and, all too often, this is what I hear:
“Oh, Dr. Lorber, I used to love to play the piano and as soon as I am out of medical school I am going to start playing again.” Make time for the life-enriching things and do it now. Spend time with your family and friends.

 

“Tomorrow I will live, the fool does say.
Today itself’s too late; the wise lived yesterday.”
Marcus Aurelius 2nd century A.D.

 

Take care of yourselves, so you can take care of your patients.

 

In the 18th century, a philosopher said, “A physician sits in the front row of the theater of life.” It’s true. We see people at the extremes of the human experience. What brings more joy than the birth of a healthy child, and what is more horrific than telling someone that they have a fatal illness? A physician sits in the front row of the theater of life. Make sure you see the curtain go up and witness the play. If you keep your senses alert and your hearts and minds open, you will experience great things. You will have a chance to be useful and maybe even gain some wisdom.

 

I shall close with a poem. In a few days you will enter the anatomy lab and begin to dissect a human body. His poem addresses part of that experience. It was written by the American poet David Wagoner, who is still going strong at 85.

 

His poem is called Their Bodies.

 

That gaunt old man came first, his hair as white as your scoured tables.
Maybe you’ll recollect him by the scars of steelmill burns on the backs of his hands,
on the nape of his neck, on his arms and sinewy legs,
And her by the enduring innocence of her face,
as open to all of you in death as it would have been in life.

 

She would memorize your names and ages and pastimes and hometowns if she could, but she can’t now, so remember her.
They believed in doctors, listened to their advice, and followed it faithfully.
You should treat themone last timeas they would have treated you.

 

They had been kind to others all their lives and believed in being useful.
Remember–somewheretheir son is trying hard to believe you’ll learn as much as possible from them, as he did,
And will do your best to learn politely and truly.

 

They gave away the gift of those useful bodies against his wish.
(They had their own ways of doing everything, always.)

 

If you’re not certain which ones are theirs, be gentle to everybody.

 

Women and men of the Class of 2015, welcome to this great profession.