“Be ashamed of miseries you did not cause”

Last Thursday I had the privilege of graduating from medical school.  The week was a whirlwind of ceremonies, dinners, receptions, trips to the airport, (and even a brewery tasting!) that I was pleased to share with my parents, sister and a few close friends who visited – people who, no doubt, deserved all the ceremony that was erroneously held for us the graduates. In short, it was a blast!

The families that made it all possible

Given that, the title for this entry probably does not seem fitting. To discuss shame and misery as well as the promise of graduation in the same entry does not seem quite right.  But these words of Antoine de saint-Exupery and the commencement address in which he was quoted left the most lasting impression of the week.  Dr. Donald Berwick gave an inspiring and meaningful address in which he told the story of his patient Isaiah.  Isaiah, Dr. Berwick told us, lived in the shadows of society: he was in and out of police custody and a drug addict at a young age.  Dr. Berwick helped cure him of his leukemia but 18 years later he died of “uncontrolled diabetes and even more uncontrolled despair.”

Isaiah’s life and death were the platform off which Dr. Berwick advocated for healthcare as a human right and reminded us that in the midst of a world that is worrying, we are not to be confused.  He told us that we have a compass that always points north: that we will always put the patient first and that we will fight injustice.

For non-medical readers, there is still plenty to inspire in Dr. Berwick’s speech. For my friends who graduated with me, we should re-read it now. (It will be published shortly, I believe)  And we should read it again when we feel our purpose questioned or our resolve wavering.

He advised us:

You are not confused; the world is.  You need not forget your purpose, even if the world does.  Leaders are not leaders who permit pragmatics to quench purpose.  Your purpose is to heal, and what needs to be healed is more than Isaiah’s bone marrow; it is our moral marrow…

It is time to recover and celebrate a moral vocabulary in our nation – one that speaks without apology or hesitation of the right to health care – the human right – and, without apology or hesitation, of the absolute unacceptability of the vestiges of racism, the violence of poverty, and blindness to the needs of the least powerful among us.

I loved all of Dr. Berwick’s speech.  I loved the lessons he drew from Isaiah’s story.  And I loved the words that are the title of this entry. My hope is that my fellow graduates and I will hold on to our compass in a profession in which cynicism seems to accompany promotion.  My hope for myself is that I never take lightly the privilege of caring for patients and the responsibility I have to bear witness to their misery – even that which I did not cause.

That, I suppose, is my oath.


One comment

  1. Kewal

    Excellently written – I like it as much as I liked the address by Dr. Berwick. Stay with this and you will do well.
    The only thing I would like to add is “always dream and never stop dreaming”.

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