Graduation: A Speech for Medical Residents

If I slur my words, thank Nicole Austin (one of the residency coordinators).  She made me sit at her table, said she’d get me “plowed” on wine--her words not mine.  I have the email to prove it.  So…not my fault…

So began my address for the graduation ceremony at the Trios Family Medicine and Internal Medicine Residency Programs.  I honestly thought I’d be one of several faculty to give such a planned speech, but upon discovering I was the only one, I must say I was honored and quite touched to be chosen.  The rest of the speech continues:

Nikki also gave me 30 minutes to speak, but I took mercy on your souls and cut it to 29.  No thanks necessary.  Relax.  It’s much shorter.

I’m an ENT doc in private practice for a long, long time and one of the--believe it or not--Clinical Faculty members.  And I must say I’m honored and quite touched to be chosen as your speaker.

BTW, my staff, whom some of you met during your rotation with me, wanted to express their best wishes to all the residents; and so Kelly, Rachelle, Austin and Jen send their heart-felt blessings and congratulations.

So here we are.  You made it!  Alright, alright, alright!  That’s my "Matthew McConaughey."  You’ve worked hard, sacrificed much, survived long hours, lumbering about the hospital like the “Walking Dead.”  You’ve journeyed far and found the light at the end of a very long tunnel.  And now you’ve arrived. 

But you know your journey has only begun.  You have far to venture.   And life’s journey is much like running a long-distance event, such as a marathon—which thankfully this speech is not.

I say this because I’m a runner.  Some of you know this.  And I do it in bare feet.  No joke.  Haven’t worn shoes for years…well, except for moments like now.  This becomes pertinent in a minute.

So, imagine yourself at the start of a marathon.   There’s doubt and fear embarking into the unknown, but there’s also nervous excitement and raw energy.  The gun fires and off you go.  Your course won’t be smooth.  You’ll hit great highs—cheering crowds, breathtaking sites, the runner’s high where everything is blissful and mental clarity is at its peak.  But in time come the dreadful lows—a storm, an impasse that scares you to death, the wall of pain and exhaustion, and sometimes really awful nastiness.   The saying “life is full of dog poop, and you just stepped in it,” takes new meaning in bare feet, which is…unsettling, to say the least.  Raises the bar on the “yuck scale” off the grid. But you drag yourself out of the mire, and you run on. 

Your journey is not just about getting from point A to B.  It’s about everything in between.  In your busy life, take the time to really savor those peaks and pleasures, large or small.  Yet expect those downfalls: the hardship, tragedy, the dog poop.  Bad stuff happens to everyone, even the best of us.  No one is immune.  Treat this as a certainty, one of the constants in the calculus of life, and a necessary part of your entire journey.

Every crisis that kicks you in the head and crumbles your world around you can be turned to advantage.  They say, “adversity builds character.”  As the dust settles and you pick yourself up, sift the rubble for that small nugget of fortune, that tiny glimmer of opportunity, and seize it.

The psychiatrist Viktor Frankl said, "…everything can be taken from a man but one thing: the last of the human freedoms--to choose one's attitude in any given set of circumstances, to choose one's own way." 

This was a holocaust survivor who lost his entire family in the Nazi concentration camps and nearly died there himself, were it not for his way of thinking.

You were thrown into the fire during your training; you can overcome any negative by staying positive.  You rule your own destiny. 

The world of medicine can be daunting and frightful.  But you’re a doctor; you were meant to do great things.  Society in many respects has placed you on a pedestal.  As with any great position, there are those who want to take you down.  But most folks view doctors favorably; they’re on your side.  And they’ve given you an awesome privilege, to enter their lives so that you can affect their lives.

But don’t let this get to your head.  In this vein, be humble and never stubbornly think you are always right.  Heck, it doesn’t work with your spouse or significant other, so why would it elsewhere?   Or as my Dad said to me, “If you’re so damn smart, why were you in school so long?”

And never hide nor bury a mishap, a mistake, an unintended consequence.  Come clean for the sake of your patient and yourself.  More often than not, you’ll be forgiven; people understand that you, like them, are only human.  With time, the after-effects seem less grim, sometimes taking an unexpected positive turn in a different light, when they feel you haven’t abandoned them, that you’re still by their side.

My motto:

 “The deeper you try to bury something, the more it’ll stink when they dig it up.”  And someone, sooner or later, WILL dig it up.  

This doesn’t mean you shouldn’t take risks.  To learn and flourish, you gotta, every now-and-then, go out on a limb.   Be daring, if what you seek is worthy.  Worthiness is any endeavor that improves you for the sake of someone else, without disadvantaging another.  See the big picture—the common good.  You’re a single but vital cell contributing to the entire organism of humanity.

Someone said:

“Security is mostly a superstition.  It does not exist in nature, nor do the children of men as a whole experience it.  Avoiding danger is no safer in the long run than outright exposure.  Life is either a daring adventure or nothing.”

Who was that?  Hellen Keller, struck blind AND deaf at 19 months of age.  Imagine…

Life is short, so make yours extraordinary.  Capitalize on what makes you, you; and be your own unapologetic self. 

I do this myself, or try.  For instance, I’ve said before I run barefoot, outside, in public.  At first it was awkward and strange, stumbling about like a fool, enduring wise-ass remarks from strangers and drive-by teenagers.  I got over the embarrassment, didn’t care what others thought, and kept at it.  I do for its childlike simplicity, because it’s liberating and sometimes painful, in a good way.  “Pain is weakness leaving the body,” the Marines say.  But each time I run, it empties my head, and I get to bask in the sublime beauty of the here-and-now.  And despite a brutal week on-call or a hard day in surgery, the stress and anxiety melt, and everything just feels right with the world.  And this carries into the workplace.  

I share this with patients to help them discover that same joy in their own way; a bit of unconventional therapy, so to speak, beyond the colder, scientific realm of hardcore medicine.  I stay curious, try to keep a sense of humor and risk being foolish, like now.  I blend in my passion for art and writing, displaying some of my art where I work.  I write and illustrate our educational content used in-office and online, often with an unorthodox—you might say weird—approach.

What I’m trying to say is: make your work your pleasure.  It’s more humanizing and more satisfying for both patient and doc.  It’s like escapism, but without needing to escape.  Remember, this is your journey.  Think of it as one great adventure novel and create a captivating plot with an awesome finish. 

Helping people in the capacity as we do as doctors, at times, still blows my mind.  Think about it.  We spent years and years studying the intricacies of the human body and mind, stretching and saturating our mental capacities, learning to fight disease and discomfort and death in ways many people cannot even fathom.  There’s no other profession like ours.  Yeah, the weight of responsibility can be enormous.  But we willingly chose medicine as our calling not because it’s easy, but because it is hard.

At this stage in my career, I still want to keep going.  I still think of it as adventure.  I still find the joy in our profession.  I still learn; I learn from all of you.  It’s been 27 years since I finished my residency, and I reflect back with a sense of satisfaction and pride--and with no regrets.  Though I look forward to one day retiring, I’m hesitant to do so, since what we do is so meaningful and so absorbing and so worthwhile, that I don’t want my professional journey, my marathon, to end.  That’s by choice.  Being a doctor is a part of who I am, imbedded in my DNA.  And hopefully it is with you.

So here's to your wonderful journey.  Throw into it all your heart and soul.  Along the way, stay curious and a bit foolish, and embrace the simple beauty of the world around you wherever you may be.  That world will open itself up to you, paving the way to opportunity and enriching experiences.  Stay daring and innovative; venture out and risk losing site of the shore.  Expect the dog poop along the way, and use it to your advantage. 

And through all the highs and the lows, the beauty and the ugliness, the success and the failures, your journey, from beginning to end, will be one glorious hell of a ride.

As an attending, a practicing doctor and as your colleague, I wish you the very best in your bright and beautiful futures.  Congratulations!

©Randall S. Fong, M.D.

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