Another Great One From a Great One

Today I was witness to another surreal experience - that sheer joy of seeing your students walk down the academic aisle as certified experts in their fields. Five years ago, they were timid, nervous young ones dressed in their white med school uniforms or in their disheveled and messed up scrubs, trembling in front of you during the dreaded Medicine morning endorsements. Now, they're proud and confident board certified internists ready to take on new challenges in their professional lives, living up to society's great expectations and their own secret dreams.

Looking at them all dolled up in their cocktail dresses and barongs, I can only be sure of one thing - that these bright and idealistic ones will one day be leaders in their fields. They will not fade away into oblivion. Instead, they will shine. They will one day teach me, one day heal me, like they already have during the past years.

I would like to believe that I was a part of their growth. Even just a miniscule part is good enough for me.

Anyway, enough for this stage mom drama factor.

Many days ago, I found out that the graduating batch chose my favorite teacher as their commencement speaker. Predictably enough, despite the many tasks lined up for the morning, I brought my thick folders of unread ECGs to the PGH auditorium to watch the great man speak. I have already posted several of his speeches in this blog, one of which, was touchingly mentioned in his latest speech.

Seeing your students graduate is definitely one of life's greatest joys. Hearing your teacher tell a huge crowd that a simple gesture you did long ago created a huge impact - oh boy, that's really something, isn't it?

But I'm not gloating here (LOL!). The point of this post is this speech. Here is another great one from a great one.

Here goes...

Dr Mejia, members of the exe-com, fellow ordinary faculty members, graduating fellows and residents, dear parents, relatives and friends, good morning!

Let me start by thanking the graduating residents of 2010 for inviting me to speak to you today. As you know, I am inherently shy about public speaking. But because I love you all, I decided to accept.

The first person I asked for advise on what to say was my worst critic –my wife. This is what she said – “Tony, you’re always so abstract when you speak to graduates. Why don’t you give them concrete advice this year? Something they can actually use?”

Medyo nasaktan ako sa kaniyang pananalita. Hindi naman ako abstract e. To which she said “Of course you are! You cant help wax philosophical. The other year you advised them to put big rocks in their jars! What does that even mean?”

Tapos may pahabol pa siya. “And for God’s sake, don’t do another SMS survey this year. Gasgas na yan!” She was reading my mind. Napadala ko na yung survey e. So i had to ignore the results. My apologies to my respondents.

But OK. Fine! I can do concrete. And no surveys, everything will be from me. These past 2 days – I have been crafting this just for you, so here they are - 5 tips on what to do after graduation to help you overcome the obstacles hurled your way. I hope you find them useful.

Tip #1. Volunteer for 1 thing you like to do, and then say no to one thing else that you don’t. The curse of the new grad is being the youngest. You’re the trash bin for things that nobody wants to do. But this is the best way to lose yourself. One way to avoid this is to find that thing that you have passion for - that thing that gets you up in the morning, raring to go - and take it. For me, it’s teaching and seeing patients. Administrative work is a chore so I try my best to be needed at the front lines!

The philosophy is simple. If you fill your time with things you like to do, then your bosses lose elbow room to make you do things you don’t like! You can do this as early as the job interview. Don’t ask what they need. Be proactive! Tell them what you’re excited to do. If you do this successfully the first time, the next time will be even easier. Soon, you’ll find yourself doing the things you love, and as Confucius says, “you will never have to work another day in your life.”

Tip #2. Revive a hobby from your younger days and protect time for it. Get a life. You need to do something other than medicine, to be good in medicine. Most of us give up the things we like to do during training, but we need them to revive our tired spirits, and keep us excited about work.

Now note that I said, pick one from your younger days. Hobbies developed during adult life tend to be expensive – gambling, golf, collecting jewelry. Avoid these. Kawawa ang patient. Also note, you need to protect your time for that hobby. Otherwise you will lose it again.

Maybe you used to have a sport? A musical instrument you’ve stopped playing? I am sure there are many things you can find. For me, it has been badminton, biking, ballroom dancing, reuniting my closet band, maintaining my aquarium, even doing carpentry. I used to play with my children, but now only my dog wants to play with me. Ok lang yan. There are many things to choose from. But for starters, just choose one. Whatever it is, keep it raw and simple and real – just like in your younger days.

Before I say tip #3, let me do a quick survey. How many of you were born after 1970? Well here’s tip #3 – if you were born after 1970, computerize your clinic. The more I have second thoughts about this tip, the more convinced I am that it’s important advice. It doesn’t need to be expensive or complicated. It doesn’t need to be perfect right away! Even a word processor will be a tremendous improvement over paper files. Computers have an immense capacity to improve patient care – from decision support systems, to medical news alerts, and drug-interaction checkers. If you don’t understand how, then you’re sinking into the abyss of antiquity.

The most common objection i have encountered is that computers can interfere with eye contact and interpersonal interactions. This is a tired excuse. If you want to improve eye contact, stop texting and throw away your cellular phone.

Tip#4 – get sick. I don’t mean to wish you bad health here. Don’t get too sick. Just sick enough to need to see a doctor. It’s a different view from the other end of the stethoscope. The tests and treatments you thought were so cheap? They’re not so cheap when you’re the one paying! The 3 hour wait outside? That isn’t as short as you thought. And the personal touch we hardly talk about– it’s more important than we thought. For many physicians, including myself, getting sick is a life-changing event. You will be kinder, more caring, and more understanding, more discriminating in your prescriptions. You’ll probably start scheduling your patients, and making sure you see them on time!

And finally tip #5. Write something about yourself that you can read again after several years.

Write about your dreams and aspirations. I don’t mean buying a house or a new car. These aren’t aspirations, they’re earthly desires. Write about your beliefs and principles. What you consider right and wrong. Or what kind of doctor you want to become, and what you want to avoid becoming. Every now and then when you feel tired and lost, or even when you just feel nostalgic, let the young enthusiastic graduate in you wake you up to remind you of who you really are.

Now I never really did this intentionally. But last year, Jean Alcover showed me something I wrote in 1986 during the graduation ceremonies of the department of medicine. I was speaking on behalf of the graduating residents. Just to give you a background, I was reacting to a challenge by then secretary Mita Pardo de Tavera, that internal medicine had become irrelevant because 90% of the population couldn’t afford the care that we were trained to give in PGH. Here was the reaction of this 28 year old graduate, and I quote:

“The lessons in PGH by far outweigh the misery. And among its lessons, the lesson of relevance is both the simplest and most fascinating. Think about it. The hospital doesn't run on equipment, for there is hardly any, and it certainly doesn't run on money. This hospital runs on the hearts and minds of men and women who have chosen the art of healing ... And healing well. It runs on patriotism and love for god and fellow man. The day these ideals become irrelevant, will be the day our dreams and aspirations end. On that day, the philippine general hospital will cease to exist.”

This was true 25 years ago. And it still is true today. The paragraph reminded me about why I was here, and what I wanted to do. It came at a time when I was tired and low and it didn’t make sense why I was wasting my career in a low income setting. Then almost right away, everything was ok.

So do yourself that favor. Write something. Even a short paragraph. Blog it, post it in facebook or tweet it. But also print it so it can’t be lost. It might rescue you in the future when your path is going astray. Sometimes, the person you need to talk to is yourself.

In summary, these are the 5 concrete tips that i offer:

#1 Volunteer for something you like to do, and say no to some thing that you don’t. Build your career around things you love to do, and you will never have to work another day.

#2 revive a hobby from your younger days, and protect time for it. Keep it raw and pure and simple and it will restore some years you’ve lost.

#3 if you were born after 1970, computerize your clinic. It doesn’t need to be complex and expensive. It doesn’t even need to be perfect at once. A word processor can do wondrous things.

#4 Get sick. But not very sick. See what it’s like at the other end of the stethoscope. Then use that experience to enrich your practice.

#5 Write something about yourself, to read when you’re down and troubled. Let the person you are today, remind you later about what you really want.

There are many more things I wanted to say, but I didn’t want to make such a long speech. Lets just meet in facebook and discuss! There you can like or unlike, agree or disagree. My ID is Tony Dans!

Now, my wife was right, I cannot help but wax a little philosophical too. So allow me to leave with a final word of advice. Your training here wasn’t just meant to make you good practitioners or teachers or researchers. You were trained to be something more – to be leaders. Maybe we didn’t train you by words, but certainly by example from your illustrious faculty.

Have no doubt about it. You will be called upon to lead. And as leaders, you are not designed to maintain the status quo. You are designed to challenge the establishment. Because of this, two things become most important in your career. First, the ability to see what’s wrong, even when no one else can. And second, the strength and courage to fight for change. In the process, some people will dislike you, because change is never easy. Some may even hate you. That’s OK. Just remember what Colin Powell said – if everybody likes you, you must be doing something wrong. You don’t have to hate anyone back. With the 5 tips I propose, you can begin this process of change. And note that none of them began with others, – they all begin with you!

So, on behalf of the faculty of the department of medicine, we bid you farewell and god speed. We are immensely proud of all of you, and what you have done during your stay. You are like our children to us. I think I speak for all faculty members when I say - thank you for touching our lives.

Now go out and change the world - one step at a time, always starting with yourself. Remember what a great philosopher once said: ”do or do not. There is no try.”

Thank you!

Keynote speech by Dr. Antonio Dans. UP-PGH Department of Medicine Graduation. February 17, 2011.