HMS Physicians and Dentists Awarded Degrees

'Focus on one patient at a time,' says Dean Daley to the Class of 2023

Daley in regalia speaking into microphone

HMS Dean George Q. Daley addresses the class of 2023. Listen to the speech. Image: Steve Lipofsky

Thank you, Nicky and Ahmed. Students, faculty, staff, family, and friends, good afternoon and welcome! It is a true honor to be here with you today.

If I seem out of breath, it’s because I rushed over here after attending our son’s graduation from Harvard across the river. So today is especially meaningful for me, and I have a deeper appreciation for your special day here on the Quad.

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Class of 2023, let’s take a moment to acknowledge this triumphant milestone: You are graduating from Harvard Medical School and the Harvard School of Dental Medicine, and you are becoming doctors!

After all the time you’ve spent in the classroom, lab, and clinic; after weathering a once-in-a-century pandemic; and after making lifelong friendships that have sustained you through it all, you are now embarking on the next phase of your professional journeys.

As a class, you hail from Egypt, Cuba, Italy, Mexico, Nigeria, and all across the United States. These are just a few of the countries you call home.

Among your many areas of study, you’ve investigated the role of the BRCA gene on sensitivity to drugs for ovarian cancer, and you’ve explored the history of health disparities in rural communities. You’ve documented the treatment of immigrants held in ICE detention facilities during the COVID-19 pandemic and you’ve conducted vaccine information sessions at Massachusetts prisons and jails.

These are all impressive accomplishments, yet right now, you may be asking yourselves: With all the challenges facing medicine and health care, how am I, as an individual, going to funnel my accumulated knowledge and experience into making a tangible difference as I go forward in my career?

Focus on one patient at a time, and let them be your guide.

I give you the following charge: Focus on one patient at a time. Ask yourselves how can I best serve the patient in front of me.

We can take inspiration from the careers of two revered Boston doctors — the late Paul Farmer, who was Kolokotrones University Professor and chair of our Department of Global Health and Social Medicine, and Jim O’Connell, president of the Boston Health Care for the Homeless Program and an assistant professor of medicine at HMS.

Paul and Jim approached their work from two different perspectives, one global, one local, but they were both, at their core, doctors trying to relieve suffering — and both were driven by a desire to do well by their patients, one by one.

Many of you already know of Paul’s legendary work. As the co-founder of Partners In Health, he believed that the cost of medical treatment was never an excuse for a paucity of care. He spent countless hours in Haiti, Peru, Russia, and Africa, proving time and again that seemingly intractable problems in global health equity could indeed be solved.

Jim O’Connell personifies the same values and aspirations as Paul did, but here in Boston.

In 1985, Jim put off — and eventually abandoned — a prestigious oncology fellowship to pursue a year of clinical work serving the unhoused. That one year serving the homeless is now going on 38. In addition to running some 60 clinics within various homeless shelters around Boston, Jim rides in a van at night that delivers food, hot drinks, and blankets to those living on the streets, and throughout the endless winter invites the most reluctant to seek refuge from the cold.

Like Paul, Jim has treated horrifying medical ailments that most of us will never confront in our careers — frostbite, gangrenous limbs, maggot-infested wounds, grotesquely metastasized cancers. And Jim’s patients live on the streets of Boston — in the shadows, sometimes literally, of some of the best and most prestigious hospitals in the world.

Under Jim’s leadership, the Boston Healthcare for the Homeless Program has become a paragon of success nationally, a beacon of pride for the City of Boston, and the subject of journalist Tracy Kidder’s wonderful new book, Rough Sleepers. I highly recommend it.

Although both Paul and Jim are extraordinary medical humanitarians, the good they’ve done rests in their accumulated ordinary deeds — soaking the coarsened feet of homeless patients, for example, as Jim often did in his early years as their doctor, or treating a child with multidrug-resistant tuberculosis, as Paul did again and again in Peru and Haiti.

And for both Paul and Jim, their singular focus on serving the patient in front of them evolved into two distinct, scalable models of care delivery —one global, one local — that have transformed medicine as we know it.

You, too, will accumulate ordinary deeds. But from the ordinary, done over time, relentlessly, generously, faithfully, you too will accumulate an extraordinary body of work.

You, too, will accumulate ordinary deeds. But from the ordinary, done over time, relentlessly, generously, faithfully, you too will accumulate an extraordinary body of work.

If you are a basic scientist, take note that your research has a critical role to play in caring for individuals, too.

I offer the work of my colleague Stuart Orkin, the David G. Nathan Distinguished Professor of Pediatrics at HMS, as an example.

In the early 2000s, Stu began to investigate the biological mechanisms that regulate the switch from fetal to adult hemoglobin, which occurs in red blood cells shortly after birth. Stu theorized that the answer might lead to new treatments for sickle cell disease.

Sickle cell research has been tragically underfunded, even though it affects 100,000 people in the U.S., most of them African American, as well as 20 million people in the rest of the world. Sickle cell anemia shortens life expectancy by decades, and the painful episodes that characterize it are so excruciating they’re called crises.

Over the past two decades, Stu and his trainees have demonstrated that blocking the BCL11A repressor effectively “turns back the clock,” restoring fetal hemoglobin expression in adult red blood cells and countering sickling.

This revolutionary discovery in basic science has spurred a renaissance of sickle cell research. We’re now on the brink of FDA approval for a CRISPR-based cure for this devastating disease.

But we must be vigilant when it comes to such advances, especially as we enter a golden age of biotechnology. Recall the COVID-19 vaccines. They were a major triumph of modern bioscience ... but the lack of equitable global vaccine distribution was a major failure of public health. If we’re not mindful, sickle cell therapies could have a similar fate, remaining inaccessible in regions like sub-Saharan Africa, where millions suffer from the disease.

As we hustle to create the therapies of tomorrow, we must remember that real people are awaiting those therapies all over the world — real people with families and hearts and ambitions. Make it your business, no matter your specialty, to keep those individuals top of mind. If you can’t see the patient in front of you, you can imagine them, and let them be your guide.

Class of 2023, we are so proud of your accomplishments and we are in awe of the promise for the future of medicine that you represent. In your quest to alleviate suffering for all, you will have many HMS role models to look to — leaders whose work runs the gamut from basic science to on-the-ground care delivery. All of us here at HMS believe in you, and we can’t wait to see what extraordinary changes transpire as a result of your many accumulated ordinary deeds. Thank you, and congratulations again!