Aaron Schwartz. Image Steve Lipofsky for HMS
It’s taken me 8 years to get used to the idea of graduating from The Harvard Medical School. Maybe it’s all the marble and columns. The majesty of this quad is a reminder of what we know from our experiences here—that practicing medicine is a sacred privilege. As students, when we stepped into the hospital, even if was 5 a.m. and we desperately needed coffee, we could sense a feeling like we were passing through an invisible curtain, into hallowed halls. We’ve had many transcendent moments here; learning in the anatomy lab, opening an abdomen in surgery, delivering a baby, sitting and talking with a dying patient about the end of life.
So let’s start with gratitude, first to the people who got us to and through medical school—those families and friends, early teachers and mentors.
Read more about HMS/HSDM Commencement and Class Day here.
You taught us from the beginning, not just to read but to love reading—and by extension to love truth and its pursuit. You gave us knowledge, and more importantly, the sense that knowledge matters—and even more importantly, the understanding that knowledge isn’t quite enough. You taught us to speak and to listen, to really listen. To care and to take care; to take risks; to take ourselves seriously but not too seriously. To seek comfort and to give it. To apologize and to mean it. To think that we matter enough to pursue our goals. We have only sailed here because you built our ship, you calibrated our compass and you were our port in the storms. So to the people here who made us who we are, please know this: You formed the bedrock of who we will be as doctors. All the things we learned in medical school, all the facts in our textbooks, all the pages in our libraries—these are just details compared to your lessons. And we are so grateful.
How we transform our successes into a life in medicine is up to us. Today we’ve earned our degrees. Tomorrow, let’s keep earning them.
And here at Harvard, we have had some fantastic support. From professors and residents who taught and mentored us, to cafeteria workers who served us, to deans running the place—many people were better at their jobs than they needed to be. Classmates befriended us. Patients allowed us to learn from their suffering, to poke and percuss them, to experience some of the worst and best moments of their lives.
All these people share in our success here today.
And we are so lucky to be so lucky. Often we’ve been the right people in the right place at the right time, with many opportunities others lacked. Had the dice rolled another way, this tent would be filled with a very different set of equally talented graduates.
As we move forward, how can we pursue a life in medicine that honors all these people and experiences? Here is my hope: substance over signaling.
To explain what I mean, I need to talk about economics, which my wife tells me to do when she is having trouble sleeping. Don’t worry, I’ll be brief.
The economist Michael Spence once had an insight. He realized that sometimes we pursue education to showcase our talents, not to improve our skills. Acing exams, getting degrees, building a nice CV—these things take talent and will make you look good even if you learn nothing useful from the process. This was Spence’s signaling model of education, and it won him a Nobel Prize. His powerful idea has made me question which aspects of my education are skill-building, and which are signaling.
We’ve learned many skills on our way here. But, we’ve also done a lot of signaling. Once, we took organic chemistry. More recently, for standardized tests, we spent countless hours memorizing facts that are accessible in seconds on our phones. I hope our future will be a bit different.
A resident once told me that MD actually stands for Makes Decisions. As MDs in residency and beyond, we will make countless decisions about how to spend our time and energy. Should I check on that scared patient again? Should I do a research project? Should I challenge my attending on a treatment decision? Some tasks will be about the real substance of doctoring—helping patients and learning to be great physicians. Some will be about looking good. I hope we will have the wisdom to see the difference and the courage to choose substance.
Yes, there will always be the next professional goal and hoops to jump through to get there. But: whatever our mission is, let’s not delay it too long. If we focus too much on climbing the medical hierarchy, we might forget what exactly we wanted to do when we achieved the status and autonomy we were seeking. We can start making the changes we want to see in medicine, and in ourselves, today.
As Harvard graduates, we are not underdogs. We can afford to look bad sometimes and to focus our efforts on what really matters. So, let’s us use our Harvard diplomas as a safety net, a suit of armor, something that allows us to be bold, take risks and blaze a trail. How we transform our successes into a life in medicine is up to us. Today we’ve earned our degrees. Tomorrow, let’s keep earning them.
Adapted from a speech given by HMS graduate Aaron Schwartz at Class Day on May 25.
