‘What I Know Now That I Wish I Knew Then’

This is one in a series of stories about Harvard Medical School and Harvard School of Dental Medicine graduation celebrations for MD, DMD, master’s, and PhD graduates.

At a time of great change and immense challenges for the health and well-being of people around the world, the skills and abilities of doctors have never been more important.

That was one of the main messages keynote speaker Sanjay Gupta conveyed to MD and DMD graduates of Harvard Medical School and Harvard School of Dental Medicine at their Class Day ceremony on May 25.

“Your ability to do some incredible things in the world at a time when we desperately need it has taken on a greater sense of urgency,” Gupta said, referencing a popular American superhero film when he added, “You are the new guardians of the galaxy.”

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Much has changed since Gupta graduated from the University of Michigan Medical School 30 years ago, said the Emmy award-winning television medical correspondent, who is also a bestselling author, a practicing neurosurgeon, and associate chief of neurosurgery at Grady Memorial Hospital in Atlanta.

Thanks to major breakthroughs in biomedical science, Gupta said, we can now treat and even cure diseases that were barely understood when he was in medical school, but he added that many of the people who need the care most don’t have access to treatments that could save their lives. The United States spends more than ever on health care but life expectancy is falling, he said.

“You have the ability to change that,” he told the graduates. “You have the capacity to restore the faith, to reverse some of those tragic trends, and reassure people who are going to come to depend on you.”

For the past 20 years, Gupta said, as a physician and a storyteller, he has kept a focus on the stories of patients and the story of the scientific process, which he said are key ingredients for the story of humanity itself.

“So many years later,” Gupta said, “I’m still learning every day from those stories.”

Learning from patients

Gupta recalled one evening when he was on call and a 93-year-old man was brought into his emergency department. A scan showed that the patient had a bleed in his brain.

“Being completely honest, I thought maybe he was too old to undergo an operation,” Gupta said.

But then he started to hear more of the patient’s story. The man was incredibly healthy, still an avid runner, and was even still working part-time as an accountant. It was also revealed that his brain bleed occurred because he fell off his roof after taking a leaf blower up to clean off leaves. The physicians decided to operate to decompress his brain.

“I was pretty nervous to see afterward how he was going to wake up,” Gupta said.

He wondered if the surgery had given the patient more time to enjoy life, or would only give him a life of prolonged suffering.

But when Gupta entered the recovery room, the patient was reading news on his smartphone, his reading glasses adjusted over his bandage.

Gupta asked about the accident and wondered if the surgery had inspired any insights from the patient.

“He said, ‘no more blowing leaves off the roof,” Gupta recalled.

“It taught me a lot,” Gupta said, reflecting on the power of learning from patients’ stories when making decisions as a physician.

Among other important lessons Gupta said he’s learned since graduating medical school were several simple truths, such as the importance of being kind, of always trying to keep fixing problems, because sometimes the attempts can be transformative, and the value of trying to become wise rather than simply smart.

He advised the new doctors to learn from their defeats and to embrace even the smallest wins. And finally, he counseled, be sure to cherish lifelong friendships.

The Class of 2023

Overall, the HMS and HSDM Class of 2023 included 167 MDs and 35 DMDs, along with 133 PhD, and 279 master’s degree recipients. The master’s and PhD programs held their own ceremonies. Forty-three of the newly minted MDs also received PhDs or master’s degrees or are candidates for their additional degrees in May 2023.

Edward Hundert, HMS dean for medical education, opened the ceremony, introducing the ceremony’s student moderators, Ahmed Ahmed and Nicky Joseph, both members of the MD class of 2023. Ahmed and Joseph, in turn, introduced the co-moderator from the Harvard School of Dental Medicine, Paulina Miller.

“Graduates, learning and growing alongside you has been the joy of a lifetime,” Joseph said. “We have watched all of you shine in your strengths, embrace moments of growth, become fuller versions of yourselves, and uplift one another along the way. Each and every one of you has led in ways that are unique and authentic to you, and for that, we are in total awe.”

Faced with remarkable challenges during their years in medical school, Joseph noted that his fellow graduates responded by creating remarkable solutions: they led efforts to build a national student response network for COVID-19, advocated for abortion care access, helped to establish mobile COVID-19 vaccine clinics to improve access to crucial care, served on health equity roundtables at the White House, helped create a climate change curriculum at HMS, and increased accessibility to voting through the health system.

“The list goes on, and I am constantly in awe of what our classmates have done,” Joseph said. “I can only imagine what they will do in the coming years.

“You all have a gift to give.” Ahmed said. “You could make us see how the world could be, in spite of the way that it is.”

The graduates acknowledged that their years at HMS and HSDM were challenging times, but said that they are looking forward to putting their skills to use.

“I think for all the med students, it’s been a long journey, having trained through a pandemic, so I think coming out the other end even more motivated to help people has been a great thing,” said MD grad John-Anthony Fraga, interviewed at the Harvard Commencement’s Morning Exercises in Cambridge.

“I’m excited to start my journey in residency,” said Fraga, who will be entering an anesthesia residency at Stanford.

The Class of 2023 includes students from all over the United States, plus 50 other countries, with graduates representing each of the Earth’s inhabited continents.

MD grad Yanet Gomez and her family came to the U.S. from Cuba when she was 11 years old.

“It’s been a really difficult journey to get here,” she said. “I keep thinking about my parents seeing me walk across the stage.”

“I think we’re all just so privileged because of the opportunities that we’ve had, and I’m really excited to serve my patients and keep in mind where I came from while I do that,” she added.

Great promise for future of medicine

In his remarks, William Giannobile, dean of the Harvard School of Dental Medicine, noted that members of the graduating class were active in a great variety of different kinds of activities, all focused on ways to make a difference for their patients and their profession.

In addition to being actively involved in basic, translational, and clinical research initiatives, curriculum design, and sustainability efforts, he said, dental students also supported efforts to improve diversity and inclusion, community outreach, mentoring promising young students considering dental school, and creating oral health literacy materials in many languages to reach historically underserved communities.

“It is clear to me through their actions, the Class of 2023 sees a future where they can serve as advocates and leaders and use their voices to lift others,” Giannobile said.

HMS Dean George Daley, in his closing remarks, challenged the graduates to do their best for their patients, one patient at a time.

Daley said he personally draws inspiration from the accomplishments of two legendary Harvard physicians: the late Paul Farmer, who was Kolokotrones University Professor and former chair of the HMS 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.

Farmer was known for transforming notions of the kinds of health care that could be possible for people living in clinical deserts in the rural districts of countries like Rwanda, Haiti, and Peru. O’Connell has revolutionized care delivery for the unhoused in Boston, who are also among those most overburdened with disease in the city, Daley said.

“Although both Paul and Jim are extraordinary medical humanitarians, the good they’ve done rests in their accumulated ordinary deeds,” he said. “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.”

Daley noted that Farmer’s and O’Connell’s transformational work was built on a singular focus on serving the individual patients in front of them.

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

Images: Steve Lipofsky