Thank you for that very kind introduction. Good evening faculty, staff, and honored guests. Aloha and welcome to the mothers, fathers, family, and friends of the incoming John A. Burns School of Medicine (JABSOM) Class of 2015. And to the Class of 2015…Alright you made it! Congratulations and welcome to medical school!
Students you are probably wondering why am I wearing a graduation cap at tonight's white coat ceremony? That's an excellent question! During your four years of medical school, there are two very special events that you will remember throughout your medical careers. One event of course will happen four years from now when you graduate from JABSOM as a doctor of medicine. This is the actual graduation cap that I had the privilege of wearing 17 years ago when I delivered the keynote speech to the JABSOM graduating class of 1994. In just four short years from now you too will be wearing a similar graduation cap with the traditional green tassel which signifies that you are a doctor of medicine.
The other very significant and memorable event during medical school is happening tonight. And that is the traditional white coat ceremony which first began in 1993 at the Columbia University College of Physicians and Surgeons. So tonight, we the faculty and staff of JABSOM, welcome you, the Class of 2015, into this honored profession and into this awesome medical school!
Students, up to this point, all of you have worked very hard and put in long hours of studying to get to where you are tonight. Not only are you the largest incoming class in JABSOM history, but all of you who are about to receive your white coats tonight were in the top 4% of the 1,600+ applicants who were hoping to be in the Class of 2015. Through your perseverance and dedication you have demonstrated your commitment in becoming a doctor of medicine. However up to this point, you have all worked very hard as individuals. Now, as you study to become a physician, you need to learn how to work well as a supportive and contributing member of a healthcare team. In order to provide excellent and comprehensive healthcare to your patients you will have to depend upon many other professionals on the healthcare team. If you think that during your four years of medical school training that you will become smart enough and skilled enough to provide excellent care for your patients all by yourself, you will fail your patients.
Let me use an example from my Emergency Department (ED). When a critically ill child is rushed in to the ED by the paramedics I sometimes literally only have a matter of seconds or minutes to figure out what's wrong with the child and to decide what life-saving interventions need to be done by the team. Despite my 19 years of experience in pediatric emergency medicine I cannot do this all by myself. I must rely upon a team of experts to perform what they each do best. The nurses, technicians, therapists, and clinical assistants all perform critical roles during a resuscitation. So the key concept for successful teamwork is to get a “team of individual experts” to function as an “expert team!” (Dr Inaba held his hands up with interlaced fingers to signify “teamwork.”) So please remember this idea of teamwork and don't wait until your residency to learn how to function as a supportive and contributing member of a team. Embrace the concept of teamwork from the very first day of medical school and you will have a much more enjoyable and much more rewarding experience as a medical student.
And speaking of medical school. (Six members of the class of 2015 got up from their seats and made their way to center stage for a demonstration. They each took out various props from Kyle's backpack to signify various elements of their medical education.) From day one of medical school you will be challenged to learn a lot of facts, and to learn how to use those facts to help you figure out what is wrong with the patient and what you need to do to fix the patient's problems. (Dr Inaba held up a magic black bag symbolizing the traditional doctor's black bag and showed the audience that there was nothing inside.)
You will be challenged to learn a lot of basic science materials such as anatomy and physiology in order to build a broad knowledge base. (Jennifer Nishioka held up a picture of an anatomy chart and placed it into the magic black bag)
You will have to learn how to interpret various diagnostic studies to help you sort through your differential diagnosis. (Raymond Machi held up a picture on an x-ray and placed it into the black bag.)
You will have to learn how to select various medications to treat your patient's conditions and you will also be expected to know all of the indications, contraindications, and side effects of each of those medications. (Jennifer Sasaki held up a pill bottle and syringe and placed both items into the black bag.)
You will have to master several technical and surgical procedures to help you treat your patients. (Sean Matsuwaka wearing surgical gloves held up a pair of hemostats and placed both items into the black bag.)
And finally you will also have to master several life saving skills if your patient requires resuscitation. (Nicole Shirakawa held up defibrillation pads and placed them into the black bag).
So with all of the knowledge and technical skills that you will be asked to master in four short years, my question to you, the Class of 2015, is this: “What should be your primary goal as a physician and what should be your promise to each and every one of your patients?” (Jennifer, Raymond, Sean and Nicole left the stage to find four poster boards each with one letter on the board. They then returned to center stage and arranged themselves to spell the word “C-U-R-E.”)
And the students have come up with the answer of “C-U-R-E.” An excellent and logical answer, but perhaps there is a better answer. Although during the next four years of medical school you will have to study very hard to learn how to figure out what to do to cure your patient's disease, pain, and suffering, please remember that curing disease, pain, and suffering should not be your primary goal and promise to your patients. Why? Because we cannot always cure a patient's disease. And we cannot always completely eliminate their pain and suffering. But that's okay, because our patients expect much more from us.
So what should be your primary goal and promise to each and every one of your patients? The correct answer is right in front of us. If you took one letter in the word C-U-R-E and changed it to another letter, then that should be your primary goal and promise to each and everyone of your patients. Medical student Nishioka please reach into the black bag of medicine and pull out the correct answer. (Jennifer Nishioka reached into the black bag held by Kyle and pulled out the letter “I.” Dr Inaba then pushed his hand through the bottom of the bag and turned it inside out to demonstrate that all of the items that the students had previously placed into the bag had now mysteriously vanished.)
The letter “I”? That's an interesting choice but not quite the letter that I was hoping that you would produce. (Jennifer Nishioka then consulted with the other students then attached the “I” onto the middle of the letter “U” in a horizontal orientation.)
Well students that still looks like the word “C-U-R-E” with a funny looking letter “U”. (Kyle then pulled out a magic wand from his backpack and showed it to Dr. Inaba and the audience.)
“Oh, medical student Watanabe, do I detect a touch of Harry Potter? Excellent!” (Kyle and Dr Inaba walked to center stage where the four students were holding up the poster boards. As Kyle waved the magic wand at the altered letter “U,” white streamers mysteriously appeared as a fountain from Dr Inaba's hand. The altered letter “U” then rotated vertically 180 degrees to now reveal that the “U” had changed to an “A”.)
Correct! Yes, your primary goal and promise to each and every one of your patients should be to CARE for them. So what do you need to learn in order to become a caring physician? Once again the answer is right in front of us. If you look at the word care, C-A-R-E stands for: COMPASSION, ACTION, RESPECT, EMPATHY.
COMPASSION: Treat all of your patients and their families with compassion and kindness.
ACTION: It is not good enough to just feel compassion and kindness in your heart and it is not good enough just to have caring thoughts in your head. You need to let your actions reflect that of a compassionate and caring physician.
RESPECT: Respect you patient's opinions about their illness and their treatment plans. And respect their families and respect their culture.
EMPATHY: Empathy is not the same thing as “sympathy.” Sympathy is merely feeling sorry for someone. Empathy on the other hand is being able to step into a person's shoes to truly understand what they are feeling and going through, and by doing so you will be better able to help and support that person.
Thank you students. Audience, how about a nice round of applause for my student volunteers: Kyle Watanabe, Raymond Machi, Sean Matsuwaka, Jennifer Nishioka, Nicole Shirawaka, and Jennifer Sasaki.
Speaking of “caring,” I would like to share a personal story with all of you. Thirty-two years ago before I left for college my pediatrician, Dr Herbert Nakata, cared enough to give me a piece of advice that he wanted me to remember throughout my medical career. So, during my freshman year at Creighton University, I went to the bookstore and purchased a poster board and some rub on letters and made a poster of what Dr Nakata wanted me to remember. This is the actual poster that I made 32 years ago and tonight I would like to share with you the advice that Dr Nakata wanted me to remember: (Dr Inaba held up the poster that he made 32 years ago and read the words on the poster to the class of 2015 and the audience.)
“In medicine always remember…FIRST treat the PERSON…and THEN…treat the disease.”
“First treat the person”…that is exactly what a caring physician should do by always demonstrating; COMPASSION, ACTION, RESPECT, EMPATHY.
So in closing I would like to humbly thank all of you for allowing me to share in this wonderful celebration tonight as your sons and daughters begin their exciting journey in becoming doctors of medicine.
And to the Class of 2015. (The entire Class of 2015 then stood up.) From day one of medical school and throughout your entire careers, please remember to embrace the concept of “TEAMWORK” (The entire class then held their hands up and interlaced their fingers to symbolize “teamwork”) and always remember to CARE for your patient as a PERSON and to CARE for them with (The class then each made a shape of a heart with their hands to symbolize “CARING and COMPASSION”):
COMPASSION
ACTION
RESPECT
EMPATHY
And now for the highlight of tonight's ceremony, the presentation of the white coats! Mahalo nui loa and please enjoy the rest of the night.
Note: This key note presentation incorporated various demonstrations by the students and a few magic effects by Dr Inaba. The italicized portions of this manuscript describes what the audience saw during these demonstrations.