Dean Hedges, Judge Burns, Mrs. Wong, as well as other distinguished guests, faculty, graduating medical students, family, and friends of the graduates, my wife of 48 years who is here today and I are deeply honored that I was selected to be the Robert T. Wong Endowed Lecturer and Keynote Speaker for the May 2014 John A. Burns School of Medicine (JABSOM) Convocation. Thank you very much. We will forever cherish this as one of the most significant honors of my professional career.
Little did I know when I started my interaction with the University of Hawai‘i back in 1975—managing research programs funded through the National Institutes of Health in Bethesda, Maryland—did I envision that I would be standing before you on this auspicious occasion. Like Dr. Wong, I saw great value in this medical school in the middle of the pacific to assist the National Institutes of Health (NIH) in accomplishing its mission—to uncover new knowledge that will lead to better health for everyone. NIH conducts research in its own laboratories; supports the research of non-Federal scientists in universities, medical schools, hospitals, and research institutions throughout the country and abroad; helps in the training of research investigators; and fosters communication of medical information.
Thanks to my dear friends and colleagues the late Dr. Fred Greenwood and his wife Dr. Bryant Gillian Greenwood, whom I met in 1975, we set about a course to facilitate the participation of the University of Hawai‘i more fully in the NIH mission. They both were internationally renowned reproductive endocrinologist. Fred spent considerable time working with Senator Inouye and his able assistant Dr. Pat DeLeon as he developed the Pacific Biomedical Research Institute into an internationally recognized institution. He played a key role in developing the foundation for launching both the University of Hawai‘i Medical School and Cancer Center. His efforts were key to making this such a special day for all of us.
Fred helped make me aware of the many needs of this community, especially evolving good health through biomedical research. Hawai‘i's favorite son—President Obama has stated many times, a healthy nation is a strong and prosperous nation. Through the many hours that Fred and I talked about the University of Hawai‘i, he convinced me that a special day like your commencement was a part of his vision and dream for you and the people of this great state. I was drawn to this university community because I sensed that there were many young minds, both faculty and students, that needed better infrastructure and other resources in order to develop their capabilities and launch careers in the biomedical sciences as you graduates are about to do.
Throughout my career at the National Institutes of Health I provided resources to the university through programs such as the Minority Biomedical Research Support (MBRS) Program, Research Centers in Minority Institutions (RCMI), Specialized Neuroscience Research Program (SNRP), Institutional Networks of Biomedical Research Excellence (INBRE), Centers of Biomedical Research Excellence (COBRE), Science Education Partnership Awards (SEPA), Clinical Research Education and Career Development (CRECD), RCMI Translational Research Network (RTRN), and the RCMI Infrastructure for Clinical and Translational Research (RCTR). These programs have played a crucial role in achieving the dream that Fred Greenwood and I dared to dream for the University of Hawai‘i Medical School.
As I thought about my message to the graduates, and I will admit sometimes I dreamed about the words that I wanted to leave with you, I woke up one night and it came to me that I was compelled to tell you… “continue to hold fast to your dreams, as so many before you especially your parents, teachers, and fellow students have done for so long.” Your becoming a physician is not simply a chance event but is holding fast to the dreams that your ancestors had for you. Without question your dedication, intellect, and persistence played a major role. However, I must tell you that your achievement after many days and nights of hard work, sometimes without time for sleep and perhaps proper nutrition, is directly related to the dreams that your parents and other ancestors have had for you for such a long time. I know this to be true since, like each of you, my career continues to honor my commitment with destiny. Like many of you, I did not start my life's journey with many creature comforts. I grew up in the government project with few if any books in the home and was the first in my family to attend college. However if there is one lesson that was instilled into my mind and my heart, it was that the greatest of all deeds is to be a servant of mankind. I came to this realization during my participation in the 1963 Martin Luther King March on Washington. In a sense this was crystalized in the words that I uttered during the first day that I taught freshman chemistry. I stated these words, “in my quest for immortality I must transmit my knowledge and lessons learned to my young. Through service to mankind, my spirit will live on forever—I will be immortalized.” The most significant words were “Service to Mankind.” As 2014 medical school graduates you have a tremendous opportunity to make this statement ring true for you and your ancestors.
As you leave these hallowed halls, I urge you to remember three things as you move quicker than you can imagine to pursue your life's dream of becoming a medical practitioner. These are: use your mind, now loaded with more information than you know what to with, right now, use your hands, and listen to your heart as well as your patients' hearts in making all decisions regardless of where your career path will lead you. The didactic experiences here at JABSOM have prepared you well intellectually for whatever career path you choose; further study, community medicine, the practice of a medical specialty, a clinical investigator, administration, chancellor of a medical school, surgeon general, or whatever. With advances in molecular medicine—genomics, proteomics, glycomics, and all other “omics” you have some important new tools for the prevention, diagnosis, and treatment of human disease. New medical IT devices, such as robotic surgery or software that helps a physician specialist detect a patient's tumor, and medical devices that can relay information to a physician's smart phone, and more IT is emerging. That will enable you to provide much needed care for patients here in Hawai‘i as well as many other parts of the world. With the very learned faculty and staff here at the JABSOM, I am confident that you are now expert in the molecular basis of human disease and you are fully aware of the fact that medicine of today is more and more becoming predictive, personalized, and preventive, the latter being especially true with the Affordable Care Act signed into law by President Obama. Your time now in medicine comes when scientific advances and technology play such an important role in medical practice of today. Not only has technology enabled the physician to keep electronic records of each patient, it has also provided medical devices such a robotic surgery, software that assists specialist to detect tumors, quantitative imaging used for diagnosing cancer, cardiovascular, and pulmonary diseases, as well as many other non-invasive diagnostic procedures. More and more technology is playing an increasingly important role.
With respect to listening to your heart as you deal with patients, you should listen to the heart felt expressions of your patients; you must become more familiar with some of the cultural traditions of many patients and be able to frame approaches for dealing with the health of diverse populations as you gain their confidence and develop a treatment paradigm. The AAMC has indicated that this lack of cultural competency contributes to health disparities or inequities in the United States. By listening to your heart and that of your patient it will open the doors to holistic treatment of each patient and will benefit the patient.
Let me end my message to you with a paraphrase of a quote from Dr. Elias Zerhouni, the 15th Director NIH 2002–2006: “Continue to hold fast to your dreams; they should be big dreams, full dreams, not half dreams. You know, it's very simple. You can't put a large dream in a small box. Well, you cannot put a full life in a small dream box. It was big dreaming inside and outside the box that led to the use of the body's own defenses to treat cancer, ie, cancer immunotherapy, taking advantage of the fact that cancer cells often have subtly different molecules on their surface that can be detected by the immune system. It took thinking big dreams outside of the big box to come up with this “cancer immunotherapy.” I challenge each of you as you go forth in pursuit of your life's dream to wonder how might the discovery of the Higgs boson or Higgs particle on July 2012 impact the future practice of medicine.
I urge you to hold fast to your dreams using your minds, your trained hands, and compassionate hearts.
Congratulations and God speed.