University of South Carolina Medical School Commencement
May 9, 1997
President Palms, members of the Board of Trustees, honored guests, distinguished faculty, families and members of the 1997 graduating class of the University of South Carolina School of Medicine.
I consider it a tremendous honor to address this class of 1997. There's a good chance my accident-prone family will have to call on your services one of these days!
Dr. Eddie Floyd on your esteemed Board of Trustees knows what I'm talking about. He was the one who stitched me up when I nearly took my head off with that barbed wire fence last year!
So I hope you learned your lessons here well. Because your governor could need you one day...especially now that I've moved up to the Harley!
But as much as I may need you, South Carolina needs you more.
South Carolinians need strong, compassionate, ethical men and women to care for their children, tend to their dying, heal their sick, cure their disease.
Such is the mission you've dedicated yourself to all these long years of study and toil: to become exemplary doctors, researchers, caregivers.
Congratulations. Today you can finally wear that banner proudly. The sleepless nights and the endless sacrifice have finally paid off.
It's like that line from the movie Tommy Boy, when Chris Farley is trying hard to defend how long it took him to get through school. He says, "A lot of people go to college for seven years." And David Spade says, "Yeah, they're called doctors!"
Class of '97, you've paid your dues. You've demonstrated a level of commitment few can duplicate...and you've reached a pinnacle that few have topped.
This is rightfully the proudest moment of your life.
But this is also just the beginning. Ahead of you awaits a succession of awesome moments that are going to make this one pale in comparison.
Along this journey in medicine, some of you will be fortunate to help a sick child run and play.
Some of you will feel a heartbeat fade on your surgical table, only to help it beat strong again.
Some of you will bring into the world new life. And some of you will be there as life ends.
The enormity of life and death all eventually comes to rest in the doctor's hands. You have answered one of life's most noble callings. And this afternoon, you will take an oath, vowing that whatever house you enter will be for the good of the sick and the well to the utmost of your power.
It is my hope that you will return to the home from which you came: the great state of South Carolina...so that your fellow South Carolinians will be touched by all you've learned here at USC.
You've been fortunate to be part of an institution so singularly focused on issues like preventive medicine and community services. I challenge you not to leave that commitment behind once you walk out these doors. Carry it with you where ever you go. Make that mission your own.
Consider the needs in rural communities across our state. All 46 counties in South Carolina are considered either totally or partially medically underserved. 39 counties are designated Federal Health Professional Shortage Areas. Sixteen counties don't have a single obstetrician. And even though we're spending $100 million a year on medical education, families still have problems with access.
At the state level, we're making public health a top priority. We're pleased to see infant mortality going way down and immunization rates among the best in the nation.
We're also attracting heavy-hitting industries that are helping families prosper...not the least of which are global leaders like Roche Carolina in Florence. Their advances in pharmaceutical R&D should be making your work easier, too!
But plain and simple, improving health without doctors and researchers is impossible. We need folks willing to go into primary care, into preventative care and certainly into rural areas where families need you most.
Of course, I issue that call to support rural health not just for you, the graduates. It goes out to the university as well, to the administration and the faculty.
USC's School of Medicine needs to continue to draw in applicants with ties to small communities and to keep emphasizing rural training every way possible.
We've got some great examples of rural doctors to learn from. There's Dr. Oscar Lovelace in Prosperity, South Carolina...population of about 1,100. He already has a practice there of seven family doctors, delivering over 200 babies a year.
Dr. Lovelace is recruiting some of the brightest residents and med students in the country to do rotations in Prosperity...teaching first-hand how rural medicine works.
Then there's Dr. Stoney Abercrombie in Greenwood. He started a program that's been sending residents on medical mission trips for the past eight years.
Residents have improved the lives of thousands of patients worldwide, from Peru to Russia to Vietnam. And Dr. Abercrombie's program is now a national model.
The world is crying out for the knowledge and healing power you have gained...and so are families right in your own backyard.
Too many South Carolina families can't afford to stay well, so we all end up paying when they get sick. Sick children can't learn. Sick parents can't work. And families become dependent on taxpayers for far more than the cost of Medicaid.
You can do a lot to help us control and reduce that tax burden by helping us provide the poor with good preventive and primary care.
We just kicked off a public-private partnership to help us extend Medicaid coverage to all children in families with incomes up to 133 percent of the poverty level.
It's the single largest expansion of Medicaid we've ever seen in our state, covering 50,000 more children than before. They'll have the benefit of preventive care and a medical home so they won't move in and out of coverage as their eligibility changes.
But we need good doctors willing to take on these children...to extend the reach of your practice to include those who need you most.
Of course, this entire Medicaid expansion could be in jeopardy, depending on what happens with federal budget talks.
We're going to keep monitoring the situation very carefully, especially the discussion of DISH funds. Cuts there could have a devastating effect on rural practices especially, and it's something we'll be keeping a close eye on in the coming days.
No question: the challenges facing us in 21st century health care are great, both as policy makers behind the scenes and physicians on the frontlines.
We're also dealing with a whole new set of challenges since those first med students graduated from here back in 1981.
1981 was the year that AIDS was first identified in our country. Now it's the number one killer of Americans ages 25 to 44.
Managed care has exploded. Since 1980, health care outlays have quadrupled to $1 trillion. Technology has mind-boggling implications. Surgeons can operate thousands of miles away from their patients. And even though notions like cloning used to only be in sci-fi movies, a sheep named Dolly reminds us that reality is quickly catching up with imagination.
But one truth will always remain in the field of medicine, no matter how radically times change or how quickly the world turns.
The doctor will forever be the healer, the caregiver, the hope provider, the hand holder, the bedside comforter, the life sustainer.
As new physicians, you're blessed to be able to serve in the best medical system in the world...the most advanced, the most head-spinningly progressive.
But graduates of this Class of '97, you are not called to be robots operating within that system. You are not meant to be medical machines.
If your job was just about saving lives, there are plenty of medicines and high-tech procedures that can do that without you. That kind of cold clinicalness requires nothing of our souls.
I challenge you today to become the kind of doctors who not only save lives, but doctors who change lives...as you commit yourself to the nobler calling of medicine: a life of service. The Jewish philosopher and physician Maimonides wrote a prayer that's become one of the great ethical lights on the duty of the physician.
"I am now about to apply myself to the duties of my profession," he prayed. "Do not allow thirst for profit, ambition for renown and admiration to interfere, for these are the enemies of truth. In the sufferer, let me see only the human being."
One of the former presidents of the American Medical Association, Dr. Joseph Boyle, tells a story from his days as a young doctor back in the '50s.
An elderly man had been admitted to the hospital with cancer of the windpipe. He could barely speak or even breath.
Dr. Boyle gathered around the old man's bed with a team of interns, residents and med students. He started discussing with them, probably in some very clinical terms, the man's diagnosis and the sort of treatment they would offer.
Dr. Boyle was in mid-sentence when he felt a hand reach up and tug on his sleeve. The old man was straining from the bed, and he started pulling Dr. Boyle down close...away from all the eyes staring at him from the bedside.
He held the doctor just close enough so he could whisper in his ear these words..."Please doctor, remember there is a man inside."
That is your challenge for the journey: to remember the soul inside...to honor your gift and the oath you will take today...to seize every opportunity to heal both the bodies and hearts of your fellow human beings.
South Carolina families desperately need that brand of care...and we thank you for willingly answering that call.
Congratulations and God bless you.