New M.D.'s Elaine Sapiro and Carolyn Greene, both cited for academic excellence, pause for a lemonade and a quiet conversation.
"Interning and residency are the best of times and the worst of times," said Henry Mankin, chairman emeritus of the department of orthopedics at Harvard Medical School, in his address. "You are doing something wholly sacred - what you and I were put on earth to do." The graduates, however, would be facing new difficulties, he warned, as a result of medicine's altered economics. "It's a managed-care world," he asserted, a world governed by a "conveyer-belt philosophy." He elaborated: "We now have same-day surgery, same-day discharge, and even same-day autopsies. It's difficult for patients, and it's difficult for physicians."
Mankin was followed by Kevin Vigilante, a Brown clinical associate professor of medicine and a former candidate for the U.S. House of Representatives. The subject of his speech was one close to his heart: the intertwining of medicine and politics. "Medicine is first and foremost an ethical endeavor. Our primary aim is to do good for the patient," he said. "Politics, as strange as it may seem in today's climate, is also ethical. Citizens reach their fullest potential in a healthy polis."
To illustrate, Vigilante described his attempt to suture a child's cut by the light of a twenty-five-watt bulb in a Romanian orphanage. "That boy will have a scar because the polis couldn't provide light," he said. Today, Vigilante's H.I.V. patients at Providence's Miriam Hospital are also afflicted with poverty, educational failure, joblessness, homelessness, teen pregnancy, and abuse. "All of these conditions are interrelated and reinforcing," he argued. "They lock people out of life, liberty, and the pursuit of happiness." And they are the reasons "physicians have a particular responsibility to be civically engaged."
Carolyn Greene, one of the few medical school graduates who did not attend Brown as an undergraduate, delivered the day's final speech. She recalled the second day of her clerkship, when she had to confront a patient with knee pain. "I think the patient and I were equally nervous," she recalled. "But look how far we've come in four years, from that first anatomy class when we wondered, where is the thorax?" Greene urged her fellow graduates to remember what life was like before they began the work of becoming physicians. "We've come so far," she said, "but hopefully not too far. When a patient is in intensive care, I hope we'll remember the family at the bedside."
And with that, the physician's oath was administered, and seventy-five graduates received their diplomas and emerged from the church as brand-new M.D.'s.