Commencement Speaker
VCU School of Medicine
May 21, 2010
Thank you, Dean Strauss, and thank you, graduates, for this precious honor. Sharing this occasion with you and your families is a pinnacle of my career. With me today are my husband, Rich, whom you all know as the Real Dr. Costanzo, and our children Dan and Becca. Growing up, Dan and Becca were unofficial medical school mascots and had honorary status at class parties and even weddings. Chris Kontos carried them around on his shoulders at end-of-year pool parties. Adam Sarbin played Madame Adam, the fortune teller, for the kids at our annual neighborhood Halloween party. Steve Crossman, now faculty here and an honorary hooder today, rescued Dan from an un-cool life by teaching him to drive a stick shift car. Kara Fitzmaurice was Becca’s surrogate older sister when she lived with us for a month. When college time came, you vied for them to choose your alma mater. You have been our family and integral to our lives – our 30 years here are inseparable from you.
August 10, 2006, your white coat processional. New dresses, shirts and ties. Collective pride. Tears of elation and of relief. The journey to that day tested doubt and endurance. Parents worked two jobs so that you wouldn’t need to. Teachers believed in you more than you believed in yourselves. Siblings doted and bragged, “my sister is going to medical school.” All of them, the wind beneath your wings. You were inspired by Dr. Fowler‘s white coat address, but in the private moments, another voice spoke that was not easily quieted: Am I good enough? Will I pass muster? Yet, for the day, smiles of elation all around, doubts could wait. Thus began this phase of your long journey on a path of excellence and a life of worth.
And you did pass muster! You grappled with mechanisms of inconceivable complexity, until steam came out of your ears. You memorized the microbiology phonebook. You learned what it would mean to work harder than you ever had in your life and to end up in the middle of the grading histogram. Harder still, to accept that reality. By the end of M2, you owned a knowledge base greater than most have forgotten in a lifetime. In M3, you cared for patients whose array of symptoms defied the algorhythms laid out in textbooks. You came to rely less on black and white and to become comfortable living in the grey. You cared for patients whose human needs were more challenging than their physical needs. Patients considered you to be “their doctor” because of the time and attention you gave them. You suffered your patients’ suffering. As Dr. Fowler predicted at your white coat ceremony, you learned the meaning of empathy, which says: “I could be you, I understand what your disease means to you.“
During long nights of burning the midnight oil, you may even have questioned the career choice. Is it worth the sacrifices I am making? The even greater sacrifices that I will make? In those times of questioning, you learned to step back and to re-connect with the people and experiences that brought you to medicine in the first place – your sources of inspiration. In the end, the answer, informed by experience and tempered with reality, would still be “yes, it is worth it.”
You may not know that I have kept every note that every medical student has ever given me – flowery Hallmarks to hand made glitter cards to notes scribbled on napkins. They are all precious to me, but over these years, one stands out. It said not “thanks for teaching the nephron or those charts or the board schedule.” It said: “You remembered my name and for that you made me feel special.” Every one of us can identify with the feeling that student dared to express. State-of-the art buildings, national rankings, and excellent teachers are points of great pride. But what makes us feel connected, what makes us want to work harder, what makes our work matter is that someone notices us as individuals, values our needs, cares if we connected, cares that we worked hard, and cares that our work mattered. In the end, it is all about the small gesture.
In Henry Longfellow’s tale, Kavanagh, Mr. Churchill, the humble village schoolmaster, laments to Kavanagh, the brilliant preacher, about his unfulfilled longing for excellence. Kavanagh advised Churchill in this way: “that is not always excellent which lies far away from us……what is best lies always within our reach, though often overlooked. We can give to others only what we have.” Unconvinced, Churchill asked: “And if we have nothing worth giving?” Kavanagh replied: “No man is so poor as that. As well might the mountain streamlets say they have nothing worth giving to the sea, because they are not rivers. Give what you have. To some one, it may be better than you dare to think.”
As you move on to the next step in your training, once again, the voice not easily quieted raises those familiar questions: Am I good enough? Will I pass muster? Of course, the answer is yes. Experience with self-doubt, especially at times of transition, has taught us that doubt is familiar, doubt is healthy, doubt is normal. Questioning our own ability and worth, that inner voice, is the single most important, and irreplaceable, step in the honest effort toward excellence. That humble ability to question our own accuracy and judgment is more important than any outside evaluation could be. It resides within and the light is always on.
Today, May 21, 2010. New dresses, shirts and ties, procession of doctoral hoods. Tears of elation and relief. Sharing your pride today are the parents, aunts, uncles, and siblings who worried over every exam, sent care packages, and reminded about sleep and vitamins. Grandparents who bragged to whomever would listen and who trusted your medical knowledge more than their own physicians’. Spouses who made lunches to save money or 'just because' (and sometimes told you to make your own). Children who begged for just one more bedtime book, wanting more time than you had to give. In turn, you worried about your “worriers,” because that is who you are.
Today, your achievements are center stage, and we revel in them with you. In the quieter moments, I hope that you will also reflect on the kind of physician you wish to become and to renew your commitment to excellence. Opportunities for excellence will always be right at hand. Even in the simplest tasks of everyday work -- in meticulous attention to detail, in your devotion to always getting it right, in remembering the details of your patients’ lives, in going the extra mile for colleagues, and in every gesture of kindness.
Today, I graduate with you. It has been an honor to be a part of your dream. We are overcome with pride – for your accomplishments, your goodness, and your unlimited potential. Bless you and your families -- always.
Linda S. Costanzo
May 21, 2010