On Friday, October 8, 2021, UVM Larner College of Medicine Associate Professor of Medicine and 2021 Faculty Recipient of the Leonard Tow Humanism in Medicine Award Devika Singh, M.D., addressed the medical student Class of 2025 and a small gathering of guests at the UVM Ira Allen Chapel during the annual White Coat Ceremony.
Below, is her Humanism in Medicine Keynote Address and a video of her delivering it at the ceremony.
Your medical career will be full of stories and sagas that sometimes make for soulful strengthening. And other times, most times, may leave you feeling very quiet.
You will be asked to wear a white coat and put on your mask. But, I am here to instruct you to take down your mask sometimes.
Some things that you confront will force you to lean on my advice.
I met a patient that was diagnosed with HIV in 1989 while living in NYC when she was pregnant. She gave birth to an HIV-infected baby boy that died at age 5 from complications of AIDS. She has, since then, never been in a loving relationship with anyone. She explained to me one day how she was counseled on one contraceptive method while she was in her twenties—sterilization.
Your path ahead will be full of hard stories to hear. You will listen and be humble and honor folks that see more struggle than you can imagine. And, you will want to cry. A lot and often. And, that is okay.
Feel free to take down your mask sometimes.
Your path ahead will be full of hard stories to hear. You will listen and be humble and honor folks that see more struggle than you can imagine.
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And, you will want to cry. A lot and often. And that is okay.
Feel free to take down your mask sometimes.
A colleague of mine took care of a young man with congenital HIV.
This patient grew up poor and isolated here in Vermont but managed handfuls of anti-retrovirals on a daily basis by incredibly loving parents. Despite this love, he experienced challenges with addiction and grew weaker, thinner, paler over time. He eventually crashed between our hospital and one in Boston with complicated infections and landed at a weight of roughly 60 pounds before finally making a decision to stop all therapy and allow himself to die of AIDS.
Your path ahead will be paved with difficulty. You will face this path with fortitude and with fierceness. But, there are times when you may slow down and sometimes slip. And that is okay.
Feel free to take down your mask sometimes.
Your path ahead will be paved with difficulty. You will face this path with fortitude and with fierceness.
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But, there are times when you may slow down and sometimes slip. And that is okay.
Feel free to take down your mask sometimes.
There was a woman named Kate. She was an audio book narrator.
One day came a catastrophic rain storm. Her recordings were in the basement of her home that was quickly flooding. She rushed to pull out her equipment but the water rose more wildly than she could anticipate. She became trapped in the basement and submerged under water until finally a crew pulled her and rushed her to the ER.
Charlene, her partner of more than two decades frantically followed and was pulled quickly aside at the entrance of the ER and asked “are you family?” She did not meet the technical definition of family and was told to wait until a blood relative provided permission for her to be at the bedside of her dying partner.
Your path ahead is full of medical injustice. You will confront this with many tools – your vision, your vigor, your vitality.
But, there are times when medical injustice will overwhelm.
Your path ahead is full of medical injustice. You will confront this with many tools – your vision, your vigor, your vitality.
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But, there are times when medical injustice will overwhelm.
Some of these stories ended with positive twists.
Charlene Strong, partner of a well-known audio book narrator Kate Fleming, became one of the foremost LGBT advocates the state of Washington had ever seen. Her testimony and her activism brought legislation that acknowledged same-sex partnerships in the healthcare setting in Washington without dispute.
I shared with you some of my powerful lessons. So many moments when I had to take down my mask.
You will have many of your own stories.
What is in your future, you may be thinking? You will think that you have so much to learn when you start your clinical training. Yes, that is true. Overwhelming curricula with abundant deadlines and expectations. And you may have many moments when you do not meet your mark.
But that is another moment when you need to lower your mask sometimes. Go easy on yourselves. And lean on each other a ton. Your colleagues will act as your greatest allies and advocates.
One of the things that we are all observing on a global scale is young people’s and student activism.
Our world is quite literally relying on young people.
One of the things that we are all observing on a global scale is young people’s and student activism.
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Our world is quite literally relying on young people.
One thing that I have learned, in my many years since medical school, was that my best years happened when I was a student. It is your time to lead on agendas that demand social change and position you in places with communities in need.
And while we may teach you in classrooms and during problem-based learning sessions, do not necessarily look to your attendings to be models within medicine. Many of us shuffle along quietly with our heads held down in our medical paths. Our masks fully cover our faces and experiences.
We attendings are instructed to navigate a fee for service model of medicine and not one based on medical needs. We work within a medical marketplace that is more about ensuring hospital profits than enduring initiatives of wellness. We work within it and we lack a collective voice and instead spend decades steeped in medical burn out.
Our medical systems need some mending.
Make your own path. And make it an enduring and fulfilling one.
Students – please stand up and stomp for change.
You arrived here believing in stories that stir your soul. Do the work to direct some change.
We have finally arrived at a time where our larger society is exploding with expressions of social equity. Medicine needs to arrive there too.
Do not tolerate being witness to how some individuals, especially those that experience poverty, receive poorer medical care.
- Demand advocacy that tackles addiction and homelessness;
- Demand racial justice and sexual justice;
- Demand an end to HIV stigma;
- Demand a separation between reproductive rights and wrongs.
Speak your minds and march in force towards gender justice.
And when things remain static—and I hope they won’t with you in charge—when systems and structures sluggishly remain in place despite your every level of agitation, then I want you to push harder. Pull yourselves together again as allies and advocates. I want to see you organize, prioritize, and perhaps even unionize, to build systems that bring and bolster equity.
We need you to lead, my students.
I will be the first to follow.
And, while you are doing all of these things, I want you to be sure to take down your mask sometimes.
And when things remain static—I hope they won’t with you in charge—when systems and structures sluggishly remain in place despite your every level of agitation, then I want you to push harder.
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I believe times have changed from my graduation from HOWARD UNIVERSITY MEDICAL SCHOOL in 1965. We had np specific ‘short coating DAY ‘ AND HENCE NO SHORT white COATING SPEECHES. IN MY TIME WE JUST BOUGHT THE COAT AND PUT IT ON OURSELVES. With no set speeches to warn us of the field we were entering . We never had the type of speeches this article alluded to . .However i do believe that these topics as were mentioned at the event were very necessary and probably will serve the students well into their future. I will add that all pts should be considered in need of your help and you should be empathetic and never judge someone initially as you enter the exam room . Learn to listen well and not do much interruption when the pt speaks. Try to avoid mindfully judging from the onset . Congrats and welcome to the society .