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May 20, 2017
Salwa Choucair Lanford,
Freelance Writer/Editor
Dear Ms. Lanford:
In preparation for our interview, which is to be scheduled, I am sending you written answers to your questions. I have always found this to be an effective way of optimizing the interview time.
In this first paragraph, I have included an annotated list of links to articles which will add background to your questions and interview. This is more material than you will want but it will give you a foundation of my work as an alumnus and physician. The last article in this list must not be ignored.
All of this and more can be found at Southeast Medical Associates, LLP’s website: www.jameslhollymd.com. After this material, I answer each of your questions.
- Several Brief Affirmations of my work by other
Interview Questions
- Why did you choose to study medicine and how did you choose your specialty?
Growing up in the country with animals and a farm, all my life I wanted to be a veterinarian. I started college at Texas A&M at 17 years of age in 1961. That year, I became a Christian and thought that I would become a minister. Being from Louisiana, now that I was not going to study Veterinary medicine, I returned home to finish college. I pursued a degree in History and Philosophy. I met my wife as an 18 year old sophomore. We married in August after our graduate from college in May, 1965.
The first year of our marriage, we taught school and in the second, I completed a master degree at Baylor in History. By this time, I realized that I was not going to become a minister and began to complete my pre-medical courses for applying to medical school. I was very drawn to the new school in San Antonio both because of its innovative philosophy and because of its interest in students from other careers.
In medical school, I was drawn to internal medicine. I knew that my interest and skills were not geared to being a surgeon. Again, through circumstances – two young children and a family to support – practice emergency medicine for three years and then started a general medical practice. My decision was not the result of an epiphany, yet, in retrospect my career path would not have been possible if I had been a specialist or surgeon.
- What do you consider to be the major highlights in your career?
Being in solo, general medical practice for the first twenty-two years of my career, and being the founder and CEO of a multispecialty group for the past twenty-two years, the opportunity to participate in healthcare transformation, particularly in regard to electronic patient records, electronic patient management, population health, analytics and development a new and novel model of healthcare was the initial highlight.
However, being involved with UT Health San Antonio through the Joe R. and Teresa Lozano Long School of Medicine over the past seventeen years has been the most rewarding and fulfilling experience of my career.
The collaboration with my wife of 52-years, who was there from my pre-med studies at Baylor and from the beginning of my medical career forty-nine years ago when I was accepted to medical school at San Antonio has added continuity, joy and fulfillment to my career. Often when I will relate a story, she will say “Do you think that I wasn’t there.” As I write these words my heart is filled with the joy of knowing that she has always been there and still is.
My highlights always invovled people and my relationship with people. Dr. Carter Pannill my dean and friend of forty-eight years and my true mentor of what kind of doctor I wanted to be. Dr. Marvin Forland, my professor and friend who was a founding faculty member at UT Health San Antonio has added depth and value to my life and career. And, the person who accomplished what I thought was impossible which was to equal in my judgement, experience and affection the place of Carter Pannill. Dr. Bill Henrich, as Dean of the School of Medicine and subsequently as the President of UT Health, has met and exceeded every expectation of a friend, colleague and model as an educator, administrator, visioonary and role model. I can never repay the debt of gratitude I have to these three and many others whose life and light have guided my way.
- What has been the most difficult/greatest obstacle you have faced in your profession?
Difficulties and obstacles which appeared negative at the time have always in retrospect simple been the opportunities for growth and development. Without these stresses, I and my practice would not have grown, matured and flourished. The transition from medical record keeping technology of dictation and transcription was expensive and stressful. Started in 1997, twenty years later, it was obvious we would not be where we are in healthcare improvement and transformation without having gone through those difficulties.
The transitioning of medical practice from a solo or small group practice where the focus was always on the performance on the physician, to a “team based” healthcare delivery system was not easy and it was not initially intuitive but, again, in retrospect without that transition, what we are currently doing would not have been possible.
The third and most current difficulty is the movement from a volume-based, quantity of work payment system to a value-based, quality of outcome payment system has resulted in great financial pressures. However, as we are in our third year of significant difficulties, we are making transitions which will allow us both to participate in and to contribute to the “new technology, methodology and compensation” of healthcare delivery.
Athletic metaphors are fraught with inaccuracies and inadequacies, but the old training mantra, “no pain; no gain,” is true of our healthcare pilgrimage. Always, complexities and difficulties were the foundations of progress and advancement.
- How did your education at UT Health Science Center School of Medicine shape your career and prepare you for your success?
Having an educational foundation of social science, but with past experience and success in physical science, I was fascinated with biochemistry, physiology, and their applications to clinical science. The Krebs cycle, the Henderson–Hasselbalch equation, Acid-base balance were like magic to me. To this day I am fascinated by Adenosine triphosphate, energy metabolism and other practice applications of the basic sciences.
However, that science fades in significance in comparison with the character and caliber of the men and women whose passion for excellence and whose pursuit of the same burned into my soul a desire to be “like them.”
I remember how tremulously, Private James Ryan, now in his seventies, approached the headstone of Captain John Miller who gave his life that Ryan might live. In perhaps the most poignant moment in a great film, tears stream down his face, as Ryan plaintively said to his wife, "Tell me that I have lived a good life; tell me that I have been a good man." The sacrifice of others, imposed upon Private Ryan a debt only a noble and honorable life could repay.
Everyone owes such a debt to someone. The circumstances of that debt may not be as dramatic, but it is just as real. Years ago, a man asked me, "Aren't you proud of what you have accomplished?" I said, "I have worked hard, but what I am is a result of the contributions of many. And, there are at least seven turning points in which it is obvious that without the providence of God my life would have been much different. Proud? Yes, but more grateful and humble than proud. And, ultimately, I am responsible for the gift and honor of being a physician."
Traditionally, the professions were law, ministry and medicine. Yet, the nobility of all contributions to society makes each person's work worthy of celebration, whether in labor, management, service, manufacturing, homemaking, government, education, law enforcement, fire fighting, military service, or other. To isolate one endeavor for special consideration is not to diminish the value of any.
Nevertheless, there are few gifts as great as that of the opportunity to be a physician. The trust of caring for others has always been a sacred trust. It is a trust which should cause each person so honored to tremble with fear that he/she will not have lived worthily of that honor. It should cause us to examine our lives for evidence that we have been good stewards of the treasure of knowledge, skill, experience, and judgment which has been bequeathed to us by our university, by our professors and by the public which funded our education.
Reflecting upon thirty plus years of being a physician, I feel a deep sense of gratitude and of humility, out of which grows a sense of honor. Gratitude is founded upon the debt owed to so many who have contributed to making it possible for us to be physicians. Humility is founded upon the confluence of known circumstances, providentially orchestrated, I think, which allowed each of us the opportunity to be physicians.
What nobler calling could one have than the opportunity to collaborate with others in their quest for health and hope? The honor of trust and respect given by strangers, who share their deepest secrets, knowing they will be held sacrosanct, is a gift which exceeds any pecuniary advantage. The pursuit of excellence in the care of others is a passion which is self-motivating.
Passion is the fuel which energizes any noble endeavor. It is what makes a person get up early in the morning, work hard all day, and go to bed late at night looking forward to the next day. It is a cause of great sadness that today's society is so devoid of true purpose-driven passion. Many only vicariously experience passion through the eyes and lives of athletes, movie stars, or musicians. Ultimately, passion and purpose are what make life worth living. Those of us, who have been allowed the privilege of being physicians, can and should know the passion of a noble purpose every day of our lives.
Never has there been a time when a physician's knowledge and skills could have more positive impact upon the lives and futures of others. Never has there been a time when the role of the physician has been more defined by the concept of "team," in which each participant - doctor, patient, family, nurse, clerk and others - coalescence into a vanguard against illness and pain.
Now, well into the last half of my career, I do not crumble by the headstone of one who has given his life for mine, but I do stand humbly before the cornerstone of my life as a physician. I stand there grateful to God, to my parents, to my wife and children, to my UT Health San Antonio Long School of Medicine, to my professors -- among many, Drs. Pannill, Taylor, Wesser, Beller, Fuller, Forland, Gold, Sears, George, Persellin and Cander -- to medical school class mates who challenged me with their abilities and drive, and now to a new generation of leaders and mentors Dr. Bill Henrich, Dr. Carlos Jaen and many others.
Each of these and others unnamed have contributed and continue to contribute to the passion and drive borne of the honor of being a physician.
- Did you have a mentor at UT Health Science Center who made a strong impact on your career?
The following is my lengthy answer to this question. The below letter was sent to the Founding Dean of the University of Texas Health Science Center in San Antonio School of Medicine upon the occasion of the Dedication February 17th, 2012 of the Dr. and Mrs. James L. Holly Auditorium.
“Dr. Pannill:
“This note is being send over night special delivery because I want you to receive it before the ceremony Friday night. It will not bear my signature as I am at my office at 4 AM writing it before we leave for San Antonio. Both Carolyn and I read your note. I repeat its content here for the benefit of my children with whom I am sharing my note to you. You said:
“Dear Larry and Carolyn:
This is written in the hope you see it before the auditorium’s dedication as I want you to know that I truly will miss seeing you on the 17th.
It is my turn to be incapacitated by a rebellious hip, and I can barely make it to the table for meals. It pleases be beyond words that the auditorium is to be named in your honor, as you deserve this and so much more in recognition of what you have done for our medical school. That has always been my favorite of all of the building as it represents new thought and new loyalties more than any other. You will be pleased to know that Harry Ransom said as much in the Commencement Address in 1970. I’ll think of you in that context but wish I could be there to join you. Send me a picture please.
I still have my piece of the foundation of the school that you and 1973 gave me and I’m glad that you will receive the honor of the name of the building.
All my love and best wishes to you and yours.
Carter”
My letter to Dr. Pannill
“Dr. Pannill, in my belief system the most valued commendation that one may receive at the end of life is to hear from the Creator the words, “Well done, thou good and faithful servant,” that and the love and devotion of my wife, Carolyn, and of my family are the pinnacles of life. But in this life, there is no commendation or affirmation which I would rather receive that the one which you have given above and the one that my beloved School of Medicine will give me, my wife and truly my family on Friday night.
“Your person, personality, professionalism and example as a physician/professor remain my professional “north star,” which provides an unwavering guide to me every day as I press toward the transformation of healthcare in my little part of the world. I have your November, 1968 letter of acceptance to the School of Medicine Class of 1969, which Carolyn had framed for me. It is one of my proudest possessions and I shall carry it with me to the ceremony tomorrow. I still read it from time-to-time, and particularly value your signature on it.
“I remember the day that I received the letter. A classmate in a class at Baylor approached me and said, ‘I understand you are going to be a doctor.’ I had received no notification and he added, ‘The Pre-Med Advisor told me he received notification of your acceptance to San Antonio.’ Immediately, I knew where the letter was. It was in the mailbox of our previous residence. I left school and drove to Bosque Avenue in Waco, Texas. No one was home and I approached the mail box with some trepidation because I had already decided that I would commit a Federal crime, i.e., I was going to look inside the mail box which belonged to someone else. I did and there it was. It was a wonderful day.
“I don’t know if you remember where we first had close contact. I was leaving the school one afternoon and your secretary rushed out and said, ‘Larry, you have to go downstairs. The Dean is there for a meeting with students who are interesting a forming a health-careers program for Hispanic children.’ I said, ‘I have to go home.’ She implored me and I went. You and I, and the other student with me, were the meeting. As a result of that meeting, I ran the Health Careers Program for two years. It was that work which led you to send me with the School’s official representative to the Student AMA meeting in Los Angeles.
“At that meeting, a discussion was held about the AAMC planning to organize the Organization of Student Representatives (OSR) which still exists today. When the students were going to elect a Founding Chair of the OSR, I asked the student who was the official School of Medicine representative if he was interested in the job. He was not and I asked him if he minded if I volunteer. He did not. I spoke to the group and was elected the Founding Chair of the OSR. As a result, I was the Chair for two years, one during the organization of the group and the second during its first year of existence. The following appears on the AAMD website currently:
“History of my involvement with the AAMC
“In 1968, the AAMC passed a resolution calling for the development of mechanisms for student participation in the affairs of the AAMC. Two years later, the Assembly adopted an addition to the bylaws, creating the OSR. At the 1971 AAMC Annual Meeting, the OSR was created with the following intentions: to facilitate the expression of students' ideas and views, to incorporate students into the governance of the AAMC, to foster the exchange of ideas among students and other concerned groups, and to facilitate students' action on health care issues.
“Past Chairs 1971-1972 Larry Holly University of TX-San Antonio
“You will remember that as a result of this, I:
- Attended the AAMC’s 1970 Strategic Planning session at Earlyhouse in Virginia
- Attended the AAMC/AMA Annual Education Meetings in Chicago
- Served on the Executive Committee of the AAMC for two years, as voting member
- Was the first medical student to be a voting member of an accreditation site visit which was at Cornell Medical College in New York City.
- Voted on the accreditation of our School of Medicine twice while I was a student.
“It was a Chicago Education meeting that I led a meeting of all of the Deans of Schools of Medicine. You and I sat on the podium. The oldest dean of a school of Medicine was dominating a discussion session. I leaned over and asked you what I should do. You said, ‘Tell him to sit down!’ With consternation, I struck the gavel and said, ‘Sir, we must move on, will you yield the microphone.’ You said, ‘My goodness, Larry, I didn’t expect you to do that!’ The audience applauded. I shall never forget that. Your sense of humor and propriety were parts of what I so admired about you.
“It was my work with the AAMC and particularly in voting on the accreditation of our school which is the capstone of our relationship. I and all of the students were shocked when you were removed as Dean. We wanted your name on our diplomas and we raised a ruckus, but alone among the students.
“I knew that the reasons given by the Chancellor for removing you were false. He quoted the accreditation report about deficiencies of the School, when the actual reason was you would not fire Leon Cander, Chairman of Medicine. I knew he was not telling the truth because I had a copy of the accreditation report. I wrote a letter to the Chancellor and to all of the Regents, one of which was Lady Bird Johnson. I sent a copy to the San Antonio Express News expecting them to publish it as a letter to-the-editor. They did not. It was front page, 40-point type, ‘Senior Medical Student Challenges Truthfulness of Chancellor.’ I still have the original pin and ink original editorial cartoons created by Bob Dale for the paper.
“There was some discussion, I understand, of the Chancellor taking steps to boot me out of school. You offered to bring me to SUNY where you were going as Dean and to graduate me. The Chancellor gave up his plans when apparently his lawyers told him that I had the document which proved that what I was saying was the truth. The wonderful thing is that the truth is always the best defense.
“Dr. Pannill, your distinguished career should have concluded in San Antonio, but the foundation you laid has been built upon with integrity and excellence by your successors. I thought I would never meet another Dean who would be held in as high esteem by me as I hold you. Bill Henrich proved me wrong. When I met him, I thought that it was déjà vu (all over again, smile) I know you have met but he shares your vision, passion, excellence and drive. I am pleased that he became the President of the Health Science Center.
“I apologize for this long discourse, but I wanted to write these memories down. They are a rich part of my life and I want to thank you for them. It was in your honor that Carolyn and I gave our first contribution to our School. It will be our honor to continue to support the Distinguished Carter Pannill Professorship and to continue to enjoy the history we share.
“I still stand in awe of having the privilege of being a physician. As I watched and re-watch the movie Secretariat, I am moved almost to tears at the portrayal of his running of the Belmont Stakes. After a brief moment, he is no longer running to beat other horses. He is running for the sheer joy of running. His owner shouts to the jockey, “let him run, Tommy; let him run!!” The jockey was holding on for dear life. Secretariat is competing only with himself and his achievement was breathtaking.
“Dr. Pannill, our school, your school, the School of Medicine, like Secretariat is running toward a goal, not before imagined possible in South Texas. You started us; Dr. Henrich and many others carry the torch, and many of us in communities around the country run this race with the abandon and joy of a Medical-Practice Secretariat. When I stand tomorrow night in the auditorium paid for by my dear friend, Wayne Reaud, with my family, friends, professors, fellow students and colleagues, these are the thoughts I will have. You are central to them all.
“God bless you, my mentor and hero. Thank you for your love and care. It places wind under my wings. Remember what the trainer of Secretariat said the night before the Belmont Stakes, ‘Tomorrow, he is going to take wings and fly.’ Dr. Pannill, our tomorrow has come and many of us, having taken wings, which you helped fashioned, are flying! Amazing.”
- Are you proud of the direction that the School of Medicine is taking and how it's growing and moving?
I participated on the Selection Committee for the President of UT Health San Antonio when Dr. Francisco Cigarroa became UT Chancellor. That was when Dr. Henrich was elected President. I was thrilled with his selection; he had been Dean of the School of Medicine. I participated in the ceremony this year when the School of Medicine was renamed the Long School of Medicine.
My overwhelming pride in the direction the School of Medicine is taking is reflected in my letter to The Longs in which is said:
“The Joe R. & Teresa Lozano Long School of Medicine
“Joe and ‘Teri,’ although, it is contrary to my Southern heritage to address my esteemed elders by their first names, I do so because forever, not only will your names be associated with my professional roots at UT Health San Antonio, from which I graduated 44 years ago, but in a very real sense, the two of you will forever belong to all of us. It would seem awkward to address dear, beloved friends by a title, so I assume the familiarity of ‘Joe and Teri.’ And, while this letter is not an official statement of the UT Health San Antonio Joe R. and Teresa Lozano Long School of Medicine Alumni Association, it is a heartfelt endorsement by this alumnus who deeply loves our school.
“The watercolor and the link to the announcement of this event are included for the benefit of others who will have occasion to read this letter, as it will be posted on Southeast Texas Medical Associates, LLP website at www.jameslhollymd.com. And, it is another opportunity for Carolyn and me to revel in the event which you created on February 14, 2017.
“Rather than an announcement, this correspondence is Carolyn’s and my personal affirmation of our delight in the renaming of ‘our’ school with your names. As I mentioned to you, Mrs. Long, (it is difficult to ignore by training, so I revert to deferring to your station), I have not been a great fan of the naming of Schools of Medicine after individuals just because they give a large sum of money to an institution, but upon hearing of the renaming of my school in your names, I was instantly and completely delighted.
“As I have thought of my comment to you, I realized that your investment in UT Health San Antonio School of Medicine was not an investment in brick and mortar; it was in people. The Long Scholars program began your support of health education in South Texas twenty years ago. The lives which have been and which continue to be changed by your vision and philanthropy will bear fruit long after all of us are gone.
“Already, you are into the second generation of health care providers whose careers were launched by you. It will not be long before the second generation of Long Scholars will be a reality when the child of one of your current scholars is accepted into UT Health San Antonio Joe R. and Teresa Lozano Long School of Medicine. I can envision the third, fourth and tenth generation of Long Scholars caring for Texans and Americans for the next two hundred years. And, they will now be launched by the school named after you. This fact has to gratify and to satisfy both of you.
“The following is the water color which was executed by Ms. Kris Doyle, Senior Director of Marketing, at UT Health, in honor of the occasion of the renaming of the University Of Texas Health San Antonio School Of Medicine as the Joe R. and Teresa Lozano Long School of Medicine. (I enjoy typing that name.)
“This painting perfectly captures the spirit of the renaming event. The formal announcement can be read at: Longs honored, celebrated, applauded.
“The story of your philanthropy is told in part in this article as follows:
“’The Longs initially gave $1 million to UT Health in 1999 to support scholarships for medical students from South Texas, and they followed this with a transformative $25 million gift in 2008 to expand scholarships for students studying to be physicians, nurses, physician assistants or scientists.
“’The Longs’ new $25 million gift will establish a $1 million distinguished chair endowment for the dean of the School of Medicine; a $4 million endowment to support scholarships for students from throughout Texas who are attending UT Health and studying to be physicians; and a $20 million President’s Endowment for Faculty Excellence in Medicine.”
“Once again the emphasis upon people and upon the lives of people is the hall mark of your heart and passion. That is clearly reflected in this brief statement.
“Please notice that I have already changed my signature to reflect my pride and pleasure in our new name. ‘Thank you, seems so inadequate but, made sincerely and from the depths of my heart, its simplicity accurately reflects Carolyn’s and my personal gratitude to you and the gratitude of the great institution which bears your name.
“It is my hope that your lives are enriched in direct proportion to how much your lives have enriched ours. God bless you both.’
The growth and stature of the Long School of Medicine, the caliber of the faculty, staff, and students are parts of my pride in UT Health San Antonio.
Also, the fact that I would not be able to be accepted to the school if I were applying today and the hope that one day one or more of the grandchildren will apply and be accepted add to my awe and pride in the school.
- How important is it for alumni to stay engaged in their alma mater?
In 2016, I gave the commencement address at Northwestern State University. In that addressed, I answered this questions as follows:
“In this setting, I place before you four admonitions:
- Make a life
- Pay your debt
- Join a team
- Prepare to be measured
“Don’t forget that those of you who begin today, will tomorrow join those who are in their autumn years. Without thoughtfulness, you will then lament, ‘Where did the years go?’
“Make A Life
“Some of you chose a degree program in order to make a ‘living’; you may be at the greatest risk as your ultimate task must be the making of a ‘life.’ Sir Winston Churchill is credited with having said, ‘You make a living by what you get; you make a life by what you give.’ Sometimes, we are so focused on the former that we fail to achieve the later.
“’Giving’ is not just related to money. And, the impact of what you ‘give’ is not judged by the monetary value of the gift; it is judged by its cost to you. The commendation of the widow’s mite was not assessed by its economic value, but by the fact it was all that she had. Second, don’t wait until you have wealth in order to learn the art and the discipline of giving. Begin now, today, and maintain that ‘giving’ spirit as long as you live.
“When I was a sophomore at Northwestern State College, I was 18. I met a freshman who was shy and never smiled because his teeth were rotten and filled with cavities. I went to a dentist in Natchitoches and asked him what he would charge for a full-mouth extraction and to fit this young man with dentures. He gave me a price, and I asked if I could pay him the next summer when I would have a job. He agreed. I saw this young man’s life transformed and I took my first serious step toward making a “life” out of the “living” I earned that next summer.
“My wife and I taught school in Golden Meadow, Louisiana, our first year out of Northwestern. You would not believe how little we earned. The brightest young girl in my class was very poor and only attended school irregularly, but always made hundreds on tests. That year, Carolyn and I took Vivian shopping and bought her clothes including a red dress. That was 1965; in 2005, I was given her current address and I wrote her. I did not hear from her for a year.
“When her response arrived it brought tears to my eyes. She said, ‘It has taken me a long time to write back. I have had a difficult life but things are better now. My children are doing well. When I was in the seventh grade a teacher and his wife bought me a red dress. Was that you? I wore it until it fell apart. It is the only dress I ever had.’ Be a giver.
“Third, give more than your resources, give your heart. A smile, a greeting, or a handshake often will do more for others than money. Recently, I entered a nursing home where as a physician, I have a prominent role. As I rounded a corner, I encountered a new janitor. I greeted him, stopped and shook his hand. This small gesture, done as a genuine affirmation of the value of our joint contribution to the health of the residents, was a great gift to him. But, as always, the giver receives the greatest return.
“Opportunities to be a ‘giver’ will abound in your life. Several years ago, my wife and I were having lunch at our regular Friday-noon restaurant. A new waitperson took our order and served us. She did a poor job but we were kind to her. And, though her performance did not warrant it, we gave her a gratuity. Ten days later, we saw this young women walking down the mall. She had two children with her. They looked at their mother as if she were the Queen of England. I said to my wife,’ Aren’t you glad we were kind to her?’ Always treat people the way you would hope they would be treated by their closest loved one.
“Pay Your Debt
“In his Letter to the Romans, the Apostle Paul counseled, ‘Owe no man anything but to love one another, for he that loveth another hath fulfilled the law.’ Throughout your life, you will incur “a debt of love.’ In the context of your college graduation, you may say, ‘But I paid my tuition and my room and board, how could I owe a debt to Northwestern State University?’
“First, your education cost more than you paid and second your professors gave you more of themselves than their salaries required. In addition, your fellow students invested in your life each day of your education. In the past four years, you have accumulated a ‘debt of love’ toward the institution and the individuals of NSU.
“A year ago, when my wife and I endowed a Distinguished Professorship and two scholarships at NSU, I asked the University not to announce the cost of the endowments. Why? Because more than a gift, they were installments paid upon a ‘debt of love’ owed for fifty years and because the example was for others to be motivated to become ‘givers,’ and the monetary value of the endowments was not the point.
“In a moment, we will return to these first two principles but let me tell you that there is an alumnus of NSU, and it is not me, who has a vision of soliciting two pennies from every person in the United States of America for healthcare. What value could that be, you ask? It costs more to mint a penny than the face value of the penny. If two pennies cost two and a half cents to produce, how can a gift of two cents be a gift of value? It is the power of geometric progression. The reality is that if everyone gives two cents a day, $1 billion dollars a year would be collected.
“Join A Team
“In his remarkable book, The Fifth Discipline, Dr. Peter Senge, addressed the value and the power of a team; he said:
“’Most of us at one time or another have been part of a great ‘team,’ a group of people who functioned together in an extraordinary way - who trusted one another, who complemented each others’ strengths and compensated for each others’ limitations, who had common goals that were larger than individual goals, and who produced extraordinary results. I have met many people who have experienced this sort of profound teamwork - in sports, or in the performing arts or in business. Many say that they have spent much of their life looking for that experience again. What they experienced was a learning organization. The team that became great didn’t start off great - it learned how to produce extraordinary results.’
“If you are fortunate, you will be part of many teams in your life - some will come and go, some will be for a lifetime. Your marriage will be by its nature a team, as will your occupation but today, you join a team which is called, ‘The Alumni of NSU’ or ‘The Long Purple Line.’
“If, as an alumnus, you contribute to this new team your commitment to ‘making a life,’ ‘paying your debt’ and ‘being part of a team,’ you should begin by giving $10 a year to the NSU’s student fund. By being a part of the alumnus team, If you add $10 a year, in ten years you will be giving $100 dollars a year. Continued until you are here for the fiftieth anniversary of this commencement, you will have given $4,540 to your university. You will never have missed this money, just as today Carolyn and I do not miss the cost of dentures or the cost of a red dress.
“If today’s almost 1,000 new alumni do the same as you, in fifty years, the Class of 2016 will have contributed $4,540,000 to NSU without accounting for interest. And, what if, the vision and commitment you begin today spreads to other classes, some older and some newer than yours? The potential is enormous. That is the power of a team.
“Prepare to be Measured
“Those of you here today for your fiftieth anniversary are in the autumn of your life. Remember the lyrics to The September Song, ‘But the days grow short when you reach September, When the autumn weather turns the leaves to flame.’ Do you remember, the spring time of your life; yes, it was just yesterday? It is in the autumn that we look back and measure ourselves.
“How do you prepare to be measured a success? Winston Church said of himself, ‘Every night I try myself by court martial to see if I have done anything effective for the day. I don't mean just pawing the ground; anyone can go through the motions; but something really effective.’ A life cobbled together with days of ‘effectiveness will produce a life of worthiness.
“Tremulously, in Saving Private Ryan, Ryan, now in his seventies, approached the headstone of Captain John Miller who gave his life that Ryan might live. In perhaps the most poignant moment in a great film, tears stream down his face, as Ryan plaintively said to his wife, ‘Tell me that I have lived a good life; tell me that I have been a good man.’ The sacrifice of others, imposed upon Private Ryan a debt only a noble and honorable life could repay.
“Everyone owes such a debt to someone. The circumstances of that debt may not be as dramatic, but it is just as real. Years ago, a man asked me, ‘Aren't you proud of what you have accomplished?’ I said, ‘I have worked hard, but what I am is a result of the contributions of many. And, there are at least seven turning points of my life, in which it is obvious that without the providence of God my life would have been much different. Proud? Yes, but more grateful and humble than proud. And, ultimately, I am responsible for the gift of life given to me.’
“At the conclusion of the 1969 version of Good-bye, Mr. Chips (the earlier version was 1939 for which Robert Donat won the Academy Award for his role as Mr. Chips. He won over Clark Gable in Gone With the Wind) Peter O'Toole reviewed his life with the following words:
"’I wonder if we were any use to them at all? I mean, What did we ever teach the boys? How to parse a sentence in ancient Greek? Was that going to help them today? Was it?
I suppose we did teach them one thing; how to behave to each other. Yes, we did try to teach them that. Is there anything more important to teach people than that?’
“Then walking from his lodgings to Brookfield School where he had taught for 64 years, remembering his beloved wife who had been killed in WWII, he sang:
"’In the evening of my life I shall look to the sunset and a moment in my life when the night is due, and the question I shall ask, only you can answer, 'Was I brave and strong and true, like you?'"
“When Kent Keith was a sophomore at Harvard College in 1968, he said,
“’I saw a lot of idealistic young people go out into the world to do what they thought was right, and good, and true, only to come back a short time later, discouraged, or embittered, because they got negative feedback, or nobody appreciated them, or they failed to get the results they had hoped for. I told them that if they were going to change the world, they had to really love people, and if they did, that love would sustain them. I also told them that they couldn't be in it for fame or glory. I said that if they did what was right and good and true, they would find meaning and satisfaction, and that meaning and satisfaction would be enough. If they had the meaning, they didn't need the glory.’
“To encourage students and to sustain them in their journey, Keith wrote the Paradoxical Commandments of Leadership, which I commend to you today. They are:
- People are illogical, unreasonable, and self-centered. Love them anyway.
- If you do good, people will accuse you of selfish ulterior motives. Do good anyway.
- If you are successful, you will win false friends and true enemies. Succeed anyway.
- The good you do today will be forgotten tomorrow. Do good anyway.
- Honesty and frankness make you vulnerable. Be honest and frank anyway.
- The biggest men and women with the biggest ideas can be shot down by the smallest men and women with the smallest minds. Think big anyway.
- People favor underdogs but follow only top dogs. Fight for a few underdogs anyway.
- What you spend years building may be destroyed overnight. Build anyway.
- People really need help but may attack you if you do help them. Help people anyway.
- Give the world the best you have and you’ll get kicked in the teeth. Give the world the best you have anyway. (© Copyright Kent M. Keith 1968, renewed 2001)
“These realities may sound cynical but they are only a reflection of reality. Take these Commandments, make them your own and you will live a life of service and significance.
“Congratulations and bon voyage.”.
- In what direction do you see the medical profession moving in the future?
- What advice would you give current medical students?
Make sure that the opportunities in medicine for personal gain do not “steal your heart” from why you became a physician. Keep your passion in focus. Make sure that the “story of your life” which will be told slowly but which will seem to appear quickly is the one you desired and designed. Let the values of your life be your compass so that you do not stray from your course, so that you can arrive at your destination proud of what you have become.
You face the challenge and opportunity of a time when medicine has a greater capacity to change the lives, the health and the future of those to whom you minister your art than in any previous generation. You have a virtual tabula raza upon which to record your contribution to the history of your college and to the advancement of your profession.
As you consider your opportunity and your obligation, picture the scene portrayed in Chariots of Fire, when the Master of Caius (pronounced "Keyes") College, University of Cambridge, speaking to the Freshman Dinner in 1918, said:
"I take the war list and I run down it. Name after name, which I cannot read and which we that are older than you cannot hear without emotion. Names which will be only names to you, the new college, but which to us summons up face after face, full of honesty, and goodness, zeal, vigor and intellectual promise. The flower of a generation, the glory of England, and they died for England and all that England stands for and now, by tragic necessity, their dreams have become yours.
Let me exhort you, examine yourselves; let each of you discover where your chance of greatness lies; for their sakes, for the sake of your college and your country. Seize this chance, rejoice in it, and let no power or persuasion deter you in your task."
By graduation, you of the new School of Medicine will have laid the foundation for who you will be as healthcare professionals. You will have collected the experiences and the memories which will guide you in your quest for greatness.
Hopefully, you will have learned the skills of collegiality and collaboration which must supplant the competitiveness which has brought you this far. It is sage counsel to admonish you: Seek greatness; not conquest; seek greatness; not surmounting others. It is in building and in participating on a healthcare team, and in working for the success of that team that each of you will have the greatest chance of greatness. Greatness is not defined by winning or by wealth; greatness is defined by honesty, goodness, zeal, vigor and of intellectual promise fulfilled in service to others.
There are few gifts as great as that of the opportunity to be a physician. Caring for others has always been a sacred trust. It is a trust which should cause each person so honored to tremble with fear that he or she will not have lived worthily of that honor. It should cause us to examine our lives for evidence that we have been good stewards of the treasure of knowledge, skill, experience, and judgment which has been bequeathed to us by our university, by our professors and by the public which funded our education.
What nobler calling could one have than the opportunity to collaborate with others in their quest for health and hope? The honor of trust and respect given by strangers, who share their deepest secrets, knowing they will be held sacrosanct, is a gift which exceeds any pecuniary advantage. The pursuit of excellence in the care of others is a passion which is self-motivating.
Passion is the fuel which energizes any noble endeavor. It is what makes a person get up early in the morning, work hard all day, and go to bed late at night looking forward to the next day. It is a cause of great sadness that today's society is so devoid of true purpose-driven passion. Sadly, many only vicariously experience passion through the eyes and lives of athletes, movie stars, or musicians. Yet, ultimately, personally-experienced passion and purpose are what make life worth living. Those of us who have been allowed the privilege of being physicians, can and should know the passion of a noble purpose every day of our lives.
Never has there been a time when a physician's knowledge and skills could have more positive impact upon the lives and futures of others. Never has there been a time when the role of the physician has been more defined by the concept of "team," in which each participant - doctor, patient, family, nurse, clerk and others - coalesce into a vanguard against illness and pain.
The tale is not yet told as to whether you and I shall have been faithful to this great honor, but it is a responsibility which motivates me daily and which must motivate you. To our university and to all who have contributed to the honor of our being physicians, we say, "Thank you."
As a student, you begin accumulating a debt of gratitude which can only be repaid with your excellence in service to all who seek your medical counsel or care. As the President of the Alumni Association of the UT Health San Antonio Long School of Medicine, I welcome you; I applaud you and I admonish you. Under the School’s leadership and of the faculty, your school will make you proud - it is your responsibility between now and the end of your career to make your school proud.
- What is your favorite part of being a medical doctor?
As I approach 74 years of age, in my 44th year of “being a doctor,” I am grateful for a “calling” which allows me to be a learner, teacher, advocate, giver, provider and change agent. My favorite part of being a medical doctor is that my role as a student and a servant will end only at the end of my life.
I also am grateful for having been given a platform from which to advocate and effect change in my life, my family, my community, my country and my profession.
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