Page 21


A Connection of Values By Robert W. Decherd Remarks by Robert W. Decherd at University of Texas Southwestern Medical School’s Fiftieth Anniversary-Year Commencement, June 5, 1993. Journalists, like physicians, bear some unusual crosses. We’re expected to be on call 24 hours a day, 365 days a year. We think we’re overworked and often underpaid. The American public expects us to be right about everything, all the time. We’re constantly the target of high-profile plaintiffs’ lawyers and usually lose jury trials, only to win on appeal. We think we know a great deal, but don’t begin to know enough. This profile probably has a familiar ring to many of tonight’s graduates who are worried about what will be expected of you as doctors. American society has historically honored a free press and the art of medicine, but today both professions are confronted with profound. changes in how our fellow citizens perceive us. Yours is a wonderfully diverse, intelligent and able class of graduates. Some of you are almost my age while others have matriculated the gruelling course here directly from undergraduate school. You hail from as far away as Hong Kong and from Texas towns like Friona. Some members of the Class of 1993 are the first persons in their family to graduate from college, not to mention one of the most rigorous medical schools in the world. You have much to be proud of this evening, and I congratulate you all! So how do we proceed from here? How do we respond to our fellow citizens’ skepticism about us and our professions? While you and I may set our professional compasses by the philosophies of Thomas Jefferson and Hippocrates, America in 1993 is defined by corporate-like seminars on “Health Economics for Senior Students” and “Health Care Delivery Systems.” Our country is in transition again, and the pace of change is quickening. Even in the space of the single generation which separates you, Southwestern’s 1993 graduates, and myself, most modern-day assumptions about the social and political order of the world have been reshaped. As a society, we can only expect this reshaping to continue sometimes in rapid and unexpected ways. take, for example, your corner of the world. I suspect that many perhaps most of the preconceptions you had about practicing medicine when you were first drawn to this truly noble profession seem wistful when compared to the political/social reality you are about to encounter. You have a choice to make soon, early in your professional lives. Will you be overwhelmed by external forces that surely have the potential to discourage you from pursuing medicine in the classic tradition? Or will you decline to be cynical about these forces and help forge a new democracy indeed, a new order that, among other things, celebrates the Hippocratic tradition? In America, in the 1990s, we are trying to create a democracy that is unprecedented the first multi-racial, multi-ethnic, culturally and religiously diverse democracy in history. This diversity is greatly complicated by the vast differences in economic well-being among Americans. We know that the democracy that served the United States so well for 200 years has strained to accommodate this diversity since the end of World War II. But now, accommodation is no longer a viable response to the diversity that is American society. This new democracy should not be confused with President Clinton’s “reinvention” of government, or national health care reform.. Those initiatives relate fairly narrowly to a single, powerful idea: economic parity. The “re-invention” of democracy is a much more fundamental undertaking that will ultimately determine the values of our generations of Americans. These values are grounded in homes, schools, churches, synagogues, and institutions of all sizes and kinds throughout our country. In America, doctors still occupy a special niche. Your actions, intended and unintended, affect the people you encounter to a disproportionate extent. Your attitude, your optimism, your kindness, radiate in ways that are hard to measure and for you, sometimes hard to shoulder. Our country’s values Will affect your professional lives far more than any government system, even the system of health care delivery. Why? Because at its core, democracy depends foremost on the human spirit and this is the same force that defines the practice of medicine and medical research. In a democracy, everyone is entitled to individual freedom, the pursuit of happiness, open access to government, and yes, the best possible medical care. Regardless of political party philosophies or racial-ethnic-religious preferences among Americans, our collective values and standards bind us together as a people. These values are created beginning at birth, and you should never underestimate the unique role you will play as physicians in shaping the individual values of your patients no matter what health care system we adopt in our collective wisdom. Cynicism and detachment are viruses that can diminish, perhaps even destroy, our democracy. The sure antidote is an individual and collective determination to make certain that American society embraces as many of our fellow citizens your patients as is humanly possible. America is not utopia; yet it is we, you and I, who will determine how far the American dream can extend and how long our democracy can flourish. What drives this creative process is individual and collective values: right versus wrong, good versus evil, greed versus sacrifice, a commitment to the individual patient versus indifference. In the last instance, the system in which you practice medicine is far less important than how you practice: how you embrace each patient, how you accommodate the overwhelming strains on families in our country, how you balance economic priorities, how you comport yourself in trying and ethically-challenging circumstances. Like the profession of medicine, my world is addressing enormous change, occasioned also by societal forces and technology. For example, there is much talk today about the information superhighway and how it will affect even make obsolete traditional media. Yet my answer to this prospect is the same as my answer to yours: high standards, strong values, and ideas will distinguish those who succeed in our generations from those who fail. The technology by which news, information and ideas are delivered to readers and viewers is far less important than the quality of what’s delivered. For us in the press, our duty is to inform and educate Americans so that they can make the best possible judgments about the governance of our country and its institutions. As doctors and medical researchers, your duty is to provide the best possible health care while bringing to bear values that emphasize the equal worth of every patient you treat. The connection between my corner of the world and yours is, at the final hour, these values. As you commence from Southwestern, and join the swirling currents of modern American society, I admonish you to protect this sense of higher calling because it will E ustain you all. Thank you and God’s speed. Decherd is Chairman of the Board of A.H. Belo Corp., publisher ofThe Dallas Morning News. THE TEXAS OBSERVER 21