University of South Carolina – PLEDGE OF COMMITMENT CEREMONY SPEECH

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I greatly appreciate the invitation to be the speaker at your 2014 white coat ceremony.  It’s been quite a while since I’ve been back, and it’s bringing back some wonderful memories as well as creating new ones.

This is quite a significant occasion in your lives and I’m really impressed with this ceremonial recognition, especially since we didn’t have this opportunity thirty years ago.

I have very distinct memories of going to the uniform store and getting my short white coat, later adding a patch and a name tag.  I remember explicitly the feeling of becoming more of a member of “the team” and the sense of pride of being a member of this small but so important cadre.

The white coat represented so much to me personally.  I had beaten the odds.  I was in medical school, I had made it through the academic years and now most importantly, wearing the white coat was the badge that let everyone know I was now entering the final leg of what we all go to medical school to do – to have the opportunity to take care of patients with a very unique set of skills.  The coat truly gave me a much greater thirst for knowledge and sense of responsibility in patient care.  I couldn’t wait to start the clinical phase of medicine.  In essence, I’d spent a quarter of a century preparing to go through this doorway.

I first had the premonition or aspiration of becoming a doctor when I wrote a paper in 3rd grade about what I wanted to be as I grew up.  Years later, I watched my father create a business legacy for our family called Span-America which created medical products.  Most notably, the advent of something called egg crate foam.  Obviously, this has persisted and evolved into every facet of medical services regularly rendered.  I was hooked on becoming the penultimate member of this team.

With that said, I’d like to welcome you all as young peers into this still, most hallowed of careers – the practice of medicine.

Today is not just symbolic.  It is transformative.  This day is steeped with tradition and honor because of the significance in the progression of your life’s chosen professional development.

One of the major beauties of this aspect is that it is unending.  By your mere presence here, you have demonstrated a core principle of needing to learn and needing to improve.  Even though the relentless challenges in medicine can seem so daunting and overwhelming, it is in actuality a GIFT for your lifetime.  There is the need to always learn, always improve, and always research better aspects of one’s field in order to better help those who rely on us for their well being.  This quest is something that is effectively unmatched in any other professional endeavor.

Possibly the most important message I would convey today is to encourage all of you to constantly, doggedly, and persistently strive to be better – in all facets of your patient care.  This is not about competing with anyone but yourself.  Make no mistake – please compete everyday – with yourself.  Nearly everyone you deal with in your future is relying on you to do that.  Perfection isn’t necessarily expected, but your sincere effort to strive towards that goal will be.

This white coat is a universal symbol of that responsibility.  It is a reminder of the commitment to this profession, your colleagues, yourself and most importantly your patients.

Henceforth, your on the job training and apprenticing will have many tangible, intangible, objective and subjective challenges.  The learning curve will seem so steep at times you will think it insurmountable.  It is not.  Just keep diligently trying to always maximize your minimums.  Please remember that phrase.  Maximize your minimums.  If you always progress in this manner, improvement will be unavoidable in your quest to optimize your patients’ outcomes.

I know that I am repeatedly reminding you of the ever-present challenges and hurdles you will face these next 2 years and throughout your careers.  Sometimes just trying to keep abreast will seem like attempting to take a sip of water out of a fire hose at full force.

But, to quote a favorite speaker of mine, Steve Miraboli, “Sometimes the greatest things to come out of all your hard work isn’t what you get for it, but what you become for it”.

I know when I entered medical school over 30 years ago; nearly the entirety of medicine was different, especially from a business and political standpoint.  Physicians were generally thought of as individualists and hence were almost feral with regards to attempts at herding us into a “cog in the machine” approach by insurers and government agencies.

Changes in our system of medical delivery, having pressures to come under the control of hospitals and other institutional bodies are the means and methods of controlling some of that individualism.  Many, many more unknown changes in this regard remain on the horizon.

However, with the certainty of these changes, the remaining constant will always be the physician – patient bond.  It is the ultimate symbiosis.  You will rightly perceive you are helping them with their problems and needs.  But as time passes, you will recognize especially what they have done for you.

They will help train your mind, body and spirit.  They will cause you to understand the weight of responsibility that comes with this profession.  They will keep your curiosity piqued, your heart empathetic and hopeful, and every now and then, expose your humility and humble you.

Treat them with respect and kindness.  They trust you with their lives.  Earn that trust.  Work each day to be the best for them and you will better yourself.

Now being that this is a white coat ceremony – I would like to address the white coats.

Little did you know that you started out as a little bowl of cotton, you would eventually become the fabric to make up the esteemed, revered symbol that universally implies the privilege of being a doctor.

If it were only possible for you to recount these next two years – oh what fascinating stories you could weave.  You could recount with great camaraderie with preceding white coats, the trials and tribulations of your wearer, the incredible challenges, their maturation, the progressions of their career.  You could remember like those white coats before you, the marathon hours, the utility of your pockets for the handbooks, stethoscopes and digital devices and technology that advance the abilities of your doctor.  You could recall holding much needed but frequently worthless calories to be eaten on the fly.  Myriad of pens, pads and pencils.

You could recall the abundance of accrued stains of all sources over those years.  But mostly, you may enjoy most the sense of pride your wearer felt when you were draped across their shoulders.

I can remember watching my wife take special care of my white coat.  We were able to afford a washer / dryer by my third year.  She would several times a week stay up quite late and get up earlier than me in order that my coat was washed and pressed.  She still says how she took great pride in caring for that white coat.

The care and symbolism of purity of maintaining this white coat will later become an analogy of your practice.  You have earned the privilege of donning this coat.  Never forget that your medical career and practice will always be a privilege as well.

Today is a very special day.  Not just for you.  Look around you right now.  Family, faculty, friends, administration, some future patients.  All have an investment in you and your future.  Remember to express your gratitude for their contribution to you past, present and future.

Finally, you deserve the right to be here.  You picked this university, and this university picked you.  Be its ever faithful ambassador.

Maximize your minimums and as you don your white coat, embrace and nurture it, for what it symbolizes.  Your patients are counting on you.  Thank you again for your time.  May God bless you and your future.

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