It’s time for graduating medical students to celebrate their dream

A transcript of the Loyola Stritch School of Medicine 2017 commencement speech, Saturday, May 20, 2017.

Angela Jiang: Good morning! As the class vice president, it is my pleasure to welcome Dr. Pamela Wible to our graduation. Dr. Wible is a family physician and a pioneer in the ideal medical care movement. After completing a family medicine residency and working in different family practices for over ten years, Dr. Wible found that neither doctors nor patients were happy with a system that felt much like an assembly line. She decided to follow her vision of practicing medicine in a way that could please both herself and her patients, and invited her community to design their own ideal clinic.

At Stritch, one of the first things we learned was how to treat the human spirit. It’s fitting for Dr. Wible to join us on this momentous day, since her clinic pretty much sounds like a spa for the human spirit. She offers relaxed office visits, house calls, and she has never turned anyone away for lack of money. With her patients, she wears glitter, throws Pap parties, and delivers balloons and homemade soup to patients during house calls. Since her clinic opened in 2005, Dr. Wible’s innovative practice has inspired hundreds of other physicians to create ideal clinics nationwide.

In addition to her devotion to changing health care, Dr. Wible is also passionate about physician mental health. She operates a suicide hotline from her home, and believes in nurturing the invincible human spirit in us all. For her contributions to physician mental health, she was named as one of 2015’s Women Leaders in Medicine by the American Medical Student Association.  Dr. Wible’s commitment to promoting mental health and innovative approach to health care has led to Ted Talks, two bestselling books, features in textbooks, and interviews by CNN, NPR (listen to award-winning NPR interview), and many other news outlets.

With someone so successful in pursuing her passions to lead our beginning as physicians, we are lucky to have Dr. Wible here to speak about how we can keep following our dreams as we leave Stritch. Please join me in welcoming Dr. Pamela Wible.

Dr. Pamela Wible: Wow! I feel like a proud mother getting ready to watch 151 doctors take their first steps. It’s so exciting!

When I found out that I “topped the list of inspiring individuals” nominated by your graduating class, I was shocked. I quickly accepted the nomination and invitation by Dean Brubaker, and then hid her letter and didn’t tell anyone (even my mom) because I was pretty sure once you all figured out what I actually talk about, I’d be disinvited. I’ve actually been disinvited as a featured speaker at a special event here in Chicago by the largest medical association in the country when they discovered that I speak on doctor suicide. So thank you all for having me. I promise my commencement speech is not on suicide.

Life is a continuum between self-destruction and self-actualization, between losing and living your dream. Today we are all gathered here for one reason — to celebrate your dream.

A dream that many of you have had before kindergarten. Back when your parents wondered why you kept doing surgery on your dolls and applying wet toilet paper casts around your Barbies. Some of you felt the calling in high school. You saw yourself on mission trips, in emergency rooms, and maybe one day in your own little clinic back home. These images of healing those in greatest need, of saving a life, energized you and filled you with joy, the same joy you felt when you got your acceptance letter and on your first day of orientation. And you feel it again today. Your dream — sometimes forgotten — still fuels you. And it follows you. Even if you ignore it.

Love, hope, dreams are fluffy words in medicine. Not easily measured or reimbursed. Not valued like GPAs and board scores. Yet — in the end — your dream is the only thing matters. It’s what tethers you here on Earth.

I know. I talk to a lot of hopeless physicians who have given up on their dreams. They search for exit strategies at conferences on non-clinical careers for doctors. They grumble about the “government” and the “system.” Some even take their grief out on you “lazy” new doctors. You “special snowflakes.”  They warn, “let’s not turn medicine into some coddling group hug where anyone with a brain can get through.” Why do they lash out at you? Maybe because they see the sparkle in your eyes, they feel your passion to serve. Your dream is still alive — and you remind them of what they lost. They used to be you.

You are not them. Loyola has prepared each of you to lead an extraordinary life as a physician, to uplift the human spirit, embrace diversity, respect life, and value human dignity.” And so you must stand up against human rights violations in medicine. Bullying, hazing, and sleep deprivation will not make you a better doctor. We’ve already wounded far too many of our physicians with antiquated teaching methods. It is time to heal our healers.

And so I ask that you always have compassion for those who have come before you. As you begin your careers, many doctors are counting down their days till retirement, living lives of silent desperation. Learn from them. But don’t follow in their footsteps. If one day you find that you do not love your work, do not love your patients, have lost all hope — you must first find yourself again. How can a hopeless doctor give hope to patients? If you feel trapped, if you feel like a victim, then you are teaching your patients (and the next generation of physicians) to be victims too. Doctor means teacher.

Medicine is an apprenticeship profession. So let us learn from those who work with joy. Like Dr. Tameika Lewis (a gynecologist in Orlando) who dances with her patients in the park every Saturday morning. Like Dr. Jennifer Zomnir (a family doc outside of Dallas) who takes her kids with her on house calls and sees all patients over 90 for free (because she doesn’t want them fiddling around with paperwork). Like Dr. Keely Wheeler (a psychiatrist in Tulsa) who takes her patients with her to the gym to work out. Is that awesome or what?  When I first met Keely she had gained 80 pounds working for a big hospital system and rarely saw her husband. He basically used to bring her dinner while she was charting at night, that was their marriage, sneaking her Whataburgers under the bullet-proof glass receptionist window. Then check this out: within two years of launching her dream clinic, Keely lost 125 pounds and does marathons. People keep asking what diet she’s on. She says, “I’m on the I love my job diet”

It’s been a total blast to help these physicians launch their dream clinics. Sometimes I feel like I run a wildlife sanctuary for wounded healers. They come to me nearly dead with PTSD, depression, suicidal daydreams and I guide them back to their real dreams.

But what if you can’t find your dream? What if you don’t love your job? Please promise me that you’ll to do one thing — ask for help. That’s what I did.

My dream was to be a small-town family doctor doing house calls and trading for produce, but I could never find my dream job out there (and I signed a lot of contracts with a lot of hospitals and they never let me do this, they wouldn’t let me barter or anything, wouldn’t let me see patients for free, you know It was against the rules). So I really felt more like a factory worker practicing assembly-line medicine, so 12 years ago I did something that doctors never do — I asked for help. I asked my entire community for help. I invited them to design their own ideal medical clinic. I literally called up the newspaper and announced that I was hosting town hall meetings throughout the county. Ultimately, I collected 100 pages of testimony, adopted 90 percent of what my community wanted (and I literally told them I’d do whatever they want as long it was basically legal), and within one month we opened — with no outside funding! The first ideal clinic designed entirely by patients. My dream came true. So did theirs. Because I asked for help.

So if you can’t find your dream job out there, create it. You are in the top 1 percent of intelligence, compassion, and resilience in the country. You can totally do this! Whether you want to design an ideal clinic or an ideal hospital, your community wants to help you!

But doctors suck at asking for help. Have you noticed that? So start practicing this weekend. Ask your family and friends. Ask me 24/7. Just got to IdealMedicalCare.org. Call me. Email me. I actually return every single phone call and letter. And I have no staff. The people who help me are my community. I have a lot of unpaid staff. The thing is when doctors ask for help the most amazing things happen.

Dr. Lissa Lubinski (a family doc in Washington state) just had a town hall this past March, and 52 citizens showed up to help her launch the first community-designed clinic on the Olympic Peninsula. Dr. Mary Ellen Hoffman (a family doc in upstate New York) shared her dream with her community, and a neighbor was so inspired she came over with a plate of homemade chocolate chip cookies and a $100,000 check! Would that help your student loans if a neighbor found out that they were living next to this really cool resident with an amazing dream and they brought you a big fat check? What’s better than a surprise $100,000 check — with cookies? Well, I know. My mostly uninsured patients give me tips. They pay me more than what I ask for. They write in the memo line of the check “for love & guidance” and they draw little hearts. Every time I get one of these checks, I feel like I hit the lottery.

So what else will patients do for you? Townspeople have raised thousands of dollars through bake sales and spaghetti dinners to help doctors launch clinics. They’ve given doctors free rent on main street. Patients have volunteered to sew gowns, blankets, decorate clinics, even work in the office for free. Why would patients do this for a doctor like you? Because they need you. The real you. The one in your personal statement. The one who is not afraid to live their dream. Because your dream is their dream.

So graduates, my question for you today is: what would happen if you started sharing your dream? What would your community do for you? What if you actually asked for help? You may be surprised.

Three tips for a success career in medicine

In closing, I’ve got three simple tips that will nearly guarantee your success. Three tips (one for today, one for next week, one for July):

1. This afternoon when you are celebrating with friends and family, I invite you to share your dream — the biggest, boldest, you-hit-the-lottery version of your dream. Just stand up, tap your glass with your fork, introduce yourself as Doctor for the first time and share your dream. To parents, family & friends: your job is to listen to this beautiful person in front of you and nurture their dream. Record the moment. Get out your iPhones. Share it on social media, and please tag me on Facebook. I’d love to celebrate with you and share your dream with the world. Ya never know who will be so inspired that they’ll write you a $100,000 check — or more! Be optimistic!

Graduates, you can’t do this alone. You must learn to ask for help because there will be times in residency and beyond, when you haven’t slept in days, when you’ve had an unexpected death, when you question WHY you are doing any of this. And in your darkest moments, you’ll need to watch the video. Save it. It may save your life. So that’s #1 — share your dream with your loved ones today — and me today — and ask for their help.

2. Next week, I want you dig out your personal statement. Read it and update it with all your cool new ideas. Decorate it with glitter stickers and smiley faces and little hearts. Then get it framed and hang it right next to your diploma. Without your dream, your diploma is just a piece of paper. There are far too many discouraged doctors with walls full of diplomas and awards. Remember: it is your dream that will bring your diploma to life.


3. In July you start residency. Share your dreams with each other. Be like a dream team. Medicine is a team sport (and we’re actually all on the same team).  Help each other become the doctors you always imagined. And here’s a big bonus. Discover your patients’ dreams. What inspires them? What’s the real reason they keep coming back to see you? I bet it isn’t to get to goal on their HgA1C or to perfect their low-density lipoprotein level, or to make sure their MRI is clear of metastases, it’s to survive long enough to make it to their 50th wedding anniversary or to witness the birth of their first grandchild, or to live long enough to watch their favorite granddaughter walk across this stage and graduate from medical school today.

Congratulations and I can’t wait to see what you all do!

Don’t forget to …

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Physician Suicide Letters — Answered and Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor. She hosts the physician retreat, Live Your Dream, to help her colleagues heal from grief and reclaim their lives and careers.

Image credit: Pamela Wible

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