“You’re a bulldog doc who hails from Yale.” Commencement speaker — and surprise singer — Francis Collins, MD, PhD, National Institutes of Health (NIH) distinguished investigator in the Center for Precision Health Research, and former director of NIH, sang these words at the end of his address to the 103 MD graduates of the Yale School of Medicine (YSM) Class of 2024.
Borrowing a guitar from a student performer and singing to the tune of Simon & Garfunkel’s "The Sound of Silence," Collins drew loud applause and a standing ovation for his creative song, which began with the 2020 COVID-centric world — “Hello Fauci my old friend, I see you’re on the news again,” — and ended with a verse focused on 2024, which he told the graduates “is all about you.”
The song was a highlight of the celebratory, yet reflective, ceremony, for a class whose medical school experience was impacted by the COVID-19 pandemic and polarizing societal issues —some affecting patient care. The responsibility of physicians, and addressing polarization more generally, were themes throughout the ceremony.
Therefore, let us rejoice
In their invocation, Class Presidents John Lyon Havlik, MD, MBA, and Ragini Luthra Vaidya, MD, MBA, recited and reflected on several passages from a poem the class had read during first-year orientation and again in the fourth-year capstone course: John Stone’s Gaudeamus Igatur, which means “Therefore, let us rejoice.” (Stone was a poet and cardiologist at Emory University.)
“For this is the day you know too little
against the day when you will know too much
For you will be invincible
and vulnerable in the same breath
which is the breath of your patients”
After reading this verse, Havlik and Vaidya noted the knowledge gained during medical school as evidenced through qualifiers, clerkships, and taking the United States Medical Licensing Exam, “and yet,” they said, “we each can admit we know a fraction of what we would want to, in order to become the physicians we aspire to be. There are the further unknowns of what medicine itself will look like, with the basic practice of medicine under attack in many states.” The co-presidents continued, “But this lifetime of learning, adapting, and questioning are what the Yale System, with all its freedoms and challenges, has been preparing us for. We have faith that each of you will continue to pursue endless knowledge, with compassion and humility, in the service of your patients’ well-being.”
"You give us hope in the future"
In her welcome and reflections, Nancy J. Brown, MD, Jean and David W. Wallace Dean and C.N.H. Long Professor of Internal Medicine, noted how many members of the class began in August 2020, when most classes were virtual and university COVID guidelines limited gatherings to no more than 10 people. “Over the last four years,” she said, “you have overcome the constraints imposed by COVID to become physicians. You have also wrestled with the role of physicians in society, in combatting racism of all forms, considering the rights of women and the medical ethics of abortion, creating a community that is inclusive and fair, and struggling with the tension between deeply held personal beliefs and your professional responsibility to care for all.”
Praising the graduates, she said, “You have taught us how to listen, and to hear what is behind the words. You have also learned to think critically and to probe deeply, to ask tough questions, understanding that the simplest answers are not always the correct answers. Only through an agnostic approach, open to all possibilities, will we solve the problems of medicine and humanity. This is the rationale behind the Yale System.”
Looking ahead, she continued, “You have demonstrated time and time again that it is possible to disagree passionately while caring for the individuals with whom you disagree. In so doing, you have set an example, and you give us hope in the future.”
In introducing Collins as Commencement speaker, Brown stated that “his visionary guidance and unwavering commitment to collaboration were instrumental” in the historic achievement of the Human Genome Project — an international endeavor to map and sequence the entirety of the human genome. Brown also noted that Collins’s 12 years as director of NIH — spanning three presidencies — made him its longest-serving director.
Commitment to objective truth
In his remarks, Collins recounted a research project he worked on during his fellowship at Yale. After months of hard work, he conducted the definitive experiment and “it was a complete and utter disaster.” Collins was “utterly devastated” and thought he should leave the program. However, to his surprise, neither his mentor nor the department chair “seemed at all rattled by this.” In fact, his chair told him how his own first research project “totally bombed out, how he learned a lot from that, and how it made him a better scientist for the rest of his career.” Collins’s advice to the graduates: "Failure is an inescapable part of being a physician and a scientist. Don’t fear it. Learn from it.”
Turning to his unexpected path leading the Human Genome Project and directing NIH, he advised the graduates, “Your life trajectory is likely to be very different than you expect today. Watch for those doors that open that you didn’t expect. Don’t be shocked when others close. Stay flexible.”
After describing the intense work and expansive collaboration that led to the remarkable scientific achievement of quickly developing highly effective vaccines for COVID-19, Collins said it initially “seemed like science had triumphed.” However, by the summer of 2021, large numbers of Americans were not getting vaccinated because of rumors and conspiracy theories about the vaccine. It is estimated that between June 2021 and April 2022, when vaccines were free and widely available, 234,000 unvaccinated Americans lost their lives. “These were deaths from science misinformation. I know of no other way to say it: our culture wars killed hundreds of thousands of Americans,” said Collins.
A wake-up call
Calling this “a wake-up call of the loudest sort,” Collins said, “These were good, honorable people who for a multitude of reasons lost trust in the scientific process.” Collins cautioned, “The consequences of this growing distrust of all institutions, including science and medicine, are truly serious for our nation, and for our world” — pointing, for example, to its impact on preparing for the next pandemic and addressing climate change.
Collins doubts the solution to the divisions and distrust will come from political leaders, since politics are so polarized. Rather, he said, “it is actually up to each one of us.” Collins challenged everyone “to a commitment to re-anchor ourselves to objective truth,” adding “there really is objective truth and there really are no alternative facts.” He urged the graduates to “have the courage to reach out to friends and family with different views to listen, really listen, and understand.”
More optimistically, Collins told the graduates that while we must address the inequities that riddle our health care system, “medical research, whether in development of vaccines, cures for rare diseases, neuroscience, or implementation of precision medicine for prevention and treatment of common disease, is at an exponential phase of rapid progress. Breakthroughs are all around us. For those of you with an interest in research, being part of this will be a fantastic adventure.”
Joint degrees & teaching awards
Thirty-five percent of the graduates received joint degrees, including twenty receiving MD-PhD degrees, nine MD-MHS degrees, and seven MD-MBA degrees, as well as four receiving a Certificate in Global Medicine that accompanies their MD degree. The Commencement ceremony also included the traditional bestowal of teaching awards. See the awardees and statements of praise from those who nominated them here.