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Finding a way to do the right thing

Yale Medicine Magazine, 2004 - Fall/Winter

Physicians must go the extra mile for patients, surgeon and writer Atul Gawande tells the Class of 2004.

As a medical student on an internal medicine rotation, Atul Gawande, M.D., M.P.H., wasn’t particularly worried about the elderly woman with a low-grade fever who was being watched for signs of pneumonia. She was one of the last patients he’d cover as a fourth-year student at Harvard, and his mind was on the surgery residency he’d soon begin. After rounding in the morning, he decided not to check in again with the patient after lunch, recalled Gawande, a surgeon and writer for The New Yorker, speaking at the School of Medicine Commencement in May.

Luckily, the woman’s chief resident was more vigilant. By the time Gawande stopped in to see her, the patient was gone—gone to the ICU in the throes of a rapidly progressing fulminant pneumonia.

The lesson, Gawande told the 109 graduates gathered on Harkness Lawn, is that being a physician requires “a particular kind of strength. ... Doing the right thing is often painful, and yet you find the way to do it anyway,” said Gawande, whose essay collection, Complications, was nominated for a 2002 National Book Award. Gawande said that physicians must go the extra mile for patients, even if doing so is a hassle, even if it’s humiliating, even though one might make a bad decision and unintentionally do harm. He urged new graduates to do the right thing “because you said you would; because it’s what you chose to do.”

The graduates listening to Gawande’s address had processed into the tent led by piper Glenn H. Pryor playing “The Athol Highlanders.” Former opera singer (and 2004 graduate) Nduka M. Amankulor opened the ceremonies by singing “The Star Spangled Banner” in his bass-baritone.

The Class of 2004 honored Barry J. Wu, M.D., HS ’92, associate clinical professor of medicine and “the nicest doctor in New Haven,” with the Francis Gilman Blake Award for outstanding teacher. They gave the Betsy Winters House Staff Award to Ashwin Balagopal, M.D., chief resident in medicine, for his “Zen-like brilliance.” The class donated $1,000 to the School of Medicine’s Society of Distinguished Teachers to “underscore symbolically our commitment to superlative teaching at the School of Medicine,” said class co-president Michael Shapiro.

Joseph E. Craft, M.D., HS ’77, professor of medicine (rheumatology), and Auguste H. Fortin VI, M.D., M.P.H., assistant professor of medicine, won the Bohmfalk Prizes for teaching. James M. Perlotto, M.D., associate clinical professor of medicine, won the Leonard Tow Humanism in Medicine Awards. The Leah M. Lowenstein Award went to Eve R. Colson, M.D. ’89, assistant professor of pediatrics, and to Rajlakshmi Krishnamurthy, M.D., assistant professor of medicine.

Outgoing Interim Dean Dennis D. Spencer, M.D., HS ’77, encouraged the new graduates to adopt a multidisciplinary approach to medicine that incorporates the continuum from basic research to patient care. Although historically scientists have spoken of medicine in militaristic terms—“conquering disease”—Spencer suggested that the new generation “will adopt metaphors other than war: metaphors of growth, and exploration and evolution.”