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On selfishness in the service of others

Yale Medicine Magazine, 2011 - Autumn


“You have to own your good works,” speaker tells Class of 2011 during May Commencement ceremonies.

Mother Nature provided the rain, but the proud teachers, family members, and friends supplied the lightning—in the form of camera flashes—during Commencement ceremonies on May 23.

The bicentennial class of 81 graduates marched down Cedar Street to Amistad Park as the cheers of loved ones and the skirl of bagpipes led them to the shelter of a tent that they entered as students and left as doctors.

In his Commencement address, Frank J. Bia, M.D., M.P.H., FW ’79, professor emeritus of medicine and medical director since 2008 of the disaster relief organization AmeriCares, discussed the virtue of selfishness in medical service. “You cannot share what you don’t even have yourself,” he said to the Class of 2011, the last group of students he taught in the classroom and at the bedside.

The altruistic model of medicine as a social contract that subsumes a doctor’s needs to those of her patients is flawed and irrational, Bia said. In his 40 years as a doctor, Bia learned that good work and service come from a selfish place—a place where “selfishness becomes a virtue when your own happiness is tied to service. What matters is that you own your own motives completely,” said Bia. “If good works are done solely at the request, or even the mandate, of others, you will not be happy—not as happy as you deserve to be.”

In 1982, Bia and his wife, Margaret J. Bia, M.D., FW ’78, professor of medicine, spent some time at Hôpital Albert Schweitzer Haiti shortly after both of his parents had passed away. When he spoke of his experiences at grand rounds on his return, he grew increasingly frustrated by colleagues who remarked that he had done such good and selfless work in Haiti.

“I needed Haiti a helluva lot more than Haiti needed me,” said Bia. “I found myself making a difference—one patient at a time—and that made me happy.” The concentrated clinical work in the Haitian countryside, Bia said, both healed his grief and renewed his understanding of medicine’s social contract.

“You deserve to be the beneficiary of your own moral actions,” Bia concluded.

The graduating class wrote an oath for Yale physicians that echoed Bia’s sentiment. “I know that I cannot effectively care for patients without also caring for myself,” the students read. Following Yale tradition, the oath is based on the Hippocratic Oath and other classical statements.

Bia’s remarks were preceded by the presentation of a class gift to the American Red Cross for disaster relief efforts in the southern United States and in Japan.

The Bohmfalk Prizes for outstanding teaching went to John Fenn, M.D., clinical professor of surgery (vascular), in the clinical sciences, and to Peter Marks, Ph.D., M.D., associate professor of medicine (hematology), in the basic sciences.

The Leonard Tow Humanism in Medicine Award was bestowed on W. Scott Long, M.D., associate clinical professor of medicine.

The Leah M. Lowenstein Award, presented by the Office for Women in Medicine to a member or members of the faculty who represent the highest degree of excellence in the promotion of humane and egalitarian medical education, went to Marcella Nunez-Smith, M.D., M.H.S., assistant professor of medicine.

The Francis Gilman Blake Award was given to Andrea G. Asnes, M.D., assistant professor of pediatrics.

The Betsy Winters House Staff Award went to Anup Patel, M.D. ’09.

The Alvan R. Feinstein Award was given to Richard J. Gusberg, M.D., professor of surgery (vascular) and of diagnostic radiology.

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