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“The patient will lead you,” speaker tells Class of 2013

Yale Medicine Magazine, 2013 - Spring


On a day when the 91 members of the Class of 2013 could easily bask in the pride of their accomplishments—acquiring the vast amount of knowledge and completing the rigorous training necessary to become physicians—humility was the word of the day at the Commencement Ceremony in Amistad Park on May 21.

In her Commencement speech Lisa Sanders, M.D. ’97, HS ’00, assistant professor of medicine and author of Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis, discussed the seismic changes taking place in medicine, from the demise of the solo practitioner to the abundance of medical information available with the click of a button. But one thing hasn’t changed. “We still make mistakes,” Sanders said. Sanders recalled Sheila, an 83-year-old woman she has been treating since her intern days. Sheila was having trouble breathing. Given her history of respiratory problems, Sanders assumed that her medicine wasn’t working and prescribed something new. But it wasn’t long before Sheila called back. She wasn’t feeling any better and she was too weak to leave her home. Sanders made a house call, discovered that Sheila’s heart was beating too slowly, and she knew that she’d made the wrong diagnosis. Sheila’s problem was with her heart, not her lungs. “It was an error that could have killed her,” Sanders said.

Sheila got a pacemaker and is doing well, but the experience haunts Sanders. “Ask any doctor,” she said. “Each has half a dozen Sheilas that live on in their memories, their private shames, their unspoken failures. “Mistakes are inevitable,” Sanders said, “but if we don’t talk about them, how are we going to get better?” The art of diagnosis, Sanders said, starts with the doctor/patient encounter. “The patient will lead you to the correct diagnosis.”

Sanders’ message of a professional humility that respects the pre-eminent role of the patient was echoed by others. In his invocation, Ramy S. Goueli, M.D. ’13, urged his classmates to “be as vulnerable to your patients as they are to you.” The Class of 2013 version of the Hippocratic oath, written by the graduates and recited at the end of the ceremony, included the passage, “When I err, I will acknowledge and learn from my mistakes. I will continue to be grateful for the privilege of caring for patients and be humbled by this responsibility.”

The graduates carried that message of humility with them as they posed for pictures and headed to lunch on Harkness lawn. Amy Forrestel, M.D. ’13, remembered the first year gross anatomy class. “It was one of the most powerful experiences I’ve ever had. It was beyond humbling,” she said of her initial encounter with a cadaver. Kenneth Ike, M.D. ’13, said he’ll always remember his first visit to the hospital as a medical student. “It was a very humbling position to be in,” he said. “Every patient has a special story.”

During the ceremony, faculty and residents received awards for excellence in teaching. The Charles W. Bohmfalk Prize for outstanding teaching in the basic sciences went to Robert L. Camp, Ph.D., M.D., associate research scientist in pathology, and for outstanding teaching in the clinical science to Auguste H. Fortin VI, M.D., MPH, associate professor of medicine. The Leonard Tow Humanism in Medicine Award went to Matthew S. Ellman, M.D., associate professor of medicine. The Francis Gilman Blake Award, given for outstanding teaching of the medical sciences, went to Dana W. Dunne, M.D., assistant professor of medicine (infectious diseases). The Betsy Winters House Staff Award, given to the member of the house staff who has made the most significant contribution to the education of medical students, went to Edward McGillicuddy, M.D., in the Department of Surgery. The Leah M. Lowenstein Award, given for promotion of egalitarian and humane medical education, went to Andrea G. Asnes, M.D., assistant professor of pediatrics. The Alvan R. Feinstein Award, for outstanding teaching of clinical skills, went to Walter N. Kernan, M.D., professor of medicine.

The Dean’s Award went to James Perlotto, M.D., associate clinical professor of medicine, to honor his service to the medical school as he leaves to begin a new chapter in his life. This award is given rarely and only to those who have demonstrated extraordinary dedication and commitment to students. Dean Robert J. Alpern, M.D., Ensign Professor of Medicine, cited Perlotto’s “compassionate care,” “dedication and service” and his “commitment to the health and well-being of our students. For almost 25 years Perlotto served as chief of student health at the Yale Health Plan. He has taught family medicine, HIV care, needlesticks and occupational exposures, and human sexuality with a focus on gay/lesbian/bisexual/transgender/queer health care issues. He has also served on the medical school’s admissions committee.