"No time to stop dreaming"

Entering the field of medicine on the threshold of a new millennium, the 165 graduates of the University of Michigan Medical School got some visionary advice from the nation's top doctor, U.S. Surgeon General David Satcher, M.D., Ph.D., during his commencement address at ceremonies in Hill Auditorium on June 8. Describing the 20th century as "a great century for medicine and health" and citing declines in death rates from diseases like cancer and cardiovascular disease, Satcher encouraged the new physicians to "bring the best available science to bear on our policies as a nation" in order to continue the gains made in health and against disease and to end racial and ethnic disparities in American health care in the 21st century.

"This is no time to stop dreaming," he said. "The American Dream does not end when it comes to you; rather, you have an obligation to help make it happen for others." Satcher read Robert Frost's "The Road Not Taken" and urged the graduates to consider all of the extraordinary options they will find in life, not just the well-traveled paths to success and meaning.

In his introduction of the surgeon general, Medical School Dean Allen S. Lichter (M.D. 1972) cited Satcher's own dream of becoming a physician like the small-town doctor who saved his life at age two when a bout of whooping cough developed into near-fatal pneumonia. "Dr. Satcher achieved his dream," Lichter said, "but his practice stretches far beyond his hometown of Anniston, Alabama."

Social equity and quality of care were strong themes throughout Satcher's remarks. The 16th surgeon general, Satcher has made it his mission to make public health work for all groups in the nation. "African American babies are two-and-a-half times more likely to die in their first year than majority babies," he said. "American Indians are three times as likely to suffer from diabetes — Hispanics, two times — as the white population.

"White women still have the highest risk for cancer of the breast, but African American women continue to have the highest mortality rate from breast cancer." Along with ending disparities in health care, Satcher identified the aging of America, along with quality-of-life issues that apply to all ages but especially to the elderly, as another great challenge facing physicians in the 21st century. Treating Alzheimer's Disease, disability, chronic pain and depression will be medical issues fundamental to the decades to come. "At every age," he said, "there are challenges to quality of life." Satcher emphasized the importance of mental health to overall human health and the need to counter the social stigma often attached to illnesses of the mind. Earlier in the day, Satcher spoke to a group of 70 middle and high school students in Ypsilanti, telling them, "If you're serious and you work hard, you will find help in all kinds of places." The students participate in the Health Occupations Partners in Education (HOPE) program, a partnership between the U-M and Ypsilanti Public Schools which helps promote interest and success in health science careers, particularly among minority groups now underrepresented in health care professions.

Satcher served simultaneously as surgeon general and assistant secretary for health from February 1998 through January 2001; his term as surgeon general continues until February 2002. He has also served as director of the Centers for Disease Control and Prevention and administrator of the Agency for Toxic Substances and Disease Registry from 1993 to 1998. From 1982 to 1993, Satcher was president of Meharry Medical College in Nashville, Tennessee.

Graduates and their guests were also treated to the sage observations of class speaker Douglas Franzen who reflected upon medical school as "hard fun, psychologically and emotionally draining" and "two years of sleeping through lectures followed by two years of not sleeping much at all."

Franzen recalled a personal pilgrimage he made not so long ago travelling U.S. Route 50 in Nevada, "the loneliest road in America," on his way to Mount Wheeler in Great Basin National Park. At first regarding as "odd" the warnings of deep snow and arduous hiking — the ground was clear at the base except for the occasional patch of snow — Franzen found, as he made his way through bristlecone pines as much as 4,000 years old, that not only did the snow deepen to knee-, then waist-level and more, but also that each ridge was followed by another, then another and yet another, his chosen goal — a certain distance toward the summit — seeming almost to recede rather than get closer. When at last he arrived at the point he'd determined to reach and sat in the snow reflecting, he mused that the point of the journey is not to arrive, but rather it's the getting there in which the essence of experience is to be found.

Residency programs, Franzen noted, are yet another ridge facing the graduates, and the process of reaching their goals should be enjoyed. "For when you get to the top," he said, "it's the journey and all its ridges you'll remember. And the very best part of the journey is the friends you made along the way."

The Medical School's Class of 2001, coming from 24 states and ranging in age from 18 to 42 when they began their studies, represented such pre-medical school occupations as grocery bagger, stockbroker, professor of electrical engineering and computer science, Chicago firefighter, world-ranked tennis player, and lawn mower repairer. Eighteen percent of the graduates will go on to complete their residencies at U-M.

Six of the new M.D.s also received Ph.D.s in the Rackham School of Graduate Studies ceremonies last April as part of the Medical School's prestigious Medical Scientist Training Program. Over 30 additional Ph.D.s were also awarded by Rackham in Medical School graduate programs.