Delivering the Charge to the Class of 2008
Dr. Dan Fletcher
I feel the need to start this address with an apology to the Class of 2008. When I arrived at Cornell in the Fall of 2006, one of my first interactions with all of you was in the Block V Emergency and Critical Care course. I was so excited that my first lecture to my first class at Cornell during the first year of my first faculty position happened to be on my first love, neurotrauma. This was going to be great! These Cornellians were going to see what those folks at that other Ivy League vet school had to offer. And so I dutifully prepared a lecture full of physiology, pathophysiology, a logical diagnostic approach, and treatment. I put in lots of great photos, some videos and animations. And I eagerly entered LH-II to start my very first lecture to all of you. I breezed through epidemiology of traumatic injury, normal neurophysiology, pathophysiology, diagnostics, resuscitation, and was just about to start the second half of the lecture, which was all about treatment, when I glanced at the clock and saw that I had exactly 7 minutes of the 50 minute lecture left. I thought for sure I had hallucinated, so I looked again. Now it said I had exactly 6 ½ minutes. And what I learned that day from the Class of 2008 is that 50 slides DOES NOT NECESSARILY equal 50 minutes, and that hell hath no fury like a vet student caught in LH-II for more than 50 minutes at a time. Panicked, I sped through a few concepts, then asked you to read the notes to get the rest of the information on treatment. And as you streamed out of the lecture hall and I sat stunned at the front of the room, my head reeled as I contemplated the fact that I had just lectured my first class of veterinary students in my first faculty position on my first love, head trauma, and I didn't get to mannitol! I didn't get to hypertonic saline! There was no head elevation or hypothermia or barbiturate coma! I was mortified, and I am still shocked that, in the face of that, you elected to present me with an honor that means more to me than anything I could imagine - the Norden Distinguished Teaching Award. Maybe you've forgotten the travesty that was my first lecture to you, but I promise you I have not. Luckily, I had a year and a half to try to catch each and every one of you during your clinical rotations to stress that, as our beloved neurologist says, mannitol should be used with reckless abandon in patients with head trauma. I hope that I was able to make up for that horrible first lecture. If there are any of you out there that I missed or that are still confused about this concept, please come up after the hooding and we can do some rounds.
14 years ago, almost to the day, I attended my first hooding ceremony as I completed my PhD. I really had no concept of what "hooding" was all about. I knew that, like you, I was excited to be done with classes, and tests, and sleepless nights fretting over some arcane concept I was sure I needed to know. I knew it was an opportunity for me to share with my family and my friends the end of my student academic career, and the beginning of a new chapter in my life. I walked across the stage to be hooded by my mentor, and as he placed the hood over my head, he said "My greatest wish for you is that someday you'll feel the pride and joy I feel today, as you do this for your own students. There's no greater gift." I was touched, and I appreciated the sentiment, but until today, I can't say that I ever really understood what he meant. Looking out at the first class from Cornell that I got to see through all of clinics, now I understand. You've worked so hard, you've made your parents, your families, your friends, your classmates, and all of us so proud. I am so very honored to be here today to share this amazing experience with you, and to play my part in hooding not one, but 80 of my own students! I am truly blessed today.
I know that today you're feeling a mix of excitement, anticipation, and yes, unabashed, unrelenting, full-on terror as you face this next stage in your professional careers. You are now the doctors, and as you walked through that door today, we pulled the safety net out from under you. But remember that you're well trained and ready for this challenge. However, veterinary medicine isn't static. There will be knowledge gaps, like treatment of head trauma, that you'll identify. You have the critical thinking skills you need to address those gaps and the drive and motivation to do it. Never allow yourself to lose that drive, or convince yourself that you no longer need it. Ours is a profession that depends on lifelong learning. As much as we've tried to prepare for you for life "out there in the real world", the honest truth is that your learning will accelerate dramatically, especially during your first year or two of practice. If you want to be a great vet, realize that you're not done, and in fact, you're never done. Be open to that process of learning, and recognize that there are many ways to approach any clinical problem. Listen to your mentors and colleagues, absorb what they have to say, but always be critical in your learning. You have a great base, and you'll spend the coming decades expanding and refining it. It's what makes this job so much fun. It's constantly changing and evolving. The only way to become a bad vet is to convince yourself that there's nothing left to learn.
There are lots of firsts in your near future. Your first big save will stay with you forever, and it'll sustain you through the tough times. Your first unexpected loss will teach you humility and keep you honest. None of us is infallible, and to make mistakes is to be human. And even though you're a veterinarian, you're still human. Your mistakes will break your heart, but they'll make you a better doctor. Learn from them, but don't let the fear of them immobilize you. Although there was always a clear correct choice on each of your exam questions in vet school, the practice of medicine is rarely so clear cut. You'll have to make tough decisions, and you'll have to make them quickly. Take a deep breath, and approach each problem methodically, bringing the full force of your training to bear, and always remember that blinders are for horses, not for veterinarians. Ultimately, you have to trust yourself and do your best. That's all anyone can ask of you.
Veterinarians hold a place of great trust in the community. A 2007 Gallup poll on professional honesty and ethics ranked veterinarians third among 23 types of professionals, surprisingly ahead of both physicians and dentists, although I'm not so surprised about the dentists - they scare me too! But remember that trust is earned, and can be lost. As a veterinarian, you must be an advocate for your patients AND your clients. Unfortunately, the best interests of those 2 interdependent but separate individuals will at times be at odds, and you'll find yourself in the position of mediator. Be mindful of your clients' limitations, and don't judge them. The hardest part of your job will be settling for non-ideal treatment for your patients due to the limitations of your clients. But remember that you have to balance the interests of both parties, and to advocate for both. These are your neighbors and friends, and the limitations imposed on them by life are known only to them. Comfort them, support them, and help them to be at peace with whatever decision they make.
Also keep in mind that nurses were ranked number 1 in that Gallup poll of professional honesty and ethics. Your nursing staff is the foundation of your practice. They're your front line, they're often the face and voice of your practice, and they deserve acknowledgement, recognition, and attention from you. Remember that they often take the full brunt of the outside world, and protect you from it. Nurture them, listen to them, and learn from them. They can be one of your greatest resources.
As I look out at you, the class of 2008, I'm astounded at how far you've come. I remember when you first arrived on the clinic floor with green dots on your name tags and that characteristic "deer in the headlights" look. I watched as you moved nervously through the ICU trying to avoid eye contact as you looked for a syringe or a bottle of saline. I saw you agonize over your first treatment sheet and vent over your first high maintenance client. I shared tears of sorrow over your first euthanasia, and tears of joy as you discharged the case that everyone else wanted to write off. Over time, I saw you gradually gain confidence as individuals, but even more importantly, I saw you begin to gel as a class. The long hours, the stress, the sleep deprivation, and the complete lack of any kind of balance in your lives could have driven you apart. But instead I saw you grow closer, I saw you lean on and support each other, and I saw you become a family. I will be forever grateful that you allowed me to feel a part of that family. And when the new "green dots" arrived on the clinic floor, you closed ranks around them and taught them the ropes, as older and wiser sisters and brothers should. And now, class of 2008, we're at that inevitable time faced by all families when some of the members are ready to leave the nest. You take with you the sum total of all of those shared experiences, and you take with you a little piece of the hearts of all of us you leave behind. And although you're now going your separate ways, you can still lean on each other. You'll be facing lots of the same challenges and triumphs, and who better to share them with than your vet school family? Whether it's via panicked phone calls at 2AM, email, Facebook, or heaven forbid, letters at 42 cents a pop, stay connected with this family. They are a treasure of immeasurable worth, and they're all yours.
And so, class of 2008, I welcome you to this amazing profession. Through all of the joys and sorrows that life brings, never forget how lucky you are to be a vet. Every day, you will have the opportunity to have an impact not only on your patients, but on the lives and livelihoods of your clients. I can't possibly express what it means to me that you asked me to be here today. You have enriched my life in more ways than I can begin describe, and now it's time for you to share those riches with the world out there. You're ready. Go get 'em.