Lewis Thomas — An O.G.

Commencement address by Susan Dentzer

Here’s what I told the graduating MD’s, Doctors of Pharmacy, and other graduate students at the Northeast Ohio Medical University commencement this year.

Greetings to all of you graduating today, and to all the people here who have helped you get where you are — your friends and family members, and your faculty, administrators, and community. If you’re lucky, you‘ve had plenty of people whom you’ll always think of as OG’s.

For those of you who are approximately my age and older or who are otherwise not familiar with this terminology, OG originally meant “Original Gangster.” Now, it may not sound like very much of a compliment to refer to someone as an Original Gangster. But nowadays, OG it has come to means someone who’s incredibly exceptional, authentic, awesome.

I want to talk to you today about another of my personal OG’s — Lewis Thomas. Lewis Thomas died in 1993 at age 80, but while he walked this good earth, he was one awesome human being — so awesome that he makes almost everybody else look like an underachiever.

Although I met him only as a younger journalist and didn’t really know him personally, I knew that he was president of the Memorial Sloan-Kettering Cancer Center in New York City. He also had been dean of the medical schools at both New York University and Yale. He was a leading advocate for the importance of federal spending on biomedical research. His own scientific work produced major advances in the field of immunology. And on top of all of that, he was a beautiful writer and poet. His prose was so widely admired that even the famed author Joyce Carol Oates used his essays as examples to teach her own writing students at Princeton.

Lewis Thomas wrote a number of wonderful books, one of which was called The Lives of a Cell. By the way, he also won a National Book Award for the book, and it was translated into 11 languages. In the book, Lewis Thomas mused about a lot of things, including genetics, evolution, and the seeming randomness of our existence. Here are just a couple of the marvelous sentences that he wrote in the book:

“Statistically the probability of any one of us being here is so small that you would think the mere fact of existence would keep us all in a contented dazzlement of surprise. We are alive against the stupendous odds of genetics, infinitely outnumbered by all the alternates who might, except for luck, be in our places.”

Listen to those phrases again: “We are alive against the stupendous odds of genetics.” We are outnumbered by “all the alternates who might be here instead of us, except for luck.” The mere fact of our existence should keep us all in a “contented dazzlement of surprise.”

Now, as a parent who has lived through the college graduations of my own children, I know there may be people who love you in the audience today who are experiencing a sense of “contented dazzlement of surprise” that you are actually, finally graduating! You should thank them for believing in you. Seriously, though, my hope for you as you graduate is that you will carry these marvelous insights of Lewis Thomas with you in everything you do, as you pursue your careers in medicine, in pharmacy, or in other aspects of science, health, and health care.

Let’s start with Thomas’s insight that there is nothing inevitable about any of us being here, including you. I don’t need to delve into the birds and the bees part of how you got to be a zygote, rather than some the result of some other gametes getting together to make a particular human being. I may not need to remind you how you got to go to school here, rather than someone else. I do want you to think about all the alternate gametes or zygotes who didn’t end up as you, born into your families, and wending all along the paths you’ve gone down in life that bring you here, today, to graduate. Don’t you feel pretty lucky, or even blessed?

What are you going to do with that feeling of being lucky, fortunate, blessed? Are you going to give back? Every major religion, whether it is Christianity, Judaism, Islam, Buddhism, Hinduism, or even the Baha’i faith, advises its followers to do good. Fortunately, almost all of you are entering fields where it’s pretty easy to do good, because you can help people achieve the blessing of good health, and provide relief from illness and pain.

Society doesn’t give everyone this privilege; many of you still have more education and training ahead of you, and you’ll have to take more tests, demonstrate competence, and even get a license to practice. Some of you have already received a white coat to wear, to symbolize professionalism, compassion, and honor. Whatever your occupation in health, science, or health care, don’t ever forget how special you are, but also how many obligations go along with being so special and important. It wasn’t inevitable that you be here, but now that you are, make the most of your obligations to yourselves and to the service of your fellow human beings.

Now let’s go to that other phrase that Lewis Thomas used — that the odds of any of us being here is so small that you would think we would all spend every minute of every day in a “contented dazzlement of surprise.” What a beautiful phrase. Surprised, because it’s we who are here, not some other grown-up zygote. Dazzled, because the world and this life can be so amazing. Contented, meaning satisfied with our lot. Why shouldn’t you be contented, given how far you have come to arrive where you are today?

I imagine many of you experienced this contented dazzlement of surprise when you learned some of the things you learned here. Maybe you learned about how the body’s own immune system can now be harnessed to fight cancer. Maybe you’re fascinated, or even scared, by the new science of gene editing.

I know many of you worked in the student-run free clinic seeing patients from the community for all kinds of reasons. Did you feel the “contented dazzlement of surprise” when you helped to figure out a patient’s problem, or let him or her know that, with some medication, they’d be all right? Did you know that 98 percent of the patients to this free clinic said they would recommend it to others? Let me tell you, for health care, that’s a heck of a net promoter score or customer satisfaction statistic. You should definitely feel the “contented dazzlement of surprise” about that!

One reason that Lewis Thomas wrote those words, though, was that he knew that we as human beings don’t always go around in a state of “contented dazzlement of surprise.” Far from it. Sometimes we become dejected or depressed as we experience failures of whatever sort. It’s sometimes hard to model the life of another OG, Winston Churchill, who once described success in life as going from one failure to another with no loss of enthusiasm.

And as you go through your careers, you may be tempted to lapse into cynicism — about the health care system, about government, about the degradation of the environment, about the roadblocks in the way of your own careers, or something else. Those of you who end up as clinicians may experience clinician burnout, as many across America are feeling. Let’s face it: Whoever said that life isn’t always a bed of roses wasn’t kidding.

Nonetheless, I hope more than anything else that you will not let this feeling of “contented dazzlement of surprise” ever disappear from your life and your world. It’s the feeling that a parent has when he or she looks into a newborn child’s eyes for the first time. It’s the feeling that your family and friends are having for you here today.

Lewis Thomas eventually died of Waldenstrom’s disease, a cancer of the lymph system, and as he approached death, he still found things to marvel about. He theorized that he would feel no pain at the moment of death because endorphins released in the brain would attach themselves to other brain cells responsible for feeling pain, and thus would neutralize the pain completely.

Right about now you should be feeling your own surging endorphins as you reflect on the wonder of your being here today. You should be feeling this surge of wellbeing as you contemplate a brilliant future when you can use your skills and talents and training to serve humankind. You should be feeling it as you thank all the OG’s who got you here today, and as you think about being an OG to someone else, someday, who may be standing where you are 20 or 50 or even more years from now.

And every day, as you who are physicians put on that white coat or loop that stethoscope around your neck — as you who are pharmacists review a patient’s medication history to make sure that the patient is on the right meds — or any of you who are scientists, public health specialists, health care administrators, or on any other path that you choose to pursue — whatever your role, please make sure to recharge your own life batteries by reminding yourself of the honor of your profession and the privilege that has been accorded you to have it, and to live it.

In that great book, The Lives of A Cell, Lewis Thomas also observed that, in evolutionary terms, we as human beings aren’t really all that old, having only emerged as a species several hundred thousand years ago. Maybe, he mused, “almost all our evolution as a species [is] still ahead of us.” And “if all goes well,” he concluded, “there is quite a lot to look forward to.”

Today, with most of your lives still ahead of you, there is also quite a lot to look forward to. May you forever look at the world through the bright lens of possibility. May you remain — forever and always — contently dazzled by the many surprises that are sure to come your way.

Good luck, and Godspeed.

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Susan Dentzer, Senior Policy Fellow at the Duke-Margolis Center for Health Policy, is a journalist, commentator, and respected health policy thought leader.