White Coat Ceremony Speech, Class of 2006

Ann E. Dwyer, DVM
December 4, 2004
New York State College of Veterinary Medicine, Cornell University

I am humbled to be on this stage, to be speaking to you on this banner day when your true work as veterinarians begins. To ready myself, I made some inquiries about the class or 2006. Apparently you are an amiable group. Dare I say a bit laid back. You help each other. You have fun together. You are not known for gunners or geniuses, but you cheer each other's talents and successes. That got me thinking about my own class, the class of 1983. We were 40 men and 40 women, the first class ever of equal gender distribution. That made us unique, but that was about ALL that made us unique. The preceding classes were full of motivated super achievers, but ours was better known for romps at the Rongovian Embassy, and for some very creative faculty practical jokes. We were a good natured bunch, but frankly, expectations for us were modest. Later I'll tell you bit about what DID happen to us. But first, back to you, class of 2006, a class with a spirit reminiscent of my own. Where are you going, just what will you DO with that white coat you now wear so proudly?

I have three messages for you today, messages that I want you to tuck in the pockets of those beautiful coats. Messages that will help you craft a veterinary career that is unique and meaningful.

First message: All of you have to make a lot of choices SOON. Internships, residencies, jobs, specialties. You will make the best choices if you use this coming year to recognize something present in all of you called FLOW. You ask, what is this thing, "Flow"? "Flow" is a measurable state of mind that has been written about by psychologists. It describes "adult play", a state where you find freedom in complete absorption, concentration in your activity. It only occurs in activities that require skill and patience. When you are in the concentration of flow, you feel present, engaged. You forget personal problems. You lose your sense of time and of yourself. You do not even think about rewards from your actions. You sense an absolute clarity of purpose.

Each of us has a genetic blueprint that makes us immunologically distinct from one another. But each of us has ALSO has a unique mental blueprint of talents and interests. These things, seasoned by inspiration from others, are our flow. If you look for flow, you'll know it when you're in it. If you chase it, you will create a work genome, a unique job fingerprint that will sustain you as your career evolves .

Musicians and artists show flow that is easily appreciated by others. My own touchstone is the cellist Yo-Yo Ma. He performs in such a joyous state that he takes others with him in his concerts. Those of you who excel in sports recognize flow on the game field-it's often the difference between winning and losing. But flow occurs in science and veterinary medicine too! It is the work equivalent of being in love. And we all know what that feels like, the deep satisfaction, the utter mandate of being, that stems from such a profound engagement. When you find flow you want to return again and again.

Me, I have found flow in a number of places. Long before vet school I felt it on the back of a horse, especially at the racetrack. I found it in musical performance. In college I discovered it studying immunology and biology. I wandered for a few years after college, because I could not figure out how to blend these things into some kind of life work. But eventually my path took me here. Cornell was a perfect place to merge the satisfaction that I found with horses and science, and I managed to work the music in on the side. After graduation, I discovered other sources of flow. I found I was swept away by the beautiful anatomy inside the eye of my patients. I felt engaged when I coached students on finding the optic nerve for the first time. I was completely absorbed when I was in a lecture hall, and it didn't matter whether my audience was a group of 4H kids or hundreds of colleagues at AAEP. And once I became a business owner, I was surprised to find complete clarity of purpose in the tasks of balancing our budget, and reconciling our books.

So here I am, with over two decades of experience as a veterinarian behind me. How to describe the "work genome" that has evolved for me? Well, I am a doctor for horses, a business woman, a hobby ophthalmologist and a teacher of people interested in these things. Did this happen by accident? NO! I just went with the flow.

How will you recognize YOUR flow? Well first, look to your past. What experiences in your life have taken you to a place where you lost track of time, forgot yourself? Where have you found efficiency, clarity of purpose, freedom in commitment? Was it on the soccer field? In the chemistry lab? The time you volunteered for Habitat for Humanity? Whatever it was, take note of it. If you are clever, you will find creative ways to revisit that state often as you craft your career. Second, seek "flow" as this final turning point clinical year unfolds. Does time seem to disappear when you finally put surgical steel in your hand and close an abdomen? How does your heart react when the ultrasound screen stops looking like fuzz and shows real structures and spaces? How focused are you when nursing a critically ill animal, calculating drug doses and fluid rates? Can you look in your soul and find just the words that will comfort a family faced with the loss of their pet? All these things are going to be new and difficult. But some are going to be easier than others, and certain experiences are going to feel just right. They will require effort, but it will not feel like drudgery. Pay attention! These are life's road signs that you are finding your core, your flow. Your tuning fork is on pitch. Noting which experiences feel closest to flow will help you choose your own distinct path. Core competency, skill and a deep satisfaction in your work will follow naturally.

On to the second message. I could go on about following your bliss. I am a very good Pollyanna. But I won't kid you. This is a challenging profession. You are all facing a climb up Everest. I have watched a lot of veterinarians work through their first few years out of school. The experience of becoming a doctor, whether your setting is a exam room, a barn full of horses, a research lab or a surgery suite, is a universal one. Your first months "out" will be preoccupied with the technical stuff- how do I place that catheter, how do I grade a heart murmur, and HOW THE HECK do I drive from Batavia to Walworth? But after a while, deeper issues will emerge. You will agonize over the fact that you are uncertain about what is going on with some sick animals, even if you have done every test possible. You'll feel like you are living in a pressure cooker, where there just isn't enough time to do everything. You'll be frustrated when economics limit the options that you can choose. You'll get irritated when your clients goad you about how expensive it is to provide veterinary care these days, but still, you'll feel ambivalent about actually profiting financially from animal suffering and disease. One day, you may be aghast to discover that you are clinically detached-that one factor in making a euthanasia decision is thinking about how, if this decision is made quickly, you will get home and get to sleep soon. In your workplace, you'll have to deal with the non-medical challenges of authority and hierarchy. And, no matter how careful you are, YOU WILL MAKE MISTAKES.

These non medical, but very human issues are not mentioned much in your training. I list them NOW, to validate the soul searching in store for all of you. I can't give you a folksy, one size fits all cliché to face these pressures and problems. However, I CAN share a roadmap that may help you navigate the bumps ahead. Thanks to the generous support of the administration, each of you will be given this book, Healing the Wounds as you leave the ceremony today. It was written by a physician, Dr. David Hilfiker, a few years after he graduated from Yale Medical School. The stories inside relate his experience with people, but resonate solidly for all of us whose patients have four legs. Read the 15 short essays that address the taboo topics of mistakes, money, efficiency, hierarchy, clinical detachment and more this month. Read the chapter on mistakes three times. Take this book with you when you leave Ithaca, and read it again a year after you graduate. Use it as a source of strength when you make your first BIG mistake, when you question your dedication to the cause. It will help you heal your own inevitable wounds while you are learning the art of healing others.

Now the third part of my message. Putting it all together. Connecting the dots. Refining YOUR work genome. Carrying on the Cornell tradition of greatness in the profession. I mentioned before that I would tell you a little of what happened to the class of 1983, our eclectic band who spent more energy planning Dr. Fox's birthday bash than we did studying for national boards. Where are we now 20 years after graduation, and what lessons can I share from our journey? Well, you have heard my story, abridged. Two other stories will reflect the sum of the whole: First, my classmate Ken Marcella. Ken loved to write, and started writing as an undergraduate at Dartmouth. He was the guy in the class who always asked the deep questions, who always wanted to know "why". We all knew Ken's career was going to Mean Something but no one, including Ken, knew just what! Soon after graduation, Ken got exposed to equine practice. He must have decided then and there that he had found his species of flow. Ken lacked an equine background, but he threw himself into the horse world while he was learning to practice. He paid attention to the nuances of horse sport and horsemanship, seeing these things with fresh and appreciative eyes. Later, he used his writer's sensibility to describe what he learned. The result has been creation of a whole collection of articles for lay and veterinary readers. I'm sure you have seen these in DVM News. Each article is a beautifully crafted pearl that details some element of equine medicine or sport in plain talk. I smile every time I read one of Ken's pieces, thinking back on the thoughtful guy in the back row. Ken did it his way by going with a flow that he never even found until AFTER graduation!

Second example, Paul Pion. Paul said in our yearbook that his career goal was to have time for wind-surfing and bicycling, but also to win the Nobel Prize. I think he may be on his way. Early in his career he figured out that a deficiency in taurine led to visual problems in cats, and he published on this fact. As a result, cat diets around the world have been changed to include this essential amino acid in their formulation, and the vision of thousands of cats has been saved. But Paul did not stop there. No-he was always a bit of a tinkerer, and very interested in technology. He kept fiddling with what he knew about veterinary medicine, computers and the emerging internet. He started a little company. I believe you may have heard of it-VIN, the Veterinary Information Network. This service has revolutionized the way information is exchanged among clinicians around the world. I hear Paul is still riding his bicycle too.

I could go on with 77 other stories of how it all turned out. But my main point is that all 80 of us have, one way or another, figured out how to stay sane while healing the wounds. We have, in 80 different ways, found what our "flow" is, and we have followed it to create 80 different "work genomes" -distinctive careers that meet the deep and varied need the world has for veterinary skill and service. We have kept our eyes open. Many of us have connected bits of information that have never been put together before, and have shared our knowledge with the world. In doing so we have joined legions of Cornell graduates, for we have given back to our colleagues, our communities, to science and most importantly, to the animals who inspired us to travel this road in the first place.

My favorite line in the great racing book SEABISCUIT, AN AMERICAN LEGEND describes the day in 1936 when the scattered lives of Seabiscuit, the washed up racehorse, Red Pollard the half blind jockey, Tom Smith, the inscrutable trainer, and Charles Howard, the hopeful owner, all came together. The book simply states "Their crowded hour had begun." You may know the rest of the story-this unlikely quartet formed a racing partnership that defied all odds and rewrote history. Well, class of 2006, YOUR "crowded hour" is upon you. Put on those white coats and jump in. Go with your flow. Along the way remember that no flower ever grew except through dirt. On the days where all you can see is the dirt-keep watering-eventually a bud will appear. Over time your new white coats will become stained and frayed with the seasoning of experience. As they do, learn from it all and try to give something back. I promise, in 20 years, I'll check in and see how it all turns out!