Tribute to the Med School Class of 2020

We hope you enjoy Dr. Donald Berwick’s comments to the 2020 graduating classes from our medical schools, a celebration coordinated by the American Medical Association. At the end of the piece is the link to the video of this speech.

Dr. Donald Berwick’s tribute to the med school class of 2020:

As I was preparing this graduation speech, some words insistently came into my head the same way that a song sometimes does—the song that just won’t go away. It was the famous St. Crispin’s Day speech from Act 4 of Shakespeare’s play “Henry V.”  It is the eve on the Battle of Agincourt, in which the English, greatly outnumbered by the French, are about to fight. A soldier wishes out loud for more troops, and King Henry reproves him. He says how fortunate are “we few, we happy few” who get to be there. He says, “And gentlemen of England now a-bed shall think themselves accurs’d they were not here, and hold their manhoods cheap while any speaks that fought with us upon St. Crispin’s Day.”

This is a tough time, and I think many of you are sad, of course, about the opportunity the virus has denied you to enjoy these final months of training together, and the proper celebrations of your well-earned Graduation Day. And you are all, more importantly, saddened by the vast suffering, especially for the poorest among us, that the pandemic has brought.  The losses are immense. The recovery will be long.

There is nothing pretty, nothing glorious about this global tragedy. But I want to ask you to notice something with me, please.

Long before the coronavirus something was growing amiss in the world of healthcare that you are entering now. Something has come off-center.

You’re entering a calling that is by any measure noble. Your fellow human beings will soon honor you with their generous trust and trembling hope. They will bring to you some of the most frightening worries and the most secret burdens of their lives.  They will tell you things they will tell no one else; permit you to probe and inquire as they would no one else; place their fates in your hands as they would no one else. That is wonderful.

But, to be honest, slowly and erosively in recent years, that sacred encounter has been invaded by tones and motives that do not help. They harm. Finance has displaced compassion too much. Technology has displaced relationship too much. Too much has greed displaced generosity; opacity displaced openness; inequity displaced equity; pace displaced patience. That may affect you. Drs. Simon Talbot and Wendy Dean have written eloquently about what they call “Moral Injury”—to doctors and nurses who want to help patients but find themselves embedded in contexts that make that confusing and hard.

And now, we have coronavirus. It is the strongest reminder—the loudest call—in decades about what really, really matters. It is a signal to every single one of you about the importance of your mission, the meaning of your calling, about true north. And, in its face, the threats to our purposes are revealed for the deceivers they are. COVID-19—with its puny 15 genes—commands us to connect to our deepest values—healing, caring, justice, equity, respect for each other, and love for our work. That is your Agincourt.

You few, you happy few. This time has brought you some short-term losses that you will soon forget, but it also brings you duties and opportunities that you will never forget. The time will come when you will tell the story of how, together, you joined your colleagues in difficult times to do what is important—which is, simply, to help. And people now a-bed will feel a tinge of envy they were not here when you joined this noble fight for survival, healing, and boundless compassion. Thank you for who you are, and for what you will do.

Watch Dr. Berwick’s speech below, from 50:43 to 56 minutes: