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Remarks by Dr. Rajiv J. Shah at the University of Pennsylvania Perelman School of Medicine Commencement

As Delivered on Sunday, May 16, 2021

Hello everyone.

Thank you, Dean Jameson, for your leadership, especially over the last year, and that kind introduction.  I also want to recognize so many professors here from my time at Penn, especially my mentors Dr. Sandy Schwartz and Dr. Sankey Williams.

Congratulations to the graduates in the class of 2021.  You made it.

As all of you know well, you are about to become medical leaders during what remains a deadly and devastating global pandemic.  The challenge is not new for PennMed alums.  This is America’s first medical school – and over the last 250 years, its graduates have fought yellow fever, treated patients for cholera and typhoid, hookworm, and polio, and done research on H1N1, HIV/AIDS, and Covid-19. After these last few years, each of you is ready to continue in that proud tradition.   And from the number of spouses, family and friends logged on to this ceremony, it’s clear you’ll have the love and support to do so.

Now, it’s a little funny that at a time when critical care clinicians and research scientists are regularly trending on Twitter, that Penn chose someone to give this address who’s neither.

Still, we’re colleagues in a different way.  Like you, I took the Physician’s Pledge at my White Coat Ceremony and dedicated “my life to the service of humanity.”

In my case, to meet that pledge, I’ve had to learn to embrace change. So, I’d like to talk to you today about two stories of change from my life – one started with a long car ride and the other on a short jog – and what I learned along the way.

The first story is about how unsettling change can be.

The day after I took my board exams, I woke up early for a 14-hour drive from Philly to Nashville, Tennessee to join Al Gore’s campaign for president.  Actually, I think my fiancé Shivam did most of the driving as I slept off the previous night’s celebration.  Either way, joining a presidential campaign is not what you’re supposed to do the day after you take the boards – so let me explain.

When I was at school here, I loved seeing patients during clinical rounds and my then-classmates’ friendship and sheer intelligence.  And I really enjoyed the cadaver lab.  But I also struggled with the question of whether I wanted to serve individual patients or work to change national policy.  As a child of immigrants from India, I fell in love with politics watching the 1988 conventions on TV in our living room.  At Penn Med, I learned about America’s deep social and health inequities by participating in programs like Students Teaching Aids to Students in West Philadelphia.  And at Wharton, I also learned about the role of incentives, economics, and policy in trying to achieve health for all.

But I had no idea how to create major social change.  So, I rather naively just applied for a job on the Gore campaign.  I got rejected a few times but kept applying until they finally said I could join as a volunteer intern.  As you can imagine, leaving school after more than 4 years in the MD-PhD program was a giant change in my career plan.

Thanks to mentors here at Penn, I was able to take a leave from school, my scholarship and all the expectations I’d grown up with. And I arrived in Nashville brimming with enthusiasm and ready to change our nation on day one.

It didn’t quite work out that way.  Rather than working on major public policy ideas, I was chauffeuring campaign staff around town and making copies of old newspaper articles at the Nashville Public Library.

After a few months of this scut work, I was panicked.  I had left medicine and I was not exactly changing the world.  I felt like an outsider.  I was ready to throw in the towel and return to school.  On one dark, rainy night, I called Shivam and told her I’d made a big mistake and wanted to return to Penn where I felt comfortable and valued.  She talked me out of leaving; and over the next few months, I kept at it.

I eventually got a proper job on the campaign.  And for a few hours late in the evening on election night, I even thought I was headed to the White House to work for a president.

Of course, it didn’t turn out that way.  By January, I was back in West Philly.  But my worldview had changed, and so had my life plan.  I was better able to understand that as unsettling and risky as change can feel, I needed that experience to pursue my real calling.

Instead of doing a residency, I was asked by someone I met on the campaign to join a new foundation created by Bill and Melinda Gates.  There I got to be a part of the team that set an audacious goal: that every child everywhere should be fully vaccinated.  To do so, we built new partnerships across industry, governments, and NGOs, and we invented new ways to finance and procure vaccines.  These efforts saved millions of lives – and created a template for the development and distribution of Covid-19 vaccines today.

A few years later, I joined the Obama Administration.  As a newcomer to Washington, that unsettling feeling of uncertainty occasionally returned when I was overseeing America’s response to the earthquake in Haiti, negotiating aid arrangements alongside the military in Afghanistan, and searching for new solutions to break transmission rates early in the Ebola pandemic.

Each of these tasks involved embracing change – trying new ways to solve problems and asking others to embrace risk and uncertainty.  On reflection, I really believe my most satisfying and successful professional experiences have all been grounded in setting big goals, taking risks, and above all, embracing change. I hope you will have those opportunities in your endeavors.

This second story I want to tell you is about using your voice.

A few months after I started at the Rockefeller Foundation in March 2017, I was in New Orleans where I met Mayor Mitch Landrieu.  We talked about how New Orleans, like many cities around the country, was not only plagued by systemic racism and violence but also stained by monuments to the Confederacy. Mayor Landrieu asked that The Rockefeller Foundation provide a grant to help take down four Confederate monuments, including a towering statue of Robert E. Lee.

I was less than 10 weeks into my job at one of the most storied foundations in America, and I was excited at the opportunity to make a mark on such an important issue.  But when I started making calls that night to discuss removing the statues, all I heard was how doing so was complicated.  It was complicated because, as one philanthropic leader argued, many of those with the deepest pockets in New Orleans liked the statues just fine and might not support our future partnerships.  It was complicated because, as some on our team rightly worried, white supremacists might take aim at Rockefeller offices, and we didn’t have security in place to protect our staff.  And it was complicated because The Foundation hadn’t worked on racial justice issues in recent years, and we worried about looking naïve on such a complex public issue.

Making a statement is often complicated.

For a time growing up, my family lived in rural Pennsylvania.  I was the one brown kid on a big yellow school bus filled with white children.  On most days, I got on that bus, sat in the back, and felt like I didn’t belong.  I stayed quiet.  You see, if I didn’t attract attention, I would be less likely to be called names, made fun of, or worse.

I hated that feeling.  Anyone who knows me knows staying quiet is comes at great difficulty.

So, when I woke up in New Orleans the next morning, I went for a short jog to see the statue of Lee, which had stood cross-armed and defiant since 1884.

As I stood there in the shadows of both the Confederacy and my own experience, I decided that I wanted to do what I could to ensure children in New Orleans no longer had to walk to school under the watchful eye of a Confederate general.  I wanted to use the newfound authority in my role to make a statement.  So, Rockefeller made the grant – and one month later to the day the statues came down.

From that day forward, our country engaged in a debate about monuments and statues – and other communities followed New Orleans’ lead.  Unfortunately, not long after, a counterreaction began as white nationalists rallied with torches in Charlottesville, Virginia to save another Lee statue and later the Proud Boys marched in Philadelphia and elsewhere.

Clearly, helping to take down a few offensive monuments did not end racism in America.  But it was the right thing to do.

After today’s ceremony, other people will address you as “doctor” for the rest of your lives.  Congratulations, you’ve earned it.  In this country and around the world, that title immediately confers respect and authority.  It is the authority that comes with knowing how to heal a suffering patient. But it’s also a signal that you’re a leader – in your community, in your institutions, in the country, and in our world.

You’re voice matters.  I hope you will use it to do the right thing.

When I look back on that long drive to Nashville and that short jog in New Orleans, I’m reminded of how much we all must change ourselves in order to realize the change we want to see in the world.

I hope you keep taking risks, keep learning, keep growing, and keep changing.  As you do, there will be moments of panic – moments when you’ll wonder what you’ve gotten yourself into.  My advice to you is to go find those moments when you’re at the edge of who you are and what you can do for your patients, your community, and our common humanity.

And when you get there, keep going – embrace that change.  Because I’ve found we all need to reimagine who we are and what we want this world to be – perhaps now more than ever.

Thank you and congratulations.

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