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Remarks at the Meharry Medical College Convocation

Remarks at the Meharry Medical College Convocation
As Delivered by Margaret A. Hamburg, M.D.
Commissioner of Food and Drugs
Nashville, Tennessee
Monday, October 15, 2012
 

Thank you President Riley for your very gracious introduction, and for giving me the wonderful privilege of delivering this year’s Meharry Medical College convocation address.
 
I want to begin with congratulations to all: distinguished faculty and alumni; members of the Board of Trustees; today’s honorees and award recipients; President Riley; and, of course, the students.

This is an inspiring occasion. Today is Meharry Medical College’s 137th convocation -- marking the opening of a new academic year and important next chapters in so many lives. 

Convocations are a time for renewal and looking forward; a time for the entire medical school to assemble as a community; and a time for celebrating Meharry’s unique contributions to education, to medicine and public health, and to human dignity, accomplishment and caring.

So speaking to you today is truly a great honor – and I am delighted to be here. 

But before talking about the great traditions at Meharry and the important years that are before you, I want to say a few words about the tragic outbreak of meningitis that is currently going on. As many of you know the first illnesses were discovered right here in Nashville.

I commend the Tennessee Department of Health for their leadership and quick response identifying the cluster of cases and alerting CDC and FDA. This tragedy now includes 205 cases and 15 deaths, including 53 cases and 6 deaths here in Tennessee.  Our hearts go out to the patients and their families exposed to this terrible contamination.

FDA has been working closely with CDC and the states, including Tennessee, to identify the source and cause of this devastating outbreak and to limit further risk.  We have been in close communication with Tennessee public health officials from the start, and that cooperation and partnership has continued as we further investigate this situation.  

As students and young doctors embarking on a career in medicine, you will no doubt face your own medical crises, big and small. And I know that the training you will receive here will prepare you for whatever you are faced with. We are counting on you.
  
This is a remarkable place.

Meharry Medical College has graduated generation after generation of health care professionals, mostly – but not exclusively – African American, who have taken the medical skills and passion they found here to communities whose medical needs were as invisible to most of society as Ralph Ellison’s famous literary creation – the Invisible Man.

One of the doctors who graduated from Meharry Medical College with that skill and passion was my own maternal grandfather, Dr. Minor Francis McCleary.

I feel confident that my grandfather is somehow a part of this convocation today—as proud as he can be, though perhaps a little surprised.

And although he graduated in 1901, it is never too late for me to say thank you to Meharry for the doors of opportunity you opened for him – doors, in turn, that eventually allowed me to become a clinician, researcher, Commissioner of the New York City Health Department, an Assistant Secretary of Health of the US Department of Health and Human Services, and now Commissioner of the Food and Drug Administration.

Unfortunately, I did not know my grandfather; in fact he died when my mother was just a young girl.  We missed many shared moments…and celebrations, so it is especially moving to know that I will soon be receiving an honorary degree from the same esteemed institution that granted him his medical degree.

Through his training here at Meharry, my grandfather embarked on a professional path  in medicine that is now a living legacy for me and my family.  My mother followed in her father’s career footsteps – attending Yale Medical School, as the first African American woman to do so.  Then it was my turn.

I enrolled in medical school and learned many important lessons, some that went well beyond diagnosing diseases and treating patients.  But sometimes the most important lessons come from the richness of culture and tradition – including this old African American spiritual:

 Don’t let nobody turn you around.
 Turn you around.
 Don’t let nobody turn you around.
 Wait until your change comes.

Inspired by my grandfather’s example – not being turned around is what I’ve tried to do my entire career.  But more importantly – not being turned around is what Meharry Medical College has done for its entire history.

Since 1876 – when you started with 11 students, 2 faculty, and classes in a church basement – you have never let anyone turn you around.  Instead, you stood firm, built a world class medical institution, and waited for justice and change to come. 

But for Meharry, waiting for change never meant standing passively on the sidelines.  It meant waiting for change to catch up with the example of professionalism, hard work, excellence, compassion and tolerance you set for our nation to learn from and follow. 

Today, Meharry stands as one of the finest academic health centers in the country – training doctors, dentists, nurses, biomedical scientists, and public health specialists, while never abandoning your core mission of primary care, treating underserved populations, and eliminating health disparities.

In addition, you are an increasingly powerful voice and leader in health policy analysis and research…something of growing importance in the era of health care reform. The Center for Health Policy at Meharry Medical College is training doctoral candidates in economics, sociology, and political science; and helping to build the intellectual base and research capacity America needs to develop meaningful and cost-effective health care policies for the 21st century.

As head of the FDA, I talk frequently about the importance of creating a comprehensive, integrated strategy that engages the full biomedical “ecosystem” to promote and protect health. This extraordinary Medical College—in all of its aspects and activities—represents a critical part of that ecosystem– and is a much needed partner for the FDA.

Working together, we can foster new knowledge and ideas, new regulatory models, and new advocacy to ensure that advances in science and technology today actually translate into real world medical products and interventions that people need and can count on, and that we have a health system that supports vital, timely access to health care, encourages prevention, and that strives to end the shame of health disparities.
The FDA is working on aspects of all of these issues. Also, we have recently established an Office of Minority Health which offers exciting new opportunities to address minority health and health disparities through coordinated leadership on regulatory actions and decision making within FDA, and through partnerships across sectors, disciplines and organizations
 

Of note, through the Office of Minority Health, we have entered into several Memoranda of Understanding with academic health centers that have expertise in health disparities, including one with Meharry Medical College relating to HIV susceptibility among minority women. The MOUs are intended to help matriculate more students into health sciences; foster collaborative research; engage FDA staff with faculty and teaching; and expand FDA’s knowledge base about the intersection of regulatory science and health disparities.

Our work together matters.  As a science-based regulatory agency with a public health mission, FDA plays a unique and essential role in assessing the safety and efficacy of products that come before us, and in helping to support the kind of innovation needed to get newer, safer and better products to people.

We need good science to ensure that this occurs, and we need to be sure that these efforts include an understanding of the impact of these drugs and devices on all populations using them. Good science must also take into account the many factors that can contribute to disease and impair the safety and effectiveness of treatments – and good science must be ethical, respectful….and must be in the service of humanity.

That is the kind of science that I insist the FDA stand for.  And it must always be the kind of science that our nation stands for.
***
Something else that we as a nation must stand for is ending the disgrace of leaving tens of millions of Americans without health insurance.

Probably no medical institution in the country has done more to help the medically underserved than Meharry Medical College.  The founding vision of this school is that all citizens – no matter what their race and ethnicity or income level – deserve the dignity and security of knowing that their health care needs will not be forgotten or ignored.

You have stayed true to that vision by focusing on primary care for underserved populations, teaching smart prevention strategies, and being a model for how a social conscience and a great academic health center can combine to knock down traditional barriers to high quality care in poor communities.

But the problem of the uninsured is national in scope and can only be solved with a national strategy. And that is exactly what the Patient Protection and Affordable Care Act is designed to provide.

Not only will it enable coverage for millions of uninsured Americans – it will improve the quality of health care, put a new emphasis on prevention, and will end much of the cost-shifting to institutions like Meharry as the provider of last resort.

There are also important provisions related to health care education and workforce training: a national commission to review the current state of our health care workforce and projected workforce needs, as well as new support for workforce training in family and geriatric medicine, nursing, dental care, psychology and social work, and cultural competency.

And under the ACA, the federal student loan program will be modified to provide greater support for nursing students, and for MDs who intend to specialize in primary care, along with a new repayment program for pediatric subspecialties who work in underserved areas, with underserved populations, or where there is a shortage of health professionals.

For these reasons and others, the Affordable Care Act is critically important to building a better, more equitable health care and public health system, including education and training our future doctors, dentists, nurses and other health professionals.

But education is about more than better national policies, increased funding, and first rate training at Meharry and other great medical schools.  It is also about who we are as individuals.
 
Dr. Martin Luther King said, “The function of education is to teach one to think intensively and to think critically.  Intelligence plus character – that is the goal of true education.”

If life has taught me anything – it has taught me that Dr. King was right.

My experiences as a med student and during my residency training taught me so many things beyond the classroom; to be humble, resilient and also optimistic.  They taught me that I was capable of stepping up and taking responsibility.  They taught me to ask questions – and to trust my instincts.  They taught me to listen, to think through problems and to defend my decisions.  And perhaps most important -- they taught me that no matter how difficult the night – and I have spent many a sleepless and anxious nigh t-- the morning always comes.

In other words, I learned I would survive and even thrive.  Those skills and perspective have served me well in everything I have done since — especially in my current job.
 
So why do I tell you this?  In part to assure each of you – that no matter what your field of study and practice – you, too, will survive…and thrive.

But I also want to make the point that education – especially medical education – is not just about studying hard, getting good grades, and impressing your attendings with your sharp minds and impressive clinical skills.

It is also about character – and the qualities that build character:  endurance, persistence, resilience, self-reliance, self-control, facing up to fear, getting back up after you’ve been knocked down, and an intangible quality best summed up by the word – grit.

Earlier this year, Paul Tough published a book entitled,  How Children Succeed:  Grit, Curiosity, and the Hidden Power of Character. I have to confess that I haven’t read it cover to cover, but the book underscores a crucial insight—one that is perhaps a bit contrarian to some of the thinking today with our societal emphasis on test scores and grades.

Being smart matters…but so does having goals, working hard, and the ability to face up to difficult challenges with courage, resilience, and grit. In the crucible of life, these may prove the better measure of future success than sheer brainpower.

And that is why I think there is real hope in this message.  Grit, curiosity, self-reliance, and optimism are not written into our DNA.  They do not belong to any one group or class.  They are not out of reach of any child. 

But we need to make character building part our message to children growing up in poor  and affluent communities alike.  It must be part of what we seek and reward in our students, our  educators, our leaders…and it certainly must be part of what we value and learn as members of the medical community.

***
Let me close with this thought.  As I look around this room I see the power of character.  You are taking on one the most difficult academic challenges, excelling in medicine and science.  If you haven’t had stressful, “what-have-I-gotten-myself-into” days yet, I promise you – you will.

But I also promise you that by choosing Meharry Medical College – whether as a student, faculty or staff -- as the place to pursue your medical and public health careers, you have made character and commitment the driving force behind your success.

You didn’t have to choose a medical school with a rich history of social conscience.  But you did.  You didn’t have to choose a medical school committed to serving poor communities and ending health disparities.  But you did.  And you didn’t have to choose a medical school that looks for students that nobody can turn around.  But you did – because that is who you are.

And for that you have my thanks, my deepest admiration, and my very best wishes for a successful new academic year at Meharry Medical College. 
 
Thank you.