Dean’s Column

The three remarkable individuals to whom we have just conferred honorary degrees (Richard Gozon, Dr. Prabhakar Basavprabhu Kore, and Dr. Marion Siegman) come from very different walks of life. The worlds of business, politics, and academics. Yet they share in common fundamental approaches to life, human qualities, and core values. Their lives reflect an optimistic embrace of life professionally and personally. Their lives are infused with commitment to service and a deep sense of social good. Their lives speak to independent thinking and being firmly grounded within an action-oriented, details-matter gestalt.

I’ve crafted my parting comments to you today with these honorary degree recipients in mind. At this landmark transition point of your lives, Class of 2022, and as a once-in-a-century pandemic winds down to an endemic, it is a perfect time to reflect deeply on how you choose to approach life in the years to come. On how you see your broader obligations to society, do listen intently.

A crystal-clear day, brilliant blue skies, a rocket heads to space with a trail of fiery engine exhaust marking its upward trajectory. Just one month ago, along with several Jefferson colleagues, I was there, at Cape Canaveral, 3.5 miles from the launchpad. Awestruck, we witnessed Axiom 1 on the first private mission to the International Space Station. Four astronauts in the Dragon capsule atop the SpaceX Falcon 9 rocket. One carrying 35 biomedical experiments, three of them designed by Jefferson scientists. As the earth beneath our feet rumbled, I was struck by the wonder of it all. A technological marvel of mankind, and now personalized. Our 200-year-old institution heading to space in the service of humanity. Our one small step for mankind, one giant leap for Jefferson.

Several years ago, I stumbled upon the writings of Haruki Murakami, one of Japan’s most distinguished literary writers whose novels are as much poetry as they are narrative. From his masterpiece novel 1Q84, “Where there is light, there must be shadow. Where there is shadow, there must be light. There is no shadow without light and no light without shadow.” This motif has resonated for me ever since.

And so, too, that day at Cape Canaveral—light and shadow coexisting, interlaced: the human condition. The light, the uplifting sense of awe at human achievement exemplified by a rocket headed to space loaded with experiments to advance human wellness. The best of the human spirit amplified by the potential each of us has, to make a profound difference. Yet, simultaneously tugged in the other direction, dragged down to earth. We find ourselves mired in a world in which humanity’s worst is manifest. Social discord, body politic fragmentation, absurd wars, shadow obscuring, and almost obliterating light.

According to Murakami, both must be embraced, the light and the shadow. But, how to square the two? Look what they share in common. One of those commonalities is that both are under our influence. We have personal agency over both. Let me explain. You and I can choose how we see the world and what we let in. We choose to admit the light. We choose to confront the shadow. We control the shutter, open, shut, and we can be purposeful about it.

First, the light opens the shutter and the many wonders that envelop us pour in. Caught up in our humdrum routines, we may ignore them, perhaps they’re too close. Like the neo-impressionist pointillism of a Georges Seurat painting. Up close, a cacophony of disconnected dots; but take a step back, and the image emerges with heightened luminosity and brilliance of color. So too, life. Most often, we’re simply too close up and so see mostly flaws. But step back, disengage and the wonder of it all emanates. What is there overrides what is missing.

As the 20th century Swiss modernist Ludwig Hohl puts it in The Notes, “Some things can only be made clearer when one distances oneself drastically from them.”

Class of 2022, from time to time, step back and indulge yourselves in a sense of awe, the magnificence of life, the gifts in your lives. A dose of wonder can do wonders for you. Therapeutic rebalancing, amidst the modern world’s crescendo of negativity, souls still sore. You must first open the shutter and let the light in, and then take a step back to see the image in its totality.

But shadow, too, is important. Seeing the light doesn’t mean a Pollyanna-like “la la land,” where we convince ourselves that all is wonderful, blind to society’s blemishes, ignorant of social needs, disengaged from a world in need of repair. Quite the contrary, where there is light, there is shadow. And shadow, too, must be confronted. We all have a moral obligation to generate rays of light to pierce the shadow. Call it social responsibility.

Last July, Sal Mangione of our Department of Medicine and I co-authored an article in the New England Journal of Medicine commenting on the passing of Bernard Lown, a 20th century luminary of the world of cardiology who devoted his 100 years on this planet advocating for physician social responsibility. Lown, a lifetime mentor of mine, was awarded the 1985 Nobel Peace Prize for his passionate stance against nuclear proliferation.

In our article, we noted the concurrence of two other centenary landmarks, the 200th anniversary of the passing of Rudolph Virchow and the 700th anniversary of the passing of Dante Alighieri, both icons in the realm of social responsibility. Indeed, Dante had so little tolerance for indifferent bystanders to social ills that he relegated them to the worst part of hell, the anti-inferno. The likes of Lown, Virchow, and Dante demanded that we see the shadows and confront them. Never be the bystander—engage.

Yes, engage. But how, and for what causes? Think Marcus Aurelius. Embrace stoicism. The philosophy that suggests we devote our energies to that which we can meaningfully impact. If you can’t control it, lose it. The solution lies in what you can control. Avoid the performative, stay away from social theater, be substantive, and frame action around realities. Be informed, probe deeply into issues. These admonitions all call upon personal agency. You are responsible.

A phrase that I’ve personally coined captures this: Social responsibility does not mean socialized responsibility. You, each of you, must think through the issues yourselves, thoroughly. Social responsibility starts with your own independent thinking, not with prepackaged, socialized thinking. Details matter. Again, from Ludwig Hohl, “People always say, on the whole, or overall, but everything comes down to details. Anyone can write a novel on the whole, but it takes a Dostoevsky to be up to the detail. Anyone can improve the world overall, that is, imagine a better world, but conceptualizing particular ideas is more difficult. Still, only the latter changes the world. Nothing can be changed overall. In this realm, ideas always remain ideas, that is, unproductive and sterile.”

In being socially responsible, here are some things to avoid: intellectual monocultures, tyranny of the crowd, political tribalism, and the curse of connective technologies. In probing matters more deeply, do not rely on cartoon images or adopt the word salad of others. In developing your opinions and passions, practice freedom of speech, not freedom from speech. In refining your arguments, make clearings in the forest and shear the overgrowth that obscures issues.

The Dutch poet and novelist Cees Nooteboom in 533 Days invokes a useful metaphor: “Negative sculptor changing the shapes of trees. So the garden receives more light.” Yes, negatively sculpt. Hack away the tree limbs and branches that block lines of sight that cast shadows. Nooteboom says, “He wandered for days in an insane twilight world. A forest of obsessions magnifications exaggerations, hysteria, microscopic observations, a reality that is creating itself. This forest needs pruning.”

Another metaphor from former Yale Law School Dean Anthony Kronman: “The wavy mirror that prevents us from seeing ourselves as we are.” In his words, most people remain slaves to reality—prisoners to illusion. Prisoners of illusion. Too often we have and present to the world, distorted images of ourselves. As digital marionettes, even slaves, we shape gestalts that are simply ill-informed. For Kronman, an antidote to such imposed icons and distortions is cherishing our individuality, which he describes in After Disbelief: On Disenchantment, Disappointment, Eternity, and Joy as “an inexhaustible source of innovation and surprise a bottomless well.”

Reinforcing this point, Kronman quotes Walt Whitman in advocating “a way of life that encourages the full flowering of every individual’s unique personality in a tapestry of infinite diversity.” Cleave to your individuality. Demand of yourselves independent thinking, even when information is being handed to you with a patina of science. Speaking as a scientist myself, science is not embodied in individuals, institutions, or philosophies. Science is not a monolithic body of knowledge.

No, science is a way of thinking and scientific knowledge evolves continuously. Science has had its share of scientific pretenders these past two years. Scientific data cherry-picked, politicized, and glued into pastiches for mass consumption to drive predetermined agendas, scientific fog. Common sense must reign in drawing conclusions from bits of science and pieces of scientific data offered. In finding your way, you have the right to question every realm, including science itself.

So, Class of 2022, in closing, life has light and shadow—open yourselves to both. Disengage from time to time to appreciate the light, but also engage to clear away shadows, to escape the anti-inferno of the bystanders. Next, in giving life to your social responsibility—let’s coin it “physician social responsibility”—be focused and intentional. Sift through the babbling brook of potential causes others would have you rally around. Thoughtfully navigate what Cees Nooteboom refers to as the “confused forest of voices, words linking into one another without immediate intelligibility, voices over and through one another.”

A kaleidoscope of worthy causes are out there. For some, it may be starving children in Africa. For others, climate change or gun control, or maybe global health inequities or past injustices to Indigenous peoples. Do your homework, give credence to complexities. And when you identify your passion, probe deeply into the matrix of attendant issues. And only then, as a stoic, pursue meaningful action. Put another way, don’t find yourself an actor in the wrong play.

Third, cherish and reinforce your individuality as you relentlessly push yourselves to think independently. And it truly takes pushing. In the words of Ludwig Hohl, “People today are simultaneously too busy and too lazy.” Try not to be lazy. One search on the omniscient internet cannot suffice. Your education has conferred upon you the intellectual tools to think contextually, critically, and creatively. Use them.

And lastly, and at the risk of channeling a preacher, let me add, the light and the shadow can contribute to a search for purpose and meaning. We are a species capable of awe, of appreciating the grandeur of nature and human life. That is light. We are a species capable of kindness, of acting in ways that tolerate others and address their just needs. That is piercing the shadow. From these vantage points come purpose and meaning and the ability to see beyond the horizon of your own lives, to the glimmer of things that are greater.

Class of 2022, Thomas Jefferson spoke of generational revolutions. You are living through one right now amidst this third machine age of the internet, where we are witness to a social fabric that is fraying, subject to social media mind control, and flattened by dreary ideological conformity. Times of change demand independent thinking. Be willing to frame new possibilities, new mindsets by thinking freely and independently. Live your own life, not the life of another. And dial up the optimism and kindness. As physicians, you are already hardwired for both. Congratulations, onwards and upwards.