John Madden White Coat Ceremony Speech

SGU alumnus Dr. John Madden, Associate Dean of Students, United States and Director, Office of Student Development and Career Guidance, was the Master of Ceremonies at the August 2008 Keith B. Taylor Global Scholars Program White Coat Ceremony.

Voltaire once said “Those who are occupied in the restoration of health to others by the joint exertion of skill and humanity are above all the great of the earth.  They even partake of Divinity; since to preserve and renew, is almost as noble as to create.”

While I know some Trauma Surgeons that have taken Voltaire’s Divinity concept quite literally, I think he otherwise has the right idea; a physician is engaged in a wonderful profession- maintaining someone’s health or attempting to restore an ill or injured patient to a healthy state.

I am an emergency physician in Delaware and also an Associate Dean of Students for St. George’s.  I work at a very busy ED where we see over 150,000 patients a year. It is a Level I trauma Center for both adults and pediatric patients. I trained at Jacobi Hospital in the Bronx where I was taught that the emergency department was the safety net in health care; when there is no where else to go for care, you go to the ED. We are the 7-Eleven in medicine- 24 hours a day, seven days a week, 365 days a year.  We care for the sick and injured, young and old, with or without a shirt or shoes on, whether they are intoxicated, abused, victims of crime, those that committed those crimes, those who think they are ill but are not and even those without the ability to pay or a place to call home.  We care for those who have experienced perhaps the most significant crisis that they will ever experience in their lives.

I wouldn’t have it any other way.

I have also been privileged to only work at places where physicians in other hospital emergency departments send their patients because they lack the ability, or in rare cases the compassion, to care for certain types of patients.

We’re here to witness you symbolically join this noble profession of medicine by donning your white coat and reciting an oath.  Today you become part of a tradition that goes back over twenty five hundred years; the physician as a servant of the sick.

During the next several years, here in Newcastle, in Grenada, in your clinical training in the US or UK and during your residency, you will hear your teachers discuss “Core Competencies.”  There are 6 Core Competencies, all of which are vital to your education;

  1. Patient Care
  2. Medical  Knowledge
  3. Practice Based learning & improvement
  4. Interpersonal and communication skills
  5. Professionalism and
  6. Systems Based Practice

Except for medical knowledge, these competencies don’t mean much to you right now. You will become adept at all of these during different phases of your training, but they all start right here – today!  A friend of mine once told me that medicine attracts the best and the brightest from college, but I am quite sure, and lucky for me, that being the brightest in organic chemistry does not make one a good physician.  It is the respect and compassion you show towards those with whom you come into contact, be it patients, fellow students, school officials or the staff that clean your classrooms and it starts right here – today.

Medicine is a team sport.  The physician doesn’t save lives, the team does. Often members of the team never lay eyes on the patient- they may be reading an x-ray many miles away or even on another continent and notice a small growth on an imaging study, or a lab tech that identifies the pathogen infecting the patient that prompts you to change the antibiotic you are giving the patient. We’re all in this great profession together.  Treat each other with respect now and you’ll treat your patients the same way.

You have many hurdles between today and your graduation.  Take it one step at a time- your first hurdle may be a biochemistry or an anatomy exam while your roommates hurdle might be microbiology.  Help each other get over the hurdles and cross the finish line together.  Thousands of Saint George’s students have preceded you.  They had the same concerns and uncertainties that you probably have right now, but they have graduated and as physicians have touched hundreds of thousands of lives.  Your ability to touch these lives starts right here and now with the help of your faculty and fellow students.

I wear a white coat most of the time when I work.  I might change into a hospital gown when I am treating someone who is actively bleeding or needs to be sutured or perhaps even has the potential to vomit on me.  Anyone who has tried to collect a urine sample from a baby boy or even changed their diaper quickly learns how to keep a safe distance.  But after a serious trauma case or a cardiac resuscitation, I’ll put the white coat back on when I go to speak with the family to tell them either the good news or perhaps the news they have been dreading since being summoned to the emergency department.  I put the white coat on so that can see immediately that the physician speaking with them is part of the profession of medicine.  The white coat is the robe of our profession.  Wear it proudly!