Leadership in a Changing World
Commencement Address to the Feinberg School of Medicine at Northwestern University, May 19, 2006
Peter G. Traber, M.D.
President & CEO
Baylor College of Medicine
It is a pleasure for me to be here this evening and join in the celebration of the Feinberg School of Medicine graduation.
We are all here to honor and celebrate your success in medical school as you take the next step of becoming a physician. Twenty-five years ago I was sitting at my medical school graduation and preparing to come here, to Northwestern, for my Internal Medicine residency. The love, support, joy and good cheer at a medical school graduation is wonderful. I clearly remember that feeling—a feeling of great gratitude for my family and all who supported my efforts to reach the goal. As each of you experience the exhilaration of this achievement, I know you will also be thinking of those who share this achievement with you today – your families, your faculty and other important individuals in your lives. On behalf of the graduates, I thank all of you who have done so much to bring them to this point.
The world of health care and biomedical science is exciting and exhilarating, maybe more so now than any time in history. It is also very challenging. We live in a time of socioeconomic inequalities, difficulties in the financing of health care, and deep ethical dilemmas brought on by controversies surrounding human and animal experimentation, individual privacy, genetic and tissue engineering, cloning, and many more. Because of this, your success in medicine will depend not only on your knowledge, but on your strength of character. You will deal with new diseases and therapies, but you will also face new problems and challenges associated with well-described diseases.
For example, when I was in medical school, a landmark was achieved when the World Health Organization announced the eradication of smallpox – the first such occurrence for a human infectious disease. However, our world has since changed. Now we must consider smallpox a possible weapon of mass destruction and scientists and physicians must determine how we might deal with this disease again.
Soon after the eradication of small pox, we were soon surprised by another deadly virus. In 1981 the first cases of unexplained immune deficiency syndrome were reported, and by 1983 the HIV virus had been identified. Over the last two decades there have been tremendous advances in our treatment of AIDS which have dramatically improved the outlook for those with the infection in this country. However, the outlook for infected patients is different in other parts of the world. AIDS is decimating many countries, and threatens the entire continent of Africa. For this disease, and in fact many others, you will see this dichotomy between what is possible and what is actually achievable, even in the communities where you practice medicine.
Most of you will practice the art and science of medicine in a high tech environment with all available instrumentation, diagnostics, and therapies at your finger tips. But at times you will need to call on your most basic skills and simple human compassion, as I saw from many Houston physicians who responded to evacuees from New Orleans after Hurricane Katrina, and as we all saw from colleagues who traveled across the world to care for people wracked by tsunamis and earthquakes.
As physicians you will be called upon to help your patients, and your communities, cope with difficult choices in health care and situations that challenge the way we conduct our lives. For your patients, and society, to effectively deal with this type of change, each of you will need to be a leader—to show leadership in both your personal and professional lives.
What is a leader? Leaders are visionaries who energize others. They stress relationships, values and commitment. Leaders are unsatisfied with the status quo and create visions of what could be. Although some are charismatic, many are humble, quiet, and persistent. Their ambition is for others, not only for themselves. The best leaders have an attitude of service and humility. They strive to improve situations and they approach their efforts with a ferocious resolve. There are also some things that leaders are not. They are not loud, showy, pompous, nor self-aggrandizing. It is important not to confuse leadership with power.
One of the best descriptions that I have heard is that leaders help their organizations or individuals cope with change. Change evokes anxiety and as John Kenneth Galbraith said: "All of the great leaders have had one characteristic in common: it was the willingness to confront unequivocally the major anxieties of their people in their time. This, and not much else, is the essence of leadership." You will be called upon many times to help your patients, their families, and your communities cope with change.
Leadership skills are not inherited and people with many different personalities have been great leaders. I believe that each of you can, and should, develop your leadership skills through introspection, study, experience, risk taking, and emulation of others. I also believe you must develop your own moral compass as a guide when you face difficult times and conflicting opinions. This compass is the set of principles and values that you individually view as crucial to the conduct of your personal and professional life.
There are many principles and values that may be important to you including honesty and integrity, justice, compassion, striving for excellence, courage, respect and tolerance for others, professionalism and trust. Defining your own moral compass will aid you in building depth and meaning in your life, developing leadership skills, and caring for your patients.
Your leadership skills and moral compass will serve you often in your daily lives and will help you make decisions, some large, some small, and on rare occasions, profound. I believe each of you will encounter opportunities for profound decisions. These might be called leadership moments. They are points in time when individuals, faced with difficult situations or problems, have been guided by their moral compass and character to make a decision that affects many lives in a positive way.
Let me tell you about one person's leadership moment. It demonstrates how one man was in tune with his moral compass and how it took him in a direction he never dreamed.
Dr. Mark Kline is a pediatrician at Baylor College of Medicine, who specializes in infectious disease and HIV/AIDS. In 1996 he made a trip to Romania that changed not only his life, but the lives of children around the world. Mark visited an orphanage in Romania where children with AIDS had literally been abandoned and simply left to die. His "moment" was standing there in that orphanage.
He had seen Texas Children's Hospital that was once filled with dying children, empty because of effective HIV therapy. He wanted to give HIV positive children in Romania the same chance for life as those children he treated in Houston. At that very moment, he resolved to do something. He came home committed to finding a way to improve the care of children in Romania with AIDS.
Mark became one man with a passion, not for recognition, but for finding a solution. He formed the Baylor International Pediatric AIDS Initiative as a way to address the global epidemic, although initially he was the only participant. It took him five years, but through this program, he opened the Romanian-American Children's Center in the city of Constanta in 2001 to provide care to some 600 children.
During those formative years, he developed an approach for providing care for children with AIDS that included partnering with government and medical leaders in developing countries as well as U.S. pharmaceutical companies. The success of the program in Romania is striking. The annual pediatric HIV/AIDS death rate for children treated at the Constanta Center dropped from 16 percent in 1999 to 7 percent in 2002 to 1 percent in 2004.
Dr. Kline's passion drew colleagues and supporters who embraced his plan and he led them by inspiring them. In 1999, while still developing the Romanian Center, he found himself leading a team to sub-Saharan Africa – a region he said he heard "screaming for help" in dealing with their pediatric AIDS epidemic.
What he found in Africa was at first discouraging. Pediatricians were in short supply and children were dying at such a high rate that an entire generation was at risk of simply disappearing. But Mark was a leader who saw great opportunities for success with a community in Botswana that was looking for hope as it faced a death rate of 57 percent in children under the age of five. Four years later, in 2003, he opened in Gaborone, Botswana, the second international Center of Excellence to treat children with HIV and AIDS.
Since establishing the Baylor International Pediatric AIDS Initiative, Dr. Kline, his team, and his public and private partners have created pediatric HIV/AIDS care centers and programs in 14 countries in Africa as well as in Romania, Ukraine, China and Mexico. Combined, they have a greater number of HIV-infected children on treatment than any organization worldwide. But more than providing care, he has also created educational programs to train health care providers in each country on how to care for these children and their families.
In December I went with Mark to Africa and saw first-hand what the work of a leader with a global vision and a strong moral compass could accomplish. It was awe inspiring. For many of you, leadership with these results might seem daunting, but I want to remind you that this success resulted from a man who calls himself a simple pediatrician just wanting to take care of children. His vision, his focus on excellence, and his quiet determination and his leadership led to success. He was prepared to take advantage of his leadership moment and it has helped provide hope for an entire continent. As Napoleon Bonaparte once said, "A leader is a dealer in hope."
In a more limited way, my leadership team and I faced a leadership moment in the aftermath of Hurricane Katrina. Tulane University School of Medicine was evacuated from New Orleans and there was no hope of reopening the school for the academic year. Students and residents faced losing at least one year of their education, and Tulane faced the loss of their medical school. Without understanding the cost or logistics, our team agreed to take them in—all of them. Other institutions in the Texas Medical Center and medical schools in South Texas rapidly joined the effort. Last weekend I attended the commencement at Tulane. The students graduated on time. I was very proud of Baylor College of Medicine, which relied on academic values, our moral compass, to step in at a time of a sister institution's need.
In medicine you will be called upon to be more than just good at practicing your profession. You are also called upon to contribute to the greater good of our community.
Therefore, my suggestion for being a leader in a period of change goes back to the moral compass that only you can develop. Contemplate what values, principles, and spiritual teachings are most important to you. Define them and discuss them with your family and others you respect, and then put them into the context of your life. Society is counting on you to take on these challenges and ensure that scientific advances benefit individuals while respecting the dignity of people and the moral constructs of those individuals and their families.
In closing, I would like to share with you a quote from the American author Leo Rosten who wrote, "I cannot believe that the purpose of life is to be happy. I think the purpose of life is to be useful, to be responsible, to be compassionate. It is, above all to matter, to count, to stand for something, to have made some difference that you lived at all."
The future before you has unlimited possibilities for making a difference, for providing hope.
You have my very best wishes as you graduate and become the next generation of physician leaders.
Thank you.