Tradition

In “Fiddler on the Roof” Tevye struggles with the blurring of traditional roles and choices for his children. Why must we keep doing what was done by previous generations? Tevye answers in song ,”Tradition!”

This past weekend I participated in a ceremony that is hundreds of years old – commencement. The end of a period of academic study, it is seen as not only the conclusion of one phase in the student’s life, but the beginning of another. So why would a 54 year old surgeon fly back to Boston from Los Angeles, to dress in medieval academic garb, and stand in the sun with 4000 others for several hours.

Tradition!

The commencement ceremonies at Harvard Yard predate the founding of this country. And from the initial class of 9, certain consistencies have been passed from generation to generation. Bagpipers escort the classes through the various gates surrounding the central yard, undergraduates congregate to the left, graduate students to the right, with the oldest schools situated closer to the stage. The President and Fellows arrive, wearing the traditional garb of their home doctoral institutions. To begin the ceremony, the Sherriff of Middlesex County, as he has for over 3 centuries, approaches the lectern and bangs a silver tipped cane three times, calling the meeting to order. Three speeches are given, from memory, by two undergraduates and a graduate student. The first was in perfect Latin (a variation of “Wheel of Fortune.”) With specific scripting, each school is asked to rise, and the President bestows the degree en masse. Symbols are waved by each class – gavels for the lawyers, angel wings for theology, stethoscopes for the med school. We in Public Health were given plastic fruit.

The awarding of the honorary degrees was a bit more light hearted, the provost introducing each honoree as if it were a game show. The high point was when Placido Dominigo, after receiving his degree, sang the citation to Justice Ruth Ginsberg, herself an avid opera fan.
The Sherriff, still regal in a top hat and tails, again banged three times, and dismissed the meeting.

On the streets of Cambridge, several of my classmates and I were stopped by a group of Japanese tourists, who wanted their pictures taken with us in full dress. I must admit it was a little strange.

In the afternoon, we did the walk across the stage to receive our copy of the Declaration of Human rights. All of the School of Public Health was present, and after another set of addresses, the 480 names were dispensed with fairly efficiently.

In the crowds afterwards, my classmates all dispersed to meet family and friends. No real chance for a formal goodbye. I turned in my gown (kept the tassel, I guess for the rearview mirror), and picked up my diploma. More than 25 years since I last graduated from a formal program. The same sense of accomplishment, perhaps a bit more pragmatism, and a bit less uncertainty. And I wondered what to do next.

When my middle child, Adam, graduated from Hamphshire College, there were no caps and gowns, the diplomas were a circle and you were identified by the year that you entered, not graduated, signifying the beginning of lifelong learning. A tradition reflecting the nature and values of this innovative institution. At Wesleyan, my oldest son, Ben, walked with his classmates down the hill between rows of faculty who formed the entrance to the field and applauded the graduates. I will feel intense emotions next year when Rachel graduates from Hopkins.

Traditions may not make great sense in a modern world. In reality, our transcripts are all electronic, and the diploma could be sent as a pdf file. Yet we as humans do things that aren’t always rational, but give us a sense of continuity. Perhaps it is our own way to assure a degree of immortality – continue the traditions of those who raised us and are no longer here, hope that our children and grandchildren will remember us through traditions after we are gone.


It’s been a while since my last post – finishing school and some new work projects have kept me busy. But I look forward to sharing with you more perspectives on Haiti and Hospital Sacre Coeur – Rachel and I will be travel there in mid June for a week.

Now there’s a tradition I hope will endure…

A World View

Last Sunday evening, I was returning from dinner with several of my classmates in Boston. Entering the hotel, we saw the television with a somber Wolf Blitzer building up to President Obama’s remark about “an issue of national security.” As we sat in the lobby, I looked around and realized that half the people I was with were from other countries. How would they react? Is this as big a deal to them as it is to Americans?

Earlier that weekend, we presented our year long practicum projects, a extensive planning and execution program. Those that have been following this blog know I worked on our ambitious inventory control project for Hospital Sacre Coeur. As I detailed what we have and haven’t been able to complete, I found myself discussing civil unrest, cholera outbreaks, and electricity that goes out twice a day during the switch from the generator to inverters. I also showed pictures of the volunteer electricians from the San Francisco bay area, Ed Constantine and his airplane, and the Haitian workers, digging out stumps and pouring concrete by hand to cultivate the sprung building. It was a remarkable examination of what can be done when committed to a cause.

At the same time, I listened to presentations as diverse as improving the experience of complex cardiac surgery patients in the Netherlands, to the challenges of attracting a new chief to a struggling academic department, and how to get specialists to cover an emergency room at night, when the patients had no insurance. Other international projects began an ophthalmology residency in Cambodia, examined the cultures and motivations of the staff in an inner city federally funded health care center, or presented the business plan for merging several multimillion dollar cardiology practices to maintain viability given massive cuts in reimbursement. The key theme was that by understanding what motivates people, aligning the incentives to meet those motivations, and realizing that all of life is shades of grey, problems can be addressed and the human condition improved.

What does this have to do with the killing of Osama bin Laden? My colleagues from other countries were happy for America that it had achieved a goal and found some degree of justice. But they were also saddened at the amount of resources and lives that we expended in fighting these wars. A recent NPR broadcast discussed the “the economic death of a thousand cuts” as one of the methods used by terrorists. There is no question that every country must defend its people, and in societies, certain segments need to take on the role of policeman. We in America have chosen that role, and also have had it has been thrust upon us.




I’ve definitely developed a broader view of the world and human needs over these past two years, both by listening to others perspectives, and experiencing it myself. I don’t have even a small number of the answers, but based on what I’ve seen from Cohort 11 of the Heath Care Management Program at the Harvard School of Public Health, I have great hope that the answers are out there, and we have talented, commited people willing to find them.