Over the weekend, I attended two commencement exercises, one to celebrate my daughter’s college graduation, the other to celebrate our medical school's graduates. Both ceremonies were replete with pageantry, music, speeches, tears, promises, and unapologetic happiness; in fact, the rituals and emotions were so similar in appearance that it took me some time to identify the fundamental differences between the two events.
The college commencement truly marked a new beginning. These young men and women were now “commencing” their journeys into adulthood. Their lives will undergo seismic shifts; many will never again sit in a classroom desk or stay up all night to write a paper. "Yesterday" and "Tomorrow" are completely different, and the new college graduate’s friends and family members, many of whom have been down the same path, can guide and support them.
Although the external trappings are identical, the medical school ceremony is fundamentally different because these new graduates have experienced a thousand “commencements” already, including:
- The first time a complete stranger unflinchingly trusted them with the most intimate details of life.
- The first time another human being allowed them – expected them – to probe for liver, heart, lungs, spleen, hernia, or cancer.
- The first time they repaired a cut, gave a shot, started an IV, plunged a knife, wrote a prescription, heard a murmur, or slid in a catheter.
- The first time they sensed the pulsation of an aortic aneurysm, recoiled from the odor of an abscess, or felt their hand enveloped by the warmth of the abdominal contents.
- The first time they watched another person die before their eyes.
Abraham Verghese has described the final two years of medical school — the clinical years — as the “cynical years” because students often dilute whatever sense of wonder, optimism, and unselfish compassion they originally possessed. It is no wonder, since, during this time, they have commenced becoming physicians without the benefit of a ceremony marking the accumulating moments that could have warned them of their imperceptible transformation.
I had the perfect seat at commencement to watch the medical students’ animated faces in the moments before they crossed the stage to receive their diplomas. Standing in cap and gown, waiting to hear the title, “Doctor,” and then their names tied together officially for the first time, they could anticipate a few short weeks off before beginning the process once again.
For the new medical school graduates, the "Commencement Ceremony" was merely one signpost in a long arc of commencement experiences that stretches far into the past and extends years into the future.