Graduation 2025

On Commencement Day, Abraham Verghese, and a Life in Medicine

© Photo by Bertie

For parents of graduating seniors, Harvard Commencement can best be described as three days of exercises comprised of a parade of speakers—where the audience is kept awake mostly by the challenge of balancing on rickety plastic folding chairs on the grass—punctuated by moments of pride, laughter, vicarious pleasure, and enjoyment.

One of those high moments was the Letterwinners Dinner for varsity athletes. Our daughter Dani, Class of 2025 and the reason we were there, matriculated as a lightweight rower and graduated as a sailor (a much better way to move the boat, I like to say—to her annoyance).

She’s never really not been part of a team, and the dinner reminded me why—and why I can’t help but love athletes, despite the fact that I’m generally not much of a sports fan. The life stories of the award winners—not to mention the modest and appreciative speeches of the athletes themselves—were moving and inspirational.

At their very best, athletes display the great human qualities—grit, camaraderie, sacrifice, excellence—and deliver them in a package that is such a perfect little metaphor for life that the highs and lows of glory and defeat come with no strings attached.

At the very least, you can count on athletes to show up and do their job.

Another high moment was the Commencement address, delivered by the physician-writer Abraham Verghese, author of the memoirs My Own Country and The Tennis Player, and the novels Cutting for Stone and The Covenant of Water.

In traditional Commencement-speaker fashion, Verghese offered three pieces of advice to the graduates. One was to make good use of your time. Another was that character is determined by decisions taken under pressure. But it was this piece of advice that resonated with me most: read novels.

Verghese spoke about how, as a child growing up in Ethiopia, he learned what he knew about America not from television, but by reading Ralph Ellison, Willa Cather, John Steinbeck, Mark Twain, and others. He singled out Of Human Bondage by Somerset Maugham as the book that inspired his calling to medicine. If you don’t read fiction, he said, “my considered medical opinion is that a part of your brain responsible for active imagination atrophies.”

I didn’t have Of Human Bondage to inspire me, never having read it.

What I did have was My Own Country, Verghese’s literary debut, a memoir of his experience as a foreign medical grad and young infectious disease specialist in the rural South treating gay men with AIDS—prodigal sons of Johnson City, Tennessee, who were coming home to die.

I first read the book at the end of my second year of med school, and took it with me onto the wards, where I experienced firsthand what he was writing about: the way in which people from completely different backgrounds will open themselves up to a total stranger in the clinic—trusting that you are there to serve them, to help them—in ways that would be unimaginable in the outside world.

I took it with me when I started my residency in Family Medicine at Beth Israel Medical Center on the Lower East Side of Manhattan. In those days, the science of AIDS had not progressed much since Verghese wrote My Own Country, and New York City was an epicenter of the epidemic.

Verghese’s book came often to mind.

I remember admitting a woman with end-stage AIDS late one night during my first-year medicine rotation. She was jaundiced and cachectic, her viral load sky-high, her brain riddled with CMV, an opportunistic viral infection. She had immigrated from Puerto Rico and contracted HIV from intravenous drug use—so different from the southern white men that Verghese wrote about, and yet…

One evening, as I was drawing blood from my patient, her arm jerked reflexively and I pricked myself with the needle. In the dark days and weeks that followed, my thoughts kept going to a passage in the book where Verghese describes the experience of being splashed in the face during a bronchoscopy with potentially infectious fluid. The anxiety and obsessive self-monitoring he describes felt like it was written as much about me as about himself.

Years later, COVID hit.

I was an experienced attending by then, but COVID was like nothing I had ever seen. As the world shut down, so did the doors of many doctors’ offices. We had three sites at the time and, one by one, our clinicians informed us that they were not coming to work. People were afraid. “I have a family to think about,” said one doctor, before he packed up and moved back to Texas.

So did I have a family to think about.

Five kids. Dani was sixteen at the time. Our youngest, Kobi, was nine. For Rachel and me, it was never really in question that we would show up and do our job. We tacitly agreed that neither one of us went into medicine to not see patients when they needed us the most.

I think that for Rachel, the decision was a natural instinct. As for me, I credit a book I read in college, The Plague, by Albert Camus. I was a History major at Princeton, and I wrote my senior thesis on Camus. The Plague was my favorite of his books.

The Plague is an allegorical novel set in the Algerian city of Oran, which is hit by a deadly outbreak of bubonic plague. The main character is a doctor named Bernard Rieux, who represents Camus’ ideal of the existential hero—someone who acts ethically and responsibly in an absurd, indifferent world.

Asked what motivates him to continue to treat his patients despite the mortal risk, Rieux identifies not heroism or ideology, but “common decency.” Pressed on what he means by that phrase, Rieux responds, “In my case I know it consists in doing my job.”

Not to sound melodramatic, but The Plague was for me what Of Human Bondage was for Abraham Verghese - the book that called me to medicine. So yes, I agree with Verghese’s advice: read novels.

Our oldest daughter, Noa, is starting medical school this summer. Now Dani, although she majored in computer science, has decided that she also wants to be a doctor. Next year she will be staying in Boston to work as a research coordinator in pediatric oncology before applying to med school.

They seem to be the exceptions, though. Few of their talented friends, and even fewer of the talented children of Rachel and my friends, are choosing a career in medicine these days.

I get it. As medicine becomes less of a vocation and more of a job; as independent practices drop like flies; as the only option becomes to work as a salaried employee in a large conglomerate managed by MBAs—the duration, cost, and rigor of medical school seem less and less worth it to many young people.

Too bad. I am not among those doctors who steer their children away from medicine. If I had the chance, I would choose medicine again.

At the Commencement ceremony, the dean of Harvard Medical School pronounced, “I have the honor to present to you, these degree candidates, who have dedicated themselves to the relief of human suffering, and prepared themselves well, for a life of learning and service.”

When I think of what lies ahead for Noa, Dani, and others who choose a life in medicine, that just about sums it up. Continued learning. Human connection through service. If you’re successful, the relief of suffering.

And all you have to do is show up and do your job.