This Is My Medical School White Coat Ceremony Speech

Just today I gave the keynote speech at the White Coat Ceremony of the very same medical school that had let me graduate 10 years ago. 10 years ago when I also gave a similar (but far shorter) keynote speech that could only at best guess what would happen in 10 years.

So today I return to the scene of the crime where I began the concept of monsooning and proof that as long as you trust, live, and become the process, privileges like these reveal you are exactly where you need to be.

Thank you Mel Jeng, Paul Woo, Justin Ng, Natalie Hearty, Lauren Zhao, and Bianca Fulgencio for helping me perfect a speech of a career and a lifetime.

PRESS RELEASES

Press Release Sept 25, 2024: SUNY Downstate College of Medicine Hosts Its 30th Annual White Coat Ceremony

Press Release Oct 1, 2024: White Coat Ceremony Celebrates 30 Years at Downstate

TEXT TRANSCRIPT

SUNY Downstate Health Sciences University, Alumni Auditorium

Friday, September 20, 2024

1:00 PM and 3:00PM EST

SUNY Downstate College of Medicine White Coat Ceremony, September 20, 2024.

Dr. Riley, Dr. Brunicardi, Dr. Putman, esteemed faculty, professors, loved ones, and Downstate for being the only school to take a chance on me, and most importantly, future doctors — thank you for allowing me to share this deeply personal moment with all you. Standing here feels surreal. Reflecting briefly on my own unexpected journey into medicine — a path I almost didn’t take — it’s hard to believe I’m here. Especially the professors here who still remember me. Are you surprised I made it this far? (Because I am!)

Some of you who have followed my blog over the past 14 years may know the story, but for those who don’t: I didn’t initially want to become a doctor. My father did. But in the summer of 2006, between my sophomore and junior year of college, he died from a sudden heart attack. In my grief, I took this loss very personally as a sign that medicine wasn’t for me. I was free to choose another path. But curiosity into serendipity and intuition eventually pulled me back.

3 years later, I took a different look and a leap of faith. And it was thanks to Downstate for believing in more than I could believe in myself – where it was only after my father’s death did I truly understand what it meant to follow this calling—and more importantly, to do so on my own terms.

My journey, much like the art of medicine itself, has been unpredictable, challenging, and transformative. As the saying goes: “It’s less about the destination, it’s the journey.” But there’s a difference between knowing those words.  And living them. 

(continued below)

As the graduating class president 10 years ago, I shared with my class, from a podium just like this at Carnegie Hall, that medicine should be approached as an art, not just a science. I return today with the experience to reaffirm that. The experience that your best decisions won’t come just from textbooks – but from a deep understanding between you and your patient, rooted in continuous learning to trust yourself and your own unique gifts of practice.

I remember – in my third year of medical school, at the bottom of the clinical totem pole, a patient was rushed in for a stroke code. He appeared confused, incoherent. The team suspected a bleed or clot in his brain had impaired his speech. Amid the chaos, with my limited clinical experience – but maybe some lived intuition – I asked him in a different language if he spoke English. He immediately responded in full, clear sentences. (He simply didn’t speak English.)

Carry this with you as you don your white coat today. Medicine is about science — yes, A LOT of science — but it’s also about complexities of a human condition that you will decipher from a combination of your compassion, curiosity, and lived experience… Using all the avenues at your disposal to interpret the stories behind the symptoms, the fears beneath a diagnosis, and the hope that every patient carries when they see you.

And how do you recognize those hopes and fears? By being attuned to your own. 

Some of these hopes and fears you will have experienced by the virtue of your next few years here. I remember mid-exam up in Carrell 5G, where, fearfully, I counted question-by-question how many I needed to get right to pass that unit by the skin of my teeth. By the nature of my standing here now, hope saved the day. I’m still here.

So when you feel overwhelmed in the next 4 or 7 or 8 years, remind yourself that you’re training, not performing. Setbacks are inevitable but they do not define your worth. In those moments, take that break and remind yourself not just what you’re studying, but also what for.

The art is in the why. Your why.

Living this art will take a lifetime of practice, but none of us signed up for this because it was easy. We have, and will, over our lifetimes, rise to the occasion and you will surprise yourself.

And it’s perfectly okay to ask. for. help. Even if help is just a reminder of the obvious. A week before taking my Step 1, I asked Dean Terracina what would happen if things didn’t go my way. She replied: 

“Why worry about something that hasn’t happened yet, or ever?”

You will experience dark times.  You may question whether you belong to the profession. But take it from me — you are more than a number on an exam or a note in a chart. Our patients aren’t defined by their numbers, and neither are you. Give yourself that same grace and compassion. When you begin to doubt yourself, reconnect with your purpose – step back to see that. This practice of reminding yourself, over and over, why you’re here will become habit — a way of seeing the world that goes beyond merely symptoms and into the whys with which someone has become your patient.  The societal injustices. The structural failures that brought them to your care. 

Let’s together, from today onwards, carry them from sick care into health care. From reactive to preventive care. And if you can do that for them, you can do that for yourself. And sometimes that step away to reconnect with your purpose can be unexpected, maybe even wild. 

I’ll let you in on a little secret (…ok not really a secret, it’s on my blog): 

During my first year at Downstate, I hit a breaking point. Only 4 months into my first year mid-December 2010, I was cramming for my first unit exam. The exam was about a week away but I was burnt out, stressed, I needed a breather. I remember it was a Wednesday and during one of my ‘study freakout’ breaks, I happened upon $300 roundtrip last minute flights including stopovers in both Vancouver and Hong Kong and back. Now, with my exam only 4 days after I’d get back, common sense told me to close that tab and keep studying. Instead, I followed my gut to book that trip.

After a Med Council meeting here the next day, which was a Thursday night, I took a cab right after it ended at 8pm, boarded the 11pm flight, studied as much as I could on the flight, spent 20 hours in a city I didn’t expect to be in, returned Sunday and continued study on the flight, and took my Genes 2 Cells exam just 4 days later, which thankfully, I passed. 

Looking back, I realized I had retained the material better because I was in an entirely different headspace, a different environment. There’s actually science to recalling information better if you vary up the environments where you study, or taking “productive breaks” instead of scrolling on a phone or watching TV. That trip still reminds me of what’s possible, even in medical school. It taught me how important it is to honor your own ways of coping, of balancing intense demands, with these moments of pure adventure.

Now, I’m not recommending everyone here to fly across the world right before an exam. But I share this story to let you know that it is possible. You can still have lived, valuable experiences that make you feel alive while balancing your medical career. That trip was just the beginning, and it’s a principle I’ve honored ever since, about once a month for the past 14 years, or the fact that just 3 hours after this speech, I’ll be on flights to Nepal, India and Bhutan for my next Monsoon Diaries trip.

Gosh now realizing how naughty I was as a medical student and what I got away with, and if I could have the time and space to say this to each and every one of you, face to face: You’ve worked so hard to get here. You’ve earned this. Every single one of you belongs here, more than I ever did.

I wish someone had told me that. As someone who was ranked in the bottom 50% of my class for all 4 years, I have struggled with imposter syndrome throughout medical school, even as class president. Even right now, giving this speech, I still question myself.

But it’s not just about getting through it. It’s about growing through it. It took me 2 years into residency before I even began to feel like I could belong, and 2 years after residency to finally feel like I did belong. Ironically that’s when the COVID-19 pandemic hit, which became a defining moment in my career. Working on the frontlines was both terrifying and humbling, yet it confirmed for me why I chose this path. Why I stayed on this path.

The resilience, the courage, the leadership, the compassion you will develop here will matter. Especially when the world seems to be falling apart around you.

At the height of the pandemic, before there was a cure, vaccine, or let alone a plan and everything seemed hopeless, we all still showed up to work. We rose to the occasion. We surprised ourselves. Not because we knew how to cure any illness, but because we were called to be with patients when they needed us the most. Those moments matter. Regardless of how correct you may be in your diagnosis or treatment plans, your patients will always remember – will always value – how you supported and stayed with them in their most vulnerable of moments.

Your patient will appreciate better when your kindness is authentic. Where a doctor not only knows how to practice medicine, but also kindness unto themselves and to those around them.  We all must do well, but more importantly – we all must do good. 

So, prioritize not just your studies but also – your friends outside of medical school. Your future friends in this room. Help each other. Support one another. Look around, these are your colleagues for life. Never postpone your opportunities for friendship and joy. You cannot pour from an empty cup. Do something non-medicine every day. Schedule the fun things first. Prioritize your joy. And I guarantee the studying in between will work out, feel more efficient, and dare I say, even enjoyable. 

Make sure you won’t look back regretting not having lived.

Take that from me where, just a few months ago, the doctor became the patient. Without barely any symptoms, risk factors, family history, I redirected gestalt onto myself and advocated for a screening that led to the random discovery of a mass in my right kidney. Within a week, I made the hard decision to have part of my kidney removed. I remember walking into the operating room not knowing what to expect, but oddly feeling no sadness or fear; simply, pure gratitude I had already lived a full life ten times over even if things were to go wrong. 

Why worry about something that hasn’t happened, yet, or ever?  

And when I woke up 3 hours later, my surgeon explained that mid-surgery he had, on his own gestalt, against the intended plan, removed the entire kidney rather than just the mass. That was not the plan. But a week later, we learned that the mass was indeed cancer and had features suggesting extremely malignant potential. Thankfully, the tumor was caught at its earliest stage. 1A. Negative surgical margins. It was the right move.

And he in turn, said over the phone — and this is only 2 months ago: ”I don’t know what possessed you to get that screening, but you just saved your own life.” Cancer free. I can’t explain it. Not anxiety, but rather a gestalt/an intuition built from the clinical knowledge and foundations of what I’ve learned here at Downstate combined with the experience of living a life beyond the textbook. So when my gestalt/gut/intuition also tells me to say, whether to a patient or to myself or to you right here in this room, “Live now,” I really mean it. Never take for granted this short time we have on this planet. Live now.

Life, much like medicine, will always be full of surprises. I never anticipated that during medical school, my journey would also take me to over 150 countries during that same time as a travel blogger. Or that I’d become an unexpected advocate during a global pandemic. I certainly didn’t imagine beating cancer before I even knew I had it.  And just four months ago, politics chose me where I was approached to run for citywide office. Specifically, as New York’s next Public Advocate, a role second only to the mayor, to hold city government accountable.

But it’s not about politics, it’s about health: To tackle the injustices and structural failures that bring the vast majority of our patients to our emergency rooms, even before a pandemic. To resolve the food insecurity, housing shortages, unaffordability, public safety, all the mental and physical crises so many New Yorkers are experiencing. These social determinants of health are all that we as doctors are obligated to tackle with the same urgency in an emergency room, just this time on a city-wide scale.  As Public Advocate, instead of treating emergencies, I want to prevent them from happening in the first place.

This life I’ve lived, these stories I’ve told, may seem like a life of pure luck – but isn’t luck just preparation plus opportunity? Work hard, prepare yourselves, be present, and when you get invited to something, show up. The mantra that got me through from clinicals to during the pandemic was “Showing up is half the battle.” – Put yourselves in your best positions to make your choice when your opportunities present themselves. 

A choice manifested when I no longer felt my father’s pressure to become a doctor, when I realized the freedom to choose and confirm a life of medicine. A decade long choice where it’s been less about what you become (whether it’s a doctor or not), and more how you become it.

My question to you, to return to again and again, what story do you want to tell?

In just a few minutes, you will put on your white coats. These coats… are not just symbols of a profession, but a promise — to your patients, to your community, and to yourself. They are a promise to remain compassionate and ethical. A promise that in difficult times, you will choose curiosity over judgment.

What you will embark on is not just a profession — but a lifelong commitment to heal, to comfort, to accompany, to recognize, and to make a difference in the lives of others. Your journey, like mine, will be filled with surprises. But if you stay present, curious and true to the art inherent in life and medicine, your every twist and turn will lead you to where you’re meant to be.

Thank you. Congratulations on arriving at your destination. So now, welcome to the most special of journeys. Thank you.

Just like old times here at Downstate.

- At time of posting in SUNY Downstate Medical Center, it was 19 °C - Humidity: 85% | Wind Speed: 18km/hr | Cloud Cover: clear and nostalgic