What I am posting here is the full text of the remarks offered to the class of 2011 by our convocation speaker, Dr. Lynn Hartmann. Dr. Hartmann was an LAS Distinguished Alumni Award winner in 2009, and anyone who wants to read more about her remarkable work can do so by clicking through to the LAS News write-up of that award here.
We're in the process, right now, of putting together our departmental newsletter, and some excerpts of this address will be printed there. But for anyone interested in the full shebang, I thought we could run it in full here.
Those who were present at the Convocation in May will recall that Dr. Hartmann had slides, and there are a few places in the address below that refer to images that I do not at present have. If I get them, I'll add them later.
Anyway, here goes...
University of Illinois
Lynn C. Hartmann, M.D.
May 14, 2011
Good afternoon. Let me begin by extending heartfelt congratulations to all graduates, upon your once-in-a-lifetime accomplishment being celebrated today. I am a medical oncologist and cancer researcher and, very proud to say, a graduate of this very department. In my remarks this afternoon, I would like to share with you the nature of my work, my journey from literature to medicine, and some thoughts for your futures.
First, let me extend greetings from Minnesota, land of 14,000+ lakes, where we enjoy over 90,000 miles of shoreline -- more than California, Hawaii and Florida combined. Here we see a beautiful picture of the Minnesota state bird, a parent loon carrying two chicks on its back -- an example of an avian minivan. Here is a photo of the upper stories of our Plummer building, built in the 1920s and the most recognized architectural landmark of the Mayo Clinic, located in Rochester, Minnesota. Its upper floors house our medical library and one of the largest carillons in the United States. In this slide you see the larger campus of Mayo and, in the spirit of full disclosure, another slide of our campus on a cold winter day. And last, after a night on call, one could come out to find their vehicle completely encased in ice. Far more work than the average car-starting service can provide. The question that I am asked most frequently is, “How did it happen that the Mayo Clinic is located in rural Minnesota?” and the most important answer to that question is demonstrated on this slide -- revealing the aftermath of a devastating tornado that struck Rochester in 1883 and destroyed half of the town. (This story illustrates how initial tragedy can bear fruit.) In 1883, the closest hospital was located approximately 80 miles away. Another key element in the story of Mayo is shown in this photo of Dr. William Worrall Mayo, an immigrant from England who settled in southeastern Minnesota, originally to examine volunteers for the Civil War. Pictured with him are his two sons, William J. and Charles, who would graduate from medical school in the 1880s. Following medical school, they brought their surgical skills back to Rochester, as well as the latest thinking on sterile technique and other new approaches, such that Mayo would grow into one of the largest centers for medical teaching and research in the world. A vital element in the beginning of the Mayo Clinic came from the local convent of the Sisters of Saint Frances, a group of teaching nuns. Immediately after the devastating tornado, they came forward to help care for the injured. Following this experience, the leader of the convent, Mother Alfred Moes, came forward and said to Dr. Mayo, “We need a hospital here in Rochester.” And his response is informally recorded as something like “You can’t be serious, we are in the middle of nowhere.” But Mother Alfred was not deterred and came back to say “If we build a hospital, will you staff it?” He agreed, and that in fact is what the sisters did, with the founding of St. Marys Hospital in Rochester, Minnesota in 1889. This hospital became the cornerstone for the physical plant of what is now the Mayo Clinic.
Now I would like to describe for you my work, which can be divided into cancer care -- namely the care of patients with cancer -- and cancer research. Numerous forces drew me to the field of cancer care, or oncology. On an intellectual level, a malignancy can affect virtually any system of the body and these challenges drew me. Moreover, as you will see in a moment, molecular understanding of the driving processes of cancer opens up very specific new treatment avenues. But I would say that the largest draw for me into cancer care was on an emotional level. Namely, here was an opportunity to participate in, and contribute to, the care of people who are facing their own mortality and moving forward with their lives. Facing our mortality is not something that Americans like to do. We are the people “who can do it” as the World War II poster of the woman with the prominent biceps demonstrates. We prefer to read "Intimations of Immortality." But there are certain diagnoses, and cancer is one of them, that force an individual to face the reality that they are mortal. What follows after such a diagnosis is where we see the mettle of a person. The emotional fortitude that I have witnessed, the generosity of spirit, goes beyond my ability to describe -- but has inspired me on a daily basis.
In cancer research, I work in breast and ovarian cancer. What you see on the slide before you is a field of breast cancer cells, large and aggressive with a red stain picking up the perimeters of these cells, their external membranes, which are blanketed with a novel cancer-associated receptor called HER-2/neu. This particular receptor is not found on normal cells. It is sending a continuous growth signal into the nucleus of these cells directing them to divide and grow -- an obvious growth advantage in a neighborhood of otherwise normal cells that wait for rare growth signals from their environment. While the presence of this novel receptor provides a growth advantage for these tumor cells, it also provides a molecular target that neighboring normal cells do not have. This in turn allows us to design a very specific treatment targeting this receptor, which would kill the abnormal cells but spare the surrounding normal tissue. This type of molecular targeted therapy is the wave of the future for cancer therapy and we are already seeing success with it in breast cancer and in other malignancies.
Now, let me address the issue of how a person would find their way from being an English major to a career in medicine. First, I’d like to consider the qualities that are required to read great literature -- and these are my observations. I would list concentration and curiosity among them -- being curious about a character and what they are going to do in a particular, stressful situation. Perception is required, figuring out the subtext. A reader of great literature has to appreciate humanity, our strengths and our foibles, and probably most importantly, possess the ability to synthesize all of this, to put it together.
What qualities are needed to practice medicine? Concentration, curiosity, perception -- what’s really going on. A doctor better like people, so appreciation or love of humanity. All importantly, the ability to synthesize all of this for oneself and then communicate those conclusions. Now, I realize that there is a vast body of factual knowledge that underlies the world of English literature and a very different body of knowledge, laws and rules that underlie medicine, but those respective bodies of knowledge can be learned, memorized. The qualities that we have been speaking about cannot easily be learned -- the ability to perceive, the ability to synthesize.
I have taken the liberty of polling some other English majors, more newly minted than I, for their thoughts on their training. From my niece Kristen, a graduate in English from Butler University two years ago: “Another key skill that I see as universal to all job opportunities and functions is the ability to communicate. Every piece of literature I experienced in school was essentially a study in communication skills. How well does an essayist argue his side of an issue; does an author convince a reader to identify with a protagonist; is a novelist able to keep the reader engaged in a plot line? The literature that is studied in schools today has endured because the author successfully communicated a purpose. In my department at Cision, projects succeed and fail based on whether the project manager is able to successfully communicate a purpose, requirements and intended outcome.” Then from my colleague, Sean, English major from Cornell and Mayo Clinic surgeon: “In high school I really struggled with writing. I was very good at science and math in particular, but I couldn't write. I worked hard at it, the only way to learn to write is to write, and came to love it. At Cornell there is no premed major, which was very fortunate. I always knew I would be a physician, but if I didn't get into med school, I would have probably been an English teacher. I even came to love reading and writing more than biology and biochemistry. My personal opinion is that those two skills [reading and writing] are so critical for personal and career development that everyone should be required to have a dual major in English.” And very recently, featured in the sports section of the Minneapolis Star Tribune, was Josh Fisher, English major, now law student, who is trying to help Dodgers fans make sense of what is happening to their team at www.DodgerDivorce.com. Note that there have been over 75,000 visitors to this website and the LA Times calls it a must-read site. Mr. Fisher says, “The practical skill that has served me well . . . is an ability to manage information and use information as currency . . . knowing when to use it, when not to use it.”
Regarding English majors and medicine, what Professor Perry doesn’t know is that my acceptance of the invitation to address you was fueled by my desire to recruit more English majors into medicine. To support this, I have very specific, non-fiction examples to demonstrate this need. Here are several quotes taken from actual medical notes demonstrating my point:
“The patient lives at home with his mother, father and pet turtle, who is presently enrolled in day care three times a week.”
“On the second day the knee was better and on the third day it had completely disappeared.”
“The patient’s gait is normal. I am able to stand on her toes.”
“The patient had pain when she saw me for several months in November.”
“She is careful when talking about her husband and her gag reflex is normal.”
“The pain is exacerbated by prolonged activities at work which include trimming hedges, taking short steps behind a lawn mower, lifting and bending, and having sex.”*
As you can see from these medical notes, we need good writers in medicine.
In closing, let me make several points. First, you already possess very important qualities. Second, you have a strong support system, or you would not be here today. Importantly, don’t focus on what you think you cannot do. Now I realize that this is a double negative. How would an artist make this point? For this, let’s look at one of my favorite books, Ann Lamott’s Bird by Bird, with the subtitle “Some Instructions on Writing and Life.” The book is filled with great “instructions” on how to approach a major task. What she describes as the single greatest obstacle to one’s success in approaching a major task is listening to a non-stop internal radio station “KFKD” that continually relates our mistakes, what we don’t do well, how impossible the task will be, etc. Lamott provides sympathetic but smart ideas for turning down that noise.
So, remember that you already possess very important qualities, you have a strong support system, don’t focus on what you think you cannot do, and choose well. Blessings to you all.
*Source: Ann Farrell, Mayo Clinic reference librarian