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Commencement Address - James J. O'Connell, M.D.

Friday, May 26, 2017

Father Boroughs, trustees, distinguished faculty, my fellow honorary degree recipients, proud parents, family, friends, and especially to all of you, the new graduates of the Class of 2017, I am deeply grateful and humbled by this invitation to address you today. I cannot tell you how proud and astonished we were when Fr. Boroughs came and visited us in Boston at our main clinic and respite care program back in January. We have lived in relatively blissful obscurity for many years, and it was the first time we had a distinguished college president come to visit.  So we thought we had arrived.

Someone once said that commencement speakers would be wise to envision themselves as the body at an Irish wake. They need you in order to have the party, but nobody expects you to say anything. I looked up a few short speeches for you and one of them stood out to me as worthy of note.  It was from Albert Einstein who gave this graduation address: "I do not have any particular thoughts to express today, so I wish you all success in the future." Then he sat down and the students gave him a thunderous standing ovation. So I may risk all and beg your indulgence for next 10 or 15 minutes. I want to celebrate with you something about Holy Cross that has always been really important to me.

In my family, Holy Cross has always had a treasured place. My uncle, Patrick O’Neill Hayes, graduated 78 years ago this year, and was the first person in our extended Irish Catholic family to get a college degree.  My mother savored a picture of that graduation in her scrapbook. She dearly loved her older brother and she always spoke about how proud she was, not only of him, but of his Jesuit education.  She came to the ceremonies that day with my grandparents, and listened to the Governor Saltonstall give the inspirational commencement address. Indeed, as she talked to me about that, she reminded me that those were very interesting times. The suffering that everyone had been through  during the Great Depression still lingered in 1939 and the events that were happening in Europe at that time cast a very darkening cloud on the future for those graduates. And, indeed, most of the graduates of that class were involved later on in World War II, which consumed their lives and changed so much of what they were doing.

In my family, discussions of discernment, moral choices, and living for others were bedrock at our family dinners. In 1954 — and I know this is hard to believe — I was an awestruck first-grader when I first visited your magnificent campus with my uncle, who was still very proud, and my cousins. We attended Mass and we went to  my very first ever college football game, and I didn’t care that Holy Cross lost to Syracuse; it was just thrilling. We bled purple where I grew up, and I listened on my transistor radio to the Boston Celtics where my idols Bob Cousy and Tom Heinsohn led the Celtics to an improbable cascade of world championships. But they were Holy Cross.

My mother thought my choice to attend Notre Dame was near heresy in 1966, and we won't talk about that today. My college years though were lived from 1966 to 1970, in the bright light of the civil rights movement but also in the darkening skies of the Vietnam War and our country was experiencing a deep, deep divide.  When I was in my sophomore and junior years, Martin Luther King was assassinated, Robert Kennedy was assassinated, and we were, in many ways, disillusioned.  When I graduated in 1970, it was two weeks after four students at Kent State had been shot by the National Guard during a protest. The country was in disarray and I can remember wondering “How were we going to come out of that? What would we learn?”

It took me, and us, a long time to recover. Let me dwell for a little bit, since I've been hearing from Haylie and from Fr. Boroughs today, about how our lives can take all sorts of different directions when we least expect it. And also, I don't want to put any pressure on anyone for certainty in your lives right now; in fact I would argue for the other.

I ended up escaping to Cambridge University where I was able to study theology, which was fabulous. I taught high school for two years in Honolulu, Hawaii, which was like paradise. Then I ran a restaurant in my hometown of Newport, RI, and then with a bunch of friends who I think were still dropping out from the 60s headed to Northern Vermont, bought an old dairy barn and lived there for a couple years trying to ski and learn how to live off the land. Then I decided to go back to school and went to New York City to the New School where I was going to study political philosophy with my hero at the time, whose name was Hannah Arendt, and she was the most powerful, articulate, and heroic woman I had ever known. But about after three months after I arrived, she came down with lung cancer and was dead within about four months. So, once again, my plans kind of became obliterated and I decided at that point to go take some premedical classes at Brown.

To my surprise, I ended up in medical school at the age of 30. My mother doesn’t let me to give any details of what happened in those 10 years other than the outline, so spare me that. The truth is I cherish those experiences because they gave me the benefit of something I had never really cherished before and that was time: time to reflect, time to study, time to read, but mostly time to just be present with the people around me, to listen to what was going on without the pressure of “where was I going tomorrow.” It was a very interesting upside down thing. But mostly it was time to try to find the passion in my life and, while I loved everything at the time, it was really hard to find what made me come alive with passion.

I didn’t expect to end up at Harvard Medical School, as I always thought Harvard was stodgy and cold and not very friendly. So when I ended up there in medical school I was actually afraid to tell my friends. But on the morning of orientation, I received a call from Dr. Joseph Murray, who had been a classmate of my uncle's here at Holy Cross. Dr. Murray welcomed me, he invited me to his home, and brought me in as part of his family over the next four years. I can still remember how important that was to me in this foreign world and scary world of Harvard Medical School and all of the antiquities that were there. Dr. Murray had actually performed the first renal transplant in the early 1950s and in 1990 was awarded the Nobel Prize in medicine. I think to this day he is the only Holy Cross grad to hold a Nobel Prize, and you should be incredibly proud. He was the first person who helped me realize what a “man for others” really meant.

And then what happened, frame shift another four years to when I was at Mass General Hospital as an intern. Another kind of scary thing because I’m getting older and internship in those days was about 120 hours a week and you’d have one day off every three weeks if you were lucky. But when I came to Mass General, I was greeted by Dr. Robert Scully who was the leading pathologist in the world at the time. He was this gentleman who invited me in and gave me coffee and then had me come to his house for dinner with a bunch of other physicians once a month until he died in 2012. Dr. Scully was fiercely proud of graduating from Holy Cross in 1941. I think he was on the board of trustees here for many years. But I started to realize as my life was transforming, in each place, the person who greeted me and led me into that world turned out to be a graduate of Holy Cross. And they were reaching out. I was actually no one and I have no idea why they would even do that, but it touched my heart deeply.

Today, so you can get out of here — and I won’t bore you anymore — I am supposed to give you some advice. I’ve been thinking about that and I've realized when I was in your position, the most important advice anyone could ever give was not to listen anyone as old as I am. But anyways I’m going to try, so here goes.

First, I would urge you to stay dynamically present to the cosmic unfolding. We don’t know what's going to happen next but you now have all the skills and all the tools and all the heart to just see what unfolds. I have always been fascinated by the double entendre of “executing a plan,” and I’m sure you have more than picked up that in my life any plan I've ever had seems to have been trashed and changed at the last moment. I decided to become an oncologist and care for those who were dying, but just a few months before I was finishing residency, my Chief of Medicine was involved in getting a grant for the city of Boston to care for homeless people around the town. And the homeless people and the advocates were insisting on a full-time doctor. They couldn’t find one so I got called into my chief’s office — and for those of you going into medicine, just remember when your chief calls you to the office, your answer is always “yes.”  I reluctantly signed on for a year and convinced myself that this job would just be a detour on my career path, that it would be a year of urban Peace Corps, or a good way to solve my late 60s lingering social conscience. That one year, as Fr. Boroughs mentioned, captured me in a way that I could never have anticipated. I asked for one more year and that has now ended up being 32 years. I’m astounded at my own self that I’m still doing the exact same thing 32 years later. And I love what I’m doing.

You’ve heard about our program and I would just say that the most important part of our program to me is that we’ve learned how to go to where people are and to listen to what they’re doing. We’ve learned to take time in engaging them. It’s also a world where I get to work with people like you — people who are young and energetic, who have chosen to think about the world through the eyes of others. I wanted to be sure to acknowledge that I am actually surrounded by Holy Cross graduates now, and I can barely ever mention that I’m a Notre Dame grad. But our development department at Boston Health Care for the Homeless Program, which is phenomenal, is run by Linda Wood O’Connor and Sarah Pacelle who are graduates of 1982. And then about a year ago,  Julie Bogdanski who graduated in 2006 came into our office and she has radically transformed our lives — certainly my life by organizing it — but also has quietly shown me, in everything that she does what you all know about giving to others and asking more. And it's been most impressive.

The second thing I would urge you to do is be humble and listen to those around you.  My last job at Mass General was to be the senior resident in charge of the Intensive Care Unit. After four years of medical school and three years of residency, you develop this kind of irrepressible ego and a sense of invincibility. It’s disgusting but we do. Anyway, I was running the ICU in June and I had to go down to the shelter to run the shelter clinic on the first of July. I kept thinking, “If I can handle the ICU, how tough can a shelter clinic be?” I walked into the clinic in early July of 1985, and I ran into this group of nurses who had been working with the homeless people for about 15 years — without the help of doctors, as they told me very clearly — and they said "Listen, we think you've been trained all wrong, and that if you want to take care of homeless people, you need to listen to us." The first thing they did, which Fr. Boroughs referenced a little, was to take away all my medical stuff: all my stethoscopes, and the things I'd use to look in the ears. And they said "That doesn't work, these people are too scared of that stuff right now." And what I had to do for two months, as this sort of apprenticeship, was to soak feet.

So you can imagine, I'm coming from the Intensive Care Unit and now they take everything away and I have to soak feet. I can remember thinking that I should have done that oncology fellowship. But it was dramatic to me because what happened is that the nurses would invite these really hardened street folks and shelter folks into the clinic, and they would always call them by their name. I learned a lesson then that most homeless people, as well as many lonely people in this country, can go for days, weeks, or months without anyone saying their name, certainly not with any gentleness or dignity. And it was like magic.

Then they would invite them in and soak their feet, and it has a kind of biblical symbolism to it, but it's actually quite practical because people have been walking around all day, standing in lines. When you're invited in to sit down, to sit on a chair, and soak your feet, it's really quite a service. What I remember is that it completely flipped the power structures. So, instead of me looking in people's eyes and listening to their heart and having my face right up in someone else's face, this was a chance to give the person lots of personal space. You're at his feet, or her feet, caring for them.

I was astonished because, just to frame shift quickly, one man who I had seen hundreds of times in the emergency room at Mass General Hospital, who we had described as someone who was "resistant to all of our treatment" (he suffered from terrible schizophrenia, and was very paranoid, and he didn't trust anything we did); the nurses had me soak his feet. And I did it for about a month or a month and a half and he finally looked down at me one night and he said — the first words he ever said to me — was, "Hey, I thought you were supposed to be a doctor." I realized I had been working in the shelter for like a month and a half and no one had called me a doctor, so I lit up just like everybody does when your name is said. I said "I am!" and he said "Then what the hell are you doing soaking feet?" I was stuck there; I didn't know what to say other than to say, "I always do whatever the nurses say." Something about that was the bond because he always did what the nurses said, so he said, "You know? You're a smart man."

Then, within about a week he started asking me for medicine to help him sleep, and soon after that he was asking for medicine to help with his blood pressure, and his legs, and within about a month he was taking all of the medications that at Mass General we had said that he would never take for 25 years. It was just this lesson that it was all about reaching out to people, listening to the stories, giving them space, and I think that's something that you probably have learned here in ways that I can't even comprehend. 

Third, never lose your sense of wonder. Wonder actually transforms routine.  Ralph Waldo Emerson once said, "If the stars only came out once every thousand years, we would be enraptured and spellbound by the mystery of the universe, and we would all go out on the night that the stars were out." Three decades later, I am still learning about homeless medicine, that we have to look at it each day as a brand new occurrence. It is something that is compelling us to learn more and to understand more. So I urge you to find things that will keep your wonder alive.

I once dreamed of doing international care, and going on oversees missions which I would still love to do more. I’ve only done a couple, but I realize that my entire clinical life now, everything I’ve done for the past 32 years, has all occurred within about a mile of where I went to medical school and literally in the shadows of the best health institutions you could imagine. So when you go looking for those populations that you want to serve, just keep your minds and hearts open to the suffering that occurs all around us. It’s not only in third worlds, it’s not only in another country; it’s frequently just outside your doorway. So please, please keep yourselves open to those vulnerable folks.

The fourth thing I would urge you to do is  embrace failure. I am an expert at doing that, so I urge you to follow me. William Faulkner insisted that our generation will be judged by the splendor of our failures. Gordon Moore, who was the legendary cofounder of Intel, always fascinated me because he used to give the largest bonus at the end of the year to the employee who had made the most egregious failure. Because he knew that if he rewarded failure, it meant people were being creative and looking for solutions. So remember that failure is really important. I’m tempted to remind you that Bob Dylan, who you may never have heard of, writes: “There is no success like failure, and failure is no success at all.” I’ve been trying to figure out what that’s meant for about 42 years now.

Lastly — and I know this is probably the toughest of all — listen to your parents and to your mentors. Not on everything, for God knows we have given you a world that is disgusting and not something we are all proud of, but we have somehow survived many failures and learned the hard way that the journey is far more important than the destination. The things that seemed important when we were young somehow seem to change as you grow older, and you will have to learn this by experience but let me just share that with you. Before he died, Paul Tsongas, who was the really wonderful Senator from Lowell, Massachusetts, quoted someone saying, "Remember that no one says on their death bed, ‘I wish I had spent more time in the office.’”

So I conclude by wishing you uncomfortable but exciting lives, full of balance, promise, failure, compassion, fun, love, and utter devotion to the core principles that are seared into the hearts and souls of all of you who have had the privilege of attending this remarkable college. There is no doubt that we are once again engaged in a struggle for the soul of our country. If ever we need you, if every we needed men and women who were willing to be for others, men and women were willing to ask more, this is the time. Just like I think of my uncle in 1939, facing a coming World War, and I remember when I graduated in 1970 with a country divided by war, you are stepping into a world where our values have been divided. We need you. So I would urge all of you to take Holy Cross into the world with you. Whether you’re going into finance or business or medicine or nursing or academia, keep bringing what you learned here to those days. As Julie was telling me, the question you often ask is, “Then how then shall we live?” And I think you should bring that with you.

I can’t tell you how honored I am to have been here and I can’t tell you how much I wish you all the absolute best in your lives ahead.

Thank you very much.