Thank you, President Knobel, Vice President Houpt, esteemed faculty Ms. Booth and Members of the Board of Trustees. Congratulations graduates, for making it to this day, and if you were out late celebrating last night, for making it to this ceremony. I am honored to receive a Doctorate of Humane Letters and to serve as commencement speaker for the 171st graduating class of Denison University; a class that has earned many distinctions:  you have been NCAA Division III Champions and recognized for excellence in academics and art; you have enriched your community by coaching, mentoring or tutoring at the Granville and Newark schools; you have volunteered at the Newark battered women’s shelter and raised funds for the Licking County Food Pantry; and you knocked “Relay For Life” out of the park and have donated thousands of hours of your time and energy for the sake of others. Your class embodies the words of Marian Wright Edelman, Founder of the Children’s Defense Fund who said: “Education is for improving the lives of others and for leaving your community and world better than you found it.” To speak before such an accomplished class makes me incredibly proud that I too am the product of a Denison education, which gave me the solid foundation necessary for all that came after.

In the next few minutes I’m going to share the ways I have tried to make the best use of my Denison education, and some lessons learned along the way. As you have already heard, my work has been focused on patient care and research in the field of Pediatric HIV/AIDS. While we’ve made tremendous progress in controlling the disease in the US, in low-resource countries in Africa, Asia and South America, one thousand babies are born with HIV every day, and half of these infants will die before their second birthday unless treatment is made available. As a result, most of my research is now focused internationally, and there is indeed still much work to be done.

My other passion has been medical education. Training competent and compassionate physicians is arguably one of the most important contributing factors to quality healthcare. I love that medical students and young physicians are virtual sponges, seeking and soaking up new knowledge with a continuous stream of questions that make me re-examine concepts I thought I had mastered long ago. Seeing a student progress to become an accomplished physician is the greatest reward for both student and teacher.  So if I may take the liberty to speak on behalf of your professors, thank you graduates, for keeping us energized and fulfilled.  

Now, on to the lessons I have learned:

    1) Spend your life doing what you love.

Your Denison education has prepared you to navigate the challenges of theworkplace but you will spend more time in your job in the next 40 years than sleeping/eating/ playing/exercising or anything else, so the onus is on you to find something you enjoy. I feel fortunate that most mornings I wake up looking forward to the day. But if you find your job is not fulfilling, change directions before you can’t afford to redirect your career. Time already invested is a sunk cost which you can’t get back, so use it to better define what you really want to do and venture forward. One of my pre-med classmates at Denison eventually realized that he much preferred music to medicine and went on to become a highly successful band leader, musician and entrepreneur. Had he continued to pursue medicine, he would have been an uninspired doctor; but to see him perform with his band today, is to see a man truly happy and successful in his career.

    2) Continue to learn.

Nothing is more effective at holding enthusiasm for your work than the “Wow, I didn’t know that” factor. When I began my Infectious Diseases training, no one knew exactly what caused AIDS - or even that children could be affected. From learning that a new virus caused the disease, to how it was transmitted, to the development of drugs to treat the virus, this disease has written a new chapter in medicine and history. I’ve seen HIV go from a rapidly fatal disease to one which is chronic but manageable (like diabetes, for example) and now I attend my patients’ graduations instead of funerals. Being part of this steep learning curve has been exciting and gratifying and keeps me hungry for the next big discovery.

    3) Be resilient.

Did you know that Thomas Edison made 1000 unsuccessful attempts at a light bulb, and R.H. Macy had 7 failed businesses before opening his flagship department store in New York City? That Walt Disney was fired in one of his first jobs because he lacked imagination? The things these people had in common was their resilience, seeing failure as just a temporary setback which did not prevent them from trying again and ultimately succeeding. Progress in any endeavor often requires taking risks, because the best path forward is usually not obvious nor a straight line.  I’ve worked on plenty of research projects which didn’t perform as expected or have been outright failures, but these experiences taught me as much or more than the ones which succeeded. By examining on a daily basis what you’ve done well (so you can do it again) as well as how you could improve on what didn’t turn out so well, you can be your most effective teacher.

    4) Work with others.

Most of my research has been done as part of a collaborative team, where many researchers design and enroll patients in clinical trials for the newest drugs to treat or prevent HIV infection in children. This group made one of the biggest breakthroughs of the AIDS epidemic, showing that treatment of HIV+ pregnant women can prevent transmission from mother to child, which is by far the most common way children acquire HIV. Further studies have now reduced the risk of HIV transmission to infants in the developed world to <1%. The impact of this work is evident, where in the early 90’s, 50 new HIV-infected infants were diagnosed each year in my clinic alone, and today, there are fewer than 50 infected infants diagnosed each year in the entire US. But this incredible progress was only possible because researchers worked together, pooling results from many different clinics across the country rather than pursuing individual research for their personal advancement.

    5) Be an advocate for those without a voice.

Early on, when little was known about HIV and the public lived in fear of being anywhere near someone with HIV (as you might feel today if anthrax spores were sprayed through the air conditioners in Slayter), one of my patients, a 10 year old boy named John, became the first school-age child in Illinois diagnosed with AIDS. Just months earlier, national news was made when Ryan White, a boy with hemophilia infected with HIV from a blood transfusion, was barred from attending school, and three brothers with hemophilia in Florida had their house burned down when they tried to enroll in school. To prevent a similar calamity, John’s school superintendent asked me to educate the staff and community about HIV risks. The word about a child with AIDS quickly dominated the headlines and the community panicked. While it was unsettling for me to face such hostility, I could share reassuring data that HIV is not spread in the school setting-- and as luck would have it, I happened to be 8 months pregnant; since most people recognized that I would not want to jeopardize the health of my own baby, I could visibly demonstrate thatthere was no risk to being around children with HIV every day. This helped calm the public’s anxiety, and allowed John to return to school for the last year of his life.

    6) Find some way to give back to the world you live in.

I say this with the knowledge that this is second nature to most of your generation. Many more of you donate time and energy to those in need than when I was a student here, and you should be proud of that. But, it’s easy to get on a career track and lose sight of that altruism, so even if you choose a demanding job which doesn’t inherently change the world, I encourage you to find something to do outside of work to improve the lot of the less fortunate among us. Do not lose sight of the fact that even small contributions add up to big changes in the aggregate.

In the past several years, I’ve had the opportunity to work with physicians in clinics across Africa, updating them on the latest information on treatment and prevention of HIV.  But it’s a humbling experience to see the clinic waiting rooms bursting at the seams day after day, with patients covering every conceivable space, including the floor. In hospitals, multiple beds are wedged into each room, with 2-3 children per bed and each child’s parent sleeping on or under the bed. Through the congestion, the clinic staff steadfastly work their way through the volume of patients, treating as many possible. At the end of each day, patients who had not been seen are asked to return the next morning to begin the long wait again. As you can imagine, health care worker burnout in these settings is high, resulting in an exodus of doctors and nurses, leaving far too few for the enormous number of patients.  In one clinic, the ratio was 4000 patients to every doctor. And yet, these few medical workers made a difference for so many; children who had started treatment would bound into the clinic, feeling well for the first time in months, and pregnant mothers smiled with the optimism that medications could prevent their unborn babies from becoming infected. These individual victories galvanized the workers’ resolve to keep going day after day in conditions which would be deemed unacceptable in this country.

    7) Sequence your life.

Most of you are used to doing pretty much what you want, when you want. However, when you enter the working world, your free time will be a fraction of what it is today and you may need to put some of your activities on hold temporarily to make room for higher priorities. The discipline of setting priorities will be hardest for those of you who have successfully juggled and been high achievers in multiple areas of your life. After college, you still may be able to do it all…… just maybe not all at the same time. It’s about being willing to sequence things. The earlier you accept that Wonder woman and Superman only exist in the comics and that setting priorities is not a compromise but a choice, the less angst you will endure.

    8) Never forget family and friends.

I agree with the NY Times columnist David Brooks who says: “Think hard about who you marry. It's the most important decision you will ever make.” So if or when you decide to spend your life with one person, choose your partner wisely and make sure you each have fulfillment in your lives and that one person doesn’t get all the goodies. My husband Peter and my now-adult children David and Hilary have been thebiggest enablers of my life, and had I not had their ongoing support, I never could have survived the challenges of the work-life balance.

Mary Schmich, the Pulitzer Prize winning columnist of the Chicago Tribune, said “Understand that friends come and go but with a precious few you should hold on. Work hard to bridge the gaps in geography and lifestyle, because the older you get, the more you need the people who knew you when you were young.” My dearest friends are from Denison and our group has continued to gather every few years since graduating over 35 years ago. It takes some effort because most of us are widely scattered, but it’s well worth it. One of my Denison roommates’ family and mine have become one big extended family, and I’m happy they are in the audience today with their graduating senior.

Please don’t forget who got you here—my parents and undoubtedly your parents sacrificed much to send us to Denison, and they will be the ones to help when you face the inevitable challenges life throws at you. Keep in touch with them regularly—there will come a time when that won’t be possible, so take the opportunity while you can to let them know they are appreciated.

In closing, I’m counting on you, graduates, to address and solve the problems that my generation hasn’t figured out. Today, you begin the next chapter of your life — for many of you, perhaps for the first time, you will be fully in charge of what lies ahead.  Do what you love. Be resilient. Find a way to give back.

Most importantly, enjoy your life after Denison and make it count.

Thank you.