Dean's Newsletter

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Commencement 2007, Keynote Address

May 24, 2007

This installment continues a Dean's Newsletter tradition of publishing the speech of the Keynote speaker at the School of Medicine and Dentistry Commencement.  This year, Commencement was held on the afternoon of Friday, May 18th at the Eastman Theatre.  Earlier that morning, we held final class exercises, in which awards were given for outstanding achievements of students, residents and faculty members.  This gave the class a final opportunity to share memories of their time together in Rochester, serving as a nice counterpoint to the more formal Commencement ceremony later in the day.  Family members and other well wishers were able to attend both events.  Needless to say, there was excitement in the air, warm feelings, and a few tears. 

There were three main speakers at Commencement, all of whom were selected by our medical students:  Drs. Craig Benson (student speaker), James Powers (faculty speaker), and Michael Gottlieb, our Keynote speaker and recipient of the Charles Force Hutchinson and Marjorie Smith Hutchinson Medal.  This week, I will publish Dr. Gottlieb's speech as well as his introduction by Dr. Bradford Berk.  Next week, I will publish the speeches of Drs. Benson and Powers.

All three speakers put a great deal of thought into the messages they wanted to send, and considerable effort in choosing just the right words.  It is my hope that by publishing these speeches here, their words will have a longer-lasting impact than if they were allowed to disappear into the rarified Eastman air, never to be read or heard again.

Introduction of Michael Gottlieb, M.D.
Bradford Berk, M.D., Ph.D, Medical Center C.E.O.

It has been a quarter century since Michael Gottlieb, then a 33-year-old immunologist at UCLA, began to puzzle over a handful of cases of unexplained pneumonia in previously healthy men.  The cause was a rare infection observed only in patients with severe immune deficiencies.

His nine-paragraph report to the Center of Disease Control—the first description of the new disease that would later become known as AIDS—was made on June 5, 1981.  That date is now considered the official start of the HIV/AIDS epidemic.

Over the ensuing 26 years, Dr. Gottlieb has remained a prominent leader in HIV treatment and research.  He joined with Elizabeth Taylor to launch the American Foundation for AIDS Research, and he was instrumental in the founding of the Elizabeth Glaser Pediatric AIDS Foundation. 

One of the first researchers to test antiviral drugs targeting HIV, Dr. Gottlieb has authored more than 60 publications in medical journals.  A faculty member at UCLA's medical school, he is also a trustee of the Global AIDS Interfaith Alliance, a nonprofit organization that does community work on HIV/AIDS in Malawi, Africa.

We are pleased to recognize Michael Gottlieb as one of our most distinguished graduates.  His keen insight in first describing AIDS and his career as a scholar, scientist and doctor exemplify the ideals we cherish.  

Commencement Address, 2007
"The Taming of HIV"
Michael Gottlieb, M.D. '73

Michael Gottlieb, M.D. '73

Thank you Dean Guzick, President Seligman, Dr. Berk, members of the faculty, most of all members of the class of 2007, your parents and friends.  It's great to be back in Rochester!  I'm sure you can appreciate what a thrill it is to for me to stand on the same stage where I received my own M.D. Degree 34 years ago.  When the Dean called and asked me to speak I felt instantly drawn back in the Rochester family.  It was as if I had never left.  Images and smells of hallways and labs, faces of classmates and faculty suddenly crowded my brain.

And now I feel like a winner on Oscar night, tempted to thank 100 people in 3 minutes.

But my mother taught me never to mistake endurance for hospitality.  So I will say only that I am deeply honored to be awarded the Hutchison Medal.  Dr. William Peck, a previous recipient of this award, was one of my teachers.  Dr. Peck is a giant in modern academic medicine, and someone for whom I have always had great respect and admiration.  To have my name listed in the company of his and the other Hutchison Medal recipients is truly humbling.  This award will further reinforce my ties and commitment to this great University and medical school.

My coming to Rochester to attend medical school was one of the best decisions I ever made.  But the way I made that decision was not entirely rational.  One of my classmates and close friends at Rutgers was a fellow named Jim Battaglini who graduated at the very top of the class of 1969.  Jim came from a blue collar N.J. family.  His dad worked at the Budweiser brewery in Newark and his mom was a nurse.  Harvard Medical School had sent him a thin envelope, but he had been accepted to the U of R and every other place he applied.  Our pre-med advisor was a big Rochester fan, and that settled it for Jim.  Now my own class rank was a couple dozen spots lower, but I was accepted here too.

Now I figured that if somebody as smart as Jim Battaglini was going to the U of R, then heck I'd go too.  We came here together from the banks of the Raritan to the banks of the Genesee and we have been life-long friends.  I didn't know a thing or even ask about the weather.  So much for my early research acumen.

No one who watched me make that minor climatologic miscalculation would have imagined that I might describe a new disease just a few years after leaving med school.

Yet I am your speaker today because in 1981 I wrote a short report to the CDC and later a paper in the New England Journal of medicine describing that new disease, AIDS.

The publication of that paper changed my life.  It became one of most frequently cited papers in the medical literature in the 1980's.  About ten years ago, when I spoke at an alumni reunion, Dean Marshall Lichtman was in complete agreement with me that I was an unlikely success story.  By that I mean to offer encouragement to some of you who, like me, did not graduate at the very top of your med school class.

I have received many compliments for recognizing those first cases of AIDS.  But it is not the academic achievement of identifying AIDS that is most personally satisfying to me.  It is something else.  And that something else is the main thing I hope you will take away from this talk today.  In the early years of the HIV epidemic as a doctor working with these very ill patients I joined their ranks, that is in the political sense.  Physician author and global health activist Paul Farmer calls it "making common cause with the sick."  Like my patients with AIDS, I was terrified by the relentless downhill course, baffled about why and who it struck, and where it came from, incredulous that funding was held up because the people affected were members of stigmatized groups.  I easily identified with many of my sick patients.  In later years, more and more poor people, minorities and women were engulfed by the epidemic.

But at the beginning, there were an awful lot of people who looked a lot like me, well-educated, Anglo men in their 30's.  There was a difference, of course.  And that made all the difference in the early course of the epidemic and the public response.  But in treating them, what leapt out at me was not the different sexual orientation, but the shared humanity.  These were just people dealing with catastrophe, typically with bravery and good humor.  I could not understand or acquiesce in the great turning away from people who had the same needs as everyone else -- except, as some of my patients pointed out, for somewhat greater needs in the way of clothing accessories. 

So, although my position was in the ivory tower, I chose a response that was not purely academic and dispassionate.  I joined the fray.  And that decision had consequences, not all of them easy.  Yet I have always been proud and grateful that I made that choice.  Because it was through political action of an affected patient group and their supporters that an intensive response to the HIV epidemic was mobilized.  I played a small part in that coalition.  It has borne fruit beyond our expectations.  The title of my talk today, "The Taming of HIV" refers to remarkable progress we've made in the treatment of this virus.  A 25 year old diagnosed with HIV today in the developed world stands a fifty-fifty chance of reaching retirement age.  Now that is a great outcome.  But a vast outcome gap remains for HIV treatment between the rich and poor continents.  In Africa and in many parts of the undeveloped world HIV is far from tamed.

Today, as our celebration runs its course, over 5,000 people will die of AIDS in Africa alone.  And at least 5 million of the 24 million living with HIV in Africa will be in need of urgent treatment, but will not find it.  It is truly an amazing thing to see people literally on their deathbeds come back to live full lives as a result of medicine which costs less than the price of a latte a day.  And yet, more often than not, the price of the latte is not found.  And the result is needless dying.  As doctors it should trouble us deeply -- no, it should make us angry -- when anyone dies of a readily treatable disease.  And so, as you graduate today I ask you to make and keep common cause with the sick -- particularly the sick and disadvantaged -- with whatever diseases they have, wherever they live and whoever they are. Don't allow this degree you are about to receive become a barrier that isolates you from social responsibility.  There is much more to you than the superb doctoring skills you have acquired here.

In closing: Graduates of the Class of 2007, Grey's Anatomy notwithstanding, you have chosen a wonderful and rewarding profession.  Within medicine's amazing range, find what you love to do.  But don't be afraid to change course if it's not right.  And don't make the common mistake of confusing your careers with your lives.  Bring enthusiasm and passion to your work.  The sage Confucius put it this way: "Wherever you go, go with all your heart."  So aim high.  Try to make a mark.  Write.  Teach. And, above all, heal when you can and always help the sick.  Each one of you was admitted to the U of R because this school saw something special in you like it did in me.  Now you are about to join the elite society of U of R medical graduates.  I wish you achievement in your careers and joy in your lives ahead. 

Congratulations!

Look for the speeches by Drs. Benson and Powers next week.  Until then,

Meliora,

David S. Guzick, MD, PhD
Dean, School of Medicine and Dentistry