Eyeworld

EW NEWS & OPINION 29 M adame president, honorable chair, distinguished faculty, parents, colleagues and friends, fellows, and residents. There are three reasons why I will never give a commencement ad- dress: Firstly, I shall never be asked. Secondly, muddling platitude for wisdom, many are, at best, eminently forgettable, at worst, downright lame. Most get it back- wards. This is a commencement, not a completion. The finest commemo- rate an event astonishingly notewor- thy: the start of life as it really is. Thirdly, the prize has been retired, the best have already been done. Three of the most worthy— a fourth carries an asterisk into the pantheon—reveal secrets that, once embraced, portend a life well-lived with few regrets. Kurt Vonnegut did not give the "Sunscreen" address to the MIT graduates in June 1997. It was U.N. Secretary General Kofi Annan who spoke in Cambridge on that late spring day. No one knows how a col- umn written by the Chicago Tribune's Mary Schmich made the rounds of the internet as the purported words of the famously sardonic author of Slaughterhouse Five and Breakfast of Champions. Before the term "gone viral" became internet-speak, the Vonnegut/Schmich hoax became a digital sensation. Ironically, Vonnegut disdained computers and Schmich referred to the internet as a "lawless swamp." When Schmich phoned Vonnegut, he said that "what she wrote was funny and wise and charming, so I would have been proud had the words been mine." You, dear graduate, cannot know what lies ahead. Kurt/Mary counsel that you enjoy the "power and beauty of your youth" now even if you don't understand them until they fade. As Scott Fitzgerald ob- served, "there are no second acts in American lives." Delayed gratifica- tion got you to where you are. Use it judiciously. Life is short. Kurt/Mary also saw that the "race is long, and in the end, it's only with yourself." Competition? Only to show how thoughtful, caring, and loving you can be to family, friends, colleagues, patients, and the little people. Everything else is vanity. Which brings me to the arche- type, the ultimate commencement address, the "preacher's" advice found in the Old Testament's Book of Ecclesiastes. Chapter 9, verse 11 posits that, no matter how swift, strong, wise, understanding, and skillful you are, "time and chance happenth to them all." Black swans come in many different guises and always appear unexpectedly. Expect to fail; everyone does. You will learn much more from failure than tri- umph. But be sure to celebrate your successes. They are your best re- venge. Be kind to yourself. As a perfectionist, be perfectly imperfect. Richard Feynman, Nobel Prize laureate and self-acknowledged patron of the art of pole dancing, gave his "Cargo Cult Science" address to the California Institute of Technology's graduating class of 1974. It remains pertinent because it addresses the very essence of sci- ence. He assailed pseudo-science's perniciousness and the fraudulence it perpetuates. When making a diag- nosis, apply Feynman's approach to the experimental method: "report everything you think might make it invalid (my italics)—not only what you think is right about it." To be- come a world-class diagnostician, be utterly, brutally honest. Correlation is not causation, implication is not truth, truth is not always scientific integrity. If it were, there would be no pharmaceutical advertisements. Feynman's first principle is "that you must not fool yourself—and you are the easiest person to fool." Step outside yourself to read your pa- tient's mind. Impossible? Only if you don't take the time to ask what hurts, what scares her, why she seeks your aid and solace. My all-time send off? That given by the late David Foster Wallace at Kenyon College in 2005. It is known as the "This Is Water" speech. I'll spoil the ending for you. Make a difference. Today, every day. Not for the honor, glory, or compensation, but because it makes you a better person. It gives your life purpose, your reason for being. As a physi- cian, you are in the enviable posi- tion to give something of great value that often costs little. DFW advises you move out of your comfort zone of preconceived, self-referential and narcissistic no- tions. Perceptions are your reality. Question them. Always. The man in the exam room is not maliciously harassing you for the umpteenth time complaining of tearing eyes. He may be seeking respite from his bedridden wife's ovarian cancer. Believe, as Thoreau did, that "the mass of men lead lives of quiet desperation." Wallace concedes this is hard to do when needing to restock the pantry, attend your kid's soccer game, or address that brain-deaden- ing stack of reports. But only you can decide "what has meaning and what doesn't." Avoid the "so-called real world" default settings fueled by "fear and anger and frustration and craving and worship of self." Now comes the big "capital 'T' Truth." I do wish that Vonnegut had said it. Better yet, I wish I had thought of it so well (curse you, Robert Frost). "Be careful whose advice you buy, but be patient with the people that provide the advice. Advice is a form of nostalgia." Thank you for letting me reminisce. Wear sunscreen. EW Editors' note: Dr. Noreika has practiced ophthalmology in Medina, Ohio, since 1983. He has been a member of ASCRS for more than 30 years. Contact information Noreika: JCNMD@aol.com July 2014 by J.C. Noreika, MD, MBA To the class of 2014 Insights J.C. Noreika, MD, MBA 12-29 News_EW July 2014-DL_Layout 1 6/30/14 8:39 AM Page 29

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