Posted 7 Sep 2001
It's great to be here at the official end of your formal training in laboratory medicine. This occasion is a first for you and me. For you, it's your first day as Medical Laboratory Technicians. For me, it's the first talk I've ever given without the aid of a slide projector. But, I'm honored that you have asked me to attend your ceremony, and I hope you'll forgive me if I occasionally slip and yell out "next slide, please!"
It occurred to me when preparing for this talk that I have been in the healthcare work force, in one capacity or another, for 26 years this summer. I do hope that I have reaped the benefits of 26 years experience, but I confess that sometimes I have the fear that I have only had one year of experience, 26 times.
Anyway, giving a commencement address at graduation is really the only means in polite society where we are allowed to give a large, unbroken block of unsolicited free advice without seeming rude or presumptuous. It's hard to turn down such an opportunity, so I put together some ideas I have gleaned over the years, some of which, I hope, may help you to become a successful and happy medical professional.
Allen's Law is named after it's author, Woody Allen. Although events of the last few years might suggest that Woody's judgement, at least in terms of his personal life, may not be the best, there is no doubt that over his career, he has made some very keen observations about human nature.
Allen's Law states: "Eighty per cent of life is just showing up." At first, this sounds rather simple and obvious, but in our modern world of telecommunications and the shrinking global village, we might be falsely led to believe that human physical presence is of little importance amidst the convenient availability of telephones, fax machines, hospital information systems, and the Internet. But the fact remains that we are biologically a social animal, and much of the power each of us has in society rests in pure physical presence. Being there says so much more than a telephone call, or a faxed note, or an e-mail message.
What does Allen's Law mean to the laboratorian? Well, the most basic practice of Allen's Law is to show up for work. As part of a laboratory team, your patients and your fellow workers depend on you to be there. It's easy to think that you wouldn't be missed if you should "call in sick" after a particularly eventful weekend off. You might think: "After all, that lab is full of techs every day, and I'm sure all of them will show up. Furthermore, when I'm not at work, I hardly miss the place. I'm sure they wouldn't miss me either."
Well, I guarantee that they will miss you, and you will be foremost on their hands through much of the day. You will also become a prominent topic of lunchtime conversation if you come to be perceived as one who takes more than his or her fair share of unscheduled three-day weekends. One clever person once said, "When you keep someone waiting, he occupies his time counting your faults." Well, you can count a whole lot of faults in the course of a busy eight-hour shift.
Another aspect of Allen's Law is your physical presence in other areas of the hospital, clinic, or wherever you end up working. I think you will find that getting what you want - from nurses, med techs, maintenance people, and personnel directors - becomes a lot easier when those individuals know you as a visible human being, rather than a voice on the phone, a memo, or a work order. It's much harder to say "no" to a friendly and courteous person standing in front of you than it is to rubber stamp a big "No!" on, say, a vacation request form. So, I think a wise use of your break time is getting around to different parts of your place of employment and striking up friendships with people who work in other departments. Consider the time you spend doing this as an investment, which, while not unpleasant in itself, will also pay off handsome dividends in the future.
About 2500 years ago, two very wise men in two totally different parts of the world wrote down similar statements. One, a Chinese bureaucrat named Kong Fu-Tzu, or Confucius, wrote "Never do to others what you would not like them to do to you." The other, a Jew calling himself Tobit, wrote, "Do to no one what you would not want done to you." We now teach versions of this basic idea to school children as "The Golden Rule." But why is it called Golden rule? And why are those who follow it so valuable to us? Why is it worth talking about in a commencement address?
Well, we know that the thoughts of unselfishness conveyed in the Golden Rule are beautiful thoughts, and objects made from gold are beautiful to look at and handle. Now, there are a lot of things that are beautiful - but not particularly valuable: a field of bluebonnets in full bloom; the pure white sand of a Florida beach; droplets of dew on an orb-weaver's web glistening in the light of the rising sun. These beautiful things can be enjoyed by all, regardless of the ability to pay.
No, what really makes gold valuable is its rarity. It is an uncommon substance in the earth. It is difficult to find, and people are willing to pay a lot to enjoy it. And so it is with the Golden Rule. Although the wisdom of Confucius and the Bible has been available to us for two and a half millennia (at least), those who scrupulously follow the Golden Rule, who consistently treat others as they would themselves like to be treated, remain not only as beautiful as gold, but as rare. By following the Golden Rule, you make of yourself something very valuable to others, not only because they find your behavior appealing, but also because they find such behavior so infrequently.
In medical care, there is an unlimited opportunity to practice the Golden Rule. First and foremost is the way you interact with patients. If you were sick, disabled, in pain, and worried about your prognosis, would you like to have your blood drawn by a glum, wordless technocrat who is concerned only with filling his tubes and getting on to the next patient? And if you were a frightened six-year-old who needed a urinalysis, would you like to be pushed into a bare, cold public bathroom in a strange place, and have a specimen cup shoved in your face by an unsmiling, white-coated lab employee whose only words to you are "fill it up"?
Of course, it's obvious your answer is "no," but everyday in the hospital we see the actions of those healthcare givers who seem to have no concept that they, themselves, will be the patient someday. It is so easy to conceive how we'd like to be treated, if we were sick, but it never ceases to amaze me that it seems so difficult for so many health care professionals to imagine that the patients in their care could possibly have similar feelings.
The value of the Golden Rule is not limited to patient care. Your fellow co-workers will also appreciate your practice of the Golden Rule. In lab medicine that means not dumping work on the next person; it means helping your teammate out when she's under a stressful workload; and it means not crowing over another's mistakes. The only thing in your career that I can guarantee will happen is that you will make mistakes, and when you do you'll be very grateful if your co-workers avoid rubbing your nose in your errors. Accordingly, you should treat your co-worker's honest mistakes with the same sympathy and constructive encouragement you would expect from them.
As a new MLT, you will routinely be entrusted with the care and welfare of machines that cost more than most people's houses. A SMAC costs more than a Rolls-Royce. A lowly, oil-smeared microscope costs more than a top-of-the-line component car stereo system. A Technicon H*2 costs more than all but the most expensive Liz Taylor-kind of diamond necklaces.
But I find that many people who work with expensive equipment tend to treat it with considerably less respect than their own more humble personal possessions.
It occurred to me that responsibility for expensive property is treated rather oddly in our society. On the one hand, a board of directors would trust a forty-million-dollar company only to a seasoned executive, typically a man or woman, age forty to sixty, with twenty or more years experience in the business. On the other hand, the US Air Force has no trouble at all trusting a forty-million-dollar F15 fighter aircraft to a fresh-out-of-school, 23-year-old junior officer. Why would corporate America be so cautious with its property, while the Air Force is so seemingly reckless with its?
The answer is that the Air Force generals know that 1) its young pilots are well-trained, and 2) the pilot knows that treating that plane right is a matter of life and death.
Why can the health care industry trust its expensive property to an MLT fresh out of school? Well, our "generals" know you are well-trained, so that's a given. But what about that chemistry analyzer being a matter of life and death?
Now, a Beckman CX5 doesn't have the snazzy lines of a McDonnell-Douglas F-15, and the annoying sounds it makes are not as dramatic as a sonic boom or the report of a Vulcan cannon. But that chemistry analyzer is just as much about life and death as that jet fighter is. That laboratory machine - enabled by the man or woman that operates and maintains it - is a deadly weapon aimed at an enemy much more subtle than an army of fighting men. That enemy is disease. You are the soldier that fights that enemy in all its many disguises, and the care you give that machine is just as important as the care a warplane, or any military weapon, gets.
So, that analyzer may not be your personal property, paid for with your hard-earned bucks, but it's someone's property, and, because of what it does, it's much more important than just about any possession that you or I own.
The secrets to a successful career, in my opinion anyway, are not secret at all. The importance of physical presence, consideration of the feelings of others, and a scrupulous sense of stewardship for the sophisticated tools of your trade - this is not hidden wisdom. I'm sure that your parents, and other people you looked up to while growing up, taught similar principles to you, as my parents and grandparents did to me. But if these principles are so obvious and so commonly taught, why is it that so few follow them?
I'm sorry, but 26 years have not provided me with the answer to that question. Maybe in another 26 I'll have it figured out.
In the meantime let me congratulate you on your achievement. You have all worked hard, and you deserve to feel proud of what you have accomplished during your course of study. I am especially humbled by those of you who have embarked on the voyage of a second career. I can only imagine the sacrifices you and your families have made to get you here tonight. Maybe you should be giving me a send-off speech!
Good night, and good luck!