Atul Gawande: Anything is possible in people’s lives (2011)

Thank you, graduates and Ohio University, for this opportunity. I am a 1983 graduate of Athens High School. Which means, yes, you invited a townie to give your graduation address. I grew up here watching you, the students, come and go. Perhaps that should make you wonder whether it was foolish to have asked a townie to speak. I’m not sure, after all, how much you want me telling your parents about what I saw as a teenager on Court Street on Halloween nights.

What I want to talk about, though, is the huge impression you, the students, and this university made upon me. My sister and I were born in New York City. Our family moved to Athens when the two of us still had our baby teeth. And among the enduring beliefs I absorbed growing up here is a core American idea: Anything is possible in people’s lives. No one should be counted out.

It might seem strange to have learned this in a small Appalachian town. Thirty-five percent of Athens County’s population lives in poverty, the worst in the state. Almost half of my classmates never made it to college. Yet everywhere around me was also evidence that ordinary people could have extraordinary strength and contain possibilities no one imagined—even themselves.

Much of the evidence was right in my home. My parents were immigrants from India and they had somehow found it in themselves to swim against the tides of rural deprivation (in the case of my father) and of restrictions and low expectations for girls (in the case of my mother) to become doctors, to find their way to New York, to meet one another there and marry against caste restrictions, and to ultimately become regarded as local leaders here. But our town and Ohio University provided the rest of the evidence.

I remember, for instance, Karl Fry, a soft-spoken kid in the neighborhood who sometimes mowed our lawn for five bucks when I was in third grade and once showed me a nest of baby copperheads he’d found. When I was in eighth grade, he went to O.U. and made the ice hockey team. By my ninth grade year, he was a starting winger, and I used to go down to Bird Arena to watch him and the team play. I’d stand up against the glass behind the opponent’s goal where I could see up close the incredible speed of the slapshots he and his teammates unleashed, and feel the force of the Bobcats checking the other players against the boards. It seemed to me I was watching a person I had known and yet never knew existed. Karl and the team won the Midwest College Hockey League championship three times. And he also somehow worked hard enough to graduate summa cum laude in computer science, going on to become a computer systems engineer and entrepreneur.

No one comes to Ohio University anointed for the future. Nothing demonstrated that more clearly than the sports. I was here during the dark years of Bobcat football. You learned not to expect much. But you also learned you could still hope for it. My senior year in high school, the O.U. basketball team thrilled us all by winning a berth in the NCAA tournament. I drove my little red Datsun twenty-two hours down to Tampa, Florida, with three friends and two cassette tapes playing over and over—Pink Floyd, “The Wall,” was on one and Def Leppard, “Pyromaniac,” on the other—and we arrived in time to watch the Bobcats pull off a stunning, down-to-the-last-minute, two-point upset of far higher-ranked Illinois State.

Sports was far from the only example showing a kid like me the ways the unanointed could pull off an upset. Graduates of Ohio University have gone on to become senators and governors and to even win a Nobel Prize in chemistry. Alumni include Matt Lauer of the Today Show, Roger Ailes, the President of Fox News, and Nancy Cartwright, the voice of Bart Simpson. O.U. graduates have become C.E.O.s of companies like Charles Schwab, Nationwide Insurance, B.F. Goodrich, Smith and Wesson, Harley Davidson, the Lexus division of Toyota, and, yes, the Olive Garden restaurants. Every one of them sat where you sit today, wondering, as you do, what the world would hold for them.

I am an O.U. alum of sorts, too. As a nerdy high school senior, I took a half-year’s worth of credits—some math and chemistry courses that my school didn’t offer. This place can embolden a kid. I took myself and my peach-fuzz mustache up to a pretty college freshman in organic chem class and asked her out on a date. I think her burst of laughter meant no.

Things didn’t show signs of going much better when I went out west to college. I walked into a medical scientist’s lab and asked him to give me a research job. What did I know about his work? Well, nothing yet, I said. I could actually hear his eyes rolling.

I took a fiction writing class. I’ll write a novel, I said to myself. But it quickly became apparent that I had nothing to say. I picked up the guitar and began writing rock songs with the most abominable lyrics. “Oh the pain, oh the misery,” that gloomy, Morrisey, eighties sort of thing. I liked imagining myself as an artist or a scientist. But I think what I really liked was just the idea of being someone important. And you know where that gets you: nowhere.

When I graduated, there remained the nagging puzzle of how I would get where I might be going, how I make the unexpected and possible happen. There is the usual advice about these matters: work hard; don’t make money or power your goal; be yourself; make a difference. It is all wise advice. But what does it mean you actually do?

I tried lots of things before I eventually ended up with the odd mix of work that I now do. There were several years of what most people would call wandering. But over time I learned that there are two very different satisfactions that you can have in your life.

One is the satisfaction of becoming skilled at something. It almost doesn’t matter what the terrain is. There is a deep, soul-feeding resonance in mastery itself, whether in teaching, writing a complicated software program, coaching a baseball team, or marshalling a group of people to start a new business. I found mine in several places. I found it in surgery, in learning the exact pressure required to take a knife through human skin without going too deep or too shallow, in making decisions under conditions of uncertainty, in drawing people together to accomplish remarkable things for patients. I found it in writing, in the way one can create images and even smells, explore ideas, make people gasp, with the right words snapped together. And I found it in public health, where you can craft small, creative changes that make people’s lives better by the thousands.

Developing a skill is painful, though. It is difficult. And that’s part of the satisfaction. You will only find meaning in what you struggle with. What you struggle to get good at next may not seem the exact right thing for you at first. With time and effort, however, you will discover new possibilities in yourself—an ability to solve problems, for instance, or to communicate, or to create beauty. I never imagined I’d find beauty in surgery. But with time I discovered there could be beauty in the way that I put things together under the skin, beauty no one might ever see, but still strangely satisfying nonetheless.

I said there are at least two kinds of satisfaction, however, and the other has nothing to do with skill. It comes from human connection. It comes from making others happy, understanding them, loving them. The relationships you’ve made are what you will miss most about college. I suspect you did not find forging them nearly as difficult as your classes. Most of you are more worried about the skills and work you will have in your future than the relationships. But neither will you find easy.

Among the many special things about college is that you live surrounded by people of all kinds. They have differences in background—they’re from the trust fund class and the welfare class and everywhere in between; they’re of races and ethnicities of all kinds. More importantly, they have differences in the way they think. They are the religious and the non-religious; they are conservatives, liberals, independents, and indifferents; some want an organic future and some want a technological future; some can’t wait to get out of Ohio and some never want to leave. In few places in life, must you contend with such multiplicity—or learn how rewarding it is. But in an increasingly interconnected world, the capability is crucial. Maintaining it will take effort. The human connections you need to thrive and get along in the world require the work of withholding judgment, seeing the complexities and imperfections of others, and discovering joy in them. People have layers. You must take the time to find them.

Your strengths as human beings come from both the abilities and the relationships you invest in nurturing. The trick you have had to learn to get through college, that you will have to carry with you for life, is how to turn the distractions away, how to focus at least a little bit every day on stuff that will take awhile.

You may ask yourself in difficult moments, “What am I doing this for?” Or worse, you may not. In the next few years, you will join the work world, settle into a town or suburb somewhere. And gradually, you will go from outsider to insider. You will become part of a team and community. In the beginning, their way of doing things, their customs and expectations, won’t make sense. Then, after awhile, they will. You’ll slot right in.

But not everything they do actually makes sense. There are flaws and failures all around, opportunities to make the world concretely better in some way. And those opportunities are among the things I hope you live for. They are why you go to college, why you came to Ohio University.

Yes, you came to begin developing your own areas of knowledge and skill, so you might have a more secure future. And yes, you came for the people you’ve gotten to know, people who will stay with you for a lifetime. But you also came for the ways those abilities and people might help you unlock the unexpected possibilities that lie inside you, the ways they might help you someday make your small mark upon this earth.

In my work, I’ve gotten to know people who have made their world better in extraordinary ways. In my hospital is a surgeon who had the imagination and leadership to successfully marshal a team of more than a dozen surgeons through the nation’s first complete face transplant, and he was still in his thirties. At the New Yorker magazine are colleagues who exposed Abu Ghraib, solved unsolved murders, and created whole new ways of writing. Among those I met at the World Health Organization and most admire is a man who led a program that has nearly accomplished what people told him was impossible—the eradication of polio from the entire globe.

There are a few things about these people that I’ve tried to emulate. All did their part inside the teams and organizations they joined. But somehow they never let themselves be completely defined by the institutions or the way they did things. They were insiders and yet poked at the customs, looking for better ways. If I’m able to do anything of meaning in the places I live and work—and if you are—it will be because we developed the strength to do the same.

For me, that comes from here in this town. I’ve not forgotten that I was an outsider—that I’m a townie and remain connected to vital people and places beyond those with titles and power over me. That is what this college has given you, too. Besides the opportunities to find a career and place for yourself in society, being an OU graduate gives you a chance to remember you are from a place of larger aspirations, a place that values nothing the more than the ability of human beings to make tiny changes to Earth.

We take this moment together, with your family and friends, to celebrate your achievements. You’ve done a difficult and remarkable thing, turning away the distractions, doing the work, and coming this far. But we also come together because you remind us: Anything is possible in people’s lives. No one should be counted out. Especially not you.

Ohio University commencement speech (11.06.2011)

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