California Northstate University Graduation Commencement Speech May 18, 2024

A Warm Welcome to the 2024 graduates of California Northstate University!

Where are the graduates of the –

• College of Graduate Studies
• College of Health Sciences
• College of Pharmacy
• College of Psychology, and 
• the College of Medicine

Let’s have a round of applause for these amazing individuals!

Congratulations! 

A Warm Welcome to the parents, siblings, spouses, children, grandparents, significant others, and friends. Each of you have undoubtedly played an important role in helping each of these graduates be where they are today.

Thank you for the invitation to speak today, Dean and Vice President of Medical and Academic Affairs, Dr. Richard Isaacs, distinguished faculty and guests.

I’m absolutely thrilled to be here and proud of what each of you have accomplished over the past few years. Each of us are shaped by the times we live in and by our experiences, and you have persevered and been resilient in your pursuit of 

one of the noblest professions anyone can do 

• helping your fellow human being in their time of need
• in the most challenging times in recent memory. 

Whether your next steps are going to 

• graduate school, 
• receiving additional medical and surgical training in residency and future fellowship programs,
• providing care soon as a psychologist, pharmacist, or in health care delivery, 
• or contributing to the advancement of science, 

you will have the privilege and responsibility of helping others with your skills and knowledge, 

• with your empathy and compassion, and 
• creating a connection with complete strangers, 
• in a way society rarely bestows on others.

I’d like to share with you things that have helped me in my career and life as a family physician.

• Always be learning. Solve problems.
• Be kind. Especially to yourself.
• When you have a chance, be a leader.

One. Always be learning. Solve problems.

When I graduated from the University of Connecticut School of Medicine in 1997, and then later completed residency in a small community hospital in Glendale, California in 2000, I didn’t know what was next. 

As the only doctor in my family from Taiwanese immigrants, I was moving to Sacramento to join the Adult Medicine department at Kaiser Permanente in Roseville, and settle down with my finance, who was doing hem/onc fellowship training at UC Davis.

But a phone call a few months later changed everything. My younger brother called me from Connecticut, over 2800 miles away, the night before his surgery.

What surgery?

It was for a Dermatofibrosarcoma protuberans (DFSP) of his shoulder. He had a hard painful lump for months. It was finally biopsied. He was told it had to come out. He wanted to make sure I knew about it and wanted some reassurance. 

After all, I was the only doctor in my family.

Dermatofibrosarcoma protuberans (DFSP)?

I never heard of it. 

My fiance pulled out a thick oncology textbook with tissue paper thin pages. 

Dermatofibrosarcoma protuberans (DFSP). One small paragraph. 

• Rare type of cancer. 50% recurrence rate or chance of coming back.
• Basically a coin toss between cure or cancer returning.. 

What’s this? Cure rate was 98% with a special surgical technique called Mohs surgery?

Huh.

Had my brother’s surgeon ever operated on such a tumor? 

• No. This was his first time. He just said it needed to come out.

Had my brother’s dermatologist who did a biopsy ever treat such a tumor? 

• No. It was his first time, and he had decades of experience. 

It was so rare, that the local hospital had the biopsy sent to the Mayo Clinic for confirmation.

“Dennis, you need to cancel surgery tomorrow. I gotta make some phone calls”

Remember this is 2000.

• There is no Facetime or Zoom. 
• There is no Google. 
• There is no iPhone. 
• It’s phone calls and emails. 
• And who you know. 
• When you go to med school, you know a lot of doctors.

In the entire state of Connecticut, only two surgeons are qualified to do Mohs surgery.

• One at Yale and one at UConn. They are orthopedic oncologists. 

• Specifically, after medical school they did orthopedics residency and then did additional fellowship training on cancer of the bone and muscles. 

They could take what would have been a coin toss between cure or recurrence to ensure my brother was basically cancer free. 

What did they do differently? 

They ordered an MRI to see where this tumor was and where the cancerous roots which typically caused the cancer to come back were hiding. In the operating room, they would run down each of these roots with Mohs surgery until the cancer was gone.

THAT is the difference between – I’m really sorry your cancer came back AND 

• I’m glad you are still cancer free for over 20 years. 

As I reflect now years later, I’m still haunted by a few questions.

What if my brother hadn’t called me that night, but after the surgery was done, too late to do an MRI or meticulous Mohs surgery? 

What if I hadn’t become a doctor? 

What if my finance wasn’t an oncology fellow?

It was because of that one phone call, I’m here with all of you today. 

Had our health care system taken care of my brother and others like it is supposed to do, high quality of care, affordable, accessible, equitable and personalized, the way we all would expect and deserve, 

• I would have never needed to intervene.
• I would have never been aware of the gap between what we aspire to be and where we were in 2000, and where we are today.

Since then, everything I’ve done professionally is to improve our delivery of care to ensure that I, by being a doctor, do not have an unfair advantage. 

Everyone should get great care no matter their background or education. 

Initially to help improve the care we provide, I became a board member at age 34 of my medical group, TPMG, the largest medical group of Kaiser Permanente, 

• helped with deploying the world’s largest electronic medical record system in civilian use, 
• And transformed workflows in primary care and chronic conditions management. 

As a result of hard work with many of my colleagues across various specialties, we helped individuals and entire populations with various ailments live their most productive healthier lives. 

In August 2015, I joined a digital telehealth start-up in Silicon Valley where we provided women a way to get evaluated and treated for a urinary tract infection (UTI) via a smartphone app. 

• By the time I left seven years later, we had 30 different medical services including options for sinusitis, cold sores, acne, menopausal hot flashes, to the service I’m most proud of, the treatment of anxiety and depression. 
• With the click of a button, anyone in America, in all 50 states and DC could access health care via our app.

About a year and half ago, I joined a new company, Curai Health, a text-based virtual care clinic which leverages OpenAI’s ChatGPT4, to improve healthcare quality and access while being affordable to those in need.

So, number one. Always be learning and solve problems. 

Helped my brother be cured of his disease. Helping medical colleagues provide better coordinated care using technology to help people live their best lives.. 

One fateful phone call. 

One intervention. 

Years later, leading a medical team using generative AI and large language models to provide personalized affordable care at scale. 

Years later, speaking to the next generation of healthcare leaders.

Always be learning. Solve problems.

Two. Be kind. Especially to yourself.

As I look around, the challenges we face as a society are greater than ever and yet the people to solve these issues are more capable than ever. 

Those people are you.

I am in awe that you have persevered through one the most challenging times in US history. During your education, you experienced 

• a global pandemic not seen since 1918
• witnessed increasing social unrest not seen since the 1960s, and 
• economic uncertainty and inflation not seen since the Great Depression and the 1970s. 

As a society, you saw the best of us and the worst of us on the news, social media and in person. 

• You saw innovation, adaptability and resilience. 
• You also saw grief, heartbreak, and loss.  
• Misinformation. Disinformation. 
• Failures of leaders. Everyday heroism. 
• Giant scientific discovery and advances. 
• Small moments of victories. 
• A decade of transformation compressed into months.  
• Setbacks and false starts. Return to the status quo.

Each of you are a product of these very challenging times and yet you continue to learn, educate and better yourselves on your path to help your fellow human beings. It is a hard journey. You should be proud. Not everyone can do what you’ve done and continue to do.

I know you will be kind to others and the people you help as a result of your experiences with your humanity, insights and wisdom. 

But I really want to make sure that you are especially kind to one person.

You.

When you first walked through the halls of California Northstate University, it might have been a little uncomfortable. Learning new skills, terminology, culture and mindset. 

Do I know enough? Am I good enough? 

And now today, you are more accomplished and confident than ever.

And yet there is so much more to know and experience both personally and professionally. 

We can have it all, but we can’t have it all at the same time exactly when we want it. 

So be kind to yourself when things don’t work perfectly or if you have setbacks. Failures and setbacks are part of life. 

Yet, we don’t live up to our true potential selves unless we challenge ourselves and explore new opportunities..

So be kind. Especially to yourself.

Three. When you have a chance, be a leader.

What should be apparent to each of you, surrounded by family and friends, is that what you have accomplished is incredible. 

• Not everyone has the gift of knowledge, desire to help others in their times of need, or the mindset of service that each of you possesses. 
• With these talents, I hope you consider that when you have a chance, be a leader..

Leading can be being a parent helping out in your child’s elementary school or going on field trips.

• Leading can be stepping up in your house of worship. 
• Leading can be taking on additional roles in your job outside your clinical practice. 
• Leading can be giving back and teaching the next generation of clinicians, like the faculty here.

What has been apparent in the past few years is that we live in an increasingly VUCA world. VUCA – volatile, uncertain, complex, and ambiguous world with challenges unlike prior generations. 

• More information than ever, in a world more connected than ever. 
• A time where generative AI, a technology as transformative as the steam engine during the industrial revolution over a hundred years ago, is something that all of us will face today and the foreseeable future. 
• More transformative than the internet or smartphones. 
• More than the human genome project, mRNA vaccines, or electric vehicles.  

What will happen? What will the future look like? What will we do?

It is in times of uncertainty, we look to thoughtful individuals, community leaders, and people who can think through and solve problems in a time where you can’t simply google the answer. Critical thinking is needed.

And those are people like you. Those people are around you.

If you think about it, the creation of California Northstate University is leadership. 

• The founding faculty and staff saw a problem, not enough well qualified individuals in health care available to fulfill the needs of our community,, and went out to solve it. 
• This leadership and vision years earlier with the investment and founding of the school made all of this possible .

You graduating today is a sign of leadership. 

• You are showing what is possible to those about to apply, enroll, and graduate in the years ahead as well as demonstrate to the world what it means to work with a graduate of California Northstate University.

You are already beginning your leadership journey. 

Keep going.

So, as I wrap up and as you begin your next step on this journey, consider what I’ve shared with you. 

The world needs people who are always learning, solving problems, who are kind and thoughtful, and when given a chance, should be leaders.

And remember two more things.

I want you to be yourself.

There is only one of you in the world. 

Share and contribute your unique insights and life experiences with others. 

And one last thing.

With all of the new technologies and discoveries still to be uncovered, I still believe that there is nothing more sacred than being in the presence of another person in their time of need. 

• There is nothing more priceless than showing a person how important they are when you commit time and energy by being there in person. 
• It can be a handshake, a hug, or simply sitting together quietly. 

This is precisely why you are here surrounded by your family, your friends, and your faculty. 

• And why I am honored to be here to share this moment with all of you.

No matter what changes in your career, the human connection and commitment to another human being matters. 

• You show that by giving your time, attention, and physical presence. 
• These are things technology cannot replace. 
• This is therapeutic. 
• This is the art of medicine. 
• Never forget that.

Congratulations California Northstate University graduating class of 2024.  

Your future is bright! This is just the beginning.

I look forward to what each of you will do next. 

Thank you.