Class of 2013: What May Come of Dreams?

The following is an excerpt from a May 13 speech I gave at The University of Bridgeport Division of Health Services Graduate Programs Commencement, where I received an honorary Doctorate of Humane Letters.

Through the medium of "Hamlet," William Shakespeare famously invited us to consider: "What dreams may come when we have shuffled off this mortal coil"? None can say. But we can, perhaps, constructively contemplate: What may come of our dreams, while by this mortal coil we remain bound?

Dreams no doubt figure prominently among us today. Dreams of futures that might be. Dreams of ambitions fulfilled, goals achieved, prizes won. That’s as it should be. This is the time for it. But what, really, may come of such dreams?

Writers and philosophers, poets and theologians have long pondered that restive interface of reality and dream.

In the poem "If," Rudyard Kipling warned against undue subordination of our sobriety to dreams. Dreams, unconstrained, might run roughshod over the best roads to better destinies. We should dream, but must remain the masters of our dreams, and destinies.

Kipling, presumably drawing from the less pleasant of his own experiences, cautioned us against the undue dominion of dream. We can get lost in dreams. Dream can make us dreamers — fatuous, and futile. Rather than leading us toward our best hopes fulfilled, they can lead us astray. So Kipling encouraged a practiced pragmatism. If you really want to change the real world, you will need your dreams to keep their feet on the ground. You will need a certain, steady stoicism.

But for those of us in the healing arts, there is an alternative peril in Kipling’s time-honored advice. If we too successfully stifle the impulses of dream, if we silence the better angels of our nature, and if we repudiate our passions — we risk an unfeeling reality. This may be a menace to all humanity, but certainly it is so for those of us whose careers are about care. Care for health. Care for people. There can be no genuine care without caring. There can be no caring without feeling.

There is risk in feeling; there is far greater risk in failing to do so. And so, I have a dream about science, and softness. I have a dream of health care carried unfailingly in currents of deep caring. I have a dream of medicine based on both evidence and empathy; where responsible use of science, and responsiveness to the needs of patients—that all too often go on when the results of randomized controlled trials run out—are fully reconciled.

I have a dream of medicine unencumbered by territorial disputes, uncompartmentalized into this kind, and that kind. I have a dream of our collective best efforts to find what works best for any given patient across a full spectrum of plausibilities.

All care should be patient-centered. Lifestyle should be medicine that actually goes down. Holism should be a replicable method in the service of real people, and not merely a platitude.

I have done what I can to advance this dream through my own practice of evidence-based integrative medicine. I have a dream that your transition today to the ranks of practitioners will advance that dream further.

But this day is not about Hamlet’s dreams, Kipling’s dreams, or my dream. This day is for you, and your dreams.

What may come of them?

That depends, at first, on the dreams.

For they must be good dreams to do good in the world. They must be dreams sized to suit a world of challenge and opportunity. We listened in as Hamlet told Horatio: “There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.”

If that was true, then Horatio’s philosophy was too small; his dreams, too pinched. Let nothing but the full expanse of possibility pinch your dreams.

If ever our dreams prove too small, our philosophies too pinched to accommodate the validated realities of heaven and earth, we are duty bound to expand our dreams and enrich our philosophies—not constrain reality to fit our preconceptions.

But as we open our minds to allow for the wings of dream to spread, we must never open them so fully our brains fall out! We must open our minds, but keep our heads.

This occasion is a lovely pause — deep with meaning and emotion. Today is a day redolent with promise. But it is also a day to contemplate our obligations to the body politic. It is a day to think of promises we must make to advance the human condition, and what it will take to fulfill them. It is a day to size up the long, arduous miles to go — and draw that preparatory deep breath: one part resignation, one part resolve, and one part restless delight.

The best way to predict the future is to create it. Dream is the cradle of creativity.

What dreams may come when we have shuffled off this mortal coil? None can say.

What may come of dreams when you have shuffled, or vaulted, past the milestone of this graduation?

Well, they are good dreams…

• If you live those dreams
• If you live those dreams, and nourish them unfailingly with today’s deep passions
• If you temper them with the lessons of experience
• If you live those dreams, and never denigrate the dreams of others
• If you live those dreams, and never quit on them

…Then what may come of them is a better reality for us all.

What may come of today’s dreams? Make them the very best of dreams—do your very best to live those dreams—and let’s find out. For what may come of today’s dreams…is entirely up to you. And for that, Class of 2013, I envy you.

Photo: Thales/Flickr

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