Advice to My High School Self

A few years ago, I was invited back to my high school, the Bergen County Academies (it was called the Academy for the Advancement of Science and Technology when I attended) in Hackensack, NJ to share perspective with current students.

Being back at my high school--more than 20 years after I first began--offered an incredible walk down memory lane and, more importantly, gave me an opportunity to reflect on what advice I might have given to my high school self. My classmates and I were in the startup magnet school's third graduating class.  It was a challenging environment and, in retrospect, taught me a lot of important life lessons.

I share my unredacted remarks in hopes that it might be helpful to current high school students as they navigate an increasingly complex academic and professional environment.

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When I was last on this stage, I was graduating high school and receiving my diploma. I had pimples all over my face and substantially more hair on my head. I wore big, thick glasses that were too large and I grinned a wide, goofy grin.  

Today, I grin wider. It's such a thrill and an honor to be here. To walk these halls again. To see my most important teachers again. To meet and address all of you. I can't express how strange and wonderful it feels to be here. So thank you for that.

In the course of thinking about my remarks today, I reached out to some of my friends from the Academy--to get their ideas on what I might tell you about those early days here. And they all agreed reluctantly that I should tell you the unvarnished truth. 

That it was freaking crazy.

We were part of just the third class of the school. We arrived here on our first day, August 15, 1994--20 years ago---with the promise of being part of something new and different and risky. All of us felt nervous and awkward and insecure. 

Did we make the right decision? Would we be happy? What the heck were we doing here? 

If you can imagine it, the Academy had no track record then. No reputation. It was just a shiny new building, a bunch of cool toys, and the dream of some visionary educators. 

Several students from the first two years had dropped out.

Teachers were quitting or were fired almost as quickly as they were hired.  

Rumors were always flying that the school might lose its funding and shut down.  

There were peanut projects, pea projects, and PPAOs.  

There were college professors who had never taught high school and high school teachers who hadn't graduated college.  

Everything was always an experiment. 

And for a few months my freshman year, I was among those who thought I might drop out because none of it made any sense to me.  

I was used to structure. In fact, I craved it. I had spent my whole young life till that point reading textbooks, doing assignments, and taking tests. It was a tried and true formula that I was good at. And this new school, this crazy new school--offered none. And I thought I wanted out. 

So I went to my parents. To Dr. Grieco who was superintendent; Mrs. Lisa who was my English teacher; and Mrs. Rosenstein, my middle school science teacher who suggested I come here in the first place--and I asked them all the same thing--should I stay or should I go? What would be better for me, my education, my life? 

To their credit, all of them said more or less the same thing: you decide.

But they also said, if you decide to stay--be all in.  

Just get off the fence.

In retrospect, it was the first adult decision I had to make in my life.

In the end, you know that I stayed. After I wrestled with it for awhile, it just felt--deep in my gut--like the right thing to do. 

I also thought I might get beat up at my local high school. 

And in the course of staying, I decided to be here--and take advantage of what it meant to be here.  

To take all the craziness of the place, the lack of definition, the richness of the people--and begin to do things with it.  

It meant: 

Embracing ambiguity and recognizing that everything that made this place scary--also made it great. 

It was my first time working within a startup--and truth be told--there were many startups within the larger startup here. 

Mr. Panicucci's Vietnam project. Dr. Landsman's electric fish research lab. The debate team we started with Mrs. Wallace. The teen journalism site we started with Mr. Polizzi and the The Record. And I could really go on and on.

We learned to work in teams. And give feedback to each other without hurting feelings. And check our egoes because there was always a classmate or teacher who was brighter or more talented or had better ideas. 

And, more often than not, it was hard. We were asked to be adults sometimes before we were ready. But it felt like what we were doing actually mattered.

And so everywhere I went after I left the Academy---oversized glasses, pimples, and all--I felt a burning, belly-deep desire to build new things, to lead change. 

And I did so in the way that this place taught me how--with others. 

In college, I worked with my friend Lewis Shi to start a homeless health clinic for the residents of Harvard Square. 

In medical school, I worked with my friend Kiran Kakarala to start an organization to teach health policy to medical students. 

When I served in the Obama administration--I worked with my mentors to help launch a new agency focused on implementing health care reform.

And, now, at the pharmaceutical company Merck, I have built a new team that's leading the company into the future of digital health and big data. 

The Academy--and all its craziness shaped who I am and enabled me to do the things that I do.

Now I am told that it is less crazy here these days and there is more structure.  

That far from being a scrappy startup, you are now ranked the 15th best high school in the country. 

Whatever changes have followed, I suspect that the core values of this institution, its underlying DNA, remain very much the same.

As I imagined what I might say today, I thought about what I advice I might give to a fifteen, sixteen, or seventeen year old version of myself. 

And I came up with a few thoughts that are worth exactly what you're paying to hear them, 

For one thing, I might have told myself to worry less about the future.  

When I was your age--and there are many teachers in this audience who can attest to it--I used to worry.  

We all did.  

This was a neurotic place. 

Will I get the SAT Score I need? Will I get into the college I want? Will the girl I like want to date me?  

Sound familiar? 

We falsely convince ourselves over time that worrying somehow makes us better. 

Give up the worry.

Now, I don't want to pretend that this is something I have figured out.

I still worry--but--as much as you can---worry about things that actually matter.  

Being a physician, taking care of sick and dying people who are forced to confront terrible things helps focus me on the people I care about and actually making a real, tangible difference in the world. 

In my observation, the world has a funny way of rewarding people who have true passion--and also disappointing people who have merely ambition.  

Try to find, as quickly as you can, what you really care about--and build your future around that.  

Remember that your parents, your teachers, your friends all want what's good for you, but, deep down, only you know what's best for you--and that's all that matters.  

The second thing I might have told myself is to prepare for things to not work out exactly as you want them to. To move beyond what I call "the illusion of control." 

When I was young, I believed sometimes that I had total control over my destiny. If you work hard and focus on your goals, you will achieve them. It's a time-honored formula fed to us by our parents, our teachers, and society.  

But I want to let you in on a little secret that I think you are prepared to hear now.  

Sometimes, despite your absolute best efforts, things won't work out EXACTLY as you want them to. 

Despite the seemingly linear narrative that that preceded my remarks, I can tell you story after story of profound failures and disappointments in my own life--some that led me away from where I thought I wanted to go, and redirected me to where I was meant to be. 

In this audience of over 1000 people, there will be one or two of you from whom life goes exactly as you think it will without hiccups.  

But for the rest of you, be prepared to be diverted--and it won't feel so much as a diversion as a necessary part of your journey.  

There is something deeply important about being prepared for things to not work out as you thought they would--which is that if you allow for it--they will sometimes turn out better.  

I want to tell you a story.  

When I was a student here at the Academy, I had browsed a book in the guidance department about summer internships.  

The book described being selected for an internship at the White House--as winning the Super Bowl of internships. 

In my junior year of college, as luck would have it, I had applied and had been selected for an internship at the White House in the Office of Science and Technology Policy. You can imagine my excitement. I was a science policy geek--and if you were in to that type of thing,--there is really nothing better. 

About a week before the internship was set to start--I received word from the White House that there was no internship.  

Sorry, they told me, we've cancelled your position.  

They offered me no explanation.  

Needless to say, I was devastated.  

After I picked myself up from this defeat, I made a phone call to a professor I really liked the previous semester--Donald Berwick--and asked if he needed a research assistant.  

He offered me a position and I took it on the spot. 

You see, on the face of it, I had a taken a huge demotion. From White House intern to research assistant for my college professor.  

Turned out --and I hadn't fully appreciated it at the time--that Dr. Berwick was essentially the LeBron James of health care.  

There hasn't been a more influential thinker in American health care in the last two decades--and I could not have imagined a kinder, more generous mentor at the stage of my life. He made me believe I could do anything. 

He took me to see some of the leading health care organizations in the world and meet with highly influential leaders.  

He helped me write the first of many articles I would enjoy writing about the health care system. 

Don's guidance and example and the exposure gave me the foundations for my career-in a funny conclusion to the story, when Don was asked by the White House to lead health care reform implementation, I was lucky to join him in Washington after all. 

You never really know how anything is going to turn out--all you can do is your best.

Which brings you to my third and final piece of advice, which is to embrace the curious and strange characters around you. Students and teachers included.  

You may not believe it--or be in a position to appreciate it--but your classmates at the Academy are some of the most interesting, strange, and amazing people you will ever meet in your life. 

I know--there will be days you go home and say, holy cow, people here are weird.  

But they are wonderful. 

One of my best friends from the Academy is a long-haired, bearded genius named Matt Teichman who is earning his doctorate in philosophy from the University of Chicago. Matt is one of the most thoughtful, authentic people in my life—and also the most eccentric. Every time we speak he teaches me something new. When he was at the Academy, he renamed himself and me and everyone in our class “Buford.” If he were on stage right now instead of me, he would call you all “Bufords.” 

And the teachers here are no less special—I can’t tell you how many important memories they have been a part of—and I just want to take a moment to remember people like Dr. Grieco, Dr. Ostfeld, Mrs. DaCosta, and Mr. Holbrook who are no longer with us—who were wonderful and to whom we all owe a collective debt. 

Bufords, this has been such a wonderful trip down memory lane. 

I want to leave you all with an offer—if I can ever be helpful to any of you—please get in touch. 

I consider all of us part of a family—and those bonds are stronger than you might realize right now.