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Graduation Address

Graduation Address delivered by
Dr S Raja Sabapathy,
Chairman, Dept of Plastic Surgery, Hand and Reconstructive Microsurgery and Burns, Ganga Hospital, Coimbatore,
India to the MBBS graduates of Karuna Medical College, Palghat, Kerala on 24th Sept, 2016.

It gives me great pleasure to be with all of you this morning and I sincerely thank Maj Gen Sree Ram for this opportunity. My mind goes back to 1980 when we had our convocation and I recollect that it was a proud moment for my parents when I collected the best outgoing medal. I started thinking as to what I remember of that day and the Graduation address. The only thing I remember was that it was a period of happiness all around, the sort of it we find on very few occasions. I do not remember much of the talks of that day. After graduation​,​ I went abroad and there I had some occasions to listen to some graduation addresses and some fellowship completion addresses. They were taken up with much seriousness both by the speaker and the listeners and I have benefited immensely by the pearls of wisdom that were delivered. For this address I thought I should tell you things that were of benefit to me and may be they could be of some use to you some day.

First, this is the day to show your gratitude to your parents and to your teachers

Justice Shivaraj Patil, Former Judge of Supreme Court of India, visited our centre and he presented me a book of his thoughts. In that he had written 'Parents are the first teachers and the teachers are the second parents'. They mean a lot to you - not only the teachers of the medical college but all the teachers right from your school. I request all of you to do one thing. Think of one teacher in your school who means a lot to you. Before you go to bed, please try to contact him or her, tell him or her that you have become a doctor. That call will mean so much to your teacher and I am sure for many it may bring tears to their eyes. It is important that we do that. It is not possible to put value to some things. One among that is the efforts that your parents have taken to make you a doctor. It is not the amount of money that they have paid, but the time they have spent in gathering it, the time they have spent in temples, churches and mosques praying for your success in every exam and praying for your good health all along. It is just not your parents, it may be your uncle or your elder brother or sister. You must always be grateful for the help received. In future, when you become a successful doctor, economic and social standings may change with time, but relationship equations should never change with time.

Second, be confident that you can achieve anything you want
(provided you deserve it)

Please listen to me -- this is important. Medicine is one field where you don't need a Godfather to become a big success. What you need is that you must become good. It is much like a sport star. I would like to tell you an example. One of my friend's son was selected for Under 19 Indian Cricket team. I asked him if there is any bias or use of influence in selection of the teams. He said, 'Uncle, there may be some. But it cannot hold back a real star. He said that when you ultimately go on to the field, when you bat and take a strike no one can hold your hand from hitting a sixer. No one can hold your hand when you bowl, nor can anyone ​prevent you from taking a difficult catch. If you don't get selected for the country , you will be in Ranji trophy, in the state team. If you score a few hundreds there, you cannot be ignored the next time. If you are of the state level calibre, if you don't get selected, you will be in the Universities team. Score well there and automatically you will be in the state team next time '. The same thing is with medicine and surgery. Ask any medical college head or a corporate hospital head as to what they are looking for – first thing they will tell you is that they need good doctors. If you are a good surgeon, there will always be someone who will recognize your talents, and take you forward to glory. If you take all the big hospitals of Coimbatore, you will find that all of them had humble beginnings but by their shear strength of hard work and skills they have sustained and become big.

Third, that brings the question what is good

Here comes the biggest and the best lesson that I have learnt. Good does not equate directly to your skills nor to the knowledge that you have. In patient care, more things matter than mere skills. I worked with Dr Harold Kleinert, in Louisville, USA the doyen of Hand and Microsurgery and who was the first person to suture a digital artery. When I asked him the important things to set up a good hand injury and trauma service he asked me to remember the 3 As – Availability, Affability and Ability and he said that their importance is in the same order. He said that no matter how good a doctor you are, if a person comes injured if you are not available it is no use. That is the first A Availability. Next is Affability – being nice to patients, talking to them well, smiling when you talk, genuinely interested in giving them hope and confidence. After that only comes Ability. It is the first two that will bring you the patient so that you prove your ability.

I was so convinced of this idea that when my brother and myself came back from abroad and started our practice we struck to one place and did not do any sessions in other hospitals. Further if I had gone home only at 11pm after a heavy day and a new​ injured person comes at 3 am I will come back to see him. Even it is a finger tip injury it did not matter. That helped to build up confidence in patients so that they felt that if you get hit and go there, they will take care. Nothing can substitute availability. It is hard work but the gains are worth it.

Fourth, Have a Hero, A Mentor

It is important that you have a mentor. Choose a good mentor. Once you choose a mentor you must believe in the mentor and work as he says. I was recently reading the book, 'The Golden Rules' by Bob Bowman, the coach of the legendary swimmer Michael Phelps, who has won 28 Olympic Medals. While talking about his coach Michael Phelps says, 'We were in phase and did not miss a beat, where if he said, Jump , I would say How high ? He told me what times he wanted me to go and I would just do them. Along the way I saw much progress toward my main goal. The main thing he taught was to be extremely devoted to achieving excellence in even the smallest of tasks. That is exactly what the great Industrialist Jamsetjee Tata said, ' If a thing is worth doing, it is worth doing it well'. It applies to all things big and small. Translated to a young doctor, if you are writing a prescription it matters if you write it clearly, it matters after you write the prescription whether you explain to the patient how to take the drugs, whether it is after food or before food. You will find that the doctor who does that will be more successful than the doctor who knows all the pharmacokinetics and bio availability of the drug.

A fortnight ago, I gave the Dr Chowdary oration at the AP and Telangana Association of Plastic Surgeons. The topic they gave me was 'Making Difficult Limb Reconstructions possible'. I first defined what a difficult reconstruction was and then I told them that the first step to do difficult reconstructions is to do simple reconstructions very well. When we started our practice, one of the sage advice we got was that, 'Big practices are built not by doing extra ordinary cases but by doing ordinary cases extraordinarily well'. Please note that down. It is very important. When someone comes with a two cm laceration on the face, I suture it with the same amount of dedication as i would when we reattach a totally amputated hand. There are no minor injuries.

Fifth, Don't feel shy to excel

Dream big. This is a phrase you would have heard many times. I could rephrase it as, "Don't feel shy to excel'. It is about a quarter of a century since we started practice. During this period when dealing with many young people, one of the things that has struck me is that many feel shy to excel. When you join any unit, you will find that 10% will be superstars, 10 % will be bad and the rest average. As a newcomer, when you join a place you should seek out the best, hitch your work plan at their pace. Instead I find that most feel comfortable to work at the average level. Not that they cannot work better, but they feel shy as to what the majority would think if as a newcomer you start shining. When you start your career, please leave that attitude at the doorstep straightaway. At all times you must work to your full potential.

Sixth, Do what you love to do

Now is the time when most of you would be making the choice of the specialty and what you would do in future. I do not know on what basis you do that. Frequently people choose the field that has the best 'scope' , based on the economical prospects in future.​ That is for an average person. If you are a good person you don't have to worry about the field or its scope. India is a land of 1.2 billion people and there is always the place for a good person in any field. There is no competition at the top. When we finished MBBS, I finished from Stanley Medical College and came out first. There were 3 University Gold Medallists and one other was from Coimbatore Medical College and it was Dr Boopathy Vijayaraghavan. At that time every one used to choose either General Surgery, General Medicine, Paediatrics or O&G. Radiology was one of the last to be taken up and many times seats went vacant. Dr Boopathy applied only for Radiology and even the ​ ​professor ​of Radiology​ was surprised. But since he was a bright person and could see the future he took that and he took to ultrasound as the field was opening up and he shone in that field. When you choose a thing you love, you will really reach great heights. Going to work every morning will be great joy.

Seventh, Work Hard

It is strange that in the social media there are more messages about working less, quality of life issues than extolling the virtues of working hard. I have to tell you two facts. First, no one has achieved more by working less. Second, hard work does not kill any one. May be tension at work kills but not hard work. It is possible to have good quality of life and family life by working for long hours. Number of working hours and happiness in the family are totally different issues. When I was doing a fellowship in the US, in one issue of Fortune magazine, there was an article about the long term follow up of a batch of management trainees from a very famous management school. At the end of 25 years it looked as if the whole of America was being run by them. Almost all of them were CEOs of major companies. There were some common denominators in all of them. First to be mentioned was that all of them were working for 14 to 16 hours a day. Second mentioned prominently was most of them were married with the same wife for at least 15 years. Divorces were much lesser than the national average. So at the beginning of your career you need to be convinced that working hard does not automatically exclude happiness and family peace. That is entirely different. If that be true, every one who comes home at 5 pm should be very happy. I am sure you will agree that is not the case. Happiness results in your ability to build in trust in relationships. When it begins at home, automatically it also extends to the workplace.

Eighth, become a team player

I believe future will be working as teams. Not just as a team of doctors, but you as a doctor as part of a team providing healthcare. You will have to work with nurses, other para medical staff and also have to deal with many Government agencies, NGOs etc. Here individual excellence alone will not matter. It is your ability to get along with every one that will matter. Even in Cricket, one Tendulkar can win matches, but you need a team to win the World Cup. That will involve ability to effectively communicate, being honest and true in relationships and not being carried away in ones own presumed talent. I go back to my teacher Dr Kleinert on team building. He said, 'When I choose a trainee, I don't mind a monkey provided he is an interested monkey. But when we choose a partner, it is just not talents and skill that we look for. He or she must be acceptable to our team, doctors, nurses, physiotherapists and office staff'. That underscores the importance of being part of a team.
First of all one must leave the, 'What is in for me ? " attitude in the workplace. Instead whenever you join any unit, think what the unit needs and you start delivering it. Soon you will find that the unit head will provide you so much than what you would have got if you have tried to grab things yourself.

Nineth, Integrity is important

It is difficult to define integrity. Simpy put, it is not doing what one knows is wrong or the society thinks is wrong. Many now feel that it is impossible to come up in life with out taking some short cuts. But at the end of the day, it will not be worth it. I had been to deliver an oration in a state headquarters and I was happy to meet one of the senior plastic surgeons. He is known for his integrity and hard work and I respect him. A discussion arose about the affairs of the association and the talk drifted to another senior person. He is a highly decorated person with many awards. During discussion many said that he is a lair. The senior person present here substantiated it saying that when they worked together, the person in question used to fudge values in paper presentations and how data was changed to suit the desired outcome. Viewed as an incident, it can be pushed aside, but my mind set thinking as to what the highly decorated person achieved at the end of the day. People were speaking about a dishonest deed he did many many years ago. I thought that all the awards he gained did not matter and became valueless. So as the saying goes

If you have integrity, nothing matters.
If you don't have integrity, nothing matters.

So from the very beginning, act with integrity. It will carry you a long way. Without it at the end of the journey nothing matters.

And finally, Believe the world is good and you will be a part of it

Be optimistic. Please surround yourself with optimistic people. And you must also radiate confidence. That will help patients develop trust in you. You have come up so far because lot of people have held their trust in you and in your future. It is for you to justify their trust. It can easily be done, by you working to your full potential so that you will make all of them happy and proud of you.
Finally I will finish off with my school days event. I was a student of Kikani High School. As the school pupil leader on every Friday in the morning assemble, I used to say the following sentences and the whole school used to repeat it.

The words were Kikani is my school Make me proud of it Make her proud of me.
With a variation as important as you take the Hippocrates Oath, you should also think and say Karuna is my institution Make me proud of it Make her proud of me.

Good luck and May God Bless you all.