Commencement Address Carroll University May 8, 2011 The Ginkgo ...

Commencement Address
Carroll University
May 8, 2011
The Ginkgo
Daniel D. Von Hoff, MD, FACP
Dr. Hastad, graduates, mothers and fathers, other student supporters, esteemed faculty, ladies and
gentlemen. Congratulation graduates. You have made it – so far!
It was about 42 years ago now that my Mother and Dad dropped me off here at Carroll
University (Carroll College in those days). That was a blessing in my life. But an even greater
blessing is that my Mother and Father are here today. Mom and Dad, please stand (65 years of
marriage) - and all mothers and fathers who dropped off their graduates at Carroll University
four short years ago, please stand and be recognized again.
Thank you, Mom and Dad, and all moms and dads. It is great to have you here today to help
celebrate this wonderful graduation day.
I have titled today’s brief remarks "The Ginkgo," subtitled "lessons learned here at Carroll
University and Beyond."
My first academic memory on this campus was at the end of the first week – the day of my first
exam in Biology 101, taught by Dr. Roy Christoph. He was one tough, but fair, professor and I
think we all felt a bit intimidated. Like most of the graduates here today, I asked myself – did I
have the right stuff
The exam seemed simple enough – it was a nature tour identifying trees by their leaves. I had
studied like a dog. I knew the leaves, the stems, the branches, the phloem, the xylem, the rings,
the genus, the species, the subspecies. I was ready. The next morning when Dr. Christoph
introduced us to the first tree we were to identify by its leaves, I froze. I had no idea what it was.
It wasn’t any one of the leaves/trees he asked us to study. I got that first question on the first test
of Biology 101 totally wrong.
I was already a failure in my first week at college. My career in medicine was finished – before it
even got started. What would I tell my Mother and Dad as they were driving me home after only
a week of college – a failure
“Well son, you have a lot to learn,” Dr. Christoph said in a somewhat kindly manner. “That leaf
and tree that you missed is the Ginkgo – it’s the world’s oldest tree.” I thought we should start
with the oldest. It was present at the time of dinosaurs 270 million years ago in the early Jurassic
age. Ginkgo lesson #1, he said, is be prepared for the unexpected – it’s the principles and
process of thinking, not just the facts. You could have deduced it by actually looking at the leaf
because it has more than four veins per segment – it’s a Ginkgo. You panicked – next time,
think! It’s the principles and the process, not the facts – it's Ginkgo Think!
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I felt a failure that day, but I never forgot that leaf and tree and that it’s the principles and the
process – it’s Ginkgo Think! That is why I have given each graduate a Ginkgo leaf in their
programs today to symbolize that it’s the principles and process of thinking – Ginkgo Think –
that is what will serve you well.
The next four years here on this campus flew by – with teaching by many great professors like
Dr. Ted Michaud, who I was so glad to see here today. I met many wonderful people and fellow
students, including my dear wife of 38 years – Ann Shields Leighton – class of 1970. I worked
like crazy and learned many great Gingko Think lessons.
But like it is for you after today, it was now time for me to move on. Because of Drs. Christoph,
Michaud, MacIntyre, Bayer and others encouraging me to stretch myself like the faculty has
done for you, I got into medical school at Columbia University in New York City. Even more
remarkable was that I was presented with a letter from an anonymous benefactor who said he
would pay for the first three years of medical school on one condition – that someday, I would
pay for all the medical school costs of a future medical student when I was able. Strangely
enough, that letter was on stationery with a Ginkgo leaf imprint.
Ginkgo lesson #2: If you had help to get here (and we all have), make it a habit to remember this
special graduation day. Remember your struggles and when you are able, give monetary support
to this university and to the students who follow you (and ask them to do the same). If we all did
that, we really wouldn’t have to worry about keeping this special Carroll University here for the
many next generations.
The first years of medical school at Columbia were brutal. I worried the science and writing and
teaching I learned on this campus might not be good enough compared to what my fellow
students from Yale, Harvard, Swarthmore, Stanford and MIT had had. I was wrong again! –
because I had been prepared to think. I had been prepared for the unexpected – I had Ginkgo
Think. I learned many important lessons at Columbia, working with pioneers of medicine, many
Nobel laureates, first cardiac catheterization, discovery of a virus that causes cancer, discovery of
four base pairs of DNA and many other incredible things.
There were so many special experiences, but one stands out as Ginkgo lesson #3: I was on a
pediatric cancer assignment with a distinguished physician of the time, Dr. James Wolfe. We
were asked to see a 3-year-old little girl with a big cancer growing out of her skull. It was the
size of a baseball breaking through the skull. She was comatose, having jerking constant
seizures. Her parents were in her room, quietly crying in despair. As we walked in, several
nurses, a social worker and an ethicist asked us why were we there “That little girl doesn’t need
you and she certainly doesn’t need any treatment. She needs to be left alone to die. It’s a
hopeless situation.” “The parents have called us,” Dr. Wolfe replied. "We are here because the
parents have asked us to be here." We pulled a curtain around the tiny helpless seizing child to
examine her. Imprinted on that curtain was the Ginkgo leaf. As we talked with the parents, the
parents were clear – do anything you can, anything to help our daughter, even if it helps for only
a short period of time. Dr. Wolfe turned to me and said, “Well, Dan, what should we do Treat
this child and be ready for the criticism which will surely follow, or do nothing” I looked up
and saw that Ginkgo leaf on the curtain again. It seemed here that the principle was listen to the
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parents who loved this child. The answer was treat. Dr. Wolfe wrote the order for the new
chemotherapy called daunorubicin. The hospital staff fought him every step of the way.
Committees met, lawsuits were threatened, nurses refused to give it, so we gave it ourselves.
That’s what the Mom and Dad who loved this child so much wanted us to do. Three days later,
like a miracle, the tumor had dramatically decreased in size, the child was up running around,
alert and loving. “Great idea to treat the child," all the nurses and the rest of the hospital staff
said. “We certainly did the right thing, didn’t we"
So, Ginkgo lesson #3: the ethics demand that you listen to what the individual person wants (be
guided by them), not what others think they should have. Or, if the person can’t speak for
himself, listen to the people who love that individual person. You will never get it wrong.
Solomon saw who didn’t want the baby cut in half!
Over the years, I have been privileged to care for many people, to give many new anticancer
agents – some that didn’t work and some that did work. Recently, our science has improved so
there are more and more effective therapies with fewer and fewer side effects. There has been a
decrease in the absolute number of cancer deaths in this country for the last four years. This is
because of both early detection and improved treatment. At present, one in 20 Americans over
the age of 20 are cancer survivors.
Cancer is at least 200 different diseases and that is why it is such a tough adversary. But there are
at least 30 of those 200 different types of cancer that can be totally cured. Overall, 68% of all
patients (regardless of stage of cancer) can be cured – four times better than it was in 1971.
Progress will continue to be made, but not fast enough for any of us. Graduates, I believe you
will see all of the types of cancer cured in your lifetime.
I have cared for many patients with all types of illnesses – helped many, and lost many. I have
seen just about everything – pain, suffering, hope, hopelessness, caring, altruism, triumph. I have
seen people in Haight-Ashbury with drug overdoses, jumpers off the Golden Gate Bridge – some
who survived and many who didn’t – and even a mother of 18 who named her newborn number
19 that I delivered after me – Daniella because that newborn was a girl – all of these experiences,
starting from this small liberal arts school in the Midwest called Carroll University. Graduates,
who knows what you will experience!
Patients have taught me how to live; they have taught me how to die. And they have taught me
the last Gingko lesson #4: which is that you must concentrate on each individual person you
meet, identify with them and try to help them in every way possible.
A recent patient, Mrs. L., a delightful 78-year-old woman, came to see us with the following
request. “I have tried every treatment possible against my cancer. Can you biopsy it Run some
tests on it to see if there is anything that will work for me now I know I am near the end. I just
want to make sure I am not missing something that could help me.” Mrs. L. wanted the new
approach – precision personalized medicine. We biopsied Mrs. L.’s tumor and profiled it in
detail, but did not find a target for a therapy that would help against her cancer. I had to deliver
that disheartening news. But I told her what we could do is offer her the best possible
personalized pain and symptom control. And that helped her – a lot.
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Our patients and their families constantly teach us that digging deep and trying to help in any
way we possibly can is so important. Here is the letter we recently received from Mrs. L.’s
daughter on Ginkgo leaf imprinted stationery:
To Everyone at TGen,
Thank you so much for all that you did to try and help my mother. She felt so grateful to
have known you all and so sad that her illness progressed so far that there was no new
therapy that could help against her cancer. While she was with you, though, she felt so cared
for and coddled – it was a wonderful experience. My mom passed away peacefully in my
arms and spent her last few days surrounded by all her family in her own home. We all
laughed, cried, prayed, reminisced and loved each other – it was a special time. Thank you
again on behalf of my father and all our family.
Gingko lesson #4: it's important to try. It is about curing, but it is also about caring – for the
autistic child, for elders, for the suffering. An anonymous writer put it best – “to cure sometimes,
to relieve often, to comfort always.”
Graduates please remember:
1. Ginkgo Think – it’s principles and the thinking process
2. Give back
3. Listen to what the individual wants
4. Try to personally help each and every person
I have gotten quite a few things wrong in my life – there have been a lot of Ginkgo lessons! But
in the very beginning, I got one thing right. Like you, I went to Carroll University.
And one more thing. A few days ago, my Mother and Dad gave me a birthday card for my 64 th
birthday and, you guessed it! There was a ginkgo leaf on the card. That card was sent with great
love and many wonderful memories like we have here today. But based on what I have told you
today, the message was clear. "Son, you still have got a lot to learn."
Congratulations, graduates. You are now ready for anything unexpected. Remember Gingko
Think!
Thank you for the honor of giving this Commencement address,
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