Remembering William Foege

William Foege’s “Lessons I am Still Desperately Trying to Learn”

Renowned epidemiologist William Foege gave the keynote address at Emory’s 171st Commencement on May 9, 2016. Here is the full text of his remarks, which continue to resonate today:

Graduates, ... faculty, staff, parents, family — everyone who is here because these graduates are important to you: Welcome to a wonderful day for all of us. To the hundreds of public health students that I heard over here (cheers), ah, you came to the right school.

Why do we have commencement talks?

I’ll tell you. But first, a diversion. In science these days it’s expected that the speaker will start by listing conflicts of interest and then give some feeling that there will be transparency.

Well, my conflicts of interest? I love Emory. And I appreciate what Emory has done for me over the years. I appreciate the medical care Emory has given to President and Mrs. Carter, so that they’ve had a long and productive relationship. I appreciate the fact that Emory has made global health a university-wide priority. And I appreciate what Emory has done in the advancement of the treatment of Ebola and I appreciate what Tim Olsen’s team has done for eye care for people who survived Ebola in Africa.

As to transparency? I can tell you with great confidence that not a single syllable, not a single word, not a single thought that I give you today has not been plagiarized by me.

Now, why commencement talks? Well, 50 years ago, I was on the way to Africa with my family. We stopped for 10 days at the London School of Tropical Medicine to talk to teachers. One teacher was Dr. Robert Cochrane. He’d been the dean of the Vellore medical school in south India. He was the world’s authority on leprosy. And I had his book on leprosy and a list of questions. And I met with him, and after 20 minutes he stopped me. And he said, “My conscience would not permit me to allow you to go to Africa knowing as little about leprosy as you seem to know.”

And he took me to his house for three days and lectured and showed some of his 16,000 leprosy slides. And I tell you it was a thrill — at first. By the third day, I realized the passion to teach far surpasses the passion to learn.

And that is why we have commencement talks. The university can’t stop. It tries to the end to teach.

G.K Chesterton said, “Tradition is the democracy of the dead.” Take a while to think about that. We are all caught now in tradition today, and you for the next few minutes will have to pretend to learn and I have to pretend to teach.

But the difference is you are only going to invest minutes. It took me 80 years to write this talk. Eighty years, and I’m still big for my age. A talk entitled, “Lessons I am Still Desperately Trying to Learn.” I have fallen short in all of these categories, but I pass this on hoping you will do better. And I actually, I’m talking to myself because I hope I will do better.

Chapter 1: Obituaries

Hod Ogden was the head of health education at CDC — and he was a wordsmith, he had a way of putting words together. And he could write a poem or a song or a talk with very little effort. He wrote inspirational guides for other health educators, such as, “Remember always to be grateful for the millions of people everywhere whose despicable habits make health education necessary.” Another was, “He who lives by bread alone, needs sex education.” 

On his deathbed he asked a colleague to write his obituary. He drifted into a coma and the word went forth that he had hours to live.

He surprised everyone by waking up the next morning and improving, and weeks later said it was such a joy to pick up old conversations. But he said the greatest joy of all was the chance to edit his obituary.

Every day we edit our obituaries. Sophocles said, “It’s not ’til evening that you may know how good the day has been.” And it’s not until you get to be my age that you know how good a life has been. But consciously, daily, edit your obituary so you realize that sooner. Edit with care and gusto.

Chapter 2: Life plans

When my grandfather was born during the Civil War, over 150 years ago, everyone who knew the family knew his life plan the day he was born. He would be a farmer, like his father and his grandfather before him.

Times changed. When I was your age, everyone was telling me to develop a life plan. My advice? Avoid a life plan. 

You cannot imagine what will be invented in the future. You cannot imagine the opportunities that will be presented. 

You enter a world of infinite possibilities, confusing ideas, continuous changes. But a life plan will limit your future.

Chapter 3: Instead of a life plan, spend your time developing a life philosophy. 

And then you will have tools to evaluate every fork in the road. What is truly important to you?

Tradition is the DNA of our beliefs. Question those traditions. Because we are slow to question traditions, we allowed slavery. Because we are slow to question traditions, we allowed gender inequities, a bias against sexual orientation, religious and cultural intolerance.

When this university was less than a decade old, the president of Emory chaired a committee that concluded it was okay for bishops to have slaves. So question the bias of traditions, the intolerance for other cultures, the fear of immigrants. 

And question the certainty of those with a bias. The physicist Richard Feynman said, “Certainty is the Achilles heel of science" … and of religion and of politics.

Chapter 4: Integrate your world of knowledge. 

E.O. Wilson, the biologist from Harvard, wrote a book called "Consilience: The Unity of Knowledge."

And he reminded us that the statement of C.P. Snow, that we would never bridge the gap between the sciences and the humanities, he showed that it is not true. We do it every day. His definition of the word consilience is “the jumping together of knowledge” — I love that phrase, "the jumping together of knowledge."

The Earl of Shaftesbury also encouraged this harmony between the parts of knowledge and the whole of knowledge. He concluded that “good” is when you concentrated on the needs of the group, rather than your own needs. And he said the larger the group, the better you are. So you see why you want to be globalists. You can tell from what President Wagner said, this is a globalist institution. Einstein said nationalism is an infantile disease. He said it’s the measles of mankind.

Not just globalists, but be futurists. Be good ancestors. Remember that the children of the future have given you their proxy and they are asking desperately for you to make good decisions, to hope you will take climate change seriously. The opposition to climate change is not only fierce, but it’s powerful since many of them are in Congress. 

Because each of us can do so little, it’s important that we do our part. If you follow basketball you may know the name Stacy King. His first year as a rookie in Chicago, he had a disastrous night where he made a single point. That night, Michael Jordan made 69 points. And after the game, a journalist needling Stacy King asked, “Could you comment on the game?” And Stacy King said, “I will always remember this as the night I combined with Michael Jordan for 70 points."

It may be a little contribution, but we each have to make that contribution.

The world will be confusing, making it hard to integrate knowledge. Kierkegaard, the Danish philosopher and theologian, once told the story of someone breaking into a jewelry store — and stealing nothing. All they did was rearrange all the price tags.

And that’s the world you are going into — a world with distorted price tags. High prices for athletes, Wall Street bankers, CEOs; low prices for school teachers, public health workers, physical therapists.

The world keeps telling you to go for power, money, publicity. And they pass this off as wisdom. Resist it.

Years ago, Dr. Laney asked me to speak to the Emory Board of Trustees about what I hoped Emory would provide for my son, who was then a student at Emory.

The U.S. was about to go to war and that fervor was everyplace. It was hard to see a balance and the night before I was reading Kipling. And Kipling wrote:

“And the talk slid North, and the talk slid South,
With the sliding puffs from the hookah-mouth,
Four things greater than all things are,
Women, and horses, and power, and war.”

I knew it wasn’t right, I knew that was offensive, and I wondered. So that night I had the audacity to re-write Kipling, to what I wished he had said, to my son and to this school:

“And the talk slid East, and the talk slid West,
And a student asked, ‘What life is best?’
Four things treasure, all else above:
Purpose, and Faith, and Wisdom, and Love.”

Chapter 5: Actively seek mentors.

Identify people who have the traits and the ideas and the philosophies you want and get their help, always asking, “How best to live?” Borrow their wisdom.

I’m in my eighties. I still seek mentors. Many now are much younger than me. And last night I mentioned how I used to supervise Jim Curran and Jeff Koplan at CDC. And now they’ve turned the tables. They have become my mentors, both of them doing things I never could have imagined.

Chapter 6: The world is expanding.

The world is expanding in promise, in complexity, in the ability to enjoy it. For all of the problems in the world, I can tell you there has never been a better time to be alive and enjoy that.

Not only does your life expectancy increase six to seven hours a day — think of that, I used to wish I didn’t have to sleep and now I get the equivalent, six to seven hours a day. But what you can do in that hour or day or year or lifetime continues to increase.

So functional life expectancy goes up faster than calendar life expectancy.  

An example: You have been exposed to as much knowledge in the last year at Emory as Aristotle was in his entire lifetime. Many of you will experience as many cultures in a year as Marco Polo encountered in a lifetime. And think what Shakespeare might have done with a word processor. He didn’t run out of ideas, he had a quill and a bottle of ink.

You will pack centuries into 80 calendar years.

Chapter 7: Seek equity.

I keep wondering why I was not born in a village in New Guinea. I am no self-made person. I was born in this country, urged on by family, traveled roads paid for by government, went to schools that required thousands of people to put together. (Schools that may seem antiquated to you: I went to a one-room schoolhouse. And I often tell students I was first in my class – in the slow group. And that’s funny if I tell you there were only three in my class.)

I avoided dying of tuberculosis, food poisoning, toxic water because of a government, rarely appreciated. Not because I deserved it but because of a coalition of government, religious institutions, and public and private groups, all conspiring to help me.

And your story is the same. So what can we do? Seek equity and justice so others can tell that story someday. And I’m going to place only one burden on you today, but it’s a big burden. The slavery of today is poverty and every one of us in this audience is a plantation owner, because people working at low wages subsidize the price of clothes and our food and our entertainment and our travel. And because I benefit it makes it so hard for me to want to change. But even $15 an hour — think of that — it’s a step forward, but it compromises life for millions of families.

Over 200 years ago, a bold figure in changing slavery was William Wilberforce, who worked for a quarter century until he finally got a bill through Parliament that made it illegal to transport slaves. William Wilberforce was influenced, as a child, by the Wesley brothers.  

We need William Wilberforces to combat poverty — and what a great thought to have graduates of Emory lead that the change. An institution also influenced by the Wesley brothers.

Gandhi said his idea of the Golden Rule was that he should not be able to enjoy what is denied to others, including education, health care and financial security.  Can you even imagine what health care would look like in this country if Congress would be obligated to receive health care no better than the average?

Chapter 8: Seek serendipity.

We often think of serendipity as a random good fortune. The origin involves three princes and Serendip, the Persian name for Ceylon, now Sri Lanka.

A professor at Emory, Marion Creekmore, was once ambassador to Sri Lanka, or Serendip. The original story tells about a lost camel and how these three men, finding small clues that other people missed, figured out where the camel was. Today, this would be the equivalent of reading a Sherlock Holmes story. And I think this is the ability comedians have, to see things that we don’t see until they say them. Then suddenly, we realize they are funny.

We are told this can be learned by being in the moment and actually looking for connections. Henry David Thoreau said, “It’s not what you look at that matters. It’s what you see.”

Chapter 9: Civilization

We like to feel we are civilized. How do you measure that? The usual versions look at science, technology, wealth, education, happiness. Every measure fails, except one. But there is one measure of civilization and it comes down to how people treat each other. 

Kindness is the basic ingredient:

At the request of a friend, I asked President Carter what his favorite Bible verse was and he sent back a verse from Ephesians: “Be ye kind one to another.”

Five months ago we attended the funeral for my brother. And his son, Tom, related that when he went to college, he asked his dad, “What advice do you have?” And my brother said, “Be kind to people.”

Plato said, “Be kind to people, because everyone you meet is fighting a hard battle.”

That is the ultimate measure of civilization: how people treat each other. It’s the measure of a civilized person, it’s the measure of a civilized university, it’s the measure of a civilized politician, the measure of a civilized state. And I am sad that in Georgia we’ve re-written Matthew 25 to say, “When, Lord, did we see you sick and not provide Medicaid?”

It is the measure of a civilized nation. The World Health Organization is criticized, correctly, for its response to Ebola. But you never hear people talk about how the United States and other countries every year reduce their budget. 

We save more money in this country each year because of the eradication of smallpox than our dues to WHO, and yet we join countries to tell them to reduce their budget. One year, the U.S. was not going to pay its dues. I wrote an editorial and I quoted Dolly Parton, who said, “You would be surprised how much it costs to look this cheap.”

And then Ebola showed how much it cost to look this cheap.

How you treat people is the healing force in the world, and William Penn, the Quaker leader, said, “Healing the world is true religion.”

And finally, Chapter 10: Finding our way home.

In the book “Cutting for Stone,” there is an unforgettable line, and may this phrase stick with you forever: “Home is not where you are from. Home is where you are needed.”

As I congratulate you on what you have done, I also hope we all find our way home. 

Thank you.