Graduate Student Speech

Cary Boyd, Ph.D. '07

Administration and faculty, distinguished guests, friends and families, most of all to my fellow students in the class of 2007, I am honored to stand here with you today.

I want to share with you a lesson that I learned during my childhood. A lesson learned the hard way...

It happened in third grade and coincided with relapse of my mother's breast cancer. Looking back on that final year with her I realize that she was condensing a lifetime of lessons into 365 days. It began like any other day...she was visiting with several of her friends when they noticed a small sesame seed size dot moving across her hairless head. Upon closer inspection they realized it was lice. I watched as each friend unconsciously took a step back. If my mother noticed her friends pulling away or if she felt any embarrassment, she did not show it, rather she broke the silence with her laughter. It was ironic to her to contract lice only after losing her hair to chemotherapy. As she laughed about the trivialness of lice, I felt an opposite emotion: fear. "Lice" was what the kids at school had who were called to the nurse's office only to return the next day with awkwardly short haircut and I was terrified of becoming one of them.

As my mother and her friends picked through my hair, guilt weighed heavily upon my small 8-year old shoulders. I knew my secret would be revealed: she had contracted the lice from me. I had noticed the brown sesame seeds crawling across my own head a week earlier, but had kept it as a secret because I would rather suffer on my own, than face public humiliation.

Later, that evening, as my mother washed my hair with awful smelling shampoo she informed me that I would have to tell my teacher, but I pleaded to keep it a secret. The shampoo would cure us, why should I embarrass myself further by sharing the information with my school. My mother posed this question: "Cary, is your own pride worth putting your classmates at risk?" My initial response was, "yes, of course", but somehow I knew that was not the correct answer.

And there in that moment I was confronted with the moral dilemma...to tell or not to tell.

The next day at school I waited until the end of the day to approach my teacher's desk. I quickly slipped her a note with the dreaded truth and rushed away. Inevitably, the next morning everyone lined up in the nurses office for inspection and I kept waiting for the students to discover I was responsible for this ordeal, but no one said a word to me. While standing there in the inspection line I realized that internalized shame is often much worse than the consequences of being honest.

To this day I remember that lesson and although it remains an embarrassing story, I wanted to share it with you to emphasize how shame often prevents us from being honest and doing what is right.

This was clearly illustrated just last month when a 31 year-old lawyer decided to board a return-flight home, knowingly infected with extremely drug resistent-TB. Although the transmission rate for his TB was low, he inevitably put dozens of lives at risk because he was fearful of the consequences of honesty. If any of the passengers contracted XDR TB, the odds are that they have only a 30% chance of being cured, at a cost of half a million per patient. I use this example, not to place judgment on the man, but rather to emphasize the moral responsibility we have as doctors, scientist and educators to be sensitive to the burden of shame that our patients and peers are dealing with.

This lesson can also be applied globally with diseases such as AIDS, SARS, and Avian Flu. The shame associated with these diseases puts us all at risk. The World Health Organization reports that in South Africa alone, 1 out of 5 people have HIV/AIDS, but families usually attribute deaths to another disease because of shame and stigma. Nelson Mandela's own son died of AIDS, inspiring Mandela to call for more publicity for HIV-AIDS research and education.

Not only do infectious diseases carry the burden of shame, many people must endure the stigma associated with mental disorders. The National Institute of Mental Health reports that 57.7 million Americans-- suffer from a diagnosable mental disorder in a given year. This figure translates to about one in four adults. The stigma associated with mental often discourages patients from seeking treatment.

The treatment of any disease cannot be entirely effective, until we alleviate the shame associated with it. We need to establish a precedence of honesty among individuals and among nations. We will all be confronted with the challenges of these diseases, whether it be in the clinic, classroom, or laboratory. Obtaining our degrees today obligates us to break the silence associated with these diseases and strive to be honest physicians, scientists, educators, and responsible citizens.

As I now graduate and head off to the University of Pittsburgh where I will be attending medical school, I pause and look back on myself as that eight-year old child who thought she would die from the shame of lice, and I realize that there are millions of people who actually are dying from shame. I challenge you, the class of 2007, to break through the silence because there is no excuse for anyone to die from shame.

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