Hello, students! As dean of the medical school I want to be the first to welcome you on your journey. It may not be the easiest road ahead, but it most likely will be the hardest.

I’ll be straightforward with you. You’re bright. You’re hard workers. You’re ready to serve the community by keeping it healthy. And talking to people about difficult things is not something you’re comfortable doing. You’re ready to become doctors.

You’ve studied hard for years to get here, and you’re ready to take the next step toward professionalization: studying hard for several more years. Of course, what you read in textbooks is only part of what you’ll learn here. You’ll also learn things from different, wider textbooks.

Look around you. You’re part of a community of learners. You’re passionate. You’re idealistic. And faculty will not have time to nurture those qualities.

In the areas of public health, the treatment of prisoners, and the treatment of soldiers or civilians in areas experiencing conflict, doctors have been at the forefront of advocating for marginalized and at-risk groups for centuries. You are part of a tradition that values human life regardless of gender, race, ethnicity, religion, or background. None of this will be discussed further, and you will not be graded on it.

Your classes have painstakingly been planned so that you will know a lot of things and not know how to communicate those things to a lay audience. You will learn how to make diagnoses and then wonder how to tell that diagnosis to a family. You will learn about all the different specialties and will come to know that people are basically just a collection of parts. If any of those parts is faulty, our job is to say three-to-five words and then get in there and fix whatever’s wrong.

If that sounds easy, believe me, it isn’t, based on my experience as a doctor from twenty years ago. I’ll give you a scenario. You have a patient who is a smoker. You tell them, “If you don’t quit smoking, you are at a high risk of having a heart attack.” They don’t quit smoking. Then they have a heart attack. What do you say when they’re recovering? I’ll give you a hint: it’s going to be words, but the hard part is which words, and in what order.

On the one hand, you want to shake them and say, “Make lifestyle changes or you will die.” On the other hand, cigarettes have been manufactured to be as addictive as possible, since tobacco companies’ profits depend on human misery. So you want to have empathy. But maybe empathy in this instance means giving some tough love. But maybe empathy means understanding that addictions can be incredibly hard to kick. It’s a tricky scenario, and luckily not one that doctors have to encounter.

Sometimes people get sick, and some people believe that this is when doctors are most useful. I’ll give you another scenario: test results come back, and you determine that your patient has a certain illness. It’s your job to discuss with your patient the results and next steps. Or, here’s an idea: maybe it isn’t? After all, there’s a nurse standing right there. Given the attitudes many nurses have toward doctors, I’m sure the nurse would be happy to do your job for you.

Practicing medicine is about building relationships. I still get Christmas cards from a patient I had named Jim, or Dale, or Winston, one of those, from when I treated him for whatever that was. He calls me Dr. Clarp even though that’s not my name, but nobody’s perfect, so I forgive Dustin.

I still recall fondly my days in medical school, and not just because I spent most of my time in a hallucinatory state due to sleep deprivation. I also smile back on my time as an intern, except of course for that floating purple tiger that tried to attack me on my subway ride home one day.

I know that you, too, will find your time here memorable and even life-changing. Whether you’re chatting with classmates or taking a high-stakes test that will determine the outcome of the rest of your life, being a student is all about learning. I’m grateful that you will be learning what you do during extracurricular activities that students organize.

Medical school, of course, is not the end of your journey. In many ways, it’s only the beginning. And with the tools we have sort of given you here, you will hopefully be able to learn what you need to know once you start practicing medicine. Tuition is $80,000 per year.