Brown's commencement address covers all the bases

When Bobby Brown stepped up to home plate more than 50 years ago, the major leaguer was a genuine American baseball hero. When he stepped up to the podium in June to speak to UT Southwestern's class of 2004, he was still a hero but to a different crowd - the patients he had cared for as a Fort Worth cardiologist.

Between his rookie year with the New York Yankees in 1946 and his retirement from baseball eight years later, Dr. Brown was a "standout player in Casey Stengel's teams that included Joe DiMaggio, Phil Rizzuto, Yogi Berra and the young Mickey Mantle," UT Southwestern President Dr. Kern Wildenthal said in introducing Dr. Brown.

"Long before Reggie Jackson be came known as Mr. October, Bobby Brown was Mr. October," Dr. Wildenthal said.

But unlike any other baseball star, Dr. Brown went to medical school and did his residency during baseball's off seasons. Although he was to serve much later as president of the American League, in 1954 Bobby Brown hung up his glove to become Dr. Brown.

Now a veteran of 25 years of medicine and many nights on call, Dr. Brown told the 2004 graduates how to cover all their bases.

* * *

My friend asked me, "Why did they ask you to be the commencement speaker?" And I thought for a minute, and I said, "Well, I looked at all the commencement speakers throughout the country. None of them got voted the best baseball player in a medical school class. And none of them roomed with Yogi Berra. And none of them took care of Marilyn Monroe." So I thought that was a pretty good triage to get me up here to the podium.

Now, let me tell you about my background. I practiced for 25 and a half years, as Dr. Wildenthal said. And during that time I didn't do any research or teach. I didn't give many talks. I didn't write any papers. And I didn't hold any high medical offices. I took care of people, lots of people.

Let me tell you about the doctor's responsibility to a patient. You must remember that when patients come to you for help that they are entrusting into your hands their two most valuable possessions - their health and their life. When they do that and you accept that responsibility, it's not something that you can take lightly.

You must remember that it goes on 24 hours a day, seven days a week. It doesn't stop at five in the afternoon and begin at eight the next morning, or stop on Friday afternoon and begin the following Monday.

If you're not on call and you're not available, then you are responsible for having someone in your stead, an associate that is equal to you in training and dedication, depend ability and compassion.

Because if that patient at a time of a health crisis calls you, and you and your associate are not available, then it makes no difference how good a doctor you are. Your value at that time is zero to the patient. Always remember this is a significant responsibility, and you have it always.

* * *

The medical profession since the beginning of time has always been founded upon the doctrines of honesty and integrity. And you have to always remember that. You cannot at any time lie to a patient. You can't, no matter how devastating the truth, skirt it and lie.

You can't lie to a patient. You can't lie to your colleagues. You can't lie, period. If you are in the laboratory, you can't alter data. You can't cheat. You can't cheat on diagnoses or insurance cases. You can't cheat on ordering tests for your benefit and not the patient. You can't cheat on your taxes. You can't cheat on your expense accounts.

You have to do what's right. Because in no profession is the bar set as high as it is for the medical profession.

* * *

I've also been a patient for 15 years, so I want to tell you what patients' main complaints are about doctors. There are three of them:

  • The doctors won't talk to me.
  • The doctors won't answer my phone calls.
  • The doctors don't seem to care.

So if you inherit patients, you've got to talk to them. You've got to tell them what's wrong with them and you've got to tell them what you're going to do, and you have to talk to the family. And you have to talk in terms that they understand. You can't lapse into medical terminology. You have to give them basic, easy-to-know terms so that they understand it.

You must recognize that most of them are very anxious and almost terrified to hear the news. So many times it goes in one ear and out the other, and you may have to repeat that story three or four times before it ever starts to sink in. Be careful to tell them the whole story and make sure the family also understands.

And you've got to answer your phone calls. You can't go to bed at night without answering all of them. I can tell you that if you have 10 phone calls and you answer eight, it's a matter of time before one of those two remaining will contain a disaster that the following morning will eat you alive.

Finally, you've got to show the patients that you care. You can't make the patient think he's just a scientific object for which you're going to order tests and pills. You've got to crawl into their souls and listen to what they have to say to you, and get to know them and to do everything you can to make them feel that you are interested in them and you care.

Those of you who are going into patient care are going to inherit terminal patients, patients whose problems have no solution and whose life's span is extremely limited. It's extremely important in that particular case that you uphold the dignity of that patient and you make certain that the treatment and the tests that are prescribed are appropriate. You have to guard against the family wanting some pie-in-the-sky scheme that has absolutely no chance of success and which will be a detriment to the patient. And above all, if that patient is in the hospital or in a hospice, it's important that you see that patient every day.

There is a temptation since you can't do much medically that you can skip a day or two and see that patient some other time. But you can't do that, because the patient's family thinks that you have abandoned the patient and that is the worst feeling for a family to have.

You don't have to spend a lot of time there, but you have to demonstrate that you do care. One of the ways you can demonstrate that is by holding the patient's hands, squeezing the patient's arm, putting your hand on the patient's forehead. Do something where there's physical contact. Because that lets the patient and the family know you care.

* * *

The demands of the medical profession are profound, and they persist. You've already found out from your studies that there's no such thing as an eight-hour day. You don't have eight-hour days when you get into your residency. You don't have eight-hour days when you get into practice. The rewards that you get for your time cannot ever be measured by time and effort on the patient's behalf.

Your spouses have to be terribly understanding because your spouses and your children will have to recognize that they've got to share you with patients. You will be on call, and I can tell you that you will be called at the worst times.

When you're getting calls at inconvenient times, remember that's what you signed up for. That's part of your life.

The older you get, the tougher it is to tolerate, but the more you have to adhere to it. You've got to see your patients when they need help.

If any of you have gone into medicine because you think you're going to be super rich, you better forget it. In this day and time, the doctors and biochemists and the psychologists are being squeezed - squeezed hard. But despite this, you ought to make a good living.

You have to remember, the main rewards in medicine are not monetary. The main rewards come from the emotional satisfaction that you get in helping your fellow citizens and fellow man, of being able to relieve pain and suffering and being able to restore people from sickness to health. It gives you a good feeling every day. If you're in the lab to come up with something that is new and original that makes a difference in civilization that's a great feeling, too.

But perhaps the greatest feeling of all is when a doctor inherits a patient who is on the very brink of death and who at that particular time is able to call on all of the things that have been taught to him here in this school and in his residencies and his practice, and he makes the right decisions. And with the help of an excellent nursing staff and technicians and courageous thinking and hard work, they bring that patient on the brink of death back to health and restore that patient to his family.

When that occurs and you look into the eyes of the patient and into the eyes of the family and you see those tears of gratitude and you hear their words of thanks and gratefulness, that's the ultimate reward. That gives you the feeling that all the effort, all of the stress, all of the work is worth while and keeps you coming back.

* * *

Now, let me end by telling you about my most memorable consultation. It occurred in 1962. It was in August on a Saturday afternoon. I was called to see a patient at Harris Hospital in Fort Worth. When I got up to that patient's room, there were two patients in the room.

My patient had the bed that was near the wall. The other patient was by the door. Separating the beds was a wire that ran along the ceiling that had a curtain, and you could pull that curtain to get some degree of privacy. At the foot of the bed, about four-fifths of the way up the wall, was a TV set on a ledge. It was controlled by both patients on their consoles by the bedside.

When I came into the room, I pulled the curtain and told the patient, "I'm Dr. Brown. Your doctor wanted me to see you to evaluate your heart." He grunted some approval that was not very enthusiastic, but I took the history and then I started to examine him. When I got to the heart and put my stethoscope in my ears, I suddenly realized that the patient in the next bed had turned on the TV set and there was a ball game on.

I listened briefly, and the announcer was Mel Allen, who announced the Yankee games back when I played. And I thought, that's odd, he's retired. This must be an old game, and the "Game of the Day" that was being broadcast nationally must be having rainouts. I knew that the Yankees were playing. And then he mentioned the pitcher's name - Joe Hatten. Joe Hatten and I had played on the same semi-pro team in San Francisco as kids. And now he's pitching for the Dodgers. So I know the Dodgers are playing the Yankees and it must be the World Series. And then he said Joe Hatten was about to pitch to Joe DiMaggio, and that he was going to purposely put Joe DiMaggio on base with a walk.

Because first base was open and on third base was Tommy Henrich and second base was Yogi Berra - they were going to walk Joe DiMaggio, then pitch to the next hitter and try to get him to hit into a double play.

I was very, very alert as to what that situation was. Because it  was the 1949 World Series, and it was the fourth game. We were playing in Ebbets Field. I knew these details because I was the next hitter.

I took the stethoscope out of my ears, and I looked at my patient. I said, "Now look, I want you to watch that screen up there. I'm going to come to bat, and I'm going to hit that ball against the right-field wall. All three runners are going to score, and I'm going to slide into third with a triple."

My patient looked at me with eyes that were about like saucers. It looked like he thought I was some kind of an extraterrestrial that had just dropped off the space station. So he watched. I pretended like I'm listening to his heart.

Mel Allen says, "Brown hits a terrific shot. It's going into right field. It's up against the wall. It's bouncing off the wall. Henrich scores, Berra scores, here comes DiMaggio around third. He scores." Then he said, "Brown slides into third with a triple."

When he said that, the curtain rocketed back. The patient in the next bed had jumped out of bed, and he got about six inches from me and yelled, "Who the hell are you? Are you really a doctor?"

* * *

I want to thank you for letting me be part of your ceremonies. This is a great day for you. My graduation day was one of the greatest days of my life, if not the greatest. And I hope that yours is the same. You're starting a great journey. Godspeed to all of you.