Though our spirits may fade and our viscera bleed, we are enabled
by the agents of our humanity empowered by ancestral song and promise.

A child is not expected to die before his or her parents.  The natural processes of birth, life and death should follow in an orderly and rational sequence  through one’s lifetime.  Any death other than one from old-age after a rich and fulfilling life is premature.  Yet when parents see their child die, or carry the burden of an unborn demise, they live with this disruption of natural order forever. The value placed on the unborn and newly born has differed through generations and periods in human history,  yet as value systems and moral codes evolved, in spite of rhetoric and practices of populations with regards to infanticide and population control, the profundity of a parent's grief has remained incontrovertible through the ages.   There has not been nor is there now one common and standardized way to manage the recovery from such grief, for it’s shadow has been and will be indelibly imprinted in the minds and souls of these parents.  Yet forms of expression implicit in symbolic language; poetry and verse, song, prayer and ritual, have served a role in all cultures and societies to dispel the tears and foster the healing of death and human loss.^[1]   Adult funeral services can talk of the accomplishments of the deceased, and describe joys and loves and relationships through eulogies and memories.  Yet when a newborn or young child dies or a child is not born alive, there is no personal history, seldom a long-standing relationship, few accomplishments and barely a discernible personality to recount.  However, a bond between mother and father and child or expectant child occurs and must be recognized.  Death tears this apart. The issues of mourning, of lost promises, of sadness and above all, of maintaining faith must be addressed.

Why poetry? What forces are implicit in its form and function that move us and arouse our most inner yearnings and emotions?  Why does the poetry of death triumph as a source of enduring inspiration and hope?

Poetry{sic}gives the patient a voice for his or her suffering. It may not alter the activity of the disease, but in merely providing a voice it comforts the patient in ways that no medication can.^[2]

If medicine protects life then(sic) literature interprets it.”^[3]

 "Art, poetry(sic) is human intelligence playing over the natural scene, ingeniously affecting it toward the fulfillment of human purpose."^[4]

"The Poet's gift… awakens in a special way the emotions of those who feel wordless in the face of loss."^[5]

"By making us stop for a moment, poetry gives us an opportunity to think about ourselves as human beings on this planet and what we mean to each other." ^[6]

Comfort may be achieved through the transfer of the poet's feelings into the reader or listener's mind. It transports the reader from the distractions and influences of the outside world inward to the internal rhythms and solace of the personal soul.  The poet becomes a healer and his poetry his staff. Through verse and meter, free of inhibition yet full with expression, the poet may articulate a sensitivity and empathy and provoke this introspection and inner peace.  A poem is transformed into a message of hope. There is wonderment and magic in the words of a poem.  Each word is selected for its individual meaning within the context of the entire poem.  A few properly selected words can move the reader to tears and awaken the primal emotions of joy, promise, despair and hope.  A poet should evoke emotion in his work and write as if each poem is written with the poet’s last words.^[7]

The language of poetry, within the broader context of its 'parent body’ (literature,) has always had as its great themes, love, loss and death.^[8]  The inclusion of hope to these thematic elements is worthwhile if not essential for, (as humans) we have the capacity to bring hope to a despair that is uniquely created by our humanity and our human conditions.

Bereavement over the loss of a pregnancy, newborn or young child is as old as mankind.  My search into the origins of the use of a poem’s graceful yet penetrating ability to soothe, into the essence of what its fragile words can create through symbolism, metaphor and rhythm^[9] has led me to the portal of pre-civilization, more than 35,000 years ago.  Here began this understanding of the primitive, even primal urges for solace and consolation for grieving parents.

"In the dust where we have buried the silent races...

we have buried so much of the delicate magic of life."^[10]

Human culture from which we are today descended emerged between 35,000 years and 32,000 years ago (BP-before the present) within an archeological period known as the upper Paleolithic or late Ice Age. This was marked by the biological evolution of modern human beings, sub-species Homo sapiens sapiens.  With this evolution into modernity from the Mousterian Period ^[11] and from our ancestral Neanderthal species, Homo sapiens neanderthalensis (100,000 and 35,000 years BP) came a "cultural explosion” marked by “symbolic behavior and language and the capacity to imagine.” ^[12]  (It is of interest to note that even prior to this period of “modernity” (80,000-50,000 BP), there is archeological evidence of  “purposeful and ritualized” burials.  Such activity demonstrated that the Neanderthal Mousterians were able to conceptualize death in such a way as to establish conventions to deal with death’s disruptive forces and externalize the emotional responses to it^[13]. This “cultural coding”^[14] is not dissimilar from what has been described of poetry today.  With poetry "the world of external reality recedes and the world of instinct, the effective emotional linkage behind the words, rises to the view and becomes the world of reality.”^[15]  Primative humans needed to survive the perils of their environment before they could learn to "live beautifully or create beautiful things."^[16]  However, a "primitive imagination flourished in the midst of this peril"^[17] and out of their concern for their physical suffering and disability, they developed religious rites which focused upon the origins of their disease and pain.  Their sickbed became their cradle of religious myths and superstitions. The fear of death invoked many of these rituals and burial customs in order to repel the spirits of the deceased.^[18]  Yet from from such thought also developed behavior, rituals and symbols to safeguard the females from the perils of childbirth and memorialize their dead children.^[19] One might consider that these death rituals of the Moustarians were the precursors to our contemporary poetry and prayers of grieving although no written record exists which could prove this hypothesis.

\Remains of a  Neanderthal child were found in Siberia.  The grave was surrounded by goat horns, deliberately placed in a symbolic pattern which demonstrated a very early expression of "animistic beliefs" that nature is personal and filled with the spirits which behave like human beings.^[20]

\Caves at Shanidar, in Northeastern Iraq, were a rich source of Neanderthal excavations.  This region of the world was considered by some to be the cradle of mankind and  there was found was evidence of purposeful burials including the inclusion of small, brightly colored wildflowers. The remains of the Shanidar Man was found on a bed  of woven, pinelike woody branches.  Within the soil were discovered pollen from several non-indiginous flowers such as grape hyacinth, hollyhock and yellow flowering groundsel. This has been 'poetically' interpreted as evidence for the capacity for ‘human feelings’ in pre-human species.  The inhabitants of Shanidar buried their dead among natures beautiful foliage after searching "the mountainside in the mournful task of collecting flowers"^[21].  One might imagine the recitation of a psalm or song, prayer or poem in the manner which we inter our loved ones today into the death rituals of the Neanderthal's as they buried their dead children accompanied by the natural beauty of wildflowers.

\This culture of the newly evolving Homo sapiens sapiens brought with it the cerebral attributes of  “knowledge, belief, art, morals, custom and …other capabilities and habits acquired by man as a member of society.”^[22]  A system of values developed along with the establishment of a moral code, and the value placed on fertility and birth in this period was among the most revered.   This is well documented by the abundant discoveries of fertility rituals and symbols, displayed in cave drawings and portable art (pottery, stones, etc.).  Birth, life, fertility and transformation into death (regeneration), akin to the cycles of nature, predominate in Paleolithic and Neolithic images, and are particularly thematic in the image of the goddess and the symbolism contained within her language.^[23]  Richly painted artifacts displayed with a wonderment of color and images have been found, emblazoned with their depiction of life.  The goddess in all her manifestations was a symbol of the unity of all life in nature.^[24]  This makes us believe that the loss of a child whether in-utero or shortly thereafter was a great loss and evoked a grief response and need which are evident through modernity.  The enduring beliefs of fertility, sterility and "the fragility of life” are rooted to these neolithic, agricultural populations.^[25]   The egg, symbolic of birth and rebirth, was among the most ubiquitous symbols during this era.  Its form abounds on vases and frescos of prehistoric periods.^[26]

\Discovery of wind instruments in Southern France some 32000 years ago and the finding of small objects with parallel markings were early evidence of rythmic arrangements and interval scales (Chatelperronian Period-35000-30000). Furthermore, evidence of recurrent patterns and structures of Magdalenian period (18,000-11000 BP) showed complex conceptualizations consistent with oral communication and development^[27].  From this we might infer that symbolic representations recorded as a primitive language along with the use of rhythm and music may be considered ancestral to the emotional responses inherent in what we consider poetry today.

\The Chinchorro people of ancient Chile lived from 7000 BC to 5000 BC.  They revered their dead, particularly their children and their stillborn, and they put special effort in funerary rites and preservation by mummification.  The process of such mummification is beyond the scope of our discussion, but the Chinchorro’s commitment to this process was evident by this purposeful, artifical mummification, turning the simple body of a dead child into a complex work of art.^[28]  Generally, artificial mumification of dead children and fetuses was rare, for many primative cultures did not consider them full members of society, yet it is evident this was not true for the Chinchorro indians.  The Chinchorro’s had no written language, and an accurate account of their rituals is not possible. The mummification process of the Chinchorro's was performed with the intent to preserve indefinitely the dead for an "afterlife and ancestral worship."^[29]  Chinchorro mummies were buried with food and implements for the afterlife. With the effort expended in this process of mummification, one is led to believe that great value was placed on the lives and therefore the deaths of these fetuses and children.^[30]

\The development of written language documented the rites and rituals which were celebrated upon the death of a child.  Much has been written and studied of the Egyptian funeary practices of mummification.  Their belief in life after death defined different spheres of a post mortum existence.  Their spiritual being flurished after death. \Early in the Egyptian civilization, the Egyptians planted their dead adults and children beneath the desert sand.  When they were exhumed, intentially or by wild animals, their bodies were discovered in a state of natural mummification, dessicated by the sun before they had began to decompose.   Artifical mummification is a purposeful dessicating or drying process. The Egyptian's further utilized oils and wrapped the bodies to provide clothing. Funerary texts descibing the relationships between the deceased and the gods were receited during the embalming and entombing. Such text, a collection of magic spells and formulas, hymns and prayers, was written on papyrus, bound together and collectively called The Egyptian Book of the Dead.  It was thought that recitation of this text by the deceased at time of their death and entombing assured their glorification in an afterlife.  It began to appear in Egyptian tombs around 1600 BC.  The text was intended to be spoken by the deceased during their journey into the underworld, enabling the deceased to overcome obstacles in the afterlife.   One pertinent allusion contained in the Egyptian Book of the Dead was to Hathor, the goddess of joy, motherhood, and love. She was rendered the "protectress of pregnant women", a midwife, a fertility goddess and the patron of all women.   She welcomed the arrival of the deceased to the underworld, dispensing water to the souls of the dead from the branches of a sycamore and offering them food. "Hathor was also represented as a cow suckling the soul of the dead, thus giving them sustenance during their mummification, their journey to the judgement hall, and the weighing of their soul."  In later periods, dead women identified themselves with Hathor.^[31]

To better understand the use of poetics in the Egyptian Book of the the Dead, I cite the following which was recited to secure for the deceased the affection of men, gods, and the Spirit-souls.

O my father Osiris, thou hast done for me that which thy father Ra did for thee. Let me abide upon the earth permanently. Let me keep possession of my throne. Let my heir be strong. Let my tomb, and my friends who are upon the earth, flourish. Let my enemies be given over to destruction, and to the shackles of the goddess Serq. I am thy son. Ra is my father. On me likewise thou hast conferred life, strength, and health. Horus is established upon his tomb. Grant thou that the days of my life may come unto worship and honour. ^[32]

Ancient Greek and Roman cultures held diverse and sometimes conflicting attitudes with regards to the values placed on the worth of a child or a fetus. This is well documented, for their culture was rich in literature and in particular poetics.   Pregnant women in ancient Rome made a sacrafice of flowers to the goddess Juno, who was thought to have the power to prevent miscarriages.^[33]

Yet the paradox of infanticide or “exposure” existed, not only for ‘defective’ newborns but also for healthy ones. Infanticide, an old and almost universal custom was commonly practiced in imperial Rome by Pegan worshippers for reasons of poverty, vanity, malformations, population control  and other less defined social reasons. Many newborns-mostly female- were brought to the columns in Rome and left to perish.^[34]   It was felt by some that humanity was not endowed or given at birth and a higher value was placed on an ability to contribute rather than the inherent value of just being human^[35], and that failure to contribute rendered man "worthless".  Likewise, children, according to the Greek philosopher, Aristotle were considered natural slaves of limited potential.^[36]  Plato and Aristotle accepted the morality of exposed infants and supposed that “value” and worth is not intrinsic but acquired.^[37]  The third century writer, Heliodorus, likewise felt, contrary to these ancient classical values,  that it was not permissible to disregard an “imperiled soul” once it has taken on human form^[38].  Within the early centuries of the Roman Empire, inspired by Constantine, there developed  a growing humanitarianism, a medical ethic of respect for human life,  which condemned abortion and active euthanasia. Christians held that "the immortal soul rested in the unborn fetus as truely as in the newborn"^[39] and revered and mourned their death. Thus, flourished a sentiment of altruism and philanthropy with regards to the value of a person and thus a capacity for compassion.

Subsequent to the primative and ancient times, there has been shown reverence for the fetus and newborn accompanied by the appropriate processes of bereavement , yet there has also been irreverence; contrasts of beliefs and rituals abound.  At one extreme, the aforementioned infanticide; at the other, a desire for large families and the blessings of fertility.^[40]  The Dark Ages, Medieval times and even the Renaissance were among the darkest periods in the history of women and child bearing.   Obsterical practices were filled with cruel and hideous atrocities. So many fetus' and newborns died from disease and obstetrical disasters that to mourn them was felt too burdensome and overwhelming for the families.   Evidence of high rates of mortality among children can be seen by observing those buried in Medieval England cemetaries.  Among two such cemetaries, more than fifty percent of those buried were children and the largest single category was children aged 0-5.^[41]  Found there also was evidence of the burial of fetuses.^[42]  Contrary to these formalized burials, there existed religious and cultural customs in which funeary rites were not observed for the miscarried fetus, stillborn or newly born infant.  There were "secret (Christian) burials of un-baptized infants…excluded from the confines of the church cemetary".^[43]  Early Jewish law, in an effort to spare parents the "pain" of mourning, restricted acknowledgement of the demise of a fetus or newborn to thiry-one days or more and these children were not "accorded full human status". ^[44]  The Yoruba tribe in Nigeria would thow a dead baby or stillborn in to the bushes fearing that if the dead baby was to be buried in the ground, it would offend the earth shrines of fertility.^[45]  Paradoxically, Hindu newborns and stillborns were buried so they may return to an "earthly life".^[46]

[1] Czeslaw Milosz, The Witness of Poetry, (Cambridge: Harvard University Press, 1983) 25.

[2] G.S Rousseau, Medicine and The Muses

[3] W. F. Bynum and Roy Porter, Literature and Medicine During the 18^th Century

[4] Irwin Edman, The World, The Arts and the Artist (New York: W.W.Norton and Company, Inc., 1928) 30.

[5] Mary Jane Moffat, In The Midst of Winter (New York: Vintage Books,  Division of Random House,Inc.,1992)xxiv.

[6] Rita Dove, in  John Fox, Poetic Medicine, The Healing Art of Poem-Making(New York: Jeremy P. Tarcher/Putnam, 1997) 4.

[7] Lisel Mueller commenting on Yehudi Amichai; Stephen Kuusisto, Deborah Tall and David Weiss, The Poet's Notebook (New York: W.W. Norton and Company, 1995) 215.

[8] Moffat , In The Midst of Winter, xxiv.

[9] “Poetry is rhythmical.  Rhythm secures the heightening of physiological consciousness so as to shut out sensory perception of the environment.  In the rhythm of dance, music or song we become self conscious instead of conscious. The rhythm of a heartbeat and breathing and physiological periodicity negates the physical rhythm of the environment." Christopher Caudwell in Melvin Rader, A Modern Book of Aesthetics, (New York: Holt Rinehart and Winston, Inc.,1965) 154.

[10] D.H. Lawrence, in Stewart L. Udall, The Quiet Crisis, 1963, 1.

[11]  Randall White, Dark Caves, Bright Visions: Life in Ice Age Europ e(New York: The American Museum of Natural History,  W. W. Norton and Company) 19.

[12] White, Dark Caves, Bright Visions, 14.

[13] White, Dark Caves, Bright Visions, 19.

[14] White, Dark Caves, Bright Visions, 19.

[15] Rader, A Modern Book of Esthetics, 155.

[16] Edman, The World, The Arts and the Artist, p.30.

[17] Edman, The World, The Arts and the Artist, p.30

[18] Emanule Feldman, Biblical and Post-Biblical Defilement and Mourning: Law as Theology,(New York: Yeshiva University Press, KTAV Publishing House, Inc.,1977) 3.

[19] Dr. Palmer Findley, The Story of Childbirth (New York: Doubleday and Co., 1934) 2.

[20] Personal Observation: American Museum of Natural History, New York.

[21] Ralph S. Solecki , Shanidar, The First Flower People (New York: Alfred  A. Knopf, 1971 ) 247.

[22] Edward Burnett Tylor in Randall White, Dark Caves, Bright Visions: Life in Ice Age Europe, 14.

[23] Marija Gimbutas, The Language of The Goddess (San Francisco: HarperCollins Publishers, 1991) 316.

[24] Gimbutas, The Language of The Goddess, 316.

[25] Gimbutas, The Language of The Goddess, xvii.

[26] Gimbutas, The Language of The Goddess, 213.

[27] Leroi-Gourhan in White, Dark Caves, Bright Visions, 157.

[28] Douglas J. Davies , Death, Ritual and Belief, The Rhetoric of Funerary Rites (London: Cassell, 1997) 133.

[29] Bernardo T. Arriaza, Beyond Death, The Chinchorro Mummies of Ancient Chile, (Washington: Smithsonian Institution Press, 1995) 139.

[30] Douglas J. Davies , Death, Ritual and Belief, The Rhetoric of Funerary Rites, 132-133.

[31] Richard Deurer, (January,1997) Egypt and Art [WWW page] http://m2.aol.com/egyptart/hathor.html)

[32] The Papyrus of Ani, (1240 bc) Translated by E.A. Wallis Budge (New York: Dover Publications, 1967)

[33] Findley, The Story of Childbirth, 155.

[34] Findley, The Story of Childbirth, 274.

[35] Darrel W. Amundsen, Medicine, Society and Faith in the Ancient and Medieval Worlds (Baltimore: The Johns Hopkins University Press  ) 52.

[36] Darrel W. Amundsen, Medicine, Society and Faith In The Ancient and Medieval Worlds, 52.

[37] John M. Rist, Human Value: A Study in Ancient Philosophical Ethics cited in Amundsen, Medicine, Society, and Faith In The Ancient and Medieval Worlds, 52.

[38] Heliodorus, An Ethiopian Romance, 61.

[39] Findley, The Story of Childbirth, 274.

[40] Findley, The Story of Childbirth, 165.

[41] Christopher Daniell, Death and Burial in Medieval England, 1066-1550, (London: Routledge 1997) 124-125.

[42] Daniell, Death and Burial in Medieval England, 125-126.

[43] Daniell, Death and Burial in Medieval England, 127.

[44] Rabbi Debra Orenstein, Life Cycles, Jewish Women on Life Passages and Personal Milestones, Volume 1 (Woodstock: Jewish Lights Publishing, 1994) 37.

[45] Colin Murray Parkes, Pittu Laungani and Bill Young, Death and Bereavement Across Cultures (London: Routledge, 1997) 194.

[46] Parkes, Death and Bereavement Across Cultures, p.194.

3. Aspire and Stand Tall by Michael R. Berman, M.D.

Commencement Address, College of Science and Technology Temple University

May 16, 2013

President Theobald , Provost Dai, Board of Trustees, Dean Klein, Faculty, Parents, Relatives, Distinguished Guests and Graduating Students: it is with much humility that I stand before you to participate in this Commencement. Graduates, today is a defining moment in your lifetime. It is my privilege to be a part of it.

I love Temple University and am a proud alumnus. The foundations of my professional and personal life were formed here. I arrived on campus with a 17 year old's vision of what college life would be like. At Freshman orientation, the class was told by then President Gladfelter to make the most of our tuition payments of nearly $700 per year. When I arrived there was one men's dormitory, Johnson Hall, and one science building, Barton Hall. I came with a few essential items: rolls of dimes for the pay phone to call home, personalized stationary and postage stamps to write home, a dissection kit for biology, a Roget's Thesaurus to help me through freshman English - and a slide rule for every other course! -The status symbol of the 60’s that said: “I am a Science Major”.

But I also carried with me a consummate determination to become a physician. It was a singular goal in my life that I was able to attain through personal commitment, a rigorous college curriculum, an inspiring faculty, and above all, Temple University’s philosophy of personal engagement in the lives of each and every student. Few among many get this opportunity to return to their College and address a new generation of graduates at the threshold of their lives. It is a daunting responsibility. It entails carefully choosing words that sear and inspire, that are honest, optimistic, transformative and relevant. Thus, I begin with these words that have inspired me for more than fifty years, words written by President James A. Garfield as an oration delivered at Arlington, Virginia entitled Strewing Flowers on the Graves of Union Soldiers. I committed these words to memory while studying at the Philadelphia City Library for they are also inscribed on the Civil War Soldiers Memorial on the Franklin Parkway across from the Library. This monument designed by the renowned sculptor, Hermon Atkins MacNeil, bares its soul as it speaks these words:

“Each for himself gathered up the cherished purposes of life, its aims and ambitions, its dearest affections, and flung all

with life itself into the scale of battle”

“Battle” in this context refers to the conflagration that was the Civil War but it serves well as metaphor for all we do and can do and all you are about to do with your lives.

In every past époque, every generation, dreamers dreamed, writers mused, philosophers wondered and scientists discovered. Their imagination and art-forms, thoughts and innovations; their genius enriched their world and the world to come. They were the bedrock of their culture, the steppingstones to the present day and future ideals towards which you too strive and seek. What matters to us today mattered to them. You must look to these great thinkers as your progenators, for each one of you can accomplish your mark and genius as did they for the benefit of mankind. This is indeed an awesome charge. How will you begin? how will you suceed? Here are my suggestions to help along the way.

First: Be a Dreamer

Dreamers are by nature optimists. They take what they know, instill hope and promise, create new visions and long for their realization. No doubt you are all dreamers and you must never stop dreaming. It is in the hearts of dreamers where inovation originates, where songs are made, where images are painted and where thoughts, deep and simple, churn incessantly to bequeath hope and wisdom to gild each of your lives. Dreamers are artisans, painters of unfading hues, infusing promises stretched on canvasses towards infinity. Dreamers seek covenants of victory between their immagination and their deeds. The fervor of their sucesses is contagious. To cite the great Chinese poet, Xie Bingxin:

“Out of my window the strings of the harp are struck, Oh, my heart! How is it so deeply entangled in the echoes! There is the limitless sound of the trees, there is the limitless brightness of the moon” ( 1 Xie Bingxin ; Fanxing (Crowded stars);verse 21; 1921 )

Dreamers know limitless “sounds”...and “limitless brightness”. They seek and find miracles in a world of miracles, they sever doubts of uncertainty and always see in others, not the darkness of the night but the shining fringes of daylight streaming into their hearts .

Second: Embrace language

Do not underestimate the influence of the words you read, write and speak as you enter your post- graduate world for they are empowering. In a moment they can help; in less time they can hurt. They can bring peace and they can create turmoil. A few simple words, prose or verse, in an appropriate situation can have inordinate influence on you and on others. And if we focus on those words of poetry, I ask that you savor them, for through verse and meter, free of inhibition and full of expression, the poet’s voice can articulate sensitivity, empathy and solemnity and provoke much needed introspection and inner peace. Contemporary Pulitzer Laureate Poets, Rita Dove and Lisel Mueller have written respectively:

“By making us stop for a moment, poetry gives us an opportunity to think about ourselves as human beings on this planet and what we mean to each other.”2

and "Poems are not just feathers drifting into the Grand Canyon...They can make a real connection with another mind and heart..." 

Properly selected words can move the reader or listener to tears and awaken the primal emotions of joy, despair and hope. Hope becomes an essential thematic element in a poem for as human beings, we all have the capacity to bring hope to despair that is uniquely created by our humanity and our human conditions.

Elie Weisel, Holocaust survivor and prolific author, writes: 

“Just as despair can come to one only from other human beings, hope, too, can

be given to one only by other human beings” 

“The poet exploits the cadence of our language to feed the soul with beauty. ” ( Mary Jane Moffat, In the Midst of Winter, New York Vintage Books, 1992),xxiv )

The Universe of poetry is an important sphere for you in your personal and professional lives. I suspect many of you have discovered this already. As a physician I have encountered elation, desperation, birth, life, death, happiness, sorrow, fulfillment, disappointment. Poetry has been and continues to be my refuge when my stethoscope, scalpel and pharmacopeia can no longer heal. Many years of caring for the well being and the illnesses of patients and their families has taught me to accept that medical science in all its depth and possibilities is not precise and that the human mind and flesh are perishable. We are today steeped in myriad medical and scientific technologies that in themselves bring hope to previously hopeless conditions and pathologies. Yet there remains inexorable suffering and disappointment which may accompany the failures and tribulations of all new technologies. Their benefits may not be realized. Thus, the paradox of new technologies to cure and cause pain is real and evident. Poetry enables us to ask why even when we already understand how. It permits us all, when witness to the frailties of our humanity, to abet healing and resolve through the very core of what makes us human, our language and our personal emotions.

Third: Have a Philosophy

The philosopher Cicero wrote: “The Existence of virtue depends entirely upon its use” ( Cicero, De re publica )As you enter the post Temple University world, you will need a foundation of reason to guide you through your personal and professional lives and the diverse opportunities and challenges that lie before you. The bricks of this foundation will be your virtue, your integrity and your sense of right and wrong. No doubt, you will prosper but your prosperities will be measured by who you are and what good you bring to others, as much as by what you accomplish. Most of us are compelled by virtuous persons; we admire them, they teach us what is truly important in our lives. They become our mentors, our role-models- those who place wholesome values and selflessness on their daily agendas, and needn't struggle to carry them out. Throughout the routine that will become your personal and professional lives, you will be challenged, face doubts, meet uncertainties and question reason. The bricks of which I speak will support you during these times and surface the good you will bring through your life’s work. Aristotle, in Book I of his great treatise, The Nicomachean Ethics, writes:

“Every art and every scientific inquiry, and similarly every action and purpose, may be said to aim at some good. Hence, the good has been well defined as that at which all things aim.” ( Aristotle, The Nicomachean Ethics Book1 )

I have been fortunate to be taught by great mentors. They taught me science. They taught me Medicine. Above all, they collectively imbued that in my life I must engender a professional and personal conscience. Galen, the renowned ancient physician who lived around the year 150 BCE wrote: That the Best Physician is also a Philosopher. In my role as physician, I think about this often. Inherent in what defines the physician-patient partnership is an unfaltering responsibility of the physician and an unconditional trust by the patient. Together these bond the chasm between the vulnerable patient and the knowledge and experience of the physician; a synergy of the need for care and the privilege of caring. I believe the medical professional –indeed the professional in every discipline- must step back from each moment in his/her daily routine, and reflect on what he or she is doing, why it is being done and what influence it is having on his or other’s lives. This self-reflection, or mindfulness, is integral to professionalism for it encourages the formation of a philosophy of care and ethic of practice which in turns fosters self-examination and meaning, empathy and compassion. ( Professionalism is the basis of medicine's contract with society. It demands placing the interests of patients above those of the physician, setting and maintaining standards of competence and integrity, and providing expert advice to society )

Recently, I find myself increasingly engaged in dialog with my students and young faculty members about the privilege of being a physician, why we do what we do and how we can best help serve our patients. This is a most promising time to become a health-care professional and / or scientist, for there is in our immediate future enormous promise in human genomics, cancer therapies and other capabilities of advanced medical and scientific technologies. Yet, we must infuse this science with humanism and philosophy ( Humanism-“The concept that concern for human interests, values and dignity is of the utmost importance to the care of the sick.” American Heritage Dictionary ) , for in all that we do, it is of the utmost importance that we have concern for human interests, values and dignity. We need to assure that the benefits of our existing and future technologies are fully realized and that their expanding sphere of influence does not disenfranchise the patient, depersonalize the physician-patient relationship, alienate research from its ultimate reason and above all, that each innovation, each discovery, permeates and reaches every family in every global community.

Fourth: Emulate the scientists of the past; Be those scientists of tomorrow

To look forward, we must look backward. In each of your respective disciplines: Biology, Chemistry, Physics, Mathematics, Computer and Information Sciences and Geology, great genius has preceded you. Innovation has drilled down through layers of molecules and tissues, iron machines and giant comptometers, and peered through glass-lensed telescopes and microscopes. Innovation has flourished in those fortunate cultures that valued freedom of thought, creativity, personal expression, collaboration, and in those that recognized genius. Innovators of today reach their horizons on the ships of yesterday’s discoveries. Discovery and invention is accelerating more rapidly today than ever before. In 1865, Gregor Mendel presented his Experiments on Plant Hybridization and was branded the father of modern genetics. In 2003, 138 years later, the Human Genome Project was completed, the result of years of multi-disciplined collaboration. The first stem-cell transplant was performed in 1959. Last Month, just 54 years later, it was reported that a trachea was bioengineered from stem cells and transplanted into a 2 year old child born without a trachea. 3D Bioprinting, a tool of the new field of Regenerative Medicine “combines the synergistic potential of engineering and biology to create living human tissues that mimic the form and function of native tissues...” ( http://www.organovo.com/   

http://www.3ders.org/articles/20120730-gabor-forgacs-scientific-founder-of-organovo-recognized-for-pioneering-

work-in-bioprinting.html ) And, it is predicated that within the decade there will be replacement human organs that are ‘Bioprinted’ and personalized to a specific patient’s need. Invented by Gabor Forgacs, Professor of Biological Physics at the University of Missouri, Bioprinting has the potential to disrupt in a positive albeit surrealistic way the traditional medical, surgical and pharmacological therapies of many diseases. Professor Forgacs calls himself “ ...a theoretical physicist turned biological physicist, turned tissue engineer, turned entrepreneur".11 These very disciplines of modern science are the result of a new integration of all fields of science, bioinformatics, mathematics and the faculties of medicine. This is the excitement and promise that awaits you as you are granted your degree today. Your commencement is your inauguration: it is your beginning; your introduction into a world of change, challenge and opportunity. The integrity of our tomorrows will be fused with the promise of your intellect, your steadfast commitment to your dreams, your relentless pursuit of unfurled truths and a vigor to unravel the endless mysteries and marvels of the unknown. You and your generation are the fiduciaries of our future. Trust the Dyad of Science and the Human condition for as George Engle, the great 20th Century psychiatrist wrote:

"To know and understand...is a dimension of being scientific... to be known and understood is a dimension of caring and being cared for". 

( Engel GL. How much longer must medicine's science be bound by a seventeenth century world view? In: White KL,

editor. The task of medicine: dialog at Wickenburg. Menlo Park (CA): Henry J. Kaiser Family Foundation; 1988:133-77.

(Conference on the Biopsychosocial Concept of Illness and Disease, 1987, Wickenburg, Ariz.)

Appropriate for an “Inauguration” is a poem and I have written a poem, dedicated to you, esteemed graduates, to your families and to your future which I would like to share with you. It’s prolog, are lines by Ralph Waldo Emerson:

To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.

Aspire and stand tall, Young men and women Upon this threshold of tomorrow. For fortunate, are those... Whose lives so fragile and in need, Whom in just being, so struggle To feel a sense of freedom From pain, malaise and hunger, And maladies Which through their years Steal their persona... Fortunate are those Whose lives will be touched by you.

For you have learned and witnessed, And now will teach and practice The tenets of what it means To give,

And live Your dream. With profound committal In your work and deeds, You will overwhelm the pity

Of physical agony. You will seek The truths of science, Solve enigmas Preserve eclogies Wisely make and use Technologies; -Even those yet revealed.

You will plant seeds of hope in gardens Disrupted by blight and sorrow. You will care when caring seems lost. You will cry when caring has lost.

You will smile when With hands you create and And with intellect, innovate... A promise for a time yet to come.

And in that time, You will see Through mists of uncertainties Which veil the world tomorrow, That with passion, skills and fervor, You can pursue cure and order For afflictions of the blameless.

As no greater worth is there Than for you to share what gift Rests inherent in your heart: Your passion for discovery; Your soul of science...

Your Art, Your sense of right and wrong. And above the rest, A righteous ethic that strives, Without pretense, To learn To think, contribute and create What is your very own, Lifelong.

Thank You and Congratulations!

© 2013 Michael R. Berman, M.D. All rights reserved