(cheering and applause)
- Wow (laughs)
That's the biggest clapping I've ever had
when I got to talk on
this stage, I must say.
Well, ladies and gentlemen,
members of the class of 2013,
it's such a pleasure to
see you hear this evening.
(clapping and applause)
This is a pretty amazing day.
We've gone from fist bumps
to the first class lecture
in about 12 hours, and that
is a pretty wonderful journey,
a good start to what is
going to be four years
of a magical journey here.
And I have a real pleasure that
I get to address you at both ends
of that pretty exciting day
when you make your first
day officially campus
day as the class of 2013.
So here we are at the first class lecture.
This has always been one of my
favorite Dartmouth traditions.
It's a time that we designed
to start your life at Dartmouth
with a discussion between a faculty member
about the great issues of our times,
about the biggest ideas, or the thorniest
intellectual puzzles.
And what's even better is
that this is just the first
of what will be hundreds
or even thousands of
such discussions about
these types of issues
that you're gonna have
with your classmates,
with your faculty, with your
friends, your family back home,
and that's what we really do dream for you
in your time here at Dartmouth
as you begin your own
academic and intellectual
journey of discovery.
The first class lecture has been
structured very differently
by different faculty.
Classes before have read the old classics.
Sometimes they've read new books,
sometimes they read fiction,
they read non-fiction,
they've read poetry,
they've read commentary,
they've even watched movies,
listened to symphonies,
and written essays.
But this time, I think
you have a very special,
unique opportunity.
You're having the chance
to meet and ask questions
of the actual heroes of
the book that you read.
That remarkable book
Mountains Beyond Mountains
written by Tracy Kidder.
So up here with me are
three very incredible heroes
of that book.
And they were people that
didn't believe in words like
no, or impossible, or aim for less,
and those people are of course,
President Jim Yong Kim, Dr. Paul Farmer,
and Ms. Ophelia Dahl.
(cheering and applause)
Tonight, they're going to
talk to you a bit about
their own journey in global health,
and try to give you some insight
from in their own words of what that
time was like for them, how
they developed their ideas,
and what it was like to
work on the problems that
they were addressing,
covered in that book,
leading to what they're doing now.
I know they really hope
that they're going to
talk for a fairly short period of time,
and they're really looking
forward to you asking questions.
So, you need to listen
to what they're saying,
and think about the questions
that you want to ask them
because we really want to bring it around
and have that full question period.
This of course, is a time
when you have a chance
to listen to your President
and their colleagues
talk about their own journey.
But what's particularly special
about this topic, I think, is that it
speaks very directly to things
that so many of you expressed,
even in your applications,
when you were talking about
coming to Dartmouth.
And that's your optimism,
and the hopefulness
that so many people in this room,
and in fact of your generation,
are expressing about your ability
and your determination
to shape a better world,
and a global future.
So not only are you lucky to hear from
these individuals who
have made a difference
in the lives of so many people,
they have said that they
feel very privileged
to be talking to you at such an exciting
and meaningful time in your lives.
So I'm just gonna take
a couple more minutes
and do very brief introductions
to three people that you
already really do know.
And I'm gonna start
off with President Kim.
As Dartmouth's first physician president,
and an academic anthropologist,
you all know that he has been
a tireless advocate for social justice.
He's pushed the
boundaries, and he's fought
to make the world a better place
in everything that he's done.
Now he told me I was not allowed
to repeat any of the many things
that he's done and that you've heard about
earlier in the day.
So I'm gonna honor that request.
But I think you also do know that
in every position that he has had,
he has really been a
person who thought about
teaching the world.
He's a teacher too.
That with determination and innovation,
intractable problems become tractable.
I've been so lucky that in
just the last couple of months
when I've had the chance to get to know
Jim better personally, I can say that
he is bringing that same
optimism, his determination,
and his never say never
attitude to everything
he is also thinking
about doing at Dartmouth,
and all the dreams that he has for you,
as the president of Dartmouth.
If you spend just a few minutes with him,
you're gonna find yourself asking,
and being asked questions
and jumping right immediately
into that tussle of
back and forth argument,
and deep passion that every faculty member
hopes will be the hallmark of
your time here at Dartmouth.
That makes me certain that the aspirations
that we all share for a just
and compassionate world,
and for a passion of seeing
people accomplish things
will lead Dartmouth also
to an exciting future
with Jim at the helm.
Our second panelist is Dr. Paul Farmer.
Dr. Farmer, as you may know,
is the Maude and Lillian
Presley Professor of social medicine,
and the chair of the
Department of Global Health
and Social Medicine at
Harvard Medical School.
He's also chief of the Division
of Global Health Equity
at Brigham and Women's Hospital.
He too does not want a long list
of all of his accomplishments,
so I'm going to talk just a little bit
about what he's done
in Partners in Health.
Of course, he's a founding
director of Partners in Health.
He was recently appointed UN
Deputy Special Envoy to Haiti.
As you all know from reading
Mountain Beyond Mountains,
he's worked there since 1983.
And along with President
Kim, he was awarded
the MacArthur Genius Award
in 1993 for this work.
He received his B.A. from Duke, M.D. from
Harvard Medical School,
and a Ph.D in anthropology
from Harvard University.
President Kim recently
said of Dr. Farmer that
"He's one of my heroes and
closest friend in the world.
"They call him the modern
day Albert Schweitzer.
"He's a person who works
tirelessly for the health
"of poor people, and I
have been very touched
"by the extent to which young people
"are motivated and moved
by his life's story."
Our third panelist is Ms. Ophelia Dahl.
Ms. Dahl is an advocate for the health
and the rights of the poor.
Again, as many of you
know, or all of you know
from reading the book, she first traveled
to impoverished central Haiti
in 1983, at just age 18,
to volunteer her services
at the I Care Haiti,
which was a very small clinic.
It was, of course, in Haiti
where she met Paul Farmer,
and since then, along with President Kim,
they've been working as
an incredibly close team
to bring healthcare to some
of the least privileged
people on the planet.
They share a belief that all people,
whether rich or poor,
should have the benefit
of access to the same
high-quality health care.
Ms. Dahl currently serves as the
executive director of Partners in Health.
Under her leadership, Partners in Health
has forged ground-breaking successes
in treating the diseases of
poor, and promoting healthcare,
and they have a real
specialty of working in areas
that are being hit by political conflict,
poverty, and international neglect.
So the areas of the world where
we really do need to
provide some assistance.
She's a graduate of Wellesley College.
Ms. Dahl also serves on the board
of her family's foundation to
honor the work of her father
the late writer Roald Dahl, whom I'm sure
many of you have held as a
special favorite, as have I.
(laughs)
And she's been engaged
in philanthropic work
in the United States
and her native England.
I asked Jim recently about
what it must have been like
for Ophelia to be a part of that team.
And he laughed and he said,
"Wow, she was a women,
she wasn't a doctor,
"and she was dealing with
these two crazy guys."
(laughs)
He said "But she is better at
working with us than anyone."
And I think it's that affection,
that shared sense of purpose,
that has brought these three
people together, so please
join me in welcoming them
one more time.
(cheering and applause)
- So it's great to see you guys all again.
You're gonna be hearing a lot from me
over the next four years.
So I wanna start off by
asking Paul and Ophelia
to reflect a little bit on
what the experience was like,
and even to go all the way back
to the undergraduate years.
I first met Ophelia when
she was applying to be,
what's the name of the word?
- Davis Scholar
- Davis Scholar.
She finished high school
then went to Haiti,
and so she entered Wellesley later.
And I had just met them and
Paul was in a car accident,
and was finishing up Ophelia's
let me just call them
what I really call them,
this is Pell and this is
Min, this is what we call it,
I can't call them by their real names.
(audience laughing)
So, Min was applying to Wellesley,
and Pell was writing her
letter of recommendation,
but had just gotten in a car accident,
was in a cast up to his thigh.
He finished the letter,
and then I got in a car
and delivered it directly to Wellesley,
and it was that delivery that got
Min into Wellesley, I take
complete credit for it.
(audience laughing)
That's how we started at
that point in our lives.
So let me just say,
Pell why don't you just
talk a little bit
these are the class of
2013, just starting out.
What was it like in those early days,
and what were you thinking
when you were at Duke?
Tell us a little bit
about how it all evolved.
- First I like to say that as usual,
you have the details wrong.
- (laughs)
(audience laughing)
- That we met before that.
- Well, that's true, that's
true, we met way before that.
In fact, let me tell you the real story.
- Wait, wait.
(audience laughing)
- The real story is, I was in my
first year of medical school.
- There you go.
- And Paul was already a pretty well
developed anthropologist.
He'd written papers already.
I'd just started being
interested in anthropology,
and I met him during a snowstorm
in Cambridge, Massachusetts
and as we were talking,
he had just told me
that he met this woman named Ophelia Dahl,
and his words were, "It could be love."
- You know, Jim.
- [Audience] Aw!
- You know, this is
- And
- This is highly inappropriate.
- (Laughs)
(audience clapping)
It was and it has been
- This is what they call,
- until today.
- in legal terms, entrapment.
- [Paul] First of all, let me try to be
a little bit more dignified,
President Kim, 17th
President of Dartmouth,
and say welcome to all of you.
Can I start again?
- (Laughs)
(audience laughing)
- You know, and say something
avuncular and class of 2013
we're so honored to be here,
it's all true, by the way.
But yes, that was 1983,
and Ophelia and I
came up here a little
earlier tonight to see
Jim's kids, and Jim's son said
"Well what are you gonna say tonight?"
First of all he said, "I
don't know where dad is."
And I said yeah, we're
not looking for him,
we came to see you.
(audience laughing)
And he said, "What are you gonna say?"
And I told him that I was gonna talk about
when we were just starting in college,
and he just rolled his eyes, by the way,
I thought that was the most absurd thing,
"Blah, blah, blah, blah,"
that's what he said.
He said, "You always say that."
And there's some truth to
it, and the reason that
we talk about
when we were young and in college
is because that's how we got on
the trajectory that we're still on today.
I think the lesson in that is,
the lesson that I'd like to share,
I'm honored to be sitting here with Jim.
I met them both in 1983,
and that was right after I went to Duke,
and the reason that I was,
I went to Duke and he went to Brown,
therefore I had a better
undergraduate preparation,
(audience laughing)
and was already studying
medical anthropology.
I can only say that 'cause
we're at the number one
- [Both Men] undergraduate
institution in the world!
(audience cheering)
- [Paul] I have to be careful
because at ten o'clock tomorrow morning,
I have to give a lecture at a little
community-based college in
Cambridge, Massachusetts.
But 1983, this is what
I would like to share,
is a couple of messages
that may seem obvious
and Jim's son, my godson may say,
"Blah blah blah blah blah,"
but the two things that
I'd like to underline
before we open this open
to a real discussion is
why did we become friends in 1983?
I think one of the answers
is we were prepared
to become friends.
It's true that there's
always happenstance in life.
I think of some great
quotation from Louis Pastor,
I forget what it is, it's written actually
in the Vanderbilt blah blah
- Blah blah blah
- [Paul] I believe in French,
I'm not gonna say it
in French, don't worry.
- [Jim] Chance favors the prepared mind.
- Yeah, chance favors
the prepared mind, right?
What does that mean for us?
Well, Ophelia comes from
Buckinghamshire, England
and ends up in central Haiti,
I come from Florida to Duke
and end up in central Haiti,
- [Jim] Swamp. Swamp.
- Then I go to Harvard to
interview for medical school.
Why? Because I wanted to go to Harvard
to go to medical school
because there was a
medical anthropology
program, and Jim was already
identified as being in it, as
being having that interest.
So, 1983 we could say,
well you know, we were
just a lucky chance and that's true.
But we had prepared.
Jim had been interested in
these issues in college,
and I had as well, and Ophelia,
I think she's the marble among us
because how she got from
England to Haiti at 18,
that was even younger than Jim and I,
When we were sort of committed to these
issues of global health.
So it's not that we're stuck
in a rut, I would hope.
It's that you learn things
when you're in college
and when you're young and you meet people
as you have already this year, today
who may be involved in
the rest of your lives.
I would hope you're as lucky as we are
in that you're gonna make
friends here at Dartmouth
who are going to be involved
in the rest of your lives.
Now that's 27 years ago almost,
all of our adults lives.
Obviously we've done different
things with our lives.
Jim and I are interested
in different things,
even though people would say, "Oh you guys
"went through the same training program,
"and we have the same mentor."
One of our teachers actually
passed away yesterday,
who helped set up this program.
He was 87.
We've all done different
and complementary things,
and we started them when we were young.
That's one of the two messages
that I'd like to get out there,
is people say all the time, you're in this
island of privilege, in
Hanover, you're at Dartmouth,
these are the best years of your life.
I'm afraid that's all true,
in the sense that there's a
lot of great things happening,
but if you should seize these four years,
and maybe for some of you it'll be longer
'cause you'll do other things
and it'll be five years.
Some of you will flunk out of course.
(audience laughing)
- Oh! Ouch!
- I'm just kidding.
- No you're not.
- But that's the first of the things
so we took it seriously, probably we were
maybe too serious about some things.
The second is, and this is why we're here,
it was mentioned already by the dean,
is the optimism that is necessary
to face the world's troubles.
I just came here from
Africa, I just flew here.
In fact, I went from Haiti
to Africa and back here.
I was hoping that once Jim was named
the President of Dartmouth,
he'd get me in jet
so I could just do that.
(audience laughing)
Is that a possibility, Jim?
- No.
(audience laughing)
- Fiscal crisis.
But the second message is that
we need you, we of course
as the three of us,
but global health and social justice,
and the serious problems
that are in the world,
whether in this country, or
in the ones where we work
'cause we work in the United States too,
they require real commitment and optimism.
That's a combination that
you don't always see.
First of all, people who
are living in poverty,
they don't get the sort of chances
that you have, and that we've had,
and we have to fight so
they can have those chances.
And to me, that requires an optimism.
If you plant a tree, I
don't want to sound corny,
but if you plant a tree,
really quite literally,
in a deforested area, say.
What does that mean?
It means you think that tree is gonna
survive, you don't think
it's gonna be eaten by
a goat the next day or get swept
away by a hurricane, right?
That sort of optimism, planting things,
not so much literally, as metaphorically,
is what we need to do, I think, now,
as your generation will
do it better than we did.
We're devout believers in your generation.
The first globals or whatever
you'd like to call yourselves,
what is it you call
yourselves, I'm not sure,
but we're real believers
in your generation.
When I was a freshman at Duke, of course
I was on the varsity basketball squad.
- [Jim] (laughs)
No, he was not.
(audience laughing)
- And so, actually I did
what some of you guys did.
There was a project at
Duke like the one that
many people do here, go into
the woods, a walk in the woods.
(audience laughing)
And I just remember
meeting people that week,
that first week of school,
and a lot of them are still friends of
ours to this day.
That's an important third message.
I said two, but I'll start with three.
Be nice to each other.
Form friendships that can endure.
It's a little bit of a
variation of the first message,
that it could happen to you, that you meet
people you'll be working
with the rest of your lives,
during this week, or next week,
or next year, or in a seminar,
but take care of each other,
be nice to each other.
And as corny as that sounds,
I think it's something that
we've grown to value more
and more as we get older.
These friendships are really critical,
and I'm very grateful for
mine with Jim and Ophelia.
Thank you.
- Reflections?
- Great friendships.
I think we've underlined that twice,
that knowing at a young age that
we connected, immediately I
say, was enormously important.
Just to go back to this love thing
that Jim brought up, I have to say,
I was taken aback when I first met Paul.
We spent a few months in Haiti together,
then I left Haiti.
And I left him with lots of the things
that I gathered in Haiti, including,
novels and various things
like that, books, novels.
And I said, "Here, you
can have my novels,"
to just have something to read.
He said, "That's great thank you so much."
And then I went back to England,
and in about a month or two weeks later,
I got a letter from
him, and then I got this
book report.
- So I'm a nerd.
(audience laughing)
- You have two academics,
I've hung out with
intellectuals and academics,
and I was falling for him
and he was falling for me,
and his idea of wooing was
to send me a book report
(audience laughing)
A six pager paper.
(audience clapping and laughing)
- Not what I thought.
We're here to talk about global health.
- Global health, back to global health.
- [Jim] I don't recommend that
strategy by the way, guys.
As a general rule.
(audience laughing)
- We're here to talk about
engagement with social justice.
- (Laughs)
- You know what that did though
because I had fallen for
him already in a major way,
we only had to spend a
couple of hours together,
and I knew that this was
someone I wanted to spend
some enormous part of my life with.
That the way he responded to me then
when I left him books or when we
traveled around Haiti together,
taught me something very early
about what it was like to be with people
who cared and saw the details,
and the way they read books,
and the way they responded.
He wasn't gonna respond with
a boring old love letter.
He was gonna actually
read what I had left him
because he thought that
would have meaning to me.
And I think that if there's one thing that
I've learned from these
fellows that's been
very important for the
growth in Partners in Health,
it is paying attention to the details,
it is making good relationships,
it is listening well and caring what
other people think and do.
I think I've had a
pretty great and worldly
upbringing in England with caring
and funny and warm parents,
but the level of detail
that I learned after I
went to Haiti and then
started hanging out with
these guys and other people
was very different than
anything I'd learned
from my wonderful, imaginative,
social background in England.
One other thing that occurs to me,
we had a Partners in
Health board meeting today.
And we have board meetings
about four times a year,
there are about 15 people on our board,
and this actually the first one that
Jim hasn't been to for a long time
because he was obviously
preparing with all of you today.
As we sat there, and we
wrestled with the effects of
the last year that I know has had
echoes and ramifications
for everyone and everywhere,
we looked at what Partners in Health
had been able to achieve.
Looking at the growth
of Partners in Health
and working with this board, and I
always think at the end of board meetings,
what it was like be young
and to have board meetings.
Our idea of board meetings was
- [Paul] Pizza.
- A regular get-together, pizza,
until two or three or four in the morning.
And that's how we would make decisions.
- [Paul] Chinese restaurant.
- Chinese restaurants.
- (Mumbles)
- But that's how we would do it early on,
and I have to say that in
order to grow an organization,
and to have the echoing
and amplifying effect
of an organization like
Partners in Health,
you have to grow and
you have to systematize,
but every single time I
attend a board meeting,
I think about the ways that we used to.
That we built Partners in
Health as a small group
through informal and
unstructured board meetings,
but just connecting,
connecting all the time.
- I must say, our
co-workers who came here us,
they'll be alarmed, they've
never heard us talk like this.
Did you ever think of that?
- About?
- About our friendship in the early 80s.
So, this is just for you guys.
- (Laughs)
- Going back to connecting, Jim and I
were then students together.
It was really actually
when Jim's father died
that we re-connected, and
this is back to the theme
of looking out for one another.
He was in Korea, Jim was, at the time,
and I remember writing
him a letter saying,
I'm really sorry to hear
that your father passed away,
and he'd come back to
California, where his family was.
That was a simple thing.
By the way, you guys don't even
write letter anymore, right?
Someone said on the
way in, "No twittering"
and I just thought, what
on earth is twittering?
- (laughs)
(audience laughing)
- Actually I know what
it is, I must confess.
(audience laughing)
- [Ophelia] You Twitter all the time.
- You know, that'll be the day.
Please don't Twitter the things
that we're saying, by the way.
This is just for the class of 2013.
This isn't being taped.
- What was your point?
- It is.
(audience laughing)
And being broadcast and taped.
- Broadcast?
(audience laughing)
This is not gonna be good
for my career at Harvard.
- (laughs)
(audience laughing)
- Can I have a room here, bud?
- Yes, you can have a room.
So, let me ask you something else.
What was it that made us think
that we could actually do this?
We especially talked with you about it
because you were the responsible one
who was always trying to look at books,
and make sure that we had enough dosh,
as you used to say, to be able
to do what we needed to do.
But what do you think made us feel,
in the face of unbelievable odds,
at a time when there was
no money for global health.
- I broadcast it on TV?
- Yeah.
(audience laughing)
- On local Dartmouth TV, but it's okay.
- What if my daughter sees it?
- She'll love it.
So tell me, this is a
fundamental question,
we had debates about this all the time,
whether we could actually do this or not.
What made us think that we
either could or we should,
or that it was worthwhile
pursuing something so difficult?
- I think in part, it goes back to
the optimism that PJ referenced.
I think that, although we all knew
what it was we wanted to be connected to,
we didn't set out with a
very specific strategic plan.
We had a very broad plan, I think.
And we tackled each problem as it arose.
So, I think some ways,
although it would be
incorrect to say that we didn't know
what we wanted to do going forward,
and it was a broad plan,
I also think that we weren't tripped up
by thinking about the things
that could possibly go wrong.
If you think about it, whether or not one
thinks about us as a reactive
organization or anything else,
I think it was actually very important
for us to be able to do just that
when, I'm thinking of all
the examples as they arose,
and we brought more
things and more people,
and more projects on board,
and there wasn't a day that went by
when we weren't troubleshooting or
putting out fires and that kind of thing.
The big things that happened,
worrying about money,
worrying about colleagues,
worrying about political situations
where we were working and what that meant
to the folks we were working with,
as those problems arose,
we put our heads together,
we had a few people
that we could turn to at times
like that to give us support.
And we moved forward
I don't want to suggest that it was
a lack of planning, or a
lack of thoughtful process,
but I do think that can
sometimes get in the way,
if you have too much of a long
term goal, I think, for us.
- Especially if you conclude that
this is just an impossible problem.
Pell you said to me once, we
were comparing experiences,
I worked for a time in the Heinz
Ketchup factory in Muscatine, Iowa,
and Pell worked in a factory
as well, do you remember?
I don't even know if
you were remember that.
She said, "You know, Jim,
when you work in a factory,
"you remember that feeling when
"the shift horn goes off, and you're done?
We will never have that feeling
ever again in our lives."
- (Laughs)
- It was heavy.
- I got exactly that same
feeling when we were in Kenya,
and we watched the Maasi be able to
put their animals into the boma
at the end of the day and then they
closed the gate and they went to sleep.
- I think you guys are saying
exactly the opposite thing.
- Really?
- But go ahead, what did you
mean, and why is it opposite?
- I think we're saying the
same thing, which is that,
how nice to be able to
have end to the day,
and be able to feel like you've completed
everything you're supposed to complete.
I think it's the same thing
Comma.
(audience laughing)
- You didn't hear what
she said, but that's okay.
It's probably being broadcast.
(audience laughing)
On the Internet.
- (laughs) Yes.
- You know about the cows going
home at the end of the day,
I guess they do that in Iowa too.
- [Jim] They do, yeah.
- We had been in a Maasi
land in the Chyulu Hills
in Kenya, and all that in
that part of the world.
Pastorless everywhere,
they have a tough life.
I'm just saying, crude generalizations,
you look at what's happening in Kenya now,
with terrible droughts, that's very hard.
We would never romanticize the hard life
of people who have an end of the day
that's letting those cows
into enclosures called a boma.
That's, on the one hand,
and then the other is,
I don't know if I recall the conversation,
but if you look at someone who
didn't get to go to Dartmouth
or Wellesley or Duke or Harvard,
and some of you come from families,
as I did, where this was the case.
My mother, she checked in in the morning,
and the best part of her day
was punching that timecard,
- Winn Dixie.
- To leave the the grocery store.
That's something that a
lot of people in the world,
they feel lucky if they
have a job at all, right?
But it's hard to not have this
vocation and this goal that I think
a lot of you in this room have,
in part born of our
privilege as a country,
this institution, Dartmouth, it is
again, an island of privilege,
but I mean that,
it's a wonderful thing we
should celebrate, I think,
that we have these universities,
and these resources that will allow you
not to just be punching a card,
although, cultivating deep respect
for people who have to do that,
or lucky enough to do that
I think is also something
that your generation can do.
One of the reasons that Jim
is excited about being here,
and we've been talking about it,
it's one of the reason we're here,
of course we're here because Jim's here,
but we're also here to celebrate
a generation that is not cynical.
Your generation, again,
gross generalizations,
they're not even allowed in
anthropology or sociology,
so generalizations are okay,
but not gross generalizations.
But your generalization
strikes us as not cynical,
as willing to engage in the world,
as willing to make errors and be wrong
sometimes, and be right often,
and I think that's one of the reasons
that we're teachers and involved in
the endeavor of higher education.
And that's true in the
places we work as well.
It's true in Haiti and Rwanada.
We need to be more involved
in bringing people on board,
but on the one hand,
anybody would love to have a
sense of the day of the day,
on the other, it's hard to have to
just think that the end of your workday
is the best time of the day.
You'll be lucky enough, many
of you, not to have to do that.
You'll be able to have projects
that go on for years, and aspirations that
could go on for years,
at least we hope that,
I would hope that for you.
I think that was the nature
of part of the discussion.
- I also think, Jim, being
able to bring other people on
very quickly made a
huge difference for us.
So that by the time we were tackling
some of the worst problems in Peru,
we already had a group of people
that we were working with that
made us feel as though this was doable.
It was very rare for us
to get down in the dumps.
- And then let me say something
to you, the class of 2013.
And I'll say it on Monday because,
is it Monday?
- [Jim] Tuesday.
- Whenever Jim gets inaugurated,
coronated, whatever.
The crown
(audience laughing)
I've been thinking about this,
but I'll be here Monday too
- [Jim] You will, yeah.
- I wasn't being glib.
- [Jim] I know.
- But this is what I'd
like to say on Tuesday,
and maybe I'm messing
it up, but there will be
a lot of people there,
beyond the most important,
or people starting with Jim, and
back to the question which you asked,
which you can't really answer,
but I would like to say one thing
to all of you and that is,
one of the reasons we
had these big visions
is because of Jim.
You need people in your lives,
and recommend this to everyone here,
find people who are going to push you,
and who are not going
to be afraid of failure
because everyone fears failure, right?
All of us fear failure.
Ophelia goes into central
Haiti when she's 18,
and all around, there
are development projects
that aren't really working
well, it's just there.
Last week there were lots that
are working well, but there's
lots of failure as well.
And there's failure in medicine,
when you have a patient who dies,
or when you fail to
prevent an adverse event,
there's failure in education,
there's failure everywhere, there's
failure in the economy,
but you don't wanna,
and I'm echoing what Ophelia said,
but I just like to pay a tribute to Jim
because so many of the
things that he's said,
or predicted, or forecast,
or encouraged us to do,
either they've been proven true,
or we've followed his advice, and then
we've moved forward to the next level.
So, I'll be expected to say
things like that on Tuesday.
That's part of the
- [Jim] But you mean it, right?
- But I mean it,
(audience laughing)
it's actually sincere.
That's part of what one is expected to do
at a rite of passage where someone,
a new leader, is coming in.
I know there's a big crowd here tonight,
I know it's being broadcast
- [Jim] (laughs)
- But I really wanna
say that to all of you
who are coming into this institution
at the same time that Jim is,
we think you're very fortunate to have
a visionary like Jim, at
the helm of Dartmouth.
So congratulations to all of you.
(audience clapping)
- So we are very determined to
have a conversation with all of you.
Carol, you wanna start?
- I'm going to field questions,
and intersperse the questions from here.
There are also people in some
other auditoriums viewing,
and they were able to
submit some questions
so we'll add their questions in.
- Line up at the two mics right there.
- I think we have a couple mics, and so
if people want to come forward,
we're really looking
forward to your questions.
I see some people here.
I told you there'd be lots of questions.
- [Jim] Let's get started.
- Okay! (whistles)
(laughs) I was gonna do that really loud.
Okay, we'll start on this side,
and the first gentleman, question?
- [Student in Crowd] My
question was, is this on?
- [Jim] Tell us your name.
- My name's Ankin Dahl, I
think you might recognize me.
- [Jim] Oh yeah!
(audience laughing)
- [Ankin] You talked about what
prompted you to start Partners in Health,
and what led to such a vision,
but my question was,
when you're at your low points,
when everything, all the
obstacles in your way,
when everything was there, what
got you through that?
What kept you on track?
What kept you with your eye on the goal.
Obviously, you three
people are amazing people,
you have that moral fiber
that got you through it,
but were there any other things
that just kept you the track to
fielding global health problems?
- [Carol] Okay, great.
- It was the friendships
and the relationships
that we'd made that kept us on track
at different times and
still do keep us in track.
It was the small victories that we had,
and it was, I think feeling a connection
to the projects and the people
that we'd already made common cause with.
Feeling as though we
couldn't let people down.
So I think it would be those three things.
- Let me just say,
there's always a tension,
and is a tension that we
talk about all the time.
And it's the tension between desire
for personal, individual efficacy,
personal, individual recognition,
and understanding what it takes
to actually make social
movement go forward.
And we struggle with this all the time
because everybody wants to be recognized,
everybody wants to feel that they
have their own slice of the
work, the slice of the pie,
but you just can't get anything
really important done
working as a single person.
I've never found that.
We used to say, whenever
we took on a project,
we'd say, if we're really
serious about this,
then we have work on at least
seven fronts at the same time.
You gotta change policy, you
gotta show it can be done,
you gotta bring prices down,
you gotta train your people.
And so that's one of the
greatest tensions and struggles
that exist in any organization.
Individuals' need for personal efficacy,
and yet the need to work together.
What I found here at Dartmouth
is that I think we teach teamwork,
how to be part of a group,
how to treat people well,
better than any place I've ever seen.
But think about that, this
is really important for you.
There's almost nothing
you're gonna be able to do
without being able to work
well with other people.
- I'm just gonna add an illustration
of what Jim and Ophelia have said.
I was asking one of our
protégés, a former student,
actually a former undergraduate
who's now a faculty member which
just goes to show the continuity.
We were talking about what's called
a programmatic area of work, and I said,
"Why do we have to reinvent the wheel?"
It was a rhetorical question, but I got
an honest answer that I wasn't expecting.
And he said, "Because we
want to reinvent the wheel."
And I said, "Oh, that's fair."
In other words, the quest for personal
efficacy is important.
The quest for individual
achievement is important.
It is celebrated in places like Dartmouth.
And then all of you linking that
to this broader, what Jim calls,
these cherished social
goals that we might have
for equity, decency, and
we mentioned global health.
Who wants there to be violence
and strife in the world?
So I think that's something
that kept us going.
Sometimes, things would
be going very poorly,
it's a very huge team we
have thousands of people
we're working with.
We happen to be three who've
been together for a long time.
There'd be that, there'd be
other people on the team.
Sometimes it would be,
well, we'd like to get
this done for this one family,
or because we think it
would be a good thing
to complete this project.
To be honest about this
quest for personal efficacy,
what we always want is to
be part of something larger.
That's a challenge, as Jim said
and it's worth striving for.
- That's what keeps you going.
The most brilliant systems are ones
that don't settle for banal
truisms that are never true.
Well if everyone just doesn't care
about being recognized, then
everything will work fine.
It's never like that.
The most brilliant systems
recognize individual effort.
Let people feel distinctive.
Let people feel they've
made their own commitment,
but have it all work as
a part of a larger goal.
This is the struggle that we go through
every, every time we've
started any project.
Think hard about how that works here.
Some of you will be
Trip Leaders next year,
will be on H Crew or Lodge Crew.
Those folks struggle a lot
with how to make all that work.
This is a really important lesson,
and it is the thing,
having that stuff work,
is the thing that lets you get
through the most difficult times.
- [Carol] Ask your
questions fairly quickly,
there's a lot of people.
We'll try to get through a number of them.
- Hi my name is Joseph Tannenbaum.
Being that we're all, well first of all,
thank you guys very much for coming.
I know you guys have very busy schedules,
but thank you very much, this was amazing.
Being that we're all 13s and we're all
trying to figure out what
classes we should take,
I know I'm struggling with that.
What was that one course
that you guys took
as undergraduate students that
made you say, "Wow, this changed my life"?
- For me that's a great question.
I took a course called
medical anthropology, 1980.
And so again, it sounds so corny,
to say "Wow, that changed my life,"
but it has the added value
of being exactly true.
That was supposed to make you laugh.
(audience laughing)
So I did, I took a class.
I was a biochemistry major and
I had a great biochemistry mentor at Duke.
Her name's Barbara Shaw, and
she's a professor there still.
And I went and talked to her, and said
"I really like this class
in medical anthropology."
She said, "You should
do what you really like.
"If you wanna go off and
major in medical anthropology,
knock yourself out."
And I did.
- The true story is
that he took the course
in medical anthropology 'cause
he thought it was about medicine,
he wanted to be a doctor.
Didn't know what it was about.
- I had no clue, I took medical ethics.
- Anything with medical in it.
- Waste of time.
(audience laughing)
- Sorry, sorry.
- [Jim] Min?
- For me, it would've been a survey
to English literature, and
it was a year-long course,
and it covered a thousand
years of literature,
and it was so important
to see how each
piece of literature had built on
each movement of literature,
each separate,
What's the word I'm looking for PJ?
- [Paul] Sonnet.
Sorry.
- (laughs)
(audience laughs)
That all of this had built on one another,
it was related to history,
it was related to politics,
it's a little bit about new historicism,
and I think that that
was fascinating to me,
to see the links, as I had not
taken anthropology at that
point, I had not taken sociology,
so it was in some ways an
eye-opening introduction
to the way things are connected.
- The most important
thing for me was actually
my extra-curricular activities.
Working Asian-American
Students Association
at Thurwell Center.
And didn't really have a
course that changed my life.
But that's 'cause I went
to Brown, and I didn't go
to Dartmouth, the number one educational
institution in the world.
(audience applauding)
(laughs)
You will all have a course
that will change your life.
- Just see if he says
that at his alma mater.
We'll see if he does that,
they're broadcasting this too.
(audience laughing)
Can I say one thing, Carol?
And that is, I want you
to know Mr. Tannenbaum,
Joe?
- [Joe] Yup.
- He said Joseph, excuse me, let me not be
too familiar after this talk.
- (laughs)
(audience laughing)
- I still am in touch with the people
that taught me at Duke.
I wanna get that out there too.
Not only can you build
friends with your peers,
but you can also make
connections with the faculty,
and the university.
I know Dartmouth is famous for
that kind of connection,
and I think that's
a wonderful thing about this place.
- Good evening, my name is Raquel Bernard.
My question has to do
with, probably the most
profound statement I found in
Mountains Beyond Mountains.
A woman was saying that if you wanna
keep these women from
getting sick, give them jobs.
What that made me think about,
since I'm interested
in educational policy,
that in my mind say, I don't
know too much about Haiti,
but in America if you wanna get someone
a good job, a good place of
employment, they need education.
So we see how on the privileged side,
people who have this education
take that to the poor, and help them
by things that you all have done.
But I'd like to look
at from the other side,
as far as educating those who are poor,
so they can in turn, help themselves.
So my question is,
how will a global improvement in education
help and benefit global health?
- Can I give that a try?
- [Raquel] Yeah. (laughs)
- Because that quotation,
if I remember correctly,
was from a patient of mine.
That was 10 years ago, almost
that he was writing this.
Is that right?
- [Raquel] Yes.
- Did I get that right?
We knew, we collectively, that was true
25 years ago, what she said,
and it's still true today.
What we've been involved in is
breaking this cycle of
poverty and disease.
And that requires jobs,
education, et cetera.
There's many ways, and I hope this is
something that comes out of
our comments to about courses,
that we liked, or the way we
got involved in this work,
is there's many ways to get involved
in global social justice efforts.
I would argue, and I think
all of us would argue,
that coming at this through agriculture,
clean water, a particular
region of the world
where you're gonna have a
concern with well-being.
Medicine, global health.
That should matter less
than the goal, the vision
of saying everybody deserves a chance
to have a decent life, I think.
I think you're absolutely right.
How can we do that without education?
You can't.
So it shouldn't be a competition
between access to basic
educational services
and say, access to primary health care,
or access to cancer treatment,
and access to treatment for Tuberculosis
can't be a competition like that.
That's where your
generation, it seems to me,
way ahead of where we were.
We already confessed that we thought
we were pretty advanced
because we got involved
in this work when we were in our 20s also.
You guys are way ahead of us.
- Let me just say one thing.
What we're gonna try to
teach you here at Dartmouth.
You'll here a lot of slogans.
Education is the solution.
Or, give a man a fish, he eats for a day,
teach a man how to fish, he
eats too much, I don't know.
- [Ophelia] (laughs)
(audience laughs)
- [Paul] Yeah the protein.
He likes tilapia.
- But here's the point.
There's not a single really
tough problem I've ever seen
that goes away with a
simple, single intervention.
Very few are like that.
So what we're gonna try to teach you here
is the patience, the calmness,
the persistence required
to really get all the dimensions
of what makes the most difficult
and important problems worth taking on.
The most profound experience that I had
in this regard is we were
in a slum in Lima, Peru.
And we were doing what we always do,
just educating a group of
community health workers
to tackle a problem in
an incredibly difficult
not as poor as Haiti, but
poor urban area in Peru.
And we went out into the hinterland,
in an area where the
people were even poorer
than the poor kids that we were teaching
to be community health workers.
When we out there, and
they met these people
who just had nothing and they were
basically undernourished,
and suffering from
Tuberculosis, and other diseases,
we said to them, so
"What's the problem here?"
Remember? Carlos said,
"Falta de educación."
Lack of education.
And Paul was there,
and he said "Oh really?
"So, they have Tuberculosis,
and they can't eat,
"they don't have any
food, and the problem is
"lack of education?
"Where'd you get that from?"
And he was very honest he said,
"Well, that's what all the banners said
in the campaigns that the government ran."
And we said, "What really is the problem?"
In other words, is it their fault
that they have no food and
they have Tuberculosis,
and if they had just educated themselves
everything would be fine?
We're not saying there's an easy answer.
We're saying that anything
that you care about
is gonna be multidisciplinary.
And you're gonna need
inspiration from Shakespeare,
and qualitative methods from anthropology,
quantitative methods from economics,
scientific and analytics methods.
There is nothing really
important to take on
that's reducible to a single factor.
Avoid that temptation.
Dig deep, that's what
you're supposed to do here.
- [Carol] Next?
- Hi my name is Becky White.
First, in the same banner,
I want to thank you
three for coming, this is
really quite a privilege.
My question is about working in an
international setting,
and doing this kind of
social justice work, public health work.
You obviously have a lot of
people behind you helping out.
How do you generate the
support and the energy?
When people do domestic
work, or something that's
a bit more accessible, there's
that energy going into it
that you can kind of feed off of
to continue their support
throughout the years.
But when the program is a little bit
less accessible, how is that done?
- [Jim] You mean fundraising and all that?
- Fundraising, keeping people involved,
keeping people active,
keeping people caring.
- Well, Min's there, Min's the master.
- I was having a hard
time hearing you exactly,
but how to keep the interest going
in an international program
rather than a domestic?
Or just in general?
- [Becky] Just in general, I guess.
- Well, this is something that we
still have to tackle everyday.
We spent an hour and a half
today in the board meeting
talking about just these kinds of things.
Over the years, it hasn't gone away.
So, thinking about the questions
of how you communicate the messages,
fundraise around those messages,
keep people's interests alive.
Jim and Paul and I had dinner
probably close to two decades
ago as we were starting up,
and trying to get people
interested in the work in general.
For all of you who are
interested in this work,
and for those of you who may already be
involved in organizations,
small or large organizations,
finding ways to spark the
interest of other people
to say, yes we'll be part of this.
How do you build and organization,
build interest in even a small
movement around something?
Remember our dinner with Larry?
- [Jim] Webber?
- Yeah.
A marketing guru.
We had dinner with this guy to say
because we had already some
success under our belt,
we were connected to a major
university in Cambridge,
we knew what it was we were
gonna do, we'd had some success.
And we still felt as
though we weren't getting
the kind of broad traction with respect to
development and raising funds.
So we sat down, the friend of ours said,
"Why don't you sit down
with this marketing guru?
"He'll be able to tell you
where the disconnect is."
And a wonderful, colorful fellow,
Spirited, and we had dinner with him ,
and he said in colorful language,
"The problem is that people care about
"what's under their noses,
"what's right here.
"They don't care," except he said it
more colorfully than this.
"They don't care about the
folks that you're dealing with
in Haiti, and Peru, and everything else."
And we've heard a lot of those kinds of
very sure statements over the years.
This is why, this won't work,
and this is why this isn't gonna happen.
And what we kept doing is discussing
amongst ourselves, and with a broader
and broader audience
about why it will work.
Why it is that you make a connection.
Why it is that people
started giving to us because,
to be honest with you first of all,
because people are connected to all of us.
That's why you give to something.
In the end, the connection
that you all have
with Dartmouth will have, I have no doubt,
in 10, 20, 30, 40 years because
of your love for Dartmouth.
I think that there's no question
that getting people interested has
gotta be your great goal.
Getting people interested in
what you're interested in,
and being a good
storyteller, making sure that
you can discuss what it is that you're
passionate about in really enlightening
and interesting ways
will be very important.
Those are just the few thought I have,
I know there's tons of
people with questions.
Did you have anything to add?
- [Carol] Well there's a related question
that came from the other room that I think
is really close.
They ask, "What would be your view
"of joining an organization,
versus starting your own?"
I think you were really touching on that,
but that's also something very relevant
to a lot of students here will be debating
whether to start their own, or join.
So, very interested in
your thought on that.
- You mean there's people
listening in another room?
- Several, and a broadcast audience,
but we don't have their questions yet.
- [Ophelia] PJ has a fear of the CIA.
- [Paul] No I'm not thinking of that.
- [Carol] A lot of interest.
- [Paul] I'm just kidding, I know
there's people in the other room.
That's a great question.
And again, back to Jim's point,
the person's in another
room, we don't know
his or her name, but
- [Carol] No name
- Yeah, I'd like to say thank you
because this gives us a chance to say
on the one hand, again, the
quest for personal efficacy
is important, it's not to be denied.
On the other, we need to have broad-based
movements to move forward, and again,
I'm sort of parroting Jim here,
he's been saying this for years.
These cherished social goals that we have,
you can't do them alone.
So if you can find, very pragmatically,
if you can find people who are doing work
that you'd like to do.
I think the previous
question was also about
how do you keep things going.
Personal engagement.
Personal engagement sounds more attractive
than the quest for personal efficacy.
If you can find people who are doing work
that you can believe in, and even if you
yourself can only do
it maybe a day a month,
or a week a month, who's gonna stop you?
Jim always used to say,
"There's not a long
"line of people waiting
to serve the poor."
You can get in that very short line.
But if the line's a little longer,
and there are more people
trying to do the same thing,
obviously that should be celebrated.
So if you can find an organization,
a group of people that you can work with,
it would be great to join
something that's already going on.
Now let me just say,
I just came back from,
as I mentioned, I went
to Haiti and Rwanda.
And President Clinton asked me,
and asked to find out, "How
many NGOs are working in Haiti?"
And this was last year
after these hurricanes.
I asked a friend of mine,
a Haitian co-worker, if
she can find out, and we did
a little background research.
And then he said, "We want you to
"compile a list, a directory."
And without making too much commentary,
I would say that we've
already got 8,000 NGOs.
That's too many.
That's too many to be coherent,
the work isn't coordinated,
and finding a way
to bring these people together,
and these groups together,
and to coordinate
is a big challenge, whereas
if you go to Rwanda,
they're saying "Look,
we don't want to have
"this enormous proliferation
of NGOs and groups.
"We'd like this to be a Rwandan project,
"and you can join it if you'd like.
"You can be part of our vision."
But we want some coordination, so I think
there's a lesson to be learned early
for your generation about
finding ways to support
something you can believe
in and feel engaged in.
And I'm sorry for such a long answer.
- I'd say you have to be able
to do both of those things.
I think some of my best
experiences in life
have been being a dedicated
number two, number three.
When I was at the World
Health Organization,
I was a senior advisor
to the Director General.
Knowing how to be of
service to the leader of
an organization, and knowing that it's not
gonna be about you,
but it's gonna be about
carrying out, in this case, his agenda
in the most dedicated
way as a great follower.
Paul, in Haiti, was a great follower
of the patriarch, who lead
the project Pair La Fontaine.
He knew how to be a great secretary.
Paul started off and endeared himself
to the people in Haiti
because he was writing things.
He's one of the people who
could actually write in French,
and wrote graduation diplomas.
Do you still do that?
The point is,
- You know, like penmanship?
- Penmanship.
- I'm going to Harvard Medical School,
and they're like, please write
the primary school certificate,
like so and so graduates.
So, humble secretary work.
- So people misunderstand leadership.
People think leadership is
standing up and giving orders,
but a big huge chunk of leadership
is knowing how to be a good follower.
Because if you really know how to
be a good follower, you
have a much better sense
of the people who you're supposed to lead,
are gonna feel about anything that you do.
So, working for another NGO means
that you put yourself at the service
of a vision that's not your own,
and you work your butt
off to try to find out
what it is that's at the core of
this organization, and
you make yourself useful.
Pell used to say, "The best advice for you
"is make yourself indispensable by
"doing the things that
absolutely have to be done,
"but are distasteful for most people."
That's when you're gonna get into
the core of a particular project.
So starting your own
thing, if you've never been
a good follower, maybe that's okay,
maybe that works for some people,
but have the understanding
of what it's like
to be of service to someone
else, and do it well.
- [Carol] Next?
- Hi my name's Daniella.
I have a question.
After having read
Mountains Beyond Mountains,
and hearing you speak tonight,
I was wondering, you three seem like
you've lead nearly perfect lives,
[Carol] (laughs) Wow.
so I was wondering if you could
admit to any mistakes that you've made
(audience laughing)
either in your careers,
undergraduate education,
personal lives, just
admit to any mistakes.
(audience applauding)
(Panel murmurs)
- [Carol] She said "You've lived
"nearly perfect lives," but she wants
you to admit to a mistake or two,
especially in your undergraduate years.
- [Daniella] Oh yeah, yeah.
- [Carol] Any time, any mistakes.
- Where shall we begin?
Really.
- My biggest mistake is I
did not apply to Dartmouth.
(audience applauding)
- Not only did all of us make mistakes,
but all of us had failures.
There's an expression in medicine,
TNTC, too numerous to count.
When you look at a lab result, and there's
too many, it's a bad metaphor,
too many white cells when
you have an infection,
we say, "Just write TNTC,"
too numerous to count.
So they're too numerous to count.
For example, how do you start
a project the right way?
I'll give you two examples
in chronological order.
I'm gonna go way back to
the undergraduate career.
Let me give an example of
things that didn't go my way.
I applied for a Fulbright
to go to Senegal,
and I didn't get the Fulbright,
and so that's the best
thing that happened to me
because then I ended up in Haiti.
And I tried to go to
one hospital in Haiti,
these are failure stories, but I'll get
to a mistake in a second, when
I was just out of college.
I wasn't welcomed there,
there wasn't room for me.
So in addition to
mistakes, there's lots of,
you try and you don't succeed.
Talking about the quest
for personal efficacy,
the first project that I was involved in,
in Haiti, was a total failure.
First of all, the first year I was there,
I was working in a dumpy clinic
that was a nightmare, and so was Ophelia.
So I would regard all of that work,
in that first year, is kind
of worthless to the poor.
The quality of the care,
the quality of the diagnoses
had no impact on their
lives, that I could tell,
which is pretty shocking right?
'Cause, you know, it's a medical clinic.
And so that's failure, but using that
to create something
better, and to not give up.
This gets back to questions
that were asked many times,
but the first project
that I was involved in
personally, where I can say, this is
something I really wanted to do,
was to build a community bread oven.
And, guess what what it used as fuel.
Trees and charcoal.
It was very destructive to the environment
to go into a place where
deforestation is a major problem,
and build a tree-consuming bread oven.
Not the smartest thing.
You don't wanna fail to learn
from other people's mistakes.
So, I would be pretty
sad if I couldn't say,
"Don't make that mistake."
In a place where there's deforestation,
better not to cut all
the trees for charcoal.
Rocket science.
But there's many, but I guess one of
my questions is, can we
learn from our mistakes,
and from each other's mistakes,
rather than making mistakes at
the expense of other people.
Medicine is like that, by the way.
The practice of clinical medicine.
There's a book that we read
when we were grad students.
I don't know that Jim
really read it because
he was too busy regretting
that he didn't go to Dartmouth.
- [Jim] (laughs)
(audience laughing)
- It's by a sociologist,
it's about surgery.
You remember this book?
It's called
Forgive and Remember
- Forgive and Remember
- It's really about
making medical mistakes,
and I think medicine is
the kind of endeavor,
you're looking out for
other people's well-being.
Dartmouth has Dartmouth Medical School,
and this university has
contributed to that literature,
how can we avoid medical error?
And I think that's a very
important are of pursuit too.
Way before we were in a position
to commit medical errors,
we were making mistakes in our own lives
that we just hope to
do a little bit better.
- Biggest mistake, not
marrying Paul Farmer.
No, I'm just kidding.
- (Laughs)
(audience laughing)
- I mean I'm just appalled
that the conversation has taken
this personal turn.
- It's better than a marriage,
I tell you, it's better than
a marriage, working together.
The mistakes are enormous,
and really too many to count
as undergraduates, but being able
to count on each other as we
made these kind of mistakes.
Now, thinking about Partners in Health,
where it is at the moment,
wishing that we had spent more time
building partnerships earlier.
We were so busy trying to get stuff done
as a relatively small
group, that we didn't
pay enough attention to building
partnerships with other groups,
and with ministries of health,
and that sort of thing.
I would say that we're
still making mistakes,
but as Pell said, we're
learning from those mistakes.
- [Carol] Now, I know that many of you
are also forward to meeting the guests.
I think we're gonna go to another room,
and have an opportunity to do that.
So we're gonna have just
a couple more questions,
and then we have one
more thing to do here,
so we can save some
time for you to do that.
So, I'm gonna ask us to
have another question here.
- My name is Rebecca Drachen,
and I've always been interested
in politics my whole life,
and one of my favorite
quotes from the book was, "Politics is
"medicine on a large scale."
I know that a lot of you have dealt with
these issues on that level,
and have been meeting
with people in power.
What do you think is the best advice
for people who wanna
go into those trenches
on a regular basis, and how do you think
is the best way to get the people up top
to care about people down below?
- You askin' me? No.
- [Jim] (laughs) Go ahead.
- That's a great question,
the conversation is,
I gotta say, one that I hope
I get to be part of here,
and I'm sure Ophelia feels the same way.
Aligning yourselves with the poor,
or the marginalized, aligning one's self,
it doesn't have to be a political act.
Are you there? That's Rebecca?
I just can't see.
I can't see that well.
I mean I can see well,
but it's the lights.
(audience laughing)
Aligning yourself, I would regard it
as a moral act, not a political act.
That is, say for example, you're a doctor,
and you're taking care
of people who are sick.
So you're well, they're sick.
One of Ophelia's father's
books is Matilda,
what is it that Trunchbull,
the headmaster would say?
"I'm big, you're small!"
The opposite of what I intended,
anybody read that book?
(audience clapping and applauding)
The asymmetry I think we can refer to,
it's why it's really important to be open
to people of all kinds of so-called
political persuasions, I would argue.
And we're not very ideological people
in the sense that, I would
like to think, we know,
I wouldn't call it a
mistake, but all of us
had youthful enthusiasms, but I feel
just as engaged now as I
did when I was in college
with, and more actually, in
these moral issues of our times,
which I would not regard
as political, per say.
So, the optimistic point of this is,
you can make an appeal to anyone
in a position of power when you have
aligned yourself with people who deserve,
which is to say, people deserve
they deserve an education,
they deserve access to water.
Who really believes, for example,
that people should die of malaria?
I actually have never
met that person, not one.
Who believes that if you get
hit by a car and break your leg
but are a Salvadoran immigrant,
that you shouldn't have
orthopedic care at Hitchcock?
Nobody I've ever met.
I'm just using examples.
So, I think that
appealing to the powerful,
and those with resources, and
power as symbolic capital,
the president of a university,
say, is a powerful person,
the President of the United
States is a powerful person.
President Clinton, who we've
been working with for years.
The mission of social justice,
the mission of providing
these basic services
is of universal appeal, regardless of
what your own political persuasions
or proclivities might be.
That's how I would look at it.
- I would add this
I'd say that, and Ophelia talked
a little bit about it as well,
that the way that you
keep people interested,
the way that you keep funders interested,
the way that you change
the minds of politicians,
there are some tricks.
We've learned over the
years, and have worked
with public relations people who help you
craft messages and get it right.
At the end of the day, though,
if you've really aligned yourself
with very very poor people,
and you've been there,
and you've felt the pain of a mother
who can't feed her child.
Or you've felt the pain of
someone who can't get educated.
If you felt that pain, and
there's a deep authenticity
to the way you present the
problem, that is everything.
In other words, there's no
trick that I can tell you
to convince these people to care.
The trick, is actually go out there
and feel the pain, and the suffering,
and the injustice through
your own skin so deeply,
that when you go to tell people about it,
they can smell the
authenticity coming from you.
It's different from the way you smelled
coming down from the trips,
(audience laughing)
but it's almost like that.
(audience laughing)
You can tell.
You guys had an authentic experience
of not showering for three days.
We could tell, and I can tell,
that when you were out in the woods,
you had a very authentic experience
of each other and of being out there.
You have to really take some gambles to
put yourself in a situation, where,
we used to put it this way, we used to say
that in order to be a good
advocate for poor people,
you have to put yourself in a situation
where you allow your soul to be fractured
by the suffering of the poor.
That's one particular area.
How many experiences have you had
in which your soul was fractured
by the suffering or
injustice done to others?
When you get there, people
will smell the authenticity
on you, and that's the most
persuasive thing of all.
- [Carol] Well I'm going
to end with two questions.
Basically, employment questions
that came from the other room.
The first is a question for Dr. Farmer.
Paul, they ask "Are you going to become
"a faculty member at Dartmouth?" (laughs)
- [Jim] (laughs)
(claps)
(audience applauding)
- [Carol] We won't hold you on record
to the answer to that one right now.
And the other one is a question
I think a lot of people really
are interested in this room,
"How do you get to work at a
place like Partners in Health?"
Is that something, Ophelia, you could
give some people direction about?
- [Ophelia] Sure.
- [Carol] How you could find
that kind of opportunity?
- Sure.
I think that that important question
touches on what we've
been talking about today.
It has to do with partnerships,
and which organizations
that you choose to work for.
I do think that there are many
incredible organizations out there,
some of whom we've been
lucky enough to partner with.
A few come to mind, including,
Heifer International, Women for Women.
There are many many
different ways in which
Partners in Health supplements,
augments, and partners
with other organizations.
Partners in Health is now an organization
that has affiliations
with different schools.
At some point, hopefully we'll have
an affiliation with this one.
We're already talking about and exploring
ways to partner with Dartmouth.
So that would be one area in the future,
that we can do this.
There are several things.
We have an internship program,
we work with students in
different universities,
we have a residency
program, we're connected to
the Brigham Women's Hospital.
There are ways that you can volunteer
by going to the website, or,
talking to any one of us.
Jim can put you in touch with
people at Partners in Health.
I think, really, the important thing
is that there are all kinds
of ways to do this work.
Certainly, we have benefited from
the enthusiasm, and skills, and goodwill,
and commitment of students.
We could not do what do if it was not for
the unfailing optimism and
amazing partnership of
students over the years.
We couldn't do it.
The things that have been done,
and are still being done by students
that we work with really
keeps us moving along.
We're completely open to that.
The question is I think something that
Partners in Health
continues to grapple with.
How can we make the best use of
student commitment and energy.
And I think the best way to do it
is not, who is lucky enough to have
the e-mail of someone and get in touch
with the right person, but rather,
how can we make, how can
we systematize something
so that this can be open to anybody
who fits with this mission,
who wants to work in this way,
and it might be that those of you
who want to work in engineering,
or want to be lawyers, or anything else,
that partnering with other organizations
who are doing the kinds of work that
Partners in Health is doing
is the best way to do it.
- And if I could add
something as a teacher
of undergraduates as well.
Mostly we've been
teaching medical students,
and doctors, and sometimes nurses,
and certainly in international settings,
and we're getting into
United States health workers.
Don't be discouraged.
These kinds of connections
take time to develop.
That's one thing.
The second is, for the next four year,
your primary residence will
be Hanover, New Hampshire,
and it's a long way to New
York, or Montreal, or Boston.
It's not like you're going to be able to
volunteer everyday, or work everyday
as a volunteer at a place that's not
physically near where you are.
Your mission here is primary to learn
and to be with each other and study.
So that said, you're gonna be living here,
and just as people at Stanford
are living in Stanford,
and on and on it goes,
there's ways of being
involved in solidarity groups,
of learning from each
other, engaging the faculty,
and with the faculty, don't forget,
there are lots of connections between
Dartmouth and the rest of the world.
Through student organizations,
some of which we've already
had the privilege of meeting.
One of the messages that
we hope come through,
is when we say global health,
And I think I'll put this
in my speech on Tuesday.
As Jim always says, when we think about
global health equity,
Boston's on the globe,
New York is on the globe.
It's not the same as
when we were students,
when we were young, what was
called international health.
We're talking about, we
have problems right here
in this country, we have things
that you can do right here
in New Hampshire, and
Vermont, and New England.
And that's another way to get involved,
and stay involved is
to, again, it's called
the quest for personal
efficacy, as we used to,
but you can also say personal
engagement is important.
That's something that you can
do right here at Dartmouth.
I hope we can be part of
that, I know we can be.
- [Carol] That's really wonderful.
I know many students have more questions,
but before we thank our
wonderful panelists,
we also have a surprise for our panelists.
So I'm gonna as Vaidehi
Mujumdar to join me up here,
and Vaidehi is a class of
2013 member from Virginia,
and she's gonna be presenting gifts
of appreciation to our guest speakers,
on behalf of this wonderful class.
- [Ophelia] Thank you.
- [Paul] Thank you.
(audience applauding)
- Woo! Yeah!
(audience cheering)
- [Carol] Before she
leaves, I want you to know
that Vaidehi herself has been very
actively involved in public health.
I have to make sure
that I say it properly.
She established a malnutrition
and education program at Simrol,
which is a village in India, and so,
I think she has a very special connection
to what you are doing,
and what you've done,
and what she's been doing.
- Thank you.
- Thank you.
- [Carol] Thank you to you too!
(audience applauding)
So, finally, for all of you students
who I know would love to
meet these three guests,
it's already getting pretty late,
but I know you guys don't even think about
going to bed for another couple of hours,
(laughs) I think that they would like
to have a chance to meet
you, and they're gonna meet
in Alumni Hall, immediately
following this presentation.
But as this morning,
we're not shaking hands.
We are fist-bumping and hip-swinging,
and whatever you decide to do.
I wanna thank all of you for
being such a great group.
And thank you to them.
(audience applauding and cheering)
