Commissioner Deidre Gifford Commencement Address to the Pharm.D. Class of 2022

Deidre S. Gifford, MD, MPH, Commissioner, Department of Social Services, Senior Advisor to the Governor for Health and Human Services, State of Connecticut gave the Commencement address to the UConn School of Pharmacy's Pharm.D. class of 2022. Her speech is reprinted here.

Dr. Deidre Gifford speaks to the PharmD. Class of 2022 from the stage in the Jorgenson Center, Storrs

Commissioner Gifford’s speech was delivered on Sunday, May 8, 2022:

 

President Maric, faculty, and staff of the UConn school of Pharmacy, and of course, to all of the 2022 graduates of the UConn School of Pharmacy, your families, friends, loved ones and supporters, thank you for inviting me to join you on this very important and pivotal day in your lives. I am truly honored to share part of this afternoon with you, and to join you as you mark this new stage of your professional and personal lives.  Congratulations Class of 2022.

And on this Mother’s Day, let me offer a special note of recognition to the mothers, grandmothers and mother-figures celebrating this day with you today.  For all the support, encouragement, sympathy, cheer-leading, and love you have given today’s graduates over the years, today is your day, too. Congratulations.

Commissioner Deidre Gifford stands at the podium and speaks to the UConn School of Pharmacy class of 2022
Commissioner Deidre Gifford

When Dr. Hritcko reached out to invite me to give an address this afternoon, I of course went back through my memory to find all the many graduation speeches I’ve listened to over the years, beginning with my own graduation from UCLA way back in 1981.    Between my own education, my son’s, those of my nieces and nephew, and between high school, college, and graduate school ceremonies, I’ve been in the audience for no small number of these events over the years. I remember all of those graduations as joyous occasions for the extended family to gather and honor the hard work of the graduate; as a time for campus tours and meeting friends and professors; and as a time for helping the graduate pack up and sort through piles of binders, worn textbooks, t-shirts and wall posters, and  the occasional empty bottle of Jack Daniels or six pack of hard cider. I treasure each of these memories, and I hope that for all of you this weekend gets added to the inventory of some of your life’s most treasured events.

But as I took this walk down memory lane, to see what I could learn about making a memorable address and in an effort to try to emulate the best of the ones I had heard, I was chagrined when I realized that I really couldn’t remember much about what anybody ever said during those commencement addresses! And I’ve been lucky to hear some pretty good speakers. University presidents, a secretary of state, a US senator, even Barack Obama just before he became our president.  This has been oddly reassuring as I prepared my remarks for today. Even presidents and senators can sometimes struggle to leave an impression.

But clearly, no matter the speech, the formula requires that I begin with a joke. So, let me be the first to offer you new graduates a pharmacist joke: Did you hear the one about the pharmacist who’s reviewing medication instructions with an elderly patient?  The pharmacist says “Now be sure not to take these more often than every 4 hours.”  “Don’t worry,” replies the patient.  “It takes me 4 hours to get the lid off.” So true! And by the way I hope one of you will be the one to finally solve that particular problem!

This is an exciting time to be entering the pharmacy profession.  Today, you are receiving your degree in Pharmacy at a time when the profession is evolving and expanding into new and critical roles in the healthcare system.  At last, there is a recognition of the vital role that pharmacists play as part of the healthcare team. Whether it’s making bedside rounds in the Intensive Care Unit, providing diabetes education in a primary care setting, administering vaccines, or counseling patients in the community pharmacy, the complexity of our healthcare system demands that you be an integral part of the delivery team, and not just a dispenser of medications.  I encourage each of you, no matter what area of pharmacy practice you eventually chose, to work hard to make this integration a reality.

More and more, our system of care is fragmented, and often our most vulnerable and complex patients are the least well served.  You will have a unique view into the care a patient is receiving, sometimes as the one with THE most comprehensive picture of the care that is being provided.  You are likely to interact with patients more frequently than any other health care provider as they fill their prescriptions, ask for advice, and even show you their rash in front of a line of perfect strangers.  In addition to that, as a result of your training, you have a knowledge and understanding of the broad array of prescription medications that is indispensable in making sure care is safe, effective and high quality.  Use what you have learned in your professional training to make safer, more coordinated care a reality. Your patients need this, your prescriber colleagues need this, and our healthcare system needs this, too.

UConn School of Pharmacy Pharm.D. Class of 2022 in a group photo
UConn School of Pharmacy Pharm.D. class of 2022 with Dean Philip Hritcko and Commissioner Deidre Gifford.

At the same time as the roles are diversifying and opportunities for pharmacy careers are expanding, we know that larger forces in the world of retail pharmacy, healthcare finance, and drug manufacturing are also making the practice of pharmacy more challenging.  Medicine in general is facing similar challenges.  Healthcare consolidation, private equity and large corporate ownership of healthcare providers have changed the landscape of care delivery, and the role and agency of the providers.  We all know that small independent pharmacies are a rare thing these days, just as the small independent physician practice is becoming harder and harder to maintain.  But I am certain that whether it was the interest in science, or a desire to help people get and remain healthy that initially sparked your interest in pharmacy, most of you started on the journey of becoming a pharmacist with the health and well-being of patients in mind.  It can be hard to keep those values at the center of your work, when the prevailing “system” isn’t always so supportive; but I challenge you to remember what brought you to this profession in the first place–to honor and cultivate it, and work every day, in ways large and small, to keep patients and their needs at the center of what you do.

I’d like to share a couple of very small examples of what I mean.  A few weeks ago, I went to a retail pharmacy to receive my second COVID booster dose.  The pharmacist who was to administer my vaccine was busy, as they almost always seem to be, but as I waited a woman approached the counter to speak to him.  While respecting their privacy, I was seated in a place where I could overhear snippets of their conversation.   She had clearly been to the pharmacy recently with a different prescription, which was for her child.  This time, she returned with a prescription which had been given to her in the hopes that it would be more affordable than the first one.  The pharmacist looked at the second prescription, and gently but factually let her know that even this new prescription was going to cost her several hundred dollars.  She was clearly distressed, but the pharmacist carefully and patiently walked her through some options until they landed on a strategy that she could manage. Despite being busy with a patient waiting to be vaccinated, the pharmacist did not just leave this mother with the option to “take it or leave it.”  Instead, he recognized her distress and made sure he helped her find a solution. It was a small but moving example of the power you have to help people who are struggling to manage this unwieldy and often baffling system we find ourselves in.

At the same time, I was inexplicably anxious about receiving my second booster dose. No idea why.  No needle phobia, no problem with vaccines, and no problems with my prior doses.  But I was not calm! Fresh off providing assistance to the anxious mom, the pharmacist greeted me with a smile.  He calmly and professionally reviewed the vaccine with me, went over the information on my card, and painlessly administered my dose, which of course I tolerated just fine.  Whether he sensed my anxiety and worked extra hard to be calming I don’t know, but his manner and demeanor made a big difference in my day.

No doubt each of you have shared similar moments of challenge with your clients during your training.  Always remember that you are in a unique position to not only provide individuals with the care and compassion they need, but to use your experience, stories and knowledge to help change this system for the better.

The last two years have taught us for certain what many have been asserting for years: that the pharmacy profession is an integral part of our public health system in the United States. Connecticut, and UConn School of Pharmacy in particular, can and should be very proud of the vaccination campaign we have implemented, and pharmacists and pharmacies have been absolutely critical to that campaign.  In our nursing homes, our hospitals, and our community pharmacies, your profession stepped up to the plate and delivered, and continue to deliver to put this pandemic behind us.  The Governor and I will always be grateful for the rock-solid collaboration between the state, UConn and the pharmacy community in helping us weather this incredibly difficult storm.

In fact, I hope that some of you will consider careers in public health. The intersections between the two disciplines are large and growing larger every day.  Whether it’s the high cost of prescription drug coverage, the opioid crisis, vaccine campaigns, healthy aging, or the mental health crisis in our country, your training and experience will ideally suit you to participate in helping solve the nation’s healthcare challenges.

For you graduates and your families, today was always been destined to be a special day because of the hard work, commitment, and sacrifice it takes to reach this point in your education.  But 2022 is not just any year, and those of you graduating today are not just any graduating class.  None of you have had the educational experience that you were expecting back in 2019.  The COVID-19 pandemic turned education and life in general on its head, and changed everything, not just for those in healthcare and public service, but for all of us.  Although it won’t show up on your transcript, in addition to your coursework in science you have had an education in hardship, in sacrifice, in adaptation, in sorrow and disappointment and in resilience. You have learned, maybe earlier than you wanted, that sometimes, maybe even often, life doesn’t turn out the way we’d planned.  The test of our metal as people is how we respond when it doesn’t.

The COVID pandemic has taken a lot from us, most importantly in the people we have lost, but also in events and occasions cancelled or postponed, experiences deferred, and plans derailed.  But we can also take something from COVID.  Take the experiences of the last two years and turn them to your advantage.  Let them inform and shape the way you approach your careers.  Think about what you have experienced, and what you have witnessed. Digest it, ponder it, analyze it, learn from it, make it your own, then turn it into action.  Let the 10,000 lives we have lost in Connecticut be honored by the systemic changes we make in response to this pandemic.

What do I mean by this:  to begin with, we have once again been reminded that our public health and healthcare delivery systems are inequitable.  The impacts of systemic bias and racism on health outcomes are everywhere to be seen, and the pandemic has shone as bright a light on this as I can remember.  People of color began this pandemic with a higher burden of chronic illness and more social risks for poor outcomes, and more of them died from COVID-19 as a result.  Make rooting out, naming, and eliminating health disparities part of what you do every day.

Our American system of care for the elderly is faltering.  Nursing homes, assisted living facilities, and home care systems were not equipped to handle this pandemic. As CT knows better than almost any other state, we need to focus on quality of care, find stable staffing, and prepare for the next pandemic.  You can play a part.  Long term care pharmacies have been a huge part of our vaccination campaign, but now is the time to learn the lessons of this pandemic and prepare our system of care for the elderly and disabled for the next respiratory illness or novel disease.

Finally, the pandemic has again shown us that we must work towards a healthcare system in the United States that provides affordable, high quality health care for everyone.  As the pandemic played out, the country quickly cobbled together a universal system of care to pay for testing, diagnosis, treatment, and prevention of COVID.  That took a heroic effort, and billions of dollars.  Now that system is unfortunately unwinding, and once again we are seeing that Americans without coverage or with high out-of-pocket costs are suffering.  I am proud that CT is continuing to expand our already high rates of insurance coverage.  But far too many people, like the mother I encountered during my vaccine visit, have healthcare costs that keep important medications and services out of their reach.  No doubt you have already begun to see the results of this challenge during your professional training.  Think about what you can do to be part of the solution.

So as of today, not only can you call yourself pharmacists.  You are pharmacists who completed your training during a world-historic pandemic, when the pharmacy professional answered the call to bring solutions to the table.  Make those experiences your superpower.

Before I close, I want to speak directly to those of you who are blazing a trail in receiving this degree today.  Maybe you are the first in your family to get a college or graduate degree. Maybe the first from your neighborhood or community.  Maybe you or your parents emigrated to the US, or maybe your gender, or race or ethnicity or sexual orientation has been underrepresented in the health professions.

I want to say this to you:

You. Belong. Here. You have earned your place. Your background and life experiences will bring richness to your practice, and will enrich your profession. Representation from you will continue to blaze a trail for those who follow behind you.  Honor your past, your heritage and your community, and bring your authentic self to your professional practice.

You should know that it’s not uncommon for certain newcomers to doubt their appropriate place on the professional ladder.  Don’t fall victim to the so-called  “imposter syndrome.” That is, the feeling that you don’t REALLY belong with everyone else in the corridors of power. That somehow everyone ELSE has earned their place, but YOU have arrived there by accident, and at any moment your deception might be revealed.   This syndrome is very common, among successful women and minorities especially.  So, follow the advice, which now that I think of it I first heard from Samantha Power at one of those many graduation events I referred to, to “Never judge your insides by everyone else’s outsides.”  While colleagues, classmates, and those you admire may seem ON THE OUTSIDE to have mastered their demons and handle every adversity with a steady hand and supreme confidence, you can never REALLY know what goes on in their insides.  Chances are good that they too, because after all they are also human, have struggled with feelings of inadequacy and a sense of not belonging.  Reach out to friends and colleagues, share your feelings and concerns, and never doubt the value that you bring to your chosen profession.

I do have a small confession.  I haven’t really forgotten all of the graduation addresses I have ever heard.  There is one that has stuck with me for over a decade now.  I was privileged to be in the audience for the novelist Jonathan Franzen’s commencement address to the graduating class of Kenyon college in 2011.  If you haven’t read it, I commend it to you. The address was published in the New York Times shortly after it was delivered.  Of the many speeches I have heard in my life, why does this one stand out? Because rather than dispensing the usual advice on life, career and happiness, the speech encouraged graduates to do only one thing: take a risk on love.

It’s a jarring theme for a graduation address, but I can tell you that as a member of the audience, my only thought was “Well of course, that’s the most important advice of all.”  Loving something or someone risks loss and rejection, and so it’s easy for us to try to find substitutes that help us manage that risk.  In his speech, Franzen reminded graduates that a lot of modern life is built around finding ways to avoid it.  But we all know deep down a life without real love is not a life fully lived.  In the end, his advice is about finding real meaning in your life, then having the courage to devote yourself to it.  Risking failure and hurt, he tells us, is the only path to real happiness.

In many ways, the last two years have given you a head start down this path. We have all been forced to dig deeper, try harder, and carry on in the face of real adversity. You may have suffered a personal loss or been tested in other ways.  Maybe you have already learned what Friedrich Nietzsche famously said: “That which does not kill us makes us stronger.”  So to the UConn School of Pharmacy graduating class of 2022, it is my honor to congratulate you, and wish each of you the gift of a long and fulfilling life and career, not one free of failure or disappointment, but one enriched by devotion to your passions and ideals, and the care and love for those you are called on to serve.