It is a great privilege to stand before you on such a special day. President Schrum, distinguished faculty, honored graduates, proud parents, families and friends, I extend to you my sincere congratulations.

In the summer of 1958 my family moved to Georgetown when my father was offered a position as professor. I quite literally grew up on campus, attending plays, concerts and lectures from the time I was 10 years old until I left for medical school in 1971. The Sub, swimming pool, and library were equally appreciated and well used, while the pipe organs were considered part of my birthright as a faculty brat. I owe a lot to Southwestern, and treasure it. Above all, the special people that have been here through the years and are here now are a treasure. These teachers and friends have been a north star for me in my career.

As we celebrate this day of commencement, I want to share a few thoughts about learning and teaching. I am a neurologist, a physician that specializes in the brain. Almost as soon as I arrived at medical school, I realized that for me the brain was the ultimate organ, the critical part of the body in which the most precious and uniquely human activities occur. Trying to understand how the brain works has been a difficult, lifelong pursuit. Learning is not a random process, but a directed one, influenced in more ways than we care to consider. Teachers play a central role in framing our understanding and learning. You will find as you commence (as you are expected to do as soon as I can wrap up this talk) that you will increasingly have choices to make about your style of learning and the teachers you select. In the last few years, I have been grappling with a diminutive but influential teacher, physically small enough to require electron microscopy to appreciate. My tutor of late has been the human immunodeficiency virus, the cause of AIDS. This teacher has led me to lessons about viruses and other areas of science, as well as about mankind and the world.

The AIDS virus has proved a formidable adversary. It evolved in ways that ultimately assure its survival. When introduced into a person, HIV immediately disseminates throughout the body, including the brain, and establishes permanent residence by converting its RNA genetic code to DNA that is inserted into the nucleus of its host’s cells. It then enjoys a symbiotic life causing few symptoms for some years. Interestingly, imperfection is one of HIV’s great strengths, as it continuously makes mistakes in copying its own genome, resulting in constant and rapid mutation. This results in chameleon like ability to change itself when faced with adversity, such as the immune system’s effort to control the virus, as well as the drugs and vaccines we make.

The sad consequences of this are all too well known. Once, a few years ago, a young man was brought to me on the verge of death. Confused, in pain, having intermittent seizures and terribly sick, he was racked with recurrent fever and diarrhea the result of AIDS. His parents let me know they had closed his apartment, sold his car and belongings, and were prepared for his death. Treatments over the past few years had been ineffectual. Having just acquired a new generation of drugs for HIV, I told them I wanted to try one more strategy. By use of three different drugs working in distinct ways against the virus, this man experienced a rebirth. He controlled the virus and went on in a few years to re-acquire apartment, car, and job. The last I saw him he was performing a leading role in a musical. This story of remarkable improvement has been often repeated in recent years, and has been a professional reward to witness beyond my dreams.

The principle that has contributed so profoundly to improvement in the outlook for AIDS patients uses the remarkable power of combining drugs working in distinct ways so that they multiply each other’s strengths. The same principles apply to challenges of many sorts. Like the drugs that we have employed combating HIV, teams successfully construct skyscrapers, land man on the moon, and operate great universities. Teamwork of diverse contributors is the way almost all of our great advances are achieved. This illustration of harnessing diverse forces is one to take with you into the future.

This principle, also has a corollary aspect. Society often singles out individuals, and honors them as if their accomplishments were done alone. This is almost never completely justified. Honest leaders know how profoundly they depend on many others in achieving their goals and are quick to share the recognition and rewards of their achievements. In the same way, being honored to speak on this special occasion, I am reminded that I have been carried through my life by a young lady I met here on campus on the first day of my freshman year at SU. I must thank my wife Judy and my family for their contributions to every area of my life. I certainly have not been able to do the things I have done without my families support.

The second lesson HIV has etched on me comes about from observations about the people that have been most affected. HIV is typically spread through sexual intercourse and transmitted blood. Our struggles with healthy attitudes of sexuality, and our misdirected notions of the place of drugs in our culture, have fueled the AIDS epidemic throughout the world. Stigma attached to the disease isolates those with it, delays diagnosis, and augments suffering from this disease. HIV was initially spread widely in men who have sex with men. Soon the stigma of homosexuality was tightly linked with this disease. The next wave of infection was carried forward through shared contaminated needles from intravenous drug use. The stigma of slavery to drugs fuels counterproductive efforts to control drug abuse through laws resulting in a groundswell of crime and disease with little attention to the root causes of this behavior. Frequently when diagnosed with HIV, our patients have to deal not just with a terrifying disease, but also with the fear of confronting the reality of their own identity as well as sharing that reality with their family and loved ones. Working with many such individuals, I have come to understand and accept the deep biological roots of sexual orientation as well as the grave proclivity of some individuals for drugs. God created some to respond to members of our own gender, while most do not share this experience. Some individuals are genetically prone to drug seeking and abuse that is not common to most people. We deny this understanding of the breadth of humanity to the detriment of all. This is part of the natural diversity of people. Our society will be far healthier when we come to understand that sexual orientation differs profoundly in different people, but this should be neither dangerous nor threatening. We will also perhaps respond in more productive ways when we recognize that the drug abuse we deplore is part of the same spectrum of behavior that causes me to seek a morning cup of coffee and champagne to flow at a wedding. Stigma that fuels this epidemic is misplaced and unproductive. We can grow to understand better ways to approach the natural diversity of mankind.

HIV’s third lesson has been to make real for me the importance of the global community. With approaching 40 million individuals infected, with deaths exceeding our experience of 9/11 on a daily basis in Africa, how can we not turn our eyes on the parts of the world most affected? The fact is, I knew too little of the rest of the world, and not knowing, I cared too little. That changed when I was lured to Africa. This virus dragged me to Ethiopia, to walk through the dismal wards of impoverished African hospitals and clinics, and to be humbled by the profound disparity that we have tolerated in this world. Were we sufficiently sensitive and caring, we could not live with this disparity, purely on a human level. However, bleeding hearts have traditionally not gotten far, and I haven’t much hope that my bleeding heart will be more effective than others. However, we now recognize on a pragmatic social basis as well that we cannot afford to continue our isolation.. We now are aware that our country is not safe. When disparity breeds hopeless anger, as it surely will, the results are predictable and ugly. HIV has provided us a convenient and sufficiently compelling fulcrum to begin the heavy lifting of assisting less fortunate parts of the world. There are already modest sums of money that have been promised to start the work, but broader commitment will be required to make the kind of progress we need. I join Jeffrey Sachs, the well known macro economist at Columbia University, in believing that we can best improve our security through investing in the development of fundamental infrastructure in the poorest parts of the world, seeking safe water, sufficient food, and basic health care for the poorest corners of the globe. Incredibly, the investment to make a real start on this mission is attainable. It is estimated that if the 22 richest nations invested 7/10ths of a percent of gross national product to relieving the root causes of poverty in the poorest nations, that worldwide abject poverty could be overcome in the next few decades. This investment contrasts to 5% of the GNP that is currently spent on our military enterprise. Indeed, the investment needed is less than the current rate of spending on war in Iraq. This is certainly attainable. Not only should we take up this battle, but we must.

So it is that my experience in the battle with the AIDS virus, has led me to some important lessons. Remember how much strength is gained by combining diverse approaches to tough problems. Don’t suppress or fear people that experience the world in a different way, but work to integrate them and support them in positive ways. Finally, don’t be paralyzed by a local view of the world. In the 21st century, the entire world is a community, and whenever we hide from this, we only diminish our own security and opportunity.

Conceiving a commencement address proved harder than I had imagined. I have unloaded a rather heavy set of charges for you. I don’t really mean to preach a heavy sermon on such a day of joy. Indeed, I see the messages as full of hope and promise, and anticipate with you the rich contributions you will make to these and other worthy causes in the coming years.

I confess I remember little of the content of the speaker from my own graduation! However, I do remember and was touched by the way Kurt Vonnegut ended a commencement address I heard at Rice University some years ago, and resonated with it so much that I thought I would share it with you today.

He told of having a respected Uncle Alex, who was an insurance agent in Indianapolis. His uncle was irritated by the fact that people often don’t appreciate the happy moments in their lives, when things were going well. To combat this problem, it was his practice to recognize and celebrate the sweet moments in life. Kurt Vonnegut describes how they might be sitting under an apple tree sipping lemonade on a hot day, when his uncle would murmur, “if this isn’t nice, what is?” We do have wonderful moments that we often fail to appreciate as we should.

So graduates, I have a favor to ask of you. When things are sweet, and when you find yourself in a happy moment, will you take the time to say outloud, “if this isn’t nice, what is?”

Hold up your hands if you promise to do that. That will surely enrich your lives.

Now, I have one last favor I would like to ask of all of you. This is not just for the graduates but for everyone here, including President Schrum (so keep your eyes on him) as well.

Have you had a great teacher at any level of your education who has opened up a new world to you, has made you more excited to be alive, prouder to be alive than you previously believed possible?

If you have, hold up your hands!

Great! Now, take your hands down, and say the name of that person (outloud) to someone near you.

“If that isn’t nice, what is?”

Congratualations!