The MAA has a tradition of asking a member of the 50-year-anniversary class to address the graduating class at the Pre-Convocation Ceremony. This year, Dr. Val Rachlis gave the address.

Dr. Rachlis is an exemplary family practitioner. In 2003, the College of Family Physicians named Dr. Rachlis one of Canada’s top 10 doctors. Here is his address to the graduating class.

Address by Dr. Val Rachlis (Class of 7T2)

To the Class of 2022, 50 years must seem an eternity. To the Class of 1972, it is a blink of an eye.

When I think back to those who graduated 50 years before me, in 1922, I realize that for many of them, graduation was delayed because they had gone off to fight on the battlefields of the Great War in Europe, some never to return. They had been in medical school during much of the pandemic that was then causing devastation around the globe, something your class has in common with them.

They had gone on to practise during the Great Depression, the rise of Nazism, Fascism, and Communism, ending with World War II, and then had continued their careers during the many years of the Cold War. Much of their professional lives was spent looking after patients with rudimentary diagnostic testing and only a few effective medications. After all, the first antibiotics would arrive two decades into their careers. It is difficult to even estimate the profound effects that all of these events had on their personal and professional lives and on the lives of their patients. It seems so appropriate that these physicians were part of what is called the ‘Greatest Generation.’

Our generation graduated shortly before the end of the Vietnam War and what appeared to be the natural and inevitable rebirth of democracies and redefined humanism around the globe. The Berlin Wall would come down. Women’s rights, minority rights, and an understanding of the complex nature of sexuality would come to take their rightful place in many societies. Looking back, however, we certainly never discussed during class such topics as social barriers to success for visible minorities, the issues for those who were not straight, and unconscious bias. Indeed, the entire issue of residential schools and their profound consequences for our Indigenous population was never mentioned by politicians or the media. All these crucial components of our education would come many years after our graduation. Climate change and its consequences for the planet we all inhabit was not even a concept at the time of our graduation.

I realize that as you look around the world today, that it sometimes appears that humanity has lost its way. With a tragic war being waged in Europe, with malignant leadership in so many countries, with basic human rights again so vulnerable, and of course with the pandemic, it may seem that your class has more in common with the Class of 1922 than with the Class of 1972. I would suggest that at times like this it is best to recall the words of Martin Luther King Jr. when he said, ‘The arc of the moral universe is long, but it bends toward justice.’

On the medical front for our class, new antibiotics, new medications for every possible health condition, and new diagnostic measures including ultrasound, CT scans, PET scans, and MRI would come to be. We would see the beginnings of our conquest of many cancers and new ways to treat heart disease. Many new and important vaccines would be made available to our patients. However, the first glimmer that the trajectory toward progress was not to be a straight line came when, early in our careers, a group of Legionnaires attending a conference in Philadelphia suddenly developed pneumonia from a deadly new infectious agent. That would be followed with HIV/AIDS, multi-drug resistant microbes, SARS, new strains of influenza, and of course, most recently, COVID.

The rise of unimagined strides in information technology would begin when we all bought our first fax machines. But even for your generation, it will be difficult to keep up with the new mechanisms of communication that will be a central part of your career. Family medicine, which appeared to be on its death bed as we began our careers, has retaken its rightful place as the foundational component for quality health care. With the onset of multidisciplinary teams, alternative payment systems, and fundamental positive changes to the relationship between family physicians, specialists, and hospitals, the future looks so bright for this specialty. Yet, for your generation, whether you choose family medicine or another specialty, all of you stand at the gates of the ultimate paradox in health care. Never before has so much information technology been made available to you and so many ways of interacting with your patients. And yet, never before has there been such a need for face-to-face contact with your patients, to be able to give bad news as well as good, to be there to share the happy events as well as the sad ones, to communicate knowledge, to be a good listener, to hold a hand, and sometimes, to just wipe a tear from a cheek.

In 2072, one of you will have the honour of addressing that graduating class. What will you tell them about the next 50 years? They will be so curious to learn that there was a time when cancers were treated with surgery, radiation, and chemotherapy. They will be amazed that so many lost their lives to these diseases. They will be somewhat confused when you tell them that infections were once treated with a now extinct class of medications called antibiotics. You will tell them about a time when Alzheimer’s and other dementias were simply observed as individuals entered the abyss of mental deterioration. They will find it hard to believe that coronary artery disease was treated with various forms of invasive surgery or that individuals with chronic kidney disease needed to spend many hours per week connected to a dialysis machine.

But just as our trajectory has not been a straight line, you can justly predict that there will be events that will negatively impact those wonderful strides in medical care, and these will require of you the same level of ingenuity, intelligence, and flexibility that you have witnessed in the last two years.

I wish you all Godspeed, happiness, and fulfilment as you enter into the next phase of what will surely be 50 years of amazing and profound advancements in health care. Congratulations to all of you.

To the Class of 2022, 50 years must seem an eternity. To the Class of 1972, it is a blink of an eye.