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The Catalyst

Cole sets course for new era of leadership


President David J. Cole delivers his inaugural speech to the audience. photo by Anne Thompson, Digital Imaging

(Editor’s note: The following is the inaugural speech delivered by MUSC President David J. Cole, M.D., FACS, Oct. 9 in the Drug Discovery Auditorium.)

Thank you all for being here today. I am deeply honored to be able to begin my service as the seventh president of the Medical University of South Carolina and I am grateful to have you present for this unique occasion.

I would like to take a moment to thank the board of trustees for their vision, service, and leadership, and for the confidence they have placed in me by selecting me to serve as the next president of MUSC.

This position is one I accept with the deepest sense of gratitude, optimism, and respect.  

I also want to recognize and thank my two immediate predecessors, Executive Vice Chancellor for Health Affairs for the University of Texas System, Dr. Raymond Greenberg, and Governor James B. Edwards.

Under their leadership, the Medical University has risen from a regionally respected health care center into a rising star on the national platform of academic medicine. I believe that we owe both of them a huge debt of gratitude for their work and vision.

Why are we here today?

For some, perhaps, today may merely be an opportunity to have a break from the daily routine, socialize, and eat great food.

When I was a senior in high school, my friends and I had convinced our fourth period English teacher that we were members of a special assembly crew required to help set up our gymnasium for school gatherings. And, so every time there was to be a pep rally or school band event, she would excuse us from class that day to “go help the principal.”

It was amazing how many special events our school had, which translated into a significant number of free periods from English literature.

I have grown a lot since those days; so let’s hope that there is some higher purpose to our gathering today beyond getting out of the MUSC version of high school English.

Actually, from where I stand right now, I should probably issue a blanket apology to my English teacher and claim that we used our time for study hall. Wisely, I was not an English major in college.

So, why are we here today?

It is a question that can be simple to state, but difficult to fully answer without some thought and introspection.

Perhaps I can start at a personal level. Why am I, an academic surgeon who grew up in New Mexico, standing here as the new president of MUSC?

The mere fact that I am a surgeon is still a surprise to a lot of people back home in New Mexico; perhaps none more than my own family.

My father was an engineer, as are both of my brothers. I think it was generally assumed that I’d do something along those lines. But somehow, that didn’t happen.

I graduated from New Mexico State with a degree in biology and ended up in New York City as a freshman medical student at Cornell Medical School in 1982. Given my background and pedigree this would seem an unlikely place for me. I believe that I was their token Westerner.

When I first started down this path, I believe I was motivated by a general thought that I could possibly do some good in a field that I found interesting.

What I discovered as I continued in this career was a simple truth- medicine is about people, not achievements, surgical procedures, grants, or clinics.

As health care providers, we are given the unique opportunity and privilege to have a direct and lasting impact on an individual’s life. 

I have been a successful surgical oncologist for 20 years and consider myself to be an excellent technical surgeon. But I will tell you that it took me 10 years to come to understand that what makes the difference — or not — is your ability to connect with your patient as a person, in other words… your humanity: for them to understand that you actually care and that you will do everything in your power to help.

Furthermore, in academic medicine we often stand at the crossroads of innovation and application with an opportunity to tangibly change the future practice of medicine.

So, as I evolved, I became more focused. I dedicated my career to taking care of people. And, through my research, I have tried to change what is possible for their futures.

As a surgeon, I am used to immediate results, but from that perspective, I started to understand that perhaps my greatest impact is not always defined by surgical outcomes.

About seven years ago, by random chance, I had to attend a noon meeting on the 10th floor of the hospital. Typically, I would never attempt to fight the noon crowds at the hospital, but nonetheless I found myself in a packed elevator stopping on every single floor on its way from the first to the tenth.

As the elevator rose, the crowd thinned until, at the top floor, there was just a young couple and me. As the elevator doors opened, the young man spoke: “Dr. Cole, do you remember me?”  

Before I could respond, he continued, “You operated on me seven years ago when I was just 17, to remove a cancer from my abdomen. The team gave me months of chemotherapy after the surgery. But I recovered, moved forward, and graduated from college last year.

He then introduced me to the young woman. “This is my fiancé, I wanted her to see in person the place and teams that changed my life and gave us our future.”

What an honor to be on that elevator. I still wonder at the circumstances that placed me there on that day.

Contemplating that moment led me to another realization: Like ripples in a pond, the work of one individual can — and in medicine, often does — spread out and touch many lives.

Further, the ripple of a team is far more lasting and potentially significant than that of one individual.

James Foley captures this imagery in his poem, Drop a Pebble in the Water:

Drop a pebble in the water: just a splash, and it is gone;
But there's half-a-hundred ripples circling on and on and on,
Spreading, spreading from the center, flowing on out to the sea.
And there is no way of telling where the end is going to be.
Drop a pebble in the water: in a minute you forget,
But there's little waves a-flowing, and there's ripples circling yet,
And those little waves a-flowing to a great big wave have grown;
You've disturbed a mighty river just by dropping in a stone.

So, when given the opportunity to be considered for the position of president, why did I step forward? Because when it is all said and done, I want to make a difference, to have a real impact.

Whether as a surgeon, or president, health care is about people: That is ultimately the most meaningful dimension. As the leader of a university that is blessed with talented and hardworking individuals at all levels, I saw an opportunity to lead a team that together could make increasingly larger ripples in the pond.

Remarkably, my professional journey has evolved to the point that I am standing here in front of you — your new president. Although one might argue that my presence on that elevator on that day years ago was random happenstance, I assure you that today I am standing before you with purpose.

I am committed to providing the leadership needed for us to be successful in the future.

Together we can make a difference.  I believe that.

So, why are we here today?

Historically speaking, we’re here today because in 1824, seven physicians shared the bold belief that our state should be second to none with its own well-trained doctors so that our citizens would have access to the best health care possible.

And, as history would bear out, that vision turned out to be a powerful, guiding force.  

I imagine those seven men would be astonished by what MUSC has become in the years since then: A comprehensive academic medical center that is recognized as one of the best in the country, consisting of not one, but six comprehensive colleges.

President Cole and wife, Kathy, during a prayer in his inauguration ceremony.

A dedicated staff and faculty of nearly 12,000, serving more than 2,700 students and 1.2 million patients each year.

Our investigators are on the cutting edge of innovations in patient care, generating more than $230 million dollars in extramural research funding each year.

We have a cadre of gifted and caring people from all over the world, eager to share their talents, interests, perspectives, and backgrounds with each other — in an effort to make a difference: to change what’s possible.

I think those seven would marvel at the richness of our evolving cultural fabric: A close–knit and supportive family that values diversity, inclusion, and equity.  As a forward thinking institution, we are committed to the continued development of a culture that is by definition diverse and inclusive. And so we draw our strength from the rich tapestry of cultures, ideas, and talent provided by a community we call MUSC.

If they were in the audience today, I am certain that they would proudly realize that all these things came through our pursuit of their singular vision: to work together to create the best health care possible, to make a difference in the lives of the people of this state and nation.

Although we need to celebrate our history and shared sense of purpose, MUSC is a dynamic part of the present and future, and so we also need to prepare for the challenges and opportunity that lie ahead.

I believe, therefore, that this inauguration highlights an inflection point for us. We are gathered here today as an institution, community, and state, not to merely celebrate our prior success, but to embrace a common vision as we move into our future.

So how do we visualize a future when we all recognize that storm clouds are on the horizon?

Nationally, this is a time of dramatic change in health care with significant financial pressure on clinical providers, dwindling resources for researchers, and pressure to change models of health care without much of a roadmap. This reality is far-reaching and affecting academic health centers nationwide.

So how do we face the future?  We face it together, boldly, with confidence, remaining true to our core values and mission.

To state it: Our common purpose is to generate breakthrough research, educate for the future, and provide the best patient care possible. That is our directive.

But if we’re going to do that… stay on course, even emerge better and stronger, then we have to set our compass by a shared navigation point.

So, what is that true north? That common purpose? Our vision? To put our patients first — now and in the future. First in clinical care, first in research, first in education.

This sounds simple, but it is actually quite complex. We have to solve this fractured, inefficient, and siloed structure called academic health care in order to accomplish this reality.

We need to evolve and adopt a new culture — one in which we are collectively focused not on a system, or ourselves, or our respective colleges or departments, but on our fundamental reason for being: our patients.

If we do this correctly, everything else will follow.

Furthermore, I fully believe that if we work together with common purpose, we can and will emerge as a truly preeminent leader amongst academic health centers.

Patients first. What does that look like? It means connecting to your care team when you actually need them. It means not having to worry whether your records will make it from one office to another. It means building an educational curriculum that promotes interprofessional care that focuses on the patient. It means fast–tracking translational research efforts — ensuring novel treatments and cures make it to the bedside faster. It means being able to assure that the patient gets the right care at the right time at the right place, and not wasting millions of dollars on care that is often redundant, unnecessary, or ineffective.

And in this reality, if you stopped anyone who was a part of MUSC and asked why they helped someone find the information desk, or spent the extra hours to make the grant deadline, they’d say it’s because at MUSC, everything we do puts our patients first.

Every single one of us on MUSC’s campus in some way has an impact on our patients.

So, for me the fundamental question is not whether we will have challenges, but rather how will we respond to them.

We can be consistent, inclusive, and strategic in our decisions. We can demand excellence from ourselves and expect to recruit the best people and leaders for this institution. We can choose to evolve as an integrated health care organization that is well positioned for the future. We can choose to develop strong partnerships with our community and across the state that leverage our strengths. We can succeed by taking an honest look at what is working with a willingness to discard what isn’t.

We must become a culture of transformational thinkers, team builders, and fully–committed partners who value what each member brings to the table.

If we respond as who we are: a close-knit family and community that cares for each other, we can turn these challenges to our own advantage and become stronger as a result.

I said earlier that I stand here with purpose, that I am committed as a leader. Now I call on you, MUSC, and leaders at all levels. If we work together, we can create a lasting legacy that none of us individually could hope to accomplish.

Patient first, now and in the future. Embracing this possibility will enable us to transform who we are and become one of the preeminent academic health centers in this country that will have a lasting impact on this state and its citizens.

After 190 years, MUSC deserves preeminence. Our colleagues demand it, our patients need it, our state expects it, and the nation will be surprised by it.

I could not be more excited about the road that lies in front of us. The triumphs, the challenges, the decisions, the rewards, the possibilities — even the setbacks.  

As I bring this address to a close, I would like to pause to give special thanks to my family who is here today for this occasion — my mom and dad, Joan and Ken; my sister, Lynn; my brothers, Bob and Brian. My other mom and dad and sister and brother, Jack — who I am sure is watching and smiling from above — and Virginia and Cindy and George.  

You have all shaped and loved me and provided unquestioning support and guidance as a family. To my wife of 26 years Kathy, my soul mate and partner; my sons, Andy and Bryan; and my daughter, Paige. Know that I love you all dearly. You, along with my faith in God, are the source of my strength and inspiration.   

So in closing, I ask for your support, confidence, prayers, and encouragement as I humbly lead MUSC forward. Thank you and God bless.

October 17, 2014



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