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Joseph O’Donnell ’71, Daniel Lucey ’81, and Sarah Johansen ‘89/’90

The Phronesis Project

In 2017 Joseph O’Donnell ’71 and Daniel Lucey ’81 devised a plan to share the accumulated practical wisdom of alumni from Dartmouth Medical School/Geisel School of Medicine with its future alumni. In the first edition, 28 alumni contributed to the Wisdom Book, which was presented to the Class of 2017 at graduation.

In 2018 Sarah Johansen ‘89/’90 joined Joe and Dan to help with the collection, review, and publication of the 2018 Wisdom Book. This year’s book includes contributions by 30 alumni from classes between 1961 and 2015. Sarah, Joe, and Dan hope that one day recipients of the books will themselves share their wisdom with graduating classes.

I hope by having our alumni share these stories you will get ideas about phronesis* and that as you teach the future doctors you will apply these lessons to your own students. In doing so you can live the Dartmouth Outing Club motto of "leaving the campground better than you found it." Do better by working at the systems level whenever you can.
– Joseph O’Donnell

Below are two alumni stories graciously permitted to appear in front of the firewall to help you see what a complete contribution might look like. As Dan Lucey MED'81 and Joe O'Donnell MED'71 wrote in their article Wisdom stories for medical students on graduation day, "Hopefully these wisdom stories will impact the lived experience of the clinical clerks and graduates as they grow in medicine and encounter situations that require wisdom."

Doctor-Patient Relationships: It's All About the Patient by John Eisold
Advice to 4th Years on Their Way to Residency by Nick Perencevich

*Phronesis is practical understanding, wisdom, prudence; sound judgment.

To preserve the privacy of the writers and their stories, you will need to log in to the Alumni Community to read the Memory Books. If you have any issues signing up for an Alumni Community account, please contact the Alumni Relations Office at or 603-646-5135. Please note, Alumni Community accounts take one full business day to become active, after which you will have full access to the Memory Books.

2023 Class Day Wisdom Book
2023 White Coat Ceremony Wisdom Book
2021 Class Day Wisdom Book
2018 Class Day Wisdom Book
2017 Class Day Wisdom Book

*Firefox users - please check your download folder for the Wisdom Books after logging in.

Below are a few quotes from the 2018 Wisdom Book. You can read the full stories the quotes are pulled from the online version of the Wisdom Book.

2018 Wisdom Book Quotes

I hope you will use your medical degree as background and the pressing issues of health and wellbeing as your foreground in your career. May you embrace the toughest problems that the country and world are facing now. The idea of letting your curiosity, passion and interests in humanity be your guide rather than taking the safest, most predictable path in your career will enable you to look back on your Geisel DMS graduation 50 years from now, as I am doing this year and say to yourself, “Yes, I helped make a difference.” Karen Kramer Hein '68

* * * * *

It is a great honor to be a physician. Patients expect good care from their doctor, but they also want to be heard and understood. It is the physician’s responsibility (and reward) to listen, no matter how busy he/she may be, because patients can teach, they can offer clues leading to better care, and they can simply inspire by relating their life stories. Take the time to listen to your patient’s stories—they are gifts to you in what I believe to be one of the greatest of all the humanities—a career in medicine. Jim Snapper '72

* * * * *

Today, we name it “burnout” and if that term existed more than 35 years ago, I cannot recall but I did know that it could negatively affect the quality of my patient care and I could not and would not allow that to happen. In addition, I loved what I was doing and was not about to quit. So I pondered that dark night until an idea came to me.

Physician burnout is a serious issue, and now is considered to be a public health crisis. The literature states that rates of burnout of physicians-in training and practicing physicians exceed 50%.

Organizational and institutional efforts to remedy this situation are underway, yet making changes from the top down will take time. From my experience, grassroots solutions are also possible and can be career and even possibly life-saving

So go forth and help build supportive, caring and flexible medical communities.This is one of the most important things you can do for you and your patients’ well-being. Cheryl A. Viglione HS 1979-80

* * * * *

My advice:
Engage your patients in decision making and healthy behaviors.
Engage your communities in population health.
Engage your policy makers in the need to align incentives between the patient population and the health care system. Michael J. Pramenko '95

* * * * *

“When you are in that kind of situation, when you feel it in your gut, stop and call someone. And if you call me, I will take your call, and I will know that you are asking me to share the burden with you.”

Throughout my training at DMS as I faced many situations I could not have prepared for; ethical, emotional, and cognitive challenges. In the rich environment of DMS I had roommates I processed much with, friends and classmates to share it with, several faculty members who would listen through email or an office visit and share their advice: “take my call.”

My advice to any new doctor developing her or his own practice is to seek out colleagues who will “take your call”. It will lighten the burdens you cannot prepare for, and enrich your practice more than you can measure. Find a team you can trust, to share your commitment to caring, best care, and best people, not perfection. Sharon Johnston '03

* * * * *

In Pirkei Avot, a section of the Mishnah (the oral law of Judaism), the Sages teach that “In the place where there are no leaders, strive to be a leader” (2:6).

As graduates of Dartmouth, you are possessed of invaluable knowledge and insights into the principles of geographic variation in healthcare utilization and its effects on population health, and you remain uniquely informed on these topics compared to the myriads of medical school graduates across the country. I urge you to take to heart the responsibility attendant to such knowledge and never to forgo an opportunity to educate, advocate, and lead the peers and faculty at your respective places of employment. William-Bernard Reid-Varley '15