Finding our own Ramesh Kumar

Thomas J. Lawley, Dean, Emory University School of Medicine

Dean Thomas J. Lawley

Commencement is always an exciting but bittersweet time around the School of Medicine. We are saying “farewell” to the next class of doctors. Before these newly minted doctors disperse around the country to start their residencies, they received some sage advice at commencement that I think our alumni would be interested to hear.

Donald Berwick, president of the Institute for Healthcare Improvement, was our guest speaker at graduation. He is considered to be one of the nation’s leading authorities on health care quality and improvement and has been appointed by President Obama to head the Centers for Medicaid and Medicare Services. (He is clinical professor of pediatrics at Harvard Medical School and a professor in the Harvard School of Public Health.)

Berwick said he doesn’t remember much from his own graduation from medical school several decades ago, so he asked our graduates to remember only one thing: find Ramesh Kumar. Berwick’s story of Ramesh Kumar profoundly changed him. It is one that I will not soon forget.

Ramesh Kumar was a young child that Berwick met on a trip to India while he was in medical school. Kumar was one of many children who lived on the streets, and the extreme poverty experienced by most Indians came as a shock to Berwick. As he walked around the city, he realized that the cardboard boxes on the sides of the streets were people’s homes. On the third day there he burst into tears.

Kumar shined shoes to earn money but offered himself as a tour guide to Berwick. During one of their outings, Kumar took Berwick to see a friend of his. The boy was about 10 years old, and his body was covered in sores from a condition that would be easily treatable in a developed country.

After several days, Kumar asked to borrow the equivalent of $6 and promised to pay the money back. Instead, Kumar ran away when Berwick saw him next. Initially annoyed that Kumar didn’t pay him back, Berwick later realized that the inequities between them settled the score.

Berwick thought that while he enjoyed good health in a developed country, Kumar could likely die from many curable diseases. He did not have the privilege of being born in a developed country.

“It was not my money; it was your money, Ramesh,” Berwick said. “I think he knew that. I thought that maybe he was ashamed to be caught as a thief. But I was mistaken—the shame is not yours, Ramesh; it was mine. So look for Ramesh wherever you go. He won’t be hard to find. He’s everywhere."


Dean Thomas J. Lawley
Emory University School of Medicine

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Emory Medicine Summer 2010

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