Teaching the Personal Side of Medicine

“Open your mouth” in Haitian Creole is “ouvri bouche ou,” and Walter Distinguished Professor of Medicine Daniel D. Federman ’49 is working to make sure even doctors who don’t know Creole can talk with Haitian patients.

Communicating well with patients is crucial for physicians, says Federman, who has spent the last four decades introducing students to the moral and personal side of medicine.

Under his guidance, a series of medical phrase books for Haitian Creole, Cantonese and Spanish were produced and sent free to hospitals throughout the country. The demand continues to be so great that Federman and Associate Dean for Alumni Programs and Special Projects Nora N. Nercessian plan to publish them on the web to keep up.

“The goal is to make medical care accessible to people who do not speak the same language as the doctor,” Federman says.

The booklets are only one of the topics he will address today in his Class Day speech, “Translations,” for Harvard Medical School (HMS) and the Harvard School of Dental Medicine.

His address is the fourth Harvard Class Day speech he has delivered and the second in three years. Colleagues point to his deep bond with students—he introduces them to their first clinical experience with a patient—and his eloquence as reasons for his popularity in the student voting for class day speaker.

“He’s the quintessential doctor and medical educator. The art and science of medicine come together in him,” says Nercessian. “He cares deeply about students.”

Translations in Medicine

Literal translations in medicine are not the only kind that Federman plans to discuss. He says he will speak on the value of translational research—that is, taking advances in the basic sciences and using them to improve medical care.

Federman’s own specialty is endocrinology, and he is well-known for his 1967 book Abnormal Sexual Development.

He has published scores of articles in medical journals, many of them in his scientific area of expertise as well as articles stemming from his vast experience in medical education, which for him began when he matriculated at Harvard Medical School (HMS) over a half century ago.

Federman graduated summa cum laude from Harvard College in 1949, after concentrating in social relations, a mix of psychology, social anthropology and sociology. After taking a class in physiology, he decided to go into endocrinology. His early interests in human interactions stayed with him through his medical work.

“I hope to represent the morality of medicine and the personal side of it,” Federman says.

That human side relates to the third type of translation that Federman will discuss today, one of the most difficult and personal for doctors and patients.

“Another meaning of translation is when the doctor has to explain what’s wrong with you,” says Federman.

A doctor must take a patient’s disease and explain it and its consequences to the patient in terms he or she can understand, Federman says.

A Longtimer at Longwood

Federman served on the HMS faculty from 1960 to 1972, when he defected to Stanford University. In 1977, then-Dean of the Faculty of Medicine Daniel Tosteson recruited Federman back from Stanford as the Dean for Students and Alumni. It was in this capacity that Federman played a crucial role in redesigning of medical education with the New Pathway program.

New Pathway is a problem-based approached to medical education introduced in the 1980s.

Over the years, his personal touch has endeared him to both students and alums and his current job includes both fundraising and guiding students through their years of medical school.

He is a strong presence in students’ lives, from orientation, through a required first-year course in genetics, embryology and reproduction, to students’ first experience with a patient.

“He was a important thread through their education,” Associate Dean for Student Affairs Nancy E. Oriol.

His close relationship with students explains his persistent popularity at Class Day.

“The letter [from the students] inviting me told me about my impact on them at their orientation. I was thrilled to be asked,” Federman says.

Still Going Strong

For the past two years, Federman has served as the senior dean for alumni relations and clinical teaching, a post that stretches his time thin.

“I’m too busy as a result of these things, but so far it’s working out,” he says.

One of his current projects, which he is pursuing with Director of Alumni Development Eric C. Graage, focuses on decreasing the financial burden of medical education.

“We’re trying to raise support for student financial aid to free up their career choices,” Graage says. “Even for those who go into standard clinical work, the compensation is not what it used to be.”

Federman’s long tenure at HMS gives him a special relationship with alum donors he once taught.

Indeed, Nercessian says that Federman is “an institution within an institution,” since he is so closely associated with HMS and known by so many.

“There’s a continuity. He has seen generations of students,” Nercessian says.

Despite 74 years, and his packed schedule of teaching and fundraising, Federman says he’s still going strong.

“I haven’t finished the work yet,” Federman says. “I’ve already diminished my activities a bit, I have no certain plan.”

His colleagues say they hope his almost 60-year relationship with Harvard continues.

“I have no idea what his long term plans are, but I hope he never retires. He is extraordinarily vibrant, active, and energetic, and I still don’t believe he is 74,” Graage says. “I think someone switched birth certificates, and that he is actually 15 years younger.”

—Staff writer Jonathan H. Esensten can be reached at esensten@fas.harvard.edu.