In front of proud family and friends, 119 medical and physician assistant students donned white coats and crossed the threshold into their medical careers.
For as long as Siwaar Abouhala can remember, she has wanted to be a healer. As a little girl, she saw her grandmother, a low-income Syrian immigrant who didn't speak English, struggle with a complex health care system. She sat with her grandmother as she took one pill after another for her chronic health conditions. Abouhala would tell her, "One day, I'm going to cure your diabetes so that you can take less medicine."
On Friday, Aug. 22, Abouhala took a symbolic step toward that childhood conviction, slipping on a white coat for the first time along with 90 of her medical school classmates at a ceremony marking their entry into the healing profession. Another white coat ceremony that day welcomed 29 students to the master's in physician assistant studies program.
Though Abouhala's grandmother did not live to see the day, her inspiration - and those of countless friends, family and mentors, past and present - was felt and celebrated at the two events.
"This day has been generations in the making," Abouhala said. "I am the first person in my family to graduate from college and now the first to attend medical school - not because no one before me has dreamt of doing so, but because the right mix of luck, privilege, and hard work overlapped in my lifetime."
At the start of the ceremony for the PA students, the entering class sat together in the audience, wearing colorful dresses and freshly pressed dress shirts, humming with anxious excitement. In the rows behind them, last year's entering class, clad in their white coats, had come to show their support.
Speakers offered congratulations and advice for the three-year journey ahead.
"My message to you today is that medicine is not just about knowledge, it's about human connection," said keynote speaker Theresa Thetford, PA-C, director of the physician assistant program at the University of California, Davis.
"You may memorize every textbook, ace every exam and master every procedure, but if you can't look a patient in the eye and make them feel heard, seen and safe, then you have missed the point of this program."
Thetford urged the students to nurture their compassion throughout their rigorous training. She offered the Dalai Llama's simple definition of compassion - the wish to see others free from suffering.
For many of the incoming PA students, the suffering of a loved one had steered their path toward medicine.
Agusta Little grew up in rural Montana and Texas, in a family where health care was only for emergencies and college seemed out of reach. But her grandmother had always championed Little's dream to be the first in the family to go to college. When her grandmother's health deteriorated, Little delayed college to step in as her primary caregiver.
"I was disheartened to find in hospitals that my grandmother, a 5-foot giant of a woman, was continuously overshadowed by her diagnoses, reduced to just another elderly person in an overwhelmed system," she said. The experience drove Little to pursue medicine with the goal of helping underserved communities like the ones that shaped her.
"It's hard to believe I'm this close to accomplishing something I once thought was impossible," Little said.
One by one, each PA student was called up on stage to receive a stethoscope and a white coat embroidered with their name. Family and friends cheered.
Growing up in an immigrant family in the San Gabriel Valley of Southern California, Robin Cadd had imagined donning a different style of professional uniform. "I originally had intended to become a nun," she said. In college, to prepare for a life of religious service, she began volunteering in the community as a crisis hotline counselor and a patient health advocate - experiences that opened another path to her.
"I realized that I wanted to build a career out of guiding people through their vulnerable moments, and I wanted to provide comprehensive care, addressing not only the social concerns of my patients, but also their physical ailments," she said. "I discovered my true calling as a physician assistant."
At the medical school ceremony, Lloyd Minor, MD, dean of the Stanford School of Medicine and vice president for medical affairs at Stanford University, welcomed the Class of 2029.
"You're entering the field of medicine at an incredible time," he said. "Never before have there been the opportunities today to translate science and knowledge to the benefit of patients, and never before has there been a greater need for impact in the way that we care for patients, in the way that we envision the profession of medicine. And you're all going to play, each of you, an important role in shaping that vision for the future."
The dean noted that the medical school class size has remained about the same for over three decades - an anomaly among peer institutions and despite the rapid growth in Stanford Medicine's research and clinical enterprises. The reason is to ensure that each student can individualize their experience, whether that means enrolling in another degree-awarding program, carrying out research with a fellowship or joining the myriad other activities at Stanford University.
"It's a tangible indication of how much we value each of you as an individual," Minor said.
"You come from different places, disciplines and lived experiences, but you are all united by a shared passion for medicine, for healing and for improving the lives of others," said Ethan Nicholls, MD, president of the Stanford Medicine Alumni Association Board of Governors.
For MD student Isaac Longobardi, growing up in densely packed New York City gave him a sympathetic view of his neighbors. "I was always acutely aware of the people around me - how they thrived and how they struggled," he said. He liked spending time with the elderly, listening to their stories, but he also saw how social and health services often failed them.
"I saw what a big difference an attentive clinician can make in the lives of older adults and people with disabilities and chronic illness as they try to access the services they need," he said.
Before receiving their stethoscopes and white coats, the MD students heard about the meaning behind each. The stethoscope - invented in 1816 by a French physician who used a rolled-up piece of paper to listen to the heart - is more than a diagnostic tool: "It is a bridge between doctor and patient, science and humanity; it requires proximity, focus, and the art of listening," Nicolls said.
The white coat, which symbolizes professionalism, trust, and an evidence-based approach to medicine, was popularized in the late 1800s to distinguish the wearer from earlier practitioners who eschewed science and usually wore black.
And the white coat ceremony signifies a commitment to the humanistic ideals of the medical profession. At the end of both ceremonies, the students - along with any Stanford Medicine clinicians in attendance - stood and read the Stanford Affirmation, pledging to devote their lives to the service of humanity, the care of their patients, and the integrity of their profession.
"It's a beautiful tradition, because it's about adopting a lifelong commitment to care - with all the urgency and responsibility that entails," Longobardi said.
Afterward, the exuberant students filed out into the late afternoon sun for photos. They had the weekend to celebrate before classes began on Monday.
"It's an amazing honor to put on the white coat," Longobardi said. "But we're not resting on our laurels."