Laura Mosqueda, MD
August 23, 2018
Thank you so much President Austin for the kind introduction.
You see how well that worked out…
At the time, from my perch as a geriatrician and chair of family medicine, my view of the medical school was about the size of the proverbial elephant’s toe. I had to learn as much as I could, as fast as I could about the rest of the elephant if I was going to do this interim job for the year or so I thought I’d be doing it. There was freedom in it being an interim gig. My focus was short term—to our community heal and to lay a strong foundation for a new dean to build on.
I needed a crash course in the Keck School of Medicine to help me better understand the issues you care about and the array of experts that populate this place. As teachers for that crash course, I turned to the most highly qualified people I could find: You.
I heard from you in listening sessions; faculty meetings and town halls; one-on-one and in groups; in whispers and raised voices; by phone, email, text, sticky note, poem, joke, complaint, picture and video. The only thing I haven’t received yet is a carrier pigeon.
You had a lot to say, especially in the early days. I heard painful stories and a sense of betrayal that a place you care about so deeply, to which you’ve dedicated so much for so long, had let you down.
But I also heard how, in the struggle, you saw a chance for redemption. How institutions, like people, can stumble, and like people, can draw on their core values to pull themselves back up and be stronger for it. I saw how your deep reserves of strength, creativity and compassion give us such vast potential. What I heard stretched my vision for this place, and of what our teachers and students, researchers and clinicians—might need from a dean.
One of my favorite parts of the listening tour was hearing about the experiences that shaped your perspectives. So it seems only fair to tell you a bit about mine. My connection to this place runs deep. It’s responsible for my existence, my husband’s existence, and my physicianhood. Los Angeles County+USC Medical Center is where my parents, Hal and Gloria Frankl, met as medical students. It’s where my mother-in-law Emilia Mosqueda gave birth to my husband Robert. And USC medical school is where I trained to be a doctor.
As for my professional background, well, family medicine, geriatrics and elder abuse aren’t exactly the usual flight paths for deans. At first, I didn’t want to be dean because I thought I lacked the skills for the job. But the more I learned what it takes, the more those Rodney Dangerfield skills—skills that don’t get no respect—began to seem like crucial ones to running a strong medical school.
Primary care physicians—like deans—are generalists. We don’t specialize in one organ system. We need to hear the whole organ recital. Deans too must focus not on one specialty, but a whole school of them. Primary care physicians and deans are also both incrementalists. Big changes are often the sum of many small ones —in care, behavior and society. But you have to learn what to tweak. And then tweak it. And primary care docs and deans are also both preventionists. I know it’s not a word. But it should be! No one ever thanked their primary care doc for preventing a fall, a stroke or a heart attack. But we do. Deans too can prevent a lot of bad outcomes by paying attention, getting to root causes, and reducing risk early.
Many patients and their families see me while they face profound issues in their lives. Helping them navigate old age, and often, hard times, has shown me the sweeping influence of bioscience and medical care—our work—on their lives. Family physicians must balance knowledge, pragmatism and empathy – just like deans.
So many people have contributed to my work and life. Some of you are in this room and some, like my mother, are here in spirit. I’m grateful to everyone who helped me map my way to this podium—family and friends, patients and professors, classmates and colleagues, mentors and tormentors. You know who you are! You’ve taught, inspired, guided, supported, loved and put up with me along the way.
I want you to know whatever my missteps as dean, I blame you.
The work we choose is of course shaped by many influences, perhaps none more formative than those we encounter at that liminal time we’re students. Providing that education is a sacred trust. Students come to the Keck School for training by our stellar faculty, and to work and live in the beautiful and diverse county of Los Angeles. We train some of the best and brightest clinicians, researchers, educators, service providers and policy-shapers. And they, in turn, infuse this school with their energy, intelligence and new ideas.
Our students also have the good fortune to work with some of the finest researchers in the country whose quest is to expand what we know about proteins, genomics, stem cells, organs on a chip, brain science, robotics, health outcomes, health systems and beyond. Knowledge that gives us more power to advance health.
Doing good research isn’t easy though. It requires the humility to say, “we don’t know”; the curiosity to look for new answers; the intellectual rigor to ask the right questions; the discipline to adhere to sound methods; and the courage to follow facts to the truth, reminding ourselves that both failures and successes advance our knowledge.
But knowledge is just knowledge unless it’s applied. That’s why medical schools are such exciting, hopeful places—because that new knowledge is imparted—hot off the presses— to students, often by the very authors of the work.
That research also informs a core purpose—and that’s patient care. Our world class clinicians serve the people of Los Angeles in many ways and places—from hospitals to homeless shelters.
Over the years I’ve done hundreds of house calls all over the Southland, seeing patients and their families where they live, learning about the multitude of factors that contribute to—or rob them—of their health. I may tell a patient “do more exercise, get more sleep, take your meds.” Then, I do a house call and I stumble on the uneven sidewalk outside her house, learn that her sleep is disrupted by the sounds of gunshots, or see she’s out of medication because she can’t afford it. And that a “throw rug” in the bathroom will likely soon throw her—a fall waiting to happen.
The science is clear. Unhealthy communities lead to unhealthy people.
I get asked a lot: “What’s your vision for the school?” In listening to you, my vision came into view, and it’s not one thing. It’s a vision unified by the concept of justice underlying and bridging all aspects of our work. Millions of people suffer and die early for lack of incremental and preventive care as well as lack of basic scientific knowledge about their illness. Whether it’s warding off cancer or Alzheimer’s disease, relieving headache or back pain, solving the problems of family violence or access to health care—we already have what it takes here. By combining the powerful skills of our researchers, educators and clinicians, working across disciplines, we can solve these afflictions. With common purpose, we can improve health—from cell to society.
As I embarked on my listening tour, I gained new appreciation for our extraordinary staff, administrators and the leadership of this university—the trustees, President Austin and her cabinet, Provost Michael Quick, Senior Vice President Jim Staten, my fellow and sister deans and my cabinet.
Thanks also to Tom Jackiewicz, CEO of Keck Medicine of USC and his team for their outstanding work, for their support, and for our partnership. Alignment of the medical school and the health system is integral to the success of both.
I’m also beyond grateful to the wonderful staff at this university who get us where we need to go, provide warm welcomes to all, serve food, park cars, prepare budgets, answer phones, keep calendars, help with IT, manage HR and, not infrequently, save us from ourselves. They provide the backbone to our infrastructure that is so important. To translate our best ideas and aspirations into realities, we must have an infrastructure that allows people to do the work they’re meant to do, without distraction. I’ve learned that administration is like prevention. Done well, it’s often invisible. Things hum along. When it’s not, then it’s a little like that bathroom throw rug.
I’m an Angeleno by birth, by marriage, and by preference. I grew up in the Fairfax area. My husband was raised in City Terrace, just a stone’s throw from this building. I really care about this community! Because our medical school is nestled in the center of LA, we have the privilege of serving a population the sheer diversity of which few others will ever know.
I thank Supervisor Hilda Solis for her tireless commitment and leadership to ensuring that Los Angeles County and our medical school neighborhoods remain vibrant and flourishing. I look forward to exploring new ways to work with you to expand the partnerships between the county and our medical school.
Being in LA also gives us the opportunity to care for its impoverished and vulnerable people, and allows our students to learn first-hand how issues of health and justice entwine. My commitment to you, as a physician, an Angeleno and a dean, is that this school will re-commit itself to revealing the linkages between health and justice, and remember that advancing one advances the other.
Nowhere is the link between health and justice more apparent than in our partnership with LAC+USC Medical Center, thanks to the outstanding leadership there. Together for the past one hundred years, we’ve attended millions of patients and train nearly 1% of the nation’s physicians.
Our close work with the Children’s Hospital of Los Angeles—where Keck’s physicians and researchers care for our young—is another critical partnership and an investment in the health of the next generation.
These collaborations are key. I’ve seen the power of collaborations in all my work, especially in elder abuse where my teammates include social workers, ombudsmen, psychologists, public guardians, police and prosecutors.
Our early elder abuse team meetings were like the Tower of Babel. We spoke different languages, came from different work cultures and had different professional missions and goals. There was conflict and misunderstanding. The stakes were high. We had different ideas about what it meant to “do the right thing.” But by hashing it out around the table week-after-week, we built trust, found a common language and forged shared goals. In fact, shocking though it may be to my fellow physicians, and even to me – now, some of my best friends are lawyers.
Having seen the abundant fruit unlikely collaborations can yield, I look forward to expanding the medical school’s partnerships with our sister schools across the great university, not just with the other health science schools, but also with engineering, gerontology, social work, law, communications, arts, and many more.
Teams also have taught me the importance of many sorts of diversity, not just in professional background but in race, ethnicity, sexual orientation, gender, nationality, ability, age and economic circumstance. In listening to so many of you, I learned how our school’s spectacular diversity deeply enriches all we do. Drawing on that wellspring of diversity is another part of my vision for this place.
So, what changed since that fateful day last October when I told the provost I had “zero interest in being dean?”
I realized that my experiences had in fact equipped me with unique skills to lead this school. I was astonished by the expanse of exciting work going on in every corner. I was reassured by the throng of talented people who offered help in big and small ways. And, most of all, I changed my mind because of the amazing people whose work and words inspired me, filled me with hope.
I saw the core values that animate their work like stars, illuminating what makes this school great: the courage and respect it takes to speak and listen with honesty, attention and generosity; the curiosity and innovation with which our students and faculty embrace teaching, learning, research, and care; the rich diversity of our differences, distinct voices converging in powerful harmonies; and the quest for justice that elevates our work for and with the people of this great metropolis.
Those values imbue the work of this medical school with meaning. Their light will guide my service to it. And by the constellation they form, we will chart our course forward. Together, we will FIGHT ON!