Graduation : Techniques in Hand & Upper Extremity Surgery

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Shin, Alexander Y. MD

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Techniques in Hand & Upper Extremity Surgery 25(3):p 129, September 2021. | DOI: 10.1097/BTH.0000000000000364
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Each July for the past 19 years, I have watched an exceptional group of young, excited, and slightly nervous hand surgery fellows depart the small town of Rochester to embark on the single most important transition in their professional careers. Along with the other ∼170 other hand surgery fellows across the United States, this is they day they have been waiting for, planning for and anticipating. In preparation for their graduation, advice for the future is often given along with congratulations for a successful year of research, surgical growth and developing friendships. Despite doing this for 19 years, this year was different, because I was.

It wasn’t so long ago (or at least that is the way I feel) that I was the junior member of the Hand Division, and I was listening to the sage advice of my senior members. All of a sudden, I am now a senior member, and am expected to say something full of wisdom. Pondering the ups and downs of my career and trying to brainstorm some sage advice led to a few clicks on “Google.” My serendipitous search brought me to 1968.

1968 was arguably one of the most tumultuous year in United States history.1 Martin Luther King and Robert F. Kennedy were assassinated, the Vietnam war and its media coverage brought horrors of an unpopular war into the living rooms of Americans, student protests swept the globe, the summer Olympics saw US athletes raise their black gloved fists to support the Black Power movement, Richard Nixon was elected President, and Apollo 8 orbited the moon. During this time of student protests, anxiety, and uncertainty, Kent M. Keith, a sophomore at Harvard College, wrote a booklet called “The Silent Revolution: Dynamic Leadership in the Student Council,” for high school leaders.2 In contrast to all the student violence and protests, he penned the “Paradoxical Commandments” to challenge others to do what is right, good and true, despite what is happening in the world and what others do. A spectacular message to share with graduating fellows of 2021, a year that has had its own number of anxiety provoking tumultuous events.

The “Paradoxical Commandments” have and continue to inspire me. I have seen versions of the commandments, including the versions attributed to Mother Teresa who put them up on a wall in a children’s home in Calcutta. All the versions echo the same message, one that is too important to share with just my graduating fellows. So here is my graduation advice:


By Kent M. Keith

  • People are illogical, unreasonable, and self-centered. Love them anyway.
  • If you do good, people will accuse you of selfish ulterior motives. Do good anyway.
  • If you are successful, you will win false friends and true enemies. Succeed anyway.
  • The good you do today will be forgotten tomorrow. Do good anyway.
  • Honesty and frankness make you vulnerable. Be honest and frank anyway.
  • The biggest men and women with the biggest ideas can be shot down by the smallest men and women with the smallest minds. Think big anyway.
  • People favor underdogs but follow only top dogs. Fight for a few underdogs anyway.
  • What you spend years building may be destroyed overnight. Build anyway.
  • People really need help but may attack you if you do help them. Help people anyway.
  • Give the world the best you have and you’ll get kicked in the teeth. Give the world the best you have anyway.

Copyright Kent M. Keith 1968, renewed 2001. All permission requests should be made to the copyright holder.


1. Twomby M. A timeline of 1968: The year that shattered America. Smithsonian Magazine. 2018. Available at:
2. Keith KM. The Silent Revolution: Dynamic Leadership in the Student Council. Cambridge, Massachusetts: Harvard Student Agencies; 1986. Available at:
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