Over the last few years, I have had the great privilege of speaking at dozens of graduation ceremonies. At this point, almost as if it is a conditioned response, when I hear the pomp and circumstance music, my eyes immediately start watering. Graduations are emotional. When you look at the faces of the parents and grandparents and faculty and friends – you can feel the pride and the joy in this tremendous accomplishment. And of course, the graduates are beaming.

From rambunctious undergraduate graduations in football stadiums to august medical school commencements in basketball arenas to zoom graduations during COVID, it is always an honor to deliver a commencement address. They are usually 12-15 minutes long, and every talk is unique to the audience and university. But the messages are usually similar – congratulating the graduates on their incredible accomplishment, but encouraging and inspiring them to make the world a better place.

When I spoke at Harvard Medical School’s commencement a few years ago, I made a couple of jokes that fell flat (I still thought I was hilarious), but I also spent quite a bit of time talking about one of my physician heroes, Dr. Alice Hamilton. The first woman professor at Harvard University, she was not allowed to march in commencement. So of course, I had all the women faculty at Harvard stand up in honor of Alice Hamilton. That was fun. 

One of my favorite graduations was 2023’s MSU CHM graduation. Every medical student graduate had a prescription pad under their seat. I asked the graduates to share a “Prescription for Health.” Medical students rose up in their caps and gowns and shared what they would prescribe - visionary things like, “I prescribe universal health care!” and “I prescribe an end to gun violence.” So awesome.

From Johns Hopkins to the University of Michigan to Washington University to even The Ohio State University (they actually do like people from Michigan), it has been a joy to be part of these special days. But also it’s a lot of time and energy to prepare and deliver these talks. This past year I have said no to every commencement invitation – I have been too busy with the launch and expansion of Rx Kids. 

Except for one. It was impossible to say no to this one. I knew it would be more meaningful and more important than any other graduation.

Last Friday, I delivered the commencement address at the Women’s Huron Valley Correctional Facility to approximately 150 inmates who obtained either their GED degree (high school equivalent) or vocational certification. Michigan’s only prison for women, the facility is outside of Ann Arbor and has about 1,700 inmates. Within the prison, there is a fully functioning high school with a principal and teachers. 

Pomp and circumstance began to play, and of course I started to cry. And then I marched into the prison auditorium with the prison principal (former elementary school principal), some of the most dedicated teachers I have ever met, the warden (just saying and writing “warden” is a little scary, but he seemed like a lovely person), and 150 beaming graduates. In bright yellow gowns, the students ranged from teenagers to seniors (not high school seniors). There were graduates with “honors” stoles and there was even a valedictorian.

I sat in awe. The student speakers were phenomenal – strong, determined, and inspiring. Another student beautifully sang an a cappella musical selection from Lauren Hill. I had goosebumps throughout.

When I accepted this commencement invitation, I knew it was important, but I had no idea what I would say to the inmates. I procrastinated writing my speech until the night before, questioning everything I would say. I even questioned what I would wear. I was planning on wearing red (the official Rx Kids color), but my teenage daughters said red would clash with prison orange. I didn’t know – was that just a TV thing? Do prisoners really wear orange? To be safe, I wore my Spartan green. It turns out inmates wear “Michigan blues” which were revealed after the yellow gowns and caps came off.

My message to Harvard Medical School graduates was no different than my message to the inmates. I congratulated them for their achievement, and I pushed them to do more and be more.

My opening excerpt:

I want you to know that I am standing here in front of you and I am inspired and hopeful. In each of you, I see your strength, your adaptability, your ability to persevere. This graduation today is a testament to the fact that you can do hard things. Do not underestimate this accomplishment - if graduating wasn’t hard enough, you are graduating years after all the homecomings and proms - and while incarcerated. You didn’t have to do this, but you did! Lean in, shoulder first, into that strength and tenacity. Don’t let today be your finish line. Let it be your beginning. 

Let it be what pushes you to limitless possibilities of what you can be, what you can do, and what you can achieve. I urge you to use what you learned here and what you will continue to learn - because learning is forever - to turn today’s momentum into tomorrow’s legacy.

Tomorrow is a new day. And you get to write a new story. Yes, you have stories that you have already written - but, your future is NOT written. You see, the journey is never done. Life is a series of stops and starts, detours, and do overs.

My address went on – the women were attentive and tearful – there was applause and cheering. I was honored to stand alongside the principal and warden as they announced every graduate’s name and handed out the diplomas. I shook every graduate’s hand, fixed their off-balance caps, and shared a lot of hugs.

I have read a lot about criminal injustice, mass incarceration, and the prison-industrial complex, but I have never been in a prison. (Must reads: The New Jim Crow by Michelle Alexander and Just Mercy by Bryan Stevenson.) I was humbled and grateful. I recognized the privilege that I carried and the unique opportunity to share this moment with them.

So much of my work as a public health pediatrician is about PREVENTION. In clinic, I give vaccines and counsel about injury prevention and anticipatory guidance. In public health and policy spaces, my work has been about strengthening and investing in the systems that promote health – from stronger environmental protections to the elimination of child poverty with Rx Kids. All of these efforts are about ensuring that kids grow up healthy and successful.

Being in prison was a reminder of how we, as a society, have failed at prevention. Despite the joy of the day, it was maddening and heartbreaking. It was a family visitation day, and my heart broke seeing the kids run toward their incarcerated mothers.

After graduation, I spent the rest of the rainy day touring the facility, talking with the staff, and spending more time with the inmates. In partnership with Michigan Humanities I spent the afternoon in book clubs with the prisoners. Like any lecture or book club, the inmates were thoughtful, curious, and engaging. I listened to their stories and insights.

After an extensive security process going in and out of the facility, I was only allowed to walk into the prison with my ID and car key. I had to leave my phone, laptop, and even watch in my car. So many times throughout the day, I went to reach for my phone that was not in my pocket. For those who know me, the lack of selfies was really hard.

When I got back to my car, I had over 300 text messages and emails. Thirty minutes before I entered prison, the Washington Post broke the story that the Harris campaign was including a $6,000 newborn credit in their policy agenda. Rx Kids is a $1,500 prenatal cash prescription and $6,000 for newborns ($500/month for the first year). When Rx Kids launched, Vice President Harris said, “The creation of Rx Kids places Flint, Michigan, at the forefront of innovation in the fight to improve maternal and infant health outcomes. Please know that your work is creating an invaluable model for other cities and states to follow."

It was one of the hardest secrets to keep, but after working closely with senior White House officials – including an 11pm call the night before, I knew this Rx Kids-inspired announcement was coming. I couldn’t imagine a more beautiful moment to share this breaking news than with the women during my speech - they roared in applause.

And that gave me so much hope. We don’t have to keep doing what we have been doing. We don’t have to accept the status quo. We can fix big insurmountable problems. We can treat people better. We can build more schools than jails. We can allow inmates and former prisoners the right to vote. We can invest in prevention.

I ended my commencement address by sharing how hopeful I was.

You know, sometimes hope is the hardest thing to find. But being with you today…all I see is hope. Everywhere. In every single one of you. YOU are the hope. A drumbeat for HOPE. And that is exactly what we need right now. Because it is in these glimmers of hope that the impossible becomes possible. 

Mona Hanna, MD, MPH