In her commencement address to the Stanford School of Medicine Class of 2026, Lily Sarafan weaves together a personal immigrant narrative, a career built on elder‑care entrepreneurship, and a deep commitment to translational medicine. She opens with a vivid childhood anecdote about wearing a yellow polka‑dot dress in a school play, using it as a metaphor for entering any system—medical or otherwise—without knowing its language. She argues that clinicians, researchers, and future physicians must act as translators, turning complex scientific data into meaningful stories for patients. Sarafan highlights Project BIG (the Brain‑Immune‑Gut Initiative), describing how the program inverted traditional multiple‑sclerosis research by making the clinic the laboratory, leading to a Nature‑published link between Epstein‑Barr virus and MS and a pioneering CAR‑T cell trial. She then discusses the transformative potential of artificial intelligence in diagnosis, drug discovery, and data synthesis, while cautioning that AI cannot replace the human capacity for empathy, judgment, and the “human compass.” The speech culminates in a call to cultivate civic virtues—listening, humility, curiosity, tolerance for complexity, and relational openness—as essential habits for healers who will shape patient care, research, policy, and public discourse. Sarafan also reflects on her stewardship of Stanford’s mission through board leadership, philanthropic gifts, and interdisciplinary initiatives, urging graduates to carry forward the university’s founding charge to promote public welfare and influence humanity.
Chapters
It is now my pleasure to introduce this year's keynote speaker. Lily Sarafan graduated from Stanford in 2003 and took an unconventional path. A conversation with a geriatric care manager sparked her interest in aging and the future care at a time when many of her classmates were pursuing careers in tech. That interest would ultimately lead her to help transform the healthcare industry. By listening to seniors and their families, Lily identified overlooked need in the market: people's desire for dignity and independence along with high-quality care. With that insight embedded in her startup's mission, She grew the company to 10,000 employees, providing care not just for symptoms, but to support the whole person. From her time as a student to today, Lily has worn Cardinal on her sleeve, continually finding ways to support Stanford and amplify its impact. In 2020, she was elected to the university's Board of Trustees, and later co-chaired the search committee that led to the appointment of our current president, John Levin. Last year, she was elected chair of the Stanford University Board of Trustees, providing strong leadership in a time of uncertainty. Recognizing Stanford's opportunity to define biomedicine's future, she's been an ardent supporter of our life sciences programs in the university. She made a foundational gift to Sarafan-Kim H, an institute dedicated to accelerating transformative molecular research. She's also a founding partner of Project BIG, the Stanford Brain Immune Gut Initiative, and is a member of the university's interdisciplinary Life Sciences Council, which guides and supports Stanford's pioneering interdisciplinary biosciences institutes. Lily has built her career on the principles shared earlier: listening with intention, building communities, and leading with conviction even when the path forward isn't clear. She is a remarkable leader, a devoted champion of Stanford, and a model for helping people reach places they can't get to by themselves. Please join me in welcoming our keynote speaker, Lily Sarafan.
Dean Minor, thank you for that kind introduction and for your extraordinary leadership. I'm so inspired standing here this afternoon. Good afternoon, graduates, faculty, families, friends, and members of the Stanford Medicine community, and congratulations to the class of 2026. It is such a privilege to be here with you today. Whether your path leads to the bedside, the laboratory, entrepreneurship, policy, education, or fields not yet created, you are joining one of humanity's most sacred endeavors, understanding life and improving it. My own story of understanding the complexity of the human condition began at age 3, not long after my mom and I arrived in America. With no networks, few friends, and little English, mother and daughter sought acceptance in a new world called Los Angeles. I remember a trip to an enormous shopping mall to find a topper for our very first Christmas tree, with pizza delivered to our apartment as the capstone. Bringing a tree indoors to crown it with jewelry while eating melted cheese that showed up in a box, I had seen enough. America was perfect. Then came the school play. It's one of my most vivid memories from early in my preschool tenure when the school was putting on a short theatrical production in which my classmates and I were supposed to play a swarm of bumblebees. Now, this was pre-internet America, and my mom had no idea that costume shops existed. So she did what immigrants have done for generations. She figured it out. She bought a formal poofy yellow dress and hand-sewed black lace trim and cotton balls onto it in a polka dot style. We thought we were ready. Then we arrived at school. The shock was written on our faces as we gawked at the uniform swarm of schoolchildren, identically clad in black and yellow stripes, as though they had all just arrived from the Honeycomb Depot. My mom and I were horrified. It was immediately obvious that everyone else knew something we did not. In a stroke of genius, my mom, not yet confident in her own English, decided to have me approach my teacher and explain that, given my distinctive ensemble, there was only one logical solution. I should be the queen bee. And so it was, the bee in the yellow polka dot prom dress came front and center in the production, my first leadership role. I've thought about that story often over the years. I used to think it was only about finding opportunity in a setback, but now I think it's also about something more fundamental. What it feels like to arrive inside a system whose rules you do not yet know. See, my mom wasn't missing intelligence or effort. Far from it. She's the most brilliant person I've ever known. She simply didn't speak the language, literal or otherwise. When you're new to a country, you spend a lot of time decoding things everyone else seems to understand automatically. invisible customs, unspoken assumptions, languages within languages. And it turns out that experience is far more universal than it first appears, because each of us eventually finds ourselves inside a system we don't fully understand. Science, and especially medicine, are full of those moments. Every day, people enter hospitals as teachers, carpenters, chefs, and lawyers. And then suddenly it's their first day of school again, surrounded by unfamiliar terminology, unfamiliar risks, unfamiliar fears, everyone around them apparently fluent in a language they do not speak. And this is often happening on one of the worst days of their lives. You will be in your many future roles a translator, Translation is powerful. It's a preschooler translating Persian into English for her mom, and it's that same mom's Stanford neurologist Michael Gracius decades later translating the discovery of a rare protective genetic variant into a blueprint for Alzheimer's therapies that could help us all. In 1885, Stanford's founding grant charged this university to promote the public welfare and exercise an influence on behalf of humanity and civilization. The Stanford School of Medicine is one of the places where that charge is most visible. Each of you will bring it to life in your own way. One way I've tried to is by collaborating with Jeff Dunn, Chief of Neuroimmunology here at Stanford, on Project BIG, the Brain Immune Gut Initiative. Dr. Dunn started with a deceptively simple question. Why, after centuries of multiple sclerosis in the human population and billions of dollars of research, had we still not found its cause? His theory was that the conventional scientific model might be working against us. MS is unique to humans. It reveals itself only in flashes and presents with daunting heterogeneity. No 2 patients look quite alike. So Project BIG inverted the model, making the clinic itself the central laboratory. We have names for diseases, often coined centuries ago to describe what an illness looks like once it has fully declared itself. Today, you know better than anyone that we're translating disease into a deeper language, one written in genes and proteins and cells. And in that language, what appears to be a single disease may reveal itself as many distinct molecular stories. Take Project BIG's very first patient. In 2015, she was hospitalized and underwent emergency surgery for a rare perforated ulcer. Years before, there had been a severe case of mononucleosis. Genetic testing hinted at a quiet predisposition. A stretch of extraordinary professional stress immediately preceded the perforation, which led to a systemic infection and extended hospitalization. Later, symptoms that were read as post-surgical anxiety but were in fact severe hyperthyroidism. A thyroid storm, tachycardia-induced cardiomyopathy, another hospitalization. Graves' disease, radioiodine ablation of the thyroid, followed by a cascade of autoimmune activity. And then on December 1st, 2016, after a battery of tests over 2 days, the on-call neurologist walked into the patient's hospital room and said, you have multiple sclerosis. In that moment, she wondered what her life would look like if the very things she relied on to make an impact— processing speed, a sharp memory, verbal fluency— were suddenly under threat from what she understood to be an incurable, progressive neurodegenerative disease. And perched in that hospital bed, she felt something she had not felt since she walked into preschool in a poofy yellow dress with black cotton ball polka dots surrounded by a sea of perfectly matched bumblebees. I was once again inside a system whose language I did not speak on what was this time One of the worst days of my life. I have always met hard things the same way. Some people process fear emotionally. I process it intellectually. It's not the healthiest coping mechanism, but it's mine. I read the papers. I chased the hypotheses. I cornered the experts, many of them in this room. I tried to assemble a coherent story out of fragments. And in doing so, I found my translator. Dr. Jeff Dunn. In the end, what I needed from him was not more information. I had plenty of information. What I needed was wisdom and insight and humanity. Vulnerability, not my comfort zone. I had learned from my mom to compartmentalize challenges and move on. But if the lesions on my brain and spine and the steady march of brain atrophy took away my ability to synthesize and lead who would I be? I remember calling myself a lily with missing petals. Dr. Dunn was a French literature major in college, and sitting across from him in our very first meeting, I could see both the humanities and the sciences at work. Literature is about stories. He helped me see this as a plot twist, but not a tragic downfall. He gave me facts and he gave me truths. He shared an original MS framework that he called chronic immune hypertension with a then contrarian treatment proposal that was proved right over time. I left 213 Quarry Road full of gratitude and hope. Dr. Dunn was my island of coherence. That translation from information to meaning is one of the most important ways you will build what my Stanford advisor called a life of spiritual and cerebral fulfillment. And the neurologist translating for me was at the same time translating for the field. The collaborative work from Project BIG tying Epstein-Barr virus to MS was published in Nature and named a runner-up for Science Breakthrough of the Year. It pointed Dr. Dunn and his team toward CAR T-cell therapy, and today at Stanford, he leads a first-in-human trial bringing that approach to progressive MS, a potentially pathbreaking immunotherapy. Dr. Jeff Dunn is here today. Thank you, Dr. Dunn. Communication is not separate from care. Patients spend their days trying to make meaning out of what's happening to them. Turning unfamiliar words and probabilities into something they can actually understand and learn to live with. Often you are the person through whom or because of whom that translation happens. That is both a great responsibility and a profound privilege. Even with everything I've experienced as a patient, as a patient advocate for loved ones, and as a healthcare entrepreneur and executive, Hospitals and labs and even home science experiments make me feel safe and steady. That may not be a universal response, but it's where I get to witness an attempt to bridge the gap between what is known, at least for now, and what is not yet understood, between technical knowledge and human vulnerability. You are stepping into your next chapter at a seminal moment. Artificial intelligence will transform diagnosis, imaging, drug discovery, and the very organization of research and clinical work in ways we can barely predict. In many domains, it will be a powerful engine for translating complexity into structured, actionable signals. Its potential to reduce error, accelerate discovery, and extend care to people who cannot currently reach it is real. But what AI will not do, what it cannot do, is stand inside the moment when those signals meet a person trying to understand what they mean. It cannot sit with a frightened public trying to make sense of a population-level statistic. It cannot look at a result that doesn't fit and wonder whether the result is wrong or the paradigm is. That space does not shrink as the tools grow more powerful. No matter how advanced the systems become, those moments need to be led with a human compass, with you. You will spend your careers working at the intersection of knowledge and uncertainty. I have been on the other side of that divide many times, in a yellow polka dot dress and in various hideous hospital gowns. And what has stayed with me is not the information I accumulated, but the sense of agency that came from grasping it, from individuals and institutions that helped me become a native speaker of my own health. That belonging is often what each of us is searching for without being able to name it. And this is part of the genius of science, of medicine practiced well. I want to close with something that reaches well beyond science. The world needs these sensibilities now more than ever. At a moment when facts are contested, expertise is doubted, and misinformation travels faster than any correction, our society grows healthier in proportion to our willingness to practice a few hard things: listening, humility, curiosity, a tolerance for complexity and uncertainty, and the capacity to stay in relationship with people who see the world very differently than we do. Those aren't only scientific virtues, they are civic ones. They are the habits that make discovery possible and democracy durable, and they are among the most important things this university entrusts to you. You leave here not only as scientists and clinicians and policy experts and translators, but as essential voices at a moment when trust, expertise, and human connection all feel increasingly fragile. Some of you will heal through direct patient care. Some will heal through paradigm-shifting research. Some will shape the policies institutions, and ethical frameworks that determine who benefits from that progress. And some will ask questions that no one has thought to ask yet. You are all healers, and what our country, our world, our public life need right now are healers. As alumni of Stanford, you are now stewards of a tradition dedicated to promoting the public welfare and exercising an influence on behalf of humanity, and civilization. That charge now belongs to you, and I know we're in good hands. Congratulations, Class of 2026. Thank you.
