Before becoming Harvard’s 31st president, Alan Garber served as provost and chief academic officer for more than 12 years, a role that gave him an expansive view and an intimate understanding of the teaching and research that define the University’s mission. The lessons of that experience have stayed with him.

Garber’s Harvard roots run deep, starting with his arrival in the early 1970s as a freshman from Rock Island, Illinois. After graduating in three years, he went on to earn two advanced degrees: A Harvard Ph.D. in economics and an M.D. at Stanford University. That was immediately followed by internal medicine training at Brigham and Women’s Hospital, where he met his future wife. He returned to Stanford, where he spent the next 25 years as a teacher, researcher, and VA physician.

In this edited interview, Garber notes that he’d never aspired to a top post in higher education before President Drew Faust called to gauge his interest in the provost’s job. Years later, when he stepped into the presidency, he was once again pushing the boundaries he’d imagined for himself. But in both cases, he says, Harvard had given him too much for the answer to be anything but a wholehearted “Yes.”

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Tell me about your childhood in Rock Island.

Rock Island, across the Mississippi River from Davenport, Iowa, was a city of about 50,000 then. My father was born there, and my mother grew up in Wisconsin.

I have a twin sister and an older brother. As you might expect, my twin and I have always been especially close. My mother was a social worker. When children arrived, she became a stay-at-home mom who did extensive volunteer work. My father was the oldest male in his family, so when his parents grew very sick and died young, he effectively became the head of the family. He worked and did not attend college. He ended up owning a liquor store and playing the violin in the Tri-City Symphony Orchestra. Both of my parents believed deeply in the importance and value of education.

During high school, I had a few jobs. They included summer work stacking paving bricks from a torn-up street and delivering plumbing supplies. During the school year, I worked as an usher in the multiplex cinema in the adjacent town, Milan. Milan was mostly rural — the cornfields started just a few blocks away. I looked forward to sitting in one of the theaters during my break, eating my bucket of popcorn and drinking a quart of Coke. When the first “Godfather” movie played, I’d usually drop in during the baptism scene. Another favorite was the chase scene in “The French Connection.” I felt listless, and my head ached, on my days off. That’s how I discovered caffeine withdrawal.

We weren’t near a big city. It was about a 3½-half hour drive from Chicago. Growing up, I had the feeling that there was a lot going on in the wider world that wasn’t happening where we lived.

Was music a big part of your upbringing?

We went to classical concerts every month, and my father played string quartets with his colleagues at our home. I didn’t really appreciate chamber music until I was much older, but from an early age I loved Beethoven and the great violin and piano concertos. Sometimes my father would invite guest soloists to our house for a cocktail party after the Saturday evening concert. At one of those parties, our dog bit Itzhak Perlman on his bow hand.

That probably killed the conversation.

Not for long. Perlman was charming and incredibly gracious. He just laughed it off.

When did you set your sights on Harvard?

Harvard seemed a grand, remote, historic, and unattainable institution that stood for excellence. At the end of my junior year of high school, I traveled to Boston and saw the school for the first time. Whatever interest I had was multiplied manyfold by visiting the campus and meeting people there.

What brought you to Boston?

I stopped there on the way to a summer science program for high school students at the Weizmann Institute of Science in Israel. I had a glimpse of both Harvard and MIT, where my cousin worked. I applied to several other colleges but didn’t visit them.

My summer experience made me think about completing high school in a new environment. A plan came together quickly. Somehow my brother, a yeshiva student in Chicago, and I convinced my parents that I should join him, studying at the yeshiva at night while attending public high school in the daytime. I had no desire to become a rabbi but wanted to explore Judaism at a deeper level than had been possible going to Hebrew school twice a week. And that’s what I did. It was an incredible experience.

In what sense?

I’d studied Hebrew, the Bible, and the Jewish religion for many years, but not in a serious way. Now I was thrown in with people who were real scholars. It made me appreciate how little I knew. We studied the Talmud and rabbinical commentaries as partners. Each one of them had far more experience and knowledge than I did. I am grateful to this day for their patience and encouragement. As I had hoped, my appreciation and understanding of Judaism deepened greatly.

You arrived on campus in 1973. How would you describe Harvard’s student body at the time?

It struck me then as diverse and international, though it wasn’t by today’s standards. My House, Dunster, was very friendly. You could sit down in the dining hall with anybody and feel comfortable speaking about almost any issue. I like to think the conversation was usually profound, and sometimes it was. But we probably talked about weekend parties, the food, and music more than anything else. My classmates were impressive. Everyone seemed to know something interesting.

Although surveys indicate that students are more reluctant to speak about sensitive topics today, in other respects the experience was similar. There was a real sense that you were around people who were going to make a difference and that, when you did have discussions, you couldn’t get by with sloppy thinking.

You finished in three years. Tell me about that experience.

The barrier to graduating in three years was low. You needed enough Advanced Placement credits when you matriculated, and you had to do enough work in three years. Only a fraction of eligible students chose to graduate early.

Like many of my classmates who took less than four years, I was motivated in part by financial considerations. Losing a year of the Harvard College experience was a real sacrifice, but those of us who entered graduate or professional school at Harvard were able to continue to spend time with many of our College friends. Under the circumstances, it didn’t seem like a bad idea.

At that point you were interested in premed?

I was interested in science, especially the life sciences. I didn’t have firm plans but assumed that I’d become a physician. I later learned my parents shared that assumption. If you plan to graduate in three years, you need to declare your concentration within a couple of months of starting college. I declared in biochemistry, one of the most popular concentrations for premeds. So I was on a path that would at least give me the option to apply to med school.

But two courses I took in the first year opened my eyes to other possibilities. They were Physics 12, taught by Edward Purcell, a Nobel laureate, and Ec 10. I loved both of them. When I moved into Dunster House the next year, I became friends with Jerome Culp, the resident tutor in economics. We talked about economics and how much I’d enjoyed it. He soon convinced me that I should change direction and concentrate in economics.

I liked physics, too, but my interest wasn’t deep, and my roommates (they later became prominent professors, two in physics and one in chemistry) set the bar impossibly high. Physics 12 contributed to my decision to pursue economics in an unexpected way: by teaching me how to structure and solve applied mathematics problems, a vital skill for an economist.

Jerome gave me other good advice. He said that I should start taking graduate courses and told me which were most important. He also urged me to become a research assistant, arranging for me to work for a prolific young labor economist who is still a member of our faculty, Richard Freeman. It was an invaluable experience. So that is how conversations in the Dunster dining hall set me on a path that led to where I am now.

“I was sure that in the long run I’d find my work as both an economist and physician more meaningful than pursuing only one of those vocations. And all these years later, I can say that I’ve never regretted that choice.”

What did you like about economics?

It was a compelling frame through which to view human behavior. It provided a set of questions and a quantitative mode of thinking about important, real-world phenomena. You learn how to formulate and rigorously test hypotheses, a skill that is important in many fields and in life.

After you graduated, you pursued a Ph.D. in economics at Harvard and an M.D. at Stanford at the same time. This is long before online learning, so how did that work, logistically?

First came the decision to do both. To get advice about whether to get an M.D. or a Ph.D. in economics, I met with distinguished faculty across the University. Economists encouraged me to go into economics. Marty Feldstein, who later became one of my dissertation advisers, was one of them. As a Harvard undergrad, he’d planned to attend medical school himself but deferred admission to Harvard Medical School while he pursued a fellowship leading to his doctorate at Oxford. After a few years, he decided against the M.D.

The dean of the School of Public Health, a physician, thought I should get a Ph.D. in public health. The other physicians urged me to pursue an M.D.

As I digested the conflicting advice, I realized that by the time I graduated college, I would have done half of the required Ph.D. coursework. If I took an additional year, I could complete the coursework, earning a master’s degree in the process. So I decided to apply both to medical schools and economics departments, figuring that I should at least get the master’s in economics. One evening, the chair of the economics graduate admissions committee saw me poring over piles of computer output and asked whether I planned to pursue the entire Ph.D. I’d been thinking of it anyway and committed on the spot. He later became the chair of my dissertation committee.

I took a deferral from medical school at Stanford, where two of the nation’s most prominent health economists taught, spending the next year at Harvard with my classmates and finishing my Ph.D. coursework as planned. Then I took a leave from graduate school and went to medical school. I did two years, took a leave from med school, worked on my dissertation, and then came back to med school. I finished the two degrees, on two coasts, nearly simultaneously.

Where was your clinical work during medical school?

At Stanford Hospital and the Palo Alto VA hospital. I was also a research assistant during my first years of medical school. One of my mentors was Hal Sox, the chief of the Division of General Internal Medicine for Stanford and also the head of general medicine at the VA hospital. When I took a leave of absence to work on my dissertation, he arranged for me to have a student general medicine clinic at the Palo Alto VA.

Thanks to that experience, when I started clinical clerkships upon my formal return to medical school, I was as well-prepared as medical students who had gone straight through. My attraction to the VA was reinforced by my first inpatient medicine clerkship, which was also at the VA. That also led to my decision to go into general internal medicine and later, when I became a faculty member, to do my clinical work at the same hospital.

Were there particular patients who made a deep impression?

There were several, but one, a Mr. Campbell, really stood out. He was a World War II veteran, dying of advanced lung cancer. The main hospital building was old enough to still have wards with as many as 12 patients in a room. That sounds unpleasant, but the wards had important advantages over private and semi-private rooms. The patients in the wards came to know each other and looked out for one another. That vigilance was better in some ways than fancy monitoring equipment. He had a prolonged hospitalization and knew the ropes by the time I met him. He always looked out for his wardmates.

He was a wonderful person and very kind to me. He knew that I was learning by taking care of him and was so accommodating, generous, and uncomplaining. In many ways, he was one of my greatest teachers. It really hit me hard when he died.

It sounds like a tight-knit group of patients.

If somebody was having trouble breathing, another patient would find a nurse to help. Most were stoical and would not complain if they were feeling worse. They might hide it, even if they had a worrying symptom, like shortness of breath. Their wardmates would make sure the doctors and nurses knew. Mr. Campbell did that and set an example for other patients. I saw firsthand what people meant when they referred to World War II veterans as the “Greatest Generation.”

Your Ph.D.-M.D. experience was clearly a marathon. Did you ever get discouraged?

When I was looking at residency programs, the interviewers at Mass General asked: Do you think you’ll regret spending all of this time in training when you could have just been an economist? I replied that one of my grad school roommates — the economist Jeff Sachs — had just been promoted to full professor with tenure at Harvard, and here I was about to start an internship in six months. It was completely possible, I said, that when I would be called in the middle of the night to do a fever workup, I might think, “If I had just done economics, what would I be doing right now? Certainly something better than this.”

But I was sure that in the long run I’d find my work as both an economist and physician more meaningful than pursuing only one of those vocations. And all these years later, I can say that I’ve never regretted that choice.

“Fear is not conducive to learning. It’s not conducive to doing great research. Sometimes we need to take risks to make progress.”

When you were hired as an assistant professor at Stanford, you went back to the VA to do your clinical work?

Yes. Just as when I was a student, taking care of veterans was a source of great satisfaction and pride. I continued to see patients at the Palo Alto VA until I returned here to be provost in 2011.

Were there certain health issues that were particular to that population?

Compared to many academic medical centers, we saw more lung disease, liver disease, and heart disease. The Palo Alto VA was also a major referral center for the care of dual (medical and psychiatric) diagnosis patients and for spinal cord injury. I taught and supervised care of patients both on the inpatient service and in clinic. For several years, I was the only tenured Stanford faculty member in general medicine at the VA hospital. During that time I took care of many former prisoners of war, some of whom had ongoing illness related to their imprisonment, like the neurological impairments resulting from beriberi acquired in World War II prison camps.

During your time at Stanford, you authored more than 100 articles on healthcare economics. Tell me about your research.

I became very interested in applying the tools of economics to evaluate medical and public health practices. In my dissertation, I examined antibiotic resistance, where one person’s overuse of antibiotics puts others at risk of becoming infected by a resistant organism. It sounded like a negative externality, where one person’s economic activity harms others. I thought that the tools of economics could be helpful in measuring and ultimately controlling the harms that antibiotic users impose on others.

Over the years, I studied areas like cardiovascular disease prevention, including cholesterol control. I used and taught the tools of decision analysis, cost-effectiveness analysis, and the application of econometric techniques to the prevention, diagnosis, and treatment of disease.

You started two centers related to health policy and economics at Stanford. Was that when you first began to think about higher education administration?

I wasn’t interested in academic leadership positions and would have been even less inclined to pursue them if they were described as administration. However, not long after I started on the Stanford faculty, my division chief went on sabbatical, and I ended up becoming the director and principal investigator of a postdoctoral fellowship program that he led. That role basically continued throughout my time on the Stanford faculty. Later, I became the acting division chief. I had no interest in doing this on a longer-term basis, so creating the centers was kind of an aberration.

The chair of the Department of Medicine came up with the idea for a center for me to run — why it became two centers is a long story. She and my mentors at Stanford somehow convinced me that the centers’ mission would be sufficiently close to my research interests that running them would not be burdensome. I was overly optimistic about that, but leading the centers turned out to be gratifying in unexpected ways. Most importantly, I discovered that I loved mentoring students at all levels, postdocs, and eventually faculty. But I wasn’t attracted to positions with greater leadership responsibilities, like department chairmanships. I never would have expected to be a candidate for provost.

You started as Harvard provost in 2011. Did the idea of someday becoming president ever cross your mind?

People ask about it, but it was not something I was thinking about. When I started as provost, I didn’t have as much leadership experience as was typical for the position. I accepted the offer because I hoped to repay my debt to Harvard for all that it gave me. I didn’t think I needed to be president to do that.

As is typical for U.S. universities, the provost is the chief academic officer and is uniquely focused on the academic life of the University as a whole. Anyone with broad intellectual curiosity can’t help but feel a sense of wonder when they learn about the work faculty do at the frontiers of the fields represented at Harvard. That promise of intellectual stimulation combined with the opportunity to do my part to help the University succeed was irresistible.

At some point during your tenure as provost, you started to notice that the community was having trouble talking across differences and remaining open to a range of views on political and cultural issues. How did that realization develop?

Over the years, there was a growing reluctance — notably among students, but also among faculty and staff — to speak openly about sensitive issues, especially with people who might have different views. A fear of being misunderstood, of giving offense, and of ostracism chilled speech. Fear is not conducive to learning. It’s not conducive to doing great research. Sometimes we need to take risks to make progress. We shouldn’t offend people gratuitously, but if the consequences of inadvertently or even intentionally giving offense become too great, dialogue about difficult issues will be a casualty.

As these problems grew, I realized that traditional debates about what speech is permissible in different settings, and other traditional speech concerns, only addressed part of the challenge we faced. There still needed to be an understanding about speech rights, but it became apparent that we also needed to ensure that our entire community had the skills to participate in difficult conversations.

Among our faculty are renowned experts on these issues. And many more can demonstrate how to facilitate dialogue with extraordinary finesse and grace. I realized that we should look at this set of speech challenges as an opportunity to empower students, faculty, staff, and all the members of our community to be able to handle difficult situations better. In other words, we have an obligation to give people the tools they need to fully participate in the life of the community. That includes exposing, discussing, and working through differences.

Are there lessons you can learn by engaging with differences that you can’t learn any other way?

By doing so, you better understand perspectives that differ from your own. More importantly, you develop general skills in listening, speaking, and identifying areas of agreement and disagreement. You might even change your mind and be better for it. Engaging with differences is important right now because there is an overwhelming sentiment in our community that we need to be brought closer together, that we should not retreat into our own corners and avoid people whom we believe to be different from us.

Do you see intolerance of opposing views and intolerance of other people as two sides of the same coin?

Yes. People associate views with identities. If you’re a wealthy white student who went to a small private school in California, people assume that you will have a particular set of political views. If you’re a Black student from the urban Northeast, they assume that you will have another set of political views. And both might happen to be wrong. There’s a diversity of views from people with different economic, social, or religious backgrounds. We all want to be treated as individuals, not as types. We don’t want anyone to prejudge us based on our demographic characteristics or any other group identity.

The University has been locked in a dispute with the Trump administration for the past year. Did you see this coming before the election? Also, how do you strike a balance between today’s challenges and longer-term planning?

In the wake of October 7, 2023, the decline in trust in institutions, especially universities, accelerated. Academic institutions were blamed, often unfairly, for many of the problems the nation faced. But there were real problems at Harvard and other campuses. Attacking universities seemed to be a successful political strategy. As a candidate, Trump warned that his administration would investigate and seek to transform universities.

So harsh scrutiny was to be expected. However, we did not anticipate the form and the severity of the attack on Harvard and other universities, nor the readiness with which precedent would be abandoned, for example in Title VI investigations and enforcement. In navigating all that has followed we have, as always, been guided by principle. In developing our responses in the past 13 months, we have always confirmed that we will follow the law. We have always strived to protect the mission of Harvard and of higher education more broadly. We will go to great lengths to protect that mission, because in the end, when we carry out our mission, we serve the public.

You mentioned that the community wants to be brought together. Is it happening? Do you see a more unified institution?

Many people have told me how pleased they are at the way we have come together as a community. We still have our differences, but we also are committed to our mission, our common goals, and each other with a dedication that would be elusive when threats to the institution seem neither imminent nor serious. Now, more than at any other time in memory, we appreciate that this is a great and precious community — and it’s extensive. It includes not only the faculty, staff, students, and alumni, but also the many friends who may have no formal affiliation with Harvard but share our aspirations for higher education and its role in the world. That’s something that validates our mission and should give us all hope for the future.