What’s Important: Giving Back (2017)

I was a 5-year-old kid sitting on the third step of a worn, narrow staircase in the Methodist parsonage in Dayton, Iowa. On the second step sat Bishop Rocky, a medical missionary from India, who told me stories about saving people. I ran upstairs and returned with my porcelain piggy bank. I broke it open on the floor, and gave my pennies to Bishop Rocky. “Take this money to save more lives,” I insisted. “I’m going to be a doctor—a medical missionary like you!” (My father, the local Methodist minister, had wanted to be a missionary, but tuberculosis of the spine, cured by orthopaedic surgeons at the Mayo Clinic, disqualified him.) I didn’t become a medical missionary after I became a physician, but I went through the stages of maturation that all physicians do. The first stage I call the “thrill of victory,” and it persists all through our training as we dream of what great things we’ll do. It is this thrill that drives us through the long years of study, and it is the thrill of healing others that fuels our pride in having unique talents. I feel fortunate because this thrilling stage has lasted my entire career, and I particularly feel it when a grateful patient brings me cookies. But once I was in practice, I experienced the second critical stage, the “agony of defeat.” Complications occurred that I never expected. Some were catastrophic for patients, and I didn’t know if I could bear the heartache. But this is the stage that defined my career. Was I going to play not to lose, or accept the risk of failure and play to win? I chose to play to win, and it has made all the difference. I don’t know if my strength to accept failure came from sports, from watching the strength of my role models (Drs. Paul Harvey and Chit Ranawat), or from my family (my parents and wife Marilyn, who always believed in me). I just know that the decision to play to win is the key to loving medicine and not burning out. The third maturation stage is the knowledge that “there is a God, but it is not me.” I think this progresses naturally from the lessons of the second stage. The consequences of failure breed humility. When a surgery didn’t go well, how did those patients have such great results? From where did the talent come that enabled me to become an orthopaedic surgeon? God’s intervention also was evident when patients who had a catastrophic result forgave me. This process of maturation from being a naive dreamer to a seasoned physician—still with dreams—brought me to the fourth stage. I realized that “giving back was better than taking.” For me, the quintessential opportunity to give back to medicine, to express gratitude for my parents’ lessons, for my wife’s belief in me, and to my God, was Operation Walk. Operation Walk is a not-for-profit volunteer medical services organization that provides free surgical treatment for patients with arthritis or other debilitating bone and joint conditions in developing countries (and occasionally in the U.S.). For others, giving back might be encouraging a medical student or resident to be a better doctor, being a medical role model in the community, or just teaching those around you to give back and live by the Golden Rule. I quickly learned that most doctors have a desire to give back—to help others in need. And I saw everyone who participated with Operation Walk receive more than they gave. It was pure joy watching patients receive new life that they otherwise had absolutely no chance of ever obtaining. The power of the human spirit enabled patients who had never met us, who had no knowledge of our skills other than what their doctors had told them, and who would probably never see us again, to lie down on an operating table and trust us to cut them open to repair their body! For the givers, it was the epiphany many had sought in their medical journey. Op Walk—giving back—was the treatment that made all of medicine’s headaches back home become tolerable. When Jeri Ward, the founding coordinator/manager of the Operation Walk missions, first expanded Operation Walk to multiple hospitals throughout the United States in 2009, it was the doctors and nurses who had already experienced it who wanted to participate. That initiative mushroomed into Operation Walk USA, whose growth has been led by Dr. Adolph Lombardi and by Olga Foley at the American Academy of Orthopaedic Surgeons (AAOS). As I write this, I am in Honduras on an Operation Walk mission. All of us here are sharing the excitement and eagerness to learn from our host doctor, Luis Boquin Orenday, and the hospital staff. We cry with the patients and their families as they walk out of a crowded ward of 8 to 10 patients into a hallway, and even better, into a new life. Op Walk volunteers bond together every night at dinner, regaling each other with joyful stories of the day’s events. At 6:00 a.m. the next morning, we are planning the 20 operations that we will perform that day. My grandson Hunter is on this trip with me. He is experiencing the self-worth that comes with unconditional giving, and learning about the responsibility to others that comes with being on a team. It is only a week of his life, but it is the best gift I will ever give him—just as my parents taught me that life is about helping others in need. I hope that all of my colleagues will reach the fourth stage of their career and realize that to “give back” is to perpetually reignite the love of medicine and of life.