I have been practicing general surgery for over two decades and I have come to feel a calling to do more than care for sick people. Don’t get me wrong, I like that I can take people who are sick, and with a surgery make them better. But over the years I have started to wonder if that is enough. My job is to take people from sick, having a diseased organ, and convert them to “not sick” by removing said organ. But “not sick” is not the same as healthy. I believe that being healthy and living a good life is more than just being “not sick.”
Too many people accept where they are in life and tell themselves, “This is just the way I am.” But it does not have to be that way. We can all improve. I don’t believe we are locked into being just one way. Who we are is a choice we make, and if who were are does not suit us, we can make different decisions. Better decisions to become a better person.
I started this blog to explore that very idea. Please join me on this journey. You can sign up for email notices below and learn more about about the mission and core principles.
Charles Black as a Philmont Ranger at Philmont Scout Ranch, Cimarron, NM
My Story
I grew up among the cornfields of middle America and will always see myself as an uncomplicated rural Iowa kid. My most significant interest at that time was the Boy Scouts, and I put in the time and effort to become an Eagle Scout. That led to what I think was the best job I ever held, that of a Ranger at the Philmont Scout Ranch in the Santa de Cristo mountains of northern New Mexico. When I completed my season as a Ranger, I headed off to college, planning to one day become a park ranger and work in the national parks.
Somewhere in my sophomore year of college, I realized that all of my biology and chemistry classes had moved from the big lecture halls to regular classrooms. Most of the students who identified themselves as “pre-med” had moved on to something else, and I realized that I was now well placed to go to medical school. I wasn’t sure if that was what I wanted to do, but I figured if I aimed for a lofty goal like medical school and did not make it, then I would still do pretty well.
A decade later, I found myself in practice as a general surgeon in a community hospital on the shore of Lake Michigan. I worked hard, and for a time, my productivity was among the top twenty percent of all general surgeons in the country. Despite my success, something wasn’t right. I had a wonderful wife, and three children with all the potential in the world, but I wasn’t happy. I tried buying a bigger house, a new car, and even a sailing yacht without relief.
It all came to a head on a Caribbean vacation. My wife and I had vacationed among the islands every winter for several years, but this would be our first trip with our three children. We were looking forward to it, but first, I had to earn that vacation. The two weeks before my vacation, both of my partners planned to spend in warmer climates. That meant I would be the only surgeon on call for thirteen out of seventeen days. I knew it was going to be grueling, but I knew two other things as well; one, the needs of the patients come before the needs of the surgeon, and two, surgeons show no weakness. I put my head down and resolved to do whatever needed to be done to get thru that two weeks and on to my vacation.
The day before we were scheduled to leave on our vacation, I woke up in the night with shaking chills, fever, and a cough. The next morning I felt so weak that I could hardly get out of bed. A consultation with an internist friend confirmed that I had pneumonia. He prescribed antibiotics and rest. The first I could comply with, but the second was out of the question. I had worked too hard, and my family had sacrificed too much to give up on our family trip. So I took the antibiotics and boarded an airplane.
Despite the warm sun and palm trees, things were not all good in paradise. On a trip to the pool our first day, my kids begged me to play in the water with them. I tried, but with a fever, I was racked by chills, and the water left my teeth chattering. I retreated to a chair in the sun where I cowered under two beach towels while the other guest bathed in the warm sun. My disappointed children climbed out of the water and stood around me, pleading with me to get back in the pool with them. As they begged, they dripped cold water on me, and I lost it. I yelled at my children, “go away and leave me alone.” The expression of shock and disappointment on their faces when I did that still haunts me today.
It was clear that rather than something to savor, this vacation was going to be something to endure. We ended up signing our children up for a “Kids Camp” at the resort, so my wife could have some time to herself while I lay in bed with the “Do Not Disturb” sign on the door. Recently, my children recounted a memory from that trip involving going into the rainforest to feed the lizards. I had no memory of this event, and when I asked, my kids told me I wasn’t there. It was a reminder that the best part of their family vacation happened while they were with the babysitter.
At my worst in 2005
When we got back from the trip, I took a long hard look at myself and did not like what I saw. I knew I had put on a few pounds over the years, but I could no longer ignore that I was obese, weighing in at about 100 lbs more than I do today. Worse than being unhealthy, I was unhappy. I had a beautiful family and all the possessions I could want for a comfortable life. Still, I couldn’t enjoy any of it. How had a nature-loving, happy with life Eagle Scout like myself ended up like this? My wife thought I was depressed, and I insisted I was burned out, but either way, things needed to change, and not in the way that buying a fancier house or bigger boat would accomplish.
In the past, I had tried to change my circumstances to fix the void I felt in my life, but now I realized that what I needed to change was myself. I started by exercising, nothing dramatic, just walking at first. Then I improved my diet, again nothing big, just eliminating the “comfort foods” that I knew were the worst for me. I worried that making even a few hours a week for myself would cause a problem at work, but I found that my energy and sleep improved, and I was more effective at my job. As my new physical discipline was showing benefits, I returned to reading. I also tried some new forms of mental discipline that resulted in me being more present and compassionate with my patients and myself.
At the summit of Imogene Pass during the 17.1 Imogene Pass Run 2018
Sometimes our lives are not improved by what we add as much as by what we subtract. As I got more in touch with my priorities, I recognized that I was doing many things out of a feeling of obligation rather than any real interest. I resigned from several hospital committees and leadership positions I had little interest in so I could focus on the ones I did. This also made it possible for me to be home to enjoy meals with my family. I lobbied the clinic management to hire a fourth surgeon to lighten the load and give me a lifestyle that better suited my priorities. Management had their own priorities and did not want to make changes in one of their most profitable departments, so I had to look elsewhere.
I want to make it clear that I did not change practices to change my life, I transformed myself first and then found an environment that better suited the person I feel I am meant to be. Interestingly, I found that place in the Rocky Mountains of Colorado — the same environment that inspired me to want to be a park ranger. Today I practice general surgery, but also make time for reading, being outdoors, photography, fitness, family, and, of course, skiing. I have found that by working to make myself a better person, I have become a better physician and surgeon. So, I have dedicated myself to trying to discover how best to live and how to become my best self.
I don’t have all the answers and doubt I ever will, but I have learned there is a lot to be gained by making an effort. Life really is about the journey and not the destination.
Telluride Colorado skiing with my son.
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