“No, sir,” I replied. “I do not give up. Thank you for your time,” I said as I left the room.
The secretary looked up at me when I walked by.
“How’d you do?”
I shrugged my shoulders. Only time would tell.
She smiled at me warmly. “I overheard a little of that in there. I have a feeling everything is going to work out for you.” She handed me a flyer. “You might want to take a look at this. The deadline has passed, but my sense is that deadlines for you aren’t acceptable either.”
The flyer was for a summer program called MEdREP at Tulane Medical School. It was a program for minority and economically disadvantaged students hoping to pursue a career in medicine. It was a summer enrichment course that gave you lab experience, and helped you prepare for the MCAT, the test every medical school applicant is required to take.
“Thanks,” I said. I stared down at the flyer. Tulane Medical School. I didn’t know anything about Tulane, but in that moment, I had a feeling it would be key to my future.
The premed committee ended up providing me with the highest recommendation possible. Ruth’s magic had worked again.
And when I called the summer program, the person who answered informed me that the deadline had passed. I asked to speak to Dr. Epps, the program’s director. I told her I had to be accepted into the program. She let me tell my story and finally she said, “Jim, send in your application. It will be fine.” And two weeks later I had the letter of acceptance to the MEdREP program in hand. Unfortunately, I didn’t have the money for airfare to get to Tulane, which is in New Orleans. Coincidentally, right after I got the acceptance letter to the program, I received a call from my father. He was in jail in Los Angeles and was about to be released and needed me to come get him. He said he needed money for food and a hotel room because my mother wouldn’t let him back in the house, and he would end up sleeping on the streets. I only had money for my food and my rent that was due in two weeks. He told me he was expecting a check shortly. Here we go again, I thought. But I knew I would help him. He was my father. My friend Keith, who knew some of my family’s history, offered to drive me to Los Angeles to pick up my dad. Dad actually seemed OK, as he had been in jail for several weeks and sober during that time. We took him to skid row and rented him a room for two weeks and I gave him $200. I told him about the summer program in Tulane, and he smiled and said he was proud of me. He thanked me. I still had no clue how I was going to pay to get to Tulane, but two weeks later an envelope arrived with writing I recognized as my dad’s and in it he had signed over a check to me for $1,000. My father had given me his last cent so I could go to New Orleans. I cried. That summer program was transformative. It exposed me to lab research and allowed me to meet several medical school faculty members. It prepped me to take the MCAT, and it gave me experience being interviewed. It was an intense summer of work, but I was completely focused and completely happy. I was going to be a doctor. I was sure of it.
In the fall I applied to Tulane and waited anxiously. I knew that I had done well during the MEdREP program, and I had done well on the MCATs, but because of my GPA I knew my application was not competitive compared to the vast majority of applicants. I was also working two jobs and the long hours were taking their toll. It was hard to stay focused. It was during this time that I got a call from my mother. My dad had been drinking heavily and had decided suddenly to leave on a Greyhound bus and visit family in Kentucky. She was worried as he had taken nothing with him, and it had been two weeks with no word from him and he hadn’t shown up in Kentucky. While my dad would disappear at times, I couldn’t recall a time when he was gone that long without reappearing or us hearing from him or from a jail. I now added this to my worry list. My mother called back a few days later saying that my father was in the veteran’s hospital in Johnson City, Tennessee.
• • •
IT WAS EVENING but I immediately contacted the hospital and spoke to the doctor on call. My dad was in the intensive care unit receiving high-dose antibiotics and on a respirator. He was only intermittently responding to commands. He had severe pneumonia and they were having difficulty oxygenating his lungs. The doctor indicated that Dad seemed to be responding but it was still touch and go. He asked me for a bit more background and his medical history and I realized I knew very little about my father. I didn’t know if he had any ongoing health issues. I didn’t know if he had been on medication, had ever been operated on, if he had allergies . . . all I knew was that he drank. My entire knowledge of my father related to his drinking.
As I hung up the phone, I tried to think of times he and I just sat and talked or just did something together. Something not related to his drinking. There were only vague, out-of-focus memories. Nothing I could hold on to. Now he had gone off on a bus to see relatives and had never made it to them. What had he done on that bus? What had he been looking for? Why had he chosen to go so far away at this particular time? They were futile questions, and I knew ultimately it was his drinking that had led to his being in a far-off hospital all alone.
I sat down on the side of my bed and cried. I needed to get there, but I had no money. My mother had no money. I had exams coming up. The next few days were spent worrying. I called the hospital several times. He was no longer conscious and his organs were failing. The doctor told me the prognosis was poor, and he was probably going to die. My roommate offered to lend me the money for the plane ticket. I made arrangements and planned on leaving at noon the following day. I had no idea what I would do once I got there. I just didn’t want him to be alone.
I fell asleep but I was restless. I had never been on an airplane. I didn’t know anything about the place I was going. I was scared. I was tired. Finally I did fall asleep, a deep sleep. Suddenly I woke up. I wasn’t sure what woke me up. I was just up and awake with my eyes wide-open. I looked around, and at the end of my bed was my father. He looked at me. He looked well. Better, in fact, than I had seen him for a long time. He was calm and had a look on his face that wasn’t a smile but a look of kindness and acceptance. He said, “Hello, son. I came to say good-bye. I’m sorry I wasn’t the father I wanted to be. I’m sorry I wasn’t there for you. Each of us has a path. I had to take mine. I want you to know that I’m proud of you and love you very much. I have to go now. Remember that I love you. Good-bye, son.” I said, “I love you too, Dad.” And then he was gone.
I sat up. I wasn’t sure if I was dreaming or if it was real. I didn’t know what to think. I just sat there thinking that when I saw him I was going to hug him and tell him it was OK. That I loved him. I fell back asleep until the phone rang and woke me up. I picked up the phone slowly, half-awake. It was my father’s doctor. He wanted to tell me that my father had passed away an hour before and that he was sorry. He said that right before he died, he opened his eyes and smiled. He wanted to let me know that he wasn’t in any pain when he died. I thanked him and hung up the phone. I called my mom and we both cried. She said he had done everything he could and that deep down he was a good man and that he loved me very much.
My father did love me.
I knew he loved me.
And I loved him.
• • •
LESS THAN A YEAR after I went before the committee at UC Irvine and two weeks after my father passed away, I was accepted into Tulane University School of Medicine. When I received the acceptance letter I went into my bedroom and sat on the side of the bed and slowly opened the envelope and thought of my father. I looked over to where he had been that night when he visited me and said good-bye. I knew he was proud of me.
As was pointed out during my interview with the premed committee, I didn’t have enough units to graduate, but I still walked in the graduation ceremony along with the rest of the graduating class of 1977. My acceptance to medical school was conditional on receiving my diploma. My junior year, I had returned home to take care of my mother after a suicide att
empt and had to drop all of my classes. As a result, I was short three biology electives. There was no way for me to complete them before medical school began in the fall. I had overcome so much and now it was all at risk. I didn’t know what to do and then I realized all I could do was to tell the truth. I picked up the phone and called Tulane and asked to speak to the dean of admissions at the medical school. I waited for what seemed like eternity and he came on the line. He seemed to know exactly who I was. I explained the situation and there was silence. Another eternity. He said, “Jim, we want you at Tulane. If Irvine allows you to transfer credits from medical school to fulfill your missing electives then you’re set.” I must have said thank you a million times and hung up. It was amazing what happened next. I explained to the professors whose classes I had dropped that I was accepted to medical school but because of a family emergency I had to drop my courses during the last quarter and would they consider allowing me to transfer a medical course to fulfill the requirement. Each one immediately agreed, congratulating me on my acceptance. I didn’t realize till later that they had all assumed that I had a stellar GPA and MCAT scores and, of course, they would overlook not completing the elective and substitute in a course from medical school.
Sometimes rules and criteria are critically important, but oftentimes they are arbitrary and act only to sift through numbers and limit opportunity. Having straight A’s or an undergraduate degree is an arbitrary barrier to becoming a doctor. I knew I had the innate intelligence and the determination to be an excellent physician.
Now was the time to prove it.
EIGHT
It’s Not Brain Surgery
I never planned on becoming a neurosurgeon. My plan was to become a plastic surgeon—I had been moved by children with craniofacial disorders and was attracted to the technical complexity of the surgery. Seeing pictures of children with facial deformities struck a nerve in me. I had a special empathy for those children who had wounds they couldn’t hide from the world and who had to constantly see others turn away from their disfigurement. But also, I really liked aesthetic plastic surgery and imagined being a university professor caring for children part of the time and then going to my Beverly Hills office to see my rich private plastic surgery clientele. Plus, being a plastic surgeon to the rich and famous paid very well, and I would meet a lot of very attractive women.
I had accepted a scholarship to pay for medical school for the first year, and after my freshman year I accepted a scholarship from the army. I felt a deep obligation to serve my country, and I wanted to give back. I remembered so vividly my dreams of being Chuck Yeager flying over Lancaster and breaking the sound barrier, and my pride in wearing the uniform of a Law Enforcement Explorer. One thing I learned during college was that Yeager was not the first choice to break the sound barrier—this honor belonged to a man by the name of Slick Goodlin. The problem with Goodlin was that he demanded a fee of $150,000—a huge sum of money in 1947—to fly the plane. Yeager, however, didn’t want to do it for the money. He wanted to break the barrier out of a quest for adventure and a spirit of discovery. He wanted to see just what man was capable of achieving when pushed to his limits. Even with two broken ribs and so much pain he had to jerry-rig a broom handle to help him close the hatch of the plane, he would not be deterred.
Who was I? Was I the guy Oscar Wilde described, the one “who knew the cost of everything and the value of nothing”? I spent a good deal of my life trying to reconcile my inner Slick Goodlin and my inner Chuck Yeager. I had empathy for others who had struggled like me, who were in pain, and I wanted to help them. But I also wanted success. Practicing Ruth’s magic had gotten me this far, and I continued to practice daily, knowing that I was only part of the way to where I wanted to be. I wanted fame and fortune. I wanted to be someone that others looked up to. I wanted to be the best surgeon in the world.
The army agreed to pay my way through medical school, all tuition and expenses, and I agreed to serve in the army as a doctor. I served a total of nine years in the U.S. Army, and eventually became Major James Doty.
• • •
MY MEDICAL SCHOOL experience was nothing like my undergrad experience. I had no difficulty academically, and I discovered I had a natural aptitude for studying the intricacies of the human body—anatomy, histology, physiology. The ability to memorize more information than it seems humanly possible for one person to memorize is the struggle for every first-year med student. I know now that my years of practicing what I learned in the magic shop had developed my brain so that I had the ability to memorize more easily than many of my fellow students. I could focus for much longer periods of time on my studies, and I never complained about my mind wandering off while I read medical textbooks. We were given mnemonics to help us remember everything from bones to nerves to how to write medical charts. Some were silly, like the mnemonic for remembering which cranial nerves are sensory, motor, or both—Some Say Marry Money But My Brother Says Big Brains Matter More. Other mnemonics were harder to remember than the original information, like OOOTTAFVGVAH for the actual nerves of the cranium.
I used some standard mnemonics, other times I made up my own, and still other times I pretended I was using them when really it was just that the information I studied seemed to simply flow into my consciousness when I needed it. A 2013 study by researchers at the University of California, Santa Barbara, found that focused-attention meditation training improved memory, focus, and overall cognitive function in undergraduate students after just two weeks of practice, as measured by improved GRE scores and other memory and focus tests. What’s amazing to me about this study is that the practices implemented by the researchers in 2013 were remarkably similar to my practice with Ruth in 1968. How much money is spent on GRE test preparation and courses? The beautiful thing about a meditation practice as a study aid is—it’s absolutely free.
The army scholarship guaranteed me an internship after medical school but not a residency. In the civilian world, those two things are connected, but I would have to apply for a residency. After finishing at Tulane in 1981, I accepted a flexible internship at Tripler Army Medical Center in Hawaii—a place where I had done a prior rotation as a student. A flexible internship meant I would be focused on various surgical specialties rather than just general surgery. I did rotations in pediatrics, obstetrics, gynecology, internal medicine, and also general surgery, as well as neurosurgery. I thought this broad and varied experience would be more beneficial to my education, but what I didn’t realize was that if you do a flexible internship it puts you at a disadvantage when you apply to a general surgery residency because you haven’t focused on just surgery and its subspecialties. A broad knowledge of a lot of areas actually hurt my chances. My plan was still to become a plastic surgeon for children, which called for a general surgery residency, followed by a plastic surgery fellowship, followed by a craniofacial fellowship. I had a plan. But there were twelve of us competing for the general surgery residency, and I was the only one doing a flexible internship. The odds were not in my favor. My eleven colleagues told me there was no way in hell I would get into the general surgery residency, and they were clearly happy for my disadvantage. I had an intensity of purpose about me that did not go over well with the others, and my great belief in my ability to manifest anything I wanted was coming across as arrogance. I understand now why they seemed to want me to fail.
You apply for your residency in November, so I applied for the general surgery residency like everyone else. In April, however, I had my neurosurgery rotation. The guys who were in charge were the nicest I had met on any rotation. Neurosurgery was fascinating—working on the brain was demanding and precise, plus it gave me a thrill that I hadn’t found in general surgery, which is mostly about the chest and abdomen. There was something about going where no one had gone before, into the deepest recesses of what makes us human, that called to me. I still wanted to help children with deformities, but exploring the myste
ries of the brain felt like a new quest that called to me. I wanted to be a neurosurgeon in the same way I wanted to go to college and to medical school, but to do that I had to do a neurosurgery residency, not a general surgery residency. I knew that I could do neurosurgery and still do a plastic surgery and craniofacial fellowship, if I wanted. It was perfect.
The chief of neurosurgery at Tripler was encouraging.
“You’re technically very talented, Jim. You should do neurosurgery. You need to do neurosurgery.”
“This is great,” I replied. I was swollen with pride. I was going to be a neurosurgeon.
“The thing is,” he added, “they train only one neurosurgeon a year in the army, and there’s a backlog of three years. You’re going to have to wait, and after your internship, they’ll send you out in the field as a general medical officer for a few years until you are at the top of the list and can start your residency.”
“Three years?” I asked.
“Only three years.”
“I’m sorry, but I can’t accept that.”
He laughed at me. “You have to do your time, Jim.”
“That’s bullshit and unacceptable,” I said more passionately and clearly out of line.
“That’s just how it goes. It’s not bullshit. It’s the army.”
“But it’s unacceptable to me,” I said.
He shook his head and showed me out of the office.
I had vacation time coming up, thirty days away from the army, so I left Tripler and went to spend a month at Walter Reed. This was where I planned to end up, so I rotated in neurosurgery on my own time and did very well. I met with the chairman of neurosurgery before my “vacation” was over.
Into the Magic Shop Page 13
