How The Class Of 2021 Can Pay Forward Their Knowledge And Skills

Recently, I had the honor of welcoming the Scholl College of Podiatric Medicine Class of 2021 to the profession at the Rosalind Franklin University of Medicine and Science Scholl College’s White Coat Ceremony. I wanted to share with you my speech as this month’s DPM Blog.

Dean Parsley, Scholl Faculty and Administration, Class of 2021 and proud families,

It is with the utmost gratitude and humility that I stand before you as the recipient of the 2017 Scholl College Honor Medallion and Alumnus of the Year Award—and it is a great professional privilege to join the company of those recognized before me.

No matter the subject or audience, when I present to students or colleagues I close with the same image: a pair of cupped hands painted with a map of the earth. The text on the slide reads: “Do good wherever you are. #GiveItUpForGood. #PayItForward.” Today, I want to talk to you about paying it forward.

I’ll start with a question for each member of the Class of 2021 to ponder. It’s an important question, but rest easy, it won’t be on the test. Why did you choose the medical profession? It’s likely that there was more than one reason, but my wish for each of you is that on some level, you chose medicine because you are compelled by the drive to serve others. Side note: You can add it in at any time. It’s never too late.

My journey as a student has been influenced by teachers, professors and physicians who have made indelible marks on who I have become as a professional, and for that matter, as a humanitarian. We don’t forget the educators or colleagues who truly strive to reach us as students, who somehow find a way to afford us, as individuals, educational breakthroughs or who present us with opportunities for growth.

There’s a common saying that we all come across in pop culture and in the media. I would even go as far as saying it has become a cringe-worthy cliché’: “He or she is or was a born leader.” I don’t believe certain people are born leaders. I believe we are all born students and one must master the art of learning before contemplating the world of leadership. I also passionately believe remaining a student for life is compulsory for a life of effective leadership.

So, you might wonder what any of this student/leadership/education stuff has to do with paying it forward. The answer is: everything. Paying it forward doesn’t begin the day that we accept a so-called leadership position. It begins with each of us at the beginning of our lives. It is the job of everyone in this room to be eager, to remain open and to never ever at any point in our careers or our lives decide that we know enough and that we can sit back and stop learning. Seek knowledge and share knowledge.

Daniel Bareither, PhD, a Scholl College legend, was my lower extremity anatomy professor. Dry, right? He taught us that everything centers around anatomy in a way that made us want to learn every last thing there was to know about it. I left his class knowing my anatomy.

Richard Lundeen, DPM, was my primary attending during my residency and fellowship. I learned from him that the skill of a competent surgeon had to be rooted in a comprehensive understanding of the biomechanics of the lower extremity.

What I Learned From My Mentors

To this day, my day-in and day-out work as a clinician, surgeon and lecturer is wholly informed by what I learned from just two mentors who found a way to reach me. They paid it forward.

Ignacio Ponseti, MD, is perhaps the most renowned pediatric orthopedic surgeon of this era. At one point in my career, I found myself becoming increasingly frustrated with the surgical treatment of clubfoot and I decided to find a way to learn the Ponseti method.

I made several trips to the University of Iowa where Dr. Ponseti, who even at that time was well into his 90s, spent hours and hours teaching me his trademark treatment. He and his wife invited me to their home for dinner on one of my trips. There I found myself drinking beer and eating pizza with the world’s most famous pediatric orthopedic surgeon and Ms. Ponseti, who herself was one of the world’s most revered scholars on Spanish literature. I will never forget that night.

Dr. Ponseti set into motion my love of foot and ankle pediatric orthopedics. During my time with him, I had the good fortune to see firsthand the impact that he was making in the lives of one child after another, and it was generally in the context of a once broken-hearted mother hugging the great doctor with tears of joy. His level of skill was awe inspiring but it wasn’t the mastery of his craft that moved me the most. It was his professional generosity and his innate decency. His approach wasn’t one that centered around my being a DPM and his being an MD. Instead, we were two physicians working together with a mutual focus on reaching more patients and serving them at the highest level of skill possible. He paid it forward.

After a few years of traveling to Haiti in an attempt to launch a Ponseti clubfoot program, I was contacted by Kaye Wilkins, MD, also a pediatric orthopedic surgeon, who explained that he too sought to bring the Ponseti method to Haiti. Dr. Wilkins had significantly more experience working in Haiti than me, yet he invited me to join him on an upcoming trip. Over time, we made several trips together to Haiti, traveling throughout the country. Dr. Wilkins is in his 80s now and just retired from the University of Texas at San Antonio. As far as I know, the time and travel that he dedicated to international medical missions is unmatched. Dr. Wilkins taught me to love serving underdeveloped countries by showing me we could make meaningful change in the lives we touch. He paid it forward.

In 2010, I traveled to Haiti one week following the earthquake that killed 200,000 people, injured 250,000, and left 2 million of the 9 million people in the country homeless. I had volunteered via Project Medishare and the University of Miami. Upon arriving I met John MacDonald, MD, a retired cardiothoracic surgeon who somehow found himself as a leader in wound care. Dr. MacDonald was managing the area that had been set up to treat patients with wounds, many of them grave. After a brief get to know you meeting, he handed the wound care management off to me so he could return home briefly.

I was sobered by the challenge and stricken by the trust that he displayed in a situation that was the most catastrophic I had ever seen—and because of him, I became a better doctor that day. After the earthquake, Dr. MacDonald went on to establish the first ever formal wound care center in Haiti and he later asked me to lead a diabetic foot program for Haiti. He taught me the importance of working with local physicians as peers and establishing sustainable programs that empower the physicians in developing countries, teaching them what we know versus doing it for them and then disappearing back to our lives at home. He paid it forward.

Why Giving Is So Enriching

By definition, paying it forward means making a contribution with no guarantee of a return on your investment. That’s the bad news. But there’s good news. With the knowledge that you’ve earned over the past four years, and that you’ll add to over the next four years of podiatry school and three years of residency, you’ll greet the podiatric profession with a powerful skill set.

You’re the future of podiatry and as a mentor, I’m going to make a promise to every one of you today. For every hour, afternoon, day, week, or month that you, as a medical professional, sacrifice for a needy patient, a struggling student, a troubled colleague, or a foreign country, you will ultimately be more enriched than any surgery will ever pay. You will reap more meaningful rewards than the most prestigious of accolades will ever afford you.

As undergraduates, podiatry students, residents, fellows and experienced practitioners, our strengths vary widely as do the unique contributions that each of us have the potential to make in our institutions, communities and beyond. Thus, when it comes to identifying opportunities to pay it forward, we’re met with unlimited options. Sometimes, they’ll appear in the form of direct patient care. Sometimes, they’ll arise in the office, the halls of the hospital or the walls of an OR. When it’s your instinct to be competitive and hoard a new skill, choose intellectual generosity instead. When you find yourself hungry for recognition, shine the spotlight on a colleague instead. You’ll be repaid in spades with the trust, respect and friendship of your peers, the value of which I couldn’t overstate.

There will be times when the gratification will be immediate. There will be times when you throw your time or effort into a cause without ever knowing whether you made any difference at all. But if you commit today to make paying it forward a core part of who you are as a physician, you will change real human lives. You will make the world better and you’ll leave a footprint that will far outlive you.

It would be utterly impossible to identify one moment as being the most satisfying that I’ve experienced since sitting in your shoes, so I’ll share the story of my very first international medical mission. It was 2002 and I was invited by a former resident named Jesse Burks, DPM, to join a group from Little Rock, Ark. on a trip to Trujillo, Honduras, located on the northeast coast of the country.

Jesse and I had had a full week of both simple and complex surgical cases, and long hours in the local hospital. A Honduran woman arrived at the clinic with her 7- or 8-year-old daughter. I didn’t speak a word of Spanish but no language barrier could have hidden the desperation in the heart of that young mother.

Eventually, through my interpreter, I had the story. In most developing countries, all of the schools are private. The students must wear uniforms to attend and the rules are rigid. I learned the little Honduran girl wasn’t allowed to attend school because of a foot abnormality that left her unable to wear the shoes required as part of the school uniform. The pressure was on.

I slipped her shoes off and was elated to discover that the only thing that stood between this sweet girl and an education was an extra fifth toe on her right foot. The realization that a young child had been denied an education based on something so easily remedied took my breath away. We scheduled her surgery for the following day. It took ten minutes. Three days later, the mother and her daughter returned for a post-op visit. I removed the dressing and her perfect little foot is, to this day, one of the greatest sights I’ve ever seen.

The girl’s mother wept and hugged me over and over. Though I was totally unable to understand her words, I was pretty sure that she was thanking me. Her daughter started school one week later.

International medicine is glamorous and exciting, but you generally won’t have to look far to find citizens within your own communities without access to healthcare. I volunteer every month in a medical clinic called the Trinity Free Clinic. Last month, I arrived at the clinic, as usual, and was greeted by the director who made a point to thank me for 17 years of volunteering. It wasn’t as dramatic of a moment as the little girl going to school in Honduras but it was enough.

Most of the days of your career will stand as an opportunity to serve your own patients. I’ve been at it for a while, which means that the number of people who have walked through my door is in the thousands, and they represent every walk of life imaginable. Some are delightful, some are frustrating, and from time to time, there are some who seem ungrateful. But they all picked me and none of them had to. And they all have a story. Thus, my job is to treat every one of them as though they are family.

After my residency, I attended a state meeting and I complained the whole way through about the quality of the meeting. At some point, I realized that my complaining was helping no one and that I was due for an attitude adjustment. The next thing I knew, I was on the continuing education committee. The following year I was asked to chair the committee. I begrudgingly agreed but made sure that it was understood that I would never get involved in the politics of podiatry. After several years of volunteering at the state and then the national level, I’m now on track to be the 100th President of the American Podiatric Medical Association (APMA).

As individual podiatrists, we’re each doing one of two things. We’re moving the profession forward, or we’re moving it backward. Podiatry as a medical field isn’t perfect. It’s a work in progress and each generation of podiatrists is charged with the responsibility of leaving podiatry a better field than it was when that generation entered it.

I hope you’ll accept your white coats with the understanding that with membership comes responsibility. I hope you decide to give back to the profession that will give so much to you. I hope you “do good wherever you are,” Class of 2021, and I’m counting on you to “pay it forward!”

To watch Dr. DeHeer's speech, go to https://www.youtube.com/watch?v=RcvWbHA4PVk&app=desktop .