The Million Dollar Question  (ck 3/1/2016)

Five years ago, for the first time, I saw the third world.  Since that time, I have been trying to comprehend something, not initially obvious to me.  The people I met, suffering severe medical ailments and the real problems of a third world country are the happiest people I know.  How is this possible?  How are the people of the third world happier than us?  You might quickly jump to the answer, “they don’t know any different” but after years of the same experiences, I believe, “maybe they know something that makes all the difference.”  Maybe we have so much to learn from a people of so much less.

First, each of us needs to individually define happiness.  We’ve all thought about what we need to be happy at some point.  Many people continue to chase it though not knowing what they need.  I believe a common misconception is that wealth would give us happiness.  I remember that saying, “If you don’t think money can buy happiness, then you don’t know where to shop.”  It’s funny but not true.  Your new house, jewelry, clothes and car would eventually get old and the novelty would wear off.  And, if you are not happy now, with all your possessions, how could more “stuff” bring you more happiness?  It wouldn’t.  There are plenty of rich people who have sold their soul, failed marriage, and/or become addicted to drugs due to their depression.  Meanwhile, like I said, these poor people are so happy! 

Conversely, I think the chase for wealth can certainly make people unhappy.  Many of the angry and upset people I know converse that they work too hard and don’t make enough money.  Meanwhile, people in Nepal work six days a week.  Many do demanding physical labor but might only make $2-3 per day.  These are the happy people I was telling you about!  Did you know that the international poverty level is $1.90/day?  Can you comprehend that or believe some people feel blessed to have a job with that wage?  In our society, as we make money, we are attracted to keep making more and more.  We strive to keep up with the Joneses and fit in.  The chase gets the best of us because there is no obtainable end.  We get stuck always wanting more, newer, bigger and better.  The chase is consuming but doesn’t end in happiness, accomplishment, or satisfaction.  It keeps going.

Next, on a tangent, I’ll say that life is hard for everyone; however, stress is not an excuse to not be happy.  Life is challenging to everyone in different ways.  A single-mother who bags groceries has different stresses than a plastic surgeon.  They may even live with the same, maxed-out stress levels despite their differing paychecks.  You might have initially thought that life would be easier for the surgeon because that person would make more money.  With “mo money” comes “mo problems” (and different problems) as Biggie Smalls once rapped.  Maybe that’s why physicians are twice as likely to commit suicide than any other profession.  Anyway, stress is something we all have and it needs to be balanced and managed but it is not an excuse or barrier to us finding happiness.     

Now, to help me better understand an answer to my question, I started to compare life in the United States to life in the third world.  There are many obvious differences.  Their problems include high infant mortality, malnutrition, lack of clean water, access to healthcare, illiteracy and lack of education, human rights, freedoms and opportunity.  We actually have a term for our problems, “first world problems.”  This term is used to joke, admitting there is a superficial nature to many of our everyday issues.  We are all guilty of them.  For example, most of us would feel stressed if you left our cell phone at home, if the traffic light turned green but the car in front of you didn’t move, or if the Starbucks barista spelled your name wrong?  Really?  Those are not real problems and they’re not worth getting frustrated over.  I think we stress too often about things in which we have no control over and we stress over inconsequential parts of life.  I was once offered the advice, “If in a year from now your current problem is likely to still be a problem, than that’s something you need to be concerned about and handle.“  Otherwise, let it go –to worry is a waste of time and energy that trades your happiness for no return.

Maybe our society is somewhat too far removed from real third world struggles to understand, empathize and enact change in our own lives.  Have you, ever in your life, had to worry about a clean water source?  Maybe on a cruise vacation while brushing your teeth?  Unless you’ve experienced a poor world, it’s difficult to imagine.  It has been several generations since most of our European ancestors immigrated here for a better life.  Now, we cannot relate to the poor, illegal immigrants who would risk everything to enter into a country, offering an upgrade.  Instead, you and I were born here, through the “lottery of life.”  How lucky?  Without thought, we feel entitled to a good life and we take that for granted.   Maybe that’s exactly the problem.

In our society, we want what we do not have.  Meanwhile, it takes loss to appreciate the value of what we used to have.  These two statements make all the difference!  The happy people in the third world tend to be satisfied, appreciate each other, and have a sense of family and purpose in life.  Here, we have so much going for us but life often moves too fast to realize how good it is.  We are so blessed to, first of all, live in this country.  We should feel so fortunate for everything, every opportunity and everyone that we have in our lives.  Instead of watching a pointless television show, reflect on that for a while.  Think about it.  Is everything you currently have in life not an incredible blessing?  Maybe it is not and you have some work to do.

I think we can reach happiness when our mind’s eye sees the valued good in all we already have.  Try it.  Show homage.  Give sincere appreciation to your coworkers and family.  Tell people what they mean to you.  Use the word “love.”  Live a passionate and purpose-filled life.  In making someone else’s day, make your own.  Consciously make the choice to see the good in the world and don’t waist your time.

For me, mission experiences in poor countries have broadened my view of the world.  It is this enriched perspective which shapes the reality of my life.  This allows me to be so happy.  I hope I shared this enlightenment with you effectively.  If not, please, travel to the third world and see it yourself.



March 30, 2016. 

I just returned from my one month, between-jobs, travel around the world.  While there was plenty of fun and adventure in Cancun, New Zealand and Australia, I had more impactful experiences in the third worlds of Guatemala and recovering Kathmandu, Nepal.  Now, like I usually do on my return from one of these missions, I’ll try to share my recent thoughts and reflections.  Gifted with about 35 travel-hours to do so, this is probably a good time…

MedShare in Guatemala.  It was a great honor to represent the MedShare organization in Guatemala.  If you don’t know by now, MedShare is a non-profit which redistributes our donated medical surplus throughout the world where it is needed most.  Different than my past mission experiences, my efforts here were not focused inside the OR.  This time, I had a unique opportunity to travel to about 10 hospitals across several cities, to meet their administrators, physicians and patients, and see the problems they face.  I also met the president of Guatemala, Jimmy Morales.  All these interactions reinforced that MedShare is making a palpable difference.  I saw the MedShare-supplied hospital beds, autoclaves, baby incubators, ultrasounds, x-ray equipment, etc. and can see how this gives these hospitals exponential capabilities to treat their patients.  Their impact is felt across the entire country….excuse me, it is felt across the world.  As I later traveled to Nepal, I again felt the MedShare impact.  As I came to understand that their good is universal, I had a God moment.  Realizing that I was part of something “right” and much bigger than myself.  Their impact is larger than anything I could do in my Atlanta-suburb clinics.  At that moment, I knew I was in the middle of something great.

Nepal News.  To finish my travel, I completed my fifth mission at the Nepal Orthopedic Hospital (NOH) in Kathmandu.  The hospital welcomed us with their warm, familiar smiles.  Our team worked intimately with theirs and we completed about 25 surgeries.  

Structurally, the hospital building still stands.  Metaphorically, it stands stronger and taller than I ever saw it.  It was special to feel the positive energy persevering them through the April 2015 earthquake aftermath.  They have worked hard and they are grateful for the universal support they felt.  I personally connected the NOH with MedShare and I repeatedly heard how useful those 1,000 boxes of medical supplies were at that time.  I saw some remaining boxes but not many.  The supplies were put to use and anything let over was spread out to the more remote villages and utilized there.  Perfect! 

As a surgeon, the best part of the mission trip is usually to examine the past surgery patients and see the progress they’ve made in their lives.  This year, the trip highlight was to see that the whole hospital doing so well one year after the earthquake.  Many of you have made donations to Nepal, the NOH, MedShare or Healing the Children.  Thank you!!!


Carl, Thank you for sharing your beautifully composed and thoughtful insights.  So well stated. 

I spent last week in India, a country of extremes - top hotels and service next door to horrific poverty.  On the last evening of my trip I had the opportunity to spend the evening with a local colleague visiting his home in Mumbai and walking around his neighborhood.  His home was very, very simple by our terms yet the family was so proud and so happy.  Parents, Grandparents and children all happy to be together and proud to show their home and share their special foods.  

Afterward we walked the neighborhood to see the local vendors, places most of us would never consider buying food from. Again, the pride in showing me the neighborhood was palpable.  On my flight home I felt almost embarrassed for all we have and the priority we put on "stuff".  Reading your blog, put words to my feelings about this.  Thank you and please keep sharing.  


March 10, 2016.  Gracias MedShare!



This afternoon's San Juan climb was gentle, with rests for those interested in shopping along the way.  "Bienvenidos" was politely repeated...each time, accompanied by the universal greeting of a genuine smile, inviting us inside.  My pack got heavier as I supported the locals, picking up canvas reminders.  Motorcycles zoomed by and watch out for the tuk tuk!  Coolness of the higher elevation rewarded us as we reached the hilltop's cathedral.  On descent, the trip was winding down too. We were delivered to Bonnie's vista for a tranquil evening's end.  As the boat turned us back, Lake Atitilan saluted us with a sunset to remember. One last dinner together, we then reminisced. Fed and full, our hearts were expanded and full as well.  The people of Guatemala remain in true need and the angels of MedShare are further inspired to improve the quality of life here.  As a physician, I witnessed how this group's far-reaching and worldly impact is greater than I could have in my clinics.  MedShare is truly improving healthcare and the lives for those across the places where people need it the most.  

Personally, it was the specialist of honors to accompany MedShare's great group and be one of their ambassadors.  Sadly, I now mentally prepare to say goodbye to my new friends who, without doubt, will be future partners in continued humanitarian efforts.  Thank you for the experience and life-changing Guatemalan perspective.  I will sleep well tonight, more confident than ever, knowing that we are doing something very right which will have a continued and forever impact. 

March 7, 2016.  Down in the Dumps…

For decades, the poor of Guatemala City have been drawn to the city’s gigantic dump for a treasure-hunt.  Collecting the reusable and recyclable materials (such as copper, glass, plastics and cardboard) does not necessarily yield great profits.  A long but successful 11-hour day at the dump might yield $2-3 depending on your finds and the market.  Can you believe this is still above the daily international poverty line of $1.90/day….and many other people have it worse?!

Unfortunately, many of these impoverished men and women are illiterate, have no education and many are tied into gangs and drug use.  They are not used to our too-easily and far-too-often forgotten blessings.  They are not guaranteed healthcare, electricity, running water, an education or government assist.  The poor here live hard lives and they do not have other great paths to choose from.  In walking through the dump, their safety is jeopardized in various ways – inhalation of methane gases, exposure to disease-ridden waste, a crushing collapse of the landfill, and even dangerous gang control of the arriving dump truck loads. 

My guilty mind turns to self-reflection and realization of my own biologic footprint as the dump’s pungent smell swallows my breath, and with a choke, I return to the moment.  In viewing the dump from afar, soaring vultures impress upon me the length of their 32-acre dump territory.  As I watch them, movement below shifts my eye to the human, land vultures welcoming a continued supply of incoming dump trucks.


In 1997, Hanley Denning, a young girl from Maine, volunteered to teach some children and adults in this area.  In doing so, she was immersing herself in this culture and becoming more fluent in speaking Spanish.  Her purpose in Guatemala, and in life, changed when she learned of their struggles and the problems the dump created.  You see, while the adults went to the dump, their children were left to the streets.  So, Hanley sold her belongings to fund an organization called Safe Passage (in Spanish, “Camino Seguro”), to take-in and tutor these children.  Unfortunately, years later, Hanley was in a fatal car accident.  Her improved and ever-evolving organization thrives.  On today’s tour, I could tell that Hanley’s spirit and vision lives on in the guides, workers and students.  Hanley would be extremely proud and overjoyed, but not finished.

The public Guatemalan City schools are not very good and Safe Passage noted a continued poor graduation and literacy rate among their initial participants.  Instead of solely tutoring, the organization then started their own school to properly teach these children.  They also found that good nutrition is necessarily to learn well.  Safe Passage can now provide their students several meals a day.  They continue to teach children and also their willing parents.  This equips them with a newfound self-respect and better ability to sustain and foster their families.

In association with Saving Passage, the adult women students sell hand-made jewelry from recycled dump metals and papers.  Their group, called Creamos, raises funds for these women directly.  In supporting their efforts you not only get a fashionable necklace with a great story but also you provide them a continued education and a family’s path to a better life.