My first divorce was mostly my fault, because I was unfaithful. There were plenty of offers, and those that were the most enticing I accepted, with guilty glee. I should have instead faced our marital incompatibilities, once they became dominant, and dealt with them face to face rather than seeking comfort elsewhere. Once that unfaithful habit pattern became established, it did not stay secret for long. Because of that exposure to the truth, and our incompatibilities not dealt with directly, we had frequent arguments. After an argument lasting into the wee hours of the morning, two very bad things often happened. One was that, although I was trying very hard to stop smoking, I would finally succumb, and reach for a cigarette, thereby becoming hooked again. The other bad thing that sometimes happened was for our children to be awakened by the ferocity of our argument, and they would all get out of their beds to get between us in an effort to stop the arguing. Even that was not enough. Once, in an effort to get Jane to stop yelling at me and pushing me, I pushed back, and she went tumbling down the stairs to the basement, becoming badly bruised. On another occasion, I left the house to get away from the arguing, and she came after me in her car, trying to run me down. She tore down bushes and ran through a gate trying to kill me, while in the car. Both of us had deserted our children to carry out those violent away from home episodes.
We were stuck in a blind alley, with no escape, and disasters were headed right for us. I had taken up smoking while in my middle twenties, because it seemed like such a cool thing to do, but by my late thirties had developed frequent upper respiratory tract infections, often prolonged, often associated with long coughing spells, spitting up blood. I knew that if I did not stop smoking, I would most likely die an early death with lung cancer. I did quit at least six times, knowing the urgency to fight through this addiction, but each time we had an endless argument, reached for a cigarette. At that point I believed that if something was not changed, someone in our immediate family was going to die an early death, if not me or my wife, then one of my children, trying to intervene in the middle of one of these intense arguments. It was one of those situations where, since I accepted most of the blame, it was up to me to do something about it that would prevent one of us from facing an early death. I am well aware that a better solution would have been for me to stop philandering, seek counseling, and face Jane directly with our problems, in an effort to resolve them. I should have made it clear to her that if she was unwilling to stop smoking, I would have to leave. For reasons which are probably not good enough, I chose to handle this crisis without that confrontation. So one day, I put my clothes in my car and left, leaving everything else behind, other than a note with my apologies.
At that point, I had nothing, other than my car, my clothes, and my job. I had no money other than what was in my pocket, and was forced to rent, at nominal rate, a one room apartment on Fourth Street in Chillicothe, Ohio. I had a child’s bed and a record player, no utensils, no tools, no other furniture, and used a kerosene heater for warmth. I used a boy scout knife to open cans and for utensils. For those of you who do not know Chillicothe, Ohio, Fourth Street is on the south end of town, quite close to the Mead Paper Company, which uses sulfuric acid to break down wood into cellulose, so that it can be used to make paper. It smells like rotten eggs. So after dealing with patient problems all day, doing surgery and taking emergency room calls, I would go home to the smell of rotten eggs. During the night, the police sirens would go off, and their flashing lights would reverberate around the room, because there was always some sort of domestic violence going on in that part of town. My tires were deflated once; others were slashed. There was no sense of security; I never could sleep without making sure all the windows and door were securely fastened, and turning off the kerosene heater, afraid it might malfunction during the night. There was never a comfortable position in a bed too small for my body. The whole place reeked, and I had no money for food. For weeks I lived on leftovers from the hospital, or chocolate milk and crackers. I had gone from comfort to temporary poverty. Fortunately, I still had a job.
And we were terribly busy. My partners and I came from the surgery residency program in Cincinnati when it was 6 years long. We were trained to do all surgery. We were everything surgeons in an era when that was possible. We took out thoracic aneurysms and abdominal aneurysms, did bypasses, carotid endarterectomies, lung resections, esophageal resections, gastric resections, colon resections, mastectomies, thyroid surgery, parathyroid surgery, gynecologic surgery, hysterectomies, bladder suspensions. I did fractures of all kinds, put in long rods in femurs and tibias, replaced hips, set fractures with plates and screws, drilled wires, put up complicated traction apparatus, took out kidneys with cancer. We took care of children and adults, dong pediatric surgery as well adult and geriatric surgery. We were the first responders for the Emergency Room day and night, and took care of the most acutely ill patients in the Intensive Care Unit. We did prolonged fluoroscopic procedures in radiology, angiograms, and did endoscopies. None of this all-inclusive surgery is possible now. Our government regulates medical care so tightly, and the lawyers are so rapacious, that we are all confined to very narrow specialty practices in order to claim competence in what we do. That era of doing all kinds of surgery is long gone, other than in developing countries somewhere else in our world.
There was one good result of all this intense work: we prospered. It was mostly because we were working twelve to sixteen hour days, if not more, seven days a week. It was the equivalent of working two or more jobs, with only sporadic breaks. There was some left over acrimony from my divorce, but we were able to get through those spells with little change. I was able to fulfill all my divorce requirements with my wife, and was able to pay for my children’s tuition though college. It was not easy for my wife, my children or me, but we were able to progress beyond that cataclysm and move ahead in life. At least we were all still alive. My partners and I were able to fight off the lawyers through demanding court trials, leaving them the message that they should either leave us alone to take care of our patients, or face a fierce fight. At one point, I had six lawsuits filed against me in a six month period of time. After we won our first court trial as defendants, all those threatened suits were dropped. It appeared pretty clear that lawyers don’t really want fights; they want easy targets. Thereafter, the only major change that occurred was that, having seen the handwriting on the wall, I elected to go back to residency for one more year. I felt that if I was going to be restricted to doing only one kind of surgery, I should select that one specialty which I did the best. So I went back into residency at Ohio State University to do thoracic and open heart surgery for a year, and confine the rest of my surgical years to thoracic surgery. My partners became angry that I had left them with even more work to do, and at the end of my additional training, locked me out. I had to move to another community to practice. Perhaps it was just as well, to get away from making further mistakes in that community, and try to move ahead, lead a more responsible life in another town.
Well, in part. One of the character flaws that continued was working long hours, seven days a week. That did allow further recovery, however, after going into poverty. I was able to buy a modest home with an adjacent yard, which allowed me to plant and tend with fruit and ornamental trees. And after a while, there was extra money. What was not needed got saved. Over time, enough accumulated that I could make plans to give away what was not necessary for me to pay my bills, and have a little reserve to help my children jump start their savings, at the time of my death. So I created a living will, which will give back to my community the majority of what I have saved. I wanted to do so in ways that will continue to benefit those who come after me for years to come. I am giving toward the construction of a Cancer Center in our community. At the time of my death, my town will receive pretty much all the rest of my accumulated savings, to develop hiking and biking trails all can enjoy and use to maintain their health.
I relate these personal issues in an effort to make a few comments about ethics and station in life. It does not matter, in my opinion, whether we are in poverty or in wealth. We still have, it seems to me, the responsibility to use whatever we have been given in that station in an ethical manner. If we have virtually nothing, we still have the obligation to work, because each of us should do whatever we can to sustain life, give back to those others who have sustained us. If we have a large income, each of us should use only that part we need to have modest comfort. All the rest should go back to sustaining other life in the most productive manner available. Ethics, by our definition, contains a deep and abiding respect for all other life, in all its forms, because all life is tied together in co-dependency. That means each of us should contribute whatever we can, in large or small amount, as long as we can, in order to support life. Anything less than these simple requirements is, to me, unethical and selfish.
That’s not the way we operate now, is it? We have this economic system where we believe in free enterprise. That’s what makes us strong and healthy, better than anyone else in the world, we say. We usually carry that philosophy forward to insist that whatever wealth is accumulated by free enterprise belongs to the person that developed that wealth. Unfortunately, that only works when there is an excess of resources to explore. When that excess is no longer there, when our resources are dwindling, when our arable land and nutrient seas are being polluted into an unusable state, when all the world is tied together by a burgeoning human population, when the circle of life is being destroyed, something more ethical has to occur, in my opinion. Free enterprise, without ethical restrictions, can be thought of as simply a form of aggregate selfishness. Free enterprise, if allowed to continue unchecked, it seems to me, will cause further division between the wealthy and the poor, and will then cause unstable societies and civil war. It is, I believe, a mistake to allow corporate America to control the political system so completely that the wealthy get wealthier. It is, I think, a mistake for corporate executives to get salaries of multimillion dollars per year, all of which they keep for themselves. It is, to me, a mistake for the United States of America to wage war on foreign countries in order to protect their oil resources and/or business interests. It seems foolish to allow tax loopholes that allow corporations to escape their duty to give back to the country which sustains them. There is something wrong about our allowing companies to exploit cheap labor in other countries in order to put more money in their own pockets. No one member of a community, in my opinion, should lead more than a life of modest comfort. Everything else should go back toward the support of all other life, in the most productive manner possible. Any political or economic system which is less than this business of all of us, always giving back, is to me quite unethical.
And then, I often see the other side of this same working coin. I am astonished at the number of people that I see every day, who come to me for some type of support, who are applying for and expecting “total disability”. They would not be there in such great number if our society did not encourage this free hand out. These are people who are moving freely, clothed, well fed, but often believe that they have no obligation to give anything back to their community, expect to be fully supported for the rest of their lives by all the rest of us, without any request for any of their time and effort. They fully expect to receive a comfortable living without other obligation, and often seem angry that anyone should expect them to do anything in repayment. Our welfare system is broken, is it not? A healthy society, in my opinion, does not support those who are unwilling to do their part, at least in some way.
I understand that when a lady comes to me in a wheelchair, unable to walk because of crippling arthritis, with hands so deformed that she can scarcely take care of her body needs, that we should feel empathy, and take care of her. I do not understand when a flood of people with various ailments come to me thinking that this means they should not have to work any longer. Most of them are probably better off than I am. I have hypertension, requiring daily medicine. I have diabetes, requiring a no sugar diet and strict calorie restriction to maintain normal weight. I have a tremor that sometimes makes it difficult to get food to my mouth, or write without shaking. I have such poor balance that I weave down the halls going from one room to the other. I have to lean forward to see the screen, because the print is too small and blurry for me to read otherwise. My right hip hurts too much for me to find a comfortable position which allows me to go to sleep at night. My back hurts. But I am still working. Why aren’t they still working? Ailments, it seems to me, are a normal part of life. We put up with them and keep contributing to our societies, keep moving forward, keep giving back what we can.
By our definition, all of life deserves to have life, liberty from oppression, and the opportunity to pursue happiness. All of life should hold the deepest respect for all other life. That means, in this definition of ethics, that even the poorest should give whatever they can back to their society. That means that, beyond modest comfort, all life who can give extra, should give that extra back to their society. Anything less than all of us doing our part, to whatever extent we can, to sustain the community of life, is to me, unethical.