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Youth (Without Surgery)

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You aren’t born to be a surgeon. There’s no natural talent for it. No one is born with a great pair of hands for surgery – for football and piano, maybe; for surgery, no. Usually you become a surgeon (or a doctor, generally) because you want to help people, or because the aspects of the discipline – intellectual, technical, aesthetic, psychological – appeal to you, or because you’re lucky enough to have a role model. For me, all three conditions held, though early on, I was aware of only the last of these. My father, John Lesesne (luh-SAYN), was a doctor (now retired), an old-school internist who made house calls in the upper-middle-class suburbs of Detroit, where I grew up in the late sixties, the eldest of six kids. His was the kind of practice, almost obsolete now, where he treated and cared for two, often three, generations of the same family. He was an allergist, specializing in asthma. Sometimes I would go on house calls with him. While Dad paid his visit, I sat in the car, curbside, scanning the windows of the home to see if I could spot him and maybe get a glimpse of what was going on inside, but it was not out of fascination with medicine; it was the fascination of a son for what his father does, a child intrigued by the grown-up world. That’s it. At least that’s what I thought at the time. Now and then I’d bike by his office and poke in for a visit or, when I got older, stop by St. John’s Hospital on Mack Avenue. I had no idea these latter visits would benefit me years later: Because I associated hospitals with Dad’s presence, they always felt like places of warmth, even invitation, sanctuaries where people went to get well. For me, a hospital was never the dark, institutional warren of hallways and machines that terrifies most people. It was Dr. John Lesesne facing a wheezing little boy sitting on a table. “Now take a slow, deep breath through the mouth,” my father would urge in his Charleston accent, soft and calm, then place the cup of his stethoscope to the boy’s chest.

Proud as I was of Dad, though, as highly regarded as he was in the community, there’s another enduring image I have of him, equally unshakable.

It’s of him not there.

Because he was always working. Frequently he came home too late for dinner. He would do anything for his patients. He made a good living. I could not respect a man more. But he was anchored in one place, Grosse Pointe, Michigan, a bucolic Midwestern suburb of Detroit, and he would be there for life.

As a kid, I dreamed privately that I was destined for more exotic things.

Throughout my childhood, everyone around me, particularly my friends, seemed to be athletic. I was a klutz at every sport I tried. Rotten at basketball, awful at football and baseball; my hand-eye coordination for sports was terrible. (If someone then had made a bet that my hands would one day be insured against career-threatening injury, so that if anything befell them, I would get $18,000 a month for the rest of my life, he would have made a fortune. ) I was the kid to beat up, though mostly I was clever enough to evade pummelings. My outlet was books – about history, foreign affairs, any culture different from mine. I had other diversions – quiet pursuits such as building models and sculpting with clay, those things that boys do if they’re not athletes – but mostly it was books. I read constantly. Thanks to these dramas about other places and times, I could dream vividly about the world beyond, and my desire to do something larger-than-life. My grandfather ran a trucking company, and I remember driving around with him through small towns scattered across the Midwest. We would travel to depots where his car-carrying trucks picked up automobiles from the General Motors plants in Flint and Pontiac, then delivered them to car dealers all over the eastern United States. I also remember Teamsters, smashed cars, and Grandpa, baseball bat in hand, once storming out of his car and threatening to kill anyone who would even think about intimidating his grandson.

That was exciting.

For a while I thought about going into the family trucking business. But I wanted something removed from Detroit. I was fairly certain my future would have the word international attached to it.

In ninth grade, a school friend disappeared – gone, suddenly, to high school far from Grosse Pointe. A prep school in the mysterious East. While it offered a better education than where I was, its more seductive pull was its location: far away. It was just the adventure I ached for. I asked my parents about it. Dad had gone to public schools in South Carolina, Mom to an all-girls private school in Michigan. My father, in particular, was taken by his firstborn’s excitement about education and he issued me a challenge. “Work hard,” he said, “and I’ll pay for the best school you can get into.”

Hard work didn’t daunt me: I was a diligent student, pulled good grades, woke up early and had jobs on the side – shoveling snow, cutting grass, hauling trash, scooping ice cream. I was fourteen and hungry, and now my hunger for the thrill of a new educational experience had a name to it: Andover.

My first year away was brutal. Overwhelming, lonely, full of awkwardness. It was hard being far from home, at an all-male school, tough living in a dorm, and the courses were difficult. At least I was consistent, though: My first semester there I got a C in everything. I wasn’t exactly living up to the bargain I’d struck with my father.

It was hardly any solace to me that getting creamed your first year at Phillips Academy Andover was pretty standard. The campus was gorgeous, pastoral and dreamy in that unsurpassable New England way, with rolling hills and redbrick Georgian buildings, giant shade trees and hockey rinks and a college-caliber library. But at night in the dorms, the school – that first year, anyway – seemed to me a place run by Eastern boys who exacted great pleasure in beating up a bewildered, bespectacled Midwestern outsider whenever they could.

To counter that sometimes helpless feeling, I took up rowing. I knew almost nothing about it. But I’d been curious ever since Dad had told me that his best-conditioned patient was a man named Gus Valenti, who rowed.

At the time, Gus Valenti was eighty-one years old.

Since I was a loser at other sports, rowing made me feel a bit as if Andover was, if not my social haven, then at least an institution where I’d earned inclusion.

As at so many prep schools and Ivy League universities, legacies – offspring of alumni, particularly the well-heeled ones – abounded at Andover. A well-circulated account of an alleged incident during my time there, involving one legacy in particular – from the most powerful family in America – impressed upon me a recurring life lesson: integrity.

No family across the twentieth century has been more associated with Andover than the Bushes, from former president George Bush Sr. through his sons. In my class – class of ’73 – was Marvin Bush, probably the least well-known of the Bush boys; President George W. (several years ahead of me) and Florida governor Jeb also attended.

In our first year, Marvin (I’d heard) was put on probation for some offense; I believe it was for having a beer in his room. Then, while on probation, Marvin allegedly did yet another thing he wasn’t supposed to, thereby violating his probation, which usually meant expulsion. The disciplinary committee convened, and a meeting was attended by students, faculty, administration, and trustees. At the time, George Bush Sr. was head of the Andover board of trustees. Many of the students assumed that, since Marvin’s father was head of the board, he’d be cut lots of slack. And, true to form, when the head of the student disciplinary committee stood, he announced that, in the matter of Marvin Bush and his violation of probation, the committee had decided to extend his period of probation. He was spared suspension or expulsion precisely (it seemed to everyone there) because he was a Bush.

Then George Bush Sr. spoke up. “Mr. Chairman,” he said, addressing the student head of the disciplinary committee, “if you violate probation, is it customary for your probation to be extended?”

It was a puzzling question since, as head of the trustees – not to mention a former Phillipian himself – he had to know the answer already.

“Well, Mr. Bush … no,” said the student head of the disciplinary committee almost apologetically.

“I want no preferential treatment for my boy,” said Mr. Bush, who then turned to face his son. “Marvin, go back to your room, pack your bag, you’re stepping down.”

The story raced through the campus. If nothing else, life was getting more exciting.

I rowed. And rowed.

And rowed.

I doubt there’s another sport or physical discipline where such a high percentage of participants will volunteer how profoundly it changed their life. I’m one of those. But not because of what happened my first year rowing at Andover. I was awful: the last guy on the eighth and last boat. During my first summer back home from prep school, though, my parents hosted a party, where a patient of Dad’s was overheard mentioning that he rowed at the Detroit Boat Club.

Proudly, my father told Mr. Ledyard that I rowed for Andover, conveniently omitting the fact that I was terrible. Intrigued, Mr. Ledyard said that the Boat Club needed an oarsman, and why didn’t I come on down to try out for them?

The next morning I met Mr. Ledyard at sunrise. (Only years later did I realize that, as a surgeon who by necessity wakes every day by five, and as a kid who always woke early, the early-bird demands of the sport of crew appealed to my inner clock. I’ve yet to meet a single successful surgeon or rower who doesn’t rise with the sun.) Down at the club, I was assigned to a four-man shell. I was the youngest by seven years.

After an hour and a half, we finished our workout. Mr. Ledyard said they could use me: A boat of theirs had been invited to race in the Canadian Henley Regatta six weeks later and I could fill the slot they were missing.

There was one problem, though. “You’re overweight for the boat,” said Mr. Ledyard as delicately as possible.

“How much?” I said gamely, not at all offended. I’d never thought of myself as overweight – some baby fat, sure, but I was fifteen and in decent shape, or so I thought. Dropping a couple pounds in a month and a half was no problem, especially for someone who loved his new sport and had grown acclimated to the rigors of crew.

“Forty pounds,” said Mr. Ledyard.

Standing on the shore of the Detroit River, sweating after a great workout, excited to be invited to join grown men in an official competition (in another country!) – all in all, I had been feeling like a stud.

But forty pounds? The race was on August 5. It was now June 26. Was he crazy?

Although I had one season of rowing behind me, nothing in my life to that point had suggested I was capable of the self-discipline, the torture, I would need to summon to get down to competitive weight. And even if I could find the discipline, was it even physically possible? And if it was physically possible, was it medically smart? I was five feet ten, 185 pounds. The boat, I discovered, was a “lightweight”: You had to be 145 pounds. If I said I would make weight and didn’t, I would fail the boat and the team.

And suppose I did lose the weight … how much of my strength would be sapped ? They weren’t going to want one of their seats manned by a teenager who couldn’t pull with maximum strength.

None of these questions mattered. I was possessed.

For the next six weeks, I trained every day, rowing twice a day. I ran. I did weights. I ate almost nothing but vegetables, mostly ones starting with the letter c. Celery. Cabbage. Cauliflower. Carrots.

After forty days – weighing in the morning of the race – I tipped the scales at 144.5.

Almost 0 percent body fat. You could count every rib. Forty pounds lighter in forty days.

Barely a third of the way into our race at the Canadian Regatta, in St. Catharines, Ontario, one of the metal clasps that lock the oars in place snapped. Our boat was finished.

All that hard work to finish dead last.

But the experience of earning my way to that seat on that boat on that Canadian lake in August of 1970 imprinted itself on me. Yes, I was a sleeker version of the boy I’d been at summer’s start. But the more important development – one that would prepare me for the rigors of becoming a surgeon, perhaps the most competitive of all medical disciplines – was an awakening about obstacles and possibility and fortitude: If you want it badly enough, you can make it happen. I’d gotten into a tough prep school by working hard, but this test of will was different. This had involved doing something that wasn’t pleasurable. This had involved denying myself.

While I may have appreciated, on an abstract level, how this crucible might strengthen me for the future, and perhaps better equip me for professional success later, I certainly did not appreciate how the self-discipline, bordering on ascetic monomania, would implant itself in my life. That is, I may just have succeeded in teaching myself that I could sacrifice so much – perhaps more than I would ever want to, including profoundly important things – to reach my goal.

In the fall I returned to Andover, where the previous spring I’d been the last man on the last boat. I moved up to a stronger boat, and by senior year I was on the first of our “schoolboy eights.” We won the New England championship.

As I prepared to go to college at Princeton, I still didn’t know what I wanted to be when I grew up. One thing I was sure of, though: being a doctor was not among the options.

At Princeton – leaner and more confident than the last time I’d found myself a neophyte at a leafy, Northeastern bastion of academic excellence – I was ready to test out my new self in a new place.

I studied but still I was lost. My driving priority was to get away from the familiar – perhaps overseas. But I had no idea how I would get there.

I continued to row because I liked it, and because a core self-discipline had been seeded in me as a young teen.

Sophomore year it dawned on me that I had to focus. It was unfair that my parents should pay for four years without something tangible to show for it. After a scattered, generally undistinguished freshman year, I became even more conscious of faraway places. The easiest route to a life of that? I had finally figured it out – and it was right in front of me the whole time:

International law.

With the world-renowned Woodrow Wilson School a mere quarter mile from my dorm, there was no better place to study to be an international lawyer.

This was going to be great, I thought. I would call on my legendary self-discipline from here on in to earn straight A’s, work my way to the head of my class, get into a top law school, make law review, win job offers from the most internationally renowned law firms and giant corporations. I’d jet all over the world. I’d live in Paris; all those hours of high school and college French would now come to real use. Someday, when I’d had enough of the bachelor life, I’d marry. We’d live together in Europe and raise a family there.

It seemed like an excellent plan. In the first days back at school sophomore year, I moved into Blair Tower, an all-male dorm and one of the most beautiful, often-photographed buildings on campus. (It’s featured prominently in the movie A Beautiful Mind, about the brilliant, troubled mathematician John Nash. In fact, during my years there, Mr. Nash would often walk by our door, mumbling to himself.) While some of my dormmates were still enjoying themselves – skiing down six flights of stairs, planning the semester’s first road trip to an all-women’s college, tossing Frisbees on the quad – I had to tune everything out so that I could be single-mindedly studious. I went to the local lumberyard, bought plywood, and returned to my tiny double. I got out nails and a hammer. I was intent to study, nothing else, for the rest of my college years.

My roommate walked in as I was hammering the first board over my window.

“What the hell are you doing?” he asked.

“Gotta work this year,” I said. “See you in nine months.”

I boarded over my window except for four inches, at the bottom, for air.

I stopped staying out late on weekends. I even gave up rowing. Too many hours that could be better spent studying.

I still had to eat, though, and I joined one of the college’s famous eating clubs – Cap and Gown, which had lots of jocks, male and female. A great deal of social life revolved around mealtime, and I found myself becoming more comfortable in such social settings. Many mornings, for the better part of two years, I ate breakfast with a likable, bright squash player named Meg, who would, in later years, serve as an example to me of the virtue of persistence. I followed news of her, postgraduation, because she married a future surgeon, and we crossed paths on occasion. For Meg, professional success didn’t come quite so quickly. She was a businesswoman, but it seemed as if the companies she worked for rarely did very well. She did not let it get her down. Eventually, she was put in charge of a tiny, off beat company.

It was called eBay.

Meg Whitman is now the CEO of a multibillion-dollar company and one of the most powerful and successful women in the business world.

There were people like that all over campus. To succeed, I was determined to work as hard as anyone.

There was only one little problem concerning my grand plan to become an international lawyer – namely, my prelaw courses.

I despised them. And I was awful at them.

How quickly my dream to be a lawyer crisscrossing the Continent was dashed. Was I abandoning it because it was a new challenge? No. Crew and getting into Princeton and losing forty pounds in forty days proved to me that I didn’t shy away from challenges, no matter how tough.

I let go of my “dream” because I would not devote my life to a professional pursuit that I didn’t love.

Someday, the dizzying, international life I’d fantasized about would, in fact, become a reality. Meeting an English princess at Ascot. Flying to far-flung parts of the world in private jets to perform work I was trained to perform. Dining with United Nations diplomats and Hollywood directors. Helping one of the most influential and high-profile politicians in America to deal with the one thing he was sure would cost him his career. Accepting a first lady’s invitation to cross the country to talk to her. Dating beautiful, intelligent, accomplished women. All of that would be part of my future.

I just didn’t know it at the time.

As I finished up my first semester of sophomore year, I was despondent that I truly had no idea of what I wanted to be. And now, suddenly, my boyhood fantasy of mystery and faraway intrigue seemed childish and unsuitable. Little did I know, though, as I took long, broody walks around the Princeton campus, past shade trees and often circling the Institute for Advanced Studies, made famous by Einstein in the fifties, that I was zeroing in on my future. That as I daydreamed while sitting in class, I was mere weeks from discovering my passion. And that that passion, like Dorothy’s dream of home in The Wizard of Oz, really was right there in front of me the whole time.

Confessions of a Park Avenue Plastic Surgeon

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