In 2014, I wrote a book called Nine Lives, A Story of Survival and Hope, an autobiographical account that focused on my battle with MDS, a kind of blood cancer (For more information, visit here.) In the process of looking back on my struggles, some “themes” begin to emerge. I saw that my nine lives were as much about reinventing myself as they were about surviving myriad obstacles and beating the odds.
I was diagnosed with MDS in 1999 and, at the time, it was a death sentence. I was given two years to live. As a disease, myelodysplastic syndromes (MDS) has always had a bit of an identity crisis. It has been called by many names, most of them unpronounceable. It is a cancer and yet for years was not labeled as such. Those diagnosed with it often didn’t know what they had or how to treat it. Only recently has it been classified as a cancer of the bone marrow and blood. The label of MDS patient was one I would grapple with for the next 15 years, but it certainly wasn’t the first label that had been pinned on me against my will. I have been struggling against labels most of my life, and if at any point I had let them define me, my life’s trajectory would have changed dramatically.
Almost everyone on the planet has at one time or another been “wrongly classified.” As children, it takes only one thoughtless comment from a teacher or parent to modify how we think about ourselves. We’ve all heard the term “self-fulfilling prophecy,” where our reactions to a label end up making it come true, even when it is patently false. But it is always possible to turn labels on their head and create our own much more positive versions of reality. I’d like to share a little bit of my experience with labels and some of the other important life lessons I’ve learned along the way.
- Question Labels and Defy Predictions:
When I was in elementary school, a cruel third grade teacher dealt with my “over-inquisitiveness” by clamping a dunce cap on my head and covering my mouth with duct tape, a public humiliation I’ll never forget. This notion of myself as a “dumb kid” was reinforced when I scored low on a standardized test, prompting my school to inform my parents that I was “slow” and would only be suited for manual labor. The reality was that a combination of missing a lot of school from sickness and not understanding “sight-based” reading (which had replaced phonetic reading at my school) had resulted in my not being able to read. And in school everything depends on your ability to read.Fortunately, my parents had a very different view of me and I remember my mother often telling me that my problem was not that I was stupid but that I needed to learn to read better. Even when she could ill afford it, she’d find money to buy me books. Then I took the Evelyn Wood speed-reading course, and the scales fell from my eyes. I learned to read not only faster, but also with far better comprehension. Although I continued to have a phobia of standardized tests throughout my life, I suddenly began to see potential rather than limitation. I had a naturally curious mind and soon I was devouring books on anatomy and designing and launching my own rockets. By the time I reached high school, I was taking all the pre-med science classes that were offered and excelling in them.It was only many years later—at a 20th-year high school reunion—that I discovered that my fellow classmates had always thought of me as a bright kid with a promising future ahead of me. I’ve thought often about what might have happened if I’d let myself be defined by that early “slow” label. I might have never gone on to college, never earned a PhD and medical degree, never become a surgeon. I am not unique in this . . . there are hundreds of stories of innately gifted children who learned “differently” or struggled in school because they weren’t sufficiently challenged or refused to be pigeonholed by short-sighted teachers.
- Envision What You Want:
I’ve always been a dreamer. Although I grew up on the ‘wrong side of the tracks,’ I distinctly remember how clean and beautiful my neighborhood was, and how much people cared about how their houses and yards looked. They may have lacked a lot by most people’s standards, but they made the most of what they did have. This self-respect made a deep impression on me. I remember lying in the grass and dreaming about becoming a doctor one day. I always had a clear goal in mind, in spite of the fact that no one in my family had gone to college, I had little money, and no connections. I knew what I wanted, dreamed it, and in spite of numerous obstacles, found a way to make it happen. This act of visualizing what I wanted has served me well. Whenever I’ve encountered a new challenge in life, whether mastering a surgical technique or running a marathon, I’ve studied, analyzed, and problem solved until I got what I needed to succeed.
- Every Limitation Has a Flip Side:
Life offers no guarantees. In some ways, I’ve had more than my fair share of challenges. But I wouldn’t have had it any other way, because out of those struggles have come some amazing discoveries and successes. One example: When I arrived at UCLA medical school, I quickly discovered what might have been an insurmountable setback in my quest to become a surgeon. I was colorblind, a fact of life that sometimes had comical implications, but was a definite impediment in medicine, where you have to be able to distinguish color differences in tissues or various parasite stains. For me, all the greens, blues and reds just blended together. So I decided to approach it another way. Perhaps I could distinguish the parasites by their different shapes instead. I headed for the UCLA bookstore and found a parasitology book with colored plates. I studied that book day and night, memorizing every shape of every parasite. In the end I earned one of the highest grades in the class. We can respond to adversity as a zero-sum game or as an opportunity to find new ways around a problem.
- Success Takes Elbow Grease:
It strikes me that a lot of people are looking for shortcuts these days, as if life were a “get rich quick” scheme involving little risk, skill or effort. In my experience, there are no shortcuts to success. I had Russian immigrant parents with a strong work ethic, and I was fortunate enough to be born in the United States where I had many opportunities I would not have had elsewhere. In his book, Outliers, Malcolm Gladwell writes that to be really successful at something, you must put in 10,000 hours of practice. I worked 120-hour weeks during residency and, as a surgeon, I easily logged 10,000 hours with my patients and in the operating room. Today, children are given trophies just for showing up, yet in my experience the real world is not like that. Opportunities are like rare jewels, and they’re not handed to you. You have to excavate them.
- Reinvent Yourself:
I don’t mean that you should behave duplicitously or misrepresent who you are. But too often, especially as we get older, we begin to define ourselves by our titles, by the people we associate with, by our financial status, etc. We resist trying new things for fear that we will look foolish or fail. And then when we are thrown curve balls—and we almost always are—we don’t know how to respond. We become defeated and depressed, and there seems to be no way forward. We can let these curve balls knock us to the ground or we can learn how to catch them with finesse. In my life I’ve been a jewelry salesman, a firefighter, a surgeon, an entrepreneur, a consultant, a lecturer, an inventor, a TV medical correspondent, and more. Often my career changes were in response to a seemingly insurmountable obstacle. For example, when I was diagnosed with MDS, I knew that I could no longer be a surgeon because of the risk of infection from my patients. What was I to do? I felt at loose ends.A big part of my identity was wrapped around my work as a surgeon. The “surgeon” label was one I had invested years, blood, sweat and tears in. That’s when I decided I could keep my hand in medicine by becoming a medical correspondent. Why not? I think I must have been blessed by my ignorance, because it never occurred to me that I couldn’t do it. Success was not immediate, however. I called dozens of stations and had some doors (metaphorically) slammed in my face. But persistence eventually paid off with gigs at CBS in Los Angeles and then in Pittsburgh. I’ve constantly had to confront “new normals” in my life, where I had to modify my self-definition. I could have just given up, but I kept looking for new endeavors and opportunities that would challenge and engage me.
- Pay it Forward:
We don’t talk about the Golden Rule much these days. I suppose to many it seems rather old-fashioned. But having empathy for others is critical to being an effective doctor. In particular, we need to be good listeners. I remember a mentor of mine once told me, “Just listen to your patients. They’ll tell you what’s wrong with them.” Surgeons have a reputation for being brash and arrogant. They can carry that attitude out into the world and into their relationships with family and friends. Although I understood that in the surgical theater I had to be the captain, I also knew that I had to leave my sometimes brusque attitude behind in the operating room. Although money and fame are attractive, they have never been my principal motivators. And when it comes to success, I’ve seen that if you treat people poorly on your way up the ladder, you will inevitably meet them again on the way back down (and sometimes to your peril). I’ve always wanted to make a difference, to give back. This isn’t entirely selfless. Helping others brings joy and fulfills my need to live a purposeful life.
- Live How You Want to Be Remembered:
I believe that in the end all we have is our reputation. It is built over a lifetime, not a moment. I grew up in a world where a handshake was binding. Today, you should trust, but always verify, because there are some pretty unscrupulous people out there. Doing the right thing is not dependent on how well things are going for you. It’s easy to make good decisions when everything is going your way. It can be far more challenging to stick to your principles when you feel as if you’re cascading towards an abyss. Whether it is a small act of kindness or saving a life on the operating table, you are in the end defined by how you chose to live.
I believe, that a meaningful life where troubles turn into triumphs requires three things: finding something you’re passionate about, embracing new challenges and opportunities, and having someone to share it all with, someone to love. To quote Andy Dufresne in The Shawshank Redemption—“Get busy living or get busy dying.”
Paul Nemiroff, PhD, MD, FACS is a nationally recognized surgeon who received his MD from UCLA and holds a PhD from Purdue University. He has published and presented hundreds of articles and research papers on surgical techniques, hyperbaric oxygen, and complementary medical therapies. He has performed more than10,000 surgeries, and scored highest in the country on the Head and Neck Surgery Exams (99%). He’s an award-winning TV medical correspondent and recipient of many national awards, including one from the American Cancer Society. He is a Fellow of the American College of Surgeons. Dr. Nemiroff was invited to the White House and considered a candidate for Surgeon General of the United States. He has been living with MDS for 15 years.
To read more of Dr. Paul’s story, please go to: http://drpaulspeaks.com. Dr Nemiroff is not receiving any profits from the book. The publisher is donating a portion of the proceeds from the sales of Nine Lives to research on MDS and cancer that will hopefully investigate parts of the protocol described in the book.
City of Hope, a Center of Excellence in MDS, is committed to providing compassionate care for patients with MDS and other blood cancers. Their Chief Medical Officer, Dr. Alexandra Levine, says: