The Bottom of Your Shoes

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Wear them out, making the world a better place.

Dr. Rick Hodes gave the following commencement address at Brandeis University, May 19, 2013.

Greetings everybody. It’s great to be here at Brandeis.

I am a quiet guy and I try to avoid speaking, especially about myself. But let me try to say something, and even make it interesting.

Shabbat in Ethiopia. The Jewish Sabbath. We have a large group of all cultures and religions. We stand in a circle, we hold hands, and we sing “IF I HAD A HAMMER,” to bring out our appreciation:

“I sing out danger, I sing out warning. I sing out love between my brothers and my sisters, all over this land.”

Often we have a question of the week. A few weeks ago I asked: “What advice should I give the Brandeis grads?”

Henok, a 15-year-old AIDS orphan who also has AIDS, said: “Stand to make a difference or a miracle. Never lose hope. A small thing can make a huge change.” He also wants you to know that he’s single – and available.

Binyam, who grew up barefoot in a mud hut is a biology student at Addis Ababa University. He said: “Be honest and do your best. Life is short, so please do better with it.”

Zemene, is a 15-year-old orphan girl, a dwarf with deforming spine disease. She said: “See everyone equally, love your religion.”

My son DJ said: “Make the Sabbath special every week. Without it life is too routine.”

My son Mesfin added: “I don’t have any advice – but they can email me their questions.”

You’ve asked ME to speak, so allow me to share my story.

I’ve made my own path, and have spent 25 years as a doctor in Africa. So let’s call this speech: "What I wish people had told me when I was on your side of the room." It’s theoretical – only because I wouldn’t have listened anyway.

I got a degree in geography, because I loved geography. No regrets. I had limited job skills. That didn’t bother me either – I wasn’t interested in a real job anyway. I painted houses, then I hitchhiked to California and spent the summer hiking in the Sierras. I continued hitchhiking up to Alaska where I lived for several years. My parents were unhappy; my grandmother called me a “vagrant.”

Winters in Fairbanks, Alaska, had four hours of sun, so I had lots of time to read and a lot of time to think. I decided that the best thing I could be is a doctor – in a place where I was really needed. So I did pre-med at the University of Alaska. In medical school in Rochester, I spent a summer in Bangladesh and a winter in south India. After training in internal medicine in Baltimore, I moved to Ethiopia, intending to teach for one year. That was in 1985.

Every Life is Precious

In 1990, I was hired by JDC – the American Jewish Joint Distribution Committee – to take charge of the health of Ethiopian immigrants to Israel. Since then, I’ve been the doctor for the last 70,000 immigrants – that’s 1 percent of Israel, before they became Israeli. Along the way, I’ve worked with refugees in Rwanda, Tanzania, Albania, and Zaire.

In Goma, Zaire I was directing healthcare for 25 percent of Kibumba refugee camp – that’s 50,000 people. Before I left for Kibumba, I knew I’d have a lot more patients than I could handle – I phoned a rabbi to ask how to do triage in a situation like this. Do I give preference to the mothers, because if a mother died her kids are endangered? Should I not treat patients over 70?

His answer: Every life is precious. Treat patients in the order they come to you. This made as much sense as anything and it’s been what I've been doing ever since.

The other day, my assistant got an email from a college student here in Boston. He wrote: “I’m a senior, interested in medicine. I’ve been offered a job in health care in America next year. Here’s my question: is working with Dr. Hodes in Ethiopia worth risking a comfortable job in the US?”

He passed me this note. I thought: What can you learn from me? I can show you how to practice medicine in a completely different way. I can show you how to start something from zero and grow it. I can teach you how one thing leads to another in life. I can teach you the importance of trajectories, and teach you how things happen if you put years of your life into them.

In our oral law, the Talmud, there is a statement which says “mitzvah goreret mitzvah,” one good deed leads to another. Whatever we do has spinoffs and side-effects. Maimonides said that when you do one deed, you will be aided from heaven, in ways you don’t even know, to do more. There is a spiritual chain-reaction.

Open Your Home

Back in 1992, a nurse at the university hospital introduced me to Bewoket, a dying 11-year-old boy who arrived on his own, from the countryside. I put his chance of survival at 5 percent – he had rheumatic heart disease, congestive heart failure, a rapid irregular heartbeat, and hepatitis B. But I took it as my personal challenge to keep this kid alive. I went to him every day, I worked on his medications. He stabilized and was discharged to a Catholic mission. I treated him there, and started treating other mission patients as well.

The nuns would phone me when Bewoket went into heart failure and I’d drop everything to treat him. I decided it was easier to move him into my house; I would see him twice a day and work without interruption. He stabilized. When he was dying of hepatitis in 1995, I started him on an AIDS drug, which also covers hepatitis B. It cured him. Then I sent him to America for heart surgery.

In 1999, I met two abandoned orphans with TB of the spine who had ended up at the Catholic mission. One had a 90-degree angle in his back – a huge V coming off his spine. The other had a 120-degree angle. I wanted to help them get free surgery. It was impossible. Eventually I realized I could adopt them, add them to my health insurance, and get them surgery that way. The problem here is that when you adopt an abandoned orphan, it's yours for good. And what if they have surgery, and end up paralyzed? Then I’m the caretaker – for the duration.

The Almighty is offering you a chance to help these boys. Don’t say no.

I was pondering this when one day a light bulb went off in my head. The answer became clear: “The Almighty is offering you a chance to help these boys. Don’t say no.”

I adopted them and got them accepted for surgery in Dallas, Texas. Another spine kid came along – another adoption. Serial adoption is probably not the answer to spine disease in Africa. Later, I met the top spine surgeon in the world, Dr. Oheneba Boachie-Adjei, and we started working together sending the most deformed spine patients on the planet to Ghana in West Africa for surgery. Dr Boachie, based in New York, travels to Ghana with an international team several times a year.

In 2006 we launched a new JDC non-sectarian spine program: I sent the first group of five patients to Ghana. Fast forward – right now I have 35 kids there. These are some of the most deformed kids on the planet.

And some of the most courageous. And we’re fixing them for less than 10 percent the cost of American treatment. For severe deformities, we drill four holes in their skulls, put a metal halo around, and stretch them in traction when they’re sitting, when they’re walking, and when they’re lying down.

In 1999, I started helping two orphans with bad backs, then I adopted them. I now have over 1,100 spine patients. Over 200 spine surgeries. We have 13 kids with traction right now. Nobody in the world has 13 kids in traction. Last year I had four paralyzed people come to me – who are now walking.

You know, it’s not just me – I can’t do this without a LOT of help. Mother Teresa said: “I alone cannot change the world. But I can cast a stone across the waters, to create many ripples.”

The first two kids were accepted in Dallas. I didn’t know a soul there. I tried to take out an advertisement in the newspaper explaining my situation: I’m a single guy with two deformed Ethiopian orphan sons, looking for a family to help us. The advertising lady said: “Doctor, you’re wasting your money. There’s a woman named Jaynie. She knows everyone. Call and ask her what to do.” I phoned and explained my problem. I was simply a stranger on the other end of the phone. “What a story,” she said to me, “I’ll take the kids.”

One thing I’ve learned here: Open up your home. It changes everything. You open your home, and soon your heart is open as well.

I’ve sent kids to North America for surgery. Tesfaye to Vancouver, Akewak to Denver. When people open up their homes, it brings out the best in everyone with amazing spinoffs.

When I treated two kids in Ethiopia for bone cancer one had a recurrence. Two lawyers in Washington, D.C., took him into their home and arranged treatment. After he died several years later, they started a major project – to upgrade the care of all Ethiopian kids with cancer, led by a full-time American oncologist who moved to Ethiopia.

Sons and Orphans

I took Bewoket into my home. Part of it was selfish – I didn’t want to be called by the nuns and have to cross the city and lose an hour to treat him when I had other things going on. Once the door was open it has not shut.

I live mostly with my family, but there are now four homes and a variety of orphans and patients, and patients’ brothers and sisters living in them. Right now in my living room I also have: Petros, an 18-year-old with a tumor the size of a tennis ball expanding his face. Petros is about to leave for 20-hour surgery in Germany.

Everyone at home is welcome to go to church or mosque, but my house runs on the Jewish calendar. On Friday night we have Sabbath. All this is quite new to them.

My patients are my inspiration – they are the ones teaching me about compassion and courage and resilience: The kids have a completely different life course than many of us. One of the adopted kids was in fourth grade in Texas. When his teacher’s mother died, he asked me what to do.

“Buy a nice card, and write some words of comfort,” I replied. He showed me his letter: “Dear Mrs. Greene, I’m really sorry to hear that your mother died. When I was younger, I lost both my parents, and I know how difficult it is.”

Every Friday night we’re joined by my spine patient Tesfaye and his sister Faytaye. Tesfaye lived for years with a spine shaped like a reptile, selling tissues on the streets, before I sent him for spine surgery. We stand and applaud his sister. Fantaye recently walked out on her husband of two years and moved to Addis Ababa to go to school. She is 14 years old, forced into marriage at the age of 12!

I want to say: Don’t be shy. Have chutzpah. Wayne Gretzky was one of the greatest hockey players of all time. He said “you miss 100 percent of the shots that you don’t take.” So take your shots.

I have my own dreams for my future – a spine center. And heart center. A place to teach others. I also have immediate needs – a better website for me, a Braille typewriter for one of my patients, an internship in finance for one of my sons.

The bottom of shoes should be worn out, making the world a better place, dancing in this world.

A rabbi taught me a tradition that when the messiah shows up, he will ask just one question – “show me the bottom of your shoes.” The messiah, who will rebuild the temple, bring clarity to our lives and peace to the whole world, he cares about our shoes? Yes. The bottom of shoes should be worn out, worn out – making the world a better place, dancing in this world.

Run to Do Good

You now start a lifelong link with a great name – Brandeis. What can we learn from Louis Brandeis? He was described as “the disturbing element in any gentleman’s club,” he owned a canoe, not a yacht, he angered clients by trying to be fair to both sides; the judge who succeeded him, called him “a militant crusader for social justice… dangerous because he was incorruptible.” Live up to his legacy.

Spread kindness. You are here because a lot of people helped you along the way. Maybe it was your 10th-grade math teacher who gave you a second chance, maybe it was someone who inspired you in a summer job.

This week, buy beautiful cards and send out four or five, to people who’ve helped you. Let them know you’ve just graduated from Brandeis and they were important to you. They’re going to feel great, and they’ll do it again for others.

Remember this: Run to do good. Create a momentum in the right direction. Get your hands dirty. Wear out your shoes. Don’t try to get too comfortable, please!

Now I imagine the start of a horse race and the bell rings. But you don’t need to race against each other. Whatever horse you choose, and whatever path you follow, I wish you great success and great happiness.

I wish you a lot more than luck, and may God bless you all.

YOU’RE OFF!

Click here to donate. Donations are tax-deductible and 100% of proceeds go towards my work in Ethiopia.

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