Story by: Steve Boyarsky
Photos provided by Dr. Worland
Q: How did you get started with international medical work?
Ron: I had practiced plastic surgery for 13 years in the Rogue Valley. I was presenting a paper on unusual nerve situations and hand surgery. After the presentation, the head of Oregon Health Science University came up to me and Ken Pons, another Medford plastic surgeon, saying, “We need some help running a clinic down in Oaxaca, Mexico.” That started it. In 1990, I began going to Oaxaca. I did that for 19 years. Over the past 35 years I’ve been all over the world with various organizations doing surgeries.
Q: Do you do primarily cleft palate surgery or are there other surgeries that you do?
Ron: I had extensive training in cleft work. But there are no cleft patients in Southern Oregon. I wasn’t using my skills. I decided to do mission work, and it became quite a passion over the last 35 years. In Bangladesh I did a fair amount of burn work. I did some hand surgery in Mexico early on, but for the last 20 years, it’s been mostly just cleft work: lip and palate.
Q: Why cleft work?
Ron: People can’t get cleft lips and palates fixed where they are living, and they don’t have the money. Children with cleft palate suffer tremendously. They’re ostracized. Several organizations support cleft surgery worldwide. The operation can be safely done with a minimum of post-operative time, maybe a one-night stay in the hospital. There’s no follow up and no revision necessary right away. It’s like ophthalmology. You can go in and do a cataract surgery and your patients are immediately better. Fixing a cleft palate is one of those few surgeries where you can fix a child and they’re better the next day.
Q: Are there organizations that have support teams and equipment?
Ron: Initially I organized the missions from Medford. I worked with Dr. Pons for about seven years, and then I did it myself. I helped raise money so we could pay for the anesthesia, the nurses, and the instrumentation. After I retired from my Medford, practice I joined a couple of groups. One is Alliance for Smiles. The last 11 years I’ve been with Operation Smile; it’s a huge organization. You see TV ads all the time for Operation Smile. What I like about Operation Smile is we go everywhere. There might be five surgeons or three surgeons, but typically I’m the only American. I just got back from Honduras two days ago, and we had surgeons from Nicaragua, Panama, Paraguay, and Honduras. Being with an international team is very interesting. And they’re really good surgeons. It’s so well organized. We bring all our equipment, suture medications, anesthesia machines. We bring staff nurses to stay with the patient at night, nurses for the daytime, nurses for recovery, nurses in the OR. It’s a full group.
Q: How large are some of the surgical teams?
Ron: I went to Honduras in the middle of Covid, with only myself and another surgeon. She was quite good. Our team was only about 20 professionals, but this last team was 55. On a trip to Morocco we had seven surgeons—two from America, two from Morocco, one from South America, one South African, one from Sweden, one from Israel, and one from Spain. That was quite a group, a team of about 60 people who were running seven operating rooms.
Q: How many surgeries would a team typically do?
Ron: Each surgeon would usually do five cleft palate surgeries in a day. So if there’s five surgeons, 25 surgeries per day. If they’re cleft lips, the numbers are higher because that only takes about an hour, but a palate surgery takes almost two hours. If I do three cleft pallets, I’m beat, because it’s a very difficult operation to do bending over, looking upside down in the mouth. Oftentimes I’ve done seven lips in a day. But if I’m doing palate, I don’t like to do more than three in a day, and then I’ll do a lip and that’ll fill a schedule.
Q: So how many countries have you been to doing missions?
Ron: I think it’s 16 different countries. Most countries I’ve been to multiple times before my wife became quite ill. I spent a lot of time on two-week trips to India, China, Bangladesh, Myanmar, Philippines. Many of those countries we can’t go to anymore. I did
several missions to Venezuela. Americans aren’t welcome and can’t go there anymore. We don’t want to go back to China. I’ve been there nine times. It’s a wonderful place to work, but we’re not too cozy with China right now. Bangladesh is just dangerous. We are doing a lot of work in Guatemala, Honduras, Ecuador, but they can be dangerous also. I was going to go to Guayaquil, Ecuador in a month, but I’ve decided to retire.
Q: Why retire?
Ron: I’m 80 years old now. Travel is hard, surgery days are long, and I don’t have the energy I used to. I fly coach, the last flight, my knees were digging into the seat in front of me for the seven-hour flight. I had nine-hour layover starting at midnight in Houston, and then another 10-hour layover coming back. I’ve had a good run. I’ve done 60 missions now; it’s been a wonderful opportunity.
Q: What do you find fulfilling about the work? Why do it?
Ron: My best answer is: “Because I can, and I know it’s needed.” I offered my skills here for low-income families. It’s just something I have a passion for. I still cry sometimes with mothers because it’s exciting for me to see what the surgery does for their children. Given an opportunity to do some good around the world, to help promote relations between the U.S. and different countries, it’s a wonderful opportunity that I’ve taken advantage of.
Q: What are typical ages that you do the cleft palate surgeries?
Ron: If we can get to young children and do their lips when they’re young: three, four, five, or six-months old, then we saved them a great deal of difficulty. Sometimes we see an 11- or 12-year-old girl with a horrible deformity. They had been locked in rooms hidden, not going to school. I remember two Mexican boys came into our clinic with bags over their heads. Imagine how difficult it is to deal with life with the community. Some families say cleft palates are jinxed or evil people. It’s nobody’s fault. We don’t know what causes it. There’s one group of people that have little holes in their lips called a pit. And if a person has that, then they have about a 50% chance of having a child with a cleft lip. But I’ve only seen about 25 of those out of 1,200 patients. It’s pretty rare. Otherwise, there’s not a dominant gene. If a person has a child with a cleft lip, the chance of them having another child would be the same as normal. It’s not a dominant gene at all. We thought it might be nutrition lack or related to medications. Those haven’t proven to be true.
Q: So Southern Oregon has been your home where you practiced medicine. How’d you find your way here?
Ron: I went to the University of Rochester in upstate New York. There were 12 doctors from the University of Rochester in the Rogue Valley. We had three plastic surgeons, two general surgeons, a nephrologist, two cardiologists, basically a large number of people. I was looking for a place to go west and I was asked to come work here. I was basically trained in the East coast and in New England. I spent five years as a general surgeon in training at UCLA. I realized what it’s like not to have snow, not to have humidity, and not to have insects. I was commuting to a head and neck cancer fellowship, 75 miles each way to Buffalo. Six months through the winter and 240 inches of snow. I decided I’m going back west. This is the place. It’s been a great place to raise a family. And schools were good, and my children have been very successful.
Q: What do you love about Southern Oregon?
Ron: I like the people. I obviously liked the climate, and we have a tremendous medical center. I had all the support: neurosurgery, orthopedic, pediatric. If there were complications, we could do full care for the patients. In 35 years of practice, I only sent three people up to OHSU because we were able to do almost everything here. It’s just a good place to work and yet we can live in a small town. I was a mile to one hospital and a mile and a half to the other. I could get up in the middle of night, take care of an accident, and be back in bed in an hour. It was convenient and I have friends here.
Q: You decided this was your last mission?
Ron: A nerve injury has bothered me with the use of one arm. You see 200 kids, getting them organized and running the clinics, that’s for younger people to do. I’ve noticed I slowed down a little bit. If you’re doing technical work and you lose a bit of an edge, it’s time to stop. Don’t get in trouble. Let the younger people take over; they’re very talented, can do just as great a job, and my leaving gives an opportunity for another person to get involved.
Q: What will you do with your time in retirement?
Ron: Well, it’s a tough time for me right now because my wife just passed. I’ve been taking care of her full time for the last seven years. Hopefully, I can get back on the golf course once this shoulder heals and go to the gym every morning. Between my involvement in Rotary, being active in my church, and trying to have dinner and lunches with friends, I’ll stay active. I read a book a day. They’re Cussler type books. Nothing extremely challenging, but I like the adventure. And I’m a fanatic Buffalo Bills fan.
Q: Was being a doctor a fulfilling career?
Ron: Most medical professionals want to help people. We all want to do good. Many times, people say, “I want to give back.” Well, if you’re really a good doctor, you’re giving all the time. I had the skills to help, so I did. My wife was incredibly supportive. Cumulatively, I was away from home more than a year and a half on missions. My family was very supportive, and friends helped support the missions financially. I’ve been very fortunate and blessed.
