Today we’d like to introduce you to Dr. Benjamin La Brot.
Hi Dr. La Brot, we’d love for you to start by introducing yourself.
One of the most common questions I am asked (aside from “where are we?” and “can you come look at this weird rash?”) is how this all started. I’m never quite sure how to answer that—the true origin of anything always seems to be just one more link further back in a very long chain of causality.
But moving the clock hand back about a dozen years finds me traveling as a new doctor in Tanzania, and for me this is where Floating Doctors truly begins. I traveled to Tanzania as a tourist to climb Mt. Kilimanjaro and to see the wildlife of the Serengeti. Kilimanjaro was amazing, but on the drive out to Serengeti the guide asked if I wanted to visit a nearby Maasai village. It sounded interesting. Of course, I said yes.
I had no idea that I was about to come face-to-face with my destiny
We turned down a dusty road and soon came to a small Maasai village of about 140 people. The village was truly located in the middle of nowhere, in the middle of a dry, dusty plain with no water, at least 30 miles from the nearest ANYTHING and a lot further from even the nearest small town. I liked the Maasai immediately. They were very poor and very proud and very confident in their strength and their identity. And very tall.
Pretty soon, it came out in conversation that I was a doctor, and what happens everywhere to all doctors happened to me: “Oh, you’re a doctor—hey, do you mind having a look at this thing on my [insert anybody part name]?” So I attended one person. Then another. Then another. Then I was sitting on a small stool under an acacia tree and seeing people as fast as I could. Lots of little problems, some big problems. Musculoskeletal issues, pregnant women, respiratory issues, old poorly healed injuries (lion wounds). The oversized personal first-aid kit I had with me was quickly emptied and I went, “Oh….resource-limited health care. So this is what that is. What do I do now?” There was still a big group of people that wanted to be seen.
I started get creative. If someone had back pain, I showed them straight-leg stretches and safe lifting techniques and explained why they could help. Everyone was chronically dehydrated and I talked about the importance of drinking enough water but acknowledged that since the village had to buy all its water, that would be difficult but maybe the pregnant women could be prioritized. I did some wound care. I wasn’t able to do everything I wanted to do for everyone, and often there was devastatingly little at all that I could offer. But I tried very hard to find something.
Hours later, it was time to go. I stood up and the chief’s son and several other village leaders thanked me and gave me Maasai jewelry as gifts. I promised that if I could ever come back, I would. Then I got back in the Land Rover and was pretty emotional. Something had happened to me. I knew that this was what I wanted to do. This was the medicine I was looking for. As we drove away from the village, I swore to myself that I would return there one day, or anywhere people were poor and far from care…and I would bring a much bigger backpack.
From that day, I thought of almost nothing else but how I would do this…with my background on the water and the mobility and self-sufficiency of a ship, I imagined bringing help by sea and began the “what if we…?” mental game that occupied me when walking through the hospital on rounds, when driving home late at night, when sitting at home, when walking through the grocery store. Eventually, I had a plan to get a ship, get a crew, get supplies, and visit many locations and conduct mobile clinical services. I found an old, beat up-ship in Florida and with my sister Sky, my friend Ryan and a small team of dedicated volunteers managed to rebuild her. It took a couple of dozen people over a full year, with about 10 of us stuffed into one house, sleeping on the floor and working every day to rebuild the 100-ton ship we had obtained. It was touching because in one of the most economically hard-hit regions in the country, a LOT of people extended themselves to us and shared their time and knowledge and resources. And after 12 brutal months, we were as ready as we were going to be….
…and then the 2010 Haiti earthquake happened, we set sail for Haiti and haven’t quit since. The rest is history. After Haiti, then Honduras, then Haiti again during the cholera epidemic, then to Panama where we determined to build our first permanent rural health care and community development service.
Years have passed since we first set sail for Haiti (it feels like a thousand years of incident-packed into that time). Many mistakes, many hard lessons, many lucky escapes and many skills learned. My own destiny (and many others) altered forever in ways I never expected. I never dreamed that by now Floating Doctors would have grown so far and so fast. Who knows what the future will hold? One day I dream of seeing the Floating Doctors flag flying over similar permanent services rendered on many different shores, and perhaps a fleet of ships offering different specialist services traveling between land-based services, offering specialist care at each location annually. Or maybe something I can’t even imagine.
It all sounds so remote and impossible, but who can tell what may happen? After all, the unlikely epilogue to our origin story is that many years after my first visit to the Maasai village in Tanzania, I DID keep my promise to return…on my honeymoon with my wife Karine. We brought a much bigger backpack, packed the way I WISH I had known to pack all those years ago. My wife and I attended nearly everyone including people from neighboring villages, and when they learned we had just been married they slaughtered a goat and we shared a feast with them. Then they dressed us and married us as Maasai. And the moment when one of the senior women in the village took the copper rings from her fingers and placed them on ours was a moment I will never, ever forget. It feels good to have kept that promise to return and to continue to keep that promise to others.
Because when you say to someone, “I am your doctor,” you aren’t just telling them your education level…you’re making a solemn promise to do and be everything that role requires as an instrument in the service of your patient’s health and life. I tell my medical students that if they aren’t prepared to live up that promise for every patient they ever sit down with, they are in the wrong profession. The worst thing you can do is to tell someone you care about them…and then NOT care about them, especially populations for whom that has been the rule up until they see you.
There’s never a guarantee that we’ll successfully make every crossing we attempt in this life…but that first voyage to Haiti and my visit back to that small Maasai village where it all began to remind me to always dream big, strike out for the far shore with all your strength and endurance and to never to save anything for swim back until your long swim ends with your feet touching down on a new world. I never saved anything for the swim back…and in fact, I’m still swimming, but now I’m no longer swimming alone. I’m part of a group of people spread all over the world, thousands of them, with whom I or Floating Doctors has worked side by side to keep the promise of ‘I am your doctor’ alive and flourishing even in the most underserved forgotten settings. And my hope is that as we continue to work with volunteers and staff from all over the world, helping them achieve (hopefully) long term improvements in their medical care and their commitment to service, that each of these will continue creating ripples of compassion and hope and that one day “crossing each other from a million different centers of energy and daring those ripples build a current which can sweep down the mightiest walls of oppression and resistance.” I don’t care if that sounds ambitious or impossible. In Floating Doctors, one of our internal mottoes from day one has always been “Just because it’s impossible is no reason not to go ahead and do it anyway. It’s DEFINITELY no excuse not to try.”
We all face challenges, but looking back would you describe it as a relatively smooth road?
Were there struggles along the way? Hmmm…how long do you have??
First of all there were no roads, either literally or figuratively. No roadmap to success, no real precedent for what we wanted to do. And we wanted to do it in areas where no one else could or would–the communities that were forgotten in every sense of the word.
We’ve been struck by lightning, rode out hurricanes, spent a year with 12 people sleeping on the floor of a three-bedroom house, getting up at dawn every day for a year to rebuild a boat that had essentially been underwater…and then sailing it to Haiti after the 2010 earthquake, arriving in Haiti with supplies and fuel and our ship…but not a single dollar to our name (no personal money either, TOTALLY broke…where we worked without money for the first few weeks till we got a few donations to survive another week, and so on). Madness, when I think about it now.
We arrived in Panama penniless and held an emergency fashion show fundraiser on the dock at the local marina to have money to eat the next week. And less than ten years later, we have a base of operations from which we launch deployments every week throughout the year, treating about 10,000 patients, doing projects, training our volunteers, and beginning to affect regional and sometimes even national health care policy in Panama.
We’ve had staff deaths, come face to face with the horror of the child sex trafficking industry in Honduras, navigated around the drug trade, been eaten by bugs, exhausted beyond what I thought a human could survive, run aground on reefs, trapped by storms in the jungle…
It’s not a case of ‘what were some of the struggles along the way,’ more like one HUGE, continuous struggle against monstrous challenges and a sea of human suffering and pain. And we see a LOT of it that we cannot address the way we would at home…but we also see quite a bit that we can provide MORE compassionate, patient-centered care for….after all, for us a consult might easily be 2 hours long and occur in the patients’ home, rather than the obscene 15-minute standard consult slot for which doctors’ patients are booked here. That just makes me want to throw up when I think about how impossible it is to give good care in 15minutes.
Lots of struggles….and of course, every time we’d overcome some and things would feel ‘easier,’ we would use our newfound capacity to start addressing other issues as well. So it’s ALWAYS a struggle, but mostly because we continually work to grow and develop and meet more needs better and have a greater impact where we work and in the home countries of our volunteers when they go home…after all, you can be comfortable, or you can be growing…but usually not both at once! And we’re always trying to grown and do better.
Thanks for sharing that. So, maybe next you can tell us a bit more about your work?
I’m a general physician who, by default, has fallen into a career of establishing better health care in areas where many factors, especially geography, make that a huge challenge. I think I’m known for being very good at system design, problem-solving without sacrificing quality of patient care, very, very patient, and probably for my approach to palliative care especially. I think one thing that makes me different from many doctors is that I view a patient as existing as an integral part of a vast health landscape encompassing the world we can see and touch, but also the patients’ inner life. Also, I do not ever view myself as having ‘saved’ a single patient…many doctors say that all the time, but the reality is that you can do everything right and a patient may still die…they might even get killed in a car accident on their way home from the hospital after your successful surgery! Not likely, but the point is I’m not God, and no matter how much I wish I would actually control outcomes…I can’t. I only know what outcome I hope for, and within my power is to do everything I possibly can, as an instrument in the service of my patient, and then accept the result that comes as having nothing to do with me. Because even if my intervention ‘saved’ the patient, it’s dangerous to take that power onto myself (since it would just be an illusion).
All I am is an instrument, and all I can do is everything I can do to be the best instrument possible. But I would NEVER say that I ‘saved’ a patient. And if I lost a patient, the only relevant question is–‘Did I do everything within my power to be the best instrument that I could and do everything I possibly could?’ And if I did, and the outcome was not what we hoped for, my ego doesn’t take on the responsibility for that, either, since that’s not really in my power either. Essentially: don’t take the credit–OR the blame–for things that aren’t in your control. Just be the best instrument you can, and leave the result up the universe. I always tell the students, “You aren’t god…though sometimes you will feel like one, and many times you will WISH you were one… But you’re not. You’re only an instrument. So perform well, and you’ll sleep well afterwards.”
Is there a quality that you most attribute to your success?
I never save anything for the swim back. That was the key. You can’t just give it all and hope to succeed. You have to give a lot more than you thought you had and then give some more. It sometimes turns out to have been a terrible mistake to climb the mountain…but it is ALWAYS a mistake never to even try. After all, if you climb, you can reach the top, or you might fall. And if you fall and hit the ground, well, them’s the breaks (so to speak). Sometimes when you fall, of course, angels appear to save you (happened to us more than once!). But there is another option: sometimes when you fall, you learn to fly.
You have to not be afraid to fall, nor afraid to hit the ground and shatter into a million pieces and have to pull yourself back together and start up the mountain again, or another mountain. You have to have faith, but be willing to accept failure and loss if they are your destiny…and then be ready to forge a new destiny when you pick yourself back up off the ground.
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