Ep. 204 - Dr. Craig Yorke: I Was Raised to be Perfect

0:01 Stories from Real Life is a production of Media Well Done, LLC. Welcome to this week's episode of Stories from Real Life with Melvin E. Edwards. Have you ever wondered what success costs? This week on Stories from Real Life, our guest is Dr. Craig York, author of Steep, A Black Neurosurgeon's Journey. His life has taken I was raised to be perfect.

0:49 You are listening to Stories from Real Life, a podcast by engaging storytellers for engaged story listeners. Here's your host, author and journalist, Melvin E. Edwards. Hello again and welcome to episode 204 of Stories from Real Life. I'm your host, Melvin E. Edwards. Thank you for joining us for the podcast where real stories are so much more interesting than fiction. Today on Stories from Real Life, I'm joined by Dr. Craig York, author of Steep, A Black Neurosurgeon's Journey.

1:32 Only 4% of neurosurgeons in the United States are black and Dr. York is here to tell us about his journey. Dr. York, welcome to the show. Thanks so much for having me, Mel. Well, growing up, I know you said you felt a lot of pressure to gain a certain type of success. Do you think you've had a successful life by your own definition? Yeah, I think that there are two virtues. There's the resume virtues and then there's the obituary virtues. And I got the resume virtues. My family kind of insisted on it.

2:13 The armament was all about credentials and capabilities and ways to feel less despised. The obituary virtues came later. A process of steeping, if you will, that began in midlife where I started to look a little more closely at the identity that the world had assigned me and start to really blur those hard edges of my persona. So, yeah, I've had some success in the effort, the work, the work of writing this little book, for example.

2:54 I really have come to believe that the Buddhists are right that the path is the goal and if you start walking the path you start to get to the trailhead ultimately and the rest I mean success conventionally defined isn't within my power so it's not my business what's my business is the effort and i've made the effort okay that makes total sense all right so what's more rare being a black neurosurgeon or a black concert violinist uh i would say that uh black concert violinist is more rare although let me give you a piece of trivia he would never admit this but louis farrakhan was a superb violinist Wow, I wouldn't have guessed that.

3:44 I never knew that. Yeah, really, I wouldn't have either. I heard him play Mendelssohn. I mean, he really could play. But no, I found out when I was about 16 that I wasn't going to be a concert violinist. I didn't have, you know, I had 98% of what it took, but not 100%. And it was a good decision not to do that. It's a tough life. Hmm. Okay, so what's more rare, being a black concert violinist or a black person in Kansas? Well, Kansas is about 12% black, just about like the national average.

4:26 It's pretty rare to be a black neurosurgeon in Kansas, I suppose. But, you know, when we came here in 1980 from San Francisco, Haight-Ashbury of all places, we were skeptical. You know, we gave the place six months. I knew it was a good job, but we wondered about whether we would be able to thrive here. But one of the first folks I met was a lady named Lucinda Todd, who no one knows anything about. I go back to the year 1950. She was the local secretary for the NAACP. and she was struggling to get Oliver Brown to do something real about his daughter, Linda.

5:10 He was always complaining about how she was in the wrong school and so forth. So Lucinda said, you know, there's this young whippersnapper lawyer coming to Topeka and you might want to have a chat with him. His name is Thurgood Marshall. And she coordinated that meeting between Oliver and Mr. Marshall And that's a little black history from Topeka that folks don't quite know about. And she, of course, was a very self-effacing, you know, modest woman, but did her bit. And she helped you feel welcome when you arrived. Yeah. And you spent a little longer than six months, we'll say.

5:50 Yeah, that's true. Yeah, yeah. You know, we worried about it, you know. Mary, my new wife at that time, pointed out that the clan was active in Tonganoxie, which was about 30 miles east of Topeka. But, you know, when we got to Topeka, we were very much welcomed. And part of that had to do with being necessary to the local medical economy. I mean, the guy that I was coming to work with was by himself. He was on call every night, every weekend for almost half a million people. So the arrival of a second neurosurgeon meant that the local hospitals could admit trauma.

6:33 They could do spine. They could do other kinds of things that would make them more successful. So they were very practical, cynical reasons for us to thrive. But we also thrived because it was a friendly place and is a friendly place. I mean, it's actually a community. which is surprising and somewhat rare. Well, I've only been to Kansas a couple of times, but I went to the same place both times. Pittsburgh, Kansas. Yeah, university. Have you ever been there? Yeah, university. Yes, I was a college student. I went to school in Arkansas and we played Pittsburgh State in baseball. I hear you. So that's when I was there.

7:15 Yeah, yeah. A long time ago. All right. So we talk about your parents putting a lot of pressure on you. What do you think your parents got right about that kind of a mindset that they put into you? Well, my parents were, not surprisingly, pretty badly wounded by the racial climate in Boston in the 1930s. And I arrived unexpectedly in 1948. I was a sickly child, and they were among the angriest, most talented people I ever knew. But what they did was to forge me as their weapon against the pain of their experience.

7:58 And, you know, I took on a lot of armor and, you know, I prospered for it, I suppose. I honor their decisions because I've seen the outcomes of the alternatives. I mean, they basically raised me in a bunker. You know, I had very little contact with the outside world from, let's say, age 11 till age 18. I went to a very, very competitive public high school, and my days were very narrow. You know, streetcar school, streetcar home, practice the violin, have dinner, study, go to bed.

8:38 I mean, that was my life for six years. and that did work. And you, you and I both have seen other choices that parents have made that have been less constructive. So yeah, I mean, I became an adult at age 11 and I did what I was told. I was aiming to be a credit to the race and that's part of the story of the book. You know, steep is an adjective. And the steep climb from a tough neighborhood to Harvard and brain surgery and all that is a well-worn narrative.

9:24 I mean, you see that in bookstores all over the place. But the second meaning of steep, the steep as verb, steep as maturing, as clarifying, that was what I was after mostly. You know, the book looks at the price of success, which I've talked about, and the power of memory, the power of memory to give you a little bit of freedom from your history. Okay. So you talk about your parents wanting you to be a credit to your race. Who do you think that was aimed at? Was that aimed at other black people as an example, as a badge? Was it aimed at white people as proof? Who would you say that was aimed at and what was the reason for it?

10:08 It was asymmetrical warfare and we were aligned against the entire world. I'll give you an example. I had a lot of success, full ride to Harvard, all that. In the middle of my time at Harvard, there was a lot of discord about the Vietnam War and civil rights issues, and I indulged in my first demonstration. I helped occupy a building with the Black Student Union to demand that Harvard expand its contracting process to include Black contractors in their construction and design and all that. The next day, the local hard-right Boston newspaper had a big picture of me on page two, one of a number of burly Negroes who were undermining an effete university.

11:00 Well, my parents' phone just lit up. The whole extended family and their friends, who were pretty annoyed at what an outlier they had raised, there was a lot of schadenfreude. There was a lot of You think you something, you ain't nothing kind of stuff. There was a lot of that. And so I guess to answer your question, the project was aimed at everybody outside our door, you know, outside our little apartment in Boston. You called it a project. Did they see it, see you as a project? Well, they saw me as a weapon. And, uh, Yeah, they did see me as a project.

11:43 One thing that I really admire about them was their ability to defer gratification. There's a little vignette in the book about my dad being excluded from one of the gigs that I played as a teenager. He was excluded because he was too dark. for a light-skinned black organization and because he hadn't gone to college. And he was a hard man. He grew up on the streets in Boston. And the moment of exclusion I talk about in the book, and the possibility of violence was heavy in the air at that moment.

12:24 But he showed incredible love for his 14-year-old kid that the world had never shown him. And he was playing the long game, the long, long game. So yes, this was a project, my friend. Wow. So you talk about growing up in Boston and among sports fans, Boston and I guess Philadelphia have some very hard reputations. But what was it like going from Boston to San Francisco from a racial aspect? What was some of the changes you noticed? Well, you know, I was protected in Boston. You know, if you go to Harvard College, you know, and you stick to your books and so forth, you weren't really beat up so much.

13:11 I went to San Francisco and it was like going to a new world. I mean, I had never left. Really, I hadn't left Boston in 25 years. I had a very narrow experience. So getting to San Francisco was, especially in that time, was extraordinary. I just wish that I could have been a tourist there, but I was there to embark on some very heavy work. Six years of surgical training, which was severe, to say the least. So is there a moment in your life that still haunts you? That haunts me. Well, on the surgical side, there's a community of ghosts that live in my head, people who died at my hands, people who had outcomes that could have been better and whose cases I remember to this day.

14:06 And the first of those is described in the book. When I was chief resident at San Francisco General, which is the trauma hospital of San Francisco, We admitted through the ER a young, I think, Bolivian or Peruvian girl knocked off her bike by a truck. And she had a head injury. We didn't have a CT scanner at that time. So kind of an exploratory operation. And she died in that operating room. First time that had ever happened to me. And so, yeah, that stays with you. I mean, it makes you a more mature surgeon.

14:46 It makes you a more cautious surgeon. And it populates the cemetery that lives in your head, you know, if you do medicine for real. Wow, that's heavy. How does your body carry that kind of pressure and those kind of memories? Well, there's a lot of, and this word escapes me now, compartmentalization. I mean, a surgeon... by necessity has to be someone who lives in the moment. You know, that cemetery is in your head, but you have to just set that aside for the problem that confronts you in the here and now.

15:28 And that's a skill that not everybody has. And it comes with training, but not everybody acquires it. How do you acquire that kind of a skill? It's a good question. It's a mystery to me. I mean, I watched... The people who are a year or two ahead of me, I don't know. I guess people can normalize a whole lot of things. And you normalize yesterday's trauma and just decide to march on with today's. I mean, in the book, I talk about the moments after we got to the recovery room with this young lady who had a blood pressure of zero at that point.

16:12 And I remember looking at the tiles of the recovery room floor as I started to dictate the operative note and saying to myself, I am not going to vomit before I finish dictating this note. And then the next few hours are a hole for me. I mean, I didn't keep a diary, so I'm sad about that. But I know that I changed my clothes because I was bloody. I know that I talked to the family I know that I talked to the police I know that I took call for the rest of that night I know that I made rounds the next morning but I don't remember any of that stuff But, I mean, it's a matter of denial, I suppose.

16:57 Yeah, that's what it is. Wow. So, at what point did you finally feel like you weren't just Mr. and Mrs. York's son, but you were fully yourself? How did that feel when you did get to that point? Well, it took a long time, and it's not over. I mean, all of us have our history inside us. And the question is, how do we connect with it? Does it keep pushing us around? Or can we get a little perspective on it and get friendly with it? I mean, the process of steeping for me really began when I left the operating room in my mid fifties and said, you know, Life is short.

17:45 If anybody should know that, it would be a doctor. Life is damn short. And there's more to life than the operating room. I mean, for all you know, you might write a book, Craig York. Anyway, over my shoulder there is steep, available on Amazon and everywhere books are sold, all that kind of thing. My parents live inside me today. It's just that their voice is not so loud. I've steeped a little bit to move away a little bit from the political, the racial identity that the world assigned me.

18:27 Did you ever feel resentful of your parents? Yeah, sure. I remember once, I was about 11 or 12, I'm enrolled in this incredibly hard school, which will soon have its 400th anniversary, oldest in the nation. And I said to my dad, you know, four hours of studying Latin and mathematics, it's just too much. I'm not going to do it. I want to play with the other kids. I want to be a kid. He said, Come with me. We got in the car. We lived in Brighton, which was kind of a mostly Jewish neighborhood where we were. And he drove to where he had grown up in the hard part of Boston.

19:10 And we drove through the streets. It was a Saturday. And he said, you know, if you fail at the Latin school, this is your future. and he would point to these guys who were laying out in the street and he said, you know, I tell you this as fact, you know, the difference between competence and incompetence is the difference between life and death. Now, that is an extreme way to talk, but that was his response. And, you know, he was an American original. He was orphaned at age 12 in Boston, grew up on the streets, had the typical depression experience of trying to stay alive, played in the colored leagues, got a hit off Sackle Page.

19:59 Nice. Yeah, it was a bunt, he later told me. It doesn't matter. He married the woman he loved, never got to college, trained himself to become an electrical engineer. He was a tough dude in many, many ways. My mother also. My mother didn't graduate from college and she would read Emerson to me and read Du Bois to me. It was a strange household. very narrow but very focused. Were you an only child?

20:39 I sure was. I was unexpected. They were getting ready to adopt when I showed up and I had serious lung problems and a club foot and that was a big disappointment to my dad because he wanted an athlete as a son and I was much more tortoise than hare. but again with their patience and with their deferred gratification and about a decade of exercises my feet turned out okay and I'm a fanatical tennis player at this point and I ran my marathon in 2003 and yeah my body's in great shape for somebody 77 I mean So if I asked your family to tell me one story about you, what story do you think they would tell?

21:27 I think the story my mother would tell, it's in the book. I'm a senior in high school and all of this effort is coming into fruition. You know, a lot of colleges want me to apply and so forth. And it's, I guess, April of 1966. And we live in a very narrow apartment and the doorbell rings. and it's four o'clock in the afternoon. I've just gotten home from school and my mother's suspicious. I mean, who rings our doorbell? Nobody. So the call is Western Union. And so she gets even more suspicious because no one ever sent us anything positive by telegram.

22:11 So this guy comes coming up the stairs. We're on the second floor. He's making a big effort because his lungs are bad. He's a Western Union courier. He hands the yellow envelope to my mother. And it's addressed to me, but she opens it. And it says, Dear Mr. York, Lady Bird and I are delighted to invite you to the White House in honor of your selection as a presidential scholar. Nice. So LBJ is sending you letters. Yeah. So, I mean, what happened next was that my mother became ecstatic, which means she was outside her body.

22:57 She's a 40-year-old woman, 43 or 44, and suddenly in the blink of an eye, she's a 16-year-old girl. She's just dancing and singing. And you probably know what a hero Johnson was in households like ours. I mean, it was the year after the Voting Rights Act. 1965 was the Voting Rights Act. So this was... validation for her and for my dad of all those decades of not partying, all those decades of not getting with the fraternities and the sororities and all that kind of black culture that they put on hold and putting everything into this weapon of their son.

23:47 So I think that would be a moment that my parents would talk about. Okay. So what did medicine teach you that Harvard couldn't teach you? Well, medicine in Kansas, doing neurosurgery in Kansas for 25 years, gave me an incredible education because I had an intimate seat for the peaks and the valleys of folks' lives. And it was an education for a young man. who is yet to face life-threatening illness. Neurosurgeons deal with that every day, but to get that education from my patients was of tremendous value.

24:34 You can't get that in a classroom. You get that at the bedside. You get that in the examining room. You get it in the ICU. You get it in the morgue. Is there any truth that you had to age into that you never would have understood when you were younger to maturing and being more wise to understand? That the outcome isn't under your control. You do the best you can, you show up, you tell the truth, you do what you can and then that's it. I mean, you've done the trying, you've made the effort and the rest isn't your business. The outcome doesn't belong to you.

25:17 That is a lesson that young surgeons struggle to learn. I certainly struggle to learn it as a young person, but I try to understand it now. All right. And at the beginning, we talked about how rare it is to have a neurosurgeon. So with that in mind, do you welcome or kind of resist comparisons to Dr. Ben Carson and especially to his book, Gifted Hands? Is there a comparison between his book and your book? That is a great question. I read that book twice and it's a good book. I set out to write something different. I think people write books for different reasons.

25:58 I think his book was written for political advantage. It was a tool for political advancement. My book is a tool for self-exploration. What I found puzzling about his book was the lack of failure. I think that if you take on big neurosurgical cases year after year after year, you will have people die. You will have people suffer significant neurological deficit. And I didn't find any of that in his book, which is fine. But I'll just say I like my book.

26:42 Okay, and I'm sure the listeners today who eventually pick up a copy will like it too. Let's talk more specifically about your book. So what does the cover image mean? Oh, good question. The cover is a pen and ink drawing done in 1890 or so by a guy named Ramon E. Cajal, who is the only anatomist ever to win the Nobel Prize in medicine. He was a crazy young man born about 100 miles south of Madrid. He was incorrigible. He was a juvenile delinquent, capital J. And his dad said, you know, Ramon, I can't apprentice you to anybody.

27:24 You won't stay in school. All you want to do is draw. So let's go somewhere where you can draw. He's the local doc. So we took Ramon to the morgue. and Ramon decided I'm going to become an anatomist. So he acquired the ability to do very fine slices of brain, cat, dog, human, pigeon. And he understood how to stain those slices. And he looked and looked and imagined. And somehow he wangled an invitation to speak at the epicenter of medical establishment, the Royal Society in London. And this upstart stands up and says, you know, everybody in this room is wrong about the brain.

28:08 Number one, it's not an infinite network. It's composed of many, many, many cells. Our microscopes are too weak to show the separations, but they're there. And I've drawn all of these drawings to show you what these cells look like. Second, I imagine that these cells communicate electrically, although I can't prove it. And it's just because of their structure. Finally, I imagine that these cells, I know that they change their form with age. And I believe that's because as the organism learns, its nerve cells change their shape very subtly. Now, the typical response is that all of these eminent people basically laugh him out of the room.

28:52 They said they were ecstatic. And on that day, what we call neuroscience was born. And he was proven right over the next 50 or 60 years about everything he said. This particular cell, there's about 15 million of them at the base of your brain and mine. They're like pages in a book. And what they do, they're very conservative. There's conservative cells. They conserve muscle tone. And why is that important? Well, if you don't regulate muscle tone, you can't stand up, you can't sit down, you can't write your name, you can't pick up a cup of coffee, you can't do anything.

29:33 The muscles of your eyes cannot track in a coordinated way across a line of print. So the cover is to me a statement of imagination, creativity, that imagination is more important than knowledge, that imagination creates science. And I just wanted to make a very high bar for the text to me. So that's what's on the cover. It's called a Purkinje song. So what's your favorite story in the book? Golly, probably the journey to Kansas. You know, it was a road trip in June of 1980.

30:14 record heat. Mary and I were in a very temperamental old German car and the AC died as we were getting into Nevada. We were hippies. We had a host of house plants in the backseat. We're spraying each other and spraying the plants. I've got the heater on max to keep the engine from blowing up. and on the on the evening of the fourth day we arrive at the Holiday Inn in Topeka and you know we've we've left a really nice apartment you know overlooking the Bay Bridge and looking out to Oakland and Berkeley and it's almost midnight the temperatures 92 degrees we get out of the car and I look at the security lights of the hotel and it looks like there are birds that are circling those lights.

31:09 It turns out that those were Kansas insects. It's just that they're so gigantic. They look to me like birds. So that was a moment where we kind of, the young couple crossed their Rubicon and entered their new life. All right. So how did you balance personal stories with social history in the book? In the book? That's a good question. It's kind of art. I wanted to surprise readers. I wanted to give them a sense of what the 20th century was like. I know that this is a black story, but a lot of other people, I mean, Chinese folks and Eastern Europeans have said, you know, my background was much like this.

31:53 You know, my parents were severe and this and that and the other thing. But I don't know. I really respect poets. I'm not a poet, but I respect their economy. And I really wanted the fancy words, the medical words, to dance politely with the common words. And I wanted every word to be to be doing useful work. And I wanted to keep the reader's attention, which is a hard thing to do. But if I alternated or combined the medical stuff with the personal stuff, with the political stuff, with the musical stuff, I thought it might be an engaging read.

32:36 And I hope that's true. Okay. So let's divide up the potential readership. But what do you hope black readers take from your book? That's a good question. First, it's not a sermon. It is not a polemic. I think that it's an invitation if you push me. You know, there aren't a lot of victims or villains in this book. The police aren't beating me up and so forth. I think it's an invitation to wake up, to wake up to all of your past, the stuff that was ecstatic, the stuff that hurt. And, you know, I think that in that waking up, there's a little bit of path to freedom.

33:19 I've never met a free person in that sense. I've never met a liberated person. But the work of writing this book, I think, has shown me where the trailhead might get there. Okay. So what do you hope white readers take from the book? Much the same thing, you know, to wake up to their history, to wake up to what was terrible. I mean, we can't change Jim Crow. I mean, all those books in the bookstore, 1619, Cast, you know, all of those books are full of crap. Yeah. This is a new book that's in the bookstore, one that I just released this month.

34:01 Yeah. Yeah. They're indispensable. No question. But the danger is that they're overly diagnostic. This went wrong. That went wrong. This was terrible. And what I would be hoping for is to look for some kind of remedy. You know, you and I know what the diagnosis is. And some of the diagnosis is in the book, you know, in my book. But, you know, my white readers, a lot of them have said, you know, this is your book is approachable you know it is understandable it causes me to rethink the past to revisit to reoccupy the past and if that if anybody does that that's success in my book okay so what do you hope physicians take from your book compassion I guess putting yourself in the other person's shoes Part of the reason we came to Kansas was to not be led into temptation.

35:08 When I finished at UCSF, I was on a high-powered academic track. I mean, the offers were coming in, assistant professor at UCLA, assistant professor at Emory. But working in overdoctored places tempts people to overtreat. And working in a system where the more you do, the more you make, also tempts doctors to overtreat. And a little conservatism there might be something that doctors could benefit from reading about. I mean, it's known. It's very well known in doctors' lounges. But, you know, it's something that that is worth saying again, I think.

35:51 Okay. So I just have a couple questions as we start to wind down the conversation. Again, it's more about your book and different segments that might be either targeted or have a specific interest. What about parents? What do you hope parents take from your book? I don't I'm not smart enough to know I know that my parents were extremely severe I know that I couldn't bring that level of desperation or severity to the raising of our boys Mary my wife was often the bad cop in that situation I know that I provided a good example I showed up I you know got to all the parent teacher conferences I did what I could but you know the peer group was the coin of the realm they were misbehaving and both of them kind of came into a high achieving peer group when they were sophomores or juniors in high school and they have had extraordinary success I'll just do a footnote here they had and Mary did final edits on the book and they took out, the boys did, all the boasting I did about them.

37:06 They said, this is your book, dad, you know, so they took it out. But I guess the outcome isn't under your control as a parent. You set an example. You try to create an environment where the peer group works and be supportive and walk the walk. You show the discipline in your own life that you're asking of your kid. Okay, as a final question today, did your parents live to see your success? Yeah, there's a moment in the book. I'm a well-known surgeon in eastern Kansas of, you know, Physician of the Year and all that sort of stuff.

37:53 And I'm 54 and I go to my dad and I say, you know, dad, I'm burning out. You know, there's life beyond the OR and the working conditions are not good and so I'm going to probably retire. And he looked at me and he said, well, if you retire, how can I keep bragging about you? But no, I think that they were gratified and that their son did well. They were gratified by their grandsons. My mom died suddenly. We were in Topeka three or four years at that point. But she saw me graduate from Harvard Medical School.

38:34 I mean, pretty unusual. She saw me save folks' lives in her neighborhood in Topeka. So yeah, I think in the scheme of things, they were gratified. Okay. So that's where we're going to conclude this episode today. Dr. Craig York has been our guest this episode. So Dr. York, thank you so much for being here and sharing your story. I really appreciate it. Melvin, thank you for having me, letting me rattle on here. Well, it was thoroughly enjoyable. So my guest today has been Dr. Craig York, and his book is called Steep, A Black Neurosurgeon's Journey. Check out the show notes to learn how you can get your copy of the book.

39:16 And be sure to follow Stories from Real Life wherever you listen to podcasts. That's it for this week's episode of Stories from Real Life. Until next time, don't forget to shine your light wherever you go. That was Stories from Real Life. Join us again next week for another great storytelling journey. See you next time.