Geoff Williams drives a dented and dusty 1992 Honda Civic, its partially detached rear panel bobbing with every dip in the road. When he goes home, it’s to a paper-cluttered bedroom across the hall from his parents’ modest master suite.
As a plastic surgeon, Williams could live in a sprawling house, cruise in a snazzy sports car and wear custom-made shoes instead of the US$5 pair he snagged at the thrift store a few years back.
Instead he spends his money on hundreds of strangers, half a world away. Grown men with rope-like tumors engulfing their eyes, nose, lips. Teenage girls with heads cocked permanently to one side because of burn-tightened skin. But mostly children — with faces split up the middle like a half-open zipper.
Williams invests in faces.
Originally it was art, not altruism, that drew Williams into the competitive business of plastic surgery.
“People think for my whole life I wanted to do something like this, working in developing countries, and it wasn’t really like that,” he explains. “I like art, I like the form of the human face. Also, I wanted to be a doctor and do surgery, and plastic surgery was a way to put these two together.”
His parents were thrilled, envisioning a life of traditional financial security and rewarding work for their eldest son.
Not all of their wishes were fulfilled.
His mother, Bev Williams, readily shows off a watercolor of a mountain lake that hangs in her bedroom.
“Geoff did this in high school,” she says. “He’s always been artistic.”
Williams didn’t develop his empathy for the disfigured from his childhood. He wasn’t teased for his appearance in high school. There was no sibling with a cleft palate to defend from the harelip jokes of elementary school students. He wasn’t even the kind of kid who picked the mangy puppy at the pound over the purebred golden retriever, or mowed his elderly neighbor’s lawn for free.
Williams and his two brothers were average kids, polite children who played sports and got decent grades.
He worked his way through medical school, with some help from his parents. He decided to specialize in children’s deformities because he found that his scalpel could heal not only disfigured children, but their brokenhearted parents. He underwent cleft palate training at the Chang Gung Memorial Hospital Craniofacial Center in Taiwan, considered one of the leaders in cleft surgery in the world. This birth defect, in which the roof of the mouth is separated — sometimes front to back, affects about one in every 800 babies.
Williams landed a lucrative job performing plastic surgery and teaching at the University of Texas.
But as he worked and taught in wealthy hospitals, his mind was preoccupied with thoughts of the hundreds of desperate mothers in Vietnam who had swarmed him during a volunteer training trip, thrusting their deformed babies at him and begging for help. Only 20 babies were treated that trip; about 180 were sent away.
As his plane took off, he was overcome with sadness.
“Leaving, looking down at those lights, I knew these mothers were going home with total disappointment,” Williams recalls. “I remember making a promise to myself then, to those mothers: I may not be able to find you, but I’ll find someone like you. I’ll come back. I’ll do more.”
Several months later, he took another volunteer trip, this time to India.
“I thought I’d do it a couple of times and get it out of my system,” he said. “After about a year, it just hit me — it would not be easy to stop doing it. It took me a while to say, ‘To heck with this sadness.’”
He took a leave of absence from the University of Texas in 2003 to immerse himself in treating the forgotten patients in developing countries. He never went back.
He went to Peru, Kenya, Bolivia, the Philippines, Mexico, Pakistan, China, Thailand. And always, back to Vietnam.
“A lot of the kids that are born with a cleft lip and palate just never go to school. Their mothers will keep them home as a way of protecting them from the cruelties of society,” Williams says. “No education means little opportunity for work, for getting married, for everything in life that brings them rewards. Those little babies don’t know what they’re in for.”
At first, he traveled with some of the many groups that organize medical missions in Third World countries. But the trips bothered him. They often ended while children were still in the critical postoperative healing period. Dozens — sometimes hundreds — of would-be patients were routinely turned away. And American doctors often had little time to train local doctors.
The turning point came during a group trip to Vietnam in 1999. A child was turned away because it was the medical team’s last day in the country — a day that had been scheduled for sightseeing and shopping.
Williams stayed and reconstructed the child’s face. Hospital administrators quietly asked him to come back on his own.
He did, making trips to more countries on his own dime. He created the International Children’s Surgical Foundation in December 2005 to raise money so his work could continue when his savings ran dry. The foundation now manages to bring in just enough donations to stay in the black, covering Williams’ airfare, hospital fees and a few other travel incidentals.
He doesn’t know when he’ll get a salary. But he doesn’t seem to care.
“His rewards from his work are infinitely preferable to what anyone would achieve doing standard plastic surgery,” says Stephen Milner, a friend and board member of his foundation.
Some of Williams’ friends have warned that the fulfillment he has found in helping others comes at too high a price. At 53, he has less than US$200,000 in his retirement account, a paltry amount for a successful surgeon.
“I know some plastic surgeons who’ve retired with US$30 million in the bank, a private jet and a bunch of other toys, and they seem really unhappy,” he responds.
Williams says he has found his life’s work the most fulfilling career he can imagine.
But keep prying, and he’ll reluctantly confide something: The price of taming his adopted heartache for disfigured children and their parents is a different sort of pain — the pain of loneliness, a life of stress and solitude.
He would like to be married, but that means finding someone willing to work by his side and live an itinerant, often indigent, life.
“I feel like I’m never going to get married because of what I’ve chosen to do. No real chance for a social life,” Williams says. “One of the reasons I can do this job is because I don’t have a bunch of little mouths to feed at home.”
His lifestyle is beyond modest — while in the US, he lives with his parents. While abroad, he stays in hostels, in the homes of local doctors or even in the on-call rooms of hospitals.
Yet, the longer he spends on his work full-time, the more alone he becomes.
“I’ve developed a bit of an anxiety disorder because I’m always planning a few missions in advance, and I struggle with not having a steady, even-keel, solid routine in my life,” Williams says. “Sometimes I feel like I’m coming apart because I need that routine.”
But those feelings are transitory.
“Whenever I feel, ‘poor me,’ then I go on my next trip,” he says. “When you find something you’re meant to do, your life’s work, you do it.”
The rewards, though untraditional, are priceless.
One patient — Cassandra Castellanos — was just three months old when a gas tank exploded and burned her wood-and-reed home around her. Hospital workers told her anguished mother, Maria Luisa Cruz, that her youngest child would not live beyond the next 24 hours.
But little Cassandra survived, with arms and face deeply scarred.
Her wounded skin drew stares from strangers, and Cruz feared her daughter’s life would be forever scarred as well.
“People like to stare,” Cruz remembers. “They gave her such cruel looks. Around Oaxaca, they don’t see many accidents.”
As a single mother to four children, Cruz didn’t have the money to pay for even one of the multiple surgeries Cassandra would need to reduce the scarring. But when Cassandra was six, they met Williams.
The first of multiple operations began with him inserting a tissue expander underneath the healthy skin near Cassandra’s burns.
The expander — essentially a silicone balloon — was filled with water each week to force Cassandra’s body to grow more skin over the device. Williams then surgically removed the expander, pulling the new skin up over her scarred cheek. In subsequent surgeries, he moved her eyelid and right ear back to their correct positions and pulled her scalp forward to cover a bald area. He operated on her hand to relieve an area tightened by a scar, improving her mobility.
The work isn’t done yet.
Williams says he’ll continue to “refine” the scars — Cassandra is scheduled in December for a surgery in which he will use cartilage from her ear and rib to reshape her nose. Another surgery is planned to give her eyebrow grafts using hair follicles taken from the back of her neck. Williams is hoping to avoid using any skin grafts — on Mexican children the grafted skin tends to turn darker than the surrounding area — but says he may have to on her upper lip.
Now 14, Cassandra grows closer every year to having the face she was always meant to have.
“The truth is, I’m really happy,” she says. “Thanks to him I’ve had these operations. The way I was before and the way I am now — it’s advanced a lot.”
Her mother is healing as well, no doubt from seeing her daughter thrive.
“She’s so much better. She’s not going to recover 100 percent,” Cruz says, “but 90 percent. That’s alright.”
It all makes the austere lifestyle worth it for Williams.
In Vietnam, he casually mentioned that he liked mangoes and was soon inundated with the tropical fruit by parents who wanted to pay him in whatever way possible for the future he provided for their children.
In the Philippines, one mother presented him with a freshly butchered chicken, carefully wrapped in plastic netting.
He knew what she was trying to say: Thank you.
His heart fills up as grateful mothers see him off on his next mission, waving their babies’ tiny fists in the air so the infants can say goodbye too.
Moments like that lift any melancholy. They’re tangible proof that he’s making a difference in someone’s life.
And for that, he says, his reward is the memory he’ll keep of all those faces.
ADDITIONAL REPORTING BY MARY CUDDEHE
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