They were poor, and though he always had enough to eat and a warm room to sleep in, Paul was sometimes embarrassed by the clothes he wore or the fact that he never had enough money to head to the drugstore to buy a Moon-Pie or a bottle of cola like his friends. Now and then he heard snide comments about those things, but instead of fighting back, Paul devoted himself to his studies, as if trying to prove it didn’t matter. Year after year, he brought home perfect grades, and though his father was proud of his accomplishments, there was an air of melancholy about him whenever he looked over Paul’s report cards, as though he knew that they meant his son would one day leave the farm and never come back.
The work habits honed in the fields extended to other areas of Paul’s life. Not only did he graduate valedictorian of his class, he became an excellent athlete as well. When he was cut from the football team as a freshman, the coach recommended that he try cross-country running. When he realized that effort, not genetics, usually separated the winners from losers in races, he started rising at five in the morning so he could squeeze two workouts into a day. It worked; he attended Duke University on a full athletic scholarship and was their top runner for four years, in addition to excelling in the classroom. In his four years there, he relaxed his vigilance once and nearly died as a result, but he never let it happen again. He double majored in chemistry and biology and graduated summa cum laude. That year he also became an all-American by finishing third at the national cross-country meet.
After the race, he gave the medal to his father and said that he had done all this for him.
“No,” his father replied, “you ran for you. I just hope you’re running toward something, not away from something.”
That night, Paul stared at the ceiling as he lay in bed, trying to figure out what his father had meant. In his mind, he was running toward something, toward everything. A better life. Financial stability. A way to help his father. Respect. Freedom from worry. Happiness.
In February of his senior year, after learning he’d been accepted to medical school at Vanderbilt, he went to visit his father and told him the good news. His father said that he was pleased for him. But later that night, long after his father should have been asleep, Paul looked out the window and saw him, a lonely figure standing near the fence post, staring out over the fields.
Three weeks later, his father died of a heart attack while tilling in preparation for the spring.
Paul was devastated by the loss, but instead of taking time to mourn, he avoided his memories by throwing himself even further into work. He enrolled at Vanderbilt early, went to summer school and took three classes to get ahead in his studies, then added extra classes in the fall to an already full schedule. After that, his life became a blur. He went to class, did his labwork, and studied until the early morning hours. He ran five miles a day and always timed his runs, trying to improve with each passing year. He avoided nightclubs and bars; he ignored the goings-on of the school athletic teams. He bought a television on a whim, but he never unpacked it from the box and sold it a year later. Though shy around girls, he was introduced to Martha, a sweet-tempered blonde from Georgia who was working at the medical school library, and when he never got around to asking her out, she took it upon herself to do so. Though worried about the frantic pace he held himself to, she nonetheless accepted his proposal, and they walked the aisle ten months later. With finals looming, there was no time for a honeymoon, but he promised they’d head someplace nice when school was out. They never got around to it. Mark, their son, was born a year later, and in the first two years of his son’s life, Paul never once changed a diaper or rocked the boy to sleep.
Rather, he studied at the kitchen table, staring at diagrams of human physiology or studying chemical equations, taking notes, and acing one exam after the next. He graduated at the top of his class in three years and moved the family to Baltimore to do his surgical residency at Johns Hopkins.
Surgery, he knew by then, was his calling. Many specialties require a great deal of human interaction and hand-holding; Paul was not particularly good at either. But surgery was different; patients weren’t as interested in communication skills as they were in ability, and Paul had not only the confidence to put them at ease before the operation, but the skill to do whatever was required. He thrived in that environment. In the last two years of his residency, Paul worked ninety hours a week and slept four hours a night but, oddly, showed no signs of fatigue.
After his residency, he completed a fellowship in cranial-facial surgery and moved the family to Raleigh, where he joined a practice with another surgeon just as the population was beginning to boom. As the only specialists in that field in the community, their practice grew. By thirty-four, he’d paid off his debts from medical school. By thirty-six, he was associated with every major hospital in the area and did the bulk of his work at the University of North Carolina Medical Center. There, he participated in a joint clinical study with physicians from the Mayo Clinic on neurofibromas. A year later, he had an article published in the New England Journal of Medicine concerning cleft palates. Another article on hemangiomas followed four months later and helped to redefine surgical procedures for infants in that field. His reputation grew, and after operating successfully on Senator Norton’s daughter, who’d been disfigured in a car accident, he made the front page of The Wall Street Journal.
In addition to reconstructive work, he was one of the first physicians in North Carolina to expand his practice to include plastic surgery, and he caught the wave just as it started to swell. His practice boomed, his income multiplied, and he started to accumulate things. He purchased a BMW, then a Mercedes, then a Porsche, then another Mercedes. He and Martha built the home of their dreams. He bought stocks and bonds and shares in a dozen different mutual funds. When he realized he couldn’t keep up with the intricacies of the market, he hired a money manager. After that, his money began doubling every four years. Then, when he had more than he’d ever need for the rest of his life, it began to triple.