I thought I was doing some good in Honduras – offering free cataract surgery on my own dime, importing equipment, making a difference. But about five years in, a 37-year-old patient walked into my clinic with posterior subcapsular cataracts. And this conversation followed:

“Yes, we’ll do your surgery.”

“I’ve been reading on the Internet. Are you going to be doing phaco?”

“No, we’re not going to do phaco.”

“I read that’s the best way of doing it, why aren’t you doing it the best way?”

“I don’t have phaco here – but if I could, I would.”

“I’m going to think about how badly I need this surgery...”

Even back in the year 2000, the patients who received charity care in Central America were, thanks to the Internet, quite savvy – and they wanted the best. I realized that I’d either have to quit – or give them the best. And that’s when I started importing more sophisticated equipment and working with local doctors to start building an infrastructure to provide a better service. The process taught me an awful lot, and I’ve gone from being a medical tourist, albeit on the provider side (I’d go down for about a week, do a bit of surgery, feel good about myself, then go home), to something more than that.