Physician Spotlight: Meet Bill Smock, MD

Place of Employment:
Medical director, WaterStep; police surgeon with Louisville Metro St. Matthews and Jeffersontown police department; detective, special operations, Floyd County (Ind.) Sheriff ’s Department; and clinical professor of emergency medicine, University of Louisville.

Why did you decide to become a doctor?
Although perhaps disingenuously for some, 100 percent of medical school applicants would respond to that question by saying “I want to help people,” and I responded the same.

At 16 I joined the Harrods Creek Fire Department as a volunteer. During my senior year in high school I became an emergency medical technician (EMT). I took a “gap year” before college to serve as an EMT in West Louisville, working the graveyard shift from midnight until 8 a.m. These experiences hugely influenced my decision to become a doctor and ultimately to practice emergency and forensic medicine in Louisville’s trauma center and public hospital.

Is it different than you thought? How?
Residency training followed by the practice of emergency medicine in an urban trauma center came with no illusions. The same victims of interpersonal and gun violence, abuse, neglect, tobacco and alcohol that I had seen in the projects and the alley ways of our city and transported to Louisville General Hospital 15 years before I now saw in University’s ER. Unexpectedly though I found the problems of abuse, neglect, interpersonal violence and chemical addiction were not limited to one area. These problems also plagued my patients from the areas of the Highlands, St. Matthews and Prospect.

How did you get involved 
with WaterStep?
Ever since medical school I have wanted to take my skills to the developing world. In 2011, I recognized the basic human need for safe and potable water during my first medical mission. In Tanzania, my team treated hundreds of patients and passed out thousands of doses of medication. However, at the end of the day, most of the diseases we treated returned soon after the American doctors and nurses went home to the comforts of indoor plumbing and safe drinking water.

Why would the diseases return? Because the majority of illnesses we treated were waterborne and without safe water our patients would continue to contract the diseases. Most would suffer and some would die.

When I returned to Louisville, I asked myself “was there a better way to treat diseases than passing pills?” I found the answer at a local nonprofit then called EDGE, now WaterStep that trained lay and professional persons how to provide a community with safe water.

Since then I have taken several groups of medical students and nurses to Kenya and the provision of water treatment systems, either for hospitals or communities, has been a part of every mission.

What is the one thing you wish patients knew and/or understood about doctors?
How fortunate we are to live in the United States with access to healthcare, especially now with the Affordable Care Act. In developing countries you must have cash in hand to be seen by the provider. You need cash to pay for lab work, cash to pay
for the X-ray and cash to pay for surgery, before you will receive any care.

A mother carrying a nine-year-old child with an open tibia fracture was turned away from a public hospital because she had no money. Sixteen months later the same child, now with a gangrenous leg and protruding bone, was carried into my exam room. Fortunately we had a plastic surgeon on the team that performed an amputation and saved the child’s life. Some octors
still work for free.

What’s one thing your colleagues would be surprised to learn about you?
That I really don’t work 80 hours a week, just 60.

What’s the last good book you read?
Atul Gawande’s “Better: A Surgeon’s Notes on Performance” (Picador, 2008). It was a gift from a local civic leader and philanthropist who is dedicating his life to making Louisville a better community.

Favorite daytime beverage?

Heine Brothers’ freshly ground Mocha Java coffee.

What’s the best advice you ever received? Who gave it to you?
University of Louisville professor of neurology Bill Olson would ask each new group of junior medical students on his rotation, “Why did you become a doctor?” The patent answer “to help people” was the response. To which he would say, “If you really want to help people, be a doctor in Africa.”

I have finally taken his advice, and I am now taking groups of U of L medical students to Kenya each summer. Thank you, Dr. Olson!