It was March of 2021.

Michael J. Ramos was training to become a family medicine doctor in Oklahoma and had just finished his urology rotation when he felt a lump on one of his testicles.

Ramos scheduled an appointment with the doctor who had just been his teacher.

“I didn’t expect to see you back so soon,” the urologist said.

The lump turned out to be testicular cancer.

The news was rough for Ramos.

“It was a surreal feeling,” he said. “Here you are pursuing your career, and all of a sudden you get diagnosed.

“We’re used to treating (patients). We’re not used to being the patient.”

Ramos was 36 at the time and had already been navigating a long journey to become a doctor. A Pueblo native, he attended college at the University of Denver, medical school in the Caribbean and traveled to different hospitals for rotations around the U.S. before starting his family medicine residency in Oklahoma.

As a child, he wanted to follow his dad into health care. His dad, Michael A. Ramos, is a family medicine doctor at UCHealth Family Medicine – 13^th Street in Pueblo.

The son succeeded in his goal and returned to his hometown of Pueblo where, just like his dad, he’s also a family medicine doctor. The young Dr. Ramos, now 40, cares for patients at a different primary care clinic: UCHealth Family Medicine – Parkview Pueblo West Hospital.

His dad, 68, is also a cancer survivor. He remembered how difficult it was for his son to receive news that he had testicular cancer.

“He was a little angry and (thought) ‘why did he get it.’ When he had to do the surgery, he was kind of down,” the elder Ramos said.

A father shares his story of getting bone cancer while in medical school

The elder Ramos’ cancer journey began almost four decades earlier when he was a medical student, and his left leg started bothering him. An X-ray showed a tumor, and it turned out to be a type of bone cancer called osteogenic sarcoma of the fibula.

“Once you get it, you go, ‘Why me? What did I do?’ I thought I was a good person and then you go through all the different emotions.”

Doctors recommended both surgery and chemotherapy, which the elder Ramos initially refused.

He had watched his grandmother suffer through chemotherapy for breast cancer. It took another perspective to change his mind.

“The dean of medical school said if I didn’t do it, he was going to kick me out,” the elder Ramos said.

Back when he got cancer, Ramos said some people were afraid even to be around a person who was going through chemotherapy.

“They didn’t want to touch you,” he said. “It was kind of isolating.”

Compounding the difficulty was the fact that he was never one to ask for help and never felt comfortable accepting help from others.

Still, years later, he told his son that he had made the right call.

“Even though I hated (chemotherapy), I’m glad I did it.”

As painful as it was for both men to go through cancer journeys, the dad’s willingness to talk about his own trials helped the younger Ramos as he coped with testicular cancer.

He developed his own set of guiding principles:

• Accept reality.
• Put in the work.
• Reap what you sow.
• Confront challenges as they come.
• And do what’s necessary to complete the task at hand.

Raised in Pueblo

The elder Ramos grew up in Pueblo and was raised by his grandparents. His grandmother was particularly influential. She taught him to give without expecting anything in return.

He always wanted to be a doctor and pursuing medicine was a way to help people like his grandmother. Even after he got into medical school, she kept him grounded.

“You don’t think you’re better than anybody else, and nobody’s better than you,” she would tell him.

He went into family medicine because it allowed him to care for patients of all ages.

“You deliver a baby one day,” he said.

The next, you might have to help someone face tough end-of-life dilemmas.

The same babies Ramos helped bring into the world then grew up to have their own kids, some of whom he also delivered.

“They’re like family,” he said.

Young Michael was born during his dad’s final year of medical school.

“I remember I’d be trying to study, and we’d both be sleeping,” the elder Ramos said recalling moments with his son when he was a newborn.

A strong community spirit in Pueblo

Back then, Pueblo was a far different place. People smoked in the hospital. Privacy regulations weren’t as stringent. It was a small town where everyone knew everyone from wealthy folks to lower-income people.

“It’s always been a tight knit community,” the younger Ramos said.

His dad agreed.

“The only downside is that you can’t go anywhere without people knowing you,” he said.

The Pueblo community always has come together to support people during tough times like when a major accident at the steel mill resulted in numerous injuries and led to an outpouring of community support.

The younger Ramos recalled how his dad exemplified this same generous spirit.

“I remember we were grocery shopping when I was 4 years old. My father had to do CPR on an individual who had gone into cardiac arrest near the entrance to the grocery store,” the younger Ramos said. “He has always been selfless and doing whatever it takes to help those in need.”

His dad often brought him to work, which immersed him in medicine.

“I vividly remember walking the halls and learning everything. I still remember how the OR looked, the tile, the color of the room, just happy memories.”

Concern, then pride about a career in medicine

Like many doctors of his generation, the elder Ramos wasn’t home much and often stayed late at the hospital. Looking back, he understands that his dedication to patients took a toll on his family and his well-being. Initially, he didn’t want his son to follow him into medicine.

“Dad tried to get me to be an attorney,” the younger Ramos said.

But then the father watched as his son found family medicine and loved it. Like his dad, he was drawn to the broader scope of practice and being able to care for patients from birth to the twilight of their lives.

And so, the son followed in his dad’s footsteps.

“I’m glad he did, because that’s what he wanted to do,” the elder Ramos said. “Medicine has changed a lot, but I was kind of excited about him doing it.”

When the younger Ramos started practicing, his dad recalled watching him navigate the challenges of today’s health care system. He remembered how upset his son would get about insurance denials for his patients.

“He was taking it to heart that it was his fault … It’s not. You’ve just got to realize this is where the system is and just do what you can,” he told his son.

The elder Ramos is especially proud of the way his son has found balance in his life.

“I like the way Michael’s doing it. He’s working and spending time with his family,” he said.

Lessons learned facing different types of cancer

For the elder Ramos, getting cancer early in his medical training changed his outlook on life. It made him aware of his own vulnerability. It gave him a greater appreciation for life, and the importance of taking good care of his own body. It made him less self-centered.

“I think I needed that. I didn’t like it, but I think it made me a better person. After I got cancer, I just realized, ‘Hey, I’m nobody special. I’m just a person, and so you better straighten up and start thinking about people a little bit more and caring more about people.’”

As far as support, his grandmother and his faith helped him through the challenges of cancer treatments.

“The biggest thing was family and prayer. We have all our training but whoever you believe in, there’s always a higher being that’s going to control things. And that’s kind of what got me through: praying every night. The only one who would ever call me would be my grandmother.”

His experiences coping with cancer gave him more empathy for his patients.

“It really helped me just to get more focused on people: how they feel and just knowing what they’re going through.”

This sensitivity often leads him to learn other important details, such as the medication side effects patients are experiencing or stressful situations like a death of a loved one that influence one’s lifestyle choices.

“I go and ask them whatever the main issue is and then ask them other stuff because sometimes they won’t bring it up,” he said.

A young doctor faces testicular cancer and the need to focus on his own health

For the younger Ramos, his cancer treatment was an opportunity to slow down and pay attention to his own needs.

“We’re trained to just ‘do’ and not think,” he said.

Sometimes doctors pay a price and neglect their own physical and mental health while investing so much time and energy in patients.

But during the younger Ramos’ training, his program emphasized the importance of taking good care of your mental health, which was particularly important during the COVID-19 pandemic.

Along with his family’s support, the younger Ramos found a good counselor who helped him process the difficulty of a cancer diagnosis as a young man.

His encounter with testicular cancer also renewed his focus on nutrition. Through much of his medical training, his diet was “trash,” he said.

After getting cancer, he made a conscious decision to eat a healthier diet.

“The awakening for me was when the hospital I was at in Oklahoma opened a fast-food restaurant in the facility. I was like, ‘No, I’m not doing that.’ It was actually in the physician office building attached to the hospital, and there was a coffee shop in there too,” he said.

Cultivating healthier habits and a wonderful garden

Ramos recently became a first-time father.

At home, he regularly does organic gardening. His close connection with food and nature has enhanced the way he supports his family and his patients.

“I have a 1-year-old at home, so I want to be healthy as possible for him and reduce my risk of cancer down the road and other diseases as well. I can prevent those disease processes now.”

He’s returning to his roots, literally.

Growing up, Ramos loved eating strawberries from the garden. He sometimes got in trouble for gulping down too many. Today, eating homegrown produce is a way to appreciate the life he’s been given. Not only is food from the garden good medicine, it also prevents disease. Ramos knows that even if he were to develop future health problems, living a healthier lifestyle will increase the effectiveness of medical treatments and enhance his resiliency.

In the same way, supporting his plants with a healthy environment has paid other dividends during difficult times.

“Two years ago, we had one of the worst hailstorms, and my garden was flourishing at that point in time, and it took everything out.”

The loss was initially overwhelming, just like his painful cancer diagnosis.

“I was ready to go rip out all the plants,” he said.

His wife convinced him to give the plants time to heal and keep the big picture in mind.

“Sure enough, it was our best garden.”

Similarly, seeing each patient through this environmental lens has shaped his approach as a doctor.

“Knowing their background, what their limitations are, if they have financial constraints, different social constraints, different family dynamics, knowing their family history helps. What helps, too, is having good insight as to their insurance coverage. Knowing what their coverage helps me direct the patient best for optimizing their care,” he said.

Medication is often not the “be-all and end-all” as far as Ramos is concerned.

Sometimes, medications allow people time to heal and get stronger until they’re ready to take control of their health, especially when it comes to eating well.

“The main thing is getting access to healthy foods and cutting out those processed foods,” the younger Ramos said. “Processed foods are cheaper than healthier foods typically, but with my patients, I try to find workarounds and try and find healthy, cheaper options for them.

“I’ll sit down and spend dedicated time talking about where to shop in the grocery store, how you find those cheaper prices for healthier foods, and how to maximize what they purchase into multiple meals rather than just one and how it compares to like if they go to a fast-food restaurant,” he said.

Once again, it’s about living with the big picture in mind.

Understanding health through community  

Both father and son know that individuals can have a big impact on their greater communities.

Cancer can do that in a negative way, so they work to do the opposite.

Cancer occurs when one cell or molecule starts growing out of control and damages the essential functions of the whole body. In a sense, it’s individualism gone awry. Whether driven by genetics, lifestyle choices or the environment, the result is the same.

Cancer says to the rest of the body, ‘I don’t need you to succeed,’ and in doing so, harms the whole.

Conversely, when it comes to health, individuals need healthy communities.

Caring medical providers, like the Ramoses, walk alongside others until they are well enough to take ownership of their health in a way that bears fruit. It begins with seeking help, accepting reality, then learning with and from one another.

When the younger Ramos was in college, he worked one summer in Africa with a group to address a variety of infectious diseases including HIV and tuberculosis. It was an unforgettable experience.

“Everyone I encountered while in South Africa had a strong sense of the term ‘Ubuntu.’ Ubuntu loosely translates into ‘I am, because we are.’ Since then, I have had a strong connection with the purpose of Ubuntu for the care of my patients, my community, my family, and myself.”

In the same spirit of the generational lessons passed down in his family, Ramos carries this communal mentality today.

After all, it takes a pueblo to raise a child.