Dr. William Howard rubs his hand through his stubbly crew cut and sighs. With his legs dangling over the examining table and his blue eyes darting around the room, he looks more like an anxious patient than a fearless surgeon. There's good reason: In between treating a stress fracture and scoliosis, he's spent the last three hours talking about himself -- his motivation, his ego, his competitive spirit, his drive. Say what you will about a life unexamined, the good doctor believes otherwise. He wants to confess.
"You know," he says, "I'm about as introspective as a cabbage."
He doesn't look like any vegetable you've ever seen. In fact, he has a body like a gnarled tree and a bedside manner like a drill sergeant. No matter, though. Patients swear by him (and occasionally swear at him) and local doctors respect him as well.
"He's one of the best surgeons we have in Baltimore," says Dr. E. George Elias, secretary of the Maryland Chapter of the American College of Surgeons. "He would be my No. 1 choice to treat me or my family."
At 6-foot-1 and 205 pounds, his thick build shows the ravages of rugby games gone awry. His nose has been broken so often it curves off his face, his elbows look as if someone's attached Christmas balls to the ends, and his fingers, some of which have been broken, bend like misshapen twigs.
The irony is that this happens to be the man who directs Union Memorial's Sports Medicine Clinic, one of the oldest local programs in the hot medical field. Sports and medicine are so intertwined in his life that he often talks about surgery in terms of wins and losses, about feeling defeated by the death of a patient, about the perfect case being akin to the perfect wave.
The impetus to found the program 13 years ago grew out of his own life. "I personally have had every sports injury known to man," he says, rattling off the many ways he's mangled his body: He has broken his nose 11 times, had four concussions, torn up both knees, lost one tooth, broken one ankle, broken one big toe . . .
The question looms: What made him return to the playing field?
?3 "That's part of the game," says Dr. Howard, 58.
A macho man
It's easy to understand why people call him cowboy. Aside from the John Wayne picture in his office ("It was a gift," he says) and his Army past, he exudes a tough-guy persona. He can turn just about anything in life -- from sports to surgery -- into a competition.
"Macho is a perfectly good word," he defends. "It's used in a pejorative way, which is wrong. It kind of aggravates me."
He once tore ligaments in his ankle while playing with the Baltimore Rugby Club in Pennsylvania. But rather than have his team play one man down (substitutions weren't allowed), he taped his ankle to his shoe to relieve the pain and finished the game. Teammates still recall their surprise when he showed up for practice days later in a knee-high cast.
"Bill Howard will compete over anything," says Greg Szoka, a friend and fellow retired rugby player. "I've seen him make a competition out of who can spit the cherry pit the farthest."
Yet Dr. Howard takes his losses in stride, except when it comes to medicine. There, he makes no apologies for his take-no-prisoners style.
"Most surgeons are cocky enough to believe we can cure anything if we try," he says. "If I was being operated on by a surgeon, I wouldn't want a guy who said I think I can do that. . . .
I'd want a guy who says I can do it."
On this day, he must apply that philosophy in two arenas. He spends the morning treating patients in the "home to injured jocks," as he calls the sports medicine clinic, and the afternoon doing general surgery in the operating room. Rather than feeling pulled in two directions, Dr. Howard, who is also assistant chief of staff at Union Memorial, finds the dual roles energizing.
Healing the healthy
"It's a break to leave the world of disease to enter the world of basically healthy people with injuries," he says. "It's fun to get somebody well -- whether it's a minor injury or major. . . . If that doesn't get you charged up, nothing will."
By noon, he's seen a thirtysomething cyclist with tendinitis, a runner with a stress fracture of the ankle and a young baseball catcher with scoliosis. They have pain, swelling, tightness, even nausea, but their final question is always the same: When can I get back out there, Doc?
When Dr. Howard replies not yet, they listen. He's known for his no-nonsense approach to recovery, which at times has startled patients. He doesn't coddle them, often believing that the body has its own way of slowing people down.
Yet, he also has a soft side. He once smuggled in sherry for an elderly patient who missed having an after-dinner drink. He finished rounds and turned up in her room with Harvey's Bristol Cream and two cups. By the time she had recovered from a broken pelvis, they had polished off five bottles.
He seems to thrive on 14-hour days that begin at 5:30 a.m. He takes the stairs rather than wait for an elevator. He has season tickets to the Orioles but rarely goes. And for his annual vacation, he takes one extra day during the Labor Day weekend.
In between, he finds time to play the bass, raise peacocks, drink Wild Turkey and make regular appearances on WMAR-TV's "Morning Show." (He made his debut carving a Thanksgiving turkey.)
Perhaps his office sums him up best. Papers and books make a minefield of the floor. A stationary bike and basketball hoop distract him, when necessary, as does the latest issue of Sports Illustrated on his desk. A concert poster -- albeit for Earl Scruggs -- hangs on the wall.
Growing up on a farm
Yet his roots are far removed from the hillbilly he says he is. A descendant of John Eager Howard, he grew up on a 350-acre farm in Harford County, one of two children. It's easy to see where his competitive drive came from: His 84-year-old mother, Harriet Rogers, competes in the Senior Olympics and recently added the shot put to her repertoire of sports skills.
He began his early education in a two-room schoolhouse but ended it at a boarding school in Delaware. By the eighth grade, he was interested in becoming a physician like his uncle, a country doctor.
As a youngster, he also made mischief, getting kicked out of the Boy Scouts after just two weeks.
"They said I was rowdy," he recalls. "I didn't get into any real trouble. I was never arrested. We did what kids did. We drove too fast, drank beer, never smoked any dope, but had fights."
He began at Duke University in North Carolina but shied away from a premed major because it looked too difficult. Two years later, however, he felt so uncertain about his future that he signed up for the Army. He ended his short military career exactly where he began -- as a corporal. (He did return to the Army during Desert Storm, working at a hospital in Fort
Campbell, Ky., for several months.)
Being in the Army gave him the confidence to pursue his first love: medicine. He returned to Baltimore and graduated from Johns Hopkins University. In 1963, he got his medical degree from the University of Maryland Medical School.
His only regret is that medicine has often kept him from spending time with his wife, Ami, who tends to their home, the same Harford County farm where he grew up, and their four daughters, ages 10 to 34. Missing graduations and birthday parties due to hospital emergencies caused tension, he says.
"I'm sure I didn't spend enough time with my kids. I hope I can make it up to them," says Dr. Howard, who is also a grandfather.
"Sometimes I say to myself, 'What am I trying to prove?' . . . I'm getting old. I have less hair on my head, and I have hair growing out of my ears," he says, tugging at the gray wisps peeking out of each ear.
His age also forced him to retire from rugby two years ago, after 28 years of playing the game. He knew he was finished when a 27-year-old player "ate my lunch" during a tournament.
He now relaxes by running, cycling and playing "hillbilly golf. It's great competition because I play with guys who are as bad as I am, or I bring them down to my level. . . . We talk on the backswing and laugh when a guy hits a sand trap."
A banjo player
But his real unanswered dream is to be a musician. "I would love to be a bluegrass banjo player," he says. "That would be my one big ambition. . . . I'd take off from medicine for at least six months and take my act on the road."
When he describes the future, he talks about wanting to reclaim more of his personal life. Whether he'll be able to do that or not remains anyone's guess.
"I'm not going to work as hard as I have," he says, racing down the stairs toward the operating room. "I'm going to spend more time in Harford County with the hillbillies. . . . Maybe I'll even learn to play the banjo."
THE HOWARD FILE
Occupation: General surgeon and director of Union Memorial's Sports Medicine Clinic.
Born: Feb. 19, 1934; Union Memorial Hospital.
Education: Bachelor of arts from Johns Hopkins University, 1959; medical degree from the University of Maryland Medical School, 1963.
Family: Married for 34 years to Ami; four daughters: Patti, Tarry, Kate, Anne.
Current home: Harford County farm.
Best free advice to the weekend athlete: "If you want to be an athlete, don't ever stop. Do it all year round. If you stop and do it once in a while, you'll get hurt."