We caught up with the brilliant and insightful Robert (CLAY) Williams a few weeks ago and have shared our conversation below.
Robert (CLAY), thanks for taking the time to share your stories with us today Can you open up about a risk you’ve taken – what it was like taking that risk, why you took the risk and how it turned out?
With aspirations of pioneering new voyages to the moon as an astronaut, I grew from a young boy to a young man, now dreaming of designing the very vehicle that would make such a journey as an aeronautical engineer. But my lack of exceptional mathematical skills and my growing and insatiable love of anatomy turned my attention towards biology and chemistry as a teenager with the goal of becoming a doctor, specifically, a surgeon. I attended Stephen F Austin State University, in Nacogdoches, Texas, behind my sister and father, as a premed student. I then attended the University of North Texas, College of Osteopathic Medicine where I found myself walking across the stage four years later as Valedictorian. And finally, I received a letter one day in the mail, announcing that I had matched at the University of Arkansas for Medical Sciences for general surgery residency. My fiancé, Michelle May, accepted my hand in marriage and were were Little Rock bound!
Medical residency is quite difficult to describe–countless books have tried. Two books of honorable mention are “The Year of the Intern,” and “The House of God,” that attempt to do so. However, painting a picture of a surgical residency is literally impossible. Even in the spring semester of my 4th year of medical school after spending several elective rotations in various surgical specialties across the country, I had serious doubts in my decision. And within 2-3 months of my surgical internship, those doubts became a stark reality. The way we were treated and sleep deprived, humiliated, no room for error, and maintain an almost Navy SEAL-like demeanor, made learning surgical theory, anatomy, and operative skills an uphill battle. Yes, internship is a right of passage, but I did not see the upper level residents look any happier — not a single day. This was not the way I was going to spend the next five years, and I was not going to spend the rest of my life dealing with the same surgical issues, as I did not see that many of the attending surgeons appeared all that delighted either!
A friend of mine, a fellow Boy Scout and Eagle Scout, who had left dental school to enter medical school and then residency, told me about the surgical specialty of “urology” while were doing some weekend volunteer work for the Boy Scouts. Now I recalled as an operating room scrub tech in Nacogdoches during the year between the completion of college and medical school matriculation, that I did not see anything remotely interesting about urology. And in medical school, the lectures seemed boring and not as aggressive as say general surgeon, or perhaps a trauma surgeon. But he sat me down as he could see I was struggling. He described urology to me the best he could, and I was intrigued. He said, “Clay, when you get back on Monday, go find Dr Alex Finkbeiner, the Chairman of Urology, and tell him I sent you. Tell him you want to do your November surgical elective with him in urology.” Upon return, I did so, and also informed the general surgery program director of my wishes.
For two more months, I plowed through the daily horrors of my general surgery meat grinder life. Within several days of the urology elective month, I realized that what I had seen as a scrub tech and learned in my medical school didactics in urology, was a far cry from my apparent reality. Urology was almost like a “gentleman’s surgical field.” It was a mix of funny metal scopes that came in all shorts of shapes and pieces to look inside kidneys and bladders; big abdominal surgeries like general surgery; a large amount of neuroscience and pelvic floor dysfunction; congenital anomalies; sexual dysfunction; endocrine and hormonal pathology; and primary care type reoccurring patient visits. The vast amount of knowledge and skills required for urology was amazing. By the end of the very first week, I was hooked! I went home that day, terrified, knowing that I would have to sit down with my wife, and tell her that I wanted to do everything possible to switch to urology.
Now, contrary to what might be popular belief, you can’t just announce this and expect you just switch. Each residency program across the country accepts residents for training and a measly salary. They also have a set number of openings determined by the residency governing body. This means, I would have to go back through the residency match. There were absolutely no guarantees I would match anywhere in the country, let alone, in Little Rock at UAMS. But I must have somehow impressed the urology residents, the staff doctors, and most of all, Dr Finkbeiner, because I did match at UAMS and thus, would not have to move. This did, however, require me to repeat the internship year, so instead of 5 years of post medical school training, I would have to complete 6.
The above paragraph is short and to the point. But what I did was virtually impossible. I am not sure of the odds, but they were leap years away from being in my favor. And asking my wife to delay my completion by taking on another year was difficult for her to swallow. With all surgery residencies there is an inherent warrior-like attitude, and I felt I was letting down the other surgical interns and of course, the general surgery residents who I fought in the trenches with — I felt embarrassed to face the program director and let him know of my decision, since I was their first choice in the match. I just cannot relay the depression and anxiety of bailing on them. But Michelle and I prayed constantly, and we knew, this was where the Lord was directing us.
Taking this risk was one of the most difficult things I have ever faced in my life even to this day. Oh, I have taken plenty of risks before this event, and probably several afterwards, some maybe even more dire. But this particular one was life changing–this wasn’t a temporary, short lived risk with an immediate or near immediate outcome. Yes, being accepted into urology was immediate gratification, but not only the subsequent years of training were meaningful, the years (2 1/2 decades) that followed have continued to be a blessing! I cannot imagine not being a urologist–I cannot think of a more gratifying surgical or medical specialty; in fact, I simply cannot fathom a more robust job that could provide so much happiness and variety in life.
Do I believe in taking risks? Yea, you better believe it. Sometimes in life, the lottery comes to you in an unfamiliar, unexpected way. It’s hard to balance your heart, soul, brain, and that deep gut feeling. I’m not sure which of these Michelle and I used to make the decision…maybe all four. But the risk payed off…..
Robert (CLAY), before we move on to more of these sorts of questions, can you take some time to bring our readers up to speed on you and what you do?
After completing urology residency, Michelle and I found ourselves back in the piney woods of east Texas, in Tyler. Here we started our family of two children and joined a private practice urology group, Urology Tyler. We have been here as of this story today, near 19 years. Although we all practiced what you would call general urology, I always had my eyes set on men’s health/sexual medicine/erectile dysfunction. And in time, began to dabble in the female sexual medicine/incontinence world as well.
But about 5 years ago, the University of Texas backed by Ardent Health Care, purchased and acquired East Texas Medical Center hospital system, and negotiated a buy-sell agreement with our group. And since then, I have been employed by UT. Over the last 7-8 years, my urology practice has blossomed into a male and female sexual medicine, pelvic floor dysfunction, incontinence, reconstructive surgery niche. I still take care of BPH (“enlarged” prostates) and kidney stones, but I am the only doctor in the group with my special niche.
My focus for men is: low testosterone, vasectomies, erectile dysfunction/penile prosthetic surgery/Peyronie’s disease (penile curvature) surgery/stress incontinence (placement of artificial urinary sphincter or advance mesh sling.
My focus for women is: pelvic floor disorders, incontinence (stress and urge) surgeries like solyx sling, bulkamid, interstim sacral neuromodulation, and vaginal vault prolapse surgery using dermal graft with sacrospinous fixation transvaginally.
In the world of male and female sexual medicine/reconstructive surgery, I find it amazing that the few urologists that I know, choose a lane–they don’t do both; I suppose its because most choose one fellowship or the other as there are no combined male and female sexual medicine/pelvic floor fellowships that I am aware of. I spent years on my own, reading, attending conferences and labs, observing, acquiring and honing my skills, to be one of the few urologists in the country that perform high volume surgery and care in these two worlds. Honestly, as a member of the Sexual Medicine Society of North America, the Society of Urologic Prosthetic Surgeons, and the International Society of Sexual Medicine, I have yet to meet another urologist who deals with both male and female genitourinary/sexual medicine/reconstructive surgery.
I had the honor of training with two household names in urology for penile prosthetics: Dr Steve Wilson and Dr Paul Perito. I am only one of a mere handful of residents who spent years training with Dr Wilson during residency, although he has traveled the world teaching others, but not to the degree of dedication I was afforded. And Dr Perito has reshaped the world of penile prosthetics with his minimally invasive approach, and I have been to Miami countless number of times to train with him. This has allowed me to enter the very small group of large volume penile implanters.
I am also very proud of my minimally invasive single incision sling (“MISIS”) technique for female stress incontinence. Most slings (TVT, TOT, retropubic slings, etc) take urologist 30-45 minutes if lucky to place such a sling using at least three incisions, with no sexual intercourse/pelvic rest and no exercising for 6-8 weeks. Using my technique, I can use one incision, not three, and requires a mere 4-9 minutes! And the recovery time and physical restrictions are lifted the majority of the time in 2 weeks, not 6-8 weeks.
And, I repair vaginal vault prolapses using dermal graft with sacrospinous fixation for cystoceles and rectoceles in less that 1 1/2 hours, all out patient surgery. This repair is completely transvaginal, so a much quicker recovery, with no incisions or punctures in your belly, and actually repairs the pelvic floor unlike other surgeries. To my knowledge, there may be only 4 or 5 of us in Texas who perform this type of state of the art repair, and I am not even sure that that number is accurate as I am almost certain it’s less.
I receive countless referrals and consults regarding all of these repairs in both men and women from around the state and even out of the state.
However, my wife, Michelle and I, started a side business to address the cosmetic and regenerative side of medicine as it deals with men’s health and sexual medicine. As empty nesters and her willingness and desire to get back into he medical field to put her RN/BSN back to use, Michelle and I started a company called, Elite Enhancement of East Texas.
Our primary goal is to restore youthfulness and confidence. Our main focus is with penile girth enhancement or enlargement. The technique is called, “UroFill,” and was invented and patented by no other than Dr Paul Perito in Miami, Florida, about 8-9 years ago as of this writing. The procedure consists of injecting hyaluronic acid or dermal filler around the penis using a very specialized technique in a staged manner over several weeks, This does not require any downtime, no anesthesia, its quick and easy, and you get to choose how much girth you want. This is not some silicone surgical implant. And, this is the only patented girth enhancement using dermal filler on the market, although and unfortunately, there are some knock off versions, some even look and sound like UroFill…but these were developed and are taught by non board certified urologists…in fact, they frequently are aestheticians or beauticians or even sales reps!
We also deal with erectile dysfunction and Peyronie’s disease with cutting edge regenerative and restorative therapies using exosomes/stem cells. We have had excellent results! We have also developed a very unique way of dealing with premature ejaculation as well with just a few needle sticks with topical numbing cream–the results last for months and months.
Our current and main offices are in Dallas, Texas, and in Texarkana, Texas. You can find us at enhancetexas.com and can contact us from that website or at [email protected] or by text/phone call at 903-732-2005.
This is a business we delayed starting for quite some time. We knew it would take a lot of devotion and time especially with my primary urology practice with the University of Texas. And with so many offices so far apart, the commitment would have to be strong, so we waited until near empty nesters. When asked how it feels to own a company with my wife and work side by side with her, all I can say is that it clearly is the highlight of my week. She is absolutely stunning to work with and watch her handle the day to day tasks. I love working with her. And we are both so happy to be offering regenerative and cosmetic restoring options.
Have any books or other resources had a big impact on you?
There are countless books, essays, speeches, videos, poems, and sermons that have reshaped and defined my life. But I will try to briefly mention 3 or 4 that come to mind quickly, perhaps because they are recent.
(1) David Goggins, retired Navy SEAL, I believe has now authored 3 books if I am not mistaking. I listened to the audiobook of the first one, “Can’t Hurt Me,” and was moved. He fell down and picked himself so many times it amazes me, and how he was even able to be accepted into BUD/S and then finish it blows me away. He accepts no excuses…none; commit or do not commit.
(2) “Never Split the Difference”
I am not sure why this is not required reading in college or law school or business school, but I have read it twice and will again 2-3 more times. It’s authored by an international hostage negotiator who teaches you how to properly navigate, accept, and win during negotiations whether for a job, a raise, a contract, buying a car or house….
He uses the same techniques he observed, learned, perfected, and utilized in hostage negotiations. It’s absolutely astounding. He doesn’t suggest scare tactics or being unreasonable, but he also doesn’t really believe in the word “negotiation” either. His idea is either you get what you want or you do not, and he will tell you how to get what you want. Simply stated, in his world, if he manages to get 2 of the 4 hostages out and doesn’t get any of the perpetrators, then you can say that he “negotiated” well and at least got 2 people out. In his mind, he still lost. He needs all 4 out, and the perpetrators apprehended. He does not believe in “a good negotiation is where neither party gets everything that they want, but at least get something.” Get what you want!!!
(3) “Green Lights” by Matthew McConaughey
This literally may be the best audio book in the world. His stories are so entertaining and vibrant with a meaning behind each story. And amazingly and to my surprise, who would have known that he was such a great speaker. He reads his book himself and with that typical and classic voice, the book comes alive. I have listened to it 2 1/2 times and need to simply restart it. I highly recommend this book. His take on life is so simple…not quite hippy oatmeal, but learn to deal with things head on, don’t be lazy, don’t make excuses, look to yourself, but chill.
(4) Joel Osteen….I cannot recall the exact sermon number, but he speaks about Shadrach, Meshach, and Abednego who have a rather interesting turn of events in chapter 3 of Daniel. They refuse to bow down to King Nebuchadnezzar 2 of Babylon, so they are tossed into a furnace, so hot, that a few of the men who got too close burned themselves. The king not only sees that they are not burning to death, but he sees a fourth man with them and says aloud that it looks like the Son of God. Upon getting out of the furnace unscathed, the king converts into believing in the Old Testament God, and releases the 3 Jews. What I find most interesting about this story, is the 3 men never see Jesus in the fire with them. He is there, protecting them, watching over them, but they don’t know it. They are in the fire (depression, loss of a loved one, illness, financial crisis, loss of job or job change, wrecked car…whatever you want to substitute for the word, “fire.”) needing desperate help and receiving it, yet not even seeing that Jesus is the one resolving the issue. Yet, others looking in or at you, can see the power of God surrounding you. The story reminds me that Jesus is always here or there, just because you can’t see him. But how you choose to live your life is how others will see Him.
If you could go back in time, do you think you would have chosen a different profession or specialty?
Yes, if I could go back, I would most definitely choose to practice urology again. I just wish I had figured that out sooner and shaved a year off of my training. I have often thought, as many of you have, is there another job you would have chosen or….you are happy, but wonder if this job or that job could have been fun and in your wheelhouse I almost went to the Air Force Academy…very close, but even so, I was still planning on attending medical school afterwards….but life would have surely been different.
Contact Info:
- Website: rclaywilliamsdo.com (for primary urology) and enhancetexas.com (for regenerative & cosmetic therapy)
- Instagram: https://www.instagram.com/enhancetexas/[email protected]
- Facebook: https://www.facebook.com/enhancetexas/[email protected]
- Youtube: https://youtube.com/@enhancetexas
- Other: TicTok www.tictok.com/@eliteenhacnement