Surgeon by day, firefighter by night: A surgeon's journey back to the fire service

Dr. James Betts had been working 80-hour work weeks at the hospital; 10 years ago, he committed to getting back to his fire service roots


Born and raised in a small, rural town in Bennington, Vermont, James Betts lived a block away from his neighborhood fire station. As a kid, he would regularly ride down to the station to watch the engine leave the firehouse as crews responded to their next call.

His interest in fire and EMS remained steadfast. In high school, he became a member of the local rescue squad. However, his dreams quickly extended beyond his hometown roots.

Betts' mother, who became a widowed single mom when he was just 9 years old, instilled the importance of strong work ethic among her three children – and she led by example. She ran a restaurant, which was open for breakfast, lunch and dinner, every day of the week, 364 days out of the year.

Dr. James Betts is a pediatric surgeon who decided 10 years ago to get back to his fire and EMS roots.
Dr. James Betts is a pediatric surgeon who decided 10 years ago to get back to his fire and EMS roots. (Photos/James Betts)

Determined to make his mother proud, Betts graduated from high school and went to college at just 17 years old – a feat no one in his family, including his mother, had accomplished. And he didn't stop there. Betts later entered medical school, leading him to new – and old – opportunities.

A career in pediatric surgery

After graduating medical school, Betts embarked on an extended residency – 10 years of four different programs – that took him to Virginia, Ohio and Pennsylvania. Each program was interrelated and gave Betts the opportunity to grow as a pediatric surgeon.

“When I was training, we were Renaissance surgeons,” he said. “We were committed to the total surgical care, and that was very attractive to me."

After completing his pediatric surgery training, in 1983, Betts decided to move to California, where he has since worked as a pediatric surgeon at UCSF Benioff Children's Hospital in Oakland for nearly four decades.

Similar to rising early with his mom during his childhood, Betts wakes up at 4:30 a.m. every day to start his work at the hospital: "I like to come in early and get my office work done," he said.

Most weeks are full – often leading to 80-hour work weeks at the hospital, which is also a trauma center for the area.

Betts is on call two out of four weekends each month: "We'll come in in the morning; we'll be here all day and through the night, and then the next day," he explained, adding that he also has clinics on Tuesdays and Thursdays. "We do have our own practices, our group practice.”

He also performs surgery on Wednesdays and Fridays: "We do a lot of emergency surgeries; they're not all trauma-related, but some are," he said. "We take care of newborns with congenital anomalies."

For many, this type of work schedule wouldn't leave time for much else. However, 10 years ago, Betts carved out time to get back to his roots.

Getting back into the fire service

In 1991, Betts was invited to give a pediatric trauma talk to the members at Big Sur Fire, a volunteer fire department in Big Sur, California, where he has had a home for over 30 years.

"I was mostly giving lectures and supporting financially as a property owner," he said.

Over the years, many members, including the chief and chief medical captain, consistently asked Betts if he was interested in going through their formal academy training, but, "I never really had the time," Betts said.

Ten years ago, he made the commitment and spent six months of weekends – altering his call schedule at the hospital – to become a firefighter. He also works as an EMT and is part of the search and rescue team in Big Sur.

Betts spent six months of weekends – altering his call schedule at the hospital – to become a firefighter. He also works as an EMT and is part of the search and rescue team in Big Sur.
Betts spent six months of weekends – altering his call schedule at the hospital – to become a firefighter. He also works as an EMT and is part of the search and rescue team in Big Sur. (Photo/James Betts)

"It was a natural progression for me,” Betts explained. “I go down probably two or three weekends a month, whenever I'm not on call at the hospital."

Big Sur Fire, which is up to 31 members, runs a wide variety of calls – about 300 a year. The department focuses its training on cliff and back country rescues, structural and wildland firefighting, vehicle accidents, EMS and back country wilderness medicine, as well as a variety of specialty exercises, such as chainsaw operations in the wildland environment.

"We run more technical rescues than most departments because we have 60 miles of coast that's all sheer cliff," said Big Sur Fire Chief Matt Harris.

This year, Harris said, has been especially taxing on firefighters.

"It has been the biggest fire season on record, as far as acreage burned,” he explained. “We're over 4 million acres in California,” adding that the recent Dolan Fire was the fourth largest fire in Big Sur's history. “We're just going through a significant fire season."

Having dedicated and highly trained members within the department, he said, makes all the difference: "When you show up, there's an expectation of a knowledge base, a skillset, a sense of professionalism, a look of professionalism and proficiency."

As for Betts, Harris says it's a blessing to have his skill set and expertise on scene.

Big Sur Fire focuses its training on cliff and back country rescues, structural and wildland firefighting, vehicle accidents, EMS and back country wilderness medicine, as well as a variety of specialty exercises, such as chainsaw operations in the wildland environment.
Big Sur Fire focuses its training on cliff and back country rescues, structural and wildland firefighting, vehicle accidents, EMS and back country wilderness medicine, as well as a variety of specialty exercises, such as chainsaw operations in the wildland environment. (Photos/James Betts)

A commitment to serve

"For me, I am a physician in the fire department," Betts said.

Betts' unique medical background, training and perspective is highly regarded amongst Big Sur Fire's members: "What he sees and deals with in the ER helps us better package patients, better treat them in the field to prepare the doctors for success and, ultimately, the patient's success," Harris said.

At 73 years old, Betts remains committed to serving as either a complement or resource to his colleagues: "I don't haul hose up the hill like I used to,” he said. “I am there and I respond, but I'm not the first one over the hill for any rescues. But I train with everyone and I want to be a resource. I want to be able to contribute."

There are days, he said, when he wishes he would have become a firefighter much earlier in his life: "But I don't know that I could have, and I pretty much tend to be a glass-more-than-half-full person,” he reflected. “I try to stay in the present and say, 'OK, it is what it is now.'"

Betts’ accomplishments, he says, were made possible thanks to one example – his mother's lifelong strong work ethic, commitment and dedication to anything she put her mind to.

"For me, it's never been about the money,” Betts said. “The mission has always been what has guided me along this long, hard path.” He added: "As long as I'm here on this earth, I want to continue to be a resource – for the hospital and the fire service. I just want to do my best. I want to try everything that I can, listen to others around me, learn from them and work as a team."

His journey, Betts said, has never been an individual effort: "It's not that at all; it's about being part of either an organization or a team. It's all about focusing that effort of many to be directed to that one person, that one child, that one individual, who is in need at the time."

Editor’s note: Do you know a firefighter who goes above and beyond in their commitment to service? Let us know at editor@firerescue1.com.

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