In the months after returning from Vietnam, I kept turning over the same problem: how to scale up surgeries by empowering local doctors. But for the moment at least, thinking was as far as I went. A lot was happening in my personal and professional life around this time.

Not long after I came back from the mission, I met Cricket.

By now, I was thirty-five years old, and although many of my friends were already settling down and having families, I confess I was enjoying the bachelor life too much to think a lot about looking for a life partner.

Cricket changed that. Our paths first crossed when she came to work in the media department at my agency. Unmistakably beautiful—not to mention smart, talented, and driven—I knew of her reputation around the office, but because of the way our company was structured, we rarely had any meetings together. Besides, I had a rule about not dating anyone at work. So it was only when Cricket resigned, accepting a job at another agency, that I decided to ask her out on a date. Lucky guy that I am, she said yes. We were supposed to meet to have dinner, but then she canceled because she had to work late at her new job. I tried again. The second time she also canceled. But I was persistent.

Third time was a charm. That night, we went for dinner and began to get to know each other. I remember I couldn’t help but notice the scar on the right cheek near her mouth, and she told me it from a nasty bite from a German shepherd when she was five years old. There was something about the imperfection of the scar and her beauty combined that caught me off guard. I learned that her given name was Kristen, but everyone has called her Cricket since she’d been a baby.

We started seeing each other, tentatively at first, and then seriously soon after. Cricket became my cheerleader, my confidant, my conscience. She was especially supportive of my work with Operation Smile; from day one, she could see how important it was to me. Over time, I learned Cricket’s inner beauty matched her outer beauty. We complemented each other—she was steady where I was hotheaded, thoughtful where I was fast moving, and sensitive where I was purposeful. In only a short time of knowing her, I knew it was going to be tough to go on with life without her.

Then, shortly after I met Cricket, there was another incredibly positive change in my life. Mike and I were offered a lot of money to sell our ad agency. We would still need to run it for the next two years—and hit our budget numbers—but running an already-established business is much easier than building one from scratch. We were on a strong financial footing, and best of all, we didn’t have to chase clients anymore—they were coming to us. Going forward, Mike and I knew that we would both be financially secure for life. It was an enormous stroke of good fortune.

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Once the sale of the agency was finalized, my thoughts turned back to Vietnam, to Soccer Boy and the conundrum of how to scale up surgeries and help more kids. Around this time, I happened to be called into a meeting with a man who wanted to work with Operation Smile on a promotional event. This man owned an antique steam train, and he wanted to fill its walls with pictures of patients and information about the charity and drive it all around America so that people could visit the train and learn about our work. I was skeptical. Who would want to go visit a train to see photos of kids with clefts? Ultimately, we told this man that we didn’t feel we could move ahead. But the idea of the train stuck with me.

A few days after the meeting, I had a brainstorm. What if we had our own train? A train that could travel from town to town in the developing world, where we could train doctors and deliver equipment and resources?

This train could have an operating room and classrooms and sleeping cars for the volunteers. We would pull into town for a couple weeks, conducting hundreds of surgeries, and provide all kinds of free training and education for the local doctors and nurses there. We could train on the train! Most importantly, the last car on the train would be filled with medical supplies and equipment, with computers and software and all kinds of resources. Before we left town, we would donate everything the local hospitals needed, ensuring that the local surgeons would have everything they needed to continue operating. It would be just like Johnny Appleseed traveling around the world bringing hope and surgery and education, empowering the local doctors and nurses to help their children long after the train left town.

I was really excited about my train idea, but I knew I needed to get some input. DeLois was head of Operation Smile’s New York chapter, managing fundraising and executing beginning-to-end organizing for every mission. But she was much more than that. She had gone on the very first small mission to the Philippines in 1985 as a scrub nurse. In the ten years since she had worn just about every hat at Operation Smile and she knew every aspect of the work. On many missions she also had the horrible job of telling the mothers of the children we were turning away that there was no room on the surgery schedule this time. I knew that if there was someone who’d be able to provide feedback and help guide me—someone who really understood the problem and wanted a solution to it as badly as I did—it was DeLois.

I told her about my idea. I explained that the notion of raising one billion dollars to go on enough missions to eradicate clefts was not even worth discussing. We have to find a way to significantly cut the cost of providing these surgeries if we had any hope of helping every kid that needed it.

“With the train, we can increase the numbers of kids we help exponentially,” I finished up. “Right now the only surgeries we provide are the ones that our surgeons do. But if we can train and empower enough local surgeons, I think we can help all the kids. We’d never have to turn anyone away ever again.”

I looked at DeLois, who was frowning.

“Well? What do you think?” I asked, bracing myself for the worst.

Then she began to smile.

“I like it,” she said. “I really like it. The Johnny Appleseed approach of leaving the equipment behind is smart, and so is training more doctors. As you know, telling mothers there’s no room for their child is the worst part of my job. When we leave and take everything with us, it breaks my heart.”

“Okay,” I said, delighted, getting ready to make my final big reveal. “One more thing: I have the perfect name for this new endeavor.”

“And what would that be?” DeLois asked with a grin.

“We’ll call it the Smile Train.”

And with that, DeLois was sold. We had a name and a concept.

After this conversation, I was so encouraged that I started learning everything I could about trains. Costs of trains, capacity of trains, staffing trains, running trains, feeding people on trains. I had train-mania. And the more I learned, the more momentum I gained. I plugged everything into spreadsheets, calculating costs at every turn. I estimated that, when all was said and done, the train would allow us to facilitate ten times as many surgeries for a tenth of the cost. With our Smile Train, instead of helping a few thousand children a year we could help tens of thousands of children a year.

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I decided to bring the idea to the biggest client at my advertising agency, Charles Wang, to see if he might be interested this kind of program as part of Operation Smile. At the time, Wang had been the highest-paid CEO in America four years in a row. He had been born in Shanghai, and I knew he would like the idea of the Smile Train program starting out in China, so that’s how I pitched the project to him. Within a couple of weeks of my presentation, Wang pledged ten million dollars toward the fledgling Smile Train project. He also brought the idea to a Swiss billionaire, who owned a substantial stake in his company, Walter Haefner, who also loved the idea to and offered to match the money already pledged by Wang.

At this point, I had a name, a concept, a business plan, and funding. It was time to bring the proposal to the Operation Smile board. My hope was that they would greenlight my project as a pilot program, so we could test out its efficacy. At the meeting, various board members raised concerns about safety and quality. How were we going to be certain that local doctors were capable of performing surgeries to the same high standards as American doctors? But after a lot of healthy debate and exchange of views, the board approved the idea as a concept and gave us the go-ahead to move forward.
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From the beginning, the project had a lot of momentum. We shared our plan with Bill Gates, who gave us one million dollars over lunch. We met with former president George H. W. Bush, and he loved the idea so much, he promised to tell Jiang Zemin, then the President of China, all about it at an upcoming meeting. Jiang Zemin also loved the idea. We had our eye-catching blue-and-red logo of a train designed and ready to go, and we even threw a fancy launch party for the new project. Now it was time to get our actual train on the tracks.

But then we learned some crucial information that had been missing from all our plans and projections until now. Although our train idea had seemed brilliant in theory, there was no way it was going to work in practice for a simple reason: the majority of Chinese train stations run on single-line tracks, especially in the rural areas where we hoped to do the most work and where there was the greatest need of medical resources. In all my months of researching trains, how had I missed this? There wasn’t going to be anywhere to park our train.

At this point, I was forced to take a long, hard look at the Smile Train project. Were we going to have to abandon the idea altogether? It was too compelling and too important to walk away—and besides, we had come so far. There had to be another way to bring this concept to life. Maybe it was just a question of approaching things from another angle. After all, the important part of Smile Train wasn’t the train; it was the new strategy of empowering local surgeons. That was the big idea. So if we couldn’t do the work on a train, we’d just have to train and empower doctors in the most obvious place of all—the hospitals where they already worked. Our Smile Train didn’t need to be an actual train; it could be a figurative one instead.

So back I went to Operation Smile with this refined concept. But the failure of the original train idea became a sticking point. All that good energy and momentum we’d built up had dissipated. There had always been people within the organization who were suspicious of the idea, and after this setback, they began to insist that the concept simply wasn’t going to work.

Over a period of many months, I flew down to Virginia for meeting after meeting, trying my best to talk through and allay these concerns. But after a while, I had to acknowledge that there were significant differences in our viewpoints, and there might not be anything I could say or do to bridge them. The naysayers felt the project was overly focused on China. It was too dangerous to let local surgeons operate on children. The model was radically different from the way things had always been done—why change?

And they had a point. There is a long-established history of Western physicians traveling around the globe to perform surgeries. Who was I to reinvent the wheel? The Smile Train self-sufficiency model required building local infrastructure and creating a robust training program so that doctors could operate on patients 365 days a year, helping more and more children. It wasn’t ever going to be easy. But I still felt it had enormous potential.

Ultimately, we decided to part ways. I would spin off our idea into a completely independent charity we would call Smile Train, with Charles Wang as my cofounder. Operation Smile generously gave us the money we had raised for this project and wished us luck. To this day, Operation Smile continues to go on missions, as they have done since 1985, and I feel honored to have been a part of their organization and board.

But by now, it had been three years since I’d waved goodbye to Soccer Boy from the back of that bus in Vietnam. I don’t think I’d ever expected that getting such an ambitious new project off the ground would be easy, but even so, there were times when I wondered if it was all going to be worth it. The same year that we put Smile Train on independent tracks, Cricket and I were married. My new wife helped me to stay the course, reminding me that ultimately, it was about helping as many children as possible, and that I had to keep that thought in the front of my mind.

And so, stubbornly, I kept going, like one of those robot vacuum machines, powering ahead until I hit a wall, then going sideways, or backward, or turning around completely, until eventually, I found my way forward.

INSERT PHOTO: BrianCricketPhoto

Good Reads: Before and After by Brian F. Mullaney, Co-Founder of Smile Train