answer:I worked on a medical disaster team in the aftermath of Hurricane Andrew in the Kendall – Cutler Ridge area just south of Miami: ground zero. I’d just graduated from nursing school and was two weeks from sitting for the boards for licensure. I was fined $2,100 (for giving injections without a license and other things) which had to be paid before I took the boards. This was paid by the doctor I had been working with in Cutler Ridge and, because of this, I was allowed to take my boards on time with a clean record. It could have been much worse. I manned a clinic for many weekends at a homeless camp of about 250 tent-dwelling residents. That was an education. I worked the Haiti Earthquake in 2010 in Port-au-Prince’s Cité Soleil and other areas from one week after the disaster for the next few months and into the rainy season. Amputations, political and logistical shenanigans (requiring two former presidents to fly in and straighten out), cholera, typhoid, hepatitis, dysentery. We also worked with engineers and post grad students in setting up a potable water supply and a less dangerous but temporary sewage system. I’ve had a lot of opportunities to pay it forward because I’m a nurse, but I don’t count the work I’ve been paid for. From working disasters to going the extra mile after hours for a patient, to throwing a ten-spot into the instrument case of an excellent coronettist, an obvious drug addict, but who plays beautifully and makes my lunch more than just a steak sandwich in the park. I know what he is going to do with the money, but I don’t give a damn; he was good and I believe in rewarded behavior. I don’t believe I’ve ever actually practiced true altruism. For me these disasters were great adventures and secretly I enjoyed myself enormously while playing a heroic role. I wasn’t paid in money, but I got a lot out of it all—I wasn’t doing it for nothing. And a disaster is a great way to vacate from the hum-drum of a research position in a windowless examination office. All the other stuff, the domestic stuff—like guarding turtle nests late at night on the beach from raccoons (with an attractive partner and a bottle of ****), or building osprey nests to provided decent breeding environments for one of my favorite birds—these were ways I could spend time with people I liked while doing something I believed in. It was socializing, as much as anything else. Much better than hanging out at a sports bar. Paying it forward has never been painfull for me, on the contrary, it has mostly been fun or an adventure. And maybe that is the way it should be.