“The place to improve the world is first in one’s own heart and head and hands, and then work outward from there.” – Robert M. Pirsig (Zen and the Art of Motorcycle Maintenance, 1974)

The New York Times recently ran an obituary on a doctor named Salvator Altcheck. He had died the previous weekend at the age of 92.

For 67 years, he worked out of a basement office in the Joralemon Street row house in Brooklyn Heights where he lived. He treated tens of thousands of patients over the years, delivered thousands of babies, saved hundreds of lives, and rarely charged more than $5 or $10 a treatment, when he charged at all. He was known as “the $5 doctor.” A former patient of his, Jimmy Rios, said, “You could walk into his office, and he could tell you what you had before you sat down.”

A Sephardic Jew (see “It’s Good to Know,” below) who spoke Ladino, a combination of Hebrew and Spanish that has been spoken by the Sephardim since as far back as the 15th century, Dr. Altcheck came with his family to America in 1914. His father worked half a dozen jobs to put his children through school.

Three of his children went to medical school. The father paid for the tuition of the first, which nearly broke him. But then the first, upon becoming a doctor, was able to pay for the education of the second, and then the second for a third. (This is how some Korean families I know do it. One child goes to school while the others work. Then each, in turn)

Dr. Altcheck was an early riser. For more than half a century, he woke at the crack of dawn, tended to his personal affairs, and opened his office doors at 8 a.m. He worked relentlessly, breaking only once a day for a half-hour dinner at 5 p.m. His office hours ended at 8 p.m., but he didn’t. He typically made house calls in the evening, often until midnight.

During the many years that he lived in Brooklyn Heights, he saw his neighborhood change from proper society enclave to wartime boardinghouse district to artistic bohemia to haven for young professionals. He knew everyone — professionals, thugs, artists, and bums — and everyone knew him. Once when he was held up at gunpoint, the robber suddenly recognized him and reached into his own pocket and gave the doctor $10.

He stopped making house calls only when he could no longer climb steps. His last spoken words, according to his obituary, concerned something about his owing a medical report to a patient.

As I edit this piece, I’m in the process of lecturing 60 people who have decided to change their lives for the better. For them, the move is going to be facilitated by a financially valuable skill — copywriting. I’m spending most of my time trying to teach them what I know about copywriting and some of the time assuring them that they can make six-figure incomes while writing from home and following their own schedules.

Some of these people want to use their skills, as Dr. Altcheck did, to help people become healthier. Others are interested in writing for nonprofit organizations — groups that want to improve the world in some particular way. Other students want to help investors make more money in the stock market. And still others want to have a wide variety of clients and do something new and different every week.

Some will succeed, but most will fail — not because of incompetence but merely because they will become lazy or distracted. Years later, they will think back to this time in their lives and wonder: “What would have happened to me if I had persevered?”

What is your greatest ambition?

What are you doing to attain it?

Do you have a financially valuable skill to support yourself and your ambition?

Do you know exactly what needs to be done to be successful?

Are you giving yourself enough extra time to get the extra work done?