Montgomery physician Jefferson Underwood III, MD may not move as easily as he did a year ago, but his wit is as still as sharp.

"ALS is a funky disease," Underwood said. "Every day brings a new challenge. Sometimes I think about the people I've known who challenge me to keep going. I had a teacher who had a cervical spinal disorder and could only move from the neck up. But she kept going. I may have a disability, but I'm still blessed to be able to work. I have two nurse practitioners who allow me to keep office hours for a few hours a day. My diagnosis qualifies me for disability, but I don't want that as long as I can keep moving."

Challenges in life are nothing new to Underwood. Coming of age in Montgomery during a time when segregation ruled the South wasn't easy.

"As a child, I wanted to be an astronaut," Underwood said. "But I was told blacks couldn't be astronauts. It's probably difficult for young people today to fathom that, but that was the time we lived in, and I accepted it."

Soon, Underwood began to notice what was happening in his own household. His mother was a professor at Alabama State University, and his father trained in internal medicine at the University of New York. His father overcame a number of challenges in order to practice medicine in the segregated south, which inspired Underwood when he made the decision to go into medicine too.

"Back then, a doctor was a part of the family," Underwood said. "He delivered a baby and took care of it to the grave. He would go to the house at night during a storm when someone had a cold. It was before Medicare and Medicaid, so you might get paid with a ham or a turkey. It always came from the heart."

Looking back on nearly 40 years in practice, Underwood said he can't see himself in any other career. The practice of medicine is in his DNA, but that doesn't mean he's 100 percent happy with the state of the profession today.

"It's discouraging is to hear so many of my colleagues who are dissatisfied with medicine now. The real question is, are they dissatisfied with the practice of medicine or are they dissatisfied within? I practiced with my father for about 10 years, and he used to tell me if you don't take care of the business of medicine, you won't have a medicine business. The principles of medicine have not changed. The technology has changed for medical practices, but not the principles of medicine."

With this in mind, Underwood offers a bit of advice for young physicians: Make sure your heart is truly in the profession.

"You have to want to be a physician," he said. "You have to have a sincere desire to help others. It's not always going to be pretty, this profession. Medical school and residency are a good filter, but it's also an expensive filter, and that's why you need to take every opportunity you can to decide if you really want to be a physician. This isn't a profession you can go into to make someone else happy. You have to make yourself happy."

And his best advice for all physicians? Become the voice that medicine needs to make change. That's what he did. In April 2018, Underwood became the first African-American male to serve as President of the Board of Censors of the Medical Association. He previously served the Association as President-Elect, Secretary-Treasurer and Vice President. He is a Diplomate of the American Board of Internal Medicine and a Fellow of the American College of Physicians. He is a member of the American Medical Association, National Medical Association, the American College of Physicians, the Alabama Chapter of the American College of Physicians, International Society for Hypertension in Blacks, as well as the Editorial Board for the Journal of Ethnicity. He is also a member of the Montgomery County Medical Society in which he has served on the Board of Trustees and as President.

"I encourage my colleagues to get more involved with organized medicine like their county medical society, the Medical Association, and the AMA so they can help bring about change. If you don't like what you're seeing, then help make change. It's amazing how politics can determine the direction of medicine," Underwood said.