Indirect Path to Direct Care

This piece is a reflection on how my journey through medicine—and around it—led me to something I didn’t even know I was searching for. It’s about purpose, disillusionment, and ultimately, finding my way back to the kind of care I always believed in. The path wasn’t straight, but it led me exactly where I needed to be.

Indirect Path to Direct Care

Early on, I chose the road less traveled because I wanted to make a difference.
The desire to help people came first—then came the desire to possess knowledge.
Fixing became my way of helping, using what I knew.

Fix diabetes so people wouldn’t lose limbs.
Fix coronary disease so hearts wouldn’t fail.
Fix depression and anxiety so people would want to live—and live well.

Why medicine, though?
To my knowledge then, only doctors had the superpowers to heal.
Only doctors had the know-how.
Only doctors had the skill.

Because I believed health—both physical and mental—was our greatest asset.
A career in medicine felt like the cure for the woes of my childhood and family experiences.
A means to break the cycle—for me, and for an entire community.

To defeat disparities in health worsened by financial hardship…
Compromised by lack of understanding and time to seek care…
Constrained by early disability and underemployment.

To help people like my folks…
Restricted by unsteady income,
Exhausted from juggling multiple jobs,
Rocked by mental health instability, housing insecurity,
Punctuated by neighborhood violence and summer shootouts.

I knew then—as I know now—that good health isn’t attainable in survival mode.
I understood the hierarchy of needs before Maslow gave me the words.
Because surviving isn’t living, and living isn’t the same as being healthy.

Is medicine for me?
Apparently, only certain people got to be doctors—or so I came to believe.
So, I chose my second option: engineering.
I’d settle for making body parts instead of curing disease.
Or maybe write code for diagnostic machines—
Tools doctors could use, so I could help vicariously.

So, I sat behind a computer—
At my desk, in my kitchen, on the manufacturing floor—
Called into meetings after hours, troubleshooting software releases,
Trying to build something that, somewhere along the line,
May help someone fix someone else’s health problem.

But who was that someone?
What was the problem?

I needed more.

Programming was interesting, but not enough.
Leading a team was honorable, but not gratifying.

Should I still consider medicine?
Sure, I could learn to diagnose and treat diabetes and heart disease—like they did for my pops.
I could treat depression, anxiety, bipolar, PTSD—like they did for my mom.
Neglect the root causes. Push prescriptions.

And so I did.
I learned how to do those things.
Much to my chagrin, I wasn’t fixing anything. Just labeling. Pushing.

So why medicine?

Somewhere between medical school and residency, I embraced the diagnosis-and-treatment machine.
I lost sight of my purpose.
Medicine became a means to an end.

In med school, the goal was to match into residency.
In residency, to land a job.
As an employed physician, the goal was throughput and reimbursement.
The more diagnoses, the better.

I found myself on the same road as everyone else.
No longer making a difference.

I sat behind a computer—
At my office desk, in my kitchen, on the living room couch.
Closed charts. Filled scripts. Responded to patient messages after hours.
Sacrificed nights and weekends to investigate patient problems.
Trying—desperately—to make a difference.

Hoping that somewhere along the way, I’d actually help one person get to the root of their problem.

But who would help me?

Had I become the problem?
Is this medicine?

No.
This is business.
And I had been sucked in.

Now I had two choices:
Get out the game, or let the game play me.

Was it me?
Was this career worth fighting for?

Yes—and no.
Yes to my purpose.
No to this version of medicine.

Because medicine wasn’t the goal after all.
It was the opportunity to put my skills and talents to good use.
To use my knowledge of the human body to improve the lives of others.

If not this version of medicine, then what?

So I chose a different road.
Again.

Not the one paved with prestige and pressure,
Not the one lined with checkboxes and chart notes,
Not the one that promised power but robbed me of peace.

I opened my own DPC practice—
Not because it was easy,
But because it was right.
Because it was what I needed to do.

Once again, I took the road less traveled.
And it didn’t just make all the difference—

It made me.

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