In Service of the Empire: The Moral Descent of the Modern Doctor
I love movies and a good story—most humans do. Stories have a powerful way of revealing truth and helping us relate to the world around us. We often connect with characters in movies or books and feel a strange sense of kinship with them. Odd, perhaps—but undeniably true.
Recently, I rewatched the riveting series The Man in the High Castle on a popular streaming service.
SPOILER ALERT: If you haven’t seen it yet, stop here and come back after watching. (It’s four seasons long—but absolutely worth it.)
One of the main characters, John Smith, faces a moral crisis that unfolds across the series. His journey struck me deeply, not just as a viewer, but as someone who sees similar moral erosion in real life, particularly among our physician colleagues.
The series is set in 1962, in an alternate reality where America lost World War II. Nazi Germany and Imperial Japan now rule much of the former United States. John Smith, a former U.S. Army officer, is forced to choose: flee with his family and resist, or collaborate with the Nazi regime to protect them. He chooses the latter. In doing so, he renounces his country, abandons his friends, and dons the red SS armband—the first of many steps down a path of moral compromise.
True to historical patterns, the moral decay doesn’t stop there. As Smith rises in power, each promotion demands a greater piece of his conscience. In time, he loses everything: his son, his daughter, his wife—the very people he originally sought to protect. The Reich demands complete loyalty, and Smith sacrifices his integrity to survive.
In the series’ final episode, his wife—now morally awakened—pleads with him as he prepares to launch a bombing that will kill millions of Americans: “How did we get here, John? You have to stop.” His haunting reply: “I don’t know how.”
It’s a devastating moment. A slow-motion train wreck that gradually builds over time until Mr. Smith’s final crash.
Sound familiar, Doctor?
Many physicians leave residency burdened with debt, juggling family responsibilities, and hoping to do what’s best for their loved ones. Enter the system—an empire of its own. The first compromise feels reasonable, maybe even necessary. But over time, the job chips away at purpose, autonomy, and passion. One small compromise leads to another, and years later, you find yourself asking the same question as John Smith: “How did I get here?”
Stories are mirrors. They show us what we often don’t want to see. What do you see in John Smith’s story?
Direct Primary Care has become a lifeline for thousands of doctors trapped in the system. It offers a path back—to independence, integrity, and meaningful patient care.
The choice is still yours.
Leave the Empire behind.
Fight the good fight.
Listen to your moral compass.
Because some things are worse than death.
Very good analogy.