My "Why Medicine" Essay

What motivated me with two engineering masters & a PMP to change careers anyway

As I promised you, my readers, in my early posts on this Substack, when I was beginning to describe the journey I was embarking on, that I would share with you the why. As might not come to a surprise to anyone, when you apply to medical school, you are asked to write an essay explaining why you want to do so. On the AMCAS application, the maximum length you are allowed is 5,300 characters. Given the relatively strict character limit, I have had to pare down some things I would have preferred to keep longer and more descriptive. So, when reading this essay, please try to remember that was a primary constraint in what and how much I could write. It has also been revised on the basis of the feedback I have gained from the few people I had sent previous versions of it to for comment.

My version of the “why medicine” essay begins below.

I'm a 40-something dual U.S./Canadian citizen, the son of a British/Canadian father who proudly naturalised in Mexico in my youth (who remains deeply proud of his Canadian roots as well, with his failing memory these days it's one of the few things he does remember), and a mother who grew up in Greece & Spain, born a citizen of both, before becoming American in the 1970s. Despite their many differences, one principle they shared was a deep mistrust of psychiatric care. That rare agreement, rooted in different reasons given their divergent histories, shaped my early years profoundly. What I now know was ADHD, layered atop significant childhood trauma, went undiagnosed, untreated, & made me entirely misunderstood.

In response, my parents sent me through a series of increasingly strict boarding schools, institutions that consumed a non-trivial portion of my family's income throughout my youth. In the end, I graduated from Kemper Military School, one of the oldest & harshest military academies in the country, until its closure in 2002. I enlisted soon after graduating since, ironically, the only university I was rejected from then was the one my parents insisted I attend (in part because of the cost savings attached) & the one I would eventually graduate from years later: the University of Washington.

I've now lived most of my life as a disabled veteran. On paper, my VA disability rating cites PTSD with major depression as my most disabling condition. Functionally, amid big institutions, it has meant building a life designed for resilience but not nuance. I spent the first 27 years of my life surviving: misdiagnosed, misdirected, & misunderstood, but always moving forward as best as I was able, grinding through life.

None of that history, by itself, is a reason to admit me to medical school. But it is not a reason to reject me either.

Here is the reason to let me in: I know with clarity that medicine is what I am meant to do. Every system I've navigated, every diagnosis I've lived with, every loved one I've cared for or helped through their own trials, & every time I've chosen purpose over comfort, it has all led here.

I've lived the "good life" in the federal sector: a six-figure salary, a security clearance that said I was in the know, a well-furnished flat, and a respected career in federal consulting & engineering. I left that behind given it was never truly mine. Medicine is.

The seeds were always there. As a Boy Scout, I pursued merit badges in First Aid, Medicine, & Public Health, the latter two entirely of my own volition. In the military, I volunteered for the Combat Lifesaver Course. At UW, my International Studies capstone was on bioweapons & terrorism. The book I gave as my graduation gift to the Philomathean Society, Black Man in a White Coat by Damon Tweedy, captured what I deeply felt but could not yet fully articulate.

But it was my elder half-brother Paul's final months that began turning that interest into my calling. After surviving a train wreck of prior diagnoses, injuries, & medical trauma from 2003 to 2006, he was told he had GI cancer too, the day after George Bush fired Donald Rumsfeld. By then, the doctors no longer saw him as a person but only as a bag of meat with diseases to treat. He felt it. I watched him slowly give up, and in the end, he drank himself to death from despair over the next eight months, even if it was the cancer that officially killed him. That loss didn't just hurt. It helped push me at the time towards the big DC career where I could fix the problems of the world that I later began the process of turning away from after the deaths of my mentors, John B. Sullivan PhD & Trevor J. Pinch PhD in 2021, who both also died from cancer; That what I had tried to fix at the federal policy level, or engineer through better systems design, needed to be fixed closer to the human scale. In the room. With the person. The great irony in all of this is that it was one cancer death that made me sure I wanted to be an engineer and two others fourteen years later that began the process of bringing me back to my first (but admittedly for the bulk of my life hidden) love, the art and science of humans that is medicine.

Even my graduate work reflects this orientation. At UVA, I wrote a behavioural game theory thesis exploring strategic decision-making and conflict modelling. At Cornell, I led a user-centred MEng design project focused on neurocognitive framing & interface accessibility. Both explored how the psychological & biological intersect with systems that on the surface appear far removed from the humane. That tension is the ground I've walked for years.

Pursuing a career in medicine is, in some ways, the least ambitious thing I've ever chosen. I've worked at scale, with large systems, in federal consulting, and in policy spaces where change is slow & often impersonal. Medicine, by contrast, is intimate. It's grounded. The scope is smaller, but the meaning is more profound, which is why I seek it now with all of my being.

It's also the last thing I imagine I will ever want. Because, in choosing to pursue medicine, I am not looking for a milestone - I am choosing a life. One I will likely work in until the day I die, not because I have to, but because it's where I know I belong. After everything else I've done, this is the only path that feels like home.

It may in fact undergo further revisions for shaping purposes, but fundamentally, this explains why I have been willing to give up my old career and life in DC to try to become a physician, and hopefully, it does so well enough to actually get me into medical school at some or most of the places I am looking to apply (and attend if they let me in).