In fifth grade I decided to become a doctor. It was a calling that came out of a realization that I was given so much more than most kids. I knew I needed to find a way to give back to the world.
I hit puberty hard. I remember wondering what was going on with my hormones (why did my hair turn curly and why I did I get acne?) I remember being in eighth grade and discovering magazines for the first time. I read Popular Science and was fascinated with how to optimize my performance after I read about fighter pilots being given modafinil to fight sleep deprivation. In ninth grade I started taking nootropic supplements to boost my energy and focus.
In high school, I knew my body had problems that I did not know how to solve. I went to early bird gym to take extra classes and after school I would go to cross country or track practice. Although I was ambitious, outspoken, achievement oriented, and hard-working, I didn’t recover properly and would work myself into the ground. I became a runner and my period stopped for 6 few months. I accomplished a lot but was out of balance.
As an undergraduate at UIUC, I was drawn to multidisciplinary International Studies major because it offered a high degree of personal autonomy over the design of my curriculum and the opportunity to immerse myself in both the sciences and humanities. It was my goal to understand how health care systems work across the world and the people existing within them. My college education enhanced my ability to think independently about complex social issues and helped lay the foundation of my worldview. But, the most important thing I learned as an undergraduate was how to efficiently learn anything I wanted to understand.
The summer in between college and medical school I worked in a hospital phlebotomist and laboratory processor. This gave me my first taste in direct patient care (outside of volunteering) and further solidified my desire to pursue medicine as a career. This experience would prove to be extremely valuable as it taught me about the entire lifecycle of laboratory testing from specimen retrieval, handling, sorting, analyzing, and delivering results. In medical school I learned about the significance of the data, and I now apply this knowledge on a daily basis in both my medical practice and work with tech companies.
College was also a time of exploration into food, circadian rhythms, and my body. I studied abroad in Spain and Mexico—two countries with culinary cultures that have had a huge influence on my world view around food as medicine and culture. I was floored at how good I felt eating exceptionally high quality, fresh food that was hand-made and not expensive. I was amazed at how people with little money could survive without the help of their governments. I realized how much my body craved sunlight. I realized I had seasonal affective disorder living in Illinois and began find ways to biohack my problem using light therapy and supplements like Vitamin D & SAM-E.
In August 2007 I began studying at the University of Illinois College of Medicine. I was under more stress than I had ever experienced. I started getting migraines, in part because was drinking multiple cups of espresso daily and was sleeping very erratic hours. I also skipped meals and was sedentary. I took my Step 1 board exam on no sleep because my test anxiety kept me up. My score came back average, and I knew it did not reflect my true intelligence. I realized that I had not been taking care of myself, which was limiting my potential.
Half-way through my third year (January 2010), I knew something had to change. I started studying lifestyle medicine on my free time and made gradual changes to normalize sleep schedule and adopted better eating, stress management, and exercise habits. I was enjoying my life again. I overcame my test anxiety and got outstanding evaluations from my professors. By my M4 year, I was performing sleep medicine research, coordinating a community education event for National Sleep Awareness Week, and studying for my second board exam—and, surprisingly, I was not stressed out. I even managed a life-changing trip to Burning Man that summer.
When I got my board exam results back, I was amazed that I scored in the 99th percentile nationally. This attracted a lot of attention from other medical students who asked me for advice on how to deal with the stress of medical school. The more students I talked to, the more I felt an obligation to share what I had learned with as many people as possible before I graduated. I created the first academic course on wellness at the University of Illinois College of Medicine entitled, “Physician Health Thyself: Evidence Based Lifestyle”. The course was wildly popular and it allowed me to share my lifestyle medicine research with my peers.
(Sadly, I learned pizza was not an example of food as medicine).
From day one of medical school, I realized I was different. I loved medicine, but I also loved the feeling of discovery and drive for innovation just as much as I enjoy taking care of patients. I wrote in my residency application, “As challenging as medicine is, my ambition expands above and beyond the completion of my M.D.. My goal is to not only make an outstanding doctor, but also become a part of the business side of medicine through entrepreneurship and consulting.” This was an interesting foreshadowing to my future career.
I visited Washington three times in my medical school career and to my state Capitol twice to advocate on behalf of my peers. Although my experience was limited, I still I believe it was valuable. After each visit, I became better educated on health care policy.
On June 10, 2010, I wrote this statement, “Health care is a complicated, multifaceted, bureaucratic system with many players, many programs and many problems. The same can be said about politics. Both are designed to help people and both have significant flaws. Lately, there has been growing concerned with the financing of health reform, the cuts being made to Medicare and the underfunding in Medicaid. As imperative as it is to fiscally support new and old programs, the answer to making effective changes in health care is not just throwing money at problems in hopes they will be fixed. That method can be likened to renovating an old house with a crumbling foundation. You can make it appear more stable, but sooner or later it is going to fall apart. Clearly, our current residence is not going to be sustainable on small repairs. The question should be: how can we save money and begin to invest in a more efficient future of health care delivery? We need to build a better home.”
Now in July of 2017, it’s clear that the small repairs to our health care system are not exactly working. Attempts to reform health care have become giant compromises that have not dramatically improved the patient experience. Yes, we have some big wins including millions of people becoming insured and giving health care to individuals with preexisting conditions. But, many of them cannot find a primary doctor, costs from chronic disease are still rising, and we still have Congress fighting over whether to keep reform or replace it with a placeholder. It’s clearly not getting much better. Many doctors are retiring early. Others are turning to Direct Primary Care or Concierge models. Meanwhile, I continue to envision what it would be like to start over and build an entirely new and fully digital health care system designed to improve and enhance the human condition and not just fix symptoms and treat disease.
(This graduation photo sure brings back memories!)
My main interest in medicine was wellness, but unfortunately, that was not a residency option. I chose to attend Kaiser Oakland because of its reputation for health promotion and because I was offered a scholarship for a Masters of Public Health at the University of California Berkeley. But, when I questioned authority and the way medicine was practiced, I received quite a lot of negative feedback. My program director and I both agreed that if I wanted to change the world, I was not going to be able to do that in residency.
I was inspired by the career of Andrew Weil—a pioneer in integrative medicine who took an unconventional path study ethnobotany and sought to bring ancient practices to modern medicine. Like Andrew Weil, I resigned from my residency after completing my internship to carve my own path. Unlike Dr. Weil, I not only looked at the past medical practices that were overlooked but I also looked into the future. I knew the next wave of innovation in health care was going to happen out of the hospital in the technology sector, and I had to be a part of it. I went to pursue a career in the burgeoning digital health industry.
I considered getting an MBA, but felt a better way to learn business would be to gain first-hand experience. I started working as a Medical Advisor at MetaMed, a digital health company that delivered personalized medical research to clients. For my first project, I performed research on research methods to train a team of researchers–you cannot get much more meta than that. I still use the methodology that I created to collect, evaluate, and analyze medical research. This job was a phenomenal prelude to my next move.
In the summer of 2013, I opened a boutique consulting company in San Francisco and began advising health technology startups and venture capital firms that needed insight into the mainstream health care system. I developed a specialization in research, clinical strategy, scientific marketing, & product development. I would dive deep into existing research and summarize the science to provide evidence for medical technology use-cases and applications. I particularly enjoyed the challenge of making meaning out of signal using bioinformatics & library science.
For companies that are pioneering new science and technology, I found analogous examples of innovations from the past to create roadmaps into the future. I used systems thinking and design thinking to provide strategic foresight to identify pathways for market entry. This work enhanced my ability to ask insightful questions, think creatively, and use my imagination to identify pragmatic solutions to my clients’ problems.
I received my medical license in California in April 2013. Soon after I was hired to perform a 3 month clinical trial of 30 people involving weekly tracking of blood lipids and chemistry tests and correlating these to daily Jawbone Up data. I enjoyed the regular contact I had with the study participants and realized I missed patient care. I left mainstream medicine not because I didn’t want to see patients, but because I wanted to “be the change I wanted to see” and practice medicine differently than my predecessors.
While working at MetaMed I met a young British doctor named Jason Camm who I learned was hired by Peter Thiel to optimize his health. When I realized this was a legitimate career path I asked Jason to teach me how he practiced. He bought me the Textbook of Functional Medicine and gave me invaluable advice which helped me gain the confidence to open my medical practice in November 2013. I was determined to help individuals optimize their health using evidence-based wellness and technology.
In February 2014, after I gave a talk at a local Quantified Self meet-up on self-tracking to achieve health goals, the CEO of a company named GeneSolve approached me. He informed me that they had created a new expert system for health optimization. I joined the company in March 2014 after I met the cofounder Dr. Richard Lee and learned he had been developing artificial intelligence software systems, or ‘Expert Systems’, at Stanford since the early 1980’s. Dr. Lee taught me his philosophy of clinical decision-making called evidential reasoning that was the underlying framework for the GeneSolve expert system named Arthur.
GeneSolve was a wonderful learning experience where I was able to apply and enhance my knowledge of optimizing health. At GeneSolve we focused on measuring and understanding our patient’s DNA, collecting and analyzing a comprehensive biometric panel, and taking an extensive medical history. Then we set targets for of optimal levels of vitamins, enzymes, proteins, pre-hormones, and hormones. We provided a scientific approach to personalized supplements, nutraceuticals, pharmaceuticals, and tailored guidelines for nutrition and exercise. It was an idea founded in existing science, but brought together in a completely new way.
Although GeneSolve no longer exists, I have continued my medical practice with a rigorous, data-driven approach to wellness. I use my expertise in laboratory testing interpretation and combine this with knowledge of genomics to help patients identify areas for optimizing their health. I use a highly personalized approach help my patients improve nutrition, implement exercise, understand sleep, engage in mindfulness, manage energy, balance biochemistry, reduce stress and enhance productivity.