My path from medicine into technology

Last month, I stopped researching vaccines at Mass General Hospital. I bundled up my stuff, moved to San Francisco, and joined Pivotal Labs as a software engineer. What is it that drives a person with a passion for medicine into the world of startups? I think I’m in a good place to answer that question.

The draw of technology

Until 2010, I planned to be a doctor, but now I’m happily engineering software. That isn’t exactly a standard move, so today I want to tell you about my journey from medicine to technology.

I should start off by telling you: I’m not pulling a tech career out of thin air. Computers have been a serious hobby for me for a long time. In fact, I’ve solved problems with them since I was little. When I was ten, it was BASIC on a VTech learning laptop. I remember my sheer excitement when I learned how to tell my computer what to do, and that I could use get it to ‘remember’ things for me. When I was in high school, it was Java and C++: bloated and overdone, but useful. Now it’s mostly modern and agile languages like Ruby and Clojure, but I don’t shun C, and I plan to learn the all-powerful Haskell. (After all, I need to be able to call myself hardcore, right?) At school, I toyed with the idea of electrical engineering, but medicine won me over. I was afraid electrons would somehow ruin my love of people. Yes, I was young and naive.

But I’m coming back to engineering, and it’s more social than ever. Engineers at agile firms like to work in pairs, especially at Pivotal Labs, where collaborating is the norm. This makes for a dynamic workplace, one where you feel a real sense of accomplishment at the end of the day but without being isolated. There’s a vibrant community around ideas that used to be considered niche. And I have to say, I’m excited that, with the startup scene, I don’t have to fall into the nerd stereotype just because I can pull the full power out of a computer.

So why is this happening now? What sparked my decision? The simple answer is that the tradeoffs of medicine don’t make sense for me anymore.

The real answer is a little longer.

Hard work, I can deal with that

For a long time, I’ve been one hundred percent on board with the rigors and rewards of medicine. At school in 2005, I mentally committed myself to the life of a research/pre-med student; there was no doubt in my mind I would make it through med school and to the other side with time and hard work. I was going to make exciting discoveries as a researcher and, after med school, would take a more applied approach to microbiology. The work during med school and residency would be hard and maybe even unrewarding. But at the end of that journey, I would have reached the beginning of a career I could really love. Yes, it might be 10 years away, but I was ready to pay that price.

So what happened?

Well, I did, in fact, discover exciting things while doing research. Both at school and (more recently) at MGH, I finished projects that have been or will be published, and those were exciting times. I loved and still do love biology.

But it turns out that being surrounded by the medical community gives you a very real picture of what life as a doctor will be like. (Who knew?) And over time, either you throw your idealism out the window, or it’s thrown out for you. Over the last year or so, I’ve come to think that being a doctor in 2015 won’t look the same as being a doctor was in 2005, and that profession doesn’t capture my imagination right now.

Being surrounded by friends in residency, I keep hearing:

  • Medicine isn’t really about spending quality with patients anymore
  • You can build personal relationships with your patients, but they’re broken up into 15 minute sessions
  • Ignoring the economics of medicine isn’t really possible anymore

The first times I heard this, I didn’t believe it, or I thought I could be different. But enough friends have confirmed this that I know it’s at least mostly true.

Now, given that the entire reason I got into the field was to connect with people who were looking for help, hearing this made me rethink its costs and benefits. Even though microbiology is a passion of mine, I’ve decided that the kind of medicine my friends are describing won’t do it for me.

So what does make me happy?

Technology and me

Being on the cutting edge of tech, pulling the power out of a computer; that’s what fascinates me. A microchip works faster that I can really understand, gives me reliable results. Will rinse-wash-repeat for me ten million times without complaining. Harnesses electron flow and remixes it into DNA sequences and military plans and the Social Web.

Having a computer in front of me is like having a tiny gnome ready and willing to do anything, no matter how mind-blowing, as long as I know its language. (In fact, just this month I discovered the James project on Github—it’s fun to turn your Mac into a personal butler.) A computer will crunch numbers all day. Or fetch and sort the day’s news in the morning. Or show me a video of almost anything I can type into a search box. (Enlightening Task of the Day: search for ‘magic power ball’ on Youtube.) Or download <del>movies</del> Linux images all day. Or tell me how dynamic my writing is. It doesn’t get bored, and it doesn’t fall asleep.

A computer, for me, is a second brain. And a third and fourth. It lets me get a lot more done than I can alone, work closer to perfect, gives me free time to keep up with the pace of progress. And this year, technology has changed me. Where before, I enjoyed tech as a hobby, I now feel confident about making it into a career. My skills have snowballed, and I’ve reached a turning point. I’m officially more interested in helping people by, say, designing electronic medical records than with a stethoscope.

Why not medicine?

So why does the Web trump med school? Don’t I want to change the world?

Well, the answer to that question isn’t easy. In a way, I’m still in love with medicine. Being on the cutting edge of biology—and especially infectious disease—thrills me. And being in an industry that focuses on curing people, with a huge focus the poor, has been rewarding. I’ll miss that. So medicine will always be a passion, in one way or another, and I won’t lose the drive to help my fellow human being.

But I’m not going to be a physician. I don’t deny that life could’ve been nice: There’s honor in the profession—and a lot of meaning. Every day brings, to some extent, a fresh challenge, an exotic disease or emergency you haven’t seen before. The balance between art and science and humanity is nothing short of beautiful.

But medicine … well, you see, medicine isn’t perfect. It’s full of politics and routine chores, and it is not all merit-based. There is too much tradition and too little innovation, and I don’t see it as a beacon of a meaningful career for me. Since college, I’ve seen exactly how the field doesn’t grok the power of technology, and healthcare/research is suffering because of that.

On the flip-side, the startup scene has shown me that the puzzle-solving side of computer science can be really meaningful. (And building something that millions of people depend on every day has got to be fun, too.) Avoiding med school will leave me with time and money to help out real people right now and solve problems that are relevant to my life.

So what, specifically, makes tech more attractive? What other factors made me reconsider the life of a doctor?

1. You can’t tackle medicine in your free time

If I find a new technology I want to try out, I can do that before bed or with friends at a coffee shop. All I need (usually) is a laptop and a clear head.

In medicine, if I find a new idea in social justice or a new vaccine candidate, what can I do? Read. And read. And read. There’s no getting my hands dirty outside of work, and that puts a damper on being creative. It means I can’t always be learning. (Or at least, that learning has to be straight from the books.) And for me, it’s always going to be harder to dive deep into a book when I won’t be able to apply it for a few years.

This doesn’t make medicine ‘bad’. But it means that I can engage technology on a much deeper level.

2. Medicine isn’t the place to see the best of technology

And for someone who loves technology, that’s excruciating. I applied to medical schools last year, and I can tell you that no med school has ever heard of agile development or table-free layouts or version control or data portability (scary, since they’re the ones deciding which medical records systems to buy). Or even serving a site over standard ports.

In the lab, copying a Word document and adding a timestamp is considered version control, because there’s no established way of doing anything better. There is a 75% chance that reading that last sentence made you shudder.

3. Med school means delaying the future

Everyone talks about how meaningful the life of a doctor is. And I do think that practicing medicine can be a noble thing. But there are huge drawbacks, too.

You’re not a full contributing member of society until you’re almost 30, for example. I am, by nature, a doer and can’t stand the thought of waiting five more years to get my hands dirty in the real world. I want to get things done now.

Even as a doctor, your life and work are only as meaningful as you make them. Without effort,  it can be routine, full of false alarms and cynical. On the other hand, I see a lot of engineers who get a thrill from problem-solving by day (for their own satisfaction) and helping people outside their very manageable working hours. So nobility isn’t cut and dried.

I know plenty of extraordinary doctors. I don’t want to diminish what they do, not at all. But I do want to kill the idea that becoming a doctor makes you a good person.

4. Learning about tech is open to everyone

A lot of techies who build the Web (conveniently) enjoy writing about the Web. That means that a lot of the quality content on the Web is, itself, about technology. And because content on the Web is mostly open, that means that quality content is available for anyone who wants it. It’s easy to start in this industry as an amateur and find yourself surrounded by interesting, accessible information. (So much so that you could, say, make a career out of it.)

Now, I know engineers are thinking to themselves, “What’s the big deal?” But this just doesn’t happen in medicine. Instead, probably because the field is so old, knowledge is often locked away behind paywalls or in text books. (That is gradually starting to change. The Public Library of Science is definitely a good thing.) It’s interesting to me that this is the case, and I’d love to see more medical blogs flourish like they have for tech.

Wrapping up, starting fresh

My take on this has obviously changed a lot this year, but I’m one hundred percent sure about the direction I’m taking. I’m excited to finally focus squarely on software, to justify all the time I’ve spent learning about tech and the current state of the Web. I love a good puzzle, and tech seems like a fulfilling, social, egalitarian way of getting that in my professional life. And who knows? Maybe some day I’ll find a way to make tech and medicine work together.