My path from medicine into technology

In 2011, 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. A lot of people want to understand why.

The draw of technology

Until 2010, I planned to be a doctor, but now I’m happily building software. Why?

I should start off by telling you: Tech is not new to me. Computers have been a hobby for a long time–since I was 10 years old, actually. Back then, 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, overdone, maybe? But useful. Now it’s mostly modern and agile languages like Ruby and Clojure—and Haskell, just for fun. 

In school, I toyed with the idea of electrical engineering, but ended up choosing medicine. I wasn’t sure then how electrons could help people. With medicine, it was obvious.

Hard work, I can deal with that

I’ve been ready for the challenge and reward of medicine since college. With a little hard work, I knew I could make discoveries and then, after med school, apply that experience to help people directly. The journey would be long, but at the end, worth it.

And I did, in fact, discover exciting things while doing research. At school and then at Massachusetts General Hospital, I learned about how pathogens like F. tularensis, V. cholera, M. tuberculosis, and S. typhi worked, firsthand and even got to publish. And those were exciting times.

But being surrounded by the medical community, it turns out, gave me a glimpse into my potential future, and it’s one that’s hard to stay excited about.

Being surrounded by friends in residency, I keep hearing:

  • Medicine isn’t really about spending quality with patients anymore
  • Your personal relationships with your patients are there, but only into 15-minute increments
  • As a doctor, you have to worry more and more about the bottom line

Now, the reason I got into the field was to connect with people and help them, hearing this made me reconsider the tradeoffs. So between tech and medicine, what made 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.

Reconsidering 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

After a lot of thought and too many mind maps, I’m sure about the direction I’m taking. I’m excited to focus squarely on technology, to justify the time I’ve spent on it, and to advance the state of the Web. I love a good puzzle, and tech is a fulfilling, social, egalitarian way of getting that in my professional life. And who knows? Maybe some day—I keep telling myself—I’ll find a way to blend the two into something even more meaningful.