Why I want to be a doctor (and not Bill Gates)

[![Bill Gates Transformational Philanthropist](http://www.medicineforchange.com/wp-content/uploads/2010/07/bill-gates-300x300.jpg "bill-gates")](http://www.medicineforchange.com/wp-content/uploads/2010/07/bill-gates.jpg)I admit it: there are days when I’ve dreamed about being Bill Gates. I’ve always wanted to be at the helm of a world-leading foundation managing a diverse portfolio of amazing work in global health. When I heard about the [giving challenge](http://features.blogs.fortune.cnn.com/2010/06/16/gates-buffett-600-billion-dollar-philanthropy-challenge/ "Giving Challenge") he started with Warren Buffett to funnel an additional $30 billion into charity every year, I went a little green with envy. Few other initiatives will have such an enormous impact on philanthropy in America as the Gates-Buffett Giving Challenge. Yet, does that mean that we should all become billionaires and focus our attention on creating and funding cutting-edge charities?

Drawn in by the allure of such a broad social impact, I worked at a foundation during my gap year after college. I believed (and still do believe) in the extraordinary work that we were doing transforming the field of cancer research by developing the careers of its best researchers. In doing this work, we would ultimately lead to improving and saving more lives than any organization working on a patient by patient basis.Our mission was very clearly stated in our website and all our marketing materials, but somehow we still got patient phone calls.

One morning, I received a call from a woman whose friend, a cancer patient, was living under deplorable housing conditions. Though she had Medicare to cover her immediate health needs, she still needed help getting in and out of her basement apartment and possible legal assistance to deal with the mice and mold plaguing the apartment.

As a foundation-employed professional, I knew what I was supposed to do. I was supposed to hang up, and go back to my grant application to raise funds for more young scientists. But, somehow, I couldn’t. I talked to her about Cancer Care, the patient advocacy organization focused on helping cancer patients in dire straits and the Medicare Rights Center, and how they may be able to get her friend (Medicare-covered) home care assistance. In the end, I ended the conversation with the problem still unresolved, but feeling like I had accomplished more in those fifteen minutes than I had all day.

I believe in foundations’ ability to serve the big picture and support their work in making it a targeted science rather than a scattering of whatever donations they can get. But, through the questions of social impact metrics and getting the best “bang” for your philanthropic buck, there is a cutting simplicity and sincerity in the demands of a patient who truly wants to get healthy. Whether it is the request of a mother or friend of someone grievously ill or the ramblings of a schizophrenic in the emergency room, I still found that the bulk of patients sincerely just want to find out what is wrong with them and do what they can to get better.

I cannot speak for everyone, but this is what I return to when I wonder why I am fighting for my 1 in 1000 chance of getting into medical school. A great foundation, run effectively, may have the greater, more widely-encompassing impact, but it is the practitioner working directly with the client that will truly make the connection between what the resources available in the world to actually helping that individual live a better life.

Someday, I may save up enough money to be able to form my own foundation, but for now, I strive for the deeper impact of connecting with and helping patients in need. My hope is to not lose the big-picture lessons of the non-profit and philanthropic world as I delve into the details of anatomy and the trials of managing rotation schedules. This blog, I hope, will provide a resource for other students to be able to do the same.

Welcome to Medicine for Change