The Patients Who Changed My Path
In 1987, I met three patients who would change the course of my medical career.
Each had been diagnosed with Lyme disease. Each had already completed treatment. And yet — each remained ill.
At the time, I hadn’t been trained to manage Lyme disease. There were no protocols for what to do when treatment didn’t work. No guidelines for re-treatment. No instruction for how to help a patient whose symptoms didn’t go away.
But I knew how to listen.
These patients weren’t exaggerating. They weren’t imagining things. And they weren’t getting better. So I made a decision to keep going — to keep trying.
I adjusted treatment plans. I watched closely. I learned as they improved.
And I never forgot what it meant to witness those first recoveries.
From Curiosity to Commitment
More patients came. Their stories were heartbreakingly familiar: lingering symptoms after a tick bite, misdiagnosed illnesses, and exhaustion that no one took seriously.
My training in geriatrics helped me see what others might overlook — subtle neurologic symptoms, unexplained fatigue, early cognitive changes. In geriatrics, I had already learned to slow down, ask different questions, and treat people others had written off.
But it was my training in epidemiology that changed the way I thought. I learned to ask: Why is this happening? Where are the patterns? What isn’t being measured yet?
That public health lens pushed me to think critically about what I was seeing in practice. It taught me not to confuse gaps in research with absence of illness. It gave me the tools to explore uncertainty, rather than avoid it.
Listening, Learning, and Leading
Over time, my commitment deepened — and so did my involvement.
I joined with colleagues who were also seeing patterns that didn’t fit the textbook. I became President of the International Lyme and Associated Diseases Society (ILADS). I helped write ILADS’ evidence-based treatment guidelines, advocating for the importance of clinical judgment and individualized care.
And I led the only independently funded clinical trial on Lyme disease by a practicing physician.
But even as my role grew, one thing never changed: the patients in front of me were still getting dismissed. And they still needed someone who would listen.
What This Work Has Taught Me
I’ve seen patients recover who were once told there was no hope. I’ve seen teenagers return to school, adults return to work, parents return to parenting.
Not every case is simple. Many require treating co-infections like Babesia or Bartonella. Others involve neurologic symptoms that mimic dementia, or autonomic symptoms that look like anxiety. This is a field that challenges you to stay curious and stay connected.
But the most important lessons haven’t come from the textbooks. They’ve come from the people I’ve treated.
People who were determined to get better — even after the medical system gave up on them. People who taught me that good medicine isn’t just about following protocols. It’s about staying present when the answers aren’t obvious.
Why I Stayed
I didn’t choose Lyme disease care because it was simple.
I stayed because the patients needed someone who wouldn’t give up.
I stayed because complex illness deserves thoughtful care.
I stayed because the work still matters.
And I’m still here — because so are they.
