Chapter 1: Not Unremarkable

There's a phrase radiologists use when something shows up on a scan that doesn't quite belong: not unremarkable. It's technically a double negative — a clinical hedge for "this warrants attention." As a patient you'd rather have the report just say unremarkable. Unremarkable means nothing to see here. Unremarkable means normal, expected, within limits.

For most of my life, I was unremarkable. I mean that as a statement of fact, not self-deprecation.

I grew up in a conservative Christian household, the second of four kids, happy by almost all metrics. My parents fed six people on a budget that required store brands over name brands — not as a hardship, just as arithmetic. We went to church. We did well in school. We didn't ask questions we didn't want answers to.

That last part is worth drawing attention to. There was a value in our household — never stated, never decided, just present — that placed a value on not rocking the boat. It wasn't incuriosity exactly. It was more like a collective agreement that the structures holding us together were more important than the questions that might unsettle them. Family structure. Church structure. Social structure. The conventions we lived inside were not sacred, but they were load-bearing. And you don't kick load-bearing walls.

I took that with me into medicine. The ambition to become a physician wasn't a betrayal of that value — it was actually the approved version of excellence inside the same system. Work hard inside the lines. Earn your place in the system. Trust what you’ve been told.

I don't say any of this critically. I wouldn’t be half the man I am today without my parents, family, church and values I learned growing up. The system I was raised in got me somewhere. It trained me well. But it also handed me a set of assumptions I hadn't examined, because examining them wasn't part of the curriculum.

Then I met Taylor.

Taylor didn't argue me into anything. That's not how it worked. She merely introduced me — mostly by proximity to her family — to something I didn't have a name for yet: a genuine growth mindset. Not the motivational poster version. The actual disposition of a person who treats received knowledge or wisdom as a starting point rather than a conclusion. Her mother, Karen, was the first person who made me see this concretely.

Karen was successful in a vitamin company at the time. I'll be direct about what that means: it was an MLM. My conventional medical school training had a very efficient filing system for things like this — it went directly into the folder labeled not worth serious attention. I was politely (and mostly silently) condescending in the way a medical student learns to be politely (and often not silently) condescending about things that don't carry institutional or convention backing. I thought I was being diligent. I was mostly being allergic to anything that didn't arrive through the approved channels.

Karen didn't hand me a stack of studies. Instead, she pointed to the authority behind the formulations: a scientific advisory board that included, among others, Dr. Stanley Dudrick. If that name doesn't land for you, it should: Dudrick invented total parenteral nutrition — TPN — the intravenous feeding protocol that keeps critically ill patients alive when their gut can't absorb anything. This wasn't a celebrity endorsement. This was a foundational figure in clinical medicine lending his name to a supplement line.

But what actually cracked my dismissal wasn't a name. It was a rehydration electrolyte product whose sodium-to-potassium ratios were precisely calibrated to match the co-transporter absorption ratios I had just learned in my coursework. That science wasn't explained to me — it was just there, embedded in the formulation, in ratios that only make sense if the person who formulated the product had a working understanding of intestinal physiology. I hadn't expected that. I didn't have a clean response to it.

What I sat with afterward wasn't really about vitamins. It was about the dismissal itself. Where had it come from? Where did I learn to almost instinctively reject anything that didn’t fit my preconceived paradigm of truth? Not from evidence — I hadn't even looked at any evidence before my initial dismissal. It had been reflexive because of the source. MLM-adjacent, and therefore not serious. The conclusion preceded the investigation. That's not diligence or intellectual rigor. That's allegiance masquerading as intelligence.

That distinction is worth naming plainly, because it will run through everything that follows in this series.

There is Science — capital S — the institutional body of knowledge that gets funded by research dollars, published in peer-reviewed journals, taught in medical schools, and codified into clinical guidelines. I was trained inside of Science and I'm not dismissing it. Science has produced genuinely remarkable things.

But there is also science — lowercase — the methodology. Observation, hypothesis, testing, revision. The actual processes the institution is supposed to be built on, but which the institution often ignores to better serve other pressures: funding sources, pharmaceutical relationships, publication bias, the slow institutional inertia of what's been taught for thirty years.

Suspect behaviors exist in both Science and science. Alternative health has its own industry logic, its own bad actors, its own motivated reasoning. I'm not making the case that unconventional equals good. I'm making the case that conventional doesn't automatically equal true — and that I had been treating it as though it did without realizing I was making that choice.

Karen didn't give me a new framework. She pointed me towards a crack in the wall through which I could see a perspective that was implicitly off limits in my conventional life.

I want to be honest about what the actual question in my heart was at that point, because it wasn't about vitamins or Karen for that matter (she’s turned out to be the best Mother-in-Law in the world, and I’d fight you over that statement, too).

The question was about who I was going to be.

Not dramatically. More subtle than existential. I was looking at a set of conventions I'd inherited and never examined — family conventions, faith conventions, medical conventions — and asking for the first time whether I was holding them because they were true or because they were safe.

Not a question of physical safety. It was something quieter — the safety of belonging, of earning the codified approval of others, of operating within unspoken limits, of being unremarkable in all the right ways. Was I going to be a physician who thinks conventional thoughts, orders conventional labs, gives conventional guidance? There's a version of that life that's perfectly good. Respected, stable, whole by almost all measures.

But something inside of me, some deep down voice, told me I wouldn't be content with conventional. I wouldn't be wholly who I was made to be if I just continued down the standard path I was on.

I didn't do anything about that voice yet. This chapter doesn't end with a decision. It ends with a question I couldn't un-ask:

Would I submit to the convention even where it violated my conscience — or would I defy it and keep true to something I couldn't fully name yet?

I wasn't sure it was safe to find out.