A new chapter.
Paying it forward.

Twenty-five years on the systems side of healthcare.

For most of my career I led engineering and development teams building the diagnostic imaging software that radiologists, cardiologists, doctors, and nurses relied on to read scans and make clinical calls. High-pressure, high-stakes, long hours. The kind of culture where stress was a badge of honor and rest sounded like an admission of weakness.

I knew healthcare from the inside. What I was ignoring was what was quietly accumulating inside my own body — signals I explained away for years.

“The gap between how I felt and what I told myself kept widening. Admitting it would have meant changing something I didn’t want to change.”

A walk in Braga.
Then nothing.

I had just moved to Braga, Portugal two weeks earlier for a university startup project, alone in a city where I didn’t speak the language and didn’t know anyone. Ella hadn’t arrived yet.

One afternoon I went out for a walk. Chest started tightening. Pain radiating across both shoulders. Sweating. That was the last clear memory I had before waking up in the ICU.

“I started leaving my front door unlocked at night — not because I forgot, but because I’d worked out that if I had to call an ambulance, they’d need to get in. I had a Post-it on my nightstand with the Portuguese emergency number because my instinct was still to dial 911.”

From passive patient
to taking ownership.

For the first two years I was mostly compliant. I believed in the system — it had saved my life. I took the medications, tracked my blood work every six months, and taught myself to read the results. Living in Portugal, navigating a cardiologist who didn’t speak English, I had no choice but to slow down and really understand what was being measured.

I had been finger-pricking daily since the diabetes diagnosis, watching how specific foods moved my blood sugar and how long it took to come back down. I wasn’t guessing anymore. I was learning my body. Then routine blood work came back with a few values shifted. Everything technically in range, just different. I could see exactly why — I had let a few things slide. Nothing dramatic, just enough.

“He didn’t ask if I had changed anything. He didn’t ask about diet or activity. Everything was still in range — and the solution was immediate escalation of medication.”

That was the tipping point. Behavior is the one thing I can actually change, and it wasn’t even part of the conversation. I stopped all medications two months later. Six months after that, my A1C had dropped a full percentage point through dietary changes alone.

Figuring out how I got there
so others could too.

What I found wasn’t a clean system I had followed. It was years of fragments — bits of research, things I had tracked, adjustments I had made, observations that had accumulated over time. I started grouping them because it was the only way to make sense of them. And when I looked at those groups, five areas kept emerging consistently.

I called them pillars because that is what they felt like — structural, load-bearing, connected. Remove one and everything becomes unstable. Understand one and the others start to make more sense.