A career spent making decisions when the information is incomplete.
Physician. Author. Independent scholar. Advisor to people and organizations in difficult situations. The résumé version spans emergency medicine, entrepreneurship, scholarship, and consulting. The honest version is a single sustained interest in how people and systems behave when the pressure is real and the information is partial.
The emergency department is a demanding teacher
I spent roughly twenty-five years practicing emergency medicine. The specialty insists that you distinguish what is urgent from what merely appears urgent, act on incomplete information, and reassess constantly as the picture changes. It also teaches humility about documentation: a chart is a record made under pressure, not a transcript of reality. Learning to read the difference between what was known, what was knowable, and what was written afterward became a professional skill in its own right. It also taught me that stabilization often has to precede complete diagnosis: prevent deterioration first, then refine the explanation as better information arrives.
Independent scholarship
My research examines the machinery around medicine as much as medicine itself: how enforcement chooses its targets, how credentialing decides who may work, how coding and classification quietly shape clinical behavior, what proportionality requires of administrative power, and where automated systems should defer to human judgment. Fifteen papers are catalogued on the research page and on SSRN.
Institutions under pressure
Working inside one of the most heavily regulated, credentialed, coded, and measured industries that exists made me as interested in institutional behavior as in clinical behavior. That interest became advisory work on regulation, incentives, automation, and organizational drift, and it extends into experimental infrastructure projects such as Universal Document, The Hive, XEO, and Omni. The same order of operations applies to institutions: contain the process causing ongoing harm, restore enough stability for judgment, then examine the incentives, rules, and structures that let the failure recur.
Operating under stress
Alongside medicine I have built and operated businesses, which means I have also experienced what it is to run one under stress: payroll that must be met, creditors who call, properties that misbehave, contracts that go wrong. That experience, combined with clinical triage thinking, shaped the turnaround and special-situations practice. Business distress rarely waits for a perfect diagnosis; the first objective is to stop avoidable deterioration and create room for a more durable solution.
Where the strands meet
The books are where the work becomes personal. GROUND was begun by hand inside a federal prison camp, while a twenty-five-year medical career came apart on the outside. THE ROAD maps the criminal process for the people inside it and the families beside them. CIRCLE and THE ADAPTIVE COUPLE continue the same inquiry into how people adapt when their circumstances change faster than their assumptions. All books are here.
The common thread is not industry. It is decision-making under pressure.
The method is simple: identify what matters first, prevent unnecessary deterioration, create stability, and then solve the deeper problem.
Start the conversation.
If your situation touches medicine, law, institutions, or a business under strain, describe it in general terms and I will tell you honestly whether I can be useful.
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