I am physician working in women’s health for the last 12 or so years. Before that I worked in basic science and since starting medicine have received additional training in bioethics and health policy. That perspective, from physical to metaphysical, offers some insights into what I see happening around me in medicine. No doubt US health care is a mess and there are plenty of smart folks writing about it. For me I write to vent my frustrations and maybe somebody reading about the madness I see around me will be the better for it.