Founder: The Caretaker Since Nineteen

The other half of my life was eleven years in data science at Meta, a Director since 2022, where the work was measurement quality: deciding whether a number could be trusted, and finding where two systems disagreed about the same thing. It took me a long time to notice those were the same job.

Nineteen

My father had a stroke that left him permanently disabled. I spent the next seven years, until his death, learning the system from the bottom of it: Medicare, then Medicaid, and the difference between them that nobody explains. A dozen institutions that had never spoken to each other. Forms that decided whether he got care, written as though someone calm and well would be filling them in.

I was nineteen. I did not know you were allowed to ask questions. I learned that you are, and that almost nothing happens until you do, and that lesson has been the whole of my working life since.

By the time I was about twenty-four we had hired a lawyer for the Medicaid side of it. That is the other thing those seven years taught me: some of this is not a paperwork problem you can out-organise, and knowing which part needs a lawyer, and how early, is worth more than any amount of diligence.

Twenty-seven

My mother had open-heart surgery. I have not managed her care every day of the eleven years since, and I want to be accurate about that. I have watched it closely and followed it, the way an involved family member does. That is the stretch where I learned the part of this work that is genuinely technical: which test actually answers the question in front of you, when in the course of things it is worth doing, who should perform it, and who should be reading it. Measurement instruments, and the people holding them. Those are not the same decision, and almost nobody tells a family that they are separate.

And here is the part that became the whole argument for this firm. It was not until I sat down recently and properly dug into her record that I found the gap. Eleven years of paying attention, from somebody who does this for a living, and it was still hiding until somebody deliberately went looking. Two institutions describing the same anatomy differently. A finding noted once and never followed. Watching closely is not the same as reconciling, and no amount of love substitutes for somebody whose job it is to look.

That is also what I was doing at work. Measurement quality is the question of whether a number can be trusted: which instrument produced it, who read it, and whether two systems that disagree are disagreeing about something that changes the decision or about noise. I am named on patents in measurement and analysis. I was running the same reconciliation in the evenings on my mother's record, with worse tooling and higher stakes.

Thirty-six

My wife was diagnosed with brain cancer. She was thirty-seven. During the same period, her mother died of brain cancer as well: two unrelated brain cancers in one family, at the same time.

That is when I understood that where you are treated is a decision, not a default. The obvious path was the hospital down the road from us in Illinois. Instead we went looking, and found the best surgeon we could reach, at Northwestern, working from the best available science rather than the local convention. Nobody handed us that option. We had to know to ask for it.

That year taught me the thing this firm is built on. You can do everything right, choose an excellent surgeon at a serious institution, and still have the decision rest on a study that was performed and read by whoever happened to be available. The referral was good. The chain underneath it was left to chance, and nobody was watching it but me.

What that year required was the habit I had been paid a decade to build: refuse the summary at the top of a complicated problem and go all the way into it, then separate the one concern that is real from the dozen that only look alarming. A family in crisis cannot afford to fight every battle. Choosing which one is most of the work.

And then my own

Stage 4 endometriosis. After years of being the one holding the folder, I became the patient still holding the folder, which is the position most people are quietly left in and the one nobody designs for. I did for myself what we had done for my wife: went looking rather than accepting the nearest option, and had my own care at the Cleveland Clinic.

I also went through the disability process myself, start to finish. Family and Medical Leave Act first, which protects your job but pays nothing. Then short-term disability, then long-term disability, each with its own deadlines, its own forms and its own burden of proof, all of it written to be navigated by somebody who is not ill.

I know where that process breaks, because it broke on me. I know which stage you cannot afford to be late for, and I know when it needs a lawyer and what kind.

Which brings me to the thing I am most useful for. I have had some of the best care in the country, and I have seen exactly what has to be documented to get it. Not the care itself, the case for it: what has to be in the record, written which way, and sent to whom, so that a decision goes your way rather than being denied on a technicality. That is what we build for a family, and it has to be built before it is needed, not after somebody has already said no.

It also made the last habit non-negotiable. Most of a senior career in that field is holding a position under pressure from people who would prefer a different answer. It is nearly all of the job when you are asking an institution to re-read a study, or telling an insurer that their denial does not survive contact with the record. It is the same skill.

What all of it has in common

Not a shortage of good doctors. I have met excellent ones at every stage of this. What every one of those years had in common is that the information was fragmented and nobody owned it, so the job of holding it fell to whichever family member was closest. That was me, four times, and every time it meant I stopped being a daughter or a wife and became an unpaid, untrained case manager instead.

That is not a personal failing and it is not bad luck. It is structural, it happens to every family, and it is the thing we were built to take off you.

The instincts came from being nineteen with a folder I did not understand. The method came from a decade of being paid to ask whether a number was true. This firm is organised around evidence quality rather than around booking appointments because evidence quality is what actually went wrong, every time.

What I am not