As a fresh medical school graduate, I entered internal medicine with a different path in mind, knowing I preferred it over domains like surgery and pediatrics, but I was drawn early on to the unique language of infectious diseases. Back then, my program director and chair were both ID physicians, and their impact on me and on their patients planted a seed.
It wasn’t until my residency in Lebanon, Beirut, however, that this academic curiosity became a calling. There, I learned that society-altering trauma takes two forms: the invisible and the explosive.
I worked on the front lines of overlapping, invisible threats. First was a health care system strained by COVID-19, mpox and a cholera outbreak. I saw firsthand how a microscopic pathogen can shut down, reshape and rewrite daily life on a massive scale. Then, I lived through the catastrophic destruction of the 2020 Beirut blast and its impact on everyone in the region. The massive explosion at Beirut’s port killed 218 people, caused approximately 7,000 injuries and devastated large parts of the city.
Standing at the intersection of these micro and macro disasters changed how I think as a physician. I realized I needed a specialty that fights back, one that pursues cures, restores a baseline and returns a quality of life.
Geographic detectives with a community focus
The most unique challenge of infectious diseases is that the field is strongly tied to geography. The pathogens threatening a community in Beirut often bear little resemblance to the ones I encounter today. When my career brought me to Missouri, the epidemiological landscape shifted, from managing a cholera outbreak to navigating tick-borne illness, endemic fungi and the shifting patterns of antimicrobial resistance across the U.S. Midwest.
Whether serving as chief fellow or on the board of the Infectious Diseases Society of St. Louis, I have come to see the ID physician as a geographic detective. The diseases may differ in different parts of the world, but the mission does not. Understanding the environment and dynamics of a community is what allows us to treat the individual and protect public health.
This same philosophy drew me to HIV medicine where the standard of treatment has been transformed. People with HIV can now live long, healthy lives, if they have access to care. We also seek to mitigate the psychosocial and socio-economic challenges of HIV in the community, which gives our mission added meaning. Short of eliminating HIV, this is its own form of restoration. This commitment is what extends the impact of ID and HIV clinicians, educators and researchers far beyond the exam room, classroom or lab.
This is why I chose ID. It is a specialty in which you treat the patient and the community around them. Through a One Health lens, human health, animal health and the environment around them are inseparable.
Infectious diseases shape societies, and ID physicians have an important voice in these stories. Whether managing an outbreak, solving a hyper-local epidemiological puzzle or helping a patient with HIV thrive, we have the opportunity to make a difference, protect public health and change our communities for the better.
