“Tell me, what is it you plan to do with your one wild and precious life?”
The woman carefully unwrapped three coins from her threadbare kanga and pushed them toward the shopkeeper. There was a mixture of desperate hope and resignation on her face. Though my Swahili was basic, I made out that she wanted to buy medicine for her son, sick at home with malaria.

The shopkeeper counted the coins and shook his head – it was not enough. The woman left empty-handed, slowly receding into a tiny speck silhouetted by the blazing African sun.

I was overcome by the chilling realization that I had denied her son lifesaving medicine. The program I ran in Tanzania was supposed to align incentives across the public and private sectors by distributing medicine to rural areas via the existing network of drugstores. Profits for shopkeepers, more lives saved for society – a perfect plan, I had naively thought. But I didn't foresee the terrible consequences that arise when the profit motive directly clashes with doing what's right.

The stakes of this conflict – between individual gain and broader societal benefit – are nowhere higher than in the field of health care. Profits are necessary so that hospitals can fulfill their mission to heal the sick. But a narrow focus on financial gains can detract from the amorphous quest for the greater good. Going forward, I want to walk the fine line between them – to make hospitals profitable while delivering high-quality care to all.

I panicked in that dusty pharmacy; shocked that this choice had to be made. As I pursue my dream of improving health care delivery, I'm more clear-eyed about the existence of such tradeoffs. Nevertheless, I hope I will always find them as painfully heart-wrenching as I did on that hot day in Tanzania.


— Lorrayne Ward