Do We Have a Problem?

What career transitions reveal about distance, leverage, and responsibility.

Mallet Y. Njonkem

Career changes are often described as reinvention: leaving one identity behind and becoming someone new.

But sometimes the subject stays the same. What changes is your distance from the problem.

You can finance a problem, study it, build around it, regulate it, organize people around it, or sit with the person living through it. Each position offers a different form of leverage. Each also carries different responsibilities.

Healthcare has been the subject across most of my adult life. The path looks nonlinear when described by titles. It becomes more coherent when viewed through distance.

Distance changes what you can see

At Yale, I studied economics and engineering. My senior capstone project involved a microfluidic prototype intended to support point-of-care screening without conventional laboratory infrastructure.

The ambition was easy to state. The work was less tidy. Channels clogged. Samples varied. A result that appeared promising once had to prove that it could be produced again. The closer I got to the mechanism, the more clearly I could see the constraints hidden inside a clean idea.

Engineering taught me to ask: What has to be true for this to work?

After college, investment banking and private equity moved me to another vantage point. I learned to examine healthcare organizations through capital, incentives, operations, and scale. The questions changed: How large is the need? What does the evidence support? Who pays? Which incentives shape behavior? Where is the hidden risk? Can the model hold as it grows?

That distance was valuable. It made the system legible.

It also revealed the limits of analyzing healthcare from across a spreadsheet or conference table. Financial and strategic questions could explain how an organization created value, but they could not fully answer what illness felt like, how trust shaped a decision, why a patient missed care, or whether an intervention improved the life it was meant to serve.

I wanted clinical grounding, human proximity, and the responsibility that comes with both. That desire led me into premedical coursework and healthcare research, bringing my earlier training closer to the people whose lives give the system its purpose.

Every distance creates leverage and responsibility

Distance shapes attention.

From an engineering bench, you see mechanisms and constraints. From economics, you see incentives and tradeoffs. From investing, you pressure-test claims about value, evidence, risk, and scale. From research, you examine provenance, uncertainty, and reproducibility. In medicine, those questions meet a person who needs an answer, a decision, or care.

These positions are complementary. Together, they reveal more of the problem.

Proximity also carries obligations. Being close to a person’s need creates an immediate responsibility to listen, explain, decide, and act with care. Working farther upstream creates a different responsibility: to allocate resources wisely, design systems that serve people at scale, and resist the temptation to reduce human consequences to clean abstractions.

The aim is to choose your distance consciously—and to understand what your position allows you to see, what it may conceal, and what you owe the people affected by your work.

A better question for a career transition

When a career path feels fragmented, job titles may be the wrong unit of analysis. A more useful question is: What problem has remained constant, and how has my relationship to it changed?

Ask yourself:

• What problem do I want to spend years understanding?

• How close do I want to be to the people experiencing it?

• Which form of leverage fits the contribution I want to make: capital, evidence, technology, policy, community, or direct service?

• What responsibility comes with that distance?

• Which parts of my prior training remain useful from this new position?

The answers may reveal more continuity than a résumé can show.

A nonlinear path can still be coherent. Sometimes the problem remains constant; what changes is where you choose to stand in relation to it.