(Melissa Houser, MD, 8/23/2026)
An excerpt from A Failure of Imagination: How the Healthcare System Fails Neurodivergent People—and What We’re Doing Instead.
I’m a physician. That’s the only formal training I have. When I set out, I didn’t know how to start or run a nonprofit. I didn’t know how to build a medical practice, let alone a model of health care delivery from scratch. But I did know this: If you want to improve the lives of neurodivergent people, you have to change the world. To do anything for the neurodivergent community, you have to do everything. It’s not just health care; it’s loneliness, it’s school, it’s work. It’s everything.
But first you have to be honest about what’s not working.
You can follow every rule and still cause harm. You can show up with compassion, with training, with a genuine desire to help, and still leave someone worse off than when you found them. That’s one of the hardest truths about working in health care, and one of the hardest truths about receiving care, too. When that harm becomes routine, built into the system itself, it stops looking like harm at all; instead, it just looks like “how things are.” We tell ourselves the system is broken, but in reality, it’s working exactly as it was built to work. Or to not work. It’s about confronting the reality that the system isn’t built for patients, who can reach care, who gets heard, who benefits, or for the people trying to care for them, too. It’s about taking on the challenge of rebuilding the system from the ground up.