A different kind of mind.

I have ADHD. I did not have language for this during most of my training, which meant I spent a significant portion of my medical education interpreting myself through frameworks that were not built for me — and finding myself consistently on the wrong side of what was valued. Too many interests. Not enough focus. Ahead of a conversation before it had started, then somewhere else by the time it caught up. Drawn to connections others weren't making yet, energized by problems that crossed disciplines rather than deepened within them, noticing signals that hadn't yet become consensus.

What I understand now — looking back across decades of work — is that these were not deficits being managed. They were a cognitive style doing exactly what it does: scanning widely, detecting early, connecting across distance, refusing the either/or. The hashtag before hashtags were medical infrastructure. The community before community was a clinical outcome. The conversation about identity before identity was a research priority. The framework for communication before communication was a surgical skill. Over and over, the same pattern: arriving somewhere early, building something connective, staying long enough to watch it become mainstream.

I am not writing this page as an outside observer of neurodiversity in medicine. I am writing it from inside it — as someone who spent years trying to fit a mind like this into structures that were not designed for it, and who is only now, in retrospect, able to see clearly what it was doing the whole time. The pattern recognition. The early foresight. The through-lines that looked scattered until they didn't.

If you are a trainee who has been told your mind is the problem, I want you to read what follows carefully. Not because it will fix the structures — they still need fixing — but because the story you are telling yourself about what your mind is may need revising first.

Medical training rewards a specific cognitive profile: linear thinking, narrow specialization, rapid execution, deference to established structures, and the capacity to memorize and reproduce. These are real skills. They matter.

But they are not the only skills that matter — and the training environment's inability to recognize other cognitive styles as assets has real consequences: for the physicians who carry them, for the patients who need them, and for the field that cannot afford to keep discarding them.

This page is for anyone who has been told — directly or indirectly — that their kind of mind is not built for medicine.

What if the problem isn't the mind? What if it's the frame?

What training environments tend to reward

• Linearity — one step, then the next, in sequence.
• Narrow specialization — depth over breadth; staying in your lane.
• Rapid execution — completing tasks efficiently within established systems.
• Local optimization — improving what exists rather than questioning its structure.
• Memorization — reproducing knowledge reliably under pressure.
• Deference — respecting hierarchies, following established procedures, not disrupting.

What connective thinkers tend to do instead

• Synthesize across domains — drawing connections between fields that don't usually speak to each other.
• Detect patterns earlier — noticing signals before they become consensus.
• Ask boundary-crossing questions — the ones that make people uncomfortable because they don't fit existing categories.
• Integrate human and systems perspectives — holding both the individual experience and the structural context simultaneously.
• Notice second-order effects — seeing downstream consequences that aren't immediately visible.
• Build conceptual bridges — creating the infrastructure that allows ideas to travel between communities.
• Challenge false dichotomies — refusing the either/or framing when the real answer is both, and asking why the split was made in the first place.

What this can look like during training

In a training environment that rewards the first list, the second list can be misread:

• "Too many interests" — may actually be cross-domain pattern recognition still finding its form.
• "Lacks focus" — may actually be monitoring multiple channels simultaneously.
• "Inefficient" — may actually be refusing to optimize a system that shouldn't be optimized.
• "Difficult" — may actually be noticing something real that others have learned to ignore.
• "Distracted" — may actually be the early stage of what later gets called innovation.
• "Doesn't fit" — may actually be the signal that a new structure is needed.

Many innovations begin as distractions before they become mainstream. The question is who gets to survive long enough to see that happen.

The connective narrative

One of the most damaging things about deficit-based framing is what it does to a person's ability to read their own career. When you have been told your cognitive style is a liability, you may not recognize it as the organizing principle of your most significant work.

Consider what a career built on connective thinking actually produces:

• Surgery + communication — before communication was widely recognized as a clinical skill.
• Surgery + social media — before digital platforms were taken seriously as medical infrastructure.
• Surgery + identity — before representation was a research priority.
• Surgery + education — designing how the next generation learns.
• Surgery + violence prevention — connecting trauma to clinical responsibility.
• Surgery + digital community-building — creating belonging where institutions hadn't.
• Surgery + narrative medicine — using story as evidence and instrument.
• Surgery + systems culture — naming what shapes everyone but is rarely examined.
• Surgery + neurodiversity — asking who gets counted as capable, and why.

Without a connective narrative, this kind of career can look fragmented. With one, it becomes a sustained body of work — built on the same underlying questions, approached from multiple angles, across time.

That is not scattered. That is a method.

What this means for institutions

If training environments systematically filter out connective thinkers — or exhaust them before they can contribute fully — they are not selecting for excellence. They are selecting for a specific cognitive style, and calling it excellence.

The costs are not abstract:

• Problems that needed early detection go undetected longer.
• Bridges that needed building don't get built.
• Innovations that were possible don't happen, or happen later, or happen elsewhere.
• Physicians who might have changed the field leave it — or are never allowed to fully enter.

This is not an argument against rigor. It is an argument for expanding what rigor means — and for building training environments that can recognize, support, and retain more than one kind of excellent mind.

Cognitive diversity is not a concession to inclusion. It is a prerequisite for medicine that is accurate, adaptive, and ready for the problems it hasn't yet seen.

This work is still developing. If it resonates — whether you are a trainee, a clinician, an educator, or someone still trying to find language for your own experience — I would be glad to hear from you.

Reach out via the Connect page →

Dr. Heather