290 days as a mechanic in a medical software factory
For ten months, between August 2018 and May 2019, I worked at Epic. Epic is the operating system for the modern hospital. If you imagine a hospital as an animal, Epic is its central nervous system. Every decision it makes, from clinical to financial, happens in Epic.
My job, in a nutshell, was to be a specialized mechanic for that operating system, and my responsibilities ranged from fixing things when they didn’t work to being a long-term guide to the hospitals using Epic, helping them plan out how to make the most of their technology.
In both market share and customer satisfaction, Epic is the king of the hill. Over 300 million people’s data is stored in Epic in some way, shape, or form. We have offices in Singapore, the Netherlands, the UK, Australia, Saudi Arabia, and of course, Madison, Wisconsin.
But this story doesn’t start in Madison. It starts far away, in the oceanside city of San Diego, where I was a college student struggling to make sense of his strange double major.
Most of my favorite college courses came in the early years. Freshman chemistry. Freshman physics. Vector calculus. I found these subjects not only intellectually demanding, but conceptually fascinating. It was cool learning how things worked. As such, engineering seemed like an obvious choice. My professors were funny and likable, but more than that, they were passionate about the topics they were teaching. They believed, and eventually I did too, that a strong grasp of the sciences was important to making a difference in the world.
But I couldn’t just study engineering for four years. I double majored with Literature/Writing. Honestly, if I didn’t have to justify it to a thousand people over the next four years, it would have been the easiest decision I’d make in college. I liked writing, I wanted to get better at it, and you couldn’t keep me from writing if you tried (case in point).
But as the years went by, I grew to dislike chemical engineering. I stopped believing the things I was learning were important. I continued to churn out good grades, and as long as I was getting good grades, I didn’t ask myself the hard questions of what I wanted to do in life. Job fairs were miserable affairs, where the jobs my major attracted were not attractive to me. I half-heartedly interviewed for jobs I hoped I’d never get (a wish that often came true).
The last summer before graduating, the summer of ‘17, my dad got me an internship at HP. It was a peek into a life I was on track to living. If I did well, it was going to lead to an offer letter. The HP internship was the closest I came to committing myself to what I thought was expected from me: a comfortable tech job in the Bay Area. I don’t know why I thought this was the default, I’m sure things were influencing me shouldn’t have been, but given the freedom to be myself, my first instinct was to be like everybody else.
And I hated it.
It wasn’t a bad internship at all. My manager was a great mentor, he looked out for me, and he taught me things I would never forget. The problem was me.
It is easy to reject something. It is much harder to choose something. I didn’t want to be a doctor. I didn’t want to be a computer scientist. I didn’t want to be a chemical engineer. I didn’t want to be a supply chain analyst. I didn’t want to be a writer (yet here we are). The things I didn’t want to be could power a country’s economy.
The HP internship forced me into a corner, and I spent the hot Californian summer of 2017 thinking about my career. I was, and still am, the same person who chose engineering as his major: someone who believed science and technology could do some good in this world.
And then, out of the blue, I received an invitation to a snowy, quiet city on the other side of the country to interview for a company whose tagline was a bold proclamation…
“Code that saves lives.”
It was stamped in white letters on a red notebook. It was the first thing I got when I arrive on Epic’s campus. This was the third and final interview, the on-site. Both earlier assessments had been difficult, and I was surprised to have made it thus far. But here I was. It was January 2018, it was snowing fiercely outside, and I was insanely sick.
Lightheaded, feverish, and coughing, I alternated between rigorous technical assessments and interviews with current employees. I talked for an hour with someone who I’d eventually work five doors down from. I asked him how he liked the job I would eventually accept. I spent an hour trying to code a simple calculator in a language I would have to painstakingly master nine months later. I had to create a ten minute presentation that would teach three panelists something they’d never known before.
It would have been exhausting even if I wasn’t sick.
The last part of the interview was with HR. Coughing between sentences, I felt sure this trip to Madison (in January, for god’s sake) was going to end in a rejection. The HR rep asked me what I thought about moving to Madison from California with a chuckle. I said I’d be interested in seeing how people live in such a different climate.
“Okay, last question,” he said, and noticing me sniffling, passed another tissue.
“What is your most important criteria when selecting a job?”
The answer came naturally.
“The chance to do some good.”
The offer came less than a week later.
9 months before
We’re sitting around a large conference table in a jungle themed room. African tribal masks hang from the walls. One’s nearly two feet tall. To say our campus is big on themes is like saying Disneyland is big on decorations (fun fact both were designed by the same architecture firm).
It’s a panel discussion for the new hires. There were over 300 new hires that started with me on August 6th 2018. It was Epic’s biggest hire class ever. That first week in August reminded me a lot of the first week of college, as more than two thirds of the new hires were recent grads. We went through the same rounds of first impressions, weekend misadventures, and forging of new friendships.
There’s seven new hires in the room, and a woman who’s worked here for eight years. She’d given us sage advice. Work like you’ve got a flight to catch. Phone conversations are better than email. The first step to getting good at something is struggling.
“Any final questions?”
There was silence for a few seconds. Then a new hire timidly raised her hand.
“How do we grow at Epic? Like, how do we get better?”
“Good question,” she said. She got up and went to the whiteboard.
“This,” she said, drawing a large circle, “is your comfort zone.”
“And this,” she said, drawing a tiny dot a couple of inches out of the black line of the circle, “is where you need to be. Just a little bit out of your comfort zone.”
Over the next few months, I’d remember that simple diagram on the whiteboard. I’d remember that small dot, out at sea, beyond where it was comfortable, and remind myself that my growth would not come despite the difficulties, but because of them.
7 months before
The first step to getting good at something is struggling.
By the end of November, I was more or less on my own. Something would break at my assigned hospital and I’d jump into the trenches trying to fix it. I was also busy learning. I passed through a grueling two-week programming boot camp, I studied the ins and outs of Obamacare, and I taught myself how to read code. I also learned how vast Epic was. Doctors did checkups in Epic, insurance companies billed patients with Epic, and the US government collected healthcare data from Epic.
Every week I had a half hour check in with my Lead, a position that loosely translates to boss, but that’s really not what our relationship was.
“Understanding the problem is 90% of solving it.”
I nod. I’m in Connor, my Lead’s, office.
“I’ve found that once you understand exactly what the problem is, the answer makes itself apparent. So if you don’t know the answer, it could be that you actually don’t know the problem.”
Connor was my role model. I looked up to him. He was the kind of person I wanted to be. He was thoughtful, assertive, and brilliant, but above all, Connor was hard-working. He got in before me, he left after me, and he successfully managed responsibilities that dwarfed mine. He was just a year older than me, but in one year he had risen the ranks by proving himself capable of producing results. There would be weeks where he’d have bags under his eyes, but his attitude was always one of resilience. Mind over matter, he’d say about being sick, about going out in the cold. He inspired me.
Seven months later, saying goodbye to him would be one of the toughest parts of leaving.
5 months before
“You look like something’s on your mind,” he says, peering at me over the edge of his coffee cup.
“Yeah…” I start, trying to figure out how to put my thoughts into words. It’s my weekly one-on-one with my mentor, George. When they asked George to mentor a new hire, he had one condition: he would never be asked to submit formal feedback on me. Our relationship would be completely off the books. As a result, George became someone could come to about anything. He was my closest confidant at Epic.
“George,” I begin, reflecting upon my now five-month tenure at Epic, “I feel like the closest I’ll come to the things that I chose this job for is watching other people do them.”
The last staff meeting, we’d celebrated the successful launch of Epic at University College London’s hospital. People I worked with had been asked to fly out to London and support the behemoth of a project. My officemate’s mentor had been in the news for it. That same meeting, our developers shared their experience of going to a refugee camp in Yemen and setting up a healthcare database for the refugees. I felt so close to these exciting events, but yet they felt years away for me. I didn’t want to do what I was doing for another five years. I wanted to do those things. Code that saves lives, remember?
He looks at me knowingly. We talk, and we make a plan. But in the coming months the gnawing feeling would remain and I would continue to drift further out of my comfort zone.
4 months before
2018 turned to 2019. I got my second customer. I was pulling fifty hour weeks, supporting two customers and working towards Epic’s grueling six month training requirements. Many of the new hires were struggling. Monday nights we’d stay til 8pm in a conference room, collaborating and complaining as the midwestern winter began its onslaught around us. When I’d left for India, it had only snowed a handful of times. On my return flight, as we began our descent over Wisconsin, the landscape that appeared through clouds was utterly unrecognizable.
The snow had covered roads, fields, buildings, and everything in between. Both of Madison’s lakes had frozen over. For the next eighty days, the temperature would rise above freezing just once.
The trip to India had knocked me behind on all my projects and commitments. One technical assignment involved getting a broken environment and figuring out where in the code the problem was. I spent night after night looking for a needle in a haystack, but it was so satisfying when I finally figured it out. I triumphantly told the Monday night squad that I’d solved it.
The next day Connor called me into his office.
“What kind of collaboration do you do in those Monday night sessions?”
I had a feeling there was an ask behind the ask. I explained that we never shared code, we only asked leading questions like, “What variable are you referencing here? Can you check how it’s value changes when you run the script?” As far as I knew, that was not cheating.
“So you never gave someone your code.”
“No one ever asked you for your code?”
He exhaled and relaxed. He said he knew I’d be fine, he just had to check.
“Is something wrong?”
“Someone submitted their project with your code in it.”
A week later, one of the new hires, my friend, told me he might be leaving Epic. He said it was to study for med school. I’d worked with him often, we’d struggled next to each other. The person who caught him would later say they gave him multiple chances to confess, and for the longest time he said it was just a coincidence that his code suddenly resembled mine overnight.
He was let go just before his six month mark.
He asked me to get dinner with him his last week. He didn’t know that I knew, and while he didn’t owe me a confession, I went to dinner hoping that we could talk about what had happened. I felt terrible for him, he was in a tougher position than I’d ever been in. Frankly, I was surprised he chose my project to copy. All our projects were on the same shared folder, he could’ve picked anybody’s, and I’m serious, there were better candidates.
We met in a hole-in-the-wall Mediterranean restaurant. The food was absolute garbage.
“How are you liking Epic?” he asked me.
I looked at him, really looked at him. I’d given him every opportunity to open up, yet he’d spent the whole dinner reaffirming his story, choosing to keep me in the dark. For a small second, I wanted to tell him I knew.
“It’s all right,” I said, feeling my eyebrows furrow.
“You look like something’s on your mind.”
But the feeling passed. He had enough to worry about without being confronted about something I’m sure he regretted. We all make mistakes.
“It’s nothing,” I say, smiling. “I’m just tired.”
3 months before
January turned into February. A fair amount of people who’d started with me had left by now. Plot twist, I actually finished my six month training project before the deadline. One cold winter night I felt the deep satisfaction of writing code that works, and I still haven’t gotten over it.
By now, I was running calls on my own. There would be calls where forty full-grown adults, some of them venerable masters in their field, CEO’s and CIO’s of hospitals, would be on the line, waiting for me to lead the agenda. I was so nervous the first time, but over time, it became the thing I was the best at. I may have been a so-so technical problem solver, but I was a strong communicator. Whether it was leading a call or writing up a technical resolution, I not only did it well, I enjoyed it.
I had my first formal evaluation coming up, and I felt confident. Project finished, customer issues under control, it was like the struggle was finally paying off.
And then I got a call from my dad. One of our family friends who worked at Salesforce had told him about a job in Portland, Oregon. My dad told me to call him. I entered the call with my mind already made up: I wasn’t going to leave Epic.
“Nikhil, you can’t reject a job you haven’t gotten yet. You should at least apply.”
“But I don’t want to apply to a job I’m not serious about. Like, I’m genuinely not interested in leaving Epic. I feel privileged to do the work I do. It means a lot to me that I get to help hospitals. I’m doing good.”
I’m sure eyes were rolled.
“The choice is yours, but you have to ask yourself, ‘Where do I want to be in five years, and what job is going to get me there?’”
What happened afterwards mirrors a story about my friend in LA who was considering buying a secondhand Tesla. He told me he thought it was too expensive, but he was still going to go look at it. I told him if he knew it was too expensive, he should not go look at it. Because when you go take a look, they have you.
“I think you should apply.”
He went and saw the car. The next day, he bought it.
1 month before
February turned into March, March turned into April. The Salesforce interviews had not only gone well, but they had offered me a much more interesting job along the interview process. What had been a grudging “Okay fine, I’ll apply,” had turned into a serious problem.
I shared the pros and cons with my parents, my friends, and my extended family. The biggest con was leaving a job I genuinely believed in before I even finished a year there.
Everyone thought I should take it.
“There’s no such thing as wasted time. Even your ten months at Epic will teach you a lot.”
“When you’re young, you have to be agile and learn fast.”
“This sounds like the right offer that came too early. There’s never a perfect job at a perfect time, Nikhil.”
Finally, I asked George. He listened intently as I spoke.
“I like it here, George,” I say, and I think more than anybody I asked, he knew I was telling the truth. I’ll always be grateful for the relationship we had. When all was said and done, it was friendships like this that mattered. He took a few seconds to think before he spoke.
“Nikhil, if you’re going to leave someday anyways, I think you should take the job.”
The last thing I did was negotiate for the maximum possible time I could have before leaving. The initial offer was to start in April. I got it pushed all the way to June. Once Salesforce agreed, I signed.
1 day before
My last day at Epic, I remembered something the managers at the University of Florida had said to me back in January. I wanted their feedback on how I was doing. While my reviews were coming in strong, I wasn’t where I wanted to be. I was sick of hearing how well I was doing only to come into my office and feel like no one knew how much I was struggling.
“I feel like I’m not fast enough at turning issues around, at finding answers, I just want to know how I can improve at this job.”
I fully expected them to say “Well, now that you say it, yes you’re slow and we do want you to be better.”
They didn’t say that.
Here, before I end this piece, I want to say that I had no idea what I was getting myself into when I accepted the job at Epic. I was an idealistic graduate who wanted to do some good, and there were many nights since when I doubted my ability to overcome the struggle.
“Nikhil,” one of them started, “before I give you feedback, I want to give you advice.
“Don’t be so hard on yourself for not knowing everything. Nobody knows everything. I don’t know everything. Your boss doesn’t know everything.”
The other manager spoke.
“We don’t think you’re slow at all. You’re just new. We’ve been doing this a long time, and I think we have a good idea of what matters in the long run.”
When I accepted the job at Salesforce, people celebrated with a vigor that wasn’t there when I said I was working at Epic. It makes sense, they’d heard of Salesforce, they hadn’t heard of Epic. But also, there was the undercurrent that I was going to Wisconsin to work for a company no one had heard of, obviously something had gone wrong.
I may have struggled, but I never doubted that this was something I wanted to spend my energy doing. I was excited when I accepted the job, and I’m proud of what I did in Madison, even if it was for just ten months.
“Nikhil, it doesn’t matter who’s the fastest at finding an answer or who knows the most. Those things will come with time. Some day you’ll be the fastest, some day you’ll be the smartest. But today, when you don’t know, when you’re still learning, you still come to work with a genuine desire to help. We hear it in your voice. ”
My last day was May 24th, 2019. It would be 290 days after I started. I shook Connor’s hand. I shook George’s hand. I could write posts on each of them and the things they taught me. It was ten months of struggle, it was ten months of growth. It was ten long, cold months of being a small dot out of his comfort zone, trying to figure out his life.
“You put your heart into what you do. We couldn’t have asked for better.”
You know what?
I couldn’t have either.