Lara Goitein, MD, is a Harvard trained physician specializing in intensive care and lung medicine. Somewhere between her residency in Boston and her fellowship in Seattle, she fell in love with the desert southwest and took a hard detour to work as a river guide in the Grand Canyon. She now lives in Santa Fe, New Mexico with her husband and two sons. There, she founded a clinician-directed quality improvement program at the Santa Fe hospital, and served as President-Elect of the Medical Staff. Her professional interests include quality improvement in healthcare, end-of-life care, the training of new doctors, physician burnout, and improving communication with patients and families. She is an editorial board member and frequent writer for the medical journal JAMA Internal Medicine, and also writes in the lay press, including the New York Review of Books. As much as possible, she spends time with her family hiking, camping, and river rafting in her stunning backyard.