At age 24, Janet Buttenwieser moved to Seattle with a resume devoted to public service and fantasies of single-handedly ending poverty. But within a year she'd developed an intestinal illness so rare she wound up in a medical journal. Janet navigated misdiagnosis, multiple surgeries, and life with a permanent colostomy. Like many female patients her concerns were glossed over by doctors. She was young and insecure, major liabilities in her life as a patient. How would she advocate for low-income people when she couldn't even advocate for herself?