Nobody is too small for the big picture
How social determinants of health define our future
“This isn’t in my job description.”
For anyone in the professional world, this phrase is loaded. It can mean establishing clear boundaries around what you will and will not accept for your pay. In other cases, it reveals who is willing to go the extra mile.
While both positions are valid, social responsibility early in my career kept resurfacing and ultimately pushed me to choose the latter of these two divergent paths. As a student—before my years as a teacher—I witnessed the quiet normalization of burnout: classrooms where exhausted teachers taught calculus to half a class while the other half slept.
Yet their behavior shifted when administrators entered. In those moments, they revealed what they always knew was right. It became clear that, in some ways, they too were “sleeping in the back,” avoiding the social responsibility they understood but sidestepped because of the perceived hassle. Ironically, it was the same excuse given by the students who slept through class.
There is an implicit message embedded in this dynamic: If you do not have all the social support and energy required, you do not matter.
For empathetic individuals especially, exposure to that kind of energy is enough to push someone into a kind of dissociative slumber.
It became painfully personal when one of the students on the “sleeping” side became someone I loved. I share a graduation photo with him and understand the pain surrounding that milestone—having no such photo of my own graduation with my family. In that picture, his expression is one of sincerity and pride as he stands beside me in his cap and gown. The photograph may be something a broken family dynamic could try to diminish, but the sincerity on his face lives permanently in my heart.
Instead, I observed what felt like a troubling absence of social responsibility in institutions that ironically depend on the social contract for survival. When administrators entered the room, they revealed what they knew was right—to care.
Most people are not in a good mood when abruptly awakened from a sleep that has been written off. But if that awakening communicates, “You matter. I will not let you be written off,” even initial resentment often gives way to later gratitude for the extra investment of energy.
I do not glamorize or excuse destructive “waking” behavior, nor do I advocate blind benevolence in situations that clearly go too far. Those extreme cases exist—but they are the exception, not the rule, and they are not a reason to shut down compassion entirely.
What surprised me most was the diversity of circumstances students revealed—conditions that extended far beyond what appeared on paper.
One student, fascinated by neuroscience, quietly shared that he had a father in jail and lived in a cold home with a single working parent.
Another, living in an expensive home in the same area and striving for a near-perfect ACT score, fixated intensely—almost harshly—on every imperfection.
I begrudged neither of them as I drove a slowly collapsing Prius, at one point literally held together with duct tape. I existed somewhere between both worlds—unsupported in ways that felt uncalled for, yet supported in ways others could not see.
As complex PTSD (cPTSD) receives more research attention, I see increasing acknowledgment of the social determinants of health (SDOH)—the macrosystem surrounding psychological pathology, disorders, and diagnoses.
Similarly, as research on narcissism becomes more rigorous, we see how environmental incentives can rigidify traits in those who are genetically at higher risk. Some Scandinavian countries have demonstrated that empathy can be cultivated, with measurable social outcomes suggesting that systemic conditions matter deeply.
We also see how, once traits rigidify into full disorders, trauma risk multiplies—impacting not just individuals but entire systems. Many professionals advocate for early detection and intervention, recognizing the broad social and economic consequences that can arise when harmful traits go unchecked in positions of power.
I founded my company by writing my own business plan during what felt like a terrifying social catastrophe, marked by the profound failure of several critical social contract–based institutions—HR, courts, labor law, and housing justice.
Nevertheless, I refused to let regression win. I committed to this broader understanding.
I committed to moving away from isolation, exclusion, and naïveté, and toward recognizing the beautiful, terrifying, and powerful macrosystem that shapes all of our lives.
I hope my story inspires anyone who feels afraid because of limited financial or social support to embrace something significant. If a big idea comes to you clearly and you are effective in bringing it to life, you are the right person to pursue it.
Nobody is too small for the big picture.
