In one study from 2018, patients with all levels of complex medical illnesses had better outcomes at academic medical centers. With all this in mind I resolved to leave my training hospital for sub-Saharan Africa to teach and practice medicine. But a young patient with a potentially salvageable life and a child at home needed intensive care and she needed it promptly. One doesn’t have to have HIV to get tuberculosis, but it is more likely to occur in patients with HIV. The statistics of HIV in young women are startling: In some parts of Africa, nine in ten new cases among adolescents occurred in girls.