WALLA WALLA - Dr. Alison Madsen will tell you her road home took more than a few curves and twists.
Back in the city of her birth, however, she's fulfilling a dream that took several miles into the journey to discover, the family practice physician said.
To do so also required a 180-degree turn in thinking. However - like Dorothy in the Wizard of Oz - Madsen discovered there really is no place like home.
And, perhaps, no place like Walla Walla's Family Medical Center.
Born to Tom and Sandy Madsen at St. Mary Community Hospital in 1978, Alison grew up like most local kids, graduating from Walla Walla High School where she excelled in sports and science in 1996.
She went on to Reed College in Portland, finishing in 2000 with a degree in biochemistry and molecular biology. The plan then was to explore medicine from a scientific angle, perhaps helping to discover and create new medicines. An idea, Madsen said, "I had from childhood."
Her fellowship following graduation, then, was the perfect fit. Working in South America and Scandinavia, Madsen spent a year exploring women's health issues, including midwifery and contraception. She saw first hand the results of American politics when tied to reproductive health during that time, she recalled.
"I was in Nicaragua when President Bush was elected. It was a very interesting experience. There were huge funding cuts that Bush enacted - like birth control, that affected large numbers of women ... family planning is a passion for me."
That fellowship year exposed her to the business of medicine, Madsen explained, and she didn't like what she saw. "I don't enjoy that part. I don't see myself in that."
It all confirmed her opinion of health care, even in her home country. "I saw that poor people couldn't get health care and that rich people get tons and tons of health care."
It was an outsider's perspective, the doctor now says.
When Madsen returned to Walla Walla in 2001 after her overseas stint, she went to work at Family Medical Center as a bilingual receptionist.
That was a lucky day for his medical facility, clinic Administrator Bruce Wilkerson said. Here was a young professional, passionate about helping people, who could speak the primary language of nearly half of those who use the clinic, he said. "Another dimension is her personality ... she's warm and humble. Approachable."
It quickly became evident to Madsen that good care for all was being provided at the clinic on Rose Street, she recalled. "It was eye opening in terms of how much family doctors in a community health center do. That was exciting to me."
Too, she saw that the government does care for poor patients - "a lot," Madsen said. "And that this community supports them."
The young woman realized the medical center puts up no barriers for Spanish-speaking clients. Indeed, people of all languages use the clinic even when they can get care elsewhere, she said.
Madsen soon expanded her receptionist duties to include translation services between Spanish-speaking patients and providers, giving her a first-hand look at the "excellent" medicine being provided in her home town, she said.
Her outlook about the medical world began to change. Even though she still harbored some doubts about the business side of things, she was ready to step more fully into that world.
Madsen decided to attend University of Washington's School of Medicine, entering into the school's WWAMI program - the initials represent the five participating states: Washington, Wyoming, Alaska, Montana and Idaho. The emphasis is training students where medicine ends up being most practiced, in the community rather than strictly in the urban, academic hospital setting.
"The goal is to bring people back to their roots," Madsen, 33, said. "That drew me to residency in Idaho."
Although Boise was her base, she spent many months in tiny, rural towns and working in Nampa at a community health center serving Latinos.
Wilkerson knew what a treasure Madsen would be for Walla Walla, he explained with a smile. "I had staff keep in touch with her. We asked her to come and visit in October of 2009."
It was the sort of situation to make any health administrator drool. Here was a bilingual medical professional who already knew the lay of the land, so to speak, he said. "Home grown in the true sense of the word."
But he held his breath, knowing Madsen would be a sought-after commodity. Her drive, compassion and education made her a prize everywhere.
In October, Madsen and Wilkerson both got what they wanted. The doctor, who completed her residency last June, joined the roster at Family Medical Center.
She and her husband, Lupe Perez - who also had worked at the clinic as a nursing assistant - wanted to be sure about their decision.
After all, like every doctor at Family Medical Center, she could work anywhere, for top pay and better geographic locations, Madsen pointed out. "Especially in family medicine. There is so much demand."
She and Perez had visited other health organizations, she noted, and when the two came here, "I treated the interview as any other place. But compared to other community health centers I interacted with, this one is so far above the others."
There was another draw, she conceded. She and Perez were expecting a baby and both their families are local. That kind of support would be invaluable, they knew.
So Walla Walla it was.
"All the parents were very happy," the physician said, with a smile echoing the sentiment. "We were essentially the missing piece for both extended families."
The environment at Family Medical Center seems tailored for Madsen's dream. "I want relationships with my patients that can go on for years and years. It's a better experience when you can see them long term," the practitioner explained.
Which helps even out some lingering stigma about her field of choice. "We get push back as family doctors that we are not experts at things."
"You're an expert in family medicine," Wilkerson interjected.
"That's right," Madsen agreed. "As long as you're willing to admit when you don't know something and to ask questions."
There are days when medicine is a very hard job, no matter how much she loves her patients and her choices, she added. "But I still come to work every day and I take a lot of pride in it."