Focusing on global health for local change

Nat Cobb took his time on the path to college. His father worked in international development, so the Cobb family moved between underserved communities, from New Mexico to Pakistan, where a teenaged Cobb grew more aware of poverty. In the 1960s, he sidestepped the Vietnam War, enrolled at Reed College in Portland, and promptly dropped out. It wasn’t time; the wild places were calling. He guided river trips through Grand Canyon and instructed Outward Bound courses in the Scottish Highlands. The world was big, and the opportunity for adventure was endless. Yet, Cobb had seen enough to realize there was work to do. 

“I had some insight turning 30 that I didn’t want to be one of those old guides with knee and back issues, migrating to the office, still not getting paid much, and wishing I was in the field,” Cobb said. “I needed to go back to school.”

In 1974, Cobb bought a house for $7,000 in Silverton, 50 miles north of Durango. He worked at Mercy Hospital as an orderly and considered what to study at nearby Fort Lewis College.  

“I went on a two-week silent meditation retreat,” Cobb said. “I wasn’t consciously trying to think in an organized way about my future, but the idea bubbled up that a career in medicine might check the boxes for me. I wanted the flexibility to move around, live in different places, and find a job. It was also important to feel like I was contributing to the world and helping people in some way.” 

Cobb enrolled at FLC, declared a major in Biology, and signed up for the Honors program. He was the oldest in most classes but saw that as an advantage. Every weekend, Cobb would drive back to Silverton and tuck into the quiet to concentrate on his studies. He ignored the constant tugs of adventure buddies inviting him to join expeditions in Patagonia and Nepal. He still instructed the occasional Outward Bound course, but his focus had shifted to a grander vision. 

“I learned things on Buddhist meditation retreats that some people know intrinsically about focus,” he said. “I didn’t have that focus intrinsically; I had to learn it. This spiritual grounding helped me get back into being a student and not be distracted, learning how to work with and control my mind. It gave me the tools I needed. Without that, I wouldn’t have been successful.” 

His motivation sharpened further when he discovered FLC’s Chemistry Department. Cobb failed chemistry four times during his previous college attempts; at FLC, chemistry clicked. He switched his major.

“When I compare my experience to what it might have been if I was at a larger university, I would’ve been one pre-med student of 1,000,” Cobb said. “There’s no comparison: I had full access to interesting faculty, like Ted Bartlett and John Ritchey, who would sit down and go over fun projects with me. It was very exciting and fulfilling. It gave me this level of comfort that if I didn’t get into medical school, I could still find an interesting career in chemistry. I hadn’t anticipated that.”  

After graduating from FLC in 1980 with a degree in Chemistry, he applied to Harvard Medical School. 

“Coming from Fort Lewis helped me; Harvard took a second look. They want to see their student body coming from left field,” Cobb said. “It was an interesting twist. Don’t set your sights low just because you come from a small school. Sometimes, that’s an advantage.” 

Harvard professors welcomed fresh ideas from nontraditional students. Cobb joined classmates who were philosophy, English, and music majors. One of those classmates was Paul Farmer, who, in the mid-1980s, was busy co-founding Partners in Health, an international nonprofit organization that provides direct healthcare services and research and advocacy activities for people living in poverty. Cobb joined Farmer in pioneering community-based treatment strategies in under-resourced places, like rural Alaska, where Cobb worked in a hospital one summer. 

Don't set your sights low just because you come from a small school. Sometimes, that's an advantage.

“It was important from day one [at Harvard], being older, I knew that I had to not be too worried and wrapped around the axle of learning all the material at once,” Cobb said. “You could drive yourself nuts learning the entire corpus of medical knowledge. I had to keep my sanity and pursue my interest.” 

While in school, Cobb met his future wife and “adventure buddy,” Sarah. After medical school, he originally planned to work in international public health on cholera outbreaks in Bangladesh. Sarah was keen to start a family stateside before traveling abroad. 

“The Indian Health Service was a compromise: we could be in the States working in a different culture and getting international health exposure close to home,” Cobb said. “Medicine offers so many ways to help, anywhere from being a doctor and treating patients individually to broad public health policy level and research opportunities. This one degree opened all those doors for me.”  

When their first son was one year old, the Cobbs moved to the Zuni Indian Reservation in New Mexico, where Cobb practiced general medicine in the remote pueblos. Their second son was born on the reservation, and the kids attended the local preschool. After three years, the family moved to Atlanta for Cobb’s two-year fellowship as an epidemic intelligence service officer with the Center for Disease Control’s Environmental Health segment. His new role as a U.S. Public Health Service epidemiologist took the family worldwide, investigating outbreaks and global health problems. He took his newfound experience back to work as director of research for the IHS and retired as chief of the Chronic Disease Branch in 2011. 

Since retiring, Cobb has moved his skills and passion into philanthropy, working on projects in Nepal installing clean water systems and funding schools. He stayed connected with his Harvard classmates. When Farmer died suddenly in 2022, Cobb and his colleagues picked up where Farmer’s work with the University of Global Health Equity left off. In April 2023, Cobb packed his 40 years of medical experience and his mountain bike for a month-long trip to Rwanda to help train locals in rural medical practices. He’s also devoted to FLC’s revamped rural healthcare focus. 

“At Fort Lewis, it’s possible to get a top-notch education, but you have to want it and go after it,” he said. “I was a late bloomer, but I really wanted it.”