/* global React */
// Read-on-web version of The Medical Decision Roadmap.
// Editorial layout: drop-cap intro, sticky chapter rail, real prose.
// Copy source: uploads/Lead Magnet 1 - The Medical Decision Roadmap v2.md

const ROMAN = ["I","II","III","IV","V","VI","VII"];

const CHAPTERS = [
  {
    n: "I",
    title: "Has the true underlying condition been diagnosed, or is the treatment based on faulty assumptions?",
    body: [
      "A treatment plan is only as sound as the diagnosis it sits on. And in practice, diagnoses often arrive faster than they’re earned. A specialist focuses on the part of the picture they were asked to look at. A report sounds authoritative when the interpreter had doubts. A default pathway gets initiated with none of the nuance taken into account.",
      "The chart records the first conclusion and from that point forward, every subsequent decision builds on an inherited foundation no one re-tests. When the foundation is wrong, the rest is bound to collapse.",
    ],
    caseTitle: "Marilyn",
    caseLine: "Late sixties · gallbladder polyp · surgery scheduled",
    caseBody: [
      "Marilyn was scheduled for gallbladder surgery. The reason her surgeon gave: a polyp in her gallbladder had grown from 8 millimeters to 10 millimeters across three years of imaging, and growth is the radiographic feature that pushes a gallbladder polyp toward concern for malignancy and thus toward surgical removal.",
      "The argument was framed to her as universal best practice. The surgeon was experienced and gallbladder removal relatively low risk; late stage gallbladder cancer catastrophic. The patient was reasonable. Marilyn didn’t want surgery, but the case for it had been made.",
      "When Carte reviewed her ultrasound reports, something didn&rsquo;t fit. The most recent report — the one with the 10-millimeter measurement that had triggered the surgical recommendation — also contained the phrase <em>stable in appearance.</em> Stable, yet grown by 2 millimeters?",
      "We pulled the original images, not just the reports, and asked the radiologist who had done the most recent study to re-measure all three years side by side. Once imaging technique and plane of the mass had been taken into account, all three years showed a polyp at 10 millimeters. The earlier &ldquo;8 millimeter&rdquo; measurements had been taken in different planes, by different radiologists, on different machines. The polyp had not grown. It had simply been measured differently.",
      "A gallbladder mass that hasn&rsquo;t grown at all in 3 years is overwhelmingly not consistent with cancer. The recommendation for surgery dissolved.",
    ],
    lesson: "Before agreeing to any treatment plan, ask whether the diagnosis driving it is built on evidence or on a chain of plausible assumptions. The fastest way to find out: ask whoever is recommending treatment to walk you through, in detail, exactly what the data says — and what it doesn&rsquo;t. If the answer to <em>what does the imaging actually show</em> is <em>the report says X,</em> that&rsquo;s not the answer. The report is a summary of someone else&rsquo;s interpretation. The data is what the report is summarizing. Ask to see the data.",
  },
  {
    n: "II",
    title: "In a setting of multiple specialists providing input, is anyone explicitly responsible for seeing and reconciling the whole picture?",
    body: [
      "Specialists are extraordinary at the parts of medicine they specialize in. They are not, by training or by incentive, in the business of integrating their answer with the answers other specialists are giving the same patient at the same time.",
      "This is not a flaw of specialists. It is how specialty medicine works. A surgeon thinks in surgical solutions because surgical solutions are the tools she has to offer. An endocrinologist thinks endocrine. An oncologist thinks oncologic. The patient sits at the center of a wheel of specialists, each looking inward at her from their own angle. What is missing — almost always — is someone whose job is to step back from the wheel and ask whether the angles agree, where they contradict, and what is getting weighted wrongly because it falls into the gap between two specialties.",
    ],
    caseTitle: "Richard",
    caseLine: "Sixties &middot; lawyer &middot; limited to a walker after a fall",
    caseBody: [
      "Richard had obesity, leg edema, and back pain that had gotten worse, not better, since a fall. He had been referred to two surgical specialists. The spinal surgeon recommended spinal surgery. The bariatric surgeon recommended bariatric surgery. Each was acting reasonably within his domain.",
      "What neither had told him — and what neither was positioned to tell him — was the answer to the question that actually mattered to Richard: would surgery, either surgery, meaningfully restore his mobility?",
      "When Carte interviewed each surgeon directly, both said the same thing: probably not. That answer didn&rsquo;t appear in either of their consult notes because neither had been asked the integrating question. Each had answered the narrower question put to him.",
      "We built a non-surgical plan instead: optimized GLP-1 therapy for the obesity, a tailored physical therapy regimen for the back, diuretic management for the edema. Richard lost more than 70 pounds, regained the ability to walk with a cane, and is on track to walk unassisted again. Neither of the two operations he was about to consent to would have done that for him.",
    ],
    lesson: "When you are seeing multiple specialists, ask explicitly: <em>who, in this group, is responsible for integrating your specific answers into a single coherent recommendation for me?</em> If the answer is &ldquo;well, I assume someone is&rdquo; — or if everyone you ask points at someone else — no one is. That gap is where the most serious errors in modern medicine live. It is also the gap Carte was built to fill.",
  },
  {
    n: "III",
    title: "Have we rigorously re-examined the original data, such as images, pathology slides, and lab data, or are we relying on someone else’s reviews?",
    body: [
      "The medical record runs on summaries. A radiologist looks at an MRI and writes a report. The next physician looks at the report. The third physician looks at the second physician&rsquo;s note that mentions the report. By the third level, the underlying data is two abstractions away from the decision being made.",
      "Most of the time, this is fine. Reports are usually accurate. Specialists are usually consistent. Decisions made on summaries usually work. But when something doesn&rsquo;t fit — when the chart contains a contradiction, when a measurement is at the threshold of an action, when a pathology read is on the borderline between benign and concerning — the worst thing you can do is trust the summary instead of investigating.",
    ],
    caseTitle: "Marilyn, again",
    caseLine: "The case Question III resolved",
    caseBody: [
      "Three years of ultrasound reports. Three radiologists. Three numbers: 8 millimeters, 8 millimeters, 10 millimeters. A surgical recommendation built on the apparent jump from 8 to 10.",
      "The reports were the abstraction. The images were the data. When we asked the radiologist to set aside the reports and re-measure the actual images side by side using identical technique, the data said the polyp had not grown.",
      "The chart had been wrong for a year. Nobody had been at fault. Each radiologist had measured carefully on the day of the study, in the plane that gave the cleanest view that day, with the equipment they had. Every report was, on its own, a defensible piece of work. The error was that no one had ever set the three reports — and the three image sets — side by side to ask whether the trend they implied was actually a trend, or three independent measurements that happened to vary.",
      "Surgery for Marilyn would have been an entirely reasonable decision based on the chart. It would also have been an unnecessary procedure, with all the real risks of surgery, in a patient whose underlying anatomy had not changed.",
    ],
    lesson: "Whenever a major decision is being driven by a specific number — a tumor measurement, a lab value, a calcium score, a biopsy classification — ask whether someone has actually re-examined the original data, in the context of the prior data, in a single sitting, by a single observer. Reports written months apart by different observers do not constitute a longitudinal review. They constitute three reports. If the answer is &ldquo;no one has done that,&rdquo; the next question is: <em>what would it take to have someone do it before we proceed?</em>",
  },
  {
    n: "IV",
    title: "Has the list of options been developed by the right experts, or has it been constrained by the specialists who are easily accessible?",
    body: [
      "Two physicians in the same specialty, with identical board certifications, can develop radically different clinical practices. Their expertise is shaped by the cases that flow into their practice — and those cases, in turn, are shaped by the institution, the referral patterns, the research interests, and the niche where each physician has built her career.",
      "A patient with a rare presentation may go her entire treatment course without ever encountering the physician for whom her presentation is routine. The specialist she sees treats her using the framework that fits 80 percent of his patients. Her case sits in the other 20 percent. She gets the standard answer to a non-standard question.",
      "This is the strongest argument for a forensic-grade specialist search before a major decision is made.",
    ],
    caseTitle: "Robert",
    caseLine: "Sixties &middot; CEO &middot; thyroid cancer, prior nerve injury",
    caseBody: [
      "Robert had a partial thyroidectomy at a top academic medical center. During the operation, the surgeon inadvertently severed his recurrent laryngeal nerve — the nerve that controls one of the two flaps that govern his voice and his airway. The team aborted the second half of the operation, knowing that severing the contralateral nerve would mean a permanent tracheostomy.",
      "When Robert woke up, the team&rsquo;s recommendation was clear: once the first nerve heals, we will go back in and finish the surgery. Robert understood the math. He also understood that &ldquo;go back in&rdquo; meant another operation in which a nerve injury would not be inadvertent but might still happen — and that &ldquo;might still happen&rdquo; meant breathing through a tracheostomy tube for the rest of his life.",
      "The Carte search was for someone — anyone — whose practice centered on patients exactly like Robert: thyroid cancer, prior nerve injury, contralateral surgery contemplated. We found him at a leading Boston institution, an endocrinologist who had spent two decades publishing on non-surgical management of exactly this presentation.",
      "His view, when we connected him with Robert&rsquo;s surgical team: for this patient, attempting surgery on the contralateral side is not necessary. Radioactive iodine is the standard of care for this scenario. The Boston endocrinologist, the original surgical team, and Robert ended the conversation aligned. Robert was treated near home with radioactive iodine. He kept his voice. He returned to his life.",
    ],
    lesson: "When a major procedure is being recommended, the question to ask is not <em>is this surgeon good at this surgery.</em> It is: <em>are you the specialist whose practice centers on patients with my specific presentation?</em> If the answer is &ldquo;I treat plenty of patients like you,&rdquo; ask how many — annually, last year, now. Specialty access is not specialist match. The two are confused often, by patients and by referring physicians, and the confusion is expensive.",
  },
  {
    n: "V",
    title: "Is this recommendation based on your specific biology and risk profile, or on population-wide guidelines?",
    body: [
      "Guidelines are designed for the median patient. They are valuable tools — clinical medicine without them would be chaos. But they are not designed for patients who fall outside the statistical center of the curve they were built around.",
      "If you fall outside that center — because of a coexisting condition, an unusual prior outcome, a genetic predisposition, or a unique life circumstance — guidelines can be too aggressive, too conservative, too narrow, or too risky. The fact that a recommendation is &ldquo;the standard of care&rdquo; is not, by itself, an argument that it applies to you. It is an argument that it applies to the median patient with your headline diagnosis. Whether you are that patient is a separate question.",
    ],
    caseTitle: "Richard, returned to",
    caseLine: "The lawyer with the walker",
    caseBody: [
      "Both of his surgical recommendations were guideline-supported. The orthopedic recommendation was reasonable for someone with his MRI findings and his back pain. The bariatric recommendation was reasonable for someone with his BMI and metabolic profile.",
      "Neither guideline was written for someone with his specific combination: severe edema, deconditioned to a walker, in his sixties, looking at recovery from surgery on top of all of those conditions. The probability of meaningful functional recovery from either operation, given the rest of his picture, was a question the guidelines weren&rsquo;t designed to answer.",
      "When we put that question to the surgeons directly — <em>given his whole picture, do you expect this surgery to restore his mobility?</em> — both said no. Guidelines had said yes to two operations. The surgeons themselves, asked the right question, said no to both.",
    ],
    lesson: "When a recommendation is described as &ldquo;the standard of care,&rdquo; ask: <em>does the standard of care apply to someone with my specific combination of risk factors?</em> If the answer is &ldquo;the standard is the standard,&rdquo; the conversation has not yet gotten to where it needs to go. Standards apply to populations. Decisions are made for individuals. Both are needed; neither is sufficient on its own.",
  },
  {
    n: "VI",
    title: "Has the team carefully considered the long-term consequences of this decision, or just the next step?",
    body: [
      "Specialists are paid to solve the problem in front of them. The problem in front of them is, almost always, an immediate one: this surgery, this medication, this referral, this admission. The decision tree they are walking is shaped by the decision they are being asked to make today.",
      "But every major medical decision has a downstream that extends years or decades. A surgery has recovery, function, complications, and the trajectory of the rest of your body weighted against it. A medication has a chronic side-effect profile, a tolerance curve, an interaction landscape with whatever medications you&rsquo;ll be on five years from now. A procedure has a counterfactual: what your life looks like without it.",
      "The downstream is rarely the responsibility of the specialist making the immediate recommendation. Sometimes it is no one&rsquo;s responsibility at all.",
    ],
    caseTitle: "Robert, again",
    caseLine: "The cumulative-risk math",
    caseBody: [
      "The recommendation Robert was given was, in isolation, defensible: complete the thyroidectomy, accept the small risk that the second nerve would also be injured, treat the cancer surgically.",
      "The downstream of that recommendation, in the small fraction of cases in which the second nerve was injured, was a tracheostomy for the rest of his life. The cumulative-risk math — small probability, catastrophic consequence — was the kind of math that gets weighted very differently depending on whether you are weighting it as the surgeon completing the procedure or as the patient breathing through the tube.",
      "Robert&rsquo;s surgical team had not been asked to think about the downstream. Robert&rsquo;s job, with our help, was to insist that the conversation get there before he consented to the operation. Once it got there, the operation was no longer the obvious choice.",
      "The downstream is not the surgeon&rsquo;s job to weight. It is the patient&rsquo;s life. Someone has to make sure it gets weighted.",
    ],
    lesson: "For any major decision, ask: <em>what does the worst plausible downstream look like, and how are we weighting it against the upside?</em> If the answer is &ldquo;we don&rsquo;t usually think that way,&rdquo; you have your answer.",
  },
  {
    n: "VII",
    title: "Is anyone truly accountable for making sure the plan makes sense for you, and is executed appropriately?",
    body: [
      "This is the question all the others build to. In practice, the answer is almost always: no one. The system is not built to assign accountability for the integration of a patient&rsquo;s whole picture. Each physician is accountable for her own visit, her own note, her own piece of the chart. Integration is presumed to happen, but it is not assigned to anyone.",
      "When integration is not assigned, integration does not happen. And when integration does not happen, decisions get made — sometimes very serious decisions — without anyone responsible for whether the whole stack of them makes sense.",
    ],
    caseTitle: "Misha",
    caseLine: "Eighteen specialists, no one looking",
    caseBody: [
      "Misha, a young woman with a complex history including Crohn&rsquo;s disease and prior abdominal surgery, came to Carte after seeing eighteen specialists, multiple emergency room visits, an overnight admission, an opioid prescription, and a previous spinal surgery that had been intended to fix her pain and had instead made it worse. The most recent piece of medical advice she had received was that nothing more could be done for her until she was &ldquo;paralyzed enough&rdquo; to qualify for further intervention.",
      "What Misha didn&rsquo;t have, despite being inside a system that had produced hundreds of appointments, was a single physician whose job was to look at all the data and ask whether the picture they painted made sense.",
      "When we did look, Dr. Alwood, Carte&rsquo;s lead physician, concluded the picture didn&rsquo;t make sense. Two of Misha&rsquo;s doctors had told her she didn&rsquo;t have hypermobility (a connective-tissue condition that affects how joints and ligaments hold together). She was sent to a specialist in hypermobility, who concluded that she did. The hypermobility diagnosis prompted a re-imaging of her spine, which her surgical team had said was unnecessary. The re-imaging showed that her disc had re-herniated in the same area as before — a finding that is rare in average patients but common in patients with hypermobility.",
      "Two diagnoses everyone had said she didn&rsquo;t have were the major components of what was actually wrong. The errors Misha encountered were each, individually, defensible. None of those things had happened sooner because no physician inside her care, before Carte, had been responsible for noticing that they needed to happen.",
    ],
    lesson: "The most important question to ask — and the hardest to ask, because it sounds blunt — is: <em>who, in this group of physicians, is responsible for making sure the whole plan makes sense for me?</em> If the answer is silence, or &ldquo;I assume someone is,&rdquo; or &ldquo;your primary care physician, I think&rdquo; — that role is unfilled. In a serious medical situation, an unfilled role is a serious problem. It is the problem Carte is built to solve.",
  },
];

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            <span>Field Guide No. 01</span>
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          Field Guide &middot; No. 01
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        <h1 style={{ fontFamily: "var(--carte-font-display)", fontWeight: 400, fontSize: 64, lineHeight: 1.04, letterSpacing: "-0.012em", margin: "0 0 28px" }}>
          The Medical<br/>Decision Roadmap
        </h1>
        <p style={{ fontFamily: "var(--carte-font-display)", fontStyle: "italic", fontSize: 24, lineHeight: 1.45, color: "var(--carte-text)", margin: "0 0 44px", maxWidth: "32ch" }}>
          Seven questions to ask before agreeing to any major medical procedure, treatment, or specialist referral.
        </p>
        <div style={{ display: "flex", gap: 48, paddingTop: 22, borderTop: "1px solid var(--carte-rule)", fontSize: 12.5, letterSpacing: "0.04em", color: "var(--carte-text-muted)" }}>
          <span><span style={{ color: "var(--carte-text-muted)" }}>By&nbsp;</span><span style={{ color: "var(--carte-text)", fontWeight: 500 }}>{author}</span></span>
          <span>2026.05</span>
          <span>~24 min read</span>
        </div>
      </header>

      {/* ─── Intro w/ drop cap ──────────────────────────── */}
      <section style={{ maxWidth: 880, margin: "0 auto", padding: "64px 40px 24px" }}>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 21, lineHeight: 1.62, margin: "0 0 1.1em" }}>
          <span style={{ float: "left", fontFamily: "var(--carte-font-display)", fontSize: 92, lineHeight: 0.85, padding: "8px 14px 0 0", fontWeight: 400 }}>M</span>
          odern medicine is extraordinary. It is also fragmented, time-pressured, and deeply specialized. Those qualities, taken together, are how patients end up agreeing to procedures and treatments that aren&rsquo;t malpractice, but don&rsquo;t make sense for them.
        </p>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: "0 0 1.1em", color: "var(--carte-text)" }}>
          This class of errors we catch at Carte often aren&rsquo;t dramatic. A surgeon recommends an operation based on a report that nobody re-read against the original images. A specialist proposes a treatment plan that wouldn&rsquo;t survive five minutes of integration with a different specialist&rsquo;s plan. A guideline gets applied to a patient whose specific risk profile took her out of the guideline&rsquo;s denominator months ago.
        </p>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: "0 0 1.1em", color: "var(--carte-text)" }}>
          These errors aren&rsquo;t anyone&rsquo;s fault, exactly. They&rsquo;re what happens when no single physician has the time or the mandate to be responsible for the totality of decisions across a patient&rsquo;s whole picture.
        </p>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: "0 0 1.1em", color: "var(--carte-text)" }}>
          That&rsquo;s the role we built Carte to fill, and these are the seven questions we ask on every Forensic Review, before any recommendation is finalized. We&rsquo;re publishing them so you can ask them too.
        </p>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: "0 0 1.1em", color: "var(--carte-text)" }}>
          If you&rsquo;re facing a major procedure, a contradictory diagnosis, or a treatment plan that doesn&rsquo;t quite add up, work through the seven questions. Each is paired with a real Carte case where asking that question — and following it to its end — changed the outcome.
        </p>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: "0 0 1.1em", color: "var(--carte-text)" }}>
          If after reading you&rsquo;d like a Carte physician to walk through your specific situation, our intake form is at <span style={{ borderBottom: "1px solid var(--carte-accent-green)", paddingBottom: 1 }}>cartemedical.com/inquire</span>. You&rsquo;ll talk to a Carte physician, not a salesperson, with whether we can help and how.
        </p>
      </section>

      {/* ─── Contents ───────────────────────────────────── */}
      <section style={{ maxWidth: 880, margin: "0 auto", padding: "44px 40px 56px", borderTop: "1px solid var(--carte-rule)", borderBottom: "1px solid var(--carte-rule)" }}>
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        <ol style={{ listStyle: "none", margin: 0, padding: 0 }}>
          {CHAPTERS.map((c, i) => (
            <li key={c.n} style={{ display: "grid", gridTemplateColumns: "60px 1fr 80px", gap: 20, padding: "14px 0", borderTop: i === 0 ? "none" : "1px solid var(--carte-rule)", alignItems: "baseline" }}>
              <span style={{ fontFamily: "var(--carte-font-smallcaps)", fontVariantCaps: "all-small-caps", letterSpacing: "0.16em", fontSize: 13, color: "var(--carte-text-muted)" }}>{c.n}.</span>
              <a href={`#q-${c.n}`} style={{ fontFamily: "var(--carte-font-display)", fontSize: 18, lineHeight: 1.4, color: "var(--carte-text)", textDecoration: "none" }}>{c.title}</a>
              <span style={{ fontSize: 11.5, color: "var(--carte-text-muted)", letterSpacing: "0.04em", textAlign: "right" }}>p. {3 + i * 3}</span>
            </li>
          ))}
        </ol>
      </section>

      {/* ─── Chapters ───────────────────────────────────── */}
      {CHAPTERS.map((c) => (
        <article key={c.n} id={`q-${c.n}`} style={{ maxWidth: 880, margin: "0 auto", padding: "80px 40px 60px", borderBottom: "1px solid var(--carte-rule)" }}>
          <div style={{ display: "flex", alignItems: "baseline", gap: 28, marginBottom: 26 }}>
            <span style={{ fontFamily: "var(--carte-font-smallcaps)", fontVariantCaps: "all-small-caps", textTransform: "uppercase", letterSpacing: "0.18em", fontSize: 12, fontWeight: 500, color: "var(--carte-text-muted)" }}>Question</span>
            <span style={{ fontFamily: "var(--carte-font-smallcaps)", fontVariantCaps: "all-small-caps", letterSpacing: "0.16em", fontSize: 22, color: "var(--carte-text)" }}>{c.n}</span>
            <span style={{ flex: 1, height: 1, background: "var(--carte-rule)" }} />
          </div>
          <h2 style={{ fontFamily: "var(--carte-font-display)", fontWeight: 400, fontSize: 38, lineHeight: 1.18, letterSpacing: "-0.005em", margin: "0 0 36px", maxWidth: "26ch" }}>
            &ldquo;{c.title}&rdquo;
          </h2>
          {c.body.map((p, i) => (
            <p key={i} style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: "0 0 1.1em", color: "var(--carte-text)" }} dangerouslySetInnerHTML={{ __html: p }} />
          ))}

          {/* Case study card */}
          <div style={{ borderTop: "1px solid var(--carte-text)", borderBottom: "1px solid var(--carte-rule)", padding: "32px 0 8px", margin: "44px 0 32px" }}>
            <div style={{ display: "flex", alignItems: "baseline", justifyContent: "space-between", marginBottom: 18 }}>
              <span style={{ fontFamily: "var(--carte-font-smallcaps)", fontVariantCaps: "all-small-caps", textTransform: "uppercase", letterSpacing: "0.20em", fontSize: 12, color: "var(--carte-accent-green)", fontWeight: 600 }}>A real case &middot; {c.caseTitle}</span>
              <span style={{ fontFamily: "var(--carte-font-body)", fontSize: 11.5, color: "var(--carte-text-muted)", letterSpacing: "0.04em" }} dangerouslySetInnerHTML={{ __html: c.caseLine }} />
            </div>
            {c.caseBody.map((p, i) => (
              <p key={i} style={{ fontFamily: "var(--carte-font-display)", fontSize: 18, lineHeight: 1.65, margin: "0 0 1.05em", color: "var(--carte-text)" }} dangerouslySetInnerHTML={{ __html: p }} />
            ))}
          </div>

          <div>
            <div style={{ fontFamily: "var(--carte-font-smallcaps)", fontVariantCaps: "all-small-caps", textTransform: "uppercase", letterSpacing: "0.20em", fontSize: 12, fontWeight: 500, color: "var(--carte-text)", marginBottom: 14 }}>The lesson</div>
            <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: 0, color: "var(--carte-text)" }} dangerouslySetInnerHTML={{ __html: c.lesson }} />
          </div>
        </article>
      ))}

      {/* ─── Conclusion ─────────────────────────────────── */}
      <section style={{ maxWidth: 880, margin: "0 auto", padding: "84px 40px 64px" }}>
        <div style={{ fontFamily: "var(--carte-font-smallcaps)", fontVariantCaps: "all-small-caps", textTransform: "uppercase", letterSpacing: "0.20em", fontSize: 13, fontWeight: 500, marginBottom: 26 }}>In closing</div>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 22, lineHeight: 1.55, fontStyle: "italic", margin: "0 0 1.1em" }}>
          The seven questions are not seven different questions. They are seven angles on the same one: when a major medical decision is being made about you, is anyone responsible for whether it is the right decision?
        </p>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: "0 0 1.1em" }}>
          The system, on its own, will not answer that question for most patients. It is not malicious or careless; it is structured around specialty visits and discrete encounters, and integration is something it has never been built to deliver consistently. When integration happens, it is because someone decided to make it happen.
        </p>
        <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 19, lineHeight: 1.65, margin: "0 0 1.1em" }}>
          If you read this guide and recognize your situation in any of the questions — a procedure you&rsquo;ve been told to consent to, a chart you&rsquo;ve been told is fine, a referral that doesn&rsquo;t quite fit, a plan no one seems responsible for — Carte may be the right next step.
        </p>
      </section>

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      <section style={{ background: "var(--carte-navy-deep)", color: "var(--carte-cream)" }}>
        <div style={{ maxWidth: 880, margin: "0 auto", padding: "72px 40px" }}>
          <div style={{ fontFamily: "var(--carte-font-smallcaps)", fontVariantCaps: "all-small-caps", textTransform: "uppercase", letterSpacing: "0.20em", fontSize: 13, fontWeight: 500, opacity: 0.7, marginBottom: 22 }}>Working with Carte</div>
          <h3 style={{ fontFamily: "var(--carte-font-display)", fontWeight: 400, fontSize: 36, lineHeight: 1.2, letterSpacing: "-0.005em", margin: "0 0 24px", maxWidth: "26ch" }}>
            Two entry points, depending on where you are.
          </h3>
          <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 18, lineHeight: 1.6, margin: "0 0 8px", opacity: 0.9 }}>
            For a specific unresolved question, the entry point is a <b style={{ fontWeight: 500 }}>Forensic Review</b> ($10,000). For ongoing engagement, it is <b style={{ fontWeight: 500 }}>Stewardship</b> ($36,000&nbsp;/&nbsp;year) or, at the higher-intensity tier, <b style={{ fontWeight: 500 }}>MD Directorate</b>.
          </p>
          <p style={{ fontFamily: "var(--carte-font-display)", fontSize: 18, lineHeight: 1.6, margin: "0 0 36px", opacity: 0.9 }}>
            Your first call with one of our physicians is where we figure out which is the right fit &mdash; and you&rsquo;ll leave it with their read on your case and at least one specific next step, whether you continue with Carte or not.
          </p>
          <a href="/inquire/" className="btn btn-primary on-navy">Tell us what&rsquo;s going on</a>
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            This content is for educational and informational purposes only. It does not constitute medical advice.
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          <b style={{ fontStyle: "normal", fontWeight: 500, letterSpacing: "0.04em", color: "#6d4f1c", marginRight: 6, textTransform: "uppercase", fontSize: 11 }}>Not for emergencies.</b>
          If you are experiencing a medical emergency, call 911. Content on this website is educational and for informational purposes only. It does not constitute medical advice, and individual medical decisions should always be discussed with your treating physicians.
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