The healthcare system doesn't work for a lot of people. When it doesn't work, for some people, that may be the difference between life and death. This book is the story of the first four years of All Brains Belong VT—a working, replicable model of neuroinclusive care built on the radical premise that access comes first, and people closest to the problem should shape the solutions. This is a model where healthcare is more than medical care—it's addressing loneliness, work, school, and the rest of what gives life meaning. Physician and founder Dr. Mel Houser shows how isolated people came into community with one another, found their way to better health, and built something anyone can replicate today.

Dr. Melissa Marotta Houser (she/they) is a board-certified family physician and the Founder and Executive Director of All Brains Belong VT, a nonprofit organization with a mission to support the health and belonging of people with all types of brains. All Brains Belong has pioneered a model that integrates medical care with social connection, employment support, and community education.

Dr. Houser received her Doctorate of Medicine from the University of Vermont College of Medicine and completed her residency at Middlesex Hospital Family Medicine Residency Program, where she served as chief resident. But her greatest teacher of all is her Sweet Little Love, Zachary.

At age 37, Mel was diagnosed as Autistic, ADHD, dyspraxic, dyslexic, and dyscalculic, which began her journey of reimagining her life and the community she needed to exist, for herself, her family, and her patients. In addition to caring for neurodivergent patients with complex chronic illness, she provides neurodiversity training to organizations around the country about creating neuroinclusive healthcare and workplace environments where everyone can get their needs met and thrive.

She lives in Vermont with her family.

"A Failure of Imagination provides the justification and the road map for changing the game of how healthcare is provided to neurodivergent people, and ultimately, for all people. As a neurodivergent physician grounded in social justice values and lived experience, Dr. Mel Houser has directly experienced the harm that can be caused by systems that are insensitive to the needs of patients, and that separates healthcare from broader quality of life issues. This book gives actionable direction for the changes that must be made. A Failure of Imagination should be read by all—neurodivergent people, families, healthcare professionals and policy makers, and anyone who has ever felt there must be another way." — Barry M. Prizant, Ph.D., CCC-SLP, Author, Uniquely Human: A Different Way of Seeing Autism

"A Failure of Imagination is a brave, clear-eyed, and deeply humane book that names what so many feel but few dare to say: Our healthcare system was never built for everyone. Dr. Houser writes with the rare authority of someone who has lived the harm and built the alternative, turning hard-won insight into a model of care rooted in belonging, access, and dignity. Rigorous yet warm, unflinching yet hopeful, it refuses to accept 'how things are' as how things must be. This is essential reading for anyone who believes a more imaginative, inclusive way of caring for one another is possible—and worth building." — Lawrence Fung, M.D., Ph.D., Ed.D. (Hon.), DFAACAP, DFAPA, Director, Stanford Center for Neurodiversity and Human Potential

"The evidence that healthcare fails autistic and neurodivergent people has been clear for years. What's been harder to imagine is what we'd build instead. A Failure of Imagination answers that question—not in theory but in practice, with the voices of the community at its center. Melissa Houser writes as both clinician and autistic person, with the hard-won clarity of someone who has experienced the failure of the system and refused to wait for it to catch up." — Dr. Mary Doherty, Clinical Associate Professor, University of Dublin
Founder, Autistic Doctors International

"How instructive these words are for all of us who desire to do right by our patients, communities, and even this health care system. I found it highly motivating and centering on how to solve real problems that impact the health of people, friends and colleagues. This is what distributed agency looks like at scale. For anyone working in healthcare, education, organizational design, or community building, All Brains Belong isn't just an inspiring story. It's a working model." — Jay Fetter, MSHA, Family Medicine Residency Redesign and Practice Transformation Leader

"This book fills a gaping hole that most people aren't even aware exists. It masterfully identifies the problems present in modern day medical practices that confront many autistic people and identifies ways to move forward. This book, filled with the lived experience and stories of patients, clinicians, community members, provides us with the very thing it is suggesting we can create—community
care: a space where people are truly heard, experience is validated, there is a commitment to sharing knowledge and resources, and the collective consciousness drives meaningful change." — Amy Laurent, Ph.D., OTR/L and Jacquelyn Fede, Psy.D., Co-Founders, Autism Level UP!

"A Failure of Imagination reveals one of healthcare's most invisible truths: Communication is not just something clinicians do, it's something institutions design. When communication is structured around hierarchy, it becomes the mechanism through which harm is perpetuated. When it is redesigned around trust, flexibility, and human variation, it becomes the foundation of healing. This book doesn't just reimagine healthcare. It challenges every institution built around the fiction of a 'normal' human." — AC Goldberg, Ph.D., CCC-SLP