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Congressman and physician Raul Ruiz MPP 2001 made a pledge to serve

The sun was high and the suit was hot. Raul Ruiz mopped his brow with a handkerchief as he walked the sunbaked sidewalks of Coachella, California, his hometown. He had a briefcase in his hand with a stack of carefully typed contracts inside.

In the scorching summer of 1990, the teenager in the itchy blue suit went from business to business with a proposition: Donate toward his college education, and he would return to the community as a physician. He made the pledge in writing, and he stapled the donor’s card to each signed contract.

These were long odds for the son of farmworkers in a poor and dusty community down the highway from the groomed golf courses of Palm Springs. Yet Ruiz made good on that promise. Not only did he return to Coachella to practice emergency medicine, but he came back with three graduate degrees from Harvard, including a master’s in public policy from the Kennedy School.

Today the 41-year-old physician represents the 36th District of California in Congress after pulling off one of the campaign upsets of 2012. In a race that even close friends doubted he could win, he dislodged Mary Bono Mack from the seat she’d held since 1998.

Friends, colleagues, and mentors describe a disciplined achiever who has never allowed his sight to wander from his hometown, whether he was studying thousands of miles away in Cambridge; providing emergency care in Mexico, Haiti, and El Salvador; or helping create disaster plans in Serbia.

For those who know him, that hopeful trek with a briefcase full of contracts epitomizes his commitment to public service and to the com-munity where he grew up. His promises were binding, signed with ink and stained with sweat.

“Raul had that fire, that ganas—in Spanish that means desire; I could see that right off the bat,” says Fred O. Deharo, who hired Ruiz for a summer job at a farmworkers’ medical clinic when Ruiz was in college. “He was determined to help, he was determined to be a doctor, and he was determined to come back to the Coachella Valley.”

A PRAGMATIC OPTIMIST | On a sunny autumn morning in Washington, Ruiz chuckled over the improbability of his election. To gauge his chances of success, he had hired a demographer to analyze voting patterns in the district. After reviewing prior election results, the consultant closed his book and said, “I have to be honest with you. You have a five percent chance of winning.”

“I looked at him, and I said, ‘So you mean I can win?’” Ruiz recalled as he strolled along Pennsylvania Avenue. He cackled in delight at the memory.

Ruiz calls himself a “pragmatic optimist”— an apt description, given how often his preternaturally young face breaks out in a dimpled smile. But his brow furrowed and a note of urgency crept into his voice as he talked about what motivated him to run for office: the income disparities in his district; the high asthma rates; the arsenic in the groundwater. “These are issues that, as a physician, I know we need to address in order to improve the health of my patients and the communities in which they live,” he said.

If Coachella is known to anyone outside this Riverside County community, it is primarily through the indie music festival that draws hipsters to concerts in the nearby desert each year. But for Ruiz, the city exerts a different kind of pull. It is his center of gravity, tugging him back again and again.

Coachella pokes up from the desert partway down the eponymous valley stretching from Palm Springs to the Salton Sea. In this city of about 43,000 people, 96 percent of the residents are Hispanic, one in four is poor, and the per capita income is just over $12,000, according to the 2010 Census. The valley, on the western end of the redrawn 36th Congressional District, is full of contrasts. Just 11 miles to the west, the town of Indian Wells is 92 percent white and has a per capita income of over $89,000; about one in 20 of its residents is poor.

Ruiz was born in Zacatecas, Mexico, in 1972, and moved as a baby to Coachella, where his mother, Blanca, picked crops in the valley’s agricultural fields, and his father, Gilbert, fixed farm equipment. They lived in a trailer until Gilbert was promoted to a warehouse job and the family was able to move into a modest house.

Ruiz describes his mother as part social worker, part guardian angel, always helping others despite the family’s own poverty. His parents stressed education: He needed to study hard to get a job inside, with air-conditioning, his mother insisted. When she asked him what he wanted to be when he grew up, he responded with a question: What do you call someone who helps the community, as she did? “A doctor, son, a doctor,” he remembers her saying.

POST-ITS AND DRY-ERASE BOARDS | Ruiz proved to be a fierce achiever at Coachella Valley High School, earning high marks and completing AP courses while serving in student government, playing in the marching band, and competing on sports teams. He was the most self-directed, disciplined student that the guidance counselor Rafael Barboza had ever seen.

“Incredible—he was just so organized, so disciplined, and so dedicated” Barboza says. “I don’t know how he was able to manage all these different things.”

Ruiz decided on UCLA for college, but it was a financial stretch for the family. He took the contracts around to businesses during the summer before his freshman year. “I’d hand it to them, and I’d say, ‘I’m offering you an opportunity to invest in your community by investing in my education,’” he says. Some gave him $20, some gave $40. Others said, “Sorry, son, times are tough.”

At UCLA’s freshman orientation, Ruiz found a lifelong friend in John Marcum. The two became inseparable, rooming together for three of their college years and the year following graduation. Among the coterie of premed students who studied together, Ruiz was the first at his books each morning and the last to bed, Marcum says. Raised a Seventh-Day Adventist, Ruiz would take a sip or two of beer and leave the rest. He labored over formulas scrawled on dry-erase boards, and peppered his room with Post-It notes that he studied as he brushed his teeth or got ready for bed.

There was a fearless quality to Ruiz, and a stubbornness. When he flagged under the school pressure, he would go home to Coachella for the weekend and return rejuvenated. When he decided to attend Harvard Medical School, some people warned that it would be a mistake. He would be too far from his family and the place where he drew his strength. Ruiz went anyway.

“He needed to prove to himself that he could go to Harvard and be elbow-to-elbow with the greatest minds in medicine,” says Marcum, 41, who is now medical director of the pediatric intensive care unit at Ventura County Medical Center.

As an undergraduate, Ruiz had gained hands-on medical training during summer breaks at the farmworkers’ medical clinic. There he learned about the travails of farmworkers and the union battles with growers. His grassroots perspective on the world comes from his upbringing and his experience in migrant camps, where the poorest in his community felt disempowered and voiceless. “They feel like what they do doesn’t really matter, and that’s evident by the low percentage of people who actually vote and the cynicism that people have with government and institutions,” he says.

Ruiz took his passion for social justice to Cambridge, where he remained an activist and became involved with a Native American rights organization.

At Harvard Medical School, the dean of students, Nancy Oriol, saw a driven, charismatic leader in Ruiz, but also a young man whose dedication could be bolstered with analysis and data. “That was who he was when he came here—a grassroots political organizer—which is a very different kind of person than somebody who has learned to hone the skills of logical political argument,” Oriol says.

She encouraged him to consider one of Harvard’s joint degree programs. He pored over course catalogs from Harvard Kennedy School and the Harvard School of Public Health, deciding on a master’s in public policy. John Marcum was dubious. Pursuing a second degree while in medical school would distract Ruiz from his goal, Marcum told him. Ruiz proved him wrong. “I didn’t agree with him at the time, but now I look back and I think that was the right decision for him,” Marcum says.

Ruiz also found time to gain a global perspective, traveling to Chiapas, Mexico, with Partners in Health and spending a year as a fellow with the Harvard Humanitarian Initiative, working in the emergency room at Brigham and Women’s Hospital and also in El Salvador and Serbia. (After the 2010 earthquake in Haiti, the actor Sean Penn asked Ruiz to be the founding medical director of the Jenkins-Penn Haitian Relief Organization in Port-au-Prince.)

For Michael VanRooyen, director of the Harvard Humanitarian Initiative, Ruiz stood out as a rare blend of excellent doctor and excellent communicator. He was gentle and empathic with patients and could connect to everyone in the hospital emergency room. VanRooyen was delighted when Ruiz ran for congress and won. “I think it’s a wonderful thing to have somebody as a physician go back to their home community and take care of them directly,” he says, “but it’s no less wonderful to have somebody who fights the battles in Washington that can make changes that really affect those populations for many years to come.”

In 2007, Ruiz finally returned to the Coachella Valley, joining the emergency room staff at Eisenhower Medical Center, in Rancho Mirage. Plaudits piled up for Ruiz as he helped open a health-care clinic for farmworkers, founded a health-care policy initiative, and launched a mentorship program for Coachella students aspiring to be doctors.

Yet as he worked in his community, he found a tangled skein of problems. Seniors went hungry to afford medication. Unemployed people came to the ER when their medications ran out. The symptoms, he could see, were beyond medicine, and he began to consider applying his public policy expertise to address those deeper problems. “My father always told me never to complain unless I was going to be part of the solution,” he says.

Ruiz consulted with friends and advisors about running against Bono Mack. Some encouraged him, fully expecting him to lose. Local politicians scoffed, telling Ruiz to aim for school board or state assembly instead. He ignored that advice and ran. It was a bruising election at times, and words from the past haunted both candidates. Bono Mack attacked Ruiz for his past political views. Ruiz skewered Bono Mack for her amusement over a radio host’s description of Coachella as a “third world toilet.” Ruiz won by 52.9 percent to 47.1 percent.

Joseph McCarthy, former Kennedy School senior associate dean and director of degree programs says that Ruiz could easily have gone off to a successful private medical practice; instead, he immersed himself in bettering his community. “I think that’s the reason he is here” in Washington, says McCarthy, who has become an ardent admirer and political supporter of Ruiz. “I don’t think there’s any ulterior motive for being here, other than to want to serve and to serve the people of his district.”

A DOCTOR IN THE HOUSE | In Washington, the frantic rhythm of Congress sometimes resembles the pace of an emergency room. On his weekend trips back to California, Ruiz might get to see his girlfriend, an ER nurse. She gave him his only piece of jewelry: an unusual leather ring with a silver ingot, which he wears on his index finger. “She’s a trouper, she’s very supportive,” he says.

Although, as a congressman, Ruiz isn’t practicing medicine on a daily basis, his expertise is sometimes unexpectedly in demand. On his flight back to California in October, a diabetic passenger collapsed. Ruiz, along with a firefighter and a flight attendant, took care of the passenger until the plane made an emergency landing in North Carolina.

It was a timely reminder of his medical training, and of how emergency medicine is similar to the legislative process: Diagnose the problem, find a solution, and act swiftly. During October’s funding standoff, Ruiz applied that ethos on the eve of the shutdown, to the consternation of some Democrats: He voted with Republicans on one measure to fund the government while delaying the Affordable Care Act’s individual mandate for a year.

To Ruiz, it was a logical move. Vote to open the government and delay the mandate that had already been deferred for businesses. In other words, treat the patient.

Weeks later, his frustration with the shutdown was palpable, but he said he remains the optimist he was when he began. Even with Congress deadlocked, he can help his constituents using the power of his office, such as by starting an initiative to aid veterans in his district.

“I want to fix the problems and improve the lives of the people I serve,” he says. “You see a problem and you fix it, and you can either cure, treat, discharge, keep them alive, and make sure that they get the further care they need. We need to get away from these partisan political games and do more problem solving.”

Theo Emery is a writer in the Washington, DC, area. He has reported for the New York Times, the Associated Press, Time, CQ, the Tennessean, and other publications.