A year ago, Rep. John Joyce, R-Pa., was a full-time dermatologist alongside his wife in his hometown of Altoona. Becoming a politician was never his plan, but when a congressional seat opened up in 2018, Joyce threw his hat into the ring because, in his opinion, none of the other candidates adequately addressed healthcare.

For Joyce, 62, it was an abrupt transition from medicine to politics. He and his wife Alice had worked in their Pennsylvania hometown for years, raising their three kids and working side by side at their own dermatology practice. They’d been together since, after medical school, John followed Alice to Naval Hospital Portsmouth in Virginia, where she was an active-duty physician and he was a civilian. He jokes that his wife outranked him then and still does.