What I got from the blog was that he was an ER doctor.  He didn't start 
specializing in tropical diseases until he actually was on the tour.
He got some whiff of it in Africa, but it was the trip up from 
Indonesia-Maylaysia-India that rubbed his nose in it.
It's been 5 years since I read the blog - somebody read the book and tell 
me if I'm wrong.

At the start, he was feeling burned out at work, was in a pub with his 
mates, and after a couple of pints decided to bike around the world.
He went back to the hospital, took a leave of absence, got a bike, made 
sure his mother was being cared for, and headed out into Europe.
So I think the answer was "Because he said he was going to, that evening at 
the pub."

NOW he's a doctor specializing in tropical diseases, after actually seeing 
how medicine worked in some of the places he biked through.  But I do not 
believe he was when he started.

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