Our journey into the Canadian health care system may be a top-down approach, starting with macro policies and regulations. However, for most of us, we relate our personal experiences of our interactions with the health care system to our impressions of the overall system. Starting from this personal perspective, we begin our journey with James, a retired 65-year old man with symptoms suggestive of chronic obstructive pulmonary disease (COPD). James needs to consult with his family doctor to get a diagnosis and treatment for his health problems. James has limited mobility and depends on his daughter, Hedy, to help him get to medical appointments. Starting from this personal situation, I will proceed to describe a shift from a problem-solving focus to a paradigm shift of constructivism where the definition of the problem is less clear and where complexity precludes a linear search for solutions and where there is no optimal solution. I will use a systems oriented design approach to explore the complexity of the issues involved in this seemingly straightforward matter. I will be using a Gigamap to visually display the complexity. “Gigamapping is super extensive mapping across multiple layers and scales with the goal of investigating relations between seemingly separate categories, hence providing boundary critiques on the conception and framing of systems (Sevaldson, 2012).” Canadian federalism pose unique challenge and opportunities in health care delivery that are more apparent what visually displayed.