Never forget that he sets up his secret Dead End clinic -- not because he has a burning need to help the poor, not because he wants to Fight The System -- but because he's BORED AT HIS DAY JOB.
That's right. Ratchet is just so incredible and awesome as a doctor that being chief medical officer to the Primes isn't challenging enough. He needs a side hustle that's exciting because it's forbidden and maybe a little dangerous. It's actually Orion Pax who suggests starting the clinic.
I think a lot of people miscast Ratchet as a bit of a rebel because he famously almost flunks out of med school, and then he runs this clinic. He's also in Prowl's bad books as a loose cannon known for "breaking rank." But it's a mistake to think he does these things because he wants to piss off people in power or challenge an overly rigid system. He does them because he's arrogant. He is so confident in his skill and value that he believes he can do what he wants and the universe will give him a pass. (He's actually a lot like Prowl, in this respect. I wonder if the commonality ever occurs to them.)
His saving grace is a good heart and sound moral compass, which generally direct his overweening ego to do the right thing. But that is literally why he runs that clinic. He's making challenges for himself because he's confident in his own exceptionalism. He's the best asshole you can hope to meet.
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