Published in 1970
by Alfred A. Knopf, Inc.
Published in 1989
by Ballantine Books

Note From Michael
Medicine had become not a changed profession but a perpetually changing one. There is no longer a sense that one can make a few adjustments and then return to a steady state, for the system will never be stable again. There is nothing permanent except for change itself.

From this standpoint, the experiences of five patients in a university teaching hospital are most interesting. It should be stated at once that there is nothing typical about either the patients described here or the hospital in which they were treated. Rather, they are presented because their experiences are indicative of some of the ways medicine is now changing.

These five patients were selected from a larger group of twenty-three, all admitted during the first seven months of 1969. In talking to these patients and their families, I identified myself as a fourth-year medical student writing a book about the hospital. As they are presented here, each patient's name and other identifying characteristics have been changed.

I chose these five from the larger group because I thought their experiences were in some way particularly interesting or relevant. Accordingly, this is a highly selective and personal book, based on the idiosyncratic observation of one medical student wandering around a large institution, sticking his nose into this room or that, talking to some people and watching others and trying to decide what, if anything, it all means.

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