Excitement was not the emotion I experienced when first contemplating this new book. The title is catchy, but the subtitle—"Reflections on Medical Education"—gave me pause and a sense of ambivalence. Was this yet another work from a senior academician, now entering the "philosopause," lamenting the decline in the morality and practices of modern medicine in general, and education in particular, wrought by the evil empire of entrepreneurial medicine and managed care?
But my hopes were buoyed by the author's name, well recognized by internists as a writer and editor of the Annals of Internal Medicine. In fact, the 41 essays were largely culled from a series appearing in the American College of Physician's monthly newsletter, ACP Observer, from 1992 to 1995. Many have been revised and expanded, partly after feedback from readers. The essays are brief and erudite and cover diverse elements from the wide landscape of medical