Prologue
Ithethis
n memoir, I look back at a life in medicine, one th
been characterized by enormous changes in my personal life
life of the institutions, the cities, and the world in my lif
Manyof these changes came from outside, but some I hope I can c
personal accomplishments.
TheMedicalSchoolandHospitalatDukeUniversity,undermy
changedfrombeingasmallandrelativelyunknownregionalschool
coming one of the top institutions in the country.We became org
as a corporation, with all our different elements and personnel w
togetherasoneorganization.Itwasnotanautocracy,becauseIfirm
lievedthatitwasimportanttomakedecisionswiththesupportoft
porateleadership.Ontheotherhand,itwasalsoimportanttoknow
somedecisionsneededtobemadeatthetop,asinthebuildingofth
hospital.Thereisanarttoknowingwhattobringtoavote,whento
it to a vote, and how to manage it.
TheotherthingImighthaveaccomplishedistohelpfosterasense
porateresponsibilityatthetoplevelbyrecruitinganumberofoutst
departmentchairmenasleadersandestablishingaMedicalSchoolad
committee.Isucceededingettingthehospitalandclinicoperations
anM.D.,sothatthatperson,alongwiththeclinicalchairmen,coul
ontheday-to-dayproblemsofthehospital.Afterdefiningtherelati
of the Private Diagnostic Clinics to the hospital, the Medical Scho
university,Ileftthepdcslargelyalonefortheclinicalchairmentom
Ibuiltasuperlativestaffofpeopletodothenonmedicalbusiness
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