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nearly catatonic with concentration. During my clinical courses in internal medicine, surgery, pediatrics, obstetrics and gynecology, I assumed a similarly focused posture. Determined to retain everything, I scribbled copious notes during lectures and after bedside rounds. Each night, I copied those notes onto index cards that I arranged on my desk according to subject. On weekends, I would try to memorize them. My goal was to store an encyclopedia in my mind, so that when I met a patient, I could open the mental book and find the correct diagnosis and treatment.
    The new interns gathered in a conference room in the Bulfinch Building of the hospital. The Bulfinch is an elegant gray granite structure with eight Ionic columns and floor-to-ceiling windows, dating from 1823. In this building is the famed Ether Dome, the amphitheater where the anesthetic ether was first demonstrated in 1846. In 1976, the Bulfinch Building still housed open wards with nearly two dozen patients in a single cavernous room, each bed separated by a flimsy curtain.
    We were greeted by the chairman of medicine, Alexander Leaf. His remarks were brief—he told us that as interns we had the privilege to both learn and serve. Though he spoke in a near whisper, what we heard was loud and clear: the internship program at the MGH was highly selective, and great things were expected of us during our careers in medicine. Then the chief resident handed out each intern's schedule.
    There were three clinical services, Bulfinch, Baker, and Phillips, and over the ensuing twelve months we would rotate through all of them. Each clinical service was located in a separate building, and together the three buildings mirrored the class structure of America. The open wards in Bulfinch served people who had no private physician, mainly indigent Italians from the North End and Irish from Charlestown and Chelsea. Interns and residents took a fierce pride in caring for those on the Bulfinch wards, who were "their own" patients. The Baker Building housed the "semi-private" patients, two or three to a room, working- and middle-class people with insurance. The "private" service was in the Phillips House, a handsome edifice rising some eleven stories with views of the Charles River; each room was either a single or a suite, and the suites were rumored to have accommodated valets and maids in times past. The very wealthy were admitted to the Phillips House by a select group of personal physicians, many of whom had offices at the foot of Beacon Hill and were themselves Boston Brahmins.
    I began on the Baker service. Our team was composed of two interns and one resident. After the meeting with Dr. Leaf, the three of us immediately went to the floor and settled in with a stack of patient charts. The resident divided our charges into three groups, assigning the sickest to himself.
    Each of us was on call every third night, and my turn began that first evening. We would be on call alone, responsible for all of the patients on the floor as well as any new admissions. At seven the following morning, we would meet and review what had happened overnight. "Remember, be an ironman and hold the fort," the resident said to me, the clichés offered only half jokingly. Interns were to ask for backup only in the most dire circumstances. "You can page me if you really need me," the resident added, "but I'll be home sleeping, since I was on call last night."
    I touched my left jacket pocket and felt a pack of my index cards from medical school. The cards, I told myself, would provide the ballast to keep me afloat alone. I spent the better part of the day reading my patients' charts and then introducing myself to them. The knot in my stomach gradually loosened. But it tightened again when my fellow intern and supervising resident signed out their patients, alerting me to problems I might encounter on call.
    A crepuscular quiet settled over the Baker. There were still a few patients I had not met. I went