This is the autobiography of a surgeon who began life in the Bronx, New York. His colorful memoirs describe his childhood and education, and critically analyze scientific contributions in vascular disease, shock and treatment of impotence. He describes what it was like do general practice in the Bronx along with experiences in New York City; in Seville, Spain as a young Air Force Officer; residency and practice in Cleveland, Ohio; Reno, Nevada; and Washington DC. Dr. De Palma reflects upon life in rapidly changing times as well as responsibilities and uncertainties that exist in academic medicine and research.