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a group of nurses standing around a water cooler or in a utilities room, and the patients' lights are on all the way up and down the corridor. They're not busy, they're simply indifferent. Or a group of interns are chatting at one of the nursing stations and a nurse comes to one of them and reports that the patient is 571 has pain in his skull and wants to see a doctor. "Give him two APE tablets. My wife's waiting for me downstairs." It's common enough and it's not really atrocious. But it's dangerous. The nurse laughs, perhaps and says. "Are you going out to eat tonight?" as she drops the tablets in the medication cup and formulates the white lie for the patient. The tradition sags a little more and the espirit de corps of the hospital personnel has moved a little further toward camaraderie and away from a common commitment. And behind that tiny incident is that question of the value of human life. And as we drift away from private practice toward organizational practice, this becomes even more important. It is a curious thing that the public is easily impressed by collective medicine: the hospital, the clinic, the medical center."

   "I suppose they are.  At any rate, as I look back on the three

months of hell that I went through, I think I was attended by a little herd of leopards."

  "In my opinion, herds are dangerous even if they are called

teams and even if they are not composed of leopards. Espirit de corps is not a good replacement for individual responsibility. It's too easily swayed and furthermore, it is irrelevant. It is a kind of miniature mass movement and, as such, susceptible to manipulation by any able leader, good or bad. The advantages of an organized medical group have always been available through the well-known clinics and anyone who preferred is by hand led by such a group because he believed that it detected the limitations or weaknesses of the private physicians or surgeon while extending both his virtues and his resources - such a patient could always go to Johns Hopkins or Mayo's or Billings. The clinics have always fulfilled a unified