Gordon Noel grew up in Montana and studied English literature at Harvard. When he started medical school at Columbia University's College of Physicians and Surgeons in New York City in the 1960's, he found himself less well prepared than many of his classmates who had studied science in greater depth and knew the ropes of how to succeed in medical school. With humor and sometimes painful honesty, Noel tells the stories of his successes and failures in highly competitive and inspiring training programs, as an Army doctor during the American war in Vietnam, and during his busy first years as a teacher and physician in an East Coast academic medical center. He writes about his gradual realization that he was missing out on his family's lives as his children grew up and lays out his struggle to decide whether to walk away from a revered institution and colleagues and patients that he deeply cared about. The memoir reveals the difficulties of finding a balance between being a good doctor and and a good father and husband and friend.