Not only our actions, but also our omissions, become our destiny.

There is that lovely feeling of one reader telling another, 'You must read this.' I've always wanted to write a book like that, with the sense that you are contributing to the discourse in middle America, a discourse that begins at a book club in a living room, but then spreads. That is meaningful to me.

I always wondered if the good people who send us bibles really think that hookworm and hunger are healed by scripture? Our patients are illiterate.

Your job is to preserve yourself, not to descend into their hole. It's a relief when you arrive at this place, the point of absurdity, because then you are free, you owe them nothing.

My VIP patients often regret so many things on their deathbeds. They regret the bitterness they'll leave in people's hearts. They realize the no money, no church service, no eulogy, no funeral procession no matter how elaborate, can remove the legacy of a mean spirit.

The flip side of suicide is that it leaves a lingering question in the minds of the people who survived. Its like a cancer thats metastasized. The suicide is the cancer and the metastasis is all these people saying, Why? Why? Why?

We come unbidden into this life, and if we are lucky we find a purpose beyond starvation, misery, and early death which, lest we forget, is the common lot. I grew up and I found my purpose and it was to become a physician. My intent wasn't to save the world as much as to heal myself. Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can. but it can also deepen the wound.