The definition of what it means to be dying has changed radically. We are able to extend people's lives considerably, including sometimes, good days.

If we took away the ability to put defibrillators in people in their last years, people would be shouting in the streets.

The battle of being mortal is the battle to maintain the integrity of one's life.

There are times when you have sharp elbows, and people are trying to muscle you out of certain meetings - because then people could leak to the press that you had a role in certain decisions. I, at twenty-six, was very impatient and didn't know how to keep my powder dry. I was running a team of seventy-five people when I had never been a boss. I was the worst boss ever.

We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.

Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.

In every industrialized nation, the movement to reform health care has begun with stories about cruelty.