The novel starts with some Canadiana and then goes from birth through some retail, medical school and the internship of a young man and some related adventures hes had: fights, erotica, events in medical practice and then what happened on the day Ms. Libby Zion died (March 5, 1984) that was when many teachers and professors of medicine and surgery said that American medicine, as they knew it, changed forever.... And a couple of wars.... All of the medical/surgical activities: CPR, malpractice, triage and acuity, the way ER should be run and much more are all updated to 2018. Through aphorisms, experts in various fields give running commentaries and while much of a medico's (medical student/intern/young doctor) experience is described, the book comes neither with an MD nor a fellowship in surgery