This autobiography compares my medical training, both in England and the United States, and portrays the complications of trying to combine two different traditions regarding the practice of surgery on the two sides of the Atlantic. Tremendous changes have occurred with regard to medical knowledge since the end of the Second World War which has had a profound effect on the attitude of the doctors and the circumstances of their practices. How this played out in my life accounts for some interesting tensions. Yet I adhered to my original ideals throughout and still believe the practice of medicine to be a ?calling?. Regrettably many factors beyond the doctor?s control have made the business aspects of medical practice of vital importance to too many of them.