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firm, irrevocable, the direction set. At La Guardia, on landing, he had sent a wire to Orden Brown. It read simply, “I accept.”
    Now, looking down at the plans of what the administrator had called flippantly “the New Jerusalem,” O’Donnell thought back to the three and a half years which lay behind. Orden Brown had been right when he had said they would not be easy. All the obstacles which the board chairman had predicted had proven to be there. Gradually, though, the most formidable had been overcome.
    After O’Donnell’s arrival the former chief of surgery had slipped quietly out. O’Donnell had rallied some of the surgeons already on staff who were sympathetic to raising the hospital’s standards. Between them they had tightened surgical rules and had formed a strong operating-room committee to enforce them. A tissue committee, almost defunct, was reactivated—its job, to ensure that mistakes in surgery, particularly the unnecessary removal of healthy organs, were not repeated.
    The less competent surgeons were gently but firmly urged to limit themselves to work within their capabilities. A few of the botchers, the assembly-line appendix removers, the incompetents, were given the choice of resigning quietly or being ousted officially. Though to some it meant partial loss of their livelihood, most chose to leave quietly. Among the latter was one surgeon who had actually removed a kidney without ascertaining that the patient had already lost one in previous surgery. The dreadful mistake had been revealed at autopsy.
    Removal of that surgeon from the hospital’s roster had been easy. Some of the others, though, had proved more difficult. There had been rows before the County Medical Committee, and two surgeons, formerly on Three Counties’ staff, now had law suits pending against the hospital. This, O’Donnell knew, was going to mean some bitter controversy in court, and he dreaded the publicity which was certain to surround it.
    But despite these problems O’Donnell and those behind him had had their way and the gaps in staff were painstakingly filled with new, well-qualified men, some of them graduates from his own alma mater whom O’Donnell had cajoled and persuaded to set up practice in Burlington.
    Meanwhile the Division of Medicine had a new head—Dr. Chandler, who had been on staff under the old regime but had been frequently outspoken against it. Chandler was a specialist in internal medicine, and while he and O’Donnell sometimes disagreed on hospital policy, and O’Donnell found the other man at times pompous, at least Chandler was uncompromising when it came to upholding medical standards.
    In O’Donnell’s three and a half years administration methods had been changed as well. A few months after his own arrival O’Donnell had told Orden Brown about a young assistant administrator, one of the best he had known in his hospital experience. The chairman had flown off and, two days later, come back with a signed contract. A month after that the old administrator, relieved to get out from under a job which had grown beyond him, had been honorably pensioned and Harry Tomaselli installed in his place. Now the whole administrative side of the hospital reflected Tomaselli’s brisk but smooth efficiency.
    A year ago O’Donnell had been elected president of the hospital’s medical board, which made him the senior practitioner at Three Counties. Since then he, Tomaselli, and Dr. Chandler had successfully broadened the hospital’s intern and resident training program, and already applications for enrollment were growing in number.
    There was still a long way to go. O’Donnell knew that in some ways they were only at the beginning of a long program which would embrace the three basic tenets of medicine: service, training, research. He himself was forty-two now, would be forty-three in a few months. He doubted if, in the active years remaining to him, he would complete in full what he had set out to