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transition was completed decades ago, it is still rumored that late at night, the ghost ofFreddy Krueger scrubs up and stalks our operating rooms.…’ ”
    “Andrew, what is with you today? Is it the chief residency? Are you just angry at not getting it?”
    “Hardly.” Truscott’s sardonic laugh was unconvincing. “I’m angry about having my all-too-meager paycheck signed by a man who raffles off elective plastic surgical procedures, sends his residents on well-publicized house calls, and has closed-circuit TV put in delivery rooms.”
    “He’s raised thousands of dollars with those raffles and contests—probably hundreds of thousands. And most families love the chance to be part of a birth. We’ve become the second busiest OB service in the city.”
    Before Truscott could respond, Glenn Paris stepped forward and tapped on the microphone. Immediately 120 staff physicians, residents, nurses, and trustees fell silent.
    Glenn McD. Paris, the president of Medical Center of Boston, exuded confidence and success. He was only five feet eight, but many described him as tall. His jaw was as square as any Boston Brahmin’s, and the intensity in his gaze was arresting. He had been described by one supporter as a mix of equal parts Vince Lombardi, Albert Schweitzer, and P.T. Barnum, with a dash of Donald Trump thrown in. Axel Devlin, on the other hand, had once called him the most distasteful and dangerous affliction to descend on Boston since the British.
    Six years before, a desperate board of trustees had lured Paris away from a major hospital in San Diego that he had turned around in a remarkably short time. The deal they struck with him included the promise of a free hand in fund-raising and all hospital affairs, generous financial incentives, bonuses tied to any hospital profit, and the rent-free use of a Back Bay penthouse, donated to the institution some years before by a grateful patient. Paris had responded with a vigorous campaign to givethe hospital a positive, easily definable image and to turn its red ink to black at all costs.
    In some ways, the man had succeeded. The hospital’s staggering debt had leveled off, if not lessened. At the same time, its increasing emphasis on whole-body medicine and personalized treatment had led to a growing reputation as a caring medical center.
    But there was still a lack of respect for the institution in many quarters, both public and academic, and the feeling among some trustees that before long, the hospital would simply have to move in other directions.
    “Good morning, troops,” Paris began. “I want to welcome you to the official beginning of MCB’s ninetieth year. The purpose of this annual kickoff is to introduce our new house staff and to help them feel at home.” He motioned for the new residents to stand and led a round of applause. “You should know,” he said to them, “that your group represents the best MCB has ever been matched up with in the national resident matching program.”
    Again applause. Several of the residents shifted uncomfortably, obviously wishing they could sit down. Paris, beaming as if he were showing off his children, kept them standing. The news of the high match—hospitals make their preferential list, prospective residents make theirs, and a computer does the rest—had been well publicized. But he was not one to miss the chance to milk such a success for all it was worth.
    Truscott leaned over toward Sarah. “Note how carefully fearless leader neglects to add that although the match is the highest in MCB history, it still ranks below any of the other Boston teaching hospitals.”
    “For true?”
    “Blankenship let that one slip out at lunch last week.”
    Dr. Eli Blankenship, the chief of staff, was also the head of the MCB resident training program. It was his impressive knowledge of alternative healing and his enlightened attitude toward Sarah’s desire to blend hertechniques that had convinced her to rank MCB number one