In this extraordinary memoir of an extraordinary surgical life, Francis D. Moore describes himself as having been a young man of irrational ambition, unforgivable ego and insufferable determination. Some readers (but certainly not all) might consider the adjectives unduly harsh, but this is essentially the way Moore has been perceived during the past five decades by the legions of Franny-watchers who have benefited from his prodigious series of pioneering advances and marveled endlessly that one person could accomplish so much.

Franny Moore—as he is invariably called even by those who have never met him—has not only left an indelible mark on medical science by his own work in surgical metabolism and organ transplantation, but has been a medical Maecenas to a unique group of biomedical researchers and clinicians and to many talented contemporaries. He served as a mentor to them with such vision, encouragement, and practical support that several generations will pass before his direct influence ceases to be felt. Only William Halsted, Alfred Blalock, and Owen Wangen-steen have done as much to create a distinctly American school of surgery. A Miracle and a Privilege is the story of how it all came about.

Moore's admission of his youthful ambition, ego, and determination is only a statement of his comprehension of what was necessary, especially because he was only 35 years old when he assumed the Moseley professorship at Harvard University and the Peter Bent Brigham Hospital in 1948. A less forceful man could not have created the legacy that is Moore's enduring gift to his colleagues and their patients; a man less certain of his capabilities could not have inspired others to make the most of their own.

In some ways, this book is an archive rather than an autobiography. Unfortunately for literary quality but fortunately for posterity, its editor was either overly forgiving or cowed by the authority of the author. The result is that the narrative flow is constantly interrupted by tangential but intriguing anecdotes that a more meticulous overseer would certainly have trimmed. Paradoxically, though, a book packed with trivia, a superabundance of names, minor events, and seemingly irrelevant experiences becomes a colorful, albeit bumpy, travelogue of not only the high roads of a fascinating man's life but of the numerous sidestreets and cul-de-sacs he visited along the way.

It is impossible to read this book without feeling at least a touch of envy. Moore has not only benefited from inborn gifts but has had the advantages of certain crucial accidents of timing and the security of prosperous origins and a large, loving family. But even greater than these privileges is another: Franny Moore has been granted the wisdom to see himself clearly and to be perfectly aware of how lucky he has been. Although the story of his personal pilgrimage should be read by every physician and most laypersons, it will teach its greatest lessons to the community of academic physicians.

Sherwin B. Nuland, MD

Yale University

New haven, CT 06510