He was a general internist in a town with one red light. Getting here had been frustrating. First, he'd spent the last 2 weeks working extra hard, trying to keep his chronically ill patients doing as well as they could, out of the hospital. The last week had been a blur of activity, attempting to get his census of inpatients down. Then there had been the inevitable last-minute crises: chest pain, fever, a dead leg. It was never a tidy process.

His wife was upset because of the extra-long days and because he'd been so preoccupied recently. Now he'd be out of town for 5 days. She didn't get to go to meetings, and she didn't buy his line that the meetings were really work. He was going to miss one son's basketball game and the other's Boy Scout Jamboree. His partner was not too happy either: more calls, more patients, and less sleep.

Then there was the cost: plane tickets, hotel, meals, and all the other incidentals. Every year it was more than a thousand dollars. Although it was tax deductible, it was still a major outlay, more than 1% of his annual income.

Nevertheless, he was happy to be here. This was his major continuing medical education effort for the year. He loved to hear about new things or to have the old things he did justified by experts. He tried to keep up with his journals, but it was a losing battle. He just didn't have protected time.

He saw old friends from training and caught up on other people from his past. The flying and staying in a hotel always seemed exciting to him, and being alone, away from his telephone, was very relaxing. He always felt rejuvenated when he returned to his practice.

She was early. The audiovisual guy was up on the stage testing the microphone and the pointer. There was already someone in the audience, hands behind his head, staring at the ceiling. She hated to be this early, but she couldn't help herself. Despite having given some version of this talk half a dozen times, she still got anxious beforehand.

She was an academic, chief of her division, a scientist of some renown. She had a lot to manage: grants, faculty, residents, and students. Getting here had been hectic. There was an important committee meeting that needed to be rescheduled. She had a grant to review and a couple of papers to edit. Then her research fellow had a problem with the cell cultures. And of course, there were always some last-minute slides for her secretary to prepare.

She wasn't on service this month, so there weren't any loose ends to tie up on the wards. Thank God she'd be able to fly out tonight and get back home. Her husband didn't mind the overnight trips. He used to come with her, but she traveled too much now. Thank God she didn't have to pay for these trips either. She didn't enjoy flying much anymore or hotels, but at least the college paid for all of this. Her income wasn't that great.

She was grateful that she didn't have to depend on these big meetings to keep up, that she could walk down the hall to hear a lecture every day at the university. She didn't have the time anymore for a meeting like this.

Although this talk was a distraction, it would at least be over in an hour and a half. These kinds of talks were good for her reputation and for the reputation of her department and institution. This talk, in particular, had been well received in the past. Reading the evaluations made her feel worth-while.

She enjoyed seeing some old friends, residents, and students. Now, however, there were faces she couldn't remember, times when she feigned recognition. And there were others whom she'd just as soon not see.

As the speaker walked toward the podium, she passed the general internist. They both nodded, and each felt a twinge of envy.