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The following is excerpted from a cassette tape recording. Numbers refer to those on the tape counter.

[000] My name is Dr. Nathan Lefkowitz. I’m recording this tape for my son David. Please make sure he receives it.

[006] David, in my bedroom, as you know, are roughly a hundred cassette tapes that I’ve recorded over the past seven years. I want you to make a book from those tapes.

[013] I’ve tried my damndest to portray the part of the illness that doesn’t come up in temperature readings, blood tests, or urine samples...the part that the surgeon can’t remove with his scapel.

[019] I’ve tried to document the difficulties of searching for the happiness that suffering conceals, to understand illness and dying as an opportunity for spiritual growth.

[023] It is my wish that you preserve the immediacy of a bedside interview, that you throw out all the useless jargon that social scientists use to befuddle themselves and everyone else.

[031] David, please stay honest. Don’t eulogize me. Don’t pull any punches. Let my rage and its ironic consequences stand. Don’t try to hide your father’s weakness or make him into a palatable character.

[037] Perhaps you should ask Robert to lend a hand. He’s sympathetic to my work. Besides, as we both know, your spelling is atrocious, and you add periods, semicolons, and commas to your poems without regard for where they land.

[042] One of my colleagues who listened to most of the tapes said to me, “Nat, you’re continuing your efforts to define the systematic problems in patient care that resulted from the explosive growth of medical technology, and the consequent separation of patient from care giver. You’ve focused your powers of observation on yourself.”

[051] What he said is true. But that kind of professional language in the book would create a chasm between me and my fellow patients. I don’t want that; I want to empower patients. I’ve dreamt of calling a completed work A Manual for Patient Survival, but do as you see fit. Besides, we should not alienate those who strive toward building institutions that are not at odds with the human soul, or those who take the time to hear the anguish, the fear, and the love of those who are dying in our houses of healing.