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In the quarter century that Victoria Sweet has been a doctor, "health care" has replaced medicine, "providers" (vastly outnumbered by administrators) look at their laptops more than at their patients, and the ruthless pursuit of efficiency has vanquished not only trust and intimacy but also, often, the effectiveness of treatment. Victoria Sweet knows that there is an alternative way, because she has lived and practiced it. In her new book, she reflects with compassion, wit, and profound insight.

San Francisco's Laguna Honda Hospital is the last almshouse in the country, a descendant of the Hôtel-Dieu (God's hotel) that cared for the sick in the Middle Ages. Ballet dancers and rock musicians, professors and thieves - "anyone who had fallen, or, often, leapt, onto hard times" and needed extended medical care - ended up here. So did Victoria Sweet, who came for two months and stayed for 20 years. Laguna Honda, lower-tech but human-paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished.