At a tender age, four or five years give a man a local attachment to place and teachers which is very natural, very nice, but not always the best thing for him. He goes out with a strong bias already in his mind, and is ready to cry, "I am of Guy's," "I am of Bart.'s," or "I am an Edinburgh man." To escape from these local trammels, which may badly handicap a man by giving him an arrogant sense of superiority often most manifest when there is least warrant, is very difficult.

- Osler [1900]

Many before have felt inadequate in trying to express the profound debt owed their teachers; I must now add my name to that list. Despite Sir William's words above, I am not hesitant to admit that this work is very much a product of the unique environment of the Johns Hopkins Hospital Department of Medicine. Foremost among its contemporary architects are Dr. Victor A. McKusick and Dr. Philip A. Tumulty, whose Olympian accomplishments and personal qualities continue to foster the Hopkins traditions of caring and clinical excellence. Only in the supportive, stimulating environment created by these two men could Zebra Cards have reached fruition. It is a lucky person indeed who has the opportunity to work with his personal heroes.

Other members of the faculty have been greatly influential, in particular Drs. John Michael, Stephen Achuff, Kenneth Baughman, and H. Franklin Herlong. Dr. Thomas Traill's current job description is inadequate; to reflect his true activities, another item must be added: routinely astonishing fellows, houseofficers, and students with the amount of information extracted from the physical examination. I will never be able to sufficiently thank Nick Belitsos for all he has done for me; I will pay for the door, however.

Unfortunately, I must content myself with naming only a few of the residents on the Osler medical service from 1980 to 1984 who taught me so much as a student and intern. Rick Munschauer, Bruce Gelman, and Jerry Granato showed me early on what a good Marine was supposed to be. Hugh Rienhoff's encouragement was greatly appreciated. Mike Schindler and Bill Balke were incredibly patient during that incredible August on incredible O3. Rick Lange, Kevin Fox, and Alison Freifeld always took an interest in the cards. The finest qualities of the physician, embodied in the Assistant Chiefs of Service, are typified by Peter Holt, Susan MacDonald, Steven Schulman, and Hacib Aoun, to each of whom I owe so much.

My debt to the other 37 members of the 1983-84 Osler intern group is incalculable and unforgettable.

The agile mind of John Leonard was the source of numerous ideas. Peter Belitsos, Rich Embrey, Dave Borislow, and John Brofman tolerated my occasional (?) ramblings with amazing good humor. Steve Holland, Gina Dallabetta, Mindy Shapiro, and Ray Wilson engaged in helpful discussions, and my brother George has become a valued contributor and critic as he progresses in his medical training. To the members of the Pithotomy Club and the RACC: You probably delayed the completion of this project by a year or two, but I would not have had it any other way. The zebra-seeking zeal of Marc Litt is appreciated. To the physicians, pararescue section, and others in the 129 ARRG, CA-ANG who so broadened my outlook on medicine (and the world), all I can say is: Move east.

I am grateful to Drs. Thomas Traill, Stuart Selonick, and Frederick Bustin for reading the manuscript and greatly improving Zebra Cards with their ideas. Responsiblity for errors, however, is mine alone. Thanks also to the staffs of the Welch Medical Library at Hopkins and the Lane Medical Library at Stanford for providing outstanding research resources, and especially to Professor Peter Travis of Dartmouth College, who, too long ago, taught me how to write a paragraph.

Finally, defeat. Several frustrating hours have proven that I am unable to write down what I feel toward the greatest of all teachers, my parents. I hope they will understand that my Muse is far too weak and this forum far too public for the task. Thank you, Mom, and Thank you, Dad ... for everything.