At the age of 12, I began my life in service at St. Rita's Home, an institution for mentally and physically disabled children. I don't wonder for an instant about my need to help people or my awareness that children can be born with handicaps, because my twin sister was born with a physical handicap and an immune weakness that was a constant challenge to her. My mother was always reading one fiction book or another describing heroic tales of brave doctors and nurses.

My unconscious path was clear. By 16, I was volunteering at Buffalo General Hospital during the summer. (I was never to see a summer camp in all of my adolescence!) It was in these understaffed, overcrowded medical wards (16 beds per ward) full of the loveliest though poorest sector of the population that I saw a great deal of suffering and began to learn hands-on care from the bottom up. My high school studies were college entrance and heavily science-oriented. I applied for the nursing curriculum at the University of Buffalo and was accepted. I graduated with an R.N.B.S. in 1971 after a summer as a nurse's aid and after my junior year as a practical nurse.

After graduation, my first job was in a neonatal intensive care unit at Buffalo Children's Hospital. The job involved ambulance work because many of the “neonates” were born in the surrounding small towns with no facilities for “high risk infants.” It was fast-paced and exciting but also emotionally draining when the infants did not survive. Over the years, I also worked in pediatrics, emergency medicine, preventive medicine, a surgical private practice and Planned Parenthood. The last three positions also involved a great deal of counseling and psychological intervention. I was required to do hundreds of interviews under a time duress. I learned to ask the most pertinent questions, and