This exploration of Canada’s health network is also part leadership manual, blending the personal reflections of the author with stories of his hands-on expertise. Those stories are taken from Rosenberg’s decades in medical practice, study, and executive positions. The book opens with the author’s career at a crossroads when he was let go as CEO of Montreal’s Jewish General Hospital as part of a restructuring of Quebec’s hospital system. Rosenberg eventually was rehired in an expanded position in the revamped system, where he has overseen its transformation into a value-based (as opposed to numbers-based) operation. The author provides real-world insights from someone who’s worked in the field, making heavy topics approachable even to readers not familiar with Canada’s health care infrastructure (or even medicine in general). Along the way, readers learn Rosenberg’s leadership philosophy: Do the right thing, take responsibility for it, stay curious, and never lose sight of the human stakes behind every decision. The book has a lot of drama—the author takes readers inside operating rooms and ERs, aboard shaky helicopters, and even to a remote Arctic medical post, offering hard-won wisdom about choosing paths forward (his time in the Arctic taught him “key leadership lessons about resourcefulness, adaptability, responsibility, and the importance of decisive action in critical situations”). Rosenberg points out that leaders lose when they rely only on strict rules and numbers, missing what works when teams band together around common purpose. The author does an excellent job of distilling complex subjects; he clearly explains value-based care, which is basically putting patient results above numbers. The material is clearly aimed at an audience steeped in medical knowledge, but lay readers will find it easy to follow. The questions he raises—who takes responsibility, how decisions are made under pressure, and what organizations owe the people they serve—are universal. Rosenberg’s book is a surprisingly readable examination of leadership in health care that eschews easy answers in favor of moral clarity.