I didn't want to do the runny noses and hot ears. What I really liked was neonatology -- the little preemies and the intensity of their care. I loved intensive care, really sick people.

You don't get on a tiger's back unless you can ride that tiger. With faxes, digital images and e-mail, it doesn't take long to find someone with the specialty a patient needs.

To take care of high-risk patients, you have to have a bit of an ego. Your ego gets you into the specialty -- and then the specialty humbles you.