On August 7, 2012 Camden Clark Medical Center announced the impending closure of the St. Joseph’s Hospital campus in Parkersburg, WV. Among the reasons provided for closure of the hospital were upcoming changes established by the Patient Protection and Affordable Care Act. Being a person who was born at St Joseph’s and raised in Parkersburg, I was moved by the news of the upcoming closure. Being a physician and a healthcare consultant whose life and career have been greatly impacted by the same legislation, I was moved even more. So moved in fact, that I decided to write a book. But when I got back home, it became all too apparent that this book was going to be about more than healthcare reform, closing a hospital, and what changes were coming for Parkersburg. Being back forced me to look at how I have changed since I left and how my career choices have helped shape that change. It also became clear that this country is composed of a lot of places like Parkersburg, places that are making similar transitions at the same time. What emerged is this book, which is part memoir and part history, combined with policy analysis and prediction. But mostly it is about change, and what type of change we can expect as a nation of patients, told through this personal prism.