Having recently become an NHS consultant, I was looking for this book without knowing it. As a trainee, I think I had been relatively protected from organizational stresses and strains, and found them somewhat bewildering (and stressful). The idea that ‘they’ were making a mess of things, with the comforting sequel that things could be improved easily, gave way to a growing sense of people doing their best in the midst of chaos. My sense of chaos may not be shared by more senior figures, more au fait with