Book excerpt: Like the 14th-century surgeon in Geoffrey Chaucer's Canterbury Tales, Dr. Augusto Sarmiento has a tale to tell. This book is both an interesting autobiographical story of a young immigrant doctor's rise to success in the United States and a critique of recent trends in American medicine by someone who is now a recognized authority in orthopaedic surgery. Educated in his native Colombia, Dr. Sarmiento immigrated to the United States not long after receiving his medical degree. His early years were difficult as he struggled to overcome the language barrier and often encountered prejudice regarding his medical training in Latin America. Feeling like an outsider for many years, he finally came to realize that his unorthodox perspective on medicine was an asset that could be used to make significant contributions to his specialty. He was among the pioneers who brought total hip replacement surgery to the United States, and his research improved the profession's understanding of the way fractures heal. In time he was elected president of the American Academy of Orthopaedic Surgeons.As someone who has practiced medicine for almost fifty years on many levels he is profoundly disturbed by recent developments in the American healthcare scene. He is especially critical of the increasing control of education and research by the pharmaceutical industry, the unconscionable overuse of surgery by many practitioners in his field, and the greed factor that has saturated the medical profession. This modern surgeon's tale is both an inspirational story of how one man made a difference and a revealing critique of the ills affecting American medicine today.Augusto Sarmiento, M.D. (Miami, FL), is currently professor and chairman emeritus at the University of Miami Medical School. A world-recognized authority in orthopaedic surgery, he has won many awards and has been invited to lecture more than 500 times in over 40 countries.