Through extensive and situational examples in the complex hospital setting, Dr. Bryce Taylor illuminates the principles of leadership, focusing on the challenges, the solutions, and the daily life of the head of a division, department, or program. In hospitals, just as in other large organizations, effective leaders must appreciate the big picture, pay attention to detail, and, above all, care about the careers of their constituents in addition to patient health. Here, Taylor outlines successes as well as failures, emphasizing that leadership, while an imperfect science, is based on common sense, integrity, an orientation to the welfare of colleagues, and a passionate and consistent commitment to the mission of an organization.