Based upon memories and stories from a life of over seventy years, this memoir weaves a narrative of good fortune, family, community, and compassion. With insight, humility, and humor, the author describes a journey beginning with the optimistic early years of the American middle class in the 1950s, through the traumas, tragedies, and triumphs of the 1960s, and the gift of fortuitous breaks leading to excellent education, medical training, and mentoring. The story spans the evolution of historic developments in the science of cancer medicine and probes the management challenges facing the delivery of cancer care in the late-twentieth and early twenty-first century. The author shares memories of courtship, family, and career decisions, and he offers candid reflections and learnings from painful loss, challenging ethical dilemmas, mistakes, and difficult life choices along the way. Most importantly, this memoir probes the tensions in the "fourth quarter" of life between the satisfaction of a life well-lived and the anxiety around imperfect decisions, missed opportunities, and regret.