This essay with its breezy title was in fact originally conceived of as an after-dinner talk – an accessible chat intended for a banquet meeting of the Society of Alumni of Bellevue Hospital. I had casually agreed to speak on medicine in New York City a century ago; it seemed like an appropriate theme for a group of nostalgic black-tie-clad physicians. But as I actually began to collect material to document the talk, I realized how very little I knew about “medicine a century ago.” Or to phrase it somewhat differently, I began to realize how little the existing scholarly literature addressed the history of medicine in terms of care, how small a proportion of it had been devoted to the medical profession as practitioners in an everyday world of sickrooms and unpaid bills, of competition for status and hospital appointments as well as patients. My preliminary research revealed the inadequacy of thinking of the profession in monolithic terms; there were clearly many professions, not just one, and many kinds of physicians, not just the elite and the innovative. While attempting to expose a cross section of medicine during one arbitrarily chosen year, I discovered a variety of surprising interconnections between intellectual, ethical, institutional, and economic factors in an already complex world of urban medicine. The very arbitrariness of my task dictated an approach rather different from the accepted canon of problems, data, and subject matter in the history of medicine.