"In the summer of 1959, as in the summer of 1957, I worked as a clerk-typist in the headquarters of the U.S. Public Health Service in Washington. The people I worked for were very nice and I grew to like them. One day, a man had a heart attack at around 5 PM, on the sidewalk outside the Public Health Service. He was taken inside to the nurse's room, where he was asked if he was a government employee. If he were, he would have been eligible to be taken to a medical facility there. Unfortunately, he was not, so a phone call was made to a local hospital to send an ambulance. By the time this ambulance made its way through miles of Washington rush-hour traffic, the man was dead. He died waiting for a doctor, in a building full of doctors. Nothing so dramatized for me the nature of a bureaucracy and its emphasis on procedures, rather than results."
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