This collection of essays and speeches, most never before available in print, bundled with newly commissioned contributed essays, captures the essence of Dr. Donald Berwick's hopeful message of innovation as the cure for the ills of our health care system. The book's title essay takes its name from a story in the book "Young Men and Fire," by Norman MacLean. In the 1949 thirteen young smokejumpers lost their lives trying to subdue a fire in Montanta's Helena National Forest. The firefighers were trapped by a fire moving 600 feet/minute through dried bunchgrass, a fire that blocked their escape route to a nearby river and whose smoke clouded their vision. With the flames just 200 yards away, the group's manager, Wag Dodge, invented a solution: he lit a patch of grass on fire, waited for it to burn out, and lay down in the middle of the scorched ground. He called to his team to join him, but they refused, choosing instead to try to outrace the fire. The fire skipped over Wag and he survived; most of the rest perished. In the essay "Escape Fire," Dr. Berwick recounts the tragedy, and applies lessons learned from the catastrophe to today's health care system: sometimes the only way out of a crisis, such as the crisis in medical error, is the extreme innovation symbolized by the "escape fire." The lesson of Mann Gulch is that we must not let ingrained processes obstruct life-saving innovation. Berwick's influence is spreading. National Public Radio in July, 2002 proclaimed that process improvement initiatives led by Berwick's group, the Institute for Healthcare Improvement, brought cost savings, better management of chronic conditions, and a drop in medical errors. The Wall Street Journal calls Donald Berwick "part evangelist, part organizer". Modern Healthcare ranked Don Berwick as number 3 in the 100 most powerful people in health care (for 2002). Each year, Don's memorable plenary presentation is the must-see event of the annual National Forum on Quality Improvement in Health Care, sponsored by the nonprofit Institute for Healthcare Improvement, which Don founded. In this collection, the speeches come together in a natural and compelling way, creating an inspiring exploration of how the health care system can truly team up and do better -- for their patients and for themselves.