As the retired chief executive officer of a major U.S. multinational firm, Roy Vagelos has already received a lifetime allotment of public attention. Whether it was standing before financial community experts to explain the past, present, and (I hoped) future of Merck & Co., Inc.; or testifying before a congressional committee in defense of the National Institutes of Health budget; or announcing Merck's gift of a new drug with the potential to eradicate river blindness – I spent years in the media limelight, receiving more than my share of newsprint, magazine pages, and TV coverage. Now, however, almost a decade after that highly visible life ended, I have collaborated with Lou Galambos on a book that has allowed us to reflect on all three of my careers: in medicine, science, and business. Along the way, we have tried to provide a balanced perspective on two important professions and on an industry, pharmaceuticals, that has aroused a tidal wave of controversy in recent years.

When Lou suggested that we collaborate on this book, I initially resisted. I was then in my last year on the job at Merck and didn't have time to reexamine the past – especially what seemed at the time to be the distant past of my family, my education, and my first two professional careers. But I was finally convinced that we could do the job expeditiously if, following recorded discussions concerning the events of my career, Lou drafted chapters and I edited them.