Amidst the horrendous carnage of World War I, three Cleveland surgeons who had practiced together in peacetime and volunteered for battlefield hospital duty in France observed firsthand the value of collaborative medical care - of specialists from different fields thinking and acting together “as a unit” for their patients’ benefit, as Dr. George Crile put it.

The idea of group practice was novel in American medicine at the time. Solo physicians were the norm. But as Crile and his colleagues, Drs. Frank Lower and William Lower, compared experiences via letters and late-night chats around the cook stove, they grasped the potential of applying to civilian care what they’d learned about military organization, efficiency, and cooperation across medical and surgical specialties.

Back home in Cleveland, the three surgeons and internist Dr. John Phillips, also a military medical corps veteran, founded Cleveland Clinic in 1921. The group practice began with 42 patients, 24 physicians, and 60 support personnel. The one-two punch of a disastrous fire fueled by toxic X-ray films and the onset of the Great Depression almost spelled Cleveland Clinic’s end in its first decade. But the founders’ vision and the drive and determination of the leaders who followed them helped Cleveland Clinic grow to become one of the world’s best and most respected healthcare organizations.

Published to commemorate Cleveland Clinic’s centennial, To Act as a Unit tells the epic story of the hospital system’s conception and rise to prominence. You’ll meet pioneering researchers and clinicians whose innovations are the basis for today’s advanced medical care - from Dr. F. Mason Sones, whose fortuitous accident with a cigarette proved that coronary angiography was possible, to the surgical team that performs groundbreaking, life-changing face transplants. There are candid accounts of the organization’s successes and struggles as it transformed from a local enterprise to a regional, national, and still-expanding international operation. Profiles of the people who have helped shape Cleveland Clinic provide insights, including the story of current CEO and President Dr. Tom Mihaljevic, whose commitment to caring for patients and communities stems from his upbringing during economic and political tumult in Croatia. An up-to-the-minute chapter recounts the harrowing and inspiring story of Cleveland Clinic’s response to the COVID-19 pandemic.

To Act as a Unit draws on first-person accounts, historical texts, and original reporting. The book is essential for history and medicine enthusiasts, and anyone who wants to understand the evolution and operation of an elite healthcare organization.