Carson begins his memoir with a letter to the reader from his mother, Sonya Carson, who recounts how the challenges she faced—being one of twenty-four children she was married at thirteen, and discovering that her husband and father of her two sons was a bigamist—strengthened her resolve to motivate her two sons, Curtis and Ben, to succeed. She quotes in full the poem “Yourself to Blame” by Mayme White Miller, a line of which she frequently quoted to her sons: “You’re the captain of your ship” (7). She wishes to convey the same message to the reader, to hold oneself accountable for one’s success or lack thereof.

Carson’s wife provides the Introduction, a retelling of the dramatic moments in the operating room as Carson’s highest profile case—separating two craniopagus Siamese twins joined at the back of the head—reaches a critical climax: both children’s brains were bleeding and all of the available type-specific blood had been used up. She tells how members of the seventy-member operating team offered to donate blood and how more blood was finally found at the city blood bank, allowing the surgeons to stop the bleeding, which required them to use “every skill, trick, and device known in their specialties,” and complete the surgery (10).