Neil Skolnik was an idealistic young doctor when he took his first job at a family medicine clinic next to a Philadelphia housing project. On the Ledge is his compelling account of two challenging, harrowing, and gratifying years spent providing medical care to inner-city patients.A baby's failure to grow can only be traced to an exhausted mother and an apartment with no stove or running water. A man sells his prescription antidepressants for street drugs. An elderly patient is diagnosed with syphilis and then disappears before he can be treated. A young woman dies of tuberculosis in spite of a barrage of modern medical intervention. In a series of linked essays in the tradition of Perri Klass and Abraham Verghese, Skolnik candidly describes the frustration of caring for patients who seem unable or unwilling to care for themselves and the satisfaction of seeing patients take charge of their health and their lives.Finally, as the clinic is forced to close its doors because of inadequate funding, Skolnik wonders what will become of his patients, whose link to the health care system, tenuous at best, will be effectively severed.As politicians at every level call for cuts in health care spending and health insurance is harder and harder to obtain, On the Ledge is a compassionate cry to consider the ramifications for the nation's poorest. Read Less