The book is a diary of a physician/father over 25 years of family life and his practice of medicine. The author kept a journal and although this journal reflects his mood and attitude at the time, it is a description about experiences, occurrences and important decisions. These transitions and tides are chronicled whether it be family life, building a practice, or operating a health system. The result is a journal that describes seemingly minor events that directed the author and his family in certain directions and as a result, this story. "e;Tides and Transitions"e; describes those people, events, and the stories that helped develop, mature, and challenge the family and medical practice. It is bits and pieces of the life of a young then middle aged physician and father.