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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. "Tides and Transitions" 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.