Can you imagine what it's like to lie awake at night, anxiously wondering if you've killed someone? Every new doctor or surgeon can have moments like that. There is a vulnerable time of transition from bright medical student to the practical, hands-on delivery of medical care. That's when mistakes can occur. It's the dark little secret that university teaching hospitals don't want you to know; everyone, in some fashion, is learning.      July is a bad time to be treated at a teaching hospital. Everyone moves up one notch: green medical student to resident one, resident one to resident two, and so forth. For the emerging, smart young doctors, all that "book learning" crashes against the infinite variability of the human condition. There are so many ways to do things right, and so many wrong. Two patients with the same diagnosis might require entirely different treatments. At the beginning of the learning curve it's natural to always stay with the familiar. But this is to risk slipping into the quicksand of mental inertia, to not advance with change, and eventually cause harm.      All those books read and exams passed can't prepare new doctors for the moral and ethical issues of life. Is an abortion a right or murder? Alone in an emergency room at two a.m., do you resuscitate a ninety-two-year-old with a respiratory arrest and a broken neck, and possibly bring back a vegetable? Is collecting research data on a patient unethical? How about if the patient doesn't know it? Who draws the line in "turf wars" over different surgical services when those doctors compete for patients in a teaching institution? Death on the Learning Curve is a novel that takes us down this path: naiveté, well-intentioned ignorance, harm, and medical triumph. The learning curve never stops.