In the late 1930s or early '40s, the Ladies' Sewing Society of Baltimore's Sinai Hospital Auxiliary gathered for an awards ceremony. The society's members mended sheets and made toys for pediatric patients. Dr. Alfred Sherman, of the Obstetrics and Gynecological Department of Detroit's Sinai Hospital, lectures to a group of interns. Dr. Samuel Frank was director of Baltimore's Hebrew Hospital between 1903 and 1906. president of Beth Israel of Boston and vet- eran of the early days. You could open up to one another. We weren't competitors. You could hang it all out on the table and others would critique you in a non-hostile way." Their talks ranged all over the lot, from the big picture, to philosophical is- sues, to little things." They talked about nursing problems, about hassles with the local medical societies, about the federa- tions, about financial issues, about how to deal with governing boards, and about whether to have separate legal counsel, about making kosher food available. Among the most persistent issues was the tumultuous demographic shift, as Jews fled in waves to the suburbs, leaving many of the old Jewish hospitals overrun by new, non-Jewish neighbors. Sinai of Detroit's huge facility, for example, was left squarely in the midst of a black com- munity, 20 minutes by expressway from the developing heart of the Jewish com- munity. What could they do about that? Could they retain their old patients? Should they move out? Stay where they were? Nor was there consensus; each hos- pital dealt with the problem in its own way. . By the late 1970s, according to Alan Weinstein, today president of the organ- ization that ultimately grew out of those early annual gatherings, they were no longer an informal knife and fork club. Now they were throwing some money in." They were meeting quarterly now, setting up little task forces, studying crucial is- sues. Should they try to organize data processing collectively? What about pro- viding employee benefits? Or group buy- ing of IVs and surgical supplies? In time, the focus of the group grew less Jewish. In 1982, they had become the Consortium of Jewish Hospitals. But now they acknowledged that while they shared a certain style and certain problems that originated in their Jewish roots, these had little to do with their being Jewish. They were big, non-profit, usually in large cities, and their mission went beyond the care of the sick to research and teaching. Perhaps, they began to think, they might take in some large, non-profit, big city teaching hospitals that were not Jewish. The first was Memorial Medical Cen- ter of Jacksonville, Florida, some of whose top people had formerly been with Mount Sinai of Milwaukee. There were Catholic and Baptist hospitals out there, too, that could benefit from joining, but just try ap- proaching them . . . "It's hard for us to go to our board and say, 'Let's join the consor- tium of, uh, Jewish Hospitals,' " they'd hear. So they debated giving up the con- sortium's Jewish identity. Some among them counseled caution. What if they