For a year afterward, Pronovost and his colleagues monitored what happened. The results were so dramatic that they weren't sure whether to believe them: the ten-day line-infection rate went from 11 percent to zero. So they followed patients for fifteen more months. Only two line infections occurred during the entire period. The calculated that, in this one hospital, the checklist had prevented forty-three infections and eight deaths, and saved two million dollars in costs.

The executives weren't used to venturing into patient territory, and didn't feel they belonged there. In some places, they encountered hostility, but their involvement proved crucial. In the first month, the executives discovered that chlorhexidine soap, shown to reduce line infections, was available in less than a third of the ICUs.

One mechanic had bought a tame female leopard. The lad kept her for a mascot on the end of a leash and collar, tied to a truck bed out in front of our hostel, with a mattress for her to sleep on. The mechanic said that this leopard was tame, but I had my doubts. Especially so after witnessing the big cat awaken from a pretended sleep and the pounce upon a mongrel that was about to steal a meal from some of her leftover food. And again, when I had been informed that this large pussycat wouldn't harm humans, I didn't know what to think. In any event, I followed the instructions of the cat's master and played with her like the others.

This leopard would permit rolling back her huge pads, where one could see long claws tucked underneath the pads. When the cat playfully cuffed one, it felt the same as soft boxing gloves, and she never extended a single claw.