The author shares the unique perspectives of a patient and his wife as they navigate through a hospitalization. The patient and his wife provide a diary of their experiences from checking in at the hospital, to waiting in recovery for a floor bed, to being cared for on the floor, and, finally, to the discharge process. A nurse manager and CEO of the same institution offer their insight into the inefficiencies and concerns for safety identified by the patient. The documented exchange provides readers with a patient’s perspective on the shortcomings of the hospital experience and how much of it is due to failed systems and not failed providers. This article is part of a special collection entitled “Quality Grand Rounds,” a series of articles published in the Annals of Internal Medicine that explores a range of quality issues and medical errors.