THE CORNERSTONE for the Montreal General Hospital (Montreal, Quebec) (Figure 1) was laid on June 5, 1821, with much pomp and pageantry,1 particularly in the bustling Montreal harbor. It was the dream of many citizens to see this small hospital open on Dorchester Street a short distance from the St Lawrence River and not far from the Port of Montreal. A major force in the development of the hospital was the Female Benevolent Society, which in 1815 began to raise concerns about the destitute situation of the poor. This problem was compounded by the continual arrival of immigrants, predominantly from Ireland. The members of the Female Benevolent Society felt that the existing hospital facilities were inadequate, and they submitted a petition to the government of Lower Canada for the erection of a new hospital. The community concern was so great that it led to a classic duel on April 11, 1819, at Windmill Point. The conflict was primarily between William Caldwell, MD, a physician and a graduate of the University of Edinburgh (Edinburgh, Scotland) who was anxious to see a new hospital arise, and Michael O'Sullivan, a local lawyer who favored the enlargement of existing facilities and felt that another hospital would involve an extravagant waste of public funds. Both participants in the duel were wounded; shortly thereafter, the government turned down the request for funding, and funds were raised by public subscription for the first Montreal General Hospital.