You can't always wait for the guys at the top. Every manager at every level in the organization has an opportunity, big or small, to do something. Every manager's got some sphere of autonomy. Don't pass the buck up the line.
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In those countries with centuries of a craft tradition behind their building methods, techniques are tightly coordinated under the direction of the architect.
For that story, I took as my subject a young woman whom I got to know over the course of a couple of visits. I never saw her having any health problems - but I knew she wanted to be married.