A patient is discharged from a hospital. Weeks later, he goes public. He says the hospital charged him 25,000 dollars he never agreed to. The hospital fires back: You signed the form. And just like that, everything hinges on a question nobody can answer. Did he actually sign it, or didn't he? This is the strange weakness at the heart of modern healthcare. A system that runs on trust still settles its most serious disputes with a piece of paper and a squiggle of ink.