Dr. Arnold S. Relman [is] 88; Dr. Marcia Angell, 72. But their voices are as strong as ever. Colleagues for decades, late-life romantic partners, the pair has occasionally, wistfully, been called American medicine's royal couple. In fact, controversy and some considerably less complimentary labels have dogged them as well. From 1977 to 2000, one or both of them filled top editorial slots at The New England Journal of Medicine as it grew into perhaps the most influential medical publication in the world, with a voice echoing to Wall Street, Washington and beyond. Many of the urgent questions in the accelerating turmoil surrounding health care today were first articulated during their tenure. Or, as Dr. Relman summarized one recent afternoon ..., Dr. Angell nodding in agreement by his side: I told you so." Their joint crusade ... is against for-profit medicine, especially its ancillary profit centers of commercial insurance and drug manufacture - in Dr. Relman's words, "the people who are making a zillion bucks out of the commercial exploitation of medicine." Some have dismissed the pair as medical Don Quixotes, comically deluded figures tilting at benign features of the landscape. Others consider them first responders in what has become a battle for the soul of American medicine.