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[Original] The concept of micro social structure is viewed as a level of predication requiring explicit reference to specific knowledge processes and memory systems initiated and sustained by conscious and unconscious contacts with self and others, including verbal and nonverbal observation of daily life settings. Communal life is enabled by micro-level, affective, cognitive, analogical, and relational reasoning; different types of communicative events; and taken-for-granted normative and tacit knowledge. “Macro social structure” refers to large or enlarged complex forms of organization activities: sociocultural, political-economic, sociohistorical, aggregated micro, behavioral, communicative actions essential for eliciting demographic, sample-survey, and archival historical data that ignores tacit, micro-level phenomena – that is, real-time, real-life, conscious episodic and unconscious procedural memory, colloquial language use, gestural events, documented elicitation procedures, and mundane forms of communal daily life. This chapter examines observed and recorded, moment-to-moment, negotiated elements of behavioral outpatient clinical medicine as it emerges in situated, ethnographic settings. One goal of this chapter is to clarify the micro of the concept of cognitive overload, a cognitive/behavioral obstacle inherent in all communicative, socially organized ecological settings. Participant observation data leverages the temporal and situational comparisons of the method required for the study and explanation of micro social structure. Thus micro social structure is essential for understanding the normative, socially organized, institutionalized macro, complex activities called medical clinics, and hospital settings embedded in abstract meso-structures, such as macro-economic systems.