A number of recent conversations encouraged me to pause and contemplate not only my own career but also changes in medicine overall. The first conversation was with Ora Smith. I arrived late to a dinner at Howard and Ora’s home in New York and was fortunate to sit at a quiet table with her. Ora is a chronological 80 years old but far younger in body and spirit. She has been integral to Howard Smith’s long and distinguished career in otolaryngology. She said about medicine that it provided an opportunity to “live a life of the mind and also provide public service—what could be better?”