Reading the surgical literature can at times be demoralizing, as even our most respected publications and periodicals seem increasingly consumed with the latest renditions of HMO- or government-initiated algorithms of cost-effective patient care, or with strategies to maximize the practice expense component of the resource-based relative value scale for individual CPT codes of the HCFA regulations. Such sessions seem to elevate to prescience the century-old prophecies of Karl Marx regarding the impending trivialization of our profession.