In March 2009, I started to review my colorectal cases. Comparison of my results with those published in the April issue of Archives could not be timelier.1 I am a 66-year-old general surgeon, practicing in the same rural location (in 2 hospitals) for the past 18 years. The nearest tertiary care center is 70 miles away. Some patients choose to go there, believing the care there is superior. A small community is a proverbial fish bowl in which the surgeon and his or her mistakes are immediately visible to all.