Patient safety is modeled after aviation safety. The checklist, the hours regulations, the briefing and debriefings. Last month a new award-winning analogy and demonstration of excellence was created by the Airbus A320 Hudson River landing by Captain Chesley Sullenberger. No better demonstration of what a team can and should achieve when, in spite of all precaution, disaster strikes. In a clinical surgical context there may be many correlates. Each of these celebrates the experience of the operator and the team. Pointedly, when all else fails, then preparation , experience, conviction and courage constitute the last final items to check on the safety list to ensure that, to the very best of our abilities, no patient will be left behind.