I wish to thank Kevin Tremper for his kind words regarding my recent Editorial and his impeccable cinematic taste, as well as for verifying that I alone am not the only baby boomer anesthesiologist suffering from “manual blood pressure posttraumatic stress disorder” or chronic otitis externa. Although the controversy related to noninvasive blood pressure accuracy has moved on from the now nearly extinct manual blood pressure measurement in the operating room, it does continue to rage with regard to invasive arterial monitoring that does systematically alter clinical management, as has been well described in the Journal.

I greatly appreciate Kevin’s request for more support for decision support systems, and in my somewhat wide-ranging and admittedly hyperbolic riffing on the future, I do apologize for giving short shrift to this important topic. Process outcomes are extremely important to patients and institutions. Given that they are often hard to...

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