“I'll do whatever it takes to stay sharp.”

These were the words of a recent patient of mine (DC) scheduled for her fourth colonoscopy in two years. I met her in the preoperative area, where she pled with me not to give her “too much anesthesia.” With each previous colonoscopy she had lost “a part of my memory.... part of myself.” “Please don't let it happen again.... I'd rather die.”

As physicians, we have a clear purpose – to improve health. And our specialty has a rich heritage in reducing perioperative morbidity and mortality through our leadership in patient safety. Always seeking new frontiers to improve patient care, our aspirations now extend beyond the basic metric of lifespan, to what matters most to our patients: their entire surgical episode of care – and beyond – to the overall...

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