As I have spoken with and observed those who work in the health care field, I have been struck by the many similarities between the early days of CRM formation and developments happening today in the patient safety movement. Not long ago, there were captains in our cockpits who acted like gods with a little “g” and cowboys with a capital “C.” You questioned the captain’s authority at your own peril, even if you were a fellow pilot. When I was a young first officer, I carried around a little notebook so I could keep track of the quirks and preferences of particular captains I fl ew with, just as some nurses today record and share such information about the surgeons they assist in the operating room.