Interesting article in the March 25, 2009 Boston Globe concerning a physician at Beth Isreal Deaconess Hospital in Boston. The physician had a history of drug and alcohol abuse, came into the OR in the morning noticeably tired and “wobbly”, fell asleep during a second surgery and abruptly left prior to finishing another — which took seven hours rather than the estimated 90 minutes. The surgeon had since been fired and suspended by the board of medicine. The hospital faced a damaging report by the Department of Public Health. The scenario shows how difficult it can be in organizations to immediately address impaired and disruptive practitioners.