New concepts that rock the foundations of current thought and established practice are infrequent in the realm of scientific discovery, and medicine is certainly no exception. But in our perennial collegial dialogue and in the ferment of medicine, there is constant questioning and reassessment of our knowledge. Novel insights emanate from this constant dialogue and help us recatalogue our medical knowledge and behavioral norms. What we perceive in medicine as new, in a normative sense, is a contemporaneous appreciation of evolving trends, as the occasional spark of true innovation is injected into the continuing stream of reassessment. Innovation is often more a process than an instant in history and is often unacknowledged until time has allowed suitable maturation of the concept.