At a recent luncheon meeting hosted by the Oklahoma Foundation for Medical Quality, a speaker preceding me at the podium began his performance by reminding audience members of the quality improvement jingle, “all of us together are smarter than any one of us alone.” This may be a major rallying slogan for quality improvers now busy at just about every hospital. Awaiting my turn in the proceedings, I found myself remembering Charles Mackay's famous warning1 that “… men think in herds and it will be seen that they go mad in herds, while they only recover their senses slowly, and one by one.” Whether agreeing to join local quality improvement sorties or choosing to say “thanks, but I'm already on too many committees,” each of us must individually recover our senses about the atmosphere in which evidence is being marshaled and massaged by earnest quality improvers choosing their “action opportunities.” There is no shortage of raw material, and surgical care continues to be a popular target.