The worst of partialities is to withold oneself, the worst of ignorance is not to act, the worst lie is to steal away. - CHARLES PEGUY (1873-1914) A few months ago, I was faced with an exceptionally difficult situation. It was fairly routine to start with. A 68 year old man was brought into A&E with a leaking abdominal aneurysm. He was in hypovolemic shock and I was the surgical doctor on call. It was obvious that he needed urgent surgery and I spoke to the vascular surgeon on call and agreed to transfer the patient to the oeprating theatre while he got to the hospital. The patient was on the operating table, fully anaesthetised, 30 mins after I first saw him in A&E. And, he was deteriorating fast. The consultant anesthetist asked me if I had clamped the aorta before. I said that I had never done it before though I had assisted numerous aneurysm surgeries and knew how to do it. I said I probably could do it if the situation was desperate. At this stage, I asked the theatre s