In medicine, almost nothing is absolute. Absolutes are strictly enforced, unless the person who decided that it was an absolute changes his mind. In the narrow world of OR throughput, this is an important factor why surgeons (and anesthesiologists) should be readily available to change an absolute to a ‘not really needed’. Too often I’ve seen patients held up for lab values that could be quickly OK’d by the anesthesiologist. Right equipment, wrong equipment…. right table, wrong table… right antibiotic, wrong antibiotic… right sedative, wrong sedative… The physician can consider it reasonable to modify his order….the nurse can consider it as potentially losing her job to modify the physician’s order….the schedule can consider it a loss of time trying to find the physician to clarify and modify the routine or order.