In Reply.—Dr Buchman makes many cogent points, and on the whole, I have to agree with almost all of them. However, I do think that the patient is best served if the operating surgeon maintains primary responsibility for postoperative care, be that care in the intensive care unit or in the ward. It should be possible, as Dr Buchman points out, for all surgeons to become proficient in managing patients in the intensive care unit. The main question is, do we really want to take on responsibility for critically ill patients? I think we should.