Hesh Green was among the Gurus in regional anesthesia. He did not teach new concepts. “That is online or in a book.” Hesh taught that each nerve block required review after review. He preached that if a block did not work or only part of the block worked, there was a critical miss in the process; the ultrasound was not set up correctly, the image on the ultrasound was misinterpreted, drug dosing was incorrect, and the process of tunneling was poorly done. Patients are often over blocked. A carpal tunnel release under a nerve block makes patients useless when they get home. Intralipid does not always work if it is expired or frozen. Sterile technique must be preserved. Despite Hesh’s mandates, he performed a block on a patient who exhibited all of the signs of local anesthetic activity. The patient ended up on cardiopulmonary bypass.