In the massive reconstruction of Chicago after the “Great Fire” of 1871, thousands of buildings were erected in a typical architectural style.1 They were four to five stories in height, had masonry foundations and supporting walls, and relied on internal staircases. Technological advances, though, would soon change architecture profoundly. Elisha Graves Otis invented the safety brake in 1853, which would distinguish modern elevators from mechanical hoists. In 1857, the first steam-driven elevator had been installed in the Haughwont Building in New York. By the 1870s, electric safety elevators and methods for building fireproof, reinforced iron-and-steel skeletons had been developed, enabling the design of larger, taller, and safer buildings. The new elevators and structural design features were used in 1885 in the construction of the 10-story Home Insurance Building in Chicago, the first “skyscraper.” By the 1890s, there were > 3,000 elevators in Chicago and 10- to 20-story skyscrapers had become the “modern” architectural form for cities. In 1902, the Flatiron Building in New York was completed and, at 23 stories, was considered a marvel. The Empire State Building, completed in 1931 and reaching > 100 stories and 1,250 feet, was the ultimate standard in “high-rise” construction. This dramatic revolution in architectural form, based on technological advances in engineering, has clear parallels to what I expect to occur soon in our approach to staging non-small cell lung cancer (NSCLC).