On January 15, 2009, a remarkable feat of flying occurred when Flight 1549, a US Airways jet piloted by Captain Chesley Sullenberger, lost all engine power following a bird strike, shortly after departing from LaGuardia Airport. The pilots made multiple, rapid, complex, life-saving decisions and guided their aircraft to a safe water landing in the Hudson River 3 min later. Several provocative, but important, questions should be asked. Could an intoxicated pilot have handled such a complex incident? (Surely not!) What about a sleep-deprived pilot? (Highly doubtful.) The article by Olson et al,1 “Sleep Deprivation, Physician Performance, and Patient Safety,” in this issue of CHEST (see page 1389) could not come at a more pivotal time.