The authors of this position statement article raise an important point regarding the issue of syndromes in critical care. While it is very likely that the “final common pathway” is an overly simplistic concept, the reality is that critical care is a discipline that treats syndromes that have deteriorated to an extreme level of dysfunctional pathophysiology. Critical illness is not a disease; we are not going to be able to get away from this for the foreseeable future. While we strive to hone our definitions of critical illness syndromes and, perhaps in some cases, establish concrete subcategorization schemes, we must realize that we may be stuck with syndrome management. The suggestion to segregate patients based on etiology, specific syndrome characteristics, comorbidities, genotype, and ecotype is a logical and testable strategy. Establishing more precise syndrome definitions is a rational first step; however, these attempts at precision should be subjected to prospective testing, lest we be left with newer, more specific, yet similarly unhelpful updates.