In addition to expert instruction regarding thoracic physiology and clinical decision-making, the authors’ instructive case study also depicts an arguably more important concept that deserves to be explicitly stated: This situation of difficult and disadvantageous intrathoracic ventilation, further confounded by an external resistive load (abdominal pressure), may have well led to an adverse or fatal outcome if left unrecognized for a further period of time. Instead, the situation was expertly managed by a well-functioning care system. For the arguably fortunate patient, the system was an expertly supervised on-site trainee model. Here, a sharp house officer recognized that something was awry despite stable hemodynamics and oxygenation. The house officer pursued the aberrancy as something potentially dangerous but beyond his or her scope of knowledge and experience. Importantly, the trainee accurately and reliably reported relevant information to the attending physician, who then immediately helped to guide the trainee toward a proper course of action.