In this hypothetical panel discussion, our protagonists have just started work at the Utopia Trauma Centre – a state of the art facility that is world renowned for its excellence in trauma care, research and teaching … Our panel includes a social worker in intensive care, a senior intensivist and director of training for ICU, an emergency physician and director of ‘physician leadership development’, a trauma surgeon, an ICU and flight nurse, a consultant high performance coach for the institution, and the director of research and global health programs As we work though a series of clinical cases and events at the hospital we consider performance – highs and lows, including the dark side of high performance/ ambition. We teeter over boundaries and ethics in pursuit of high performance. We consider the impact of diversity in our staff profile. When it all goes wrong we discuss resilience, and dealing with human fallibility - mental health, substance abuse, physical illness, and aging. What does it all mean for our own practice and our critical care communities. Food for thought.