As I sit by the window of our suite in Bear Creek Lodge, I am immediately overcome with a feeling of ease, relaxation, and comfort as I gaze out at the breathtaking mountains and the greenness of the leaves rustling in the wind. This beautiful place truly is the ideal location for a time of reflection and conversation. It was a long and busy, but certainly enriching, first day in Telluride at the roundtable on patient safety, and already I feel that I have gained a great deal of new insight into the many topics of quality improvement, mindfulness, and negotiation. I have also greatly appreciated the opportunity to learn from the diversity of experiences that people here have shared with us throughout the day. As a first year medical student who is still rather unaware of many of the challenges and pitfalls of the system that await me once I begin my clinical rotations, it was interesting to hear details of stories from more experienced healthcare students and professionals to learn more about the reality of practicing medicine. As such, I am eager for the rest of this trip to continue thinking about ways that the change in culture that is so desperately needed in the medical field can begin early in medical school. Another theme of the day that really stood out for me, especially after watching the Lewis Blackman video and discussing other cases of medical error, is the enormous lack of inter-professional communication that exists throughout the “hierarchy” of medicine.