The decision to have surgery was identified by chronically disabled adolescents as one of the events that was critical to their hospitalization experience. Twenty-four adolescents who had been randomly selected from a list of planned surgical admissions and their parents were tracked through hospitalization in a pediatric-orthopedic setting. Participant observation and intensive interviewing were employed to gather the adolescents' and the parents' perceptions of the structure and management of their experiences. The resulting field notes and interview transcripts were first examined to delineate topical themes, including the decision to have surgery and various activities and relationships in which the adolescents and their parents participated. Second, the data were coded with categories that reflected these themes. Third, data from topical categories were combined to describe conceptual themes including critical events and the strategies used to participate in them. Fourth, the data from conceptual categories were combined to form an overall description of the experience, including the structural framework derived from the critical events and management strategies that were derived from the various forms of participation used by the adolescents and parents during the hospitalization. The decision to have surgery was examined as a selected critical event, including a description of the characteristics that shaped the content or meaning of the decision; the strategies used to manage the decision; an evaluation of both the event and its management; and clinical, research, and theoretical implications for nursing practice. Case history material complements the discussion.