We introduce this issue of TEM with a reflective article by one of the “fathers” of emergency medicine, Dr. John Pantridge. In his discussion, Dr. John Pantridge concentrates on prehospital coronary care. The fact that cardiovascular disease was the stimulus from which the entire prehospital care system sprang and that cardiovascular disease continues to be the leading killer of humans throughout the modern world make it especially propitious to consider this subset of prehospital care as the introduction to a more general reflection on emergency medicine today.—The Editors