Marcus and Danita Cobb first came to see me in North Carolina in the mid 1990s. He stood 6 feet 1 inch, weighed in at 185 pounds, and had brown eyes and blue skin. Marcus' first words to me set the tone for our visit: “Listen, Dr Ely, I’m blue ’cause I was born with holes in my heart, and I’ve had one foot in a casket since I was a lil’ boy. Many ‘all-knowin’ ’ doctors have told me I’m ’bout to die. They’ve all been wrong so far, but now at 32, I’m wondrin’.” Marcus had cyanotic heart disease, and his skin told the tale. With lips blue as faded jeans, he lived his life deprived of oxygen, with sats in the death-defying range of 60% to 75%. He came to our nascent heart-lung disease program that day with his wife, Danita, to inquire about a new heart and lungs to enable him to help Danita raise their children—Kristie, Ty, and Ariel—whom he cherished above all else.