Pete Smith is nothing without the energy and commitment of the amazing people who surround him. Just as it takes a village to raise a child, so it takes a world of people to change the world. Increasing the technical skill of a health care clinician makes for incremental change. Improve the culture within which they work, think and communicate and suddenly quantum change is possible. Two perioperative nurses from a regional hospital in Victoria, Australia, innovated a simple, elegant solution to the problem of noise and distraction in the operating room. Pete Smith was one of them. Now they are on the cusp of a clinician-led safety culture transformation in healthcare settings around the world. With iatrogenic misadventure more prevalent than most would dare imagine, patients, nurses and doctors all stand to benefit. We cannot afford to be ignorant, nor arrogant. No one should have to die for their care. Not even on the inside. But first one must make the individual decision to act. You already have all the permission you need to be the change you want to see in your world. 'Below Ten Thousand ' Dare to care