As a junior member of the faculty, I was sent to an annual meeting of the AANS in New Orleans. The honored guest spoke on the subject of “The difference between zero and one.” I remember a great deal about that lecture given by Harvard Professor William Sweet. The talk emphasized the importance of epiphany in medicine and science. The classical example being the apple that fell on the head of Isaac Newton. Over the years, there have been a number of these Aha moments that have led to changes in my thoughts and approaches to neurosurgery and patient care. This is especially important in the complicated problems of hydrocephalus and intracranial pressure. I am going to use this opportunity to describe a few of these epiphanies and what l have learned from them that affected my thinking and pondering subsequently. There were many more.