For Yes Minister's Sir Humphrey Appleby, “courageous” was the most damning way of describing a proposed course of action (“controversial” only means that you will lose votes; “courageous” means you will lose the election, he explains to Bernard Woolley in an early episode of the show). Telling Jim Hacker that a plan was courageous was a sure way to get it dropped, whether or not the proposal was in the public interest. The rooms and corridors in which Canadian health policy is formed are a long way from the setting of the humorous television show, but tests of courage, small and large, abound. I recently had the privilege of participating in a Canadian College of Health Leaders/Institute for Health Policy, Management, and Evaluation panel on leadership for healthcare integration. Panelists held leadership roles in different parts of the health system and were at different points in their careers, but all agreed that individual and collective courage on the part of leaders was essential for achieving meaningful health sector transformation. This insight is neither unique to the panel nor to healthcare. For example, Warren Bennis and Robert Thomas (2002) compared the leadership styles of Generation X and Y with those of their grandparents' generation. They found that successful leaders of both eras were able to adapt to unforeseen circumstances and overcome obstacles, an ability that was put to the test early in their careers through an intense “crucible” experience involving adversity that tested their values and perseverance. These turning points forced individuals young and old to decide who they are and what they are capable of. It takes courage to venture into the unknown. And it takes courage to work towards ambitious goals for healthcare transformation, building coalitions for change and persevering in spite of challenges that arise. Good research can help to bolster courage. For example, better information can make it possible to reach a little further or with more confidence. It can focus attention, clarify context, decrease unknowns, spread knowledge of best practices and blind alleys and suggest effective approaches to change. The articles in this issue of Healthcare Policy/Politiques de sante tackle challenging policy questions and leadership challenges. Their focus ranges from issues highlighted by recent measles outbreaks to questions about access to family planning services, quality of physiotherapy for injured workers and use of antiretroviral medications by individuals who are HIV-positive. In all cases, the issues involved are complex. There is no one contributing factor. Neither is there a single, quick, simple solution. It is these complexities which the authors address, shining light on the issues involved and bringing new knowledge to inform policy options. Courage is also an appropriate theme for this issue because in it we provide tribute to Pat Martens. Pat was a leading health services and population health researcher, a compelling communicator and a generous contributor to our community, including serving as an editor for Healthcare Policy/Politiques de sante. She asked important and challenging research questions, forged new frontiers by engaging a broad range of partners in creating and using knowledge and continued to devote her time to protecting the health of others even after she was diagnosed with mesothelioma. Speaking personally, I am very grateful to have known and learned from Pat. I, along with so many others, miss her greatly.