We are 2 seasoned orthopaedic surgeons who, prior to the coronavirus disease 2019 (COVID-19) pandemic, had not taken more than a consecutive week or 2 off from surgery (sports medicine and joint arthroplasty) during 30-plus years of practice each. Others in the orthopaedic community may well relate. In Outliers: The Story of Success, Malcolm Gladwell popularized the “10,000-hours” rule as the time that is required to obtain expertise in any field or “the magic number of greatness.”1 The current hiatus from elective procedures has left us wondering: can the technical expertise required in orthopaedic surgery, or any surgical subspecialty, be maintained if disrupted? How will COVID-19 impact surgeons’ 10,000 hours? Several years ago, after personally undergoing a surgical procedure that necessitated absence from the gym for 4 weeks, one of us found that lifting 25 lb (11 kg) felt like 50 lb (23 kg). Ten minutes on a treadmill felt like 30. It was striking just how rapidly conditioning can be lost. Repetition fuels “muscle memory,” and distancing (social or physical) from any activity likely requires some degree of reintroduction or reeducation. In professional baseball, after 2 to 3 months in the off-season, players have traditionally gathered in warm climates to work out, refresh their skills, and then play exhibition games. Only after spring training does the “real” season start, with games and individual statistics that count. Similarly, even seasoned U.S. Air Force pilots and squadron commanders are required to fly in simulators and have “check rides” with an instructor to remain “certified.” Of course, in an emergency, any trained military pilot will jump into the left-hand seat despite a layoff if so ordered, despite the risk. In our state of North Carolina, as in other U.S. states, the “stay-at-home” order was extended as the COVID-19 crisis evolved. For us, that translates to a minimum of 6 weeks without elective surgery. What does that mean for our own and others’ surgical skills and intraoperative judgment if an embargo on elective orthopaedic surgery extends from 2 weeks to 2 months or longer? When shooting free throws or swinging a golf club, it is generally agreed that the less “thought about it” the better. If a surgeon’s mind is focused on what the hands are doing, that could be problematic. Will performing shoulder arthroscopy, a total knee arthroplasty, or even simple knot-tying become more labored (i.e., take longer and be more prone to mistakes)? Once you have truly mastered something, Zen Buddhism would teach “simply be.” Do not let the mind interfere. Perhaps resuming complex orthopaedic procedures that require manual dexterity, mental acuity, and proper intraoperative judgment could resemble returning to the gym after a lengthy absence or the off-season in baseball. We certainly do not have the correct answer for any and all surgeons, but expertise without repetition may be hazardous to one’s health—especially for the one beneath the scalpel or the power saw. Perhaps it is sufficient to be aware and mindful of what could happen after an extended hiatus from complex surgical procedures. Our advice: above all, do no harm, and “lift” no more than you can confidently handle. We are concerned that hospital or practice administrators, department chairs, or the surgeons themselves will want everyone to “do more” immediately to make up for lost weeks and RVUs (relative value units). In a paper on resident workforce and education during the COVID-19 pandemic, the authors noted that “we expect that [as] the healthcare system emerges from this crisis, surgeons may creatively work extra hours (evenings/weekends) to catch up on pent-up surgical demand from patients whose elective procedures were delayed because of the crisis.”2 We do not favor such an approach. Perhaps you should not restart your surgical practice layoff with 6 cases and 2 rooms. We do not think that extra elective cases should be added at the end of the day or on Saturdays. Be patient with yourself and your colleagues. Build up slowly. It will come back in due time. Our mistakes could result in permanent complications for our patients. We welcome the thoughts and the plans of other surgeons.