The fourth annual Russell M. Nelson Educational Endowment Lectureship of Cardiac Surgery was held on Thursday October 11, 2018. We welcomed keynote speaker Robert S. D. Higgins, MD, MSHA, who is the William Stewart Halsted Professor and Director and Surgeon-in-Chief in the Department of Surgery at Johns Hopkins. Dr. Higgins is a leader in the field of heart and lung transplantation as well as coronary artery bypass surgery. His research has addressed health economics and policy, competency-based residency training, and racial disparities in post-transplant outcomes. He has authored over 150 scientific articles and book chapters and holds leadership positions in a number of organizations. He is the President-elect of the Society of Thoracic Surgeons and previously the president of the United Network for Organ Sharing as well as the Society of Black Academic Surgeons. Nearly 120 members of the community joined the Division of Cardiothoracic Surgery in their annual celebration of the educational legacy established by President Nelson. Dr. Higgins’ keynote address was entitled “Honoring Our Past and Creating a Sustainable Future.” He presented three interwoven stories: overcoming personal tragedy as he experienced with the death of his father, confronting adversity as he did by becoming the first African American Chair of the Department of Surgery at Johns Hopkins, and describing our core obligation to contribute to the well-being of underserved communities, such as with the high school mentoring program he developed at Johns Hopkins. Attendees of the lecture commented on Dr. Higgins’ warm and personable style, calling it one of the best programs they had attended in recent memory.