Long before 1955 and the description of the disease that bears the names of Zollinger and Ellison, surgeons feared complicated peptic ulcer disease refractory to all treatment short of total gastrectomy. This recounting of the initial description is evidence of the essential elements of discovery that remain important in the 21st century and likely beyond including serendipity, expertise, curiosity, persistence, diligent follow-up, observation, and collaboration. The lessons for current and future surgeons are to be prepared, closely follow your patients and use your expertise if clinical outcomes deviate from an expected course and seek collaboration from others until you have an explanation and resolution. Who knows, if the time and place is right, you may even describe a new clinical entity.