J. Randall Curtis (“Randy”) has had a profound impact on the culture and state of the science of palliative care in serious illness, particularly in the critical care setting. He has accomplished this by bringing rigorous and innovative empirical research into understanding and improving communication, decision-making, and culture around end-of-life care in the intensive care unit (ICU). His legacy extends far beyond his scientific contributions through the personal impact of his compassion, creativity, and visionary brilliance on the cultures of ICUs and hospitals around palliative care.