Summary of the September 6, 2011 issue of Annals of Internal Medicine: Original research reports address transfusion safety, bariatric surgery, type 2 diabetes, and cognitive impairment. The issue also includes a review on quality of care during housestaff changeover, an exploration of informed consent, two Ideas and Opinions commentary, two On Being a Doctor essays, and an In the Clinic review of sickle cell anemia.