At Washington University and Barnes Hospital Dr. Spray and his team stacked up number of firsts in adult cardiac surgery including: the hospital’s first mitral valve repair program; early adoption of the Ross operation for aortic valve replacement for adults, children and neonates; the first successful pediatric lung transplant (1990) that led to establishment of the largest and most successful pediatric lung transplant program in the world; and the first ECMO bridge to lung transplant. As Dr. Spray’s first congenital heart surgical fellow James S. Tweddell, MD, recalls, “It seemed every week we were performing a ‘‘first-of-its-kind’’ operation.” Although Dr. Tweddell rates Dr. Spray a virtuoso surgeon of unparalleled skill, in-depth knowledge, and unwavering commitment, he considers his single greatest quality was being a “courageous and generous teacher of congenital heart surgery.” Over his career, Dr. Spray trained more than 42 congenital heart surgeons, including 28 fellows from the United States and 14 fellows from 10 other countries.