To the Editor: I read with interest the Clinical Case Conference by Mel Blaustein, M.D., and Anne Fleming, M.D., M.S. (1), published in the October 2009 issue of the Journal. A few years ago, I visited the Golden Gate Bridge and took a picture (Figure 1). The sign at the edge of the bridge read as follows: "Emergency Phone and Crisis Counseling." Under the sign was a telephone wrapped in yellow CAUTION tape with the words "Out of Order."