The question may seem redundant but here is the situation. 30 y/o female, alcoholic, no other medical history. Scheduled for elective incisional hernia repair (from C/S site) NPO. Slightly overweight. "Never been put to sleep" MP-2, good thyromental distance, good neck mobility, ie based on exam-"easy to inutbate." Everything else is normal. Surgeon wants a general with paralysis. Push 2mg versed, 100 fent, 200 mg propofol- can NOT mask ventillate-at all. Tried repositioning, oral airway-NOTHING. I am a senior resident and I have masked thousands of people- I do not think it was technique. WHAT is YOUR next step? SUX? ROC? LMA? WAKE UP? Take a peek with DL? Seriously this raised a big philisophical question and I would appreciate the input from the more experienced folks.