An editorial discusses why did the trial failed to show benefit and suggests it is likely that the concept of delirium is flawed. It notes the neurochemistry of sudden alteration in mental state is complex and involves several neurotransmitters as well as structural, immunologic, and network alterations and possible brain infection that is not clinically evident. It commends the investigators for conducting a difficult trial, and adds that “it would have been astounding if there were a single magic bullet for the restitution of normal brain function in ICU patients with delirium.”