Since returning to the United States from a three-month stint working in rural Guatemala, I’ve been thinking about how messy and random global health delivery—even when it’s really effective—can be. Specifically, I’ve been struck by the central role that luck or serendipity plays in achieving positive health outcomes. I’m talking about that moment when a patient walks out of the clinic and you sit back and think about all of the stars that had to align in order for that patient to get the care she needs. I want to tell a story about a child who brought the idea of luck in global health delivery into focus for me.