This paper explores whether surgeons and intensivists differ through the effect of the "surgical covenant of care". This covenant is very much a product of the shared journey taken by both surgeon and patient and is well described in medical literature. This literature is reviewed and learnings highlighted. In addition to this covenant, a number of other differences that may impact on how surgeons behave are also explored. These include the culture of surgeons and their training, models of administration for ICU units, the nature of professional decision making and the effects that age, experience and visiting surgical appointments might have on Intensivist- Surgeon relationships in an ICU. Finally, a number of pointers to better inter-professional practice are offered.