The evolution of perioperative care in cardiac surgery is uniquely captured by the 2 paradigms that define its modern history: fast-track recovery and Enhanced Recovery After Surgery (ERAS) (Figure 1). This review examines these paradigms through the perspective of their originators: Richard Engelman, who introduced fast-track recovery in the 1990s, and Daniel Engelman, who founded the ERAS® Cardiac Society in 2017 (Figure 2). This “2-generation” framework provides a unique lens through which to trace the maturation of perioperative cardiac surgical science from a focus on efficiency to a holistic, patient-centered model of care.