This interview with Dr. Frank Gotch was conducted in New York City in February 2008. Dr. Gotch graduated from medical school in San Francisco in the early 1950s and began providing acute dialysis with an artificial kidney at San Francisco Hospital in 1961. In this conversation, he reflects on his distinguished career in both clinical medicine and research. He describes his early experiences delivering dialysis therapy during its formative years, as well as his pioneering research contributions, including the development of the hollow fiber dialyzer and the foundational work behind our current understanding of dialysis adequacy through Kt/V.