Horizon Cancer Institute has built its future around a breakthrough—an AI model that appears to show which lung cancer patients will benefit from a promising new therapy. Then a routine data management plan begins to expose what no one wanted to examine: missing patients, old consent language, a pipeline held together by workarounds no one meant to keep. Physician-scientist Lena Suarez, data platform director Dev Malik, research coordinator Naomi Brooks, and compliance specialist Rosa Gutierrez each carry a different part of the question of what the institution is willing to put on the record.