Academic health sciences libraries support the educational, research, clinical, and service missions of the universities and healthcare institutions of which they are a part. In the recent past, this has meant primarily building print and web-based collections of health and research information, and providing classes and services that facilitate the use and integration of these collections into the skillset of the local academic healthcare community. In Spring of 2007, the University of Michigan Medical School purchased an island in Second Life. In supporting the activities associated with this initiative, we have found that many of the activities and services we have traditionally offered are not immediately relevant in the new environment, are needs that are being filled by others, or are beyond the scope of what is possible with the resources currently available to us. Examples of these might include teaching how to search Medline, offering classes relating to health skill sets, building collections of health information. Similarly, many of the activities and services we have found ourselves embracing in Second Life are hard to imagine ever happening in our real life libraries. Examples of these might include building freebie collections, teaching classes on how to make clothes, setting up a Spirit Shop for the university (along with making the inventory), hosting in-world and out-world events to engage community, setting up a patient support group, as well as helping folks navigate Orientation and Help Islands. Here we present information about the similarities and differences between what we do in which environment and why we do or do not offer similar services in the other environment, as well as discuss the planning process and skill sets required. We would particularly like to focus on tools that have formed the basis of our community building efforts, which have largely depended on resources that bridge Second Life and the broader online and analog environments. So, when it comes to leading the way in a new and emerging technological environment, what are librarians going to do? Our answer: whatever needs to be done.