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Following Lewis (2012)’s call for a (more) “engaged approach to non profit organization (NPO) communication scholarship (.) by identifying best practices” (p.189), I present what I’ve experienced (and learned) during my seven years involvement with the renown international humanitarian organization Médecins sans Frontières/Doctors Without Borders (also referred to as ‘‘MSF’’) . In line with recent research on the communicative constitution of organizations (a.k.a “the CCO perspective,” see Ashcraft, Kuhn & Cooren, 2009; McPhee & Zaug, 2000; Putnam & Nicotera, 2009; Taylor & Van Every, 2000, 2010), this paper highlight what I’ve name “figures in/and tensions”, allowing to call attention to what volunteers evoke/convoke during interactions and therefore, encapsulating what the organization is all about, that is, the treatment of patients in distress around the world. Accordingly, I illustrate the communicative ways by which some tensions embody and express themselves during the daily activities of MSF’s work.