When Steve Hansen was handed the unenviable task of replacing Graham Henry as Wales head coach in 2002 there were two very different directions he could have taken the side.
With the 2003 Rugby World Cup fast approaching the easy option would have been to push for an extra season out of ageing veterans such as Scott Quinnell, Rob Howley, and Robin McBryde among others.
Instead, Hansen took the bold option and, as one Kiwi scribe eloquently put it, shot the patient.
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The canny New Zealander put his own reputation on the line by jettisoning a large chunk of Wales' senior players and opting to put his belief in youth, knowing full well it would entail going through some major short term pain.
Now, 21 years on, Gatland finds himself in an almost identical situation to Hansen.
Throughout his first tenure as Wales head coach Gatland was extremely loyal to a core group of players, keeping them in the side even when they were out of form, and in the main they repaid him.
But age catches up with everyone in the end and Saturday's humiliating record defeat to Scotland means Wales have only won three of their last 14 Test matches, even though the majority came under Gatland's predecessor Wayne Pivac.
Gatland likely knows he has to be ruthless and continue wielding the axe as he did before Saturday's Test at Murrayfield where he dropped veterans Alun Wyn Jones and Justin Tipuric while also bringing in young Exeter Chiefs forwards Dafydd Jenkins and Christ Tshiunza.
Wales were awful in the Scottish capital but ironically the only players who came out of the game with any real credit were Jenkins, Tshiunza, and Tommy Reffell, another youngster.
The younger players Gatland had thrown in were the ones leading the charge, and he must stick with these while also considering further radical changes.
Dan Biggar has been a tremendous servant to Welsh rugby and is still a quality player, but he has been below par in the opening two rounds of the Championship.
Against Scotland the Welsh pack provided enough of a platform for the backs to do some damage but the attack was as blunt as the back of a knife.
This was a collective failure but Wales do need a new focus at outside-half. It's a bit of a head scratcher why Scarlets playmaker Sam Costelow isn't in the squad.
The 22-year-old is a work in progress and has a few rough edges but his ceiling is high. He might only be 173 cm tall but Costelow throws himself into everything defensively while he has a neat all-round game.
Costelow has a very good kicking game, is an explosive runner, his game management is strong, while he also possesses tons of peripheral vision.
The balance in midfield also seems off. Joe Hawkins has bags of potential and Wales should persevere with the Ospreys man at 12, but the time has come to question George North's position in the side.
The 30-year-old has been a world class player but he has more miles on the clock than most given he has been playing international rugby non-stop, barring one or two injury lay-offs, for 13 years.
He remains a solid performer but there's a lack of dynamism and invention in the Welsh midfield. Gone are the days where taking a route one approach in midfield suffices with more nuance needed.
Pairing Hawkins with giant 20-year-old Cardiff centre Mason Grady would be a risk but the long-term gain could make it worth it.
Of course, it would be foolhardy to completely bin off the squad's elder statesmen, they haven't got a big enough player pool for one thing, while the likes of Biggar, Ken Owens, and Tipuric still have an important role to play with regards mentoring the next generation of player.
But there has to be a shift in focus when it comes to selection, with the squad's ageing veterans used more sparingly.
When Hansen went down this radical path Wales ended up with a Six Nations whitewash, but they had a decent enough World Cup and his successor Mike Ruddock reaped the rewards with the bulk of those players the bedrock of the 2005 Grand Slam winning side.
Of course, there are other deep rooted issues in Welsh rugby beneath the national side which have to be fixed if Wales are going to thrive at Test level in the long run but Gatland at least can kick-start the long road to redemption.
Gatland may have to take Wales through the same pain as his fellow countryman did two decades ago, but he could leave Welsh rugby in a better place if he follows suit.
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