The observational picture of the enigmatic O-type spectrum variable HD 191612 has been sharpened substantially. A symmetrical, low-amplitude light curve with a period near 540 days has recently been reported from Hipparcos photometry. This period satisfies all of the spectroscopy since at least 1982, including extensive new observations during 2003 and 2004, and it has predicted the next transition during 2004 September-October. Measurements of the Hα equivalent width reveal a sharp emission peak in the phase diagram, in contrast to the apparently sinusoidal light curve. The He II absorption-line strength is essentially constant, while He I varies strongly, possibly filled in by emission in the O6 state, thus producing the apparent spectral type variations. The O8 state appears to be the ``normal'' one. Two intermediate O7 observations have been obtained, which fall at the expected phases, but these are the only modern observations of the transitions so far. The period is too long for rotation or pulsation; although there is no direct evidence as yet for a companion, a model in which tidally induced oscillations drive an enhanced wind near periastron of an eccentric orbit appears promising. Further observations during the now predictable transitions may provide a critical test. Ultraviolet and X-ray observations during both states will likely also prove illuminating.