Friday March 6

      Yesterday was a good day with a number of challenging cases. Sepehr and I did a parotid tumor which was quite a bit larger and more involved than we expected. It was supposed to be a benign pleomorphic adenoma; these typically shell out easily. However it turned out to be quite involved surgically, invading or compressing the internal carotid artery up to its entrance into the skull. We opted to back out, and just remove the 90% of the tumor we could, rather than risk an uncontrollable disaster to try to remove it completely. As surgeons, it’s in our nature to be aggressive in surgery for cancer, but particularly here we need to recognize our limitations.
      We arrived back at the hotel around 9:30. Adamah was there with Ben, Matt, Mary, and Sam; we had a fun dinner then off to bed.
       Today was another long, but good day. I started with a thyroid which I did with Dr Albertha Clark, and it was quite fun. The patient is an older woman with a monstrous unilateral goiter, the size of it made the dissection difficult but we got thru it well. Later on Santiago and I did a young woman (27 yo) with a parotid tumor. It was another difficult dissection in an area fraught with hazard because of the risk of damage to the facial nerve. After Santiago expressed his misgivings about our decision to do the surgery, everything came easier and we completed the surgery successfully. And her smile in Recovery showed eat her facial nerve was intact !
       While we were doing the parotid, Sepehr and Mohammad did a hernia. It was a very good feeling to know that after 5 days of assisted and supervised work, these 2 residents were ready to do a hernia repair on their own with minimal supervision! They were rightfully proud. So we had them do another! We ended up finishing the day with 4 hernia repairs, and a total of 11cases for the day. We got back to the hotel around 10:15, had dinner, and then to bed. We will work again tomorrow.