I started the day with two cleft palate revisions, both teenagers with hypernasal voices and regurgitation of liquids into the nose when swallowing. The plan was to raise a flap of mucosa from the posterior pharyngeal wall to reach the shortened palate, while leaving a small, but adequate breathing space on either side of the flap. Not one of the plastic surgery residents had a headlight, so I was glad to have mine. Unfortunately, I could never relax and stretch my neck without leaving the resident sewing in the dark.

In the afternoon, I went to the Social Security Hospital, which is a more modern facility for government employees. It reminds me of our Veteran’s Association Medical Centers – well-equipped and built with grand intentions, but often overcrowded and running inefficiently. Chris Perry and I saw about a dozen patients with Jesus Aguilar, the Argentinian-trained son of the first Honduran otolaryngologist.

Dinner was a feast of barbecued beef, pork and chicken served family style at El Patio, which advertises itself as the best steakhouse in Honduras. It was a good time to relax and get to know the residents outside of the OR.