Heather took this at the end of a thyroidectomy. Mary bagged the ether anaesthesia the whole case , watch her hand behind my back. Dr. Mlai "helped"-actually he usually got the right instrument from Cecelia. Cecelia is looking bored. The smell of ether coming from the exhaust tubing made us worry about the use of the bovie cautery. However, these lage symptomatic goitres would have challenged me imensely without. We did 55 cases including three thyroidectomies. They were less extensive thyroidectomies than I would have done in Canada because we had no access to lab tests or long term thyoid hormone replacement. I did have a small supply of L-thyroxine that I gave 3 months of 100 micrograms followed by 3 months of 50 micrograms to empiracally reduce the TSH surge post op. Who knows what good that does but they are coming back to see the surgeons next Feb.