Farewell, 2009!

One of the stunning emerald-furred trees dotting the trails at the Long Ridge Open Space.

It's funny how, the older I get, the faster time moves. Remember summers as a kid, when it seemed like the days were endless and vacation would never end? Now, it the year whooshes by straight-faced, without drama.

Well, there is always plenty of drama in the wondrous world of plastic surgery, right?

2009 was no exception - new techniques for breast enhancement, a competitor for Botox (welcome again, Dysport!), a resounding defeat for the cosmetic procedure tax. And small steps in my personal year of plastics - a little but big move for the office (all the way up the street to Palo Alto), a big anniversary for this partnership of two women trying to conquer the big bad boys' club of plastic surgery (couldn't do it without you, Dr. Weintraub!), and yes, another year of semi-devotion to this blog.

Thank you for putting up with my wordiness in 2009. I promise more exciting revelations as the days move swiftly in 2010. Happy new year!

Bo-tax goes down, and other news in the world of plastic surgery

Good news, the Bo-tax got defeated. It seemed like the entire "community" of cosmetic proceduralists temporarily put their differences aside and organized together to make it happen. Apparently even the NOW rallied against this crazy idea, since it unfairly targeted women.

In an interesting twist, the Senate decided to go after tanning salons instead - hefting a 10% use tax on consumers who aren't convinced by the "pale is beautiful" trend or the fact that UV exposure correlates to skin cancer. Seriously, does anyone tan anymore? I thought that unnatural bronzed look went out sometime in the late 80's/early 90's.

And finally, I caught this article through the online version of the San Francisco Chronicle. It doesn't tell you anything new, dear readers, but I must admit to a base fascination with plastic surgery horror stories with the tiniest little modicum of sadness and regret that I can't help everyone see the light about finding themselves a good (female!) plastic surgeon.

Another reason to celebrate being a woman: more wrinkles?

Personally, I thought the actual reference article in this piece discussing how women have the great luck of being prone to more and deeper wrinkles than men was just fine.

But come on, Amanda Gardner, HealthDay Reporter for BusinessWeek, get it straight. When you lead off your article with "Dermatologists have discovered yet another gender inequity. . ." and proceed to quote the senior author, who is identified as a plastic surgeon in said article, it becomes clear that someone didn't do their homework.

For the last time, dermatologists are NOT the same as plastic surgeons.

Okay, I'll put the soapbox away again. Thanks for listening.

To be young and beautiful

A lookout sullied by low lying clouds two weeks ago at Fremont Older Preserve, part of the Open Space lands of the Peninsula.

This morning I had the wonderful opportunity to speak to Tracey Gunn's honors anatomy and physiology class at Santa Clara High School. I've been working with the HealthTrust of Santa Clara; part of their mission is to get high school students interested in careers in the health sciences.

I've done a handful of these little talks now, and the caliber of these students never fails to impress me. They are all so bright and beautiful, curious and clever.

In these talks, I skim over the nuts and bolts of how to become a doctor - all the classes, applications, tests, etc. These students aren't dummies - they're all college-bound (and right now, waiting anxiously for the legendary fat envelopes) - when I ask them how old you have to be to become a physician, they're pretty accurate. Usually they guess around 30, although today someone blurted out "80!" which is sometimes how old you feel at the end of the day...

I also talk a little bit about what it means to me to be a plastic surgeon, how it's not all boobs and Botox, and most importantly, why I love what I do. In this part of the talk, it gets more graphic and interactive - I put up pictures of tough cases I've confronted in my surgical career and challenge the students to "be the plastic surgeon". Their response is always impressive, perhaps revealing a few aspiring surgeons in the crowd.

So thanks again to Ms. Gunn and her students for graciously hosting me this morning. It was fun, and hopefully we all left with something more to think about.

Happy surgeons = happy patients?

Photo illustration courtesy of Veer

Perhaps you've seen this article circulating out there in the ether - it talks about how doctors who feel burnt out or depressed admit to making more medical errors.

Lucky for all of you Duet fans out there, Dr. Weintraub and I love what we do and are very happy doing it.

The Botax-man cometh

We've all heard this one was coming. Plastic surgeons and their patients make a very easy target for politicians, right? But will it really go through?

Everyone points out the disappointment of New Jersey, which levied a 6% tax on cosmetic procedures in 2004. Some speculate that the tax has actually cost the state $3.39 for every $1 collected.

So maybe the question is not, will the "botax" be passed by the Senate, but if it does, what will it actually do?

I can do *what* with my frequent flier miles?

Photo from Veer


Harrumph. Maybe I'm just getting old and grumpy already, but it seems like this is another one of those really terrible ideas.

Caveat emptor

We've talked about this before, but it's still frightening.

Running the numbers

Have you ever read the Harper's Index? You've probably seen some permutation of it, usually a pithy or surprising factoid phrase, followed by a defining number. I've been a big fan of Harper's ever since high school, when my history teacher would hurl the facts and numbers at us in his amazingly deadpan voice (thanks, Mr. Brown!).

I was reading this month's Index, and it happened to have a couple professionally relevant tidbits, which I found so interesting, as the Index items always are.

Estimated length of human nose removed by U.S. plastic surgeons each year, in feet: 5,469

Factor by which this exceeds the length of George Washington's nose on Mount Rushmore: 260

Discussing the do-over

The New York Times' Thursday Styles had another great piece about plastic surgery, this time discussing the challenge of revisional, or secondary, surgery.

These types of surgeries can give any plastic surgeon pause, to be sure, and this article proffers some choice quotes from some of the luminaries of the American plastic surgical world.

Magic with muffins

Illustration from MSNBC.com

This photo was just too good not to share... It accompanies an article on the MSNBC website discussing the conjunction of so many women's dreams and the miracles of modern day science: moving the fat from your hips to give you a bigger bust.

It's a great idea, and not a new one, as the piece discusses. Plastic surgeons have been doing this sort of thing - fat grafting - for decades. Unfortunately, not all of the transferred fat stays where you put it; fat cells are fairly finicky creatures, and reports of 50% volume loss over time aren't unusual. Plus, there is the added risk of confounding cancer detection when fat cells (which often calcify) are moved to the breast (where calcifications are warning signs on mammograms).

The twists that the article reveals are two: MRIs these days are better at sussing out true malignancies from benign calcifications; and you can apparently keep transplanted fat cells happier with giant suction cups on your breast.

Anyone remember seeing ads for the Brava device in the back pages of Glamour or Cosmo? It was basically two giant suction cups, one for each breast, that promised to increase your size by a cup or two. The catch? Other than two giant suction cups - you had to wear the vacuum assisted bra all the time.

So despite decent results, the Brava device never took off - women just couldn't commit to the bulk of the machine. Reenter Dr. Khouri, the inventor of Brava, who has found a new application for the unloved device. A recently published small study of his reveals that using Brava gives patients longer lasting, more predictable breast augmentation with fat grafting.

Dr. Khouri's disclosures and all, you still have to examine these results with an eyebrow raised. I'll be curious to see how the patients do in other plastic surgeons' hands, and whether or not women will be ready to commit to giant suction cups on their breasts this time around.

The verdict is in...

... well, sort of. As you know, Botox finally got some competition earlier this year in the form of Dysport. Same drug, essentially, but with a couple tweaks to give it some sort of market advantage over the industry standard (can you really be the industry standard, if you're the only game in town?).

Dr. Weintraub and I were intrigued by Dysport, as were many of our patients. Who wouldn't be - with promises of quicker onset, longer duration of action, and cheaper? Although we've seen the scientific studies and heard the testimonials, we've been trying to reserve our professional judgment until we used it ourselves.

This is purely anecdoctal "evidence", but I will share with you the reactions of two patients with you, which have been pretty representative of our overall experience.

One woman in her mid-thirties, who was a "botulinum toxin virgin", tried Dysport to correct her glabellar folds and a few crinkles beside her eyes. She reported back to us, saying that the medication seemed to kick in that very night. The morning after the injection, she called the Duet office, absolutely ecstatic over the results: "I look like I have the face of an 18-year old again!"

The other story is perhaps a little more telling. This woman in her early forties is a long-time patient of ours who got Botox regularly. She was willing to try Dysport, and she too was thrilled with the outcome. Being very familiar with the action of Botox, she liked how Dysport seemed to work slightly faster but was really enthralled by how this injection was equally effective, but had a "softer look and feel."

And the verdict? It's still a little early to tell whether or not the longevity claims will pan out, and by no means is this a scientifically unassailable conclusion, but our patients seem to really like using Dysport and having the choice between products. I'll keep you posted.

Scientists say...

This article in Thursday's New York Times Style section got me thinking for a while.

The section's Skin Deep column always runs pieces that I find interesting - both professionally and personally.

This latest column discusses the trend of skin care companies pushing over-the-counter creams, lotions, and potions that work with the body's day and night cycles. That is fascinating enough - what woman doesn't have a random assortment of bottles and jars, some for daytime, some for nighttime, some for work, some for going out, some for really special occasions?

But the part that caught my curiosity was the discussion of what being a "cosmeceutical" really means. Companies want us to believe that there are hard data and stern scientists behind their claims of "47% improvement in radiance in just 7 days" when we buy their products; but if there were any real, objective proof, they would require regulation by the FDA, which is clearly something they're not interested in getting mixed up in for their drugstore brands.

It makes sense, right? How effective can these over-the-counter promotions be at "reducing the appearance of fine lines and wrinkles" or "tightening loose skin without surgery"? Otherwise the FDA would be regulating whatever "special active ingredient" as the latest, greatest drug...

Should seem obvious to a medical school-educated person with loads of practical experience in dealing with the FDA's fine print and convolutions. I guess it was just the hopeful consumer in me that was lulled into suspending disbelief by the pretty pictures and fancy words of cosmeceutical ads. Yeah, I bought it. A lot of it. But, now, both eyes are open - I'm on to you companies now.

Can it be? A plastic surgery app for your iPhone?

For all you iPhone addicts out there...
http://www.reuters.com/article/pressRelease/idUS103166+14-Oct-2009+PRN20091014

I'll have to rely on you hip folks out there to let me know how it is. Unfortunately, I am personally still in the dark ages of cell phones, with my old-fashioned flip phone without a text or data plan (the horrors!).

Settled in

It's been a week since the big move for Duet to Palo Alto. Dr. Weintraub and I have settled in fine. This office complex is actually quite familiar to us; it's the same site as the Stanford Chief Residents' Cosmetic Clinic.


Our signs will be going up soon, but in the meantime our patients seem to be finding us in our new location okay.

Goodbye, Mountain View... Hello, Palo Alto!

The old Mountain View office, RIP 2008-2009.

Well, it's moving day for the Duet ladies. We're not going far, just up the Peninsula a little way.

Nearly everything else is staying the same - our phone number, our website - Dr. Weintraub and I are just relocating the physical space of our unique little plastic surgery practice to a rather convenient location in the heart of Silicon Valley, Palo Alto.

New office hours, though, and new neighbors. Although I'll certainly miss our old neighborhood in Mountain View, I'm definitely looking forward to showing everyone our lovely new office.

Forget Tupperware parties

Image courtesy of Allergan


Speaking of breast augmentation, Dr. Weintraub and I met with our local Allergan rep at the Duet office a little while ago. The rep showed us an interesting package the company just started promoting a few months ago.

At the risk of sounding like a corporate shill, I'll go on, but only because I genuinely think it's a neat idea.

Called their "pre-consultation kit", anyone interested in breast augmentation can send away for this package, which includes information about augmentation (both a booklet and a DVD), a bra, and best yet - "sample implants" to try out in said bra.

It's pretty brilliant because it allows women to toy around with "implants" in the privacy of their own homes. You can imagine inviting a couple girl friends over, opening a bottle of wine, and cracking up over the grown-up attempts at "we must, we must, we must increase our bust". . .

The "implants" in the kit aren't real surgical implants, of course - they're plastic, filled with mineral oil - which give just a general approximation of size and feel.

At the office, at our consultations and pre-op visits, we do a similar process with a range of real surgical implant samples. We often get asked by women (and sometimes, the men who accompany them) if they can take a few home for a sort of "test drive". The problem was, the silicone gel-filled samples are so irresistible to squeeze, that a lot of the samples never made it back to the office.

The kit from Allergan helps solve that problem - and provides a closer idea of what breast implants might look like in a bra and clothes than the old stand-bys, rolled up socks or sandwich baggies filled with rice.

Perhaps the most redeeming feature of this offer is the handful of rebates. You do have to purchase the kit, and pay for shipping; but if you really are interested, you do get a rebate on your future implant purchase, which evens out the expense.

And even if you're not actually interested in breast augmentation, the kit includes rebates that can be used for Botox and Juvederm, which are worth more than the cost of the kit. . .

My secret Sunday addiction

I remember first seeing this photo a few weeks ago on Postsecret. Visiting the site has become a nicely anticipated part of my weekend, sort of like the soul-satisfying thud of the Sunday Times, ready to be perused and lingered over with a steaming cup of coffee.

That postcard, that image, that secret have stuck with me, for some very obvious reasons.

But it makes me wonder again about what a charged topic breast augmentation truly is. As a plastic surgeon, for whom it literally becomes an everyday kind of thing, if you're not careful, you can quickly become inured to the whole idea: Woman wants larger, fuller breasts. Woman gets implants. Woman is thrilled.

It is, however, so much more complicated than that. As the confessor in the postcard implies, there is so much emotion and judgment and conflict and mystique wrapped up in breasts and the concept of augmenting them. And not just for the women who are thinking about it, the women who are planning to have it, and the women who have already done it; but also for their partners, friends, family, coworkers, and acquaintances.

In the end, it is a very personal decision. And it should be.

Keeping cool

I am in a calm, happy cool place, not worked up by maddening articles about Botox, not sweating in a very indelicate manner in this latest Bay Area heat wave.

I am back at Lassen National Park, overlooking one of the lovely Sifford Lakes which you see above, where the air between 7000 and 8000 feet was cool and clean and crisp last week.

Sigh.

Botox-To-Go. Really?

It's a little bit funny - I was just chatting with a patient this afternoon about how crazy it is that there are folks out there who will let anyone touch their faces. And we weren't talking about your monthly facial or whatnot; we were talking about injecting Botox.

As my patient put it, gesticulating wildly about her face, "There is an awful lot of stuff I like going on here!" We agreed - we wouldn't let just anyone even begin to approach our precious faces with a needle and neurotoxin in their hands.

Which is why I was amazed by this news article, which landed in my inbox this afternoon. A piece in the online version of the Tampa Tribune, it describes taking cosmetic enterprise to a whole new level, almost like Botox-To-Go. A company envisioning bustling storefronts in busy shopping malls is set to capitalize on shoppers who happen to wander by and decide to pop in for a little Botox on a whim. One location is already doing business, "tucked between a Chico's and, yes, a LensCrafters."

If that doesn't make you squeamish, maybe this will do it: "Licensed technicians" will be performing your medical procedure.

Seriously? Will they do my mani/pedi when they're done injecting my Botox?

It is absolutely serious. Botox Cosmetic (and its counterpart, Dysport) is a neurotoxin, a FDA regulated medication, and despite so many attempts to downplay it, injection is a medical procedure that is not suitable for everyone who walks through the door.

No offense to the many talented nail technicians out there, but I definitely want someone who knows what they're doing if they're putting a needle to my face. I want someone with solid medical training, like a nurse or a doctor. And when push comes to shove, I want someone who is intimately familiar with every intricacy of facial anatomy and what Botox can do to it - like a surgeon who has been inside the face and understands what's going on.

And so does my patient.

Last days in China: Changde to Changsha to Shanghai to Home

Alex, in the borrowed team office, with the local charge nurses.

Friday was the team's last day in Changde. A few people had already left earlier in the week, so our numbers were sadly dwindling as our memorable trip to China was quickly drawing to a close.

After morning rounds on the handful of our remaining patients, we took one last opportunity to thank the local staff for their kindness, patience, and fantastic care.


Alex and me, flanking the very capable Dr. Fu - the local doc who helped make things happen on the first floor ward.


Back at the hotel, a pensive-looking Johnny, displaying the framed and signed scrub shirt for our translator/guide/friend, Pan.

The giant custom frame was extraordinarily cheap, by U.S. standards - I think we paid less than twenty bucks, for a very nice job that would have fleeced us for hundreds of dollars here.

If you can zoom in on the scrub top, there are a lot of very sweet messages and meaningful sketches. Quite a few of us managed to scrawl our Chinese names beside our American ones, myself included.

On this, the last day of the trip, after I had been "signing my name" repeatedly with all the grace of a struggling kindergartner, a couple native speakers pointed out that I was writing my name wrong... Part of the character for my given name was backwards! Apparently, I've been doing this for the last twenty years... And there it is, on the shirt, behind glass, preserved for Pan and posterity.

Well, now I know.


Saying our goodbyes in the hotel lobby. Here's Faith, soaking it up like a regal princess.


Almost unbearably cute, Alfred and Rosa. Newlyweds (I think six months still qualifies). Rosa - who is a periodontist in Hong Kong - joined us for the second week of the trip.


The scene as we tried to board the bus. There were a lot of tearful goodbyes, and promises were made to see each other again at next year's trip. All of our translators were so sweet, kind, and helpful - not to mention quite good at helping us understand and communicate throughout our stay. I am sure each of them will go on to achieve great things.

And so another bus spirited us away, this time a nearly three hour journey to the city of Changsha, where most of us would fly to Shanghai, spend one night, then find our ways home.

This bus ride was a bit more subdued, from a combination of exhaustion and contemplation.

And the flight from Changsha to Shanghai, on China Eastern, was much less memorable than our first flight to Changde. In a good way.


But there was still more Pan to enjoy! Here he is, captured as he tries to figure out a logic puzzle.

The Shanghai crew finally settled in at the hotel late, around 9 pm, but we were determined to see at least a glimpse of the city - which was nearly an hour's taxi ride from the hotel. Ever patient, Pan - who was in Shanghai for some very important interviews - convinced this restaurant to stay open to serve us.
















One last feast, in Shanghai.

Left photo: center bowl, fish soup laced with Sichuan peppercorns. Clockwise, starting at 12, barbecued rabbit, deep fried whitefish, braised fungus, a dried rice and syrupy tropical fruit amalgam, spicy pork, another spicy dish, mashed potatoes!, and roast duck.

Right photo: my favorite dish of the night, silky tofu with the slightest touch of spice, in broth.


I had about 6 hours in Shanghai proper. But we made the most of it, before heading back to the airport and finally returning home.

Thank you to everyone who's been following this sordid tale.

This cleft trip to China was such a rewarding experience - not just seeing a tiny slice of this giant nation firsthand as an amazed tourist, but being able to give back a little something of myself too. Thanks to everyone behind the scenes (Jackie, Judy, all the foundations who helped us get to Changde) and the generous locals who helped us all the time, every day. It was a privilege to be part of the American team; every single one of whom rallied to make it happen for the children.

In China, day twelve

Thursday was the last day of operating for the team in Changde. With only two cases for the entire day's schedule, I had the day to myself, after checking in on the patients in the morning.

One of our translators, a very smart and spunky girl named Zhong, wanted us to try lamb noodles - and she knew just the place, a very short walk from the hospital.

Breakfast was never so good. The meat was sliced thin, cooked perfectly tender without any of that gaminess that often plagues lamb cooked in the States. The soup was spicy, of course, but not mind-numbingly so.


Quite a few members of the team raved about a beautiful lake they had been to during the week, easily accessible by hopping on the bus just outside the hotel for 1RMB and riding it to the end of the line. It sounded like "New Year Lake", with pagodas and weeping willows and boats.

With my bad Mandarin and the help of an assortment of English-speaking locals (everyone, it seemed, had a friend they could dial up on their cellphones), Heidi and I eventually made it to Liuye Lake.

The AC on the bus was lovely, and we were treated to a motley parade of sights through the windows. Changde is a medium sized city, but even within city limits, there is still a surprising amount of rural character.


Even though it was a hot summer day, the breezes off the lake kept it bearable. Apparently Liuye Lake is another famous area in Changde, developed as a resort complete with a five-star hotel.

We were surprised by how few children there were at the lake's grounds. The ones we did see, though, were definitely having a great time.


Heidi and I had heard that you could take a boat out to an island in the middle of the lake. These ones clearly weren't going anywhere.


We eventually figured out how to purchase a ticket for a boat ride, provided by this politely curious gentleman.


Passing some of the other boats. With all the haze, it was a little hard to see to the distant shore. The internets tells me that there are several beautiful mountain peaks hiding back there.


We eventually "docked" at a rough stone pier, where our boatman gestured we could get off. Heidi and I looked at each other, and as we climbed a rustic path away from the boat, hoped that he would still be there when we returned.

The island was small, and we were immediately accosted by a family, who appeared to be the caretakers of the island and its small temple. A man offered us the most giant stick of incense I've ever seen, as thick as a baseball bat but longer; we politely declined. He eventually gave up.

Wandering around, we found this grove of trees, perfectly spaced for hammocks. A woman was taking advantage of the quiet setting, peacefully reading a book.


I don't know why I love chickens so much.


Our friendly boat man was indeed waiting for us, and he ferried us back to shore, taking a leisurely course past a large pagoda where men were fishing.

Heidi and I bravely tried out a tandem bike. I must say we were pretty successful - riding to the pagoda and back. Although we did get dusted by a mom with her young daughter.

In China, day eleven

The mission was nearing its end; today was my last day of operating. For me, it was a full day of working hard to piece together both revisions and a "fresh" cleft lip.

This gentleman was 20 years old, and he just wanted whatever could be done to make his lip look a little better. His initial bilateral cleft lip repair was done some time ago and looked fairly good - just a few minor adjustments needed.

He seemed pleased by the results - realignment of his upper lip border, and a tiny little flap of tissue tucked to give him a little more fullness where a notch had existed before.


This six year old girl had also had a bilateral cleft lip repair done previously. She had extremely wide "train-track" scars, and as you might be able to tell in the photo above, she had some bulkiness on either side of her upper lip.

The orbicularis is a muscle that circles the lip and allows us to do things like pucker and whistle. In children with cleft lips, that muscle is discontinuous and misaligned. If at surgery, the muscle edges aren't approximated well, things can look a bit off.

After surgery. Her wide scars have been excised, and the muscle aligned properly.


My last patient of the mission was perhaps the most remarkable of the trip. You can see the little 7 year old guy in the photo above (courtesy of my new friend, William Zhao), sandwiched merrily between his parents. In Tibet.

This incredible story (and the photos shared above and below) was told to me by William, whose kindness and dedication will become evident shortly.

Word of the Chinese Agape mission in Changde had somehow made it to this little boy's family. With a lot of help and planning (and William, who lives in an entirely different city in China far from Tibet, was instrumental as guide, translator, and friend), the little boy and his father made the fourteen day trek - mostly on foot, but also via donkey, bus, and train - from their village in the mountains of Tibet to our hospital in Changde.

The brave little fellow, before surgery. I was only allowed to repair his bilateral cleft lip; despite the team's pleas, the hospital would not allow us to perform the repair of his palate as well.

Resting the next morning after surgery. When he was shown pictures after the repair, it took him a long while before he seemed to recognize himself.

With William and the patient's father at his bedside. His father was so happy. And I'm happy to report that everyone made the long journey home safely from the hospital.
















Another day ends with dinner. This night, our graceful translator, Anita, organized an outing to a more "homestyle" restaurant that her family has enjoyed frequenting.

Just a few of the many dishes we enjoyed. Left: a bowl of cold fermented rice soup. Refreshing with effervescent rice grains, this dessert-like soup was about two steps away from becoming shochu. Right: flavorful fish soup. The girls were so sweet and insisted on finding the big chunks of meat to serve us.

In China, day ten

Another day at First People's Hospital in Changde. Johnny and Alfred with one of the local nurses.

Steph, modeling the latest and greatest in gown couturewear. The attached muff is a brilliant idea - handy, convenient, stress-reducing for hawkeyed circulators breaking in new medical students... We should get these on all our paper gowns in the States. Who do I have to call?


All right - caution signs and blinking lights here, for all of you with weaker stomachs. Photos of a slightly more invasive surgical nature (two, to be exact) are next in the lineup.



One of my cases of the day: a big kid (17 years old) with an unrepaired cleft palate.


In a way, working on the older patients is easier in terms of cleft work. The structures are bigger and easier to see, and often their tissues are a little more generous when you're trying to get holes closed and covered up.

Unfortunately, if patients wait too long for surgery, you do lose a lot of the advantages of early repairs, like bony molding and speech development (which I mentioned briefly in an earlier post). There are always trade-offs in surgery.



Dinner that night: a barbecue and hot pot place. Off to the right of the photo, behind where everyone is congregating, is the open room where the grilling was done, over a charcoal brazier. Notice the hot red glow.

The young man who tended the fire was also the one who schlepped all of our food up to the second floor. Shirtless and sweaty, he seemed astounded that we would attempt to eat all of it.


Left: fresh lotus seeds, which you shell and eat. Right: butterflied chicken drumsticks, fresh from the coals. I had no idea you could butterfly a drumstick. It was tasty. Part of a seemingly endless parade of grilled foods - squid, lamb, peppers, potatoes.


"Uncle Johnny" and his women. The young translators all adored Johnny, as you can see in the photo. They also called him "opa", which Korean girls use to address an older brother. Some of the rest of us started calling him "opa" too.