“I had so much more to say to my daughter,” our patient says through tears as we begin to induce general anesthesia for an emergency exploratory laparotomy. Her pale blue eyes wince in pain from a perforated viscus, weakened by a freshly diagnosed metastatic tumor. “Please don’t let me die today, I need to talk to my family.”

The surgeon is morose as she describes the cancer’s spread. The patient’s gastric perforation, like her malignancy, had gone undiagnosed for too long. A great deal of her intestine was without perfusion and deemed unsalvageable. The poor condition of her ischemic mucosa made a direct repair of her stomach extremely difficult. “I anticipate this woman will develop severe sepsis – we should keep her intubated” suggested the well-respected surgeon as she finished suturing a patch over the woman’s stomach.

Remarkably, the...

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