My first case in the Philippines: a gunshot wound to the abdomen 20 hours old. We jury-rig a chest tube with suction, and I open his belly. The bullet has perforated the esophagus and has penetrated the vertebral body. He's lucky, his spinal cord is uninjured. I leave the bullet in. One week later, he's doing fine, but I leave for home and never find out whether he ultimately survives. It's been 18 years. He'd be about 42 now.