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December 6, 1985

The Board Case

Author Affiliations

Los Angeles

JAMA. 1985;254(21):3094. doi:10.1001/jama.1985.03360210110043

I considered it a fortunate coincidence that he came to see me in the first place. I was in the infancy of my plastic surgery practice, at a time when any truly challenging patient is considered a windfall, an act of God, perhaps even a "board case."

Everett was 24 and handsome, with a large, deep malignant melanoma on his lower eyelid margin—a prognostic, anatomic, and cosmetic disaster. His understandably frantic mother took him from the dermatologist who had performed the original biopsy to another, perhaps in the hope of obtaining a better diagnosis. The dermatologist referred them both to a plastic surgeon, who was on his way out of town, and thus they were directed to me.

Everett seemed much less concerned than his mother or, as a matter of fact, than I about the seriousness of his problem. I presented everything as optimistically as I could. They told