Today Carolyn and I performed a brief evaluation on a complex patient s/p R basal ganglia CVA with left neglect, aphasia, and an attention span of less than 8 seconds in front of medical professionals at the national rehabilitation hospital in Mangua, Nicaragua. The presentation started late so we had less than half the time we had planned for to perform the evaluation. We were quickly able to improvise and prioritize the most important information that we thought these medical professionals should have. The audience was very engaged and asked some very tough questions that we were able to answer confidently. Although the presentation did not go as planned, I think it was very informative and beneficial to the medical professionals involved in this patient’s care. This presentation, and this trip as a whole, has made me realize how much we learned in the past three years and the impact that we can make in the healthcare system around the world.