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Dear Tony, Not all of Dr. Iocona's patients rave about their experience with him. Here is my account. I came to Dr. Iocono approximately three years ago. I had had a previous pallidotomy (unilateral) by Dr. Laitinen with good although unilateral results and I came to Dr. Iocono in an effort to avoid another trip back to Sweden. My chief complaint was a very debilitating dyskinesia. I had been in correspondence with Dr. Laitinen and he knew of my intentions to have the other side done more locally. He had written me and told me specifically to tell the surgeon that the new lesion was to be placed in a lateral position to avoid damage to speech. I showed this letter to Dr. Ioconna. His reaction was that "the old boy had obviously lost it in his old age" and he felt a more medial positioning was indicated for the best results. By this time all the pre-ops were completed and due to my desperation (or wishful thinking) I consented to his performing the surgery. At the time I was being examined by him and his entourage of assistants I specifically requested that he perform the surgery himself. However, at the time of surgery he was not in the OR and only after my intraoperative remarks that "he wasn't even in the room" did his assistant summon him to the OR. Post-operatively my dyskinesia was gone but just as Dr. Laitenen had predicted I now had a severe dysarthria. The impact of this severe dysarthria has been most profound on interpersonal relationships especially between me and my wife and two young children. A contrite Dr. Iocona said, "maybe the old boy knew what he was talking about after all". Dr. Iocona's attitude is one of self-righteous arrogance. Such an attitude can be the result of knowing your right in the face of criticism from one's colleagues. But such a posture is also assumed by those whose reluctance to accept the criticism of one's colleagues borders on paranoia and false fears of irrational persecution. As a former surgeon myself I realize that an aggressive attitude can many times produce results that a more conservative approach would not achieve and I don't doubt that Dr. Iocono has many patients who have gotten excellent results. Yet there is often a price one pays for that aggression in terms of complications. It is those complications which are rarely reflected in testimonials. Ultimately testimonials are in fact meaningless because the results are statistically insignificant and are not subject to independent, objective evaluation. When a PWP becomes an advocate for a surgeon he potentially does great harm to his fellow patients who are open and vulnerable to optimistic reports especially from fellow sufferers. In fact the only way to judge the efficacy of a surgeon is through peer review of published results. Regards, Tom Riess