Improvisation is the buzz word in this thrilling second bonus episode centred on South Africa (you can find the first here). We were delighted to sit down with TCR veteran Dr Jimmy Lee, Consultant in Emergency Medicine in University Hospital Galway. With a passion for Global Health & Humanitarian Medicine, Dr Lee recalls his unforgettable experience completing his Trauma and Resuscitation fellowship in Chris Hani Baragwanath Hospital in Soweto, South Africa. With over 2,000 inpatient beds and a dedicated trauma unit, Barra hospital ranks as the 5th largest hospital in the world.  Coupled with its location in an area with unfortunately high rates of violent crime, and variable reliability and access to resources, working in the trauma unit poses unique challenges not often faced here in Irish EDs.  Dr Lee’s experience and pearls of wisdom are not to be missed.  Right then, let’s get to it. Get ready to pivot, and pivot fast!