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ADVANCE FOR USE MONDAY, MAY 22 - In this May 1, 2017 photo, relaxed but awake, patient Mikaela Rueter, of Madison, has carpal tunnel surgery on her hand performed by UW Health hand surgeon Dr. Abhishek Julka, cener right, and orthopedics resident Dr. Walker Flannery at UW Health's American Center Clinic in Madison, Wis. Julka prefers having patients stay alert during the procedure so they can tell him if his instruments hit a nerve. (John Hart/Wisconsin State Journal via AP)