180417-N-UP035-0041 PUERTO BARRIOS, Guatemala (April 17, 2018) A Guatemalan patient sits with Lt. Cmdr. Reggie Middlebrooks before a surgery to remove his plexiform neurofibroma at the Hospital de Puerto Barrios in Puerto Barrios, Guatemala, during Continuing Promise (CP) 2018. U.S. Naval Forces Southern Command/U.S. 4th Fleet has deployed a force to execute CP-18 and conduct civil-military operations including humanitarian assistance, training engagements, medical, dental and veterinary support in an effort to show U.S. support and commitment to Central and South America. (U.S. Navy photo by Mass Communication Specialist 1st Class Mike DiMestico/Released)