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You hit the nail right on the head. Good post.  And you are right when you say that your first sale is your last. I've found this to ring true after selling a C-MAC. After the purchase, there is no need for anything else at that point. Steel doesn't break. Flexible scope? Maybe. Bonfils? Yeah right. Brite Blades? Normally too pricey for them because they get stolen. Pocket Monitor? Well, maybe I guess, so then you sell them one, THEN what? I don't have any new hospitals going up, so where to now? :\