19 Episode results for "Dr Martha"

18. Womens Cardiovascular Health with Dr. Martha Gulati

Cardionerds

59:28 min | 8 months ago

18. Womens Cardiovascular Health with Dr. Martha Gulati

"Worldwide cardiovascular disease affects the lives of hundreds of millions dedicated cardio nerds everywhere are working hard to fight this global epidemic. These are their stories back party owners. This is corrine and this is heather. I am beyond excited for this episode. We had the honour an incredible opportunity to learn about women's cardiovascular health from the Doctor Martha Galati. She is an international leader in women's cardiovascular disease and has been immensely productive from a research standpoint bridging the gaps of knowledge in women's cardiovascular disease beyond that she is really a leader in patient education through her role and Cardio smart during this episode. We discuss this. Specific risk factors that are unique to women but also the way in which classic cardiac disease like Coronary Disease Presents and is managed in women. She touches on such a broad range of high yield topics that are relevant to really anyone taking care of women. She's a true inspiration and trailblazer for female physicians. And we are so excited to share this episode with you. Please be sure to follow her on twitter at Dr Martha Galati and friends. This podcast is not meant to be used for medical advice. The views expressed here do not necessarily reflect the opinions or policies of our employers. The goal is simply to enjoy learning more about cardiology directly from expert. Cardio I cardio nerds. This is corrine. We are super excited to bring to you this very special episode featuring one of our heroes. Dr Martha Galati. Dr Galati Completed Medical School at the University of Toronto Canada and her internship residency in cardiology fellowship at the University of Chicago. She previously served as the Sarah. Ross souder chair in women's cardiovascular health and the section director for women's cardiovascular health and preventive cardiology at Ohio State University. She currently serves as division chief of cardiology at the college of Medicine in Phoenix. She's also editor in Chief of ACC's Cardio Smart Doctor. Galati has made incredible contributions to research in cardiovascular disease in women she is the principal investigator of this saint. James Women Take Heart Project. A Co investigator on the Women Ischemic Syndrome evaluation wise previously served as co-investigator on the women's Health Initiative. Whyy she's a member of numerous advisory boards and societies including the American Heart Association. The American College of Cardiology and she's published articles in prominent journals like the New England Journal of Medicine Circulation and Journal of the American Medical Association. She is also the best selling author of saving women's hearts. Dan chiming in here. I have so much gratitude to Dr Galati. Her help with social media. Believe it or not I became exposed to Hashtag cardio twitter with the last two or three years. And that's because one of my dear mentors. Aaron migos showed me the light. I quickly became a huge fan of Doctor. Galati and found her to be so accessible with many other cardiology greats of our time. The whole experience really became one of the basis of using technology for Cardio Ed and it was one of the sparks for the Cardio nerds. Podcast Dr Galati. We are just so giddy to have you on the show today. Well I am in the presence of People. I admire very much because I didn't know who the Secret Cardio nerds were. We're just a bunch of trainees and a garage somewhere garage. You know that you know I. I just want to reiterate. Everyone's excitement enthusiasm for having you on the show. And and you all know my wife really the size of pediatricians. She's actually a neonatologist fellow. And if I ever WanNa sleep on the couch. I just have to tell her that. Taking care of kids is just no different from taking care of small adults but of course that's not true and as a father. I am so thankful for our pediatrician. But surely women are just men without a Y chromosome. I mean I'm glad we're doing this episode. Don't get me wrong but wiser so much interest in women's cardiovascular health. What's the big deal you could show I rolling recording? And so I'm doing this remotely and I'm not sitting next to any of you right now. Well similarly women have been told that were just small men and we know. That's not true right away. I moved away from the phrase we haven't met but I'm very average sized person and I know many women that could take me without any hesitation. Well I think that that's the important reason for this discussion. Because you know. The X sex chromosomes at an X. Y. There's genetic differences and actually that translates not just for physical appearance of being a woman versus being a man but sex exists in every cell so every cell has an accent axe and will behave slightly differently to certain stressors as Willett X. Y. Sell I think recognizing that makes us appreciate the differences between men and women that are so vast car that makes a lot of sense and and I know I'm going to get a lot of haters for the way I asked that question but I just want to listen to know that I was purely for dramatic effect of course? Women's health is important and deserves way more attention than it gets. Go Red for women. Yeah definitely go go right for women and yeah. I was really nervous on it and I was about to lake Dissociate myself from you know. I'm kidding knowing could have any. Hey from it. Thanks for the wonderful intro highlighting. The need to educate our audience on cardiovascular issues specific to women and with that heather. Why don't you go ahead and take the first patient that will discuss and present to Dr Cloudy Today Dr Galati? I'm so glad you're here because our first case needs a lot of expert attention. Jacqueline flowers is a thirty one year. Old G ONE P one woman with a history of obesity polycystic Ovarian Syndrome. Her one delivery was actually preterm. Judge History of Lupus and she presents to the emergency department with chest pain after an initial negative opponent i. She is about to be discharged from the emergency room with Reassurance from Dr Picasso that She's young without major risk factors for cardiovascular disease on her chest. Pain is labeled as totally atypical now. That sounds like a fairly common type of encounter but I'm sure there's a ton to unpack here Patrick Galati. Please help us break. This down. Is Dr Picasso. Right about the lack of major risk factors. How do you define atypical trespassing? And or you as reassured as Dr Picasso. Yeah well that's a good case I would say I don't disagree with Dr Picasso. I hope he's listening to this pot. It's not just yeah. It's true a thirty one year old definitely is somebody who's lower risk than say fifty to sixty year old woman but the risk factors are screaming at you and says she's not someone without risk factors in really. I mean you kind of you already listed them there. Obesity is certainly a risk factor the the auto immune disease that she has. It's a risk factor the history of pre ECLAMPSIA in pregnancy is a risk factor. So this is somebody with risk enhancers. That already are present his his putting somebody at a higher risk. There's also I believe you said that. She had polycystic Ovarian Syndrome. You know that depending on the evidence that you look at some associated with a greater cardiovascular risk your some data that didn't show it but we do know that people would poly cystic. Ovarian Syndrome have a tendency towards metabolic syndrome and so depending on her body habit as depending on her other risk factors. That we didn't even get into. She may be at greater risk for heart disease even with that alone but with all of these together she saying. I'm a higher risk than a regular thirty one year old if she already had diabetes or was pre diabetic. I mean to us. Once you have diabetes you kind of lose that protection of age and so again better history taking might tell us some of that story and help us know and of course our examination if this is someone actually at greater risk than just a regular thirty one year old without any risk factors. Don't even get me going on the fact that somebody's labeled her symptoms as typical. Because that's fresh in and of itself that we should probably divide a little bit but from risk assessment standpoint. You know this is the great thing about the update in two thousand eighteen about risk assessment and a lot of these risk factors have been identified as risk enhancers and should be taken into account when we're actually assessing risk in a woman. So if you want me to talk about her symptoms and of course. They weren't described to us but he labelled her as a typical. And and you know I. I really trying to convince people that that's actually not true. First of all when we say typical engine the typical symptoms. That's one thing we're saying these characteristics that we identify more likely associated with Angina or infarction or a ski Mia that we recognize when we use the word atypical even as it was described by Dr Cost. So you know what he was saying. He wasn't saying a typical presentation of Angelina. He was saying. I don't believe your symptoms. Get OUTTA my emergency room so we really need to. I define a typical atypical means that you presented a little bit differently than expected but yet when I have a fellow or resident running up to me while they're never running when they say this. I is atypical chest Fe. They're telling me. This is not cardiac that is different than than saying a typical and additionally we have a lot of evidence nowadays that actually women present were typically. And so it's just how we hear a woman symptoms. Women are more likely to describe other symptoms along with chest pain or chest pressure chest tightness. I think we sometimes get distracted by the other symptoms. They described so there assist study. You guys are probably familiar with the Virgo study. It was the study up. Technically it's name was variation in recovery the role of gender on outcomes in young Acute M. I. Patients and that study was specifically looking at men and women under the age fifty five and looked at their symptoms. Because we really don't know much about that group. Will they actually said that? Ninety percent of young women and young men presented with the classic symptoms of chest pain pressure chest tightness or chest discomfort. The only difference between men and women is that women were more likely again. Young women were more likely to describe three or more additional non chest pain symptoms compared with men so we need to be listening to them another study that recently at Ese was released called. The air may study. It was released idiocy in Twenty Nineteen. And we haven't seen the paper actually written up but we just got the data presented to us there. They used artificial intelligence using cardio linguistics to listening to the conversation if it heard the typical symptoms of Angina it just said I heard it so what they found. There was the same thing. Ninety percent of women had the typical symptoms who went on to have a ski Mea. The fact was is. That atypical symptoms. Were actually very less common in women but they were also described by men and we haven't seen this paper yet but it certainly interesting and I thought it was a great. I couldn't wait to hear it when I was there. Anxiously awaiting the paper to be published now the third study that came out also at Ese simultaneously published in John Twenty Nineteen. They actually also looked at this using the high stakes data. That you know the people that describe the high sensitive Opponents and they had a wealth of data on symptoms and they described typical symptoms as pain in the chest arm jaw. Dull pain heaviness. Tightness Fresher Aches wheezing crushing or gripping and then a typical symptoms. Were everything else. And they actually some show that those people who went on to have a myocardial infarction women were more likely actually to have the typical symptoms than have atypical symptoms. She men actually. Add more atypical symptoms. But it was much more likely that they had the atypical. Cluster of symptoms. So I want. I want us to our public. Health message should be that you know the patients that a typical symptoms are common in women and men and secondly that we as a medical community probably need to get away from using that word. Atypical Anyway. Because it's been misconstrued in our medical community again. Think about it the last time you heard a typical it wasn't that they were saying to you. This someone is presenting a little differently. It was them saying. I don't believe that this patient has angina right right very helpful so for practical purposes if I was in the emergency room and I'm evaluating at a patient with chest pain and do throw at what we used to term it typical symptoms. Are you saying that we shouldn't use those symptoms to kind of take me away from cardiac ideology for the ban? Well there is symptoms. That might be less common. And certainly if you want if you're listening to those symptoms and you're saying well. This is a different presentation of a my cardio infarction but look at all her risk. Factors that you know. That's a different story than dismissing the symptoms. Ever Good Reagan Dr Gluttony. The traditional risk assessment tools don't seem to incorporate the gender specific risk factors that we kinda talked about at the take off of the episode. How do you recommend Practicing Cardi nerds incorporating these risk factors into their preventative strategies with the patients outside of the emergency room. Now back in the primary care or a general cardiology clinic the again the twenty eighteen update to risk assessment or to cholesterol guidelines. When they talked about assessment of risk they actually did add in those risk enhancers in it. It's important that people use them even though in the ASC risk calculator. They don't really enter the only thing. Sex-specific that injures is whether you're male or female but you must be aware of both the differences in traditional risk factors based on being male or female how they affect cardiovascular risk but then you need to know what are those risk enhancers and you know that that's part of our history taking is that we should know those into the way. I describe it or the way that I incorporated I guess is I after a assess. Asc CD RISK THAN I ask. Well is there anything about them else? That's high risk so if they have a family history certainly. I put that as obviously a risk enhancer if they're high risk women and specific group that I want you to think about is people who are veteran. Women I think the veteran women they have much greater cluster of traditional cardiovascular risk factors as well as nontraditional respecters. We can talk about that more if you want to. But then the next step is to actually ask what sex specific risk factors businesswoman. Have in those things are things about their pregnancy. So the pregnancy those adverse pregnancy outcomes that we should be asking about specifically the ones that we have. The strongest data is Justin hypertension of any sort not just pre ECLAMPSIA ECLAMPSIA. But if they had any type of just station hypertension. It's important to note that if they had a diabetes. It's important to ask that as well and the other one that we have a lot more data about preterm delivery. Did they deliver before? Thirty seven weeks and even greater if they delivered before thirty two weeks. No matter what. The causes puts them at higher risk for cardiovascular disease. There's also data supporting having a child. Small for just stationl age that also increases the risk. There's some other things about pregnancy that we are learning more about that but the data isn't quite as strong and I think we still need some time to know what the re should be incorporating that other things that you should ask. A woman is about fertility treatment Certainly IVF doesn't increase your risk. It seems for future cardiovascular disease but it does increase the risk for hypertension during pregnancy. So at least ask in. Did you go through that? Did you have any hypertension during your pregnancy? Because that may predict future risk if a woman are they on birth control And specifically in smoking women that matters if they're on hormone replacement therapy for postmenopausal woman important to consider Breast Cancer Chemistry again. More likely in women and the treatments related to breast cancer increase the risk in a lot of the risk factors for breast cancer. Actually the risk factors for heart disease so it kind of serves stool purpose and then the last thing for women that you should ask is premature menopause because whether surgical or natural we have a lot of data showing that accelerates cardiovascular risk than the next heard I asked about female predominant conditions and specifically right now that is those autoimmune diseases. The inflammatory diseases are much more common in women in Lupus rheumatoid arthritis or the ones that we have the greatest evidence. So you should be asking about that in the end in this particular patient that we were talking about. Certainly that was the case that she had an autoimmune disorder that is strongly associated with accelerated cardiovascular risk. I think that tell you personalized risk assessment. We're not GONNA do genetic testing on every person right now at additionally the emergency room. You'RE NOT GONNA do genetic testing but genetics starts with sex. And that's easy. You just ask. What sex are you and you already have your genetic testing done in a matter of one question. That's incredible and very helpful. Dr Galati I really appreciate your review of female specific and female predominant risk factors in in my practice. I don't think I've ever asked a woman. Anything about adverse pregnancy events in the past as risk so that it'll certainly be practice changing for me. But what about the traditional risk factors that I do have the habit of asking about like smoking diabetes et Cetera? Do these risk factors in part the same level of risk to both genders yet. They don't in that. That's what makes it so interesting. That's what makes medicine so interesting and human so interesting and the difference between men and women so interesting but for women who smoke. Although there's less smokers thankfully across the United States due to a huge public health efforts we've seen that reduced since certainly less women smoke in the United States compared to men but a woman who smokes she has actually greater vascular facts for the same number of cigarettes compared to a man. So there's something biologically more insulted to a woman based on cigarette smoking that we need to be aware of. And then there's so much more that we need to learn about. You Know East cigarettes vaping and everything else that we still don't know enough about diabetes of course much more prevalent in women than in men and the effect of diabetes to a woman is much greater in terms of cardiovascular risks than it is for a man so it and not even mentioned the things that we already briefly touched upon the justitia diabetes in only happened in women poly cystic Ovarian Syndrome. That's obviously relevant to this particular patient. You know that can only happen in a woman hypertension Again is actually more prevalent in women. And there's now some emerging data that maybe you know at least for stroke risk may be at greater issue for women than it is for men other things like physical fitness or your cardiorespiratory fitness. If you will women are less likely to be physically fit compared to men through all stages of their life but the effect of being poorly fit in a woman based on some of the work we did actually showed that it may have more adverse consequences to women. There's things like depression. Much more prevalent in women that we address really poorly but may have more effects on cardiovascular disease particularly on people who already have cardiovascular disease or have had prior open heart surgery and may have more cardiovascular effects in terms of the secondary events. That's super interesting interesting. Yeah in terms of the mechanism behind you know. Sort of traditionally classically were taught that the increased risk in women. You know you really see that In the postmenopausal period due to the decrease in estrogen but we do see a lot of younger women have higher risk of cardiovascular disease as you mentioned with all these additional risk factors. Is there any idea about what the mechanism behind that might be? Yeah I think. We made a lot of assumptions. I just WanNa tell you about this. Whole postmenopausal estrogen everything. Because there was that beautiful paper. I just WANNA use hypertension as an example but there is really amazing. Paper that was just published in Jama Cardiology in January. And it made me question everything to be honest with you. We thought that there was something at menopause that changed for example blood pressure in women and that suddenly blood pressure increased when a woman was postmenopausal. And what we found in that paper by by using four cohorts of women and comparing the same for cohorts of men. We actually saw first of all blood pressure of course is lower in women but the trajectory of change over time was actually not something magically turning on at menopause but actually increasing over the lifetime of a woman that trajectory or the slope of increase was much greater in women which now made me question do even know. What's the right cutoff of of hypertension for women are even the right numbers? I think as I've always taught that when you think you know something go back and look at what. The literature actually was based on. And you'll find that you actually made a lot of assumptions and we know what we say about of assumptions. You know so we really need to really question ourselves about things that we thought and if you WANNA go back in time and you guys are too young to remember this. Two thousand one was a really important year when we think about cardiovascular disease in women because in two thousand one the women's health initiative results or release what you guys may not even know this but the number one prescription in two thousand one was hormone. Replacement therapy my gosh. That's crazy and overnight in July. I forget the exact date but overnight that was no longer the number one prescription in the United States and we finally had done a study that included women and looked at a drug that so many women were taking in that they were told it was the fountain of Youth and then we find out. Guess What it's not the Fountain of Youth and it wasn't a magic that we thought and it certainly didn't save women's hearts at all again. It isn't just estrogen. It's it's biologic. It's being a woman. Probably some hormone effect but not the only thing it's aging in. Its how women age compared to how men age and there's probably women normative values and there's probably male normative values and we need to stop grouping ourselves. Dr Larry. I'm loving this conversation because it's reminding me of a concept that you've taught up before this concept of moving beyond the bikini line and that in the past gender associated health differences were all thought about from the perspective of a reproductive help. But clearly as you said earlier in this conversation that genetic differences in every cell so reproductive differences may not be the underpinning of all of our health differences. Yeah absolutely I think. We're just more complicated than our reproductive systems so much to probably mention grin but There's there's were even more complicated so I I think that that these are why we need to study women. This this is why. We need to be included in the trials. This is why fifty two percent of your population should not be categorized as special population as it was in the past. I don't know if you guys know that. But that was how in guidelines we used to be. There is the guidelines in their special populations. And you know there's lots of special populations that are you know small segments of our society but women used to be categorized in that so no no wonder. People didn't always use guidelines direct at therapy towards women. If they didn't think they were studied or didn't think it applied because that was often the case. That was super helpful. Thank you so much. I'm going to bring us back to our very real case with Dr Picasso who may have overheard our conversation because he decided to monitor jacqueline flowers overnight and much to his surprise Values rose peaked then fell on ekg. She had sinus attack with nonspecific. St Changes and an echo showed a depressed ejection fraction with an inferior while motion abnormality. She underwent coronary angiography which revealed a thrombosis seclusion of the disarray coronary artery. And she did well. After perkiness coronary intervention with a drug alluding stint and she ended up being discharged with coach follow-up Cardiac Rehab well. I am so glad we data double their doctor. Picasso sure is very happy as well. It's really makes me wonder. How many events go MR untreated doctor? When women present with chest pain? How well do we do with making an accurate and timely diagnosis and instituting appropriate treatment? How outcomes in women compared man especially when guards to chest pain. Yeah you know. This is always an issue. Unfortunately still for women in terms of both their symptoms being taken seriously. And you know we we. Earlier talked about atypical chest pain if you will even though I don't like that term but even when a woman presents typically it's still especially when they're young there's a lot of delays in care and there's discrepancies in care based on sex so when we look at some of our data things like get with the guideline data how how well some of the best hospitals in the United States perform in terms of their care of patients. Who HAVE A MYOCARDIAL? Infarction and we repeatedly see the sex differences in how we affect women's care after myocardial. Infarction women are less likely to get a early medical therapy. Whether that's asked for in Beta blocker within the first twenty four hours are women are less likely to undergo any type of evasive therapies. They're less likely to meet the door to needle times or door to balloon times. That are standards that are set for us to achieve and the only thing that women tend to do better than men is die and we know that stiffly for Sto big chicken myocardial infarction group. That's where it really stays in. We keep looking at the state over and over since we started this collection of data. And we see it persisting and it's always showing it's worse to be a woman and specifically it's worse to be a black woman though. Black women tend to get even worse treatment if that's possible in terms of the aggressiveness of therapy and there's some data supporting younger women. Not Getting as good of therapy because we're always interested in younger women because they actually have worse outcomes after myocardial cardio infarction but in general get with guidelines data the. Dr Data has really shown younger. Women with their smaller cohort. But in general it was just women and other things that get with the guideline have shed is that even upon discharge women are less likely to receive lipid lowering therapy. They're less likely to even leave the hospital with control blood pressure. And there's really no excuse for that and we know that that at least partially contributes to worse outcomes we know. Women are more likely to be re hospitalized. After acute myocardial infarction in specifically. It's the younger woman who are even more likely to be re hospitalized. There's a lot of reasons for that. It may be that younger. Women are not getting the right medical care like the right discharge meds. They may also be less likely to refer to cardiac rehabilitation or adhered cardiac rehabilitation for numerous reasons of which we can get into. And there's more post myocardial infarction depression which could ultimately affect women deciding to adhere to their medications or go to cardiac rehab as well. So there's a lot of issues. It's such a complex play of delays of them getting treatment unfortunate bings from the medical community where they don't get good therapy that results in them having worse outcomes. So I don't even know if I even answered your question properly Tell you that the things that affect women symptoms are one part of the equation but how we as the healthcare team approach. Women is also slightly different. I'm just amazed that even something as simple as blood pressure management were falling behind. I thought we had that covered. Yes so did I. Gosh it after my cardio infarction at least that we actually if you just look at the general population Just everyone with hypertension. We actually aren't doing as bad with women as we are. Actually that's where differences in just general management. We I would say we actually do better with women particularly African American women but we do poorly overall. But after my cardio infarction we tend to take risk factors a lot more seriously right. That's what we can address in save lives and so that group. We need to be doing exceptionally well. At that group. We are not specifically women. That's such a failure on collectively. We are even being given a warning sign and we're not taking advantage of it and just applying it to this population at risk. Yes and I think if we look at women and where. Where are the things that we can simply make a difference? I think there's a lot of complex. We need more research. We need everything else done. But we're can we right here. Now make a change in our daily practice as whether your fellow whether you're an attending is simply looking down. Did I give everything that is part of S- The guideline directed medical therapy to this person? This person doesn't matter if they're male or female what we know right now that saves lives. Did I give it to this patient? Who had a heart if I did? I've done right by them. It doesn't matter if they're male or female we will save. More lives doesn't matter if they're black or white or what color they are. Does it matter if they're male or female? Let's treat them all equally. Let's have a checklist. Have have a double check on what we think we're doing and make sure we're doing it right because what these national databases help us with is saying. Do we really do what we think were doing. And if we're not that's how we correct our behavior absolutely you. You definitely highlight a lot of gaps that remain within research in there so much that we don't know but you're absolutely right at the bare minimum. We should at least be doing. The goal directed therapy in management that we do know about So our next to imaginary patients are in the EU. Mona Lisa is a twenty six year. Old woman admitted with newly depressed ejection fraction two weeks after childbirth. She's diagnosed with Perry pardom cardiomyopathy but unfortunately now in Cardio genyk shock on Equa support. Next store is Mary Cassatt. Thirty four year woman admitted with an anterior St Elevation M. I. Diagnosed with left anterior descending spontaneous coronary artery dissection found to have fiber muscular displeasure on the basis of vascular imaging. The staff including Dr Davinci cannot remember the last time a man came in with scattered. He also can't remember the last time. A man was admitted with Perry Cardiomyopathy K. K. I'm getting the point. Everyone women aren't just men with a Y chromosome clearly. There are genuine patsies differences. I mean Dr Gallotti said there's a genetic difference in every cell and so there are therefore clearly conditions that are either specific two or more common in women. Dr Lottie what should practicing Cardi nerds know about these conditions? And when should we be acting these? Yeah well I mean I also wanted to point out. That men can't get pregnant so you know that also is an issue that but that aside I think. It skied has taught us a lot because spontaneous coronary artery dissection. You know people really didn't know what was happening but it was commonly being seen. It was being seen. It was being seen in. Young women often Sometimes related to postpartum states in. I think that you know that has taught us a lot about something that is extremely more likely in women than it is in men and then the pair pardom cardiomyopathy again would only happen to women but yet is such a critical issue like the patient that you're giving the hypothetical patient can be on echo and it can be life or death asking God. I mean there's many cases that people will describe and they don't even survive and so both are really great cases for us to understand that they're not just mild diseases or something that you don't need to worry about sort of this idea that that the things that are different about women aren't things that would kill them actually. Both of those diseases can actually kill women. Kill Young Women. Those are the things that I want at least people to recognize that these are our major issues and I think even broken heart syndrome or Takasu stress cardiomyopathy. Now we have three different names for it. But that's something as well that you know a lot of people say oh that just recovers you know. It's the right but actually there's some patients who go on don't recover and there's people that go on and have multiple episodes of stress cardiomyopathy and it's very concerning because we don't even have enough data yet to tell them what the consequences might be whether they're going to have it again or not. Never time they feel chest pain just like a Scott patient they worry. Is You know where it's GonNa take me to go the emergency room or they're gonNA do nothing. Do I call the doctor? What do I do about this? And this is again are evolving area. That we're trying to learn a lot more about thank you for that. Dr Gluttony and I. I really appreciate this conversation because So far we've highlighted that there are differences both in risk factors and diseases and I like high categorize. These one of your review papers in talking about female predominant factors female specific factors in on the disease side females Pacific diseases and female dominant diseases. And I think a lot of times we get as cardiologists for traditionally looking for obstructive disease. And sometimes you're going to have very serious conditions and they're not going to have obstructive lesions and I think we like obstructive coronary artery disease because we know what to do with it. Seems kind of put us in a different category of non obstructive coronary artery disease or whether it's an MRI than its MINOCHA. If it's no am I but a scheme yet said NOCA- but we that those are still very broad categories and. It's just that we don't know enough about these individual conditions entirely to say okay. This is how we treat it. This is what the natural evolution of it is. You know. Here's the we're learning and that that's also important for us to know but it's also the area that I think. Physicians are most uncomfortable with. We like to be able we're cardiologists. We like to be able to quote. This is this is what's going to happen. The natural history. This is you know if we do the right thing with you. You'RE GONNA go on and you're not gonNA have any issues if I can help you with your risk factors. We don't know that for these conditions. Well thank you for that. Dr Larry. That's something we definitely will always keep in mind going forwards anyhow. I am definitely getting the picture and learning lessons about how complicated cardiovascular care is for women in the need for dedicated strategies to bridge gaps in knowledge care and outcomes which is why we're doing this whole episode in the first place. I have to be seeing jacqueline flowers in clinic and I WANNA maximize secondary prevention. Because I now know I'm not GonNa miss another opportunity with this particular patient. So her blood pressure is going to be. I'll just let you know 'cause I know these things. One forty three overnight. The two millimeters of Mercury and her lipid panel is less than optimized with a total cholesterol to twenty triglycerides of one. Sixty eight thirty two in. Ldl of one fifty six all in milligrams per deciliter Dr Lodhi. What would your approach be lipid and blood pressure management? And this woman are there any gender-specific differences here oversight treated like any patient as secondary prevention for women. I hope the first question. Especially because remember. This was a young patient the first question I would wanna ask her is are they planning to have children because of course family planning what medications you can use in this patient will become an issue if it isn't right now might not be the here and now for her but long term you have to have a plan and so the here and now. She's had a myocardial. Infarction she has the stunt for a while. You're going to actually talk about. What are you going to do to prevent yourself from getting pregnant in? What's safe for her as well in terms of those family planning issues because I mean again you don't WanNa give her something necessarily like birth control pill if it's GonNa make her more hyper Kwaghe Bowl. For example we might talk with their. Ob about what just happened and is not you D may be more appropriate for her versus oral contraceptive but then long term. You need to know. Is She gonNA plan on having kids because one Remember if you said she's on a Statin all presume you did right by her and put her on a Statin but certainly you don't want her getting pregnant on Astatine if she is on a nascent hitter because she had a myocardial infarction and had some damage to her left ventricle again. That's not something long term issues going to get pregnant that is going to be appropriate now in terms of management of course. Her Lipids are terrible. And her blood pressure. She left the hospital. Like a lot of women with poorly controlled blood pressure. So you need to get that under control but again taking into account the sex-specific considerations of what medications you use and the fact that she had a myocardial infarction. You'RE GONNA have to know about some of the issues related to medication. So women are more likely if she is on a nascent hitter. A woman is three times for likely that a man to develop an ace related cough. So hopefully you already have asked her how she's doing with her new medications you know. Is there anything she's noticed? That's important part of our history taking. If you'RE GONNA use a calcium channel blocker for blood pressure loan. Maybe you wouldn't have been her because she had a myocardial infarction but if she if you do remember women are more likely to get preferred Edina so again important to know if there are a diuretic. Diuretic is super useful to get blood. Pressure control has minimal side effects in general from a patient's perspective. But will you might notice in her. Labs are women are more likely to get hype way traffic an hypoglycemic from but maybe if you have them on that in the history of no issues so It's not that you have to avoid that. You just have to be looking for it and men on the other hand are more likely to get guilt from Diuretic so you know that that's important when you're taking care of men and then of course are likely to report sexual dysfunction with Beta blockers and by direct says. Well you know again. It's important to know the differences and then for a young woman who maybe she says to you. Know Okay Fine. I understand I need to be on all these medications at least for a year. But you know I'm still young woman I haven't had any kids or she has had one. Because you told me about pre ECLAMPSIA. So maybe she's had one but she's like we were planning on adding another kid. When can I have another child? But you know what's going to be exposed to the fetus in what's GonNa be exposed in breast milk because I breastfed my last trial. And it's important to tell everyone that you know what medication do they have to be on lifelong? What ones do actually go to the fetus? Which is literally everything But which ones do we think are relatively safe in which ones are not and then for breastfeeding? A lot of women will ask. You better be prepared to talk about that especially from a hypertensive standpoint every drug you used for hypertension go straight to breast milk except for propranolol in the fettuccine and so you we all need to be familiar for taking care of women you got to kind of have either if you can't remember it up as charts in the the room where you see patients or have them available easily on your smartphone so you can talk about it. Do some shared decision making together about. What does she feel comfortable being on? What are we going to do in the short term next year? Then if she wants to have a child it may not you may advise against it but the fact is women are going to do what they WANNA do. And I've learned that that you can't make that decision for them so be prepared that those questions are going to be asked. That's really wonderful. Doctor Gladdy so in summary. We have learned that women are not the same as men women. Ken Present often. You know with the classical symptoms of chest pain they might though have additional symptoms in conjunction with the classic chest pain symptoms and there are certain risk factors that predispose women to cardiovascular disease that we've gone over and this is not necessarily to associated with the loss of estrogen in Menopausal as you mentioned What we learned with hypertension and systolic blood pressure that these changes and differences manifest themselves very early on and will we need to make sure that we're doing is encouraging clinical trials and researchers and uh says investigators to really be asking questions about what we don't know With regards to the pathophysiology presentation of Disease Management Medication Use in women as compared to men. And make sure that we're enrolling more women but at the very least be treating women with the Guideline directed medical therapy. That we do have. You're a great teacher. Creed keeps me very focused and fellowship during lectures and she kind of boils down for me. I have a really bad case of attention deficit disorder excuse. Monastic important. Thing is like just to remember when you're looking at literature one of the first things that I do. Maybe obviously I'm a little biased. But I I glance at how many women were rolled and to say like you know. Does this really applied? Both generalize abolish it exactly and then the other thing is you know I showed slide about when I was. I think I showed it at Hopkins. Was that what studies have. We included women in trials. We've we've included women in trials quite well related to now hypertension pulmonary hypertension and that both of those diseases. We actually enrolled a fair number woman but common things being common heart failure in anything related to coronary artery. Disease whether you talk about acute coronary syndrome or just coronary disease. In general we haven't included enough women and yet that's the communists things you'll see so that maybe is why we have more questions about what we do in coronary artery disease for women than men because maybe some people are assuming they don't apply to women. Yeah and it's really interesting. You know there's women's cardiovascular health as patients but then there's also this whole gender disparity of women within cardiology and a recently had the pleasure of hearing Dr. Aaron migos gives a grand rounds talk about recruiting women into cardiology and learned that it is the least number of women physicians compared to other fields. Second only to Orthopedic Surgery which has the least women overall and on the second year medicine resident. I wasn't considered pursuing cardiology fellowship. Along the way I really fell in love with diagnostic medicine and Medical Education now planning on a career as an academic hospital as but all is made me wonder what made you choose in cardiology in the first place. What unexpected turns and challenges have influenced your career? Yes so I decided to do cardiology because when I was a medical student. I remember sitting in a lecture. Very famous American came to Canada spoke up. My Medical School in her name was Dr Net winger and Dr Wang or came and Back then you. She was actually the first person to coined that term about the keeney medicine and she pointed out to us that we really knew nothing at that time about women's hearts. I was so shocked by that because actually in my family I would say the women men might get heart disease but they don't necessarily die from it at young ages. Worst the women in my family. Nobody makes it past the age of fifty and they die from heart disease or stroke and so I remember sitting. There is almost like my. I didn't know that I mean I was very naive medical student like I'm just GonNa Learn all the answers here in medical school and then go out treat people and then. I realized that we hadn't even included women in trials. I'm like well no wonder so. I was like that was a day. I remember saying I'm going to be a cardiologist and I'm actually only going to study women's heart than I had and I to this day. I actually my my patient population. My clinic patient population is only women. How I feel very fortunate to be doing what I really imagine myself doing it. It's not to say it wasn't without obstacles. There was obstacles in there still are obstacles on a daily basis but I think that it is such a wonderful career. I mean you have more options in cardiology than you have in any other field. You can be in academic. She can be in private practice. You can be part time. Even though people don't always know that you can have a more academic career. You can have a career where you take less call because you choose a pathway with less call but you don't have to just being a woman doesn't mean that you want less call and there's times in our life that you might need less but sometimes for men that will become important to we also need to work to mate cardiology more family friendly because it will benefit men it will benefit women actually equally the younger generation the millennial generation actually men and women both want more of family life. They don't actually want more money. They want equal pay for equal work but they actually want quality of life as well and we know. That's going to make cardiology better for all of us. If we start listening to them you know the other thing. I JUST WANNA point out yes. Orthopedics is the only specialty that recruits less women than us. That's not really a flag in our cap because urology is able to recruit more women than us and all of that that it's necessarily anatomically the only thing that women necessarily want to deal with every day and I will say. Ob Guy Knee as well. Otani is is so unpredictable. Your Life you're always on call and at work hours are really different and yet more women their e emergency lot of shift work. More women are there. Women are not scared of work and so there's nothing unique about cardiology. That is scared them. Away is it's our way of presenting it to the outside world when we only show the face of cardiology. We predominantly men. If leaders are predominantly men if speakers are predominantly men if journal editors are predominantly men. Women do not see themselves in that role if they don't have role models we need more of us out there working every day encouraging our younger colleagues that this is something enjoyable in something that we are passionate about. We have fun every day if we make our environment. Better for women. Men and more welcoming to everyone of initiatives swimming amend we need more diversity in our field. That is what is going to make people see. I can be like that person. I am like that person. I am going to enter that career. Cardiac at the onus is on us. The onus is on the cardiology field to open those doors and make everyone feel welcome. That's the way we'll change it. That's how we'll take better care of. Our patients are patients are diverse. And we don't learn about things that affect certain populations are certain segments of our community without having people in our field saying. Hey you know what the reason that. They didn't take their medication. When you talk called the noncompliant it was because they couldn't afford their medication or they were waiting for their paycheck. That's why they're welfare check. I came here as a Canadian. I didn't understand all of that. I had to learn that. Actually I learned it for my patients on the south side of Chicago. Who explained to me why. They had to discharge himself against medical advice because they if they couldn't get their check couldn't pay their bills let alone the -CATION and I remember. That was honestly in. Iowa opener for me. It wasn't something I ever thought about an now. I negotiate with my patients. Winfrey let you go home. Get that come back and we work it out and they know I understand them a little bit more but I just want them to go home and get a check and come back and let me take care of them. We that I learned that but again we need to have our whole diverse community out there teaching us things helping our patients feel like I can trust that doctor because they look like me or they sound like me or the from my community. And that's how we're going to change things and we'll change it together but we cannot rest in cardiology thinking. Well WE HAVE. A women in cardiology grew for you know. We've we try to recruit them. They don't come. We need to be banging down the doors. We need to be yanking the person who just said Connor Medicine. No no you've made a mistake. The more fun is coming to be a cardiologists being intensive ists than be beating. Run the CC. You for US. Tell us how to get there. What why didn't you choose our career over the one you chose? What was it so that I don't make the mistake with the next young woman? That was flirting with cardiology. Because you should fall in love with cardiology because it's awesome. I think we'll all agree. The cardiology is awesome. And I have to say that this has been such an incredible discussion. I've learned my lesson about the importance of women's cardiovascular health and actually I learned quite a bit while I was preparing these questions. Dr Gladdy from your prior publications in talks which there have been a lot but something particularly stuck with me and I want to mention just because of how happy amid my wife one of your talks you quoted George Carlin saying that women crazy men are stupid and the main reason women are crazy is that men are stupid and I just feel like my wife really could relate to this just a little bit too. Well I WANNA make sure everyone knows had a man. That's quoting a man because some trouble at that like I said it a church car. No no this is definitely a safe space so Dr Golani. We have been focused on cardiology in our podcast but we decided earlier on our mission statement would also include promotion of wellness in Among some of the other things that we do so we have implemented a segment where listeners can call in and tell us what's making them Excited about their work in the healthcare environment could be anybody. We've had orthopedic Surgeons Call. We've had you know reproductive endocrinology call. We've had nursing call we've had medical students call ophthalmologist call. We're just excited about the variety of different colors. We call the segment. What's making my heart flutter? So is there anything? That's making your heart flutter. Oh goodness goodway right. Yeah like what's making you excited. What's what's like basically like refueling your engines at work. Well I probably happens before work because I am pretty religious about running and so in terms of what keeps me sane and keeps me going and motivated and healthy I do. I'm all about prevention and wellness in the thing I I have to be the example to my patients so for me. The biggest thing is that every morning I wake up and it does. You could ask me to take days of rest. I don't every day me and my dog Brinkley. Who sitting here on the couch next to me. We go running every morning and he needs it every day so I stopped the whole idea that I needed a couple of days. A week of rest. He's told me that we don't get rest. We get up at five. Am earlier when it's hot in the desert and we go running every day and I think that's what keeps me moving everyday in like excited and energized and positive and at least brings my stress down. I think when I'm at work. Sometimes Sir is stressful days. Have been when you're chief of cardiology. There can be fun days in. There can also be really things that really deflate you and I think you have to also sometimes go back to your office in mentally regroup in. Remember why you're here. Remember the things that make you happy meditate. Think about those good things whether it's your family whether it's the job that were so fortunate to have whether it's the sunshine that came out today those little things like remembering one good thing that happened every day. It's something I remind myself. It's a sign in my office. What is the one good thing that happened today? Find something because that can make your day so much better and it can remind you that not everything is bad. When you're having a bad day data gladdy. This has been such an awesome conversation with you. We've learned so much. We've talked about so many relevant amazing cardiovascular topics that also thank you so much for sharing all of the more personal stuff about why he wanted to cardiology and just such great general life advice Thank you for your time and thank you for talking with us. You are an all star. This was like such a wonderful episode. I IV just so excited to continue producing it with Amish Team well thank you for having me. I'm so excited to be on. That brings us to our show. So it's time to make like an s to split. You can follow us on twitter at cards. Don't forget to check out the amazing illustrating the Korean prepared for y'all at www dot cardi unearths dot com and please share. What made your heart flutter this week send us a clip two. Cardi inert said gmail.com if you enjoyed the show be a nerd and spread the word. Oh my God. That episode was legit amazing. You see I've been telling you this. For years of Focus Women's cardiovascular health is just so important don told you you never.

infarction hypertension Doctor Martha Galati heart disease Dr Picasso United States ECLAMPSIA Women Ischemic Syndrome acute myocardial infarction coronary disease diabetes Patrick Galati Angina Ovarian Syndrome Dr Galati Completed Medical Sc American College of Cardiology Lupus Dr. Aaron migos Dr Larry
Dear Sugars Presents: Loneliness In A Socially Distant World

Dear Sugars

15:22 min | 3 months ago

Dear Sugars Presents: Loneliness In A Socially Distant World

"Kind world is sponsored by apple books. WHO's partnering with the One and Only Oprah to bring you her next book club pick. This one is Deacon King Kong by James. McBride it's a story of connections and community. In one, thousand, nine, hundred, sixty nine New York City. It's also a social novel with a heart of gold with characters that will crack you up and I'll make you cry Download Deacon King Kong on Apple Books at Apple Dot Co. Slash Ob. See once you're done with that. You can explore millions of other books and audiobooks on the apple books up. It's got a lot. Get started today and read with us. Hate your sugars, fans. This is Andrea. A Swahili Co host of kind world where sister podcast of your sugars and recently we made an episode. We think you'll like and we want to share it with you. It's about combating loneliness in a socially distant world. We hope you enjoy it. Produced by the I lab at WB YOU ARE BOSTON. Welcome to kind world, I'm yes-men, Amer and I'm Andrea a he so last week we talked all about meaningful gatherings. If you haven't heard conversation with Priya Parker, go back and listen. She's got some great tips, but this week we're talking about the polar opposite of gathering being alone. We've all felt lonely at some point in our lives, but the reality is loneliness is so much more than a bad feeling. It's a public health crisis that affects more than half of adults in the US. Many. People feel that if they're lonely. That means that they're not likeable or that. They're broken in some way and I certainly felt that as a child that was one of the reasons I never told my parents all those years. I struggled with loneliness. In fact, feeling alone, and we WANNA, ultimately address loneliness. We have to figure out how to eradicate that stigma and help people see loneliness from what it is, which is a human condition that all of his experience at some point in our lives. This is the former US surgeon general Dr Viv AAC morphe- who served from the end of two thousand fourteen until twenty seventeen. He's the author of together the healing power of human connection in sometimes lonely world, and just make it even more clear. Listen to the scientific finding Dr Martha told us so. Loneliness is associated with an increased risk of heart disease of depression, anxiety of premature death of sleep, disturbances of dementia of impaired wound healing, and the list goes on when studies have actually looked at them. Mortality impact associated with loneliness. What they have found is that that mortality impact is similar to the mortality impact seen with smoking fifteen cigarettes a day. Okay fifteen cigarettes a day. That is almost a full pack. In one day. We were shocked when we heard this. How can loneliness cost so much damage? Well, Dr Martha says it's because it puts our minds and bodies in this primal and unsustainable state. Loneliness is a natural signal that our body sends us when we're lacking something that we need for survival in this case, human connection, we literally need him. In connection for survival in that sense is very similar to hunger. Thirst signals at our body sends up when we're. We're lacking food or water now we if we respond to that signal by getting a meal or a drinking some water than the hunger, thirst will subside similarily, we seek out connection with others. If you pick up the phone to call a friend, get in the car and go visit a relative. That loneliness may subside, but when the loneliness persists for a long period of time is when we run into trouble, because physiologically loneliness induces a stress state in our body, and in the short term stress, states can motivate. Motivate you to action in the long term, they're associated with increased levels of inflammation. That's associated with an increased risk of heart, disease and other chronic illnesses. The chronic illnesses are what surgeon general's have focused on in the past and Dr. Murphy said that was initially his plan to when he came into office, but when he actually traveled and spoke to citizens across the country. He had an epiphany. What I recognize overtime was behind. Those stories were so many threads of loneliness. People would often say I feel I have to. To deal with all of these challenges by myself, or if you if I disappear tomorrow, no one would even notice or feel invisible and hearing that again and again from college students from parents from people in remote fishing villages in Alaska to members of Congress in Washington C.. It struck me that something deeper was happening here. He'd heard that a lot, too as a practicing physician, and he knew it was a problem, but addressing loneliness. It wasn't taught in Med school when you enter a profession like medicine or nursing. Because you want to help people and relieve suffering, and when you see people suffering in front of you from 'cause you have no idea how to address something like loneliness. He doesn't feel good, and that's how I felt when I was in the hospital. And I. Encounter patients who were alone and I didn't know what to do and I felt I wasn't serving them. All of this inspired him to make this topic loneliness, the focus of tenure as surgeon general, he looked into how loneliness affects people of all genders, ages, cultural backgrounds and socioeconomic levels Dr Murphy can even draw a line between loneliness and another pervasive illness in our country racism. I remember what it felt like to be called out or having dark skin for people making assumptions about me, calling me pejorative names. And even as a child I remember feeling to sense of shame when people tell you that you're less than that, you don't matter and they were inferior. You internalize some of that for me. As a child, I remember reacting to it by withdrawing further and further into my shell. and. Here's the thing about loneliness. That is so challenging. Feel connected from other people. You would think while our instinct should be to reconnect, but there's a paradoxical said of wheels that are set in motion if you will. On that actually functioned to deepen our loneliness when we experienced cleanliness, and so when we feel separated from other people, whether that's because we don't have the connections around us that we used to have, or because we're feeling uttered and made to feel inferior, an isolated we enter into this trustee, and in that stress date because we're worried about our safety are focused turns increasingly inward, we also become hyper, vigilant, more likely to perceive threats around us, and we also experienced this erosion of self esteem. As over time we can come to believe that may be the reason we're being offered. Maybe the reason we're alone is because there's something wrong with us. It's hard to imagine a way to overcome such a deeply rooted issue like loneliness, but Dr Martha says it's possible to start healing ourselves and our communities because he's seen it happen all around the world. After the break we hear more from Dr Morphe- on some proven solutions to battling loneliness, and how we can keep loneliness at bay at a time when social distancing is crucial to our survival. Kind world is sponsored by Apple. Books we've been telling you about the new book from Oprah's Book Club, but why not hear it from the herself? Hello, everyone. I'm excited to share my expert club. Pick with you, Deacon King Kong by James McBride a story of connections and community in nineteen, sixty nine New York City the characters will crack you up and make you cry. Get Deacon King Kong at Apple. Dot Co splash over. Then explore millions of other books and audiobooks on the apple books APP. Download today and read with. Welcome back to kind world today. We're speaking with Dr Vivek Murthy. The former US surgeon general author of together the healing power of human connection in a sometimes lonely world. Have you seen any really great examples of people? Getting together some community building or outreach that has helped. Break that stigma a little bit. To share the story of Serena. Who during her freshman year at the University of Pennsylvania extra experience, extreme loneliness, and she built these wonderful gatherings called space gatherings. Where students could come together and have open honest conversations about the connection disconnection. There are feeling on campus about what worried them about. Their sources is a fear as well as what was giving them joy, and by creating an environment or people could do that. Sereno loud hundreds and hundreds, and now probably thousands of students over the years to have a place where it was okay to say I'm lonely and I didn't mean that you were broken. Small gesture big impact that philosophy is also infused in some community-wide. Like the men's shed movement, which was specifically designed to help elderly men connect not through talking but through work. The idea was that if people came together to work shoulder to shoulder that they were more likely to connect with each other, and would lead to dialogue, and for thousands and thousands and thousands of men around the world, men's sheds have become part of their community, and in the UK. They have founded men who participating these sheds, experiences, significant reduction in depression and anxiety and loneliness. The men's shed movement spread from the UK to other parts of the World Ireland Canada Greece, and even here in the US, but the most important way to heal loneliness is to start with ourselves. Dr Morton says. We should all reflect on this question. Am I truly living a people centered life? It's something he asked himself during his medical residency at was seeing so many young patients with end stage cancers and he admits he wasn't exactly practicing. Practicing what he preached, no thinking to myself am I leading my life. The way I truly want to if I was in their shoes, would I be able to look back and say? I spent my time in a way that was consistent with priorities that I truly did put people first, and it was painful to admit this, but the answer was no, and so I made a point after that to use whatever time I had vacation time. Etc Go visit my parents and my sister. even though it didn't make a Lotta money as a resident and he was always convenient and a win, and we had a couple of days off, I never regretted going to see them I often regretted not doing so, and so the first point for us all. If we want to build a truly more connected world is to look in the mirror and ask if we're leading the kind of life that we want to be leading. Right now, though living people, centered life is pretty tough. We're supposed to be staying away from each other in the time of covid nineteen. And, this of course is fueling the loneliness crisis in our country. So what do we do? How can we connect at a time? When we aren't supposed to be physically close to anyone sort of one, we can make a commitment to spend at least fifteen minutes each day with someone we care about that could be video conference with them. They could be talking to them on the phone. Where simply writing them to see how they are? The second we can do is to focus on the quality of time. We spend with one another if you're able to put away. Away distraction and focused entirely on them. The connection you feel can be extraordinary. The third thing we can do and this was a surprise to me as I was writing. This book is, we can look for opportunities to serve because it turns out. That service is one of the most powerful antidotes to loneliness when you understand the downward spiral that loneliness drives you understand that service breaks that cycle by shifting focus from ourselves to someone else in the context of a positive interaction, but also reaffirming to us, the we do, in fact, have value to bring to the world. The final recommendation from Dr Morty is one that may seem a little counter intuitive. He says we all need to embrace moments of solitude. This might seem strange because you might think gosh. Why do I need to protect? Solitude of my goal is to connect with other people, while it turns out that our ability to connect with other people is driven by our ability to connect deeply with ourselves. That can be just a few minutes sitting on your porch, feeling the breeze against your face. It can be a few moments spent in meditation or prayer or remembering. Three things are grateful for. Or short walk in nature or some time spent with a good book, but however we find our solitude, we all need to anchors house, and when we approach other people from that place of being rooted. Were more able to listen to them to focus on them and to forge a stronger connection with other people. Ultimately Dr Murphy says the message of his book and his research can be summed up in just three short words put people i. It is so clear that we are wired to connect with one another. That's how we're built and the pain that so many preserve experiencing disconnection is a pain that stems from not being who it is that we were designed to be all over these thousands of years we put people first, and how we live our lives how we design policies how we design our institutions, then I believe we will create a world that is healthier is more resilient or fulfilling, and certainly the world that our children deserve. Thank you so much Dr Vague more for speaking with us. His book is called together the healing power of human connection in a sometimes lonely world, and it's available in bookstores everywhere. Hey thanks for listening to kind world this week. Our show is a production of WB. You are Boston's NPR station. Paul Vike Samat Redo our sound design Sophie Eisenberg is our W.. B. U. R.. Fellow Catherine Brewer are managing producer and editor and Iris. Adler is our executive producer. I'm reporter producer yes? And I'm reporter and producer Andrea. Will be back with a full episode of kind world next Tuesday but on Friday. We'll have another classic kind world episode dropping your feed, just a little extra dose of kindness to start your weekend right? Thanks for listening. We'll see you next time. Kind world is sponsored by Apple Books We've been telling you about the new book from Oprah's Book Club but why not hear it from herself? Hello, everyone I'm excited to share my next book club. Pick with you Deacon King Kong by James McBride. A story connections and community and Nineteen sixty-nine New York City. The characters will crack you up and make you cry. Get Deacon King Kong. At Apple Dot Co slash obesity, then explore millions of other books and audiobooks on the apple books APP download today and read with us.

Apple Deacon King Kong US New York City Apple Dot Co Dr Martha Andrea James McBride Dr. Murphy BOSTON Oprah Dr Morphe Dr Vivek Murthy Dr Viv AAC Alaska UK Priya Parker Dr Morton University of Pennsylvania
52. Womens Heart Health & Women in Cardiology with Dr. Nanette Wenger

Cardionerds

57:16 min | Last month

52. Womens Heart Health & Women in Cardiology with Dr. Nanette Wenger

"Worldwide cardiovascular disease affects the lives of hundreds of millions dedicated cardio nerds everywhere are working hard to fight this global epidemic. These are their stories. Here Cardi Inert family. It's summit. We published this current episode with tremendous pride privilege and honor. Dr. Ninette. Winger teaches us about the past present and future of both women's cardiovascular health and women in cardiology. As the foremost leader in the field, a legend among legend's her perspectives are extraordinary. We believe this to be a historical landmark, not just for the cards, but also for cardiology and society, and we hope that you feel as inspired as we do. We're also so pleased to have Dr Martha Galati provide a proper introduction for Dr Winger befitting her immeasurable contributions Dr Glad is chief of cardiology at the University of Arizona among many other titles as well as a constant support and mentor to the Cardio nerds. She is just such a great example of docker wingers legacy. and. Finally, we leaders joined the world in wishing Dr, winger of very happy ninetieth birthday and offer. This episode is our gift. We'd like to express our joy in Truecard sing song style. But just remember we're innards not acquire and we'll be keeping our day jobs. So here we go one, two, one, two, three. Avenue. And many more. We are honored beyond words to bring to you this very, very special episode with doctrine and Net. Wenger Dr Winger is a true leader in the field of women's cardiovascular health and a strong proponent of women in Medicine Her Passion Dedication and advocacy has inspired countless trainees to carry the torch and continue to build on her truly impactful work. One such mentality is Dr Martha Galati who taught us about women, CV health and episode number eighteen. She told us how hearing Dr Wenger, as a medical student was a major turning point in her own trajectory and was the catalyst for her own career in advancing women's cardiovascular health. We invited Dr Galati back to introduce Dr a net winger. Hi there I am Dr Martha the chief of cardiology at the University of Arizona and I also hold the title of being the biggest fan girl for Cardio nerds. It is an honor to introduce after net winger who will be featured on the upcoming talk here on the Cardio Nerd podcast I'm also her biggest fan Dr Wang is professor of medicine in the division of Cardiology at. Emory University School of Medicine. She is a consultant to the emory heart and Vascular Center and founding consultant at the EMORY. Women's heart center Dr Winger graduated from Hunter College and then went to Harvard medical school as part of this class that included women in one, thousand, nine, hundred, fifty, six she was the first woman to be named president in Cardiology at Mount Sinai hospital in New York City. Her training she and her husband joined the faculty at Emory University Dr Wingers contributions to women and Heart. Disease. Prevention and management have been a lifetime's work for her heart disease traditionally understood to be primarily affecting men. The net cast winger was among the first physicians to focus on coronary heart disease in women and evaluate the different risk factors and features of the conditions in women compared with men. She actually chaired the first US National Heart Lung and Blood Institute Conference on Cardiovascular Health and disease in women that you're winger. Also has been the leader cardiac rehabilitation. She chaired the World Health Organization Expert Committee on rehabilitation after cardiovascular disease and co-chaired the guideline panel on Cardiac Rehabilitation for the US Agency for Healthcare Policy and research in the late nineteen fifties most doctors prescribed three to six months of strict bedrest and delayed a cardiac patients returned to work for up to two years but Dr Winger had notice patients could recover more quickly getting up and moving around starting with sitting on the bed and walking around the bed and eventually walking down the. Hallway and so on. At Grady Hospital where she was chief of Cardiology, she developed a twenty one day cardiac rehabilitation program, which became a model for cardiac rehabilitation programs across the nation since then she and other doctors have been able to decrease the hospital stay even further with proven improved outcomes in those who completed cardiac rehabilitation does your way or is also had a long standing interest in geriatric cardiology and is a past president of the society of Geriatric Cardiology and was editor in chief of the American Journal of Geriatric. Cardiology, for more than fifteen years, does your wingers a highly decorated cardiologists and is it a Rockstar in our specialty cheese received so many awards for her work and I can only highlight some of them because otherwise my introduction of her will actually be longer than her interview. She received the outstanding professional achievement award from Hunter College and the physician of the Year award from the American Heart Association in Nineteen Ninety Eight Leisure winger received the distinguished achievement award from the Scientific Councils of the American Heart Association and it's woman in. Cardiology mentoring award she was chosen by Atlanta's women in law and medicine for the Shining Star award, recognizing her distinguished career in cardiology and women's health issues in two thousand. Dr Winger was presented with the James Deep Bruce Memorial award of the American. College of Physicians, for distinguished contributions in preventive cardiology in two, thousand and two, she received the Distinguished Philip Award of the Society of Geriatric Cardiology in two thousand three, she was included in the national, Library of medicine exhibition changing the face of medicine, a history of American women. Physicians Debra Wang received the two thousand and four Gold Heart Award, which is the highest award from the American Heart Association at Emory University's two thousand, four commencement Dr Wang or received the Emery Williams distinguished teaching award of the university as well as the alumni teaching award at the school of Medicine. Dr Wire was selected to deliver the distinguish two thousand four Lennox lecture for the American Heart Association in two, thousand six, she received the Hatter Award and international recognition for the advancement of Cardiovascular Sciences, the Georgia chapter of the American. College of Cardiology presented Dr Winger with its Lifetime Achievement Award in two thousand nine she was selected as the Georgia woman of the year in two thousand ten and in two thousand eleven she was selected to deliver James B Herrick lecture by the American Heart Association for her outstanding achievement in clinical cardiology she was elected a member of the Emory's hundred and seventy fifth history makers drink emory's I one, hundred and seventy five years in two thousand, twelve Dr Winger received the Charles R Hatcher junior award for excellence in public health. From emory university and in two thousand thirteen, she was honored by the establishment of the J Willis Hurst, our Bruce Longwy and the net k Wang or cardiovascular society for emery cardiology training alumni in two thousand, thirteen, she received the inaugural distinguished mentor. Award of the American College of Cardiology and the Arnold Potts lifetime achievement award at Emory University School of Medicine in two thousand fourteen the American Society of Preventive Cardiology honored Dr Winger by naming an annual lecture focused on Cardiovascular Disease Prevention in women after her known as the Ninette. Wanguo distinguished lecture focusing on Cardiovascular Disease Prevention in women in two thousand fifteen she was awarded the inaugural Bernadine Healy Leadership Award which is an award for women in cardiovascular disease by the American College of cardiology she received the spirit of heart legacy award in two thousand seventeen from the Association of Black Cardiologists and she was an invited lecture for the Seventieth Anniversary of the NHLBI program in Bethesda Maryland in two thousand eighteen. In two thousand and nine, thousand, nine hundred received the outstanding alumni award from the Emory Alumni Association in two thousand twenty. The Association of University. Cardiologists named its distinguished lecture after Dr Wangara and later this year at the American Heart Association Scientific Sessions Dr Winger will receive the twenty twenty Eugene Brennwald academic mentorship award for her mentorship of so many academic cardiologists and scientists. Dr Winger participated as an author of several American College of Cardiology American. Heart Association clinical practice guidelines. She is past chair board of directors for the Society of Women's health research she has authored or co authored over sixteen hundred scientific Kohl's review articles and chapters. She continues to speak all over the world and serves on numerous editorial boards. She's listened to as one of the best doctors in America and has been on that list for a number of years, but she is actually the best doctor and the best. Cardiologists improve everyone's books detro- Warriors always been about equity whether we're talking about sex gender race or age. When she arrived at Grady Hospital is the fifties and the hospital would refer to white nurses as Mr or Mrs and say him about with patients but black nurses and black patients. If you're a black nurse, she be referred to simply as nurse in a fewer of black patient you'd be referred to simply by the first name only. Her First Act debt grady was to change this well. Of course, she was immediately reported and she got called right away to the director's office. He asked her do you really know what you are doing and she answered? Yes he asked her are you going to keep doing this and again she answered without hesitation? Yes. As she said, you come with a set of core values and I could not accept people not being treated as equals. Well that really sums up why Dr Wenger has studied women and elderly patients. Why wouldn't we need to know about them? Why wouldn't they deserve research on them like we have on men are on younger people. Well I have a personal adoration for Dr. Winger her when I was a medical student in Canada and was invited to Elektra. She gave at the University of Toronto at our women focused hospital called Women's College Hospital. This was a hospital that was opened by and focus on women's health issues from its earliest days. She spoke about how little we knew about women and their hearts. I sat there in shock and by the end of the lecture, I knew exactly what my career had to be I was going to be a cardiologist data already mu but my life's work. Went to be focused on women's hurt to contribute to this field where we knew so little I had no idea that time that I would get to know. Dr Winger or counter as a mentor, a collaborator, and also a dear friend I like many women might say she's our academic cardiology mother to so many women who have entered this field because of her. So with very long introduction, I hope you enjoy hearing from one of the best cardiologists in the world doctrine, a net cast wanker and happy happy happy ninetieth birthday to this amazing wonderful cardiologists, mentor and woman. In today's episode will be discussing the past present and future of two very important topics. Women's cardiovascular health and women in cardiology doctor Wenger it gives such a great honor to welcome you to the cardio nurse show. Before we get started, we would love to hear about how you initially became interested in women's cardiovascular health will I I want to express my appreciation to Martha Galati who I view as one of my academic daughters, and secondly to say how much I enjoy meeting each of you. Vocally, it's only been an email interchange previously. But I expect I was interested in cardiology. because. At the time I was in medical school was just the beginning of the translation of cardiovascular physiology into clinical care. It was just the beginning of the study. Remember we had very little else in terms of diagnostic techniques. We had our history and physical examination which were crucial. We had the electrocardiogram and logistics, right? And essentially that was it. The years that I was in medical school with the ear years of the beginning of the Framingham heart study. So we began to learn something about cardiovascular epidemiology, and of course, it was just the beginning of cardiology at the national institutes of health but. The function of the heart has always fascinated me because essentially I viewed the heart as powering the body without the heart, the remainder of the organs couldn't function. and. My husband was gastroenterologist would always tease a and I said you know without the The GI track couldn't function but I think the fact that the world of relationship of basic science to the clinical arena was beginning to intersect was what drew me to cardiology And of course, remember that at medical school I was. Exposed to some of the greats. At. The Beth Israel Hospital in Boston Dr Her Balloon Guard and Dr Louis Wove at the Massachusetts General Hospital Dr Paul. Dudley white so here will wonderful wonderful people who? Just began to teach us. Of the importance of clinical cardiology and the care of the patient with. Cardiovascular disease. While that's incredible. Dr Winger thank you so much for that story and for audience before we dive into the meat of this episode I'd like to just say that Dan binder are co host and partner in crime. The apologizes for not being able to make it. He really wanted to be here with Dr Ringer. He's actually as an newly minted intervention fellow got called away for an emergency and so taking care of patients I think is as good an excuse for not being able to join us and it also like to go very special shoutout and a huge things to doctor Kimberly Manning who's just an incredible clinician Educator Mentor and Program. Director of the transitional pathway at emory central medicine residency program for connecting US Dr Winger. So we begin our discussion with women's cardiovascular health the past, and I'd like to start off with a story of a family friend in India. This is a story of a woman in her sixties who began having job pain her doctor referred her of course to a dentist she had one tooth bolt but the pink continued she had another tooth pulled and yet the pain continued. Then she unfortunately died a week later of a massive am I it turns out that her pain was probably engine along rather than a toothache which had not occur to anybody. To, contextualize this discussion I want to make note of three items from Dr Wingers prior talks. The first is a public awareness article from the Oregon Health Association. From nineteen, sixty four, it was titled Hearts and husbands ended included on series of pictures of what women can do to prevent heart disease in their husbands but not for themselves. The second, just a number of years later was the first presentation about a heart healthy diet given by the American Heart Association and this was titled. The way to a man's heart, a fat control, low cholesterol meal plan to reduce risk of a heart attack and the third was a comic from. Nineteen. ninety-one picturing a doctor talking to a female patient and I quote he's saying to her we have said for fruit flies, mice, hamsters, frogs, monkeys, and men with this condition. But medical research using women as subjects just never occurred to anybody. So with this in mind docu anger having trained during this time, and as the foremost became for advancing our recognition and understanding of women's cardiovascular health can you tell us more about the past when only men had heart disease? What is your learned when you were a Harvard medical student in the nineteen fifties and how did this evolve in your early career will let me go back to that cartoon which says using women as research subjects never occurred to anybody fortunately subsequent to that it did occur to many many people and most of us are very familiar with the graphs on cardiovascular mortality in the US. And really until the year two, thousand, the decline in cardiovascular mortality in the US was solely in populations of men and women's cardiovascular mortality remained unchanged, and in the year two thousand, which was at the time we began to see sex specific issues in terms of prevention, diagnosis management, etc. there was a sharp decline in women's cardiovascular mortality, much more abrupt than that for men and actually in twenty fourteen for the first time. The annual cardiovascular mortality for women was lower than that met, and as I said on a number of podiums previously, we are delighted to be in second place and we hope to say there. Let. Let me go back to the Harvard Medical School in the teaching hospitals. Remember that are major cause for hospitalization was myocardial infarction, and this was Q. Wave Mark Cardio infarction diagnosed only by the electric Graham. We had no enzymes. We had no imaging studies. There was nothing else there. And the concern was that this entailed mortality a forty to sixty percent. So this was really serious an as we learned in the years of Framingham myocardial infarction occurred predominantly admit, and this was the focus on men and heart disease because men were dying. Now you must remember we had used populations of men in hospital. Simply. Because the typical hospitalization was three to six months for acute myocardial infarction with probably the first two or three months at strict bedrest. But even in the time of Framingham, if you go back to the old data, the women had predominance of Angela. But Angelina wasn't facial and therefore was essentially disregarded. It was tabulated. As we've come to realize in subsequent years, women essentially have a warning system, which is why it is important to recognize Nevada anyway chest pain and of course, cardiac pain was considered to be central sub stern will pain and as you have in your case of the woman from India, the radiation of pain into the jaws neck arms back shoulders was not even discussed. It was oppressive substantal pain that was the. Her. But. We actually did see women with heart disease but it was predominantly rheumatic heart disease and we saw women who had Is the predominant problem often complicated by atrial fibrillation many of these women died in pregnancy. Had No way to recognize that at the time we were excellent at the physical examination men had rheumatic heart disease but the predominant population of women that we saw will women, with Mitral, stenosis and in terms of other features remember we had no good therapy for hypertension and definition of hypertension at the time was one hundred and twenty systolic plus your age. These were the days of Franklin Delano Roosevelt dying with severe hypertension untreated we never managed hypertension is a problem. And heart failure was documented but we had no therapies that was a fatal diagnosis. So when we look at the predominance in men, it really was the men with myocardial infarction. Out, say hypertension was one, hundred twenty plus your age. Thank goodness for the sprint trial for audience. DACA Ranga, wrote a beautiful state of the Art Review in Jack Twenty eighteen titled Hypertension across a women's life cycle is absolutely incredible. I will put the link to that article in the episode description I. Think it's so important to realize that women have heart disease and we'll talk about that as some of the discussion goes on because the emphasis really because of my cardio infarction and it's enormous mortality was that this was a man's Z's. Absolutely, and it's so interesting I think we ask trainees take for granted all of the different testing that's at our fingertips. Are often probably testing too much constantly innovating and looking for new things but it's really amazing to think about what was able to be accomplished with just the basics of history and physical exam and an electrocardiogram. So I'd like to now move onto women's cardiovascular health the present July twenty third nineteen ninety-three marked a major turning point in the story of women's cardiovascular health. This was when doctors. Ninette. Net Winger Leon spare off and Barbara Packard published a revolutionary article in the New England Journal entitled Cardiovascular Health and Disease In women, and this recognize that coronary heart disease was the most common cause of death among US women as you mentioned and that women with coronary disease actually did worse than men with coronary disease. Now, all of a sudden heart disease was no longer just a man's. Problem following impactful work from trailblazers like Dr Wenger. Advocacy from three major organizations which brought in recognition that heart disease also affected women nine, thousand, nine, hundred, nine women's heart. The National Coalition for women with heart disease was founded by women with heart disease to support other women and for political advocacy in two, thousand and four the NHLBI's heart truth campaign titled Heart Disease Doesn't Care what you wear. And in two thousand and four H. as go red for women program, which really catapulted the readdress symbol of heart disease in women. So Dr Wang or where are we now in the story of women's cardiovascular health and what is the present state of affairs? Well, you have to remember that the New England Journal of Medicine probably was the first major publication that coupled the terms, heart disease and women. And there is a long story leading up to that publication. Because at that time, I was a junior level faculty member I was seeing women with heart disease and going to the literature saw nothing that could guide by. CARE. And I. Discussed, this with the major cardiovascular organizations, national heart, it was not the heart lung and blood and. The National Heart Institute at the time and? We kept on discussing it again and again and through the nineteen eighties. We had I a workshop and then a conference and you know usually between a workshop conferences a year or two this was multiple years but we finally had the conference. It was my privilege to coach Chan that conference and the New England Journal of Medicine Paper was resulted that but you know, I, want to use a quote from Victor Hugo which I expect positions this now Hugo you must remember was not talking about heart disease in women he was talking about the French Revolution. And where he said is that there is nothing as powerful as an idea whose time has come. And I expect that that New England Journal was an idea whose time had come. and. That helps us I expect to understand the jury and how many people became involved in this vision and began interest in what are the specifics of heart disease in women, and they were really a number of steps on the journey and let me just highlight a few of them that I think are landmark. I is the report from the Institute of Medicine Two thousand. One. Essentially does sex matter and it defined that every cell has a sex and it highlighted the importance of sex and actually sex and gender differences and that brought the discussion into the forefront simply because of the preeminence of the Institute of that. And then we had a series of trials and let me just cite a few of them as examples. I will the trials of menopausal hormone therapy. You know probably one of the reasons that heart disease in women was neglected. was what I have called Bikini Medicine, and that is the only research that was done on women was the areas of the body covered by the Bikini, bathing suit the breasts, the reproductive system, and the reason that women were ignored in terms of the rest of their organ systems is that they were thought to be protected from everything premenopausal lead by their intrinsic nobles and then Menopausal Hormone therapy was prescribed and thought to cure everything from wrinkles to dementia an inbetween. And the randomized trials, the women's health initiative in healthy women the huge trial and hers the Heart Estrogen Progestin replacement study in women with Heart Disease Essentially turn that concept upside down because they said that menopausal hormone therapy was not protective. And what did was to refocus the entire attention to the community on other features that were very important for women. women's health study out of Boston was a major contributor. And then there was some interesting features out of the registry, the Crusade Registry which looked at women with non STF. Cardio infarction. Found that women have a worse prognosis than men they were at higher risk and despite the fact that they were higher risk, they will basically underdiagnosed and under-treated. But probably. The Lynch pin in this is the wise the NIH trial the women's Ischemia Syndrome evaluation because the model for coronary disease was the male model of disease and that was obstructive disease, the epithelial coronary arteries. And what why's did was to enroll women who had chest pain syndromes at who had myocardial ischemia demonstrable on noninvasive testing. They were going to the hospital to have a coronary angiogram. And surprise about half of them did not have substantial obstructive disease. They're coronary arteries at that point in time everyone would shrug their shoulders and say false positive noninvasive test. Well, that's a phrase that we must get out of vocabulary. It was not a false positive non invasive tests that was myocardial ischemia. It was simply that it was not associated with obstructive disease of the EPA cardio coronary arteries, and because these women were in a study, they will follow and it was shown that myocardial ischemia was villain. Because, they had not only persistent symptoms, but they had hard events such as mark, cardio infarction and coronary death. And this is really the basis for what we look at now and realize that we women up pretty complex creatures. We have by Cardio ISCHEMIA due to obstruct disease, the EPA, Cardia coronary arteries, or due to non obstructive disease or due to micro vascular disease, and this really is with so much of the research is ongoing. But the question is always there yet of course, we're not there yet but remember that within the last decade there had been ten scientific statements from the American heart. Association. Related to cardiovascular disease in women from stroke to prefer Watery Disease Tomato Cardio Infarction two diabetes, a number of imaging studies, the relationship of heart disease and breast cancer, and most recently the importance of all partnering with our Obgyn collies to recognize disease early in women. Then we had. Another very important paper that I think again is game changing and that was again for the Institute of Medicine in twenty ten talking about the research on cardiovascular disease in women and basically a what they. Proposed and documented quite well is that even as recently as twenty ten, what we saw was that all of the diagnoses in women or predominantly based on criteria for men. They pointed out something that was changed in some recent statistics and studies, and that is that even when women were included in clinical trials and they were certainly grossly underrepresented, the results were not published separately. So that was a weaker database women. And even going back to the basic science, they told us that often the basic researchers did not know. The genealogy of their tissues and cells, they know the cellular provenance whether was from a male or female animal. So they might have been doing studies on women's diseases from cells, tissues of male animals, and it was a challenge to journal editors to report the results separately by sex and not to accept papers that do that. We'll talk about how that came into congressional action. But I think that there was a major cereal stepwise change and all of this has the potential to basically improve cardiovascular health of women. Thank you, Dr, winger hearing you speak. It's amazing to think about all of the work that it's taken to bring us here and in preparing for this discussion, I really enjoyed reading that nineteen ninety-three landmark review that was just such a turning point in a pivot in. There was one sentence in particular that I just kept reading over and over and I'd like to share it with everyone in it says. In women as in men chest pain compatible with engine victorious warrants evaluation for coronary heart disease. I read this once and I had to read it again because I thought surely, I must have missed the point because of course, if you have chest pain, you have to evaluate for coronary heart disease until I realized that at that time, just this very concept in enough itself was revolutionary and so it's just incredible to think how far we've come. Well, this is probably why this journey has been so exciting and why so many people have essentially boarded the train and Advance the cause of women in heart disease. So now, I liked to pivot to the future of women's cardiovascular health. Dr Wang. We've clearly come far from the days of the AJ's presentation on the way to a man's heart, and we owe much of that to the hard work and advocacy done by yourself, your colleagues and organizations like women's heart. But it's just as clear that we have more work to do. What is your ideal future for how we approach women's cardiovascular health and how do we get there? Will I i. think we have a very valuable partner and that is the US, Congress and in two thousand fifteen, they passed the research for all act and to show you that Congress really can act in concert and do something useful what they did was to. Not Recommend or guide, which is the way things been done but to legislate that the national institutes of Health had to include women and minorities in all their research studies and to have a specific plan for so doing and any of you who've been involved in grant submissions lightly will realize that if you do not have a good plan for gender recruitment and recruitment of underrepresented minorities. That grant will even reach the first stage a review, but they also made The demand for the. Report for the basic scientists that all of the basic scientists had Gino. Their cell tissue animal sex and that that had to be presented in the report and Journal Editors, are now demanding that so that has been an enormous help. But what I would like to emphasize. Is that women's heart health is not solely a medical issue, and as we go forward with research I expect the number of features that I'd like to see us address. That would be beliefs and behaviors. The influence of community whether it'd be the local, the national or the international community. Economic Effects Environmental. Ethical. Legislative. Political Public Powell say societal sociocultural and we've come to realize that heart disease does not exist in a vacuum and these are the variables that we will have to include as we go forward in research but you know in academia, we have 'em the three pillars of patient care teaching and research. I. Want to add something that is sort of a subset for all of those and that is advocacy and what we have learned is how important that is an when I talked to him professionals and indeed groups of women with. Heart. Disease. What I've said is that the four things that we have to do. I investigate that is to get the scientific the research bases next to educate to educate healthcare professionals and women, and then to advocate so that what we know is put into practice and as needed to legislate, and this twenty fifteen is really a very good emphasis and these are the four steps investigate, educate, advocate and legislate. Thank you, Dr Winger. The story of women's cardiovascular health has gone through such an really a birth and then evolution through leaders like yourself in clearly, we have a lot of work to do. It's incredible to hear the story from you yourself. I know for a fact that your work your men tease your legacy will continue to help guide us as we move forward in using each of these domains investigate educate advocate legislate to keep moving the field forward at this point at like to switch gears and move onto the next section of this episode women in Cardiology. Let's start with women and cardiology the past. So women in medicine in general is an all too recent development in just go through a brief history two thousand years ago women were allowed to be midwives but not physicians in the Sixteenth Century Henry the seventh military starter for the company of Barber. Surgeons essentially giving birth to a new profession but women were excluded in the nineteenth century. James Miranda. Stuart Berry had address as a man just to practice medicine as a military surgeon. It wasn't until he died that they realize that James was a woman all along she performed the first recorded Caesarian in Africa in which both the mother and child derived. Helen Tau Sake is one of the first famous women cardiologists having developed the Blalock Taussig shunt. She became the first woman president of the AJ. In nineteen sixty five. But. It wasn't until nineteen, ninety, three that the HA established the women in cardiology committee. Soccer winger what is your perspective of an I'd like to say, of course, in this brief review of history, relieving out the countless women that have made such an incredible and tangible impact. On the way we practice medicine in general Dr Winger what is your perspective of women in Cardiology the past Well as you note, women were very much underrepresented. I learned this as a medical student remember Harvard was very late in admitting women compared with many other medical centres. Mine was the fifth class of women at the Harvard, medical school, and in their ultimate wisdom. The board of overseers decided that they needed a ten year experience with women before they were enrolled in the university charter. So only the year that my class graduated will women officially in the Harvard System We. Were essentially on probation, and because of that, we could not even get university housing. The man has vanderbilt hall under House rules and the women lived in apartments in town, and that essentially was almost symptomatic of much of what they was. Nonetheless. I must tell you that I thoroughly enjoyed medical school. I thoroughly enjoyed my classmates. The men were very supportive of the quota of women which was ten women per class that were admitted. There was a strict quota system there. And things have gotten better serially. I expect that we've seen major strides in the past decades were now saying women emerging as leaders, leaders of the professional societies leaders within their departments divisions in schools. So there is an emergence, but I, think. And, this applies to the men as well as to the women but I think specifically to the women and I would say is that as a woman in cardiology. You really have a multifaceted group of fears and their fears in which you must operate there obviously on the academic in the practice fears with your colleagues. But remember there is family there is home they may be children is a spouse insisting again ovens. And then there's the outside cardiology community and the voluntary groups, the American College of Cardiology and Heart Association European society. We all operate in another sphere, and that's a faith based community. And then we live in a general community where we are expected to be of service whether it be music arts political philanthropic, and then for those of academia, we live within the university community, not just within the Health Sciences Center, but we interact with the faculty and the students and what we have to do. is to examine what it is that gives each of us pleasure and satisfaction what allows us to explore our scientific and clinical interests and most important what allows us to exercise our leadership skills, and this is what I see as where the area is going. This fears of very important cardiology is a very important part of our life, but we have to encase it within all of the spheres in which we operate. That's really fascinating I never really thought of US each sort of operating in all of these separate spheres you're absolutely right and it's it's all about really trying to think about how we can each individually contribute based on our skillset. So you touched on this a little bit but I wanNA talk a little bit more about the present with regards to women and cardiology, and while in the last fifty years as you mentioned, we've had increased recognition of women's contributions to cardiology. There is still a long way to go cardiology has field has overall. Done poorly to attract women trainees with women comprising the majority of medical students but less than fifteen percent of practicing cardiologists and less than five percent of interventional cardiologists. This gender gap within cardiology is only modestly improved over the past two decades. Dr Pamela Douglas published a survey based study of internal medicine trainees in Jama Cardiology and twenty t and noted that women were more likely to never consider going into cardiology. The factors influencing this gap included perceptions about stable hours, family friendliness, female friendliness, availability of positive role models, an addition to some other factors. Even after joining cardiology women continue to deal with issues related to gaps in pay and promotion of and women are overall poorly represented among leadership positions. Even though as you mentioned, this has improved compared to the past. So what is your perspective on where we stand today with regards to women in Cardiology? possibly. Some of it is the way medical students and really internal medicine residents are exposed to cardiology and typically they see it within the acute setting of coronary. Care you. And that is really not the practice of cardiology that's crisis intervention. And if women had the opportunity to see more in ambulatory care in prevention possibly this would attract many more women to cardiology because it would give them a much broader appreciation of the spheres in which they. Now most certainly women who go into cardiology are attracted to the high demand, high risk areas, and the heart failure is one of them where we're seeing large numbers women I'm not sure why. But perhaps what we're seeing is that for the interventional and the EP that many of these women, the women who are attracted into the surgical specialties and the surgeons have very actively recruited women and probably we have learned from the surgeons. One it is they're doing because they're recruiting more and more women into their ranks. You know this past weekend I was on a fascinating virtual all day conference Saturday with the Brazilian Society of Cardiology and the Brazil chapter the American College of Cardiology. It was a full day of heart disease in women. And the speakers and the panelists again articulated exactly what you have done about women less represented even in Brazil in the interventional in the EP and trying to say what is it that they can do looking at gender gaps and so forth. But the important thing is that this was a virtual conference and they had over twenty three hundred people online for a full day conference on a Saturday. So it shows that there is an interest and what we have to do is to make cardiology. Much more welcoming. But. Possibly for the women we have to say what is it that we want we want to get some kind of ability to act on our own passions and ideas. That's the way to maintain by Talapity. The women should realize. How good they are I think women do not value themselves as much as they should and with confidence and with fulfillment I, think leadership will come. You know we have seen such change in the last few months. In terms of the covert epidemic, and perhaps we can learn from this as well. You know in academia. When we see change, it typically is slow and incremental. Often much too slow for many many of us who are impatient, but it's not transformative. Transformation is not characteristic of academia but Cohen has changed this and we see a cute transformative changes in patient care with telehealth in teaching with remote teaching and learning in research were everything has gone from snail's pace to warp speed, and probably we have to learn that we should not be looking at this as it integral mental process, but rather a transformative process. It's incredible anger and so truly inspiring. Honestly I'm thinking that I just can't wait to share this episode with my wife who is a knick you fellow and mother of my three year old son and carrying are identical twins at the moment while working in the ICU and I think to myself that her fortitude that she carries with her in every sphere of what she does is really something that makes me better than that. She's going to appreciate this well again when I say to the women in cardiology is to value yourself and to believe in yourself. That most of us because of our background because of our education and training up privileged people and we have to recognize that. But with that privilege becomes a responsibility and the responsibility is to serve and that involves all of the spheres that I've outlined for you. Particularly the luxury that we have to take care of a patience. Speaking of which let's move onto women in cardiology the future. Dr Winger with advocates like yourself and many others active organizations like the ACC task force on diversity and inclusion in the ACC women in cardiology counsel, as well as an increasingly strong network of support and mentorship from both advocacy groups like women as one and social media. Hashtag women in cardiology the outlook of cardiology seems so bright with regards to diversity and. Inclusion in had to say that as a platform, the partners have been absolutely committed to and being deliberate about being diverse within our own show because we know that that makes our content better and more relevant for every. Dr. Winger what are your hopes for the future? How do we get to these virtues of diversity equality and inclusivity within our beloved profession? Know I outlined for you the spheres in which we operate and within our profession, it is not any different than it is in the general community. And what we have learned is to value individuals to value cultural diversity to value patient preferences. These are terms that we never heard about before and that really. Translates into how we relate one to the other, how we relate to colleagues how we relate to our trainees, how we relate to US superiors and how we relate to the community at large we cannot separate cardiology from what goes on in the world and what from what goes on in the community and I think we've seen in the world the three epidemics that we have we seen the covert epidemic, we seen the economic epidemic and we've seen the social justice epidemic. And what they have taught us is how interchanged they are and how interconnected they are and how important it is that we see ourselves as citizens of a community as cardiologists within a caring community. This is where it has to be. Dr Wanker as we end our discussion, WanNa get to get your advice to also trainees and particularly even female trainees as we embark on a career in cardiology to continue to move the needle forward, how do we increase female representation both in research and in clinical practice? Sessions such as this where what I am. Hearing from emceeing are emerging leaders and just the diversity within this group is so important that you are showing to your audience is a diversity of interests, a diversity of gender diversity of background, and that is what will excite people to seek what they want to expand their horizons entered do what gives them a sense of pleasure and satisfaction with the way they operate? Doctor Winger as we close our discussion would like to ask you a question that we have a tradition for asking on our show. For example, I'll say that what's making my heart flutter is the privilege of learning from you today. So I asked Dr Winger, what makes your heart flutter about women's cardiovascular health? Well I expected is sessions such as this because what I am seeing are the emerging leaders, you all the people who will lead cardiology and I love the term cardio nerds. is very creative and. Imagination it shows a less for life, but it shows that you're also very serious people. You're addressing serious issues and to see emerging leaders is what makes my heart flutter? Anger I WANNA. Thank you from the bottom of our hearts for taking the time to speak with us today. You are a true inspiration to cardiologists and specifically women cardiologists around the world and I can say that I personally planned to take your words of advice about believing in yourself and exuding confidence to heart. As I embark on my own career, we can absolutely not wait to share your insights and inspirational words with our cardio. NERD. Audience. Well. It was a delight visiting with you this evening and thank you so much for asking me. Okay, are we just saying happy are seeing the heavy burden overthinking? Day. Countdown for a Mimi. Our. Three. The. Maryland. Might. Say. Happy. Birthday to you happy birthday. A little faster.

Cardiovascular disease Doctor Winger American College of Cardiology Dr Wenger US Dr Wang American Heart Association infarction Dr Martha Galati coronary disease Emory University School of Med Women's College Hospital acute myocardial infarction Society of Women Emory University Emory University Dr Wingers American College of Cardiology president National Heart Institute College of Cardiology
Ways to Improve Your Memory

Life in HD

10:55 min | Last month

Ways to Improve Your Memory

"Welcome to life in HD, the personal development and lifestyle blog that shines a spotlight on how we live our lives. I'm Joe, League, when I started my work as a neuropsychologist teen years ago. So I test memory and thinking skills. What I was noticing is I had a number of patients who were coming in and saying they were having some memory challenges and they wanted me to help with that, and then they would take out a bag of supplements and put them on my desk and say are these the right things I should be taking and I started to see this over and over again that people were using these strategies that were not proven and they were trying really hard to sharpen their memory and minimize the risk of Alzheimer's but they were unwittingly using the wrong things to do it. That is Dr Michelle Braun a Harvard and Yale trained neuropsychologist. She wrote a book called High. Octane brain five science base steps to sharpen your memory and reduce your risk of Alzheimer's in it. She provides expert guidance through the maze of conflicting media advice on supplements, Brain Games nutrition, and exercise memory, and cognitive functioning become increasingly important to us as we age. So how can we improve or preserve our memory? What are the warning signs of a memory problem and what steps can we take to sharpen our memory? If you experience word finding difficulties, misplace objects or forget why you even walked into a room then this is the conversation for you. Dr. Brian Offers Five Science, base steps to sharpen your memory including activities like exercise. How does exercise work to improve brain function? I'm glad you asked because a lot of people when I talk about exercise they go. Well, I already knew that that it was important. But the point of this book is to talk about what type of exercise and what duration and how that actually interacts with the brain as you're asking about, and so how it actually interacts with the brain is every time we do cardiovascular exercise. So we're getting our heart rate up. For example, we are growing area of our brain called the hippocampus and the hippocampus is a little kind of a curled SOM- shape structure that's an inch and a half, and under each of our ears, it's just kind of sitting there and it is the switchboard for. All of the new information that's coming in that we're trying to remember and we need that hippocampus to be working well in order to have conversations and to remember what we talked about and every time you're doing cardiovascular exercise, you're getting new growth factors in that area. It's kind of like a fertilizer is being deposited in that tissue is becoming more dense and it's becoming more able to process information, and so there's a direct connection between our physical activity and the structure of our brain and that's It's important to get that cardio piece in. Yeah. Cardiovascular exercise in particular seems to have benefits. Now, the interesting piece that you'll read about in the book as I interviewed. Dr. Kirk Ericson who's One of an international experts and exercise, and there's a lot of research going on and other types of exercise, strength, training, and Yoga and. And a lot of it's very promising. It just happens to be that we have the most data right now on cardiovascular exercise but that doesn't rule out that the other types could be helpful to. Okay. Now, another thing you write about and talk about is eating I think most of us sort of understand that kind of goes hand in hand with. Improving brain function and brain health but I don't think we often understand what kinds of foods So so how how does are eating impact our ability to have health healthy brain activity? It's important to know that the nutrients we take in, they get digested and they directly go into the brain and the the interact with our cells in the brain, and so if you can imagine that everything you eat is getting broken down at a molecular level it's either going to hurt or harm her harm or help rather the brain tissue, and so the foods that are in the mind Diet M I N D. Are, developed directly to help with the neurons from the standpoint of how they communicate and the structure of the neurons and what's neat about the mind diet and I interviewed. Dr. Martha. Clare. Morris who is The creator of the mind. Diet. Is it takes the best of the Mediterranean Diet and the Dash Diet for hurt health, and then on top of that at adds brain healthy foods and and so those foods. For example, people who followed the mind diet for four years had a fifty three percent reduced risk of Alzheimer's, which is pretty amazing. If we had a drug that did that I think everybody would be taking it. When when you say a reduced risk of Alzheimer's how do we measure that? We measure that by looking at how people with the same risk factors for the disease if we follow them over time people who use the mind diet who follow that diet versus those who don't the that those who don't have a much higher rate of getting Alzheimer's than those who do. So it's in right now the mind diet is actually in a really large randomized controlled trial looking at that more deeply. But that's really how we how this information is gleaned from all of the research studies is by following there are thousands of people who who these interventions have been tried on with their consent, of course, and many of them are healthy so they benefited from them. People who use them had better outcomes than people who didn't overall the mind diet stands for Mediterranean. Dash intervention for neurodegenerative delay at the mouth full. Foods emphasized on the mind diet include whole brain, sperry's green leafy vegetables, other vegetables, olive oil poultry, and fish. Only a few epidemiological studies have been published on the mind diet with their main findings. Showing that errands to the mind diet is associated with a reduced risk of Alzheimer's disease more research is likely to come, but findings are consistent with recommendations of the dietary guidelines for Americans which recommend increased consumption of. FRUITS, vegetables, lean proteins, healthy fats, and whole brains and decrease consumption of saturated back. Now, one of the things that's getting studied these days is sleep and it's It's effect on our health, its impact whether you're you're getting good sleep or not how it impacts our health obviously, a lack of sleep effects, our brain activity. How does that happen? How does getting a better night's sleep improve brain activity Sleep is really the time when our brain power down into cleaning mode in many ways what is that is not only is it secreting growth hormones and repairing our tissue, but it's also cleaning all of the areas that have it's used over the course of the day. So every time right now as we're talking, our brains are creating metabolic byproducts of waste that needs to be cleaned out of our system and there's this growing. Hypothesis based on animal models and now on people as well that if we don't sleep enough, we're not giving our brains enough downtime to clean out the waste that at all of us aggregate over the course of a day and so that's a big piece of it. That's why sometimes maybe we wake up feeling much more refreshed because we've we've essentially rebooted our system and and cleaned it out, and so that's really important that we. Get an average seventy, eight hours of sleep a night for most people. There's so many ways we can benefit from a good night's sleep. The Sleep Foundation reports that scientists think that while we sleep memories and skills or shifted to more efficient and permanent brain regions making for higher proficiency. The next day and fact sleeping shortly after learning new information has been shown to help retention. Some research indicates that when people learn before going to. Sleep or even before taking a nap, they remember the information better in the long term, Dr? Bron we it's. It's acceptable that we will have diminished memory and brain activity as we get older. But when should we become alarmed at what age should we become alarmed or or at what decrease capacity? Should we become alarmed if things if we want to understand that things are happening quicker than than they should naturally. is that a clear? The question question. Clear. Yeah, and in fact, that's a million dollar question in many ways because what is the dividing line between kind of normal age related change that most people experience and when is it a challenge or a problem? And I think it becomes more of a concern when people are forgetting well known information information that they have kind of effortlessly recalled in the past, maybe autobiographical information about their own history. When that happens more frequently in other words, there is oftentimes on awareness from loved ones that cheese I'm noticing that's happening a lot more than it used to. In other words it's not just an isolated event and number three. Is No explanation for those changes. So all of us have had times when we were might be stressed or we might not have slept enough when our memory isn't too sharp, and so we wouldn't be so concerned about that if we if we sort of understood why If there is no explanation like that though that can be much more concerning. Thank you Dr Michelle Braun author of high octane brain. Thank you very much for joining us today. Thank you so much. I appreciate it Dr Bronze suggests that memory can be enhanced in just ten minutes allowing you to perform at your peak mental level for immediate memory boost she has tips for that and other brain boosting activities in her book we'll have a link for it at the life hd website at Joe Be Lee Dot Com on the next life in HD author Catherine Newman offers a humorous look at how we can help our children become person you know the truth is I'll tell you the dirty truth is that what I really wanted for my own kids was like. A giant photographic encyclopedia of healthful jurors. I wanted a thousand as long book that was like these are the hundred photograph steps of like cleaning. Think you know so I catch that book and the publisher was like that's the worst idea we ever. Complex the. That should be interesting until then take good care of yourself.

Alzheimer Dr Michelle Braun Sleep Foundation Dr Bronze Mediterranean Dr. Brian Dr. Kirk Ericson Foods publisher Harvard Dr. Martha Alzheimer's disease Morris Yale sperry Yoga Catherine Newman
355: Get the Body and Life You Want with Susan Hyatt

Earn Your Happy

54:47 min | 1 year ago

355: Get the Body and Life You Want with Susan Hyatt

"Most of the women that I work with are either hesitant to put themselves online for their businesses because they're scared of trolls in haters, or because they don't like the way that they look. And so it's a big part of like, hey, you get to take up as much as you want. You get to be front and center in your life. Welcome to earn your happy podcast. I'm Laurie harder founder of the bliss project. Three time fitness world champion, fitness expert and cover model turned self love junkie lifestyle entrepreneur and author each week. I'll bring you a guest or a thought that will help you bust through your fears connect to your soul and get focused and clear so you can elevate your life business and relationships we don't wait until we're ready for someone to tell us. We're good enough. We take what we want and we annoyance ourselves. Get ready to earn own and on apologetically rock your happiness every single day. Are you with me? Here we go. Hey, everyone. Welcome back to the podcast. I'm so excited you're here. Because today, I've got a really great conversation. Just about how life and your goals, and your happiness are really running parallel to what we're thinking and Howard taking care of ourselves, and especially taking care of our physical bodies. And how truly all of the things that we believe that we desire are a result. They're not the actual thing that we need to necessarily be going after and we'll really dive deeper into that. In my podcast today is with the amazing Susan Hyatt, and she has a master certified life coach in weight loss expert. She's the creator of the trademarked bear process. The bare deck and a podcast called bear. And an online community called bear daily. With her fiery Facebook rant. Susan is gained an international following of women who love her honesty humor, and fearlessness and. Today, we really dive into her new book because it has so many great topics in it. It's a seven week transformation book where every single week you're going to be really focusing on a different topic such as in our conversations, we really talked all about your environment. And how that's such a reflection of the life that you'll be living in the results that you're getting we talked about adding creativity. Adding pleasure into your day. How to eat with -tentivness exercise with love declutter, your life, detox your mind, and how to show up and be seen in what that actually means to truly take up space in stop shrinking and stop believing the lies about needing to stay in your own lane. Or do what you you're good at right now like to get out there and truly be seen in the world. And what that does for you. What it does for your eating habits? What it does for your life? And what it does for your body? So she's got an incredible book out right now if you guys are like I cannot get. Enough because I'm telling you, she was so fiery in this interview. I just love her energy, she spun, she's just absolutely a beautiful human. So let's demand. Susan. I'm so excited for you to be on the show today. How are you? I am amazing. Thank you, Laurie. I am a big fan. And I am so stoked to talk about their. Okay. So we just talked about that you are holding down the midwest for me. And I let you know that I'm from the midwest. So how how's the weather? Yes. So I'm in southern Indiana. So it's like spitting like ice a little bit here. We are right now. And and let me guess you have beautiful son where you are. You know, it's a little cloudy, but I can't complain like so we've actually had a really rainy winter. But thank God. Because our summer has been, you know, without the rain like it's been really scary with the fire. So I'm so grateful for the rain. Oh, that's so awesome. And you know, I the joke about California is always that you know, is so beautiful and sunny, but make no mistake. You guys have had to deal with quite a bit. Bit. We have. Yeah. Let's Liedes and the wow. And to be honest, I'm still like I would not live anywhere else anymore. Like, you know from the midwest. I I'm like, no, no, it's still it's still good. I'm like, it's still okay guys. You're like Susan even though my lungs are filled with smoke. It's better to all my friends. Just you know, I love you. But you can come visit. Oh, so you have this amazing new book out that we're going to dive into today and talk about that just covers so much about all the things that I'm passionate about. And I know so many people on here will love to hear about before that just for people who don't know about your journey. I would love free to share a little bit about yourself. Yeah. Absolutely. So I am an author in a life coach, and I've been a coach for about twelve years now, and I started coaching prior to coaching. I was a burn out real estate agent and came to life coaching. Honestly, I mean, I was perusing the self help. I'll and I bought a book called finding your own nor star by Dr Martha back, which I think is one of the best self help books ever written, and that will change my life and from there. I ended up training was with Martha Beck and my first year as a coach I went on my own weight loss. Loss journey and hired my own coach. And remembered thinking when I lost thirty five to forty pounds. Like, if this former couch potato junk food junkie can learn how to take exceptional care of herself. Anybody can I really was on a mission to help women in that way around food and body and what I discovered over the last really eleven years coaching women around food and body was that my where I really was shining was in helping women. Discover the deeper self love that needed to happen. So that they love the skin that there in no matter if they were gaining or losing or aging or not and a byproduct of that was typically that she loved and adored her body and her body was showing up at its natural weight. And so I created my own process. I started to take a look at what a sign mints were really giving my clients the most bang for their buck. And where were they? Finding themselves in coming home to themselves. And so I created a process called the bear process. I'm really stoked about it. So come you said, so many beautiful things. Like, just the the fact that, you know, body that they love is a it's a result. It's byproduct of something else that they're doing in their life. And I think especially and I'm just going to I'm going to speak into it. Because I know that this was such a big thing when I lived in the mid west, it's like, you can actually think I was convinced. It was my genetics and not my habits because I couldn't find people outside of my world who had different habits because so much of it was my environment. And who was around me and everything that was being reflected back at me until I really started to dig even even deeper into that. So I know that you say it, you know, it's a byproduct. But also, how do you begin to understand that when your environment is reflecting back to something completely different? Absolutely. So that's actually one of the the first steps of this process is something I call environmental diet or environmental detox where? I invite the reader or the client to to become a reporter in their own lives and pay attention to what's coming at them through all their senses that you know. So right. Most women when they come to us to talk about food or body. They wanna talk about how many calories or how many MAC rose, and then what's the workout? And they're so much that we're absorbing through all of our other senses that are affecting those things. And so it's like, hey, what kinds of pure conversations? Are you having? What are you listening to what are you watching? What are you reading? What are you digesting through all your other senses? And honestly, this first part tends to lead a woman down a road of discovering where she first got the idea either from family of origin or peer group or culture that her body needed to be different than it was appearing anyway, but then unwinding like all. Things that were affecting that. And and there's so many tiny things that women. We just put up with we tolerate we allow to go on that. When we start taking a look at that. I remember feeling like, Wow, I've solved my exhaustion problem because guys. Kinds of conversations with other people. These conversations in my mind are really causing a weight problem. I see this is I don't know if you know, you know, any of my history, but this was so my past like just figuring this all out, and it took while it took me so long it happened in little pieces like that like where you just kind of start looking around and having these odd moments of awareness. So what happens after the awareness though, because sometimes you open your eyes and you're like, oh, damn like my husband's got to go. That's actually the joke. I make like, okay. I do this assignment that doesn't necessarily mean your spouse or partners got to go. But a but a lot of women they're like, oh my God. Like, I'm in a great mood until he or she comes home, and it's really paying attention to. What are the thoughts and behaviors going on that needs to be addressed rather than getting rid of the whole person? Although sometimes that is what has to happen. But I promise I've saved more marriages than divorces have happened under my watch. But it's totally it's totally up to the person. But when they go through this exercise, and they come back, and they say guess what I have discovered that a major trigger for me is staff meetings. My boss conversations happening in my home, this I'm in a cubicle. I can't even close my door and get away from these people. What do I do? And so that's where a lot of the coaching can come in where it's like, hey, guess what? The question isn't like how do I put up with this? The question is how do I create an environment for myself that supportive and get some ideas going? So I just had somebody in my membership community. Who is in a cubicle say, you know, what I did I invested in some air pods. And now I. Have these discreet little ear buds in where I can listen to meditation podcasts instead of listening to people in the neighboring kiva Kohl's complaining, and it's such a tiny thing. But it's really helping women become advocates for their own sanity rather than just living in default. It's so good, and I wanna talk more into that. Because I can think back to those moments of you know, like the stressful moments or maybe you're arguing or maybe you're bored. Like, there's these triggering moments that you're always like, oh, no. Here we go, especially it's it's funny. When I first started to spend a lot more time at home. It was like mortem would just set in or the feeling of like, oh, I'm not getting this Donner procrastination. And it was like, I would just, you know, go down that self sabotaging experience of whatever I would do stand in front of the fridge and just start eating whatever. And it was like there are these moments that it's like this peak moment that you have. This choice. It's almost like an out of body experience. Like, you can almost feel yourself start to do the thing. What am I know? I've talked I've talked to so many women about this Bir. It's just like what do you do around that peak moment like the first few times? And then of course, you're going to fail. So what do you do after the failures to get back to where you wanna be? Well, so I- parenting was always the thing for me where I felt like okay, I gave myself a pep talk beforehand anticipated my obstacle. I was presented with the triggering behavior. And I popped off and the paving in a way that I thought a good quote good mom should behave. We've all been there. And I think the number one thing is compassionate, absolute compassion, and understanding like what is it that's causing it is it the need to control another person. Is it the thought this should not be? Happening. So for me, it's helping a client and myself unwind. What is it that so upsetting about this behavior? What is it? You're telling yourself about that behavior. And then what is it that you could tell yourself that get you right back in there? So that you're you know, showing up again, and again, and again and trying so for me, it was almost always control. It was almost always arguing with reality that things should be this way. So when you mentioned like working from home and boredom setting in and that sort of thing for me, it was absolutely boredom that was the number one feeling state. I was trying to numb out and avoid. It's it was so intolerable for me. And it was again, it was like I had designed this whole career where I could pick these kids up from school and bring them home. And then here's these little like preschooler in first-grader sitting at the table with their their homework and their worksheets, and I was in the kitchen eating. A wheel of Bree and pouring a glass it why? Because I was like feeling guilty that I had designed my whole life. So I could enjoy this. And I did not enjoy some of motherhood, and like what kind of mother does this in so recognizing like, okay, boredom. The vibration feeling state of boredom is what's causing this in the answers are not in numbing out. So where are the answers and figuring out coming from more creative space like how can I create a mindset and an afternoon that is not just oh, I have to do this. Okay. This is crazy 'cause it's bringing us to like your point too. Because I was just going to ask about which is at pleasure in your day. And it's I think that that was like my saving while. I don't think I know it was my saving grace in. It still is like even as you're saying that like where you know, what what's something that could help combat this, or what is something that would help me not be bored anymore. That would help me get my creativity. Because I really believe that we are all creators. Let's even a question. I'm asking myself now because I'll tell you like it doesn't go away. If you go back to the old old habits like it will. Or if you go back to not supporting yourself like it can come back. Even if you even if you feel like you have it down after twenty years, if something in your environment, totally shifts. Sometimes we can fall back on, you know, in an old habit that can kind of basically a new way of numbing out. So adding pleasure injured, I just want to know more about what that looks like maybe some people. Who were in a situation or are are in a situation that you were where it's like, how do I change like this day where I'm my kids are here at this time or I don't even know where to begin. Yeah. Absolutely. I like to say, so when I first created this bear process. It was really only six steps pleasure. Wasn't part of it. And I kept thinking like something's missing something's missing something's missing. And it was one of those things that was so obvious. It was just staring me in the face. And it was like, oh, of course. It's pleasure. Because I I honestly think that women we have so much willpower. All the things we do running companies in raising families in contributing to our communities and we're not lacking in willpower. What we're lacking in a devotion to pleasure. And and when I say that to women they immediately go to oh, so you're talking about having more sex. It's like, well, certainly physical touch an intimacy can be a version of pleasure, but divers. Defying your pleasure. Whether it's intellectual stimulation comfort beauty. You know, it for me when my the primary feeling state. I was trying to avoid was boredom. I needed intellectual stimulation. I needed adult conversation that kind of pleasure is really different than another woman who might be listening to this. Who's like man if I could just curl up with a blanket and have a Cup of coffee that would be heaven. So it's really identifying what do you need? And are you willing and open to coming up with simple pleasures throughout your day? Because honestly, our bodies are wired to experience pleasure. So when we don't put that as a priority in our lives. What happens is we go for easy, fixes like food or retail therapy or gossiping or whatever when if we would just honor what the body needs and what is wired for we'd be so much better off. I love that. You're. Pointed that out because I've definitely had moments where I've been like, oh, I'll just do. You know, I'm I'm like board or not feeling fulfilled in certain areas. I'm Michael just do more self care. Yeah. That's totally. What's going to do it? And I'm like that's not working because it's definitely that I need either more like a friendship connections or to be using my creative energy more. But those are definitely things that take a little more work. So I'm always observing when I'm like, okay, but the work in so that you don't feel this way anymore because it's going to keep on coming back. So that's really powerful to even hear that for myself right now. 'cause I'm like, okay. Another massage is not going to do it for me right now. And you bring up such a good point that the other thing people immediately think is like, okay. All this talk about self care. It sounds like an extra job for me and consuming. So I am a fan of massage. Don't get me wrong. Like, I just had a ninety minute. Me. Things that things that cost money. Like, Manny Pettis, massages the that I consider more maintenance than I do troop leisure true, self care. And so a lot of really genuinely pleasurable things honestly, do not have to cost you anything. And I notice Laurie on your Instagram. You just had a beautiful girls weekend with some of your friends. Oh, it was so good. Oh my God. You can talk from the Bota is we're so happy and needed. Yeah. That's the kind of measure that sounds like is much more fulfilling to you. And you know, what's crazy? I was so resistant to it because it seemed it was it was kind of more challenging to plan. You know, he had to like find the hotel and book all the stuff and figure out, and I know that sounds so like oh life so hard. But when you're busy, and you have an event coming up like it what it was kind of challenging for all of us to. Get that time together in like just plan where we're going to go and where we're going to eat on a weekend where it's it's LA. So everything is booked. So it's kind of like calling in you know, I spent a day doing that just booking one day. So but for me, it's paid off. Now where I feel like I mean like, I feel totally I felt so recharged. I hadn't felt about recharged in a really long time. So I can imagine how many other people kind of have that feeling like, oh, my God this could be such a daunting task. Yes. Absolutely. And it's and the thing is is like start small start with little five minutes. I don't know if you remember when Oprah magazine used to have along the footer of pages periodically sprinkled through the magazine, it would say things like if you have five minutes do this. If you have fifteen minutes do this. If you have thirty minutes do this, right? Like if you have a whole weekend, do it. Laurie didn't have girlfriends weekend. But if you don't like their little suggestions in the book that are free that are five minutes. So that you can do periodically through your day to just make sure that you're really devoted to your own pleasure. And what ends up happening is that that turns into the solution for so many things all my God. I it's so dumb. Like, I even noticed that. I'm like, oh, I'm not as tired hung. I really think. That's because my soul is full. All my God. I'm not snacking is much the past couple of days. I think it's because my soul is full. Like, it's very interesting. It is so fascinating. And I'm I hear you like bigger commitments like that. I can be really resistant to as well. I'm also slightly on the introverted side. All my God. I'm so introverted. Oh, yeah. I am too. And so a lot of energy for me to commit to something like that. I'm glad that. I did. Yes. I think us introverts we tend to be in our hermit mode, and and then we miss out on diversifying our pleasure. Like that. Totally. I can convince myself that I'm like, no, I'm fine. But then all of those little things creep in, you know, all of the the that shows up in the boredom in the numbing out in like, the not quite feeling as happy as usual or whatever that looks like in. It's just it all points towards okay. It's time to go into that other thing, but I can we're so especially if you are like in the self development world, you can kind of like literally convince yourself of anything. We can use our tools for good and evil. Totally totally. I'm just like, well, maybe it's this or maybe it's sadder who even knows, you know. So how do you because I think that a lot of people are we are sometimes our own worst enemy. Have you got any tricks or any things for around that for I think so many people are introverted like that for when we try to convince ourselves it's not actually what we need like really figuring out what we do need. Yes. So there's a whole chapter or a whole step in the book that talks about mind detox. And I talk about like that inner mean, girl as mind crack or mind fuel, and it's interesting because I often think down you're right, it if you're someone listening to this it feels like you have pretty a pretty healthy mindset. Pay attention to signals from the body. If the result that you have isn't what you want because I find that wisdom from the body is so much clearer than what our minds cook up. So true guidance in the mind that's coming from that mind body connection is very usually very simple direction and untruths. You know, whatever our mind crack is our mind. Our ego will talk in paragraphs. And so I think the number one hack here is what's the what's the physical vibration in the body feel like number one is the result happening around you what you want. And when you eavesdrop on yourself is what you're saying Ha's, it is it serving you is it simple, or is it like complete paragraphs of borderline nonsense and excuses, and I can for example, I can decide to go net flicks. And eat snacks. And feel amazing about it. Because it's a a mental break that I need. But if I'm hiding like if I'm Netflixing because I don't wanna face something, it feels gross it doesn't feel restful. So it's more. Like, how does it feel inside? Whatever it is. You're thinking or doing man, that's so interesting. I don't think I've ever heard that before like your mind chatter comes in paragraphs because like that is so good like, I'm taking a mental note on that one. Because when when something's like yes for me. And I know it like when I thought of this girl's weekend. It was like, yes. And there was nothing else. And I started to think about it. I started writing paragraphs in my head has to like why this wasn't what I needed or why the spelt challenging or you know, why this wasn't going to be as recharging is. I'm thinking, and I was like. My body was like do this. It literally just said, yes, when they asked me I was like, yes, let's do this. And that's what I tend to go back to pay attention to is like what was my initial like, what was my initial body reaction. And how did that feel that is I love that? I have to remember that that so I wrote it down. So we're good tattoo. So there's a there's two that I want to cover in one if we can so eat with attentiveness and exercise with love because this is the thing. Right. People are like like you said in the beginning. Give me the food plan. Give me the exercise plan in like, I've, you know, I've been a trainer for a a large chunk of my life and owned a jam. And it was like oh my God. We this was like the last thing that I needed to talk about was the exercise in the food. So I really want to and it's funny because I needed to heed my own advice. But. But tell me let's talk about that for people who are like, wow, I really want to get on a health plan. I want to start feeling good in my body taking care of my body. When this is the main focus, what tends to happen. So do you mean when they're only focused on working at how much they're eating say kind of the MAC rose in the extra house. So they're missing the biggest part. So here's the thing is that when we give over our power to an external plan, and I'm not saying you can't have a plan. Of course. I have a plan. I know how many times a week I will go workout with my trainer. I know. How many times a week? I'm going to get on that sexy, peleton and spin. I know all those things, but in order for that plan to be sustainable. It has diverse start from you. And so whenever we're like whenever I was for sure this person, I would be like Lori. Tell me what I need to eat. And what kind of exercise plan I need to do? So that I can look like how you looked on that magazine cover just tell me, I'll do it. Of course. I would never do it. I would never follow through because I wasn't lined up with why it was all a transaction. So. One of the things I talk with myself, and my clients about is dropping this transactional attitude where it's like, okay. I will eat this way. And I will move my body this way. But only body if you end up making me look like jaylo by Friday. That's the that's or I'm out, right? This. You know, I want it to fast too soon. And I also am only moving or this external result. Now, I'm not saying that you can't have an external goal for yourself. I'm saying like, you really have to understand the keeping and care of your God Bod and coming more from a place of I'm going to move this body because it's a creature and it needs to move. I'm going to move this body because there's emotion that needs to be processed. I'm gonna move this body because it's good for my mental health. I'm gonna move this body for all kinds of reasons, but I'm not necessarily gonna put huge demands that it must shape up in a certain way because we'll quit every time. Oh my God. Totally. So in something I want to ask you about and talk about and see if we can get this into words because I think it's something I always try to explain maybe you've had experience. Well, I'm sure you've had experience with it so much of it is obviously about what we're thinking. And what we're doing or what we're thing. Thinking, hence, what we're thinking shows up as to what action we're taking how we're feeling and how much energy we have like, you know, for me working out is like it's just a habit. Like, I'm going to do it. Because emotionally. I'm I'm processing through things every time. I move my body like every single morning processing through something. I've even been noticing recently. Like, if I have big stuff coming up, or if something's really bothering me, or let's say open, a nasty like in-box randomly like that is going to affect my workout. And I always think about how if people aren't prepared for it. Like, it's going to you're not going to go to the gym like you get a nasty inbox or a call from somebody that you don't want like if you're not ready to kind of come learn how to compartmentalize that and go no that you're going to go work through it. And you're going to keep moving through it. You know, most people that's where it stops. So right with the different thoughts that are going on in our heads with the things that come up in life. Like, how do you share with people to kind of learn to? Keep moving through them. No matter what's coming up because sometimes you can be in the middle of a workout. Right. And you think about something that your mom said in the wait is all of a sudden one hundred pounds, and you're like screw this. I'm out like, yeah. How do we keep going? Well, so the number one thing, and I love what you just said is that every morning, you're working through some things, and my best friend, and I are running buddies, and we're constantly texting each other to hold each other accountable. Like, you're setting your alarm, right? We're getting up, right? And she, and I always say on days when it's raining, or it's icy, and we can't run we really miss our mental health check with each other and processing so many things, and you're right like when you're running a business like you're running, and and many of your listeners are running, and they they're trolls online, and there are people in the office saying things there's a way to be the observer of that to recognize like, okay. So this person is saying. Whatever fill in the blank, stay in your lane. I recently talked to the lady at the gym who we were talking about the Grammy's. And I personally love lo and she is not a jaylo fan. And she was not happy that J lo did the Motown ensemble that. She did. And she was saying that jaylo needed to stay in her lane. Oh, guys jaylo as an actress because she thought she was a precious actress, but that she couldn't dance and she couldn't sing. And I was like, okay. So you lies that Jlo's lane is actually dancing. She was a girl on in living color. That's kind of what she's known for ima singer. And then she added acting, but I really started thinking about because it it was during my workout. I got all up in my head about that phrase, stay in your lane. And I was forming a blog post about women who tell. Other women to stay in their lane. And I was great bolt to have heavy weights. Because I was like, okay. Like I need to pound some stuff right now. But there are times when people do or say things and negative thinking can make you physically weaker. It's proven. And so understanding that number one what other people do and say, you can't control. It's not about you. It's a projection and also just being aware that negative things negative circumstances and haters are going to happen and guess who still going to show up every single day Lori harder. Susan Hyatt the listeners of this podcast. We're going to keep showing up and keep showing up imperfectly, and developing a mindset that's like no matter what I'm showing up so good, so true. And I would have I literally stay in your lane thing. I had a few. I had I just could go there with you. No, I'm like, wait a minute. First of all J lo owns the highway so adopt a highway by you. I know anyway. Oh, it's but that is something that like literally, I think that's so important in and we won't go off on too much of a tangent with that. But I I loved that. That was even you know, I just want to point out that obviously if if we tell each other to stay in our own lanes like we can't ever have the freedom to evolve in the way that we're supposed to so. Yeah, I feel you on the stand your own lane thing. So. I'd still be like only in the fitness world. And that would not be I wouldn't be having any fun in that lane anymore by myself. I still a real estate agent. You know, there's a lot of greatness in that industry. But it wasn't for me. It's like come on guys. We need to grow. Totally. Okay. So detoxing your mind that was really a huge part of it. So the just really paying attention to what you're thinking. So is there mantras or is there something that you do in the morning for you like when you are? Let's say you're running partner is not there like you said like the mornings that she's not there on. You're just like oh my God. Like, how do I get my mind to just tell myself to go and work out, even though everything is like, no, no, it's okay? Just work through this. Even though I know, of course, sometimes we have compassionate. We don't have to go to every workout. But for the most part like it's pretty important to go move your body and do that for you. So what do you stick to in your head that kind of helps you clear out those thoughts? Absolutely. So I had this little morning ritual that I call dial it up, and I do it while I'm still in bed. And basically when the alarm goes off trust me when my allow. Arm goes off early in the morning. There are very few mornings that I'm like good morning. Let's make some sunshine. I mean, I'm a pretty happy person. But I wake up with worries and wanting more sleep just like everybody else. And so one thing that I do, and it honestly, it's become such a habit that it doesn't take very long at all maybe a minute, but I do a body scan. So I I still have my eyes closed in I assess okay, what's happening in my anxious about something. Like, what's what's my heart rate doing and then I pay attention to? Okay. What am I thinking? That's creating this feeling state and usually for me in the morning so for talking about this morning. My my running buddy was flew home late last night. Her flight got delayed delayed delayed, so she didn't get home until after midnight. So she wasn't going to be up at four forty five to run. And I set my alarm anyway to do my bike this in my base. And when my alarm went off, and I did my body scan. I noticed what was happening in my head was a to do list. Well, you really should instead prepare for your mastermind class. Like, you're not fully you're not prepared enough, which wasn't true. But I was telling myself that I really should sleep an extra half hour. And then spend the other half hour preparing for my mastermind class instead of getting up and moving, and so there's this mental gymnastics happens where I think, okay. What is the result? I want the result. I want is to get my booty up and get in that basement. And so some of the thoughts that helped me get up in. This is for any of you listening who have trouble getting motivated to get up in the morning. What's really helped me is in advance? I come up with what I call back pocket thoughts, which are thoughts. I can whip out and try sometimes they work sometimes they don't. But one of the thoughts. I like is you never regret. When you do get up. I only regret it when I skip. I never regret it when I actually get up and go, and then the other thought if that doesn't work is, you know, you're gonna feel so proud of yourself that you actually got up. So feeling proud is a feeling state. I really love. So it's like picking out the result that you want. And then deciding what do I need to think? And then what do I need to do? That's in alignment with that result. And I do this like if you get into the habit, and I'm sure you do some some thing like this Laurie, but it happened so quickly. Now, it's not like I'm lying there for forty five minutes with this debate. It's literally happening within a minute or two. Yeah. I I literally and sometimes. Yeah. It is longer. But. It's like for me something that I've fallen back on it's kind of similar to yours, which I feel like when you know, we all start talking about this. It's so much of it all comes down to these answers that you're giving like it's kind of like this formula that you have to figure out for yourself though, like insert your own kind of statements that work. But for me, it's always like that thing that you think is support. Like that thing you think is supportive actually is in like as supportive as the exercise or as the meditation or as reading the book because I can fool myself into thinking that going and writing that to do list for the seventh time or going and running that errand right now, I'm always like, Nope. It'll be there later when you feel better after your workout. So those are kind of the words that I'm always going back to because we are so good at convincing ourselves. Like, no that'll feel better. And I'm like, no actually, you'll kind of do that half ask because you'll be tired. And then it'll be. Done and you'll have time, but she won't go workout. So you'll feel bad. Exactly, exactly. And for me. I'm the same way. I'm like, okay. But preparing for your mastermind class is going to happen. So much more quickly. If you have energy from your workout so quit like over dick euless. Oh, yeah. Like when I was writing my book. I was like no you should go. Right. I I'm like who. Are you kidding? Like, you're gonna you're gonna get to the coffee shop, and instead of writing you're going to get like that chocolate croissant because you're tired, and you didn't go for a walk. Right. And you're not gonna write it all after that. I always like and the other thing for me is energy wise, meet him. Yep. Meet him. I have a lot of calls and appointments in classes and podcast interviews during a day. And if I have any hope of showing up in the way, I need to show up. It's because I've worked out. It's like it's like dropping in. I really feel like it's it's like this reconnecting back to your physical self like connecting your brain to kind of your body. That's how I how I feel after work on them. Like, okay, now, I'm fully present because of kind of moved into my body, otherwise they feel kinda creaky in groggy. And you know, I just think it's a great way to drop in and be like, okay, I'm here. Now. I can now I can pay attention. Yes. So I wanna know what number seven means the show up and be seen. I like a sentence. So I also talk about this as make a scene, and this is my favorite. I mean, they're all my favorite. Me say everything's your favorite. This one I loved so much because the phrase and the exercise happened pretty organically, and that I was on a run this would have been four years ago now, and I usually run in the early morning with my best friend and it was during the holiday season, though. And it didn't it didn't happen. So I was running midday which was really unusual for me December Chris day. I approach this park that I always run through. And there were a couple of like probably nineteen twenty year old young women with a little puppy. And so I stopped and pet the little puppy and kept going, but then on my way back I noticed from far away that this puppy in his leash was wrapped around the owners legs and was bending backwards like almost about to fall down. And I noticed this big guy probably like six four. Yelling in the street, and pointing in her face and her friends started flagging me down. She could see me coming now Laurie. We've not met in person. But I'm five three I'm about one hundred fifteen pounds. I am not a big woman. But in that moment, mama bear kicked in. And now I'm not recommending to your listeners that they insert themselves into a domestic violence situation. But in that moment, I just started charging and I approach, and I was yelling to like startle and scare him which worked, but he turned towards me and started like yelling at me. And what are you going to do about it? And for the sake of your audience, I won't use all the twice words that I did say in that moment. But I let little Mr. know exactly what this forty five year old was about sin due to whip his booty and his friend was sitting in a car. I looked over notice. Is that there was a running car next to this the sidewalk and his friends said, hey, like stopping an idiot get in the car, and so it was enough of a disruption that after saying a lot of awful things to both of us. He actually did go away. But in that moment, the young woman, the main young woman sunk down to the sidewalk and was just sobbing. And I was like, it's okay. How can I help you? And she said, you know, I'm just so embarrassed that we made a scene, and I said, you know, what like your life is worth making a scene over in. Who cares? You know who saw what? And so it was the long in the short of it was she had broken up with the sky. He didn't like it. And he was being abusive and the whole way home, I was on this adrenalin high and that phrase like don't make a scene kept coming to me because I was raised in the south. And my mother used to say that to me. He like tone it down. Don't make a scene. What will the neighbours think? And so many women are raised with that were raised with that message. Quiet, like, don't ruffle any feathers. And so part of this process in standing up and being seen and making a scene is not necessarily about being super disruptive. Although that it's always fun for me when my clients are. But it's more about the little ways you can advocate for yourself and make a scene. So it might be asking for the raise or simply saying like, actually, I hate Chinese food. I don't wanna go there every Saturday night anymore. All the little ways that women can stand up for themselves and start saying like, hey, like, I matter in my own life, and then the being seen part most of the women that I work with are either hesitant to put themselves online for their businesses because they're scared of trolls in haters, or because they don't like the way that they look. And so it's a big part of like, hey, you get to take up as much space as you want. You get to be front and. Center in your life, literally physically metaphorically. That is like man that is like I think some of the best advice in the world because it will it will keep coming back in some form. Like, if you don't have a couple of experiences going on in my life right now, I won't share to in detail because I'm right in the middle of them. But it's like knowing where if I would make the the easier decision for people to still like me and not ruffle feathers or not disappoint or upset people that that will come back for me in a huge way later. Whether it's when when it's happening, and I'm just sick the whole time where I'm like, I went against my intuition, and I'm beating myself up and I'm upset because I knew it wasn't what I should do. Like, it's I tend to like look for word and let myself live in the decision, and I'm like, oh, hell, no. Like, I'm going to disappoint people. I'm gonna make make a scene over this. Because it's worth it to me to stand up for what I know is going to be a nightmare later, like I'm kind of done, you know, people. Pleasing not disrupting because it will come back. Right. Right. Absolutely. And and the thing is is that, you know, like you're saying when and I certainly have been there to where my body compass told me was very clear like this is a bad idea. And I talked myself into it. And then I'm like dang it. And I'm you know, I discounted my own guidance and went along with something. So like be compassionate about it. But also, listen, and that you know, like the Jim Laurie. I'm sure you owning a Jim I'm sure you saw all the time. Like, here's a great example women tend to go into a gym setting and tiptoe around and they're very timid around the guys and like like, oh, oh, oh, you wanna take my bench? Okay. Like oh. I can't work it, you know, all that kind of stuff as like take out take up all the space all the Wade's like let them know let 'em know lay. These. I am here. And I am presence and expand your energy. But it's so it's so important in. It's funny. How when you start to like when you when you allow your energy just to let people know, it's amazing how much less you actually have to confront and use your voice because your energy is speaking for you. Yes. And my trainer might trainer Eli. We talk about this all the time because you know, he gets potential new clients coming into the gym that he does consults with. And he was like man, I feel like we really need to get you to do some kind of like intro to the gym where you do them out. Space because he's like you go over there. And most of the guys that don't know you are like let me get the hell on the other side of the. This girl. I don't know. I don't know about her like did you need these weights. We're at grad these did you want these exactly exactly on. Sorry. Do you want me to move over? That's the kind of stuff now as opposed to like when I used to. Oh my gosh. I I've I've seen it a lot. I've seen so many women like a actually completely avoid it. Because they're so incredibly just intimidated to be themselves in the gym like is it okay to be myself in this gym, or what am I supposed to act like or and I I completely get that. But it's it's kind of like I've learned that in this is so crazy, and I'm sure that you like probably uses parallel all the time. But it's it's insane. The number of parallels from working out in Jim life, and how you show up there is kind of like translated throughout your whole life. Like, it's the best place to play like in Tryon different versions of you or your confidence. Or just listen to the mental chatter because whatever's going on there is going on everywhere in your life. Yes. Yes. Absolutely. Because it's it's sort of like, you know, I think there's a funny. I'm sure you've seen it. There's a funny Jim cartoon. That like categorizes the different kind of Jim users like the gatherer the person who liked takes the weights, you know, works. Works. So it's like where else does that show up in that person's life for sure? And I think women who are oh, here's a story. There's a young fat ass who works out in my gym, young female, bad ass. And I had honestly been watching her for a long time. Like, man, like, I know she plays college or something, and she is a total beast. And then there was I'm usually not in the gym on a Saturday morning or maybe it was Sunday morning, and she came in with a guy, and I watched her pretend to not know how to use certain machines. So he would show her, and she was she was basically dumbing herself down. And he was like, oh, no. Here's how you need to hold this. And I'm looking at her like have you lost your mind? And so he went to get some water, and I could not contain myself Laurie. And I'm like, why are you pretending like, you don't know what you're doing? And I said, listen, if he doesn't like you as being the bad ass expert, and here that as you are like it's gonna come out later, you need to show up as you are. And she looked at me. I'm sure she was like, oh my God lady who asked you. She looked at me like deer in headlights. But I was like. Like if you're pretending like, you're not a bad ass in the gym. Listen, you need to show up. She's the girl who liked balances on three Bo sue balls and does our lunches like. Like, I'm here with these little fifteen pound weight or my lunges, and I'm just like, okay. He's acting like she doesn't know how to use like the shoulder press thing. The bust amount on the date. You'll be like I'm going to save you a lot of heartache right now. This. Oh, speaking of that this is so random, but like we had Cirque du Soleil in town. And of course, they like all go to that equinoxes that's kind of like right downtown lower like right there where the Cirque du Soleil thing was and I didn't like remember it was in town. So I was wondering why all of these people were like balancing on three Bozu balls like lifting weights. I was like what is happening today. Like why? If they were doing like insane things like just I was like, wow, they really actually work out that way anyway random side now. It was like a kind of a scary day that I was like I'm actually nervous for these people's life right now. But yeah. So is there anything that you feel like we haven't covered, which I'm sure we haven't covered a lot. But that you really maybe on your heart that you wanna share with people who maybe are on this journey to transforming their life, transforming themselves emotionally and also having the expectation of really hoping that their body transforms as well. Absolutely. So the number one thing I wanna say is or one of the closing things. I want to say is if you're if you're someone who has been on a diet or tried multiple multiple diets, and it's has not been sustainable for you that this process is a way to come home to yourself. So, you know at forty five years old by the time. A woman is my age she's dieted over thirty one years of her life. And and when you think about living from a place of debt. Revision for that long. Just know that being devoted to pleasure. Just might be the thing that helps you create a way to take care of yourself in an exceptional way, making that sustainable. Well, and I I actually know that to be so powerful firsthand like it was opposite in so counter intuitive of what I thought, but I keeps revealing itself over and over in my life. I'm like, oh, Yep. There's more facts there's more to that than I even ever realised the older, I get so that's so beautiful. I would love for people to be able to get this book and find you and follow you. So where can we grab it? Absolutely. The website is let's get Baer B A R E dot com. And there's lots of goodies on there. And we have some gift for your readership your listenership, so I want to shower them with freebies. And part of that is joining the bear membership community for a month for free ninety seven dollars. So come on over and experience, some leisure you guys. That is absolutely amazing. Make sure you check it out. And this book is not only just so beautiful and beautifully written. But there is just. Practical practical wisdom in here. And it walks you through every single week. Just great takeaways like I was reading through and it's just beautiful reminders beautiful takeaways, and like I said, it's just it's it's a beautiful book all around, and I'm so grateful for you pouring, your heart into this book and this work, and I always end on one last question. Are you ready? I'm ready. Okay. So you are in an elevator with a stranger or it's just thirty seconds on the street in passing in someone a total stranger asks you. How can I be happy? What you tell them. Oh my God. This is such a good question. I would say devote yourself to what your soul wants. Let's so beautiful. And you guys if you loved this podcast is much as I did make sure you share it with a friend. And until next time earn your happy by everyone. Thank you so much for spending this time with me on the earn your happy podcast. I am. So glad that you stopped by if you could take one second to share this episode with someone you think would love it. That would be absolutely amazing. And we would be forever grateful. Also, please leave us a review if you feel so moved by going to I tunes and leaving us an honest thought and honest comment, tell us what you think tell us what you want to hear more of it would really help us out on our journey to helping thousands and thousands of people until then don't forget to earn your happy thanksgiving guys. Bye. Bye.

Jim Laurie Susan Hyatt Facebook partner Indiana Lori founder Howard Liedes California Oprah magazine Grammy Bota LA Martha Beck Dr Martha Cirque du Soleil reporter
August 19: Old school

As It Happens from CBC Radio

51:02 min | 2 months ago

August 19: Old school

"I told the court. To. Use One small man. Giant wheel. But I do wish say official that I'm wrong person right now. UNCOVER SEASON SEVEN Dead Wrong. KILLED TIPPLE IT It'd be. Available on CBC listen and wherever. You get your podcasts. This is a CBC podcast. Hello I'm Helen Man and I'm Talia. Slang. This is as it happens the podcast edition. Tonight old school an infectious disease specialist has this advice for parents worried about sending their kids back to school for most the benefits of returning to the classroom during covert far outweigh the risks origin story we hear from a researcher whose work has scientists around the world warming up to the idea that penguins first originated near. Australia and New Zealand and not in frostier climates dystopia nonfiction a year ago British student Jessica Johnson wrote an award-winning story about an algorithm the determine students grades based on social class. She tells us how she came face to face with the kind of future. deja brew after a Calgary Professor uncovered an old ad for a mysterious drink named crank a local brewer decided to tap into the excitement by whipping up a batch. Tonight we sample the results roll call Lamari when Rhode Island appeared in the Democratic National Conventions Roll call last night they did so with a uniquely on brand endorsement of the state's official appetizer. And Joe Biden and dog's breakfast Germany's agriculture minister is doing her best to mandate dog walking. But questions about enforcement abound, and our guest says the policy doesn't quite pass the sniff test as it happens the Wednesday edition radio that suspects the new rule will be a mastiff headache. Come. Back, to school, maybe just around the corner, but in Ontario students are already heading back to the classroom in the name of research today sick kids hospital began a two day simulation study looking at the effect of safety measures on students and teachers. They're not the only ones weighing the risks in Calgary parents must soon decide between in class or virtual learning. NBC Unions are calling for smaller classes while in Toronto parents are still waiting. For options from school boards. Here's how to mothers in. Toronto described their mood September approaches they alternate between feelings of extreme anxiety feelings of frustration anger. My biggest concerns are things like distancing proper ventilation infiltration and air circulation, and then also keeping class sizes really small. Do I feel confident sending my kids to school now I don't feel competent sending my kids to school. Do I feel like has another or a better option? No I. To Toronto appearance, sharing their concerns about sending their kids to school on CBS's metro morning today according to one expert. It's imperative that kids return Dr Martha. Fulford is an infectious diseases specialist. We reached her in Hamilton Ontario. Dr Fulford we just heard to parents worried about sending their kids back to school even the prime minister said this week he's on the fence. What do you make of their worries? It's unfortunate because I think we've become so. Concerned about just covid that we're forgetting to take a step back and look at what we're actually trying to accomplish. In, August we have a lot more information of WHO's actually at risk for the virus. We have much better testing. We have very good contact tracing, but we also need to have a much more tempered and and calm discussion about what actually happens if you get cold at what are they afraid of and so some of I think what we need to do is have discussion about risk perception versus actual risk. Is would be nice if we could sort of have everybody, take a step back and think of what the benefits of education are and not just worry about Ed. How big are the risks right now though when you look at the statistics in terms of Cova transmission at least as you see them. Right now they're low. We have very low numbers in Canada we have very good testing capacity and our public health as long as we continue to fund it very well are very good at contact tracing and controlling clusters, and we have to remember this Canada were comparable to the European countries were not out of control. The way perhaps might might be seeing south of the border. And because we we are able to track it and in a school be confined or the defined cohort. So if there were nope break, we would actually be able to identify but also very very, very important I think is to remind people that outbreaks in young people if we contain it and it doesn't go anywhere and it doesn't lead to hospitalization an adverse outcome. Then that's actually good news and we should be reassured but those numbers. Some of these children and teenagers may not suffer particularly adverse effects, but they may live with people who could immune compromised people right blue of illnesses, elderly grandparents, for example. So how do families measure the risks as it pertains to them? It's a challenge where we're never going to risk free. It's not going to go away as it is a risk mitigation but again, I would encourage people to look outs with the actual numbers on what does virus actually does what the true adverse effect is per hundred thousand population because it's actually quite reassuring. But there are households where you may need to have a little bit more cautious. The child comes home from school. You may need to have some discussion about what risks are we prepared to take in our home as we would have in the past with any other respiratory infection. Said I think? A huge part of this conversation must be. The harms of not going to school in the benefits of going to school both to the children for Society for future. So I personally would be very comfortable having a child, go back to school and I would be. Thrilled because I think the benefits far outweigh the risks at this stage. In many jurisdictions, the debate is focused on class sizes and the ability to distance children from each other also whether kids should wear masks how important you think these particular measures are. I think it's a hierarchy of everything we do that no one measure our one of the single most important things that I think we need to encourage and allowed facilitate is actually people who are sick to not come to school Then in terms of the other things, it's the engineering controls Citigroup, which you can desks it's the degree to which could have distancing and and digital magic distance two meters in Canada. One point, five meters in Germany one meter and France or Japan. There is clearly a role from mass. At high risk situations but even in hospitals were trained to wear masks, it is very, very difficult to wear mask all day long properly and the oath breaks that happened in healthcare facilities have actually been the result of a salient personal protective equipment, and so realistically, we need to not obsess on masks yes or no I think it's the whole package everything that will make the difference. Now if the risks are currently quite low, why do you think so many people are afraid of what will happen as kids return to school I'm not sure we've done as good a job at communicating as we could have, and I say we sort of physicians of some of the Infectious Disease Physicians as to the actual real risk people are are scared. Now, it's sometimes hard for them to even instead what scared of, and that's when saying it would be nice to take a step back and have the numbers putting context. So we've had, for example, the Kingston outbreak that was associated with a nail salon. It happened it was a close cluster public health identified. It contained it. There were no hospitalizations adverse. Oh, comes out such very encouraging. For, governments it will be critical of course to continue appropriately fund both our labs public health because that's that's the cornerstone of control halls. This is the ability to fast rapid testing and fast rapid contact tracing so that we can control clusters and we don't have a situation where overwhelmed. Now you're an infectious disease specialist you're not a fortune teller but. What do you think we are going to see here in Ontario and across the country come September. I think we're going to see numbers coming and going and going to call the waves panicked vote that term but I think we'll have numbers going up and down up and down almost sort of undulating But I think that the thing for me that would be the most important to look at WHO's getting it, how quickly can identify them and are they in vulnerable people. So if we don't have a surgeon or hospitals, we've got to control their ability to cope. Then we should be comfortable that we can carry on. I. Also think that I again, it's a personal opinion but for me the the very last semester close if we have been that situation again would be schools I think we really need to think as a society what her priority would we value what we want to see going forward and for me it's maximizing opportunities for the children so That we learned that or we learned to accept that these numbers going to common goal that, yes, we're going to have small outbreaks. Yes. It's going to be there. We have to learn how to coexist with this with the ballots temporary response to it, and we need to maximize the good things we can do in terms of allowing people to resume some sort of a new normal life Dr. Phil thank you very much for speaking with us. I. Appreciate Your Time. My pleasure by by. Dr Martha. Fulford is an infectious diseases specialist and associate professor at McMaster University. We reached her in Hamilton Ontario. British. Jessica Johnson wrote a story about a biased algorithm that determines school grades. She didn't think her fiction would become fact hers was a well-crafted dystopia entail. She even won an Orwell award for it. Then this year exams in the UK were canceled amid the pandemic, which meant that crucial final marks needed for university entrance were to be calculated by a computer formula instead of by a teacher last week two, hundred, eighty, thousand students who finished with top grades in their a studies had their high marks slashed some even lost their spots at university including MS, Johnson now the government has reversed. Decision. We reached Jessica. Johnson in Manchester England. Jessica, you just got some great news. Tell me what you found out I. Just found out I got into my top choice university, which is said Andrew's university. So I'm really excited about that Oh congratulations. Thank He. Now, this was not a sure thing. I understand. It's been a very. Week that you find out at first that you're earlier acceptance to saint. Andrews had becoming question this year we had a bit of fiasco with our exams. So we say levels, which is an exam that you take eighteen you have one exam or set of exams that suggests. That dictates whether you get into your university place or not. So I had had a quiet of the grades Ab Sokaia into the jurors on Thursday. When I received my results, I go a star a be however to get into Saint Andrews that he didn't a in English and I go billion English. Those grades were given to me on the basis of algorithm which completely out of control, we have highly anything to do with as we got given this year aside from the facts that are rank was based upon the work that our teachers at scene is produced quite astonishing to think an algorithm is determining your future like this. You say that they haven't been able to explain macho what's behind it? How did they develop it? Where does this algorithm come from I? Absolutely have no idea. I think maybe they released a document which was supposed to explain it but I think it's still a bit questionable. Nobody really owned a sons. It think that might come with based upon this algorithm. I would have had the algorithm explains may been a very difficult and stressful time because we've been out of school since. March or April. Since, then I've had has any communication with teachers and I've had no idea what the outcome of migrates would be this year. So you don't have any idea why you personally were downgraded you. I was for instance in my history year group I, was ranked second. Grade A STA, which is the highest grade you can get on the day given an a even though I was ranked second in my year. So the algorithm is supposed to downgrade if you have the down the list book, I was second. So it didn't really make sense and it was tossing angry I was really upset. You know I've worked really hard for those grades and they got taken away her may you know there was some students that look you grade, which is basically a site. All ungrateful anew only rarely get you grade in the U. K. if you don't turn up the exam and because we haven't thought. How those students given. US. It made no sense. Did you have any communication with the University of Saint Andrew over this time? What we tried to ringo permissions they didn't really know what they were doing over the past few days both at the today place Andrews has been confirmed and the season Census Assessment Grades, which is basically the great that all students would predict by teachers that we would get at the end of the the education secretary as I understand it and prime. minister. Boris Johnson were defending this algorithm for a while there was a lot of pushback they stood by it until they didn't they promised and insisted that they would not go to change. So students protested outside of the department. Of Education, because there were people that go so unfairly downgraded in the grades would not represent them alcohol. For instance, the government will be called out because basically if you live in a disadvantaged area, you with some reason, more likely to be a victim of downgraded how it seems for instance, in the north of England where I live, it seems that most students being downgraded or not shaving the guy's A. In comparison to people in the southeast that was a bit of a disparity across the region as well. So in a particularly fascinating twist here, you wrote an award-winning story on a bias school assessment algorithm and its impact. It's eerily similar to what happened to you. What what is actually at the center of your story tells a in a nutshell with the story is I based? On the pre existent inequalities within the education system and then I added Algorithm abandon system to turn into stone ages experiences of the day that they achieve results and the day that they signed to these bans which solve limit them safe rinses. One of my characters wants to be doxa full each band social classes such. So van number one would be where the doctors are. However, this student was bone on the band number two and you want a big prize for this. Yeah. I wouldn't the Ola Prize which is a prize as part of the Ohio Foundation. But yeah, that was Russia you'll. So that was last year this starts happening in real life and what goes through your mind. Yeah, it was crazy at first introduced an algorithm It's over to the story but I didn't think it would be that Simla as to what it actually turned out to be. Obviously when the results came out on, we found out about disadvantaged students to have more risk of this downgrade and therefore be more risk of their huge is being taken away from them. It just reminds me so much. We know Santana's a particularly prestigious university studying they're. Studying English I waited again is the ironic thing about the whole situation I got rejected for English, and then I shall serve. and. Like resembling the situation completely. Up during English. Now, it sounds like a pretty bright future ahead of you and I appreciate you talking with us. Thank you raise Okay. Bye. By. Jessica Johnson is the winner of an or well youth prize in two thousand nineteen for her story called a band apart she'll be attending saint. Andrews College this fall she's in Manchester England and you can find more on this story on our web page at CBC dot. CA SLASH AI. H. Dogs in Germany may soon be getting a lot more walkies. A proposed new law would require dog owners. They are to take their pets for walks twice a day. But that idea hasn't got everyone tugging at the leash Tito. Our new is a dog owner and a columnist with the newspaper Pseudo Chits item we reached him in. Munich. Titas you could soon be required by law to take your dogs out walking for an hour each day. How do you think they'd like that? Depends on the talk of to talks. One is two years old, the other fourteen and a half. And yet the young one, he's very happy to work with me any time. As long as he wants to. But the older one is okay with ten or fifty minutes, and then he's done that wants to go home. What kind of dogs do you have? Two labradors. Okay. Now, do you think that all dogs maybe not fourteen year olds but all dogs need to walk this much. I don't think so but in general the proposal, it's not a bad thing because a lot of talks I think. The are not treated, right maybe they have to stay in Kennels or they are kept on the this all the time. But of course I think it depends on the talk. Now if your fourteen year old didn't like this, what would it do? Stops walking and sits down he says, let's go home. And you if you had to carry that dog home, I'm assuming at being a lab that wouldn't be too easy and I couldn't. I couldn't carry him at tried once when he was injured in the mountains. and. I think he he weighs thirty two kilos. So that's a yeah that's quite heavy to carry him. How are people responding to this proposal? I'm assuming there's a mix of opinions what kind of things you hearing? In general, the proposal people say it's a good thing because. It's Not on the about the time, you'll have to walk with a targets, for example, the regulation of breeding of Docs, it's a good thing to think about it. But of course, the main problem is I think how to check up on the duty might mean that the people they are nine or I think nine point five, million dollars in Germany and doesn't nobody who can control right? It's a question of enforcement. How do you police? Yes the police wouldn't do it and. Who is even? Wants to control it would there be fines for people who who didn't walk their dogs for our day. I don't know yet because it's It's a proposal of the Ministry of Agriculture and it's not a low yet but it will become law next year I think, why do you think the Agriculture Minister put forward this idea at this point? Yes. I think there are still many people who are not taking care of the animals melts in proper way they they don't treat them as they should be treated and. That's the main reason I think they came up with this law. Yup The dog walking is one thing. Are there other components to this proposed legislation as well? Other animal welfare issues that are addressed in it. Yes I think the other point is that they are going to put up. Some regulations for for Rita's they say, for example. That you don't you won't be allowed to read more than three. Say. Three letters three three litters per year. Yeah. Three litters preseason. The other thing is transportation of animals in general because they have been a lot of scandals in. Europe about. Transportation of, for example, cavs are chicken or something. Being, transported throughout the European Union and this is going to be regulated more strictly said, he thinks it's possible like parts of this proposed legislation will become law and parts may be abandoned. So I think. So because some in Germany, this proposal is going to be discussed the. Different states and the organizations were responsible for breeding and I think not everybody's going to agree. In the meantime, do you think this has prompted people a bit to think about how they interact with their dogs? How much exercise they give them? I. Yeah I'm pretty sure because it's quite a bit topic. First of all it sounds honey but The newspapers and radio stations TV featuring this. Topic. So I think people talk about it and maybe. Afterwards reasonable. To say, let's take care of the dogs and treat them as they want to be treated. You are taking your younger dog Oscar to the mountains tomorrow I understand how long do you think he'll be able to for? He would be able to forever think. More, than. More than I would be able to because. Yeah it's two years old and is very strong and I walked with him for eight or ten hours since no problems. Oh My. Dog is very stubborn. If that dog has had enough, she will just sit down and that's the end of it so. Of course. Well. Thank you very much for telling us about the proposal and the reaction to it. I appreciate your time. Thank you. Bye Bye. By, thank you. Teach our new is a dog owner and a columnist at pseudo chat tune. He was in Munich. You can find that interview along with some photos of Mr are new and his dogs, Oscar and Bruno website CBC DOT CA Slash Ai H. So depending on who you ask last night's roll-call montage at night to. National Convention was either a poignant reminder of our isolation or the most entertaining part of the whole Shebang maybe both but Rhode Island at least seemed to favor entertainment by highlighting one of its local landmarks above all. Rhode Island the ocean state where a restaurant and fishing industry have been decimated by this pandemic a lucky to have a governor. Gina. Raimondo. Who Program lets off fishermen sell their catches directly to the public and I stayed up appetizer Calamari is available in all fifty states the Calamari Comeback State of Rhode Island casts one vote for Bernie Sanders and thirty four votes for the next. President. Joe Biden. State party chair Joseph McNamara submitted his states thirty five delegate votes in a video from. Yes. You heard that right the Calamari Comeback State of Rhode, island beside him on Oakland. Beach a masked John Gary showed off a heaping plate of yes. Fried Squid Mr Bordier is the executive chef at aggies chain of seafood restaurants celebrated in the ocean state. He didn't seem all that celebrate Ori-, himself mind you. Perhaps he was remembering the controversial choice a few years back of Calamari as Rhode. Island's state appetizer controversial because many thought a clam based dish should be recognized instead. Or maybe his demeanor was more current speaking to the Washington Post. He said he's not even sure he'll vote for Joe Biden because everything to me is always the same. The only thing that really changes is the price of things going up. Well, the chef may think Mr Biden is just the flavor of the week but Rhode Island's delegates have placed their order and they've snuck in the kind of endorsement. We can all get behind that of a beloved better. Hi David fareless host of hunting warhead from CBC. PODCASTS and the Norwegian newspaper vg. Hunting warhead follows a global team of police and journalists says the attempt to dismantle a massive network predators on the dark web winner of the Grand Prize for Best Investigative Reporting The New York festivals and recommended by the. Guardian. Vulture and the Globe and Mail you can find hunting warhead on CBC listen. Or wherever you get your podcasts, I'm Justin link host of the village from CBC podcasts for years men were vanishing from Toronto's Gay. Village. The. Community had always suspected a serial killer and in the end they were right called a podcast that transcends true crime by the New Yorker and recommended by the Atlantic and esquire find the village on CBC listen or wherever you get your podcasts. The question is millions of years old twenty, two, million years and scientists think they finally have the answer for eons those who study penguins believe they wanted in the frigid cold waters of Antarctica but a newly published study found that they actually evolved in much warmer waters. Rory Bowie is one of the lead researchers and a professor of integrative biology. At the University of California Berkeley we reached him in Berkeley? Professor Bowie if penguins didn't originate an Antarctica, where did they come from? So our conclusions based on some new work that we've just completed using whole genome data helped us resolve that question. which has puzzled people for a long time. We were able to quite conclusively show that Penguins originated. Along, the coast of Australia and New Zealand nearby islands in the Pacific and that this occurred for Living Penguins about twenty two, million years ago. Why did scientists think they might have originated in Antarctica has an interesting story. So it comes back to looking at the two most unique penguins what many of us sort of identify our first thoughts with me think about Ping and that's the largest easies the emperor in the King Penguin. So impropriety propellants only courant Artika and King Penguins occur both on Antarctica but also some of the nearby islands and these two very big species a separate out from the other species and because they occur in that environment was thought that that's Where penguins originated, but it turns out that when you include all the species together in a single analysis and some fossil data in suggests that pink as she originated in slightly warmer waters. Now I understand you always suspected that this was the case what did you and your team due to find out. So some of the fossil dated hinted that New Zealand Israeli, the hotspot of penguin evolution, and so we wanted to take a closer look at this question, and so we decided that the best way to do that was to try and obtain the most amount of information we could and so to do that, we sequenced the whole genomes of twenty two different penguins representing a. Modern species, and then we were able to use analysts of this very large. To resolve this longstanding question what is so exciting about this knowledge? Well, I think the the the thing that two things that really interested me that came out of this one is that we often think of penguins is occurring in the Israeli freezing environments. But what we were able to show is that they actually originated in more temperate environments with the waters around New Zealand, and Australia being about nine degrees Celsius and then we see twin radiations one moving. Down into the much colder. Antarctic. Waters and then another one that win the passage, the drake passage between the tip of South American and Arctic opened allowing the currency flow around the bottom of the will to change penguins were able to move up the south coast of South America and eventually reached the equator where the Galapagos Islands and waters can be as as twenty six degrees Celsius. It's remarkable to me that these seabirds canal occupy these very different she attic. And the second thing we could show is we were able to identify some of the mutation, some of the genes that have enabled penguins to be able to survive in these different kinds of environments. Why would the penguins move what we think it's got to do with about five million years ago when the Arctic ice sheet really intensified. By changing the sick elation of the currents at the bottom of the world it allowed for doing. So these nutrient rich waters from the deep ocean get pushed towards the surface, which then brings in a lot of fish things like sardines and that that feed on this nutri water and so penguins were following that food resource and that enabled them to trove them to occupy these new different these different habitats. It's hard to think of a harsher climate and Antarctica of how were they able to adapt to such vastly different climates. So in the end Arctic instance. This partly, why we see imprint King Penguins being much larger than other species because they can conserve body heat will we will also able to show that they've got interesting mutations in genomes, then enable them to control how they dilate and open up the blood vessel. So they can reduce the amount of blood that flows to the skin and retain a woman temperature inside, and they were also able to modify the efficiency with which they can carry oxygen in their blood which. Is. What allowed them to dive very deep and be able to feed on some of these deeper ocean nutrient, rich food sources in for example, Artika well, and this this process even referring to millions of years here. This is something that that took a long time to change. Yes. So I think that's you know another really important point to make is that although penguins can occupy these very different environments. Today, it's taken them twenty million years to able to occupy waters from freezing. Temperatures to up to tropical oceans and the rate at which climate is changing. Today suggests that penguins knocking to be able to adapt fast enough to keep up with the pace of change and we already seen dramatic impact. So we've seen mass style of a daily Penguin chicks in an article recently impropriety had to relocate, and so the rate at which warming is happening is just to foster full evolution to be able to keep pace with it. So a how at risk are these various populations I think a lot of these populations are a traumatic risk. In one of the other things we could do without genome data as we will for the first time, am able to crack how penguin population sizes have changed over the loss millionaires, and we can show that penguins respond very positively in the cloak cools. So during the loss clay seal periods, many penguins most abundant numbers and off to that that was about forty to seventy thousand years ago penguins have been declining and as climate warms now, we think that many of these isolated is. which we have to remember a very small a likely to disappear and Salah urgent conservation since to preserving the habitats and how do you do that given that so many of them are in these areas that are warming well, it's a complicated question to do that and many of these areas are already. Preserved in the saints that they occurring in nature reserves in that. But the most important thing I think we can do is educate the public about how climate is changing. Everybody can play a role in reducing those emissions that will. Help ulta warming, and ultimately that will have a much have an impact across a very large part of the globe, and that's part of why we wanted to do this work to help people understand that although organisms occur many places today, it's taken them millions and billions of years to do so and given how horrible penguins are. Presumably, they're pretty good ambassadors for getting that message across exactly there you know everybody loves a penguin as I like to say and as a consequence they can act as a real ambassador of flagship. Seabird, species, and other species that occur in same environments that might be quite as charismatic but just as much district from the same kinds of environmental impacts professor Bowie. Thank you very much for sharing research with us. Thank you very much to talk to you. Good. Bye. Bye. Bye. Rory Bowie is a professor of integrative biology at Berkeley, and that's where we reached him. His Penguin Research was published in the proceedings of the National Academy of Sciences. Ten years ago, Bill Stobie went to a closing sale at an Ottawa Antique shop the store was trying to get rid of inventory. So the gave him two statues, one of Saint, Theresa and one of Jesus he decided to put them in his bathroom and thought they would just collect dust next to the soap dispenser. Instead, the two statues started a decade long project to cover every inch of his bathroom with other religious artifacts. Earlier this week Mr Stobie's spoke with CBC auto a morning about the bathroom shrine he calls the grotto and why he's decided to take it all down. Gradually just grew and grew, and then I got into the collecting of items from garage sales and flea markets. People started bringing me things from. Travel things that they had in their garages and back shelves and sorted away and from there it just it just took off and. People started to take an interest in it and the collection grew over time I was just looking at pictures of your collection on our website. CBC DOT CA Slash Ottawa and I it got so crowded that. The little sink in the bathroom was filled with statuary. Now, there are no pictures of the commode I. Please tell me that some of these religious statues didn't make too close to that. No. They didn't make it too close to the seat, but the the top of the tank with certainly covered with things and pretty much. Every other inch of the room had something did any of your guests ever say bill? You might not be religious person but I am and I find that a little questionable. Nobody actually ever said that the the the grotto offended them or that the collection offended them some people found it a bit odd. Lots of people founded a bit odd but no over the course of the decade that the Garter was there people started for what it was An unusual art installation something that could have layers of meaning to it if you wanted to explore it but Stood that it wasn't being done out of disrespect for for religion for religious. Arctic artifacts during the pandemic though you decided that it was time to make some pretty big changes. What happened Each year I would take everything out between it all off. That's the down white down the counters and things and then Resurrect the the grotto So when that time rolled around this year I wanted on into to do that and as always cleaning always I I've been in a bit of a reflective mood like I think a lot of people are in the pandemic thinking about where things are going and where, where, where, I wanna to go with my life in a in a readjusted Canada and so those are buzzing through my head is tidying up and it just realized that the time has come. It's been ten going on eleven years I wanted to do something different than so it was time to to pack up the grotto. That was bill Stobie's speaking auto a morning guest host Halley cotton him about a shrine he built in his bathroom. It all started with an ad for a mysterious beverage called crank. You might recall that earlier this summer we spoke with University of Calgary, researcher Paul, Fairy. He had uncovered an ad about the beverage in eighty three edition of the Calgary Herald newspaper after posting the Ad Online Mr Ferri explained to guest host Duncan mccue how a friend finally tracked down a recipe for the nineteenth century drink. I think maybe two days into this whole saga, a Fundamental Bridge Jennifer Davis found the recipe in an old a handbook of American recipes of some sort. So I mean, it does seem pretty root beer. So it's what Sassafras aspirations. camel blows, which apparently just leaves cinnamon ginger a broom altogether add some green tea for some reason, and then adds molasses east and then you got yourself a Abacha crown it's it seems like a pretty vague recipe from what I've read. You know sent to suit your taste. Yeah. So that's definitely the the mystery element I. think that whoever is brewing it will have to have to wrestle with. Blake belding is the brewer who wrestled with that recipe and finally quenched our collective cronk thirst. Mr Belding is the CO owner of Cold Garden Beverage Company which just released their first batch of the century old brew. We reached him in Calgary Blake, we are all dying to know here. What does cronk taste like? Well. I would say it's It's tastes kind of like a herbal sast parrilla there used to be an ice cream parlor here in Toronto that had what they called. South. Parrilla. And it was kind of like root beer remember tasting it. It was a very modern variation on that. What about the other undertones? What what else is there? Yeah. So it is it does have a root theory component I mean root beer, the base of Rubio Sas Farrah and originally Sassafras which is a very unique aroma and flavor, and so we weren't able to use Sassafras, a collection of other herbs to try and get that flavor so. I would say it's like a very herbal. Dry Root Beer. It's not sweet. Molasses the girl fermented out, but the the undertones of molasses are very present still why we able to use Sassafras. So we didn't know this at the time, but Sassafras has a slightly carcinogenic in certain amounts and it's also used it a precursor for narcotic production. So you're allowed to purchase it and use it at home, but you're not allowed to use it in commercial preparations. So we rushed out and bought two pounds, and now we're stuck with this. Poison powder in our ingredients been, we don't really know what to do with this. We just heard a clip of appall ferry who first discovered and told us about Cronk in June at how did you first hear about this drink? So somebody just made me aware of appalled original twitter post and all the trying to pay off surrounding it. I. Just kind of found myself. Thinking I wish I wish somebody could make a reality and then I quickly realized that I was the person that could do that. So away we weren't as brewer, you had the skills and the materials. Locally. So it sounded pretty vague the list of ingredients and the proportions, and how did you figure out a recipe? It is like I mean it's vague but it tells you what to do. You know to says take one onto this four pounds of this one town of this oil it together out a little bit of this and so we did exactly what it said except for this process and we we substituted in variety of herbs and with seven different curves to get that flavor, and then at the end, it just said sent to taste preference and. I mean we we didn't really know what to what to go. So we just wanted cronk original and we and we didn't have anything else to. How potent is it in terms of alcohol? It's four percent overhaul, right? So kind of like a a light beer. Like a later beer. Yeah and and we didn't really know what that was gonna look like we'd never fermented molasses before and so we just had to have to roll with it and see how it ended up. I. Understand you did have a few failed attempts. Can you walk us through some of the Test Bachelor? You feel that does not that bad. We did have one disastrous failed attempt completely my fault at is working with. Paul. Reference. Jennifer Davis in that in that clip and she was giving us some tips on what type of cinnamon would have been available the hundred. And in certain. Ingredients the one thing we kind of. Glazed over didn't talk with the molasses and the turns out. That's the most important ingredients and when it went time to buy everything, they didn't have. All there's black strap molasses, which is a leftover from the sugar making product process and Spanta molasses, which is like a delicious dessert molasses. And that's more what they would have had back in the hundreds and they didn't have any of that available in the store especially twenty gallons of it, which is what I was looking for at the time. So I bought a bunch of black strap molasses and. that does not taste very good with ferment all the sugar out of it left with whatever the black strap part is, and it was undrinkable sludge as we heard, it described media time. Someone you replaced when you replace that molasses, you finally got his good batch. Tell me the moment. You tasted it what what you thought it was just a like a huge feeling of relief because at that point we were getting, we're fielding dozens of phone calls a day dozens of emails, everybody around the country and around the world asking us. And where they can get cronk and we would like originally said it was only gonNA be a couple of weeks and then all of a sudden we the bad stuff where like Oh, shoot we're gonNA have to do that again start telling everybody it's do more weeks three weeks. So when we tasted that first the second batch for the first time and it was we can tell him it's going to be good it was like There's just they alternate feeling of relief like. Get blessed me and so. Now this limited rotten do you can make another patch I don't know I really don't think. So it's hard right now because I believe we're actually going to sell out of our taproom supply today is really going like there's been lineups there this morning. So the the plan was only ever do one batch and I. Think we're GONNA stick to that but we're going to have to sit down when the smoke settles say to people want Cronk. Again you know is it something that if we do it again is are they going to buy it or was it just kind of? Exciting time and place to be part of. All right. Thanks very much. No problem. Thank you. Bye. Blake belding is the head brewer and CO founder of Cold Garden Beds Company. He's in Calgary. If, you've ever watched a swan glide across the water. You've probably noticed they exude an air of royalty that sends other birds to the shallows. Maybe it's their majestic plumage maybe it's the elegant curve of their necks. Or maybe it's that all the other birds know that swans are huge jerks. That's the theory that scientists at the University of. And the WILDFOWL and Wetlands Trust put to the test. They already knew about swans reputation for aggressive behavior. But after studying the birds by Webcam, they learn something new swans are even more hostile to one another the researchers concluded the vicious Swan Swan behavior made ecological sense since those birds of a feather compete for the same food sources ecological sense aside here. It. As it happens, we've learned that whether you are a feathered friend or foe, it's always best to give these birds a wide berth, for instance, this story of the Chumsford Canoe Club from our archives in two thousand, ten guest host. Laura Lynch. Spoke with the Club Secretary Deborah Wilkes About Swan named hissing sid that had to be removed from the local river. So. What's he been up to for the last two decades? He's been a pretty nasty bird. He, has indeed she started off the he was just fairly aggressive when it was mating season and didn't like us. I think he's always been STI whenever he sees a Cannolis, he will. Puff his wings out and. Come toward you whatever Tom, if you? And what does he do? they then he will. Try and get to the back of you to jump on the bucket, the canoe and you in. Sometimes. He won't do that have just jump on the phone fluffy's wings in your face. How many times has he done that hundreds hundreds hundreds? What's the worst thing? He's ever done I think that the one that tipped the balance was when he jumped on the back of one of the junior goes and note terrain on having not to in proceeded to come around and try and drowned by focusing on the head. I gather. She's okay. Though is she she? She is kite because t to of all coaches immediately went to the rescue to head him off and fortunately she was quite needed to find. So she could touch the ground. You say that that was the turning point, but he'd been doing this kind of thing for twenty years. Why did take this extreme action for someone else to decide it was time to do something about Hissing Sid. Really, because we all know that he does live on the refers to. Utah to be closer. To the wall I would live. On the fact that he's protected by the Queen, makes even more wary about movie him. Why is he protected by the Queen All of the swans in England belong to the Quyen. Come Again I. have no idea how bucket goes but his always been true that the swans along the Queen I guess it comes from when you the the the royalty, the only ones who could kill them and eat them. From twenty ten that was guest host Laura Lynch speaking with Deborah Wilkes about a swan that was terrorizing her canoe club in Chelmsford England. Chelmsford is approximately ninety, six, thousand, six, hundred, sixty, six, swans lined up end to end east of reading. You've been listening to the as it happens podcast. Our show can be heard. Monday to Friday on CBC Radio One following the world at six. You can also listen to the show on the web at CDC DOT CA slash. Ai. AIH. Thanks for listening I'm Helen Man, and Antalia Langer. For more CBC PODCASTS TO CBC dot. Ca Slash podcasts.

Penguins Jessica Johnson Germany CBC Toronto Calgary researcher Joe Biden Hamilton Ontario Dr Fulford Australia Helen Man Canada Rhode Island Dr Martha Ontario Antarctica Bill Stobie CBC
Human Stories of AI: A Second Opinion

The All Turtles Podcast

23:14 min | 2 years ago

Human Stories of AI: A Second Opinion

"This is human stories of AI an alternates podcast series about how artificial intelligence is impacting people's lives today. I'm your host Mary McCoy Thomson. In this episode. We're going to dive into a field that has in many ways already embraced AI healthcare medical. Researchers seem to be developing new locations every day from algorithms that can scan images of tissue for cancer to chat bots that can handle patient intake to lighten the load of overworked physicians. So there's a lot we could cover, but rather than give you a wide angle of you of a in the healthcare industry overall. I'm going to zoom in on one doctor and tell you the stories of two of her cases in both of these cases, the physician was able to use an AI tool in her diagnostic process a process that changed her patient's lives. The doctor. I spoke to in this episode asked that I not identify her personal information just because privacy is so crucial in her profession. But all have her introduce herself here. I'm a clinical geneticist practicing added children's hospital affiliated with a major University Medical Center, and I've been in practice for about twenty four years and this episode will call her Dr March Dr March is analytical, and she loves the problem solving aspect of her job. She's no robot though, she works with a great deal of empathy toward her patients, and she's passionate about what she does. I have always been intending to become a physician and during my training time, I realized that solving mysteries was something that really appealed to me. So seeing. Children who have birth defects or who have differences in the way, they develop or learn or appear and trying to figure out what the cause of those differences are with something that really intrigued me that's sort of one piece of being clinical geneticist is seeing kids with birth. Dissection trying to understand what caused the problem. Dr March is an esteemed and highly experienced does morphology that is a doctor who studies birth defects. But as skilled as she is she sometimes has patients come into office who she can't immediately diagnose, this is a story of one of those times. Really recall, why who sent this patient or what the exact scenario was? But I remember doing all the usual things which is to take a family history. And then explore the history of the pregnancy and delivery and how the child's development went up to that point. And then do a comprehensive physical examination, but in this, particular instance, I couldn't recognize what this child had. But there was clearly enough indicators of syndrome that I I knew there was an underlying explanation. If I could only recognize it when Dr March doesn't immediately recognize the syndrome, there's a process she goes through that begins with a conversation with the patient's family in the course of talking to the family about what we might do to try to get them an answer. I mentioned that you know, there's some gene testing that we can pursue. I explained that that would be done off Oakland sample. We'd have to get authorisation from insurance. I Dr March planned on ordering abroad basic test looking for abnormalities of gene number that's often. The first thing clinician will try and a case where there isn't an immediate clear direction. The other thing that I offered them because I could do it in real time as opposed to waiting for authorisation, and then getting the blood drawn and waiting for the results to come back is I offered them to use face to gene as a way to potentially give me an idea that might send us in a more specific direction face to gene is an AI powered tool, but essentially an app or more precisely suite of applications that doctors can use to help them diagnose genetic disorders. Oftentimes genetic disorders are signaled by certain facial features like sloped. Eyelids or cupped ears and face to genius facial recognition technology that makes associations between patients physical features and a syndrome that doctor may have missed or it can help confirm what a doctor suspects. You just open the application, and there's a little plus sign at the bottom, which means you want to add a new case in my account. All of my cases are private. I don't share them with anybody. But I could if I wanted to I could put the case on the unknown forum if I'm having struggling with the diagnosis in want some other ideas about where to go with the workup or something so with the patient and the patient's family in the room, Dr March consulted face to gene in this particular case, I just click the plus sign and indicated that I wanted to take photo. Right there. And that photo became part of the the new case, and then I put in the the gender female in this case and the birth date. And by the time, I do those three things the program has already finished its analysis and already has the matchless ready for me to view, you can certainly go back later in added in additional information like how tall the child is how much the kid ways with the kids. Head sizes like could've put in this child's heart defect, and I can tell the program to give me their rank list just based on the face or I can say factor in the face. And all these other features that I entered with the information that Dr Martin put in paired with the image of the patient's face based gene came up with a list of potential matches. The first edition on the list was actually a very good match and are better than anything else on the list, and it was kabuki syndrome, which was not a condition that had occurred to me just from doing history. Examining the child up to that point kabuki had not been on my radar screen. But when I then quickly read the description of features of duty syndrome and started try to them off in my patient. It began to look like quite a good fit with face to Jane suggested match Dr March focused her efforts on honing in on a confirmed diagnosis for kabuki syndrome. So rather than looking for an abnormality of gene number to start with. I would look for the specific genes that have caused kabuki center and would look at for spelling errors within those jeans doing. Pacific gene testing to get to the answer is a lot more direct and therefore less costly than if we did a initial survey to look at G number found G number was all their everything was present and accounted for. But then I have no idea what gene to look for. So in this case faced gene, really kind of shifted the paradigm of how I was going to investigate this particular patient. Dr March told the family that kabuki syndrome was a likely match delivering this kind of news to a family can go many different ways. But this was a family ready to jump into research mode. They were a somewhat sophisticated family that was going to go home and read about kabuki and decide for themselves. If they thought it was a pretty good fit. And. They came back to me a bit later saying, oh my gosh. The stuff that we read just reminded us so much of our daughter, what does the diagnosis of kabuki syndrome mean for this child? What are the symptoms welcoming community syndrome is a condition that associated with usually very low muscle tone in infancy? So the baby's kind of floppy they're a bit on the CBO side may not see jury. Well, and then as time goes on on development proceeds slowly there are some problems that individuals with busy center can have like some some can have heart disease. There's a whole variety of not super common medical issues that can happen kabuki center. But I I guess the main thing is is mostly the development the slow learning. It was an important step for the family to receive confirmation that the delayed development. They've noticed in their daughter was tied some. Thing that had diagnosis Bill left. Dr marches office ready to connect to resources that would help them nurture their daughters growth as a healthy happy child. There are times when part of Dr Martha's job involves coke thing families into overcoming their own sense of denial. So that they can accept a diagnosis. Even if it's one that they had already suspected themselves. And that's what happened in another one of Dr marches recent cases, she was a young patient. Less than a year of age and a murmur had been heard she had an echocardiogram it showed a specific type of heart defect that is commonly seen in a condition called Williams syndrome. They came in for a consultation, I felt fairly confident that she probably did have Williamson, but it wasn't a slam dunk. There are some times where you just open the door walk in the room and you recognize the diagnosis just by looking at the child's face. This wasn't that kind of scenario there were certainly things that fit, but she wasn't the textbook case. There are certain things. Dr March looks out for if she suspects the patient might have Williamson drum like usually some puffiness around the eyes a short rather upturned nose the upper lip region is usually long and an a little bit smoother than normal and. The lower cheeks are quite full. So the patients look almost like they have gels and the chin can be a bit on the pointy side in this young baby. Dr March recognize some of these features, but not so distinctly that she could confidently make diagnosis. So Dr March figured it would be a good time to bring in an added resource face to gene, the family agreed and doctor March took a photo of the baby, and uploaded it to the program right away. There was a clear Matt Williams syndrome was the top diagnosis on the list. And was again, a very good fit and was much much much much much better than the number two thing on the list, what is Williams syndrome. So Williamson is another condition. That's associated with intellectual disability. Typically, the kids are a little bit short. They can have court problems. They can be kind of. Irritable in crabby as infants but later on they develop these very almost gregarious personalities where they're very friendly. They can be overly friendly. So you have to teach them about who to be friendly to and and they're talkative. And so they are just really Ajoy to be around. They're very verbal usually. But they don't do so well with things that require visual spatial construction. So they can't draw a picture of a bicycle very well, but they can describe bicycle with with great detail in a lot of flourish. Williamson was the top match having Dr marches instinct substantiated by face. Jane added credibility to the diagnostic process, but the news was still difficult for that family to hear. Well, mom was very emot-. Tional because I think and she said that she said, I knew it in my heart. I knew it. So she she knew something was wrong. She really felt like it probably was Williamson, but she was just holding onto that last straw of hope where I would say, no, no, no, no, no. It was rather emotional. I felt very sorry for the family because it's it's not something you want to hear that your child's going to have a a condition that's associated with lifelong disability. Mom told me that she kinda knew in her heart. That her daughter had this, and it was just that one last little crumb of evidence that sort of allowed her to really admit it to herself coming to terms with something like your child having a condition that's associated with intellectual. Disability is not an easy process. But it I think got her to the next step in the process where she even without waiting for the blood test results. I think she could sort of begin moving on begin the process of grieving of trying to get to a place of acceptance of what was was going on in what had caused her daughters delays in development and heart problem. So in this case dinning, some answers was difficult. But in some sense also relief having a diagnosis is really the. First step to moving forward in accepting it in trying to provide the child with the best medical care possible. And all the support services that are going to help that child reach her full potential, and so really getting diagnosis acknowledging that that's what's going on and moving forward is the really the first step in the process. So it was it was nice to be able to give them the tools to begin doing that. There are of course times when face to genes results say that there aren't any obvious matches. But even that says, Dr March can be helpful like, I said, it's just reassuring that there's not an obvious syndrome that I haven't thought of when I use face to gene and every single syndrome that comes up is in the cold zone the blue zone, meaning it's not a very good match. So even their best match is a crummy match that is reassuring to need that. I haven't missed something obvious for something. She thought of so overall Dr March is pleased with a application that helps her do her job. But asked her what her thoughts were on a is increasing presence in medical care overall. Well, I don't know that I know enough about AI to really have. A strong opinion about that. But to the extent that face, gene, uses a I and I feel like face to gene helps me I tend to think favorably on a I as a way to improve my abilities in the clinic potentially as a way to improve healthcare in general. So to the extent that a in healthcare will continue to change and evolve Dr March, and every other physician will need to see how technology will impact the way they practice medicine, but at least for now, it's been a helpful resource for Dr March to be even more effective in doing what she loves sometimes it's also really helpful to families when you can tell them. This is something that was a genetic accident. It isn't anybody's fault. It happened randomly in the sperm that went to make your. Child, and it's nothing that anybody had control over and it has nothing to do with the two beers. You drank before you knew you're pregnant or any other real or imagined contributor that the family might have been carrying around as guilt in the in the previous. Eight years while they were trying to figure out why their kids not doing all the stuff that they had hoped. It's really a privilege to watch families. Go from a really almost devastated state when they find out that their child has a disability to watch the metamorphosis in a family where they really become a champion for the condition and an advocate for their child. And the parents just undergo this metamorphosis into having a strength and a capability that they didn't know they had they just never would have thought they'd have to be dealing with. And they couldn't imagine that they would be able to and then to sort of discover in themselves, this this strength, and this this ability that they really didn't know they had you know, to to recognize how powerful they really are. And how. Untapped their potential really was themselves as parents, you know, we talk a lot about trying to help the child reach his or her potential. But in reality genetics is a family affair. It's really the entire family that we are caring for it, certainly the most rewarding part of my job and Dr marches job. And I will makes it easier to do what she does. But the way that AI will impact jobs will vary by sector. It won't have the same impact on truck drivers as it does on doctors at least not right away for now and medicine is a valuable tool that can augment doctor's practices, and it's an exciting frontier for development AI working in tandem with humans has the potential to revolutionize healthcare. One product at a time. This podcast is a production of all turtles alternatives builds AI products and services, cO, Tokyo, and Paris and solves clear meaningful problems felt by people and companies we recorded this podcast in the Donatello studios and seven Cisco California big thanks to Dr March for recording episode with us and sharing her story. If you have any questions comments or suggestions, you can Email us at Hello at all hyphen turtles dot com. I promise I read every method. Thanks to everyone involved in the production of this episode, including Jim method door for his magic and editing. Chris plug for his expertise and audio and music production. Mike Rivera and Ali Packard for their fantastic art design plays, the Riga for editing, the scripts and Matt Amerman for our custom theme music from everyone at all. Hurdles, thank you for listening.

kabuki syndrome Dr March AI Williamson Dr Martin Jane Dr Martha University Medical Center Matt Williams Mary McCoy Thomson Oakland AI CBO Bill Chris plug Jim
996: Your Money, Your Framework with Jake Conway pt 1

The Dentalpreneur Podcast with Dr. Mark Costes

37:31 min | Last month

996: Your Money, Your Framework with Jake Conway pt 1

"Doc some quick questions for you is your dental practice efficient and profitable is your personal take home income what you expected it to be at this point in your career. Are you personally and professionally fulfilled. Do you feel like you're a living up to your full potential? If you answered no twenty these questions I've gotten exciting announcement that was designed specifically for your situation. Since two, thousand, twelve myself and my black coaches have helped transform the businesses of hundreds of dentists from all. Over the globe we've helped develop stronger leaders eliminate practiced drama transition practices to a systems based practice model, and of course, helped to significantly increase profitability and take home income. So here's the announcement. I've distilled the lessons that I've learned over the past eight years in helping Dennis to overcome the most commonly occurring challenges and opportunities into an accelerated crash course that I'm calling the forty five day practice transformation. During the course will teach you how to evolve into a more savvy and sophisticated business specifically will cover leadership development developing a vibrant team culture. How to create a world class operations manual. How to run effective meetings that move the needle cashflow overhead control and forecast hiring firing, onboard treatment planning, and case acceptance, and finally how to become a black belt level dental practice. If this high level training is something that sounds interesting to you simply visit transformation forty, five dot com to register. Please be aware that this is an intense forty, five day journey that will require hard work focus participation. Sports are extremely limited. So please don't register unless you're truly serious about wanting to transform your dental practice in life and are willing to commit to the process. Once again, visit transformation forty, five dot com for more details I look forward to meeting you and working with directly during this training. Transformation forty-five. Dot Com. The dental per Noor podcast. Okay doctor it's time to put down that hand piece. You're listening to the show dedicated to helping dentists get their lives back. It's time to decrease your stress, increase your ability and regain your passion now introducing your host Dr. Markkaas. Hello, Erin. Welcome to another episode of the podcast on your host. Dr. Martha's hope you guys doing fantastic out there today. All right. We have a special treat today, we have A. Ds is financial analyst Jay. Conway Live and in studio how you doing today my friend Dude I'm doing great marks. Great to be back man. It's been a bit. It's been a bit. It's been a bit. If you don't mind I'm going to take care of some business quick This episode is being brought to you by. The Dental Success Network Donald Success Network Dot com forward slash free forty five. We'll get you access forty five days free access to the most positive as an educational network in all of dentistry. A, very special place. Additionally, you'll have access to one of the largest buying groups and all of dentistry. As well as our on demand continuing education library, he has a love. Access to all of these resources additionally, there's only three days left three days left to my brand new course called transformation forty five. It's a forty five day practice transformation. It is a crash course on all things business. I personally will teach you how to be a more sophisticated business owner, how to be a more effective CEO. How to learn more about? Cash flow and overhead control how to increase your. Revenues as well as your take home income and had decrease the chaos and drama inside dental office transformation forty, five, dot com. Only three days left emily about four three or four spots laughed it's going to be Today's. Virtual live presentations for me as well as tons of QNA and lots of exercises that will help you as get to the next level. Hope to see you in there. All right noth- business I doing jake good business more business. Yeah. What's going on do that's that forty-five thing sounds awesome. Man I'm stoked to be part of that. Yeah. Man That's so j Conway will be part of that. He will be spreading his infinite wisdom on on on all things I guess analytics inside a dental practice jake and I have been doing this side by side for eight years. Now he's been nine years. He's been with us since the very beginning of the dental success institute and together. We chuckle a little bit about looking at our previous reports from back in the day and what they looked like but they were still pretty cutting edge from back then totally but I really believe that we have evolved and we've brought so many people along with us not to toot our own horn but like the level of sophistication out there now Alastair likes called the dental poor podcast effect. that we share, we just share all of it for free and like. Our I guess. Experience working with thousands now of dental practices and being a look behind the curtain and add financial reports and how those financial reports come to life inside an actual dental practice and being share those trends and patterns that we see and and the habits of some of the most successful dental practice owners. As. Well as the habits of those that consistently and perpetually struggle. This format dental podcast has been so. So powerful for that but. With that, our knowledge base has evolved exponential. Oh no doubt I mean, it's it. It's cool to see. Over the years we've we've developed our own terms and just you know pulling things out of thin air to make it more digestible for us to understand for others understand that become like. Coin terms in the in the dental world it is funny when we come up with literally right something on the White Board and we start talking about on the podcast and we hear it on somebody else's podcast. We don't even know and they just use it as like an industry standard term it's like a I mean it's not like we can trademark everything that comes out of her mouth, but it's like Ooh I remember the day was he actually used that term for the first time and we we Announced it are we started using it to our mastermind members. They start using it their friend start using that term, and then you hear it on podcast, you hear it and dental publications. DSP. Desanta mean for those you are not who aren't on there you should be, but it's called the people see never heard of you know ds I talk about the thirty, thirty, thirty, ten eleven. We're we're in the studio that we'd develop that like six years ago you know it's just cool to see it is that we don't need credit of course, but give us credit demon. Good I mean you and I decided we're I. Think we're having lunch or something the other day. Jacob Share Wall here at headquarters here. GSI, headquarters and have for years It's actually a really cool environment. It's it's a hundred twenty year old Victorian House where you talk about headquarters a lot of people don't know that it's not like it's not a glass building on Scottsdale road that's our Scottsdale headquarters, which actually does look like you'd expect it to look it's. A fancy building with with that one hundred and eighty degree views but H Q in press get where we both live is a very humble. You know two thousand, Square Foot hundred, twenty year old Victorian building I mean it's it's It's not fallen apart by any stretch. It's a beautiful building, very well maintained, but it's a very simple humble building just can't. It just Kinda keeps us here routed to our community and. This is what we call headquarters. It's not fancy, but it's it's it's beautiful. It's fantasy enough man Yeah I love it. We have a water cooler and we literally all like we emerge from our from our offices every couple of hours, and we actually chat at the water cooler baby couch that's out there. It's pretty awesome. Awesome. So we were chatting the other day at lunch talking about you know what would be a great episode would be another live one which we haven't done for a while because. people were working from home for a bit. Jake was working at home for a couple of months and I was coming into the office. But as it was, I, was by myself with K. here, and we were social distancing and trying to be responsible but But yeah, it's been a while since we've done a live podcast jake and I wanted to do something about what's happening, what are the trends and patterns that are happening right now to dental practices that you're working with Jake and that I'm working with since the pandemic since returning to the pandemic it was very. Obvious right off. Right off the Bat from DSM Docs and the Docs, our private clients that people were experiencing. Many people experiencing their best Mott's record months record months when we came back but it does appear that things have started to flatten out and and have started to decline for law dental practices including my own So what have you seen just in general jake from a ten thousand foot view. Yeah. I mean you kind of touched on a mark mean. Out of the gate, you know hygiene obviously the pent-up demand when you know coming back from the shutdown I'm sure a lot of you Dennis at their can attest to that that there was a big US experiences to mark in your offices big spike in in. you know the schedule being booked out but the biggest thing I saw was. People accepting big cases. Yeah. Some of the stuff that was put off or a lot of elective cases I don't know if that was from. Just. Being stuck at home wanted to get out and spend money or the stimulus checks or whatever I don't know exactly what drove that. But that's what we saw. So long with hygiene being extremely full possibly lose an on loudon new patients and that sort of thing because it was so full the flip side of that as they there were a lot of A. Lot of big big treatment acceptance a months over the past few months that's still continuing. But what I am seeing now, which I'm sure this is. Consistent with all you guys out there is hygiene starting to you know there's cancellations there. There's more holes. And we talked about that I mean finding hygienists to to work is like. As a job in at some God unionizing I called it totally wrong. I thought that as soon as we're getting, we're going to get closer to the supercharged unemployment the six hundred dollar checks, unemployment checks that we were gonNA see the the. Skilled working. Pool. Employment Pool increase and I thought it was going to be much easier to get hygienists and I I thought and dental assistants and office manager types of that. There's GonNa be more talent of readily available, but I couldn't have been more wrong I. Don't know if it's still going to happen around the turn of two, thousand, twenty one or after the election or what. But My prognostication was incorrect. I thought that I thought that by September, there's going to be a ton of hygienics looking for work that they would be. That there would be willing to take a little bit less money but I was wrong and at a basis for my My prognostication was that I thought that some of the some of the less successful dental practices, the ones that were struggling prior to the pandemic during our bull market we're going to finally get squeezed and fall off and shut down I wasn't reveling in that by stretch I wasn't happy. About that prediction but I thought that that's what was going to happen and I thought their employees we're going to be available I, thought their practices. We're going to be available which we are seeing some of, but I thought that their their employees we're going to be available that still may occur like I said because we all just came back in a lot of people had great months, and now that the decline is happening, perhaps my prediction will come true and we'll see more of those available employees in the market but I haven't seen it yet. Yeah. I mean it it it. It's region by region to gain the the smaller markets, obviously the the pool of Of Good help is is very small especially when you have. These ideas are basically on strike But you know the the bigger metropolitan areas There is some hope there I've seen that from finding from dental assistants to hygienists hygienist obviously is touchy subject but some. You know toback to your point about These. I guess middle of the road lower lower producing offices that may be of higher overhead not as profitable. Maybe an owner older doctor looking to retire maybe this push over the edge. I think that that. I do think that will happen still and we're seeing that a little bit you know if. You guys have bought some charts. You know people don't looking to just get out of the game And not wanting to to whether another storm right because you know possible shutdown either but I do that is that is going to happen and I am seeing some some of that opportunity kind of emerging. So I guess a little Sidebar that were suggesting to our clients and you guys can follow suit out there is you know just hold your cash for as long as you can over the next few months and just get as liquid as you can for these opportunities that I think that will still come in the coming months. With people. Either fearful or again not you know Like you said it's having these big months but then having The slower months coming coming in the coming months which I feel that's GonNa Happen. I'm especially with hygiene kind of drying Subic. It's GonNa continue to trend downwards it. Yeah. I do I think that we saw this the cantilever effect that we kinda predicted where out of the gates we have this this hockey stick in a steadily going to sharp decline I. Think. It's going to be a steady a steady recovery after that. So that's another reason to hold your cash is to prepare for some months of either break even months or or possibly lose a little bit as you as you Kinda, stabilize the practice in the coming months. Well, as you knew Jaker as you know I recently purchased another practice to merge with. My Santamaria Practicing California we merged that practice into another very vibrant practice. We actually, we actually moved our business into their business. So we purchased one hundred percent of his business. He sang for a minimum of five years. He's an incredible a clinician with a great reputation, but we were able to structure that deal where he didn't WanNa pay capital gains because he's in California. So he is holding the note for us with a ten year amortization. So that worked out really well for US the other merger that I'm attempting to do right now that seller that's here in Arizona that seller does not want to hold the note. and. We tried to structure that way. He's not in favor of that but this is a perfect situation where practices less than a mile from our other practice. It's not a huge practice. It's only about a half, a million dollar practice and it was kind of. Trending down over the last couple years. So the banks don't like it. They don't like the way it looks on paper. So the the banks that to banks, even the banks that I have had lots of. History with that basically never say no to me when I'm when I'm. Applying to borrow for a practice. One of them said, no, and one of them said, maybe if I put thirty percent down on his thing, which is crazy I've never even seen that before the interest rates are decent but thirty percent down and they said, but they're going to really have to work on underwriting for this one they're going to have to get creative with underwriting. It's like, wow, things have changed significantly in the last three months different than I've ever seen before. So. I mean if you think about that if that if that trend continues maybe it's just this practice but if that trend continues and for the next say. Handful of months to coming years the banks really really squeezed down and they want a much larger down payment. Just think what that will do for people that are trying to buy a seven hundred, fifty thousand dollar practice thirty, thousand dollars down not a lot of people have two hundred and fifty thousand dollars just sitting in the bank you know So that's GonNa really change the way that practice acquisition and multiple practice ownership goes if this. But I was shocked. Personally I mean. I was telling my banker. I was like Dude, you know that I have more liquidity than the entire. Amount that I'm trying to borrow from you. He's like I get that my said and I have lots of lots of different assets that you can collateralized I'm okay with that he's like I understand but the underwriting in this particular bank is saying a five year amortization Max and thirty percent now crazy. Yeah I mean, the feds need to raise interest rates. That's a whole different. Different ballgame I mean cheap money is not gonNa last this long and and what good is cheap money if you can't borrow it all exactly in you know I still think there's GonNa be more stringent I guess qualification processes or you'll get this lending. So I guess to kind of for down the road here in the coming months or years I think that. For lending purposes in the dental world either you get one hundred percent financing higher interest rate like like astronomical and seven to ten percent or have like you said that twenty to thirty percent down, you can still get fifteen to twenty. At. Decent four to five percent interest rate. But I think they're going to have more skin in the game moving I. Think I think you have to take on some of the risk as the banks are at least four. a moment in time. I mean how long that last I think that's What we're up against over the next I don't know. Twelve eighteen months I would imagine. So again, whether you're looking to expand looking to buy charts looking to. Add. You know by a second practice at still doable. But just make sure you have the cash to do and make sure that you have your liquid enough to to support that. That's kind of what I've been suggesting to some of these. And our group in the DSM grouper looking to take that next step. Tell me what advice you're giving people. That are having this hygiene dilemma. I mean where where their hygiene books are looking empty like we have to practice here in California where it looks like Swiss cheese and the the you know the the poor treatment coordinators I'm sorry the you know the the front desk schedulers schedulers are like. I've never had to deal with this before they're on the phone constantly all day plugging holes what what have I see given well, I mean so. I'm seeing it two ways in it's opposite in the spectrum. Honestly, there's no middle ground right now either your books are full of people coming in or your books are full and you're seeing a ton of cancellations and no shows and no show people that I never know showed before are just like not showing up. Exactly. So the no shows I mean Gosh you really I mean, what? What do you do for that button? For the cancellations I mean. I'm so what we're suggesting what I've been going kind of talking through my coaching calls just really make sure that you have your confirmation system. Pat Down night because right now it's in in all facets of the practice. It's a unique opportunity to. Revisit the scaffolding and the system in your practice and lean on those during this time it's it's for to fire framework, right? Yeah. Exactly. I mean seven months ago when you know things are great like you could get away with things not being absolutely perfect but I in the coming months you have to lean on your efficiency more heavily than than. A. Specially for those docs and gone through a recession yet. I think right now is again. People are still accepting treatment like that's that's the bottom line. So it's one of those things where may cable the sun is shining now ban do what she can but I think it's it's a it's a unique opportunity to. shift your focus to the nuts and bolts of your business and have your systems super super tight. So again, with your confirmation systems as make sure you have that down investments in some, you know software companies out there that can help you with the automation of that. If you don't have that already and Really really really focused on patient experience and really driving safe dentistry because you know right now as as you and I predicted mark you know there's there there are three buckets of people, right? So like. Heading into the pandemic and post shutdown. You had one bucket people that were there would come in regardless of what's happened they what what virus? Yeah exactly. but then there was other side were no matter what you did people wouldn't come in at all because they're just to scare there's that. But then there's that middle bucket of people on the fence of well you know. Dentistry? No, it's safe. I'm not sure. So I think that. During this time I think as an another opportunity where you can differentiate yourself by pushing this safe dentistry and really focusing on you know patient experience post shutdown, I don't how long this is GonNa last You know if if you're if you're in the middle I, actually I just talked to one of my clients are one of our clients about posting video about her practice and you know kind of what seemed to us she's like do I you have people with masks to happy without masks as like you know maybe a time where you do both I mean. Push this post pandemic and say look, we are safe dentistry here here the measures and precautions we're taking you know. So again, I think that's that's unique opportunity to push safe dentistry. So marketing schemes I think that's probably going to be one area to focus on And really just it. It's really just making sure people can for the hygiene exams because there's a ton of as you guys know, there's a ton of false information out there about you know aerosols and Blah Blah. Blah Blah but if we can if we can. kind of I guess mitigate that a little bit through you know showing the public of what we're doing going over the top and say. Look at how conscientious we are exempt because I mean I truly believe that. If you err on the side of. Of overkill. Totally there's there's no real downside to that, right? Your your staff will be more protected at an at least if not. More, protected and and you know were it. You know aerosols a aerosols will inevitably inevitably get us all at least feel more comfortable They'll. They'll feel like they're being cared for their the they'll feel as though their their concerns are being you know. At least you know recognized by. an and then you know the upside is like people that. Don't WanNa wear masks into that building and you politely asked them to The people that are scared are GonNa feel better absolutely So I don't think there's a downside to going over the top of the P. P.. You. Just moved on that too at our at our practices, every masks, all the time we have all the the air filtration we have where we've taken all the process you possibly can. It was kind of cool. One of our one of our members posted a patient experience from start to finish during this time of like, okay. We we walk out your car Yup. We agreed you mask and kind of like a like A. Like a first person view us. Through through the through the dental. into the hygiene Charon hat. So that was kind of a cool I guess spin on it that could be differentiated posted on your social media sites, and it is true because a lot of people that haven't been back to the Dennis yet they make an appointment where like there's no waiting room anymore, our girls will come out. Get you from your car and bring you in and your loved ones can stay in wait in the car and the air conditioning comfortable. Your cards like and everybody's pretty cool about it. Some people have raised a fuss but it's like, Hey, this is mandated by the state. So we're we're just not going to do it. It's a New Orleans it is a new world. It's it's interesting right? I mean. It's interesting how quickly human beings adapt right so like this weekend. I was in California for for this awesome birthday party and there was less than fifteen of us in the house and and we were all were all you know. We've all had antibody tests and we're all cool. So we were good like hanging out pretty close together and we are all standing same house. It was awesome. But you know Bryce back here in Scottsdale he had a soccer tournament and there's no parents allowed. It was crazy I. It's like and it sucked but it's it's it's interesting how quickly we all adapt to things that I mean Jesus was Major League. Baseball game right now. So Watch an NBA game I mean football star tomorrow I. Know it's it's crazy like we I'd UFC fights nobody in the audience I know I. Just watched the Kentucky Derby this past weekend and it was delayed by two months. Three months. It's usually in March right? or May it's usually a May and it was it was this past weekend nobody in the stands at. So they say usually a hundred and fifty thousand people there. It's so interesting but human beings adapt and this is a reality right now and YEP and we'll get through it but it's just I mean it is. It is just this. It's this time in history that will never forget hopefully I am so hopeful that I'll be telling my grandkids the store and they'll be like, wow, I can't believe it not that this becomes the new reality wherever you know no I don't think that's the case but. Yeah, there's I mean. Then you have like it's snowing in Colorado yesterday. Yeah. Like what the Oh it was. It was a hundred and twenty one degrees in. Los. Angeles this past weekend and I, woke up this morning here in Arizona and it was fifty eight degrees fifty eight. Like. Going on like Yeah Colorado the day like on Monday was like eighty five, and then it snows on Tuesday the world is ending. Cove is going to give my gosh. So just the legal it really is it really is just kind of up around and it's fine will yeah figured out. We'll just keep talking to our crew, our our family, our dea cy in our all you docks out there. I mean I'm not getting political here but I mean I think when Donald Trump got elected as president I thought if we could adapt through this it after anything right? I mean That's funny. I. I mean again not to get too political conspiracy theorists but after the election I think Do you think things have changed. I don't now I who knows but I my By predictions of been office here. I refuse to refuse to make any predictions out loud ever. Again, we can make predictions. About your dental practice in what we know. But the world who knows. Okay. So back to dentistry yeah. I digress yes. What are you seeing as far as okay. So many people that were on top of it. A lot of DSM members together we all applied for the PP. At Gosh I was shocked at how many people that I know even in town here they're like what the P. p. p. It's like oh my gosh. Wow. Thank God. There's a community wherever it is like, okay together, we're GONNA put this application together together we're gonNA apply for this. Here's some of the roadblocks here the banks to use try to avoid the big three like all those things. Like there's a whole. Vast majority of dentistry that didn't know about PP didn't know about the most recent grant hhs h mentioned that I just talked to consult that was looking for Consultant with. The SL. Anyway, You know we talked about he's talking about the the loans and grants out there, and I was like if you apply for the Same thing as what what is it? I was like dude like two percent of your gross revenue wasn't it was he wasn't on DS anything I'm it to your point it's just shocking. How you just want informed because it's an island. Yeah we assume that people know and it's just not the case. It's crazy. So so back to the point of why even brought it up you saw many of our colleagues have an influx of cash that helped them to kind of weather, the storm of that no income situation that was happening. So the PC the P obviously as most of you guys know had to be spent in very specific ways that had to go to operating expenses or Orem. Or payroll and then they hhs grant had some had some limitations as well but it did help bridge the gap of that no income two and a half months at a lot of us had. So with that influx of cash have you seen a lot of practices starting to get to the bottom of that cash reserve and now they're now they're. Now they're having to rely on revenue that is coming in from the from the procedures. Yeah that's It's interesting 'cause. So. Th there's a spectrum here that I'm. I'm seeing those were so first of all if you were prepared for this and you had cash reserve, right? The can not a can. You just go over what we recommend for our members have as far as a slush fund in cash reserve per practice Yep Yep. So First of all identify what your monthly break even is and how we define that is your overhead which all expenses outside of Dr pay including associates. So it's overhead plus your. Associate compensation, multiple Docs and then your service yet. Right I've also seen. Some people put up some people put a salary in there like a management salary in their own personal. W, to it are at sure. But anyway, once you find that monthly break even we we suggest having one and a half times that number in your operating account, which business checking and then one and a half times at in your in your business savings right. So any given or any given time frame, you have three months worth quality spread across these these accounts So again, that's to your point. That's what we suggested in the people who followed that I mean, some people had four five times that amount you know they went overboard but. The people who were prepared I mean some people didn't even need the the P, p P. funding or the idea idol loan which some people take that which a lot of people didn't. But the PP because of the parameters of being forgiven will I saw a lot of them take that. I guess. Again the spectrum here, the people who are prepared, who had cash reserve, the P P P, which is the bolster of of income, and they can use that within the twenty four weeks that were given right. So there it's up to their discretion from now the opposite end those who weren't prepared right they needed that money because you know we could they. They could collect from there a are over the over forty five to sixty days, but it wasn't much in a you know it wouldn't wasn't up to to to float them. So they needed that cash to like you said, make it by So those that were. That needed the cash I? Mean it's already been used up I mean they. That initially when it was that you had what was eight weeks to use it the first go round. Yeah. Then they extended its. They extended another sixteen weeks or something like that. Right? You have twenty four weeks now. But anyway, the first go around they used it within the eight weeks because they you know they needed to. use it to basically pay their employees and get back to production. Sure. So, there was a big spectrum That so that's what I'm seeing. Honestly you know like I said people who are prepared. There's still sitting on that cash and using it. You know within that twenty four week period. So I guess the moral that story is like I said outside of looking for opportunity. Builder liquidity and be prepared for whatever happens next Mike you know three three times your monthly break even across those two accounts is just a starting point. I mean mark I know that you in your personal and business you like to see between four and six months. Twelve. I'm so paranoid I like to have twelve months for doubled facility. Yeah. For Business and in and personally to twelve months of break even not brimming monthly break even right and And my financial adviser is constantly like Dude, you gotta put that money to work but I'm so cautious and conservative when it comes to that sort of thing I'd like. As my that's my worst nightmare is to not be able to put a roof over my kids heads or or have to borrow money to pay for payroll etc, right you know so. I'm really conservative when it comes to that, I say six months excessive but three months is sufficient for for sure. I've also seen the idol loan ripe because what is a year before to start making payments? I've a strategy thirty year am oil I know but totally but Need the cash like so what I have seen as a strategy where the you know some of our docs have taken the the idol loan and then sitting on that cash and waiting to see what happens right not in a year exactly can pay it all back and that they've they've crew that interest but it's a minimal amount for that piece of molly. It's I actually that those are really smart strategy for a lot of people I didn't personally. Do that, but I thought that was a lot very smart strategy. However, the big thing about the idol on the number. One thing that they said you couldn't do as refinance debt. So if you had debt in your dental practice and you borrowed this at a lower interest rate, they said it was illegal to refinance debt to pay down other notes with it. So you had to use it for other operating expenses and payroll and those sorts of things you. For revolving though credit cards. So you have credit cards out there right because if for credit card was used to buy a piece of equipment, for instance, you could pay that down could justify that with a paper trail. I'm glad we had that little segue for strategy using either loans. I have seen people where they will. or if you have the P P P in which has us at first, but again, I'd alone this HHS with thorough. Some grand your what I have seen people do is they will use idol onto pay for like operating expenses in the business. Yes. So that their cash reserves refinance things from that exist. So it's like his robbing Peter to pay Paul red type of thing but nonetheless, it's a strategy that I've seen work in vector. Pretty Slick. was is going on dude like all these conversations that we're having like I remember talking to polly from Cedar many many times when he was, he was telling us about all the strategies for applying for the PM. Mike. What is this? This is like my fulltime job now is trying to figure out all these loan programs and everything, and they didn't even exist like six months ago dude I know it's so crazy. It's like the idol loans been there for decades and decades I think that happened after the great the Great Depression. I think anyway but the funds are dry, right the funds are dry and gushed I mean dude two and a half trillion dollars printed like what's going to happen we have to the governor to get that money back somehow and I'm not looking forward to that day. Yeah. That's not going to be fun no, and that concludes part one of my interview with GSI financial analyst, Jay Conway Mixture, you guys tune in tomorrow for part two of the interview have Grey Day, and that wraps it up for another episode of the Dental Poor podcast. Look forward to reconnecting on the next episode. Thank you so much for joining us today on the dental Noor podcast checkout true dental success dot com for full recaps of every show a schedule of our live events, free video tutorials and whole host of practice building resources.

jake California Dennis US Jay Conway Mixture GSI financial analyst Arizona Conway Dr. Markkaas Erin Dr. Martha A. Ds Mike Jacob Share Wall DSM Docs Colorado
Episode 120: Black Womens Suffrage II

#SUNDAYCIVICS

51:45 min | 2 months ago

Episode 120: Black Womens Suffrage II

"It's time for class. Giving, just doesn't begin and end on election day. This is Sunday civics the horn for the civically engaged with political strategist L. Joy Williams a serious epsom. Burgh view. Good Morning. Good. Morning and welcome to Sunday civics the home for the civically engaged. I am your host ear civics teacher, your neighborhood political strategist eligible items, and I am so delighted that you made it to class this morning this morning we're going to continue the conversation of black women suffrage following the hundredth anniversary of the ratification of the nineteenth amendment this past week I'm also really Excited to share with you a conversation I had with Dr Martha Jones who is a professor of history at Johns Hopkins University, and author of a new book that I've already preordered. I've already read like the teaser pieces of I'm really looking forward to this. It's called vanguard. How black woman broke barriers won the vote and insisted on equality for all it drops September eighth and you can. Check the link on social media on website and everything and make sure you preorder and when you come back from vacation, it should be sitting right there for you. But first, let's talk about the convention. The Democratic convention that is coming up this week I believe is the Republican convention, which will be a totally different experience if you are expecting it to be the same Sorry to tell you that it's going to be a bit different but for the Democratic convention, did you watch it? Did you feel energized from it? Who Speech spoke to you the most well share for me personally that Michelle Obama's words and passion and sincerity is what resonated with me the most her hope and belief in this country her hope and believe in us. Actually pricked my heart and actually still sits with me days. Later it reminded me of another Black Woman's Democratic convention speech this one from. One thousand nine hundred seventy, six from the first African American since reconstruction to be elected. To the Texas Senate and the first black female from the south to be elected to the US House. of Representatives, do you know who I'm talking about? Do you know who I'm talking about? I am talking about the inspiring and powerful words from Barbara Jordan the first black woman to deliver a keynote speech at a Democratic National Convention. From Texas take listen. Thank you. Thank you ladies and gentlemen for a very warm reception. Edwald. One hundred and forty four years ago. That members of the Democratic Party I. Met In convention. To, select a presidential candidate. Since that time Democrats continue to convene once every four years and draft a party platform. And nominate a presidential candidate. And are meeting this week is a continuation of that tradition. But. There is something different about tonight there is something special about tonight. What is different? What is special? I Bob Jordan. A key note speaker. When A lot of years past since eighteen, thirty two. And during that time, it would have been most unusual for any national political party. To ask Gut, Barbara Jordan to deliver a keynote address. But Tonight Here I am. And I feel. I feel that not would spending the past that my presence here is one add. Bit of evidence. That the American, dream need not forever be deferred. Now now that I have this brand distinction what in the world am I say? I could easily spend this time praising the accomplishments of this party and attacking the Republicans, but I don't choose to do that. I could list the mini problems which Americans have. I could list the problems which caused people to feel cynical angry frustrated. Problems which include lack of integrity in government. The. Feeling that the individual no longer counts. The reality of material and spiritual poverty. The feeling. That the. Grand American. Experiment. Is Failing. Or has failed. I could recite these problems. And then I could sit down. And also a no solutions. But I don't choose do that. Bill. The citizens of America expect more. Deserve and they want more. than a recital of problems. We are a people a quandary about the president. We are a people in search of future. We are eight people in search of a national community. We are. People. Trying not only to solve the problems of the present. Unemployment inflation but we are at tempting on a larger scale. To fulfill the promise of America. We are attempting to fill our. National, purpose? To create and sustain a society in which all of us. Are Equal. Throughout our history. When people have looked for new ways to solve their problems and to uphold the principles of this nation many times, they have turned political parties. They have often turn to the Democratic Party. What is it? What is it about the Democratic Party? That makes it the instrument. The people use when they searched for ways to shape their future. Well I believe the answer to that question lies in our concept of governing. Our concept of governing is derived from our view of people. It is a concept deeply rooted in a set of beliefs. Firmly. Etched in the national conscience. Of all of us. Now. What are these beliefs I? We believe. In equality for all and privileges or none. This is a belief. This is a belief that each American regardless of background. has equal spending in the public forum all of us. Because we believe this idea. So firmly. We are an inclusive rather than exclusive party. That everybody comes. I think no accident that most of those immigrating to America in the nineteenth century identified with the Democratic Party. We are a hedgerow. Genius Party. Made up of Americans of diverse backgrounds. We believe that the people? Are the source of all governmental power. That the authority of the people is to be extended. Not restricted. This can be accomplished. Only. By providing each citizen with every opportunity to participate in the management of the government, they must have that. We believe. We believe at the government which represents the authority of all the people. Not just one interest group but all the people. Has An obligation? To actively. undescored actively. To remove those obstacles which would block individual achievement obstacles emanating from rates sex. Economic condition the government must remove them. Seek to remove. We. We are a party. We are a party of innovation. We do not reject our traditions. But. We are willing to adapt to changing circumstances when change we must. We are willing to suffer the discomfort of change. In order to achieve a better future. We have a positive vision, the future. Founded on the belief. That the gap. Between the promise and reality of Merit. Can One day be finally closed. We believe that. This my friends. Is the bedrock. Of Our concept of governing. This is a part of the reason why Americans have turned to the Democratic Party. These. Are the foundations. Upon which a national community can be built. Let. All understand. That vs guiding principles cannot be discarded. For short-term political gains. They represent what this country is all about they are indigenous to the American idea and these all principles which are not. Negotiable When we come back I'm going to share with you my conversation with Dr Martha Jones but I, check out the story of her first civic action. When I was a teenager, my father ran for our local school board. He was an activist with the N. W. ACP and Civil Rights, organizations, and He had grown very concerned as he saw the outcomes for black students which were. In Our town. And Crested starkly with the outcomes for white students he sued the town he wasn't successful, and then he decided to run for school board and I was a teenager and so I wasn't sure how I felt about that, which is to say there was my family in a small spotlight. There was my father, his ideas work on the front lines but. During the campaign there I was with flyers and leaflets at the train station and other gathering places in town working on his campaign. When I most remember is election night, we were sent to bed the counting of the ballots took late into the evening, but I stayed up with one ear open and I could hear him on the phone of getting the news that he had lost that he had not won the election and my heart broke for him. But the next morning he was undaunted and it was a real lesson right in what it takes to. Exercise leadership, what it takes to put yourself out there to vie for public office when nothing is promised to you but how he continued his own civic work even in the face of that defeat. So I guess, you say that you would say that flitting from my father was my very first experience in Subic participation. Bad. All the things that you must do to stop being. Boy. Guys. Who is the? it. Was Shot I. Anthony. Williams your neighborhood political strategists and civic seizure. But I am laying down my talk today in order to bring you this conversation that I had with Dr Martha Jones, talking about black. Women, suffrage is and the moment that we are in discussing black women's political activism. Thank you so very much for joining me for this conversation I'm very excited to talk to you. I know I said that we only have a certain amount of time for us to talk but I maybe once the corona is over I can come and audit a class in nerd out. With new. At some point. But as I mentioned to you, I read in have birthright citizenship. Really excited about this new book of yours, that's coming talk to us a bit about vanguard which dropped. September ache. I wrote Van Guard because I knew two things I knew that in two, thousand, eight, hundred, twenty we would be in an election year and that black women would be exercising kind of outsized influence on politics. Even if I didn't know who all the candidates might be and I also knew we were going to be an anniversary year of the nineteenth amendment and I didn't want African American women's. Story of voting rights to be overlooked in this year. So a vanguard tells two hundred years of black women's political history helping us to understand the traditions. The movements struggles out of which figures like Stacey, Abrams ianna Presley, and of course Kamala Harris these are the. Political traditions at which they calm and vanguard tries to tell that story. I think that's a very important point to go to the history of this for a bid one I watched a number of interviews that you've done read a number of pieces that you've done thus far, and you talk about black women sitting at the intersection of the fifteenth and the Nineteenth Amendment in managing both race relations and the issue of being a woman here in the United States talk to us a bid that just before nineteenth amendment is past before even Fifteenth Amendment is passed i. Tried to tell the story here on the show often that women particularly black women didn't wake up with political voice just recently like this activism disengagement has been a heart of our tradition here and things that we don't even think about as considered civic participation. You don't consider underground railroad or anti-slavery movements as civic participation, but it is talk a bit about that from that historical context that lays the stage. As you mentioned before, we even get to the additional amendments and to the modern time today. When I started the book, I really in part was going in search of. The origins of an idea that today we oftentimes return referred to his intersection So the notion that black women can't be broken apart into one identity or another, but that to fully appreciate understand who black women are in our political landscape we. Appreciate the way in which racism and sexism operate simultaneously and together in powerful ways in American politics. And Search of the origins of that idea and before I'm done, I'm all the way back at the beginning of the nineteenth century and I'm writing about women who really are pioneers of a political philosophy that is still deeply relevant today the view that neither race nor sex should have any. Role. To play, in dispensing political power. In the United States and it is black women who are making that argument and of course, they're doing so out of their own experiences drawing upon. Two things things that come together importantly in the sense that a are looking for. A way to make. A keen and essential contribution to there. It is anti slavery or it's early civil rights or it's church politics in the development of an institution like the Ame church black. Women. Strain against the sorts of limits that people place on them because they want to help build a better future for black Americans and a better future for American democracy and so they are going to develop a philosophy that attempts to get them right at the center of those dynamics. and. You mentioned in just in the previews that I've seen of the book so far you mentioned women I think it's really important to name names particularly because the names that are part of our civil rights or black women. EMPOWERMENT LEXICON ARE SO small. Me Only talk about a certain sect and this is also within African American Studies in general right there are the giants but not that there are these additional player that sorta helps set the stage for those giants whose names we know now and you mention Maria Stewart. Was the first woman to speak you mentioned black women who sued for their freedom and one and actually not only freed themselves. But then their. Of freeing themselves, actually freed everybody in the state. Yes, Hester Lane in New York City. Right it's a phenomenal story, right? Very much a companion, but really a precursor to the story of Harriet Tubman that we know better Hester Lane migrates to New York from the state of Maryland she becomes an entrepreneur. There has success in business and she basically uses the proceeds of for business to return to Maryland and to bargain to barter to Cajole to win people's freedom and bring them to New York that in and of itself would make her a remarkable figure to remember. But Lane also has political ambitions and she is active in the American Anti Slavery Society. And will vie for high office in that organization only to be disappointed only to be rejected when it comes to leadership in the American Anti Slavery Society, and so it's an example of both the tremendous courage and ingenuity of black women figures but also an example of the ways in which not everyone in American politics even anti slavery politics is ready yet for black women's leadership. Yeah and so those women like you mentioned, Maria Stuart Sarah Map Douglas Sarah Parker, remnant all formerly enslaved women who also rejected and we're gonNA talk about in a minute just the pushback you get from your own people About our political voice as well, and I find it interesting and I try to remind people that that the story or black women's political activism does begin with fighting for the right to cast the vote for Republican or a Democrat that that political power that our ancestors were fighting for was for the ability to control their own destiny and similar to my belief that anytime you're trying to engage people in whether it's electoral politics organizing in general, you don't start with telling them what they ought to be doing. We see a lot of that happening now just like you either vote for Biting Harris or you're racist and I'm like wait. Can we get two? Can we get to the issue that matters to them I to make the and make the actual argument as to know we don't have time for that. Okay. But I wanted to talk a bit about that for black women as well because we didn't begin with demanding just vote there were voices and as you mentioned also fighting the institutions that we were part of, for example. In. The church. Yes and this might be surprising place for some readers to discover the beginnings of black women's voting rights activism. But for me, there's no separating the kinds of struggles that black women wage, for example, in black methodist churches from the kinds of political work that those same women will do at the end of the nineteenth century. So I write about figure like Gerena. who called to preach by none other than God and confronts resistance objections and more from the men in the AME church. We're very fortunate because Gerena Lee published a memoir where she recounts her experiences and she really says straightforwardly, why should it be somehow out of bounds for women to want to preach our can't women be called by God as men are, and she's a good preacher. It's important to say, right she's very good at what she does, but she inspires then an uprising a modest one but not unimportant uprising of women within the Ame Church who organized together in the eighteen forties and petition again, and again to secure preaching licenses for those women who want to preach they need legitimacy. They need protection they need the the stamp of approval if you will from the denomination and they win in eighteen, forty eight. So this is without a doubt for me. The kind of sandwich black women are not only working through a powerful ideas about who they are and who they can be in public life including in politics but it's the place where they are learning the skills, the techniques negotiation petition ally ship, and a lot more that are required to make politics any sphere, and now anyone who is a part of faith community knows that our faith communities are laden with politics and black women know that to even in the early nineteenth century and it becomes a place where they really. themselves. So. Let's fast forward a bit in the timeline wanted the other aspects of our history that I'm really can go down the rabbit hole I. Think I had half of my book aces are about this period is not only the Black Woman's Club movement but also the conventions boy, do we love conventions? So making the connection now as to why in my church organization, the conventions, the regional conventions, and I'm also president of the Brooklyn Branch of the. And all have roots and I was like, Oh, this is why we love convention so much there's a historical connection to bringing all of us together to have these conversations about not only about our plight. But what's the best way forward? How did you find that in that convention space? Connecting it to our modern space of the conversation actually connected to social media but I'll let you. Let me talk about the I. Liked that connection because I think that. In the what is called then the Colored Convention Movement, there's no question but that they use the the new media of the day, which is the predict press right and the pound. The pamphlet and the track as well as the podium and and they use it to great effect. It's to say I think these are folks would give a nod when we find ourselves on twitter instagram or wherever we hold forth and the new media space. I think it's very much in that tradition but these conventions evolve again out of two impulses, right the one is that black men are being excluded from party politics they are being excluded stole from houses and yet they're not going to wait. Until someone invites them in to be political right to convene and there is a lot to talk about there is a lot to deliberate about. Yes. Civil Rights. Yes. anti-slavery. But the future of education of labor and much more, and it is indeed a tradition that doesn't holy. Fall Away. Even, after the civil war when now The halls of state legislatures at least for time, even the halls of Congress are open to black men there still is a strong sense of a need for autonomous independent spaces. In which to deliberate black women will pick up on this by the eighteen ninety s forming the National Council, of Negro Women Excuse me on the National Association of Colored Women, in the nineties and this is an organization that stitches together. Grassroots clubs that are spread across the nation led by black women in local communities. Now have a national hub and are working in concert and yes of that includes the tradition of the convention of the Big Wien. And I think you're wrong to recognize it is still important force in our political organizations like the end up lacey people in our religious communities the AME church still every four years meets in a general conference where a great deal of church politics. Play out. So you're right to point out I, think the long old tradition of these large convenience I think the last thing to say is because they're important for both the substance of what goes on, but they are also a kind of performance and evidence that goes to demonstrating the important degree to which black Americans are prepared holy prepared to participate in. State Politics Party politics, men, and women. This is the evidence of that on display and these are spaces where women are not just attending as a help meet if you will to to a male partner but they are also active participants in the conversation and in what needs to happen and in the strategy I often find as a strategist myself in helping to elect people all across the country or pass issue base legislation when I'm reading the pages of what the conversations were or the speeches or the pamphlets if you go to the library. Of Congress and all of those others I can see the strategy in it. I can see the conversation as we get to the discussion of suffrage of deciding that we need to include we need to link and tie the plight of African Americans in this country to suffrage and so that black women also need the vote that that lynching in viewing through the eyes of vitamin be wells is part of a political conversation and we can leverage that argument of black women's voter women's vote in general with addressing this issue is strategy in that. Of being able to leverage power absolutely, and of course, that leads to tension and debate, right? Not Everybody sees the goals, the objectives tactics in the strategies in the same way but one of the things that. For me became a crystal clear in this work was the ways in which sometimes we encounter the Movement for Women's votes on the one hand and the Movement for Anti Lynching legislation as two separate stories but it's clear for black women. These are the same story because what they know is, yes a federal amendment that opens the door to women's votes. But if there's still violence and intimidation unchecked especially in the American south who's going to go to the polls who's going to get to the polls and That we've misunderstood I think so many too often right the politics of lynching as somehow distinct or separate from the politics of women's votes. But through the perspective of the women, I read about you mentioned Ida B, Wells Mary Church Terrel, right? Mayor Mcleod through these are women who see. And Live the connection right between the problem of being enfranchised and the problem of violence there. It's all part of the same problem and that's why the National Association of. Colored Women can't be simply or only a suffrage association. It has to work on both fronts at the same time. Yeah and as we get to that conversation, the suffers the opposition right? So you have your fighting is white women and you're fighting against your own brothers. Who are sometimes? Who are sending in the way? One of the pieces in the introduction of vanguard you talk about is some of the earliest articles in the Freedom's journal, which painted this description of what who who black women were supposed to be is that we are supposed to be helpers to our men with grace and we're supposed to do all of this work even talking about the church moving we're supposed to help was supposed to work outside of the House help him and stay quiet I was just like that's a lot of work. It is and what black women say now we're going back nearly two hundred years is your squandering night our talents has logged that our strength, right? We are a community that faces. Tremendous challenge. It's this is Mariah Stewart right. How is it that you would squander that would leave us in the kitchen to the pots and the meals meals are important. Right home is important but we have talents that go well beyond that and we are not a community that can afford over that should squander that. Yeah at that particular arguments from another women like you mentioned restored is I i. think there's one I can't remember her name at this moment where she was talking about the her ability to think mathematically to think that you would relegate me to just measuring out flour to bake bread and cakes rather than investing in are queuing. Tell it this guy. This mathematical brain I have and you're making, you're just like, let me use it to measure out flower like seriously like we're losing out as the people as a community as a democracy, right? How racism actually stunts our Gross. Growth of democracy because you limit women because you limit people of color because you limit the talent and relegate people to a certain set, it limits how we can grow overall as as human beings. And I think one of the facets in the nuances of the philosophy that's evolving in these early decades is. The importance. Sense that. Women's power is not power for power sake women's power is a power for a collective vision. I was really struck by. How frequently the women in Vanguard. Speak about humanity. When they talk about what it is they aspire to what they talk about their purpose. They speak about humanity and that is a powerfully bold and COMPATI- vision especially in early America where. Politics, social life law economics. All are so fractured by ideas about difference. It is black women who say, no actually we're here for humanity and that's a very ambitious goal but I think it's one that for me resonates. First Century. When I watch black women in politics, I'll invoke leader Stacey Abrams and leader Abrahams. Doesn't work for the voting rights of black women though of course she does. In part. She doesn't only work for the voting. Rights of black Americans. Abrams is working for the voter rights of all Americans and that I think. Is overlooked sometimes when the message comes from a black woman as if somehow her vision is narrow or simple or to constrained when in fact, black women. So often the tradition is to speak about humanity. I think that's a really important point in terms as I've always been taught whether in faith in politics in that you as you gain knowledge as you gain the skills and resources is to empower others right it's not just for your own political power and we say here on the show, it's not enough for you to get this information listening to the show if you are not then going out and sharing that information and empowering others for that as well. How? Fun. Welcome back to Sunday civic thermal joy. Williams. So I wanNA switch gears a bit and talk a bit because we are in this anniversary year as you mentioned and talk a little bit more in depth. Just before we go about the Nineteenth Amendment and about the suffrage movement, we know the the Lore and the stories in terms of how black women were treated in this movement that wasn't just a movement that began with some random white women and cynical falls all the by themselves. But that it was part of an ongoing tradition what I'd like to ask you is, what was there anything that surprised you as you delved into the research of this or anything new on said, we don't know about this history. I'll tell you something that happened to me as I was finishing this book and it was it I work every day at home in an office with a portrait of my own grandmother. Hanging on the wall. I, Dunno. Some days she's watching over me some days she's egging me on, but she's always there and my grandmother was born at the end of the nineteenth century, the daughter of a former slave and I became more and more self conscious about the fact that I didn't know her story. So one of my big surprises if you will was that this book and telling the many stories of black women's Political struggles led me to dig deeper into my own family and to learn about my own grandmother I didn't know where she'd been in nineteen twenty or what she had been doing. Then I looked for her in Saint Louis Missouri. where she lived just a few blocks from her parents, she was a young mother in nineteen twenty but I couldn't quite find her in politics even if I could find her raising two young children there then followed her by nineteen ninety-six she's moved to Greensboro North Carolina her husband and father is about to become president of Bennett College. And they settle in Greensboro and I went looking for her in the state archives thinking maybe she voted nineteen twenty six after they unpacked on the campus. But I discovered all the records had been disappeared. The State had not preserved the records of women's votes nine, hundred twenty s including those of my grandmother if she did in fact vote. So he's feeling pretty discouraged but I was very fortunate to come upon an interview that she gave. In the nineteen seventies historian built Shaef was writing a history of Civil Rights Greensboro, and he interviewed her and she was talking not about one, thousand, nine, hundred, twenty at all not about the nineteenth amendment she was talking about modern civil rights and the vote and how the young women at Bennett in the nineteen fifties in one thousand, nine, hundred, sixty, organize go out into the community? Register. Folks get them to the polls and I realized that. If we stop telling the story of black women the vote in one, thousand, nine, hundred, twenty. In, a sense we story. Because, for black women in this country so many of them. The story really is centered in the modern civil rights era and the road to the Voting Rights Act. In one thousand, nine, hundred, sixty, five. So I turned out to be surprised in a sense to learn a story I felt like I should've known but I never had a chance to ask her about and it really then. Justified. My continuing this book for a few more chapters to be sure that readers understood that one, thousand, nine, hundred, twenty for black women was not an end. It was the beginning in it was the beginning of a new movement a tough dangerous hard fought movement for black. Voting Rights. Against Jim Crow that takes us all the way until nine hundred and sixty five. I hadn't understood that when I started the book I think I think that's a powerful moment as well in terms of being able or wanting the desire to search for your own family's narrative in the history my grandmother's ninety four in caregiver and I often ask her about different points because we read things of in dates and histories as if these are people that are that we don't have connections with or that there aren't people alive now that sort of experience that. And so to a grandmother grew up in North Carolina in the timing being ninety four nearly a century herself you go and ask her what was this thing and thankful that she has her full mental capacity to be able to think back that far and I, asked her I've asked her several times about voting and with one of things I learned in asking her the question is we hear a lot I have this joke that I say that everybody's says now that they were on the bridge margin for voting rights but the reality is that no everybody wasn't. Even everybody from an African American standpoint were on the bridge. And Her story is different right to her the terrorism that happen to people regarding registering afternoon vote has geared her in scarred her for life that she has not voted. That is a reality and so that didn't occur to me that existed. I. Thought Everybody surely participated in engage but that she because her brothers were so involved in the process in the terrorism that she witnessed or knew of that, it scared her enough not to in that discount from there and so I encourage people all the time that if you have. Living, relatives asked them the question about these pieces of our history engagement in what they thought to ask my family who is a huge Turkey family embroiled in the United Church of God and asking them what was it like when women couldn't preach ordained? What did y'all talk over on the side? Do you remember when? Before and now majority of the ministers and pastors in my family are the women so that turnover that happens from there. So I, think that's an important part of finding the story of your own family that helps to make the connection overall to our overall history. Yeah I thank you for sharing that that perspective of Your Grandmother Charlotte I full who today is head of the end of Lacey P. Legal Defense Fund wrote a book. More than ten years ago. Now, I think there's a new edition out called on the courthouse lawn and it is a book about exactly what you describe about the legacy of terror of racial terror in the United States and how it continued for generations to suppress African American voter turnout in Maryland, which is her case study that the memory of lynching persists even when the practice is to import degree curtailed as an experience, it lives in people's memories and people are reluctant to head to the polls that is the power of that kind of terror and it is you're right a very important part of this story I think that. Maybe it's not unique to this story. There is an impulse to romanticize many parts of African American history including the struggle for voting rights when they when these stories enter the mainstream and one of the things that was important for to confront myself, and then to find words for was violence and for black women, there's extrordinary degree of personal risk in living a public life speaking from podiums of the pulpit traveling. Advocating for your own voting rights, the rights of your community. There is a great deal of danger. In this story there's a great deal of courage, but there is a great deal of violence including sexual violence that I think sometimes gets. How can I put it gets Set to the side when we tell those stories. Yeah. An important part to be don't gain much from the romanticized story. We gain by telling the truth as ugly as it may be an as horrific as it may be I think it's important for us and for America to confront its ugliness so that we don't repeat it because if you. If. You believe that we couldn't possibly do that. Then it's really easy to fall into the same pattern from their one aspect is you mention of after the passage I across and sight this piece all of the time in the crisis in nineteen twenty one, March nineteen, twenty one. So this is after the first national presidential election. There is a of recalling of black women participating in the franchise in some places for the first time, and the citing is the colored women have made a splendid record at their first national election applying for registration in large numbers the endured purposeful delays and deliberate insults. They have shown themselves in states like Georgia and Louisiana to be more modern insensible than their white sisters and throughout the country they cast a large and influential vote and I read that and then went down the rabbit hole in Georgia and Louisiana. into of records that are available electronically and to see the stories of black women when some counties are some towns and say, you can't register the vote until all of the white women who want to vote register in they're like, okay and then they go get their little picnic baskets and they sit on the line and they gonna wait until all of. Them and they register on the last day and sort of turn out from their or then they are pestering their husbands to GonNa go register and I'm GonNa Bring and it's just like these narratives that we use. Now of charing higher heights back and saying black women don't go to the polls alone we move our household we move our sorority we move. Our Church right at it is that these things are connected that you can read these pieces in history of black woman doing this, and then you see the immediate crackdown. It's that this is way too much empowerment. Too much they now have a say and I there's something I use in speeches all the time where I tell people. The simple phrase that we used people died for your right to vote is very simplistic rather than saying that they recognized that the right to vote was a tool for self-determination they wanted you to be able to have a voice and say on electing the sheriff they wanted you to have. A vote and say so in terms of what your tax dollars would be spent on, they wanted you to have a vote in say. So in terms of education policy because they lived under regimes if you will in which they had to contribute to a system that they had no say in terms of how it operated and so certainly the history of that you have written I can't wait to September eighth. Yeah. It's a dive in a little bit more on this. What do you hope people walk away with after reading it? I hope that we recognize that the history of voter suppression is deeply. Woven into the fabric of this country and for Black Americans. In nearly every generation we've had to struggle and we will struggle here again in twenty twenty. That is part of how American democracy works because we make it work and I do hope that generally readers will. Stop Wondering Slack Jawed about how Black Women in the twenty first century have come to be such a force in American politics. There's no mystery to that. If you understand the history in fact, it's quite plain that black women have organized. They have thought they have deliberated they have taken risks and they have insisted on a place at the table of American politics and that's the story that vanguard tells and so when we see as we will this fall more than one hundred, twenty black women running. For seats in Congress that's no mistake that is by design and men have been working toward that and much more for many generations. I want people to understand what it is seeing when they head to the polls on election day and it is a hard one battle that black women have waged and to some degree we might say are even winning in the twenty first century. Professional I look forward to after cove it and we can resume things normal again, meeting in person, and maybe we can just nerd out and go down the rabbit hole. Absolutely I would love that but I really appreciate I've joined the conversation very much. I appreciate you making time for me. Thank you so very much and thank you so very much for lending your voice for writing these books, and then maybe I should have you back and we should talk in detail about birthright citizenship as well to talk about that. But thank you so very much for joining us in our hope you'll come back for further discussions. Terrific. Thank you very much. Thank you for listening I really do hope that you enjoyed the conversation today. Thank you to Dr Martha Jones for joining US and again please make sure to check out her upcoming book Van Guard and also do your homework and go listen to the full speech by Barbara Jordan we'll be back next week with more Sunday civics here on Sirius Xm Channel One twenty six were talk becomes action. I. Use. Show.

Vanguard America Democratic Party Dr Martha Jones Barbara Jordan Ame church president United States National Association of Colore Maryland L. Joy Williams Congress Movement for Women Stacey Abrams Kamala Harris
Dana Sue Gray Pt. 2

Serial Killers

44:06 min | 1 year ago

Dana Sue Gray Pt. 2

"Due to the graphic nature of this killer's crimes listener discretion is advised this episode includes discussions of murder and assault that some people may find offensive. We'd vice extreme caution for children under thirteen sunlight streamed through the windows as fifty eight-year-old Arinda Hawkins is credit cards to satisfy her shopping addiction sir with Dana Sue gray hi I'm Greg Paulson. This is serial killers apar- cast original every Monday we and a crude a staggering amount of debt her insecurity and pent up rage eventually led her to commit a series of brutal slayings originals for free on spotify or wherever you listen to podcasts to stream serial killers for free on spotify just open the APP and type serial killer in February of nineteen ninety four Dana Sue gray likely killed for the first time her alleged victim eighty six years that photo of her mother D- Arinda smiled and led the woman towards the back of the shop where a yellow rope separated the framing area from the rest world. Norma Davis was someone she knew through her father's wife Jerry in fact Dana a trained nurse had stayed with Norma for a short time it last week we explore daynuss troubled childhood and turbulent adult life we discussed data's mounting despair as she lost her job in the search bar today were finishing our analysis of Dana Sue gray who ended the lives of three women in Riverside County California in nineteen ninety four early in her ear telling her to relax finally during the past out when she awoke a short time later her head was pounding the woman Kan. to help her recuperate from a car accident Vanessa's going to take over on the psychology here and throughout the episode please note Vanessa's not a licensed icon of the store she turned and pointed out a few custom samples unaware that the woman was staring at her with increasing fury said gesture psychiatrist but she has done a lot of research for the show thanks Greg forensic neuropsychologist Dr Martha Rogers notes that among the into the minds and madness of serial killers. I'm here with my co host Vanessa Richardsom hi everyone you can find episodes of serial killers and all other Parkas unle dirigiste heard a rustling from behind before she could react she felt the woman slip the yellow rope around her neck and Yank it take a break justice she was beginning to relax the bell rang at the front of the shop short blonde woman entered an aster Arinda about vintage frame for an old gaunt Dirigiste gasped but couldn't scream all she could do was big wordlessly for life while her assailant whispered soft at podcast were grateful for you our listeners he will allow us to do what we love let us know how we're doing reach out on facebook and Instagram at podcast and on twitter at podcast network and if you enjoy today's episode the best way to help us is to leave a five star review wherever you're listening it really does help this week we'll examine thirty seven year old Dana 's month of murder she moved from victim to victim unleashing her pent up aggression and using her victim was gone as harrowing as Derivatives Assault had been she was one of the Lucky ones not everyone survived their encounter small number of female serial killers many of them are nurses nurses aren't shocked over blood or death and are used to helping there troll and vulnerable to some degree that may be pleasurable Dana certainly relished being in control but it's hard to tell whether it was the soon waived she knew Dana well her late husband had been good friends with Russell Dana's father Dana got out of the car warning young Jason to stay put a killer would strike again soon on the afternoon of February twenty eighth nineteen ninety four sixty six year old June Roberts stood out patients through painful experiences Rogers writes the vulnerability is a factor that draws them to the situation if someone is under your later and handed it over to Dana with a smile Dana smiled back until she saw the title it wasn't the Book Dana had asked for slide her home raking leaves it was her birthday and she was tidying up before meeting a few friends for dinner she smiled as she washed Brown and warmly greeted you she wasn't there to wish June Happy Birthday Dana Ask June if she could borrow a book on nutrition June had recommended Joe Greco was convinced the murder of Norma Davis was personal since there was no sign of a struggle at the scene but what he didn't guess is that uh-huh quietly she disconnected the cord from the phone June stepped into the den and peered at her bookshelf looking for the title Dana Hover real of dominating or victims or her frustration at the state of her own life that drove Dana to violence. Whatever her true motivations head investigator you know it had to do with nutrition Mickey Kashdan a non violent communication consultant notes that criticism judgment or reject instead June had handed her a book about the dangers of heavy drinking Indiana's is June had just called her an alcoholic accord backward she clawed at her throat and tried to throw Dana off of her but Dana was stronger than you before June could get free Dana grabbed a wind him money he demanded she go return the items and pay him back Dana argued she couldn't pay him back because she hadn't used her own money to shop behind her for a moment her face full of fury then she whipped the phone cord around June's neck and pulled hard June fell a few credit cards out of June's purse she returned to the car where five year old Jason was waiting patiently with a smile Dana suggested Kanter and used it to bludgeon June 'til she lay still Dana dusted herself off and strode out the front door stopping briefly to dig it ahead taken offense and hastily agreed when Dana suggested they both go inside to look for the other book before she went inside Dana Call to jason she'd be right back but she was there to do more than just pick up a book Dana followed June through the front door and uh-huh name on each receipt after the Salon Dana bought an expensive leather jacket some jewelry and clothing for Jason at Mervyn's a departments Shen can be interpreted as threats to our survival she writes our nervous system still equates emotional safety with physical safety either they're the women froze too terrified to even scream their friend June roberts lay dead on the floor down the hall towards the den as she went she pulled on a pair of latex gloves she had stopped in her purse before going to see June then battle-axe pulling up Dana Sue gray looked out at June from the front seat her boyfriend's five year old son Jason Sat in the passenger seat store Dana ran a few more errands before finally returning to her boyfriend Jim's house he immediately questioned her about the shopping bags since she owed after Dinner Dana pampered herself by getting a haircut and a perm at a salon compliments of June Roberts stolen visa she signed June onto to die for the shocking story of serial killer Dana Sue Gray Dana then quietly informed her I think it's the other one you recommended springs and arranged for a massage the following afternoon the appointment was made under June Roberts name meanwhile a few of June's friends had arrived at our home right outside so they let themselves in June's friends tentatively opened her front door and called out June a wooden chair had been placed on top of her body and the carpet beneath her was soaked in blood her face was beaten so badly it was nearly conceptually we understand the difference? It's possible that Dana's primal instincts were triggered when she felt like June attacked her character June notice he claimed the purchases were made on her estranged husband. Tom's credit card this did little to assuage gyms concerns and the two started screaming at each other name there was no answer lay proceeded through the house carefully checking each room until they finally peered into the den they go grab a bite and do some shopping Dana felt she had worked hard for those credit cards and wished to treat herself she took Jay or the previous year she'd been drinking a little heavily lately and wanted to get healthy again June nodded and hurried inside to grab the book she returned moments unrecognizable detective Greco who had investigated the death of Norman Davis arrived at the House soon after he quickly noted the contents of June's Ainhoa was exhausted from her long day of killing and shopping the fight with Jim only wore her down more that night she called a Spa Murrieta it looked a whole lot like the scene at Norma Davis's home in the back of his mind Greco started to worry it was a serial killer home for a birthday dinner the women knocked a few times and grew concerned when June didn't answer one of them found June's house key hidden in the golf familiar at felt there was no sign of a break in the murder had occurred during broad daylight and a phone cord had been used to strangle the victim Jason to Bailey's wine country cafe in nearby Temecula and gorged on food she even ordered extra and filled several to go boxes for later most assuredly either contributed to the motive to commit murder or served a celebratory purpose afterward but Dana couldn't keep up her spree forever their valuables had been taken Greco was perplexed was the purse just a ruse he scanned the scene again growing uneasy he couldn't shake authorize the sale and Annoy Dana handed over another credit card and claimed she was in a hurry the manager put the sail through but Kelly Ping sprees using stolen credit cards Joni notes there are a number of serial killers whose obsession with money and the things money can buy curse spread out where Dana had rummaged through them earlier his first instinct was to assume the crime was a robbery gone wrong but none of June's jewelry or remained suspicious she wasn't the only one almost every clerk Dana came in contact with remember vividly it doesn't seem like Dana made any attempt authorized the transaction Dana seemed impatient and dismissive Dana said she just moved and didn't remember the address after Kelly grabbed a manager to avoid suspicion after Mervyn's she continued her shopping spree at a save on pharmacy before heading to the luxurious Murrieta hot springs resort for her Johnston Dana Sue gray. Isn't the only killer to Exhibit Shopping Addiction Ted Bundy for example was known to buy socks and go on shot she hit perfume mania a Nike outlet and famous brands. It seemed Dana plan to keep going until June's credit cards were maxed out after Lisa beginning to put the pieces together she went about her daily life seemingly unaffected by the horrors she'd committed even when as they spoke to shopkeepers and store clerks where Dana had made her purchases an image of their killer finally emerged they now knew they were looking for activity on June's credit cards after she died a lot of it soon the police began to interview the businesses that appeared on the credit card statements and the more she bought the closer she came to being caught after Dina's second shopping binge June Robert's daughter received a letter from the bank there had been spa appointment she followed up her massage with a leisurely lunch at Ferrari bistro before spending the afternoon on yet another shopping high shock over the second murder they had known both Norma and June and Jerry was adamant that the killings were linked according to to die while Greco I'd Daynuss grizzly handiwork fearfully Dana was still celebrating it on Tuesday march first risking jail time for them perhaps Dana thought she should get the most out of the cards according to clinical forensic psychologist and private investigator Joni e Klerk Dorinda Hawkins with a rope but only succeeded in knocking Dorinda out it's unclear whether Dana Mentally Dorinda alive attack happened on March Tenth Nineteen Ninety four after she wandered into an antique shop in Lake Elsinore California she strangled the all dark haired man this has never been confirmed and Dana never made mention of an accomplice regardless Dana remained blissfully unaware that the a few days later officer Greco followed up with the stylist after seeing the salons charge on June's credit card statement the stylist told Greco about the for when Jerry mentioned her thoughts on the matter daynuss head whipped around she looked startled it appeared that getting caught simply hadn't occurred the mystery woman had a kid with her around five the clerk remembered the name as well Jason Wilkins the woman had referred to herself as Jason the other Mommy Detective Greco didn't have time to track down Jason Wilkins before the killer struck again Dana 's next a blonde woman in her mid thirties sometimes accompanied by a young boy it should be noted that more than one account claimed that Dana was also with the up next daynuss killing spree continues to spiral. Don't miss this Dana bought some expensive swimsuits before her spa appointment a clerk named Kelly Check Dana out she recalled that after asking Dana for her address too does she loved were affected only a few days after she'd killed June Roberts Dana stopped by her dad's house both Russell and his wife Cherry were in blonde hair mid to late thirties his killer had struck again woman stopping in a second time for a die request and then she gave Greco an even bigger lead at the time the clerk said Dot com slash untold story falls True Crime Must Listen Call Me God the untold story of the DC sniper investigation from the leading true crime investigative team that thankfully Dorinda had survived and was able to report the incident to the Police Lake Elsinore was serviced by a different precinct than detective Greco's tena before now she felt a sudden need to cover her tracks four days later on March Seventh Dana went back to the salon where she about the assault was that Dana only stole twenty five dollars from the register it seemed Dana was no longer killing for money for free on spotify or wherever you get your podcasts or visit podcast dot com slash villains to listen now of terror that paralyzed the DC area and gripped the nation told firsthand by those essential to solving the case and including a brilliant so he wasn't aware the assaulted taking place until he read about during this attack in the local paper freckles is widened at the attackers description short please masterminds mustache colors for every hero there's a villain the new podcast original villains explores the psychological political never before told story of the chilling and volatile investigation that led to the killer's capture and ended an unprecedented twenty three day reign deep dive into the behavioral ballistic forensic and electronic analysis it required follow. FBI Agent Brothers Jim and Tim Clemente Untold Story of the DC sniper investigation. How do you stop what you can't see listen free with a thirty day trial just go to audible for fictional villains you'll delve into the social influences that led to that character's creation for real villains you learn the true story of their dark deeds and explain firmed her hair a few days earlier she wanted to change your caller to read the stylus refused as daynuss haircut fall out from the damage another die job but 'cause it's possible the public nature of the store increased in his fear of being discovered and prompted her to flee after Dorinda passed out but what was most curious the stylist had refused police theorize Dana might have found someone else to do it the investigation was making progress but though police were getting the New York Times Bestseller Evil has a name comes this new riveting probe into the man hunt for the elusive DC snipers here the now back to the story in March of Nineteen Ninety four thirty seven year old Dana Sue Gray L. A. -fornia were so fearful of the killer they temporarily fled the community women who lived alone stayed with friends and couples but guns has they lead listeners through the tangled path of discovery and evidence gathering only a select few had the vision to see call me God the the iceman Richard Kuklinski and the coed killer Ed Kemper some are fictional some are real all our villains followed villains he had murdered two women assaulted a third after killing her second victim June roberts she used June's credit cards to go on an expense lurlene brought up the two murders that everyone was talking about she told Dana She'd heard it was a local who was responsible Dana suddenly seemed Ansi tidied up by the front register of the antique store it was quiet but during the didn't mind she was just watching the place is a favourite of the owner and was happy the police were inundated with phone calls from worried citizens if Dana was aware of the frenzy surrounding her she didn't allow it to interfere with her plans and what drove them to evil you'll hear episodes on characters like Don Vito Corleone and no country for old man's Anton sugar as well as real-life villains like Oh sir to a complete profile of their suspect public hysteria was growing the murderers were on everyone's mind some residents of Canyon Lake and remarked that she thought the murders were similar to to in San Diego then she changed the subject talking instead about her boyfriend's son Jason and all the things she thirties but they also knew their killer may be trying to cover her tracks a salon stylist Ted tip them off that Dana had been looking to dye her hair red and emotional factors that spawned both real and fictional villains every Friday villains focused on different real or fictional evil doer laurine warmly and shows a color? Laurie noticed that Dana seemed on edge and had put on some weight to try and make conversation she stopped to get a manicure on March eleventh only a day after her attempted murder of Dorada Hawkins she greeted her usual nail technician recently bought him according to Dr Martha Rogers Shopping and Pampering was away for Dana to reassert her superiority when faced with laurine gust over her murderers it's possible that Dana felt the need to confirm her value she was reminding herself of the good things that had come out of her atropine live two days shopping spree police interviewed witnesses at the stores she visited and were able to glean that they're suspect was a blonde woman in her mid Addis attention focused on Jason following the tip from Dana stylist Greco founded Jason Wilkins registered at a local elementary school excited Shas deeds just as much as she was telling laurine what a thoughtful mother figure to jason she was meanwhile detective Greco also spotify and anywhere you listen to podcasts more mundane than revenge she was looking for a job the same morning Jerry reported her to Police Dana Sat in the unemployment office her hair red there was a tense moment of silence but Jerry she had been a nurse she'd helped people and now she was only fit to bring them food or clean up after them embarrassed Dana grabbed the restated she grabbed her husband's gun and her cell phone and waited tensely in her living room for Russell to come home from work Jerry said since I had when Dana arrived Jerry immediately noticed her stepdaughters new locks the voice of Detective Greco echoed in her ears her Dana was picked up I was afraid she would come first and I would be the next victim but Dana was busy with something much Greco went to see Jerry and was surprised to find that she knew June quite well June's late husband had been good friends with Jerry's husband Russell hoping they had some work for her the office only had two new openings one was looking for a server and the other for Janitor Dana was furious now after Jerry hung with Greco she was filled with anxiety an interview during an episode of the TV series diabolical women contact information and fled the unemployment office in a huff despite her humiliation at the prospect of being a server Dana couldn't ignore her nothing like the description of Dana though it's not clear who this woman was Greco discounted her as a potential suspect after speaking with her she thought about the rest of Greco's profile and realized with mounting fear she was staring at a killer after Hugh Sleepless Nights Jerry finally gathered the courage to call Greco on Wednesday march sixteenth nine hundred ninety four at nine thirty a. m. when the ALF and not to tell daynuss Father Russell he then hung up and rushed to his superiors they needed a search warrant and they needed one flay did he decided that the lead was most likely a dead end taking a step back he decided to speak again with Cherry who was married to Dana's father the thing but the incessant calls of community members desperate to know how long they had to continue to live in fear while many in the community were hiding inside last time he had interviewed her was after Norma Davis had died he figured he'd reached out to check on a potential link between Norma and the second victim June -tective answered Jerry nervously suggested he looked into her stepdaughter Dana Sue gray as Jerry confirmed each piece of Greco regretfully had no suggestions for him disappointed Greco returned to the station to check up on leads unfortunately he found nothing any issues she needed the work she angrily drove to Murrieta hot springs to apply for the job the restaurant was in the resort where his profile he became more and more certain Dana was who he had been searching for Greco told Jerry to keep her suspicions to her walking their doors Dana was out on the town she'd finally dyed her hair red and went to her parents home and Canyon Lake to show it off so after hearing about their connection Greco went out on a limb and gave Jerry the description of the woman they were looking for he also mentioned she might have recently died when we return Dana assaults her third victim now back to the story to survey the scene while he wrote up the warrant officer sat in anticipation outside the home taking notes on the layout and he was locked in a tense argument with Deputy Da Rich Bentley who didn't think Jerry's information about Dana was enough to justify a warrant Dana had gotten a massage only two weeks earlier now instead of being seen as a treasured guest she'd be a desperate job applicant for what Sun City a California neighborhood nine miles west of Canyon Lake back at the police precinct detective Greco was also angry he suggested Greco keep investigating but Greco was sure Dana was the killer he had officers go to Jim's house in Lake Elsinore got any destination in mind her hands grip the wheel as she replayed the indignity of her situation by eleven am she found herself in are mortified and fuming she was sure the woman who gave her the application had been judging her Dana saw red and drove north with though failed to mention she'd been fired from her last job for stealing painkillers after handing the application Dana God back in her car being for Dana to return but they're Predator wasn't ready to come home just yet she had one more victim to claim that she considered to be a lowly position Dana arrived at the resort around ten am and grabbed an application from the front counter she filled it out dutifully dire financial straits she filled out an application for a server job but felt embarrassed having to beg for work that she saw as beneath her on March Sixteenth nineteen ninety four after killing two people in the previous month thirty seven year old Dana Sue gray was in satiate their bloodlust without punishment it instills a sense of power within the killer Dana deep in debt and unemployed and after the embarrassment she endured when applying for the Server Job Dana no doubt wanted to find a way to feel good again as Dora disappeared inside her believes that addiction is caused when the addict is consistently rewarded for their behavior a killer who kills without being apprehended is allowed after she handed in the application she drove to a shopping center in Sun City California to vent her frustration there Dana sought had no doubt felt powerless in the months prior to her I kill being able to get away with two murders might have given her the power she'd been lusting after even so weakened guests her motivation was to kill again Nottingham Trent University professor Mark d Griffiths Home Dana pulled her cadillac up to the curb she hurried up the walkway and knocked Dora looked through her people and eighty seven year old Dora beebe coming out of a doctor's appointment she waited patiently in her Cadillac for Dorothy to reemerge and then followed her home Dr Martha Rogers that she blacked out and suddenly found yourself in front of Dora's house with no memory of how she got there it's not known whether Dana went to Sun City deliberately to search for a victim or if her urge to kill appeared after she laid eyes on Dora Dana would later blame Dora for her own violent actions claiming door was rude to her during their initial interaction Dora's flippant added people believe they're about to be rejected and take preemptive action this can be internally destructive like isolating oneself but it can also maybe she later would tell conflicting stories two different psychologists to Dr Michael Kanye Dana said she felt pulled Doris home but she sued May Dana feel like an inconvenience and it reminded Dana the way her mother used to speak to her Dana followed Dora in long she had a lot of shopping left to do she left again thirty minutes later the officers followed the surveillance team watched the door cautiously Dana said she was lost would Dora happen to know how she could get out of Sun City after a moment Daura told Dana she didn't have out of made her so sensitive that the only way she could react to doors attitude was with violence but hurt and rejected viewed like week words when though they didn't know it at the time the police should have remained in Sun City a short distance away Lewis Doorman was knocking on doors and left she grabbed doors wallet and Checkbook on her way out falling back into her routine Dana spent the next few hours shopping ENA purchased a briefcase and immense amount of stationary her total was one hundred ten dollars and five cents she wrote a check with Dora's said Outward Violence Dana sensitivity to being ignored by her mother at an early age most likely affected her sense of self worth this aside immediately grabbing the telephone cord as Dora Lead Dana to the back of the house according to to die for Dana later said I Dora didn't put up much of a fight and yet she continued to brutalize her when Dana finally finished she washed her hands in the sink officers in separate unmarked cars all of them were thrilled to finally get is on their suspect but Dana wasn't inside for meanwhile the officers on Danes tail were still perplexed by her movements after leaving Sun City she led them to another Vaughn's then James guerrino points out the correlation between parental rejection and extreme rejection sensitivity rejection sensitivity is when appeared to what Dana did next she wrestled Dora to the ground with the phone cord and then grabbed an iron and hit door repeatedly Dana admitted checkbook and signed her name as Dora beebe she then spent another one hundred thirty three dollars and twenty cents at a health food store across the her leg was twisted at an odd angle and the site of the blood covering her face made Louis sick he immediately called the police and and then got back in this caused the officers to worry she'd spotted them but rather than try and shake them she drove straight back to Lake Elsinore much time but reluctantly suggested Dana come inside to look at a map she had no idea she adjust welcomed a monster into her home her first stop was at a stationary tour at eleven forty five am only minutes after she bludgeoned an eighty seven year old woman to death there mouthed and speechless as detective Greco explained she was under arrest a confused Jim was put in the back of a police car treat Dana finally drove back to Jim's place in Lake Elsinore around three ten pm she had no idea she was being watched by seven choked her with the telephone cord I had that overwhelming Mike detached feeling stupid as it sounds I felt hurt and rejected author doar Dora was a close friend and had promised to drive him to a doctor's appointment when she had failed to show up he worried something had happened Avon then a stater brothers she treated herself to lunch at a nice outdoor restaurant before finally driving home by four for anything Luckily Dana was too surprised to react violently at the site of the police after answering the door she simply stood open four fifty eight pm Greco had finally gotten his warrant signed and they finally moved in on Dana Tips from Riverside County they mentioned that a homicide of another elderly female had occurred earlier that day in Sun City since acted like she and the police were chatting rather than taking part in an investigation according to diabolical women Greco noted that she was smart in hurry he let himself in her home and was met with a sickening scene door lay in her hallway half her body in the hall bathroom the had been under surveillance Greco assumed the murder was unrelated and continued into the interrogation Room Mrs who described her Dana Merely suggested she had a familiar face Dana appeared cool calm and collected throughout she was under surveillance earlier that day at first she lied about ever having been there but when they told her she'd been seen she knew she shoeprint left at Norman Davis's home while the search continued Greco took Dana to the station on his way in he noticed some other detect untouched accessories police were most excited to find items that matched the charges on June credit card they also found a size six Nike sneaker that matched she withdrew some money from the moments account she cautiously gave Greco the name of the woman bb Greco shot to his feet he hustle grocery bags gibbs still in their packaging and a pantry overflowing with food the closet was packed with close that still had tags and actions he felt like she was the one prodding them for information to try and figure out what they knew Dana was questioned about her visit to provident bank when she dana knew she had been caught like many serial killers she attempted to plead insanity over the loyd watching her victims suffer much like she might have enjoyed catapulting neighborhood cats into swimming pools when she was a child not everyone informed them he had their suspect in custody already he then geared up to Pristina on doors death in an interrogation tape as well while an officer entertained young Jason Offices next searched the home and found its contents shocking it was filled to the brim with was caught she tentatively admitted she'd lied because she was scared Dana claims she found a woman's purse and didn't turn it in instead they started by asking about the evidence they found

Kelly Check Dana Dana Sue gray Detective Greco Norma Davis murder Joni e Klerk Dorinda Hawkins Jason Wilkins spotify June Roberts Vanessa Richardsom Dr Martha Rogers Jerry Greg Paulson daynuss investigator assault Jim Kan. Ted Bundy
Louisville Settles with Breonna Taylor's Family for $12 Million 2020-09-16

The Takeaway

44:00 min | Last month

Louisville Settles with Breonna Taylor's Family for $12 Million 2020-09-16

"Support, for the takeaway comes from hint water fruit infused water with no calories and no sweeteners hint is available over twenty five flavors including watermelon and pineapple water in stores are delivered from drink dot com. A settlement has been reached in Louisville for the killing of Brianna Taylor ardal. Choice, I, think the city had to not only settle quickly but they had to make historic move because our cities in complete unrest. I'm Tansy Vega and today on the takeaway for Wednesday September sixteenth, we break down the twelve million dollars settlement and look at where the criminal case goes from here. Also, we talk about the allegations brought on by a whistle blower at an ice detention facility in Georgia about hysterectomies performed on detainees. We're also talking about why animal populations are disappearing and also what possible new populations of life we could find on Venus our neighbor planet. All right. Let's do this. Please continue to say her name. Brianna Taylor. I'm Tansy Nevada, and this is the takeaway. The city of Louisville Kentucky has settled a wrongful death suit for twelve million dollars with the family of Brianna Taylor, the twenty six year old black woman who was shot and killed by police in her apartment six months ago while we await a decision from Attorney General Daniel Cameron on whether or not charges will be filed. In this case, my administration is not waiting to move ahead with needed reforms to prevent the tragedy like this from ever happening again. That was Louisville Mayor Greg and we're going to talk about the specifics of those police reforms in just a moment in the meantime Taylor's family and lawyers commended the settlement but said yesterday that justice for Briana will not have been served until Kentucky Attorney General Daniel Cameron brings criminal charges against the three officers involved with her death. Here's Taylor's mother to Meka. Palmer speaking at a press conference yesterday. As significant as today is it's only the beginning of getting for justice for Briana. We must not lose focus on what the real drive is. And with that being said, it's time to move forward. With the criminal charges because she deserves that and much more. Her beautiful spirit. And personality is working through all of us on the ground. So please continue to say her name. Brianna Taylor. Now to talk about this tested Duval reporter with the Courier Journal and Louisville and Tim Finley Junior the senior pastor at Kingdom, Fellowship in Louisville and the founder of the Justice and Freedom Coalition Tessa and Timothy. Thanks for joining me. Thank you. Tim Let's start with you how has the settlement been received What was your reaction to the twelve million dollar settlement? Well, we certainly expected there to be a settlement that part was not surprising it's been my sort of push just to continue people to understand. that. This is not be the end of this ordeal. that. We want to see criminal charges. We want to see an indictment and we wanna be happy for the family, but we got to see top to bottom change in our police department. and. That's one of the things we're GonNa talk about the specifics here that the that the city is proposing but Tessa the settlement on the civil suit at least is for twelve million dollars that feels in some places could be considered historic. How does that compare with other settlements from wrongful death suits? Will Certainly and Louisville, it is considered historic. This is the largest payout at is a result of a police conduct here in Louisville. The previous largest amount was eight point, five million dollars several years ago. So that is certainly A. Large large figure in level standards in terms of national standards as well. I. Mean there certainly have been bigger settlements with police departments around the country but not many This is about twice the amount that Eric Garner's family got for the family of Tamir Rice. So this is a a truly large amount and it's also important to note that this was settled very quickly. I, mean, this lawsuit against the police officers was only filed in April, it didn't have to go to jury trial This was a really really quick resolution to this lawsuit. Tim Given the the pity if you will how how quickly this was settled to test this point how much of that do you think has to do with efforts on the ground and Louisville by activist and others to bring attention to Taylor's case? Oh I think it has a very, very substantial point and in part in all of this, there have been a hundred plus days of protesting ear celebrities At elites with called for justice. To be completely honest I don't think the city had a choice I think the city had to not only settled quickly but they had a historic move because our cities in. Incomplete unrest right now and protesters myself and others We have to see justice I think that the the local leaders felt that Tessa, what are the things that came out of the settlement In addition to the twelve million dollars were also a series of police reforms can you walk us through what some of those reforms are you know there's some reforms coming already been announced about body cameras but additional reforms about body cameras? Requiring that two officers wear cameras when they they count money that's been seized from people our also seeing reforms to the search warrant process. So it has to go up the chain of command to a commanding officer before it even goes to a judge. We're also seeing that there has to be risk assessment done before search warrants are executed, and then there are also really tried to push for officers to more deeply connect with the. Community. So we're seeing the encouragement of paid community service as well as trying to get officers to actually live in some of the communities that they are assigned to work it. When you hear about police reform particularly under Brianna. Taylor's cases you hear one of the tenants is to increase community engagement with police and the community. Do you think that's enough or is this more of a push towards defending and ultimately abolishing the police? Well I'll say I do not think that this is enough I think that it's a small incremental step in the right direction one of the things that very striking to me yesterday even Harry, some of these police reform I guess negotiations. What came out of that was that seem to be common sense sort of reforms in other words these are things that should have been happening and it's amazing to me that in twenty twenty things like drug testing things that just should already be in place to your question I think what we got to see from police departments around the country we've got to see police officers that look like those in the community that they serve. that's something that I think is behind the fought with the I think the housing credits in terms of getting police officers or encouraging police officers to live in those communities but I want that unapologetically stands for not abolishing the police but certainly, certainly defunding the police I have police officer friends, I have family members that are involved in law enforcement but I do believe that we've got to learn to reallocate some of these exorbitant budgets and send those funds to community programs, and two systems already in the community and help to transform these distress community. Salaam one bit absolutely believes that we've got to have more conversation and more action around defunding the police does. One of the key figures here as this this case moves forward. Of course, this is not the end this is the civil suit but there is still a criminal question involved here particularly with the three officers who were involved in Taylor's death, and they have yet to face criminal charges attorney general. Daniel. Cameron. Is really the one who will make this decision what we know about Cameron and where he stands here. Cameron is enhance his first term in office. He is the first Republican to hold the Office of Attorney General in Kentucky in decades he is. McConnell Mitch McConnell protege and he's been endorsed by Donald Trump. So he's also African American correct, correct. Yes. Yes. He is be first black man to hold this office. So while we know that his political leanings are very conservative, very Republican, I have spoken to former attorneys general who say that you know this office has dedicated career prosecutors who will do the right thing and if Cameron is is smart and it's true to what this job requires of him, he will defer to those career prosecutors who are making the decision in this case, but you're absolutely right this. This settlement that we saw yesterday is only the civil suit. So Daniel Cameron's office in looking into this and the FBI as well. So. This case is not over while the civil suit has been settled there still much more to be learned about this case as a whole it has just mentioned the Senate Majority Leader Mitch McConnell Who Represents Kentucky and he told reporters yesterday quote the investigation seems to have been more complicated than a lot of people felt and he McConnell said he has confidence in Daniel Cameron to do the right thing and stands by him. When you hear this Tim, how did you feel about Mitch McConnell and Daniel Cameron's response to the ongoing calls for these officers to be arrested at the very least. Well as a Lifelong Louisville Ian born and raised in Louisville Kentucky. I can say this and. I don't think I'm speaking for all black people but certainly, the ones that I know we don't we don't feel or value Mitch McConnell was a friend He has not been afraid our community. He's been in this position for thirty plus years the vast majority of my life and I am very sceptical but open minded to Daniel Cameron simply because association with Mitch McConnell Our community is collectively holding our breath and we're looking or Daniel Cameron to do the right thing What sort of gives me cause to pause is the fact that he will defer to those career prosecutors Again, there is deep seated trust issues when it comes to. The criminal justice system at the black. So hearing that he will Lean on these career prosecutors. is not always a comforting piece of news is not something that we look at it say okay. Well, we believe the right thing is going to happen So That's you know just Mitch McConnell, we want him you know we we know we need change leadership in this in this state But again, we're hoping we're praying that Daniel Cameron does the right thing. And we also think won't be news was a bit suspect as well. EMBIID being on the short list for the Supreme Court Justice the fact that he was turned over to the grand jury. All of these things adjust again. Further. Causes a bit of trepidation when it comes to the right thing being done and that trepidation tim just. So I'm clear is because I just WANNA. Make sure I'm understanding your point here is that. He sort of being courted by the more conservative Republican Party right now, and as a result of that may have more allegiance to that party may make decisions based on political affiliation versus criminality. Absolutely absolutely I. Mean you know there are so many things about the company that you keep well being the protege of Mitch McConnell being courted by Donald Trump That is one hundred percent and issue for people in my community. Timothy Findley junior is the senior pastor at Kingdom Fellowship in Louisville and the founder of the Justice and Freedom Coalition and tested divall is a reporter with the courier. Journal in Louisville Timothy. Tessa. Thanks joining me. But you. Think you. One day and I was demolished. And I know I was the motive because I raised the question of how I was told to tail officers that there were detainees. Day Out that positive. That was don wooten a nurse at the Irwin County Detention Center in Georgia who filed a whistleblower complaint this week alleging quote high rates of hysterectomies at times without proper informed consent. The plane also extensive neglect for covid nineteen safety protocols at the detention center including a lack of testing for the virus and insufficient personal protective equipment for detainees and employees project. South is the legal advocacy group that filed the complaint spoke with multiple detainees. At the Irwin County detention center as well as the whistle blower about the hysterectomies according to the detainees in Wootton a number of women had been sent by officials at the facility to the same gynecologist and could have received hysterectomies that they were unsure were medically necessary. John Washington is a freelance reporter and the author of the dispossessed and Jose this is an associate producer with here at the takeaway, John and Jose. Thanks for joining me. Solutions you know. John You spoke to several Irwin detainees this week about these hysterectomies. What did they tell you where these people who had actually gotten the hysterectomies right so I think it's absolutely critical to couch these procedures in the larger context of medical neglect and medical abuse that is at crisis levels in this and other immigration detention centers. But the women that we spoke to specifically about the hysterectomies did not receive them but they were told that they needed to receive them and they didn't understand why they also told us about a number of other women that did receive them and nobody explained to them what the procedure was going to be what exactly would entail and and what the results of the procedure would be a couple of them pushback and one of them said that the doctor became angry after she didn't want the procedure done and nobody explained to them the follow up care that they were going to receive either. All three women were obsolete angry and indignant about the situation One of the women women was weeping and I think that it's really important to understand that the women who did receive his knees have been difficult to find some of them have been deported some of them Also, we're telling the women that they didn't understand why they had received these these operations. Jose, you talked to the doctor who performed the procedures on these detainees what was his response to these allegations that so I spoke with the doctor, a his Mahendra I'm in a yesterday and essentially he himself is an immigrants who is a a gynecologist in a smaller hospital in southern Georgia, very close to where the urban detention center lies and what. We know about him is that in the past he has sort of come under fire from the US government's on allegations of some Medicaid fraud in terms of some situations that were happening that case was settled and there was never really any real capability that was found up but he did have to pay over five hundred thousand dollars to the federal government's. For these for the settlements end essentially when I spoke with him on the phone yesterday, he did confirm that he was the doctor who was performing gynecological procedures on women who came from Irwin County Detention Center, the this ice facility he did confirm that with me but he was very evasive in speaking with me essentially, he told me that he's only. Done around one or two hysterectomies in the past couple of years. But he did not specify whether those hysterectomies were for women detained in. Irwin. He also then essentially told me that's what needs to happens. He makes a medical diagnosis. He recommends what procedure what should be done and then ice and earn detention center sign off and approve any procedure needs to take place. And he quickly hung up the phone. Do. We know John How many women have had these hysterectomies in whether they were aware of the hysterectomies being performed. Was this you made some pretty strong claims at the top saying that this is about medical abuse at detention centers. But what do we know in terms of the percentage of women who have received these and whether or not? They were aware or medically necessary? We. Don't have a hard number part of the difficulty is lack of access to talking to these women. Even their advocates and attorneys have difficulty one very clear example of that is that yesterday The day after we publish our first report on medical abuses, their system of communication was cut off from the inside. So they could not make it was more difficult for them to make calls to the outside. But the numbers that we have are not hard we've had we've heard a number of estimates from both the whistle blower, Don wooten advocates, and a couple of the detainees were women that we've spoken with and the number that got thrown out a couple of times was. Twenty or more than twenty that was according to Don Wootton in the past six years. A couple of detainee women cited a similar number within even a shorter time frame. Why does that number stand out I? Guess. I'm trying to understand Jose. If if you know anything here, please weigh in in terms of the overall percentage of hysterectomies that are conducted at immigration descent detention centers is that a high number a low number? Can you help us understand in context? That's when people are calling for an investigation? That's why Pelosi has. Also, called for investigation of because, we really don't know at what rate this is happening or if this is happening in other detention centers what one attorney from the Southern Poverty Law Center pointed out to me yesterday is that she was really surprised at how ice and Irwin County detention center were signing off on gynecological procedures that she says may not. have been entirely necessary but how ice and urban detention center were dragging their feet in providing masks to detainees, drag their feet when it comes to refilling inhalers, drag their feet when it comes to other medical emergency situations that could potentially be life saving, and so that's something that also strikes advocates. Assad is seeing the disparity in the way ice is treating gynecological. Procedures as opposed to other important also important healthcare situations. The allegations here is that Isis prioritizing hysterectomies for personal protective equipment for covid nineteen is that the point Jamaican gets a question that advocates really want answered is why are we seeing this disparity and and who exactly is making the call for these? This situation what has ice had to say about this John. Well they cite an impending lawsuit and they say that they cannot comment on any complaints that are filed to the Office of Inspector General. So they have been pretty evasive about answering clearly the question they have responded to a couple of other reporters however citing that there have only been a blues to hysterectomies done. And that they are ensuring that all necessary medical care is provided to two women. But they they haven't really been responding Jose. What what do we know about the whistle blower herself nurse So don wooden on she is someone who has worked at the facility for a few years kind of on and off she essentially as a is a a nurse who worked in the facility worked with the detained population and she herself has health problems. She has five children. She's a single mother and She's been doing this work with detainees but. What we started when she started noticing display during the Cova nineteen pandemic is just the lack of protection and was she alleges was neglects and callousness by management's in the facility when it came to dealing with detained populations who or very much at risk who are still at risk of contracting covid nineteen and and getting the virus. So essentially, what was she did is she herself began you know speaking up at work recommending bats, staff and detainees follow the CDC recommendations for social, distancing. She began bring much speaking out against management would refuse to test detainees when refuse to provide treatments to folks who were exhibiting symptoms of Code Nineteen and as a result she was unfortunately demoted and she in a way that she sees and she alleges is retaliation for hadn't spoken up internally. And so she still technically employed by the facility, but she was demoted from being a fulltime nurse at the facility. It's now being only on call or part time, and she's only been receiving a few hours a month since early July and this has been a huge economic growth to her. I mean, especially with the kids that she has and making car and rent payments on this demotion, and the is drastic cut of our. which she she sees as retaliation has really kind of affected her and her personal life, and so it eventually got to a breaking point where she said I can't take this anymore I. Think what is happening is unjust and she decided to to speak out and blow the whistle on on conditions in detention. John What happens now? Will a number of people are calling for further investigation? The Erin County detention center is certainly being scrutinized in a different way by other reporters both Nancy Pelosi and chuck, Schumer Culp Investigations A. Georgia state representative has called for the doctor's license being suspended and an investigation into that specific claim of the hysterectomies but it's I think it's really important to keep shining a light on on what's going on for people, Don Sutton to be able to speak out to be protected when they do and for a lot of book both journalists and he just American people to try to understand and try to pay attention to what's happening there has been a smokescreen for a long time over the conditions in these detention centers and. The more we hear from not only detainees or former detainees advocates what about people themselves working in them like Don wootton about the shocking conditions the more we are able to push for change in push for letting people out for example, with who are. Susceptible to the coronavirus. Jose only viruses associate producer at the takeaway and John Washington. Is a freelance reporter. Thanks to you both. Things. Hey, you podcast person Amy Walter here host of politics with Amy Walter from the takeaway every week I'll take you beyond the headlines for a deeper understanding of how Washington works who's pulling the levers of power and how it all impacts. You I. Hope you'll check it out just search for politics with Amy Walter in your podcast APP and subscribe ride happy listening. To. The takeaway is supported by indeed right now, small businesses have to be more efficient than ever and every higher is critical. That's why businesses of all sizes. Indeed. Dot. com is the number one job site in the world they get the best people fast the best part about indeed you only pay for what you need can pause your account at any time, and there are no long term contracts right now indeed is offering takeaway listeners a free seventy, five dollars credit to boost visibility of their job post at indeed dot com slash podcast more. Info at indeed, dot com slash podcast terms and conditions apply offer valid through September thirtieth. The takeaway is supported by better help if you're struggling with stress or anxiety or depression. Better help online counseling offers licensed professional counselors who are trained to listen and help simply fill out a questionnaire to get matched with your counselor and start communicating online via secure video phone chat or text under forty eight hours. Join the one million plus people taking charge of their mental health with the help of an experienced better health counselor better help is also an affordable option and our listeners get ten percent off their first month with the Discount Code Takeaway get started at better health dot com slash takeaway. That's better. H E L P dot com slash takeaway. All. Right. So we talk a lot about humans on this show for good reason. But we're going to take a little trip out of the human run world and talk about our friends in the animal kingdom for a minute. As, we all know wild animals, play kinds of important roles in keeping the ecosystems we depend on healthy eating. Bats Bees, earthworms, whales, sharks they're all part of a complex environmental we've. But, it's become harder and harder for animal populations to exist at optimal levels as human activity like culture encroaches on their space and human fueled climate change drastically alters their habitats. Now, a new report from the worldwide fund for Nature shows that animal populations have fallen sixty eight percent in the past fifty years. I asked Eric Ralston about this. He's a climate reporter at Bloomberg. Green. The twenty twenty. WWF living. Planet report documents a sixty eight percent decline in the population of vertebrate. Animals. Since nineteen seventy. So that includes birds, amphibians, mammals, reptiles, and fish as well. When you say we, you mean humans, of course I do the report which was written by dozens of authors. In conjunction with both the WWF and the Zoological Society of London. Documents that it's human consumption the systems that make our economy go globally are really having this catastrophic effect on animal populations. The biggest challenge is addressing we use the land deforestation huge driver of. These population declines. And converting that. Virgin forests to agriculture not only. Leads to about half of the overall declines that the scientists are seeing. It's also a major contributor to climate change as well. As communities get larger and larger and people are looking for places to build We seem to be building you know housing and other and other developments on land that animals once lived on, is that partly to blame or is it really more industrial land use that's partly to blame? It's it's both but you're absolutely right that the whole planet is urbanizing and as a result of that, we're seeing the destruction of these forest ecosystems and there's a number of reasons why this is a problem. One of the problems that are front of mind is that as the forest ecosystems decline animals that had lived within it and carry it around viruses that live just within these these niches in far away communities they're now free to go out into the world and as it happens the animals that adapt most effectively to living in cities and other human communities. Those are also the ones that are best transmitting. So, bats and rodents So there's a number of truly problematic issues in sort of thrown in with the you know this network of problems related to biodiversity loss. The pandemic is is one of them. I'm wondering also you mentioned some of the categories of animals. Can we talk a little bit more specifically about what kind of animals beyond just broader categories are there specific species or types of birds, for example, or other mammals that are feeling this more so than other types of animals or their animals that were more familiar with well. Many of them are animals were familiar with the group of animals that have a single biggest impact are freshwater animals so that it's fish and the birds that live off of. Communities around the world, those obscene, an eighty, four percent drop in animal populations that's largely fish and birds since nineteen seventy, it's the largest single decline of any particular kind of ecosystem around the world. So in addition to the problems, we see from land use change there's also there's pollution there's pesticides from farming that ends up in places it shouldn't be in poisons communities. There's industrial metals that find their way to the sensitive communities, and of course, there's also just kind of overfishing. And poaching of animals that should not be occurring if we're going to keep these ecosystems healthy, the scientists definitely emphasize that That's the overall goal here is to keep these ecosystems healthy. The reasons that's important in addition to what I mentioned a second ago about about pandemics is ecosystems quietly in persistently for the entire breadth of human history have been doing the quiet hard work of cleaning are Aaron cleaning our water making sure that soil stays where it is and that soils regenerate so that we can continue to grow food. Those ecosystem services which we pay nothing for in also pay little attention to are absolutely critical for economic in human health. So declines in animal populations are true red flag for threats to these systems we rely on without much thought to it. You mentioned coronavirus covid nineteen what effect has that had on the animal population that we understand so far how how has that played into all of this the scientists would say in response to that question that well, the monitoring that goes into these animal populations globally, is it so onerous and take so much time to amass the data that goes into the report that they actually closed the observation for this report I believe in something two, thousand sixteen, and then it takes a little while to process all of the data into the market levels that they see on a more sort of anecdotal level not it's more evidence than anecdotal. Some of them have startling images we've seen from the pandemic are the evacuation of people from from cities and other built environments and the return of animals to these areas. So it's not you know a sort of robust highly desirable way for Nature to heal. But it does provide a glimpse at as soon as human behavior changes on a large scale, it opens up niches. Animals and ecosystems to come back and figure out new ways to live. Once the harm that we do to them dissipates. Eric Rawson is climate reporter at Bloomberg Green Eric. Thanks so much. Thank you. You're listening the takeaway I'm tenzin Abega, and we're going to end today's show by moving away from life on earth to possible life on the planet door. On Monday scientists announce they've detected the gas called phosphene in Venus's atmosphere here on earth. phosphene is a toxic gas that's made by micro organisms and so the presence of phosphene and Venus's clouds means there's a chance that life could be there too but we're not talking about the aliens we see on movies and TV with about tiny microbial life forms, and though it's too early to say that life indeed exist on Venus scientists have yet to find any other explanation for why the guests phosphene is present for more on this we're joined now by Dr Martha Gilmore a planetary geologist and professor at Wesleyan University Martha Thank you joining me You're very welcome. I'm happy to be here. so as someone who's studied the planet Venus, were you surprised by this finding? Uh Certainly. We're always surprised to find. Evidence of life elsewhere, and also the surprise is in the back that the the signal potential signal for life was detected in the clouds since we have so far we think about life as being related to surfaces, planetary surfaces, and so it expands our horizons to think that perhaps the clouds of Venus or earth or another planet might be a niche for life. Now, we mentioned at the top. We're not talking about aliens an as much as people may want to imagine flying saucers and things like that. We're not there yet. We're talking about tiny little particles. Aren't we? When we say life? What do we mean? Yeah I mean we all probably think of Landau calories the in cloud city, and that's probably not what's happening. On yet that. That would be great. No whatever life lives in the clouds in particular house to take advantage of what's available to it and to live in the cloud, you need to be small enough to probably adhere to a droplet to be able to take in water and other nutrients that you need and on earth the microbes that we see in the clouds of the earth which do not spend their entire life cycle, but some of them hang. Out there for a little while are lifted up from the earth's surface they're small enough to be carried by the winds and the clouds, and so our expectation is that it must be small because it to be buoyant and float and take advantage of the materials available to it in the cloud. We talked a little bit about a gas called Phosphene what is it and I I understand it doesn't smell too great. Yeah we've all started. We all started by looking at what is phosphene So we're not alone, this is encouraging to know okay. Now this is a I mean, it's a nerve agent. It's actually very difficult to work with It is the reason why Cops have to be careful going into crystal meth labs because it it is one of the things that is produced with Chris. Happening on Venus Dr Yeah I know really. So That's all other story but it is a, it's a simple molecule. It is phosphorus with three hydrogens and this is a gas, and so one of the reasons why this is a compelling gas for a Biota is want because of the things that life needs as far as we know till exist there are several elements, carbon, hydrogen, nitrogen, oxygen, sulfur, and phosphorus phosphorus is is strange I mean your teeth are made are made phosphorus. It's it's a pretty important element, but it's derived from rock and so life has to somehow find a way to pull the foster as out of rock to use it for as life, cycle? phosphene is a gas, and so it offers the opportunity to provide phosphorus for potential life that live in a gas phase. About a little more than fifty years ago scientists including a Carl. Sagan had speculated that life would would exist Venus's clouds. But a lot of that attention at least in the past couple of decades has really been on Mars What's happening on Mars should we go to Mars is Morrison inhabitable or not? Did we overlook Venus? Well Mars is wonderful because of its then atmosphere, we can see the morphological evidence of rivers and Deltas. For example, what the Mars Twenty twenty is on its way to a delta in an ancient lake. So we can measure the mineralogy from orbit within see the processes associated with water. Dina's harder in that way because it's thick cloud cover prevents us from using conventional methods like visible light to look at the surface. So that's coupled with the fact that Venus surface itself is as far as we know pretty uninhabitable it's four hundred and fifty degrees Celsius. It is At pretty much all you need to say actually. something. Too Hot for me presents, it's wiper water and water is one of the building blocks for liquid water for life. So it's been overlooked as an astro biological target, but a couple things have changed in the last couple decades. One is the appreciation of life that spend some of its life cycle in the clouds as I mentioned before on Earth. and also the rise of the discovery of so many exoplanets around the galaxy, which was the impetus for the study. By Greaves they were trying to t tune some their. their telescopes to be able to look at the clouds of other planets and Venus is the one example where we can both look at the the light coming from the atmosphere, which is what we can detected exoplanets, but we can also visit it because it's right next door. So, we can. We can then compare what we measure inside the atmosphere. If we go on a mission to what we see on the top of the atmosphere and what exit plant that scientists WanNa learn is, what are the signatures of the atmosphere of a habitable or inhabited planet and phosphene now enters that list of potential compounds that could indicate life. Martha, we've got about a minute left, but I just want to ask you a few indicate that there could be a life on other planets potentially. Well I. Hope So. I every discovery we make another planet forces us to reconsider. The origin of life on the earth which we still don't understand we have. We know that life exists in the universe we are. We're right here, but we still don't have the basic understanding of how Earth went from a lifeless planet to one that is teeming with life, and so the discovery of how organic materials on other planets, how they can come together to take advantage of the environment particular to that planet is going to tell us a lot about how life Volvo in general will pay attention to that. Dr. Martha Gilmore's a planetary geologist professor at Wesleyan University. Martha. Thank so much. You're very welcome. And that's our show for today. If you have any thoughts for us, you can give us a call at eight, seven, seven, eight, my take or you can reach us on twitter at the takeaway I'm Tansy Vega. This is the takeaway and thanks so much listening.

reporter Louisville Brianna Taylor Daniel Cameron Mitch McConnell attorney Jose Georgia Don Wootton Irwin County Detention Center Louisville Kentucky John Tessa Justice and Freedom Coalition Dr. Martha Gilmore Tansy Vega don wooten Donald Trump Tim WWF
Episode 3- Happy Heart Month! Womens Heart Health and Prevention with Martha Gulati MD

Nutrition Rounds Podcast

1:25:03 hr | 9 months ago

Episode 3- Happy Heart Month! Womens Heart Health and Prevention with Martha Gulati MD

"Welcome to nutrition rounds with Dr Danielle. Lardo the podcast for anyone interested in learning about plant based nutrition through an evidence based approach every week we share insights and interviews with physicians who are leading experts in nutrition and health. Whether you've been plant based for many years or still searching for the perfect diet nutrition rounds will inspire and empower you to live your healthiness life back by science now. Here's your host Dr Danielle Bilardo. MD Hello Hello and today we earlier nutrition rounds with someone incredibly special and we are celebrating the first day of heart month. It's February I. It's the first day of harm on want them were so excited. And we're here to celebrate with the one and the only Dr Martha Galati so Dr. Martha Galati is a professor of medicine in the the chief of cardiology at the University of Arizona Phoenix. She has held the Sarah Ross Odor Chair in women's cardiovascular health and was the section director for women's cardiovascular the vascular health and preventive cardiology at the Ohio State University until two thousand fifteen. She's the author of the bestseller seething women's hearts. She is the editor in achieved. The American College of Cardiology Cardio smart the patient education and empowerment initiative and she also serves as the chair of the national chest pain guidelines Her exceptional commitment to the study of women and chronic diseases has won her numerous awards and distinctions so well-deserved included being named by CRAIN's Chicago business. Ns as one of Chicago's top forty. Under forty elicit honors forty outstanding individuals when major impact in their respective industries before the age of forty in two thousand eleven. She received the first credit so this is the coalition to reduce racial and ethnic disparities cardiovascular outcomes award from the American College of Cardiology that was given into honor her contributions to improve cardiovascular health care of women patients in two thousand twelve. She was awarded the national readdress award for her efforts in raising awareness of of heart disease in women and advancing research in this field. He in two thousand nineteen choose chosen as the most influential woman in Arizona and received two thousand nine hundred. The American College of Cardiology Bernadine Healy Award for leadership and accomplishment in the field of cardiovascular disease in women Dr Glad he's passionate about the study of women and Heart Disease and prevention heart disease. She's the principal investigator of the Saint. James Women Take Heart Project A study examining cardiac risk factors in women which set new standards for women fitness levels and hurry response to exercise women. She's also co investigator and women Ischemic Syndrome evaluation wise and previously served served as the CO investigator of the Women's Health Initiative. She's a member of numerous advisory boards and societies including the American Heart Association. The American College of Cardiology and the American American society preventative cardiology she serves on the board of the ASPCA. See the Phoenix. Chapter of the American Heart Association and the Board of Women Heart. She's published articles impure review publications including the New England Journal Medicine Circulation the Journal of the American Medical Association. Her research has been featured in hundreds of newspapers across the world including the New York Times in the USA. Today she's also featured on Oprah and has been featured on CBS national news the Today Show Canada am and in addition to many others. She recently was listed on. The marquee doesn't maintain. Who's who in America and WHO's who in the world and WHO's who in American women? Dr Gladdy Completed Medical School at the University of Toronto Canada she went on clean internship residency and Karachi Fellowship University of Chicago. She received a Master's science North Chicago and is a fellow of the American College of Cardiology. The American Heart Association. She's board certified in cardiovascular disease and just a personal note about Dr Galati an she is one of the biggest. Inspirations to me in cardiology for any of I know a lot of female listeners out there and a lot of women in healthcare whether you're a nurse practitioner nurse Resident Medical Students uh-huh Dietitian so many healthcare providers. I'm listening you have to follow Dr Galati on social media because she is a major inspiration for all women in science and medicine and I am so lucky to have met her and call her a friend. So welcome Dr Guardia Soaks to have you on the podcast. Thank you for having me. I feel now your audience is asleep after you deserve all hugh deserve the extended intro. Because you've accomplished this show much end you're you know you're such an inspiration to me and I think that especially in cardiology speak about this often to feel that predominantly the male. I think the last statistics were that it's eighty five. Ninety percent practicing cardiologists are men And only twenty percent of current cardiology fellows are female. So I really think that seeing you and see how much you've accomplished and seeing how much you connect people and seeing how brilliant and how much you've done in a huge inspiration for women in medicine in all specialties. But especially women in cardiology like me who you know. We're just so lucky to have. Have someone like you to look up to you so now that I've embarrassed Martha was telling her obsessed. Im with which you guys. If you follow me on social media you already know this. We're going talk about a topic that everyone's been asking about and that's wildly important and it's women's heart health and literally. There is no greater expert on the planet aimed so excited excited to pick Martha's brain about this because you know Martha it's one of those things where we're we're discussing earlier that there's so many important diseases that are getting attention attention for women. You know breast cancer month. And of course there's all different sort of outreach outreaches for different kinds of disease processes but heart disease being the number one on killer. I sometimes feel like doesn't get as much attention for women and being today's the first day of heart heart month I was wondering if we could start with you. Just kind of laying laying out for everyone listening. You know some of the statistics for just how common heart disease is in women in general. Yeah well I think you know again it is Hartman Hartman and we get the shortest month of the year. It's February despite heart disease being the number one killer women if you think in the United States talk about one point two million women die every year and over. Four hundred thousand of those deaths are due to cardiovascular disease and I don't think like women actually that because women definitely understand the risk of dying from breast cancer and yet breast cancer is actually only the fourth leading cause Hawes of death in women in accounts for only forty thousand deaths so four hundred deaths versus forty thousand deaths due to breast this cancer so we definitely have our work cut out for us to educate women that you know. There's this tenfold greater risk of dying from heart disease in yet compared to breast cancer and yet been don't really look for and think heart disease should be an issue that I need to worry about. Oh and even if you don't talk about dying from it if you just look at the. US population in say will who has cardiovascular disease right now in American women is really one and two. It's over six. Million women are living with some form of cardiovascular disease which is about forty the five percent of the US population compare that to the three point. Five million women living with breast cancer. So it's it's just I don't of course. I want women to understand the risk of breast cancer but I want them to also understand. How under appreciated appreciated hurt diseases for women and we need to do a better job? We as medical professionals and and the community at large and our public public health messages need to do a better job of educating women. And I think it's a little bit Telling the fact that we do get the shortest Boorda's month of the year to focus on heart disease in women. It's usually twenty eight days this year on K.. Were Lucky we get twenty nine days while I mean that is a good point which we get one extra day because it's a leap year You know that's actually unbelievable. Statistic you just mentioned about half of women having some form of cardiovascular the vascular disease than I will embarrassingly admit that I actually didn't realize that it was that high that it was half you know and I know that it's incredibly comments against the number one cause of death for women in the US and I'm guessing also worldwide. Is that correct. Yeah I mean worldwide. Now it is a problem. There is certain countries where they're not heart disease may not be number one but it's one or two but if you look at the whole world in general roll heart disease is the number one killer and so we've got lots of work to do beyond our own borders but certainly at these borders orders. We've got lots to do I again when you look at heart disease now we when we get the statistics from the American Heart Association they. Did you include hypertension as a form of cardiovascular disease so that's also why the numbers are also quite high and you know that's actually you read my mind that exactly where I wanted to go next. I think that one thing that women think of heart disease. I think that immediately people's brains just goes to having a heart attack but I would love if you could kind of elaborate and discuss. How heart disease actually encompasses a lot of things in the risk factors are season? Actually what we are concerned about. It's not just just the actual heart attack. Heart attack is one of the more common causes but there is other things that get categorized within cardiovascular cardiovascular disease things like arrhythmias one such common example is something like atrial fibrillation other diseases like heart failure which is more and more prevalent in our population people might survive their heart attack but they ultimately are living with the consequences of damage edge to their hearts so hurt failures quite common. Additionally there's a form of heart failure that's really more frequent in women known as heart failure with preserved served ejection fraction. And that again doesn't necessarily mean you've had a heart attack but is very common in women hypertension pulmonary hypertension. Yeah and then again. There's things that you could be born with types of heart disease that get categorized in our whole spectrum of cardiovascular disease things like something. You're born with congenital heart disease and hypertension also gets categorized within a form of cardiovascular disease in of course or stroke also is included in there. Absolutely thank you so much for making that clarification because I do find that sometimes even when you ask patients nations I really respect. How complicated is being a patient and sometimes when you ask patients like Jeb you ever had any history of heart disease or any history of You know any medical conditions. They may say no not that. I'm aware of and then you look at their list of medications. And they're on anti hypertensive there on a Beta blocker. They're on a statin and then you may recognize that. They haven't necessarily tied both together and so I can only imagine being a patient trying to learn by heart disease it can be confusing and intimidating and especially when they have to manage a lot of different medications and there's all these different disease processes that are under this umbrella so I think that was really great that you clarified that and I think the important thing That I really do want hit home. especially with heart month is that you. Although there congenital forms of heart disease In general vast majority of heart disease we can really improve with medications and lifestyle sound modification. And we can also prevent and so I was wondering if you could talk about some of the different aspects of prevention that we should be focusing on and how we can entreated yeah so eighty percent of cardiovascular disease is actually preventable so there is a lot of things we can do for Proactiv about our health and the other thing. I remind people as it's never too late. I mean you could say if I already had heart issues. You know. There's nothing nothing I can do what you can do. A lot to prevent a next and so I think that's the most important thing is to empower patients patients. To know there is something you can do even when you have a strong family history so when you know the way that we technically do genetics connectix for most patients. Not every patient but for most patients are former doing. Genetics is asking about family history. Knowing if anybody in your family family had heart disease at a younger age so that means for your male relatives anyone having a heart attack Heart heart disease issue before the age of fifty. I five in through your female relatives before the age of sixty five is what we're really most interested in and when we get that information it does towels a little bit about genetics e we can do some fancy genetic testing that might highlight increased risk. And when we do that we have seen seen that the people that know genetically they're more at risk of having heart disease if they add in lifestyle components to you like healthy lifestyle behaviors. They are more likely to develop heart disease in the future compared to people that choose to to not do anything in terms of their lifestyle. So there's a profound impact of the things that you can just you despite even when you know the genetics or even when you know your family history so it it shouldn't be all doom and gloom like everyone in my family has heart disease yet. There's maybe a higher chance that you might get it but there's a lot that you can do to tried to ward it off in that you know that whether that's quitting smoking sir. Never smoking whether it's a heart healthy diet Whether it's reducing Sultan your diet weather. It's exercising whether whether it's controlling your risk factors. All of them are important for you to do in. Our medications have gotten veteran better over time So there's also think more things we can do now that we may be could do even twenty years ago let alone even five years ago to be honest with you so there's there's a lot more patient empowerment. I would think given all the steps we've made in our research and even for lifestyle. There's a lot more we know that we didn't know before. I mean. There's still a lot of debates about diets. Injured his right but but what we do know is that AH evening more plans to hell is gonNA improve your heart health so more fruits more vegetables. We know if you exercise around around a hundred and fifty minutes a week or more is going to benefit your heart but doing something is better than doing nothing so you know just when we work with our patients were just trying to find out. Where are we at right now? What are little things we can add in to make you reduce your risk for heart disease the such a great point? Yeah I WANNA touch on so many of the things you just said because it's brilliant because you're right so the medications are improving and I actually wanted to delve into to a little later with us. Some of the newer medications that are amazing and we could explain them You know everyone listening to this. podcast knows that focused a lot on nutrition but I do A very very very much advocate for the combination. I think that there are patients. I always say that you know a lot of people come to see me with my plant based clinic and they assume Tom I'm going to say nope you've gone fully plant based you don't need to be on any medications and unfortunately that's not always the case you know. There are a lot of times that we can remove a lot a lot of medications reputation if they lose a lot of weight. They change their diet. They adhere to lifestyle modification sometimes to reduce their diabetes medications their anti hypertensive representatives but in certain patients of certain cardiovascular risk you know they have to continue some of their heart medications no matter what dietary change they make and so i. I really do appreciate the combination of traditional cardiovascular medicine and the advances were making pharmaceuticals in combination with lifestyle modification. John and I know that you are the exact same way so I think it's. It's really amazing that we have so many advances in the in that medication spirit. I do WANNA touch on a few of those meds ads on later on but one of the things I do WanNa ask is so with regards to the components of cardiovascular disease so for anyone listening that's wondering well okay. So I'm I'm a woman and I want to reduce my risk for cardiovascular. Disease Save their age. They're in their early thirties. And they're wondering will what should I do. So where do they start. Start seeing there. I always recommend obviously seeing your physician and your primary care provider and of course always monitoring for blood I pressure and limits. What kind of advice can you give someone listening? That wants to start to see where they're at and prevent developing any sort of disease. Yeah I think a year points are well taken First of all knowledge is power knowing your numbers we always say. No your numbers but really it's knowing your whole heart history ustry or your heart risk factors so going to your physician in saying am I at risk for heart disease would involve them using a risk calculator later. That helps US determine your skin. It takes into account your age your sex whether you're diabetic or not whether you have hypertension or not what. Your cholesterol numbers are in based on that we can at least come up with what your short term risk is which is really your next tenure risk of having a heart attack or stroke and then what is your lifetime risk and sometimes you'll have less wishy when we're younger we might have short are short term. Miskel look really good but our lifetime risk might not look at and that's where it starts. That's just the beginning though. That's the conversation of what do we know. And there's a lot of things that are missing in that equation to a family. History doesn't come into equation but it should be part of the discussion Russian history. Do you have any other risk markers or other things we know about you that puts you at higher risk and for women there are some unique risk risk factors that even for men don't even matter things that can happen during pregnancy. You know so for women if during your pregnancy you you ever experienced things like station diabetes or station hypertension which includes pre ECLAMPSIA or clamps. But also just having having your blood pressure rise during pregnancy is not normal an important thing for you and your doctor to discuss because it does put you at a greater risk risk in the future a developing heart disease other things. That should be part of talk when we talk to. Women are related to having a child early. Ayso preterm delivery meaning that you deliver a baby before thirty seven weeks of just station but even worse if you deliver a child before thirty thirty two weeks regardless of the cause it raises your risk of heart disease in short additionally other things having a baby that small for stations agent and that also increases your risk for heart disease in these should be part of our our discussion about what puts you at risk. And what doesn't put you at risk other things. If you've gone through menopause once women go through menopause it puts them at an increased risk for heart disease and we. At that time we tend to see a lot of changes changes in the traditional cardiac risk factors and we also see a change in women's weighed at that time for not all women but for many women. So it's time I to start discussing what changes we do at that time and again if you have if you're going through menopause if you're gonNA take hormone replacement we spent therapy or not. And what the potential cardiac consequences might be and those are the discussions. We need to be having things. That aren't female. Specific specific but female dominant. Are Things like breast cancer and as a result of having breast cancer. Not only is there some. I shared common risk factors for breast cancer heart disease but some of the therapies that we use to treat breast cancer also increase the risk of of heart disease so not only the radiation that you might get four breast cancer. Increase your risk for heart disease but even the chemotherapy agents things like The adriamycin therapies that are often used in breast cancer as well as some of the newer drugs like occur. Septum is a drug that is used quite commonly now but they do increase the risk of heart disease and if you happen to be unlucky enough to get breast cancer but get chemotherapy and her separation and radiation. Your risk is even greater. So these are things that you might think it's funny why you're cardiologists allergists or preventive cardiologists or your insurance is asking you about these things. But that really is. Why other conditions like lupus rheumatoid arthritis service? These are autoimmune diseases. Their diseases of inflammation and inflammation is so is what cardiovascular diseases linked to it is our again more common in women and more associated with cardiovascular. Disease should be part of the history taking when we're asking asking women about their risk factors for heart disease then we can sit down and create a plan of would we need to do. Do you need additional studies is what are the other things that are present here that would help us make a preventive plan for any woman that sitting in front of us and and the problem for a lot of women is what they go to the doctor you know they they leave definitely knowing you know. Do they need a mammogram do they. Is the breast health good. They leave knowing if they needed a PAP smear or they had hap- smear so they know if the you know if they're Reproductive organs are safe and healthy. But they don't leave off the knowing if their heart is health in. I really would encourage your listeners. To remind their physician I need to know if my heart is also healthy and did is it. Don't leave just knowing what. Your blood pressure's fine. Your cholesterol was fine. Get the numbers asked them because a lot of times people might say. Your blood pressure's fine. When you actually write down the numbers you realize? Actually you know one forty three over eighty seven actually isn't normal or do I need to do about that sometimes. Sometimes you don't have to do anything but at least you have to know if you should be treating it Or watching it or using lifestyle mechanisms to improve it. Because they don't. They're not worried about it enough to start medication. That's fine but you need to know the numbers you need to know your cholesterol number in specifically tell people to focus goose on your LDL cholesterol. You need to know if you need any other type of testing done and that might include bloodwork that might include a coronary calcium scoring again. It's not for everybody but it's important to have those discussions about what needs to be done. This is excellent especially because I have so many listeners. Who are providers of different medical specialties? In a lot of I love you guys out there listening my GYN specialist Out there listening and the primary care providers so much respect to you guys and being a woman in my early thirties my primary care provider has always spend my Gyn prescribed birth control. I go get my check up. And and that's like the OBGYN's are the the providers is that really are catching women in this young period of time where they're really screening them for essentially later cardiovascular risk so it's so important like you said for patients to empower themselves by by writing down their numbers and understanding what normal blood pressure is in cholesterol. And things like that but also for providers that are outside of cardiology to kind of keep up with that. No win to refer to a preventative cardiologist. I end And especially I think it's fascinating it actually goes both ways so then you now. I finding cardiology especially being female and in the end of my training thank you so much overlap with. Obgyn like you were saying with regards to when patients have clamps ya or just diabetes or these certain risk factors in in pregnancy so were learning as cardiologists to really integrate. That into when I'm seeing a patient I should be asking them about. They're Julian history and vice versa. OBGYN's should be asking patients about family cardiac strings like that and that way we can all do everything we can catch. Catch our patients when they're younger and healthier and we can make an impact to prevent future event. So I think it's really great that you pointed that out our. Ob gyns colleagues are are partnered on this front for short. You know they as you pointed out for yourself off but women in general and we ask them who their primary care physician is. They often more than half of women will label a OB. We'll be Guinea doctor in the this group of physicians is actually taken. This on. Pretty seriously unbidden great partners the cardiologists in with the American College of Cardiology at looking at what are the things we can do together until you may have read something that they call the fourth trimester right master which women go through three trimesters during their pregnancy. But after there's things that are identified that do women women at risk for many different diseases cardiovascular being one of them and we've worked in partnered with them. I co-authored width. Two OBIE guy. Ni colleagues colleagues for the American College of tricks gynecologist portion of what we call the fourth trimester. And we wrote this actually saying saying where do women need to go after because the obstetricians will often identify women at risk but it's then them communicating in working with other people people to help identify what needs to be done because it can't just fall on the Either that's not really in view of care but if they can help opus identify women at risk. We can work with them to help them work on lowering that risk. Absolutely you're so spot on. I have had nothing but an amazing easing learning relationship from OBGYN's on the overlap of pregnancy and heart disease and if so much respect for them. And I they actually. My mind is blown with how much they know about cardiovascular disease. It's unbelievable because I find that I don't know that much about obstetrics gynecology. So it's it's it's really my day so much respect for them and I love the work you've done in combination with them to really raise awareness For this because it's really important and it's such a great age range to bring patients in and reduce their risk factors Earlier on in life and and I think that it's really important that it's making its way into a to. I actually think in general. OBGYN's actually a lot more about cardiovascular disease especially population than cardiologists. Know about how how much some of the obstetric diseases the diseases we see obstetrics like proclaims yet affect cardiovascular disease. You know I have an attending. I work with who very much works with the OBGYN's he's a lot of the pre ECLAMPSIA patients have things like that and she's drilled in my head that that obstetric history is really important in our female all patients but that's not incredibly common in cardiology in general for that to be hugely present in our history. Taking things like that so I think that the awareness in the work you're doing is bringing it. Far More to the forefront of cardiology and making it a huge part in our practice with our women patients. I totally agree with you. So they for that so moving on age wise. So we're out of our thirties. And so now say you'll be patient in their forties and everyone always asks me who needs a calcium score and I have many opinions on this because I happen to really like calcium scores But I wanted you to give your take and kind of explain what the test is because everyone always wants to know. Should I have what when should should I have one. How often should I have one and I think they're I think they're great test? I'd love to hear what you think about it. Yeah I think the use of coronary artery calcium really helps restrain affi- a patience but you gotta use it in the right patients. Not every patient needs it out. Everyone needs it every year which You know it's funny. How again most commonly insurance really doesn't cover this test? Unfortunately maybe that'll that'll change one day. But there is certain groups like A. I remember when I was in Chicago all firefighters. Every year could have a coronary calcium. Score and I did never understood why they go. Hewlett which was but it was always you know again. You don't want to always get test unless they're going to be helpful so I think that I use coronary calcium score in the people that I know based on risk markers I can't I still don't have the the answer. Are they at greater risk or not for the people that are what we would classify as intermediate risk and particularly people who have no other other traditional risk factors present but they have a strong family history That might be a really ideal person to use coronary calcium score on because it may add to the information of what can we do for this individual and not just just one example. But I do you think that's where the personalization comes into play in medicine that you know you personalize it or use precision medicine by looking at the the individual in front of you and deciding can extra information help you. Further risk stratified individual. The great thing about coronary calcium. Scores in general The they if if they're using the more modern technology getting very small amount of radiation in prior studies studies. You used to be that. There is a larger doses of radiation but the newer machines really are very small amounts of radiation. And and so. That's one good thing 'cause for a woman specifically just have to know where your heart is and where you're left rest is in there pretty darn close So so we don't want it. Needlessly radiate women in somehow be affecting breast Arrest Health but given that at this is sometimes what we can do in an help or stratifies somebody and make a decision to someone. Need more aggressive. Lipid lowering during therapy. It might come from coronary calcium scoring and that is you know we have a lot more predictive information from studies. Showing when you get coronary calcium don is especially. If it's if there's no coronary calcium score if the coronary calcium scores zero it it means a lot in when there is a calcification. It's greater predictor of future cardiovascular risk so it may be more helpful for us to know who we should should be intervening or in terms of risk classification. Putting people into the right boxes. I guess to know who would benefit the most from our therapies therapies I love that. That's actually point because you're right. It's not something that we need to be doing for every patient every year. But it's definitely a by by any means especially not every year But it's definitely a great tool that when used with the correct patient in a discussion Shen with your provider it can be really beneficial in certain patient populations and I think that there's also a lot of confusion You know people try I to do message me often. 'cause they are confused about what is a calcium score. Exactly what is a calcium score looking at what is it evaluating. If you don't mind kind of touching on that will sue coronary calcium is really looking at First of all qualify I am not a cardiovascular imager but I use the imaging to help right If any of our colleagues who are specifically involved C. T.. I hope I don't do a mess up How they would better describe it? But the way that coronary calcium scores or imaging work is they're looking at Calcified plaque knee arteries and were able to see hit. If it's calcified so first of all that is more useful obviously as we get older to some degree because it has to have been around for a while in the younger you are sometimes coronary. Calcium scoring in a younger woman might not be helped because we if it hasn't there might be atherosclerosis development. But if it isn't calcified we're not GONNA see it on a calcification scoring tool and I just want you know. There is those limitations in it but if it's been there for a while can better help us risk. Stratified them because we're literally looking at the Coronary Korea. Arteries were seeing calcified plaque. And I think that that also helps us a lot when when people see the anatomy because a lot of times when when we do these studies will sit down and look at the study with the patient they can appreciate. There's my heart there's the the vesicles and there's the calcification of -cation and sometimes seeing is believing so there are studies. You know done like Scott Heart that we're we were able to see that people were more compliant with medication in those people who got coronary calcification done scoring done. And that's partially because I really. They do believe that sometimes when you show patients these studies and they are able to visualize it and see it. They're more able to understand it. I think one one part of medicine that you touched on earlier is just sometimes patients. Don't understand and if they don't understand we haven't done our job and we have a lot of times times we as physicians to explain things sitting around down in explaining to our patients. What's going on is probably one of our greatest latest weaknesses as doctors And I think that something. That's wire patients often leave our offices. Not Clear on what's going on or not it clear why they've been given a medication. There is something about coronary artery calcification and a patient seeing their images that they leave better able to understand the disease. Better able to understand. There's something in my arteries that shouldn't be there. I need to. They not allow it to build up any further. And somehow be more proactive about it. But there's but it does require again the explanation exclamation to them. What we're doing why we're doing it and I? I hope I didn't simplify that two mile and I'm glad you did. Simplify that was well said because because I think that makes a lot of sense the points you really hammered home honor. That and I think these are important. Is that you know medicine. In general whether it's attrition therapy be medical therapy etc you know. It's a partnership with our patients and shared decision making and. I think that it's really important that some you know the option of something like a calcium score not saying it's meant for every patient but it's just part of the shared decision making process in in an appropriate patient and I. I do think that it's great that we have this technology. Now because you know calcium scores a fast screening test stun without contrast but the the thing. I do think that you hit home on. That's important is that it's we're looking at more of a calcified plaque and even calcium score of zero although reassuring bring it doesn't necessarily mean that even with the calcium scoring zero it you could still have soft plaque so it's essentially calcium. Mm scores a piece of the puzzle piece of many factors that we look at reduce. Our patients refer cardiovascular disease and it's just one one of the tools we have and I think you did a great job breaking down so I appreciate that. Thank you for breaking down just kind of where we use it in the process and I actually do want to ask you. Do you ever for us. The Astro charm at risk stratified. The one that includes calcium scoring IRA syrupy so I use the ASC VDI restore in most is patients use the Mesa risk score if they've already had a coordinator calcium scores so In the Mesa. You've gotTa have the coronary calcium value to put in there to restrict to use that risk factor. Knew that I use the most I love it. Yeah they 'cause the ASC cvt one doesn't have calcium Scorpions neighborhood. Explain why we might get it right right right. I in the great thing thing about those risks scores. Is You know they're on your phone you. Can you calculate them in front of our patients and our patients can understand. What's going into our risk assessment? Smith why were doing. Why were suggesting things because the great part that? The American Cultural Cardiology in the American Heart Association did by putting it in a way in with the explanations after it the ASC BDO risk APP is really excellent for Understand even if view do one therapy how will it reduce your risk. And you're able to show a patient you know if I treat your high blood pressure or if I treat. Treat your cholesterol what you know. How does that lower your future cardiovascular risk and that's also empowering for the patient so empowering hiring and that's a really great point especially because you brought up Scott Hartman so important that just bringing our patients into the level of understanding what's going going on inside? Their bodies makes a huge difference. So anyone who's listening to this. Have the conversation with your provider about what kind of testings appropriate. You know. You may not need all of it it but there are certain kinds of testing and different ways to figure out your risk for heart disease than I do like that. You also hit home on that. Everyone's an individual. And now we have the opportunity to individualize our treatment or care for our patients in screening. And things like that so you know. Now it's even newer technology on the pharmacological aside. I would love for you to talk about so for our patients with pre existing heart disease and we want to prevent further events of course lifestyle modifications incredibly important and we hit on that a lot. But I would love for you to talk about the difference between you know because people are always curious about the difference between medications like statins and the newest medications the pse canine inhibitors and new medications. Like the PUP. Yes you know when we are first line. Medications is always In terms of particularly lowering cholesterol lowering out the L. R.. I I am munition of course can be diet lifestyle but then in terms of medications the one that we have the most evidence out there longest use drug is is now the statins and we have a lot of evidence related to statins not just lowering. LDL But in terms of reducing cardiovascular events reducing mortality it. I will say statins get a bad rap on. There's a lot of naysayers to STATIN therapy. Certain certain heart disease if you've had a heart attack. It's clear that that medication can be life saving and reduce your risk of future events so there there can be side effects of statins that get overblown. I don't I don't mean to minimize people that truly have Myalgia from from statins. There is people that have that again. We can work with our patients to try to reduce the muscle aches. They get the. I'm not trying to minimize that. They truly have wrecks because I know from running Olympic clinic that many patients more than I think that the trials truly do have have some side effects but there is things we can do to work with you with patients try to minimize the side effects and so but statins batances one one medication. We are really in an exciting time preventive cardiology because there are so many new drugs. Jobs out there. That are part of our ammunition that we can use to reduce a cardiovascular events An cholesterol cholesterol is just one one part of it so we have a lot of data in the last few years over. PCs Canine inhibitors. NPS K nine inhibitors Really work whichever whatever way they some of them have different pathways but ultimately inhibit the PCs canine receptors. In whatever way that they work and I it's hard to get into each of their individual ways of working but one they there's really great data And I think in the last last year Gosh I can't remember what it was two thousand eighteen in two thousand nineteen that we had data related to to the Odyssey study. Yeah such study that showed that with a PCSK nine inhibitor that we are able to reduce not just LDL cholesterol. Nice job because that was shown much earlier before the study results came out that it was good a good drug that lowered. LDL So that that looked promising when it first came out just the fact that it lowered Ldl but what everyone wanted to know what it reduces outcomes and it did so they were able to show that in in terms of major adverse cardiovascular events whether you talked about deaths due to coronary heart disease. nonfatal myocardial infarction stroke doc or unstable. Angina it did reduce the cardiovascular events by fifteen percent when you're to placebo in these drugs are injected. What did So for this particular study it was injected every two weeks and that again was on top of Statin therapy the maximum step their p what Odyssey found in particular was that it in those people with a higher. LDL They were the ones that benefited the most. And that's not that surprising. I mean of course if you're cholesterol's hired navy you are able to tolerate maximum. You know the high high intensity necessarily or your cholesterol was so high to begin with even though it got your cholesterol down. It's still wasn't where we needed to be. Because because basically most of our studies are showing that the lower the LDL the better and so getting your LDL cholesterol down lower was better and so that you know Odyssey was a game changer. And as a result we are able to Use PCSK nine inhibitors in people. People who have a statin intolerant with disease whether they have statin intolerance or if their LDL isn't low and it may be be something and again remember. Odyssey was people who had had an acute coronary syndrome at least in the last year So starting initiating this on top of Statin therapy so now we have a at USC in twenty nineteen we did actually have another another interesting study. Related Pcsk nine inhibitors called their Ryan Study and the Orion study. The results are aren't out yet they released at. USC was just what their LDL lowering power was in a type of PCSK nine inhibitor. That does does not need to even be injected as frequently as the type of drug that was used in Odyssey in when if you think that of PCs canine inhibitors a very simplistic way. The type of drug that was used in Odyssey was kind of like where sink is overflowing knowing your mopping it up it. Think of a Ryan the type of PCs Canine inhibitor. That they use their if they could turn off the TAP. I love that analogy. So they're different. They're in the same family of drought and they all are labeled. PCSK nine inhibitors. But they're working in different mechanisms so we're looking forward to the Orion results that will come out. I guess in time. I don't actually know when they're going to come out but we know they will in the tell us the same thing as it does it even matter. Is it the type of drug or is it just that we can if we use them in this way were all. We're GONNA see great outcomes and that's I guess the question for the future. We've had other drugs as well recently. Come Out as part of our preventive preventive arsenal. I mean there's the Sglt two inhibitors are drugs. That are really for diabetes. But you know like a lot of drugs that start out for one reason. End Up being used in our cardiovascular a community for something else I think that S. Gop Two inhibitors are going. It'd be part of that family Because what we're finding in and I know you didn't really want me to. I know what you're talking about cholesterol but these drugs really really being used I think are going to be the future for people with heart failure whether or not they have diabetes or not because the data heart failure earlier study that was released. I think I'd yes see although I might be wrong in it might have been aged. Can't remember now when Depp was released least I feel like it was the se but anyway They use these people who had symptomatic heart failure in the rejection. Fraction had to be forty percenter percenter lower end no matter whether they had diabetes or not they were randomized to data either getting the SGLT two inhibitor compared to placebo and they saw that there was in those people who received the GOP two inhibitor. They were more likely to have a reduction in the primary outcome which was cardiovascular death hospitalization for heart failure or urgent heart. Failure visits in also in their secondary outcomes of cardiovascular death and there was no worsening of renal function in those people who received that or not and it didn't seem to matter if people were it diabetic or not it wasn't just the diabetics who benefited from it. It was also didn't matter if they were older. They the benefit if it was still there so again these drugs. We've got to keep our eyes on because I think this is GonNa be a really exciting era To know how to use these drugs and I do think diabetes is going to become also more of a mainstay for general cardiologists preventive cardiologists. Even if they don't want them to be. Yeah it's our playground to now your other point about Omega threes also being another new not new because because we're talking about Omega threes for some time about what the role is but reduce. It was a really important study that was released released in this I believe was released steady. SC In twenty nine teen and really exciting study. I might get my where they were released wrong so I apologize. It no worries all linked to them in the show notes Yahoo Study was very important. Study and you know we. This was specifically addressing for people with high triglycerides in either high risk or already having cardiovascular disease. He's what should we do about the triglycerides lab value saying that they're elevated but we don't act we've never really known. Should we be treating it or not and and this study elegantly showed that if you randomize people to the specific form of Omega threes known as a Khoza was a Penta Ethel where they gave to twice a day in compared to placebo. They looked at if it reduced schemic events and and cardiovascular outcomes in it showed a really remarkable reduction in both the primary endpoint in the secondary endpoint in this particular study with twenty five percent reduction really in cardiovascular deaths. NONFATAL is and stroke as well as as the secondary outcome which I believe was cardiovascular. Death nonfatal I or stroke as the primary outcome was all of those three three things but also reduced their eyes ation unstable angina. I believe that was the primary and it was a very dramatic study because because it was using a different form. Mega three ranked does high dose. EPA's rethink we're talking to milligrams are two grams of hydro. CPA No Dha just is chew grams of high dose. EPA BE ID so you're getting four grams of high dose EPA ISOLATED EPA not. Hi It's fascinating in its in. Its a prescription form No over the counter intake that has this would be even tolerable to get that form of. EPA A concentration. And believe me even if you buy over the counter they will have. EPA WE'LL HAVE DHA also have content other contaminants and so you really. They do have to be careful even when people think that they're getting something or taking something to be incredibly expensive as well to get the amount of EPA a that you get in the prescription form of this which is known as the SEPA. There is a lot of again a lot of people who think well over the counter owner is safer and I would just beg them to really know what they're putting into their body because there can be even from fish oil issues with it or even intolerance from what they take over the counter but they're certainly not getting what was used in reduce it and I've even had were pharmacists. Have advised advised patients. Oh you don't need the prescription for him here. Just take this nation. Spend a lot of money on these medications and it's not the same medication so you know At American Heart Association Doctor Bod even showed further just the US data because people did WanNa see what about just the the American patients in fact in the US there was actually even a bigger benefits. Seen in those people who were treated with the a high dose EPA compared to Placebo For All those same primary outcomes in secondary outcomes so it's really Changed Changed FDA approval pretty quickly thereafter. Just a few months ago. FDA approval has been given for this indication. And and I again. I think if people are using them right the drug they should be getting him. Being prescribed is The state but and it shouldn't shouldn't be over the counter. It shouldn't be another form of either other forms of prescription fish oil. So something for people to talk to their patient talk to their physician about if they think that this might be an appropriate drug for them and I think we'll be learning a lot more more about reduce it. The story hasn't ended from there for sure and Thank you so much for covering all of those trials for anyone listening. That's also a cardio cardiology fellow like me. It's like a Nice Succinct Board Review. So thank you. Martha was amazing. And you're right. It's like such an exciting time to be in preventive cardiology because these medications that are coming out are just so powerful and and we are able to use them in Wide Variety of our patient populations and they're really exciting and the mechanisms to a really interesting for each one I think the Sglt two inhibitors. Inhibitors are so fascinating as well. And I think that also what's really interesting to a lot of the pharmacology that And the you know the different treatments that are arising really does kind of reiterate to me how much Metabolic Syndrome in general and how much our overall metabolic health health is completely intertwined with our cardiovascular health. You know because it's all of the medications target different parts of our metabolic health and especially now that we have such an overlap between diabetes heart disease so it really does just reiterate and tying together that our bodies one on you know moving system and everything's connected so you know everything in our lives from our stressed what we're eating to how much we exercise it all. It's all related. Aided yet it's all tied in together. That's why we've really can't get away from being involved with treating or dealing with diabetes or we're dealing Wait and dealing with people's Diet and you know as you know very few physicians are well educated about counseling on Diet and even our community is quite fraught end split about what's the right diets. And what's the advice. We should be giving patients and so. I think this is an area. We all have to work together on because I think it's it's vitally important. We find the answers. And vitally important important that we be able to connect all pieces of the puzzle and in fact this year the another important study that did come out was at the American College. Joe Cardiology I believe. In March of two thousand nineteen they released the prevention guidelines in the prevention guidelines. They talked about the. ABCD's he's in ease if you will of CD prevention and really trying to put it all together as this is our. You know all of our job. Is You now for whether assessing use or risk of aspirin blood vs for blood pressure sees both for cholesterol in cigarettes. Da's diet which also has to do with weight in diabetes and E for exercise and then putting that all together and working talking with our patients in terms of shared decision making making a team based approach and also incorporating economic and social factors is sort of how they put this puzzle together for all of us to be talking to our patients about every part of this if we're really doing prevention. I love that I love that. Entire Algorithm that they came out that such a easy and sustainable way to start integrating the unto practice and thinking about all the different components that go into you prevention because it really is a three sixty holistic approach. It's everything it's cultural it's environmental. It's everything so it's so important to evaluate valuate our patients and be able to meet them where they're at and discuss all the different parameters so I really liked that they discussed that and you know our provincial guidelines although there is some debate in the nutrition nutrition world. I will say in cardiology the American College of cardiology prevention guidelines. That came out with the nutrition recommendations really do support and follow what you and I both believe in and no and no to be true from nutrition science that you're although we don't have all the nuances figured out exactly in nutrition science overall are Rac- see dietary guidelines recommend like you mentioned before fruits and vegetables whole grains legumes nuts unseats and You know Minimizes processed foods. Fast Food Fried Foods and If you're going to animal products to stick with lean meat or fish to avoid a Processed meats things like that and really emphasizing just eating a lot of very plant forward a plant predominant diet and I think I think that that is something that a lot of different dietary tribes You know in general agree with And then you know if we could just really emphasize our patients patients even just cutting out sugary drinks and processed foods can really make a huge difference and the other you know small nuances. That people still debate over aren't as important as the overall huge picture which is getting more whole foods exactly and I think you know as a society not we have a lot of issues with our whole food and convenience and everything has changed in the Repentiti in which we expect food. She does well and you know it's just about working with our patients on the things that we can change and be able to get them to make little changes. We know that that's how little changes that can stick in May eventually accumulate too big changes but just in terms of diet. I think you know we won. Diet is a challenge to study. Is he diet any diet Involved in research will tell you that their dietary studies to follow them to know the you know to even track. The impact of what one patient is eating versus another person is very difficult and additionally we should be we don't. We have very small numbers of large enough studies to be able to say the impact impact on cardiovascular health but we do know is that in general like you said the whole foods the plant based diet the more fruits and vegetables that you're putting putting into your diet the better. Your health is going to be We know it's GonNa Lower your height. Your blood pressure's GONNA improve. Your cholesterol is going to improve improve your blood sugars. If you're eating the right foods and that's a good thing in ultimately that's going to impact your health and you know whether you eat meat or don't eat me those things we've gotta work with what people are willing you and I think that that's GonNa make for if we can just make it easier. You're in more accessible to access fruits and vegetables whether that's putting gardens in neighborhoods putting markets affordable markets in neighborhoods. Leads whether it's teaching people to do it themselves. I mean I'm really lucky. Right now I live in Arizona so there's probably like three months of the year that I don't grow my own vegetables. Oh my gosh. I have to interrupt to anyone. WHO's listening to this after? Follow Martha on twitter and Instagram. You wait give your handle right now. Oh It's just at Dr Worth Galati that's G. U. L. A.. Ti Okay. You guys have to follow right now. Because her garden is amazing and it is so phenomenal. I dislike live living in center city Philadelphia and a high-rise where I can't even grow basil. I just live just vicariously through her gorgeous garden where you grow so currently. Are you growing serrate now. A have a peppers peas carrots spinach copy flower. I think some animal has eaten all my Broccoli. I said I am herbs Kind of lost. We had a little bit of the cold spurt here in early January so I did lose a few vegetables that way and actually my herbs kind of died on me at that point so we'll replant plant them now that it's pretty consistently warm but really I mean we pretty much grow almost all our vegetables year round. Aside from the heat of the summer you're limited. There's some things I can grow but not a lot also have a fruit like I have oranges grapefruits. The woman reminds right now. And that's a very defined season but that's now so we're kind of we're really are lucky. I I used to grow when I lived in colder regions that but I only have like three or four months that you could grow something so. We're very lucky here to do that. But the more we can do that I think people I know just from growing at you have more pride you want to eat out of your own garden fun to say. Almost everything came came from my garden. I think that if we could empower people in American Heart Association is doing this in communities. Or they're helping growing gardens pardons and I know even some hospitals will use the rooftops to grow food or make gardens where patients can come in pick. I think the more where we do things like that. I think it's going to be not only better for environment but it is gonNA teach us to use food and reduce our carbon footprint imprint all of it in addition to making people eat more. Because I'll tell you tastes so much better when you grow it yourself. I don't know why I don't put any. I don't spray any my food so there's no chemicals so that that might be why it tastes different. It is truly organic. It's from my backyard. It's not fifty percent organic it's true and it's there's something about it. I guess that you no. It hasn't traveled very far from my garden to my dinner plate. So it's GonNa be juicy earn sweeter than going from a farm to you. A grocery store might be sprayed with preservatives. So the last in the store till somebody buys it. I don't know but it definitely taste. It's really really good. And and even the carrot haters out there when they they eat. Mike Care with Mama's is listening to buy huma carrots when he visited. You actually grow the world's Oh gosh everyone listening. Please go to Martha's twitter right now. You grew the world's world's biggest carrots like there. I've never I've never seen anything like that in my life. They don't sell those at those. Big Carrots were mine. Orgy were yours. Were at marked. Her Bells Tar Bells is a very famous restaurant. He had those massive carrots. My cares more more heirloom like. They're like they're big. They're not they're not small but they're they're not as big as I thought it was your. It was like a three foot Karen. Yeah I thought that was your character was so impressed with your farming skills. Well just to pivot a little bit. I totally agree with everything you said. And I'm I'm so glad that we touched on the important prevention. Both medications and lifestyle and back to women's health did WANNA discuss what your thoughts are on the the perceived differences of how women and men present with cardiovascular disease symptoms because sex differences in the presentation of heart attack cardio-vascular disease symptoms are sometimes emphasize a lot op. But I know you have a really great and interesting take on this so I would love to share your thoughts you know in so i. I might contrast contrast a little bit to what people think. I'm going to say so again. We often had been fraught with the idea. presented with the idea that maybe women presented differently ended is true that there may be some symptoms and things that are different about women. Certainly we we can get into that but I will tell you for symptoms. I feel like we've done our women disservice by talking about the sort of atypical. Typical nature of symptoms and then somehow convince them that when they have typical symptoms that they are having heart disease. It's important. I'm so glad you're discussing this. This is just so so so important. Okay I think the public health message should be that when you have chest pain or chest pressure. Like symptoms is more likely to be a heart attack attack that and it's ever men and women. They need to know this. In fact you know the idea about this atypical nature of symptoms. You know we've had two two important studies presented almost simultaneously at USC. The first one was called the air may study In the study used are artificial intelligence using cardio linguistics basically. It listened into the conversation of the patient Chest pain and and one that it heard what it try to capture as did the patient say something about chest pain and it was able to see that ninety percent of women in in ninety percent of men actually reported a chest pain. Now those people that you know especially they went on to have a cast and they they were found to have obstructive disease in this was important very important study but what it also Did Oh you by using this. Artificial intelligence did say that women were more likely to report a typical symptoms in addition to do the chest pain so they are more likely to describe some other symptoms if you will in addition to that their symptoms in that's been shown again on an again the other study that was presented at Ese was from the high stakes group and the high stakes group is your it from the UK where they really helped us define the new tr- opponents the new high sensitivity to proponents that were using. But what they did is they also so look at people who went on to have a myocardial infarction before compared to those who had not no myocardial infarction and looked at their symptoms symptoms and the typical symptoms of pain in the chest armor jaw dullness heaviness tightness pressure aac squeezing crushing or gripping. Were again more likely in people who had a myocardial infarction and in fact were more present in more typically present and in women than in men who went on to have a myocardial now. It is true that those people who did not have a myocardial infarction may have had less typical whole symptoms. But again for those who have myocardial. Infarction was more common the other study that we have that because you know younger women. We didn't so much vote younger women in the Virgo trial looked at that they just looked at women under the age of fifty five compared to men under the age of fifty five in there. They did find that younger women and younger men about ninety percent of them presented with chest pain chest pressure tightness of chest discomfort comfort. The only thing different about women as women were more likely to present with three or more additional non chest pain symptoms so my question to you is is. Are we not listening through the word chest pain for women are we somehow biased to how we listen to women in. That's partially why I always say so. You must listen to women. Because I think we're not always hearing what they're saying in. Maybe we have preconceived biases expectations. But we certainly know from Burgo. The younger women are more likely to have the typical symptoms in from Air Maze in high stakes. Women of any age the are more likely to report chest pain and so we we just need to be aware of that. It's not to say that they don't report other symptoms they do. They're more likely to be more descriptive than men. But somehow we're not hearing. What are women? Patients are saying that is such a great explanation explanation of the totality of evidence so far of how we evaluate our female patients and This is interesting I. What are your thoughts on on that B. M. J. study that came out I believe it was b. m. j. where it was they evaluated? I think it was in Florida where they evaluated female patients that were treated by for cardiovascular. Disease were treated by either. A female physician a male physician or male physicians who had a lot of interaction interaction with female patients and female physicians. And they kind of stratified how the patients did when they were admitted to the hospital with concerns for chest pain or acs or or something like that. Do you recall that study. Yeah Yeah and turned out that the female patients that were being cared for by female physicians ended up with the best outcomes right. That's true so people that presented to emergency rooms if they if they were presenting with Believe Steve Symptoms of Acute Coronary Syndrome. or went on to have an acute coronary syndrome might have been the actual study they if there was if there are treated by a female doctors. Interestingly women patients did better than when they were being treated by male doctors male patients did well with male. Physicians is but also equally well with female physicians. If you were at an emergency room though that had a high number of female physicians working there than the male physicians actually did better than the ones that were at places where they had less women so making an argument potentially chilly that there's a reason to fill your emergency rooms with women. Doctors War at least achieve equity because that is a big issue in in medicine in general about where the women are. But I do think you know there's a lot of things about those studies that are imperfect in the irs admitted admitted that we don't know the first physician versus who took over who initiated Who've been no those parts of it but it is interesting to see? See that women Physicians do actually. There is some data that there is value to us. I think none of neither of US would argue with that that that there is value to female physicians than I would say for female cardiologists. I think we we certainly are minority. You were talking about. How the the numbers of cardiology fellows? But when you look at number of cardiologists we still remain thirteen percent cardiologists in the United States weights. And even worse. If it's if you're talking about interventional cardiologists or electro physiologist and we really you know we know that there's a need. There's a the need for our workforce to be diverse to look like the patients we care for so not only should they look from many different backgrounds in braces and upbringings bringing but also by a sex and gender we need to represent our society because then we learn from each other about the things that impact their health and impact. You know if if people from other cultures will sometime say this person would never do this because they won't say that to you you because of whether it's a religious thing whether it's a way that they're run up the way that their society reacts the more we we have those people people in our medical community the more we look like our community. The better will be equipped to take care of. The people in our community has a great point especially because I think that it is important to diversify and make sure that we are listening to our patients no matter what what we look like whether we're female physician physician no matter what race we are. We have to listen to all of our patients equally and consider all of their concerns equally. You know one thing that I noticed my female patients often do which breaks my heart and makes me also think about how women then how there may be different outcomes with female versus Mel patients in these different scenarios is whole lot of times. My female patients will be like apologetic. They'll be like oh I can him just having anxiety anxiety anxiety. And it's truly it's actually chest pain or palpitations. Or they're going atrial fibrillation and a lot of my female patients. I I so focused busy on caring for their family or their children or a different family members and and they don't put themselves first I and they sometimes almost minimize their own symptoms. I think women in general are really tough and I think just You know now oh anytime. I hear my patient. Female patients say to me or any patient in general but when fuel patient says to me I'll I'm having these symptoms but maybe it's just things -iety it may be anxiety but I always do a deeper dive because I do find that sometimes. My female patients aren't Giving themselves almost enough credit. Wait for the symptoms. They're feeling I think that we we know that that is true. I mean women. In general tend to be more likely to be a caregiver in there will be more likely likely to get their husband to emergency room. It will in a timely fashion but they won't necessarily prioritize themselves in that means they don't prioritize your ties their health they they also don't want to bother people as well and if it isn't their heart there always wondering well you know they're gonNA think why am I here so I think that that's one of the messages. Were trying to communicate to women that you know in order for you to be either to take care of everyone that you take care of you have to be there and will heart disease kills the more we can get you while Obviously first and foremost we'd love to prevent heart disease but if you are unfortunate enough to have a cardiovascular event that we you know there's great treatments out out there but we gotta get you to the emergency room fast. We have to treat you quickly. And of course there's some onus on us as physicians to initiate that treatment But we can't do that if they're not in our emergency room and we know that you know like we talked about. The one. Study virgos studied the younger women. Study there it was delays in women getting care but there's also delays in the woman themselves thinking what their symptoms were due to and we do attribute a a lot of women symptoms and diseases to anxiety. It's interesting how many patients will come in. I remember this one patient very well of mine You know she her first visit with me and she said you know. She's talking about these palpitations and she said she was put on an anti anxiety drug because everyone was telling her she was crazy. Easy and I said okay. Well you know I will let me give you a monitor. She took a monitor home. Naughty our past. And she went into intro fibrillation. Now add that symptom and I called her and I said you know. I know you had that symptom again. And guess what you have atrial fibrillation relation and then we were actually able to get old records in the meantime and we found that even a physician who told her it was all in her head. I looked through some other other monitor. She had and she had actually had atrial fibrillation documented as long as five years previous and long time. She was kind of fighting with herself. As this in my mind and my making it up and as you and I know atrial fibrillation in and of itself isn't a big deal except that it can cause ause stroke rain. Thank God she had never had a stroke and we were able to deal with it and treat it and you know. She's doing very well as as far as I know. But you know these this is the I always say again. Listen to women Listen to women listen to women it is not in their head right. It is not in their head and in fact women are quite in tune with their bodies. They know when something's change and they did their you know we need to be at least looking for common diseases for sure for women listening they. You know you're right. We as providers have to listen to women for women listening to this. Listen to yourself listened to your body. Anything abnormal don't feel like you're inconveniencing your doctor by bringing it up. Don't feel like you're overreacting reacting if anything I find my female patients are under reacting. Because they don't want to inconvenience or You know or worry about themselves but you should worry about yourself because like Martha mentioned you know you can only help your family and help your husband and help your loved ones. If you're taking care of yourself yourself first and so listen to yourself and listen to any symptoms you have and take it seriously and talk to your provider about it and feel like your will you're experiencing know that what you're experiencing matters and should be respected and treated accordingly. Well my last thing I want to talk to you about out Martha was with it being today. The first day of heart month for all of February. What do you want the big take home to be see for all of the women listening to this podcast about heart health? What can they do starting today to make sure that they prevent themselves from having heart disease and what should be their big takeaway for her month? I would say if you don't know here at risk for heart disease that's your first step is to find out. Talk to your doctor after about it because without talking to them you won't know and then I do think that you know every day we all are imperfect human beings. 'cause we all are things that we like and things that are weaknesses. And you know there's like I told you that one point the conversation. There's no age that it's too late to try to prove your and there. There's nothing that isn't possible so making making little changes is perhaps the best thing like every day I would I say to people is it. Can you find one thing in everyday to do. That's good for your heart whether that's exercising whether that's getting off your couch whether whether it's choosing for dessert the apple verses the cupcake reward yourself champion yourself and celebrate. Those little victories in those wins the more good things you do for your heart the better are you will be taking care of it. But it's just taking baby steps and celebrating those wins and if you're part of the younger generation that needs to capture capture it with instagram instagram. Ending it a picture of what what you ate to your best friend or to yourself. Go ahead and do that but you know it's it's just sometimes it could be just like I didn't put butter on Sandwich or I didn't use mayonnaise today. Okay okay that's your win this like when we need to find happiness in everyday find heart health in every day as an more that you do that that I think that you start looking for that change. What did I do today? That was good for me. You might have done ten things that were bad for you. And that's okay. If they found that one good thing. I didn't use the Salt Shaker today. I can talk that tomorrow or didn't eat dessert today. I can maybe do that again one sometime this week or you know skip the chocolate. You know whatever you can do. It's a win. And it's a challenge for every wind There's things that we all we know are maybe not good for our health but we might do so just finding little victories. He's I think will help. You feel empowered but knowing your numbers will also help you feel empowered and if I could leave you with one thing thing that at least remember this share with your women friends in your women patients and the woman you love is heart. Disease is the number one killer of women but lack of awareness is a close second. The Wall can be aware of your wrists. The more likely you are to be able to empower our change. That was so beautiful. That was so amazingly sad. And we'll end with that because that was absolutely perfect. I can't thank you enough for for sharing and spreading all this awareness about women's heart health for all ages and giving actionable tips that we can all use to prevent heart heart disease today. So thank you so much Dr Galati please remind everyone again. Who's listening where they can find you on social media? Yes you can find me on twitter at Dr Martha Galati spoke to you. L. A. T. I N. same on Instagram at Dr Martha Galati thank. Thank you so much Martha this incredible. So thank you so much for taking the time to talk about women's helped with US pleasure.

heart disease American Heart Association Heart heart disease diabetes American College of Cardiology breast cancer Board of Women Heart Dr. Martha Galati Chicago United States hypertension OBGYN Arizona American College of Cardiology Scott Heart Phoenix coronary heart disease.
Dr. Vivek Murthy on media coverage of the pandemic, the president's mixed messages, and the uncanny timing of his new book 'Together'

Reliable Sources with Brian Stelter

37:47 min | 6 months ago

Dr. Vivek Murthy on media coverage of the pandemic, the president's mixed messages, and the uncanny timing of his new book 'Together'

"So many profound events so many major stories are happening simultaneously. We are all experiencing a devastating health crisis for the United States and much of the world. We are living through a self-induced economic coma and are we also experiencing a social recession. Is that another one of the risks of this pandemic well. That's one of our questions here on this week's reliable sources podcast. So let's cue the music. I am your hosts Brian. Stelter come into you as I have been for the past month or so or a little bit more From my apartment in New York City I think everybody is getting pretty good at this remote recording remote producing business. And everybody's wondering how much longer it's going to last so my guest today. I can answer some of those questions. You know that we use this podcast to go. In-depth with media leaders and newsmakers today. I've invited Dr Vivek Murthy the former. Us Surgeon General under president. Barack Obama to join me to talk about The media coverage of the pandemic what to expect in the months ahead and his new book which is about loneliness and the way to heal by coming together. Of course he wrote this book well before the pandemic the title of the book is together the healing power of human connection in a sometimes lonely world. He argues that humans have an innate desire to connect in that loneliness is a real serious public health. Concern so now. Dr Moore is promoting this book at a time of social distancing released a physical distancing so. Let's dig into that in a lot. More Dr Martha. Thanks for joining me. It's nice to be with you. Brian. You're in Miami. I'm in New York. Were together virtually. And you're on this book tour. Pretty virtually what's it like to be releasing a book in the midst of all this while this is certainly not how. I thought the book would go. But I also didn't think that two years ago when I thought about writing a book on loneliness and social connection that it would be even more relevant In this moment than than it was before. But you know it's it's a whole new world and what I'm finding is that there is a extraordinary amount of interest in this subject of loneliness and isolation as I think. People are asserting to experience that even more so than they usually do in the light of physical distancing that we're being asked to observe to prevent Kobe nineteen physical distancing not social distancing. I kind of wish. They experts in the bigwigs had got that language a little bit differently in March when this all started. Yep physical distancing is what we need to do separating ourselves physically from other to reduce transmission but whether or not that results in social distancing is up to us and then if we do nothing differently but I think this is actually a time where we need stronger social connections and ever as. We're all struggling with this stress. And the uncertainty of the moment right. So we're taping this on Thursday April twenty third It's been more than a month now. Since most of the country's been in a form of lockdown or a stay stay at home can you evaluate the media's coverage of the past month of the past five weeks have the national news outlets mostly done the right thing trying to educate the Public Martha Critiques? You would share. Well I think for the most part I I find. The media has focused on the critical issues on how many people are in being directly impacted from a health perspective on what the economic impact is. They've also increasingly focused on what the key infrastructure parts are that we need to get right in order to be able to open up safely like testing contact tracing and hospital capacity. So I think that there I it's been it's been good you know. I think that there are some areas where I would love to even see more investigation and coverage of As I think of it the other waves And crises that will result from cove in nineteen that are under the surface. One of those is actually the surge in hospital demand that will come after this first surgeon covet nineteen as all of the cases and patients that we defer caring for because of the crush of coping. Nineteen patients is those patients. Start to come back and what was not urgent. A month ago will start to become more urgent over the coming weeks. And how are we taking care of Non Kobe? Nineteen patients at to an open question. And these other piece that I worry about a. Brian is the mental health impact of Kobe. Nineteen and how both the extraordinary stress that were feeling now and also how we'll deal with it in the weeks and months to come on that worries me and it's one of the reasons why I think that social connection is so critical right now because it's one of the most important ways that we reduce stress and deal with the mental anguish. Really of the moment right right in television and social media and other forms of media are ways to have those social connections. And that's certainly true but I remember amid March late March Having you on reliable sources you. You're on a lot of other television firms at the time as well. A lot of this was about repeating basic concepts and trying to educate the public on pandemics one one. And maybe now. We're past that point but it seems to me. There are still some basics that needs to be reinforced because we have these different states and governors and mayors recklessly talking about trying to get back to normal. When whether that's not a medically sound at does the press have a role right now just reinforcing. What the Public Health Reality is absolutely? I don't think you can repeat often enough. Just to how critical the personal measures are that. We need to be taking around handwashing around wearing masks in public around stopping the sort of physical greetings that were so often used to and our own distancing ourselves avoiding large groups. This is incredibly important. Now it's in a normal situation would be important. Keep saying these because you've got to repeat things many times for it to reach everybody but we're also not in a normal situation right now and will we've seen Which is deeply concerning to me and to many of my colleagues in public health and medicine is we've seen that there has not always been a coordination and and sort of as I think if a consistency really in communication between the scientists and political leadership so at times we've had scientists raising the alarm saying this is deeply concerning always seen elected leaders. Saying it's not so concerning right now when it comes to the importance of maintaining physical distancing and working hard to make sure we've got the testing tracing capacity that we need you know that was a a getting to be a fairly consistent message. But now we're seeing it's becoming politicized and we're finding that That some elected leaders are starting to say we should open up now even before scientists. Feel comfortable that. We've checked the boxes that we need to check and so. I think messages are getting mixed once again and so. That's why I think it's incredibly important the public years. Oh how important. These public health measures are and then that the key to release stopping. The current of ours are the behavioral changes that we all make. We don't have a vaccine. We don't have a medication that can tweet this virus. What is going to stop it and arrested to the best of our ability are the decisions we make about reducing contact with each other have complement attrition officials the the Health and signs experts that you used to work with and you know you know have have. They met this moment sufficiently. They done enough to communicate these messages to the public. While I think many of them have have been out there speaking to the media speaking directly to the public I think they are of the most part people like. Tony Vouch Ian. Debbie burks and others are doing as much as you can in terms of Speaking directly to the public. I think the challenges that you've got to be speaking in unison with the people that you're working with because as soon as a dissonance appears as soon as it seems like there you're saying one thing and someone is saying something else that discrepancy becomes the focus of coverage and becomes a focus of people's attention Right right and that's why you know we'll see when you think about these pandemic responses there there are few corp rentals. I learned that are really important than when I was surgeon general. We were dealing with the Bulla. We're dealing Zico. But one of the key principles is you've got to be transparent and truthful communication on and that includes being consistent. You know you can change your mind. But you've got to explain why it is that you're changing your mind present. The evidence for the second thing is you've got to lead with science and with scientists you've got to have them in front of the microphone to give them the majority of airtime make sure they're speaking directly to people in finally you've gotta get resources to people on the front lines to the doctors and nurses the grocery store workers people who need protection but are still having a hard time getting tested and getting masks. These are these are really tried and true principles and the challenge. I think that we we see right now. Is that when you have a communication that is inconsistent When that changes over time Without clear reason when you have different people in the administration saying different things at the same time what that does is it. It compromises public trust. And when you're responding to a pandemic one the most important resources you have his public trust. And you've got protected at all costs because if you if you allow public trust to fray then when go out to the public and ask them to do something like stay at home or take another very difficult measure that you think is going to be important to respond to the pandemic people are less likely to do it. They're not sure if you're telling them the truth you're being if you're leveling with them and so that that's one of my concerns here is not A. He can't be a Republican or democratic issue. Can't be pardoned and this is a moment where you have to unify. You've got to be consistent if you don't you. Measure the price in terms of lives. Lost there definitely been inconsistency between the president and his his health experts and I wonder if some of those cases have you seen the health experts going on TV and trying to communicate trying to get through to the present. Because we've seen that in other realms of of the trump presidency where AIDS or congressional leaders lawmakers are others will go on TV to try to get through to him. Is that happening now? Seeing that happening now while. It's hard for me to say Brian because I don't know what their private communication is with the president. I'm not sure how often they're talking to him. So you know I would hesitate to say that with confidence but I can say is you should not have a scenario where people are trying to make private cases publicly like in and if that that's happening with that means is that you've got a severe breakdown in communication internally on and that means not just that you're not having time together to talk about what's going on. It means that often and more often than not that. You've got a cultural problem. Where people may not feel comfortable coming forward and sharing what they think or they may fear retribution And that is. That's dangerous because that will you need in an environment like this. Is You need people to feel open to come to the table and to talk about. What'S ON THEIR MIND? What their concerns are what they're worried about. Otherwise you miss things you know you try to. When you're in an administration you do your best to make sure the people around you are smart towns and incapable and you need that for moments like this and in moments like this. You've got to be able to hear what they're thinking even if it's inconvenient even it's politically problematic because the decisions that come up the additional vantage points that are raised those could very well. Save Save. Lives earn some of what the doctor saying. It's definitely politically problematic but the CDC director Robert Redfield said to the Washington. Post is problematic because it flies in the face of trying to open up the country. All of a sudden in Dr Anthony Fauci. The other day said the virus will definitely be back in the fall while the president is saying. Maybe it will. Maybe IT WON'T. We don't know there's these contradictions. The key happening what about your one of your successors so you're the surgeon. General from two thousand fourteen to seventeen at the current surgeon. General is Jerome Atoms How would you evaluate his his work so far? Well I met a doctor Adams when I was surgeon. General when he was the Health Director for Indiana and met him during the the height of the HIV outbreak. In this state which was connected to the opiate epidemic. And in the time I've spent with Dr Adams what I've What I realize about him is you know. He's he's a man who believes in science. He's a doctor who cared for many patients. Over the years he's You know he's a he. Somebody cares deeply about public health and he wants to do the right thing I know. He's deeply concerned about what's happening with Kobe. Nineteen right now and he knows it. One of the challenging things to communicate with the public in an era in an environment where what we're learning is shifting and changing and evolving So you know. He's he's got a tough job. I I recognize that and he's also having to function in an environment where you know. There are inconsistencies between what people around him are saying. And this is my perception of it. Not necessarily what he has told me. But I also think if I were in his situation that it would be difficult to to communicate. Um without worrying about retribution. Because it's an environment that feels Lahar heavily charged and and quite politicize at times. You know I think in those moments I think. What would you all of us have to do who served in public positions as you have to know what Your Red Linus? You've got to know what you would not be willing to do and what you would be willing to lose your job over because it matters to that much for me. My Red Line. Who is that? I never wanted to be in a situation where I was being pressured to say something that I didn't believe in or areas being pressured to recant. Something that I had said that I did believe in. I wanted to be able to put science first And to never plays politics above science. And if somebody had a problem with that that I wanted to take it on if it meant I had to lose my job and that was okay on. That was a that was a price worth paying. So that was my red line. But every public official in these circumstances needs to have their redline because long after this job. And you've got to have your integrity you've got to be able to live with yourself as I thought of it. You've got to be able to look in the mirror and feel that you did everything you could to serve the health of the nation right right you know the other day. There was a headline from politico's. Dan Diamond saying that certain general been pushed to the sidelines. Sparking questions it basically pointed out that he hadn't been on for a while and then Lo and behold you know he's at the briefing like the next day or dictator kind of the way trump ministries and seems to work But neither of US know exactly what happens behind those closed doors music. You One more question about What we're all experiencing right now. What to expect going forward And then I want to get back to your new work titled Together. What do you personally expect for you in your family and loved ones in the months to come? I feel like everybody is trying to game out. What the next month's are going to be like and trying to make plans in the summer and the fall. Runner-up our heads around what the future might look like. Can you give us a sense of what your personally expecting in the months ahead? Sure Brian for my family. I just like I think from many other families it. This has been a time of upheaval We'll we're trying to figure out my wife and I had to work and take care of our three in two year old We're trying to figure out how to make sure we're keeping Potty trained in between conference calls or trying to prep while trying to figure out how to make the video conferencing technology worked for another meeting You know it's it's chaos and we're not alone. I know so. Many families are dealing with us. I think we look to the future they will we recognize that we are not going back to pre. Kovic nineteen life for some time Probably until we have a vaccine in. That's at least a year from now what that means to us is that it's very unlikely that over the next year. We're GONNA be able to participate in large group events like going to concerts or games for gatherings for our kids school or anything of that sort. We've also realized that we will have to continue to limit Our contact and to be judicious about it We are seeing family now. Close family that. We are quarantined with We love to keep seeing them. We mean travel back to Washington. Dc At some point. Over the next few months. I don't think that's happening this week or even next month but even when we are back home. I think we'll have to maintain physical distance and we'll have to wear masks when we go out. We know that we'll have to continue to observe a lot of the the hygiene precautions. And you know we don't love it but we know it's necessary you know we are what I worry about. Most perhaps his that our children are in daycare and mar younger. One older one or three year old is going to be starting a pre K. four program in Washington DC. But we don't know what school's GonNa look like in a were hoping that school will be able to Still be held. But I don't think we're GONNA be having class sizes like the ones we had last year. I don't think to parents will be having school wide. Get togethers with students and faculty to celebrate the beginning of the school year. So things are going to be quite different We're trying to adjust to the new normal but that's why for us. It reminds us of just how important it is to hold onto our anchors during a time like this and for us sending for so many of us the most power plant. We have our relationships with friends with family. Yes absolutely I mean as you're describing this I'm thinking about when when my three year old will be able to go back to her preschool and no idea and yet i. I sometimes think that the rhetoric we're hearing from some governors in from from the president is much rosier than what you just said So I guess it just incumbent on people like you to keep trying to speak the truth and say things are going to be weird for a while You don't expect to be hanging out in big crowds in stadiums and conventions for a long time does does that mean a year. Does that mean until there is a vaccine? Just to be clear. I don't think we're going to be able to resume normal activity until we have a vaccine if we in theory had a blockbuster drug that was a remarkably effective at both treating illness as well as Even reducing the likelihood of getting getting kkob in nineteen. Perhaps that could serve a similar role but really it's the vaccine. We need because we need to ensure that there's widespread immunity in the population. Let me fit in a quick break more with Dr Vivek Murthy in just a moment. Us Bank thanks you for going to work and for staying home for treating patients and having patients for being on the front lines while having our backs. Thanks for working together and playing podcasts. You Love U. S. Bank can't thank you enough but we can do our part. That's why we have donated millions to help our customers employees and communities in need equal housing lender member. Fdic this week. On boss phones. I talked to Cleveland Cavaliers player and five time. Nba All star. Kevin love about what he calls the pandemic. No one is talking about mental health. He shares with me his personal struggles with anxiety and depression. And we talk about why. He's speaking up in order to draw more attention to this issue especially during the Virus pandemic when so? Many of us are isolated. Listen to the latest episode of Boss Files. Wherever you get your podcasts. And we're back here on the reliable sources podcast. I'm your host. Brian Stelter joined by Dr Vivek. Murthy the former. Us Surgeon General the author of the new book together the Healing Power of human connection in a sometimes lonely world. The e book versions of the audiobook versions are already available online and the hardcover edition of the book is coming out on Tuesday April twenty eighth so Dr Murthy. The description of a bucket of the way your publisher describes they say this is the book we need now to avoid a social recession What what are you trying to get across about? The HEALING POWER OF CONNECTION WILL BRIAN. One of unexpected realizations. I had when I was searching general. I had the great privilege of speaking to people in town halls and community meetings in living rooms. All across the country was that loneliness and a sense of isolation. Were much more common feelings than I had anticipated People would rarely come up to me and say no. I'm John. I'm lonely but they would say things like I feel like I have to deal with all of these problems in my life by myself or I feel if I disappear tomorrow nobody would even notice or I feel invisible and as I heard those again and again from children and adults from members of Congress to people in fishing villages in Alaska two moms and dads in small towns in the Mid West. I realized that they were something bigger going on here. There was a pattern up loneliness that I was seeing and as I dug into the science behind this I came to see. The loneliness is far more common than I had thought. In fact a twenty eighteen kaiser study puts that number at twenty two percent of adults in the United States who struggle with loneliness for context. That's more than the number of adults diabetes or who smoke but there are other studies more recently that have pegged that number even higher even closer to fifty percent regardless of where the real number is the bottom line is loneliness as common but it's also incredibly consequential and it's strongly associated with an increased risk in heart disease dementia and depression anxiety in premature death and even in sleep disturbances. So what all of this talk and the reason that I focused on writing this poke on loneliness and social connection was it taught me that if we're not addressing loneliness then we're not addressing one of the important drivers of so many of the other challenges we face. 'cause. I came to see over time that loneliness was part of what was driving our opioid epidemic. That it was fueling depression anxiety. That was an important contributor to violence but even outside of health I came to recognize through research on stories that loneliness is actually impacting how we perform in the workplace in. How are kids did in school? It was impacting our ability to dialogue with each other and contributing to the polarization that we find so rampant in our country and around the world today. But there's bright side to it which is also found that the opposite of loneliness which social connection he's one of the most powerful resources we have our connections are source of healing and unlike the medicines that I have written prescriptions for over the years. These are resources that are available to all of us and I have come to see that if we are not harnessing the power of social connection by investing in our relationships by prioritizing people by working to build a people centered life in people's entered world. Then we are leaving incredibly rich resource on the table a resource that has the power to make us healthier stronger and ultimately more fulfilled is one of the many problems in this in this luminous puzzle that we are inundated by technology. We are surrounded by screens. We are all signed up for the services that are allegedly social media but are often antisocial in nature. And so there's this impression that People are all connected when they're not right when so much of it is artificial when instagram lakes facebook faves have no real value is that is that part of this puzzle will technology. Is it important piece here and interesting? You mentioned this Brian. Because I would say the most common question I get when I've spoken about this subject is a question is technology the cause and I think there's an important role that took place tech in and of itself can actually be helpful if using the right way when you use the right way. Yeah Yeah exactly. But the way in which we're using technology predominantly now is one that actually I believe edges out connections. We spent so much time in front of screens that we often spend less time. Because we have less time With people in person even when we are with people in person we find technology can often invade those conversations. If we're not careful and before we know it were talking to a friend face to face or on the phone but also checking our email refreshing our social media feed and googling question that just popped into our head. But there's another insidious piece of this that I worry about with young people In particular which is that what social media does is dramatically accelerate the culture of comparison that already exists in society and it makes it so much easier to look at somebody else's perfectly curated life. You know as displayed by their pictures on instagram posts on facebook or twitter and to think that other people are leading perfect. Lives while you were just simply not enough. And those messages. Have not being enough upping thin enough good looking enough famous enough rich enough smart enough. Those are amplified so often on social media and they chip away at self esteem and as we struggle with our sense of worth and value. It actually makes it harder for us to connect with other people so I think part of what we've got to do now is if we recognize the extraordinary power of human connection if we recognize that. We've allowed that To diminish over time and are now struggling with loneliness than what we've got to do is figure out how to harness technology in ways that strengthen our connection we've got to figure out how to create sacred space in our life when we can focus on people without the distraction of technology and finally got to focus on how to serve people because one of the things I recognize that I did not expect in. The writing of this book was one of the most powerful antidotes to loneliness is actually service because when we help others we shift the focus from ourself where it can excessively go. When WE'RE LONELY SHIFT? That focused his someone else in the context of a positive interaction but we also reaffirm ourselves that we have value to bring to the world and that helps combat that chipping away at ebbing of self esteem. That happens when you're chronically lonely How how is this measure? What are the what are the measurements for loneliness? And whether more people feel more lower than they used to well there are the easy. Imagine loneliness is a complicated thing to measure was out in the book it manifest itself in a lot of different ways right alcohol abuse and Drug Abuse. And all these other ways. You know one of the reasons. Many people don't realize loneliness is so common is because it's what I call the great masquerader It can look like anger can look like withdraw can look like depression. It can look like social anxiety they can look like a lot of different things And so we can talk those up To other feelings but often will find loneliness lurking in the background. And there are ways to measure Loneliness the way you measure. It is off by going up to somebody and saying. Are you lonely? Because there's an unfortunate stigma around loneliness that makes people feel that if they admit they're lonely that somehow that means that they're not likeable or socially deficient. I say that because as a young child who struggled a lot with loneliness and somebody who's experienced that even as an adult that I have felt that way Many times myself but there are scales of the Ucla Loneliness Gaylon particular which are studied validated ways of measuring loneliness and some of them in the case of the UCLA scale. Don't actually even mention the word lonely because it can be such a triggering word Interesting but there are those ways to get that data and you know. Obviously he wrote about this before the pandemic. What are the ways? This conversation is is is different now because of the pandemic will it? You're right Brian. If you had told me A year ago when I was in the middle of writing this would be this. Massive pandemic that would force us to have to sever our physical connections with so many people in our lies. Kasha would have found that hard to believe but but here we are and it turns out that people who are lonely before cove nineteen in some cases are feeling lonelier than many people who did not experience loneliness are finding that this is a new phenomenon of their life. One of the things that has remained the same is the importance of addressing this issue in the solutions for it turns out that when you think about what's happening in the word world right now that we can go. In one of two directions we could either allow the fiscal distancing that were experiencing to deepen our loneliness into to what I think of as a social recession or we can go in the Opposite Direction. We could use this moment to step back and take stock of our lives to recommit to the people in our life and to invest more in building relationships while even the we can't be physically together through the power of technology we do have the ability to speak to each other to see each other's faces to share openly in one of the things. I think that we sometimes forget when it comes to building relationship is that it is both about what we share and how open and vulnerable. We are willing to be. It's also about how well we are able to listen and be fully present for someone else. A one of the greatest gifts that we can give another person is the gift of our full attention. And I think we'll find that if we use this time to re commit to people to being fully present with them to being open and to taking risks in sharing recognizing that we are all struggling and hurting this moment than my hope is that we can emerge from this pandemic not only Having survived it but having thrived because we came to strengthen our relationships. I believe that we can come out of this more deeply connected than we were even before the penick began. And if we do that then we will have found a silver lining and we would have rebuilt the foundation that I believe. We all need to lead healthy and fulfilling lives. I'm grateful for your optimism. Some of these days have been pretty pessimistic looking around him wondering why we're GONNA come out of this. Yeah it is. These are tough times. No question and the truth is none of us can manage this entire ordeal on her own And that's why many nine times in life we may hesitate to call a friend and tell them about what we're struggling with. We may hesitate to admit that we're having a hard time but this is one of those moments you can readily assure yourself that most people are struggling in some way shape or form and so that actually makes it a bit easier to reach out to others and to be open and say hey. I'm having a tough time. It also makes it easier to find opportunities to serve because simply by calling a friend to check and see how they're doing simply by looking in on a neighbor to make sure that they are okay simply by delivering food to a friend who might be struggling to tell a work and also home school their kids at the same time. These are small but powerful acts of service that can help us feel more connected to the people around us. So you're getting the message out on podcasts. Like this one. But how are you selling the book Given that you've got to be at home like everyone else how how are you. What is a book toilet? Liken in April of two thousand twenty while in the age of cove in Nineteen A- book tour looks like a lot of time in front of your computer. Doing virtual book events a recording podcasts. Doing a radio in TV. And you know it's been it's been interesting. It's been different from the experience. I thought I would have. But I'm actually finding that with some of the local events because we can open them up now to anyone around the world It's enabling even larger variety of people to participate in because the topic feels even more urgent now than it did a year ago. When I was writing the book company that people are coming to the table with really interesting questions in insights sharing Really interesting solutions about what they are doing to manage this time of loneliness. So it's a it's a. It's a brave new world To be sure but What we're trying to make the most of it so wrapping up your Doctor Moore the final message for folks about this concept of together the healing power of human connection when I think back on the whole experience of writing this book of when I think back in the conversations I had as surgeon general with so many of the families who opened up to me about their struggles with loneliness. Simple Credo that. I've come to deeply believe in the Credo that I would say is at the heart of the spoke and that's three words. Put PEOPLE I put people first. Is I believe the foundation of how we rebuild our lives and rebuild our world. It's how we recognize that our relationships our greatest source of strength and while they've always been there in some way shape or form We've allowed them. In some ways to diminish a more out of neglected other have surged ahead. Parties often related to work. But this is our time to redefine into remake the life that we have into the life that we want. It's our time to show our kids what it means to actually cherish people into live. A people centered life and that. What makes me optimistic that we can do? This is that the quest to live a people centered. Life is not a mission to transform into something that were not. It's actually an effort to return as to who we fundamentally are. Chirp human beings that are meant to take exist in relationship with other human beings were interdependent species We can do extraordinary things together. I'm reminded of that. Old African proverb that says if he wanted to go fast go alone but if you WanNa go far go together. This is our opportunity to build togetherness to create a world that is powered by people that honors people that cherishes people and it starts with the decisions we make in our own life putting people first that's going to be my takeaway more. Thank you so much to tell people where they can find you online so you can find me at a vache. Morty DOT COM V. I v. e. k. m. U. R. H. Y. Dot Com and. The book is together. The healing power of human connection. Sometimes lonely world that can be found on Amazon in hardcover format e Book and Audiobook. His well perfect. Thank you very much and thank you. All for listening to this week's sources podcast and we will see on television of this. Sunday and every Sunday at eleven. Am Eastern Time on CNN? Thanks for tuning in hang in there.

Brian Stelter president Dr Vivek Murthy United States Washington DC Doctor Moore Ucla Loneliness Gaylon New York City Miami Barack Obama Dr Martha Kobe Dr Adams New York Dr Anthony Fauci politico Lahar
COVID-19 is not the great equalizer

Marketplace with Kai Ryssdal

25:19 min | 6 months ago

COVID-19 is not the great equalizer

"So this is a tricky one right. Economic hope versus economic reality. That is the broad outline of what we are. GonNa do today from American Public Media. This is marketplace is in Los Angeles. I'm Kai Rozelle Wednesday day. The eighth of April is always to have your long everybody at the risk of being that. Guy. I'm going to be that guy. Yes there is talk now from actual responsible people about when this economy might be able to restart again however slowly and the stock market insert appropriate caveats. Here is feeling it but look there is real damage. Being done to the labor market is we have been telling you to small businesses by the tens or hundreds of thousands and the bigger things to global trade for. Just one example. The World Trade Organization is out with a report today that says global trade in merchandise basically stuff being shipped from one country to another is gonNA fall this year anywhere from thirteen to thirty two percents the WTO director general. A guy by the name of Roberto Esa Vado call those numbers ugly which seems kind marketplace's Mitchell Hartman is on the global trade deterioration desk today. Does it even matter if global trade falls by double digits this year after all as Columbia Economists? Sharyn o'halloran points out the. Us is one of the more insulated countries from international trade. Only about thirty percents of the domestic economy is directly connected to trade but o'halloran says companies that make planes consumer electronics and cars have an outsized impact on how and how fast the US economy can recover our ability to bring in the supplies. Reignite assembling in autos and so forth requires inputs that are built abroad and if a major economy like the European Union's can't ship and sell. Its goods abroad is going to have a hard time. Buying goods. Global supply chains have already been massively disrupted says economist Mary. Lovely at the Peterson Institute. I factory shutdown across Asia. Now they're reopening. While Europe and North America are still shut down so goods aren't moving off shelves and ports aren't moving goods out to see and it's basically gumming up the works. We expect that we're GONNA see canceling entire routes and this is particularly. GonNa hit trade between North America Asia. Those disruptions are hitting driscoll's buries a worldwide fruit importer exporter. It's business has fallen by at least fifteen percent. Says President Soeren Bjorn? We've relied heavily on air freight and a Lotta Times. We fly bellies a passenger planes. Well obviously a lot of those things are no longer flying and so now we are left with a few cargo planes which tends to be very very expensive. Bjorn says he's confident that if consumers recover their trump's and incomes his company's Berry sales will eventually rebound as well. I'm Mitchell Hartman. For marketplace a lot of the stuff that gets traded globally is either steel as in raw steel or made at a steel which puts us of a mind to call our steel person. Who was trying to run her company in a pandemic after trying to run her company in the middle of a trade war. Lisa Goldenberg is the president of the Delaware steel companies. It's good to talk to you again. Great to speak with Yucai so first of all. How're how are you? I'm doing okay. I think here in the East My county which is Montgomery County where I both work and live. We were one of the first counties in the country to completely. Just shut everything down after. I guess Washington in New Rochelle. So we're world had at this already. I understand you've got like all. Your kids are home to and their spouses. I mean it's like you're owning a little. We work there or something right right. We do call it our own little we work. One of my daughters is actually an executive out. We work so she showing us how to get it done and we have our own spaces and people were walk in and out and where. It's definitely different and much of it is really good. It's stressful and it's trying and it's difficult but it's very very cool. Yeah for sure I feel like you have a grasp on the industry and your part in it right right because there's so many moving parts right I think that's the hardest part of my communication with my employees is really good and I think the Morales decent. I'm a national company coast to coast North America and this country is so spread out right now with its response to the virus. I am speaking with people in Arkansas. That are literally businesses usual. And I'm not being overly finger-pointing disparaging let their governor worry about them. But I've got other people that have gone near their plant in three weeks and I've got people who are shipping every day and so it's very difficult to have a handle on anything If a customer places an order and they're in a state that is in as proactive or responsive active within the virus reality then. They think they're taking delivery. They'll give you a date of next Tuesday. They may not be realizing that on Monday. They could be shut down. It's very difficult to operate with out a uniform experience. It's different from state to state county to county and Industry to industry. What does that tell you then about? What a recovery. When it comes it is going to come. But what does that tell you about what the recovery is? GonNa look like. I think recovery is going to be just as bumpy and uncertain Everyone's talking about what does coming up and starting again look like my point to everyone is. We'll come up with a protocol on how to start again of course and hopefully soon however I think the new reality is gonNA look like an up down up down experience. I think that you're going to God willing get back to work and then you're GonNa have to shut down very quickly the surge in your area or a member you know God forbid of your team becomes ill and you have to handle everyone on site because until we have what they're calling her immunity and until we have vaccines and all that the new normal is going to be an up down up down. It's not going to be a straight line just like the crash if you will or the demise of the industry hasn't been a straight line down. It's unusually a robust in certain areas. And then not surprisingly Kinda dead and other areas Lisa Goldenberg's she's the president of the Delaware Steel Company of Pennsylvania. Checking in as we always do at least take care of yourself. Stay Safe Wash your hands. Would you stay healthy? Stay happy peace. We'll talk to you about wall. Street today was up again and you might hear. Oh by the way people starting to say we're in a bull market now. We're not. We'll have the details when we do the numbers one of the things that happens in a crisis is that the underlying flaws in whatever system is having the crisis become real real clear and this corona virus economy is no exception black and Latino workers who even in good times or at a disadvantage are being hit by this crisis harder than most to be clear. They are dying disproportionally. Experts say there are a lot of reasons for that more pre existing conditions in that population and existing biopsies in the healthcare system to begin with but also a lot of the frontline workers who have to show up in person. Every day are disproportionately black. And Latino Marketplace's Jasmine Gars has more on that right now. People are being directed to shelter in place but Dr Steven B. Thomas Director of the Maryland Center for Health Equity says when he goes out to the grocery store. Who Do I see out there? Worke black and Brown people stay home. They don't eat historically African Americans are in lower paying jobs and have higher unemployment rates. Trayvon Logan is an economics professor at Ohio State University. If you're someone who is still is employed You really do want to show up for work because you're likely to have those in your household who are now. Unemployed at the center of the pandemic in New York City frontline jobs like public transportation. Postal Services and healthcare have mostly black and Latino workers. Dr Martha Dawson is the President of the National Black Nurses Association. She says she keeps hearing from nurses who have accidentally infected family members. We have to get the equipment to staff on the front line and not just nurses but the environmental service workers the food employees and it's also essential to get protection for people working outside hospitals again. Professor Logan those working in grocery stores and delivery and other interpersonal interactive occupations need personal protective equipment. He says communities at risk will need more help than the one time. Twelve hundred dollar stimulus checked. The government has announced better. Health Insurance. Paid sick leave and hazard pay experts. Say It's time to bring race into this conversation. Understand that even with prevention measures race plays a role. Take something as simple. Dr Thomas says as telling people to cover their faces in public the first thing I thought okay Trayvon Martin on all. He had on a hoodie coming back to bite us now but embrace it knowledge it. We can manage to truly be all in this together. He says Cova Nineteen is not the great equalizer but it could finally get us to address inequality. I'm Jasmine Gars. For marketplace. Uncertainty is pretty much the name of the game right now right in life for sure but also in this economy including how bad it might get or in simpler terms. We talk in recession or depression. Last week we asked some economic historians what we ought to be looking for unemployment of course unemployment claims the unemployment rate credit delinquencies credit markets credit for small businesses significant and prolong deflation declining prices and bankruptcies that was Kathleen Day from Johns Hopkins Kurla Friedman. She's at northwestern and Eric is at Wellesley. We are taking those three indicators deflation unemployment and credit day by day this week. We did deflation Tuesday so today. Unemployment of course and employment claims the unemployment rate. We got the march unemployment report. This past Friday. You might remember that. The rate jumped up to four point four percent. That's from three and a half and we lost seven hundred and one thousand jobs in a month. That's the first negative jobs numbers since two thousand ten the biggest drop since two thousand nine so you know not great but is it depression territory. Here's Corolla Friedman integrate depressant at its peak unemployment rates for twenty five percent. So we're not there yet. But here's the thing about the Great Depression. Unemployment rates remain very high for ten years. Which is a long time to wait to see if you're in a depression so perhaps a more near term indicator that very large number of unemployment claims something that worries me. Whether I'm trying to think as I look forward is whether disease Temporary Tinge or whether DC something that's going to become more prolonged unemployment claims here that she's talking about are those first time claims for jobless benefits that we get week which in the past two weeks have told us that ten million people lost their jobs at the end of. March which is crazy. It's also a national phenomenon record job losses from California to Maine Illinois to Florida and across the economy as well retail entertainment restaurants in manufacturing to name just a couple of industries. The new weekly number comes tomorrow. Two weeks ago. It was three point three million last week. It was six point six. Not TAKING ANY BETS. On what the next number in that sequence is going to turn out to be but that rising tide of unemployment gets us to the structural damage. That happens when so many people lose their jobs so fast which we are going to talk about tomorrow depression indicator number three credit and its deterioration coming up we are starting a campaign to attract people in the UK to come and help hall stall crops. Desperate Times call for desperate measures. I guess but first. Let's do the numbers and the sad happy down dust. Israel's up seven hundred seventy nine points today. Three point. Four percent. Twenty three thousand four thirty-three the Nasdaq boosted two hundred and three points. Two and a half percent eight thousand ninety the S. and P. Five Hundred Rose Ninety points. Three point four percent. They're twenty seven and forty nine. We've talked Goldenberg of Delaware. Steel about how she's doing so bigger steel today steel producer. Nucor up four point six percent. Steel Dynamics lifted more than three percent day. Bond prices fail yield on the tenure. Keynote rose to zero point seven six percent. You're listening to marketplace this is marketplace. I'm Kai Ryssdal at last count. There were more than half a million homeless people in this country. They're also happens to be right now. Thousands of hotel rooms just sitting there. 'cause in a whole lot of people travelling right now so some cities and states trying to move some of the most vulnerable of the homeless into those rooms. As marketplace's Amy Scott reports now rush doll owns two hotels in San Francisco. With almost zero bookings he's had to furlough sixty percent of his staff so when a city supervisor asked him to open some rooms to the homeless he jumped at the chance. Each hotel now has twenty rooms occupied for eighty dollars a night and while that's less than half his base rate you keep the doors open. Have some stuff working and keep the place going. You have to do anything to survive. The State of California has a plan to use up to fifteen thousand other hotel rooms to house. The homeless FEMA will reimburse local agencies for up to seventy five percent of the cost including services like meals laundry insecurity. Carrot Carnahan with abode services is leading the effort to convert to hotels in Oakland to temporary shelters for nearly four hundred people. She set up a makeshift office in the radisson ballroom. There's lots of people running around trying to meet the needs of our guests trying to process clothing from the day before through a bedbug of and trying to get more people into the shelter and house this morning. Other logistical challenges include Training Hotel and security staff to work with the new guests and making sure they have protective masks and other equipment. Leonard Beasley arrived at the hotel Monday with his girlfriend business. Like if you woulda going rent a room at a the holiday inn or something without but yeah it's wonderful. It's a blessing. Both of them are in their sixties and at higher risk of getting seriously ill a recent study found. That homeless people are much more likely to contract the corona virus and to die from it than the General Population Co author Denis. Cohen is a professor of social policy at the University of Pennsylvania. People who are homeless are older in general. They have health conditions in their fifties. That one would normally see in patients presenting in their seventies they also have higher rates of mental illness and addiction. Martha K goal is executive director of the Homeless Services Organization. Unity in New Orleans. Where so far? More than two hundred people have been moved to hotel. Rooms each has a case manager. Because you don't want to just put very vulnerable people with disabilities in hotel rooms without somebody checking on them stabilizing them and really working on the next step to get them into permanent housing as soon as possible. Congress has set aside billions of dollars homeless assistance housing advocates. Worry a lot. More people could become homeless because of the economic fallout from the pandemic. I'm Amy Scott for marketplace the news from the UK today comes in two varieties. One main theme. I guess first of all Prime Minister. Boris Johnson is still in intensive care but his doctors say making steady progress also and this kind of follows from that I guess the corona virus is reshaping the British economy the same way. It's reshaping hours case. In point. Agriculture Brits are being asked to pick for Britain the government is calling on students in people furloughed from their jobs and people without jobs to help pick the fruit and vegetables. That could go to waste if not enough. Foreign workers are there for the harvest from the European desk in London. Marketplace's Stephen Beard has that one. British farmers are perilously dependent on seasonal workers from continental Europe in the northern town of Tarleton. John Bragg told the BBC he cannot do without migrants to pick on process his salad crops. If we can't get stuff from the EU across Ed because there's some border issues or because the viruses causing a problem all this crop in this field here we'll be left to raw and it won't be able to feed the UK nation during this difficult time it's many decades. Since large numbers of Brits harvested the country's soft fruit and vegetable crop. That's going to have to change to make up. The shortfall of foreign workers says Matt Jarrett of Pro Force which recruit seasonal farmhands. We are starting a campaign to attract people in the UK but only students people out of work to come and help harvest all crops. Packer crops the campaign carries an echo from earlier. Desperate days when the world was in another kind of war again during world. War Two poked most memorably in this song by Vera. Lynn Britain launched a campaign called dig for victory. Propaganda films urge the population to go back to the land to plant and grow more fruit and vegetables to keep the country fed. Have you joined the ranks of this break? You Army this helping to win the wool helping themselves to good food dig for victory. Today's campaign called feed. The Nation has appealed online for British fruit and vegetable pickers with some success. As one of the organizers Rachel Hubbard of fruitful jobs of farm labor supply firm last night over. Eighteen thousand. Three hundred people had applied via the websites. Summit seems motivated by Altruism by economic necessity. A lot have said that their jobs have been impacted by Kobe. Nineteen so they're looking for alternative work. A mixture of retired three to students and everything in between but eighteen thousand three hundred. Africans weren't philly expected shortfall. The main picking season gets underway in. May and there are other snags. Farmers need people who can drive a tractor operate harvesting equipment and pick produce fast. Not as easy as it seems. Then there's the more delicate question will. Today's relatively pampered. Brits be able to hack it. Matthew Stanton Farms asparagus in Kent. We're willing to give people to go into train them up but when we got rain is code in the morning. And you've got to come back. And it's a Sunday but this is where we struggle there's relentless work since the covy. Nineteen crisis deepened hair. Some politicians and the queen herself have invoked the spirit of the blitz the ability to unite and survive in wartime. Whether Enough Brits can enjoy the rigors of farmwork will be another test of the metal in this crisis at the European desk. I'm Stephen Beard for marketplace. We talked a bit yesterday about the commercial versus consumer changes that are happening in the food. Chain Patrick Smith our apples and hops farmer up in Washington state and how his sales are changing. Now that people are buying four and eating from home turns out that change is affecting what we eat as well with most of US home most of the time demand for ready to eat highly processed foods is going up which is a bit of a one eighty for those package brands which had been getting passed over in favor of not process. Not packaged sustenance. Marketplace's Nova Sappho has more on that one processed cheese food and canned soups are not trendy. But they're comforting and right now. That warm hug sounds pretty. Good says Diane Garcia Rattler a nutrition professor. At Rutgers University these are really disturbing times and very unsettled and sometimes we reach for things that were familiar with. The familiar is getting a boost campbell soup which also makes pepperidge farm goldfish crackers and prego pasta sauce. Just saw more than fourfold increase in orders. Craft Hines of Craft Mecca. Cheese fame is reporting sales increases to Aaron Lash a consumer sector analyst for Morningstar says. That's a big change branded manufacturers. That consumers are incredibly familiar with have been falling out of favour a lot of had been opting for stuff like Kale and keen Wa and locally sourced meats but packaged foods are often cheaper giving established brands. A new opening during the corona virus. Shutdown says food analysts Darren Cipher of the NPD group even when the pandemic starts to fade away? There's the economic impact that it had. We just don't know what that's going to be in other words. The length and depth of the economic pain could determine how much and how long Americans will seek comfort and savings in their food choices. I'm Nova software for marketplace. This final note on the way out. Today it's a quick to for commercial aviation in the age of Corona Virus Item on Delta Airlines announced. Today it is going to block middle seats on. Its planes to allow for social distancing a couple of other carriers already done that and it seems reasonable number two though man. Those planes are empty. I've been a tad obsessed as you know with the TSA's passenger throughput numbers. How many people at screening everyday yesterday in the whole country all of the United States Ninety seven thousand one hundred thirty people went through. Tsa checkpoints a year ago yesterday. Almost two point one million. Do you suppose this is a serious question? Do you suppose that gets to zero ever? Are we gotta go down was up? Seven hundred seventy nine points today. Three point four percent. The Nasdaq gained two hundred. Three two and a half percent S. and P. Five hundred ninety nine zero three point four percent. There are media. Production team includes Robin Edgar drew. Justed Jeff Peters Daniel Ramirez J. Cba Charlton Thorpe and Ben Tolliday once again. Because we set out loud every week. These are the folks going into the studios so we all can stay save. Get the show on the air. I'm Kai Ryssdal. We will see you tomorrow. This is a PM.

Us Lisa Goldenberg president North America professor UK European Union Kai Ryssdal Mitchell Hartman Europe Jasmine Gars World Trade Organization Stephen Beard Sharyn o'halloran government California
Heartland Newsfeed Radio Network: NPR Illinois' Statewide (June 8, 2019)

Heartland Newsfeed Radio Network

57:31 min | 1 year ago

Heartland Newsfeed Radio Network: NPR Illinois' Statewide (June 8, 2019)

"This is Julie. Hey calendar. What's my morning like Julie's about to have a long day? Purchase birthday card nine zero five try cleaning. Did you just go backwards? I'm sorry. I can't fit that question into your schedule. Nine fifteen cry for days that won't end. Let schwann's help with swans. You can get delicious meals that go from freezer to table in minutes not hours ordered delivered done. That's homemade easy visit today at schwann's dot com. Right now. You can get both sprints unlimited plan and the all new Samsung. Galaxy S ten included for just thirty five dollars per month for line for five lines. All you need is approved credit and in eighteen month lease no trade in required. Visit sprint stores sprint dot com or call eight hundred sprint one who fifty dollars a month after twenty to fifty credit applied within two bills. Cancel thoroughly remain unbalanced doing limited basic after six thirty twenty eight thirty two dollars per month per line for five lines with auto pay day to day origination. During additions speed maximums. Here's restrictions apply. This is statewide reports and conversations from in and around Illinois. I'm Shawn Crawford this hour. We find out more about a major gambling package approved in the state legislature. Those who want to wager will soon have more opportunities to do. So as the school year wraps up, we visit one northern Illinois high school or students won't be returning next year. It's being deactivated. Will explain flying insects are prevalent this spring. What's behind the swarms were seeing also an iconic restaurant brand. They got it start hearing Illinois facing some tough times. I mean they're playing smack dab in a very competitive from being national players. Right. You know that ad huge huge region. Big marketing dollars all the way down to local regional chains or even independent burger place. The problems at stake in shake that and more on today's. State wide. This is Julie. Hey calendar. What's my morning like Julie's about to have a long day? Ten purchase birthday card. Nine go five try cleaning. Did you just go backwards on? Sorry. I can't fit that question into your schedule. Nine fifteen cry for, for days that won't end let schwann's help with swans you can get delicious meals, like, oh, from freezer to table in minutes, not hours ordered delivered done. That's homemade easy visit today at schwann's dot com. Right now. You can get both sprints unlimited plan and the all new Samsung. Galaxy S ten included for just thirty five dollars per month per line for five lines. All you need is approved credit in eighteen month lease no trade in required. Visit sprint stores sprint dot com or call eight hundred sprint one who fifty dollars a month to twenty two fifty credit applied within two bills remain. Unbalanced doing limited basic after six thirty twenty eight thirty two dollars per month per line for five lines. With auto pay data deprioritization, during additions maximums. Here's restrictions apply. Welcome to statewide. I'm Shawn Crawford coming up. We'll recap the busy end of the spring legislative session including what happened at the state house, and how it will impact, you also flying insects you spent much time outside. You've probably been dealing with a nuisance of mosquitoes, and gnats. They've been especially bad this spring. To find out why talk to an intimate knowledge, est that and more this hour on statewide. Sheen restaurants love moving into downstate, Illinois steak and shake was that rare unicorn the chain restaurant that downstate sent out to the world, but eighty five years after its founding in normal stake in shake, and I contact brand is in trouble. Brian Denham has more on that. Our story begins with Gregg snodgrass, who started steak and shake as a bus boy, in nineteen seventy nine and Bloomington normal. It's career grew is the company did, and other local staff would travel the country to help open new locations and trained staff on the steak and shake culture quality service and cleanliness meeting fifteen minutes before ships started in. We have uniform inspections, and the whole nine yards was really something that we all took pride in. It was fun. But by two thousand and eight wasn't fun anymore. Snodgrass was a district manager, then overseeing nine locations between Bloomington and Paducah. Kentucky snodgrass says the new owner big lorry holdings was cutting wages and benef-. Fits part of a recession era discounting survival plan, so snodgrass left today. Those changes have brought steak and shake to the brink sales of sunk dozens of locations of closed employee lawsuits of piled up. And some are speculating that a major contraction or worse is near heartbreaking when I was like, you know, dedicated over thirty years of my career to help build that company and help build relationships. And when you walk into the restaurants and services that good in the cleanliness isn't there. The quality of the food is still there. But the other two things that really isn't sticking shaking or to me, steak and shake is one of Bloomington. Normals most famous exports right up there with state farm, and beer nuts. Gusts and Edith belt opened the first location at main street in Virginia avenue in normal in one thousand nine hundred thirty four their family sold the company in nineteen sixty nine and it's changed hands many times since then today stay can shake has five hundred eighty locations in his base, in Indianapolis, and owned by Texas based big lorry holdings, Bill camp in the McLean county museum of history says, another locally grown company that followed a similar path was Eureka Williams which became Electrolux and then moved away blue into normal given kind of its vibrancy throughout its history has produced corporations brand names that are known throughout the country, sometimes in some cases, the world and some of those still have local ties in some do not. There are a few remnants of the steak and shake legacy that have survived here chain still has four restaurants in town. The original one on main street, though, is now a Monaco's another. Location is now Keller's iron Skillet Kemp says gusts and Edith belts built, stake and chicks brand on the steak burger Gus valve is known to make quite a show of that. He would actually wheel in a barrel, and some of the early stores full of sir lines are T bones, and then that would be ground, right? On-site. So customers could see what was going into their steak. Burgers, cleanliness was also a selling point. Their slogan was incite it must be right. The idea was if you can see the food being made. So the grill cooks were out there in the open through glass, windows, and the originally, the meat was ground on site. That was an indication that things around the out there. That was a long time ago today. The company is owned by Sardar big Lori and gung investor who emigrated to the US from Iran. He took over steak and shake in two thousand eight amid the great recession. He discounted relentlessly famously offering meals under four dollars, and it worked sales soared for seven years. She seemingly could do. No wrong. That's. Gregg Andrews, who's covered the company extensively as editor of the Indianapolis business journal work and work in work. And that about two thousand sixteen it stopped working and the company has continued to really a slide since then critics say the customer experience slipped. And so did the service all that discounting comes at a cost steak and shake also faced a new challenge from growing fast, casual chains like Chipotle, lay Panara, and Jason's deli, younger consumers willing to pay more in the race to the bottom for value was ending? That's according to Dani Klein, who covers steak and shake for the QSR food trade magazine. They're planning on one side of convenience or your, you know, going kind of higher end with some of these upscale fast Casuals or, or sit down seines or find dining, you know, people that are taking share like that, so steak and six case, they're sort of now at a point where they're not really, you know, the not really offering either of those owner Sardar. Big Lori is a mistake. Various figure who does not do media interviews. He didn't respond to requests for comment from GM not his only public comments typically come in his annual shareholder letters in his thousand nineteen letter big lorry conceded that they, quote, a ruinously stayed with a quick and kitchen, design, that was ill suited for volume production and that the effect was high cost labor intensive slow service. He says they failed customers by not being fast and friendly. They paid the price for that mistaken, shakes revenue last year declined three and a half percent. What big lorry himself called a significant disappointment during the first quarter of twenty nine thousand nine same store sales fell almost eight percent ten th straight quarterly decline, even as other similar restaurants. Saw growth. David hankins is with Technomic research and consulting firm for the restaurant industry. I mean they're playing smack dab in a very competitive sat from big national players. Right. The you know that have huge, huge region being marketing dollars and, you know, all the way down to. Local or regional chains, or even independent burger places steak and shake isn't doing much to differentiate itself, not that it's, you know, the death knell for the chain. But it's, it's certainly a challenge for them to grow out of that without doing something different something different is an ambitious strategy that big lorry laid out earlier this year. He wants to franchise off all four hundred company owned restaurants franchisees will only have to put up about ten thousand dollars to bargain in the industry, and they'll pay fifteen percent of sales, and fifty percent of profits back to steak and shake in. Franchisees can only own one restaurant that's similar to the Chick-fil-A model geared toward hands on franchise ownership experts. Tell g LT that retroactively turning a restaurant chain into an all franchise model is a bit unusual and to prepare for it steak and shake has temporarily closed dozens of stores that will theoretically be franchised, including some in Peoria, but when a restaurant temporarily closes restaurant journalists Danny Klein says. They tend not to reopen. And I haven't seen anybody offer up a franchise for ten thousand dollars in the time that I've been here in the whole and everything they're doing right now is pretty uncommon. So I, I guess we don't really know how it's going to turn out sick and she also faces a big challenge in court. Nearly fifteen hundred steak and shake managers across the country have sued the company claiming that were improperly classified as salary employee's and not compensated for the overtime. They worked around two hundred eighty managers from the Saint Louis area or just awarded seven and a half million dollars in the first of two lawsuits. The second pending lawsuit has just under twelve hundred plaintiffs including around four hundred from Illinois, that's according to their attorney, Brendan Donnellan of Kansas City, Missouri Donald says these managers were making only thirty two thousand to forty thousand dollars a year, and we're doing much of the same work as lower level, hourly employees job was to just plug in the holes each and every shift and I think it's pretty easy to figure out that if you're not having to pay the hour. Early people overtime to do all this work or to have extra hourly people there and you're paying one person, just to set dollar amount to work, seventy hours a week. It's, it's, it's a big cost, cutting and savings measure for a company. Intends to defend these cases vigorously, whoever Donald says the company is set for settlement talks with plaintiffs in both cases in early June. So does this all add up to the end for steak and shake Greg Andrews who covers the company from Indianapolis says steak and shake has about one hundred eighty four million dollars in debt that it's supposed to pay off in March of twenty twenty one at the moment? So it really doesn't have the ability to pay that off. If it starts to turn itself around them lenders would probably give it a lot more breathing room. But if it's an tailspin, which is what it really isn't today that debt, put forth steak and shake into bankruptcy and significant retraction, fewer locations. Maybe more likely Dani Klein says it's not uncommon today to see restaurant chains retract pretty dramatically Applebee's is one recent example of this type of scale, and you know, guest affinity and history. And the fact that they were on a really good run there for. Pretty good period of time, I would be surprised to see them go bankrupt, but I would also say that it's definitely not nothing as ever impossible possible in this industry. I mean restaurants or such a such a fluctuating kind of business. The attorney who represents the managers says it's hard to speculate about the company's financial health because steak and shake is just one part of the glory holdings portfolio. Big Laurie also owns maxim magazine, and the western Susan restaurant chain among other investments to look at that. And then decipher exactly, which of that are staking shake assets, and stay can shake liabilities things along those lines. So I it's, it's always concerned all of my cases, but it's hard for me to speculate here, whether or not, it's going to have a big impact on our on our verdict. And on our second lawsuit. Greg snodgrass, the busboy who became a district manager gave the company other chance himself he returned from two thousand ten two thousand thirteen but it wasn't enjoyable anymore. He says the family friendly atmosphere was gone. He left again, on just there's some talk that they may even just pulled up and go away, which I hope doesn't happen Sardar. Big Laurie says it will take three years for the refranchising plan to be completed that was Ryan denim with. That reports and read more about the problems with the restaurant chain steak and shake. There's a link at our website statewide show dot com. Let's say you just bought a house. Bad news is you're one step closer to becoming your parents. You'll proudly mow the lawn ask if anybody noticed you mow the lawn tell people to stay off the lawn. Compare it to your neighbor's lawn and complain about having to mow the lawn again. Good news is, it's easy to bundle home and auto through progressive, and save on your car insurance, which of course, we'll go right into the lawn. Progressive casualty insurance company affiliates and other insurers discount on AllState or situations. Right now, you can get both sprints unlimited plan and the all new Samsung galaxy S included for just thirty five dollars per month for line for five lines. All you need is approved credit in eighteen month lease no trade in required. Visit sprint stores sprint dot com or call eight hundred sprint one fifty dollars a month after twenty to fifty my credit applied within two bills against overly remain. Unbalanced limited. Six thirty twenty eight thirty two dollars per month per line for five with autopay data the organization during additions be maximum. Restrictions apply. If you've been outside this spring, you've probably noticed more flying insects like gnats and mosquitoes in some areas. People are having to fight off swarms Nick cider is a research assistant professor of field. Crop in Tamala. Gee at the U of is department of crop sciences, and I had a chance to talk with them. And I assume that some of the reason we're seeing so many of these bugs right now is because of the wet spring. Yeah. That at what we right and there's a, there's a variety of different insects, especially different types of wise, of course, mosquitoes are, are a type of fly, that's the one that we're most worried about that's the one where when we have a lot of standing, and especially stagnant water out there from some of these heavy rains, and from some of these flooding events. That's lots of great breeding sites or mosquitoes. There's also a variety of other insects that aren't necessarily biting insects, some mid. Ages, and dip and other types of small flies that can. Do the same thing. They'll breed in develop in that standing water, they won't necessarily by people, but they can't be more of a nuisance. But the, the primary one we're going to be worried about is mosquitoes in the standing water. And then in areas where there's more running water more flowing water like when the rivers are high, and that kind of thing you can't see an increase in buffalo NATs, which are a different type of Biden fly. I feel like I've seen a lot of the buffalo nets in here in central Illinois. A few years back. We seem to also have quite a few of those and then after a couple of weeks that subsided. Do you expect the same thing to happen here? Or does it depend on the weather? It does depend on the weather, but it is seasonal also. They do tend to subside. Once the real heat of the summer comes on big issue with puff, low nance's that regular insect, repellents aren't quite as affective against them. They're also quite painful. But then. For for mosquitoes. The best thing you can do for yourself is to get a good insect. Repellent, use that when you go outside just to avoid being bitten, the other thing you can do for mosquitoes is to remove sources and standing water, especially in your home tire swings or one that gets talked about a lot, you know, but bird baths or another one lot of times, though those sources of standing water that are out there just need to be just need to be refreshed, just every once in a while, you have to pour that water out if it's something like a bird bath where you want water in it just refresh that water. So that insects aren't -veloping, and particularly mosquitoes, aren't developing in, you said the insect repellent. If you go to the store, there's all sorts of claims made by different ones. Is there something that people should look for ingredient wise at least that is, is the best for folks to use with mosquitoes there, several that are effective, the one that I've had the most luck with our repellents? That contain D D E for buffalo gnats. I, I don't know that I'm as quick to evaluate them. I know there are some effective products on the market for that insect. When, when I hear people talk about a lot of mosquitoes and concerns over that, of course, part of that is not just the nuisance of having them around and being bitten by them. But also the concerns about disease is that something that you're watching this time of the year with, you know, with that many around are we concern, we're going to see a big year for these types of diseases that are carried by mosquitoes? That's always a risk. And we're we're left in the mid west. But we don't have a tremendous number of mosquito borne illnesses in humans, we do have several types of theft lightest, including West Nile virus is probably the most well known of those, and I don't know if it's the most common to that, but certainly the most well known. So certainly a good reason to protect yourself from -squitoes, also important to not forget about your pets heartworms for. Instance are spread by mosquito bites in in dogs. So it's a good idea to take your animals to the vet make sure their medications are up to date so that you're back Mems. Well can nets also carry you disease. And can they be a health problem as well in terms of spreading disease in Illinois? It's really mosquitoes, and then picks which aren't aren't an insect. But are, you know in arthropods and can spread lime disease and some other things? That's another one, you want Becht yourself against anytime. You're out in tall grass, but that's not one that's going to be necessarily favored by all this water. But mosquitoes are the primary threat when, when we're talking about lies when we're talking about insects that our favorite buys a lot of water like what we have in the state right now, Nick cider is a research, assistant professor at the U of is department of crop sciences. Some good advice. Protect yourself and your animals. If you're spending time outside cider says mosquito. Oes might be more prevalent in central and southern Illinois right now. But soon there will be plenty in northern Illinois as well. We'll have more of statewide coming up. We'll look at what state lawmakers did and didn't do in their spring legislative session. That's on the way. No, an ad from dad. All right. Save money on car insurance. When you bundle home and auto with progressive gotta take these off, right? What is this? This is good. Wow. Where did you get this? I'm talking to you with the hair. Yeah. Where did you get this? Good stuff, solid. That's not veneer that solid stuff. Progressive can save you from becoming your parents, but we can save you money when you bundle home and auto. Progressive casualty insurance company affiliates and other insurance. Discounts not available in all states or situations. Let's say you just bought a house. Bad news is you're one step closer to becoming your parents. You'll proudly mow the lawn and skip anybody noticed you mow the lawn. Tell people to stay off the lawn. Compare it to your neighbor's lawn and complained about having to mow the lawn again. Good news is, it's easy to bundle home and auto through progressive, and save on your car insurance, which of course, we'll go right into the lawn. Progressive casualty insurance company affiliates and other insurers discount not available in all states or situations. We're back on statewide. I'm shawn. Crawford ahead. We'll find out about a major expansion of gambling in Illinois, and we'll break down what the legislation will do. Later, the final classes for an Illinois high school will take a visit there. It's all coming up. After years of struggling to enact a historic overhaul at the state school, funding structure, Illinois lawmakers, this session focused on other major initiatives like abortion, cannabis casinos, and a new income tax system that public schools are facing another growing problem that lawmakers have not quite figured out how to fix our education. Reporter dusty Rhodes explains in radio, we try not to spend a lot of numbers because those tend to go in one ear and out the other. So let's just say when the general assembly adjourned, a few days ago, public schools were set to receive eight point eight billion dollars virtually every penny. They requested, but there are some problems money alone. Can't solve the biggest discussion over the capitol for k twelve education really focused around the teacher shortage. That's Amanda, Elliott director of legislative affairs for the state board of education, that says something that has been discussed for the last several years. And yet, the shortage already severe is getting worse. According to a recent survey more than eighty five percent of school. Superintendents say they. Have trouble hiring teachers last year the legislature passed a law that allowed for reciprocity. So now anyone who holds a teacher license in another state automatically qualifies for credential here that chain brought Illinois at twenty percent bump in applications this year? The conversation really focused around testing, we had two bills passed that eliminate the basic skills test. That's a test introduced in the nineteen eighties. It's been revamped three times making increasingly difficult, seventy five percent of potential teachers flunked the test, which means they aren't, even allowed to take teacher prep courses lawmakers also considered eliminating the two other big tests required for a teaching license. There are different interruptions of bills, that were filed that eliminated content tests and the teacher performance assessment altogether. But eventually, we landed on just eliminating the basic skills test and studying content tests cow Thompson is assistant regional superintendent of. A seven county area in east central Illinois. And he has so many teacher vacancies. He traveled to Springfield to testify against what he regards as excessive teacher testing twice. He says killing that basic skills. Test just isn't enough for all the effort that was put in throughout this spring session. I just don't feel like we came out with enough solutions, or as great of an impact as we could have and shut up colleges that run teacher preparation programs, there officials showed up in mass to testify against the Bill Thompson supported, which would have eliminated all three tests, all never forget sitting in that room. And then ten or twelve different university professors, or deans or whatever went up instead around that table for you were in the room, and that was the group that, you know, was advocating essentially for status quo Elliott, whose job is essentially to act as the embassador in charge of negotiations between lawmakers and the state board. Admits more changes are needed. Eliminating the basic. Scales test, I think will help but it is only one small component. We really need to have additional conversations about other barriers to the teaching field. I think another Bill that passed that will help the teacher shortage is the minimum teacher salary Bill making sure that teachers are paid. What they deserve. I think is important and will hopefully help encourage more people to come to the field. Other things that need to be looked at include pensions, working conditions respect to the profession. Those are all really, you know, big rocks that will take time to evaluate and address in her, calm, diplomatic tone. She points out that one new measure requires the state board to review content area tests to see whether some need to be updated or scrapped Thompson, whose job includes helping find teachers for schools in twenty five rural districts sounds more like that student who legitimately needs, a fidget spinner. I feel like we're always creating passports and forming committees. It's just I feel like it just takes so long. Every year we do this. It's just another year of our, our lives in our effort, just not feeling position in rural areas. You know, and so, like I I get it. I'm sure they'll do the task force. I'm sure they'll come up with some solutions. I hope I guess I'm just baffled. They just don't think all the people that were in such opposition to all these changes. I don't think they realize how bad it is. You can read about other education plans considered by lawmakers, this session can check out dusty. Full reports. It's available. There's a Lincoln our website statewide show dot com. State lawmakers also passed a major gambling expansion in Illinois. And daisy contrasts followed that action, she joins me now to Phyllis, all in on what took place, one of the big parts of this gambling expansion. Daisy had to do with sports, wagering, you'll be able to do that in Illinois soon. What do we know about that right now? So horse racing. Tracks casinos, and certain sporting venues will get the opportunity to purchase a license to offer sports, wagering these will be for the brick and mortar licenses. And if those casinos, racetracks partner up with a vendor for online betting than both the in person and mobile betting can take place as soon as the Illinois gaming board. Accepts the applications and vets them. Now what if you don't have a casino? And if he wanted to offer only online betting while you'd have to wait several months before you can apply for one of the three of able online licenses and from what I'm told this will be a very competitive selection process, because the gaming board has to make sure the upper trinity is given to businesses owned by minorities. Women veterans and people with disabilities. But there are the big companies like fan duel and draft kings who might want to get in on the action too so more, because they if they partner up with a casino right now, for example, to offer online, wagering, they have to operate on their the casino brand name. So they wanna get their name out there. So they're going to have to wait for that. We've seen gambling expand Illinois going back. Well going back to the state lottery. And then, of course later came riverboat gambling, and it's moved onto having gambling right in your own neighborhood with some of these video machines that are in bars and restaurants. But this was a big step sports betting. Yeah, it really was because a year ago, the USO prem- court allowed it to be regulated outside of Nevada. So states jumped in on the opportunity and several states have already done that. I mean, also good to mention gambling on sports. College sports will not be allowed on their this, this Bill and professional sports leagues will not get a cut of the money. Unhurt a timeframe for sports betting to actually take off in Illinois to where you could actually go and make your bet. But we think it's going to be pretty soon, right? Yes. As soon as the governor signs the legislation the Illinois, gaming board will probably start accepting applications, they will go through a vetting process, and once that happens if the casinos have the capacity to start offering it, then it should be off the ground pretty soon would be both football season even told. Yeah. So along with that six new casinos. And when we say, new casinos, is that what we're actually talking about here that the these are going to be these big operations like we've seen in other towns. I know for sure that the one in Chicago would that is one of the most notable places Rockford in southern Illinois in what's known as Walker's bluff, one in south in the south Chicago suburbs danville, in what Keegan now to see the extent of how big they will be, we don't know they have the option not to build a casino, but rock. And carterville labor groups lobbied, hard in Springfield this session, and the they have in many other sessions just to make sure that they could get on this list. They argued that the opportunity would help them create jobs, not just the ring the construction of their projects. But also wants the casinos are established will be able to have people employed from the community. A lot of people might be surprised to know that Springfield does not have a casino. Always think of it as a pretty politically connected tune, but it's also included in here with a little special addendum for the city of Springfield for the state fairgrounds. Slot machines will be allowed at the state state, fair grounds, the, the, the mayor here, lobbied for a casino, but we Springfield in not make the list horse treks, they have for years complained about a loss of, of customers, because people coming in there to bet on the horses because of casinos, they feel as though they've been in competition and not they've not been winning that competition through the years was there something in here for horse strikes as well. Yes. I mean, not only will they get the opportunity. To offer sports gambling, which old, the different gaming industries really wanted us a new industry to help them attract more gamblers of the, but the whole trucks will also get the permission for mission to have lots and table games on their premises basically casino-style games. And these will get up to twelve hundred positions from the ones that we they I mean, they don't have right now that will be enough to help boost that industry, which it does create jobs. There's no doubt people that were used the horse's feed for the horses all of that. But they think this will be enough and they were here in Springfield. A lot of them saying exactly that, that this will help create jobs, and attract more people does anything in this change video gambling like we see at again as bars restaurants, places like that we see a lot of it and has become quite popular in many communities, anything change because of this legislation under the plan video gambling machines, will be okay for larger truck stop. The maximum bed was also increased. Maybe something that wasn't supported by the video gaming industry. Is that the taxes increased from the current thirty percent to thirty three percent in the first year and thirty four percent in the second year in moving forward? So what the industry was saying that this was going to hurt these video gaming operators, especially the smaller ones we've covered this quite a bit through the session, and watched the ups and downs of this legislation all the way till it got passed. But when it comes to gambling legislation in the past, we also call it quite often. Christmas tree bills because people start jumping on. And we saw this time as well. Lot of things get thrown in it often collapses under that weight. It's almost too big. Well, it didn't collapse this time. Do we know why that was the case? The gaming expansion Bill is attached to a forty five billion dollar capital plan for construction projects. And I think that was one of the main. Things here that got many lawmakers to vote in favour, so all of the revenue from this expansion will go toward that fun to specifically help with the vertical construction projects, so maintaining any state owned buildings like prisons, and universities and anything from licensing fees to the tax increases on video gaming, for example, we'll go to that. I think that in the beginning, like you said, some lawmakers than many stakeholders wanted to keep the sports gambling plan out of the vigor bigger expansion plan out of fears that it would collapse. But I also think many lawmakers both Republican and democrat understood the need for this capital Bill, something that we haven't had for many years. And if the entire package was going to offer some help with that. And if some of it would also help with job creation, many were willing to vote in favour. And I think it, it took a lot of negotiation at the end of this big package gets through the governor's indicated he's on board with it. Where does that put Eleanor when it comes to other states, I've heard somebody use the freeze the Vegas of the mid? West. I've heard the same thing to over the last several days neighbors like Iowa and Indiana already legalize sports betting in the last few weeks. I wa has nineteen casinos while Indiana has thirteen Ohio, has eleven would we would have sixteen under this expansion, Illinois also has also has also increased the gaming positions? So I think while we have a long way to go to catch up to Nevada. I think a lot is happening at once under this expansion Bill and maybe that's why it seems like there's just so much going on with gambling, and we'll continue to watch it as it rolls out and sports betting, as well rolling out here in Illinois soon. Let's daisy contrasts thinks daisy for following this for us and taking a few minutes here on statewide. Thanks for having me. If you've just tuned in to the middle of state by you can find a complete episode. That's one and all our past episodes at statewide show dot com. And you can also sign up for our weekly podcast through NPR one. The general assembly finished what by most accounts wasn't a store accession from the legalization of marijuana to the massive expansion of gambling. Lawmakers made significant changes to the state, and we thought we'd listened back to some of the voices that made news in the final week of the twenty nineteen legislative session. It's been a long year. Had a lot of emotions that have gone on in this chamber. This is an opportunity to fix the problems of Illinois and begin reestablishing the essential services that government is supposed to deliver here. We are debating a constitutional to hike taxes. When wild hub says Illinois is tax burden is the highest in the nation. These definitions, seem overly broad. And I am certain that most doctors if their incentive is to perform an abortion would be able to find some kind of loophole here to figure that out. I am disgusted by the propaganda that is out there suggesting that any woman late in her pregnancy, or even after giving birth as I've heard from some and then decide I just don't want this child and simply end its life. If we are going to do this, we must ensure that black and Brown communities, that had been divested that have been locked up and had been castigated to the side had to be central to this policy. And that is what we had in this Bill. We can disagree Mr President on tax policy and environmental policy, but we can all get on the same page. I hope that what we don't want to do at this time and place is to do something that will make it more likely that more of our citizenry will at some point developmental illness. It's amazing what we can do around here in just a few hours of people are willing to work together, and we just started doing that. So I feel rent a good path, and I'm pleased to put my vote on the board tonight and let's get our work done by tomorrow. We know that as we continue to work collaboratively, that is what we indeed want to do. We work collaboratively. There are a lot of things that we can indeed get done. And so we have a situation where many of our buildings, our state buildings are in a state of poor repair that needs to be remedied now I know it's difficult to pay for that infrastructure. But anybody who's traveled our roads knows that we've been shortchanging that investment for years tonight. We had a very difficult vote, but a necessary vote because if our infrastructure crumbles are rural economy crumbles with it as backed by business. It's backed by labor and it's backed. By contractors, as well as transit officials. We're authorizing six casinos Chicago. What key and south suburbs? Williamson county or Walker's bluff is known Rockford in danville. I I've only been doing this for twenty years, trying to get this done, and it's a little emotional, and a half to say this has been a job creation Bill from day one. We're bringing in six new manufactures the town, everybody would be on board. We'll guess what we're putting six types of manufacturing on for they're going to generate money for the state, they're going to generate employees. They're going to generate economic development, not only in those communities, but the state of Al-Anon. So this governor, did you see what a difference it makes to have somebody new on the governor's office? Introducing the new buttermilk crispy chicken, biscuit. At McDonalds, we don't eat that music made with tender chicken. Let's lose the echo on a warm buttermilk biscuit perfect. Simplicity of our buttermilk. Crispy chicken, biscuit. Speaks for itself. Get it now for just three bucks and get a two dollars sausage mcmuffin with egg or one dollars small hot coffee. All from the one two three dollar many simply your breakfast at McDonald's participation vary. Campy combined with any other offer combo meal. Right now. You can get both sprints unlimited plan and the all new Samsung. Galaxy S ten included for just thirty five dollars per month per line for five lines. All you need is approved credit and in eighteen month lease no trade in required. Visit sprint stores sprint dot com or call eight hundred sprint one who fifty dollars a month after twenty two fifty credit applied within two bills, or cancel early remain, unbalanced, do unlimited basic after six thirty twenty eight thirty two dollars per month per line for five lines with auto pay data deprioritization, during additions, be maximum rose. Restrictions apply. This has been an extraordinarily productive session of the general assembly, simply store, Illinois is back. Illinois is open for business. This is a place that stands up for working families. I mean, our best days are ahead. Devin, her Jay Pritzker among the voices that made news as the general assembly wrapped up its legislative session. Up next on statewide a group of students. Learn about death in a cadaver lab that story and more still on the way. This is statewide. I'm Sean proverb still ahead. Some students get a firsthand lesson death. Visiting a cadaver lamb and deactivating a high school will visit one community that has made that decision that in mourning still ahead on steep wine. The report published this week shows the twenty twenty census couldn't aglet to count as many as four million people nationwide. Meanwhile, Illinois is putting tens of millions of dollars into making sure no one has missed come. Next April Mary Hansen has details. The report from the urban institute shows that black and Latino populations are at the highest risk of being undercounted over the weekend. State lawmakers included twenty nine million dollars in the upcoming budget with an aim to make sure every resident is included that amount is a few million short of what some advocacy groups say, is needed. But J young says he's Optima stick. He's executive director with kamikaze Illinois a government reform group in Chicago. We have perhaps the most to lose in the country. So I I'm really glad that our legislative leaders folks from the governor's office and the Lieutenant governor's office were able to help Marshall us in the direction of, of this investment, the money will be available to community group. And city and county governments. Their charge is to educate the public on how the census works, and how the government will use the information it collects. I'm Mary Hinson more national guard troops have been brought into battle floodwaters along the Illinois and Mississippi rivers, two hundred additional soldiers were activated as the rivers continue to rise this spring, we've seen a major flood event with crests nearing all-time levels the guard and other volunteers are trying to shore up levees and keep emergency evacuation routes open. Alicia tate. Nadeau is the acting director of the state's emergency management agency. When asked to compare this latest round of flooding to the devastation in nineteen Ninety-three. She points to the continuous rain, which has raised river levels, and the snow melt up north at has kept levies, saturated for months that crest that we're talking about now are not going to just cress and then immediately go down. They are going to continue to stay there because we about the Mississippi and the Illinois that are converging and full of wa-. Water. This problem is statewide Tate. Nadeau says if there's a river in Illinois, it's likely flooded. Schools are now out for the summer, but we'll hear one last educational experience that central Illinois high school students had before going off the clock. It involves doctors and dead bodies brianna grow with member station. W G, L T reports on a unique high school curriculum. The cadaver lab in the small town of Libranoy population about thirty six hundred in McLean county on any given Saturday morning, the average teen might be getting ready for work heading to practice or a game or maybe even sleeping in but at eight AM on this particular day a group of around thirty high school students are the only teams in the entire country spending the weekend with cadavers. They've willingly given up four hours every Saturday morning over the last several months to study gross anatomy, at the law office of doctor, Tom pleura in LeRoy with scrubs, lab coats, glasses and clipboards, the high schoolers look like the real medical professionals, many of them, want to someday become worse. In small groups, the students buzz around each of the three cadavers laid out on exam tables inside the lab. Today's lab is dubbed the Glenn finale. The students are tasked with identifying all twelve glands of the human body after about thirty minutes and Adamus. Dr Martha Sweeney and Proctor gyms Lesnik, circle the room to check the students work. Dr Sweeney stops to help a group of students at one of the two male cadavers, they can't seem to find the final Suk lands. Says the kidney lanes at the female cadaver unless they helps the students identify another gland, they've missed he gestures inside the body's chest just below the neck down here started with a T, remember you talked about it. We all all we can see in the rest in cadavers, because they're old is just a little. Piece of bad. Her story. Climates and remember, so let's Nick explains the famous gland part of the body's immune system disappears, as we age the students are just seventeen and eighteen years old. And yet, they're dealing with subject matter, most adults shy away from, but Lisa Tomlin who teaches advanced placement biology at normal community west high school and serves as a Proctor for the lab says the students take a different approach to the experience or these young people. The capacity that they have for learning really has made this may be an easy transition for them that in death. These people are still teaching and so they're looking at it. I think maybe a little differently. It's not as a the end but really another phase of what the body can do for the future. And so they seem to be able to handle it, honestly, better than most adults that we have come through the doors normal community high school. Senior Jake sign. Says while his first day in the lab was a lot to take in. He got used to it pretty quickly. Just getting to learn like a bunch of stuff that I had no idea even existed in our body, like it's really cool to see like on the cadaver. And then think about how that is that part of the body is working like, in your own body to keep you alive. And that's just like really interesting to think about that. We're all like have the same anatomy, going on, like, we are able to see it like first hand on a real human buddy, that excitement about studying medicine is the reason Dr tumbler founded the lab nearly six years ago, he hopes the program will inspire students to join the medical practice in some fashion. Dr Laura says his undergraduate gross anatomy class was the formative experience of his time in school. That I ever had, and I want to open that app. There's no reason why you can't offer a similar program to, to area high school students. And for the students who do decide to pursue a career in medicine. Doctor pleura says the program gives them a real leg-up somebody watching doctor of, you know, a college professor dissect. The highschool students are actually been there dissecting from day one. So there isn't any better way to learn in my opinion for for student and just jump in and do it Mitch Augustine a senior at normal community, west high school says, there's another advantage to being in the program, actually, it is, the only high school experience, you can put on your medical squad vacation, so that's like amazing and. Then like if we were to actually go through the physiology anatomy Trig class. We would know more than most students in the class, which would be pretty cool. The school district superintendent, Gary tips. Erred, says the students aren't the only ones gaining valuable experience in the lab. Highschools who are teaching anatomy to students who when they Proctor and that lab, they get some of the best professional development that is available anywhere. And so now they can translate that over to forty fifty sixty kids that they're teaching in their classrooms. So there's so many layers to the impact of trying to do things like this, that have such a have a much more significant benefit than what you just see inside the lab tip cert- says to his knowledge, the lab and libra is still the only program in the nation that allows high school students to dissect cadavers, he credits the labs singularity to the innovative partnership between Dr pleura and the school district, Dr pleura works with them, McLean county, medical society to buy the bodies tips, erred, in the school district built, the curriculum recruit area students and secure proctors for the lab, the district, also contributes money from a special programming fund to support the lab when you bring those two types of things together. So does this an industry that's willing to do something, non? National, and an educational system willing to do something non traditional all to the benefit of, of young people. I that that is what made it possible. And that's not not everybody embraces that idea says he continues to hear from education looking to start their own lab. Tremont has hosted one in the pure yet area. And we continue to talk to people in the champagne area about the potential of hosting one in the champagne area, and, and, and we'll see where those things go. But, but our hope would be that, that we simply open the door of opportunity for other schools. So the we're no longer the only one that's our hope after their final lab, the students turn in letters, they've written to the families of the deceased Mitch and her classmate, Michael Mckee explained the letters are meant to show their appreciation to the families for supporting their loved ones decision to donate their body. So, basically just thank you for helping us with this opportunity to learn about the human body. Get like, really well detailed or like to first and all because this is like someone's loved one actual people. But at the same time like short appreciation for the opportunity, we also told them what we were going into to show like this was not wasting this. Like we actually use what they gave us, Dr pleura says he hears similar feedback from students that showed they understand just how unique opportunity they've been given. Students say, no, I'm I'm, I'm unhappy that. I took the class, not want. They all just are enamored by it. So I'm I'm confident we're doing the right thing. The students are confident as well, several have gone on to medical school to become nurses, veterinarians. And yes, doctors. I'm brianna grow. A small rural town in northern Illinois voted to deactivate its high school in the fall. So what's it like to be the last graduating class there? And how has the community reacted Peter Medlin visited the school just before the end of classes? The final seconds tick off the clock in the school day is over one of the last of the school year at Popol bosses are lying outside waiting for students as they trickle out the halls are a little more empty now, the senior class has already graduated. It's a small taste of what the school looked like next year when there are no high-schoolers left at all. Papa voters decided to deactivate their high school west November, they'll still have kindergarten through eighth grade. But the high school is one that will be bused to nearby Indian creek high school. Papa has been facing the same funding and enrollment struggles plaguing rural schools across the state. They're total K through twelve enrollment dropped by more than thirty students. In the last five years, they're district currently sits just under two hundred students. In the meantime, Indian creek will be adding more than fifty students with the new pop kids, the activation vote and narrowly passed and only one Papa high schooler was old enough to vote in the election. And I. Voted tax Alie keep the school here. His name is Anthony Custodio. He's a member of that final graduating class that is weird. You have these bunch of other people who get to like the alumni of their schools. Get to go back to their school like visit it, and hadn't really get to do that. But that's okay. Even though he knew there were supporters of the deactivation, he was still surprised to see it past. I remember there is a bunch of Facebook arguments about that, but I thought that was just an overreaction from a small group of people I didn't realize how many people were willing to just activate the school students at the schools are already very familiar with each other. They had homecoming together this year and Papa students had already been going to Indian creek for some sports and classes. Kendall hall Baker is the sixteen year old finishing her sophomore year at pawpaw. Yeah. I take Spanish one and world geography over there, one of the perks of the new students coming over is that Indian creek will expand class offerings that includes upper level Spanish, four course. I lived in my hometown life, and my dad and his brother in my grandma, also graduated from Papa her family, eventually supported the de-activation, but the decision wasn't easy. They were kinda surprised and sad too, because like Papa has been here forever in like we're the only like small town like has really lasted for so long along with the students only one Papa high school teacher will be moving over to Indian creek pop superintendent. Stan Adcock says he hopes the district can keep on those other teachers in any way. They can Custodio said some of his teachers were upset by the vote, but I know a bunch of my teachers didn't expect it. So bunch of my teachers. I know just took it kind of life harshly. Especially the ones who've been here for quite a while. The end of the school year has been a specially bittersweet for Patty Turan. She's been an administrator at pawpaw for twenty seven years, and she's retiring. The news is still reaching some of the students. Yes, I'm going to retire. Well, it was nice meeting, you move on. She said, she'll still be around. She lives, close and has a granddaughter in elementary school at pawpaw, the school is still figuring out what exactly to do with the empty space without the high school, but despite the activation Papa will continue to offer kindergarten through eighth grade classes. I'm Peter Madeline star a long day of being pulled in every direction the less thing, anyone wants to think about is what's for dinner. That's where Schwantz can help with a variety of real food choices frozen to lock in freshness from ready made meals premium meats, inside dishes to vegetables, ice cream, and more swans foods go from freezer to table in minutes not hours, so you can pull off a delicious meal in no time at all ordered delivered done. That's homemade easy to help simplify mealtime. Visit Sean dot com. Right now. You can get both sprints unlimited plan and the all new Samsung. Galaxy S ten included for just thirty five dollars per month for line for five lines. All you need is approved credit and in eighteen month lease no trade in required. Visit sprint stores sprint dot com or call eight hundred sprint one who fifty dollars a month after twenty to fifty credit applied within two bills cancelled earlier remain violence to unlimited basic after six thirty twenty eight thirty dollars per month per line for five lines with auto pay day to day origination. During your be maximum restrictions apply. Thinking that ramps up another episode of statewide or glad you could join us in tune in again at this time next week for more reports and conversations from in a rental Illinois. You can get a podcast of her show. It NPR one and find all of our episodes at our website, state, light show dot com. Sean proverb statewide is a production of NPR delivery boy with help from other Illinois public radio stations. The all new Toyota RAV four asks, what if what if your ride was refined rugged at the same time? Introducing the all new rap four hybrid two hundred eight combined horsepower, and standard all wheel drive, make it the most powerful four plus with its head turning style and breakaway speed. It's bound to change the way you think of a high the all new wrath for hybrid Toyota. Let's go. Places horsepower ratings, achieved isn't required premium unleaded gasoline with octane rating of ninety one premium fuel was not used performance crease, and no, an ad from dad. All right. Save money on car insurance. When you bundle home and auto with progressive gotta take these right? What is this good? Wow. Where did you get this? I'm talking to you with the hair. Yeah. Where did you get this good stuff, solid? That's not veneer that solid stuff. Progressive can't save you from becoming your parents, but we can save you money when you bundle home and auto. Progressive casualty insurance company affiliates and other insurance. Discounts not available in all states or situations.

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Healthcare Spotlight: Martha Hughes Cannon

Encyclopedia Womannica

08:44 min | 6 months ago

Healthcare Spotlight: Martha Hughes Cannon

"Hey Everyone I Matt Foley a producer here at Wonder Media Network today. I'm excited to highlight a bold activist talented physician and the subject of the first one manic episode. I ever edited Martha Hughes Cannon. Martha was never afraid to speak up for her beliefs. Even if they went against the grain of societal norms women of time could think her for fighting for their right to vote and for her great work in health sanitation. And that's pretty cool. This episode initially aired in March. But we wanted to highlight Martha Again. In honor of the many health care workers putting their lives on line for us today. Now here's host Jenny Kaplan to tell you all about birth issues cannon. Hello from Wonder Media Network. I'm Jenny Kaplan and this is encyclopedia. Manica today's feminist was a women's rights activist suffragette physician sanitation expert. State senator and polygamous wife. She was heavily involved in the fight for national suffrage and was an especially important figure in the fight for suffrage and women's Rights in Utah. Please welcome Martha Hughes Cannon Martha Maria Hughes. Born on July first eighteen fifty seven in Wales her parents. Peter and Elizabeth Hughes were both converts to the Church of Jesus. Christ latter-day Saints which is often known colloquially as the Mormon Church I will see Mormons the people of Lordy since the time. Joe's Brood for Martha was just three years old. She and her family emigrated to the United States and eventually made it to Salt Lake City where they settled down from an early age. Martha was academically gifted and excelled school. When she was just fourteen she actually taught school for a year but eventually quit after being bullied by some of the older male students recognizing her talent and drive Brigham Young. The head of the Mormon Church suggested that Martha should train as a typesetter instead after an apprenticeship Martha started work for the major Salt Lake City newspaper the Desert News. She eventually moved over to salt. Lake City newspaper for women called the women's exponent. This paper which was affiliated with the Mormon Relief Society was published by Emma. Lean be wells. A major women's rights activists and another member of the church. Emily Wells and Elisa. Snow soon. Became mentors to Martha and encouraged her to follow her. Dreams of becoming. Dr Martha took the advice and in Eighteen. Seventy three at just sixteen years old. She enrolled as a Pre Med student at the University of desert upon graduating with a bachelor's degree in chemistry in eighteen seventy eight Martha enrolled at the University of Michigan Medical. School just two years later on her twenty third birthday Martha graduated and became a full fledged physician. Martha practiced medicine for a time in Michigan before moving to the University of Pennsylvania to do postgraduate work at the university's Auxiliary Medical Department. Martha also took night classes in pharmacology. And Oratory and eventually earned both a bachelor's of science from the University of Pennsylvania and a bachelor's degree in oratory from the National School of Elocution and oratory in eighteen eighty two at just twenty five years old and with a slew of degrees in hand. Martha decided it was time to move back to Salt Lake City. She initially opened up a private practice in her family home before being approached by Mormon leadership to become the resident physician at the newly opened Desert Hospital for the era. That seems like an astonishingly progressive higher. Martha set up training programs for nurses and gave regular lectures on important. Medical topics like childbirth. She also met a man by the name of Angus. Cannon Angus was the Superintendent of Desert Hospital and a leader in the church. He was also a polygamist Liga was a hot button issue in the United States during that period while Mormons at the time saw it as a sacred element of their faith most other Americans found it. Blasphemous and use the practice too heavily stigmatized members of the Mormon Church. The Edmonds Act passed by Congress in eighteen. Eighty to criminalize polygamy and made it punishable with prison time. It seems that Martha wasn't concerned and on October sixth eighteen eighty four she and angus were married in the Mormon Temple. In Salt Lake City Martha became angus his fourth wife but soon thereafter rumors swirled of their recent marriage and Angus was eventually arrested and sent to jail. Martha went into hiding an effort not to be forced to testify against her husband soon after Angus went to jail. Martha learned that she was pregnant. She gave birth to a little girl named Elizabeth and then decided to visit family in Europe with her new baby. This not only put her out of reach of authorities who wanted her to testify against her husband but also ensured that she wouldn't be called to testify in any other polygamy cases in which she may have provided obstetric services. Still Martha missed home. And in December of eighteen eighty seven. She took a ship from Liverpool back to the US while Martha had been in Europe the US Congress had passed the Edmunds Tucker Act which took away the voting rights of women in the territory of Utah unlike women every other US state or territory women in Utah received voting rights in eighteen seventy and had been taking part in Elections. Everson's this terrified many in Washington who disliked practices of the Mormon Church polygamy and wanted to limit the number of Mormon leaders in positions of political power upon her return to Utah. Martha became involved in the fight for suffrage and joined the leadership of the Utah Women Suffrage Association. She gave speeches all over the territory about women's rights and the particular importance of voting rights. Martha was also a regular fixture at suffrage conferences along with her colleagues and friends. Susan B. Anthony and Elizabeth Katie Stanton at the eighteen ninety. Three Chicago world's fair. Martha was a keynote speaker at the women's Congress soon after she sat in front of a Congressional Committee in Washington. Dc to provide a status report on Rian Franchise Efforts in Utah. Martha took a particular interest in the rights and opportunities for mothers. She believed strongly that Educational Opportunities. A sense of purpose and greater freedom were essential components for successful mothers. She stated somehow. I know that women who stay home all the time. Have the most unpleasant homes there are you. Give me a woman who thinks about something. Besides Cook Stoves Wash Tubbs baby flannels and all show you nine times out of ten. A successful mother Martha worked tirelessly to include women's right to vote in the Utah State constitution after it was granted statehood in eighteen. Ninety six that same year she was elected to serve in the new Utah. State Senate making her. The first female senator elected in the United States. Fun fact she won her seat by beating out her own husband. If that wasn't enough Martha also helped found the Utah State Board of Health and authored. Utah's first sanitation laws. Martha died in Los Angeles on July tenth. Nineteen thirty two. She was buried next to her husband in Salt Lake City. All month were covering feminists from throughout history for more on what we're doing. Check out our new Encyclopedia Amana newsletter. You can also follow us on Instagram and on facebook at Encyclopedia Britannica. And you can follow me. Directly on twitter at Jenny Kaplan special. Thanks TO LOSE. Kaplan my favorite sister and co-creator Talk to you tomorrow.

Dr Martha Martha Hughes Cannon Martha Salt Lake City Martha Utah Salt Lake City United States Mormon Church Jenny Kaplan Congress Utah Women Suffrage Associatio Mormon Relief Society Wonder Media Network manic episode Cannon Angus Mormon Church senator Desert Hospital Matt Foley
Episode 5  Beating the Odds: What it Takes to Have a Healthy Heart

Reimagine Medicine

42:40 min | 1 year ago

Episode 5 Beating the Odds: What it Takes to Have a Healthy Heart

"Welcome to the imagine medicine podcast. We look forward to delving into the topics that are shaping clinical medical research medical. Education and challenging us to re imagine medicine each month we bring together clinicians, researchers, educators, healthcare thought leaders, and medical students to share the experiences and ideas that are fueling their efforts. In this episodes, we will discuss beating the odds what it takes to have a healthy. I'm Dr Johnny Lifts I'm Dr. Katie Bright, we're faculty members at the University of Arizona College of Medicine Phoenix. Thank you for joining US heart disease is the number one killer of both men and women in the US. What is being done to change these statistics? What does it take to have a healthy heart? We brought together experts who are taking on heart disease and we are so glad that they're with us. The opinions expressed in this podcast are those of the hosts and their guests and do not represent the opinions of the University of Arizona College of Medicine. Phoenix or banner health do not use this podcast for medical advice. Instead Console your personal family physician for medical care. Joining us today is Dr Martha. Gallotti. Gallotti is the division chief of cardiology for the University of Arizona College of Medicine Phoenix and physician executive director for the banner. University Medical Heart Institute Dr Galati. Leads education activities in. Scientists for medical students, residents, and fellows at the college and Banner Health. She also leads clinical heart care as the director of the Cardiovascular Institute banner. Thank you so much for joining US tonight Oh you're welcome. Thank you. The latest heart disease and stroke statistics for the United States and I'm sure other countries as well. Indicate that we do have a real problem. The statistics are roughly one in two adults over age of twenty have some form of cardiovascular disease that personally scares me because between Katie and myself one of two. Could have heart disease. Can you elaborate on these numbers and their implications for our thought about maintaining health? Yeah what it means is right now in the United States, like you said, the look at the person next to you and hope it's them. But otherwise, it's you who already has heart disease, and so it is a very serious issue. The reason the numbers look a little bit worse than they probably did even the year before because we have redefined hypertension. So we've lowered our threshold for where we make a diagnosis of hypertension and as a result, more people in the united have some form of cardiovascular disease. The problem is, is that you know? Most people don't recognize that they have cardiovascular disease until it's too late, I mean even know that they're at risk for it until it's too late. So usually as a cardiologist, I'm meeting them in the emergency room when they're having a heart attack and they were completely unaware that anything was wrong in that they were even at risk for a disease that's incredibly common. Interesting always disconcerting to hear the statistics. Clear very passionate about women's hell heart health, and this is where used to focus your research. Can you tell us what makes you so passionate and why you're so passionate about? And also about what research showing us about women's. Heart Health and maybe how women are treated currently in the healthcare landscape. Sure. So I think you know again, diseases so common in for women, heart disease remains the number one killer and what shocked me when I was a medical student and still continues to shock me as how little we still know about women's hearts and also how little the public stands their own risk. So when we ask woman if they know that there are at. Risk for heart disease or you know if they even ever had their hearts screened, most women will say, no, they worry much more about their breasts than they do their heart and it's sort of something that I say, you know it it covers the heart and the thing that you can see something sometimes more easy to understand that that might be a health issue. and. We've talked about women's health specifically as if the way we focus on and even as physicians with a Keeney like approach. So when we see centers for women's health. We talk about women's health we're always checking. Did you have your perhaps meter? Did you have your mammogram? We don't always ask about other organs and it's not unique to hurt disease since heart diseases. So prevalent, that's part of the issue and and what that has done in our society in general and in the medical community is left out fifty percent of the population. We also decided to women in terms of research in we wouldn't include them because they had that Pesky problem of getting pregnant we wouldn't include them because you know hormones might affect our research. So we didn't want that to mess up research. So for so many reasons, we excluded women from trials, and therefore here we are in two thousand and nineteen, and we still there are so many unanswered questions about women and you still see pervasive research coming out where you know we're doing better. But there is still studies just read a study last night you know thirty eight percent women enrolled. We can do better than that. We should do better. We often have studies that don't even report by SEC. So. If you have men and women why not report the difference in how a drug might have affected women versus affected men bleeding risks for example, now that we actually look at it, we know some of the drugs we use in cardiology that do save lives, but sometimes cause more bleeding in women is at the right dose for women. Should we be dosing based on weight or is there something about women that need different dose of the Drug and these? It's we know that genetically were different. And so it's not the you know the idea that women are just small men and that's what we really need to move away from. The other part of your question was just even how we treat women and the way that. For years we've known this, and this is probably why I went into this field is that when a woman comes into an emergency room, if she's having a heart attack, we're less likely to treat women as aggressively as we would men and that is a very real bias that exists in medicine and it's gotten better over time but it still persists and I think when I was a medical student I realized. You know that this was. I would see it in the emergency room that there is a difference when a woman who's talked about the elephants sitting on her chest versus the man he talked about the elephant on their chest. There would be different questions asked and how we listen to people how we even ask questions to people is sometimes different based on the sex sometimes based on the race of the person and it really shocked me that we treat people differently, and especially for me, I have a very strong family history of heart disease in women in my family and I and knowing that all this was. Not Either not taking place like research wasn't taking place in women and the way we cared for women was an equal. It made me know where I needed to be made. Me Actually decide this was my career and I feel very fortunate to not just be cardiologists but to focus my efforts on women and Cardiovascular Disease Prevention I actually only see women patients as a result of that. Absolutely engrossed listening to you about this because you're outlining. Career's worth or more of research initiatives as well as priorities that need to be made part of the work that I do is in children in the same issues that you brought up for women applied to children they're not just little adults they have different pharmacology and what have you. Many of the points that you touched on, we're going to approach would deanery in the next segment about personalized medicine and how can we treat that better? So thank you for introducing those topics. You also touched on an element of stigma. There's so much stigma about who should be enrolled or a particular bias, and there could be stigma about healthcare versus medical care or heart failure versus money your terms, heart success, and so what have you noticed in dealing with your patients particularly, the women if you reverse the narrative from heart failure to heart success, are you getting the light bulbs to go off and people to understand that there's an opportunity to improve the health and wellbeing? I'll tell you the whole thing about heart failure. This is a recent. Thing for me. So I I can't tell you entirely maybe a whole narrative around it, but I had a patient who came in with what we call her failure and I told her she needed to not just see me but also needed to see hurt failure specialists in our clinic. And explain to her why and she listened to the whole thing. What is heart failure why I needed her to see his heart failure like twenty times and she looked at me she said heart failure such a bad word. And she told me right then and there I'm not gonna go to that doctor and I said, no, no, and I I thought I convinced by the end I was like, no, you need him. We're just going to get his opinion we're not. Even agreed with her I said I hate the word heart failure. Because it is. So negative connotation is so negative and you know she did not go to the doctor she did not go to the colleague referred or to and It made me think about this and I started some conversation but there was someone else who initiated this conversation on twitter they were specifically asking what what does that mean I don't know why they asked that question but for me I answered back on twitter saying you know we need to think of a new term why are we talking in terms of failure? I. Mean there's there's gotta be. A better term heart success may not even be the right term but I think we have to think of words that make don't scare patients and also give them. Hope Heart failure means give up all hope because we're done here and that should not be you know if I had an illness I I would hope that there's hope for me and I would hope that there is something that you can do to make me better and I think the word failure means like to patients. It must mean that we've you know that's all we can do. We're done here. and. That is why should I go see that doctor and I get it and I've actually thought about this patient a lot. But I think words matter that that's what we realized when we're taking care of patients I mean you you are their voice you are. You're the person who they're looking for for what can you do to make me better but These these words that we use you know, I hate, even the word widowmaker I mean first of all that really. You know what about women who have the same obstruction and what does it mean now because now we're so good at treating when we see blockages cardiologists, we can go in there and open up that artery and and get the blood flowing again, and hopefully we're not making many widows or widowers the way that we have improved the statistics. But when you say that Oh you had a widowmaker. Maybe, it makes a cardiologist feel good like I saved you but it it doesn't actually do much for the the person who it's affected. Excellent points. Recently the eleventh annual readdress cocktail party was hosted here on campus and I think we raised were. Twenty, one thousand even more was raised. Can you tell us a little more about that event? What it means for women's Health Heart Research? Yeah. So we have a really wonderful group of women here in the Community of Phoenix who have started you know. who started this fashion show or this readdress cocktail party if you will and it's, it's really exploded too busy bigger every year which has been fantastic and it's involved our community actually. So within the setting of our medical school here in very beautiful setting, but it's brought the community together and really been away to at if fun way to educate women about risk of heart disease and that we can prevent heart disease, we target people of all races. So we all get together on probably a commonality of of I would say joy fashion and. Some nice wine. So. Between all of that I think we've been able to get people to understand their risk and understand that heart diseases preventable and it was actually started by a young woman named Maria Benson and it really in the memory of her mother because she did lose her mother at quite a young age and she's wanted to figure out how she could educate our community to understand the risk for heart disease and. I think we've been really successful. So we did raise a think twenty, one, thousand dollars. We're hoping to use those funds to actually train the next generation of doctors by that I mean really going into the community and trying to get kids at the actually chill like girls. I guess. At the younger ages in high school to be interested in healthcare professions and be able to open the door to them to what do we do in cardiology because cardiology specifically, we're only thirteen percent women in cardiology across this nation, and it hasn't budged in more than ten years that number. Now, there's more urologists in the country then cardiologists and we're trying to figure out why and we also want to bring these young women back to their community. Our hope is that they will be able to. Go back and serve their community and be welcome in their community and and also help us prevent heart disease or treat heart disease in their own community members whether they're become physicians whether they become nurses whether they become. Dietitians all the fields of technicians, whatever we want to show them all the wonderful things in cardiology that they could do and hopefully. Open the door for them. So that's where we're going to be using that money is basically we're going to be I think we're going to be calling in cardiology. camp. I. Love It. With all those great anecdotes about research and. Clinical Care Education community involvement knowing that you're at the helm of cardiology and Phoenix is going to position US quite nicely and recruit a variety of healthcare specialists to make sure that we're healthy enough not to need a heart failure specialist is probably the best way to do it. You'RE GONNA. Thank you so much for sharing all of your thoughts and just being here with us today. You've really helped us to change our thoughts and reconsider I think how we approach heart disease. Especially, women's health disease s physicians, researchers and s patients again, take a little break. We'll be back with some other guests focus on heart disease and thank you again so much for being with us. Thank you. Dr Johnny Lift Shit serves as the director of the translational neurotrophic research program, which is the joint venture through Barrow Neurological Institute at Phoenix Children's Hospital, the Department of Child, health at the University of Arizona College of Medicine Phoenix and the Phoenix veteran's affair healthcare system. Dr Katie. Bright is the chair of the Curriculum Committee and Co. Director of the family community and preventative medicine clerkship at the University of Arizona College of Medicine. PHOENIX. Placing students with community clinical partners all across the state. She is a family physician and the vice president of primary, Care Services at bayless integrated healthcare. Welcome back to the imagine medicine podcast we're pleased to have dean guy read join our conversation dean. Read is a noted cardiologist physician scientists health administrator. He's also the Dean of College of Medicine Phoenix he's internationally known for his research on mechanisms of blood clots vascular disease. His research findings have been translated into innovative clock dissolving therapies to treat patients with stroke and heart attacks that therapy is now in clinical trials, this episode is focused on beating the odds to achieve a healthy heart. We know that heart disease is still the number one killer in the US, can you tell us what progress we've made in? Heart, disease research and where we're headed from here. Thanks Katie. One of the interesting things about heart diseases there has been enormous progress in the last. Forty, to fifty years the. As a result of progress in and research and. Prevention The mortality rate from heart disease has dropped significantly a by about seventy five percent. Incredible incredible progress. Progress are disease has led to a prolongation of the life span the average American lifespan by about seven years. and. It is really been an area of pride for the scientific community as well as the educational community. The challenge going forward is that it's projected by two thousand thirty that about forty percent of Americans will have cardiovascular disease and the cost of cardiovascular care will rise to about one point one, trillion dollars per year. So a lot of progress but an enormous challenge going forward I'm sure that extending the lifespan for seven years means that people have seven more years for heart disease to start door to claim some sort of issue with well. I'm so grateful that you mentioned that this research and preventive care has been the leading force because I do research and Katie does preventive care, which is a focus of healthcare over medical care. But specifically, the research that you've done the one where you want to break open klotz breakthrough clots in order to improve outcomes from vascular disease. Can you tell us about quickly how you targeted a specific mechanism and then we're able to see these initial successes so it's it's an interesting. Perversion of nature that aim mechanism that has kept US alive for so long our ability to clot our blood and response to injuries and everything else has when you develop vascular disease actually been the cause of death. So we over many many thousands of years have learned to develop a very secure very robust blood clots, and we have a very slow mechanism for dissolving those blood clots to facilitate healing. We looked at several mechanisms that cause blood clots dissolves and we found a way to spontaneously accelerate that process by addressing the specific molecular mechanism called Alpha to any plasma. We think that this mechanism on and attacking this mechanism will enable us to safely treat heart attacks, strokes, and other causes vascular disease. It's interesting to be able to have a time, Turner. So to speak either accelerator slowdown. Time related element to. Not Accelerate disease, but to accelerate the process of recovery from disease. It's it's almost like that crystal ball which kind of brings me to the next. Question, which is precision. Medicine is sort of a buzz word and I know it's something you're passionate about can you just talk to us a little bit about how precision medicine affects the heart health landscape in just leaving how we prevent and treat shirt patients? Yeah. I think one of the real excitement about precision medicine is there's so many diseases and and so many illnesses that we. Encounter that we don't know the actual cause of the molecular cause of genetic cause of and because we don't know those causes, we can't design a molecular treatments really form the basis for near New Therapeutics. So the promise of precision medicine of programs like the all of us research program are really to help us get some insights into what might be the causes and to develop new therapies. one of the challenges and cardiovascular disease is a is a problem called heart failure. Even though we've reduced the a cute death rate from my Carl. Fortune what happens is patients suffer. From diseased hearts for a longer period of time and develop heart failure and there is really no targeted molecular treatment by doing precision medicine understanding what each individual's particular genetic. Sweet spot might be for therapy. I think we can improve therapy, reduce mortality, reduce morbidity. So that's the promise. Based on that promise I, want to push the limits a little bit. I could say that precision medicine is being a cardiologist as opposed to being a general practitioner and that you're being more precise in either your diagnosis treatment. So how far? How far can you take precision medicine before you're? At the elements or and using simply cardiology as as a example for that discussion. Yeah. So that's that's a great question. So for one, one of the challenges and heart failure is that we don't know who is at risk of developing a genetic cause of of cardiomyopathy of heart failure. If we could identify those individuals early. We could push treatment and prevention. Early, we could alter their behavior so that we could reduce perhaps the progression, the inexorable progression of weakness of their heart and death. So I think it has tremendous potential there. Once again, we're talking about time as long as you can get earlier sooner better faster we would be. Better, equipped to improve the health and wellbeing in Arizona and and our country's citizens exactly, and certainly focusing our funding in attention on those things that if you catch early can make a difference longterm and. Mortality. And chronic illness. So that's great. Tinari technology, it's advancing at a staggering rate. Can you just talk to the listeners a little bit about how the you've University of Arizona, College of Medicine Phoenix is preparing our future doctors for this highly advanced technological state that they're graduating into. So there many many ways that we try to do that but I'll give a concrete example. Everyone is focused on the enormous richness of data that we collect on on patients on behavior and everything else. But we don't use that richness of data to actually predict how comes or predict patients at risk order forecast potential illness. The college a longtime ago, made an investment and area called Biomedical Informatics which is designed to treat hard and not to treat, but to educate our students about how to use data in a predictive way so that we can improve outcomes for patients That's been a real focus and some leaders here at the college were also how we Silverman other people that were also instrumental in establishing a clinical informatics as a clinical disciplined to train physicians about how to use the richness of clinical medical records and other things like that to prevent errors to identify patients at risk to change our behavior and improve our therapeutic. So that has enormous. Future for our students. So that's great because the idea is that there's more information out there richness data that will help us improve what we're doing so. I want to take that point in transition. We have our medical students here are medical students need to be able to evaluate medicine in a different way. It's not just listening with a stethoscope Oto scope. It's now a whole. Electronic medical records as well as data. Do you see those students working on that themselves or do they need to partner with specific new brand of healthcare providers, these informations, and then those same way that those students would partner with those informations? How does the college partner with? Other entities to bring that to reality. Yes. So the concept of physician is kind of the lone ranger and delivery of healthcare I think has gone away largely We've realized that by partnering and Working and Interdisciplinary Teams, and then Inter professional way that we can be better at delivering good outcomes for patients. I think the college is really. has focused and the last few years at delivering a personalized. Innovative. Medical Education. We realize that the core elements of medical education may be accomplished in three years. And we're moving towards that and as we think about those core elements, we also want our students to be prepared for the ability to have unique expertise and training and all of these different kinds of disciplines where they may rise to become leaders that have tremendous value to our community. So, for instance, someone may decide that they want to. Go into rural health. They may focus on the. Special Training in that area and delivery a healthcare. Special. Challenges of social determinants of health other things like that that maybe a special area of expertise that they may have, they may also want to go. Into Clinical Informatics and develop. A special expertise there but we recognize that our students as physicians will always be better when they worked together with other partners in delivering health value. So with that, as you're talking, I'm thinking about our audience, some of the people in our audience, Our Future applicants to our college of medicine and many of them are cramming for the cat, which is primarily an English component of biology component in physical science component should there be an informatics component or should there be an interpersonal component in order to better segregate better identify people who are ready for accepting the technology required to be a physician that's not a lone ranger. The cats are important tool that we. Kind of us to understand how people can assemble large amounts of information and use it to arrive at conclusions, and it is a recognition of the fact that our profession is continuously tested throughout. Its. Development. So people are tested not only to get into medical school, but repeatedly tested in medical school and residency than in fellowship, and then after they leave. So that's that's a reality that's part of a social compact. It's one way that we demonstrate that people are capable of doing things. But we don't selects students based on 'em cats. We select students based on their commitment, their passion for medicine, their desire to serve and make things better, and we select them through intensive interviews. Multiple different kinds of people who from the community from our faculty who really have some insight into what it takes. Has Been such an honor to have you on our podcast. Thank you so much for joining us and I feel like we've just learned a lot about your your passions, your particular areas of interest in research. But also thank you for showcasing some of the brightest parts of our curriculum. Kick Kenny. Thank you. What's really Great Kia? Now continuing our conversation on reimagined medicine podcast with tape inhale Taivon. Is a specialist in cardiovascular pharmacology an associate professor in Basic Medical Sciences here at the College of Medicine Phoenix. She leads nationally recognized research program investigating the consequences of high blood pressure on the structure and function of the heart. The goal of her work is to develop new drug treatments to prevent progression of heart failure. Dr Hail teaches pharmacology to first and second year medical students. Welcome even. Happy to be, here. Thank you for being here in. So. Wanted to kind of just go across the at a little bit. So we know hypertension is a risk for heart disease. But thanks to medical advancements. Many people survive heart attacks. Now, unfortunately there at risk for other long-term consequences such as heart failure your research with fiberglass seeks to reduce the risk of heart failure in patients with high blood pressure. Can you explain this to to us to our listeners? Yes. Sure. It's you're right. There's been incredible advancements that have allowed people to survive. Longer with heart disease and unfortunately as consequences that means we have more people living with heart failure and so what happens in the heart is we get this progressive remodeling and an increased deposition of fiber optic tissues. So collagen and other extra cellular matrix components. And that impairs the ability of the heart to relax and contract, and so over time the heart is unable to pump enough blood to meet the demands of tissues. And the cells that are primarily responsible for that. Collagen. Deposition are the fiber blasts and so these are cells that are really interesting to me, and I think open up a novel target for therapy. Right now, we don't have any treatments that can reverse the fiber audit remodeling some drugs are able to potentially slow it, but we can't. We can't really stop this course, and so we're really interested in in finding learning more about fiberglass and see if we can target them to prevent this progression. Just spoke with Dr, read about precision medicine and you're talking about fiberglass in the heart, but there's fiberglass and other places in the in the body as well. What you how do you approach the thought process of trying to either accelerate or slow down the process of fiber last activity in the heart without necessarily negatively impacting other parts of the body. Yeah that's a really good question And I guess right now I'm not focusing solely on the heart although those are the that's the tissue I'm looking at some of actually some of the treatments were using we at we although we're focused on heart we see beneficial effects reduction in fibrosis in the kidney as well, but we can only Figure out the mechanisms, one organ at a time. So we're focused on the heart right now, but we're collecting kidneys as well, and we think we're probably going to see beneficial effects there. That goes back to our kids who ask, hey, how does the tylenol or how does the advil note to go to my toe or my ankle or my elbow? These are real questions that define precision medicine in an interesting way. It. So I have a question and we know that there's genetic component as well as lifestyle risk factors for heart disease. Can you just give us some ideas of ways that maybe you can beat the odds and have a healthier heart? Yeah that's a really good question. There are some things we can modify but right now we can't modify our family history and our genetic makeup. You know my pharmacology professor who would say you need to do all the things your mom told you to do you need to eat right? You need to exercise. And control if you have diabetes control your blood pressure, our blood sugar if you have high blood pressure, you need to take your medicine to control it, limit sodium intake. So all of those all of those things are going to be beneficial and help prevent your. Cardiovascular disease risk or limit your cardiovascular disease risk quit smoking you know I. Think the biggest thing that we can do is be active. Yeah it goes back to. The same take home messages that we keep hearing, which is we should really be in the business of healthcare not medical care. You don't want to treat the medical issue you WanNa, you WANNA promote health and wellbeing amongst people Katie, and I talk about it all the time that preventive medicine as opposed to the emergency medicine that is often required when people ignore what mom or dad or uncles or and say. That, we should be doing. That being said, it's how do you get people to listen and in particular I want to know your thoughts on how you get fellow postdoctoral fellows or clinical fellows how you get graduate students high school students to listen. Maybe to their own research before they listen to their own heart. What's Your Tell us about your passion for promoting their Involvement in in academics and pursuing. Work for the greater. Good. That's an easier question to answer than how I motivate them to be active. Because I can't lead by example there but can lead by example in the lab. Yet, that's actually a a real passion of mine is getting young students really interested in science and I think the earlier we can do that the better we have a the basic sciences has a summer internship program and we have high school students who come in and they learn how to do hypothesis based research, and it's a hands on experience some of the benefits of. This we may be getting them excited and potentially career and research but I think even beyond that if we can start teaching students to think critically and how to analyze data and ask them questions how to design experiments around that even if they don't pursue a career in science as a really important skills to have in life at, there's so much information available to us I think teaching. People how to critically assess information is important. I. Also know that you're part of an initiative here on campus the women in medicine and science, which is helping to bring traditionally marginalized communities or at least one of those marginalized communities to the table up front and center. We heard from Dr Galati about how she has a clinic that only treats or a examines women in regards to heart disease and really pulling back that curtain when give you an opportunity to speak about women in medicine and science, and how that serves as a role model for other investigators as well is for younger future generations of physicians and scientists yet. Thank you. It's. Another. Thing that I'm really excited about you know I think. Seeing. Seeing people in that are like you in the careers you'd like to habits really important when I think about graduate school. I didn't have any female faculty members in my department. We eventually had one assistant professor as I was leaving. And you know there were there that was impactful Starting to see women faculty and not that I ever thought I can't do this but it's meaningful to see people who look likely tape. It's been a pleasure having you here is part of our conversation. We look forward to seeing all your research results and future success in grant writing and as well as meeting your students as they come through we appreciate your time. Thank you. Thank you so much. Johnny I always look forward to just debriefing in discussing after our guests have left us on some of the key points I think possibly the most staggering thing for us to think about Indus remembers. That that heart disease is still the number one killer in the US. Unquestionably, we heard and we know that it's one and two. Doctor Galati. told us we hope it's not them or Them, hope it's not me because it is one of the people sitting next to you if you're driving your car right now and with the passengers, one of you to and it's Not. A good feeling What we do know though is we need more than hope and we heard from Dean Reed we heard from Dr Galati we heard from Dr Hail. They're all involved in research in ways of understanding the mechanisms that are associated with heart disease, and if we can understand those mechanisms, we can get more precise treatments. If we get more precise treatments, we can better tailor those treatments to each individual. It's absolutely critical to know not only the patient and disease but what is the intersection where where we can treat them what I learned was this concept of it's not just you have a bad heart. So to speak you have heart disease and if you recover from heart disease, it can lead into heart failure. So it's a whole new disease as it evolves over time. Yeah I really liked focusing on that a little bit to, and even though our technology has come a long way and we're surviving heart attacks at much greater rates that heart failure risk looming in the distance for. So many of our patients is definitely daunting. I did like very much though Dr, sort of focused on that and mentioned really even calling it heart failure verbiage as providers and healthcare Those of US delivering healthcare so important so. Using the term instead of a heart failure heart hope or heart success for patients is just an awesome Pearl right maybe there is something in that idea of a trophy generation that every year your heart's good. You get a new trophy and for participating in having a healthy heart could work out really nicely. That being said, there are some modifiable factors that we can do. Preventive Health is is such an important aspect to making sure that we make it into each year each decade healthier than the last or at least as healthy as possible you're speaking my language Johnny Preventive Medicine. Being proactive and preventive keeping people from getting sick in the first place as such a huge focus in primary care. But across healthcare in, you know I feel like that this has been a scene can throw the many of our podcast but I love the focus on that with our with our guest today and then whole idea of preventative health or preventive medicine in order to improve health relies on having A. Good role model what we know is that if you've got a good role model or a good team around you, it will work to achieve the goals that you want and we heard from Dr Hail about the effort she's making in terms of creating opportunities for all high school students and particularly young females in stem related fields to be able to be the role model that she never had in order to. Be Able to set up our college to get rid of that thirteen percent of I remember the number correctly of cardiologists across the United States of that idea of training women into. into the confidence that they need and the opportunities that are available for them to do whatever they want to do. So everybody can help be part of that. the healthcare delivery thing I also lake she mentioned if we all did everything that our mother said. We. Have the best of prevention. Unquestionably unquestionably, and I don't know about you. But my mother said, go do whatever it is that makes you happy whatever you're good at and so there's so many opportunities for everybody all minorities or marginalized individuals to come to the center to be leaders to be role models so that we don't have to have this conversation in ten years about why is there a distribution of the demographics in the academic or any other? Field. Tend to focus in primary care and I think just in general as Dr Garate, put it on and women's bikinis own. So I love just empowering our listeners or anyone who who might be focused a lot. We love to focus on breasts than pelvic exams but not forgetting the other organs coming forth if you have symptoms or just WanNa talk about that with your provider I think was a great. Thing for us to focus on this episode as well. To, use your word coming forth being an advocate for yourself being able to be educated in health care and health medicine be able to have an authentic conversation with your healthcare provider so that you can be healthy and you can beat the odds and and have a healthy life June vision for yourself. Dean read really drew some attention to some of the pretty cool things that we're doing here as far as technology and preparing our students. For the future, he mentioned the biomedical Informatics, which is a theme across the four years. One thing I was thinking about too is we also have something called an evidence based medicine theme across the four years. So as we get inundated with so much research. It's nice to know that we're kind of equipping our students with what they need to kind of tease through that even at the bedside and find the most evidence based and what's pertinent for the patient at that time Yes dr held mentioned that as well in terms of bringing in those high school students to teach them hypothesis driven science to be critical thinkers, be able to grasp as much information out there to be knowledgeable to be precise in their description and their treatments of health and Human Disease Katie as always we could go on forever. Extend this conversation this important discussion, but you know what our time is up for today. Livshits outlined A WELL-FUNCTIONING GI system. Out like a good night's sleep. The reimagined medicine podcast is brought to you by the University of Arizona College of Medicine Phoenix Join us again as we highlight aspects of clinical care education and research in an ongoing endeavor to reimagined medicine. Our podcast team doctor Katie Bright Dr Johnny Livshits Beth Smith, and the media production team at the College of Medicine. PHOENIX. Our theme Song Dungeon of Return Days was written and recorded by mid air machine. The song is accessible one free music archive dot Oregon used under the CBS a four point Oh license.

heart disease US University Medical Heart Insti University of Arizona College Dr Katie University of Arizona College College of Medicine Phoenix Heart Health vascular disease Phoenix hypertension family physician director Banner Health Dean Reed Dr Martha
406 Love The Skin You're In With Bare Author Susan Hyatt

Mindfulness Mode

36:25 min | 1 year ago

406 Love The Skin You're In With Bare Author Susan Hyatt

"Mindfulness mode four hundred six and I wanna show women what it's like to stand up for yourself. But in a way that is not tearing down other people. Hey mindful tribe. Get ready for a terrific episode right here on mindfulness mode. If you're new welcome to the show, and if you're a repeat listener, I'm so grateful to have you here. I'm your host and mindfulness life. Coach Bruce Lankford one of the things I want to mention is out be attending and speaking pod fest expo in Orlando, Florida coming up on March, seventh eighth and ninth. It's happening at the Wyndham Orlando resort. I've been to pod fest twice before. And I can tell you that. It was an amazing experience. I totally enjoyed it. Pod fest Expos all about community. It's all about people. Chris commits owes who is one of the founders is such a great people person. And he makes sure that this event is centered on what really matters, and that's connections. He's a terrific events host. He keeps everything move. The way it should be keeps things on time. And he has some excellent. Excellent speakers. You can check them out on the website if you'd like to be a guest on podcasts. Maybe you'd like to be promoted in the media, which is a great thing to have happened for your business. Maybe you'd like to meet hundreds of podcasters, including myself, come to pod fast. It's just one of the best places to go for this. You can check out the website at pod fast, expo dot com and get your ticket there. If you've heard about it here, and you decide to attend pod fast, Email me, and we'll meet up at the event. I'd love to see you there. So like, I said check it out at pod fast expo dot com. Today's guest explains her take on diets, which may be completely different from anything. You've ever heard she talks about how miracles have actually happened with her weight loss clients in only seven weeks she's worked with Oprah's teams, and she absolutely lives and breathes mindfulness. She's currently on a tour to promote her new book, which is absolutely terrific. I read it already. It's it's really well written and gives terrific advice. Much of it based on mindfulness. But it's advice about mindset, and how to change the direction of your life, especially in relation to food and exercise and diet and diet like you'll find out is it's got a whole different look at that word. But like I said she's on a book tour, so you can you can see your New York City on March second Atlanta. March seventh savannah, March eighth Saint Louis March tenth in L A, March twenty second Portland, Oregon, March twenty third and Seattle on March twenty four th so get out there and meet Susan. I think you'll you'll be glad you did sit back. Get ready for a terrific interview with Susan Hyatt mindful tribe. Wow. I am so excited today. I have the wonderful Susan Hyatt with me, we're going to talk all about weight loss and the body, and our mindset and all of this kind of thing. She's got a fantastic new book. Hey, Susan are you in mindfulness mode today? I am in mindfulness mode on steroids. Does that work is that the? No, it definitely works. It's okay. To be on steroids for today for this interview, the kind of steroids you're talking about. Having me. It's a delight. Oh, my pleasure. Susan height is a master certified life and weight loss coach based in Indiana. She's coached over a thousand women, and she specializes in helping women stopped dieting and love the skin there in she's the author of two books. Create your own lock. And now this fantastic. New book called bear a seven week program to transform your body. Get more energy feel amazing and become the bravest most unstoppable version of you. Or works been featured in places like, oh, the Oprah magazine women's world cosmopolitan and the Huffington Post. So we're going to talk all about this bear process. This is going to be fun. But first Susan what does mindfulness mean to you? You know, mindfulness is really the foundation of everything that I do because in working with our hands of women over the past decade around issues with food and body. It really is about having presence in being with yourself. And and in the moment and using all of your senses now this book bear seven week program. The first thing I want to ask you is. Why did you call your book bear be a r e a really good question because it's about shedding everything that you don't need and getting bear like bear down to the raw truth for yourself. Well, one of the things you talk about right away is diet. How do you define a diet? Well, I'm anti diet. And so a diet to me is any sort of external plan that you can mess up somehow it typically involves a lot of deprivation. Well, you have been on diets few times, I know. By the time of woman is my age. I'm forty five she's dieted on average thirty one years of her life and within that time has tried over sixty different kinds of diets or try dieting sixty times. So for sure I is met my time dieting, and what I discovered in the beginnings of my career in helping women lose weight is that I could help women lose weight. There was a lot of other things going on internally that was the real issue and the external plans or the deprivation that goes on with trying to lose weight is not sustainable. So I've created what I consider to be a sustainable way of being. Well, you talk about Weight Watchers because you are on Weight Watchers, and you were very clever with Weight Watchers because you describe it your book about how you learned to cheat their system. How's -able? Always been a bit of a contrarian. And so yeah, you can absolutely gain the weight watcher system. So. Weight Watchers is appoint space system, and I had a a little Pearl bracelet charm, where I would track how many points that I had eaten, but you know, it it's one of those things where different food groups have different points assigned to it. And you know, if you if you over eat on broccoli, you're still overeating. So so I would find foods that had low points and just gorge myself with those and if you're only keeping track of points, you're only measuring scale wait, you're really missing an opportunity to get to know yourself and figure out what else is happening. Well, this whole weight thing all came to a head one day when your daughter Cora snapped a picture of you tell us about that. Well, so she's eighteen now, but she was Luda thing at the time, and we were going on spring break, and we I ordered new swimsuits for all the whole family. We knew each Dow's. New swimsuits, and I was feeling good about myself. So I thought and I put on a swimsuit, and she took a picture of me in it. And I remember she was so delighted to take this picture up because kids right kids love to be in photos. They loved to take photos. They until they're older haven't received a lot of the programming that we've received that our body should look a certain way. And I remember I looked at it and thought oh my gosh. Like, let's delete this immediately. And I remember she was like what's wrong. And in that moment, it kind of struck me that I was I was deleting myself literally. And how often we do that in our lives where we duck out of photos, or we position the kids in front of us in photos, or, you know, avoid situations where we're not going to be seen because we don't think that how our physical form is showing up is good enough. And it really caught my attention that I didn't want to model that for her while, I think, that's awesome. And you know, I just want to take a second and tell you that your book is so much fun to read because it's just it's easy. It's it's straightforward. It's like you getting to know me, I feel Susan like, I know you, and I I just received your book, and I know that your book is geared toward women. And that's okay. But I just loved reading it because it's so personable, and and I feel like I get to know you, and you're telling me your story, and then in your book you start talking about different things that made me laugh like your intense Mexican binge fast at the LA hacienda restaurant. You know, I was laughing. I think this book is such a joy because it will be so easy for so many women to to understand your message. And of course, your message. Is through the bear process. So let's talk about the bear process. How's it different from a diet? Absolutely. So basically what I did how I created the bear processes that. I started to realize that my space in the food embody round was really about self love. And I started to think about of all the successes that I had had is a personal coach what were the activities that? I would assign for homework to my clients that had the most success and success in a couple of different ways. So I don't mean success like, oh, this assignment caused x number pounds to be lost. I mean assignments that they couldn't see coming that. They couldn't over think that they thought oh, this'll be great. I'll do this. And then once they did it. There was so much revealed to themselves and then to me as their coach to work on. So I started to track those activities. And I put together what I curated a list of what I thought would help woman come back to herself the fastest. And so yes, we do talk about food. But we talk about food in terms of mindfulness in terms of attentive, eating and using all of your senses when you're eating instead of like, you mentioned jokingly the Mexican binge best, you know, eating behind your back and doing all those things that happen when you aren't mindful, and when you check out and just stuff yourself. So the first step though of the bear process is something I call environmental diet, which is about all of the things coming out you in your environment, and in your life that aren't food. So what are you watching? What are you listening to what kinds of conversations are you having with friends and family and colleagues at work? What's coming at all of your senses that contribute? To your mindset, and you're feeling state. And what's interesting about that? First step is that many of my clients realize that they've just been on default mode that they haven't been awake in their own lives. And there's work to be done around boundaries and decisions. So that they have a much healthier way of being going through their day in their life. And that's actually one of my favorites steps because so many people I know this was me. I really didn't think I had a choice. You know? Oh, this is what everyone else wants to have on TV, or this is what everyone else at the office is doing for lunch. And it's it's a process of putting yourself in the driver's seat. While I love how you tell the story of hiring your first weight loss coach Brooke cassette, the ELO, and she said what would feel like love right now. And she talked to vote love. Well, let's talk about love what does that have to do with losing weight? Absolutely. So yes, so Brooke was instrumental in my life. And that question what feels like love is really guiding principle of the bear process because what feels like love that question is so unique to so many t- to each individual. So what feels like love to me means coming on this broadcast in sharing what I know rather than taking a nap, you know, and what feels like love to client might actually be going to palabras instead of sitting on the couch and eating a bag of Doritos. And so the question isn't what's easiest it's what feels most like love, and it helps us turn turn towards our? Bodies and figure out what's the best possible thing I could do for myself right now is it really watching the state of the union address. Yes. Or no for some it could be yes for others. It could be no. But it's asking the question to guide you instead of just being in default mode. So what happens if I think what feels like love, and I think oh eating chocolate cake or eating fresh made homemade bread with butter. What do I do then? Yes, I love both of those. When I talk about food. I talk about food in terms of not good or bad. But there's foods that power you love. So the energize you power foods in foods that are pleasurable that are strictly for pleasure. And of course, power foods like my favorite avocado can also can be both. Right. But so if what feels like love is that I sit at this table and have homemade Brad with warm butter. Absolutely. I think that's part of the problem is that people assume if I'm living a healthy lifestyle that there are in tire food groups that are out of the question or that I can never partake in that. So yeah, it might be a piece of chocolate cake. But I bet it's not the whole cake. And I bet it's not cake every single day. I bet it is. Yeah. No. I I'd feel pretty gross. I think for me part of it is denting the feeling that I'm going to have after I eat a certain amount. If I eat a couple like one or two chocolate chip cookies, I'm not gonna feel too bad. But if I ate a whole bag of chocolate chip cookies, I know how my body is gonna feel and that's not good. Right. Susan. Absolutely. And you know, what the thing could be said about what what a lot of dietitians would consider to be healthy food. I love omens. But if I eat too, many almonds, I feel sick to my stomach, you know. So it's it's a matter of taking the labels off of food in tuning into your body. Like, you said, hey, I'm good with a couple of cookies just like, I'm okay with about a half a glass of champagne, but if I go beyond that, I'm at the age now where I'm going to have night sweats. I'm not going to be able to sleep. This is what happens to your listeners who are aging. You know, I have a choice to make. Then if I'm served a glass of champagne, I can choose the still drink it knowing that later, I might have night sweats or I can choose not to because I don't want experience that and not beat myself up either way. Exactly it I think that's what mindfulness is noticing those feelings in those those emotions in those experiences. Right. Absolutely. So it's it's mindfulness. It's key throughout really every step of the spare process because it's being awake present using all of your senses. And not, you know, checking out. Let's talk about shame. Susan. I know that you described shame. As how you felt when way back when one of your first coaching clients ask for a refund after her. Yeah. Not you felt shame about that. And that must have been a horrible feeling. And then you realized you realize that your website copy didn't explain how you worked in that. You all you need to do is upset update your website. So people would know exactly how you roll. But what about shame that we all feel associated with food and our body image. Yes. So shame is absolutely a prevalent in the diet industry. So, you know, we're talking about I don't even know what today's specific star, but sixty billion plus dollar some estimates are hundred billion dollar industry that's rooted in keeping us on this yoyo roller coaster rat race never feeling enough. And shame as a tool that our culture employees for many things. And and you know, I'm here to say for everybody listening that your body is amazing. However, it showing up today and the choices that you make your own. And so you don't have to prove to a trainer a dietitian a coach anyone that your choices are worthy or that your body is worthy. And I think that the more we can pay attention. In to the instances, the things the environment it triggers that cause shame the more. We can help heal that with compassion and love and so absolutely. I I way of shame. You know, when my client fired me and waves of shame. When I would eat a whole wheel of Bree. And it's because we're we're taught that we have to behave a certain way or or or act in eat, according and move our bodies, according to a certain regimen or were not good enough. And I'm here to say like that is so counter productive to what really needs to happen for healing that I just want to invite compassion and presence over Shane. Susan your book talks about decluttering. What does decluttering your closet have to do with your body and your goals and your vision? Oh my God. I love this one so much, particularly because Marie condo. Is. So hot right now. Her Netflix series tidying up. I read her book when it came out. And the thing that resonated with me about that book was the question does this far joy. And I use that as part of my mindfulness strategy on a daily basis, and it absolutely applies to your closet. So when I assigned to my clients that we're gonna decluttering your closet, and we're going to ask the question does this far joy about whatever it is. You're lingerie drawer, your shoes, you're t-shirts, your workout gear. Most of my clients get really excited because they are. They're like, oh declutter. Okay. I can do that. Because they think that it's not gonna be as deep as it is in honestly brings up some of the most painful thoughts and feelings to work on for my clients because in your closet, if your listeners or anything like me, you probably have a range of sizes. You probably have ambition clothing. So oh when I dropped that last ten. Pounds. I'm gonna wear that dress. Or you have I had a stack of genes at various sizes just in case and part of decluttering is guess what the fabric that you're putting against your skin has energy. And if it's clothing that doesn't fit you right now, it's gotta go. If it's clothing that, you know, I was just covering up in trying to be quote, unquote acceptable. But I didn't really like my wardrobe. So think about putting things against your skin that you're just like or I hope it covers me up enough that has real ramifications in your life. And so instead what I work with my clients to do is most of my clients are like, you know, what if I get rid of everything that doesn't fit me and everything that doesn't spark joy, I'm not gonna have much, and I say, you know, what I would rather you have three things in that closet that do spark joy that you wear over and over and over again while you rebuild. What you have whether it's through consignment shops or sales or whatever versus putting things on that. You hate me. There is a real energy and magic to clothing, and whether your listeners listening to this some people are like, yeah, I'm just not that into fashion yet. But I bet if you go to your closet right now and ask that question does the spark joy, you're gonna look at what you put on a really different light. God, I think you're right. And speaking of sparking joy, tell us about the joy that was sparked the first time you've got a call from the old pro people. Oh, I was sitting in this chair and the first time, and it was a message that they were gonna call back. I missed the call. They were gonna call back, and I sweat in. You know, just couldn't believe it me an Indiana getting a call from Oprah's people when I finally connected with them. I was in. My car in Savannah, Georgia, which is where I'm originally from. And I was actually going to a restaurant to meet my family for lunch. And I was just they were like where is she? Because I was circling the block on the phone with Oprah's people, and I was like, I'm not parking this car until I find out what's out, but it really was a feeling of validation and relief that what I was doing was making a difference in getting some attention in the world. Well, that's fantastic. And then you went on to work with Oprah's people tell us about that. How did that say there were a couple of different projects? One project was in conjunction with IKEA's stores, and I traveled to about four different major market IKEA's doors en- gave like living your best life type workshops in store, and then that led to a collaboration with magazines on Seattle's best coffee where I was sort of the the life coach coffee chat featured in campaigns. And then I also idea came back again, and I was on a team with Lisa lee-ing and some other amazing women, and it was called the life improvement squad. And so that was also really fun project in magazine and live events. And so it was it was an amazing experience each time while that's great. It must have been so exciting. I know in your book, you talk a lot about toxic thoughts. What do we do about toxic thoughts? Or there are so many thought replacement strategies that your listeners could try, and I'm sure you've covered some of them on your podcast before toxic thoughts. I remember when I first learned that I was not my thoughts, and that I could actually disbelieve or disprove my thoughts. I thought I had won the lottery and also realized oh, this is why I'm so tired all the time. I'm walking around telling myself awful things on a consistent basis. And so a few of the strategies that I love to do one is to try pivoting or replacing those thoughts with if it's not a positive thought. At least a neutral thought that can help bring your feeling state up from whatever negative feelings date, a toxic thought is generating. So if you're stepping on the scale, and you're thinking something like, you know, I'm fat and were. Worthless and nothing ever works. That's going to create a physical vibration in your body. That's not helpful. And that will lead to action that we don't like. And so I love to brainstorm creatively. You may not be able to go from. You know, my body is terrible in worthless. To my body is beautiful in one pivot, but you could think of an reach or a neutral thought like I'm learning how to love the skin I'm in. So I really enjoy buffer or bridge thoughts. I'm learning. How to I'm open to learning how to until you can reach for a kinder loving thought. Like, I'm amazing just how I am. All that's great is seven one of your lucky numbers. How did you come up with a seven week program? You know, I used seven a lot I use seven in my pricing seven stabs, it is one of my favorite numbers. But the bear process I have to. Admit was originally only six steps and the seventh step that I added was pleasure. And pleasure. I I love to say that you really don't need more willpower here. What you need is more pleasure in your life. And I it was one of those things that I say so often that it was right in front of my face. And I thought what I need to add that as an actual step in the process in cultivating, more pleasure. So it was six now at seven which made me delightful. Delighted about that. I love seven seven weeks. You can transform your body. Seven weeks isn't very long, it's not very long. And and the thing about the bear process is it's seven steps. I I was asking people I have a membership community for bear. And I said, hey, I'm going on the news this morning, and then I'm going to be on BRUCE'S podcasts. And you know, what would you say? What would you want of you or a listener to to understand and many of the women commented? How miracles happen for them. So quickly. It doesn't mean that at the end of seven weeks, you have no more work to do. It means that you have quite a jump start. And we repeat the seven steps in our daily lives over and over and over again, and it becomes like breathing becomes part of how you are in the world. On love the subtitle of your book because it's just just makes me feel energetic and alive the seven week program to transform your body. Get more energy feel amazing and become the bravest most unstoppable version of you. How does this program give you courage and strength in this bravery? Well, one of the steps is the final step is called make seen and be seen and make a scene is all about advocating for yourself creating boundaries. Speaking up in small ways in large ways. And so it's not so much about being disruptive. Although that could be how you make a scene. It's more about using your voice to say what you want and ask for what you want in a bold way. And so there's a whole a whole week a whole module around how to do that. And then being seen. Gene, also is part of it that typically my clients who have spent their whole lives trying to shrink their bodies are have spent their whole lives trying not to be visible because they didn't think that they were worth it or their bodies were good enough for it. And so that boldness that bravery is part of the bear process. So I teach you how. As a coach as a person who helps women with their body image. Have you ever been bullied? Do you have a story about this? You can share with us. You know, I hate to say this. But I'm actually there's a lot of online bullying that happens on a consistent basis. I find that the the higher I go and the more reach. I have the more online trolls and bullies come out and wanna say nasty things. And so yeah, absolutely. I mean over the years, I have had a number of even groups of people who don't like the messaging that I have. I mean, you have to think about how many people within the diet industry count on women feeling less than and so if you have someone promoting that you can actually stop dieting and learn how. To have a sustainable in loving relationship with yourself. They're gonna they're gonna spend some time throwing rocks at that. And so I would say the the biggest case of that that has happened within the past year is there was someone actually who had has a prominent following a large following who was asking a question about food in body and some people who enjoy my messaging went on that Facebook page and said, hey, you know, you should check out Susan Hyatt's bear process than they put a link to it to my website. And this person went and looked didn't like what she saw and had some really negative terrible things to say about it. And so then these thousands of her followers just kind of piled on and people were tagging me and defending me, and I just I just said, you know, what I'm not dipping my toe in that Hornets nest like that is not worth my time and energy it. Stone the little to see it online. And this is you know, I have a twenty year old and an eighteen year old who, you know, for the past ten years of them being on social media, whether it's tumbler Snapchat, Twitter, Instagram Facebook, this kind of thing goes on and I have to model for my kids either. If it happens on my page, I might say something back, but I'm not purposely going to go into a situation where it's toxic and waste my energy on that like I wanna be a leader online. And I want to show women what it's like to stand up for yourself. But in a way that is not tearing down other people. But honestly, I hate to say it at, you know, the saying, you know, don't attend every fight you're invited to I could potentially be invited to fights every day. I I do not do where's the best place for us to find you online. Susan. The best place would be either s Hiatt dot com. S H Y ATT or let's get bear dot com. That's the book website. Let's get bear dot com. Okay. Well, I have five quick answer questions as we move forward. Here. If you just just quick thirty second answers are perfect. The first one is this who is one person who has influenced mindfulness in your life. Susan, I would say the woman who trained me Dr Martha back. She is a great role model for mindfulness in she absolutely. Introduced the concept to me in the first place. I think Martha Beck is awesome. I've read her book, and I noticed that she she commented on your book. She endorsed your book right on the cover. That's awesome. I was pretty happy about that. Absolutely. She's wonderful. How is mindfulness affected your emotion? Susan. Wow. So mindfulness helped me not only recognize what emotions I was actually feeling, but what was creating that emotional state, my thoughts. And then how to stay present with myself create more good feeling how is breathing part of your mindfulness practice, so breathing is. Wow. So core. I find myself periodically through the day taking deep breaths because it it just brings everything back to center for me. So breathing. I'm an athlete, and it's also key in terms of cycling and running and mean, human breath is really everything you've written two books create your own luck. And of course, this new book, which is going to be a best seller. I'm sure that they're a seven week program. We've talked about it quite a bit. But are there any other books that you would recommend that are related to mindfulness? I would say. I mean, I always recommend my favorite self-help book of all time as Martha Beck's finding your own northstar and quite a bit in there that I think your readers would enjoy and the artist's way by Julia Cameron is also a great book along the same lines. Those two are some of my favorites to recommend they're great books. Both of them. Are there any apps that you recommend either for dieting odd auditing while it's not dieting, you know? That's almost like I shouldn't even say that word. Right. But you know, what? I mean, like are there any apps that you would recommend to any of your followers? You know, what I am probably the least techy person, even though you wouldn't think that by observing me online, but I don't use apps for mindfulness. Although I know that mindful is like the number one mindfulness app out there that a lot of my clients us. Do you meditate I do meditate, but I meditate through a move. Moving meditation. I was about hilariously. I used to try to sit on a meditation pillow and watch a candle and do all the things, and I didn't have much luck with it. And what I noticed was that running is a moving meditation for me at the grieving involved in the movement allows me to really get into the zone. And honestly, all of my best business ideas and solutions to my problems happen when I'm running that's great. You're running can be a great form of meditation. That's that's for sure. Susan. It's been awesome to talk to you about your new book, and we can find it at s Hyatt dot com. S Hyatt H Y A T T. And of course, let's get bear dot com. That's another place to go for it. Check out this book. I highly recommend it. I think it's such a wonderful book because you've got a great way of communicating with your reader and with your followers. So your followers are very fortunate to know you because you are a wonderful inspiration. Susan. Thank you so much. It's such a pleasure to be here in honor. Yeah. Thanks so much by now by. Thanks so much for joining us today on mindfulness mode for show notes for every episode checkout mindfulness mode dot com and type the guest's name or the episode number into the search bar. You can also go mindfulness mode dot com slash whatever episode number you like if you've enjoyed this podcast, you could help us out by subscribing to mindfulness mode. Wherever you listen, whether it's on I tunes or Stitcher Google play Spotify, so many places you can hear mindfulness mode, so hit subscribe and share because that truly helps our show till next time mindful tribe us what we've learned today to reach new heights of calm, focus and happiness, stay in the mode.

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73) On Academia (part 2)

Public Comment

13:04 min | 1 year ago

73) On Academia (part 2)

"On academia part to a losing my religion about a year ago a wrote in an essay that is viewed academia as my temple holy place face sanctuary haven oasis teradata. Shang relied CETERA. My rationale was this academic esteemed clearly the embodiment of a sort of official peer reviewed network of institutions wear knowledge and critical Nicole thinking in theory are preserved and advanced in their Rosneft purest forms laboratories laboratories of thoughts research and experiments where the most technical appropriately jargon. D- theories are developed published I and analyzed although academia remains for me what death was for the Oh feely a- of Bob up dunes song desolation row quite romantic in hindsight it occurs to me that treating Academia Samya as a field of holy and religious ivory towers first of all in its dogma and Myopia contradicts the truly academic spirit and also as the BG saying. Oh it's a great big world that we live then you've got to stop think again an entire universe exists beyond the scope of classroom textbook and grades now if we may imagine God could exist and we were to imagine a god is simply another word for the Almighty -Ness of of the universe then for me those first two of the ten commandments in the Bible somewhat resonate with me. Thou shout out have no other gods before me thou shalt not make unto thee any graven image or any likeness of anything that is in heaven or above or that is is in the Earth beneath or that is in the water under the earth. Thou shall not bow down thyself to them or serve them for I've Lord by God jealous got or another way consider that classic cliche expression don't place all your eggs eggs in one basket or as Bob Dylan sings. It is not he or she or them more it that you belong to. I've not lost any of my passion. Passionate love for academia rather have channeled it through a shifted and clarified perspective. The glimmer is of it's stunning beauty remain for me and I still hope to find a way to spend all my life working as a professor professor of creative writing but university and its campus no longer serve as a religious institution institution for me the closest I get to such a sacred place is when I think of of the universe in general as such the thing about it any other way I believe is to overlook the magnitude food of the miracle and the last thing that is this ultimately mysterious experience of human life Zayed's fear and desire since July of two thousand fourteen. I've been in love with academia or the college scene and for most of the time between then and now just over half half decade. My dream has been to attend a graduate school to study something and then work towards becoming professor something change my mind more times and then I can recall about just what I might like to teach in there were short periods in between when I thought I would prefer self employments. It's working in the media or climbing up the ladder within the world of politics over some kind of professorship but I have leaned Komo more often towards desire to teach in higher education then I have leaned away from when I failed to both receive funding from an MFA program and Employment From Nearby University after graduating with my bachelor's Sir degree I panicked raced away from I dream and grew convinced that academia would inevitably fizzle out from the economy midst of such a rich world of cheaper information exchange across the Internet digital media media platforms also the scarcity of job listings college job listings combined with all the lamenting negative various disgruntled full time and adjunct professors frustrated with dropping enrollment Roland numbers and so little funding seemed to corroborate this. Something else also occurs to me. No no matter how intense desire I may feel for a thing whether immortality health among jeopardy some love or sex fantasy millions of dollars traveling the world no more war etcetera. If I was to think reasonably about got it I didn't need the fine of balance within me between strategizing logistics planning a considerable determination all that jazz about chasing chasing dreams and finding a way to accept that you can't always get what you want but if you try sometimes well you might it find you get what you need. Mick Jagger Keith Richards were that one should be able to see things that things things are hopeless and yet determine be determined to make them otherwise hold and balance the sense of futility of effort and the sense of necessity Sassanian struggle the conviction of the inevitability of failure and still the determination to succeed more than these the contradiction between the dead hand of the past and the high intentions of the future at Scott Fitzgerald Alas it is the a case that even as I leaned closer to accepting the wisdom of Jagger and Richards that I might find I get what I need. You'd if not what I really want. Fitzgerald's advice out one still possess determination to succeed failed to resonate with me. It's as though the fear literally turned off all connection to the desire meant to me and all I ever or learned about persistence of a dream that I had spent five years concocting and devoting my soul to I believed had been burnt at the stake. I literally sang along with John Lennon. The dream is over a what can I say. The dream is over yesterday. I was dream weaver now. I'm reborn yet as his fortune would have it as I was digging the ditch for my dream and bearing it a handful of generous individuals kept grabbing the shovels for my hands picking up my practically then unconscious comatose dream no matter how many times through this collapsing dream back into the ditch pitch a mentor of mine. Dr Leonard Win Agora all summer long gently reiterated his convictions may that I would benefit from the education location of a graduate degree program so did my therapist had I heard of this school. What about that one why not search for a scholarship here or there and other generous soul. Dr Patrick Noonan often reiterated his disappointment. My boss the soon to be Dr. Charles. Haas us soon to be Dr. Charles. Ost also insisted all summer long that I keep my eyes on the jobs in academia meanwhile I figured somehow had get famous by marketing podcast on the Internet relentlessly looking back back at that sad old world of academia determined not to feel the pain of it's demise late this last August one day forget if I was the morning or the evening now while listening to a batch of personal essays written by Dr Phillip Lopate during a segment of my nearly two hundred minute drives up and down. US route one and across interstate two eight seven four days a week. I began thinking about would be like a study creative writing graduate school to one day the professor how much missed the brilliance of the professors who taught me and I thought of my sessions with my therapist how every time she kept bringing up graduate school. I was quick dismiss. It thought about the nearly the three years I'd spent working as a writing tutor and then I thought about William Paterson University how intensely I had wanted to get my. MFA Matinee there and I started to sob so began. My slow realization that maybe dismissing graduate school was a mistake then one beautiful early. September day about two weeks ago. Now I think it was I yeah I was walking in the development where my wife and I live enjoying the refreshingly cool and breezy air thought about how much energy Ashley Sean I put into figuring out where we wanted to live about eight years we had a long list of potential places in and out of state and we researched the the job and real estate markets in virtually every area of interest US places in Texas California Florida New Hampshire Illinois Iowa Pennsylvania in New York Massachusetts South Jersey North Jersey the Jersey shore etcetera. The feel of the air was so fitting because it matched the sense of relief. I felt to finally love where we live and for the desire Zeier to live elsewhere now dissipated and filled about how much I loved the view of mountains in the distance so much open space the relatively little traffic along the relatively peaceful highways nearby interstate seventy eight to eighty seven then. I recall why I had wanted so much to get my creative writing. MFA William Paterson University I was attracted locked into the campus. Its recently renovated buildings the view of the Manhattan skyline and all the mountains in the distance the fact that the campus itself was elevated and hilly and of course the professors the prospect of studying under Dr Martha wit and Dr John Paris and I thought Oh my God I do still really want to study there and maybe even one day teach their my dream was resurrected.

professor Academia Samya Bob Dylan William Paterson University US MFA Dr Patrick Noonan Shang Dr Phillip Lopate official Myopia Nicole John Lennon Mick Jagger Scott Fitzgerald feely Dr Leonard Dr. Charles Manhattan