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Speaker 1: This is let's be clear with Shannon Dorney. Hi, everyone,

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Speaker 1: this is Let's be clear with Shannon Doherty. I want

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Speaker 1: to thank you for listening to my podcast and for

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Speaker 1: your kind and encouraging words on social media. As you

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Speaker 1: may know, there are many people with me on this

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Speaker 1: cancer journey, and today I'm joined by someone instrumental in

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Speaker 1: my treatment. The Hollywood Reporter named him one of Hollywood's

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Speaker 1: top doctors. Please welcome doctor Lawrence Piro.

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Speaker 2: Hey, Shannon, happy to be here. Hi.

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Speaker 1: How are you.

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Speaker 2: I'm good?

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Speaker 1: How are you? I'm good. I had a very long day,

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Speaker 1: but nothing I would look forward to more than a

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Speaker 1: glass of wine and a conversation with you.

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Speaker 2: Something we've done quite often and every time it's enjoyable

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Speaker 2: and unpredictable.

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Speaker 1: Unpredictable it is a really, really good word for it.

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Speaker 1: Can you please, just for you know the people listening in,

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Speaker 1: tell us your full title, your specialty, and what hospitals

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Speaker 1: you're affiliated with.

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Speaker 2: Well, I'm doctor Lawrence Pirerou. My title is CEO of

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Speaker 2: the Angels Clinic and Research Institute, which is an affiliate

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Speaker 2: of Cedar Sinai, which we started about twenty three years ago,

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Speaker 2: and I'm an medical oncologist, so kind of the overall

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Speaker 2: quarterback of the ecology team in terms of diagnosis and

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Speaker 2: planning treatment and coordinating all the treatments.

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Speaker 1: And is your oncology specialty breast or a multitude of

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Speaker 1: different cancers.

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Speaker 2: Well, it's a multitude of different cancers, and I've done

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Speaker 2: research in a number of different areas, but breast is

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Speaker 2: an area where I've treated in an extensive amount of

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Speaker 2: patients over my entire forty year career.

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Speaker 1: And you are published, are you not?

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Speaker 2: I am?

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Speaker 1: Can you tell me a little bit about that.

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Speaker 2: Well, I've been a researcher and a developer of treatments

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Speaker 2: from the beginning of my career. I was actually still

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Speaker 2: a fellow when published on the first which was a

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Speaker 2: drug that put a disease called harry sel leukemia into

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Speaker 2: remission in ninety eight percent of cases, and it was

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Speaker 2: a kind of a worldwide attention item because there was

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Speaker 2: almost nothing that would put that number of people into

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Speaker 2: a mission with a single treatment. So I was quite

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Speaker 2: a breakthrough and that spawned my career starting when I

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Speaker 2: was in my late twenties. That spawned my career in

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Speaker 2: investigative oncology and creating targeted treatments, and I was part

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Speaker 2: of the development team for all of the clinical trials

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Speaker 2: that led to the approval over Tuksan, which was the

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Speaker 2: first monocle and antibody ever used in Man and approved

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Speaker 2: as a drug. So we had a really great experience

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Speaker 2: with all that, and that of course opened up a

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Speaker 2: whole new field of drugs and now there are you know, many,

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Speaker 2: many and a lot of people actually got monocle antibodies

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Speaker 2: for COVID. I remember, yes, I'm sure that was a

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Speaker 2: fun thing to be involved with. And I have a

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Speaker 2: medium to large institute with a lot of oncologists doing

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Speaker 2: great work and doing research and all different kinds of things.

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Speaker 2: And I treat a wide variety of diseases because a

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Speaker 2: lot of times the relationship is the important thing.

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Speaker 1: Yeah, So in other words, you're like no joke, You're

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Speaker 1: like the no joke doctor. So, just to give our

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Speaker 1: listeners a bit of history, I got diagnosed with breast

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Speaker 1: cancer in twenty fifteen. I went to a different oncologist

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Speaker 1: and had not a very successful sort of treatment in

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Speaker 1: the sense of nothing was really changing. I still had,

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Speaker 1: you know, a tumor in my breast. I still wasn't

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Speaker 1: getting surgery. I kind of was feeling a little bit lost.

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Speaker 1: The drug that this particular in college just had me

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Speaker 1: on put me in a menopause. I wasn't properly warned

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Speaker 1: about that. I was definitely feeling adrift, if you will,

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Speaker 1: in my sort of cancer journey, and I knew that

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Speaker 1: something needed to change. I just didn't know how to

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Speaker 1: change it. And most of the time, a lot of

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Speaker 1: patients feel as if they don't have the right to

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Speaker 1: ask for a better doctor or to change doctors, or

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Speaker 1: they're scared their insurance won't cover a new doctor, or

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Speaker 1: they feel like they can't change doctors. And I felt

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Speaker 1: that for a minute until I got a phone call

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Speaker 1: from my friend Chris, who said he was good friends

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Speaker 1: with a mutual friend of ours, David, and David really

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Speaker 1: wanted to introduce me to this oncologist that he said

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Speaker 1: saved his father's life with cancer and he felt very

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Speaker 1: strongly about and that meeting happened to be when I

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Speaker 1: met you. Do you want to tell us about it?

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Speaker 2: Sure? Well, David Charvey called me and said, would I

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Speaker 2: be willing to have dinner over at Chris's house and

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Speaker 2: meet Shannon. She was going through a little cancer problem.

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Speaker 2: They thought if we'd met up, we might be a

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Speaker 2: good team, and so I said, yea, I'm sure, I'm

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Speaker 2: happy to. So we had dinner. You know, usually in

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Speaker 2: that kind of a situation, it's a it's kind of

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Speaker 2: a dance, you know, because you're like, it's like a

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Speaker 2: blind date. Two people who are invited to a get

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Speaker 2: social gathering for a purpose, and everyone kind of knows

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Speaker 2: the purpose, but you're supposed to act like you don't

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Speaker 2: know the purpose.

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Speaker 1: It's so true, that great way of describing it.

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Speaker 2: Yeah, So you usually dance around each other and like, well,

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Speaker 2: who's gonna who's going to reveal that they know the

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Speaker 2: purpose first and put it out on the table and

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Speaker 2: square it all up. And that, however, didn't play out

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Speaker 2: that night, because neither you nor I are kind of

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Speaker 2: beat around the bush people. So we just like jumped

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Speaker 2: right in. Yeah, and within five minutes we were pretty

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Speaker 2: connected and pretty sure that we understood one another and

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Speaker 2: pretty good, pretty sure that we'd be a great team together.

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Speaker 1: Yeah. I felt like you understood why I was feeling

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Speaker 1: a bit lost, and you definitely had opinions on what

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Speaker 1: should change and what needed to get done immediately, And

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Speaker 1: I really respected the fact that you had like a

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Speaker 1: strong standpoint and you weren't intimidated by me by who

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Speaker 1: I am, but also more importantly by my personality. You

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Speaker 1: you know, you have just as bigger for personality as

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Speaker 1: I do. So we were able to really mesh on

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Speaker 1: that level. And I know that for me personally, I

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Speaker 1: kind of felt like, oh, I think that this is

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Speaker 1: somebody who is going to really be thoughtful with my care,

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Speaker 1: which was incredibly important to me. And he understands that

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Speaker 1: there's nothing more integral than me tackling this and getting better.

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Speaker 1: And you insisted that I come in like right away.

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Speaker 1: You were like, Okay, let's get started. I think we've

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Speaker 1: met on like a Friday or Saturday night and you're like, great,

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Speaker 1: we're getting you into the clinic on Monday. You were like,

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Speaker 1: let's go.

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Speaker 2: Yeah. Well, you know, you you had there are a

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Speaker 2: lot of things going on in your situation that we

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Speaker 2: knew that we needed a change, and I wanted to

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Speaker 2: get changed right away because time was of the essence

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Speaker 2: for many reasons, not the least of which was you know,

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Speaker 2: there were delays and diagnosis, and then you'd been on

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Speaker 2: a form of therapy that didn't seem to be really

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Speaker 2: you know, anything getting the job done the way, and

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Speaker 2: you had a lot of side effects from it. So yeah,

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Speaker 2: I wanted to get started right away. And you know,

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Speaker 2: I said earlier that you know, sort of who I

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Speaker 2: choose to treat is guided in part by how important

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Speaker 2: the relationship is. And that is the most important thing,

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Speaker 2: because you know, everyone deserves world class self care and

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Speaker 2: that's required, but not sufficient. Everyone requires also a world

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Speaker 2: class patient experience because if you get even if you

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Speaker 2: get great care, if you get PTSD trying to get

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Speaker 2: the care, then the coalit of your life is not

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Speaker 2: good at all. And so that there are a lot

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Speaker 2: of things which affect that process, the patient experience. But

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Speaker 2: a big part of it is the doctor patient relationship.

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Speaker 2: And that's kind of a hackney term, you know, it

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Speaker 2: sounds so especially in our case, it sounds so like

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Speaker 2: official and a doctor patient relationship, but it is a

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Speaker 2: very important thing and it's about, you know, it's about

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Speaker 2: the patient believing that you're going to do everything for them,

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Speaker 2: that you're going to think about their case thoughtfully and

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Speaker 2: importantly individually. You're going to think about their individual case,

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Speaker 2: not just you know, what category you fit into you're

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Speaker 2: fit into this stage and this disease and third line

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Speaker 2: treatment or whatever, but actually your individual case and what

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Speaker 2: are the nuances for for example, we've chosen things at

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Speaker 2: times that you know, we're guided by efficacy against the cancer,

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Speaker 2: but also by whether it makes you lose hair or not,

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Speaker 2: because that sounds like super trivial hair versus cancer, but

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Speaker 2: it's not at all, because hair affects your view of yourself,

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Speaker 2: and your view your self effects your engagement with the

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Speaker 2: treatment and how much you believe in the treatment. It

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Speaker 2: affects one's ability to work in some cases. You work

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Speaker 2: in a business where you can't work much if you

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Speaker 2: look like you're sick. And so there's like so many

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Speaker 2: things that come into the factor of individualizing the treatment

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Speaker 2: or other side effects that you're willing to have or

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Speaker 2: not willing to have, not necessarily because they are visible

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Speaker 2: to other people, like hair, but they're important to you personally,

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Speaker 2: whoever the patient is. And some people can tolerate certain

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Speaker 2: kinds of side effects like they're charging to a war,

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Speaker 2: and other people are just completely debilitated by those side effects.

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Speaker 2: I don't think that most people realize that patients do

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Speaker 2: make choices almost as much by side effects as by efficacy,

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Speaker 2: not as much. I mean, there's always more power given

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Speaker 2: to efficacy as there should be, but it's a pretty

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Speaker 2: close balance because you know, especially in these days where

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Speaker 2: fortunately we have lots of treatments that if they can't

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Speaker 2: make you go into omission completely, they can keep you

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Speaker 2: in our mission for a long period of time with

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Speaker 2: a low level of cancer, and then there's going to

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Speaker 2: be another thing after that and another thing after that.

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Speaker 2: So it's a long journey. And if you are having

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Speaker 2: side effects that are just intolerable to you all through

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Speaker 2: that journey, then it's a long journey of miserable life.

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Speaker 2: And what people's goal is and of course should be,

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Speaker 2: and what the doctor's goal should be for you is

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Speaker 2: a lot if it's not curable, then a long journey

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Speaker 2: of the highest quality life.

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Speaker 1: Yeah, I mean, I think quality of life is so

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Speaker 1: incredibly important because if your quality of life on a protocol,

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Speaker 1: on a treatment is very poor, then you definitely fall

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Speaker 1: into a depression, and that depression leads you to kind

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Speaker 1: of give up. And I you know, I know there's

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Speaker 1: no like science behind my particular kind of thinking that

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Speaker 1: you know, med speak for themselves and everything else. But

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Speaker 1: I do believe that mind over matters incredibly important. I

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Speaker 1: believe in the power of the brain and power of suggestion.

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Speaker 1: So if you're feeling really good, if you're in a

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Speaker 1: good place, and you're believing in your protocol and you're

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Speaker 1: okay with it and it's not totally working your quality

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Speaker 1: of life, then you're going to feel all sorts of

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Speaker 1: positive energy towards that protocol, which I think ends up

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Speaker 1: making the protocol work a little bit better. That's just

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Speaker 1: been my experience thus far on the protocols i've been on. Again,

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Speaker 1: I know that there's zero science behind that.

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Speaker 2: Well, certainly, certainly, you know, there's lots of hormones and

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Speaker 2: signals that are released by the brain that you know

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Speaker 2: translate into a sense of well being, And if you

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Speaker 2: have a sense of well being on a treatment, you

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Speaker 2: know it may go better. I mean, in the case

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Speaker 2: of breast cancer, for example, there are studies that show

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Speaker 2: that you know, if you exercise during chemotherapy, that the

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Speaker 2: actual outcome of the chemotherapy may be better. The outcome

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Speaker 2: on the tumor may actually be better. So I think that,

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Speaker 2: as you know, indirect evidence that doing things with your

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Speaker 2: body or your mind may influence the milieu of your

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Speaker 2: body while you're getting the chemotherapy and change the outcome.

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Speaker 2: So I think what you say is you know, is

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Speaker 2: completely correct.

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Speaker 1: So we I came into you know, your office on Monday,

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Speaker 1: and you had taken the weekend to access, you know,

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Speaker 1: all of my medical records, you know, with my authorisation obviously,

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Speaker 1: but so that you were completely on top of like

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Speaker 1: where I was at. Can you explain, because I don't

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Speaker 1: think a lot of people know, particularly with breast cancer,

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Speaker 1: like the her positive the her negative, But what is

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Speaker 1: the difference between that? People always ask me what I am,

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Speaker 1: and I'm like, I kind of don't remember.

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Speaker 2: Well, you're a technically a strodener receptor positive progestion receptor

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Speaker 2: positive and her too negative. But it's a bit of

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Speaker 2: a complicated technicality, but there's the initial way that you

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Speaker 2: do that her testing and her is is one of

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Speaker 2: the genes that can be expressed in breast cancer, and

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Speaker 2: it's actually a target for treatments, some treatments that are

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Speaker 2: very very successful at helping in breast cancer, though it's

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Speaker 2: expression in the breast cancer can be associated with a

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Speaker 2: less good outcome. And you are her too negative, which

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Speaker 2: you know is a good prognostic indicator. But the way

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Speaker 2: that that test is initially done, it's done in kind

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Speaker 2: of a qualitative way. So they test the cells for

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Speaker 2: that expression, and you get sort of a one plus

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Speaker 2: or two plus or three plus, and a certain cutoff

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Speaker 2: of the pluses is considered negative in a certain kind

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Speaker 2: of positive. But if you're equivocal, meaning meaning that you're

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Speaker 2: in sort of a mid range, then we do a

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Speaker 2: more refined test, which is a quantitative test, and it's

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Speaker 2: a very accurate quantitative test. So you were in the

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Speaker 2: equivocal range, but when we then did the more complicated tests,

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Speaker 2: you were negative. So we're happy about that because you

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Speaker 2: know it's a better prognostics sign. However, fast forward many

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Speaker 2: years later in your treatment, when you're in that equivocal zone,

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Speaker 2: it's called HER too expressor, so you're expressing it even

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Speaker 2: though you're not technically positive. You're expressing it at a

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Speaker 2: low level. And so right when we were needing to

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Speaker 2: have another novel therapy in your case, a paper came

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Speaker 2: out that shows that patients who are HER two expressors

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Speaker 2: respond to one of the newer monocline line of body

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Speaker 2: drug conjugates that targets her too, and these people actually

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Speaker 2: respond well to it. So the fact that we had

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Speaker 2: all that data and we remember that data and we

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Speaker 2: access that data when we were having again to think

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Speaker 2: novelly and individually about you, because there were reasons why

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Speaker 2: going back onto chemotherapy wouldn't have been ideal at this

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Speaker 2: particular juncture, so we chose an antibody drug conjugate. Unfortunately

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Speaker 2: data had come out just in time. And you know,

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Speaker 2: that's something I've talked with you a lot about and

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Speaker 2: other people that you know, we know together, that I've treated.

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Speaker 2: You know, it's sort of in the beginning of my career,

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Speaker 2: we were all focused on you sort of pretty much

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Speaker 2: either cure something or you kind of limp along with it.

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Speaker 2: But there isn't a long period of being along with it,

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Speaker 2: you know, back in the day. Now there are so

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Speaker 2: many treatments that and since we've been able to sequence

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Speaker 2: the human genome and since we've you know, really unleashed

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Speaker 2: a lot of or unlocked the line of the secrets

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Speaker 2: that allow us unleash immunotherapy, which is the body's immune system,

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Speaker 2: you know, being repped up to fight the cancer. Now,

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Speaker 2: there are many different chapters to what we can do.

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Speaker 2: And so early on, if you achieved a partial remission

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Speaker 2: and we're limping along, it may not have affected your

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Speaker 2: overall survival even though you were in remission because because

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Speaker 2: it might not last that long. But now, if you

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Speaker 2: can achieve a partial remission that lasts for a decent

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Speaker 2: amount of time, in that time, developments are so fast

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Speaker 2: that something new may show up that might then give

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Speaker 2: you a much longer, more meaningful remission. So I always

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Speaker 2: say that, you know, it's important to think of each

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Speaker 2: therapy as a horse. And you want to ride in

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Speaker 2: a horse race, So you want to ride every horse

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Speaker 2: as long as it rides, and then you ride the

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Speaker 2: next horse as much as possible. When you hope by

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Speaker 2: the time you make a few laps, you know there's

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Speaker 2: altogether another set of horses to ride, you know, to

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Speaker 2: make the race that much longer.

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Speaker 1: Somebody was asking me today and they were like, wow,

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Speaker 1: you know, like stage four breast cancer says like five years.

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Speaker 1: It's like, yeah, but that's like old data that you

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Speaker 1: have found on the internet, and things are different. I mean, yes,

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Speaker 1: there are people that have only survived five years. You know.

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Speaker 1: I think my best friend Dub was one of those.

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Speaker 1: But there are so many different things right now, and

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Speaker 1: you and I always talk about the fact that, like

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Speaker 1: we just need to squeeze out another three to five

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Speaker 1: years and then there's going to be you know, T

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Speaker 1: cell therapy, or there's gonna be this, or there's going

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Speaker 1: to be that, like whatever it is, there's going to

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Speaker 1: be a lot more options that will give another five years.

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Speaker 1: Then in those five years, there's a whole other, you know,

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Speaker 1: group of options, and then eventually there's going to be

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Speaker 1: a cure. So I always look at it as I'm

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Speaker 1: I'm the horse analogy is a really good one, Like

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Speaker 1: I'm constantly chasing I'm riding those horses so that I

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Speaker 1: get to the fresh set of horses, and I'm trying

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Speaker 1: to get the one that I'm on right now to

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Speaker 1: like last for as long as humanly im possible.

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Speaker 2: And that's why I like that analogy, because when you're

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Speaker 2: the one riding the horse, which is the much more

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Speaker 2: difficult job than the one picking the horse, it gets

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Speaker 2: exhausting at times, but then you think, well, okay, this

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Speaker 2: is still working, right, Yeah, this is hard, but it's

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Speaker 2: still working, and we don't want to abandon that because

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Speaker 2: if we abandon it too early that one decision could

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Speaker 2: foreshorten a lot of other things, and then your timing

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Speaker 2: can be just exactly off for the introduction of new therapies,

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Speaker 2: like the fact that our timing was so fortunate of

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Speaker 2: you know, of finding this study about the Hurtwo expressors

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Speaker 2: and being able to put you on that.

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Speaker 1: Right which the funny, I mean, the funny story behind

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Speaker 1: this is that I kind of bunt my head after

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Speaker 1: Ristmas party that I threw and I called you and

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Speaker 1: was like, and it was right after New Year's or

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Speaker 1: whatever when I called you and I was like, hey,

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Speaker 1: you know, over the holidays, I kind of hit my

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Speaker 1: head pretty badly, and I know that it was bleeding.

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Speaker 1: What do you think. I'm probably fine, right, Like, I

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Speaker 1: didn't die in my sleep, so I'm okay. And you're like, no,

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Speaker 1: you need to come in for a CT scan like

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Speaker 1: pronto and I did, and we found, you know, mets,

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Speaker 1: and I guess we can call Bob a tumor.

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Speaker 2: He was a tumor, yeah, I mean, And that, interestingly

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Speaker 2: is my bigger concern with the way the trauma you had.

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Speaker 2: You know, there's something called a subdural humanitoma that is

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Speaker 2: a chronic slow oozing of blood that can present with

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Speaker 2: symptoms coming you know, a week or ten days after

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Speaker 2: the initial trauma. And some very famous people have died

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Speaker 2: with that sort of thing and if you don't evacuate

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Speaker 2: that blood quickly, and since you were having some symptoms

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Speaker 2: a little bit still at that time, that's what I

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Speaker 2: was concerned about, more so than a tumor in some ways,

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Speaker 2: because you know, you weren't exhibiting any signs which I mean,

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Speaker 2: you weren't having paralyzed and anything. You weren't having seizures.

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Speaker 2: You know, you were you know, dizzy, and I'm not

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Speaker 2: I'm not even still sure, you know, given the you know,

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Speaker 2: relatively small size of those things, of whether they were

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Speaker 2: definitely causing symptoms.

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Speaker 1: Or not right, because what ended up happening is we

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Speaker 1: found some mets and we found one that was larger

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Speaker 1: than the others, and Dutch Piro said, you need to go, like,

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Speaker 1: get this. We're going to go get it removed immediately,

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Speaker 1: mainly because I want to, you know, study it, and

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Speaker 1: I want the pathology on it, and I want to

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Speaker 1: see is this is this breast cancer that's moved into

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Speaker 1: Like I need to know specifically the cancer that's there

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Speaker 1: that we're dealing with, so I know how to treat

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Speaker 1: it properly. And I think like six days later, I

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Speaker 1: was at Cedars. I'm getting my head cut open, and

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Speaker 1: a you know tumor that's Bob. By the way, I

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Speaker 1: named him Bob, no offense to any Bob's. He just

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Speaker 1: seemed like a Bob to me. You know, we got

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Speaker 1: almost all of him and the rest we handled with

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Speaker 1: brain radiation well.

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Speaker 2: And the reason why it was so important to study

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Speaker 2: the tissue is that sometimes after you've had treatments for

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Speaker 2: long periods of time, the tumor's morph in their expressions,

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Speaker 2: so it may not have been expressing the same set

377
00:21:32,840 --> 00:21:37,000
Speaker 2: of determinants and markers that the original one had. But secondly,

378
00:21:37,040 --> 00:21:41,600
Speaker 2: and somewhat more importantly, chemotherapy does not penetrate well into

379
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Speaker 2: the brain, right.

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Speaker 1: Because there's a blood brain barrier that it's got.

381
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Speaker 2: To break through to sanctuary. And it's intended it's intended

382
00:21:48,840 --> 00:21:54,440
Speaker 2: to leologically because there are toxins. Chemotherapy is a form

383
00:21:54,480 --> 00:21:58,479
Speaker 2: of toxin, right, and their toxins all over in nature, right.

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Speaker 2: I mean the drug, the chemotherapy drug vin Christine comes

385
00:22:02,200 --> 00:22:05,879
Speaker 2: from it's a vinca alkaloid. It comes from the vinca plant,

386
00:22:05,920 --> 00:22:09,080
Speaker 2: which is a ground common groundcover. So if you were

387
00:22:09,680 --> 00:22:12,040
Speaker 2: back in your rooting days, when you were rooting around

388
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Speaker 2: in the four.

389
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Speaker 1: It's actually just looking at that by the way plant

390
00:22:15,760 --> 00:22:19,280
Speaker 1: because it's also drought tolerant. If I and I was

391
00:22:19,440 --> 00:22:22,359
Speaker 1: quite attractive, Yeah, it's very attractive. I was looking at

392
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Speaker 1: it for my driveway.

393
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Speaker 2: So if you were like rooting around in nature and

394
00:22:26,920 --> 00:22:29,639
Speaker 2: you were chewing on the vinca plant, you would be

395
00:22:29,680 --> 00:22:33,479
Speaker 2: getting some of the you know, sort of precursor molecule

396
00:22:33,520 --> 00:22:35,919
Speaker 2: of vin christine or the exact one. And so you

397
00:22:35,960 --> 00:22:38,080
Speaker 2: don't want that in your brain because your brains, your

398
00:22:38,200 --> 00:22:40,720
Speaker 2: you know, your central computers and operating zone. We don't

399
00:22:40,720 --> 00:22:43,239
Speaker 2: want toxins in there. So the blood brain barrier has

400
00:22:43,280 --> 00:22:46,520
Speaker 2: pumps that pump those things out, so it can't it

401
00:22:46,560 --> 00:22:49,919
Speaker 2: can't get there. And so as a result, however, therefore,

402
00:22:49,960 --> 00:22:54,240
Speaker 2: when we treat with chemotherapy, sometimes it doesn't penetrate, you know,

403
00:22:54,320 --> 00:22:56,879
Speaker 2: into the brain, and so there are other therapies that

404
00:22:57,000 --> 00:23:00,320
Speaker 2: do and certain chemos will penetrate into the into the brain.

405
00:23:00,760 --> 00:23:03,640
Speaker 2: And so again this is the whole individualizing of the

406
00:23:03,640 --> 00:23:06,000
Speaker 2: therapy thing. We need to choose something. I wanted to

407
00:23:06,000 --> 00:23:09,040
Speaker 2: see if the expressions of the tumor in your body

408
00:23:09,040 --> 00:23:11,199
Speaker 2: and the expressions of the tumoring the brain were the

409
00:23:11,240 --> 00:23:14,159
Speaker 2: same or not, And make sure that whatever we treated

410
00:23:14,200 --> 00:23:16,840
Speaker 2: you within your body would also treat the brain at

411
00:23:16,840 --> 00:23:18,960
Speaker 2: the same time, if possible. Even though we were giving

412
00:23:19,119 --> 00:23:21,760
Speaker 2: we removed the one and we were giving radiations the brain.

413
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Speaker 2: We don't want to treat the whole brain because that

414
00:23:24,840 --> 00:23:28,080
Speaker 2: has too much bad effect on normal brain tissue and

415
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Speaker 2: so and so we want only to treat those few spots.

416
00:23:32,760 --> 00:23:35,920
Speaker 2: And we didn't want any other brain tumors developed, if possible,

417
00:23:36,000 --> 00:23:39,040
Speaker 2: So we really wanted something to penetrate and bathe the brain,

418
00:23:39,680 --> 00:23:42,320
Speaker 2: you know, in that treatment. And therefore, if there were

419
00:23:42,400 --> 00:23:47,280
Speaker 2: seeds of cells that were ultimately destined to create other

420
00:23:47,359 --> 00:23:52,240
Speaker 2: brain tumor, spots of brain tumor, we would kill them

421
00:23:52,320 --> 00:23:55,679
Speaker 2: by using that treatment, and then they would manifest as

422
00:23:55,720 --> 00:23:58,399
Speaker 2: another spot of metastatic breast cancer.

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Speaker 1: Right, But we also need did a treatment that didn't

424
00:24:02,359 --> 00:24:04,760
Speaker 1: just take care of the brain mets. We needed the

425
00:24:04,800 --> 00:24:08,399
Speaker 1: whole body. Like everything else that was going on. My

426
00:24:08,520 --> 00:24:11,479
Speaker 1: breast cancer was spread into my bones, so it was

427
00:24:11,760 --> 00:24:16,720
Speaker 1: very important that be kept under control. And we found

428
00:24:16,760 --> 00:24:20,560
Speaker 1: it when we did the pathology on Bob the tumor.

429
00:24:20,960 --> 00:24:24,919
Speaker 1: What was the difference of that pathology that allowed me

430
00:24:25,200 --> 00:24:27,320
Speaker 1: to be okay for this sort of new treatment that

431
00:24:27,359 --> 00:24:30,959
Speaker 1: he was talking about a second ago, that the papers

432
00:24:31,000 --> 00:24:34,840
Speaker 1: had just come out about it being a good alternative

433
00:24:35,080 --> 00:24:36,479
Speaker 1: for something like I was.

434
00:24:37,040 --> 00:24:40,280
Speaker 2: It was also expressing her too. It was not her

435
00:24:40,320 --> 00:24:42,720
Speaker 2: too positive. It was in that expressor zone. It was

436
00:24:42,760 --> 00:24:46,720
Speaker 2: in that low level zone that this paper showed patients

437
00:24:46,760 --> 00:24:49,119
Speaker 2: respond to. And that was, you know, made me very

438
00:24:49,119 --> 00:24:51,439
Speaker 2: happy because we could treat both the body and the

439
00:24:51,440 --> 00:24:54,880
Speaker 2: brain with that, and this drug antibody conjugate penetrates into

440
00:24:54,920 --> 00:24:58,320
Speaker 2: the brain. So it is a perfect particularly good choice

441
00:24:58,440 --> 00:25:02,600
Speaker 2: and that has proved not only was that a reasonable

442
00:25:02,600 --> 00:25:04,800
Speaker 2: theory by which to choose a treatment, but that's proven

443
00:25:04,840 --> 00:25:07,600
Speaker 2: out to be a good result for you as we've had,

444
00:25:07,720 --> 00:25:10,560
Speaker 2: as we know, with some recent scans that let's just say,

445
00:25:10,560 --> 00:25:11,920
Speaker 2: it made us very happy.

446
00:25:11,720 --> 00:25:14,320
Speaker 1: Made us very happy, yeah, which I think is really

447
00:25:14,400 --> 00:25:17,920
Speaker 1: interesting because you know, we scanned me quite often once

448
00:25:17,960 --> 00:25:20,840
Speaker 1: I went on this other treatment. You know, it didn't

449
00:25:21,119 --> 00:25:23,359
Speaker 1: it didn't really look like it was performing that well,

450
00:25:23,760 --> 00:25:25,760
Speaker 1: and I think it was after the fifth treatment that

451
00:25:25,800 --> 00:25:29,359
Speaker 1: you and I had a conversation about it, and the

452
00:25:29,440 --> 00:25:32,240
Speaker 1: conversation was maybe we should move to a different treatment,

453
00:25:33,000 --> 00:25:36,160
Speaker 1: and we sort of both sat with it and took

454
00:25:36,160 --> 00:25:40,800
Speaker 1: our time to think about it reconnected, and you know,

455
00:25:41,400 --> 00:25:43,440
Speaker 1: I think I started by saying I want to give

456
00:25:43,480 --> 00:25:46,720
Speaker 1: it more time, and you really sort of went back

457
00:25:46,760 --> 00:25:49,360
Speaker 1: and did research and then called me and said, actually,

458
00:25:49,640 --> 00:25:52,200
Speaker 1: I ordered a very specific test for you to get done,

459
00:25:52,240 --> 00:25:54,760
Speaker 1: which was for your tumor markers. And it's not something

460
00:25:54,760 --> 00:25:57,160
Speaker 1: that you get done every single month with your blood work.

461
00:25:57,640 --> 00:26:00,840
Speaker 1: It's specific that you have to order and I ordered it,

462
00:26:00,880 --> 00:26:03,600
Speaker 1: and your tumor markers were you know, they're cut in

463
00:26:03,680 --> 00:26:07,359
Speaker 1: half basically, so we know that it's working. And you said, so,

464
00:26:07,560 --> 00:26:12,880
Speaker 1: I feel comfortable with you staying on this as long

465
00:26:12,880 --> 00:26:15,520
Speaker 1: as you agree to get MRIs a little bit more

466
00:26:15,520 --> 00:26:18,520
Speaker 1: often because you wanted to stay on top of it.

467
00:26:18,760 --> 00:26:22,080
Speaker 1: And then after my seventh treatment, you came into my

468
00:26:22,720 --> 00:26:26,359
Speaker 1: infusion room and you were I mean, you came in

469
00:26:26,440 --> 00:26:31,439
Speaker 1: You're like, yes, you were, you know, you were I

470
00:26:31,440 --> 00:26:33,639
Speaker 1: don't want to say more excited than me, but you

471
00:26:33,680 --> 00:26:37,280
Speaker 1: were equally as joyous as me.

472
00:26:38,160 --> 00:26:40,719
Speaker 2: And I almost never do that. And the reason I

473
00:26:40,720 --> 00:26:43,520
Speaker 2: almost never do that isn't because I'm not joyous. It's

474
00:26:43,600 --> 00:26:47,800
Speaker 2: because I fear if I do that, then every subsequent

475
00:26:48,000 --> 00:26:51,160
Speaker 2: time we have scans, if I don't walk in that way,

476
00:26:51,760 --> 00:26:54,560
Speaker 2: people will read and patients will read into it that

477
00:26:54,600 --> 00:26:57,919
Speaker 2: I'm really not joyous, and then they'll think whatever I'm saying,

478
00:26:58,080 --> 00:27:03,399
Speaker 2: you know that I really secretly, you know, upset because

479
00:27:03,440 --> 00:27:05,480
Speaker 2: we didn't get better results or something like that, you know,

480
00:27:05,600 --> 00:27:08,840
Speaker 2: And yeah, and that such an important part. We accidentally

481
00:27:08,840 --> 00:27:12,840
Speaker 2: tripped onto a zone of conversation. It's so important. It's

482
00:27:12,880 --> 00:27:16,080
Speaker 2: really so important as a doctor to realize that people

483
00:27:16,119 --> 00:27:20,120
Speaker 2: are watching every single move you make and every single world.

484
00:27:20,200 --> 00:27:22,480
Speaker 1: So it's your eyebrot. So I'm like, what does that

485
00:27:22,680 --> 00:27:28,240
Speaker 1: mean exactly? But you and I have sort of we

486
00:27:28,280 --> 00:27:31,000
Speaker 1: have established the way of doing things because your clinic,

487
00:27:31,200 --> 00:27:35,440
Speaker 1: the Angelus Clinic in Los Angeles, is it's extraordinary in

488
00:27:35,480 --> 00:27:38,800
Speaker 1: the sense that you can go in, you can go

489
00:27:38,840 --> 00:27:40,920
Speaker 1: get a PET scan, you can go get an MRI,

490
00:27:41,160 --> 00:27:43,480
Speaker 1: you can go get a CT scan. And whereas traditionally

491
00:27:43,600 --> 00:27:46,040
Speaker 1: I know people that have had to wait ten days

492
00:27:46,040 --> 00:27:49,000
Speaker 1: for their results, at your clinic, you get the results

493
00:27:49,040 --> 00:27:52,479
Speaker 1: the same day. And most of your patients, you know,

494
00:27:52,600 --> 00:27:56,520
Speaker 1: wait for their scans. They wait there and then they

495
00:27:56,560 --> 00:27:58,480
Speaker 1: have an appointment with you or one of the other

496
00:27:58,560 --> 00:28:02,320
Speaker 1: doctors like whatever, and they get their results in person

497
00:28:02,840 --> 00:28:05,960
Speaker 1: the same day. And I chose to do it very

498
00:28:05,960 --> 00:28:08,800
Speaker 1: differently from the beginning with you, where I said I

499
00:28:08,800 --> 00:28:12,840
Speaker 1: don't want you, I don't want to know my results

500
00:28:13,440 --> 00:28:20,080
Speaker 1: in person. I let me go home and call me

501
00:28:20,200 --> 00:28:23,600
Speaker 1: with my results at whatever time works for you throughout

502
00:28:23,640 --> 00:28:26,760
Speaker 1: the day, whenever you have a moment, whenever you have

503
00:28:26,800 --> 00:28:29,240
Speaker 1: a break, whenever you know you're not seeing a patient,

504
00:28:29,359 --> 00:28:31,480
Speaker 1: if it's at night, doesn't really matter to me when

505
00:28:31,960 --> 00:28:37,720
Speaker 1: because I didn't want to monitor my reaction for you,

506
00:28:37,920 --> 00:28:40,360
Speaker 1: or for the nurse practitioner, or for anybody that was

507
00:28:40,400 --> 00:28:42,840
Speaker 1: in the room with me, for my mom, like whoever

508
00:28:42,840 --> 00:28:47,280
Speaker 1: it was, right I whatever you told me, good or bad.

509
00:28:48,000 --> 00:28:52,120
Speaker 1: I wanted to be alone so that I could have

510
00:28:52,680 --> 00:28:58,280
Speaker 1: an authentic, like true reaction for myself and not try

511
00:28:58,320 --> 00:29:00,560
Speaker 1: to put on a like game face for everyone. Because

512
00:29:00,560 --> 00:29:04,280
Speaker 1: there's nothing worse than getting bad news face to face,

513
00:29:05,040 --> 00:29:07,720
Speaker 1: and you feel like you have to make the person

514
00:29:07,800 --> 00:29:11,640
Speaker 1: giving you the bad news feel good. And I'm that person.

515
00:29:11,720 --> 00:29:14,320
Speaker 1: It feels like it's my responsibility to make sure everybody

516
00:29:14,360 --> 00:29:14,959
Speaker 1: is okay.

517
00:29:15,200 --> 00:29:19,080
Speaker 2: You're the first person in my entire career whoever wanted

518
00:29:19,120 --> 00:29:24,680
Speaker 2: that format. No, No, it totally works, and it makes

519
00:29:24,680 --> 00:29:26,880
Speaker 2: subtle sense. And to be honest with you, which probably

520
00:29:27,360 --> 00:29:30,400
Speaker 2: you know is part of the underpinning of the closeness

521
00:29:30,400 --> 00:29:33,480
Speaker 2: of our friendship through all these many years, is that

522
00:29:34,360 --> 00:29:36,800
Speaker 2: I realize that I'm probably the same way like I

523
00:29:36,800 --> 00:29:39,360
Speaker 2: would probably you know, be the other person who had

524
00:29:39,360 --> 00:29:42,280
Speaker 2: wanted that way, because I realized that, you know, when

525
00:29:42,320 --> 00:29:46,000
Speaker 2: I hear something, whatever it is, I want to process

526
00:29:46,080 --> 00:29:49,920
Speaker 2: it personally to figure out how I feel about it

527
00:29:50,000 --> 00:29:52,960
Speaker 2: before I want to tell somebody else. Because the minute

528
00:29:52,960 --> 00:29:55,080
Speaker 2: you tell someone else whatever, if it's good news, you've

529
00:29:55,080 --> 00:29:57,720
Speaker 2: got a new job, you know, if it's bad news, whatever,

530
00:29:58,360 --> 00:30:02,320
Speaker 2: people are going to learn out their response. And it's

531
00:30:02,360 --> 00:30:05,440
Speaker 2: hard to hear other people's reaction, especially we're talking about

532
00:30:05,440 --> 00:30:08,320
Speaker 2: cancer and cancer results and all that when you're not

533
00:30:08,400 --> 00:30:11,800
Speaker 2: yet sure what your response is, because therefore you have

534
00:30:11,920 --> 00:30:17,760
Speaker 2: no defense or no ability to reformat their misguided reaction

535
00:30:17,920 --> 00:30:20,760
Speaker 2: to it. And often often the people in one's lives

536
00:30:21,240 --> 00:30:25,880
Speaker 2: have misguided reactions to data they don't you know, they're

537
00:30:25,880 --> 00:30:29,520
Speaker 2: getting bits and parts pieces of your story, and they

538
00:30:29,600 --> 00:30:34,120
Speaker 2: can be very misguided. And it's very hard to unhear something. Yeah,

539
00:30:34,280 --> 00:30:38,680
Speaker 2: and that is an underappreciated axiom. It's very hard to

540
00:30:38,720 --> 00:30:42,520
Speaker 2: unhear things. And if there's anything that in this conversation

541
00:30:42,600 --> 00:30:46,160
Speaker 2: we're having that people who are listening who are caregivers

542
00:30:46,240 --> 00:30:49,400
Speaker 2: or loved ones or people friends, people in the lives

543
00:30:49,440 --> 00:30:52,400
Speaker 2: of people who are going through the cancer journey, is

544
00:30:53,480 --> 00:30:58,080
Speaker 2: be very careful what you say because they can't unhear

545
00:30:58,160 --> 00:31:02,560
Speaker 2: what you say. There's such a desire of well meaning

546
00:31:02,640 --> 00:31:07,840
Speaker 2: people who care about someone to establish to you that

547
00:31:07,920 --> 00:31:11,640
Speaker 2: they understand what you're going through by saying, oh, well, yes,

548
00:31:11,720 --> 00:31:14,239
Speaker 2: you know, my sister had breast cancer too, or my

549
00:31:14,400 --> 00:31:18,200
Speaker 2: so and so had breast cancer too. Unfortunately, it often

550
00:31:18,360 --> 00:31:21,600
Speaker 2: leads most people when they're telling the story, don't think

551
00:31:21,600 --> 00:31:26,360
Speaker 2: about the punchline and whether the punch yeah, and they say, yeah,

552
00:31:26,360 --> 00:31:28,760
Speaker 2: well what happened to your sister? Says the patient, and

553
00:31:28,800 --> 00:31:31,840
Speaker 2: they said, well, yeah, she died three years ago, and like,

554
00:31:32,040 --> 00:31:34,760
Speaker 2: oh my right, I mean, and no one does that intentionally,

555
00:31:34,800 --> 00:31:37,240
Speaker 2: but it's mortifying because if you don't think about where

556
00:31:37,280 --> 00:31:39,520
Speaker 2: the story ends up before you choose to tell it

557
00:31:39,560 --> 00:31:43,280
Speaker 2: to this particular person. It's you know, it doesn't.

558
00:31:43,000 --> 00:31:47,240
Speaker 1: Help that one all the time, all the time. And

559
00:31:47,360 --> 00:31:49,680
Speaker 1: you know, I know that the people are very you know,

560
00:31:49,800 --> 00:31:53,200
Speaker 1: well intentioned. It's like a way of connecting with me

561
00:31:53,320 --> 00:31:55,440
Speaker 1: and of saying, I know what you're going through, and

562
00:31:56,120 --> 00:31:58,320
Speaker 1: you know, I really like they always follow it up

563
00:31:58,360 --> 00:32:02,080
Speaker 1: with like I so admire, like you're journey, but it

564
00:32:01,680 --> 00:32:05,600
Speaker 1: is always sort of my mom, my grandmother, my sister,

565
00:32:05,760 --> 00:32:10,280
Speaker 1: my friend, they died, and I'm always like what do

566
00:32:10,360 --> 00:32:13,040
Speaker 1: I do with that information? It's a hard one. It

567
00:32:13,120 --> 00:32:17,280
Speaker 1: was I was being interviewed today and the woman interviewing

568
00:32:17,320 --> 00:32:20,080
Speaker 1: me her father is a doctor, and so I guess

569
00:32:20,080 --> 00:32:23,280
Speaker 1: she spoke to him about, you know, more in general

570
00:32:23,400 --> 00:32:28,920
Speaker 1: terms of like stage four you know, cancer, like I

571
00:32:29,080 --> 00:32:32,760
Speaker 1: have her knowledge of what I have and gave that

572
00:32:32,800 --> 00:32:35,480
Speaker 1: to her dad, and she kept on using the word

573
00:32:35,560 --> 00:32:38,280
Speaker 1: like terminal and like, you know, there is no cure,

574
00:32:38,360 --> 00:32:41,160
Speaker 1: like this is really bad, and I just I kind

575
00:32:41,160 --> 00:32:44,600
Speaker 1: of was like, based on what because your dad may

576
00:32:44,640 --> 00:32:47,360
Speaker 1: be a doctor, but he doesn't know my particular cancer.

577
00:32:47,440 --> 00:32:49,880
Speaker 1: He doesn't know where my tumor markers is. There are

578
00:32:49,920 --> 00:32:52,680
Speaker 1: so many things. But also I just kind of sat

579
00:32:52,720 --> 00:32:56,200
Speaker 1: there like huh, Like I don't know what you're getting at,

580
00:32:56,400 --> 00:32:59,080
Speaker 1: Like what do you are you looking for me to

581
00:32:59,120 --> 00:33:02,200
Speaker 1: break down and in this conversation because it's on camera

582
00:33:02,280 --> 00:33:04,200
Speaker 1: and that's going to be a great moment for you guys.

583
00:33:05,000 --> 00:33:08,320
Speaker 1: Like I couldn't figure out what the endgame was, except

584
00:33:08,360 --> 00:33:11,400
Speaker 1: that I think she was truly concerned and truly you know,

585
00:33:11,520 --> 00:33:15,960
Speaker 1: tried to come in with knowledge, but probably got fed

586
00:33:16,000 --> 00:33:18,880
Speaker 1: a bunch of stuff that perhaps she shouldn't have repeated

587
00:33:19,880 --> 00:33:24,160
Speaker 1: because I think I think it's very dangerous for other

588
00:33:24,360 --> 00:33:30,840
Speaker 1: people to have the conversation about your cancer besides your doctor.

589
00:33:30,960 --> 00:33:34,400
Speaker 1: I think it is an extremely dangerous conversation.

590
00:33:34,920 --> 00:33:38,680
Speaker 2: Well, I always tell patients at the first diagnosis, I

591
00:33:38,800 --> 00:33:42,680
Speaker 2: say to them that they should tell all of their

592
00:33:42,720 --> 00:33:46,760
Speaker 2: friends who are going to wonder what they're supposed to

593
00:33:46,760 --> 00:33:51,680
Speaker 2: talk about with you. And they think, well, if I

594
00:33:51,800 --> 00:33:54,880
Speaker 2: don't talk about the cancer, they'll think that I'm afraid

595
00:33:54,960 --> 00:33:59,560
Speaker 2: in ignoring it. And if I do talk about the cancer,

596
00:33:59,680 --> 00:34:02,479
Speaker 2: then I might not say the right things. So they

597
00:34:02,480 --> 00:34:04,240
Speaker 2: don't know what to do. But they usually talk about

598
00:34:04,280 --> 00:34:06,120
Speaker 2: the cancer. They're call it how are you, How are

599
00:34:06,160 --> 00:34:09,160
Speaker 2: you doing? Are you okay? Do you need anything? Whatever?

600
00:34:09,360 --> 00:34:12,080
Speaker 2: All of which sounds nice, right, But if these are

601
00:34:12,080 --> 00:34:14,319
Speaker 2: the people who you talked about dropping your kids off

602
00:34:14,360 --> 00:34:17,960
Speaker 2: to school, and you know how the drop offline, you

603
00:34:18,000 --> 00:34:20,200
Speaker 2: know they should manage it better at the school, and

604
00:34:20,680 --> 00:34:22,680
Speaker 2: you know you want to meet to play, you know,

605
00:34:22,760 --> 00:34:25,160
Speaker 2: pick a ball, And I want to have a dinner

606
00:34:25,160 --> 00:34:27,439
Speaker 2: party this weekend. You know, do you want to come?

607
00:34:27,440 --> 00:34:30,640
Speaker 2: And what should we cook? Right instead? There? How are you?

608
00:34:30,960 --> 00:34:32,920
Speaker 2: Are you okay? Do you need anything?

609
00:34:33,160 --> 00:34:33,239
Speaker 1: Like?

610
00:34:33,320 --> 00:34:36,960
Speaker 2: It's just you become not normal, you become a cancer person. Yeah,

611
00:34:37,000 --> 00:34:38,600
Speaker 2: and you don't want to be a cancer person. So

612
00:34:38,640 --> 00:34:41,359
Speaker 2: I tell everyone, Tell your friends to talk about with

613
00:34:41,440 --> 00:34:44,840
Speaker 2: you everything that they always used to talk with you about,

614
00:34:45,080 --> 00:34:48,359
Speaker 2: and don't talk about cancer. And here's the clue. When

615
00:34:48,400 --> 00:34:50,680
Speaker 2: you want to talk about cancer, you'll tell them you'll

616
00:34:50,680 --> 00:34:53,759
Speaker 2: bring it up, and then then go for it. Then

617
00:34:53,920 --> 00:34:56,719
Speaker 2: I'm bringing it up, but I'm guiding you as to

618
00:34:56,760 --> 00:34:58,879
Speaker 2: what why I want to talk about? Do I want

619
00:34:58,920 --> 00:35:01,680
Speaker 2: to talk about how I'm feeling emotionally? Do I want

620
00:35:01,719 --> 00:35:04,839
Speaker 2: to talk about how sad that my personal life has

621
00:35:05,760 --> 00:35:08,760
Speaker 2: been influenced by cancer and this unfortunate thing my personal

622
00:35:08,760 --> 00:35:11,640
Speaker 2: life happened, or wheneverbody just take the lead and focus

623
00:35:11,719 --> 00:35:14,040
Speaker 2: on what they want to talk about. Don't put your

624
00:35:14,080 --> 00:35:18,239
Speaker 2: own stuff into it. And it's complicated, right because people

625
00:35:18,239 --> 00:35:21,440
Speaker 2: are not therapists and they're not aware of cancer and

626
00:35:21,480 --> 00:35:23,839
Speaker 2: they don't have the medical stuff. But this is so

627
00:35:23,920 --> 00:35:25,840
Speaker 2: important to the quality of life of a person with

628
00:35:25,920 --> 00:35:29,600
Speaker 2: cancer because when people are always making you a cancer person,

629
00:35:30,200 --> 00:35:33,719
Speaker 2: it just it attracts from your quality of life and

630
00:35:33,760 --> 00:35:37,840
Speaker 2: it changes yourself image of yourself, like I'm a cancer

631
00:35:37,880 --> 00:35:38,959
Speaker 2: person now, you know.

632
00:35:38,880 --> 00:35:40,120
Speaker 1: And then you start feeling sick.

633
00:35:40,360 --> 00:35:44,879
Speaker 2: Yeah, it feeds the beast, it really does.

634
00:35:45,480 --> 00:35:49,640
Speaker 1: Versus I mean, I don't have many people that I

635
00:35:49,760 --> 00:35:53,279
Speaker 1: talk to cancer about. Like for me, I talk to

636
00:35:53,320 --> 00:35:56,680
Speaker 1: you about cancer because I think you're qualified to talk

637
00:35:56,719 --> 00:36:01,040
Speaker 1: to me about cancer. And everybody else where you getting

638
00:36:01,040 --> 00:36:05,600
Speaker 1: your information from, if it's from the internet, I literally

639
00:36:05,760 --> 00:36:08,880
Speaker 1: no desire to hear one word that comes from the internet,

640
00:36:09,120 --> 00:36:11,640
Speaker 1: not just about cancer, but pretty much about everything at

641
00:36:11,640 --> 00:36:16,120
Speaker 1: this point, but particularly about cancer. And so I want

642
00:36:16,160 --> 00:36:19,400
Speaker 1: to I want to speak to people that are, you know,

643
00:36:19,520 --> 00:36:23,400
Speaker 1: leading the charge in research. I want to. I want honesty.

644
00:36:23,719 --> 00:36:27,640
Speaker 1: I want, you know, hope where there's hope. I want

645
00:36:29,000 --> 00:36:32,520
Speaker 1: someone to be pragmatic where it's called for, Like, but

646
00:36:32,600 --> 00:36:37,279
Speaker 1: I don't want information that can't be verified or backed up.

647
00:36:37,880 --> 00:36:41,560
Speaker 1: And I also don't want to be a cancer person.

648
00:36:41,719 --> 00:36:44,880
Speaker 1: I want to you know, And I've often done some

649
00:36:45,080 --> 00:36:49,000
Speaker 1: very stupid, stupid things since being diagnosed because of my

650
00:36:49,120 --> 00:36:52,680
Speaker 1: desire to be normal, because I've like rejected the idea

651
00:36:52,840 --> 00:36:58,040
Speaker 1: that I'm a cancer in quote patient, Like, i have

652
00:36:58,200 --> 00:37:01,200
Speaker 1: cancer and I'm managing it. I'm managing it with you,

653
00:37:01,280 --> 00:37:04,080
Speaker 1: and I'm managing it with you know, doctor Ju and

654
00:37:04,120 --> 00:37:07,440
Speaker 1: like whoever else we need to bring in to help

655
00:37:07,680 --> 00:37:11,040
Speaker 1: in those moments. But I don't want it to define

656
00:37:11,239 --> 00:37:12,880
Speaker 1: my everyday life.

657
00:37:13,000 --> 00:37:17,160
Speaker 2: Well so much so that you know, And we've always kept,

658
00:37:17,200 --> 00:37:20,719
Speaker 2: which I think is a super healthy and amazing way

659
00:37:20,760 --> 00:37:24,239
Speaker 2: to do it. We've always kept our lane separate. Yeah,

660
00:37:24,280 --> 00:37:27,279
Speaker 2: so when we're together as social aized friends, it's a

661
00:37:27,320 --> 00:37:30,760
Speaker 2: friend lane. When we're doing medical self to medical lane,

662
00:37:30,840 --> 00:37:32,640
Speaker 2: and you know, every once in a while those things

663
00:37:32,680 --> 00:37:35,160
Speaker 2: have to cross over, but it's extremely rare. And you,

664
00:37:35,560 --> 00:37:39,440
Speaker 2: for example, will never ask me anything medical when we're

665
00:37:39,440 --> 00:37:41,640
Speaker 2: doing something social, or if you have to, you'll say, look,

666
00:37:41,680 --> 00:37:43,640
Speaker 2: I'm really sorry for asking this right now when we're

667
00:37:43,640 --> 00:37:45,480
Speaker 2: having dinner, but just blah blah blah blah. It's some

668
00:37:45,560 --> 00:37:47,200
Speaker 2: little knit or whatever that you have to do.

669
00:37:47,360 --> 00:37:52,680
Speaker 1: I've been to dinners with you. I've seen your phone.

670
00:37:53,000 --> 00:37:55,080
Speaker 1: I mean I haven't seen it, but like i've seen it.

671
00:37:55,080 --> 00:37:59,440
Speaker 1: How many you know you were inundated twenty four hours

672
00:37:59,480 --> 00:38:02,080
Speaker 1: a day, days a week. You do not get a

673
00:38:02,160 --> 00:38:05,520
Speaker 1: day off of you know, medical questions, and your patients

674
00:38:05,640 --> 00:38:08,239
Speaker 1: have your cell phone, and you know you've given full

675
00:38:08,320 --> 00:38:11,080
Speaker 1: access to yourself. So when I'm able to steal you

676
00:38:11,080 --> 00:38:13,640
Speaker 1: away and we go to dinner somewhere, I don't want

677
00:38:13,680 --> 00:38:15,799
Speaker 1: to do that. Like, if I have a question for you,

678
00:38:16,400 --> 00:38:18,879
Speaker 1: I'll text you during business hours or I'll come into

679
00:38:18,920 --> 00:38:22,279
Speaker 1: the clinic and I'll ask you. You know, we just

680
00:38:22,320 --> 00:38:26,319
Speaker 1: went to Italy together. You invited me on this amazing

681
00:38:26,640 --> 00:38:32,120
Speaker 1: yacht and with your family, and I got to go

682
00:38:32,160 --> 00:38:35,480
Speaker 1: to Italy with you, which was like bucket list. By

683
00:38:35,520 --> 00:38:37,600
Speaker 1: the way, you knew it was on my bucket list,

684
00:38:38,080 --> 00:38:40,960
Speaker 1: And when you called me, you said, like, it's kind

685
00:38:41,000 --> 00:38:44,120
Speaker 1: of bucket list, Shan, And I was like, I was

686
00:38:44,200 --> 00:38:45,000
Speaker 1: so excited.

687
00:38:46,239 --> 00:38:47,960
Speaker 2: We had the best time, such.

688
00:38:47,719 --> 00:38:51,000
Speaker 1: A good time, what an amazing went, an amazing trip.

689
00:38:51,239 --> 00:38:53,120
Speaker 2: We made some amazing restaurant.

690
00:38:53,239 --> 00:38:56,120
Speaker 1: So yeah, I wish i'd coordinated my outfits better with you.

691
00:38:56,200 --> 00:38:58,160
Speaker 1: But now I know what to expect.

692
00:38:59,320 --> 00:39:02,239
Speaker 2: And she was is you know. I mean, it's just incredible,

693
00:39:02,760 --> 00:39:06,719
Speaker 2: like jumping off of every level of the yacht, even

694
00:39:06,760 --> 00:39:10,200
Speaker 2: the highest of like Shannon is fearless. I mean, she

695
00:39:10,239 --> 00:39:10,759
Speaker 2: truly is.

696
00:39:10,880 --> 00:39:11,840
Speaker 1: I did injure myself.

697
00:39:11,920 --> 00:39:13,640
Speaker 2: Well I know you did, but I was going to

698
00:39:13,680 --> 00:39:17,600
Speaker 2: skip over that. It wasn't It wasn't jumping off the boat, however,

699
00:39:17,719 --> 00:39:18,040
Speaker 2: it was.

700
00:39:20,760 --> 00:39:23,239
Speaker 1: I mean that's the crazy thing, Like you jump off

701
00:39:23,360 --> 00:39:28,239
Speaker 1: like the highest points of this ginormous yacht and you

702
00:39:28,320 --> 00:39:30,680
Speaker 1: go to climb back on, and I got scared of

703
00:39:30,719 --> 00:39:35,240
Speaker 1: the of the jellyfish, so I went the long way.

704
00:39:35,800 --> 00:39:37,360
Speaker 2: That was at night, I think, yeah.

705
00:39:37,120 --> 00:39:40,920
Speaker 1: And the dangerous way, and that's when I gave myself

706
00:39:40,920 --> 00:39:42,600
Speaker 1: that that big bump on my leg.

707
00:39:42,680 --> 00:39:45,319
Speaker 2: And that was really crazy too, because since it was night,

708
00:39:45,600 --> 00:39:49,640
Speaker 2: the crew had the bright light shining onto the sea,

709
00:39:49,840 --> 00:39:51,920
Speaker 2: and all of a sudden we can see all these

710
00:39:52,000 --> 00:39:55,200
Speaker 2: jellyfish floating around in there. That's, of course we never

711
00:39:55,239 --> 00:39:58,680
Speaker 2: saw during the day, and it was like, oh, did

712
00:39:58,719 --> 00:39:59,879
Speaker 2: she really just jump in there?

713
00:40:00,120 --> 00:40:02,640
Speaker 1: Yeah, because they didn't see them when I did the jump.

714
00:40:02,680 --> 00:40:05,359
Speaker 1: It's like jumping in a shark infested waters like I

715
00:40:05,400 --> 00:40:08,080
Speaker 1: never would have done it had I known. But then

716
00:40:08,120 --> 00:40:12,360
Speaker 1: once I was swimming around, I was like, whoa, that's nuts.

717
00:40:12,400 --> 00:40:13,520
Speaker 1: I'm going to go the long way.

718
00:40:13,719 --> 00:40:15,680
Speaker 2: You know, Southern Italy is number for seafood.

719
00:40:17,920 --> 00:40:18,360
Speaker 1: I don't know.

720
00:40:18,400 --> 00:40:19,920
Speaker 2: In this case, you were the seafood.

721
00:40:20,120 --> 00:40:21,120
Speaker 1: I was seafood.

722
00:40:22,480 --> 00:40:22,760
Speaker 2: Wow.

723
00:40:22,960 --> 00:40:26,320
Speaker 1: Yeah, I mean we sort of did it fast forward

724
00:40:26,760 --> 00:40:30,120
Speaker 1: because I was going back to us meeting and you

725
00:40:30,239 --> 00:40:34,320
Speaker 1: sort of taking over my protocol and instantly saying, listen,

726
00:40:34,320 --> 00:40:37,439
Speaker 1: you gotta go get surgery, like that's the first thing.

727
00:40:37,719 --> 00:40:40,399
Speaker 2: Are you surprised that we did a fast forward. Yeah.

728
00:40:40,719 --> 00:40:44,200
Speaker 2: We always start down a road and shortly turned down

729
00:40:44,200 --> 00:40:44,680
Speaker 2: a lane.

730
00:40:45,040 --> 00:40:47,440
Speaker 1: Unpredictable is the word that you use to start with,

731
00:40:47,520 --> 00:40:48,920
Speaker 1: and that still matches and.

732
00:40:48,920 --> 00:40:51,279
Speaker 2: There it goes, and that's the magic at all.

733
00:40:59,760 --> 00:41:01,719
Speaker 1: So you said you got to get the tumor out

734
00:41:01,760 --> 00:41:04,720
Speaker 1: of your breast, like, let's like, that's the first thing.

735
00:41:05,120 --> 00:41:07,760
Speaker 1: And then once that's done, you're going to go on chemo,

736
00:41:07,880 --> 00:41:11,160
Speaker 1: You're going to get radiation, and we did. We did

737
00:41:11,200 --> 00:41:15,040
Speaker 1: all of that, and I made the decision at some

738
00:41:15,160 --> 00:41:20,560
Speaker 1: point to not take tomoxifen, which is you know, obviously

739
00:41:20,600 --> 00:41:25,640
Speaker 1: a drug that everybody recommends that you take because it

740
00:41:25,680 --> 00:41:28,120
Speaker 1: is a hormone blocker.

741
00:41:27,920 --> 00:41:31,440
Speaker 2: And it was adgivant therapy, meaning that you had no

742
00:41:31,480 --> 00:41:34,200
Speaker 2: known cancer and it was being given. It would be

743
00:41:34,239 --> 00:41:37,480
Speaker 2: given to increase the chances that cancer not come back

744
00:41:37,600 --> 00:41:41,920
Speaker 2: by staying in your system and blocking the cell's ability

745
00:41:41,960 --> 00:41:44,880
Speaker 2: to grow. Estringe is a growth factor for cancer cells,

746
00:41:44,920 --> 00:41:49,520
Speaker 2: So tomoxism would block the estrogen to the cancer cell,

747
00:41:49,760 --> 00:41:55,120
Speaker 2: and hopefully any microscopic disease that maybe have been in

748
00:41:55,160 --> 00:41:57,680
Speaker 2: your body that's too small to show up on imaging

749
00:41:57,719 --> 00:41:59,399
Speaker 2: and that we didn't know about that maybe it would

750
00:41:59,480 --> 00:42:03,160
Speaker 2: kill that and increased the odds that it wouldn't come back.

751
00:42:03,680 --> 00:42:06,960
Speaker 2: That was the principle of adgement therapy of demoxmin.

752
00:42:06,680 --> 00:42:10,120
Speaker 1: Which is a you know, solid argument, Like I look

753
00:42:10,200 --> 00:42:12,759
Speaker 1: back and I go, well, maybe how to do that?

754
00:42:13,160 --> 00:42:15,919
Speaker 1: Taking it? You know? I mean, I've had some people

755
00:42:15,960 --> 00:42:17,759
Speaker 1: in my life have sort of forced me to look

756
00:42:17,840 --> 00:42:21,040
Speaker 1: back like that, But I can't, right, because what good

757
00:42:21,120 --> 00:42:22,680
Speaker 1: is it? It doesn't do you.

758
00:42:22,680 --> 00:42:25,440
Speaker 2: You make the best decision you can at the time

759
00:42:25,480 --> 00:42:29,800
Speaker 2: you make it, and in retrospect you often cannot remember

760
00:42:30,520 --> 00:42:33,200
Speaker 2: many of the factors that were influencing you. So when

761
00:42:33,200 --> 00:42:37,080
Speaker 2: you look back, you have an erroneous evaluation of your decision.

762
00:42:37,480 --> 00:42:41,640
Speaker 2: But at the time, you had been on estrogen blockade

763
00:42:42,440 --> 00:42:46,640
Speaker 2: before you ever had surgery, and it wasn't very effective

764
00:42:46,680 --> 00:42:50,239
Speaker 2: on shrinking your tumor, and you had a lot of

765
00:42:50,640 --> 00:42:53,200
Speaker 2: effects on your body that you didn't like. So those

766
00:42:53,200 --> 00:42:57,359
Speaker 2: two factors were influencing you to not choose to take

767
00:42:57,400 --> 00:43:00,200
Speaker 2: that drug at that time. And you were disease free,

768
00:43:00,760 --> 00:43:03,319
Speaker 2: and the balance of things to you at the time

769
00:43:03,480 --> 00:43:06,600
Speaker 2: seemed reasonable. And you did not make that lightly, and

770
00:43:06,640 --> 00:43:11,040
Speaker 2: you made it over and over again because I asked

771
00:43:11,080 --> 00:43:14,080
Speaker 2: you every single time for a year, are you sure

772
00:43:14,280 --> 00:43:15,719
Speaker 2: you don't want to do this? Issue? You want to

773
00:43:15,719 --> 00:43:19,080
Speaker 2: do this? So you were. You were resolute in your decision,

774
00:43:19,320 --> 00:43:22,040
Speaker 2: and you can't judge that decision, and no one else

775
00:43:22,080 --> 00:43:24,560
Speaker 2: can force you to because you made the best decision

776
00:43:24,560 --> 00:43:26,600
Speaker 2: you could at the time. And it's a it's an

777
00:43:26,760 --> 00:43:29,320
Speaker 2: erroneous set of analyzes when you look backwards.

778
00:43:29,680 --> 00:43:33,600
Speaker 1: Yeah, I mean, I also think that I was fairly

779
00:43:33,640 --> 00:43:38,560
Speaker 1: certain it wasn't going to come back, because I believed

780
00:43:38,680 --> 00:43:41,440
Speaker 1: that the reason why I got cancer was because I

781
00:43:41,520 --> 00:43:45,640
Speaker 1: did IVF right. I met my husband at the time.

782
00:43:45,960 --> 00:43:50,440
Speaker 1: Later in years and you know, a multitude of things happen.

783
00:43:50,560 --> 00:43:53,200
Speaker 1: And so when it was time to have that decision,

784
00:43:54,239 --> 00:43:57,880
Speaker 1: we chose to have we needed IVF, and I did

785
00:43:58,360 --> 00:44:00,799
Speaker 1: a bunch of rounds of it, and I i, you know,

786
00:44:01,120 --> 00:44:03,920
Speaker 1: through a lot of other women that I knew that

787
00:44:04,000 --> 00:44:07,480
Speaker 1: did IVF that ended up getting breast cancer as well.

788
00:44:08,160 --> 00:44:10,480
Speaker 1: Sort of the numbers all started stacking up in my

789
00:44:10,680 --> 00:44:14,160
Speaker 1: head that if you know, you sort of have a

790
00:44:14,280 --> 00:44:16,920
Speaker 1: cell that's a little wonky and that's sitting on the

791
00:44:17,080 --> 00:44:20,960
Speaker 1: edge of maybe turning spreading cancer, blah blah blah, that

792
00:44:22,200 --> 00:44:24,640
Speaker 1: the all the hormones that you're pumping into your body

793
00:44:24,680 --> 00:44:27,920
Speaker 1: from IVF are only going to up that chance of it.

794
00:44:28,640 --> 00:44:31,960
Speaker 1: That was at least my thinking. So when I got

795
00:44:32,040 --> 00:44:35,160
Speaker 1: the you know, you're all clear remission after chemo and

796
00:44:35,280 --> 00:44:38,960
Speaker 1: all of that, I knew I wasn't doing IVF anymore

797
00:44:39,000 --> 00:44:41,759
Speaker 1: because I was already a menopause, so like there was

798
00:44:41,840 --> 00:44:45,000
Speaker 1: no need for it. I was pretty sure, you know,

799
00:44:45,040 --> 00:44:47,120
Speaker 1: I don't want to say that I made a very

800
00:44:48,160 --> 00:44:53,320
Speaker 1: uninformed decision, Like I am a researcher. I'm hardcore about

801
00:44:53,560 --> 00:44:56,040
Speaker 1: you know, backing up some of my data, certainly not

802
00:44:56,120 --> 00:44:59,040
Speaker 1: at your level and certainly not at doctor's levels, and

803
00:45:00,160 --> 00:45:05,320
Speaker 1: researchers levels. So my decision was at the time based

804
00:45:05,320 --> 00:45:08,120
Speaker 1: on sort of the facts that I knew that I

805
00:45:08,160 --> 00:45:12,560
Speaker 1: had investigated, and you, in fact, did keep on encouraging

806
00:45:12,600 --> 00:45:14,920
Speaker 1: me to take the demoxifin, and I was just like,

807
00:45:15,160 --> 00:45:16,040
Speaker 1: absolutely not.

808
00:45:16,400 --> 00:45:20,879
Speaker 2: You're a resolute yeah, but also yes, you did research things.

809
00:45:20,920 --> 00:45:23,200
Speaker 2: But also there was another factor in there, which is,

810
00:45:23,400 --> 00:45:26,480
Speaker 2: even though you know, anyone who's sort of close to

811
00:45:27,160 --> 00:45:32,359
Speaker 2: menopause often goes into menopause with chemotherapy, sometimes people who

812
00:45:32,400 --> 00:45:35,200
Speaker 2: are not close to menopause go into it as well,

813
00:45:35,239 --> 00:45:39,680
Speaker 2: but then it sometimes returns, menstruation can return, and you

814
00:45:39,760 --> 00:45:42,640
Speaker 2: were still hopeful that it might return for you because

815
00:45:42,680 --> 00:45:43,520
Speaker 2: you still want.

816
00:45:43,360 --> 00:45:45,759
Speaker 1: To have a baby, yeah, desperately.

817
00:45:45,320 --> 00:45:48,200
Speaker 2: And I think that played a role in the demoxpin thing, which,

818
00:45:49,000 --> 00:45:52,480
Speaker 2: you know, people at this stage where you're at doesn't

819
00:45:52,680 --> 00:45:54,920
Speaker 2: seem like a factor, but that was a factor at

820
00:45:54,920 --> 00:45:58,080
Speaker 2: the time, this sort of hopefulness that maybe you could

821
00:45:58,320 --> 00:45:59,120
Speaker 2: still have a baby.

822
00:45:59,760 --> 00:46:02,399
Speaker 1: Yeah. Yeah, I mean, thank you for reminding me of that,

823
00:46:02,520 --> 00:46:06,400
Speaker 1: because it did definitely play a huge role of you know,

824
00:46:06,520 --> 00:46:09,600
Speaker 1: wanting not only not only did I want a child

825
00:46:09,600 --> 00:46:12,400
Speaker 1: for myself, but I wanted it, you know, for my husband.

826
00:46:12,440 --> 00:46:15,440
Speaker 1: I wanted it for our marriage. I wanted, you know,

827
00:46:15,840 --> 00:46:18,879
Speaker 1: I wanted him to have that part of him self

828
00:46:18,960 --> 00:46:23,359
Speaker 1: fulfilled as well. So it seemed like a calculated risk

829
00:46:23,440 --> 00:46:27,040
Speaker 1: that wasn't too bad of one to take. Plus I

830
00:46:27,080 --> 00:46:30,920
Speaker 1: can't remember, you'll correct me. I think it's cervical cancer.

831
00:46:31,239 --> 00:46:35,400
Speaker 1: That there's a percentage of demoxifensity to increase. You'ine cancer,

832
00:46:35,480 --> 00:46:37,680
Speaker 1: thank you, And I was like, well, you know, that

833
00:46:37,840 --> 00:46:40,439
Speaker 1: just gave me one more reason to say no to it,

834
00:46:40,800 --> 00:46:42,759
Speaker 1: and yeah, and you're right, and I can't look back,

835
00:46:42,960 --> 00:46:43,960
Speaker 1: and so.

836
00:46:44,000 --> 00:46:46,520
Speaker 2: Moving forward, I think, but I think also, don't forget

837
00:46:46,600 --> 00:46:50,080
Speaker 2: that cancer and cancer treatment you know, caused you to

838
00:46:50,120 --> 00:46:52,400
Speaker 2: look back at you know, your own life and to

839
00:46:52,440 --> 00:46:56,080
Speaker 2: be very philosophical. You know, it made you want to

840
00:46:56,080 --> 00:46:59,000
Speaker 2: have a child for another reason too, which is, you know,

841
00:46:59,080 --> 00:47:02,680
Speaker 2: to be able to part you know, the very many

842
00:47:02,760 --> 00:47:05,200
Speaker 2: things that you've learned in life and the many feelings

843
00:47:05,200 --> 00:47:08,759
Speaker 2: that you had into raising a human being, you know,

844
00:47:08,880 --> 00:47:14,000
Speaker 2: I mean, that's that's the ultimate diary, is to raise

845
00:47:14,040 --> 00:47:17,919
Speaker 2: a child and try to infuse their life with all

846
00:47:17,920 --> 00:47:22,000
Speaker 2: the wisdoms that you had and and helping them try

847
00:47:22,040 --> 00:47:25,640
Speaker 2: to avoid the mistakes that you made and that they're

848
00:47:25,680 --> 00:47:27,719
Speaker 2: going to not make some of their own of course

849
00:47:27,760 --> 00:47:31,160
Speaker 2: they will, but there's a you know, you were in

850
00:47:31,160 --> 00:47:36,879
Speaker 2: the spotlight since you were a young girl, and you've

851
00:47:36,920 --> 00:47:40,640
Speaker 2: lived a million lives when most people, you know, we're

852
00:47:40,719 --> 00:47:42,600
Speaker 2: just starting out or we're in the beginning of the careers.

853
00:47:42,600 --> 00:47:46,440
Speaker 2: You've already had two or three careers, and you know

854
00:47:46,480 --> 00:47:50,319
Speaker 2: fought your way, you know, in a Hollywood scene that

855
00:47:50,600 --> 00:47:53,799
Speaker 2: you know didn't necessarily you know, regard what you had

856
00:47:53,840 --> 00:47:57,319
Speaker 2: to say. And I mean, I've never met anybody as

857
00:47:57,360 --> 00:48:00,319
Speaker 2: well educated as you who was schooled on the set.

858
00:48:00,440 --> 00:48:02,520
Speaker 2: And I of course, as you know, many many people

859
00:48:02,520 --> 00:48:05,040
Speaker 2: were schooled on sets. But you have a you know

860
00:48:05,200 --> 00:48:10,680
Speaker 2: a level of comprehension and power of intelligence and use

861
00:48:10,719 --> 00:48:14,319
Speaker 2: of that intelligence, and you know, in a very incisive

862
00:48:14,360 --> 00:48:17,640
Speaker 2: way in cooking as well, for example, there are not

863
00:48:17,800 --> 00:48:21,720
Speaker 2: that many people who go on to be these amazing cooks.

864
00:48:21,760 --> 00:48:23,960
Speaker 2: And I mean everything you do is full tilt. That's

865
00:48:24,000 --> 00:48:26,960
Speaker 2: who you are, and that's how you make your decisions.

866
00:48:27,640 --> 00:48:32,719
Speaker 2: And so I actually find it very gratifying that you

867
00:48:33,000 --> 00:48:36,640
Speaker 2: research things and you you know, make your definitive decision,

868
00:48:36,760 --> 00:48:41,440
Speaker 2: because you see in medical decision making, people want shared

869
00:48:41,440 --> 00:48:43,799
Speaker 2: decisions with the physician, which I'm all about. I mean,

870
00:48:43,800 --> 00:48:46,440
Speaker 2: I'm all about that. I love that, as you know

871
00:48:46,560 --> 00:48:50,400
Speaker 2: and as all my patients know. But part and parcel

872
00:48:50,480 --> 00:48:53,960
Speaker 2: of shared decision making is accepting responsibility for the decision.

873
00:48:54,800 --> 00:48:59,560
Speaker 2: And you always do that. Sometimes people want share decision making,

874
00:49:00,040 --> 00:49:02,439
Speaker 2: and if it's not the right decision, then they want

875
00:49:02,480 --> 00:49:05,560
Speaker 2: to look to everyone else for you know, why the

876
00:49:05,600 --> 00:49:08,600
Speaker 2: wrong decision was made or whatever. But when you when

877
00:49:08,600 --> 00:49:11,279
Speaker 2: you're a person who really owns it, and like all

878
00:49:11,360 --> 00:49:13,640
Speaker 2: my patients do, but you are the you know, the

879
00:49:13,760 --> 00:49:17,479
Speaker 2: prime example of that of someone who you know, wants

880
00:49:17,480 --> 00:49:19,800
Speaker 2: to part, to stay in process, wants to know the data,

881
00:49:20,400 --> 00:49:22,840
Speaker 2: and once you make your decision, you own responsibility for

882
00:49:22,840 --> 00:49:25,880
Speaker 2: your decision. And I love that because that's that's just

883
00:49:26,080 --> 00:49:28,360
Speaker 2: the being a person of truth.

884
00:49:28,840 --> 00:49:33,640
Speaker 1: Accountability I love nothing. Accountability is like my favorite thing.

885
00:49:34,280 --> 00:49:37,239
Speaker 1: So if I made a decision that put me in

886
00:49:37,280 --> 00:49:41,440
Speaker 1: a certain place, then I hold myself accountable like you

887
00:49:41,560 --> 00:49:41,880
Speaker 1: have to.

888
00:49:42,120 --> 00:49:44,040
Speaker 2: I've seen that over and over and over again, and

889
00:49:44,120 --> 00:49:46,480
Speaker 2: everything you've said and done and even in stories we've

890
00:49:46,480 --> 00:49:50,719
Speaker 2: talked about about your career, Yes, and certain decisions that

891
00:49:51,000 --> 00:49:53,640
Speaker 2: you've made in response to things that happened or this

892
00:49:53,760 --> 00:49:57,200
Speaker 2: or that you've you know, you've always accepted responsibility for

893
00:49:57,239 --> 00:49:59,600
Speaker 2: those and you know, the thing is that even when

894
00:49:59,680 --> 00:50:03,839
Speaker 2: when things happened that weren't your responsibility, you will describe it,

895
00:50:03,920 --> 00:50:07,000
Speaker 2: but you're also not You've never been finger pointing of people.

896
00:50:07,080 --> 00:50:09,120
Speaker 2: Say that person did that.

897
00:50:09,120 --> 00:50:09,719
Speaker 1: That's a new thing.

898
00:50:10,880 --> 00:50:13,600
Speaker 2: As that person did that, you'll say what they did,

899
00:50:13,640 --> 00:50:16,720
Speaker 2: but you'll also understand the other factors that we're bearing

900
00:50:16,760 --> 00:50:20,080
Speaker 2: on the scenario. Yeah, and I've always respected.

901
00:50:19,640 --> 00:50:22,120
Speaker 1: That for the most part. I think every you know,

902
00:50:22,160 --> 00:50:24,919
Speaker 1: there's always the exception to the rule where I point

903
00:50:24,960 --> 00:50:28,759
Speaker 1: the finger and go, you're bearing the full brunt of

904
00:50:28,800 --> 00:50:31,040
Speaker 1: this one because this is all on you.

905
00:50:32,000 --> 00:50:33,880
Speaker 2: And when you do that, it's very believable because you

906
00:50:33,920 --> 00:50:34,760
Speaker 2: don't do that often.

907
00:50:35,200 --> 00:50:39,000
Speaker 1: Doctor piro LP. Thank you so much for being on.

908
00:50:39,719 --> 00:50:41,760
Speaker 1: There is so much more for us to talk about.

909
00:50:41,880 --> 00:50:45,400
Speaker 1: So I'm going to have you on for another episode

910
00:50:46,000 --> 00:50:49,759
Speaker 1: and just keep digging and keep exploring because I just

911
00:50:50,239 --> 00:50:53,279
Speaker 1: I think you have so much to offer and this

912
00:50:53,320 --> 00:50:56,080
Speaker 1: conversation is incredibly important to a lot of people. So

913
00:50:56,719 --> 00:51:00,960
Speaker 1: thank you very much and I love you end Yeah,

914
00:51:01,120 --> 00:51:01,680
Speaker 1: see you soon.