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What’s Up, Doc? Featuring Dr. Zack Oakey | The Eye Believe Podcast · The Eye Believe Podcast

• 0:03
  hey everyone
• 0:03
  welcome to another episode of the Eye Believe Podcast
• 0:06
  this is another episode in our series
• 0:08
  What's Up, Doc?
• 0:09
  and today we are featuring Doctor Zack Oakey
• 0:12
  founder of Blue Coast Retina
• 0:13
  welcome Doctor Oakey
• 0:15
  what's up everyone how's it going
• 0:17
  very excited to have you on the podcast
• 0:20
  and learn a little bit more about you
• 0:21
  so
• 0:21
  start with giving us a little bit about your backstory
• 0:24
  what was your childhood like
• 0:27
  I had an awesome childhood
• 0:28
  I grew up in southeast Idaho
• 0:31
  in the middle of nowhere uh
• 0:33
  in a little city called Rexburg
• 0:36
  it's like 40 minutes from Wyoming
• 0:38
  every time I woke up
• 0:39
  I'd see the Teton Mountains and the snow and stuff
• 0:43
  um my parents own gas stations and car washes
• 0:47
  I'm the first person with a medical degree in my family
• 0:50
  so it was a chill vibes I
• 0:53
  I was a manager at a car wash and stuff and uh
• 0:58
  you know I guess that's all I can think of right now
• 1:03
  perfect and when did you know you wanted to be a doctor
• 1:09
  well uh
• 1:10
  I knew this at the car wash
• 1:11
  so I I go to work every morning um
• 1:15
  that is every Saturday morning
• 1:17
  and then every summer work there
• 1:20
  and I see people of all shapes and sizes
• 1:24
  all varieties of life coming in
• 1:26
  washing their car filling up the car with gas
• 1:29
  and I noticed something well
• 1:31
  first of all being in a little town
• 1:34
  you know everyone
• 1:35
  so like
• 1:36
  the guy who was the doctor who delivered me
• 1:39
  when I was a baby he was a customer of my parents
• 1:42
  car washes and gas stations and stuff
• 1:45
  so I would see him among all the other doctors in town
• 1:49
  and I'd say hi to him and stuff
• 1:50
  polishing their wheels
• 1:52
  and I just noticed these guys are smart
• 1:55
  they're always friendly they're always happy uh
• 1:58
  they tip pretty well so I thought
• 2:01
  you know I don't wanna be in the car wash
• 2:03
  gas station business my whole life
• 2:05
  and just looking around at the options
• 2:07
  this seemed like a really good option
• 2:10
  and later on I found out that
• 2:13
  you know you gotta be smart
• 2:14
  you have to have a scientific interest
• 2:17
  and stuff like that and that
• 2:19
  that's kind of in my family
• 2:20
  my dad has a graduate degree in Arabic actually
• 2:23
  so we're kind of familiar with the whole
• 2:25
  educational situation
• 2:28
  um so that
• 2:30
  I mean that was my initial
• 2:31
  shall we say inspiration
• 2:33
  purely looking around and seeing who's happy
• 2:36
  who's having a good time the doctors were
• 2:40
  I love that and
• 2:41
  how did you first get involved
• 2:43
  in treating ocular melanoma
• 2:46
  oh this uh
• 2:48
  I learned first about eye cancer in residency
• 2:52
  I think that's a common thread
• 2:53
  most people get into ophthalmology
• 2:55
  for all sorts of reasons um
• 2:58
  the first time I saw ocular melanoma
• 3:01
  was just reading about it
• 3:02
  when you go to ophthalmology residency
• 3:05
  you have to read all these books
• 3:06
  like I have this one right here
• 3:10
  the basic Clinical Sciences series
• 3:13
  on eye medical topics
• 3:16
  and I
• 3:17
  I realized that I had to understand ocular melanoma
• 3:20
  specifically a little bit
• 3:21
  just to pass some tests
• 3:23
  um but I remember reading it and I was like wow
• 3:26
  this is this is something
• 3:28
  this is not like LASIK this is not cataract surgery
• 3:31
  this is like
• 3:33
  really basic medical stuff
• 3:35
  and I think that was like
• 3:36
  the thing that drew my interest
• 3:37
  I I compared myself with my other co residents
• 3:41
  um and I love them and I respect them
• 3:44
  but I just felt like
• 3:46
  I don't want to let go of my medical doctor past
• 3:50
  like going into medical school
• 3:52
  learning about the body
• 3:54
  interacting with multiple um
• 3:58
  consultants and various experts within medicine um
• 4:02
  ocular oncology at least
• 4:04
  as I just read it
• 4:05
  it sounded like you're a medical doctor
• 4:07
  not like
• 4:08
  doing LASIK not that that's not valuable
• 4:11
  it's awesome but um
• 4:14
  it just had this like
• 4:16
  breadth and depth and a lot of room to explore
• 4:19
  then one day someone came into the
• 4:21
  into my resident clinic with an eye melanoma
• 4:25
  and it was really big and I kind of looked around
• 4:28
  and I realized like
• 4:29
  not a lot of people know this
• 4:31
  like
• 4:31
  we all have to thumb through our textbook to kind of
• 4:33
  know like what
• 4:34
  what do we do and to me
• 4:36
  that whenever doctors are kind of
• 4:38
  looking around at each other
• 4:40
  kind of confused what do we do
• 4:41
  that that
• 4:41
  to me is a sign of like
• 4:43
  we got some work to do
• 4:46
  and I like to be that kind of guy
• 4:48
  let's get to work let's understand it
• 4:50
  you know join the join the fight
• 4:53
  that is awesome I love that outlook
• 4:56
  and now what type of doctor are you
• 5:00
  yeah so I'm a uh
• 5:02
  like many ocular oncologist
• 5:04
  if you listen to interviews here
• 5:06
  and I'd encourage you to listen to everyone
• 5:07
  cause everyone is really cool
• 5:09
  I know the ocular oncology community is really small um
• 5:13
  but like everyone here I've done multiple
• 5:16
  at least most people
• 5:17
  they've done two fellowships in ophthalmology
• 5:20
  but speaking of which what is a fellowship
• 5:22
  well we all go to college
• 5:24
  medical school do a residency in ophthalmology
• 5:27
  learning about the basics of eye medicine and so on
• 5:30
  many people just graduate like that
• 5:32
  and they go off and they do great things
• 5:33
  they're called general ophthalmologist
• 5:35
  but um
• 5:36
  I did a fellowship in retina medicine and surgery
• 5:40
  um that was done at the university of Wisconsin
• 5:45
  which played a big role in some large research trials
• 5:49
  conducted for ocular melanoma
• 5:51
  and I actually selected that place because um
• 5:54
  at the time
• 5:54
  I really wanted to be in the ocular oncology realm
• 5:58
  and there are only a couple retina fellowships
• 6:01
  where the retina faculty take care of ocular melanoma
• 6:05
  among other eye cancers
• 6:07
  so I thought when I would go there um
• 6:10
  that I would be able to graduate learning
• 6:12
  knowing how to do all sorts of things
• 6:14
  and indeed it was a very um
• 6:16
  intense education
• 6:18
  I graduated retina fellowship
• 6:20
  and then
• 6:20
  I got into the normal life of being a real doctor
• 6:25
  with everyone looking at you for the answers
• 6:28
  and I decided I
• 6:30
  I need to study this eye cancer thing a little bit more
• 6:33
  before I start getting really into it
• 6:34
  because I wanted to present to my patients
• 6:37
  in the community a learned individual
• 6:40
  someone they can have confidence in um
• 6:43
  and show my patients that I know what I'm doing
• 6:46
  and so on so
• 6:46
  I decided to do another fellowship in ocular oncology
• 6:51
  and I did that at the Cleveland Clinic
• 6:53
  with a man named Arun Singh
• 6:55
  who is one of the coolest people you've ever met
• 6:57
  in my opinion
• 6:59
  so I I did that
• 7:01
  and then I came back
• 7:02
  and I actually started my own practice
• 7:05
  and that's my next question
• 7:06
  tell us a little bit about that practice
• 7:09
  yeah
• 7:09
  so most people when they have any kind of eye cancer
• 7:14
  they go to a large academic medical institution
• 7:17
  like around me uh
• 7:18
  we have uh
• 7:19
  UCLA USC Stanford UCSF
• 7:24
  university of California San Diego
• 7:26
  et cetera but
• 7:28
  if you start interacting with ocular oncology
• 7:30
  long enough you'll run into people like me
• 7:33
  who have a private practice
• 7:35
  now it's not like an average private practice
• 7:37
  in a sense like
• 7:39
  like a general ophthalmologist
• 7:41
  who does like
• 7:41
  LASIK and cataract surgery
• 7:43
  they have their own clinic and their own staff
• 7:45
  and so on
• 7:46
  and they might interact with a couple operating rooms
• 7:48
  but when you're when you're in ocular oncology
• 7:51
  you have to have resources from various
• 7:55
  um medical institutions
• 7:56
  and so I've done that I work with the city of hope
• 8:01
  which is a large cancer hospital
• 8:03
  that's really close to my clinic
• 8:05
  uh there's also some other regional hospitals
• 8:08
  with large oncology practices
• 8:11
  um and I'm not alone in this
• 8:13
  there actually a couple more famous than me
• 8:16
  ocular oncologists who also are in private practice
• 8:19
  and we all have a shall we say
• 8:22
  the same pattern
• 8:23
  we're all associated with various institutions
• 8:26
  in our local area
• 8:28
  in order to deliver the highest level of care possible
• 8:32
  including organized clinical trials and uh
• 8:37
  obtain pathology specimens
• 8:38
  and deliver specialized medications and so on
• 8:41
  that might be necessary
• 8:42
  so while it's a private practice I
• 8:45
  I have my own clinic this is my office
• 8:47
  I got my lava lamp and my books and so on
• 8:50
  I'm not in an academic medical center
• 8:52
  but I'm still proud of the fact that we can deliver
• 8:54
  the highest standard of care
• 8:57
  and what do you believe makes a great doctor
• 9:03
  so many answers to this question
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  um
• 9:08
  well there are
• 9:08
  there are always the three A's of medicine availability
• 9:12
  affability accountability
• 9:14
  I think we have to achieve all three
• 9:16
  for sure I would consider that
• 9:18
  shall we say the foundation
• 9:20
  if a patient receives any kind of medical care
• 9:23
  we need to be available to talk to them
• 9:24
  and speak in a cordial tone
• 9:27
  and also be accountable for our results
• 9:29
  but um
• 9:34
  I always put a lot of stock in
• 9:36
  when you meet someone for the first time
• 9:38
  what's your impression about them
• 9:39
  I I try to achieve something with my patients
• 9:42
  when particularly
• 9:44
  we're talking about something that is
• 9:45
  potentially life threatening
• 9:48
  how do we set the tone how do we um
• 9:52
  show that we've understood this for a while
• 9:55
  you're not walking in as our first patient
• 9:57
  I like to demonstrate to my patients
• 9:59
  that we've thought about this for a while
• 10:02
  every little step every little question that they have
• 10:04
  we have an answer for
• 10:05
  at least we've attempted to answer it
• 10:08
  also in my little clinical exam rooms
• 10:11
  we have these big TVs
• 10:13
  they're like a picture of the
• 10:15
  of the eye I give a little
• 10:17
  like mini lecture
• 10:18
  like a little eye anatomy lecture
• 10:20
  like here's the cornea
• 10:21
  here's the lens here's the retina
• 10:24
  this is where melanoma arises
• 10:27
  I think that's really helpful
• 10:29
  but trying to establish a tone that we got you
• 10:35
  we're gonna take care of this as best as we can
• 10:38
  and if we don't succeed on the first try
• 10:40
  we're dedicated to on the next
• 10:42
  I think that's really important
• 10:45
  absolutely so my next question
• 10:48
  you've kind of already answered
• 10:49
  but I'm gonna ask it
• 10:50
  just in case you wanna add anything else
• 10:51
  if someone becomes your patient
• 10:53
  what can they expect from you
• 10:57
  well I think the
• 10:59
  the first thing they
• 11:00
  they will interact with is my secretaries
• 11:04
  people who answer the phone
• 11:07
  these people are handpicked
• 11:10
  I
• 11:11
  when I interviewed people to join our practice
• 11:14
  I made sure that they had a lot of experience
• 11:16
  and they're able to uh
• 11:19
  deliver
• 11:21
  um accurate information
• 11:23
  and set up the clinic appointment correctly
• 11:26
  but then when you walk in the door
• 11:28
  what you'll expect is a nice little TV
• 11:32
  and there's a mint right on the countertop there
• 11:35
  so you can get fresh breath
• 11:37
  and a little hand sanitizer
• 11:39
  and then when you walk in
• 11:41
  you meet one of my technicians
• 11:42
  and these are awesome people
• 11:44
  they're all future doctors and nurses and stuff
• 11:47
  we take a photo of the eye
• 11:48
  I come in I give you my card
• 11:50
  I shake your hand and I give you a smile
• 11:53
  I think that's really important
• 11:54
  I just want people to know that we're part of a
• 11:58
  we're part of a an effort here
• 12:00
  and then no matter what the condition is
• 12:02
  whether it's something that isn't even ocular melanoma
• 12:05
  or eye cancer we get a mini lecture
• 12:08
  a little intro into eye health
• 12:10
  eye anatomy
• 12:12
  I kind of orient people into who am I sometimes
• 12:16
  and a lot of patients who have had ocular melanoma
• 12:18
  particularly kind of experience what I'm describing
• 12:21
  they've maybe they've developed some visual symptoms
• 12:25
  they go to a local like
• 12:26
  optometrist
• 12:27
  like at Costco or Lens Crafters or something
• 12:30
  and then the optometrist says
• 12:32
  I'm not sure go to an ophthalmologist
• 12:34
  so someone goes to someone who's had like
• 12:36
  LASIK or cataract surgery
• 12:38
  and they say this is not me
• 12:39
  go to a retina specialist
• 12:41
  let's say and then the retina specialist says
• 12:44
  this isn't me so by the time someone comes to my clinic
• 12:47
  they've already met several people
• 12:49
  in the whole eye medicine spectrum
• 12:52
  so part of my initial introduction to people
• 12:54
  is to orient them about why are
• 12:56
  why are you here
• 12:57
  why have you made such a journey to come here
• 13:01
  so
• 13:01
  I think that's part of the initial introduction to me
• 13:04
  I use the terminology it says right on the like
• 13:07
  there's a door to our clinic
• 13:08
  it says right on there ophthalmic oncology
• 13:11
  tell people I'm an ocular oncologist
• 13:13
  I treat eye tumors and eye cancers
• 13:16
  and once we've established that
• 13:18
  that tone I think people understand
• 13:19
  like
• 13:20
  we're gonna talk about some really important things
• 13:22
  today but still
• 13:23
  I try to maintain a nice fluid conversation and not
• 13:26
  not try to scare people too much
• 13:28
  because it that that's easy to do
• 13:32
  I can totally see that
• 13:33
  because I think you have such an amazing personality
• 13:36
  you're very optimistic but also very relaxed
• 13:39
  and I can see where that would really
• 13:41
  put your patients at ease
• 13:43
  well thanks
• 13:45
  absolutely yeah I
• 13:46
  I tell my patients
• 13:47
  I'm a little pathologically optimistic
• 13:50
  like
• 13:51
  sometimes I I need to bring in a little seriousness
• 13:54
  but um I
• 13:56
  I just think about this from my perspective if
• 13:59
  if I had melanoma in my eye
• 14:02
  and I was looking down a pathway in which my vision
• 14:06
  or my life could be threatened
• 14:08
  what do I want
• 14:08
  I want someone to introduce me to who they are
• 14:11
  why are they there the details
• 14:14
  um but try to have an open dialogue with someone
• 14:18
  so that they don't feel like
• 14:19
  I can't ask the questions that I want to
• 14:21
  and of course actually
• 14:22
  in many visits that I have with my patients
• 14:25
  I'll even make a diagnosis on the first encounter
• 14:28
  and then
• 14:29
  I will actually suggest that a patient go home
• 14:31
  and think about their thoughts and their questions
• 14:33
  because I've gotten a lot of feedback
• 14:35
  particularly from just in person
• 14:38
  but patients that I've met with A Cure In Sight
• 14:40
  who told me their eye
• 14:41
  their ears were closed the moment they'd heard melanoma
• 14:45
  they couldn't really think straight
• 14:47
  I've taken that to heart
• 14:48
  so I actually apply that in my own clinical practice
• 14:51
  I usually like to suggest like
• 14:53
  come back in a week this is not a threat to anyone
• 14:55
  if you wanna develop some thoughts
• 14:58
  let some things digest bring in family members
• 15:01
  sometimes people meet me and they say oh
• 15:04
  I've been told it's a threat goal
• 15:05
  in fact it's not a freckle
• 15:07
  it's melanoma and it's kind of a shock
• 15:09
  so they're not quite ready to fully appreciate
• 15:13
  all of the important questions that they have
• 15:15
  so I always like to bring in
• 15:17
  invite my patients to bring in their neighbors
• 15:18
  or their family or whatever
• 15:19
  people who
• 15:20
  whom they trust to kind of go through the details again
• 15:24
  and what is your overall approach
• 15:26
  to treating ocular melanoma
• 15:29
  yeah these days
• 15:31
  it's so it's so crazy
• 15:34
  um it used to be that if someone had ocular melanoma
• 15:38
  we take out the eye and that's the end of it
• 15:41
  like that's how it was done for decades
• 15:44
  and then radiation was developed
• 15:46
  and various forms of radiation has been developed
• 15:49
  in the late 90s early 2000s
• 15:52
  and these days
• 15:53
  there are certain clinical trials that are happening
• 15:55
  which might provide other options
• 15:58
  things called immunotherapy
• 16:01
  treatment for medium small
• 16:03
  large ocular melanoma of the choroid ciliary body Iris
• 16:07
  etcetera
• 16:09
  the the days of this is how we do it here are
• 16:13
  they may be over I mean
• 16:15
  we're going through a giant evolution right now
• 16:18
  um I've heard plenty of talks
• 16:20
  with my medical oncology colleagues
• 16:21
  the other internal medicine doctors
• 16:23
  with whom we interact
• 16:24
  who are just listing all the available options
• 16:27
  even in the case of a metastasis
• 16:29
  and that's changing
• 16:30
  when we're treating the tumor primarily in the eye now
• 16:33
  but by far and large
• 16:35
  our treatment strategies are radiation
• 16:38
  that is for small and medium tumors
• 16:41
  some large for example
• 16:43
  so when there are multiple treatment options
• 16:45
  how do you guide your patients through the decision
• 16:47
  and what role do you believe patients should play
• 16:50
  in the decision making
• 16:52
  oh they
• 16:53
  they are in the driver's seat
• 16:54
  they're the VIP they are the decision makers
• 16:57
  in fact I I I'm so
• 17:02
  I believe so strongly in this
• 17:04
  um at the end of my recommendation
• 17:08
  I always tell people this is your body
• 17:11
  I'm a consultant I'm a learned advisor
• 17:14
  if you say
• 17:15
  you do not want to treat your ocular melanoma
• 17:18
  understanding the totality of the risks
• 17:20
  this is your choice I'm here to help you
• 17:23
  I think that's like
• 17:25
  the ethical premise we all should have
• 17:27
  now I may express a disagreement
• 17:29
  I may say I disagree with your decision
• 17:31
  if I were you I would treat it this way
• 17:33
  but um yeah
• 17:36
  my approach is always to make a concrete recommendation
• 17:39
  whether it's plaque brachytherapy
• 17:41
  proton beam enucleation
• 17:44
  etcetera but the way we're incorporating immune therapy
• 17:48
  and chemotherapy like medications
• 17:50
  it's still evolving there's not like
• 17:53
  an exact clear role quite yet
• 17:55
  we really only have one immune therapy
• 17:57
  that's approved by the United States FDA
• 18:00
  so I'd say that's still an open conversation
• 18:03
  but
• 18:03
  we ought to offer patients clinical trial enrollment
• 18:06
  and other options again
• 18:08
  based on the fundamental premise that um
• 18:11
  someone who has this within their body
• 18:13
  they are the decision makers
• 18:45
  and how do you work with other specialists
• 18:48
  to provide the best care and
• 18:49
  what should patients know
• 18:50
  about being part of a multidisciplinary team
• 18:54
  the way to work together
• 18:56
  there are certain things about me that I insist on
• 19:00
  number one if someone refers a patient to me
• 19:02
  I wanna see the photos and I wanna have your cell phone
• 19:06
  and I wanna talk to you for example
• 19:09
  um but as this is before meeting
• 19:12
  let's say a member of the treatment team
• 19:14
  but once someone arrives into my orbit um
• 19:18
  I am in constant communication with every colleague
• 19:21
  across the whole spectrum
• 19:24
  so every every person I interact with
• 19:26
  whether it's a medical oncologist
• 19:28
  a social worker a cancer geneticist
• 19:31
  radiation oncologist pharmacist whatever
• 19:35
  I have all their cell phones
• 19:37
  this is a priority to me like I
• 19:39
  I have plenty of patients who
• 19:41
  they come into my clinic they say oh
• 19:43
  I wasn't able to schedule an appointment
• 19:44
  with such and such person
• 19:46
  because of whatever
• 19:47
  and I say
• 19:49
  I'll be right back come into my office
• 19:51
  make a phone call come back
• 19:53
  and I say they will call you this afternoon
• 19:55
  and a call happens this is so critical to me
• 19:59
  so a patient should expect there to be
• 20:01
  multiple individuals in the whole treatment team
• 20:04
  no matter what
• 20:06
  it's never just an ocular oncologist and the patient
• 20:09
  it can be as simple as interacting with a radiologist
• 20:12
  to obtain an image for example
• 20:13
  but I always incorporate a medical oncologist me
• 20:17
  and if we do radiation a radiation oncologist
• 20:21
  all in our giant treatment team
• 20:23
  and like I said with a high standard
• 20:25
  where I can call these people and ask them
• 20:27
  please help us with this and arrange and so on
• 20:31
  I feel like in the in the modern era
• 20:33
  we should have a high standard for our communication
• 20:35
  like the days of sending over a FAX
• 20:38
  and hoping things work out
• 20:39
  those are over haha
• 20:41
  absolutely I love that
• 20:43
  I think a lot of patients are going yes
• 20:45
  right now they're happy to hear this
• 20:47
  what advancements are most exciting to you right now
• 20:52
  yeah the
• 20:54
  the pattern of medicine right now
• 20:56
  is from invasive brutality
• 20:58
  to less invasive less brutality
• 21:02
  and that's where we're headed right now
• 21:05
  like I said decades ago it was take out the eye
• 21:08
  and that was it
• 21:09
  and now even just radiation
• 21:12
  although it's kind of an old technology
• 21:14
  the way radiation is delivered is changing
• 21:18
  there are organizations
• 21:19
  who are thinking about how to deliver the radiation
• 21:22
  in the lowest possible dose
• 21:24
  while still treating the tumor effectively
• 21:26
  even if we don't discuss
• 21:28
  all of the medications that are becoming available
• 21:31
  but the advancements that are interesting to me
• 21:35
  are those that could spare us even of radiation
• 21:38
  if that's possible that would be an amazing thing
• 21:41
  there are so many cancers that in the
• 21:43
  in history of medicine
• 21:46
  were treated just with excision and radiation
• 21:49
  and now
• 21:50
  they're treated with immune therapy or chemotherapy
• 21:52
  to me that that's the next step now
• 21:55
  how that looks in what in which stage
• 22:00
  of various stages of therapy
• 22:02
  that's still being clarified
• 22:04
  we're still kind of in the early days
• 22:05
  of ocular melanoma particularly
• 22:07
  but there are many examples
• 22:09
  in which this has been worked out
• 22:11
  there plenty of plenty of cancers were described as
• 22:15
  we will never treat this with
• 22:17
  with immunotherapy or chemotherapy
• 22:19
  and now they are
• 22:20
  because we're all thirsty for a way to deliver
• 22:25
  less invasive more effective therapy
• 22:28
  that might answer multiple things
• 22:30
  multiple demands that we have right
• 22:32
  right now we're treating the eye directly
• 22:34
  with radiation or enucleation
• 22:36
  for example
• 22:38
  I feel like that's going to still exist
• 22:42
  in particular context
• 22:43
  but take less of a role in the future
• 22:47
  that would be great
• 22:49
  alright
• 22:49
  we're gonna switch gears to some personal questions now
• 22:52
  what keeps you going on the hard days
• 22:56
  my wife
• 22:59
  best answer well
• 23:01
  she's been she's been with me uh
• 23:04
  since medical school when uh
• 23:07
  when I have a migraine or whatever
• 23:09
  she's like you got it
• 23:10
  I'm like you know what
• 23:11
  thanks to you I do got it
• 23:13
  and my patients too
• 23:15
  um I love coming to work
• 23:17
  and I love shaking my patient's hands and thinking
• 23:19
  you know like
• 23:20
  this is a special moment
• 23:22
  you can't have this moment anywhere else
• 23:24
  outside of a medical clinic
• 23:25
  like you go drop off your car to get the oil changed
• 23:29
  the mechanic is a cordial fella
• 23:31
  but when you're with the doctor
• 23:33
  and they know you and you've interacted with them
• 23:36
  I feel like the whole world just like
• 23:39
  it's gone it's like a
• 23:40
  a hallowed ground
• 23:42
  there's a special tone in the air that keeps me going
• 23:46
  for sure no matter what's going on in my life
• 23:48
  like you know
• 23:49
  my my 18 year old failed her math test or something
• 23:53
  and I got a text from my wife
• 23:54
  I go and meet a patient and I just completely
• 23:57
  it's like the world disappears
• 23:59
  that that's what keeps me going
• 24:02
  how has this work changed you as a person
• 24:05
  oh
• 24:06
  I think it's given me a lot of perspective about life
• 24:10
  I I'm sure there
• 24:11
  and I've I've talked to plenty of patients
• 24:13
  who have been diagnosed with ocular melanoma
• 24:15
  and other eye cancers they don't
• 24:18
  they say they say certain things about their life
• 24:20
  they say I didn't realize how common this is
• 24:23
  or I I didn't understand how common even cancer is
• 24:28
  and when you walk a mile in my moccasins
• 24:31
  and you diagnose ocular melanoma regularly
• 24:33
  and you see people with eye cancer all the time
• 24:37
  you gain a perspective about what's important in life
• 24:40
  and what's not important
• 24:42
  um
• 24:44
  you know like having some dust on the countertop
• 24:47
  it's nice to be have some cleanliness
• 24:49
  but I I feel like I just
• 24:52
  I don't really care about tiny
• 24:54
  little details that often anymore
• 24:56
  that are outside the medical context
• 24:58
  um
• 25:00
  life is so valuable
• 25:02
  and
• 25:04
  when you are challenged with something
• 25:06
  that could threaten it you realize how
• 25:09
  how important people are in your life
• 25:10
  and how important the basic things are how
• 25:13
  how important certain moments are
• 25:15
  go to like
• 25:16
  I went to a basketball game with my 13 year old
• 25:19
  this is before the Lakers lost the playoffs
• 25:21
  I feel kind of tough about it
• 25:22
  but I remember sitting there thinking like
• 25:25
  there's the state you know the
• 25:27
  the the court
• 25:28
  and I'm sitting there there's my my
• 25:29
  my boy there and I'm like wow
• 25:31
  this is something else you know
• 25:33
  I remember when I was a 13 year old
• 25:34
  these are the critical moments in his life
• 25:37
  and in my life
• 25:38
  I think treating eye melanoma and other eye cancers
• 25:41
  kind of brings you down to earth a little bit
• 25:44
  to realize what are the important priorities
• 25:49
  and what have your patients taught you over the years
• 25:54
  oh my gosh what a list
• 25:56
  you know I mean
• 25:58
  there's so many things that are important to me
• 26:01
  like for example
• 26:02
  I have a little like social media thing happening
• 26:04
  I have a TikTok Instagram
• 26:06
  YouTube um Facebook
• 26:08
  I post content all the time about retina medicine
• 26:11
  and eye cancer and so on
• 26:13
  and it's just amazing to me
• 26:15
  I'll post a video that I think is so cool
• 26:17
  like um
• 26:19
  I'll get a patient's permission to share their image
• 26:22
  and I'll show the world and the video kind of does okay
• 26:26
  but then someone will like
• 26:27
  make a comment on one of my videos
• 26:30
  and I'll go
• 26:31
  and I'll make a whole video just on that comment
• 26:33
  thinking like
• 26:34
  this is not really that important
• 26:36
  um it's
• 26:37
  it was clearly important to that person
• 26:39
  I think it's worth you know
• 26:40
  paying some attention to it
• 26:42
  but it's just not something that like
• 26:44
  really struck me as critical
• 26:46
  in the whole grand scheme of things
• 26:47
  and yet I'll get comments left and right
• 26:49
  thank you so much I I
• 26:51
  I was always wondering like
• 26:52
  what is the source of floaters
• 26:55
  for example or how do I treat dry eyes or whatever
• 26:58
  um they've taught me that
• 27:02
  um in my little corridor of life
• 27:05
  I can pigeonhole myself
• 27:06
  into thinking what I think is important
• 27:09
  and yet they kind of my patients refresh my mind about
• 27:13
  like this is how they're approaching the world
• 27:15
  they haven't seen what I've seen
• 27:17
  and therefore starting with like
• 27:18
  the fundamental understanding of things is
• 27:21
  is critical because a lot of people can
• 27:23
  like me can lose touch of the
• 27:25
  of the priorities that my patients might have
• 27:27
  that I don't necessarily share
• 27:29
  or I don't conceive as important at the outset
• 27:31
  what does hope mean in your work
• 27:36
  ah man hope
• 27:40
  honestly I don't know
• 27:42
  haha
• 27:43
  well I
• 27:44
  and I don't mean to say that like pessimistically
• 27:47
  um
• 27:48
  hope to me is
• 27:49
  is looking at the future with an under
• 27:54
  with a framework a plan
• 27:56
  an understanding and
• 27:57
  and knowing all the people with whom you'll be there
• 27:59
  with
• 28:02
  and I try to establish this right at the outset
• 28:06
  I always tell my patients
• 28:08
  I'm here for you no matter what happens
• 28:11
  no matter what surprise comes
• 28:12
  we will tackle it we will approach it
• 28:15
  we'll challenge whatever thing is in front of us
• 28:17
  and we'll take care of it as best as we can
• 28:19
  to me that is hope
• 28:21
  knowing that you have people around you who respect you
• 28:25
  and honor you
• 28:26
  and they feel privileged to take care of you
• 28:28
  and they'll be there for you in the future
• 28:32
  and not only that
• 28:33
  there are all sorts of other little pieces
• 28:34
  little things happening in the background
• 28:36
  that patients aren't necessarily aware of
• 28:38
  that bring me hope like we're discussing immune therapy
• 28:41
  we're not necessarily introducing
• 28:43
  introducing this to every patient
• 28:44
  but to me there's a lot of hope
• 28:47
  like I said Mr
• 28:48
  Pathological optimism I see the glass
• 28:50
  I've half half full glasses all over the place
• 28:53
  what do you love doing outside of work
• 28:59
  oh boy um
• 29:02
  I love seeing the world
• 29:03
  and I love doing it with my family
• 29:06
  we just got back from Japan on spring break
• 29:08
  what a place it's all in the news these days
• 29:11
  it's like
• 29:12
  all anyone's doing I swear
• 29:13
  like everyone in my neighborhood's like
• 29:15
  oh yeah
• 29:15
  I went to Tokyo you know whatever
• 29:17
  but just seeing the world
• 29:19
  seeing how people are outside of my little county
• 29:23
  here in my little country
• 29:26
  um even just traveling with my family to local
• 29:30
  little cities
• 29:30
  and going to games and seeing concerts and stuff
• 29:33
  I just love being with the people I know
• 29:35
  and we all get to experience things together
• 29:38
  even as something as simple as the beach
• 29:40
  I love Irvine being close to the beach is just great
• 29:45
  absolutely how do you unwind after a long day
• 29:50
  oh I go to the gym
• 29:53
  I know it doesn't look like it
• 29:54
  I'm not super muscular but um
• 29:57
  that's a great place I
• 29:59
  I just joined a gym where they have like
• 30:01
  yoga too
• 30:03
  and every time I'd walk past
• 30:05
  you know I'd go to like
• 30:06
  lift the weights to be like
• 30:07
  a manly man I guess
• 30:08
  I don't know and I'd walk past the like
• 30:12
  little yoga zone and one day I was like
• 30:14
  you know what I'm gonna try it
• 30:16
  see what happens and I went in there
• 30:19
  and now I go all the time
• 30:20
  it's like
• 30:23
  I feel like part of unwinding
• 30:24
  is just having an open mind about like
• 30:27
  what your needs might be in reality
• 30:29
  you know um
• 30:31
  I also
• 30:32
  I've been listening to Enya a lot
• 30:35
  this is something I did in high school
• 30:38
  on occasion
• 30:38
  we kind of make fun of people that listen to it now
• 30:41
  I love her I
• 30:42
  I can't get enough of her
• 30:43
  like when I
• 30:44
  on my ride from clinic to home
• 30:46
  pop in a little Enya it's good
• 30:49
  nice what's something that helps you reset
• 30:53
  when things feel overwhelming
• 30:56
  oh I have some breathing techniques
• 30:59
  I think this is so important for everyone
• 31:01
  knowing how to manage stress
• 31:03
  we talk about stress all the time
• 31:05
  manage your stress do better
• 31:06
  it'll be good for your health
• 31:07
  your blood pressure whatever
• 31:09
  um
• 31:11
  I have this little routine where
• 31:14
  um I like
• 31:15
  if you have an Apple Watch
• 31:17
  it'll tell you like
• 31:18
  take a breath breathe in and out
• 31:20
  I've kind of simulated that
• 31:21
  like when I'm walking from my
• 31:23
  from my clinic to my car
• 31:24
  and it was kind of a stressful day
• 31:26
  I'll just kind of close my eyes a little bit
• 31:28
  do a little breathing exercise
• 31:30
  it's amazing what you can accomplish
• 31:32
  I mean like I said
• 31:33
  I grew up in like
• 31:35
  you know rural Idaho
• 31:37
  you don't really talk about like
• 31:38
  these kinds of little techniques to get rid of stress
• 31:41
  but even someone who grew up in a place like that
• 31:44
  can do it so if you feel stressed out
• 31:47
  just finding a little breathing
• 31:49
  little moment it really does help
• 31:52
  what brings you the most joy outside of medicine
• 31:58
  um
• 32:00
  watching my kids grow up
• 32:03
  just seeing them become many adults
• 32:06
  I I remember when I was like
• 32:08
  I hadn't had kids yet I was married and so on
• 32:11
  and I was looking at little babies
• 32:13
  and I was like that's crazy that we do that
• 32:15
  and now I see my my babies
• 32:17
  one of them is going to college
• 32:19
  the other one's 13 and he has his friends
• 32:21
  and he has his life and then
• 32:24
  being with my wife and witnessing the whole thing
• 32:26
  it's crazy
• 32:28
  we we do this
• 32:30
  all of it almost everyone does this
• 32:32
  it's funny
• 32:33
  yeah it is a cool experience
• 32:38
  who has had the biggest impact on your life
• 32:44
  um my wife and my parents
• 32:47
  probably but
• 32:48
  I mean just along the way
• 32:50
  those guy those people are on like
• 32:52
  the peak like
• 32:53
  on the mountain of importance
• 32:54
  they're on the peak but Dr
• 32:56
  Singh at the Cleveland Clinic
• 32:58
  he just changed my life
• 32:59
  I thought I knew medicine before I met him
• 33:01
  and I I didn't really understand it that well
• 33:05
  he he reoriented my mind
• 33:07
  if you know him if you're a patient of doctor Singh's
• 33:10
  you'll know what I'm talking about
• 33:12
  um
• 33:12
  all of my fellowship mentors played a big role for me
• 33:17
  um
• 33:18
  the first doctor I ever shadowed
• 33:20
  so when I was growing up in
• 33:22
  in Idaho I knew I wanted to be a doctor
• 33:25
  so I I just figured I'd go shadow someone
• 33:27
  and everyone was kind of busy around me
• 33:29
  so my parents drove me to Salt Lake City
• 33:34
  and the first doctor I shadowed was an ophthalmologist
• 33:37
  his name is Geoff Tabin he's a cornea specialist
• 33:39
  he used to be in Salt Lake City
• 33:41
  now he's at Stanford
• 33:42
  uh he took me in and it was amazing
• 33:45
  I think he changed my whole life because I
• 33:47
  I don't know that I would have even known
• 33:49
  what an ophthalmologist was
• 33:51
  but yeah
• 33:52
  there's so many people to point out
• 33:55
  what does a perfect day look like for you
• 34:00
  oh a perfect day
• 34:02
  well a perfect day to me is wake up
• 34:06
  go to the gym
• 34:10
  you know hang out with the kids before you go
• 34:13
  get the lunch packed go to the gym
• 34:15
  little sauna afterwards come meet some patients
• 34:20
  have a good vibe
• 34:22
  go home delightful
• 34:23
  dinner with the with the family
• 34:25
  watch a playoff game go on a walk with the dog
• 34:29
  that's it that's perfect
• 34:32
  that does sound perfect I love that
• 34:35
  alright we are now gonna go into the lightning round
• 34:37
  where
• 34:37
  I'm gonna pepper you with some quick answer questions
• 34:40
  first one what is your go to Starbucks or coffee order
• 34:45
  cafe misto little hazelnut
• 34:50
  perfect morning person or night owl
• 34:55
  morning
• 34:57
  what's your favorite way to spend a day off
• 35:01
  do nothing
• 35:04
  relatable
• 35:07
  what is your favorite vacation spot
• 35:12
  uh
• 35:13
  Geez
• 35:15
  I went to Amsterdam I love that place
• 35:18
  I'd say Amsterdam
• 35:20
  I mean I
• 35:21
  what is you know
• 35:22
  I know we're in the lightning round
• 35:23
  forgive me for going into detail
• 35:26
  oh boy
• 35:27
  do it if you've ever been there
• 35:28
  it's like canals and the food the
• 35:33
  oh I
• 35:34
  sorry we're in the lightning round
• 35:35
  but do yourself a favor Old Amsterdam
• 35:39
  what a place alright
• 35:40
  it's on my list now what is currently on your playlist
• 35:46
  Enya I think I already mentioned that
• 35:50
  no I uh I
• 35:51
  I got all sorts of things I
• 35:52
  I love my car
• 35:53
  just show up and I hit the play button and it's random
• 35:56
  but yeah
• 35:57
  I've been needing to relax a little bit more lately
• 36:00
  so me and Enya are tight
• 36:03
  love that what is your favorite movie or TV show
• 36:08
  the good the bad and the ugly
• 36:11
  it's my favorite movie TV show Breaking Bad
• 36:18
  are you more of a planner or go with the flow
• 36:21
  go with the flow for sure
• 36:23
  you ask my wife what
• 36:24
  you know uh
• 36:25
  where is my mind when I'm coming home
• 36:27
  it's like what are we doing today
• 36:29
  you know like I
• 36:30
  I plan ahead stuff but like
• 36:32
  you know those kind I
• 36:33
  I wanna be surprised
• 36:36
  what's a small thing that makes your day better
• 36:39
  coffee
• 36:41
  100% there's nothing like that feeling
• 36:44
  you're a little tired
• 36:46
  just woke up go to the coffee shop
• 36:48
  take off the lid and you feel the warmth
• 36:51
  first sip Whoo
• 36:54
  yes there is a calming ritual with a hot coffee there
• 36:58
  it's like a baby bottle for adults
• 36:59
  I think is it not amazing you
• 37:01
  I mean you can get it with soup
• 37:02
  you can get it with tea whatever
• 37:04
  just for me it's like a warm
• 37:07
  it's a hug it's like a food and a hug all together
• 37:10
  I love it in fact
• 37:11
  I remember one time I was at Starbucks
• 37:14
  and this was like
• 37:16
  pre covid I remember this
• 37:17
  like when all the cream and all that was out
• 37:20
  still the world was kind of normal
• 37:22
  and I remember I went up to the little cream zone
• 37:25
  and I took off my lid
• 37:26
  and I was putting a little sugar and cream in there
• 37:28
  and I look over and I'm stirring
• 37:30
  and the guy next to me he takes a sip
• 37:35
  he looked at me he's like
• 37:36
  there's no feeling like that
• 37:38
  is there and I'm like
• 37:39
  you're right total stranger amazing
• 37:43
  you know yeah
• 37:46
  do you have a favorite quote or mantra that you live by
• 37:50
  oh yeah
• 37:51
  I was a literature minor in college
• 37:54
  um in my graduation
• 37:57
  you know like when you graduate high school
• 37:59
  you can do a little thing
• 38:00
  mine was James Joyce's Ulysses
• 38:03
  to strive to seek
• 38:05
  to find and not to yield favorite
• 38:10
  wow
• 38:11
  what's the best advice you've ever received or given
• 38:16
  you're not the most important person in the world
• 38:20
  that's a good one I was uh
• 38:23
  a little bit about me I
• 38:25
  I grew up in the Mormon religion
• 38:27
  the Mormon church so I served a mission in Armenia
• 38:30
  so I speak Armenian fluently
• 38:32
  and when I went there I was a teenager
• 38:35
  and um
• 38:38
  I would be communicating with people
• 38:40
  about how I was feeling in a foreign land
• 38:43
  about six months in uh
• 38:45
  one of the leaders of the organization
• 38:47
  he said I just want you to remember
• 38:49
  you're not the most important person in the world
• 38:52
  and I thought this is
• 38:54
  this is like a critique kind of
• 38:57
  but at the same time I applied this whole lesson
• 39:01
  to everything that I've done
• 39:02
  I mean um
• 39:03
  particularly in medicine
• 39:05
  I think this is the source of empathy
• 39:07
  if you can get beyond the hubris
• 39:09
  that naturally develops in the mind
• 39:11
  to arrive at the mental state of the person
• 39:14
  who was in the exam room with you
• 39:16
  it's really important I think that's
• 39:18
  for me that's been important
• 39:21
  what advice would you give your younger self
• 39:28
  um
• 39:30
  cherish the moments because they'll never come back
• 39:35
  truth man truth
• 39:37
  we our kids are the same ages
• 39:39
  and I'm my middle is graduating high school
• 39:42
  and I'm I'm right there with you like oh
• 39:45
  it just goes so fast it's so hard
• 39:47
  so I'm having feels um
• 39:49
  he graduates this Friday so yeah
• 39:51
  um congrats
• 39:52
  that's great yeah
• 39:53
  all the time I'm like I got my phone out
• 39:56
  and I'm taking a picture of something
• 39:57
  and I'm like what am I doing
• 39:59
  like my eyes are looking at the screen
• 40:02
  why don't I put my eyes on the world
• 40:05
  and maybe I'll remember it
• 40:06
  like even if I just hold the phone like this
• 40:09
  like I don't have to look at
• 40:10
  you know maybe I can take a picture like this
• 40:12
  but also let me feel it you know
• 40:14
  yeah absolutely
• 40:18
  okay do you have a hidden talent
• 40:23
  do I have a hidden talent I feel like you do
• 40:29
  ha ha
• 40:30
  uh or maybe a talent that's not hidden to you
• 40:33
  but that we wouldn't know about
• 40:35
  oh yeah yeah secret
• 40:36
  well I am uh
• 40:37
  I am the 2,001 state of Idaho Quake champion
• 40:42
  so Quake is a old video game
• 40:44
  I used to play a lot of video games
• 40:46
  when I was a teenager so you don't
• 40:48
  you don't see me doing that much anymore
• 40:50
  but I spent a lot of time behind the screen
• 40:52
  I don't really talk about it that much
• 40:54
  partly out of shame I guess
• 40:55
  I don't know I mean
• 40:57
  back in the day like
• 40:58
  it wasn't normal for like
• 41:00
  video games to be so accepted as they are these days
• 41:03
  I mean
• 41:03
  these days it's a giant multi billion dollar industry
• 41:06
  those days it was like the first internet game
• 41:09
  so yeah
• 41:10
  that's a
• 41:10
  that's a secret about me that I don't normally share
• 41:13
  you got it out of me I did
• 41:15
  that's exciting well
• 41:17
  my next question was actually
• 41:18
  what is something
• 41:19
  that people would be surprised to learn about you
• 41:21
  do you have a second one or should we move on
• 41:24
  hahaha
• 41:25
  well I mean uh
• 41:28
  when my patients who are Armenian they
• 41:30
  they come into the clinic and I say
• 41:32
  barotsa sinchpesik inchkachka
• 41:35
  you know like all the Armenian stuff
• 41:37
  they're not used to that
• 41:39
  that's a secret talent and I love going to Los Angeles
• 41:42
  cause Los Angeles has like
• 41:43
  the largest Armenian diaspora
• 41:46
  so we'll go to like Griffith Observatory or something
• 41:49
  and it's happened to us a couple times
• 41:50
  we're looking at Los Angeles
• 41:52
  and there's like a Armenian couple there
• 41:53
  and I'll just be like hey
• 41:55
  what you know
• 41:55
  in Armenian hey
• 41:56
  what's up and everyone's like oh
• 41:57
  you know
• 41:58
  some American speaks our secret little language
• 42:01
  that's a secret
• 42:03
  that's fun I always wish I could do that
• 42:08
  um if you could instantly master a new skill
• 42:12
  what would it be
• 42:15
  uh
• 42:16
  I could master a skill
• 42:21
  I think play the drums
• 42:25
  that would be like I was in bands growing up
• 42:28
  but I never I regret it
• 42:30
  I never learned the drums
• 42:31
  like the rhythm and the feeling
• 42:32
  I always felt like
• 42:33
  the person playing the drums had the most fun
• 42:35
  I was always jealous so let's go with that one
• 42:39
  well what do you play
• 42:42
  well it's most like vocals
• 42:43
  and I played the clarinet
• 42:45
  believe it or not so I'd bring on my little instrument
• 42:48
  it was it was sad
• 42:49
  it was just you know
• 42:51
  when you're a teenager
• 42:52
  you don't know what the world is made out of
• 42:54
  I tried
• 42:56
  that's awesome I played the clarinet too
• 42:58
  not in a band though
• 42:59
  in like school
• 43:01
  school band but not like that kind of band
• 43:03
  um that sounds more fun
• 43:05
  okay what is a fun or quirky habit that you have
• 43:10
  well being in the
• 43:12
  like growing up in the car care space
• 43:16
  my my fun
• 43:18
  little thing I like to do is detail my car
• 43:20
  and my wife's car
• 43:22
  so like
• 43:23
  every Saturday uh
• 43:24
  aside from wanting to do nothing and the chores
• 43:28
  I like to take the car go to the little car wash
• 43:32
  and just just get to work
• 43:34
  there's when you when you do like
• 43:36
  manual labor over and over
• 43:38
  and it's been something you've done as a teenager
• 43:40
  and you're now in your 40s
• 43:42
  I'm in my 40s now it's like this place you can go
• 43:46
  you can reliably put yourself there
• 43:47
  and the world just goes away for a minute
• 43:51
  it's kind of like being in the clinic
• 43:52
  but that's that's what I like to do
• 43:56
  so that's also my husband's hobby
• 43:59
  is detailing car our cars
• 44:01
  and I always think it's because
• 44:02
  it's a combination of being outdoors
• 44:04
  like the fresh air
• 44:05
  the sunshine and then the water
• 44:07
  like all the positive ions
• 44:08
  I think you're getting this
• 44:10
  like nature um water
• 44:14
  I don't know and then the
• 44:15
  the satisfaction of watching
• 44:17
  the before and after of it coming clean
• 44:21
  oh there's
• 44:21
  I totally get it my
• 44:22
  my wife complains about it all the time
• 44:24
  I'll I'll detail the car
• 44:25
  and I'll park it in the in the driveway there
• 44:28
  and I'll like look back at it
• 44:29
  my wife will like roll her eyes like what are you doing
• 44:32
  you know I just love the coming to a thing that's dirty
• 44:36
  and whatever and then you work on it
• 44:39
  and you get all the tiny little details
• 44:41
  so that by the time you're done
• 44:42
  you zoom out and there's this
• 44:45
  there's this thing you can admire
• 44:46
  you know oh yeah
• 44:49
  alright next question
• 44:50
  coffee or tea and I think I know the answer
• 44:52
  oh coffee by far
• 44:54
  I love tea I respect my tea drinking friends
• 44:57
  don't get me wrong my mom's a big tea drinker
• 45:01
  but no no
• 45:02
  coffee is it for me
• 45:04
  beach or mountains
• 45:06
  beach oh
• 45:08
  that was easy
• 45:11
  I was a snowboard instructor
• 45:14
  so like I know the mountains really well
• 45:16
  but yeah um
• 45:18
  now the beach is where it's at
• 45:19
  cause I mean you can hang out
• 45:21
  you know like you go on the top of a mountain
• 45:23
  you can hang out with people
• 45:24
  but you go to the beach you get fat
• 45:26
  you know you kind of hear the roar of nature
• 45:29
  the origin of life if you will I like the beach
• 45:33
  early morning or late night
• 45:37
  well to have fun
• 45:38
  late night no doubt about that
• 45:41
  I agree sweet or salty
• 45:44
  sweet for sure
• 45:47
  and what is your favorite sweet treat
• 45:50
  oh Krispy Kreme
• 45:53
  I mean I have a little funny taste there
• 45:55
  I like the raspberry filled with the glazed on it
• 45:58
  every time so my 13 year olds in football and all that
• 46:01
  so we'll go to that and when it's over
• 46:04
  we'll go get some pizza or whatever
• 46:05
  and then
• 46:06
  it's kind of funny at this point
• 46:08
  I don't even have to say anything
• 46:09
  me and my wife and my kids get in the car
• 46:11
  and I look over at my wife
• 46:13
  with my hand on the steering wheel
• 46:14
  she knows what I'm thinking
• 46:15
  are we going to Krispy Kreme or not
• 46:17
  you know yeah gotta treat yourself
• 46:23
  alright well
• 46:24
  that was my last question
• 46:25
  is there anything else that you wanna add
• 46:26
  before we wrap up
• 46:29
  well I guess I just wanna say thank you
• 46:32
  I think this is awesome
• 46:33
  what this whole organization does
• 46:36
  every patient that comes to my clinic
• 46:37
  they hear about this among all the other details
• 46:40
  I always tell people like
• 46:42
  you're gonna hear a lot of stuff
• 46:43
  that are gonna go in one ear and out the other
• 46:46
  it's important to have a community
• 46:47
  I think what this organization
• 46:50
  what you're doing Megan and everyone else it's
• 46:52
  it's so cool congrats
• 46:54
  it's great
• 46:56
  well thank you so much for the kind words
• 46:58
  we do put a lot of effort
• 47:00
  into all kinds of patient resources
• 47:02
  so we really appreciate that
• 47:04
  and the whole goal is
• 47:05
  to make this a little bit easier for patients
• 47:07
  when you're going through something
• 47:08
  that is so life changing and so difficult
• 47:12
  any any amount of help
• 47:13
  we feel like is hopefully very valuable
• 47:17
  and we want to thank you for coming on
• 47:18
  we appreciate your time
• 47:19
  we know you're busy treating patients
• 47:21
  and making a difference in their lives
• 47:23
  so the fact that you're here
• 47:24
  bringing us just a little bit about yourself is is um
• 47:28
  it's so valuable to us and we're so thankful
• 47:33
  I appreciate it Megan
• 47:35
  absolutely and to all of our viewers
• 47:37
  thank you for watching
• 47:38
  this podcast doesn't function without you
• 47:40
  we need the viewers because we have sponsors
• 47:42
  and that is my next point
• 47:44
  thank you to our sponsors
• 47:45
  we have the best sponsors
• 47:48
  if you go look at their websites
• 47:50
  they are doing amazing things
• 47:51
  for ocular melanoma patients
• 47:54
  there's a lot of stuff on the horizon right now
• 47:56
  so check them out and go to our website
• 47:59
  ACureInSight.org
• 48:00
  there's a button at the top to subscribe to
• 48:02
  our newsletter comes out once a month
• 48:04
  occasionally
• 48:05
  we'll send other emails if there's something that's
• 48:06
  like really timely and important
• 48:08
  but we don't spam you and then on our website
• 48:10
  you'll find other things like our physician finder
• 48:13
  our cure companions program
• 48:15
  all kinds of different things
• 48:17
  so please check out our website
• 48:18
  find those resources
• 48:20
  if you have any questions or you need any help
• 48:21
  you can email any of us our emails are our first names
• 48:24
  @ACureInSight.org we'd be happy to help you
• 48:27
  I hope you guys all have a wonderful week