AME: The Worst Case Scenario

[00:00:01] This is a production of the Very Dental Podcast Network.

[00:00:10] Alan Mead is a dentist with too much time on his hands and too much recording equipment

[00:00:15] in his basement. Armed with an obsession to bring entertaining and informative content

[00:00:19] to the dental world in a way that's never been done before, I give you the Alan Mead

[00:00:26] Experience. Well, hello and welcome to another episode of the Alan Mead Experience. I'm your

[00:00:34] host, Dr. Alan Mead. I'm a dentist, podcaster, and amazingly enough, this universe's version

[00:00:42] of Deadpool. So if you are not a nerd and you don't get that reference, just understand

[00:00:50] that I just saw Deadpool and Wolverine. I highly approve of it. I think you should go see it.

[00:00:56] Don't take little kids though. Just say it. It was excellent. Apparently it broke all

[00:01:00] things of records this weekend, so I just got back from 100 again. So that's what I've got.

[00:01:05] I have a story, I have several stories actually, of informed consent for you. I've talked probably

[00:01:12] more about informed consent on this podcast more than anything else. And in these, in the Alan

[00:01:17] Mead Experience is where I'm doing a, where I'm doing like a monologue, somehow or another

[00:01:22] I always seem to come back to informed consent. In my whole concept of informed consent, I mean,

[00:01:28] patients are unable to make great decisions for themselves unless they know what they're getting

[00:01:36] into. What's cool about dentistry is our informed consent, our complications for the most part are

[00:01:46] quite predictable. But what's interesting is I still think sometimes we struggle to be completely

[00:01:54] honest with people about it. But before I even get into the dental aspects, I want to tell you a couple

[00:02:00] stories about medical informed consent. And, and frankly, I'm going to tell you these stories about

[00:02:05] medical informed consent, just so I can explain why we should be doing much better in dentistry than they

[00:02:11] are in medicine. I will tell you medicine does informed consent really poorly. They are shit at informed

[00:02:19] consent. I'm sorry. I got to say it is true. They're terrible at it. So I had a surgery a couple years ago.

[00:02:29] Long story short, it was a, well, it was a, it was a surgery on my, on my, my male parts. Let's just say that.

[00:02:39] I had a weird, it was called a, it's called a hydroseal. I had a bunch of water in, in the, around one of my testicles.

[00:02:49] This is great, great podcast talk. I love it. And so I had a surgery and, and the surgery was fantastic.

[00:02:55] And I, interestingly, my, my urologist told me months before that when you have this surgery, this is what's

[00:03:02] going to happen. And you're going to think it's all done. And then it's going to come back for a couple

[00:03:06] weeks and then it's going to go away and it'll be fine. He told me that. And I honestly, I honestly put

[00:03:12] the surgery off for like a year and then came back and, and we scheduled the surgery because,

[00:03:18] because, you know, the, the thing had come back and I needed to have it taken care of. So I went in and

[00:03:23] I remember as I was waiting to go in for surgery, a nurse came in to talk about, you know, what was it,

[00:03:29] what was going to happen? It was an, it was a, an outpatient surgery. I literally went into the

[00:03:33] surgery center. My dad waited in the waiting room and, and he drove me home and I, I was, I was fine.

[00:03:38] I shook off the anesthetic. It was literally, honestly, I can't imagine a surgical outcome

[00:03:43] being any better than all of this. And it was, I didn't, I mean, I stayed home for the week because

[00:03:49] he told me that I should, but I was kind of fine. I could have done whatever it was. It was a great

[00:03:55] experience. But when the nurse was discussing informed consent, she literally said to me,

[00:04:01] well, Dr. So-and-so said, you must know what's going on here. So he figures you've got

[00:04:08] informed consent because you showed up. So basically, you know, what's happening here

[00:04:12] because you showed up. That was the informed consent. I feel like, and I think I signed

[00:04:18] something, but it was something to the, it was like a slot on one form that said that informed

[00:04:25] consent was discussed. And of course at the surgery, it was absolutely not discussed. I never even saw

[00:04:29] the surgeon. I saw, I saw him as I was coming out of the anesthesia and he said, you did great.

[00:04:34] And that's all I, like it was medicine is medicine is so fucked that way. I'm sorry,

[00:04:37] but it totally is. It's ridiculous. I like the guy. I think he, I did, he did a great job for me.

[00:04:43] I have no complaints, but even then their informed consent was a complete joke and they kind of know

[00:04:47] it, I think. But more than that, I have a story that's a little more tragic and a little more awful

[00:04:52] than that to tell you. So I want you to imagine the person who runs the office that you work in,

[00:04:59] whether it's your office or, or it's, it's the office that you work in. I want you to imagine

[00:05:04] the person who runs the front desk, like a, like a finely tuned machine. And I want you to imagine

[00:05:10] that that person is gone for three and a half weeks from work and there's no sub, there's no one

[00:05:17] coming in to do their job. There's no one there to answer the phone. There's no one,

[00:05:22] there's just, they're just not there. And that's the way my office has been operating for the last

[00:05:28] three weeks. And if I had it, if I had a time machine, if I, if I, if I had something like they

[00:05:37] had in Deadpool where you could go into different timelines, I might use it. I might have done

[00:05:41] something a little differently, but the reality is we didn't. So we, I've been without a front desk

[00:05:45] in an office manager for three plus weeks in my office. It has been excruciating.

[00:05:52] Worse than that, of course, you can imagine the cashflow in the office isn't so red hot because

[00:05:55] the person who's up, up front day in and day out asking me uncomfortable questions about

[00:06:00] how are we going to get paid has not been there. Uh, and part of it is like, okay, so she needed to

[00:06:09] have surgery. She had a diagnosis. Um, actually I, I'm not saying too much to say that she had a lung

[00:06:16] cancer diagnosis. She had found, uh, they'd found in a scan, they'd found a small spot on her lung a

[00:06:22] couple of years ago. And as they followed up, it got a little bit bigger. She finally had another

[00:06:26] scan and they're like, okay, it's, it's big enough that they did a biopsy and they found that the

[00:06:31] biopsy that it was cancer. It wasn't serious and it was small enough. There were no symptoms. She

[00:06:37] had no symptoms whatsoever. It was basically, she'd been a long-term smoker and she was, she had been

[00:06:41] worried about it for as soon as she stopped smoking. So she'd always had these scans and they found it

[00:06:46] and it was tiny. It was a tiny spot. And so she went in and talked to a pulmonologist and an oncologist

[00:06:53] and the, and a surgeon. And they said, well, you could do radiation and, and that might take care

[00:07:00] of it, but it could come back or you can do surgery and that'll take care of it. It'll never come back.

[00:07:07] And, and she was all in on getting the thing taken care of. So she knew she was going to have

[00:07:12] surgery. So they kind of explained the surgery said, you know, it's a, they called it minimally

[00:07:19] invasive. Uh, she went in and she felt like this was definitely the way to go. She was feeling good.

[00:07:24] She was nervous, but she was, she was definitely feeling good about her decision. And she went in

[00:07:30] and two things happened. First off, literally when she came, they wheeled her in from the surgery.

[00:07:36] Uh, she was in a room with someone who just had open heart surgery. And the nurse told her

[00:07:41] with a straight face, like, Oh my God, I can't believe you did this. I mean, I'd rather have

[00:07:45] open heart surgery three times and have the surgery you had. These lung surgeries are really hard to

[00:07:49] come back from. They're tough. And, and so my office manager was really taken aback by that because

[00:07:55] no one had said anything about the recovery being tough. They, they described a recovery process that

[00:08:00] was, they, she'd be in the hospital for a couple of days because they want to make sure there's always

[00:08:04] a risk of the lung collapsing after this kind of surgery, that sort of thing. It makes sense.

[00:08:08] It's a lung and it's, but apparently the way that they do the surgery, there's just, I mean,

[00:08:13] it is a brutal, brutal recovery, painful and really hard. And of course she heard them say

[00:08:22] she'd be in the hospital for a couple of days and she kind of counted on just having her feet up at

[00:08:27] home and relaxing. And then on top of that, she had a rare surgical complication and she was in the

[00:08:35] hospital for three weeks. Um, and we went and visited her and we talked with her, texted with

[00:08:43] her and stuff like that. And her, not only was she in physically just a lot of pain and she was

[00:08:48] really tired and she was struggling, but also her, her mental and emotional state was, she was crushed

[00:08:55] because she just, she just felt like she, this was not an expectation of hers at all. So, so I'm going

[00:09:04] back to informed consent. You know that something went wrong with the informed consent when literally

[00:09:10] you're rolled out of surgery and the nurses that are going to be taking care of you like, oh my God,

[00:09:14] I would have never done this compared to this is, this is the toughest surgery to come back from.

[00:09:17] Why didn't she know that going into it? Like maybe this was the best choice that she could make.

[00:09:24] Maybe that was the case. Uh, and, and even now she's saying she's still glad that she had the

[00:09:32] surgery because she did get some excellent news a couple of days ago saying she's all clear of the

[00:09:36] cancer and for, it's just monitoring for the next five years with scans, nothing more. So the outcome

[00:09:43] is good. And she honestly has said, well, that, that was, that's probably worth it.

[00:09:49] But I talked to her a lot of times. She was so down. She was so, she couldn't believe she was in the

[00:09:55] hospital for as long as she was. And she could not believe. So the, the complication she had,

[00:10:00] I'm not going to tell you what it was, but it was just a matter of it. The complication was super rare.

[00:10:04] It was not mentioned. And it was something that the treatment of it could have been more surgery or it

[00:10:09] could have the, the, what they ended up having to do was something where there was no anesthesia.

[00:10:13] She said it was the most pain she's ever been in, in her entire life. And she had to lay there for

[00:10:17] an hour and she wished she was dead. And she was, I mean, she had a horrible, horrible experience.

[00:10:22] And none of this was anything she had any idea about when she went into it.

[00:10:29] I do not mind saying that this was a complete and total failure of informed consent.

[00:10:35] It was, she did not know that these were problems that could happen.

[00:10:38] And that doesn't mean that she would have necessarily chosen anything different had they

[00:10:42] gone into this, but she didn't know it was a rare complication. So they didn't talk about it.

[00:10:49] And she didn't know my friends. That is not fair. That is not fair. This patient,

[00:10:56] my office manager, my employee that I've known, I hired her in 1998. Okay. 1999, something like that.

[00:11:05] I've been working with her for more than 25 years. She knows a little bit about informed consent and she

[00:11:11] did not have the information that she needed to make the right choice. Midway through this whole

[00:11:16] process, she said, God, if I had known it was going to be like this, I would have done radiation.

[00:11:19] If I had known there was any chance it was going to be like this. In retrospect, she's, you know,

[00:11:23] the outcome has turned out that she liked it, but she did not know what she was getting into.

[00:11:28] And she, she, she was frustrated and mad and emotionally. She's still really having a hard

[00:11:33] time coming back. I I'm comfortable to say the day that this comes out, she is supposedly going

[00:11:39] to be back in the office on Tuesday, the day after. So that's fantastic. Although she thought

[00:11:43] she was going to be back last week and she, she decided she couldn't do it. So I don't know if

[00:11:47] she'll be there Tuesday or not. We actually have her set up. She has been working remotely. So it

[00:11:52] hasn't, we haven't been completely without her services, but let's be honest. Uh, office manager is a pretty

[00:11:56] important position and it's, and we're missing it like crazy. So my thing is that, uh, and I'm

[00:12:03] convinced that I'm right about this. She did not have the proper informed consent to make a good

[00:12:08] decision. And everyone always used to say that, Oh, medicine really has this figured out. I'm going

[00:12:13] to tell you the opposite. I think medicine does not have this figured out. I think, I think there's a

[00:12:17] lot of people that have had a lot of bad experiences because they just didn't know the risks involved with

[00:12:21] treatment. I think medicine is very patriarchal. And I think they make a lot of these decisions

[00:12:26] for us. And part of the reason that they do is because we're not paying for it. They don't have

[00:12:30] to talk about it. They don't have to talk about money. Like not to say that you're not going to

[00:12:34] end up paying thousands and thousands of dollars after the fact. It's just that they never talk to

[00:12:38] you about it. You just get a bill. Oh my God. Or you don't even get a bill. Sometimes they just

[00:12:42] send you to collections. The whole thing is such a fucking nightmare. I'm sorry, but it's medicine is

[00:12:47] screwed. Medicine is so screwed, but this informed consent thing really has me bothered.

[00:12:52] Now I have a whole other story I want to tell about this long-term foot wound that I've had and how

[00:13:00] the informed consent on that was fallen was just a horrible situation too. And I, I am not,

[00:13:06] I'm not really bullish on medicine nowadays. Am I your best, your best bet for all this is stay

[00:13:14] healthy. Good God, stay healthy. Cause one of the worst places in the world for you right now is a

[00:13:18] hospital. And frankly, if you're young enough that you can, you can still be thin, a thin person and

[00:13:26] not be diabetic like I am and not be fat for most of your life. Uh, medicine is in a, it's a bad

[00:13:32] place to be. The best place to be is out of anyone's doctor's office, any hospital, stay healthy for God's

[00:13:39] sake, just do it. But let's bring it back to, I'm not, so I'm not going to talk about my foot because

[00:13:43] it's too depressing and I might cry on, on, in the podcast. I want to do that. I'm doing great now,

[00:13:49] by the way, but I mean, years later, I'm doing great anyhow. So I think dentistry needs to talk

[00:13:55] a little bit about informed consent. First off dentistry, if you're talking about procedures,

[00:14:00] there are just not that many procedures that we do. Now an oral surgeon may do a wider variety of

[00:14:06] procedures because they're talking about different treatments. I mean, oral surgery is not just

[00:14:11] shucking wisdom teeth and not just taking teeth out. I mean, there's, there's biopsies, there's,

[00:14:15] there's other treatments that, so informed consent in surgery is probably more important because they

[00:14:19] have a wider variety of complications that can happen. And I honestly, the informed consent that

[00:14:24] I use for taking teeth out is the informed consent that one of my best friends who's a normal surgeon

[00:14:30] gave me a hundred years ago and we just update it. You know, we, we keep our eyes on it, but basically

[00:14:35] it's a good informed consent. Now for all of you dentists out there that say that I don't have to worry

[00:14:40] about informed consent because I have patients sign an informed consent before every single procedure

[00:14:45] that we have. I'm going to tell you, and I've told you on this podcast before, good luck with that

[00:14:50] because a signed piece of paper does not mean that your patient understands a goddamn thing.

[00:14:55] It actually means that the patient doesn't want to read anymore and they're just signing their name.

[00:15:01] They don't understand the procedure and they will still be mad at you if things don't go the way

[00:15:05] they expect. So on some level, an informed consent that is signed, that's great. And in someone

[00:15:10] who's really legalistic says, well, they signed the informed consent. The reality is, is that are

[00:15:15] these patients even able to understand the informed consent or do we owe them an explanation eye to eye

[00:15:21] looking straight at them and making sure they have an understanding? I believe we do that. Sure,

[00:15:26] sign all the papers you want, but the reality is an angry patient's going to be mad at you if you

[00:15:31] didn't explain stuff no matter what they signed. So let's be honest. That's, you know,

[00:15:37] I'm sure that the medical informed consent that was done for my office manager was probably

[00:15:42] by the book, but she was really unhappy with the situation nonetheless because she just,

[00:15:47] it wasn't explained to her. And that's, we owe that to our patients. You know, you need to get

[00:15:52] better at using words with patients explaining. And I have to tell you, I still fall into it where

[00:15:57] I'm using too many words with patients and we just need to do better than that. And understand,

[00:16:01] you need to use the, the, my best friend, Bart, his, this, and we've talked about it before on

[00:16:08] the podcast. Are you going to be mad at me if, and then explain the complication because the patient

[00:16:13] needs to understand that this, this is something that could happen to them. And how are they going

[00:16:17] to feel about it? If it does happen to them, that's informed consent. They, not only do they

[00:16:22] understand what could happen, but they, they actually have taken some of the physical and emotional

[00:16:29] ramifications to heart. So that's one of the reasons I love the whole, are you going to be

[00:16:33] mad at me if, are you gonna be mad at me if we do this root canal and the tooth still fails?

[00:16:38] Are you going to be mad at me if we take this tooth out and you have, and you have extended bleeding,

[00:16:45] extended pain? I think informed consent when done well in dentistry is not as hard as it is in

[00:16:54] medicine because the stuff that goes wrong is so common and that stuff we treat is so common. But I

[00:17:00] do believe that we owe our patients an informed consent so that they're never surprised. So here's

[00:17:05] what I'm saying. I believe that even for the most basic procedures, the most run-of-the-mill procedures,

[00:17:12] we should probably describe the worst case scenario of if the treatment doesn't go well.

[00:17:19] So do I always explain that when I'm working on a patient's cavity that they could need a root canal

[00:17:27] because the cavity is deeper than I expected? I don't. I don't. And I should. I should. Why do I

[00:17:32] think the worst case scenario explanation is worth telling people first off? If my office manager

[00:17:40] had gotten a worst case scenario description of what might happen to her, she may well have

[00:17:47] chosen a different treatment. This treatment was, I mean, it's great when it works out, but the fact

[00:17:53] of the matter is that she was not explained how tough the recovery was. You might need a root canal

[00:18:01] after we treat this tooth. That's not that big of a deal. And you can explain that in about a minute.

[00:18:05] And the patient could realize, okay, this tooth is broken. It needs a crown. It might need a root canal

[00:18:13] after this crown. Am I prepared to go through that as well? Or, and if you don't do the root canal,

[00:18:18] if it needs to, we'll end up taking the tooth out. Maybe I don't want to do this crown. Maybe, maybe,

[00:18:24] maybe I'm looking at taking this tooth out and live my life without it. Maybe I'd go to an implant.

[00:18:28] How likely is the root canal doctor? And then you can say, well, I've seen situations like this.

[00:18:33] Because bottom line is if you give the patient the worst case scenario, you look like the hero

[00:18:41] in any situation. Okay. You do the crown and they feel great. They don't need the root canal.

[00:18:46] You're a hero because they didn't need the root canal. You do the crown and they do need the

[00:18:51] root canal. And they say, God dang it. Yeah. You told me, you told me I might need this. So now I got

[00:18:56] to decide what I'm going to do. Either way, you're the hero. If you can swallow telling the patient the

[00:19:02] worst case scenario every single time, you are the hero. They always say, you know, tell them,

[00:19:07] you know, it's, it's an explanation. If you tell them beforehand, it's an excuse. If you tell them

[00:19:12] afterwards. And I do believe that, but more importantly, that's not, that's not a, that's

[00:19:17] about you. The explanation versus, versus an excuse. That's about the dentist. What I'm saying,

[00:19:22] the patient has agency and gets to make a choice because you have explained this to them. I have,

[00:19:27] I have a kiddo. I opened up a brutal root canal. It was Thursday. It was the last time I was in

[00:19:32] the clinic. He was great. He did fantastic. It was a deep cavity and, and it looked like a pretty

[00:19:38] straight, it was number 19. I was opening up a, I was doing root canal and oh my God, it took forever

[00:19:45] for me to open this tooth up. And I, and the canals were so skinny. And I, I finally, I finally found all

[00:19:51] the canals. I, I wasn't patent on the mesial buckle. I got patent on the mesial lingual. I got patent on the

[00:19:57] distal. And this was after a while. I couldn't get them numb. That was the thing. It took me like an

[00:20:01] hour to get them comfortably numb. It was awful. And I'm like, okay, I knew I was going to open the

[00:20:06] tooth up and I was going to put medicine in it. I was going to put calcium hydroxide in and let it sit

[00:20:09] for a while. And you know, I didn't get patent. And of course that's the, every dentist likes to beat

[00:20:13] themselves up about what didn't work. But I told him that I, I told him, I first off, I think we're

[00:20:19] going to be able to get patent. I didn't get it in the first appointment, but I also told him, I said,

[00:20:23] here's the thing. You are going to be, you're going to be a mess in the next couple of days.

[00:20:27] You're going to be, it's going to be rough because a, I had to give you about a thousand shots to get

[00:20:33] you numb all over. I gave you a PDL shots. I gave you blocks. I gave you, I gave, you're going to be,

[00:20:37] you're going to be sore from all the shots I gave you. Plus this tooth is going to be sore as hell.

[00:20:41] We got a lot of the nerve out of there. We got a lot of the tissue out of there, but we really worked

[00:20:45] you over and you, it's going to suck to be you for the next couple of days. And I gave him some

[00:20:49] medication to make him feel better. But I also told him, get ready. This is going to suck for a

[00:20:53] little while. And guess what? I didn't get a phone call this weekend because you know why? Because I

[00:20:58] told him it was going to suck. And I told him what we're going to do to make it better. And that he

[00:21:01] was going to do, this was going to be okay. I gave him the worst case scenario. And frankly,

[00:21:07] I didn't want to give him the worst case scenario. He'd been through a bunch already with me. I didn't

[00:21:10] want to give him the worst case scenario, but I did. Cause I, A, I kind of didn't want to hear from

[00:21:14] this weekend, but B, I just had my office manager go through hell and back because they didn't give

[00:21:21] her the worst case scenario. She didn't get to make the decision based on potential reality. And guess

[00:21:27] what? If I talked to this kid next week and he said, it wasn't that bad, then I'm a hero. I told

[00:21:31] him it was going to suck and it didn't suck because I did such a great job, right? We owe it to our

[00:21:36] patients to give them not only informed consent, but frankly, if there are potential complications,

[00:21:41] we need to give them the worst case scenario so they can be ready for it. If you want your patients

[00:21:47] to trust you and frankly, like you, you're the hero when you tell them what can happen the worst.

[00:21:53] And, and I think sometimes we are so used to these procedures cause we do, it's so repetitive.

[00:21:59] Everything in dentistry is just repetitive as hell, whether it's a direct restoration or a crown or

[00:22:04] root care, it's all, they're all similar, right? We're not reinventing the wheel typically with

[00:22:09] the procedures that we do. So we're used to the complications. We're used to what happens. These

[00:22:14] patients, this might be the only time they ever have such a thing. So you have to approach each

[00:22:19] patient new for the complication potential and the informed consent. And I think that's really hard

[00:22:25] for what we do is really repetitive. So you bring your team into it too. So you talk about it, but you

[00:22:30] also let your team, you give them a, you give them some room to talk about potential problems with

[00:22:36] these things. And even though Dr. Mead is really good at this stuff, sometimes these things can

[00:22:40] happen. You just, your patients hear that and it can help them. It, it, it helps them get through

[00:22:48] the stuff if it goes bad. I'm not going to lie to you. I mean, I've had a few times where I've,

[00:22:53] I've gotten patients through a tough weekend because I was on the phone with them and called

[00:22:57] them and blah, blah, blah. But honestly, I've never regretted telling a patient how rough it might be

[00:23:05] because you know, everyone's kind of got a different variation of how they tolerate pain

[00:23:11] and how they tolerate. Some people you could work on them like with no anesthesia and they bounce back

[00:23:16] with nothing. Some people, you can't do anything they're going to feel and you, you can't be sure

[00:23:21] how people are going to take it. So what you can be sure of is what you've told them. And if you tell

[00:23:25] them to expect the worst case scenario, you're always going to be the hero. So friends, I want you to

[00:23:32] think about informed consent. I want you to think about informed consent, not only to cover your

[00:23:37] old ass as a dentist, but like if you have, if you are lucky enough to have not had a lot of

[00:23:42] interaction with the medical industry, with medical situations, first off, be glad because it sucks.

[00:23:48] But secondly, think about it. If you were the patient, what information would you want to know?

[00:23:54] What would you need to know to be okay with this? And what, what information would you want to know

[00:23:58] before going home when you might be sore or in pain or cold sensitive? Wouldn't it be better if

[00:24:05] you were told all these things so you knew to expect it? And then if it didn't happen, great. You can tell

[00:24:10] the dentist, no, no, I had no problems at all. Or it was really cold sensitive, whatever. So do yourself

[00:24:15] a favor, learn your script and talk with your patients. If you have them sign things, great, but make

[00:24:22] sure that they're not just signing something. Make sure they understand what they're getting into.

[00:24:27] I'm telling you as a patient, as an employer of someone who had, who expected to shrug this surgery

[00:24:33] off and has been off for better part of a month, you owe it to your patients to let them know what

[00:24:39] they might be getting into. I, you can tell, I feel strongly about this because it's affected me a lot

[00:24:44] lately. And I think it's something that we might not do as well as we could. Very Dental people,

[00:24:49] I appreciate you listening to the show. If you want to talk about this, go to the Very Dental Facebook

[00:24:53] group. Um, I would, I'm going to give you the names that I asked someone to give a password.

[00:24:59] There's five names, McQuethy, Papa Randy, Lipscomb, Hornbrook, and Timmerman. I have to tell you,

[00:25:04] I've thought about opening up the Very Dental Facebook group to non listeners because our group

[00:25:10] is awesome, but it's not super busy. And, and I'm curious if you have a feeling like, no, no,

[00:25:16] I really liked this group that it's quiet and it's not as, it's great. But if you, if you,

[00:25:20] if you like a rambunctious crazy group, I want to know about that too. I'm, I'm thinking about

[00:25:24] opening it up because I think we get a little bit more action in the group. Maybe if there were less,

[00:25:28] I don't know, or go on the group and stir some shit up. I don't care. I'm, I'm down for it. I'm

[00:25:33] here for it, but I want it to be functional for you. And I want it to be interesting for me too.

[00:25:36] Uh, so join the group, uh, tell a friend about the podcast and I really appreciate you listening.

[00:25:41] I'm, I'm still, I'm sort of on my summer break still. And I sometimes wonder on a day-to-day

[00:25:45] basis if I want to keep going. So any words of encouragement would be very helpful. I know

[00:25:50] that sounds a little self-serving sometimes. I've been doing this for 10 years and it's hard

[00:25:55] to keep original videos. I could use that. Thank you a ton for listening. I appreciate you guys.

[00:26:05] We'll catch you next episode.