All Up In My Lady Business

Bioethically Speaking with Dr. Emily Anderson

Mary Nisi Season 5 Episode 76

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0:00 | 59:37

In this episode of AUIMLB, Mary sits down with bioethicist Dr. Emily Anderson to unpack how humanity went from the cautionary tale of Frankenstein to the very real ethical debates shaping medicine today. Along the way, they get into wartime atrocities, medical scandals, Olympic-level discipline, and why politics keeps sticking its nose into scientific research.

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SPEAKER_00

My business is your business. It's all within my lady business with me. All right. Hello, everybody. I got a very exciting guest today. At least exciting for me. It's my friend Emily Anderson. Doctor Emily Anderson. That's right. And she is my smartest friend. Sorry, all my other friends. Thanks, Mary. And she is a doctor. I mean, doing better than anybody else's. I'm a PhD. Which stands for phony doctor.

SPEAKER_01

Oh, it does? Do people when people find it? That's a joke someone told me like 30 years ago. And I say it once a week. Do you do you know what PhD actually stands for? I don't. I'm gonna be using the Socratic method a lot during this podcast. I need to be reminded of the Socratic method. It it means when I ask you questions. Like I'm Socrates.

SPEAKER_00

Oh, okay.

SPEAKER_01

Do you know what the Ph stands for in PhD?

SPEAKER_00

Is it like balanced, like a woman secret?

SPEAKER_01

Like Ph balanced for her for your I don't even remember what that stands for. I don't remember what that stands for. It stands for philosophy. So PhD means doctor of philosophy. So no matter what you have a doctorate in, you are a doctor of philosophy in that subject. Oh I'm a doctor of philosophy in healthcare ethics.

SPEAKER_00

Um and thank you for bringing that up because I didn't get further further into your uh your C V. So Emily.

SPEAKER_01

Please introduce me.

SPEAKER_00

So this is Dr. Emily Anderson, and she is has her PhD in medical history? Medical Healthcare ethics. Healthcare ethics. That's what your PhD is in, is healthcare ethic ethics. Healthcare ethics, yeah, technically. Does it say that on the on the diploma? Yep. So Emily, how did you get there? Like, why did you decide to be a medical ethicist or a healthcare ethicist?

SPEAKER_01

That is the that is a great question. I'm trying to imagine where to start. Um What was your undergrad in? My my undergrad was actually in English and anthropology uh and gender studies. And I was always well, I'll I guess I'll start here. When I went to college, I was an accounting major because I wanted to be in I wanted to be in the FBI. Oh. Because of Twin Peaks.

SPEAKER_00

Oh, yeah. Yeah. I was about to say Dana Scully, but that's that's that's a little too late.

SPEAKER_01

Yeah, I wanted to be in the I wanted to be in the FBI, I wanted to like solve mysteries. And accounting you thought was your path? Well, yeah, because like that is actually a someone had told me that actually was a path, and I was really good at math. And so I was like, I'll be an accounting major. And I don't know if you remember the 90s. Uh but if you do you weren't there. We don't really get a lot of counseling and direction about college and careers and all of that. And so I went to college to be a FBI agent like Agent Cooper, Dale Cooper, or Dana Scully. And I did really bad in my microeconomics class, but I did really well. I actually didn't even do that well, but I really enjoyed my composition class that I had to take, where we read, we focused on monsters the whole semester, and I had to write a paper on Frankenstein, which was which is very timely. Um and Frankenstein is very influential in bioethics, which is the field that I ended up in millions of years later. Yeah. Because it's like the story of, you know, men playing God with science and you know, things like that. So, anyways, and I haven't seen the new Frankenstein movie. So it's good.

SPEAKER_00

I actually I did watch it.

SPEAKER_01

We have that on our list. So, anyways, I got I've always all of that is to say, like, I love writing, and I uh I I fell in love with writing, which is not something that I enjoyed much in high school. But in college, I really fell in love with writing and I fell in love with anthropology and like studying humans. And I always was very interested in health, but I knew very early on that I didn't want to do anything clinical. I didn't want to be a doctor, I didn't want to be a nurse, I didn't want to touch people or deal with individual deal with individual people. It's not really about bodies, it's more about I am a very I I learned very early that I am a very empathic person and I'm very sensitive. And so I could never be in a job where like every day I was absorbing other people's like pain or trauma or or difficulties. So I knew but but again, because it was the 90s and I didn't really get a lot of good guidance, I didn't really understand what other careers were like available to me. So I moved to Washington, DC after I graduated college. I was looking for jobs in some sort of women's advocacy something. So I had interviewed at places like League of Women Voters, I was looking at like NARAL. I had been offered a job at a place that's now called Catholics for Choice, which is like a Catholic pro-choice organization. And those jobs were very, very low paying. I needed to make money because my boyfriend was a graduate student. I ended up taking this random job.

SPEAKER_00

Why why does you why is your boyfriend being a grad student mean you had to make money?

SPEAKER_01

Well, he was only making like$10,000 a year. So I had to be the bread I had to be the breadwinner.

SPEAKER_00

Yeah and make and make$15,000 a year because you could live off of that in 1998.

SPEAKER_01

Exactly. And so I took a job at the American Psychiatric Association in the Office of Research, and I ended up as when I was there, I was learning about a lot about mental health and how mental and how psych psychiatric services are funded at the time were funded differently than health services. You know, most people's insurance wouldn't cover, wouldn't cover mental health services. Mental health parity advocacy was a big thing. I was also learning a lot about research and things that were happening um in psychiatric research at the time. And I got a lot of a lot of opportunities to be exposed to a lot of different issues in in mental health and research and a little bit in ethics. But everyone that I worked with who was sort of like a step above me professionally had a master's degree either in psychology or public health. So then when that boyfriend, who is not the man that I'm currently married to, as Mary knows, when that guy finished his master's, then it was time for me to get my master's, and I decided to go for a master's of public health. I focused on health education. I worked for a professor that did a lot of research, and I got very interested in research and issues related to ethics both in research and public health, because a bunch of a bunch of things that were going on at the time that I won't bore you with. And so then I decided, um, I didn't necessarily think I was gonna get a PhD when I got my master's. But then I realized that if I didn't get a PhD, I was always gonna be working for people with with PhDs. And that was a little bit frustrating because in academia and academic research, you're always very limited if you don't have the PhD. Um so then I decided to go get a PhD and I was trying to decide, you know, do I wanna, do I wanna get a PhD where I'm very much focused on crunching numbers and doing statistics and doing that kind of research, which would be more the public health route. But I was very be I was very much becoming interested in ethics and like normative questions, which means like what should we do? And so I decided to take a little bit of a chance and go into this very like niche field and focus on research ethics and get an interdisciplinary PhD, which is that that's the risky part of it. Because, you know, if you get a PhD in psychology, then you get a job at a psychology department and you teach psychology. Not every university has a big bioethics center. Some universities invest more and usually these are in medical schools. Sometimes people with bioethics degrees get jobs in philosophy. So it's just you're sort of like a weird match. It's not as much of like a one-to-one match as if you're like an English professor or a psychology professor or history.

SPEAKER_00

When did the concept in history? When did the concept of like bio I mean, obviously going back as far as Frankenstein? Yes. But like the when did bioethics become a were like like were they always like is bioethics gone hand in hand with like medical education or is Yeah, that's something that's such a good question, Mary.

SPEAKER_01

I I said it sounded fishes when I well the way I said it, but it's not. Because it is a very new field, and there's a lot of, you know, as a new field, there's a lot of like navel gazing and a lot of like histories of bioethics. And it was sort of a it was a convergence of a bunch of different things. So a lot of times when people tell the history of bioethics, they start with another movie that's out right now, Nuremberg. Um, because of Mengele? Well, because of Mengele, but also because of the way that, you know, what drove World War II, what drove Hitler, right? Oh, yeah. The the quest for a pure race. So it was very like eugenics driven. And there's, you know, I'm trying to kind of shortcut it here, but this idea that medicine was like pervert the the the knowledge medical knowledge was like perverted for this political agenda was kind of at the center of of um what was happening in World War II. And then there was also the experiments that happened in Nazi concentration camps that were both to advance the agenda of the Nazi Party and also to generate knowledge that would help the German army or the Naz the Nazi army. So um, how do we care for wounds? How like if somebody, I mean, this sounds really crass, but some of the questions they were looking at it were things like if someone falls off a boat into if a soldier falls off a boat into freezing water, how long before they die so that we know if it's worth trying to save them or not?

SPEAKER_00

Mm-hmm. So a lot of that that does seem like a like a good thing to know. I mean, it's like hard because you have to test on some he's like throw somebody in.

SPEAKER_01

Yeah, but that's really that's like really at the center. So my the focus of a lot of my work is ethics in research with humans. And that's really at the center of ethics with of research with humans is like if you could abuse people and do anything to them without their consent and treat people as less than human, cut open their brains, you know, test a variety of different things, we could actually gain a lot of knowledge. And there is debates about, you know, is it ethical to use some of the knowledge that was discovered, you know, through those experiments? A lot of those experiments were garbage because they were totally driven by racist agenda. But some of the stuff that was kind of trying to look at how do we keep soldiers healthy, fun tidbit, like everything we know about how to prevent and cure sexually transmitted infections comes from World War II. Because what's the number one reason that soldiers weren't fit for battle? They had syphilis and gonorrhea and things like that. Really? So yeah. So there's, you know, a lot of a lot of like the whole fact that we have all this investment in medical research in the US really came out of World War II and money that we were investing in our country to try to keep sold soldiers healthy as well. And then Germany was doing research and Japan was was doing research and yada yada yada yada yada yada.

SPEAKER_00

Didn't we like import like after after well, and I would like to know the Nuremberg part of it too, but like with like Project Zeus or something, didn't we like bring a lot of Nazis over after the war, like kind of secretly to work in like engineering, like in the Rand Corporation and stuff? Like I feel like I I'm sort of probably butchering the I do not know.

SPEAKER_01

But I do know yeah, yeah, that I do not that I do not know. I have not read that history. Um, and I do need to read more. One of the things I on my long list of things I need to read more about is sort of the history of military research in the US, because it's not something I know a ton about. I know a little bit about like MKUltra and like the psychedelic research. But I need to learn, I need to learn more about that. But so then sort of like this well, okay, so what happened at the Nuremberg trials was that in order for the Nazi doctors who were conducting research in the death camps to be tried against a standard, some American doctors had to put put together what's called the Nuremberg Code, which is sort of the first international code of research ethics, which is basically a list of principles of how people should be treated when we use them in research. And the first thing is we shouldn't do research on people without their consent. And then there's other things like there has to be social and scientific value. People who are doing the research have to be qualified to do it. And it's a pretty, it's a very thin document and it's a it's a static document because it was just a one-time thing. And then since then, there's been evolutions of like international codes of ethics, but it started with Nuremberg so that those Nazi doctors could be tried against, you know, what was considered to be a global st a global standard at the time.

SPEAKER_00

So they put it forth like this is what this is what we've decided is what you should have been doing. Yeah. And so you're like better, like retroactively holding them accountable to something that didn't exist a little bit. Not to defend the Nazis, but Right.

SPEAKER_01

But it was sort of based on it was based on sort of what is common practice at the time because that hadn't really been delineated or coded or put in writing. The interesting thing is that there was one country, this is a Jeopardy question. I know you love Jeopardy. There was one country in the whole world that actually had a code of ethics for research with humans prior to the Nuremberg Code. Would you like to guess what country that was?

SPEAKER_00

Okay. It's so it'd be a country like was is it an old country? It has to be an old country.

SPEAKER_01

Yeah.

SPEAKER_00

Okay. So like in Egypt.

SPEAKER_01

But don't overthink it. Don't overthink it. It was a I said. Is it Egypt? No, it's Germany.

SPEAKER_00

Oh.

SPEAKER_01

So they did have a code of ethics. They did have a code of ethics that they weren't following, yeah. And it didn't even went by the wayside. Like that was from, I don't know, again, I now I feel like I'm out of my depth, but it was like that was from like the pre like the previous administration before Hil Hitler came in and take over and took over. But they that version of the German government had some sort of code of for doctors for when they were conducting medical, medical research. But then the other part of the story is that because the US had made such an investment in scientific research and medicine in World War II, medicine actually started to be able to come up with things that kept people alive longer. So, you know, if it was 1899 and you had tuberculosis, the doctor came and kept you to your house and kept you comfortable while you were dying. Now all of a sudden we had like things that could cure people and keeping them live longer. And then we had to think about making decisions and who gets what and rationing and you know, all of that sort of thing.

SPEAKER_00

And so when when were we making those what were we making those decisions around?

SPEAKER_01

Like like what kinds of things? Well, like dialysis.

SPEAKER_00

During wartime?

SPEAKER_01

Well, this is maybe like the 50s. This was like the 50s and 60s. We started to have things like dialysis. And dialysis was like a really big issue where kind of bioethics started to bloom or blossom because doctors were saying, like, we can do dialysis. Dialysis saves people's lives, it extends people's lives, but we don't have enough resources. Who's gonna pay for dialysis? And so dialysis is one of the few things, right? That like if you need dialysis, the government will pay for pay for your dialysis.

SPEAKER_00

And that's is that all but is that di when I think of dialysis, I think of like like um like kidney? Diabetes, like it's so it's all so is dialysis only for that, or is there like other things that dialysis helps with?

SPEAKER_01

Well, anytime you go into kidney failure, one of the main reasons is diabetes, but there's other things that that could send you into into kidney failure. But so when doctors started to have to make these difficult decisions about what to do and patients, there were more choices for patients. That was when bioethics really grew as a profession because physicians started to invite, this is sort of the language of some of these of these histories. Doctors started to invite philosophers, theologians, and others like to the bedside or into the clinic to help them make decisions about what to do. And policy started to have to think you know, policy start had to start to integrate ethics. And part of it was because again, I think it's really I think it's really important for ri for people to realize like how short of a time it's been since medicine was actually able to do anything helpful.

SPEAKER_00

I mean, yeah, like when you think about like, you know, the Civil War was when they like began to figure out that you washing your hands can keep you from not dying.

SPEAKER_01

I also think, you know, just between you and me, like once you turn 50, you realize like how short modern history has has been. And you think like, oh, all this stuff was like very um like very recent. And so the other thing I'll mention, you know, talking about the history of bioethics is that, you know, the uh the US Public Health Service study of syphilis in Negro in the Negro Mail, which is the official name of the Tuskegee, what a lot of people call this Tuskegee syphilis study, and a lot of people have heard about that. I call it the U.S. Public Health Service study of syphilis in the Negro Mail because number one, I want to remind people that this was a study that was funded and conducted by the U.S. Public Health Service. And number two, the people of Tuskegee would like everyone to stop calling it the Tuskegee syphilis study because they didn't ask for it and they didn't have anything to do with it. They were just the people that were used in the in the study.

SPEAKER_00

Oh, like they and then weren't they giving it to them? Like weren't they giving to them?

SPEAKER_01

So that is a major that is a major misconception, and I will come I will come back to that because there's another story of what happened in Guatemala. But what happened in um the syphilis study that took place in Macon County, Alabama was that there had been some observational studies of syphilis that had took place in Scandinavia where men that had syphilis were just observed to figure out what happened to their bodies. And that's when they figured out, you know, there if un untreated syphilis will have will affect your heart, it will affect your brain, it will affect your your other organs. And at that time in the 20s, when the syphilis study started in the US, there weren't a lot of great treatments for syphilis, and they were pretty like gnarly. Like it involved like putting ointments on your shankers and all of that sort of stuff. And it wasn't like it didn't work very well. It was kind of gnarly, had a lot of risks.

SPEAKER_00

So were they like making up what it could potentially be because they didn't like like how do you like when you have a when it when you've got like bad solutions to a problem like that, like is that because they're just they weren't studying or they were just like throwing shit at the wall to see what they're doing.

SPEAKER_01

It just was a scary. You know, so like in the 20s, like there were there were not yet very many antibiotics. So this is so this is like part of the story. So at the time, there wasn't much known about how to treat syphilis, but there was very much known about what happened if you didn't treat syphilis. So in the 20s, when the study started, what the public health service was looking for was an area where there was a lot of untreated syphilis and a place where people wouldn't really have access to syphilis treatments. So they started this observational study, and what they did was they tested everybody in the county for syphilis or men, black men in the county for syphilis, and they followed them, some people that had syphilis and some people that didn't have syphilis, and they didn't tell them that they had syphilis. So men were followed for decades and they were never told that they had syphilis. And when they would come in for research data collection, like and they would get things like spinal taps and blood draws and you know all sorts of things. They were actually told that that was treatment. When it wasn't treatment, it was it was data.

SPEAKER_00

So wait a minute. These guys had syphilis, they were diagnosed with syphilis. They didn't tell them they had syphilis. And so they were just going off giving syphilis to other people unknowingly. Correct.

SPEAKER_01

Then what happened in the 1950s, Mary? What was one of the greatest medical inventions of our time or discoveries of our time?

SPEAKER_00

Penicillin? No.

SPEAKER_01

Yes, penicillin was discovered in Peori, Illinois, sometime in the 50s. Uh I know that because that's where I was born. And so the the big the biggest scandal of the syphilis study is that men were can continue to not be told that they had syphilis and not treated for syphilis when penicillin was discovered. But here's the thing about penicillin: super cheap, super effective, no bad side effects. So it's like if you get syphilis today and you're diagnosed early, like easy peasy breezy. It's just penicillin, just no big deal. I mean, I don't know, it could be another antibiotic and there's like antibiotic resistance, but we weren't worried about antibiotic resistance in 1950. You know, that would very easily treat your your syphilis infection. And so that study started in the in like 1932 and it continued until 1972. And it had it wasn't not a secret study. There were publications from the data. People knew about the study uh at the Except the people in it. Except for the people in it. Yeah. So the scientific community knew about the study. And finally, someone who had tried to who had tried within CDC several times to say um this study should be stopped went to uh a friend who worked at the Washington Star, which is a Washington DC newspaper that doesn't exist anymore. And there was a front page news story about this study, and the the public demanded that something be done, and then Nixon put together a commission. And now we have act now since 1981, we have which is very recent, we have regulations um for what the rules that scientists have to follow if they're gonna do research with people. So that's kind of the like in a very, you know, simple nutshell, the story of why the field of bioethics exists.

SPEAKER_00

And so it really so it didn't really become kind of like mainstream and normalized until the eighties? Yeah.

unknown

Yeah.

SPEAKER_00

And so would you say that like a majority of medical schools have a bioethics side of things, or they did, and then because of funding cuts, they don't now?

SPEAKER_01

No, in the U. US most medical schools have require some sort of ethics education for medical students. And that's part of the accreditation process because there's like a body that accredits U.S. medical schools. Some academic medical centers have one person who is responsible for like coordinating all of that. Some medical schools have really big centers of bioethics that get, you know, do a lot of research, do a lot of teaching, do teaching in other health professional programs, do teaching, you know, at the undergrad level, do continuing medical education. Because I'm at Loyola, which is a Jesuit medical school, there's four Jesuit medical schools in the United States: Loyola, Creighton, Georgetown, and St. Louis University. St. Louis University is where I got my PhD. The Jesuit medical schools are all of them have invested pretty heavily in bioethics because it's consistent with the Jesuit mission, which is like caring for the whole person and caring about people who are suffering and so medicine as a calling and all those sorts of things.

SPEAKER_00

So I like, and I'm gonna probably butcher the history of this, but like from what I understand, like Reagan did a real big hatchet job on medical health or mental health services. Like he was he cut a lot of the public funding for and so it's interesting that at a time when they're kind of collapsing the medical the mental health infrastructure, now we're now we're finally getting codified and good ways to do the studies in the bioethics. I don't know if you can even speak to that, like the the how the how one part of it is being kind of decaying when one kind of part is coming up. I'm not saying this right, but do you understand what I'm trying to say?

SPEAKER_01

Well, I mean, I think they're related in the sense that like as all as all of like as medicine got more complicated, physicians realized that they couldn't just like show up every day and do the treatment. And they had all of these other things, right? Like they were having patients that couldn't that didn't have insurance or that couldn't afford the treatment. They had patients who uh didn't didn't like the treatment options that they had. They had family members um getting involved in treatments. They had, you know, we are a pluralistic society. Not everybody agrees on things like end of life and beginning of life and you know, reproductive rights and whether everybody deserves healthcare. Like whether healthcare is a basic human right. So as the things were crumbling, physicians were like, we can't just, you know, it's not the good old days of, you know, what was the famous, this is where, okay, this is this is where my brain fog is coming in. Marcus Welby, you know, it's not just the guy with working in the small town. That was the TV, uh medical TV show. It's not just the doctor working in the small town with his medical bag, you know, going around and being able to give everybody what they what they need. Medicine became more complicated. So it is, it is related in the sense that, you know, these questions just as life got more complicated, as medicine got more complicated, as insurance and financing got more complicated as our population grew, as different, you know, the country, the government needed to make decisions or we needed to make decisions as a country about um, you know, what are we what do we owe to our citizens in terms of health and healthcare? Um just questions got more interesting and more complicated, and there was a need for like an interdisciplinary approach to answering these questions.

SPEAKER_00

So, as like, so would you when you bring up the concept of insurance? Because it, you know, that's obviously a real thorny, sticky, shitty situation that um America is uniquely dealing with. Like on the bioethics side of um of insurance and and treating everybody and having that be a basic right, how like how do you how do how do you do you teach to that, or is that something that you have to that you understand that you talk about in your world?

SPEAKER_01

Yeah, I mean, I don't I so most of my research and scholarship is on the ethics of research with people. I do a little bit on medical, I've done a little bit, I would say done, not so much right now, done a little bit on like medical professionalism and what I like to call like doctors behaving badly or like why do doctors do bad things. Because I'm also interested in like why do scientists do bad things? So why do people like what should the rules what's a bad thing? Um, you know, doing research on people without their consent, falsifying their data to make their results look better, having financial, you know, doing that because they have significant conflicts of interest, things like that. But mostly I'm interested in like how do we set rules around research that we do with people to make sure that people are safe, but that we're also, you know, continuing to advance science in a way that helps future patients. So it's always this balance between, you know, current patients and the future, individual people and the greater good. Like these are these are again sort of like these are the things that bioethicists talk about. But because I have, you know, training and and colleagues who do this kind of work, it's like I have opinions about healthcare and you know, healthcare as a as a human right. I would say that there's, you know, there isn't a ton of consensus among bioethicists. We are rooted in sort of philosophy and debating these like big, big questions. And so part of constant disagreement and constant discussion is kind of at the root of what we do. I would say that if you ask most American bioethicists, is how sh is healthcare a human right and is it something that the government should provide, it would be shocking to hear someone say no. And it would be extremely shocking to hear someone say that our current healthcare sys system is not in need of massive reform.

SPEAKER_00

Massive reform. Yeah. Right now we would we're dealing with Trump having, you know, we've been dealing with for a while with the Doge cutting all of the aid and, you know, unless the the the universities behave. And like we just had, you know, a couple days ago, Northwestern paid$75 million to, you know, have eight hundred and seventy million dollars of of research money going back to them. And that sucks. Like I really wish they hadn't done that. But and I'm sure most people do too. But I guess with that happening, and so many, I mean, was I'm assuming Loyola had to have been affected by that. Like when you lose all that funding, like how far back does that set the world? Like, is that is it something that we can get back to?

SPEAKER_01

No.

SPEAKER_00

Oh, cool.

SPEAKER_01

No, I mean, like, and the biggest issue, and I will refer you to my op-ed from Crane's business from a few months ago. Anyone know that? If anyone wants to, wants to Google that. I mean, a lot of people have written on this, and I was just sort of like adding my voice to the cacophony of voices. But, you know, it's disinvesting in medical research is bad for everyone because research grants pay for the people that clean our buildings at the university, up to, you know, the salaries of the scientists that are doing the work and everything in between. Importantly, they pay for students. So I think one of the worst that, you know, there's a million bad things that are happening, you know, particularly people who are currently enrolled in trials uh and had those trials stop and you know might have their health significantly affected, not just because they might not have access to treatment, but because they're not able to be monitored uh once they were given an expert, you know, an experimental treatment. I think one of the biggest issues is that we have cut off our pipeline at the knees because we are there's not there's less money to train future scientists. So we use the shorthand like dirty words. So, you know, if you have to get all the dirty words out of your research grants like diversity and gender and woman and things like this. We are disinvesting in future scientists, and we're also making scientific science an unfriendly place for people, and especially an unfriendly place for the people that we were just a few years ago trying to bring in women, minorities, people, you know, underrepresented, people who grew up in rur rural areas, you know, all this sort of stuff. And so we're gonna have we're we drained the brains. So I and so who's gonna be the person who could have cured cancer in the future is now gonna say, why would I want to go to medical school? I, you know, there's a cap on my loans, nobody listens to doctors anymore. The health department of health and human services is filled with people that don't have medical degrees. Why would I want to go into public health? I can't get a loan because it's not a professional degree anymore. I mean, there's like all of these things, all of these things going on. And I think even if it's it, it I don't like to use war metaphor, but it is a war in the sense that like there will be a need for rebuilding because we have like destroyed the infrastructure has been has been destroyed.

SPEAKER_00

The infrastructure wasn't that great in the first place, though, I have to imagine.

SPEAKER_01

No, and I think if you had asked anybody working within the infrastructure for ideas of how to make it better, this was what was so frustrating about Doge was it's like, yeah, a lot of smart people who have been working in these systems for a long time, whether it's like the way NIH funds research or the way universities oper operate with this research funding, like people have a million ideas, good ideas worth testing about how to fix this. Nobody needed to bring in outsiders to like try to fix things.

SPEAKER_00

I mean, isn't the answer pretty much always across the board more money?

SPEAKER_01

Yeah, but then there's also, I mean, more money is always good, but there's also it's I it's so tricky to say efficiency because it's like such a scary word now, but there were ways to make the system more efficient. You didn't need to bring in a bunch of outside people and scare everyone and fire a bunch of people to make things more efficient. There's like some very simple lots of people have lots of ideas about how it could have been made simpler. And those people, a lot of those people got fired.

SPEAKER_00

So, like, and I guess it probably just pushes, I mean, our I know the US is basically the place where people do a lot of this because we've got this ridiculous healthcare situation where there's so much money involved and lobbying and blah, blah, blah, that kind of make it so that there's a lot of money here in America. Now that Trump has done that and taken it away, is there like another country or another system waiting in the wings that's kind of taking these mines and well yeah, Canada, Ger Canada, Germany, they are heavily recruiting.

SPEAKER_01

I think what did I read the other day? I I want to say Japan. They're like heavily recruiting American scientists. Like, come here and do your and do your research. And so you know, we're gonna lose mid-career people. But mid-career? Yeah. Like like people like me. I've been around long enough that I know what I'm doing, but I'm not so old that I'm like retiring immediately. We're kind of people in their 40s, 50s, like we're the most productive people, I would say. Or I would say like a lot of people are at the height of their productivity of their research careers when they're in their, you know, mid when they're middle age. Like the average, the average age of recipient of first NIH grant, don't quote me on this, is like early 40s.

SPEAKER_00

One thing you I I there's I'm totally switching gears here, but I kind of want to go back to something you said earlier on. So you said earlier on that part of the reason why you got a PhD was that you didn't want to be working for PhDs, not a PhD. Now, is there some like I have to imagine that I mean, acad I mean, I actually know that academia is a very misogynistic situation. And that if you would you'd probably be primarily working for men if you were working for PhDs, that would probably never see you as an equal. Do you feel that they even see you as an equal now as a PhD?

SPEAKER_01

That's a very loaded question.

SPEAKER_00

That you may not want to be answering into a microphone.

SPEAKER_01

Well, no, I mean, I think I can speak very generally about it because I do interact, you know, inside and outside my institution. I interact with a lot of men and women every day. So, you know, my in public health, it's actually a majority uh women profession. So I had mostly, I I mean, I feel like I've had a mix of like before I got my PhD, I had a sort of a mix of men and women bosses. And at that time, the women that I worked for were sort of raised in that, like, in order to be successful in the world, you have to act like a man, you know, mindset. Which can be more difficult than inter uh than interacting with a a man them themselves. But I mean, I I think that things have definitely changed. I think even by the time I started my PhD, sort of, you know, the like we everybody has to earn their dues, and it's like it's okay to to mistreat your graduate students. That was kind of a thing of the of the past. I'm trying to answer your question in a very, I guess like balanced and maybe I'm being like cagey, but like I have had, you know, I have had men talk down to me that, you know, I know as much or more than they do about what we're talking about. I've had things mansplained to me. I've had, you know, in every industry, in every field, we know that women, you know, take the notes and make the action items and clean up the coffee cups after the meeting is over. And, you know, all of those sort of uh ru one of the things I feel like I've been, you know, has been something I think a lot about is how much reminding I have to do in the in the workplace of uh of other colleagues. And there's definitely these these like smaller inequities that persist that are gonna take a really long time um to to go away. I mean, how would how how would they? How would they go away? I mean, you know, it's like this slow march of time. The slow march of time, and these things are not specific to academia. I think, you know, one of the things that I'm super grateful for is at this point in my career, and this is, you know, something that's that is unique about being an academic, is that I get to choose who I work with now. Like very rarely is there anything that I like have to do. And if you look at all the projects that I'm working on now and who I'm working with with, I tend to choose to work with other women uh in my field and a lot of younger women. Um and I will joke with them like I'm a vampire and I'm stealing your youthful energy.

SPEAKER_00

Um I I've been saying that to my employees since time immemorium.

SPEAKER_01

But but you know, now that I have choice, that's who I tend to gravitate to. I still a lot of the men that I work with are men that I have been working with for a long time and I enjoy working with them and I still want to work with them. So why do you think I get to choose? I don't I don't have to work with anybody that I don't want to anymore. So I work with cool, awesome people, and many of them are women and some of them are men.

SPEAKER_00

How did you get to the point where you could choose? Like what what's what is the path that gets you to the point of choice to be able to make those decisions?

SPEAKER_01

Yeah, I mean, I think when you're there's just sort of this like natural progression where, you know, when you start your career, you are working on other people's projects. And then as you advance in your career, you're driving the project. So you're what you what you know, you're the lead investigator, or you're the person who's organizing the course, or you know, you're the person who's chairing the committee. So you get to choose who is involved in your projects, who's on your team, as opposed to having to join somebody else's team. And feeling like you can't say no to joining other people's teams because, you know, that's you know, there's this big it's it it's it's it's interesting because I, you know, I listen to a lot of the well, let me rephrase that. The only podcasts I tend to listen to are comedy podcasts. So I listen to a lot of actors talking about this feeling that you can't say no to a job because you might not ever get offered another job. And just because you want an Oscar doesn't necessarily mean that you're gonna get offered a bunch of like great, great roles. It's very similar in academia. Like you feel, especially when you're young, you feel like you have to anytime anybody asks you to be part of their project, you know, whether that's like write a paper with them or be on a panel with them or write it, try to write a grant with them because you bring, you know, whatever data analysis or methods, knowledge to the team, you feel like you can't say no because you feel like no one's gonna ever ask me again. And, you know, I got to be part of this person's this person's team. Uh the only industries I really understand are Hollywood and academia. So they have those things in common. They might be there in other in other fields as well.

SPEAKER_00

I love the idea that you think that you know a lot about Hollywood because you listen to the I know a ton about Hollywood Island. Is it all through the Lonely Island Seth Matters? I totally understand.

SPEAKER_01

No, I also have listened to Smartless and uh WTF. So, you know, I know how Hollywood works.

SPEAKER_00

Yeah. It's I mean it we'll at least know how it works for for white guys specifically.

SPEAKER_01

Yeah. Well, and I know how at old how it works for old women, you know. Yeah, and the younger ones. They don't get roles, you don't get roles unless you write and produce yourself. You know, what have we learned from Reese Witherspoon and Nicole Kidman? And, you know, if you want to work, you gotta be a producer. So it's kind of like academia.

SPEAKER_00

Wow. I mean, it it's like that also in like, you know, DJ world too. I mean, you know, although it's weird now because it's like the older you get, the less the less relevant you seem. But also it's like you also know more and you're better at, you know, looking at rooms and understanding them. It's like, and I've been feeling like I have been, I definitely in the last like two or three years, I've been feeling like I've been like I'm I'm getting olded, like like that I'm seen as irrelevant. I went to Sephora the other day to get some eye cream, and the woman said, Well, you've got mature skin. And I was like, the fuck I do. The fuck I do. I am I am fucking coming back in three months after I get a full laser face off, and then we'll have a conversation about my mature skin.

SPEAKER_01

Yeah, I mean, I I think I'm I I do think in academia that the g the the getting older like age, I I do I don't think it's as bad as it is in other industries. And I I also think that, you know, I joke about I joke about this, and I don't know if every female academic would agree with me. I don't think the pressure to like look good is as strong as it is. I mean, certainly it's not as strong as it as it is in some professions, but I feel like it might be like the lowest pressure.

SPEAKER_00

Yeah, it might be actually the best job for for women to grow old in. Yeah. You know, because like the older you get, the more knowledgeable you seem. And yeah.

SPEAKER_01

And I mean, I even I will tell you that when I was on the job market and I was a very young looking 32-year-old when I finished my PhD, you know, I had women my age are a little bit older than me telling, telling me that they let their grays grow out and they wore glasses when they went on job interviews because it was actually better to seem a little bit a little bit older because the decision makers were generally, you know, men in their 60s. And the older you could sort of the more gravitas you could give yourself, sort of, sort of the better.

SPEAKER_00

What a shudder. What a fucked up. I mean, it's it I mean, I I think on the one hand, like you should like be able to let your grades grow out and wear your glasses and do all of that. But that's so fucked up that that's the kind of career advice that women academics get, and men are like, you know, be more assertive and maybe you can have sex with a co-ed. I don't know. I I feel like the the advice is different.

SPEAKER_01

I think, yeah, and I think the ad that maybe the advice is, you know, you don't want to look too hip or fashionable that you could be seen as not being serious, right? Like you want to look serious. I don't, I it's not possible for me to be or look anything other than the way that I am. So I I feel like I struggle a little bit with like that balance. But on the other hand, I really appreciate that I I'm in a field where looking good is not gonna be the number one reason that I would get, you know, a job, a promotion, or or whatever. I do feel like I don't have the pressure to look good every day when I show up at work the way that other people in other professions probably feel.

SPEAKER_00

Speaking of other times when you had to look good uh in a professional way, you spent a lot of time as a uh child amateur gymnast.

SPEAKER_01

Well, yeah.

SPEAKER_00

I don't know if I said that correctly.

SPEAKER_01

I don't know if I if I if I said your title correctly with the uh Um, I mean I was a child and I was not a professional. I wasn't getting paid. So yes, I was a I was a gymnast as a adolescent. I was a high-level athlete.

SPEAKER_00

I have a feeling you probably have some medical ethical issues to talk about with uh that whole entire world of the Larry Nader. What was his name? Larry Nasser. Yeah.

SPEAKER_01

So okay, so I mentioned that I had previously studied, I don't know if you remember this. So I I had previously studied um physician misconduct. Um, and so I was working on a project with my mentor from my grad from my PhD program, and we were looking at Medicare fraud, we were looking at overprescribing of opioids and things like pill mills, we were looking at unnecessary procedures, uh, so kinds of these, these like scams where there would be a cardiologist who would do who would say, like, oh, you have a blockage, you need a coronary artery stent, and then they'd send people to a surgeon and so that they could, you know, charge Medicare and do these procedures.

SPEAKER_00

Wait, really?

SPEAKER_01

Yeah.

SPEAKER_00

They would like give people unnecessary procedures so that they could get paid by Medicaid.

SPEAKER_01

Yeah, yeah. And and then we were also looking at physician sexual abuse, which is a very understudied and under-reported, you know, sexual assault we know is very under-reported. Sexual assault by a f by a physician is even less reported than um than you know, date rape or or stranger rape or other kinds of other kinds of sexual assault.

SPEAKER_00

I think a lot of women don't realize it's sexual assault. Like you when you're in those you're trusting the person, you think, well, I guess this is part of the deal.

SPEAKER_01

Right. Well, and I mean let me ask you this when you went in for your first pelvic exam, did anyone And tell you like what was normal and what was outside of normal?

SPEAKER_00

Like did they say like this is like did it have a heads up on what like a speculum is gonna feel like? No.

SPEAKER_01

Yeah, no.

SPEAKER_00

I mean, other than like friends saying that it's cold and it sucks.

SPEAKER_01

Right. But how long if it would if if if there was inappropriate touching during it or it went on too long, how would you know what was, you know, what was too long or outside of the norm? So, anyways, I was studying professional, I was a former gymnast studying physician sexual misconduct when the Larry Nasser story broke. I was getting a lot of questions from colleagues about like, what's your, you know, what's your opinion on this? And then you also get a lot of during that, you get a lot of like, oh my God, I don't know how this happened. Like, this is crazy. How did this happen? And I was like, I don't think it's that crazy. I can tell you exactly how it happened. I wrote a a little blog that was in because I kind of woke up one morning and I was like, all right, here's my thoughts on Larry Nasser, and then I'm then I need to be done. I wrote a blog and then something happened. I can't remember what happened during the trial, uh, but I woke up in the morning and I had an email from ESPN and um they asked me if I would be on a show called Outs Outside the Lines, I think it was called, which was like one of like a really long. I know that John knows this because talking to John. Uh for those of you who don't regularly listen to Mary's podcast, John is her husband. And I was like, this impresses my male friends, because I know they all know this show Outside the Lines and ESPN and Bob Le. Bob Lee? Bob Lee. I and I I famously don't want to do any media. I have not done very many. So that was like this my first media appearance professionally was live on ESPN. Wow, wait a, wait aim high. And I have not done much between this media appearance and that media appearance. And that was that was horrifying. I never watched myself. Here's the thing all I did was go on TV and say doctors shouldn't be sexually abusing young girls. One of the least controversial things that anyone could say, I was, it was not risky or controversial. I mean, bioethics is a field that focuses on controversies, right? Like beginning of life, end of life, all of these sorts of things. To say doctors shouldn't sexually abuse young patients and doctors of athletic teams shouldn't take advantage of the trust and the environment, the very stressful environment that those young women are in, is just so not even a a risk or or anything. What ended up happening was, and I can't remember at all, I think it was basketball, some player got caught on a hot mic saying something under their breath when a ref made a call, and that knocked our store that knocked our time down from like five minutes. It was me and another woman who has this very famous gymnastics podcast. We were supposed to have like five or six minutes, and we ended up having like a minute total. So it was like, and I never and again, I never watched it.

SPEAKER_00

Ironically, wait, it's because just because somebody said something dumb on a mic. Yeah, it might have it might have been that somebody said something like racist or sure. But like I mean, you know, some it just feels like this is a much more salient and important thing to be talking about than you know, some hot gossip around somebody being, I mean, racist.

SPEAKER_01

Yeah, so it was like a breaking story. So that was that was on, and so I wasn't on for very long. Yes. So I was I was a former gymnast. I happened to be in this like weird place at a weird time studying this issue. And I always, you know, when I talk about it, I always say, like, I am the only, as far as I know, I am the only person who is both a former gymnast and an expert expert in physician sexual misconduct. So I was, I guess, the best person to be talking about about that issue. And it was, you know, more to me, it was kind of more about gymnastics than it was about medicine, but it really highlighted the trust that athletes have in their in their doctors. But it was really more about how fucked up the world of gymnastics is and the fact that, you know, no matter what, the best gymnasts in the world are always gonna be young women. Simone Biles, the fact that she's still doing gymnastics in her late 20s is like amazing, but that's not also freakish. Yeah, it's like she just is an incredible athlete, just like so many standard deviations outside of the norm that, you know, the rules that you would have to make, you know, the rules that I would want to make for gymnastics just wouldn't work because it would be about not having young girls competing in such high pressure situations. But it's just that's not the way that the that's not the way that the sport works, you know. You can't say like um, you know, if you look at the recommendations from places like the American Academy of Pediatrics about like kids in sports, they're like kids shouldn't specialize until they're in high school until they're in college, right? You know, even some of the best college athletes um will have played multiple sports all through through high school, but you can't do any other sport other sport and do gymnastics. And I think our like other sports are sort of moving to become more like gymnastics. I would say, like, you know, when I hear people talk about their kids in soccer or hockey and all of that, oh my god, the way it is now like that's how gymnastics always has been. Like it's you know, um expensive. It's very stressful. Yeah. So I I worry that like more that more sports are becoming like gymnastics, and that's putting a lot of pressure on on kids. There's still only the same number of people that are gonna be able to become frozen all of that. Anyways, this now I'm getting into like a whole thing that I don't that I don't really know about.

SPEAKER_00

But well, I mean, I see it, I see it here a lot. Like where because you know, a lot of my friends have kids that are sporty. This is where I'm I feel like I really lucked out with having a very unsporty child because I don't have to go to like the but they do like you know, travel hockey and travel soccer and travel swimming, and you know, it costs like tens of thousands of dollars a year between like the traveling and the in the bees and the equipment and all the gear. And it's like you do realize that the likelihood of your kid actually doing anything with this is very low. You know, and even if you do get like a scholarship for sports, like what happens if it if they get wounded? It's it's an interesting thing that we've kind of pushed ourselves into from a competitive, like just to kind of create this weird competition. And it's almost like it's more for the parents to look good than it is necessarily for the kid, like just that they can afford to do these things or what I no offense to my friends who are doing these things, but and I don't really, you know, but it does seem like weirdly competitive and putting a lot of pressure on the kids that are it's really parent-based.

SPEAKER_01

Yeah, I mean, I'm not a parent, so I don't know. What's interesting to me is, you know, my parents they did not have the experience of being in sports. I mean, my dad played sports, my five foot five father was on the basketball team at his high school because it was so small. But my parents didn't have any experience being in like high level sports. And so my parents had like nothing to compare what my life was like or, you know, to kind of navigate the world that I'm in. Now I think it's interesting and I think it is better that parents have the experience that some or at least some of the experience that their kids are having, and they can navigate it a little bit better and make different choices maybe than the choices that I made or the choices that were made for me in terms of I was gonna say work life balance school sports balance and was the pressure from to prefer was the pressure from gymnastics like was that self-inflicted, or were your parents also like, Emily, you gotta hit that high beam? No, I mean that's kind of what that's what I'm getting at is my my parents, this was like a totally foreign experience to them. The only time I've ever heard any heard my mom talk about it was Debbie asked my mom about this. And my mom said, you know, I was having a bunch of people tell me that my daughter was really good at something that I didn't understand. And so she what she expressed was like, as a parent, she felt like what she should do was help me develop my talent. And that was kind of what she understood her role to be. And so my coach, there's a lot of deference to my coach about things, and you know, my parents were very supportive and very along for the ride. I am a person that has always had very high standards for myself. I don't, you know, it's like a chicken and egg thing. Was that gymnastics or was that did gymnastics create that, or was I good at gymnastics? Because of that, no one will ever know. But my parents certainly were not like overly pressuring me. But then you also feel in a sense, it's like I understood the um and and I didn't even understand the way I understand now, but even then I understood like the investment that they had made in me and like the sacrifices that they that they made in me. And it wasn't it's you know, I did I did express the desire to quit many times and was kind of talked out of that. But that was, you know, maybe that I can't say that that was the right or the wrong thing for anyone, anyone to do. And I think, you know, I I've spent a lot of time reflecting on, you know, what it was like to be the kid that I was or have the experience that I had as a kid. And I think there's like it de it created a lot of things for me that I still struggle with, and it created a lot of like good habits in me. And I think, you know, kind of back to academia, there's a lot of there's a I think having the childhood that I had is one of the reasons that I think I'm successful as an academic. Like I will also joke about that, and I have another I have a I have a colleague at Northwestern who we we learned only after we had been working together for a couple of years that we were on the same gymnastics team, but she's 11 or 12 years younger than me. And I had actually coached her when she was a young kid because we had met on Zoom during the pandemic. I was on an advisory committee that she had put together. And she's a bioethicist? No, she's a statistician. She's a biostatistician, and um, she uses her husband's last name, and I use my I used my the name I was born with. Uh, and I so I didn't recognize her name. She was like six, and I was 17 when I taught her, so she didn't remember my name. And then when she talked, she had had dinner with our coaches and she realized we made this connection. Anyways, she and I have had a long had long conversations about sort of like gymnastics and academia and like, you know, all of that. But you know, a lot of a lot of academia is like you write something and then it goes through peer review, you get judged, you get feedback, you're told like, you know, what's wrong with it and you need to fix it if you want to get it published or you want to get this grant or whatever. And I kind of noticed when I was early starting out, you know, some of my colleagues really struggled with like getting that judgment and that feedback. And I'm like, you know, when I was 12 years old, I basically naked, I spent hours in the gym to go dance for 90 seconds and flip around on a tiny little piece of wood. And then a woman in a suit would hold up a number.

SPEAKER_00

Tell me your entire worth was based off of that.

SPEAKER_01

My entire worth was based on that number. So I'm pretty good at when I get feedback that's like this is what you need to do to improve this, you know, whether it's a research project or a, you know, conference proposal or a pay or a paper for a publication. I'm pretty good at just like putting my head down and being like, okay, I can deal with that. I don't take it like super like personally.

SPEAKER_00

Yeah. I also just assume that everything I do is a little wrong. So like when I get feedback, I'm like, I just accept it as like a normal thing. Like they say this all the time on on uh the Lonely Island podcast, but where they talk about like first thought, best thought.

SPEAKER_01

First thought, best thought, yeah. That's a big like improv thing, right?

SPEAKER_00

Yeah, yeah. And I never think my first thought could t could possibly be the right one. Like I I always think that I have to go through two or three thoughts before, you know, or some, you know. So I'm actually I I kind of like criticism because, you know, all right, you say I did this wrong, I'm gonna fix that. And then, you know, but then it winds up being this diminishing returns when they keep telling you you're doing it wrong when you know you're doing it right. This has been all over the place, but really like intellectually stimulating. And I'm I was really fun to ask questions of you. We've never really talked about. We didn't even talk about why I even know you.

SPEAKER_01

I don't know if it matters, but well, it's you don't often get like uninterrupted time to sit down and just like talk about work stuff. And I guess I don't really like talk a ton about where we're no, you really don't.

SPEAKER_00

I'm hearing things that I just I mean, because all of this stuff has happened while I've known you. So like I mean, with the exception of like the DC stuff.

SPEAKER_01

I think when we met, I was when we met, I was finishing my PhD.

SPEAKER_00

You were still at you were still at St. Louis. Were you commuting back and forth from it here today?

SPEAKER_01

Yeah, I was yeah, because I moved before I moved back to Chicago while I was writing my dissertation. So I think that's probably when I met you, like around that time.

SPEAKER_00

What was your dissertation on?

SPEAKER_01

My dissertation was like so arcane. It was on like public engagement in the process of research ethics oversight.

SPEAKER_00

Well, those are a lot of words.

SPEAKER_01

Yeah.

SPEAKER_00

Uh and also one of the other amazing things is that Emily is the only, literally the only person in the history of all time that graduated from Notre Dame that doesn't casually mention that they went to Notre Dame every five minutes.

SPEAKER_01

Well that's not true. I we went the entire time. You know other you know multiple other people who graduated from Notre Dame.

SPEAKER_00

That don't talk about it?

SPEAKER_01

I don't think so.

SPEAKER_00

Who who graduated from Notre Dame that I wouldn't I don't know I wouldn't.

SPEAKER_01

Chris Norberg.

SPEAKER_00

I knew he went there.

SPEAKER_01

But he doesn't casually say it all the time.

SPEAKER_00

No, but I knew he went there.

SPEAKER_01

I'm just saying that you you well, you just don't I normally high I normally don't don't talk about it because it generally invites conversations about football that I am then not able to engage in and sometimes disappoint people with my lack of a football fandom.

SPEAKER_00

Yeah. My my relationship to Notre Dame as a college institution is that a lot of my previous clients went there. And so I used to have to play the Notre Dame fight song a lot at weddings.

SPEAKER_01

Yeah. I'm sorry for that. I apologize.

SPEAKER_00

So, Emily, as you guys can tell, she's a doctor of healthcare ethics.

SPEAKER_01

Yeah, also known as bioethics, but my degree is specifically called healthcare ethics.

SPEAKER_00

I like bioethics. It sounds like badass. It sounds like you're gonna like in a movie. Yeah, but it sounds like you're being brought in during a movie to like figure out the pathogen that's infecting everybody. Have you watched a Pluribus at all?

SPEAKER_01

Yes. Uh I have watched we've watched four episodes. So yeah, it's uh the all my colleagues are watching it. We love to talk about pleuribus and severance. Yes.

SPEAKER_00

Severance? Oh, god, that we could just do this forever. I could talk that would have been a really interesting conversation.

SPEAKER_01

I'll I'll I'll I'll share with you. There's a bioethics book about Orphan Black. Somebody I know is writing one about a bio like bioethics and severance. Really? Yeah.

SPEAKER_00

Like, are they interesting books? Like, could like non-bioethicists read it?

SPEAKER_01

So I feel like the Orphan Black one was pretty was pretty accessible.

SPEAKER_00

The Orphan B Orphan Black was one of my favorite shows. Yeah, me too. Like Hans, what happened to her? Where has she been? Yeah, where has she been? She can't play like 15 characters.

SPEAKER_01

Tatiana Maslansky.

SPEAKER_00

Maslani. Maslani. All right. Well, thank you so much for coming and everybody for tuning in and bye. Thanks for listening to All of the Millady Business with me, Mary. Uh, we'd love for you to like, review, subscribe, follow us to All of the Millady Business on the RAM. And if you're a female identifying person and you want to dance, you can follow us. I mean, everybody can follow us, but if you want to be a part of the magic bad hot watch dance party, for the find out where our next parts of the video, if you want to be hot area, or anywhere else. You know, money's same color everywhere. Why is that? Twitchcommunity.com has the butt. And listen to my radio show at the radio show on trip radio at trip radio.org. That's Monday. Every Monday called Today's episode is pretty data. Alright, guys, peace out.