{"version":"1.0.0","segments":[{"speaker":"Charles Goldfarb","startTime":5.25,"endTime":7.44,"body":"Welcome to the"},{"speaker":"Charles Goldfarb","startTime":5.25,"endTime":7.44,"body":"Upper Hand Podcast where Chuck"},{"speaker":"Charles Goldfarb","startTime":7.47,"endTime":8.85,"body":"and Chris talk hand surgery."},{"speaker":"Chris Dy","startTime":9.51,"endTime":11.43,"body":"We are two hand"},{"speaker":"Chris Dy","startTime":9.51,"endTime":11.43,"body":"surgeons at Washington"},{"speaker":"Chris Dy","startTime":11.43,"endTime":14.37,"body":"University in St. Louis here to"},{"speaker":"Chris Dy","startTime":11.43,"endTime":14.37,"body":"talk about all things hand"},{"speaker":"Chris Dy","startTime":14.37,"endTime":16.59,"body":"surgery related from technical"},{"speaker":"Chris Dy","startTime":14.37,"endTime":16.59,"body":"to personal."},{"speaker":"Charles Goldfarb","startTime":17.13,"endTime":19.02,"body":"Please"},{"speaker":"Charles Goldfarb","startTime":17.13,"endTime":19.02,"body":"subscribe, wherever you get your"},{"speaker":"Charles Goldfarb","startTime":19.02,"endTime":19.8,"body":"podcasts"},{"speaker":"Chris Dy","startTime":20.4,"endTime":23.28,"body":"Thank you in advance"},{"speaker":"Chris Dy","startTime":20.4,"endTime":23.28,"body":"for leaving a review and rating"},{"speaker":"Chris Dy","startTime":23.31,"endTime":26.01,"body":"that helps us get the word out."},{"speaker":"Chris Dy","startTime":23.31,"endTime":26.01,"body":"You can email us at"},{"speaker":"Chris Dy","startTime":26.04,"endTime":29.46,"body":"Handpodcast@gmail.com. So let's"},{"speaker":"Chris Dy","startTime":26.04,"endTime":29.46,"body":"get to the episode."},{"speaker":"Charles Goldfarb","startTime":30.75,"endTime":31.65,"body":"Oh, hey,"},{"speaker":"Charles Goldfarb","startTime":30.75,"endTime":31.65,"body":"Chris."},{"speaker":"Chris Dy","startTime":31.98,"endTime":32.82,"body":"Hey, Chuck, how are"},{"speaker":"Chris Dy","startTime":31.98,"endTime":32.82,"body":"you?"},{"speaker":"Charles Goldfarb","startTime":33.27,"endTime":36.99,"body":"I'm good. I'm"},{"speaker":"Charles Goldfarb","startTime":33.27,"endTime":36.99,"body":"good. It's new for us recording"},{"speaker":"Charles Goldfarb","startTime":37.02,"endTime":41.31,"body":"on a Saturday afternoon, the day"},{"speaker":"Charles Goldfarb","startTime":37.02,"endTime":41.31,"body":"before the pod drops, right?"},{"speaker":"Chris Dy","startTime":41.34,"endTime":43.8,"body":"This is right up to"},{"speaker":"Chris Dy","startTime":41.34,"endTime":43.8,"body":"the wire. Usually we kind of get"},{"speaker":"Chris Dy","startTime":43.8,"endTime":46.56,"body":"things, you know, tucked away"},{"speaker":"Chris Dy","startTime":43.8,"endTime":46.56,"body":"early on. But you know, we"},{"speaker":"Chris Dy","startTime":46.56,"endTime":48.54,"body":"wanted to give people something"},{"speaker":"Chris Dy","startTime":46.56,"endTime":48.54,"body":"super fresh."},{"speaker":"Charles Goldfarb","startTime":49.17,"endTime":51.0,"body":"Yeah,"},{"speaker":"Charles Goldfarb","startTime":49.17,"endTime":51.0,"body":"absolutely. I feel like I hadn't"},{"speaker":"Charles Goldfarb","startTime":51.0,"endTime":52.77,"body":"seen you in person in a while,"},{"speaker":"Charles Goldfarb","startTime":51.0,"endTime":52.77,"body":"either."},{"speaker":"Chris Dy","startTime":52.95,"endTime":55.08,"body":"Well that's because"},{"speaker":"Chris Dy","startTime":52.95,"endTime":55.08,"body":"you haven't seen. We haven't"},{"speaker":"Chris Dy","startTime":55.08,"endTime":58.77,"body":"seen each other in a long time."},{"speaker":"Chris Dy","startTime":55.08,"endTime":58.77,"body":"It's been a while. You know, so"},{"speaker":"Chris Dy","startTime":58.77,"endTime":61.77,"body":"you've been, you know, you've"},{"speaker":"Chris Dy","startTime":58.77,"endTime":61.77,"body":"been globe trotting, doing quite"},{"speaker":"Chris Dy","startTime":61.77,"endTime":63.87,"body":"a bit of a work overseas. Is"},{"speaker":"Chris Dy","startTime":61.77,"endTime":63.87,"body":"that right?"},{"speaker":"Charles Goldfarb","startTime":64.08,"endTime":65.79,"body":"Yeah, we"},{"speaker":"Charles Goldfarb","startTime":64.08,"endTime":65.79,"body":"should talk about that. We"},{"speaker":"Charles Goldfarb","startTime":65.79,"endTime":69.87,"body":"should talk about your travels."},{"speaker":"Charles Goldfarb","startTime":65.79,"endTime":69.87,"body":"And yeah, I think we you and I"},{"speaker":"Charles Goldfarb","startTime":69.87,"endTime":72.18,"body":"have talked about what we could"},{"speaker":"Charles Goldfarb","startTime":69.87,"endTime":72.18,"body":"accomplish in this pod. And"},{"speaker":"Charles Goldfarb","startTime":72.18,"endTime":74.58,"body":"maybe we have a couple of"},{"speaker":"Charles Goldfarb","startTime":72.18,"endTime":74.58,"body":"interesting cases we can go"},{"speaker":"Charles Goldfarb","startTime":74.58,"endTime":76.74,"body":"through that are new and"},{"speaker":"Charles Goldfarb","startTime":74.58,"endTime":76.74,"body":"different for at least for"},{"speaker":"Charles Goldfarb","startTime":76.74,"endTime":77.4,"body":"discussion."},{"speaker":"Chris Dy","startTime":77.88,"endTime":79.5,"body":"Yeah, no, I think we"},{"speaker":"Chris Dy","startTime":77.88,"endTime":79.5,"body":"have some great cases to"},{"speaker":"Chris Dy","startTime":79.5,"endTime":83.46,"body":"discuss. I'd love to hear about"},{"speaker":"Chris Dy","startTime":79.5,"endTime":83.46,"body":"what you've been doing. And I"},{"speaker":"Chris Dy","startTime":83.46,"endTime":86.28,"body":"just came back from somewhere"},{"speaker":"Chris Dy","startTime":83.46,"endTime":86.28,"body":"about to go somewhere else. So"},{"speaker":"Chris Dy","startTime":86.94,"endTime":90.33,"body":"yeah, it's really interesting"},{"speaker":"Chris Dy","startTime":86.94,"endTime":90.33,"body":"that I don't know how much maybe"},{"speaker":"Chris Dy","startTime":90.33,"endTime":93.72,"body":"not where you just went. But the"},{"speaker":"Chris Dy","startTime":90.33,"endTime":93.72,"body":"podcast has a very far reach."},{"speaker":"Chris Dy","startTime":93.75,"endTime":96.39,"body":"And you know, there are a lot of"},{"speaker":"Chris Dy","startTime":93.75,"endTime":96.39,"body":"people that really enjoy it."},{"speaker":"Chris Dy","startTime":96.39,"endTime":99.63,"body":"And, you know, I really"},{"speaker":"Chris Dy","startTime":96.39,"endTime":99.63,"body":"appreciate when people come up"},{"speaker":"Chris Dy","startTime":99.63,"endTime":102.18,"body":"and say how much they enjoy the"},{"speaker":"Chris Dy","startTime":99.63,"endTime":102.18,"body":"podcast and what they've"},{"speaker":"Chris Dy","startTime":102.18,"endTime":107.04,"body":"learned. And you know, why? Why"},{"speaker":"Chris Dy","startTime":102.18,"endTime":107.04,"body":"it helps. So, I am a big as I've"},{"speaker":"Chris Dy","startTime":107.04,"endTime":110.13,"body":"learned over the years, my love"},{"speaker":"Chris Dy","startTime":107.04,"endTime":110.13,"body":"language, I'd like to receive"},{"speaker":"Chris Dy","startTime":110.13,"endTime":113.1,"body":"his words of affirmation. So if"},{"speaker":"Chris Dy","startTime":110.13,"endTime":113.1,"body":"you're out there, keep telling"},{"speaker":"Chris Dy","startTime":113.1,"endTime":114.0,"body":"us how much you love it."},{"speaker":"Charles Goldfarb","startTime":115.47,"endTime":117.93,"body":"There's so"},{"speaker":"Charles Goldfarb","startTime":115.47,"endTime":117.93,"body":"much truth to that, because we"},{"speaker":"Charles Goldfarb","startTime":117.93,"endTime":121.26,"body":"need that affirmation, because I"},{"speaker":"Charles Goldfarb","startTime":117.93,"endTime":121.26,"body":"think we're both at least"},{"speaker":"Charles Goldfarb","startTime":121.26,"endTime":125.22,"body":"somewhat busy. And it's hard to"},{"speaker":"Charles Goldfarb","startTime":121.26,"endTime":125.22,"body":"keep this card to keep the pie"},{"speaker":"Charles Goldfarb","startTime":125.22,"endTime":129.9,"body":"going. But I think it is a"},{"speaker":"Charles Goldfarb","startTime":125.22,"endTime":129.9,"body":"passion for both of us. And it"},{"speaker":"Charles Goldfarb","startTime":129.93,"endTime":135.06,"body":"the little things matter. For"},{"speaker":"Charles Goldfarb","startTime":129.93,"endTime":135.06,"body":"example, the way podcast"},{"speaker":"Charles Goldfarb","startTime":135.09,"endTime":138.36,"body":"listeners are calculated are now"},{"speaker":"Charles Goldfarb","startTime":135.09,"endTime":138.36,"body":"different than they were six"},{"speaker":"Charles Goldfarb","startTime":138.36,"endTime":141.78,"body":"months ago. And even that type"},{"speaker":"Charles Goldfarb","startTime":138.36,"endTime":141.78,"body":"of stuff kind of makes you makes"},{"speaker":"Charles Goldfarb","startTime":141.78,"endTime":145.2,"body":"you second guessed the impact"},{"speaker":"Charles Goldfarb","startTime":141.78,"endTime":145.2,"body":"that we're having. But when"},{"speaker":"Charles Goldfarb","startTime":145.2,"endTime":147.9,"body":"someone speaks to the impact, it"},{"speaker":"Charles Goldfarb","startTime":145.2,"endTime":147.9,"body":"says everything,"},{"speaker":"Chris Dy","startTime":148.29,"endTime":150.18,"body":"right? Absolutely mean"},{"speaker":"Chris Dy","startTime":148.29,"endTime":150.18,"body":"literally every place that we"},{"speaker":"Chris Dy","startTime":150.18,"endTime":152.85,"body":"go, I'm sure you hear to"},{"speaker":"Chris Dy","startTime":150.18,"endTime":152.85,"body":"somebody who's like I see you."},{"speaker":"Chris Dy","startTime":152.88,"endTime":155.73,"body":"I'm sure you hear us all time,"},{"speaker":"Chris Dy","startTime":152.88,"endTime":155.73,"body":"but we love the podcast, and it,"},{"speaker":"Chris Dy","startTime":155.79,"endTime":159.66,"body":"it really does help to know that"},{"speaker":"Chris Dy","startTime":155.79,"endTime":159.66,"body":"we're reaching people. So you"},{"speaker":"Chris Dy","startTime":159.66,"endTime":162.18,"body":"know, we do like to hear from"},{"speaker":"Chris Dy","startTime":159.66,"endTime":162.18,"body":"folks. So send us your"},{"speaker":"Chris Dy","startTime":162.18,"endTime":164.91,"body":"questions, your comments. You"},{"speaker":"Chris Dy","startTime":162.18,"endTime":164.91,"body":"know, we've had some really"},{"speaker":"Chris Dy","startTime":164.91,"endTime":168.33,"body":"great episodes come from people"},{"speaker":"Chris Dy","startTime":164.91,"endTime":168.33,"body":"emailing and writing in. And"},{"speaker":"Chris Dy","startTime":168.33,"endTime":170.31,"body":"yeah, you're right. I mean, I"},{"speaker":"Chris Dy","startTime":168.33,"endTime":170.31,"body":"think the metrics are changing."},{"speaker":"Chris Dy","startTime":170.31,"endTime":172.53,"body":"And, you know, maybe we should"},{"speaker":"Chris Dy","startTime":170.31,"endTime":172.53,"body":"change to meet the metrics. But"},{"speaker":"Chris Dy","startTime":172.53,"endTime":176.43,"body":"I think we do what we love, and"},{"speaker":"Chris Dy","startTime":172.53,"endTime":176.43,"body":"we love what we do. And it is"},{"speaker":"Chris Dy","startTime":176.43,"endTime":179.61,"body":"really honestly super fun once"},{"speaker":"Chris Dy","startTime":176.43,"endTime":179.61,"body":"we find the time to do it."},{"speaker":"Charles Goldfarb","startTime":180.09,"endTime":182.7,"body":"Yeah, exactly."},{"speaker":"Charles Goldfarb","startTime":180.09,"endTime":182.7,"body":"Right. So let's start I'd love"},{"speaker":"Charles Goldfarb","startTime":182.7,"endTime":187.02,"body":"to hear first about your recent"},{"speaker":"Charles Goldfarb","startTime":182.7,"endTime":187.02,"body":"travels and your upcoming"},{"speaker":"Charles Goldfarb","startTime":187.02,"endTime":191.85,"body":"travels. You know, no food"},{"speaker":"Charles Goldfarb","startTime":187.02,"endTime":191.85,"body":"related travels, hopefully just"},{"speaker":"Charles Goldfarb","startTime":191.88,"endTime":193.05,"body":"work related travels."},{"speaker":"Chris Dy","startTime":193.0,"endTime":196.9,"body":"I did sneak some food"},{"speaker":"Chris Dy","startTime":193.0,"endTime":196.9,"body":"in but no, I was. I had the"},{"speaker":"Chris Dy","startTime":196.9,"endTime":200.83,"body":"honor of being invited to the UT"},{"speaker":"Chris Dy","startTime":196.9,"endTime":200.83,"body":"Houston orthopedic residency as"},{"speaker":"Chris Dy","startTime":200.83,"endTime":204.79,"body":"their visiting professor. It was"},{"speaker":"Chris Dy","startTime":200.83,"endTime":204.79,"body":"super fun. I did not realize how"},{"speaker":"Chris Dy","startTime":204.79,"endTime":207.82,"body":"big that department has become"},{"speaker":"Chris Dy","startTime":204.79,"endTime":207.82,"body":"and really how much they've"},{"speaker":"Chris Dy","startTime":207.82,"endTime":210.25,"body":"changed since when I was a"},{"speaker":"Chris Dy","startTime":207.82,"endTime":210.25,"body":"medical student looking at that"},{"speaker":"Chris Dy","startTime":210.25,"endTime":214.27,"body":"program. I looked at the roster"},{"speaker":"Chris Dy","startTime":210.25,"endTime":214.27,"body":"and saw just how many like first"},{"speaker":"Chris Dy","startTime":214.27,"endTime":216.46,"body":"off how big it is and their"},{"speaker":"Chris Dy","startTime":214.27,"endTime":216.46,"body":"reach and just like every"},{"speaker":"Chris Dy","startTime":216.46,"endTime":220.33,"body":"academic medical center and"},{"speaker":"Chris Dy","startTime":216.46,"endTime":220.33,"body":"department looking to expand"},{"speaker":"Chris Dy","startTime":220.33,"endTime":222.94,"body":"their reach through, you know,"},{"speaker":"Chris Dy","startTime":220.33,"endTime":222.94,"body":"through outpatient surgery"},{"speaker":"Chris Dy","startTime":222.94,"endTime":226.69,"body":"centers and satellites, you"},{"speaker":"Chris Dy","startTime":222.94,"endTime":226.69,"body":"know, et cetera. But then just"},{"speaker":"Chris Dy","startTime":226.72,"endTime":230.08,"body":"so many people that are"},{"speaker":"Chris Dy","startTime":226.72,"endTime":230.08,"body":"recognized along the way, so I"},{"speaker":"Chris Dy","startTime":230.08,"endTime":233.14,"body":"had a great time. I shared some"},{"speaker":"Chris Dy","startTime":230.08,"endTime":233.14,"body":"stories about how I met my wife"},{"speaker":"Chris Dy","startTime":233.14,"endTime":236.77,"body":"in Houston and when we were both"},{"speaker":"Chris Dy","startTime":233.14,"endTime":236.77,"body":"17 years old and how we got"},{"speaker":"Chris Dy","startTime":236.77,"endTime":239.14,"body":"married in Houston. I spent a"},{"speaker":"Chris Dy","startTime":236.77,"endTime":239.14,"body":"year in Houston enjoyed going to"},{"speaker":"Chris Dy","startTime":239.14,"endTime":242.56,"body":"Houston Rockets games and the"},{"speaker":"Chris Dy","startTime":239.14,"endTime":242.56,"body":"Yao Ming Shane Battier era;"},{"speaker":"Chris Dy","startTime":242.65,"endTime":246.04,"body":"McGrady was there too. So it was"},{"speaker":"Chris Dy","startTime":242.65,"endTime":246.04,"body":"it was super fun to see"},{"speaker":"Chris Dy","startTime":246.04,"endTime":249.28,"body":"everybody and you know, gave a"},{"speaker":"Chris Dy","startTime":246.04,"endTime":249.28,"body":"couple of talks, got to have a"},{"speaker":"Chris Dy","startTime":249.28,"endTime":251.86,"body":"really great dinner with some of"},{"speaker":"Chris Dy","startTime":249.28,"endTime":251.86,"body":"the residents, one of whom just"},{"speaker":"Chris Dy","startTime":251.86,"endTime":255.34,"body":"matched in the hand. So shout at"},{"speaker":"Chris Dy","startTime":251.86,"endTime":255.34,"body":"the Shireen going to Philly for"},{"speaker":"Chris Dy","startTime":255.34,"endTime":259.3,"body":"her hand fellowship. And, you"},{"speaker":"Chris Dy","startTime":255.34,"endTime":259.3,"body":"know, we got to hang out with"},{"speaker":"Chris Dy","startTime":259.3,"endTime":262.48,"body":"Hayden, who's going to be"},{"speaker":"Chris Dy","startTime":259.3,"endTime":262.48,"body":"applying next year. So it was it"},{"speaker":"Chris Dy","startTime":262.48,"endTime":267.37,"body":"was really fun saw some friends"},{"speaker":"Chris Dy","startTime":262.48,"endTime":267.37,"body":"James Saucedo Dean Smith, it was"},{"speaker":"Chris Dy","startTime":267.37,"endTime":270.13,"body":"great. It's always fun to kind"},{"speaker":"Chris Dy","startTime":267.37,"endTime":270.13,"body":"of share the how we approach"},{"speaker":"Chris Dy","startTime":270.13,"endTime":273.58,"body":"things in last few and you know,"},{"speaker":"Chris Dy","startTime":270.13,"endTime":273.58,"body":"give it give a case presentation"},{"speaker":"Chris Dy","startTime":273.58,"endTime":276.19,"body":"and try to keep things spicy for"},{"speaker":"Chris Dy","startTime":273.58,"endTime":276.19,"body":"the residents during their"},{"speaker":"Chris Dy","startTime":276.19,"endTime":276.67,"body":"rounds."},{"speaker":"Charles Goldfarb","startTime":277.39,"endTime":280.33,"body":"I have two"},{"speaker":"Charles Goldfarb","startTime":277.39,"endTime":280.33,"body":"questions. I know you've missed"},{"speaker":"Charles Goldfarb","startTime":280.33,"endTime":284.26,"body":"that. Two questions. First. What"},{"speaker":"Charles Goldfarb","startTime":280.33,"endTime":284.26,"body":"are you there for the 100 mile"},{"speaker":"Charles Goldfarb","startTime":284.26,"endTime":287.77,"body":"an hour winds and this crazy"},{"speaker":"Charles Goldfarb","startTime":284.26,"endTime":287.77,"body":"storm I read about so"},{"speaker":"Chris Dy","startTime":287.77,"endTime":290.89,"body":"I got out I guess a"},{"speaker":"Chris Dy","startTime":287.77,"endTime":290.89,"body":"few hours before the reason that"},{"speaker":"Chris Dy","startTime":290.89,"endTime":294.4,"body":"I heard about it is that our I"},{"speaker":"Chris Dy","startTime":290.89,"endTime":294.4,"body":"guess my friend James Saucedo"},{"speaker":"Chris Dy","startTime":294.43,"endTime":297.79,"body":"who I met when I was way back"},{"speaker":"Chris Dy","startTime":294.43,"endTime":297.79,"body":"when doing research down there."},{"speaker":"Chris Dy","startTime":298.0,"endTime":300.82,"body":"He's on faculty there now and he"},{"speaker":"Chris Dy","startTime":298.0,"endTime":300.82,"body":"had texted Uh, both me and"},{"speaker":"Chris Dy","startTime":300.82,"endTime":304.66,"body":"Daniel say about something. And"},{"speaker":"Chris Dy","startTime":300.82,"endTime":304.66,"body":"Dan was like, Hey, how the"},{"speaker":"Chris Dy","startTime":304.66,"endTime":307.36,"body":"pictures look crazy down there."},{"speaker":"Chris Dy","startTime":304.66,"endTime":307.36,"body":"I was like, what happened? I"},{"speaker":"Chris Dy","startTime":307.36,"endTime":309.7,"body":"didn't see any of this. So I"},{"speaker":"Chris Dy","startTime":307.36,"endTime":309.7,"body":"learned about the weather"},{"speaker":"Chris Dy","startTime":309.7,"endTime":313.45,"body":"afterwards after I got back home"},{"speaker":"Chris Dy","startTime":309.7,"endTime":313.45,"body":"to St. Louis. Yeah, something."},{"speaker":"Charles Goldfarb","startTime":314.71,"endTime":316.18,"body":"And then it"},{"speaker":"Charles Goldfarb","startTime":314.71,"endTime":316.18,"body":"goes from there still power"},{"speaker":"Charles Goldfarb","startTime":316.18,"endTime":319.69,"body":"outages and yet it's 100"},{"speaker":"Charles Goldfarb","startTime":316.18,"endTime":319.69,"body":"degrees there. So it's not a"},{"speaker":"Charles Goldfarb","startTime":319.69,"endTime":322.03,"body":"great time for Houston. Houston"},{"speaker":"Charles Goldfarb","startTime":319.69,"endTime":322.03,"body":"had some rough go with the"},{"speaker":"Charles Goldfarb","startTime":322.03,"endTime":323.05,"body":"weather. Yeah,"},{"speaker":"Chris Dy","startTime":323.1,"endTime":324.63,"body":"they had that crazy"},{"speaker":"Chris Dy","startTime":323.1,"endTime":324.63,"body":"thing where all the toilets"},{"speaker":"Chris Dy","startTime":324.63,"endTime":328.23,"body":"froze a few years ago. I mean,"},{"speaker":"Chris Dy","startTime":324.63,"endTime":328.23,"body":"it's, it's insane. But it's got"},{"speaker":"Chris Dy","startTime":328.23,"endTime":330.48,"body":"a soft spot where I had a really"},{"speaker":"Chris Dy","startTime":328.23,"endTime":330.48,"body":"good time. So I really wanted to"},{"speaker":"Chris Dy","startTime":330.48,"endTime":333.57,"body":"thank that program at Houston"},{"speaker":"Chris Dy","startTime":330.48,"endTime":333.57,"body":"for inviting me out. They have a"},{"speaker":"Chris Dy","startTime":333.57,"endTime":336.0,"body":"really great energy down there"},{"speaker":"Chris Dy","startTime":333.57,"endTime":336.0,"body":"and I really enjoyed it."},{"speaker":"Charles Goldfarb","startTime":336.27,"endTime":339.27,"body":"And what"},{"speaker":"Charles Goldfarb","startTime":336.27,"endTime":339.27,"body":"aspect forgive me if I'm wrong,"},{"speaker":"Charles Goldfarb","startTime":339.27,"endTime":342.27,"body":"what aspect of nerve surgery did"},{"speaker":"Charles Goldfarb","startTime":339.27,"endTime":342.27,"body":"you discuss?"},{"speaker":"Chris Dy","startTime":342.78,"endTime":346.29,"body":"I have a fun talk that"},{"speaker":"Chris Dy","startTime":342.78,"endTime":346.29,"body":"I like to give about, you know,"},{"speaker":"Chris Dy","startTime":346.32,"endTime":351.03,"body":"common issues or you could say"},{"speaker":"Chris Dy","startTime":346.32,"endTime":351.03,"body":"complications after orthopedic"},{"speaker":"Chris Dy","startTime":351.03,"endTime":353.49,"body":"surgeries are common with big"},{"speaker":"Chris Dy","startTime":351.03,"endTime":353.49,"body":"surgeries. I feel like that's a"},{"speaker":"Chris Dy","startTime":353.97,"endTime":356.67,"body":"if I was coming in and giving a"},{"speaker":"Chris Dy","startTime":353.97,"endTime":356.67,"body":"grand rounds. I wanted to find"},{"speaker":"Chris Dy","startTime":356.67,"endTime":359.58,"body":"something that was applicable to"},{"speaker":"Chris Dy","startTime":356.67,"endTime":359.58,"body":"a lot of people, not just the"},{"speaker":"Chris Dy","startTime":359.58,"endTime":361.74,"body":"hand surgeons out there. So"},{"speaker":"Chris Dy","startTime":359.58,"endTime":361.74,"body":"there was all sorts of cases"},{"speaker":"Chris Dy","startTime":361.74,"endTime":364.59,"body":"there's peds, you know, shoulder"},{"speaker":"Chris Dy","startTime":361.74,"endTime":364.59,"body":"arthroplasty, sports"},{"speaker":"Chris Dy","startTime":364.59,"endTime":367.5,"body":"arthroscopy, hip, and knee"},{"speaker":"Chris Dy","startTime":364.59,"endTime":367.5,"body":"arthroplasty. It's all the"},{"speaker":"Chris Dy","startTime":367.5,"endTime":370.44,"body":"issues that can come up, which I"},{"speaker":"Chris Dy","startTime":367.5,"endTime":370.44,"body":"love about nerve and being a"},{"speaker":"Chris Dy","startTime":370.44,"endTime":373.05,"body":"hand surgeon, you kind of get to"},{"speaker":"Chris Dy","startTime":370.44,"endTime":373.05,"body":"go anywhere and do everything."},{"speaker":"Chris Dy","startTime":373.47,"endTime":376.02,"body":"So that was good talking to give"},{"speaker":"Chris Dy","startTime":373.47,"endTime":376.02,"body":"another talk about controversies"},{"speaker":"Chris Dy","startTime":376.02,"endTime":378.99,"body":"and ulnar nerve management, both"},{"speaker":"Chris Dy","startTime":376.02,"endTime":378.99,"body":"for compressive neuropathy and"},{"speaker":"Chris Dy","startTime":378.99,"endTime":382.32,"body":"for trauma. So that great case"},{"speaker":"Chris Dy","startTime":378.99,"endTime":382.32,"body":"discussions and they presented"},{"speaker":"Chris Dy","startTime":382.32,"endTime":385.98,"body":"some very interesting cases. And"},{"speaker":"Chris Dy","startTime":382.32,"endTime":385.98,"body":"one of which was actually a case"},{"speaker":"Chris Dy","startTime":385.98,"endTime":388.56,"body":"from one of our former"},{"speaker":"Chris Dy","startTime":385.98,"endTime":388.56,"body":"residents. Erica Giles, who is"},{"speaker":"Chris Dy","startTime":388.56,"endTime":392.55,"body":"now a tumor attending down"},{"speaker":"Chris Dy","startTime":388.56,"endTime":392.55,"body":"there. So it was really fun. Ah,"},{"speaker":"Charles Goldfarb","startTime":392.58,"endTime":394.62,"body":"sounds sounds"},{"speaker":"Charles Goldfarb","startTime":392.58,"endTime":394.62,"body":"great. And where are you off to"},{"speaker":"Charles Goldfarb","startTime":394.62,"endTime":397.44,"body":"next? are you stopping to see a"},{"speaker":"Charles Goldfarb","startTime":394.62,"endTime":397.44,"body":"few patients in St. Louis? Are"},{"speaker":"Charles Goldfarb","startTime":397.44,"endTime":398.64,"body":"you just heading out again?"},{"speaker":"Chris Dy","startTime":399.47,"endTime":402.89,"body":"Oh, I had a clinic"},{"speaker":"Chris Dy","startTime":399.47,"endTime":402.89,"body":"yesterday. It was it was a"},{"speaker":"Chris Dy","startTime":402.89,"endTime":408.29,"body":"banger as they say. It was busy."},{"speaker":"Chris Dy","startTime":402.89,"endTime":408.29,"body":"I was doing the solo clinic life"},{"speaker":"Chris Dy","startTime":408.29,"endTime":412.91,"body":"and it was uh, it was intense."},{"speaker":"Chris Dy","startTime":408.29,"endTime":412.91,"body":"But it was good. I saw a lot of"},{"speaker":"Chris Dy","startTime":412.91,"endTime":416.48,"body":"patients got a lot of good"},{"speaker":"Chris Dy","startTime":412.91,"endTime":416.48,"body":"follow up. You know, had a I had"},{"speaker":"Chris Dy","startTime":416.48,"endTime":419.36,"body":"a good time. And then, you know,"},{"speaker":"Chris Dy","startTime":416.48,"endTime":419.36,"body":"working this week, and then I'm"},{"speaker":"Chris Dy","startTime":419.36,"endTime":420.23,"body":"heading to Singapore."},{"speaker":"Charles Goldfarb","startTime":421.04,"endTime":423.23,"body":"Oh that's"},{"speaker":"Charles Goldfarb","startTime":421.04,"endTime":423.23,"body":"right now is this this is part"},{"speaker":"Charles Goldfarb","startTime":423.23,"endTime":424.22,"body":"work part family."},{"speaker":"Chris Dy","startTime":425.13,"endTime":427.59,"body":"Yeah, so the first"},{"speaker":"Chris Dy","startTime":425.13,"endTime":427.59,"body":"half is work. I was invited by"},{"speaker":"Chris Dy","startTime":427.59,"endTime":430.83,"body":"the group out there a shoo in"},{"speaker":"Chris Dy","startTime":427.59,"endTime":430.83,"body":"our friend. And a couple other"},{"speaker":"Chris Dy","startTime":430.83,"endTime":434.7,"body":"folks invited me to do a"},{"speaker":"Chris Dy","startTime":430.83,"endTime":434.7,"body":"research seminar with none other"},{"speaker":"Chris Dy","startTime":434.7,"endTime":438.54,"body":"than famous hand surgeon Kevin"},{"speaker":"Chris Dy","startTime":434.7,"endTime":438.54,"body":"Chung. So we're doing a two day"},{"speaker":"Chris Dy","startTime":438.54,"endTime":441.51,"body":"research seminar. They are"},{"speaker":"Chris Dy","startTime":438.54,"endTime":441.51,"body":"definitely getting their bang"},{"speaker":"Chris Dy","startTime":441.51,"endTime":444.12,"body":"for their buck. I'm giving I"},{"speaker":"Chris Dy","startTime":441.51,"endTime":444.12,"body":"think, three or four talks and"},{"speaker":"Chris Dy","startTime":444.12,"endTime":446.67,"body":"having to you know, kind of"},{"speaker":"Chris Dy","startTime":444.12,"endTime":446.67,"body":"workshop and mentor some people"},{"speaker":"Chris Dy","startTime":446.67,"endTime":449.52,"body":"and it's gonna be exciting. It's"},{"speaker":"Chris Dy","startTime":446.67,"endTime":449.52,"body":"gonna be fun. Sure, I'll be"},{"speaker":"Chris Dy","startTime":449.52,"endTime":451.74,"body":"doing the majority of my work on"},{"speaker":"Chris Dy","startTime":449.52,"endTime":451.74,"body":"the plane on the way there."},{"speaker":"Chris Dy","startTime":452.58,"endTime":452.97,"body":"Yeah,"},{"speaker":"Charles Goldfarb","startTime":453.0,"endTime":455.13,"body":"yeah. Well,"},{"speaker":"Charles Goldfarb","startTime":453.0,"endTime":455.13,"body":"that that's, that's great. I"},{"speaker":"Charles Goldfarb","startTime":455.13,"endTime":457.74,"body":"know, you guys will have a good"},{"speaker":"Charles Goldfarb","startTime":455.13,"endTime":457.74,"body":"time. And it's a family just"},{"speaker":"Charles Goldfarb","startTime":457.74,"endTime":459.93,"body":"staying in the Singapore"},{"speaker":"Charles Goldfarb","startTime":457.74,"endTime":459.93,"body":"specific area, you guys"},{"speaker":"Chris Dy","startTime":461.22,"endTime":463.35,"body":"just in Singapore. And"},{"speaker":"Chris Dy","startTime":461.22,"endTime":463.35,"body":"that's more than enough for us"},{"speaker":"Chris Dy","startTime":463.35,"endTime":465.3,"body":"and the kids are going to have a"},{"speaker":"Chris Dy","startTime":463.35,"endTime":465.3,"body":"good time. We've got some family"},{"speaker":"Chris Dy","startTime":465.3,"endTime":469.14,"body":"out in Malaysia, so they'll see"},{"speaker":"Chris Dy","startTime":465.3,"endTime":469.14,"body":"them and yeah, it's gonna be a"},{"speaker":"Chris Dy","startTime":469.14,"endTime":471.99,"body":"whirlwind trip, though. We're"},{"speaker":"Chris Dy","startTime":469.14,"endTime":471.99,"body":"looking forward to it. Hopefully"},{"speaker":"Chris Dy","startTime":471.99,"endTime":475.83,"body":"all the flights go okay. And so"},{"speaker":"Chris Dy","startTime":471.99,"endTime":475.83,"body":"often, but before I want to hear"},{"speaker":"Chris Dy","startTime":475.83,"endTime":479.07,"body":"about your recent trip, and"},{"speaker":"Chris Dy","startTime":475.83,"endTime":479.07,"body":"we've got those cases to get to,"},{"speaker":"Chris Dy","startTime":479.07,"endTime":481.53,"body":"but before we do that, we should"},{"speaker":"Chris Dy","startTime":479.07,"endTime":481.53,"body":"probably give her a shout out to"},{"speaker":"Chris Dy","startTime":481.53,"endTime":482.55,"body":"our friends at practice, Link."},{"speaker":"Charles Goldfarb","startTime":482.76,"endTime":484.56,"body":"Absolutely."},{"speaker":"Charles Goldfarb","startTime":482.76,"endTime":484.56,"body":"The upper hand is sponsored by"},{"speaker":"Charles Goldfarb","startTime":484.56,"endTime":487.98,"body":"practice link.com, the most"},{"speaker":"Charles Goldfarb","startTime":484.56,"endTime":487.98,"body":"widely used physician job search"},{"speaker":"Charles Goldfarb","startTime":488.1,"endTime":490.11,"body":"and career advancement resource."},{"speaker":"Chris Dy","startTime":490.41,"endTime":492.87,"body":"Becoming a physician"},{"speaker":"Chris Dy","startTime":490.41,"endTime":492.87,"body":"is hard finding the right job"},{"speaker":"Chris Dy","startTime":492.87,"endTime":496.77,"body":"doesn't have to be joined"},{"speaker":"Chris Dy","startTime":492.87,"endTime":496.77,"body":"practicing for free today at www"},{"speaker":"Chris Dy","startTime":496.77,"endTime":501.27,"body":"dot practise lync.com/the. upper"},{"speaker":"Chris Dy","startTime":496.77,"endTime":501.27,"body":"hand. Yeah,"},{"speaker":"Charles Goldfarb","startTime":501.27,"endTime":504.69,"body":"so just got"},{"speaker":"Charles Goldfarb","startTime":501.27,"endTime":504.69,"body":"back from a mission trip a week"},{"speaker":"Charles Goldfarb","startTime":504.69,"endTime":510.84,"body":"or so ago. slowly recovering."},{"speaker":"Charles Goldfarb","startTime":504.69,"endTime":510.84,"body":"Have to say it was it was great"},{"speaker":"Charles Goldfarb","startTime":510.84,"endTime":515.67,"body":"in every way that we would hope"},{"speaker":"Charles Goldfarb","startTime":510.84,"endTime":515.67,"body":"it was also exhausting. I work"},{"speaker":"Charles Goldfarb","startTime":515.67,"endTime":519.06,"body":"with a group that is called the"},{"speaker":"Charles Goldfarb","startTime":515.67,"endTime":519.06,"body":"world pediatric project, which"},{"speaker":"Charles Goldfarb","startTime":519.06,"endTime":522.81,"body":"has recently renamed itself"},{"speaker":"Charles Goldfarb","startTime":519.06,"endTime":522.81,"body":"world pediatrics for a broader"},{"speaker":"Charles Goldfarb","startTime":522.81,"endTime":527.61,"body":"appeal. It is far from just"},{"speaker":"Charles Goldfarb","startTime":522.81,"endTime":527.61,"body":"orthopedic surgery. We focus on"},{"speaker":"Charles Goldfarb","startTime":527.61,"endTime":531.69,"body":"the eastern Caribbean and"},{"speaker":"Charles Goldfarb","startTime":527.61,"endTime":531.69,"body":"Central America, but do have"},{"speaker":"Charles Goldfarb","startTime":531.69,"endTime":534.99,"body":"some relationships outside those"},{"speaker":"Charles Goldfarb","startTime":531.69,"endTime":534.99,"body":"two regions. And so I'm involved"},{"speaker":"Charles Goldfarb","startTime":534.99,"endTime":539.01,"body":"in the board here in St. Louis,"},{"speaker":"Charles Goldfarb","startTime":534.99,"endTime":539.01,"body":"and it's a big and growing"},{"speaker":"Charles Goldfarb","startTime":539.01,"endTime":543.66,"body":"organization with multiple hubs,"},{"speaker":"Charles Goldfarb","startTime":539.01,"endTime":543.66,"body":"Atlanta, Richmond, Southern"},{"speaker":"Charles Goldfarb","startTime":543.66,"endTime":548.55,"body":"California, Miami to become a"},{"speaker":"Charles Goldfarb","startTime":543.66,"endTime":548.55,"body":"hub. And so it's great. It's"},{"speaker":"Charles Goldfarb","startTime":548.55,"endTime":553.65,"body":"great and Lindley wall and I"},{"speaker":"Charles Goldfarb","startTime":548.55,"endTime":553.65,"body":"swear to divide up the hand and"},{"speaker":"Charles Goldfarb","startTime":553.65,"endTime":557.43,"body":"upper extremity work in the"},{"speaker":"Charles Goldfarb","startTime":553.65,"endTime":557.43,"body":"Eastern Caribbean, and typically"},{"speaker":"Charles Goldfarb","startTime":557.43,"endTime":561.87,"body":"make a trip about once a year."},{"speaker":"Charles Goldfarb","startTime":557.43,"endTime":561.87,"body":"And so this was our trip."},{"speaker":"Chris Dy","startTime":563.22,"endTime":565.47,"body":"So that's amazing."},{"speaker":"Chris Dy","startTime":563.22,"endTime":565.47,"body":"I've heard from you and"},{"speaker":"Chris Dy","startTime":565.47,"endTime":567.57,"body":"literally about those trips. And"},{"speaker":"Chris Dy","startTime":565.47,"endTime":567.57,"body":"our fellows have really enjoyed"},{"speaker":"Chris Dy","startTime":567.57,"endTime":569.94,"body":"participating in this trips."},{"speaker":"Chris Dy","startTime":567.57,"endTime":569.94,"body":"It's really kind of you and"},{"speaker":"Chris Dy","startTime":569.94,"endTime":574.71,"body":"generous of you to to bring them"},{"speaker":"Chris Dy","startTime":569.94,"endTime":574.71,"body":"and you know, have them see, see"},{"speaker":"Chris Dy","startTime":574.71,"endTime":576.81,"body":"the work that you're doing,"},{"speaker":"Chris Dy","startTime":574.71,"endTime":576.81,"body":"participate in it and"},{"speaker":"Chris Dy","startTime":576.81,"endTime":580.8,"body":"contribute. I know they really"},{"speaker":"Chris Dy","startTime":576.81,"endTime":580.8,"body":"appreciate that. I think it's"},{"speaker":"Chris Dy","startTime":580.8,"endTime":583.77,"body":"great that you develop the"},{"speaker":"Chris Dy","startTime":580.8,"endTime":583.77,"body":"system where it's not just a"},{"speaker":"Chris Dy","startTime":583.8,"endTime":587.04,"body":"kind of drop in and do your work"},{"speaker":"Chris Dy","startTime":583.8,"endTime":587.04,"body":"and then leave. I know a lot of"},{"speaker":"Chris Dy","startTime":587.04,"endTime":589.53,"body":"work goes into it beforehand."},{"speaker":"Chris Dy","startTime":587.04,"endTime":589.53,"body":"Can you talk about how you've"},{"speaker":"Chris Dy","startTime":589.53,"endTime":591.84,"body":"set up the system, I know that"},{"speaker":"Chris Dy","startTime":589.53,"endTime":591.84,"body":"you will literally go separately"},{"speaker":"Chris Dy","startTime":591.84,"endTime":594.72,"body":"and that's very intentional. And"},{"speaker":"Chris Dy","startTime":591.84,"endTime":594.72,"body":"there's a lot of prep work that"},{"speaker":"Chris Dy","startTime":594.72,"endTime":598.02,"body":"goes on, you know, while you're"},{"speaker":"Chris Dy","startTime":594.72,"endTime":598.02,"body":"not there in the Eastern"},{"speaker":"Chris Dy","startTime":598.02,"endTime":598.5,"body":"Caribbean."},{"speaker":"Charles Goldfarb","startTime":599.04,"endTime":603.03,"body":"Yeah, well set"},{"speaker":"Charles Goldfarb","startTime":599.04,"endTime":603.03,"body":"So, the way we have done it is"},{"speaker":"Charles Goldfarb","startTime":603.03,"endTime":606.99,"body":"that you know, the group we work"},{"speaker":"Charles Goldfarb","startTime":603.03,"endTime":606.99,"body":"with has boots on the ground on"},{"speaker":"Charles Goldfarb","startTime":607.05,"endTime":610.47,"body":"in all of the Eastern Caribbean,"},{"speaker":"Charles Goldfarb","startTime":607.05,"endTime":610.47,"body":"multiple different islands. And,"},{"speaker":"Charles Goldfarb","startTime":610.74,"endTime":613.32,"body":"you know, we think about I was"},{"speaker":"Charles Goldfarb","startTime":610.74,"endTime":613.32,"body":"in St. Lucia, but we think about"},{"speaker":"Charles Goldfarb","startTime":613.32,"endTime":616.68,"body":"St. Lucia and we think beautiful"},{"speaker":"Charles Goldfarb","startTime":613.32,"endTime":616.68,"body":"beaches and fancy resorts. And"},{"speaker":"Charles Goldfarb","startTime":616.68,"endTime":620.46,"body":"that is true. But that's, you"},{"speaker":"Charles Goldfarb","startTime":616.68,"endTime":620.46,"body":"know, 2% of the island and the"},{"speaker":"Charles Goldfarb","startTime":620.46,"endTime":622.47,"body":"rest of the island. While there"},{"speaker":"Charles Goldfarb","startTime":620.46,"endTime":622.47,"body":"certainly are healthcare"},{"speaker":"Charles Goldfarb","startTime":622.47,"endTime":626.82,"body":"services, what we do is not"},{"speaker":"Charles Goldfarb","startTime":622.47,"endTime":626.82,"body":"represented on island or is not"},{"speaker":"Charles Goldfarb","startTime":626.82,"endTime":632.28,"body":"accessible. And so this trip"},{"speaker":"Charles Goldfarb","startTime":626.82,"endTime":632.28,"body":"actually, I think, required more"},{"speaker":"Charles Goldfarb","startTime":632.28,"endTime":636.24,"body":"preparation in a good way than"},{"speaker":"Charles Goldfarb","startTime":632.28,"endTime":636.24,"body":"others. And I say that because I"},{"speaker":"Charles Goldfarb","startTime":636.24,"endTime":639.75,"body":"did three telehealth clinics"},{"speaker":"Charles Goldfarb","startTime":636.24,"endTime":639.75,"body":"with different island"},{"speaker":"Charles Goldfarb","startTime":639.75,"endTime":645.21,"body":"populations, St. Kitts,"},{"speaker":"Charles Goldfarb","startTime":639.75,"endTime":645.21,"body":"Dominica, St. Vincent, and"},{"speaker":"Charles Goldfarb","startTime":645.24,"endTime":649.17,"body":"really had my surgical list"},{"speaker":"Charles Goldfarb","startTime":645.24,"endTime":649.17,"body":"pretty prepared before we ever"},{"speaker":"Charles Goldfarb","startTime":649.2,"endTime":654.24,"body":"got there. And what we do, and"},{"speaker":"Charles Goldfarb","startTime":649.2,"endTime":654.24,"body":"then then we have follow up as"},{"speaker":"Charles Goldfarb","startTime":654.24,"endTime":657.69,"body":"well. So it's not just the"},{"speaker":"Charles Goldfarb","startTime":654.24,"endTime":657.69,"body":"glamour of fly in fly out,"},{"speaker":"Charles Goldfarb","startTime":657.69,"endTime":661.53,"body":"because that is not the right"},{"speaker":"Charles Goldfarb","startTime":657.69,"endTime":661.53,"body":"way to do things. And so we"},{"speaker":"Charles Goldfarb","startTime":661.53,"endTime":665.1,"body":"arrived there, we had travel"},{"speaker":"Charles Goldfarb","startTime":661.53,"endTime":665.1,"body":"issues, but we arrived there"},{"speaker":"Charles Goldfarb","startTime":665.1,"endTime":669.18,"body":"late Saturday night, clinic all"},{"speaker":"Charles Goldfarb","startTime":665.1,"endTime":669.18,"body":"day Sunday, and then we operated"},{"speaker":"Charles Goldfarb","startTime":669.18,"endTime":674.13,"body":"for days took care of 20 kids"},{"speaker":"Charles Goldfarb","startTime":669.18,"endTime":674.13,"body":"and those great it. The one"},{"speaker":"Charles Goldfarb","startTime":674.13,"endTime":678.15,"body":"thing that I would like to be"},{"speaker":"Charles Goldfarb","startTime":674.13,"endTime":678.15,"body":"different, but it is what it is,"},{"speaker":"Charles Goldfarb","startTime":678.33,"endTime":682.23,"body":"these islands are not conducive"},{"speaker":"Charles Goldfarb","startTime":678.33,"endTime":682.23,"body":"to a significant amount of"},{"speaker":"Charles Goldfarb","startTime":682.23,"endTime":686.97,"body":"orthopedic surgery education,"},{"speaker":"Charles Goldfarb","startTime":682.23,"endTime":686.97,"body":"simply because there are not the"},{"speaker":"Charles Goldfarb","startTime":686.97,"endTime":691.2,"body":"orthopedic surgeons that are"},{"speaker":"Charles Goldfarb","startTime":686.97,"endTime":691.2,"body":"either interested or available"},{"speaker":"Charles Goldfarb","startTime":691.2,"endTime":694.08,"body":"to learn in these areas. And so"},{"speaker":"Charles Goldfarb","startTime":691.2,"endTime":694.08,"body":"that differentiates us in a"},{"speaker":"Charles Goldfarb","startTime":694.08,"endTime":697.2,"body":"negative way. I would say,"},{"speaker":"Charles Goldfarb","startTime":694.08,"endTime":697.2,"body":"anesthesia wise, there's lots of"},{"speaker":"Charles Goldfarb","startTime":697.2,"endTime":700.74,"body":"people interested in learning"},{"speaker":"Charles Goldfarb","startTime":697.2,"endTime":700.74,"body":"about the blocks Ahalya Kodali"},{"speaker":"Charles Goldfarb","startTime":700.74,"endTime":705.42,"body":"was doing and the processes but"},{"speaker":"Charles Goldfarb","startTime":700.74,"endTime":705.42,"body":"but not the orthopedic"},{"speaker":"Charles Goldfarb","startTime":705.42,"endTime":708.36,"body":"education. So that that's a I"},{"speaker":"Charles Goldfarb","startTime":705.42,"endTime":708.36,"body":"guess that's a missed"},{"speaker":"Charles Goldfarb","startTime":708.36,"endTime":710.55,"body":"opportunity, but it's not really"},{"speaker":"Charles Goldfarb","startTime":708.36,"endTime":710.55,"body":"a missed opportunity. Because,"},{"speaker":"Charles Goldfarb","startTime":710.76,"endTime":713.4,"body":"again, it's just not just, it's"},{"speaker":"Charles Goldfarb","startTime":710.76,"endTime":713.4,"body":"just not needed."},{"speaker":"Chris Dy","startTime":714.39,"endTime":715.47,"body":"Well, I think you're"},{"speaker":"Chris Dy","startTime":714.39,"endTime":715.47,"body":"playing the hand that you're"},{"speaker":"Chris Dy","startTime":715.47,"endTime":717.75,"body":"dealt, right. I mean, so if you"},{"speaker":"Chris Dy","startTime":715.47,"endTime":717.75,"body":"are in a place where there were"},{"speaker":"Chris Dy","startTime":717.75,"endTime":720.33,"body":"a lot of people that wanted to"},{"speaker":"Chris Dy","startTime":717.75,"endTime":720.33,"body":"educate, I'd be I'm sure you"},{"speaker":"Chris Dy","startTime":720.33,"endTime":723.12,"body":"would be educating. I think"},{"speaker":"Chris Dy","startTime":720.33,"endTime":723.12,"body":"that's probably the"},{"speaker":"Chris Dy","startTime":723.33,"endTime":725.76,"body":"differentiator between that and"},{"speaker":"Chris Dy","startTime":723.33,"endTime":725.76,"body":"something like what Jim Chang's"},{"speaker":"Chris Dy","startTime":725.76,"endTime":728.91,"body":"evolve with with that resurge? I"},{"speaker":"Chris Dy","startTime":725.76,"endTime":728.91,"body":"think is what they do. Yeah. So"},{"speaker":"Chris Dy","startTime":728.91,"endTime":731.4,"body":"I mean, if there was an"},{"speaker":"Chris Dy","startTime":728.91,"endTime":731.4,"body":"audience, I'm guarantee you"},{"speaker":"Chris Dy","startTime":731.4,"endTime":734.7,"body":"would be teaching them how to"},{"speaker":"Chris Dy","startTime":731.4,"endTime":734.7,"body":"assess and evaluate and treat"},{"speaker":"Chris Dy","startTime":734.7,"endTime":737.19,"body":"these patients. But that's not"},{"speaker":"Chris Dy","startTime":734.7,"endTime":737.19,"body":"what's available to you. So"},{"speaker":"Charles Goldfarb","startTime":737.0,"endTime":742.16,"body":"the I think"},{"speaker":"Charles Goldfarb","startTime":737.0,"endTime":742.16,"body":"Emily's Zoldos who came with us"},{"speaker":"Charles Goldfarb","startTime":737.58,"endTime":738.3,"body":"yeah,"},{"speaker":"Charles Goldfarb","startTime":742.76,"endTime":747.17,"body":"will never do pediatric hand"},{"speaker":"Charles Goldfarb","startTime":742.76,"endTime":747.17,"body":"surgery again, her life. I'm"},{"speaker":"Charles Goldfarb","startTime":747.17,"endTime":750.77,"body":"certain when she's in remarkable"},{"speaker":"Charles Goldfarb","startTime":747.17,"endTime":750.77,"body":"Peachtree orthopedics in Atlanta"},{"speaker":"Charles Goldfarb","startTime":750.77,"endTime":754.76,"body":"next year. But I think she had a"},{"speaker":"Charles Goldfarb","startTime":750.77,"endTime":754.76,"body":"great time and certainly had a"},{"speaker":"Charles Goldfarb","startTime":754.76,"endTime":758.27,"body":"great time with her. You know,"},{"speaker":"Charles Goldfarb","startTime":754.76,"endTime":758.27,"body":"the pathology is interesting,"},{"speaker":"Charles Goldfarb","startTime":758.27,"endTime":761.51,"body":"and I think it's relatively"},{"speaker":"Charles Goldfarb","startTime":758.27,"endTime":761.51,"body":"characteristic birth, brachial"},{"speaker":"Charles Goldfarb","startTime":761.51,"endTime":765.62,"body":"plexus palsy, secondary"},{"speaker":"Charles Goldfarb","startTime":761.51,"endTime":765.62,"body":"manifestations of bat, cerebral"},{"speaker":"Charles Goldfarb","startTime":765.62,"endTime":769.4,"body":"palsy, you know, largely"},{"speaker":"Charles Goldfarb","startTime":765.62,"endTime":769.4,"body":"untreated, post traumatic,"},{"speaker":"Charles Goldfarb","startTime":769.4,"endTime":773.69,"body":"whether that's burns, or just"},{"speaker":"Charles Goldfarb","startTime":769.4,"endTime":773.69,"body":"trauma that doesn't heal well."},{"speaker":"Charles Goldfarb","startTime":773.87,"endTime":776.81,"body":"And then a little congenital,"},{"speaker":"Charles Goldfarb","startTime":773.87,"endTime":776.81,"body":"it's actually I think we've hit"},{"speaker":"Charles Goldfarb","startTime":776.81,"endTime":780.26,"body":"a lot of the congenital and we"},{"speaker":"Charles Goldfarb","startTime":776.81,"endTime":780.26,"body":"bring some of the more severe,"},{"speaker":"Charles Goldfarb","startTime":780.29,"endTime":783.14,"body":"more serious congenital up to"},{"speaker":"Charles Goldfarb","startTime":780.29,"endTime":783.14,"body":"St. Louis, which is part of the"},{"speaker":"Charles Goldfarb","startTime":783.14,"endTime":788.78,"body":"program. But yeah, good mix of"},{"speaker":"Charles Goldfarb","startTime":783.14,"endTime":788.78,"body":"pathologies, and you know, nice"},{"speaker":"Charles Goldfarb","startTime":788.81,"endTime":789.65,"body":"early results."},{"speaker":"Chris Dy","startTime":790.23,"endTime":792.57,"body":"Yeah, I heard that you"},{"speaker":"Chris Dy","startTime":790.23,"endTime":792.57,"body":"saw one of our postop brachial"},{"speaker":"Chris Dy","startTime":792.57,"endTime":796.35,"body":"plexus free functioning or Silis"},{"speaker":"Chris Dy","startTime":792.57,"endTime":796.35,"body":"patients. I was like, saw the"},{"speaker":"Chris Dy","startTime":796.35,"endTime":797.64,"body":"videos like that's crazy."},{"speaker":"Charles Goldfarb","startTime":797.88,"endTime":800.97,"body":"Yeah, so it is"},{"speaker":"Charles Goldfarb","startTime":797.88,"endTime":800.97,"body":"crazy. So the story is, you"},{"speaker":"Charles Goldfarb","startTime":800.97,"endTime":806.37,"body":"know, kind of a silent, maybe"},{"speaker":"Charles Goldfarb","startTime":800.97,"endTime":806.37,"body":"he's 18. Now silent. You know,"},{"speaker":"Charles Goldfarb","startTime":806.37,"endTime":809.22,"body":"very quiet kid comes in, and he"},{"speaker":"Charles Goldfarb","startTime":806.37,"endTime":809.22,"body":"has sort of a rope around his"},{"speaker":"Charles Goldfarb","startTime":809.22,"endTime":813.6,"body":"neck with his arm, and like a"},{"speaker":"Charles Goldfarb","startTime":809.22,"endTime":813.6,"body":"makeshift sling. And he walked"},{"speaker":"Charles Goldfarb","startTime":813.6,"endTime":816.75,"body":"in, I'm like, Hi, how you doing?"},{"speaker":"Charles Goldfarb","startTime":813.6,"endTime":816.75,"body":"And he didn't really have much"},{"speaker":"Charles Goldfarb","startTime":816.75,"endTime":819.75,"body":"to say. And then I kind of sift"},{"speaker":"Charles Goldfarb","startTime":816.75,"endTime":819.75,"body":"through some materials and"},{"speaker":"Charles Goldfarb","startTime":819.75,"endTime":822.72,"body":"realize that he had come up to"},{"speaker":"Charles Goldfarb","startTime":819.75,"endTime":822.72,"body":"St. Louis and had a pre"},{"speaker":"Charles Goldfarb","startTime":822.72,"endTime":827.37,"body":"functioning or Silis transfer."},{"speaker":"Charles Goldfarb","startTime":822.72,"endTime":827.37,"body":"And he had been educated on"},{"speaker":"Charles Goldfarb","startTime":827.37,"endTime":831.36,"body":"therapy. We tried to connect him"},{"speaker":"Charles Goldfarb","startTime":827.37,"endTime":831.36,"body":"with therapy in St. Louis, in"},{"speaker":"Charles Goldfarb","startTime":831.6,"endTime":834.6,"body":"St. Lucia and just hadn't really"},{"speaker":"Charles Goldfarb","startTime":831.6,"endTime":834.6,"body":"happened. But what was"},{"speaker":"Charles Goldfarb","startTime":834.6,"endTime":837.09,"body":"remarkable and I haven't seen a"},{"speaker":"Charles Goldfarb","startTime":834.6,"endTime":837.09,"body":"lot of these patients in follow"},{"speaker":"Charles Goldfarb","startTime":837.09,"endTime":842.31,"body":"up. What was remarkable is that"},{"speaker":"Charles Goldfarb","startTime":837.09,"endTime":842.31,"body":"he's doing incredibly well. anti"},{"speaker":"Charles Goldfarb","startTime":842.31,"endTime":847.32,"body":"gravity, elbow flexion is really"},{"speaker":"Charles Goldfarb","startTime":842.31,"endTime":847.32,"body":"good. And he has I'm sorry,"},{"speaker":"Charles Goldfarb","startTime":847.35,"endTime":850.17,"body":"gravity eliminated. elbow"},{"speaker":"Charles Goldfarb","startTime":847.35,"endTime":850.17,"body":"flexion is really good. And anti"},{"speaker":"Charles Goldfarb","startTime":850.17,"endTime":854.04,"body":"gravity. elbow flexion is"},{"speaker":"Charles Goldfarb","startTime":850.17,"endTime":854.04,"body":"excellent as well. So the"},{"speaker":"Charles Goldfarb","startTime":854.04,"endTime":857.19,"body":"therapist who came with us,"},{"speaker":"Charles Goldfarb","startTime":854.04,"endTime":857.19,"body":"Stacy Baker, who's amazing."},{"speaker":"Charles Goldfarb","startTime":857.31,"endTime":860.22,"body":"Spent some time with him on a"},{"speaker":"Charles Goldfarb","startTime":857.31,"endTime":860.22,"body":"couple of different days. And"},{"speaker":"Charles Goldfarb","startTime":860.28,"endTime":863.19,"body":"yeah, he's doing great. Yeah,"},{"speaker":"Charles Goldfarb","startTime":860.28,"endTime":863.19,"body":"that's"},{"speaker":"Chris Dy","startTime":863.19,"endTime":865.44,"body":"that's basically all"},{"speaker":"Chris Dy","startTime":863.19,"endTime":865.44,"body":"of our fragrance illustrators"},{"speaker":"Chris Dy","startTime":865.44,"endTime":868.2,"body":"for his for elbow flexion. They"},{"speaker":"Chris Dy","startTime":865.44,"endTime":868.2,"body":"kind of do their own thing, no"},{"speaker":"Chris Dy","startTime":868.2,"endTime":871.14,"body":"therapy. Now he is He's great."},{"speaker":"Chris Dy","startTime":868.2,"endTime":871.14,"body":"He's actually pretty early on. I"},{"speaker":"Chris Dy","startTime":871.14,"endTime":874.11,"body":"don't remember the exact time"},{"speaker":"Chris Dy","startTime":871.14,"endTime":874.11,"body":"but he is exceeding"},{"speaker":"Chris Dy","startTime":874.11,"endTime":877.14,"body":"expectations, which is"},{"speaker":"Chris Dy","startTime":874.11,"endTime":877.14,"body":"remarkable. So thank you for"},{"speaker":"Chris Dy","startTime":877.14,"endTime":880.02,"body":"seeing him and I'm glad Stacey"},{"speaker":"Chris Dy","startTime":877.14,"endTime":880.02,"body":"was there. She is a really a"},{"speaker":"Chris Dy","startTime":880.02,"endTime":882.84,"body":"wizard with with the therapy"},{"speaker":"Chris Dy","startTime":880.02,"endTime":882.84,"body":"which is so critical after that"},{"speaker":"Chris Dy","startTime":882.84,"endTime":883.47,"body":"kind of surgery."},{"speaker":"Charles Goldfarb","startTime":884.25,"endTime":887.25,"body":"Yeah, I know"},{"speaker":"Charles Goldfarb","startTime":884.25,"endTime":887.25,"body":"that mission trips are, you"},{"speaker":"Charles Goldfarb","startTime":887.25,"endTime":891.03,"body":"know, it's interesting. They"},{"speaker":"Charles Goldfarb","startTime":887.25,"endTime":891.03,"body":"there had to remind our group"},{"speaker":"Charles Goldfarb","startTime":891.3,"endTime":894.15,"body":"that this is not going to be"},{"speaker":"Charles Goldfarb","startTime":891.3,"endTime":894.15,"body":"easy. Everything's not going to"},{"speaker":"Charles Goldfarb","startTime":894.15,"endTime":897.39,"body":"go according to plan. And in"},{"speaker":"Charles Goldfarb","startTime":894.15,"endTime":897.39,"body":"some respects, that's the"},{"speaker":"Charles Goldfarb","startTime":897.39,"endTime":899.97,"body":"appeal. You have to sort of"},{"speaker":"Charles Goldfarb","startTime":897.39,"endTime":899.97,"body":"think on your feet you have to"},{"speaker":"Charles Goldfarb","startTime":900.0,"endTime":903.48,"body":"To deal with situations where"},{"speaker":"Charles Goldfarb","startTime":900.0,"endTime":903.48,"body":"you don't have anything that you"},{"speaker":"Charles Goldfarb","startTime":903.48,"endTime":908.22,"body":"want, and it's the flow is not"},{"speaker":"Charles Goldfarb","startTime":903.48,"endTime":908.22,"body":"going to be good, we were"},{"speaker":"Charles Goldfarb","startTime":908.34,"endTime":910.98,"body":"ambitious in getting 20"},{"speaker":"Charles Goldfarb","startTime":908.34,"endTime":910.98,"body":"surgeries done, we got them"},{"speaker":"Charles Goldfarb","startTime":910.98,"endTime":914.97,"body":"done. And the group we had was"},{"speaker":"Charles Goldfarb","startTime":910.98,"endTime":914.97,"body":"amazing. So we travel with an"},{"speaker":"Charles Goldfarb","startTime":914.97,"endTime":920.16,"body":"anesthesiologist and or nurse"},{"speaker":"Charles Goldfarb","startTime":914.97,"endTime":920.16,"body":"therapist and our hand fellow,"},{"speaker":"Charles Goldfarb","startTime":920.31,"endTime":924.39,"body":"and it was a amazingly good"},{"speaker":"Charles Goldfarb","startTime":920.31,"endTime":924.39,"body":"group. And really great, but"},{"speaker":"Charles Goldfarb","startTime":924.42,"endTime":927.9,"body":"these are less than ideal"},{"speaker":"Charles Goldfarb","startTime":924.42,"endTime":927.9,"body":"situations. But that if you"},{"speaker":"Charles Goldfarb","startTime":927.9,"endTime":929.61,"body":"think about the right way,"},{"speaker":"Charles Goldfarb","startTime":927.9,"endTime":929.61,"body":"that's part of the fun."},{"speaker":"Chris Dy","startTime":930.33,"endTime":932.1,"body":"Well, yeah, of course,"},{"speaker":"Chris Dy","startTime":930.33,"endTime":932.1,"body":"you want to avoid the medical"},{"speaker":"Chris Dy","startTime":932.1,"endTime":935.46,"body":"tourism aspect. And I think that"},{"speaker":"Chris Dy","startTime":932.1,"endTime":935.46,"body":"you and I did talk to a wall and"},{"speaker":"Chris Dy","startTime":935.49,"endTime":938.46,"body":"all of world pediatrics, they've"},{"speaker":"Chris Dy","startTime":935.49,"endTime":938.46,"body":"really done a great job, as you"},{"speaker":"Chris Dy","startTime":938.46,"endTime":942.54,"body":"know, to provide really a"},{"speaker":"Chris Dy","startTime":938.46,"endTime":942.54,"body":"service to that community into"},{"speaker":"Chris Dy","startTime":942.54,"endTime":945.54,"body":"that country. So kudos to you"},{"speaker":"Chris Dy","startTime":942.54,"endTime":945.54,"body":"guys mean, if anybody wants to"},{"speaker":"Chris Dy","startTime":945.54,"endTime":948.54,"body":"learn about world pediatrics,"},{"speaker":"Chris Dy","startTime":945.54,"endTime":948.54,"body":"how do they learn about it,"},{"speaker":"Chris Dy","startTime":948.54,"endTime":951.87,"body":"we're just getting involved in"},{"speaker":"Chris Dy","startTime":948.54,"endTime":951.87,"body":"you know, that kind of work, you"},{"speaker":"Chris Dy","startTime":951.87,"endTime":955.26,"body":"know, as they get into practice,"},{"speaker":"Chris Dy","startTime":951.87,"endTime":955.26,"body":"either as a therapist or as a"},{"speaker":"Chris Dy","startTime":955.26,"endTime":955.71,"body":"surgeon."},{"speaker":"Charles Goldfarb","startTime":957.39,"endTime":959.19,"body":"Yeah, I would"},{"speaker":"Charles Goldfarb","startTime":957.39,"endTime":959.19,"body":"be neglectful if I didn't"},{"speaker":"Charles Goldfarb","startTime":959.19,"endTime":962.61,"body":"mention that we were supported"},{"speaker":"Charles Goldfarb","startTime":959.19,"endTime":962.61,"body":"in part by touching hands"},{"speaker":"Charles Goldfarb","startTime":962.61,"endTime":965.22,"body":"through the hands society. And"},{"speaker":"Charles Goldfarb","startTime":962.61,"endTime":965.22,"body":"so this was, you know, Scott"},{"speaker":"Charles Goldfarb","startTime":965.22,"endTime":971.94,"body":"Kosan, sort of ran with the"},{"speaker":"Charles Goldfarb","startTime":965.22,"endTime":971.94,"body":"concept of outreach as a part of"},{"speaker":"Charles Goldfarb","startTime":971.94,"endTime":976.32,"body":"the hands Saudis effort, and he,"},{"speaker":"Charles Goldfarb","startTime":971.94,"endTime":976.32,"body":"with others has elevated the"},{"speaker":"Charles Goldfarb","startTime":976.56,"endTime":979.77,"body":"outreach concept for the"},{"speaker":"Charles Goldfarb","startTime":976.56,"endTime":979.77,"body":"American Foundation for Surgery"},{"speaker":"Charles Goldfarb","startTime":979.77,"endTime":982.5,"body":"of the Hand is one of the major"},{"speaker":"Charles Goldfarb","startTime":979.77,"endTime":982.5,"body":"buckets. So there's a lot to"},{"speaker":"Charles Goldfarb","startTime":982.5,"endTime":986.19,"body":"learn from the hand society. And"},{"speaker":"Charles Goldfarb","startTime":982.5,"endTime":986.19,"body":"there's a lot of different"},{"speaker":"Charles Goldfarb","startTime":986.19,"endTime":989.07,"body":"organizations, we mentioned"},{"speaker":"Charles Goldfarb","startTime":986.19,"endTime":989.07,"body":"research, and there's many"},{"speaker":"Charles Goldfarb","startTime":989.07,"endTime":993.03,"body":"others, aside from World"},{"speaker":"Charles Goldfarb","startTime":989.07,"endTime":993.03,"body":"pediatrics doing this, but the"},{"speaker":"Charles Goldfarb","startTime":993.03,"endTime":997.86,"body":"hand study for those listeners"},{"speaker":"Charles Goldfarb","startTime":993.03,"endTime":997.86,"body":"is really a good one. And"},{"speaker":"Charles Goldfarb","startTime":997.86,"endTime":1002.18,"body":"certainly, I can connect anyone"},{"speaker":"Charles Goldfarb","startTime":997.86,"endTime":1002.18,"body":"with any background, whether"},{"speaker":"Charles Goldfarb","startTime":1002.18,"endTime":1005.6,"body":"that be ham therapy, or general"},{"speaker":"Charles Goldfarb","startTime":1002.18,"endTime":1005.6,"body":"orthopedics to people who are"},{"speaker":"Charles Goldfarb","startTime":1005.6,"endTime":1009.02,"body":"interested in doing this, but"},{"speaker":"Charles Goldfarb","startTime":1005.6,"endTime":1009.02,"body":"it's really it's a great thing"},{"speaker":"Charles Goldfarb","startTime":1009.02,"endTime":1011.84,"body":"that we have the opportunity to"},{"speaker":"Charles Goldfarb","startTime":1009.02,"endTime":1011.84,"body":"do this. And it's not to suggest"},{"speaker":"Charles Goldfarb","startTime":1011.84,"endTime":1014.96,"body":"that we don't have enough"},{"speaker":"Charles Goldfarb","startTime":1011.84,"endTime":1014.96,"body":"opportunities in this country."},{"speaker":"Charles Goldfarb","startTime":1015.08,"endTime":1018.98,"body":"The United States has plenty of"},{"speaker":"Charles Goldfarb","startTime":1015.08,"endTime":1018.98,"body":"need it this is just a little"},{"speaker":"Charles Goldfarb","startTime":1018.98,"endTime":1019.67,"body":"bit different."},{"speaker":"Chris Dy","startTime":1020.6,"endTime":1022.7,"body":"Yeah, absolutely. I"},{"speaker":"Chris Dy","startTime":1020.6,"endTime":1022.7,"body":"mean, you see that the touch"},{"speaker":"Chris Dy","startTime":1022.7,"endTime":1025.34,"body":"hands program also has some"},{"speaker":"Chris Dy","startTime":1022.7,"endTime":1025.34,"body":"domestic projects. And I think"},{"speaker":"Chris Dy","startTime":1025.34,"endTime":1028.4,"body":"that, you know, many of us are"},{"speaker":"Chris Dy","startTime":1025.34,"endTime":1028.4,"body":"also helping patients that are"},{"speaker":"Chris Dy","startTime":1028.4,"endTime":1033.14,"body":"underserved and underinsured in"},{"speaker":"Chris Dy","startTime":1028.4,"endTime":1033.14,"body":"our populations. And, you know,"},{"speaker":"Chris Dy","startTime":1033.14,"endTime":1035.75,"body":"I think that's, that's part of"},{"speaker":"Chris Dy","startTime":1033.14,"endTime":1035.75,"body":"our professional, professional"},{"speaker":"Chris Dy","startTime":1035.75,"endTime":1040.79,"body":"obligation. So, before we get"},{"speaker":"Chris Dy","startTime":1035.75,"endTime":1040.79,"body":"into some cases, first off, I"},{"speaker":"Chris Dy","startTime":1040.79,"endTime":1043.4,"body":"want to say if anybody has"},{"speaker":"Chris Dy","startTime":1040.79,"endTime":1043.4,"body":"questions for Chuck about that"},{"speaker":"Chris Dy","startTime":1043.43,"endTime":1047.9,"body":"hand podcast@gmail.com send him"},{"speaker":"Chris Dy","startTime":1043.43,"endTime":1047.9,"body":"an email, send us an email and"},{"speaker":"Chris Dy","startTime":1047.9,"endTime":1051.11,"body":"we'll make sure that he gets"},{"speaker":"Chris Dy","startTime":1047.9,"endTime":1051.11,"body":"them and y'all should mark your"},{"speaker":"Chris Dy","startTime":1051.11,"endTime":1055.58,"body":"calendars for October 25 and 26,"},{"speaker":"Chris Dy","startTime":1051.11,"endTime":1055.58,"body":"or checkpoint, surgicals, next"},{"speaker":"Chris Dy","startTime":1055.61,"endTime":1060.17,"body":"categoric course upper extremity"},{"speaker":"Chris Dy","startTime":1055.61,"endTime":1060.17,"body":"nerve distress strategies for"},{"speaker":"Chris Dy","startTime":1060.17,"endTime":1064.28,"body":"surgical management. Join the"},{"speaker":"Chris Dy","startTime":1060.17,"endTime":1064.28,"body":"course faculty Dr. Fraser levers"},{"speaker":"Chris Dy","startTime":1064.28,"endTime":1068.21,"body":"edge and Dr. David Brogan. We"},{"speaker":"Chris Dy","startTime":1064.28,"endTime":1068.21,"body":"know those guys in Denver,"},{"speaker":"Chris Dy","startTime":1068.21,"endTime":1070.67,"body":"Colorado is a review management"},{"speaker":"Chris Dy","startTime":1068.21,"endTime":1070.67,"body":"strategy for commonly"},{"speaker":"Chris Dy","startTime":1070.67,"endTime":1073.22,"body":"encountered challenging nerve"},{"speaker":"Chris Dy","startTime":1070.67,"endTime":1073.22,"body":"injuries and conditions"},{"speaker":"Chris Dy","startTime":1073.22,"endTime":1076.1,"body":"affecting the upper extremities."},{"speaker":"Chris Dy","startTime":1073.22,"endTime":1076.1,"body":"Graduated"},{"speaker":"Charles Goldfarb","startTime":1076.1,"endTime":1078.08,"body":"let me"},{"speaker":"Charles Goldfarb","startTime":1076.1,"endTime":1078.08,"body":"contribute to this, you left me"},{"speaker":"Charles Goldfarb","startTime":1078.08,"endTime":1081.23,"body":"a little bit to learn more about"},{"speaker":"Charles Goldfarb","startTime":1078.08,"endTime":1081.23,"body":"this and other educational"},{"speaker":"Charles Goldfarb","startTime":1081.23,"endTime":1085.16,"body":"programs, please visit nerve"},{"speaker":"Charles Goldfarb","startTime":1081.23,"endTime":1085.16,"body":"master.com Checkpoint surgical"},{"speaker":"Charles Goldfarb","startTime":1085.19,"endTime":1088.13,"body":"driving innovation in nerve"},{"speaker":"Charles Goldfarb","startTime":1085.19,"endTime":1088.13,"body":"surgery. So"},{"speaker":"Chris Dy","startTime":1088.13,"endTime":1090.14,"body":"it's funny, I was"},{"speaker":"Chris Dy","startTime":1088.13,"endTime":1090.14,"body":"driving home today I was running"},{"speaker":"Chris Dy","startTime":1090.17,"endTime":1092.24,"body":"with my daughters. We're"},{"speaker":"Chris Dy","startTime":1090.17,"endTime":1092.24,"body":"celebrating my daughter's"},{"speaker":"Chris Dy","startTime":1092.24,"endTime":1094.67,"body":"birthday today with the school"},{"speaker":"Chris Dy","startTime":1092.24,"endTime":1094.67,"body":"party. Her birthday was actually"},{"speaker":"Chris Dy","startTime":1094.67,"endTime":1096.95,"body":"earlier this week. And that's a"},{"speaker":"Chris Dy","startTime":1094.67,"endTime":1096.95,"body":"whole separate story of what we"},{"speaker":"Chris Dy","startTime":1096.95,"endTime":1100.91,"body":"did. But I was driving home from"},{"speaker":"Chris Dy","startTime":1096.95,"endTime":1100.91,"body":"picking up all the things for"},{"speaker":"Chris Dy","startTime":1100.91,"endTime":1103.97,"body":"this party. And there's I don't"},{"speaker":"Chris Dy","startTime":1100.91,"endTime":1103.97,"body":"know if you've seen this chuck."},{"speaker":"Chris Dy","startTime":1103.97,"endTime":1110.18,"body":"But on. On Big Bend, there is"},{"speaker":"Chris Dy","startTime":1103.97,"endTime":1110.18,"body":"this recording studio that has a"},{"speaker":"Chris Dy","startTime":1110.18,"endTime":1113.87,"body":"sign out now for voiceover"},{"speaker":"Chris Dy","startTime":1110.18,"endTime":1113.87,"body":"lessons. And I thought it was"},{"speaker":"Chris Dy","startTime":1113.87,"endTime":1116.96,"body":"like hey, they often have like"},{"speaker":"Chris Dy","startTime":1113.87,"endTime":1116.96,"body":"ads for like podcasts,"},{"speaker":"Chris Dy","startTime":1116.96,"endTime":1119.84,"body":"recording, et cetera. And like,"},{"speaker":"Chris Dy","startTime":1116.96,"endTime":1119.84,"body":"alright, we got that down. But I"},{"speaker":"Chris Dy","startTime":1119.84,"endTime":1122.63,"body":"was like, Maybe I should take"},{"speaker":"Chris Dy","startTime":1119.84,"endTime":1122.63,"body":"some voiceover lessons. Be the"},{"speaker":"Chris Dy","startTime":1122.63,"endTime":1125.15,"body":"movie Phone Guy. Yeah, look, do"},{"speaker":"Charles Goldfarb","startTime":1125.15,"endTime":1126.98,"body":"you need a"},{"speaker":"Charles Goldfarb","startTime":1125.15,"endTime":1126.98,"body":"backup career plan? And that's a"},{"speaker":"Charles Goldfarb","startTime":1126.98,"endTime":1129.17,"body":"good one. You know, I have a"},{"speaker":"Charles Goldfarb","startTime":1126.98,"endTime":1129.17,"body":"future. I was"},{"speaker":"Chris Dy","startTime":1129.17,"endTime":1133.43,"body":"on a patient this year"},{"speaker":"Chris Dy","startTime":1129.17,"endTime":1133.43,"body":"or this week about my retirement"},{"speaker":"Chris Dy","startTime":1133.43,"endTime":1136.55,"body":"plan. And I think it is good to"},{"speaker":"Chris Dy","startTime":1133.43,"endTime":1136.55,"body":"go to culinary school. But maybe"},{"speaker":"Chris Dy","startTime":1136.55,"endTime":1139.04,"body":"I'll be a voiceover guy will"},{"speaker":"Chris Dy","startTime":1136.55,"endTime":1139.04,"body":"say, yeah,"},{"speaker":"Charles Goldfarb","startTime":1139.04,"endTime":1142.07,"body":"so many"},{"speaker":"Charles Goldfarb","startTime":1139.04,"endTime":1142.07,"body":"options, so little time. All"},{"speaker":"Charles Goldfarb","startTime":1142.07,"endTime":1145.13,"body":"right. And we have two cases"},{"speaker":"Charles Goldfarb","startTime":1142.07,"endTime":1145.13,"body":"we'd like to discuss these are"},{"speaker":"Charles Goldfarb","startTime":1145.13,"endTime":1148.01,"body":"cases that we have or"},{"speaker":"Charles Goldfarb","startTime":1145.13,"endTime":1148.01,"body":"pathologies we have not"},{"speaker":"Charles Goldfarb","startTime":1148.01,"endTime":1151.88,"body":"previously discussed. And why"},{"speaker":"Charles Goldfarb","startTime":1148.01,"endTime":1151.88,"body":"don't we start with a case that"},{"speaker":"Charles Goldfarb","startTime":1151.88,"endTime":1156.02,"body":"you had. So throw it out there?"},{"speaker":"Charles Goldfarb","startTime":1151.88,"endTime":1156.02,"body":"Sure."},{"speaker":"Chris Dy","startTime":1156.11,"endTime":1158.87,"body":"So this is really"},{"speaker":"Chris Dy","startTime":1156.11,"endTime":1158.87,"body":"interesting. It's a patient who"},{"speaker":"Chris Dy","startTime":1158.87,"endTime":1162.02,"body":"I'm going to try to remove as"},{"speaker":"Chris Dy","startTime":1158.87,"endTime":1162.02,"body":"many details as they can, in"},{"speaker":"Chris Dy","startTime":1162.02,"endTime":1167.24,"body":"their 40s A person who relies on"},{"speaker":"Chris Dy","startTime":1162.02,"endTime":1167.24,"body":"their hands to make a living in"},{"speaker":"Chris Dy","startTime":1167.24,"endTime":1171.89,"body":"terms of their a proceduralist."},{"speaker":"Chris Dy","startTime":1167.24,"endTime":1171.89,"body":"And they've got this insidious"},{"speaker":"Chris Dy","startTime":1171.89,"endTime":1176.18,"body":"onset of pain at their middle"},{"speaker":"Chris Dy","startTime":1171.89,"endTime":1176.18,"body":"finger at the base kind of"},{"speaker":"Chris Dy","startTime":1176.18,"endTime":1179.69,"body":"proximal phalanx region was"},{"speaker":"Chris Dy","startTime":1176.18,"endTime":1179.69,"body":"nagging was getting, you know,"},{"speaker":"Chris Dy","startTime":1179.69,"endTime":1182.6,"body":"problematic and then had some"},{"speaker":"Chris Dy","startTime":1179.69,"endTime":1182.6,"body":"free time so they decided to"},{"speaker":"Chris Dy","startTime":1182.6,"endTime":1186.38,"body":"stop in and get a visit and one"},{"speaker":"Chris Dy","startTime":1182.6,"endTime":1186.38,"body":"of our very convenient injury"},{"speaker":"Chris Dy","startTime":1186.38,"endTime":1191.9,"body":"clinics but got an x ray and I"},{"speaker":"Chris Dy","startTime":1186.38,"endTime":1191.9,"body":"happen to be next door and"},{"speaker":"Chris Dy","startTime":1192.14,"endTime":1196.49,"body":"demonstrated a lytic lesion"},{"speaker":"Chris Dy","startTime":1192.14,"endTime":1196.49,"body":"within the base of the proximal"},{"speaker":"Chris Dy","startTime":1196.49,"endTime":1201.26,"body":"failings but no fracture and"},{"speaker":"Chris Dy","startTime":1196.49,"endTime":1201.26,"body":"findings. We're, you know, to me"},{"speaker":"Chris Dy","startTime":1201.26,"endTime":1203.72,"body":"at first blush and the"},{"speaker":"Chris Dy","startTime":1201.26,"endTime":1203.72,"body":"radiologist fortunately agreed"},{"speaker":"Chris Dy","startTime":1203.72,"endTime":1208.16,"body":"we're consistent with an N"},{"speaker":"Chris Dy","startTime":1203.72,"endTime":1208.16,"body":"conundrum. So Chuck, how do you"},{"speaker":"Chris Dy","startTime":1208.31,"endTime":1211.55,"body":"approach this patient? I mean,"},{"speaker":"Chris Dy","startTime":1208.31,"endTime":1211.55,"body":"there was no actual trauma. It"},{"speaker":"Chris Dy","startTime":1211.55,"endTime":1215.9,"body":"hurts. Not terrible, you know,"},{"speaker":"Chris Dy","startTime":1211.55,"endTime":1215.9,"body":"they made they had some time,"},{"speaker":"Chris Dy","startTime":1215.9,"endTime":1217.79,"body":"and they got it checked out. I"},{"speaker":"Chris Dy","startTime":1215.9,"endTime":1217.79,"body":"mean, how do you think about"},{"speaker":"Chris Dy","startTime":1217.79,"endTime":1221.87,"body":"these kinds of lesions within"},{"speaker":"Chris Dy","startTime":1217.79,"endTime":1221.87,"body":"the bone?"},{"speaker":"Charles Goldfarb","startTime":1223.28,"endTime":1225.11,"body":"Yeah, you"},{"speaker":"Charles Goldfarb","startTime":1223.28,"endTime":1225.11,"body":"know, in conundrum was are"},{"speaker":"Charles Goldfarb","startTime":1225.2,"endTime":1229.85,"body":"relatively classic looking, they"},{"speaker":"Charles Goldfarb","startTime":1225.2,"endTime":1229.85,"body":"can be expensive to the bone,"},{"speaker":"Charles Goldfarb","startTime":1229.88,"endTime":1233.57,"body":"they have that sort of ground"},{"speaker":"Charles Goldfarb","startTime":1229.88,"endTime":1233.57,"body":"glass appearance. Sometimes"},{"speaker":"Charles Goldfarb","startTime":1233.57,"endTime":1237.08,"body":"there's calcifications, but you"},{"speaker":"Charles Goldfarb","startTime":1233.57,"endTime":1237.08,"body":"can generally make the diagnosis"},{"speaker":"Charles Goldfarb","startTime":1237.08,"endTime":1243.14,"body":"on X ray findings alone, they're"},{"speaker":"Charles Goldfarb","startTime":1237.08,"endTime":1243.14,"body":"often eccentric a bit. And, you"},{"speaker":"Charles Goldfarb","startTime":1243.14,"endTime":1247.01,"body":"know, I think once you're"},{"speaker":"Charles Goldfarb","startTime":1243.14,"endTime":1247.01,"body":"confident in the diagnosis, than"},{"speaker":"Charles Goldfarb","startTime":1247.01,"endTime":1251.27,"body":"a surgical intervention makes"},{"speaker":"Charles Goldfarb","startTime":1247.01,"endTime":1251.27,"body":"sense. You know, I was taught,"},{"speaker":"Charles Goldfarb","startTime":1251.3,"endTime":1253.82,"body":"and I'm curious as to what you"},{"speaker":"Charles Goldfarb","startTime":1251.3,"endTime":1253.82,"body":"were taught, I was taught that"},{"speaker":"Charles Goldfarb","startTime":1253.82,"endTime":1256.85,"body":"if you have a fracture related"},{"speaker":"Charles Goldfarb","startTime":1253.82,"endTime":1256.85,"body":"to an enchondroma, which I know"},{"speaker":"Charles Goldfarb","startTime":1256.85,"endTime":1259.94,"body":"this patient did not have, but"},{"speaker":"Charles Goldfarb","startTime":1256.85,"endTime":1259.94,"body":"if you do have a fracture, I was"},{"speaker":"Charles Goldfarb","startTime":1259.94,"endTime":1264.71,"body":"taught to wait, let the fracture"},{"speaker":"Charles Goldfarb","startTime":1259.94,"endTime":1264.71,"body":"heal, and then go back out, go"},{"speaker":"Charles Goldfarb","startTime":1264.71,"endTime":1268.13,"body":"and do your surgery where you"},{"speaker":"Charles Goldfarb","startTime":1264.71,"endTime":1268.13,"body":"curretage and bone graft or plus"},{"speaker":"Charles Goldfarb","startTime":1268.13,"endTime":1271.7,"body":"minus bone graft. It's not how I"},{"speaker":"Charles Goldfarb","startTime":1268.13,"endTime":1271.7,"body":"think about I'm curious to how"},{"speaker":"Charles Goldfarb","startTime":1271.7,"endTime":1275.48,"body":"you think about the patient with"},{"speaker":"Charles Goldfarb","startTime":1271.7,"endTime":1275.48,"body":"the fracture, and also what you"},{"speaker":"Charles Goldfarb","startTime":1275.48,"endTime":1276.35,"body":"did for this patient."},{"speaker":"Chris Dy","startTime":1276.98,"endTime":1279.44,"body":"That's exactly how I"},{"speaker":"Chris Dy","startTime":1276.98,"endTime":1279.44,"body":"was taught. Probably because"},{"speaker":"Chris Dy","startTime":1279.44,"endTime":1282.74,"body":"somebody like he taught me that."},{"speaker":"Chris Dy","startTime":1279.44,"endTime":1282.74,"body":"But so it's interesting, because"},{"speaker":"Chris Dy","startTime":1282.74,"endTime":1284.87,"body":"it's like, if you have a"},{"speaker":"Chris Dy","startTime":1282.74,"endTime":1284.87,"body":"fracture, you're supposed to let"},{"speaker":"Chris Dy","startTime":1284.87,"endTime":1287.27,"body":"it heal and like, cool off, but"},{"speaker":"Chris Dy","startTime":1284.87,"endTime":1287.27,"body":"then you go back and do"},{"speaker":"Chris Dy","startTime":1287.27,"endTime":1289.91,"body":"something else. Like that"},{"speaker":"Chris Dy","startTime":1287.27,"endTime":1289.91,"body":"doesn't make a lot of sense. But"},{"speaker":"Chris Dy","startTime":1289.91,"endTime":1294.02,"body":"that is the teaching. This"},{"speaker":"Chris Dy","startTime":1289.91,"endTime":1294.02,"body":"patient had pain. And because of"},{"speaker":"Chris Dy","startTime":1294.02,"endTime":1297.2,"body":"the teaching, I said, Look, you"},{"speaker":"Chris Dy","startTime":1294.02,"endTime":1297.2,"body":"don't have a fracture. If you're"},{"speaker":"Chris Dy","startTime":1297.2,"endTime":1299.69,"body":"cool with just watching this,"},{"speaker":"Chris Dy","startTime":1297.2,"endTime":1299.69,"body":"why don't we just watch this,"},{"speaker":"Chris Dy","startTime":1299.72,"endTime":1302.48,"body":"I'll get, you know, therapists"},{"speaker":"Chris Dy","startTime":1299.72,"endTime":1302.48,"body":"can make you a splint if you"},{"speaker":"Chris Dy","startTime":1302.48,"endTime":1305.15,"body":"want, if you need support. But"},{"speaker":"Chris Dy","startTime":1302.48,"endTime":1305.15,"body":"honestly, if you know, you can"},{"speaker":"Chris Dy","startTime":1305.15,"endTime":1307.55,"body":"tell me when this reaches a"},{"speaker":"Chris Dy","startTime":1305.15,"endTime":1307.55,"body":"threshold where you're like, I"},{"speaker":"Chris Dy","startTime":1307.55,"endTime":1311.51,"body":"need to do something. And that's"},{"speaker":"Chris Dy","startTime":1307.55,"endTime":1311.51,"body":"initially what we talked about."},{"speaker":"Chris Dy","startTime":1312.14,"endTime":1314.3,"body":"How do you you said you think"},{"speaker":"Chris Dy","startTime":1312.14,"endTime":1314.3,"body":"about things differently than"},{"speaker":"Chris Dy","startTime":1314.3,"endTime":1315.83,"body":"the textbook. Now? How do you"},{"speaker":"Chris Dy","startTime":1314.3,"endTime":1315.83,"body":"think about it?"},{"speaker":"Charles Goldfarb","startTime":1316.55,"endTime":1318.32,"body":"Yeah, for the"},{"speaker":"Charles Goldfarb","startTime":1316.55,"endTime":1318.32,"body":"reasons you said, it makes no"},{"speaker":"Charles Goldfarb","startTime":1318.32,"endTime":1322.34,"body":"sense to me to let a fracture"},{"speaker":"Charles Goldfarb","startTime":1318.32,"endTime":1322.34,"body":"eel and then do surgery. I do"},{"speaker":"Charles Goldfarb","startTime":1322.34,"endTime":1325.19,"body":"think these don't get? Well, I"},{"speaker":"Charles Goldfarb","startTime":1322.34,"endTime":1325.19,"body":"should say that more clearly."},{"speaker":"Charles Goldfarb","startTime":1325.4,"endTime":1327.92,"body":"These don't get better, right?"},{"speaker":"Charles Goldfarb","startTime":1325.4,"endTime":1327.92,"body":"They're not going to go away."},{"speaker":"Charles Goldfarb","startTime":1327.92,"endTime":1331.61,"body":"And I sort of wonder why that"},{"speaker":"Charles Goldfarb","startTime":1327.92,"endTime":1331.61,"body":"became the teaching. And I think"},{"speaker":"Charles Goldfarb","startTime":1331.61,"endTime":1335.84,"body":"it's because if you think of"},{"speaker":"Charles Goldfarb","startTime":1331.61,"endTime":1335.84,"body":"pediatric lesions, and you think"},{"speaker":"Charles Goldfarb","startTime":1335.84,"endTime":1339.65,"body":"of something like a unicameral"},{"speaker":"Charles Goldfarb","startTime":1335.84,"endTime":1339.65,"body":"bone cyst, if those fracture,"},{"speaker":"Charles Goldfarb","startTime":1339.95,"endTime":1345.41,"body":"they can disappear. And then con"},{"speaker":"Charles Goldfarb","startTime":1339.95,"endTime":1345.41,"body":"drama with a fracture does not"},{"speaker":"Charles Goldfarb","startTime":1345.41,"endTime":1349.16,"body":"disappear. And so my philosophy"},{"speaker":"Charles Goldfarb","startTime":1345.41,"endTime":1349.16,"body":"is if you have a fracture, and"},{"speaker":"Charles Goldfarb","startTime":1349.19,"endTime":1352.28,"body":"honestly, even if you don't, I"},{"speaker":"Charles Goldfarb","startTime":1349.19,"endTime":1352.28,"body":"certainly it's a patient driven"},{"speaker":"Charles Goldfarb","startTime":1352.28,"endTime":1355.4,"body":"decision. But I encourage going"},{"speaker":"Charles Goldfarb","startTime":1352.28,"endTime":1355.4,"body":"ahead with the curretage and"},{"speaker":"Charles Goldfarb","startTime":1355.4,"endTime":1359.81,"body":"bone graft and I bone graft"},{"speaker":"Charles Goldfarb","startTime":1355.4,"endTime":1359.81,"body":"most. But not all of these"},{"speaker":"Charles Goldfarb","startTime":1359.81,"endTime":1365.33,"body":"depends a little bit on the"},{"speaker":"Charles Goldfarb","startTime":1359.81,"endTime":1365.33,"body":"size. I haven't gone with either"},{"speaker":"Charles Goldfarb","startTime":1365.96,"endTime":1368.93,"body":"autograph from the destroy"},{"speaker":"Charles Goldfarb","startTime":1365.96,"endTime":1368.93,"body":"radius, or off the shelf, I"},{"speaker":"Charles Goldfarb","startTime":1368.93,"endTime":1371.63,"body":"don't have a strong opinion"},{"speaker":"Charles Goldfarb","startTime":1368.93,"endTime":1371.63,"body":"about that. I think the key is"},{"speaker":"Charles Goldfarb","startTime":1371.63,"endTime":1372.59,"body":"in the aggressive curretage."},{"speaker":"Chris Dy","startTime":1373.68,"endTime":1375.57,"body":"taking away all the"},{"speaker":"Chris Dy","startTime":1373.68,"endTime":1375.57,"body":"discussion points. So you just"},{"speaker":"Chris Dy","startTime":1375.57,"endTime":1380.64,"body":"really just blew right through"},{"speaker":"Chris Dy","startTime":1375.57,"endTime":1380.64,"body":"that topic. You know, I had a"},{"speaker":"Chris Dy","startTime":1380.64,"endTime":1383.55,"body":"discussion with the patient, and"},{"speaker":"Chris Dy","startTime":1380.64,"endTime":1383.55,"body":"we decided to keep an eye on it."},{"speaker":"Chris Dy","startTime":1384.12,"endTime":1388.62,"body":"But lo and behold, the patient,"},{"speaker":"Chris Dy","startTime":1384.12,"endTime":1388.62,"body":"who I happen to know, contacted"},{"speaker":"Chris Dy","startTime":1388.62,"endTime":1392.67,"body":"me and said, I had this actually"},{"speaker":"Chris Dy","startTime":1388.62,"endTime":1392.67,"body":"really hurts. What can we do"},{"speaker":"Chris Dy","startTime":1392.67,"endTime":1396.33,"body":"about it? So I gave them the"},{"speaker":"Chris Dy","startTime":1392.67,"endTime":1396.33,"body":"options that you discussed. I"},{"speaker":"Chris Dy","startTime":1396.33,"endTime":1399.15,"body":"mean, so for those of you that"},{"speaker":"Chris Dy","startTime":1396.33,"endTime":1399.15,"body":"may not be as knowledgeable"},{"speaker":"Chris Dy","startTime":1399.15,"endTime":1401.82,"body":"about this topic just yet. I"},{"speaker":"Chris Dy","startTime":1399.15,"endTime":1401.82,"body":"mean, so what this is, this is a"},{"speaker":"Chris Dy","startTime":1401.82,"endTime":1406.44,"body":"benign cartilage tumor. tumor,"},{"speaker":"Chris Dy","startTime":1401.82,"endTime":1406.44,"body":"not necessarily cancer, of"},{"speaker":"Chris Dy","startTime":1406.44,"endTime":1410.97,"body":"course, but it's, it's benign."},{"speaker":"Chris Dy","startTime":1406.44,"endTime":1410.97,"body":"The recurrence risk is there."},{"speaker":"Chris Dy","startTime":1410.97,"endTime":1413.16,"body":"But I think what Chuck talked"},{"speaker":"Chris Dy","startTime":1410.97,"endTime":1413.16,"body":"about is that thorough"},{"speaker":"Chris Dy","startTime":1413.16,"endTime":1416.19,"body":"curretage, meaning you're"},{"speaker":"Chris Dy","startTime":1413.16,"endTime":1416.19,"body":"scraping out all of this stuff,"},{"speaker":"Chris Dy","startTime":1416.22,"endTime":1418.89,"body":"this cartilage stuff that's"},{"speaker":"Chris Dy","startTime":1416.22,"endTime":1418.89,"body":"sitting within the measure"},{"speaker":"Chris Dy","startTime":1418.89,"endTime":1422.07,"body":"layer, canal, the bone. And as"},{"speaker":"Chris Dy","startTime":1418.89,"endTime":1422.07,"body":"it kind of presses on the bone,"},{"speaker":"Chris Dy","startTime":1422.07,"endTime":1425.01,"body":"it can, you know, thin out the"},{"speaker":"Chris Dy","startTime":1422.07,"endTime":1425.01,"body":"cortex and eventually lead to a"},{"speaker":"Chris Dy","startTime":1425.1,"endTime":1428.85,"body":"fracture. So yeah, I mean, the"},{"speaker":"Chris Dy","startTime":1425.1,"endTime":1428.85,"body":"teaching to me was, you know, if"},{"speaker":"Chris Dy","startTime":1428.85,"endTime":1431.4,"body":"it's painful bothers them, they"},{"speaker":"Chris Dy","startTime":1428.85,"endTime":1431.4,"body":"want to do something you sure"},{"speaker":"Chris Dy","startTime":1431.4,"endTime":1434.67,"body":"attach it. So Chuck, how do you"},{"speaker":"Chris Dy","startTime":1431.4,"endTime":1434.67,"body":"decide where to go into the bone"},{"speaker":"Chris Dy","startTime":1434.67,"endTime":1438.69,"body":"to cure attach it? Is this a big"},{"speaker":"Chris Dy","startTime":1434.67,"endTime":1438.69,"body":"incision? Is it a small one? And"},{"speaker":"Chris Dy","startTime":1438.69,"endTime":1441.6,"body":"then what's your what's your"},{"speaker":"Chris Dy","startTime":1438.69,"endTime":1441.6,"body":"magic technique for getting all"},{"speaker":"Chris Dy","startTime":1441.6,"endTime":1444.18,"body":"of it out? Like you talked about"},{"speaker":"Chris Dy","startTime":1441.6,"endTime":1444.18,"body":"earlier? Yeah, I"},{"speaker":"Charles Goldfarb","startTime":1444.18,"endTime":1448.29,"body":"think the"},{"speaker":"Charles Goldfarb","startTime":1444.18,"endTime":1448.29,"body":"approach is, can be many. To me,"},{"speaker":"Charles Goldfarb","startTime":1448.29,"endTime":1453.18,"body":"it's whatever is simplest, and"},{"speaker":"Charles Goldfarb","startTime":1448.29,"endTime":1453.18,"body":"often that's dorsal, through the"},{"speaker":"Charles Goldfarb","startTime":1453.18,"endTime":1456.87,"body":"extensor, or adjacent to the"},{"speaker":"Charles Goldfarb","startTime":1453.18,"endTime":1456.87,"body":"extensor tendon, and often"},{"speaker":"Charles Goldfarb","startTime":1456.87,"endTime":1460.5,"body":"through the thinnest part of the"},{"speaker":"Charles Goldfarb","startTime":1456.87,"endTime":1460.5,"body":"lesion, if it's expands out, so"},{"speaker":"Charles Goldfarb","startTime":1460.5,"endTime":1463.32,"body":"the thinnest part of the bone, I"},{"speaker":"Charles Goldfarb","startTime":1460.5,"endTime":1463.32,"body":"open it up. You know,"},{"speaker":"Charles Goldfarb","startTime":1463.32,"endTime":1466.38,"body":"classically for weight bearing"},{"speaker":"Charles Goldfarb","startTime":1463.32,"endTime":1466.38,"body":"bones. We're taught to do that"},{"speaker":"Charles Goldfarb","startTime":1466.41,"endTime":1472.11,"body":"in a elliptical type fashion or"},{"speaker":"Charles Goldfarb","startTime":1466.41,"endTime":1472.11,"body":"a not a square, kind of"},{"speaker":"Charles Goldfarb","startTime":1472.14,"endTime":1474.45,"body":"perforation of the bone. I don't"},{"speaker":"Charles Goldfarb","startTime":1472.14,"endTime":1474.45,"body":"know that it really matters"},{"speaker":"Charles Goldfarb","startTime":1474.45,"endTime":1477.96,"body":"here. And then I just think it's"},{"speaker":"Charles Goldfarb","startTime":1474.45,"endTime":1477.96,"body":"aggressive Portage. Whoever's"},{"speaker":"Charles Goldfarb","startTime":1477.96,"endTime":1481.02,"body":"with me is pure dodging. I'm"},{"speaker":"Charles Goldfarb","startTime":1477.96,"endTime":1481.02,"body":"pure dodging. I'm irrigating."},{"speaker":"Charles Goldfarb","startTime":1481.38,"endTime":1484.8,"body":"And then plus minus packing with"},{"speaker":"Charles Goldfarb","startTime":1481.38,"endTime":1484.8,"body":"Bhangra. What about you?"},{"speaker":"Chris Dy","startTime":1485.58,"endTime":1488.28,"body":"Similar? You know, I"},{"speaker":"Chris Dy","startTime":1485.58,"endTime":1488.28,"body":"think for this particular case,"},{"speaker":"Chris Dy","startTime":1488.28,"endTime":1492.39,"body":"we're able to go adjacent to the"},{"speaker":"Chris Dy","startTime":1488.28,"endTime":1492.39,"body":"extensor mechanism. And yeah,"},{"speaker":"Chris Dy","startTime":1492.39,"endTime":1495.3,"body":"really is kind of aggressive"},{"speaker":"Chris Dy","startTime":1492.39,"endTime":1495.3,"body":"curatorial, getting your caret"},{"speaker":"Chris Dy","startTime":1495.3,"endTime":1497.61,"body":"in there and scraping all of it"},{"speaker":"Chris Dy","startTime":1495.3,"endTime":1497.61,"body":"out getting it from different"},{"speaker":"Chris Dy","startTime":1497.61,"endTime":1500.94,"body":"angles. How do you know when"},{"speaker":"Chris Dy","startTime":1497.61,"endTime":1500.94,"body":"you're done?"},{"speaker":"Charles Goldfarb","startTime":1502.95,"endTime":1506.49,"body":"You're done"},{"speaker":"Charles Goldfarb","startTime":1502.95,"endTime":1506.49,"body":"when you keep securitizing and"},{"speaker":"Charles Goldfarb","startTime":1506.49,"endTime":1509.49,"body":"all you're getting back is bone"},{"speaker":"Charles Goldfarb","startTime":1506.49,"endTime":1509.49,"body":"at least that's my take."},{"speaker":"Chris Dy","startTime":1509.94,"endTime":1513.84,"body":"And is there is there"},{"speaker":"Chris Dy","startTime":1509.94,"endTime":1513.84,"body":"is it possible to push too hard"},{"speaker":"Chris Dy","startTime":1513.93,"endTime":1516.57,"body":"and when you're curious dodging"},{"speaker":"Chris Dy","startTime":1513.93,"endTime":1516.57,"body":"and fracture that kind of thing"},{"speaker":"Chris Dy","startTime":1516.57,"endTime":1517.65,"body":"or weekend cortex"},{"speaker":"Charles Goldfarb","startTime":1517.89,"endTime":1523.05,"body":"For sure."},{"speaker":"Charles Goldfarb","startTime":1517.89,"endTime":1523.05,"body":"never happened to me but why did"},{"speaker":"Charles Goldfarb","startTime":1523.05,"endTime":1523.59,"body":"that happen?"},{"speaker":"Chris Dy","startTime":1524.09,"endTime":1526.31,"body":"It did it but I"},{"speaker":"Chris Dy","startTime":1524.09,"endTime":1526.31,"body":"thought about it as you're doing"},{"speaker":"Chris Dy","startTime":1526.31,"endTime":1528.23,"body":"it. You know, it's always"},{"speaker":"Chris Dy","startTime":1526.31,"endTime":1528.23,"body":"someone to things like when"},{"speaker":"Chris Dy","startTime":1528.23,"endTime":1530.84,"body":"you're harvesting distal radius,"},{"speaker":"Chris Dy","startTime":1528.23,"endTime":1530.84,"body":"kids Ellis autograph, you know,"},{"speaker":"Chris Dy","startTime":1530.84,"endTime":1533.96,"body":"the attendings got that extra"},{"speaker":"Chris Dy","startTime":1530.84,"endTime":1533.96,"body":"move that gets, you know, tons"},{"speaker":"Chris Dy","startTime":1533.96,"endTime":1537.35,"body":"of bone graft? I was like, if"},{"speaker":"Chris Dy","startTime":1533.96,"endTime":1537.35,"body":"I'm gonna push hard, this is"},{"speaker":"Chris Dy","startTime":1537.35,"endTime":1539.0,"body":"probably not the best situation"},{"speaker":"Chris Dy","startTime":1537.35,"endTime":1539.0,"body":"to do it in."},{"speaker":"Charles Goldfarb","startTime":1540.8,"endTime":1543.92,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":1540.8,"endTime":1543.92,"body":"the morbidity is low. So used"},{"speaker":"Charles Goldfarb","startTime":1543.92,"endTime":1546.23,"body":"autographed. Did you use"},{"speaker":"Charles Goldfarb","startTime":1543.92,"endTime":1546.23,"body":"autographed on this one? Well,"},{"speaker":"Chris Dy","startTime":1546.23,"endTime":1548.48,"body":"actually, I had a"},{"speaker":"Chris Dy","startTime":1546.23,"endTime":1548.48,"body":"discussion with patient I mean,"},{"speaker":"Chris Dy","startTime":1548.48,"endTime":1551.27,"body":"from the teaching that, you"},{"speaker":"Chris Dy","startTime":1548.48,"endTime":1551.27,"body":"know, I remember from training"},{"speaker":"Chris Dy","startTime":1551.27,"endTime":1553.49,"body":"and actually went looked up this"},{"speaker":"Chris Dy","startTime":1551.27,"endTime":1553.49,"body":"topic again, just to make sure"},{"speaker":"Chris Dy","startTime":1553.49,"endTime":1556.31,"body":"nothing had changed. Because"},{"speaker":"Chris Dy","startTime":1553.49,"endTime":1556.31,"body":"it's been a while since I've"},{"speaker":"Chris Dy","startTime":1556.31,"endTime":1560.69,"body":"trained. There's no difference"},{"speaker":"Chris Dy","startTime":1556.31,"endTime":1560.69,"body":"between using an allograft"},{"speaker":"Chris Dy","startTime":1560.69,"endTime":1564.23,"body":"versus, you know, so cadaver"},{"speaker":"Chris Dy","startTime":1560.69,"endTime":1564.23,"body":"bone versus using somebody's own"},{"speaker":"Chris Dy","startTime":1564.23,"endTime":1567.68,"body":"cancellous bone. So, with that"},{"speaker":"Chris Dy","startTime":1564.23,"endTime":1567.68,"body":"in mind, and with this person"},{"speaker":"Chris Dy","startTime":1567.68,"endTime":1571.64,"body":"who wanted to get back to using"},{"speaker":"Chris Dy","startTime":1567.68,"endTime":1571.64,"body":"their hands and doing procedures"},{"speaker":"Chris Dy","startTime":1571.64,"endTime":1574.76,"body":"as quickly as possible, we had a"},{"speaker":"Chris Dy","startTime":1571.64,"endTime":1574.76,"body":"discussion, but honestly, I kind"},{"speaker":"Chris Dy","startTime":1574.76,"endTime":1576.77,"body":"of steered her towards Allah"},{"speaker":"Chris Dy","startTime":1574.76,"endTime":1576.77,"body":"graft. And that's what she"},{"speaker":"Chris Dy","startTime":1576.77,"endTime":1577.22,"body":"picked to."},{"speaker":"Charles Goldfarb","startTime":1577.94,"endTime":1579.71,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":1577.94,"endTime":1579.71,"body":"that's great. I, you know,"},{"speaker":"Charles Goldfarb","startTime":1579.71,"endTime":1583.76,"body":"healing time is variable. In my"},{"speaker":"Charles Goldfarb","startTime":1579.71,"endTime":1583.76,"body":"experience, it could be six to"},{"speaker":"Charles Goldfarb","startTime":1583.76,"endTime":1587.42,"body":"10 weeks to really feel"},{"speaker":"Charles Goldfarb","startTime":1583.76,"endTime":1587.42,"body":"competent. But yeah, I think"},{"speaker":"Charles Goldfarb","startTime":1587.42,"endTime":1589.79,"body":"people get back to activities"},{"speaker":"Charles Goldfarb","startTime":1587.42,"endTime":1589.79,"body":"much sooner than that."},{"speaker":"Chris Dy","startTime":1590.12,"endTime":1593.18,"body":"So when you when you"},{"speaker":"Chris Dy","startTime":1590.12,"endTime":1593.18,"body":"pack this, after you've packed"},{"speaker":"Chris Dy","startTime":1593.18,"endTime":1598.97,"body":"it with as much of the choice,"},{"speaker":"Chris Dy","startTime":1593.18,"endTime":1598.97,"body":"you know, graft, how do you know"},{"speaker":"Chris Dy","startTime":1598.97,"endTime":1602.03,"body":"when you're done? And then what"},{"speaker":"Chris Dy","startTime":1598.97,"endTime":1602.03,"body":"do you do after?"},{"speaker":"Charles Goldfarb","startTime":1602.9,"endTime":1605.84,"body":"Yeah, you pack"},{"speaker":"Charles Goldfarb","startTime":1602.9,"endTime":1605.84,"body":"it till you can pack it anymore."},{"speaker":"Charles Goldfarb","startTime":1606.35,"endTime":1609.44,"body":"Ideally, it's not spilling out,"},{"speaker":"Charles Goldfarb","startTime":1606.35,"endTime":1609.44,"body":"but you pack it nicely."},{"speaker":"Charles Goldfarb","startTime":1610.01,"endTime":1613.37,"body":"radiographs, you know, mini c-"},{"speaker":"Charles Goldfarb","startTime":1610.01,"endTime":1613.37,"body":"arm look really great when you"},{"speaker":"Charles Goldfarb","startTime":1613.37,"endTime":1619.88,"body":"pack it nice and full. I tend"},{"speaker":"Charles Goldfarb","startTime":1613.37,"endTime":1619.88,"body":"to, in the OR, put a big, bulky"},{"speaker":"Charles Goldfarb","startTime":1619.94,"endTime":1624.59,"body":"forearm based splint, and then a"},{"speaker":"Charles Goldfarb","startTime":1619.94,"endTime":1624.59,"body":"week to two weeks later, haven't"},{"speaker":"Charles Goldfarb","startTime":1624.59,"endTime":1627.77,"body":"go to clinic and get something"},{"speaker":"Charles Goldfarb","startTime":1624.59,"endTime":1627.77,"body":"really small and removable and"},{"speaker":"Charles Goldfarb","startTime":1627.77,"endTime":1630.47,"body":"start moving. So we don't worry"},{"speaker":"Charles Goldfarb","startTime":1627.77,"endTime":1630.47,"body":"about the stiffness piece."},{"speaker":"Chris Dy","startTime":1630.98,"endTime":1633.56,"body":"So when do you think"},{"speaker":"Chris Dy","startTime":1630.98,"endTime":1633.56,"body":"they're okay to start doing"},{"speaker":"Chris Dy","startTime":1633.59,"endTime":1636.95,"body":"things with their hand in terms"},{"speaker":"Chris Dy","startTime":1633.59,"endTime":1636.95,"body":"of light activities and beyond?"},{"speaker":"Charles Goldfarb","startTime":1637.67,"endTime":1639.26,"body":"Yeah,"},{"speaker":"Charles Goldfarb","startTime":1637.67,"endTime":1639.26,"body":"obviously depends a little bit"},{"speaker":"Charles Goldfarb","startTime":1639.26,"endTime":1643.1,"body":"on how thin the cortices are. If"},{"speaker":"Charles Goldfarb","startTime":1639.26,"endTime":1643.1,"body":"it's a typical case, where maybe"},{"speaker":"Charles Goldfarb","startTime":1643.1,"endTime":1646.16,"body":"there's mild thinning, but not"},{"speaker":"Charles Goldfarb","startTime":1643.1,"endTime":1646.16,"body":"dramatic. I think it you know,"},{"speaker":"Charles Goldfarb","startTime":1646.16,"endTime":1648.65,"body":"they can obviously the light"},{"speaker":"Charles Goldfarb","startTime":1646.16,"endTime":1648.65,"body":"activities, essentially right"},{"speaker":"Charles Goldfarb","startTime":1648.65,"endTime":1651.89,"body":"away, or heavy gripping or"},{"speaker":"Charles Goldfarb","startTime":1648.65,"endTime":1651.89,"body":"hitting the gym or playing a"},{"speaker":"Charles Goldfarb","startTime":1651.89,"endTime":1654.98,"body":"sport. I do think you have to be"},{"speaker":"Charles Goldfarb","startTime":1651.89,"endTime":1654.98,"body":"a little careful. So probably,"},{"speaker":"Charles Goldfarb","startTime":1655.01,"endTime":1657.77,"body":"again, depending on the details,"},{"speaker":"Charles Goldfarb","startTime":1655.01,"endTime":1657.77,"body":"six weeks. Right,"},{"speaker":"Chris Dy","startTime":1657.8,"endTime":1659.57,"body":"right, right. So yeah,"},{"speaker":"Chris Dy","startTime":1657.8,"endTime":1659.57,"body":"no, I think that's the balance"},{"speaker":"Chris Dy","startTime":1659.57,"endTime":1663.23,"body":"is trying to figure out kind of"},{"speaker":"Chris Dy","startTime":1659.57,"endTime":1663.23,"body":"what you will let them do an"},{"speaker":"Chris Dy","startTime":1663.23,"endTime":1665.99,"body":"even little things about when"},{"speaker":"Chris Dy","startTime":1663.23,"endTime":1665.99,"body":"you will let them sweat and"},{"speaker":"Chris Dy","startTime":1665.99,"endTime":1668.0,"body":"shower and that kind of thing. I"},{"speaker":"Chris Dy","startTime":1665.99,"endTime":1668.0,"body":"mean, you So you went through"},{"speaker":"Chris Dy","startTime":1668.0,"endTime":1670.94,"body":"this recently in the past with"},{"speaker":"Chris Dy","startTime":1668.0,"endTime":1670.94,"body":"various surgeries? I mean,"},{"speaker":"Chris Dy","startTime":1670.94,"endTime":1673.22,"body":"what's your threshold? And"},{"speaker":"Chris Dy","startTime":1670.94,"endTime":1673.22,"body":"actually asked this question"},{"speaker":"Chris Dy","startTime":1673.22,"endTime":1676.19,"body":"when I was doing a case recently"},{"speaker":"Chris Dy","startTime":1673.22,"endTime":1676.19,"body":"with our partner, David Bergen."},{"speaker":"Chris Dy","startTime":1677.15,"endTime":1679.43,"body":"Like, hey, when do you let"},{"speaker":"Chris Dy","startTime":1677.15,"endTime":1679.43,"body":"people start to let things get"},{"speaker":"Chris Dy","startTime":1679.43,"endTime":1682.58,"body":"wet? And when do you let them"},{"speaker":"Chris Dy","startTime":1679.43,"endTime":1682.58,"body":"start to sweat? So what's just"},{"speaker":"Chris Dy","startTime":1682.85,"endTime":1685.82,"body":"backing out of this case, but"},{"speaker":"Chris Dy","startTime":1682.85,"endTime":1685.82,"body":"like, you know, what's your"},{"speaker":"Chris Dy","startTime":1685.82,"endTime":1686.54,"body":"threshold for that?"},{"speaker":"Charles Goldfarb","startTime":1686.93,"endTime":1689.12,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":1686.93,"endTime":1689.12,"body":"we've talked I don't know if we"},{"speaker":"Charles Goldfarb","startTime":1689.12,"endTime":1693.92,"body":"have but I've gotten really what"},{"speaker":"Charles Goldfarb","startTime":1689.12,"endTime":1693.92,"body":"I think is liberal, for most"},{"speaker":"Charles Goldfarb","startTime":1693.92,"endTime":1697.52,"body":"conditions is three days if I'm"},{"speaker":"Charles Goldfarb","startTime":1693.92,"endTime":1697.52,"body":"gonna let them take off a splint"},{"speaker":"Charles Goldfarb","startTime":1697.52,"endTime":1701.15,"body":"or dressing. If I'm worried for"},{"speaker":"Charles Goldfarb","startTime":1697.52,"endTime":1701.15,"body":"whatever reason, it's five to"},{"speaker":"Charles Goldfarb","startTime":1701.15,"endTime":1705.77,"body":"seven days. As far as getting it"},{"speaker":"Charles Goldfarb","startTime":1701.15,"endTime":1705.77,"body":"wet. Soaking, it probably is"},{"speaker":"Charles Goldfarb","startTime":1705.77,"endTime":1708.2,"body":"fine at those same time at"},{"speaker":"Charles Goldfarb","startTime":1705.77,"endTime":1708.2,"body":"rolls, but I generally ask them"},{"speaker":"Charles Goldfarb","startTime":1708.2,"endTime":1710.51,"body":"to wait until they see me at the"},{"speaker":"Charles Goldfarb","startTime":1708.2,"endTime":1710.51,"body":"first post operative visit."},{"speaker":"Chris Dy","startTime":1711.05,"endTime":1713.3,"body":"These do you feel"},{"speaker":"Chris Dy","startTime":1711.05,"endTime":1713.3,"body":"different about getting wet"},{"speaker":"Chris Dy","startTime":1713.3,"endTime":1716.87,"body":"versus sweating? Of course this"},{"speaker":"Chris Dy","startTime":1713.3,"endTime":1716.87,"body":"person needs wants to run."},{"speaker":"Charles Goldfarb","startTime":1717.65,"endTime":1719.57,"body":"I don't feel"},{"speaker":"Charles Goldfarb","startTime":1717.65,"endTime":1719.57,"body":"different at all. I think the"},{"speaker":"Charles Goldfarb","startTime":1719.57,"endTime":1722.9,"body":"epidermis is sealed by three"},{"speaker":"Charles Goldfarb","startTime":1719.57,"endTime":1722.9,"body":"days. I think they're fine."},{"speaker":"Chris Dy","startTime":1723.77,"endTime":1727.07,"body":"yeah. So I've actually"},{"speaker":"Chris Dy","startTime":1723.77,"endTime":1727.07,"body":"because of our my trip to"},{"speaker":"Chris Dy","startTime":1727.4,"endTime":1730.7,"body":"Washington, DC and switching my"},{"speaker":"Chris Dy","startTime":1727.4,"endTime":1730.7,"body":"wound closure, based on the"},{"speaker":"Chris Dy","startTime":1730.7,"endTime":1733.76,"body":"advice of our colleagues, Sam"},{"speaker":"Chris Dy","startTime":1730.7,"endTime":1733.76,"body":"moved to Terry. I've gone to"},{"speaker":"Chris Dy","startTime":1733.76,"endTime":1737.72,"body":"three days for carpels triggers"},{"speaker":"Chris Dy","startTime":1733.76,"endTime":1737.72,"body":"and anything that I close with"},{"speaker":"Chris Dy","startTime":1737.84,"endTime":1739.52,"body":"subcuticular closure and double"},{"speaker":"Chris Dy","startTime":1737.84,"endTime":1739.52,"body":"bond."},{"speaker":"Charles Goldfarb","startTime":1740.27,"endTime":1742.79,"body":"Yeah, I love"},{"speaker":"Charles Goldfarb","startTime":1740.27,"endTime":1742.79,"body":"that. I would dermabond I get"},{"speaker":"Charles Goldfarb","startTime":1742.79,"endTime":1747.41,"body":"one day but hope one day, all"},{"speaker":"Charles Goldfarb","startTime":1742.79,"endTime":1747.41,"body":"right, one day, and then before"},{"speaker":"Charles Goldfarb","startTime":1747.41,"endTime":1752.33,"body":"we switch gears, you know, and"},{"speaker":"Charles Goldfarb","startTime":1747.41,"endTime":1752.33,"body":"this is maybe for the residents"},{"speaker":"Charles Goldfarb","startTime":1752.33,"endTime":1756.62,"body":"or medical students. Ali aids"},{"speaker":"Charles Goldfarb","startTime":1752.33,"endTime":1756.62,"body":"disease spelled Ali eres disease"},{"speaker":"Charles Goldfarb","startTime":1756.62,"endTime":1759.05,"body":"is a really interesting"},{"speaker":"Charles Goldfarb","startTime":1756.62,"endTime":1759.05,"body":"condition associated with it and"},{"speaker":"Charles Goldfarb","startTime":1759.05,"endTime":1762.32,"body":"Kendra was actually multiple and"},{"speaker":"Charles Goldfarb","startTime":1759.05,"endTime":1762.32,"body":"kendama ptosis. And these can be"},{"speaker":"Charles Goldfarb","startTime":1762.32,"endTime":1766.91,"body":"very different players much more"},{"speaker":"Charles Goldfarb","startTime":1762.32,"endTime":1766.91,"body":"aggressive. They require more"},{"speaker":"Charles Goldfarb","startTime":1766.91,"endTime":1772.58,"body":"significant and multiple bone"},{"speaker":"Charles Goldfarb","startTime":1766.91,"endTime":1772.58,"body":"procedures. And what's super"},{"speaker":"Charles Goldfarb","startTime":1772.58,"endTime":1776.48,"body":"interesting about this is it it"},{"speaker":"Charles Goldfarb","startTime":1772.58,"endTime":1776.48,"body":"affects only one side of the"},{"speaker":"Charles Goldfarb","startTime":1776.48,"endTime":1779.27,"body":"body. That's the that's the"},{"speaker":"Charles Goldfarb","startTime":1776.48,"endTime":1779.27,"body":"trivia there."},{"speaker":"Chris Dy","startTime":1779.42,"endTime":1781.49,"body":"So there you go."},{"speaker":"Chris Dy","startTime":1779.42,"endTime":1781.49,"body":"There's your first aid for the"},{"speaker":"Chris Dy","startTime":1781.49,"endTime":1786.74,"body":"Board's from Chuck Goldfarb."},{"speaker":"Chris Dy","startTime":1781.49,"endTime":1786.74,"body":"Yeah, so, so all yeas aside, how"},{"speaker":"Chris Dy","startTime":1786.74,"endTime":1789.89,"body":"do you counsel patients with an"},{"speaker":"Chris Dy","startTime":1786.74,"endTime":1789.89,"body":"isolated Anton drama about"},{"speaker":"Chris Dy","startTime":1790.1,"endTime":1791.75,"body":"potential recurrence risk etc."},{"speaker":"Charles Goldfarb","startTime":1792.83,"endTime":1794.9,"body":"Knock on wood,"},{"speaker":"Charles Goldfarb","startTime":1792.83,"endTime":1794.9,"body":"I haven't seen much I can tell"},{"speaker":"Charles Goldfarb","startTime":1794.9,"endTime":1799.25,"body":"them. It's somewhere between"},{"speaker":"Charles Goldfarb","startTime":1794.9,"endTime":1799.25,"body":"five and 10% for a typical if I"},{"speaker":"Charles Goldfarb","startTime":1799.25,"endTime":1803.42,"body":"feel like we've done Good job"},{"speaker":"Charles Goldfarb","startTime":1799.25,"endTime":1803.42,"body":"which we have for Fallon, Gio"},{"speaker":"Charles Goldfarb","startTime":1803.42,"endTime":1807.02,"body":"and candriam. I say five to 10%."},{"speaker":"Charles Goldfarb","startTime":1803.42,"endTime":1807.02,"body":"What? What is your number?"},{"speaker":"Chris Dy","startTime":1807.32,"endTime":1809.66,"body":"I basically say the"},{"speaker":"Chris Dy","startTime":1807.32,"endTime":1809.66,"body":"same thing. I think I tell them"},{"speaker":"Chris Dy","startTime":1809.66,"endTime":1812.87,"body":"it's low, but it's not zero. So"},{"speaker":"Chris Dy","startTime":1809.66,"endTime":1812.87,"body":"I think I use that for a lot of"},{"speaker":"Chris Dy","startTime":1812.87,"endTime":1815.33,"body":"things if even if for the"},{"speaker":"Chris Dy","startTime":1812.87,"endTime":1815.33,"body":"residents and fellows that have"},{"speaker":"Chris Dy","startTime":1815.33,"endTime":1817.82,"body":"been in my clinic, because I"},{"speaker":"Chris Dy","startTime":1815.33,"endTime":1817.82,"body":"think if you're the one, it's"},{"speaker":"Chris Dy","startTime":1817.82,"endTime":1821.63,"body":"all relevant or so. All right."},{"speaker":"Chris Dy","startTime":1817.82,"endTime":1821.63,"body":"Well, that was a good"},{"speaker":"Chris Dy","startTime":1821.63,"endTime":1824.15,"body":"discussion. Thank you for"},{"speaker":"Chris Dy","startTime":1821.63,"endTime":1824.15,"body":"sharing your thoughts on that."},{"speaker":"Chris Dy","startTime":1824.15,"endTime":1827.99,"body":"And bucking the textbook. Tell"},{"speaker":"Chris Dy","startTime":1824.15,"endTime":1827.99,"body":"me about this case that you have"},{"speaker":"Chris Dy","startTime":1827.99,"endTime":1829.97,"body":"as we kind of wind things up."},{"speaker":"Chris Dy","startTime":1827.99,"endTime":1829.97,"body":"Yeah,"},{"speaker":"Charles Goldfarb","startTime":1830.03,"endTime":1831.56,"body":"I this is"},{"speaker":"Charles Goldfarb","startTime":1830.03,"endTime":1831.56,"body":"something we haven't really"},{"speaker":"Charles Goldfarb","startTime":1831.56,"endTime":1836.24,"body":"touched on. I had a patient a"},{"speaker":"Charles Goldfarb","startTime":1831.56,"endTime":1836.24,"body":"couple of months ago, that I was"},{"speaker":"Charles Goldfarb","startTime":1836.24,"endTime":1841.94,"body":"taken to the operating room for"},{"speaker":"Charles Goldfarb","startTime":1836.24,"endTime":1841.94,"body":"a presumed foveal TFCC tear. And"},{"speaker":"Charles Goldfarb","startTime":1841.97,"endTime":1845.18,"body":"I had seen and treated him over"},{"speaker":"Charles Goldfarb","startTime":1841.97,"endTime":1845.18,"body":"a couple of months, I think I'd"},{"speaker":"Charles Goldfarb","startTime":1845.18,"endTime":1847.79,"body":"given him a steroid injection,"},{"speaker":"Charles Goldfarb","startTime":1845.18,"endTime":1847.79,"body":"which helped temporarily,"},{"speaker":"Charles Goldfarb","startTime":1848.06,"endTime":1853.16,"body":"someone back in clinic the last"},{"speaker":"Charles Goldfarb","startTime":1848.06,"endTime":1853.16,"body":"visit before x rays looked fine."},{"speaker":"Charles Goldfarb","startTime":1854.39,"endTime":1858.17,"body":"But not only did he have pain at"},{"speaker":"Charles Goldfarb","startTime":1854.39,"endTime":1858.17,"body":"the fovea, you know, just volar"},{"speaker":"Charles Goldfarb","startTime":1858.17,"endTime":1862.88,"body":"to the ulnar styloid. He had"},{"speaker":"Charles Goldfarb","startTime":1858.17,"endTime":1862.88,"body":"tenderness over the pisiform and"},{"speaker":"Charles Goldfarb","startTime":1862.88,"endTime":1866.36,"body":"owed by over I mean directly"},{"speaker":"Charles Goldfarb","startTime":1862.88,"endTime":1866.36,"body":"bowler, but also on the owner"},{"speaker":"Charles Goldfarb","startTime":1866.36,"endTime":1868.46,"body":"side of the piece of form. And"},{"speaker":"Charles Goldfarb","startTime":1866.36,"endTime":1868.46,"body":"so, you know, there are"},{"speaker":"Charles Goldfarb","startTime":1868.46,"endTime":1871.67,"body":"specialized X rays one can"},{"speaker":"Charles Goldfarb","startTime":1868.46,"endTime":1871.67,"body":"obtain to rule out easier to"},{"speaker":"Charles Goldfarb","startTime":1871.67,"endTime":1875.69,"body":"track which arthritis. I don't"},{"speaker":"Charles Goldfarb","startTime":1871.67,"endTime":1875.69,"body":"find those to be invaluable."},{"speaker":"Charles Goldfarb","startTime":1875.69,"endTime":1879.98,"body":"Meaning I think people can have"},{"speaker":"Charles Goldfarb","startTime":1875.69,"endTime":1879.98,"body":"symptomatic pain at the pizza"},{"speaker":"Charles Goldfarb","startTime":1879.98,"endTime":1883.94,"body":"trick which will join even"},{"speaker":"Charles Goldfarb","startTime":1879.98,"endTime":1883.94,"body":"without obvious arthritis. But"},{"speaker":"Charles Goldfarb","startTime":1883.94,"endTime":1887.69,"body":"it's an interesting diagnosis."},{"speaker":"Charles Goldfarb","startTime":1883.94,"endTime":1887.69,"body":"And so how do you think about"},{"speaker":"Charles Goldfarb","startTime":1887.69,"endTime":1890.75,"body":"pico trek mutual pain plus minus"},{"speaker":"Charles Goldfarb","startTime":1887.69,"endTime":1890.75,"body":"arthritis?"},{"speaker":"Chris Dy","startTime":1891.83,"endTime":1893.6,"body":"Well, I mean, I think"},{"speaker":"Chris Dy","startTime":1891.83,"endTime":1893.6,"body":"it's certainly has to be in the"},{"speaker":"Chris Dy","startTime":1893.6,"endTime":1896.57,"body":"differential. You know,"},{"speaker":"Chris Dy","startTime":1893.6,"endTime":1896.57,"body":"basically, every patient who I"},{"speaker":"Chris Dy","startTime":1896.57,"endTime":1899.96,"body":"see with on their side of wrist"},{"speaker":"Chris Dy","startTime":1896.57,"endTime":1899.96,"body":"pain, I will examine, and"},{"speaker":"Chris Dy","startTime":1899.96,"endTime":1902.81,"body":"palpate a piece of form and do a"},{"speaker":"Chris Dy","startTime":1899.96,"endTime":1902.81,"body":"piece of track, which will boost"},{"speaker":"Chris Dy","startTime":1902.81,"endTime":1905.84,"body":"tests, essentially, you're"},{"speaker":"Chris Dy","startTime":1902.81,"endTime":1905.84,"body":"trying to really provoke the"},{"speaker":"Chris Dy","startTime":1905.87,"endTime":1908.09,"body":"pisifrom against the track,"},{"speaker":"Chris Dy","startTime":1905.87,"endTime":1908.09,"body":"we're trying to see if you can"},{"speaker":"Chris Dy","startTime":1908.09,"endTime":1911.3,"body":"get some pain going there. And"},{"speaker":"Chris Dy","startTime":1908.09,"endTime":1911.3,"body":"that's a very distinct kind of"},{"speaker":"Chris Dy","startTime":1911.3,"endTime":1915.47,"body":"pain. So I it's certainly seen"},{"speaker":"Chris Dy","startTime":1911.3,"endTime":1915.47,"body":"me I've seen it a fair number of"},{"speaker":"Chris Dy","startTime":1915.47,"endTime":1918.83,"body":"times, it's probably see me more"},{"speaker":"Chris Dy","startTime":1915.47,"endTime":1918.83,"body":"than I've seen it. But, you"},{"speaker":"Chris Dy","startTime":1918.83,"endTime":1921.35,"body":"know, honestly, after reading a"},{"speaker":"Chris Dy","startTime":1918.83,"endTime":1921.35,"body":"few articles, I became much more"},{"speaker":"Chris Dy","startTime":1921.35,"endTime":1923.54,"body":"attuned to the diagnosis and"},{"speaker":"Chris Dy","startTime":1921.35,"endTime":1923.54,"body":"started looking for more."},{"speaker":"Charles Goldfarb","startTime":1924.44,"endTime":1927.14,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":1924.44,"endTime":1927.14,"body":"I think we have to look for it,"},{"speaker":"Charles Goldfarb","startTime":1927.17,"endTime":1930.11,"body":"because it's very easy to"},{"speaker":"Charles Goldfarb","startTime":1927.17,"endTime":1930.11,"body":"attribute that, especially if"},{"speaker":"Charles Goldfarb","startTime":1930.11,"endTime":1933.2,"body":"the pains more vague to whatever"},{"speaker":"Charles Goldfarb","startTime":1930.11,"endTime":1933.2,"body":"on the owner side of the wrist."},{"speaker":"Charles Goldfarb","startTime":1934.4,"endTime":1938.21,"body":"The boost test or you know,"},{"speaker":"Charles Goldfarb","startTime":1934.4,"endTime":1938.21,"body":"direct pressure dorsally"},{"speaker":"Charles Goldfarb","startTime":1938.21,"endTime":1941.84,"body":"directed pressure on the"},{"speaker":"Charles Goldfarb","startTime":1938.21,"endTime":1941.84,"body":"pisiform or radially directed"},{"speaker":"Charles Goldfarb","startTime":1941.84,"endTime":1946.1,"body":"pressure, the pisiform also"},{"speaker":"Charles Goldfarb","startTime":1941.84,"endTime":1946.1,"body":"typically have them farther FCU"},{"speaker":"Charles Goldfarb","startTime":1946.7,"endTime":1952.04,"body":"to see if that elicits any pain."},{"speaker":"Charles Goldfarb","startTime":1946.7,"endTime":1952.04,"body":"Long story short is I didn't see"},{"speaker":"Charles Goldfarb","startTime":1952.04,"endTime":1956.06,"body":"evidence for arthritis by MRI or"},{"speaker":"Charles Goldfarb","startTime":1952.04,"endTime":1956.06,"body":"X ray on this patient. Pain was"},{"speaker":"Charles Goldfarb","startTime":1956.06,"endTime":1960.83,"body":"absolutely consistent. And so I"},{"speaker":"Charles Goldfarb","startTime":1956.06,"endTime":1960.83,"body":"talked to a patient about the"},{"speaker":"Charles Goldfarb","startTime":1960.83,"endTime":1965.87,"body":"options and my plan was at the"},{"speaker":"Charles Goldfarb","startTime":1960.83,"endTime":1965.87,"body":"time of arthroscopy, a confirmed"},{"speaker":"Charles Goldfarb","startTime":1965.87,"endTime":1969.62,"body":"there was a folio TFC tear, so"},{"speaker":"Charles Goldfarb","startTime":1965.87,"endTime":1969.62,"body":"we repaired it, and one can"},{"speaker":"Charles Goldfarb","startTime":1969.62,"endTime":1973.97,"body":"sometimes scope the"},{"speaker":"Charles Goldfarb","startTime":1969.62,"endTime":1973.97,"body":"pisotriquetral  joint. I and"},{"speaker":"Charles Goldfarb","startTime":1973.97,"endTime":1976.79,"body":"others talk about that I think"},{"speaker":"Charles Goldfarb","startTime":1973.97,"endTime":1976.79,"body":"it's often a long run for a"},{"speaker":"Charles Goldfarb","startTime":1976.79,"endTime":1980.81,"body":"short slide. So it's not a huge"},{"speaker":"Charles Goldfarb","startTime":1976.79,"endTime":1980.81,"body":"part of what I do. In this case,"},{"speaker":"Charles Goldfarb","startTime":1980.81,"endTime":1984.86,"body":"I told him that if I didn't see"},{"speaker":"Charles Goldfarb","startTime":1980.81,"endTime":1984.86,"body":"any other reason for pizza"},{"speaker":"Charles Goldfarb","startTime":1984.86,"endTime":1989.15,"body":"tracheal pain that I would"},{"speaker":"Charles Goldfarb","startTime":1984.86,"endTime":1989.15,"body":"perform an open open pisiform"},{"speaker":"Charles Goldfarb","startTime":1989.15,"endTime":1994.97,"body":"ectomy which felt a little"},{"speaker":"Charles Goldfarb","startTime":1989.15,"endTime":1994.97,"body":"aggressive. But in retrospect,"},{"speaker":"Charles Goldfarb","startTime":1995.03,"endTime":1999.62,"body":"it wasn't. And in this patient,"},{"speaker":"Charles Goldfarb","startTime":1995.03,"endTime":1999.62,"body":"there were a number of there was"},{"speaker":"Charles Goldfarb","startTime":1999.62,"endTime":2004.12,"body":"probably 15 Kandra loose bodies"},{"speaker":"Charles Goldfarb","startTime":1999.62,"endTime":2004.12,"body":"in the Pietro cultural trial and"},{"speaker":"Charles Goldfarb","startTime":2004.12,"endTime":2007.84,"body":"are visible by you know, but"},{"speaker":"Charles Goldfarb","startTime":2004.12,"endTime":2007.84,"body":"that's not really the point of"},{"speaker":"Charles Goldfarb","startTime":2007.87,"endTime":2010.81,"body":"this discussion. It's just be"},{"speaker":"Charles Goldfarb","startTime":2007.87,"endTime":2010.81,"body":"aware of the pisotriquetral"},{"speaker":"Charles Goldfarb","startTime":2010.81,"endTime":2011.05,"body":"joint."},{"speaker":"Chris Dy","startTime":2011.29,"endTime":2014.83,"body":"ya know, when I see"},{"speaker":"Chris Dy","startTime":2011.29,"endTime":2014.83,"body":"somebody who has well, who I"},{"speaker":"Chris Dy","startTime":2014.83,"endTime":2018.31,"body":"think has pain, because of"},{"speaker":"Chris Dy","startTime":2014.83,"endTime":2018.31,"body":"pisotriquetral synovitis or"},{"speaker":"Chris Dy","startTime":2018.31,"endTime":2021.34,"body":"arthritis, I will typically send"},{"speaker":"Chris Dy","startTime":2018.31,"endTime":2021.34,"body":"them for an ultrasound guided"},{"speaker":"Chris Dy","startTime":2021.34,"endTime":2024.28,"body":"steroid injection, i Yes, I"},{"speaker":"Chris Dy","startTime":2021.34,"endTime":2024.28,"body":"could do it in the office under"},{"speaker":"Chris Dy","startTime":2024.28,"endTime":2028.21,"body":"fluoroscopy. To be very honest"},{"speaker":"Chris Dy","startTime":2024.28,"endTime":2028.21,"body":"with you, it tends to be it"},{"speaker":"Chris Dy","startTime":2028.21,"endTime":2031.15,"body":"kills workflow. So I send them"},{"speaker":"Chris Dy","startTime":2028.21,"endTime":2031.15,"body":"for that injection. And that way"},{"speaker":"Chris Dy","startTime":2031.15,"endTime":2033.52,"body":"I know it's exactly where it"},{"speaker":"Chris Dy","startTime":2031.15,"endTime":2033.52,"body":"needs to be. It tends to be"},{"speaker":"Chris Dy","startTime":2033.52,"endTime":2035.08,"body":"under ultrasound guidance,"},{"speaker":"Chris Dy","startTime":2033.52,"endTime":2035.08,"body":"although depending on the"},{"speaker":"Chris Dy","startTime":2035.08,"endTime":2039.34,"body":"student, they may do it under"},{"speaker":"Chris Dy","startTime":2035.08,"endTime":2039.34,"body":"fluoroscopy. I like that I've"},{"speaker":"Chris Dy","startTime":2039.34,"endTime":2043.21,"body":"had to do a piece of form ectomy"},{"speaker":"Chris Dy","startTime":2039.34,"endTime":2043.21,"body":"on one patient for that reason"},{"speaker":"Chris Dy","startTime":2043.24,"endTime":2045.85,"body":"for this condition, but most"},{"speaker":"Chris Dy","startTime":2043.24,"endTime":2045.85,"body":"people I feel like tend to get"},{"speaker":"Chris Dy","startTime":2045.85,"endTime":2048.37,"body":"better with with a steroid shot."},{"speaker":"Charles Goldfarb","startTime":2049.06,"endTime":2050.98,"body":"Absolutely. So"},{"speaker":"Charles Goldfarb","startTime":2049.06,"endTime":2050.98,"body":"well said steroid shots have"},{"speaker":"Charles Goldfarb","startTime":2051.01,"endTime":2055.39,"body":"absolute role here. And if you"},{"speaker":"Charles Goldfarb","startTime":2051.01,"endTime":2055.39,"body":"do find yourself performing a"},{"speaker":"Charles Goldfarb","startTime":2055.39,"endTime":2058.03,"body":"piece of porn recommend, there's"},{"speaker":"Charles Goldfarb","startTime":2055.39,"endTime":2058.03,"body":"two things that are maybe self"},{"speaker":"Charles Goldfarb","startTime":2058.03,"endTime":2062.14,"body":"evident one, there's a little"},{"speaker":"Charles Goldfarb","startTime":2058.03,"endTime":2062.14,"body":"nerve, which is really close."},{"speaker":"Chris Dy","startTime":2063.37,"endTime":2065.08,"body":"So we made a call"},{"speaker":"Chris Dy","startTime":2063.37,"endTime":2065.08,"body":"there, we took"},{"speaker":"Charles Goldfarb","startTime":2065.32,"endTime":2066.94,"body":"We took care"},{"speaker":"Charles Goldfarb","startTime":2065.32,"endTime":2066.94,"body":"of the ulnar neurovascular"},{"speaker":"Charles Goldfarb","startTime":2066.94,"endTime":2070.45,"body":"bundle. And that pisiform is"},{"speaker":"Charles Goldfarb","startTime":2066.94,"endTime":2070.45,"body":"bigger than expected. Every"},{"speaker":"Charles Goldfarb","startTime":2070.45,"endTime":2073.99,"body":"single time. It's bigger than"},{"speaker":"Charles Goldfarb","startTime":2070.45,"endTime":2073.99,"body":"expected. In this case, there"},{"speaker":"Charles Goldfarb","startTime":2073.99,"endTime":2076.42,"body":"was arthrosis there were the"},{"speaker":"Charles Goldfarb","startTime":2073.99,"endTime":2076.42,"body":"comforter, loose bodies, so we"},{"speaker":"Charles Goldfarb","startTime":2076.42,"endTime":2079.06,"body":"felt very good about it. And"},{"speaker":"Charles Goldfarb","startTime":2076.42,"endTime":2079.06,"body":"patients don't miss their"},{"speaker":"Charles Goldfarb","startTime":2079.06,"endTime":2081.82,"body":"pisiform thankfully, and they"},{"speaker":"Charles Goldfarb","startTime":2079.06,"endTime":2081.82,"body":"tend to get better not always"},{"speaker":"Charles Goldfarb","startTime":2081.82,"endTime":2084.85,"body":"immediately, but they tend to"},{"speaker":"Charles Goldfarb","startTime":2081.82,"endTime":2084.85,"body":"get better. What do you do with"},{"speaker":"Charles Goldfarb","startTime":2084.85,"endTime":2091.21,"body":"the FCU I repair it back to"},{"speaker":"Charles Goldfarb","startTime":2084.85,"endTime":2091.21,"body":"itself. And it doesn't seem to"},{"speaker":"Charles Goldfarb","startTime":2091.24,"endTime":2094.36,"body":"it's not as if it loses his"},{"speaker":"Charles Goldfarb","startTime":2091.24,"endTime":2094.36,"body":"attachment. So I just repair it"},{"speaker":"Charles Goldfarb","startTime":2094.36,"endTime":2097.51,"body":"back over the top and and it"},{"speaker":"Charles Goldfarb","startTime":2094.36,"endTime":2097.51,"body":"still fires later."},{"speaker":"Chris Dy","startTime":2097.84,"endTime":2099.7,"body":"Yeah, it's funny like"},{"speaker":"Chris Dy","startTime":2097.84,"endTime":2099.7,"body":"you would never really see the"},{"speaker":"Chris Dy","startTime":2099.7,"endTime":2102.43,"body":"piece of For him, because it's"},{"speaker":"Chris Dy","startTime":2099.7,"endTime":2102.43,"body":"always covered by the FCU. You"},{"speaker":"Chris Dy","startTime":2102.43,"endTime":2105.67,"body":"know, insertion. So I agree with"},{"speaker":"Chris Dy","startTime":2102.43,"endTime":2105.67,"body":"you early on. Once you're taking"},{"speaker":"Chris Dy","startTime":2105.67,"endTime":2108.91,"body":"it out, you're like, Whoa, so as"},{"speaker":"Chris Dy","startTime":2105.67,"endTime":2108.91,"body":"long as you get the nerve Adalet"},{"speaker":"Chris Dy","startTime":2108.91,"endTime":2109.3,"body":"okay."},{"speaker":"Charles Goldfarb","startTime":2109.96,"endTime":2112.03,"body":"You got to"},{"speaker":"Charles Goldfarb","startTime":2109.96,"endTime":2112.03,"body":"take care of the nerve first. So"},{"speaker":"Charles Goldfarb","startTime":2112.06,"endTime":2116.74,"body":"those nerves centric people tell"},{"speaker":"Charles Goldfarb","startTime":2112.06,"endTime":2116.74,"body":"me awesome What else you got?"},{"speaker":"Chris Dy","startTime":2117.43,"endTime":2119.41,"body":"You know what I think"},{"speaker":"Chris Dy","startTime":2117.43,"endTime":2119.41,"body":"we're at our point where we"},{"speaker":"Chris Dy","startTime":2119.41,"endTime":2122.68,"body":"should wrap the case. But I"},{"speaker":"Chris Dy","startTime":2119.41,"endTime":2122.68,"body":"think next podcast, we're gonna"},{"speaker":"Chris Dy","startTime":2122.68,"endTime":2126.13,"body":"dive into the latest edition of"},{"speaker":"Chris Dy","startTime":2122.68,"endTime":2126.13,"body":"What's New in hand surgery, an"},{"speaker":"Chris Dy","startTime":2126.13,"endTime":2129.04,"body":"article that I used to write and"},{"speaker":"Chris Dy","startTime":2126.13,"endTime":2129.04,"body":"I'm happy I don't anymore."},{"speaker":"Charles Goldfarb","startTime":2129.34,"endTime":2131.5,"body":"I know that is"},{"speaker":"Charles Goldfarb","startTime":2129.34,"endTime":2131.5,"body":"true. Well, I look forward to"},{"speaker":"Charles Goldfarb","startTime":2131.5,"endTime":2133.3,"body":"that conversation. All"},{"speaker":"Chris Dy","startTime":2133.3,"endTime":2135.34,"body":"right, well, I gotta"},{"speaker":"Chris Dy","startTime":2133.3,"endTime":2135.34,"body":"go because I've got to head to a"},{"speaker":"Chris Dy","startTime":2135.34,"endTime":2139.81,"body":"T ball game. Have fun. All"},{"speaker":"Chris Dy","startTime":2135.34,"endTime":2139.81,"body":"right. Take care."},{"speaker":"Charles Goldfarb","startTime":2140.02,"endTime":2142.81,"body":"Bye. Hey,"},{"speaker":"Charles Goldfarb","startTime":2140.02,"endTime":2142.81,"body":"Chris. That was fun. Let's do it"},{"speaker":"Charles Goldfarb","startTime":2142.81,"endTime":2143.71,"body":"again real soon."},{"speaker":"Chris Dy","startTime":2144.22,"endTime":2146.44,"body":"Sounds good. Well, be"},{"speaker":"Chris Dy","startTime":2144.22,"endTime":2146.44,"body":"sure to email us with topics,"},{"speaker":"Chris Dy","startTime":2146.44,"endTime":2148.54,"body":"suggestions and feedback, you"},{"speaker":"Chris Dy","startTime":2146.44,"endTime":2148.54,"body":"can reach us at"},{"speaker":"Chris Dy","startTime":2148.54,"endTime":2150.43,"body":"handpodcast@gmail.com."},{"speaker":"Charles Goldfarb","startTime":2151.15,"endTime":2153.28,"body":"And remember,"},{"speaker":"Charles Goldfarb","startTime":2151.15,"endTime":2153.28,"body":"please subscribe wherever you"},{"speaker":"Charles Goldfarb","startTime":2153.28,"endTime":2154.24,"body":"get your podcast."},{"speaker":"Chris Dy","startTime":2154.66,"endTime":2157.48,"body":"And be sure to leave a"},{"speaker":"Chris Dy","startTime":2154.66,"endTime":2157.48,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":2157.48,"endTime":2157.9,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":2158.65,"endTime":2161.2,"body":"Special thanks"},{"speaker":"Charles Goldfarb","startTime":2158.65,"endTime":2161.2,"body":"to Peter Martin for the amazing"},{"speaker":"Charles Goldfarb","startTime":2161.2,"endTime":2162.52,"body":"music. And"},{"speaker":"Chris Dy","startTime":2162.52,"endTime":2164.65,"body":"remember, keep the"},{"speaker":"Chris Dy","startTime":2162.52,"endTime":2164.65,"body":"upper hand come back next time"}]}