{"version":"1.0.0","segments":[{"speaker":"Charles Goldfarb","startTime":0.0,"endTime":7.14,"body":"Chuck, welcome"},{"speaker":"Charles Goldfarb","startTime":0.0,"endTime":7.14,"body":"to the upper hand podcast, where"},{"speaker":"Charles Goldfarb","startTime":7.14,"endTime":8.88,"body":"Chuck and Chris talk hand"},{"speaker":"Charles Goldfarb","startTime":7.14,"endTime":8.88,"body":"surgery."},{"speaker":"Chris Dy","startTime":9.54,"endTime":11.46,"body":"We are two hand"},{"speaker":"Chris Dy","startTime":9.54,"endTime":11.46,"body":"surgeons at Washington"},{"speaker":"Chris Dy","startTime":11.46,"endTime":14.4,"body":"University in St Louis, here to"},{"speaker":"Chris Dy","startTime":11.46,"endTime":14.4,"body":"talk about all things hand"},{"speaker":"Chris Dy","startTime":14.4,"endTime":16.62,"body":"surgery related from technical"},{"speaker":"Chris Dy","startTime":14.4,"endTime":16.62,"body":"to personal."},{"speaker":"Charles Goldfarb","startTime":17.16,"endTime":19.14,"body":"Please"},{"speaker":"Charles Goldfarb","startTime":17.16,"endTime":19.14,"body":"subscribe wherever you get your"},{"speaker":"Charles Goldfarb","startTime":19.14,"endTime":20.84,"body":"podcasts, and thank"},{"speaker":"Chris Dy","startTime":20.84,"endTime":23.54,"body":"you in advance for"},{"speaker":"Chris Dy","startTime":20.84,"endTime":23.54,"body":"leaving a review and rating that"},{"speaker":"Chris Dy","startTime":23.54,"endTime":26.36,"body":"helps us get the word out. You"},{"speaker":"Chris Dy","startTime":23.54,"endTime":26.36,"body":"can email us at hand"},{"speaker":"Chris Dy","startTime":26.36,"endTime":29.42,"body":"podcast@gmail.com so let's get"},{"speaker":"Chris Dy","startTime":26.36,"endTime":29.42,"body":"to the episode."},{"speaker":"Charles Goldfarb","startTime":30.95,"endTime":34.01,"body":"Oh, hey Chris,"},{"speaker":"Charles Goldfarb","startTime":30.95,"endTime":34.01,"body":"Hey Chuck. How are you? I'm"},{"speaker":"Charles Goldfarb","startTime":34.01,"endTime":35.87,"body":"fantastic. It's that time of"},{"speaker":"Charles Goldfarb","startTime":34.01,"endTime":35.87,"body":"year"},{"speaker":"Chris Dy","startTime":36.08,"endTime":37.97,"body":"That's great, you"},{"speaker":"Chris Dy","startTime":36.08,"endTime":37.97,"body":"know. So every time in"},{"speaker":"Chris Dy","startTime":37.97,"endTime":40.79,"body":"conference, I want to say, Hey"},{"speaker":"Chris Dy","startTime":37.97,"endTime":40.79,"body":"Chuck, and I can't, because"},{"speaker":"Chris Dy","startTime":40.79,"endTime":44.51,"body":"everybody mocks me when, uh, you"},{"speaker":"Chris Dy","startTime":40.79,"endTime":44.51,"body":"know, there. So the thing is,"},{"speaker":"Chris Dy","startTime":44.51,"endTime":48.02,"body":"now that the fellows either want"},{"speaker":"Chris Dy","startTime":44.51,"endTime":48.02,"body":"to make the podcast or they"},{"speaker":"Chris Dy","startTime":48.02,"endTime":52.61,"body":"don't want to make it on the"},{"speaker":"Chris Dy","startTime":48.02,"endTime":52.61,"body":"podcast. So as everybody knows,"},{"speaker":"Chris Dy","startTime":52.82,"endTime":55.76,"body":"first fellow of the year with"},{"speaker":"Chris Dy","startTime":52.82,"endTime":55.76,"body":"me, Dan Hong was all about being"},{"speaker":"Chris Dy","startTime":55.76,"endTime":59.06,"body":"on the podcast, and subtly, not"},{"speaker":"Chris Dy","startTime":55.76,"endTime":59.06,"body":"so subtly, requested that I drop"},{"speaker":"Chris Dy","startTime":59.06,"endTime":61.1,"body":"his name on the podcast, because"},{"speaker":"Chris Dy","startTime":59.06,"endTime":61.1,"body":"he's going to getting all these"},{"speaker":"Chris Dy","startTime":61.13,"endTime":65.45,"body":"text messages from his friends."},{"speaker":"Chris Dy","startTime":61.13,"endTime":65.45,"body":"Second fellow year, something"},{"speaker":"Chris Dy","startTime":65.45,"endTime":67.76,"body":"happened. And he's like, you're"},{"speaker":"Chris Dy","startTime":65.45,"endTime":67.76,"body":"going to talk about this on the"},{"speaker":"Chris Dy","startTime":67.76,"endTime":72.68,"body":"podcast, aren't you? And he"},{"speaker":"Chris Dy","startTime":67.76,"endTime":72.68,"body":"started saying, hey, Chuck,"},{"speaker":"Chris Dy","startTime":72.95,"endTime":77.72,"body":"guess what happened? I said I"},{"speaker":"Chris Dy","startTime":72.95,"endTime":77.72,"body":"would never do that. I had such"},{"speaker":"Chris Dy","startTime":77.72,"endTime":79.97,"body":"an enjoyable time with the"},{"speaker":"Chris Dy","startTime":77.72,"endTime":79.97,"body":"second fellow Nick colada. He"},{"speaker":"Chris Dy","startTime":79.97,"endTime":83.93,"body":"was so fun to have on rotation"},{"speaker":"Chris Dy","startTime":79.97,"endTime":83.93,"body":"because he nerds out about the"},{"speaker":"Chris Dy","startTime":83.93,"endTime":88.25,"body":"same stuff I drew out about. But"},{"speaker":"Chris Dy","startTime":83.93,"endTime":88.25,"body":"we'll see how the third fellow"},{"speaker":"Chris Dy","startTime":88.25,"endTime":90.71,"body":"goes, Eric. He's on rotation"},{"speaker":"Chris Dy","startTime":88.25,"endTime":90.71,"body":"with me now. Loving Eric Jiang,"},{"speaker":"Chris Dy","startTime":90.71,"endTime":94.61,"body":"so, yeah, best time of the year"},{"speaker":"Chris Dy","startTime":90.71,"endTime":94.61,"body":"for her. For surgeons, you know,"},{"speaker":"Chris Dy","startTime":94.67,"endTime":96.32,"body":"proceduralists, I will say in"},{"speaker":"Chris Dy","startTime":94.67,"endTime":96.32,"body":"general,"},{"speaker":"Charles Goldfarb","startTime":96.68,"endTime":98.06,"body":"it is really"},{"speaker":"Charles Goldfarb","startTime":96.68,"endTime":98.06,"body":"funny when you talk about"},{"speaker":"Charles Goldfarb","startTime":98.06,"endTime":100.82,"body":"conference, because we were"},{"speaker":"Charles Goldfarb","startTime":98.06,"endTime":100.82,"body":"doing our research conference on"},{"speaker":"Charles Goldfarb","startTime":100.82,"endTime":104.69,"body":"Monday, and it's just going down"},{"speaker":"Charles Goldfarb","startTime":100.82,"endTime":104.69,"body":"this freaking nerve pathway. And"},{"speaker":"Charles Goldfarb","startTime":104.69,"endTime":108.11,"body":"I felt like I was on the pod,"},{"speaker":"Charles Goldfarb","startTime":104.69,"endTime":108.11,"body":"and I just, I felt like I needed"},{"speaker":"Charles Goldfarb","startTime":108.11,"endTime":111.11,"body":"to be careful not to interact"},{"speaker":"Charles Goldfarb","startTime":108.11,"endTime":111.11,"body":"with you like I would on the pod"},{"speaker":"Charles Goldfarb","startTime":111.11,"endTime":115.4,"body":"to say, enough of the freaking"},{"speaker":"Charles Goldfarb","startTime":111.11,"endTime":115.4,"body":"nerve stuff. But hey, it is what"},{"speaker":"Charles Goldfarb","startTime":115.4,"endTime":115.52,"body":"it is."},{"speaker":"Chris Dy","startTime":115.52,"endTime":118.4,"body":"It was the research"},{"speaker":"Chris Dy","startTime":115.52,"endTime":118.4,"body":"meeting that I lead you know,"},{"speaker":"Chris Dy","startTime":118.4,"endTime":121.85,"body":"which I guess, for those that"},{"speaker":"Chris Dy","startTime":118.4,"endTime":121.85,"body":"aren't familiar with it, but if"},{"speaker":"Chris Dy","startTime":121.85,"endTime":125.24,"body":"our division, we do a monthly"},{"speaker":"Chris Dy","startTime":121.85,"endTime":125.24,"body":"research meeting, and a couple"},{"speaker":"Chris Dy","startTime":125.24,"endTime":127.88,"body":"years ago, we made a change so"},{"speaker":"Chris Dy","startTime":125.24,"endTime":127.88,"body":"that there was a rotating"},{"speaker":"Chris Dy","startTime":127.94,"endTime":130.49,"body":"moderator for the meeting that"},{"speaker":"Chris Dy","startTime":127.94,"endTime":130.49,"body":"would be a different faculty"},{"speaker":"Chris Dy","startTime":130.49,"endTime":132.65,"body":"member to talk, you know, just"},{"speaker":"Chris Dy","startTime":130.49,"endTime":132.65,"body":"in general, about what's going"},{"speaker":"Chris Dy","startTime":132.65,"endTime":135.77,"body":"on in Division, ask the fellows"},{"speaker":"Chris Dy","startTime":132.65,"endTime":135.77,"body":"for updates on their projects"},{"speaker":"Chris Dy","startTime":135.77,"endTime":137.99,"body":"that they're working on, and"},{"speaker":"Chris Dy","startTime":135.77,"endTime":137.99,"body":"then talk about their own"},{"speaker":"Chris Dy","startTime":137.99,"endTime":140.54,"body":"research program, which I think"},{"speaker":"Chris Dy","startTime":137.99,"endTime":140.54,"body":"has been really fun, because all"},{"speaker":"Chris Dy","startTime":140.54,"endTime":144.68,"body":"of us do a ton of research. But"},{"speaker":"Chris Dy","startTime":140.54,"endTime":144.68,"body":"just, you know, we have our"},{"speaker":"Chris Dy","startTime":144.68,"endTime":147.29,"body":"little spaces and niches. Just,"},{"speaker":"Chris Dy","startTime":144.68,"endTime":147.29,"body":"you know, like I do the nerve"},{"speaker":"Chris Dy","startTime":147.29,"endTime":149.87,"body":"stuff, the clinical research,"},{"speaker":"Chris Dy","startTime":147.29,"endTime":149.87,"body":"David does basic science, nerve"},{"speaker":"Chris Dy","startTime":150.14,"endTime":152.51,"body":"you and Lindley do a ton of"},{"speaker":"Chris Dy","startTime":150.14,"endTime":152.51,"body":"stuff with, could you do a lot"},{"speaker":"Chris Dy","startTime":152.51,"endTime":155.72,"body":"of stuff with the adolescents"},{"speaker":"Chris Dy","startTime":152.51,"endTime":155.72,"body":"and sports? So, you know, it's"},{"speaker":"Chris Dy","startTime":155.72,"endTime":159.2,"body":"nice to be able to catch up on"},{"speaker":"Chris Dy","startTime":155.72,"endTime":159.2,"body":"that. But yes, I also almost"},{"speaker":"Chris Dy","startTime":159.2,"endTime":162.68,"body":"slipped into podcast mode"},{"speaker":"Chris Dy","startTime":159.2,"endTime":162.68,"body":"because we were on Zoom, we were"},{"speaker":"Chris Dy","startTime":162.68,"endTime":163.55,"body":"talking about her,"},{"speaker":"Charles Goldfarb","startTime":164.02,"endTime":165.82,"body":"yeah, it's"},{"speaker":"Charles Goldfarb","startTime":164.02,"endTime":165.82,"body":"really hard to keep up with one"},{"speaker":"Charles Goldfarb","startTime":165.82,"endTime":168.04,"body":"another. I mean, we have eight"},{"speaker":"Charles Goldfarb","startTime":165.82,"endTime":168.04,"body":"hand surgeons. We're all super"},{"speaker":"Charles Goldfarb","startTime":168.04,"endTime":170.32,"body":"busy. We're all doing different"},{"speaker":"Charles Goldfarb","startTime":168.04,"endTime":170.32,"body":"things. Obviously we have"},{"speaker":"Charles Goldfarb","startTime":170.32,"endTime":172.9,"body":"overlap. The other thing, I"},{"speaker":"Charles Goldfarb","startTime":170.32,"endTime":172.9,"body":"mean, I do love just getting"},{"speaker":"Charles Goldfarb","startTime":172.9,"endTime":176.02,"body":"together in person or even on"},{"speaker":"Charles Goldfarb","startTime":172.9,"endTime":176.02,"body":"Zoom. It's a nice it's a, you"},{"speaker":"Charles Goldfarb","startTime":176.02,"endTime":179.26,"body":"know, it's a substitute, but"},{"speaker":"Charles Goldfarb","startTime":176.02,"endTime":179.26,"body":"it's fun to hear what you are"},{"speaker":"Charles Goldfarb","startTime":179.26,"endTime":183.36,"body":"doing, because I get a sense,"},{"speaker":"Charles Goldfarb","startTime":179.26,"endTime":183.36,"body":"but talking details is really"},{"speaker":"Charles Goldfarb","startTime":183.36,"endTime":185.88,"body":"helpful. So I do like the"},{"speaker":"Charles Goldfarb","startTime":183.36,"endTime":185.88,"body":"research meeting for that"},{"speaker":"Charles Goldfarb","startTime":185.88,"endTime":188.34,"body":"reason, for sure, absolutely."},{"speaker":"Chris Dy","startTime":188.82,"endTime":190.74,"body":"So yeah, it's a busy"},{"speaker":"Chris Dy","startTime":188.82,"endTime":190.74,"body":"time of the year. Everybody's"},{"speaker":"Chris Dy","startTime":190.74,"endTime":194.34,"body":"met their deductibles, and I've"},{"speaker":"Chris Dy","startTime":190.74,"endTime":194.34,"body":"been hearing about it for many"},{"speaker":"Chris Dy","startTime":194.34,"endTime":197.7,"body":"months now. I'm glad that our"},{"speaker":"Chris Dy","startTime":194.34,"endTime":197.7,"body":"eighth hand surgeon has joined."},{"speaker":"Chris Dy","startTime":197.7,"endTime":201.68,"body":"Jason Strauss joined us from the"},{"speaker":"Chris Dy","startTime":197.7,"endTime":201.68,"body":"University of Chicago, and"},{"speaker":"Chris Dy","startTime":201.74,"endTime":204.62,"body":"that's I've certainly heard"},{"speaker":"Chris Dy","startTime":201.74,"endTime":204.62,"body":"less. I've been waiting four"},{"speaker":"Chris Dy","startTime":204.62,"endTime":208.64,"body":"months to get in. Honestly, it"},{"speaker":"Chris Dy","startTime":204.62,"endTime":208.64,"body":"hasn't come up, but that's been"},{"speaker":"Chris Dy","startTime":208.64,"endTime":212.84,"body":"replaced by so I met my"},{"speaker":"Chris Dy","startTime":208.64,"endTime":212.84,"body":"deductible, and I was on the"},{"speaker":"Chris Dy","startTime":212.84,"endTime":216.92,"body":"unfortunate end of the schedule"},{"speaker":"Chris Dy","startTime":212.84,"endTime":216.92,"body":"this holiday season because I"},{"speaker":"Chris Dy","startTime":216.92,"endTime":220.96,"body":"had the surgical center where I"},{"speaker":"Chris Dy","startTime":216.92,"endTime":220.96,"body":"work is closed on Christmas Eve,"},{"speaker":"Chris Dy","startTime":221.32,"endTime":224.2,"body":"obviously closed on Christmas"},{"speaker":"Chris Dy","startTime":221.32,"endTime":224.2,"body":"Day, but Christmas Eve is my or"},{"speaker":"Chris Dy","startTime":224.2,"endTime":227.56,"body":"day. Christmas Eve is also or"},{"speaker":"Chris Dy","startTime":224.2,"endTime":227.56,"body":"New Year's Eve is also my or"},{"speaker":"Chris Dy","startTime":227.56,"endTime":231.28,"body":"day. Surgery Center where I work"},{"speaker":"Chris Dy","startTime":227.56,"endTime":231.28,"body":"at is closer too, so I've"},{"speaker":"Chris Dy","startTime":231.34,"endTime":235.12,"body":"scrambling to find extra time,"},{"speaker":"Chris Dy","startTime":231.34,"endTime":235.12,"body":"which I successfully have, but"},{"speaker":"Chris Dy","startTime":235.48,"endTime":239.26,"body":"my schedule will Off, off kilter"},{"speaker":"Chris Dy","startTime":235.48,"endTime":239.26,"body":"for in the next couple of weeks."},{"speaker":"Charles Goldfarb","startTime":239.38,"endTime":242.1,"body":"It's hard, but"},{"speaker":"Charles Goldfarb","startTime":239.38,"endTime":242.1,"body":"yesterday, I had just, I mean,"},{"speaker":"Charles Goldfarb","startTime":242.1,"endTime":245.7,"body":"when you have a it's almost like"},{"speaker":"Charles Goldfarb","startTime":242.1,"endTime":245.7,"body":"you don't want to get injured on"},{"speaker":"Charles Goldfarb","startTime":245.7,"endTime":249.06,"body":"July 1 with a new round of"},{"speaker":"Charles Goldfarb","startTime":245.7,"endTime":249.06,"body":"residents and fellows, or"},{"speaker":"Charles Goldfarb","startTime":249.12,"endTime":251.94,"body":"residents at least, you don't"},{"speaker":"Charles Goldfarb","startTime":249.12,"endTime":251.94,"body":"want to get injured right about"},{"speaker":"Charles Goldfarb","startTime":251.94,"endTime":255.9,"body":"now, because the schedule is"},{"speaker":"Charles Goldfarb","startTime":251.94,"endTime":255.9,"body":"booked solid, like I have"},{"speaker":"Charles Goldfarb","startTime":255.9,"endTime":259.92,"body":"squeezed and pushed, and there's"},{"speaker":"Charles Goldfarb","startTime":255.9,"endTime":259.92,"body":"almost no leeway. So if you have"},{"speaker":"Charles Goldfarb","startTime":259.92,"endTime":263.96,"body":"a trauma now, either it gets"},{"speaker":"Charles Goldfarb","startTime":259.92,"endTime":263.96,"body":"taken care of immediately, but"},{"speaker":"Charles Goldfarb","startTime":263.96,"endTime":266.48,"body":"kind of walking the office and"},{"speaker":"Charles Goldfarb","startTime":263.96,"endTime":266.48,"body":"expecting to get a fracture"},{"speaker":"Charles Goldfarb","startTime":266.48,"endTime":270.38,"body":"taken care of is just almost"},{"speaker":"Charles Goldfarb","startTime":266.48,"endTime":270.38,"body":"impossible. It's honestly"},{"speaker":"Charles Goldfarb","startTime":270.38,"endTime":270.98,"body":"frustrating."},{"speaker":"Chris Dy","startTime":271.76,"endTime":274.28,"body":"It makes it very, very"},{"speaker":"Chris Dy","startTime":271.76,"endTime":274.28,"body":"challenging. I mean, it's been,"},{"speaker":"Chris Dy","startTime":274.94,"endTime":278.36,"body":"you know, it's been busy with"},{"speaker":"Chris Dy","startTime":274.94,"endTime":278.36,"body":"the nerve stuff too. I was we"},{"speaker":"Chris Dy","startTime":278.36,"endTime":283.72,"body":"did four Plexus cases in five"},{"speaker":"Chris Dy","startTime":278.36,"endTime":283.72,"body":"days, big cases, one, super big"},{"speaker":"Chris Dy","startTime":283.72,"endTime":286.96,"body":"one and three kind of medium"},{"speaker":"Chris Dy","startTime":283.72,"endTime":286.96,"body":"sized ones, you know. So it was,"},{"speaker":"Chris Dy","startTime":286.96,"endTime":291.34,"body":"it's been a busy time, and I'll"},{"speaker":"Chris Dy","startTime":286.96,"endTime":291.34,"body":"be looking forward to some"},{"speaker":"Chris Dy","startTime":291.34,"endTime":295.3,"body":"quieter times in January. But"},{"speaker":"Chris Dy","startTime":291.34,"endTime":295.3,"body":"it's, you know, nerve, nerve,"},{"speaker":"Chris Dy","startTime":295.3,"endTime":299.08,"body":"nerve, a lot of other stuff."},{"speaker":"Chris Dy","startTime":295.3,"endTime":299.08,"body":"Nerve, NF, nerve, which I love,"},{"speaker":"Chris Dy","startTime":299.14,"endTime":303.54,"body":"but it's a. I'm sure this"},{"speaker":"Chris Dy","startTime":299.14,"endTime":303.54,"body":"current phase is sustainable the"},{"speaker":"Chris Dy","startTime":303.54,"endTime":305.22,"body":"month of December. Case, no,"},{"speaker":"Charles Goldfarb","startTime":305.22,"endTime":308.34,"body":"I think we all"},{"speaker":"Charles Goldfarb","startTime":305.22,"endTime":308.34,"body":"feel that way. I understand one"},{"speaker":"Charles Goldfarb","startTime":308.34,"endTime":311.76,"body":"of those cases you did, maybe"},{"speaker":"Charles Goldfarb","startTime":308.34,"endTime":311.76,"body":"started at 730 to finish around"},{"speaker":"10 or 10","startTime":311.76,"endTime":317.88,"body":"30pm and for me, a"},{"speaker":"10 or 10","startTime":311.76,"endTime":317.88,"body":"three hour case is is more than"},{"speaker":"10 or 10","startTime":317.88,"endTime":322.76,"body":"I ever want to do. But, you"},{"speaker":"10 or 10","startTime":317.88,"endTime":322.76,"body":"know, I it, I admire those who"},{"speaker":"10 or 10","startTime":322.76,"endTime":324.68,"body":"have more endurance than me."},{"speaker":"Chris Dy","startTime":325.34,"endTime":327.38,"body":"To be fair, it was a"},{"speaker":"Chris Dy","startTime":325.34,"endTime":327.38,"body":"Wednesday, so it was an 830"},{"speaker":"Chris Dy","startTime":327.62,"endTime":330.44,"body":"start, and then by the time you"},{"speaker":"Chris Dy","startTime":327.62,"endTime":330.44,"body":"actually start the case after"},{"speaker":"Chris Dy","startTime":330.44,"endTime":334.1,"body":"setting up a plexus, you know,"},{"speaker":"Chris Dy","startTime":330.44,"endTime":334.1,"body":"you're solid 45 minutes into the"},{"speaker":"Chris Dy","startTime":334.1,"endTime":337.46,"body":"room. But for us, you know,"},{"speaker":"Chris Dy","startTime":334.1,"endTime":337.46,"body":"obviously you don't want to have"},{"speaker":"Chris Dy","startTime":337.46,"endTime":340.46,"body":"to do those cases, but they are"},{"speaker":"Chris Dy","startTime":337.46,"endTime":340.46,"body":"really engaging and exciting"},{"speaker":"Chris Dy","startTime":340.46,"endTime":343.24,"body":"cases to do. And I think David"},{"speaker":"Chris Dy","startTime":340.46,"endTime":343.24,"body":"Bergen and I have come up with a"},{"speaker":"Chris Dy","startTime":343.24,"endTime":346.96,"body":"pretty good system, and we did a"},{"speaker":"Chris Dy","startTime":343.24,"endTime":346.96,"body":"lot of work in that time, and"},{"speaker":"Chris Dy","startTime":346.96,"endTime":352.0,"body":"patients doing well so far. So"},{"speaker":"Chris Dy","startTime":346.96,"endTime":352.0,"body":"very excited to continue the"},{"speaker":"Chris Dy","startTime":352.0,"endTime":356.44,"body":"nerve adventures in 2025 we do"},{"speaker":"Chris Dy","startTime":352.0,"endTime":356.44,"body":"have a fun episode that we're"},{"speaker":"Chris Dy","startTime":356.44,"endTime":360.3,"body":"going to do today about the"},{"speaker":"Chris Dy","startTime":356.44,"endTime":360.3,"body":"future of hand surgery. I think"},{"speaker":"Chris Dy","startTime":360.3,"endTime":362.82,"body":"you came up with this idea while"},{"speaker":"Chris Dy","startTime":360.3,"endTime":362.82,"body":"you were sitting in business"},{"speaker":"Chris Dy","startTime":362.82,"endTime":363.9,"body":"school class. Is that it?"},{"speaker":"Charles Goldfarb","startTime":365.16,"endTime":367.26,"body":"I try to"},{"speaker":"Charles Goldfarb","startTime":365.16,"endTime":367.26,"body":"focus, but hey, sometimes the"},{"speaker":"Charles Goldfarb","startTime":367.26,"endTime":369.54,"body":"mind drips. I don't know when I"},{"speaker":"Charles Goldfarb","startTime":367.26,"endTime":369.54,"body":"came up with the idea, and I"},{"speaker":"Charles Goldfarb","startTime":369.54,"endTime":372.0,"body":"don't I, you know, hopefully"},{"speaker":"Charles Goldfarb","startTime":369.54,"endTime":372.0,"body":"that, you know, we come up with"},{"speaker":"Charles Goldfarb","startTime":372.0,"endTime":375.3,"body":"enough interesting topics, but I"},{"speaker":"Charles Goldfarb","startTime":372.0,"endTime":375.3,"body":"hope our listeners will also"},{"speaker":"Charles Goldfarb","startTime":375.3,"endTime":378.0,"body":"pepper us with different"},{"speaker":"Charles Goldfarb","startTime":375.3,"endTime":378.0,"body":"concepts for what the future of"},{"speaker":"Charles Goldfarb","startTime":378.0,"endTime":379.62,"body":"hand surgery will look like. So"},{"speaker":"Chris Dy","startTime":379.62,"endTime":382.22,"body":"when you emailed this"},{"speaker":"Chris Dy","startTime":379.62,"endTime":382.22,"body":"to me, I immediately thought of"},{"speaker":"Chris Dy","startTime":382.22,"endTime":386.66,"body":"the the Conan O'Brien skit, and"},{"speaker":"Chris Dy","startTime":382.22,"endTime":386.66,"body":"this is totally gonna date me."},{"speaker":"Chris Dy","startTime":386.96,"endTime":392.42,"body":"But when Conan was on NBC, and"},{"speaker":"Chris Dy","startTime":386.96,"endTime":392.42,"body":"he was following Jay Leno, so he"},{"speaker":"Chris Dy","startTime":392.42,"endTime":394.94,"body":"was in, like, the in the eastern"},{"speaker":"Chris Dy","startTime":392.42,"endTime":394.94,"body":"time zone, that's like the, I"},{"speaker":"Chris Dy","startTime":394.94,"endTime":399.5,"body":"guess, they 1230 slot. Yeah, I"},{"speaker":"Chris Dy","startTime":394.94,"endTime":399.5,"body":"loved watching Conan back in the"},{"speaker":"Chris Dy","startTime":399.5,"endTime":403.0,"body":"day, and it was, I guess, in the"},{"speaker":"Chris Dy","startTime":399.5,"endTime":403.0,"body":"late 90s, and they would have"},{"speaker":"Chris Dy","startTime":403.0,"endTime":406.12,"body":"this segment with he and Andy"},{"speaker":"Chris Dy","startTime":403.0,"endTime":406.12,"body":"Richter would would have called"},{"speaker":"Chris Dy","startTime":406.12,"endTime":410.02,"body":"in the year 2000 where they"},{"speaker":"Chris Dy","startTime":406.12,"endTime":410.02,"body":"would just make these off the"},{"speaker":"Chris Dy","startTime":410.02,"endTime":413.56,"body":"ball predictions, many of them"},{"speaker":"Chris Dy","startTime":410.02,"endTime":413.56,"body":"hilarious, about what was going"},{"speaker":"Chris Dy","startTime":413.56,"endTime":416.74,"body":"to happen in the year 2000 and"},{"speaker":"Chris Dy","startTime":413.56,"endTime":416.74,"body":"then then we add the whole y 2k"},{"speaker":"Chris Dy","startTime":416.86,"endTime":419.32,"body":"thing and everything. I feel"},{"speaker":"Chris Dy","startTime":416.86,"endTime":419.32,"body":"like the future of hand surgery"},{"speaker":"Chris Dy","startTime":419.32,"endTime":421.98,"body":"could be a little bit like that."},{"speaker":"Chris Dy","startTime":419.32,"endTime":421.98,"body":"So we'll see. We'll see what you"},{"speaker":"Chris Dy","startTime":421.98,"endTime":422.52,"body":"come up with."},{"speaker":"Charles Goldfarb","startTime":422.76,"endTime":424.8,"body":"Well, we'll"},{"speaker":"Charles Goldfarb","startTime":422.76,"endTime":424.8,"body":"let the listeners be the judge"},{"speaker":"Charles Goldfarb","startTime":425.16,"endTime":429.72,"body":"of how poorly or how well we may"},{"speaker":"Charles Goldfarb","startTime":425.16,"endTime":429.72,"body":"do. Yeah, I think there's some"},{"speaker":"Charles Goldfarb","startTime":429.72,"endTime":431.16,"body":"interesting, interesting things."},{"speaker":"Chris Dy","startTime":431.52,"endTime":433.86,"body":"So first off, want to"},{"speaker":"Chris Dy","startTime":431.52,"endTime":433.86,"body":"thank our sponsors over at"},{"speaker":"Chris Dy","startTime":433.86,"endTime":436.38,"body":"practice. Link, the apprehended"},{"speaker":"Chris Dy","startTime":433.86,"endTime":436.38,"body":"sponsor at practice. Link.com,"},{"speaker":"Chris Dy","startTime":436.74,"endTime":438.84,"body":"the most widely used physician"},{"speaker":"Chris Dy","startTime":436.74,"endTime":438.84,"body":"job search and career"},{"speaker":"Chris Dy","startTime":438.84,"endTime":440.1,"body":"advancement resource."},{"speaker":"Charles Goldfarb","startTime":440.28,"endTime":442.16,"body":"But coming a"},{"speaker":"Charles Goldfarb","startTime":440.28,"endTime":442.16,"body":"physician is hard. Finding the"},{"speaker":"Charles Goldfarb","startTime":442.16,"endTime":445.58,"body":"right job does not have to be"},{"speaker":"Charles Goldfarb","startTime":442.16,"endTime":445.58,"body":"joined. Practice link, for free"},{"speaker":"Charles Goldfarb","startTime":445.58,"endTime":449.36,"body":"today at www dot practice"},{"speaker":"Charles Goldfarb","startTime":445.58,"endTime":449.36,"body":"link.com, backslash the upper"},{"speaker":"Charles Goldfarb","startTime":449.36,"endTime":452.24,"body":"hand, and we are grateful to"},{"speaker":"Charles Goldfarb","startTime":449.36,"endTime":452.24,"body":"practice link. They have been"},{"speaker":"Charles Goldfarb","startTime":452.24,"endTime":455.3,"body":"with us, I don't know, couple"},{"speaker":"Charles Goldfarb","startTime":452.24,"endTime":455.3,"body":"years now, three years, maybe."},{"speaker":"Charles Goldfarb","startTime":455.3,"endTime":458.42,"body":"So thank you very much to them."},{"speaker":"Charles Goldfarb","startTime":455.3,"endTime":458.42,"body":"Yes,"},{"speaker":"Chris Dy","startTime":458.42,"endTime":461.5,"body":"and they're always"},{"speaker":"Chris Dy","startTime":458.42,"endTime":461.5,"body":"great resource for our local"},{"speaker":"Chris Dy","startTime":461.5,"endTime":465.28,"body":"residents and fellows, and you"},{"speaker":"Chris Dy","startTime":461.5,"endTime":465.28,"body":"really do take care of them in"},{"speaker":"Chris Dy","startTime":465.28,"endTime":468.76,"body":"terms of providing access to"},{"speaker":"Chris Dy","startTime":465.28,"endTime":468.76,"body":"sporting events. So we were the"},{"speaker":"Chris Dy","startTime":468.76,"endTime":471.28,"body":"beneficiary of that for a blues"},{"speaker":"Chris Dy","startTime":468.76,"endTime":471.28,"body":"game recently. So thank you"},{"speaker":"Chris Dy","startTime":471.28,"endTime":475.42,"body":"practice, Lee. So these are your"},{"speaker":"Chris Dy","startTime":471.28,"endTime":475.42,"body":"hot takes that you came up with"},{"speaker":"Chris Dy","startTime":475.42,"endTime":480.48,"body":"for the future of hand surgery"},{"speaker":"Chris Dy","startTime":475.42,"endTime":480.48,"body":"in 2025 and beyond. So the first"},{"speaker":"Chris Dy","startTime":480.48,"endTime":482.76,"body":"one, I think is really"},{"speaker":"Chris Dy","startTime":480.48,"endTime":482.76,"body":"interesting. And I know I've"},{"speaker":"Chris Dy","startTime":482.76,"endTime":486.66,"body":"talked about this before, carpal"},{"speaker":"Chris Dy","startTime":482.76,"endTime":486.66,"body":"tunnel release will be performed"},{"speaker":"Chris Dy","startTime":486.66,"endTime":490.8,"body":"by others, such as physiatrists"},{"speaker":"Chris Dy","startTime":486.66,"endTime":490.8,"body":"and neurologists."},{"speaker":"Charles Goldfarb","startTime":492.06,"endTime":494.7,"body":"Go and I might"},{"speaker":"Charles Goldfarb","startTime":492.06,"endTime":494.7,"body":"even and people are gonna, are"},{"speaker":"Charles Goldfarb","startTime":494.7,"endTime":497.7,"body":"gonna wince when I say this. It"},{"speaker":"Charles Goldfarb","startTime":494.7,"endTime":497.7,"body":"might be podiatrist. It's"},{"speaker":"Charles Goldfarb","startTime":497.7,"endTime":500.78,"body":"interesting. I learned a lot"},{"speaker":"Charles Goldfarb","startTime":497.7,"endTime":500.78,"body":"about podiatry. Podiatry is"},{"speaker":"Charles Goldfarb","startTime":500.78,"endTime":503.42,"body":"licensed to do hand surgery in"},{"speaker":"Charles Goldfarb","startTime":500.78,"endTime":503.42,"body":"some states, which makes no"},{"speaker":"Charles Goldfarb","startTime":503.42,"endTime":508.16,"body":"sense to me. But I think the"},{"speaker":"Charles Goldfarb","startTime":503.42,"endTime":508.16,"body":"point is, have we gotten to a"},{"speaker":"Charles Goldfarb","startTime":508.16,"endTime":513.98,"body":"stage where the technology"},{"speaker":"Charles Goldfarb","startTime":508.16,"endTime":513.98,"body":"allows a simplistic approach to"},{"speaker":"Charles Goldfarb","startTime":513.98,"endTime":517.58,"body":"treating carpal tunnel syndrome?"},{"speaker":"Charles Goldfarb","startTime":513.98,"endTime":517.58,"body":"And you know, some of this"},{"speaker":"Charles Goldfarb","startTime":517.58,"endTime":520.06,"body":"prediction is tongue in cheek,"},{"speaker":"Charles Goldfarb","startTime":517.58,"endTime":520.06,"body":"because I don't know that. I"},{"speaker":"Charles Goldfarb","startTime":520.06,"endTime":523.96,"body":"truly believe that, but I do"},{"speaker":"Charles Goldfarb","startTime":520.06,"endTime":523.96,"body":"think it's not going to be 100%"},{"speaker":"Charles Goldfarb","startTime":524.62,"endTime":528.1,"body":"of hand surgeons indefinitely."},{"speaker":"Charles Goldfarb","startTime":524.62,"endTime":528.1,"body":"It's not right now. Well, it's"},{"speaker":"Charles Goldfarb","startTime":528.1,"endTime":531.64,"body":"not right now. What percent it's"},{"speaker":"Charles Goldfarb","startTime":528.1,"endTime":531.64,"body":"got to be, I don't know."},{"speaker":"Chris Dy","startTime":531.64,"endTime":535.36,"body":"But I mean, I think"},{"speaker":"Chris Dy","startTime":531.64,"endTime":535.36,"body":"the you know, as listeners may"},{"speaker":"Chris Dy","startTime":535.36,"endTime":538.48,"body":"know, at least in the US, there"},{"speaker":"Chris Dy","startTime":535.36,"endTime":538.48,"body":"is a new ultrasound guided"},{"speaker":"Chris Dy","startTime":538.48,"endTime":541.26,"body":"carpal tunnel release device and"},{"speaker":"Chris Dy","startTime":538.48,"endTime":541.26,"body":"an ultrasound guided trigger"},{"speaker":"Chris Dy","startTime":541.26,"endTime":544.86,"body":"finger release device. And while"},{"speaker":"Chris Dy","startTime":541.26,"endTime":544.86,"body":"they are currently training hand"},{"speaker":"Chris Dy","startTime":544.86,"endTime":548.58,"body":"surgeons only, I I am fully"},{"speaker":"Chris Dy","startTime":544.86,"endTime":548.58,"body":"aware that their plans are to"},{"speaker":"Chris Dy","startTime":548.58,"endTime":552.3,"body":"train non hand surgeons to do"},{"speaker":"Chris Dy","startTime":548.58,"endTime":552.3,"body":"this surgery too, and that could"},{"speaker":"Chris Dy","startTime":552.3,"endTime":555.6,"body":"be neurologists pm and are"},{"speaker":"Chris Dy","startTime":552.3,"endTime":555.6,"body":"they've approached people in our"},{"speaker":"Chris Dy","startTime":555.6,"endTime":558.66,"body":"pm and our division about doing"},{"speaker":"Chris Dy","startTime":555.6,"endTime":558.66,"body":"the surgery, and I think they"},{"speaker":"Chris Dy","startTime":558.66,"endTime":561.8,"body":"were internal discussions, from"},{"speaker":"Chris Dy","startTime":558.66,"endTime":561.8,"body":"what I understand, and the"},{"speaker":"Chris Dy","startTime":561.8,"endTime":564.68,"body":"carpal tunnel release remains"},{"speaker":"Chris Dy","startTime":561.8,"endTime":564.68,"body":"firmly in the domain of the hand"},{"speaker":"Chris Dy","startTime":564.68,"endTime":568.58,"body":"surgeon, but you know, and also"},{"speaker":"Chris Dy","startTime":564.68,"endTime":568.58,"body":"orthopedic surgeons and plastic"},{"speaker":"Chris Dy","startTime":568.58,"endTime":571.22,"body":"surgeons and general surgeons, I"},{"speaker":"Chris Dy","startTime":568.58,"endTime":571.22,"body":"mean people who have trained to"},{"speaker":"Chris Dy","startTime":571.22,"endTime":575.42,"body":"do the actual surgery. But,"},{"speaker":"Chris Dy","startTime":571.22,"endTime":575.42,"body":"yeah, no, that's coming. It"},{"speaker":"Chris Dy","startTime":575.48,"endTime":580.36,"body":"scares me. I think one of the"},{"speaker":"Chris Dy","startTime":575.48,"endTime":580.36,"body":"our our partner, David Bergen,"},{"speaker":"Chris Dy","startTime":580.36,"endTime":582.88,"body":"talks about how he's more"},{"speaker":"Chris Dy","startTime":580.36,"endTime":582.88,"body":"stressed about a carpal tunnel"},{"speaker":"Chris Dy","startTime":582.88,"endTime":587.2,"body":"release than a crazy Plexus"},{"speaker":"Chris Dy","startTime":582.88,"endTime":587.2,"body":"case, because the expectations"},{"speaker":"Chris Dy","startTime":587.2,"endTime":589.9,"body":"are completely different. I"},{"speaker":"Chris Dy","startTime":587.2,"endTime":589.9,"body":"mean, you have to be perfect on"},{"speaker":"Chris Dy","startTime":589.9,"endTime":594.64,"body":"every carpal tunnel. I mean, you"},{"speaker":"Chris Dy","startTime":589.9,"endTime":594.64,"body":"should be. I think, whereas a"},{"speaker":"Chris Dy","startTime":594.64,"endTime":597.16,"body":"crazy Plexus is like there are"},{"speaker":"Chris Dy","startTime":594.64,"endTime":597.16,"body":"only a handful of people, you"},{"speaker":"Chris Dy","startTime":597.16,"endTime":599.68,"body":"know, not a handful, but there's"},{"speaker":"Chris Dy","startTime":597.16,"endTime":599.68,"body":"only a certain number of people"},{"speaker":"Chris Dy","startTime":599.68,"endTime":601.74,"body":"in the. And then"},{"speaker":"Chris Dy","startTime":599.68,"endTime":601.74,"body":"internationally, of course, that"},{"speaker":"Chris Dy","startTime":602.1,"endTime":604.8,"body":"are, you know, really doing"},{"speaker":"Chris Dy","startTime":602.1,"endTime":604.8,"body":"Plexus surgery. So there's a lot"},{"speaker":"Chris Dy","startTime":604.8,"endTime":607.08,"body":"of variability in the case"},{"speaker":"Chris Dy","startTime":604.8,"endTime":607.08,"body":"presentation, a lot of"},{"speaker":"Chris Dy","startTime":607.08,"endTime":610.08,"body":"variability in treatment and"},{"speaker":"Chris Dy","startTime":607.08,"endTime":610.08,"body":"expectation. So the bar is very"},{"speaker":"Chris Dy","startTime":610.08,"endTime":611.28,"body":"different. So"},{"speaker":"Charles Goldfarb","startTime":611.28,"endTime":614.1,"body":"should hand"},{"speaker":"Charles Goldfarb","startTime":611.28,"endTime":614.1,"body":"surgeons be teaching non hand"},{"speaker":"Charles Goldfarb","startTime":614.1,"endTime":616.5,"body":"surgeons? And again, we're not"},{"speaker":"Charles Goldfarb","startTime":614.1,"endTime":616.5,"body":"trying to exclude orthopedic"},{"speaker":"Charles Goldfarb","startTime":616.5,"endTime":619.2,"body":"surgeons and plastic surgeons"},{"speaker":"Charles Goldfarb","startTime":616.5,"endTime":619.2,"body":"who are trained, but should hand"},{"speaker":"Charles Goldfarb","startTime":619.2,"endTime":621.62,"body":"surgeons be treating non hand"},{"speaker":"Charles Goldfarb","startTime":619.2,"endTime":621.62,"body":"surgeries. To do these surgeries"},{"speaker":"Charles Goldfarb","startTime":621.62,"endTime":622.76,"body":"like carpal tunnel"},{"speaker":"Chris Dy","startTime":623.72,"endTime":626.48,"body":"release, I think it"},{"speaker":"Chris Dy","startTime":623.72,"endTime":626.48,"body":"depends on, you know. I think,"},{"speaker":"Chris Dy","startTime":626.66,"endTime":630.38,"body":"you know, there are some people,"},{"speaker":"Chris Dy","startTime":626.66,"endTime":630.38,"body":"you know, who feel very strongly"},{"speaker":"Chris Dy","startTime":630.38,"endTime":633.32,"body":"that if you can't handle and"},{"speaker":"Chris Dy","startTime":630.38,"endTime":633.32,"body":"deal with the complications that"},{"speaker":"Chris Dy","startTime":633.32,"endTime":635.36,"body":"a procedure generates, you"},{"speaker":"Chris Dy","startTime":633.32,"endTime":635.36,"body":"should not be doing said"},{"speaker":"Chris Dy","startTime":635.36,"endTime":640.1,"body":"procedure, you know. But also,"},{"speaker":"Chris Dy","startTime":635.36,"endTime":640.1,"body":"there are probably access issues"},{"speaker":"Chris Dy","startTime":640.1,"endTime":643.0,"body":"in terms of getting in. And I"},{"speaker":"Chris Dy","startTime":640.1,"endTime":643.0,"body":"think some of the marketing"},{"speaker":"Chris Dy","startTime":643.0,"endTime":645.76,"body":"around at least this current"},{"speaker":"Chris Dy","startTime":643.0,"endTime":645.76,"body":"ultrasound guided device is that"},{"speaker":"Chris Dy","startTime":645.76,"endTime":648.28,"body":"there are a lot of people don't"},{"speaker":"Chris Dy","startTime":645.76,"endTime":648.28,"body":"want to have quote surgery, and"},{"speaker":"Chris Dy","startTime":648.28,"endTime":651.58,"body":"you're seeing a hand surgeon,"},{"speaker":"Chris Dy","startTime":648.28,"endTime":651.58,"body":"you know, even though a lot of"},{"speaker":"Chris Dy","startTime":651.58,"endTime":653.56,"body":"what we do is non operative,"},{"speaker":"Chris Dy","startTime":651.58,"endTime":653.56,"body":"people still have that"},{"speaker":"Chris Dy","startTime":653.56,"endTime":655.66,"body":"mentality. When you're seeing"},{"speaker":"Chris Dy","startTime":653.56,"endTime":655.66,"body":"the surgeon, they're going to"},{"speaker":"Chris Dy","startTime":655.66,"endTime":658.6,"body":"want to do surgery. If you can"},{"speaker":"Chris Dy","startTime":655.66,"endTime":658.6,"body":"make a carpal tunnel release a"},{"speaker":"Chris Dy","startTime":658.6,"endTime":662.34,"body":"quote procedure that's done in"},{"speaker":"Chris Dy","startTime":658.6,"endTime":662.34,"body":"the office by a non surgeon."},{"speaker":"Chris Dy","startTime":662.4,"endTime":664.5,"body":"Maybe it's a little less"},{"speaker":"Chris Dy","startTime":662.4,"endTime":664.5,"body":"intimidating, and, you know,"},{"speaker":"Chris Dy","startTime":664.5,"endTime":666.72,"body":"makes people more interested in"},{"speaker":"Chris Dy","startTime":664.5,"endTime":666.72,"body":"having it done."},{"speaker":"Charles Goldfarb","startTime":667.62,"endTime":670.26,"body":"Yeah. I mean,"},{"speaker":"Charles Goldfarb","startTime":667.62,"endTime":670.26,"body":"this is the hallmark procedure"},{"speaker":"Charles Goldfarb","startTime":670.26,"endTime":673.08,"body":"for hand surgeons, no doubt"},{"speaker":"Charles Goldfarb","startTime":670.26,"endTime":673.08,"body":"about it. And it's not"},{"speaker":"Charles Goldfarb","startTime":673.08,"endTime":677.1,"body":"glamorous, but there are, I"},{"speaker":"Charles Goldfarb","startTime":673.08,"endTime":677.1,"body":"guess I would say there are"},{"speaker":"Charles Goldfarb","startTime":677.1,"endTime":681.2,"body":"challenges, both diagnosis,"},{"speaker":"Charles Goldfarb","startTime":677.1,"endTime":681.2,"body":"counseling and technical. And"},{"speaker":"Charles Goldfarb","startTime":681.2,"endTime":684.8,"body":"the vast majority of time,"},{"speaker":"Charles Goldfarb","startTime":681.2,"endTime":684.8,"body":"things go just fine. But, you"},{"speaker":"Charles Goldfarb","startTime":684.8,"endTime":687.14,"body":"know, I don't know the numbers"},{"speaker":"Charles Goldfarb","startTime":684.8,"endTime":687.14,"body":"you quote for a successful"},{"speaker":"Charles Goldfarb","startTime":687.14,"endTime":692.84,"body":"outcome in carpal tunnel"},{"speaker":"Charles Goldfarb","startTime":687.14,"endTime":692.84,"body":"release, but it's not 95% you"},{"speaker":"Charles Goldfarb","startTime":692.84,"endTime":696.2,"body":"know, it's just not. So it's an"},{"speaker":"Charles Goldfarb","startTime":692.84,"endTime":696.2,"body":"interesting concept, yeah,"},{"speaker":"Chris Dy","startTime":696.2,"endTime":698.72,"body":"and I agree, and you"},{"speaker":"Chris Dy","startTime":696.2,"endTime":698.72,"body":"know, I will say, to be fair,"},{"speaker":"Chris Dy","startTime":698.72,"endTime":703.3,"body":"there I've seen some incredibly"},{"speaker":"Chris Dy","startTime":698.72,"endTime":703.3,"body":"skilled, you know, PM, and our"},{"speaker":"Chris Dy","startTime":703.3,"endTime":706.12,"body":"docs and neurologists use the"},{"speaker":"Chris Dy","startTime":703.3,"endTime":706.12,"body":"ultrasound to do some really"},{"speaker":"Chris Dy","startTime":706.18,"endTime":709.54,"body":"skilled procedures, like very"},{"speaker":"Chris Dy","startTime":706.18,"endTime":709.54,"body":"challenging procedures. I mean,"},{"speaker":"Chris Dy","startTime":709.54,"endTime":712.66,"body":"when I was up at, when I was up"},{"speaker":"Chris Dy","startTime":709.54,"endTime":712.66,"body":"at Mayo for as part of the"},{"speaker":"Chris Dy","startTime":712.66,"endTime":716.62,"body":"government travels, government"},{"speaker":"Chris Dy","startTime":712.66,"endTime":716.62,"body":"scholarship travels, I watched,"},{"speaker":"Chris Dy","startTime":717.04,"endTime":719.5,"body":"you know, them, do some"},{"speaker":"Chris Dy","startTime":717.04,"endTime":719.5,"body":"ultrasound guided thread carpal"},{"speaker":"Chris Dy","startTime":719.5,"endTime":723.12,"body":"tunnel releases, which is really"},{"speaker":"Chris Dy","startTime":719.5,"endTime":723.12,"body":"cool to do. You know, Alex Shin"},{"speaker":"Chris Dy","startTime":723.12,"endTime":728.16,"body":"was doing that with with the"},{"speaker":"Chris Dy","startTime":723.12,"endTime":728.16,"body":"physiatrist together, and did a"},{"speaker":"Chris Dy","startTime":728.16,"endTime":732.18,"body":"lot of them, and they looked"},{"speaker":"Chris Dy","startTime":728.16,"endTime":732.18,"body":"great. I think it's probably a"},{"speaker":"Chris Dy","startTime":732.18,"endTime":734.34,"body":"combination approach, or"},{"speaker":"Chris Dy","startTime":732.18,"endTime":734.34,"body":"collaboration approach, that"},{"speaker":"Chris Dy","startTime":734.34,"endTime":737.46,"body":"would be best. But just the"},{"speaker":"Chris Dy","startTime":734.34,"endTime":737.46,"body":"physical amount of time that you"},{"speaker":"Chris Dy","startTime":737.46,"endTime":741.14,"body":"need for two people to two busy"},{"speaker":"Chris Dy","startTime":737.46,"endTime":741.14,"body":"doctors to do something together"},{"speaker":"Chris Dy","startTime":741.14,"endTime":744.02,"body":"is is hard for something as"},{"speaker":"Chris Dy","startTime":741.14,"endTime":744.02,"body":"relatively routine as a carpal"},{"speaker":"Chris Dy","startTime":744.02,"endTime":744.68,"body":"tunnel release?"},{"speaker":"Charles Goldfarb","startTime":746.06,"endTime":748.64,"body":"Yeah, I have"},{"speaker":"Charles Goldfarb","startTime":746.06,"endTime":748.64,"body":"nothing to add. So, so, yeah,"},{"speaker":"Charles Goldfarb","startTime":748.7,"endTime":753.8,"body":"maybe, maybe, I don't know. In"},{"speaker":"Charles Goldfarb","startTime":748.7,"endTime":753.8,"body":"2030 will it be 25% of cases are"},{"speaker":"Charles Goldfarb","startTime":753.8,"endTime":756.62,"body":"done by non answers. I don't"},{"speaker":"Charles Goldfarb","startTime":753.8,"endTime":756.62,"body":"know. Yeah,"},{"speaker":"Chris Dy","startTime":756.62,"endTime":758.24,"body":"I don't know. And I"},{"speaker":"Chris Dy","startTime":756.62,"endTime":758.24,"body":"don't know if there's a, I guess"},{"speaker":"Chris Dy","startTime":758.24,"endTime":760.9,"body":"there's an admin data study"},{"speaker":"Chris Dy","startTime":758.24,"endTime":760.9,"body":"waiting to happen in the future."},{"speaker":"Chris Dy","startTime":760.9,"endTime":761.5,"body":"So we'll see."},{"speaker":"Charles Goldfarb","startTime":762.1,"endTime":765.7,"body":"We will see,"},{"speaker":"Charles Goldfarb","startTime":762.1,"endTime":765.7,"body":"all right. Number two, the thumb"},{"speaker":"Charles Goldfarb","startTime":765.7,"endTime":770.14,"body":"CMC joint, will be treated with"},{"speaker":"Charles Goldfarb","startTime":765.7,"endTime":770.14,"body":"implant arthroplasty"},{"speaker":"Chris Dy","startTime":770.26,"endTime":772.84,"body":"alone. You mean in the"},{"speaker":"Chris Dy","startTime":770.26,"endTime":772.84,"body":"United States, because it's"},{"speaker":"Chris Dy","startTime":772.84,"endTime":774.94,"body":"already being done other places"},{"speaker":"Chris Dy","startTime":772.84,"endTime":774.94,"body":"in"},{"speaker":"Charles Goldfarb","startTime":774.94,"endTime":779.02,"body":"the United"},{"speaker":"Charles Goldfarb","startTime":774.94,"endTime":779.02,"body":"States, by 2030, CMC will be an"},{"speaker":"Charles Goldfarb","startTime":779.02,"endTime":785.46,"body":"implant arthroplasty procedure,"},{"speaker":"Charles Goldfarb","startTime":779.02,"endTime":785.46,"body":"and we won't be doing fcr, we"},{"speaker":"Charles Goldfarb","startTime":785.46,"endTime":789.06,"body":"won't be doing suture suspension"},{"speaker":"Charles Goldfarb","startTime":785.46,"endTime":789.06,"body":"plastic, we won't do an implant."},{"speaker":"Charles Goldfarb","startTime":789.06,"endTime":794.16,"body":"I like the suture implants. What"},{"speaker":"Charles Goldfarb","startTime":789.06,"endTime":794.16,"body":"do you think? No,"},{"speaker":"Chris Dy","startTime":795.72,"endTime":797.28,"body":"I do not think that's"},{"speaker":"Chris Dy","startTime":795.72,"endTime":797.28,"body":"gonna happen,"},{"speaker":"Charles Goldfarb","startTime":797.28,"endTime":799.68,"body":"and why and"},{"speaker":"Charles Goldfarb","startTime":797.28,"endTime":799.68,"body":"why not. I"},{"speaker":"Chris Dy","startTime":799.68,"endTime":802.58,"body":"think that the it's"},{"speaker":"Chris Dy","startTime":799.68,"endTime":802.58,"body":"going to take a lot to change"},{"speaker":"Chris Dy","startTime":802.58,"endTime":807.44,"body":"surgeons minds about what to do"},{"speaker":"Chris Dy","startTime":802.58,"endTime":807.44,"body":"in the US. And I think the track"},{"speaker":"Chris Dy","startTime":807.44,"endTime":812.12,"body":"record of multiple unsuccessful"},{"speaker":"Chris Dy","startTime":807.44,"endTime":812.12,"body":"launches of implant arthroplasty"},{"speaker":"Chris Dy","startTime":812.12,"endTime":816.38,"body":"for thumb, CMC in the US market"},{"speaker":"Chris Dy","startTime":812.12,"endTime":816.38,"body":"has honestly, I think it's"},{"speaker":"Chris Dy","startTime":816.38,"endTime":820.42,"body":"probably, you know, killed the"},{"speaker":"Chris Dy","startTime":816.38,"endTime":820.42,"body":"procedure, potentially for"},{"speaker":"Chris Dy","startTime":820.42,"endTime":823.9,"body":"future generations. I was"},{"speaker":"Chris Dy","startTime":820.42,"endTime":823.9,"body":"intrigued. We had a visitor come"},{"speaker":"Chris Dy","startTime":823.9,"endTime":827.14,"body":"from South Africa last year, and"},{"speaker":"Chris Dy","startTime":823.9,"endTime":827.14,"body":"he was talking about his thumb"},{"speaker":"Chris Dy","startTime":827.44,"endTime":830.86,"body":"CMC experience and implant"},{"speaker":"Chris Dy","startTime":827.44,"endTime":830.86,"body":"arthroplasty. And I was"},{"speaker":"Chris Dy","startTime":830.86,"endTime":833.98,"body":"intrigued. And then I have"},{"speaker":"Chris Dy","startTime":830.86,"endTime":833.98,"body":"enough happy thumb CMC patients"},{"speaker":"Chris Dy","startTime":833.98,"endTime":837.7,"body":"who are treated with trapezium"},{"speaker":"Chris Dy","startTime":833.98,"endTime":837.7,"body":"and suspension of some sort,"},{"speaker":"Chris Dy","startTime":837.88,"endTime":841.44,"body":"where I'm not going to change."},{"speaker":"Chris Dy","startTime":837.88,"endTime":841.44,"body":"So we're to require a fair bit"},{"speaker":"Chris Dy","startTime":841.44,"endTime":845.46,"body":"of evidence, and those studies"},{"speaker":"Chris Dy","startTime":841.44,"endTime":845.46,"body":"are expensive and are probably"},{"speaker":"Chris Dy","startTime":845.46,"endTime":846.48,"body":"not going to be done. I"},{"speaker":"Charles Goldfarb","startTime":848.04,"endTime":849.96,"body":"think that's"},{"speaker":"Charles Goldfarb","startTime":848.04,"endTime":849.96,"body":"well said. You know, it's so"},{"speaker":"Charles Goldfarb","startTime":849.96,"endTime":853.14,"body":"interesting and sometimes"},{"speaker":"Charles Goldfarb","startTime":849.96,"endTime":853.14,"body":"frustrating, and I will leave"},{"speaker":"Charles Goldfarb","startTime":853.14,"endTime":856.32,"body":"the person nameless, but, and I"},{"speaker":"Charles Goldfarb","startTime":853.14,"endTime":856.32,"body":"don't, I don't think you do it"},{"speaker":"Charles Goldfarb","startTime":856.32,"endTime":861.14,"body":"this way, but as an example of"},{"speaker":"Charles Goldfarb","startTime":856.32,"endTime":861.14,"body":"kind of the challenge of having"},{"speaker":"Charles Goldfarb","startTime":861.14,"endTime":865.64,"body":"surgeons change. In conference,"},{"speaker":"Charles Goldfarb","startTime":861.14,"endTime":865.64,"body":"we were talking, I think, in"},{"speaker":"Charles Goldfarb","startTime":865.64,"endTime":868.1,"body":"research conference, we were"},{"speaker":"Charles Goldfarb","startTime":865.64,"endTime":868.1,"body":"talking about, or else clinical"},{"speaker":"Charles Goldfarb","startTime":868.1,"endTime":871.4,"body":"conference, we were talking"},{"speaker":"Charles Goldfarb","startTime":868.1,"endTime":871.4,"body":"about how we approach the CMC"},{"speaker":"Charles Goldfarb","startTime":871.4,"endTime":874.76,"body":"joint, straight dorsal or"},{"speaker":"Charles Goldfarb","startTime":871.4,"endTime":874.76,"body":"Wagner. You might call it the"},{"speaker":"Charles Goldfarb","startTime":874.76,"endTime":876.2,"body":"Wagner approach,"},{"speaker":"Chris Dy","startTime":876.38,"endTime":878.72,"body":"and not as fancy as"},{"speaker":"Chris Dy","startTime":876.38,"endTime":878.72,"body":"you with the Wagner"},{"speaker":"Charles Goldfarb","startTime":879.74,"endTime":881.56,"body":"and one of my"},{"speaker":"Charles Goldfarb","startTime":879.74,"endTime":881.56,"body":"partners, who I have immense"},{"speaker":"Charles Goldfarb","startTime":881.56,"endTime":886.36,"body":"respect for, only uses the"},{"speaker":"Charles Goldfarb","startTime":881.56,"endTime":886.36,"body":"Wagner, and I just don't"},{"speaker":"Charles Goldfarb","startTime":886.36,"endTime":889.36,"body":"understand it. It doesn't"},{"speaker":"Charles Goldfarb","startTime":886.36,"endTime":889.36,"body":"provide better access. You do"},{"speaker":"Charles Goldfarb","startTime":889.36,"endTime":892.72,"body":"have more nerve, you know, nerve"},{"speaker":"Charles Goldfarb","startTime":889.36,"endTime":892.72,"body":"irritation afterwards. Why in"},{"speaker":"Charles Goldfarb","startTime":892.72,"endTime":896.14,"body":"the world will we do that? It's"},{"speaker":"Charles Goldfarb","startTime":892.72,"endTime":896.14,"body":"just that's how that person was"},{"speaker":"Charles Goldfarb","startTime":896.14,"endTime":900.96,"body":"trained. And deviating from that"},{"speaker":"Charles Goldfarb","startTime":896.14,"endTime":900.96,"body":"course, you. It's just hard,"},{"speaker":"Charles Goldfarb","startTime":900.96,"endTime":901.14,"body":"right?"},{"speaker":"Chris Dy","startTime":901.14,"endTime":903.42,"body":"It's very hard to"},{"speaker":"Chris Dy","startTime":901.14,"endTime":903.42,"body":"change people's minds when they"},{"speaker":"Chris Dy","startTime":903.42,"endTime":906.6,"body":"have success with something,"},{"speaker":"Chris Dy","startTime":903.42,"endTime":906.6,"body":"right? Like, why would they"},{"speaker":"Chris Dy","startTime":906.6,"endTime":909.3,"body":"change? Like, you know, that's"},{"speaker":"Chris Dy","startTime":906.6,"endTime":909.3,"body":"what works. What works in your"},{"speaker":"Chris Dy","startTime":909.3,"endTime":912.36,"body":"hands, right? You know, we"},{"speaker":"Chris Dy","startTime":909.3,"endTime":912.36,"body":"actually have two partners that"},{"speaker":"Chris Dy","startTime":912.36,"endTime":920.12,"body":"use the Wagner routinely. So,"},{"speaker":"Chris Dy","startTime":912.36,"endTime":920.12,"body":"no, no, you know, I'll let we're"},{"speaker":"Chris Dy","startTime":920.12,"endTime":922.58,"body":"not going to call them out"},{"speaker":"Chris Dy","startTime":920.12,"endTime":922.58,"body":"because, you know, but actually,"},{"speaker":"Chris Dy","startTime":922.58,"endTime":926.18,"body":"I think if you're doing the, if"},{"speaker":"Chris Dy","startTime":922.58,"endTime":926.18,"body":"you're doing the genie Delson,"},{"speaker":"Chris Dy","startTime":926.18,"endTime":930.02,"body":"your technique, you know, it's"},{"speaker":"Chris Dy","startTime":926.18,"endTime":930.02,"body":"actually easier from a Wagner,"},{"speaker":"Chris Dy","startTime":930.14,"endTime":932.72,"body":"it's quite challenging, I think,"},{"speaker":"Chris Dy","startTime":930.14,"endTime":932.72,"body":"to do from a dorsal approach."},{"speaker":"Chris Dy","startTime":932.72,"endTime":936.56,"body":"But our partners are using that"},{"speaker":"Chris Dy","startTime":932.72,"endTime":936.56,"body":"technique as of right now. But"},{"speaker":"Chris Dy","startTime":936.56,"endTime":939.08,"body":"you know, just saying, there are"},{"speaker":"Chris Dy","startTime":936.56,"endTime":939.08,"body":"technical reasons to use a"},{"speaker":"Chris Dy","startTime":939.08,"endTime":944.26,"body":"Wagner, you know, if that's your"},{"speaker":"Chris Dy","startTime":939.08,"endTime":944.26,"body":"preferred suspension, what's you"},{"speaker":"Chris Dy","startTime":944.26,"endTime":947.26,"body":"know, you're much older than"},{"speaker":"Chris Dy","startTime":944.26,"endTime":947.26,"body":"much, much older than me, much"},{"speaker":"Chris Dy","startTime":947.56,"endTime":950.68,"body":"and trained in, you know, back"},{"speaker":"Chris Dy","startTime":947.56,"endTime":950.68,"body":"when I think, you know, people"},{"speaker":"Chris Dy","startTime":950.68,"endTime":953.86,"body":"were being admitted before"},{"speaker":"Chris Dy","startTime":950.68,"endTime":953.86,"body":"carpal tunnel releases and sent"},{"speaker":"Chris Dy","startTime":953.86,"endTime":959.32,"body":"home after three days in the"},{"speaker":"Chris Dy","startTime":953.86,"endTime":959.32,"body":"ICU. So what was the feeling"},{"speaker":"Chris Dy","startTime":959.32,"endTime":962.94,"body":"about implant arthroplasty, back"},{"speaker":"Chris Dy","startTime":959.32,"endTime":962.94,"body":"when some of those implants were"},{"speaker":"Chris Dy","startTime":962.94,"endTime":964.56,"body":"being introduced in the 90s in"},{"speaker":"Chris Dy","startTime":962.94,"endTime":964.56,"body":"the"},{"speaker":"Charles Goldfarb","startTime":964.56,"endTime":968.46,"body":"States, I was"},{"speaker":"Charles Goldfarb","startTime":964.56,"endTime":968.46,"body":"taught with the classic Burton"},{"speaker":"Charles Goldfarb","startTime":968.46,"endTime":974.76,"body":"and Pellegrini fcr, and there"},{"speaker":"Charles Goldfarb","startTime":968.46,"endTime":974.76,"body":"was a widespread skepticism with"},{"speaker":"Charles Goldfarb","startTime":974.76,"endTime":980.1,"body":"the introduction of any implant"},{"speaker":"Charles Goldfarb","startTime":974.76,"endTime":980.1,"body":"arthroplasty. And so, you know,"},{"speaker":"Charles Goldfarb","startTime":980.1,"endTime":982.82,"body":"at in since where I did my"},{"speaker":"Charles Goldfarb","startTime":980.1,"endTime":982.82,"body":"residency, here at Wash U in"},{"speaker":"Charles Goldfarb","startTime":982.82,"endTime":986.06,"body":"Cincinnati, with Peter Stern,"},{"speaker":"Charles Goldfarb","startTime":982.82,"endTime":986.06,"body":"Tom kefir and others, and then"},{"speaker":"Charles Goldfarb","startTime":986.06,"endTime":989.66,"body":"back at WashU. I don't think"},{"speaker":"Charles Goldfarb","startTime":986.06,"endTime":989.66,"body":"anyone's I've never seen an"},{"speaker":"Charles Goldfarb","startTime":989.66,"endTime":991.16,"body":"implant arthroplasty performed."},{"speaker":"Chris Dy","startTime":992.54,"endTime":996.62,"body":"Do you feel like there"},{"speaker":"Chris Dy","startTime":992.54,"endTime":996.62,"body":"is a chance for it to be adopted"},{"speaker":"Chris Dy","startTime":996.68,"endTime":1000.9,"body":"in the United States? That"},{"speaker":"Chris Dy","startTime":996.68,"endTime":1000.9,"body":"wouldn't take Yeah?"},{"speaker":"Charles Goldfarb","startTime":1001.02,"endTime":1003.78,"body":"It would take"},{"speaker":"Charles Goldfarb","startTime":1001.02,"endTime":1003.78,"body":"an amazingly convincing study,"},{"speaker":"Charles Goldfarb","startTime":1003.96,"endTime":1008.16,"body":"and it would also take an"},{"speaker":"Charles Goldfarb","startTime":1003.96,"endTime":1008.16,"body":"articulate proponent of the"},{"speaker":"Charles Goldfarb","startTime":1008.16,"endTime":1014.16,"body":"procedure sharing his or her"},{"speaker":"Charles Goldfarb","startTime":1008.16,"endTime":1014.16,"body":"results repetitively at national"},{"speaker":"Charles Goldfarb","startTime":1014.16,"endTime":1017.34,"body":"meetings. I mean, it's just it"},{"speaker":"Charles Goldfarb","startTime":1014.16,"endTime":1017.34,"body":"would be a slog to change the"},{"speaker":"Charles Goldfarb","startTime":1017.34,"endTime":1021.32,"body":"perspective of so many people. I"},{"speaker":"Charles Goldfarb","startTime":1017.34,"endTime":1021.32,"body":"think it could happen. I mean,"},{"speaker":"Charles Goldfarb","startTime":1021.32,"endTime":1024.74,"body":"given the success of hips and"},{"speaker":"Charles Goldfarb","startTime":1021.32,"endTime":1024.74,"body":"knees, and I mean, you would"},{"speaker":"Charles Goldfarb","startTime":1024.74,"endTime":1028.4,"body":"think that there's a, at least"},{"speaker":"Charles Goldfarb","startTime":1024.74,"endTime":1028.4,"body":"amongst orthopedic surgeons,"},{"speaker":"Charles Goldfarb","startTime":1028.58,"endTime":1033.38,"body":"there is an underlying"},{"speaker":"Charles Goldfarb","startTime":1028.58,"endTime":1033.38,"body":"acceptance that implants are"},{"speaker":"Charles Goldfarb","startTime":1033.38,"endTime":1038.48,"body":"great, but it's just not for"},{"speaker":"Charles Goldfarb","startTime":1033.38,"endTime":1038.48,"body":"hand surgeons. Do you think that"},{"speaker":"Charles Goldfarb","startTime":1039.32,"endTime":1039.62,"body":"there's"},{"speaker":"Chris Dy","startTime":1039.619,"endTime":1043.479,"body":"a market to develop"},{"speaker":"Chris Dy","startTime":1039.619,"endTime":1043.479,"body":"said device, and, you know, and"},{"speaker":"Chris Dy","startTime":1043.479,"endTime":1046.359,"body":"obviously, it's been developed"},{"speaker":"Chris Dy","startTime":1043.479,"endTime":1046.359,"body":"in other countries, and there"},{"speaker":"Chris Dy","startTime":1046.359,"endTime":1048.999,"body":"have been reports of excellent"},{"speaker":"Chris Dy","startTime":1046.359,"endTime":1048.999,"body":"results in, you know,"},{"speaker":"Chris Dy","startTime":1048.999,"endTime":1049.959,"body":"internationally, I"},{"speaker":"Charles Goldfarb","startTime":1051.28,"endTime":1052.72,"body":"like to your"},{"speaker":"Charles Goldfarb","startTime":1051.28,"endTime":1052.72,"body":"point earlier, I just don't"},{"speaker":"Charles Goldfarb","startTime":1052.72,"endTime":1055.06,"body":"think in the United States,"},{"speaker":"Charles Goldfarb","startTime":1052.72,"endTime":1055.06,"body":"we're ready for it. I think"},{"speaker":"Charles Goldfarb","startTime":1055.12,"endTime":1059.32,"body":"that's the hope that colleagues"},{"speaker":"Charles Goldfarb","startTime":1055.12,"endTime":1059.32,"body":"overseas will share compelling"},{"speaker":"Charles Goldfarb","startTime":1059.32,"endTime":1065.04,"body":"results that aren't like a skosh"},{"speaker":"Charles Goldfarb","startTime":1059.32,"endTime":1065.04,"body":"better than our results. However"},{"speaker":"Charles Goldfarb","startTime":1065.04,"endTime":1068.82,"body":"we're doing it, they have to be"},{"speaker":"Charles Goldfarb","startTime":1065.04,"endTime":1068.82,"body":"notably better. You know,"},{"speaker":"Charles Goldfarb","startTime":1068.82,"endTime":1072.3,"body":"decrease early failure rate,"},{"speaker":"Charles Goldfarb","startTime":1068.82,"endTime":1072.3,"body":"decrease late failure rate, and"},{"speaker":"Charles Goldfarb","startTime":1072.3,"endTime":1074.82,"body":"really happy patients. Because"},{"speaker":"Charles Goldfarb","startTime":1072.3,"endTime":1074.82,"body":"the reality is, I think we all"},{"speaker":"Charles Goldfarb","startTime":1074.82,"endTime":1077.7,"body":"know there is one truth, and"},{"speaker":"Charles Goldfarb","startTime":1074.82,"endTime":1077.7,"body":"this one truth that will prevent"},{"speaker":"Charles Goldfarb","startTime":1077.7,"endTime":1081.14,"body":"me from ever doing a prospective"},{"speaker":"Charles Goldfarb","startTime":1077.7,"endTime":1081.14,"body":"randomized trial again, if the"},{"speaker":"Charles Goldfarb","startTime":1081.14,"endTime":1084.2,"body":"results are always about the"},{"speaker":"Charles Goldfarb","startTime":1081.14,"endTime":1084.2,"body":"same, whatever you do, yeah, I"},{"speaker":"Charles Goldfarb","startTime":1084.2,"endTime":1084.68,"body":"mean, it's"},{"speaker":"Chris Dy","startTime":1084.68,"endTime":1087.92,"body":"really, I won't say"},{"speaker":"Chris Dy","startTime":1084.68,"endTime":1087.92,"body":"that, you know, a thumb CMC"},{"speaker":"Chris Dy","startTime":1087.92,"endTime":1093.2,"body":"surgery is as reproducible as a"},{"speaker":"Chris Dy","startTime":1087.92,"endTime":1093.2,"body":"carpal tunnel release. But, I"},{"speaker":"Chris Dy","startTime":1093.2,"endTime":1096.2,"body":"mean, I think that's the issue"},{"speaker":"Chris Dy","startTime":1093.2,"endTime":1096.2,"body":"that, you know, studies have"},{"speaker":"Chris Dy","startTime":1096.2,"endTime":1099.5,"body":"when they're trying to show that"},{"speaker":"Chris Dy","startTime":1096.2,"endTime":1099.5,"body":"they're not significantly"},{"speaker":"Chris Dy","startTime":1099.5,"endTime":1105.4,"body":"different, you know, compared to"},{"speaker":"Chris Dy","startTime":1099.5,"endTime":1105.4,"body":"an existing gold standard, gold"},{"speaker":"Chris Dy","startTime":1105.4,"endTime":1109.36,"body":"being a relative term, right?"},{"speaker":"Chris Dy","startTime":1105.4,"endTime":1109.36,"body":"And then, you know, you actually"},{"speaker":"Chris Dy","startTime":1109.36,"endTime":1112.0,"body":"have to show that you're better,"},{"speaker":"Chris Dy","startTime":1109.36,"endTime":1112.0,"body":"which, in some ways can be"},{"speaker":"Chris Dy","startTime":1112.0,"endTime":1116.08,"body":"harder. So I just don't think"},{"speaker":"Chris Dy","startTime":1112.0,"endTime":1116.08,"body":"the evidence is going to come,"},{"speaker":"Chris Dy","startTime":1116.08,"endTime":1119.26,"body":"and I think it does have to come"},{"speaker":"Chris Dy","startTime":1116.08,"endTime":1119.26,"body":"from somebody who is respected,"},{"speaker":"Chris Dy","startTime":1119.32,"endTime":1123.06,"body":"articulate, and not crossing"},{"speaker":"Chris Dy","startTime":1119.32,"endTime":1123.06,"body":"into the line of evangelistic,"},{"speaker":"Chris Dy","startTime":1123.48,"endTime":1125.52,"body":"which I think a lot of people"},{"speaker":"Chris Dy","startTime":1123.48,"endTime":1125.52,"body":"who when they feel really"},{"speaker":"Chris Dy","startTime":1125.52,"endTime":1127.74,"body":"passionate on something that"},{"speaker":"Chris Dy","startTime":1125.52,"endTime":1127.74,"body":"they've innovated, it does come"},{"speaker":"Chris Dy","startTime":1127.74,"endTime":1130.5,"body":"across as evangelistic at times,"},{"speaker":"Chris Dy","startTime":1127.74,"endTime":1130.5,"body":"which you know right or wrong,"},{"speaker":"Chris Dy","startTime":1130.68,"endTime":1134.58,"body":"but you're just so into it and"},{"speaker":"Chris Dy","startTime":1130.68,"endTime":1134.58,"body":"in the weeds and invested, yeah,"},{"speaker":"Charles Goldfarb","startTime":1134.88,"endTime":1138.6,"body":"well said. I"},{"speaker":"Charles Goldfarb","startTime":1134.88,"endTime":1138.6,"body":"mean, what was the last great"},{"speaker":"Charles Goldfarb","startTime":1139.2,"endTime":1143.42,"body":"shift in surgeon, hand surgeon"},{"speaker":"Charles Goldfarb","startTime":1139.2,"endTime":1143.42,"body":"behavior. Was it the volar plate"},{"speaker":"Charles Goldfarb","startTime":1143.66,"endTime":1145.28,"body":"with George or Bay? I think"},{"speaker":"Chris Dy","startTime":1145.28,"endTime":1147.2,"body":"the volar plate is"},{"speaker":"Chris Dy","startTime":1145.28,"endTime":1147.2,"body":"probably the one that we would"},{"speaker":"Chris Dy","startTime":1147.2,"endTime":1150.26,"body":"recognize, you know, I think"},{"speaker":"Chris Dy","startTime":1147.2,"endTime":1150.26,"body":"that, I think we're having Sanj"},{"speaker":"Chris Dy","startTime":1150.26,"endTime":1152.54,"body":"back on pretty soon, and you"},{"speaker":"Chris Dy","startTime":1150.26,"endTime":1152.54,"body":"guys will talk a little bit"},{"speaker":"Chris Dy","startTime":1152.54,"endTime":1154.88,"body":"about, you know, maybe a shift"},{"speaker":"Chris Dy","startTime":1152.54,"endTime":1154.88,"body":"in, you know, arthroscopic"},{"speaker":"Chris Dy","startTime":1154.88,"endTime":1159.68,"body":"treatments before the volar"},{"speaker":"Chris Dy","startTime":1154.88,"endTime":1159.68,"body":"plate, you know, microsurgery,"},{"speaker":"Charles Goldfarb","startTime":1159.68,"endTime":1162.734,"body":"yeah, yeah."},{"speaker":"Charles Goldfarb","startTime":1159.68,"endTime":1162.734,"body":"And the other, the other distal"},{"speaker":"Charles Goldfarb","startTime":1162.805,"endTime":1166.924,"body":"radius innovation that I think"},{"speaker":"Charles Goldfarb","startTime":1162.805,"endTime":1166.924,"body":"has been rapidly and widely"},{"speaker":"Charles Goldfarb","startTime":1166.995,"endTime":1171.47,"body":"accepted is the spanning plate."},{"speaker":"Charles Goldfarb","startTime":1166.995,"endTime":1171.47,"body":"Those are both, you know, we're"},{"speaker":"Charles Goldfarb","startTime":1171.541,"endTime":1175.873,"body":"big changes, but yeah, let me,"},{"speaker":"Charles Goldfarb","startTime":1171.541,"endTime":1175.873,"body":"let me back up. And just maybe"},{"speaker":"Charles Goldfarb","startTime":1175.944,"endTime":1179.779,"body":"as a future of hand surgery"},{"speaker":"Charles Goldfarb","startTime":1175.944,"endTime":1179.779,"body":"number three will be wrist"},{"speaker":"Charles Goldfarb","startTime":1179.85,"endTime":1183.828,"body":"arthroscopy will continue to"},{"speaker":"Charles Goldfarb","startTime":1179.85,"endTime":1183.828,"body":"evolve, maybe some fits and"},{"speaker":"Charles Goldfarb","startTime":1183.899,"endTime":1188.16,"body":"starts, but open scape, Fauci"},{"speaker":"Charles Goldfarb","startTime":1183.899,"endTime":1188.16,"body":"lunate ligament repair will be"},{"speaker":"Charles Goldfarb","startTime":1188.231,"endTime":1192.422,"body":"historical. And I think the"},{"speaker":"Charles Goldfarb","startTime":1188.231,"endTime":1192.422,"body":"future of hand surgery includes"},{"speaker":"Charles Goldfarb","startTime":1192.493,"endTime":1196.896,"body":"all arthroscopic treatment, just"},{"speaker":"Charles Goldfarb","startTime":1192.493,"endTime":1196.896,"body":"like the evolution of rotator"},{"speaker":"Charles Goldfarb","startTime":1196.967,"endTime":1197.82,"body":"cuff repair."},{"speaker":"Chris Dy","startTime":1199.38,"endTime":1201.5,"body":"I think that's."},{"speaker":"Chris Dy","startTime":1199.38,"endTime":1201.5,"body":"Probably right. I mean, you"},{"speaker":"Chris Dy","startTime":1201.5,"endTime":1204.14,"body":"know, and I also think to"},{"speaker":"Chris Dy","startTime":1201.5,"endTime":1204.14,"body":"piggyback on your three, I'll"},{"speaker":"Chris Dy","startTime":1204.14,"endTime":1208.22,"body":"make it a three A. I think in 10"},{"speaker":"Chris Dy","startTime":1204.14,"endTime":1208.22,"body":"years, you're going to have"},{"speaker":"Chris Dy","startTime":1208.46,"endTime":1212.24,"body":"arthroscopy fellowships for"},{"speaker":"Chris Dy","startTime":1208.46,"endTime":1212.24,"body":"hand, wrist and elbow."},{"speaker":"Charles Goldfarb","startTime":1213.62,"endTime":1215.3,"body":"Yeah,"},{"speaker":"Charles Goldfarb","startTime":1213.62,"endTime":1215.3,"body":"interesting. Just like people"},{"speaker":"Charles Goldfarb","startTime":1215.3,"endTime":1215.6,"body":"have, like,"},{"speaker":"Chris Dy","startTime":1215.6,"endTime":1218.0,"body":"you know, your extra"},{"speaker":"Chris Dy","startTime":1215.6,"endTime":1218.0,"body":"three months, you do for six"},{"speaker":"Chris Dy","startTime":1218.0,"endTime":1221.32,"body":"months for peds, and some people"},{"speaker":"Chris Dy","startTime":1218.0,"endTime":1221.32,"body":"do it for micro, I think they're"},{"speaker":"Chris Dy","startTime":1221.32,"endTime":1224.26,"body":"going to be arthroscopy"},{"speaker":"Chris Dy","startTime":1221.32,"endTime":1224.26,"body":"fellowships, mini fellowships."},{"speaker":"Charles Goldfarb","startTime":1225.22,"endTime":1228.64,"body":"That implies"},{"speaker":"Charles Goldfarb","startTime":1225.22,"endTime":1228.64,"body":"programs where there's an"},{"speaker":"Charles Goldfarb","startTime":1228.64,"endTime":1232.6,"body":"abundance of volume that would"},{"speaker":"Charles Goldfarb","startTime":1228.64,"endTime":1232.6,"body":"allow that. I've always"},{"speaker":"Charles Goldfarb","startTime":1232.6,"endTime":1237.94,"body":"struggled with that because I,"},{"speaker":"Charles Goldfarb","startTime":1232.6,"endTime":1237.94,"body":"I, you know, I do a lot of"},{"speaker":"Charles Goldfarb","startTime":1237.94,"endTime":1243.9,"body":"elbow, which I don't think is"},{"speaker":"Charles Goldfarb","startTime":1237.94,"endTime":1243.9,"body":"done a lot, and we have a"},{"speaker":"Charles Goldfarb","startTime":1243.9,"endTime":1244.98,"body":"visitor."},{"speaker":"Chris Dy","startTime":1245.04,"endTime":1247.2,"body":"We do have visitor."},{"speaker":"Chris Dy","startTime":1245.04,"endTime":1247.2,"body":"Did you want to introduce"},{"speaker":"Chris Dy","startTime":1247.2,"endTime":1252.9,"body":"yourself? Okay, go ahead. My"},{"speaker":"Chris Dy","startTime":1247.2,"endTime":1252.9,"body":"name is Evelina, and I'm six"},{"speaker":"Chris Dy","startTime":1252.9,"endTime":1253.68,"body":"years old."},{"speaker":"Charles Goldfarb","startTime":1255.12,"endTime":1256.68,"body":"Thanks for"},{"speaker":"Charles Goldfarb","startTime":1255.12,"endTime":1256.68,"body":"joining us, for talking about"},{"speaker":"Charles Goldfarb","startTime":1256.68,"endTime":1258.9,"body":"your future in hand surgery."},{"speaker":"Chris Dy","startTime":1260.88,"endTime":1264.86,"body":"I can't hear you"},{"speaker":"Chris Dy","startTime":1260.88,"endTime":1264.86,"body":"because I have headphones. Okay,"},{"speaker":"Chris Dy","startTime":1264.92,"endTime":1268.1,"body":"Can daddy finish the podcast?"},{"speaker":"Chris Dy","startTime":1264.92,"endTime":1268.1,"body":"Yeah? Okay, daddy, thank you."},{"speaker":"Charles Goldfarb","startTime":1269.72,"endTime":1273.5,"body":"Yeah. So, so I"},{"speaker":"Charles Goldfarb","startTime":1269.72,"endTime":1273.5,"body":"do a lot of elbow work, and yet"},{"speaker":"Charles Goldfarb","startTime":1273.5,"endTime":1278.18,"body":"the challenge is having enough"},{"speaker":"Charles Goldfarb","startTime":1273.5,"endTime":1278.18,"body":"to welcome visitors, or, you"},{"speaker":"Charles Goldfarb","startTime":1278.18,"endTime":1281.02,"body":"know, enough localized but I"},{"speaker":"Charles Goldfarb","startTime":1278.18,"endTime":1281.02,"body":"think you're right. An upper"},{"speaker":"Charles Goldfarb","startTime":1281.02,"endTime":1284.8,"body":"extremity arthroscopy fellowship"},{"speaker":"Charles Goldfarb","startTime":1281.02,"endTime":1284.8,"body":"makes a lot of sense. I think"},{"speaker":"Charles Goldfarb","startTime":1284.8,"endTime":1284.98,"body":"you're"},{"speaker":"Chris Dy","startTime":1285.04,"endTime":1287.02,"body":"going to be doing more"},{"speaker":"Chris Dy","startTime":1285.04,"endTime":1287.02,"body":"and more through the scope, and"},{"speaker":"Chris Dy","startTime":1287.02,"endTime":1289.78,"body":"people are going to want to come"},{"speaker":"Chris Dy","startTime":1287.02,"endTime":1289.78,"body":"to learn, and I think I'm going"},{"speaker":"Chris Dy","startTime":1289.78,"endTime":1291.94,"body":"to be doing less and less"},{"speaker":"Chris Dy","startTime":1289.78,"endTime":1291.94,"body":"through the scope. I mean,"},{"speaker":"Chris Dy","startTime":1291.94,"endTime":1296.14,"body":"that's honestly as and I'm"},{"speaker":"Chris Dy","startTime":1291.94,"endTime":1296.14,"body":"interested. Just personally, I"},{"speaker":"Chris Dy","startTime":1296.14,"endTime":1298.96,"body":"want to remain broad as a hand"},{"speaker":"Chris Dy","startTime":1296.14,"endTime":1298.96,"body":"surgeon, but I also recognize"},{"speaker":"Chris Dy","startTime":1298.96,"endTime":1301.86,"body":"there's too many fields to keep"},{"speaker":"Chris Dy","startTime":1298.96,"endTime":1301.86,"body":"up with, like, you know, to be"},{"speaker":"Chris Dy","startTime":1301.86,"endTime":1304.92,"body":"honest with, even in our narrow"},{"speaker":"Chris Dy","startTime":1301.86,"endTime":1304.92,"body":"lane of hand surgery, there's"},{"speaker":"Chris Dy","startTime":1304.92,"endTime":1308.34,"body":"various things that I'm just not"},{"speaker":"Chris Dy","startTime":1304.92,"endTime":1308.34,"body":"going to be up on as much. And,"},{"speaker":"Chris Dy","startTime":1308.34,"endTime":1310.8,"body":"you know, I think that I'll"},{"speaker":"Chris Dy","startTime":1308.34,"endTime":1310.8,"body":"probably have to select at some"},{"speaker":"Chris Dy","startTime":1310.8,"endTime":1311.1,"body":"point."},{"speaker":"Charles Goldfarb","startTime":1311.28,"endTime":1313.56,"body":"It's so true,"},{"speaker":"Charles Goldfarb","startTime":1311.28,"endTime":1313.56,"body":"and you're wise not to narrow"},{"speaker":"Charles Goldfarb","startTime":1313.56,"endTime":1315.96,"body":"too soon. We've talked about"},{"speaker":"Charles Goldfarb","startTime":1313.56,"endTime":1315.96,"body":"that. I firmly believe, stay"},{"speaker":"Charles Goldfarb","startTime":1315.96,"endTime":1318.78,"body":"broad as long as you can. But at"},{"speaker":"Charles Goldfarb","startTime":1315.96,"endTime":1318.78,"body":"our institution, oh, it would be"},{"speaker":"Charles Goldfarb","startTime":1318.78,"endTime":1322.4,"body":"okay if you decided to just do"},{"speaker":"Charles Goldfarb","startTime":1318.78,"endTime":1322.4,"body":"nerve but you drive 100 miles,"},{"speaker":"Charles Goldfarb","startTime":1322.4,"endTime":1324.98,"body":"or even 50 miles, or 30 miles"},{"speaker":"Charles Goldfarb","startTime":1322.4,"endTime":1324.98,"body":"outside of the academic"},{"speaker":"Charles Goldfarb","startTime":1324.98,"endTime":1328.58,"body":"institution, and you can't be"},{"speaker":"Charles Goldfarb","startTime":1324.98,"endTime":1328.58,"body":"that narrow. So it does get"},{"speaker":"Charles Goldfarb","startTime":1328.58,"endTime":1332.72,"body":"harder and harder to stay up to"},{"speaker":"Charles Goldfarb","startTime":1328.58,"endTime":1332.72,"body":"date. So is there going to be"},{"speaker":"Charles Goldfarb","startTime":1332.72,"endTime":1335.54,"body":"increased specialization? And I"},{"speaker":"Charles Goldfarb","startTime":1332.72,"endTime":1335.54,"body":"think that may be the future of"},{"speaker":"Charles Goldfarb","startTime":1335.54,"endTime":1337.64,"body":"hand surgery that you're"},{"speaker":"Charles Goldfarb","startTime":1335.54,"endTime":1337.64,"body":"alluding to. I don't think it's"},{"speaker":"Charles Goldfarb","startTime":1337.64,"endTime":1340.16,"body":"three a I think it's four. I"},{"speaker":"Charles Goldfarb","startTime":1337.64,"endTime":1340.16,"body":"think that that we will continue"},{"speaker":"Charles Goldfarb","startTime":1340.16,"endTime":1342.94,"body":"to narrow what hand surgery"},{"speaker":"Charles Goldfarb","startTime":1340.16,"endTime":1342.94,"body":"looks like. Yeah,"},{"speaker":"Chris Dy","startTime":1342.94,"endTime":1346.66,"body":"and I but, you know, I"},{"speaker":"Chris Dy","startTime":1342.94,"endTime":1346.66,"body":"think it is, is important to"},{"speaker":"Chris Dy","startTime":1346.66,"endTime":1350.98,"body":"have that broad base, not only"},{"speaker":"Chris Dy","startTime":1346.66,"endTime":1350.98,"body":"for just, you know, in access"},{"speaker":"Chris Dy","startTime":1350.98,"endTime":1354.4,"body":"for patients, but my own sanity."},{"speaker":"Chris Dy","startTime":1350.98,"endTime":1354.4,"body":"I mean, I can't do only nerve,"},{"speaker":"Chris Dy","startTime":1354.4,"endTime":1358.84,"body":"because doing only nerve means a"},{"speaker":"Chris Dy","startTime":1354.4,"endTime":1358.84,"body":"lot of pain, and then you need,"},{"speaker":"Chris Dy","startTime":1358.84,"endTime":1361.26,"body":"I need the winds. I need the"},{"speaker":"Chris Dy","startTime":1358.84,"endTime":1361.26,"body":"carpal tunnels, the trigger"},{"speaker":"Chris Dy","startTime":1361.26,"endTime":1365.22,"body":"fingers, the basal joints, you"},{"speaker":"Chris Dy","startTime":1361.26,"endTime":1365.22,"body":"know, the dystopia stretchers. I"},{"speaker":"Chris Dy","startTime":1365.22,"endTime":1368.58,"body":"need balance in that regard to"},{"speaker":"Chris Dy","startTime":1365.22,"endTime":1368.58,"body":"to give me the energy to keep"},{"speaker":"Chris Dy","startTime":1368.58,"endTime":1370.68,"body":"going on some of the nerve,"},{"speaker":"Chris Dy","startTime":1368.58,"endTime":1370.68,"body":"because the nerve can really"},{"speaker":"Chris Dy","startTime":1370.68,"endTime":1371.04,"body":"drain you."},{"speaker":"Charles Goldfarb","startTime":1371.22,"endTime":1374.16,"body":"It's so true."},{"speaker":"Charles Goldfarb","startTime":1371.22,"endTime":1374.16,"body":"Well, not just nerve. So I've"},{"speaker":"Charles Goldfarb","startTime":1374.16,"endTime":1376.5,"body":"said to my nurse, she doesn't"},{"speaker":"Charles Goldfarb","startTime":1374.16,"endTime":1376.5,"body":"listen to me, but I've said to"},{"speaker":"Charles Goldfarb","startTime":1376.5,"endTime":1379.8,"body":"my nurse, you know, my sweet"},{"speaker":"Charles Goldfarb","startTime":1376.5,"endTime":1379.8,"body":"spot for wrist arthroscopy is"},{"speaker":"Charles Goldfarb","startTime":1379.8,"endTime":1383.54,"body":"two in a single day. I'm happy"},{"speaker":"Charles Goldfarb","startTime":1379.8,"endTime":1383.54,"body":"to do three when I have four is"},{"speaker":"Charles Goldfarb","startTime":1383.54,"endTime":1386.36,"body":"too much. There's too many"},{"speaker":"Charles Goldfarb","startTime":1383.54,"endTime":1386.36,"body":"scopes total."},{"speaker":"Chris Dy","startTime":1386.36,"endTime":1390.08,"body":"I've actually so I'm"},{"speaker":"Chris Dy","startTime":1386.36,"endTime":1390.08,"body":"now working with a new with an"},{"speaker":"Chris Dy","startTime":1390.08,"endTime":1394.28,"body":"athletic trainer as my primary"},{"speaker":"Chris Dy","startTime":1390.08,"endTime":1394.28,"body":"support person for my team, and"},{"speaker":"Chris Dy","startTime":1394.28,"endTime":1398.06,"body":"she's wonderful. But, you know,"},{"speaker":"Chris Dy","startTime":1394.28,"endTime":1398.06,"body":"she booked me, I think, four"},{"speaker":"Chris Dy","startTime":1398.06,"endTime":1400.64,"body":"older nerve transpositions in a"},{"speaker":"Chris Dy","startTime":1398.06,"endTime":1400.64,"body":"day. And I'm like, I love that"},{"speaker":"Chris Dy","startTime":1400.64,"endTime":1403.84,"body":"surgery. I know I do a lot of"},{"speaker":"Chris Dy","startTime":1400.64,"endTime":1403.84,"body":"them, but that's just a lot. And"},{"speaker":"Chris Dy","startTime":1403.84,"endTime":1406.36,"body":"then I told her, I have a limit"},{"speaker":"Chris Dy","startTime":1403.84,"endTime":1406.36,"body":"on the number of, well, not"},{"speaker":"Chris Dy","startTime":1406.36,"endTime":1411.82,"body":"cases I'll do in a day. And I"},{"speaker":"Chris Dy","startTime":1406.36,"endTime":1411.82,"body":"think because of the way that"},{"speaker":"Chris Dy","startTime":1411.82,"endTime":1415.6,"body":"the scheduling happened, I think"},{"speaker":"Chris Dy","startTime":1411.82,"endTime":1415.6,"body":"I have six, well, on cases the"},{"speaker":"Chris Dy","startTime":1415.6,"endTime":1418.3,"body":"day after Christmas, which is"},{"speaker":"Chris Dy","startTime":1415.6,"endTime":1418.3,"body":"just going to be a lot. It's"},{"speaker":"Chris Dy","startTime":1418.3,"endTime":1422.28,"body":"just it's really taxing on my,"},{"speaker":"Chris Dy","startTime":1418.3,"endTime":1422.28,"body":"on my ability to entertain at"},{"speaker":"Chris Dy","startTime":1422.28,"endTime":1424.86,"body":"the same time as doing surgery,"},{"speaker":"Chris Dy","startTime":1422.28,"endTime":1424.86,"body":"it's a lot"},{"speaker":"Charles Goldfarb","startTime":1424.86,"endTime":1428.1,"body":"and, and,"},{"speaker":"Charles Goldfarb","startTime":1424.86,"endTime":1428.1,"body":"yeah, three or four valance are"},{"speaker":"Charles Goldfarb","startTime":1428.1,"endTime":1431.1,"body":"plenty for me, and I would say"},{"speaker":"Charles Goldfarb","startTime":1428.1,"endTime":1431.1,"body":"the same about owners. My"},{"speaker":"Charles Goldfarb","startTime":1431.1,"endTime":1435.12,"body":"goodness, after three in one"},{"speaker":"Charles Goldfarb","startTime":1431.1,"endTime":1435.12,"body":"day, it's, it's, that's, that's"},{"speaker":"Chris Dy","startTime":1435.12,"endTime":1439.32,"body":"too many. So one more"},{"speaker":"Chris Dy","startTime":1435.12,"endTime":1439.32,"body":"prediction, maybe carpal tunnel"},{"speaker":"Chris Dy","startTime":1439.32,"endTime":1442.22,"body":"releases and trigger finger"},{"speaker":"Chris Dy","startTime":1439.32,"endTime":1442.22,"body":"releases will not be done in the"},{"speaker":"Chris Dy","startTime":1442.22,"endTime":1443.24,"body":"operating room in 2035"},{"speaker":"Charles Goldfarb","startTime":1444.56,"endTime":1447.74,"body":"100% agree."},{"speaker":"Charles Goldfarb","startTime":1444.56,"endTime":1447.74,"body":"100 Wait, we got one more after"},{"speaker":"Charles Goldfarb","startTime":1447.74,"endTime":1451.22,"body":"that. 100% agree that we will"},{"speaker":"Charles Goldfarb","startTime":1447.74,"endTime":1451.22,"body":"not be doing the little cases in"},{"speaker":"Charles Goldfarb","startTime":1451.22,"endTime":1454.04,"body":"the OR. And honestly, I don't"},{"speaker":"Charles Goldfarb","startTime":1451.22,"endTime":1454.04,"body":"think it's gonna take 10 years"},{"speaker":"Charles Goldfarb","startTime":1454.04,"endTime":1454.34,"body":"to get"},{"speaker":"Chris Dy","startTime":1455.78,"endTime":1458.54,"body":"there. Um, okay, well,"},{"speaker":"Chris Dy","startTime":1455.78,"endTime":1458.54,"body":"why don't we before we jump into"},{"speaker":"Chris Dy","startTime":1458.54,"endTime":1459.08,"body":"the next"},{"speaker":"Charles Goldfarb","startTime":1459.14,"endTime":1461.44,"body":"Wait, wait,"},{"speaker":"Charles Goldfarb","startTime":1459.14,"endTime":1461.44,"body":"wait, wait, I want to do the"},{"speaker":"Charles Goldfarb","startTime":1461.44,"endTime":1463.72,"body":"next hot take. Oh, you're going"},{"speaker":"Charles Goldfarb","startTime":1461.44,"endTime":1463.72,"body":"to do you're going to thank"},{"speaker":"Charles Goldfarb","startTime":1463.72,"endTime":1465.7,"body":"another sponsor. I'm going to"},{"speaker":"Charles Goldfarb","startTime":1463.72,"endTime":1465.7,"body":"thank our sponsor."},{"speaker":"Chris Dy","startTime":1467.44,"endTime":1470.8,"body":"Stop that can't stop"},{"speaker":"Chris Dy","startTime":1467.44,"endTime":1470.8,"body":"that, and it's relevant to the"},{"speaker":"Chris Dy","startTime":1470.8,"endTime":1474.1,"body":"next top take. So the upper hand"},{"speaker":"Chris Dy","startTime":1470.8,"endTime":1474.1,"body":"is sponsored by checkpoint"},{"speaker":"Chris Dy","startTime":1474.1,"endTime":1476.8,"body":"surgical provider, innovative"},{"speaker":"Chris Dy","startTime":1474.1,"endTime":1476.8,"body":"solutions for peripheral nerve"},{"speaker":"Chris Dy","startTime":1476.8,"endTime":1480.66,"body":"surgery. Did you know that"},{"speaker":"Chris Dy","startTime":1476.8,"endTime":1480.66,"body":"checkpoint offers an accessory"},{"speaker":"Chris Dy","startTime":1480.66,"endTime":1483.3,"body":"to the Guardian nerve"},{"speaker":"Chris Dy","startTime":1480.66,"endTime":1483.3,"body":"stimulator, the intraoperative"},{"speaker":"Chris Dy","startTime":1483.3,"endTime":1486.66,"body":"lead accessory, which connects"},{"speaker":"Chris Dy","startTime":1483.3,"endTime":1486.66,"body":"easily to Guardian with a simple"},{"speaker":"Chris Dy","startTime":1486.66,"endTime":1490.74,"body":"push on motion, enables hands"},{"speaker":"Chris Dy","startTime":1486.66,"endTime":1490.74,"body":"free stimulation delivery to a"},{"speaker":"Chris Dy","startTime":1490.74,"endTime":1493.38,"body":"consistent assessment site. This"},{"speaker":"Charles Goldfarb","startTime":1493.38,"endTime":1495.84,"body":"makes it"},{"speaker":"Charles Goldfarb","startTime":1493.38,"endTime":1495.84,"body":"easier to repeatedly assess"},{"speaker":"Charles Goldfarb","startTime":1495.84,"endTime":1499.14,"body":"motor nerve excitability"},{"speaker":"Charles Goldfarb","startTime":1495.84,"endTime":1499.14,"body":"throughout a procedure such as"},{"speaker":"Charles Goldfarb","startTime":1499.14,"endTime":1502.58,"body":"in a neural. Or decompression,"},{"speaker":"Charles Goldfarb","startTime":1499.14,"endTime":1502.58,"body":"and also enables repeated"},{"speaker":"Charles Goldfarb","startTime":1502.58,"endTime":1505.28,"body":"confirmation of nerve function"},{"speaker":"Charles Goldfarb","startTime":1502.58,"endTime":1505.28,"body":"and procedures with risk of"},{"speaker":"Charles Goldfarb","startTime":1505.34,"endTime":1508.04,"body":"iatrogenic nerve injury. To"},{"speaker":"Charles Goldfarb","startTime":1505.34,"endTime":1508.04,"body":"learn more, visit"},{"speaker":"Charles Goldfarb","startTime":1508.04,"endTime":1512.42,"body":"www.checkpointsurgical.com"},{"speaker":"Charles Goldfarb","startTime":1508.04,"endTime":1512.42,"body":"checkpoint surgical driving"},{"speaker":"Charles Goldfarb","startTime":1512.42,"endTime":1516.08,"body":"innovation and hand surgery. Can"},{"speaker":"Charles Goldfarb","startTime":1512.42,"endTime":1516.08,"body":"you please translate? Well, I"},{"speaker":"Charles Goldfarb","startTime":1516.08,"endTime":1516.8,"body":"just heard,"},{"speaker":"Chris Dy","startTime":1517.88,"endTime":1520.78,"body":"do you know how you"},{"speaker":"Chris Dy","startTime":1517.88,"endTime":1520.78,"body":"own so Guardian is the unipolar"},{"speaker":"Chris Dy","startTime":1520.78,"endTime":1523.78,"body":"stimulator. So that's the blue"},{"speaker":"Chris Dy","startTime":1520.78,"endTime":1523.78,"body":"one. That's what I call the blue"},{"speaker":"Chris Dy","startTime":1523.78,"endTime":1527.44,"body":"one. The purple one, which is a"},{"speaker":"Chris Dy","startTime":1523.78,"endTime":1527.44,"body":"bipolar stimulator, which is the"},{"speaker":"Chris Dy","startTime":1527.74,"endTime":1531.64,"body":"Gemini, so the Guardians, the"},{"speaker":"Chris Dy","startTime":1527.74,"endTime":1531.64,"body":"blue one the monopolar so you"},{"speaker":"Chris Dy","startTime":1531.64,"endTime":1535.36,"body":"put this little doohickey on it,"},{"speaker":"Chris Dy","startTime":1531.64,"endTime":1535.36,"body":"attaches to it, and then,"},{"speaker":"Chris Dy","startTime":1535.36,"endTime":1538.66,"body":"instead of applying the"},{"speaker":"Chris Dy","startTime":1535.36,"endTime":1538.66,"body":"stimulator directly to the"},{"speaker":"Chris Dy","startTime":1538.66,"endTime":1542.28,"body":"nerve, you can then hook a lead"},{"speaker":"Chris Dy","startTime":1538.66,"endTime":1542.28,"body":"on. It's like a little plastic U"},{"speaker":"Chris Dy","startTime":1542.28,"endTime":1545.28,"body":"shape that can hook around the"},{"speaker":"Chris Dy","startTime":1542.28,"endTime":1545.28,"body":"nerve a dramatically. There are"},{"speaker":"Chris Dy","startTime":1545.28,"endTime":1547.98,"body":"some holes if you want to put a"},{"speaker":"Chris Dy","startTime":1545.28,"endTime":1547.98,"body":"couple of stitches in it to keep"},{"speaker":"Chris Dy","startTime":1547.98,"endTime":1551.22,"body":"it there, but then you can"},{"speaker":"Chris Dy","startTime":1547.98,"endTime":1551.22,"body":"stimulate the nerve consistently"},{"speaker":"Chris Dy","startTime":1551.22,"endTime":1553.98,"body":"without having to take the"},{"speaker":"Chris Dy","startTime":1551.22,"endTime":1553.98,"body":"device on and off, touch it on"},{"speaker":"Chris Dy","startTime":1553.98,"endTime":1557.46,"body":"and off, etcetera. So I think"},{"speaker":"Chris Dy","startTime":1553.98,"endTime":1557.46,"body":"there are other applications"},{"speaker":"Chris Dy","startTime":1557.46,"endTime":1559.68,"body":"that checkpoint is thinking"},{"speaker":"Chris Dy","startTime":1557.46,"endTime":1559.68,"body":"about down the line for said"},{"speaker":"Chris Dy","startTime":1559.68,"endTime":1564.02,"body":"lead, but I should not say more"},{"speaker":"Chris Dy","startTime":1559.68,"endTime":1564.02,"body":"than that, but yeah, it's a nice"},{"speaker":"Chris Dy","startTime":1564.02,"endTime":1566.9,"body":"way to keep the lead in the same"},{"speaker":"Chris Dy","startTime":1564.02,"endTime":1566.9,"body":"place, if that's your if that's"},{"speaker":"Chris Dy","startTime":1566.9,"endTime":1569.36,"body":"your goal, to stimulate the"},{"speaker":"Chris Dy","startTime":1566.9,"endTime":1569.36,"body":"nerve in a consistent place, if"},{"speaker":"Chris Dy","startTime":1569.36,"endTime":1569.6,"body":"that's"},{"speaker":"Charles Goldfarb","startTime":1569.96,"endTime":1572.54,"body":"your goal,"},{"speaker":"Charles Goldfarb","startTime":1569.96,"endTime":1572.54,"body":"gotcha, that's over my head. But"},{"speaker":"Charles Goldfarb","startTime":1572.54,"endTime":1576.92,"body":"sounds, sounds interesting. So"},{"speaker":"Charles Goldfarb","startTime":1572.54,"endTime":1576.92,"body":"what's nerve repair gonna look"},{"speaker":"Charles Goldfarb","startTime":1576.92,"endTime":1579.2,"body":"like in seven years? I"},{"speaker":"Chris Dy","startTime":1580.34,"endTime":1582.58,"body":"think it's an"},{"speaker":"Chris Dy","startTime":1580.34,"endTime":1582.58,"body":"interesting question, because"},{"speaker":"Chris Dy","startTime":1582.58,"endTime":1587.74,"body":"of, you know, the for many years"},{"speaker":"Chris Dy","startTime":1582.58,"endTime":1587.74,"body":"when you've been trying to look"},{"speaker":"Chris Dy","startTime":1587.74,"endTime":1592.42,"body":"at nerve conduits, things to get"},{"speaker":"Chris Dy","startTime":1587.74,"endTime":1592.42,"body":"away from sutures, perhaps a"},{"speaker":"Chris Dy","startTime":1592.42,"endTime":1595.9,"body":"suture less nerve repair, the"},{"speaker":"Chris Dy","startTime":1592.42,"endTime":1595.9,"body":"question is always, does it"},{"speaker":"Chris Dy","startTime":1595.9,"endTime":1601.62,"body":"generate more scar debris, etc,"},{"speaker":"Chris Dy","startTime":1595.9,"endTime":1601.62,"body":"than you know that it's worth"},{"speaker":"Chris Dy","startTime":1601.62,"endTime":1604.5,"body":"but sutures also generate scar."},{"speaker":"Chris Dy","startTime":1601.62,"endTime":1604.5,"body":"And sutures introduce the, you"},{"speaker":"Chris Dy","startTime":1604.5,"endTime":1609.3,"body":"know, human variability and"},{"speaker":"Chris Dy","startTime":1604.5,"endTime":1609.3,"body":"technique. Newer devices have"},{"speaker":"Chris Dy","startTime":1609.3,"endTime":1613.26,"body":"been introduced, you know, using"},{"speaker":"Chris Dy","startTime":1609.3,"endTime":1613.26,"body":"small hooks that kind of go into"},{"speaker":"Chris Dy","startTime":1613.26,"endTime":1619.86,"body":"the epineurium and can keep a"},{"speaker":"Chris Dy","startTime":1613.26,"endTime":1619.86,"body":"nerve together. I'm not sure"},{"speaker":"Chris Dy","startTime":1619.86,"endTime":1623.96,"body":"that nerve repair is going to go"},{"speaker":"Chris Dy","startTime":1619.86,"endTime":1623.96,"body":"in that direction. I think many"},{"speaker":"Chris Dy","startTime":1623.96,"endTime":1627.62,"body":"will, many will use said device,"},{"speaker":"Chris Dy","startTime":1623.96,"endTime":1627.62,"body":"or a conduit or something to go"},{"speaker":"Chris Dy","startTime":1627.62,"endTime":1631.16,"body":"to a suture less repair. I still"},{"speaker":"Chris Dy","startTime":1627.62,"endTime":1631.16,"body":"think we need to train our"},{"speaker":"Chris Dy","startTime":1631.16,"endTime":1634.22,"body":"fellows and residents about how"},{"speaker":"Chris Dy","startTime":1631.16,"endTime":1634.22,"body":"to use micro sutures to put"},{"speaker":"Chris Dy","startTime":1634.22,"endTime":1638.66,"body":"nerves together. I think there's"},{"speaker":"Chris Dy","startTime":1634.22,"endTime":1638.66,"body":"a training aspect to it. I'd"},{"speaker":"Chris Dy","startTime":1638.66,"endTime":1642.04,"body":"like to see if we can get away"},{"speaker":"Chris Dy","startTime":1638.66,"endTime":1642.04,"body":"from a number of st like the"},{"speaker":"Chris Dy","startTime":1642.1,"endTime":1645.7,"body":"vast number of stitches, so"},{"speaker":"Chris Dy","startTime":1642.1,"endTime":1645.7,"body":"maybe go to just a single or two"},{"speaker":"Chris Dy","startTime":1645.7,"endTime":1648.28,"body":"stitches and use something else"},{"speaker":"Chris Dy","startTime":1645.7,"endTime":1648.28,"body":"to keep the CO optation"},{"speaker":"Chris Dy","startTime":1648.28,"endTime":1654.34,"body":"together. My prediction is that"},{"speaker":"Chris Dy","startTime":1648.28,"endTime":1654.34,"body":"these devices will then be used"},{"speaker":"Chris Dy","startTime":1654.34,"endTime":1658.06,"body":"as drug delivery devices, and I"},{"speaker":"Chris Dy","startTime":1654.34,"endTime":1658.06,"body":"think that's probably where"},{"speaker":"Chris Dy","startTime":1658.06,"endTime":1658.3,"body":"things"},{"speaker":"Charles Goldfarb","startTime":1658.3,"endTime":1660.72,"body":"are going to"},{"speaker":"Charles Goldfarb","startTime":1658.3,"endTime":1660.72,"body":"go. It makes a lot of sense."},{"speaker":"Charles Goldfarb","startTime":1661.56,"endTime":1666.36,"body":"We've watched our previous chair"},{"speaker":"Charles Goldfarb","startTime":1661.56,"endTime":1666.36,"body":"and senior partner dedicate our"},{"speaker":"Charles Goldfarb","startTime":1666.36,"endTime":1671.28,"body":"career towards the manual suture"},{"speaker":"Charles Goldfarb","startTime":1666.36,"endTime":1671.28,"body":"repair of flexor tendons. And as"},{"speaker":"Charles Goldfarb","startTime":1671.28,"endTime":1675.84,"body":"he sort of finished his 40 years"},{"speaker":"Charles Goldfarb","startTime":1671.28,"endTime":1675.84,"body":"with NIHR one funding, he was"},{"speaker":"Charles Goldfarb","startTime":1675.84,"endTime":1680.24,"body":"into the drug delivery game for"},{"speaker":"Charles Goldfarb","startTime":1675.84,"endTime":1680.24,"body":"tendon healing. It just makes"},{"speaker":"Charles Goldfarb","startTime":1680.24,"endTime":1684.26,"body":"sense for tendons, for nerves,"},{"speaker":"Charles Goldfarb","startTime":1680.24,"endTime":1684.26,"body":"or whatever."},{"speaker":"Chris Dy","startTime":1685.22,"endTime":1687.86,"body":"I think, I think, you"},{"speaker":"Chris Dy","startTime":1685.22,"endTime":1687.86,"body":"know, hopefully that's something"},{"speaker":"Chris Dy","startTime":1687.86,"endTime":1690.56,"body":"that the appropriate cocktail"},{"speaker":"Chris Dy","startTime":1687.86,"endTime":1690.56,"body":"will be figured out, and that,"},{"speaker":"Chris Dy","startTime":1690.68,"endTime":1693.68,"body":"you know that's probably not"},{"speaker":"Chris Dy","startTime":1690.68,"endTime":1693.68,"body":"going to be ready for prime"},{"speaker":"Chris Dy","startTime":1693.68,"endTime":1697.88,"body":"time, I think, for, you know, a"},{"speaker":"Chris Dy","startTime":1693.68,"endTime":1697.88,"body":"solid one or two decades. But I"},{"speaker":"Chris Dy","startTime":1697.88,"endTime":1699.68,"body":"think this is laying the"},{"speaker":"Chris Dy","startTime":1697.88,"endTime":1699.68,"body":"groundwork for that."},{"speaker":"Charles Goldfarb","startTime":1700.34,"endTime":1702.46,"body":"So for doing"},{"speaker":"Charles Goldfarb","startTime":1700.34,"endTime":1702.46,"body":"long term predictions, are you"},{"speaker":"Charles Goldfarb","startTime":1702.46,"endTime":1704.62,"body":"ready to go off the nerve?"},{"speaker":"Charles Goldfarb","startTime":1702.46,"endTime":1704.62,"body":"Because I don't. I know it's,"},{"speaker":"Charles Goldfarb","startTime":1704.62,"endTime":1707.68,"body":"it's tough to stop talking"},{"speaker":"Charles Goldfarb","startTime":1704.62,"endTime":1707.68,"body":"about, do you have anything else"},{"speaker":"Charles Goldfarb","startTime":1707.8,"endTime":1710.26,"body":"you possibly there's no more"},{"speaker":"Charles Goldfarb","startTime":1707.8,"endTime":1710.26,"body":"nerve talk this episode. So I"},{"speaker":"Charles Goldfarb","startTime":1710.26,"endTime":1711.16,"body":"want people"},{"speaker":"Chris Dy","startTime":1711.16,"endTime":1714.7,"body":"to email saying how"},{"speaker":"Chris Dy","startTime":1711.16,"endTime":1714.7,"body":"much more nerve they want, or if"},{"speaker":"Chris Dy","startTime":1714.7,"endTime":1717.16,"body":"they want, you know, I want to"},{"speaker":"Chris Dy","startTime":1714.7,"endTime":1717.16,"body":"say, email us and say what you"},{"speaker":"Chris Dy","startTime":1717.16,"endTime":1719.56,"body":"want, right? Like, you know, we"},{"speaker":"Chris Dy","startTime":1717.16,"endTime":1719.56,"body":"have a, we have a great grab bag"},{"speaker":"Chris Dy","startTime":1719.56,"endTime":1722.7,"body":"episode that's going to come out"},{"speaker":"Chris Dy","startTime":1719.56,"endTime":1722.7,"body":"in next month. At some point,"},{"speaker":"Chris Dy","startTime":1722.7,"endTime":1725.52,"body":"we've had some great emails, so"},{"speaker":"Chris Dy","startTime":1722.7,"endTime":1725.52,"body":"we appreciate all the emails,"},{"speaker":"Chris Dy","startTime":1725.52,"endTime":1730.68,"body":"including some fun facts about"},{"speaker":"Chris Dy","startTime":1725.52,"endTime":1730.68,"body":"the origin of Halloween. So we"},{"speaker":"Chris Dy","startTime":1730.68,"endTime":1737.04,"body":"had a correction the that'll be"},{"speaker":"Chris Dy","startTime":1730.68,"endTime":1737.04,"body":"a great episode. But if you want"},{"speaker":"Chris Dy","startTime":1737.04,"endTime":1740.04,"body":"more nerve, please email us hand"},{"speaker":"Chris Dy","startTime":1737.04,"endTime":1740.04,"body":"podcast@gmail.com more and more"},{"speaker":"Chris Dy","startTime":1740.04,"endTime":1742.26,"body":"of anything. I'm sure you want"},{"speaker":"Chris Dy","startTime":1740.04,"endTime":1742.26,"body":"more sports. Whenever I see"},{"speaker":"Chris Dy","startTime":1742.26,"endTime":1744.38,"body":"people in person, people in"},{"speaker":"Chris Dy","startTime":1742.26,"endTime":1744.38,"body":"person, they always talk about"},{"speaker":"Chris Dy","startTime":1744.38,"endTime":1748.4,"body":"how they want more sports and"},{"speaker":"Chris Dy","startTime":1744.38,"endTime":1748.4,"body":"arthroscopy stuff. So I admit"},{"speaker":"Chris Dy","startTime":1748.46,"endTime":1751.34,"body":"I'll have to. I do enjoy"},{"speaker":"Chris Dy","startTime":1748.46,"endTime":1751.34,"body":"learning during those episodes."},{"speaker":"Chris Dy","startTime":1751.34,"endTime":1753.5,"body":"So thank you for that,"},{"speaker":"Chris Dy","startTime":1751.34,"endTime":1753.5,"body":"absolutely."},{"speaker":"Charles Goldfarb","startTime":1753.68,"endTime":1756.32,"body":"So I'll talk a"},{"speaker":"Charles Goldfarb","startTime":1753.68,"endTime":1756.32,"body":"little bit what I think the"},{"speaker":"Charles Goldfarb","startTime":1756.32,"endTime":1760.1,"body":"future of congenital hand"},{"speaker":"Charles Goldfarb","startTime":1756.32,"endTime":1760.1,"body":"surgery is."},{"speaker":"Chris Dy","startTime":1760.1,"endTime":1762.88,"body":"And you didn't tell me"},{"speaker":"Chris Dy","startTime":1760.1,"endTime":1762.88,"body":"you're going congenital On this"},{"speaker":"Chris Dy","startTime":1762.88,"endTime":1764.08,"body":"episode, there's"},{"speaker":"Charles Goldfarb","startTime":1764.08,"endTime":1766.18,"body":"been a"},{"speaker":"Charles Goldfarb","startTime":1764.08,"endTime":1766.18,"body":"clamoring the listeners, for the"},{"speaker":"Charles Goldfarb","startTime":1766.18,"endTime":1767.2,"body":"three of you that like"},{"speaker":"Chris Dy","startTime":1767.2,"endTime":1770.32,"body":"congenital, please,"},{"speaker":"Chris Dy","startTime":1767.2,"endTime":1770.32,"body":"please keep listening if you're"},{"speaker":"Chris Dy","startTime":1770.32,"endTime":1772.66,"body":"if you're not in the congenital"},{"speaker":"Chris Dy","startTime":1770.32,"endTime":1772.66,"body":"just, you know, you can keep"},{"speaker":"Chris Dy","startTime":1772.66,"endTime":1773.5,"body":"listening to it."},{"speaker":"Charles Goldfarb","startTime":1773.68,"endTime":1776.86,"body":"This is going"},{"speaker":"Charles Goldfarb","startTime":1773.68,"endTime":1776.86,"body":"to be short and obtuse. Gene"},{"speaker":"Charles Goldfarb","startTime":1776.86,"endTime":1779.68,"body":"therapy will be there one day."},{"speaker":"Charles Goldfarb","startTime":1776.86,"endTime":1779.68,"body":"You know, right now, gene"},{"speaker":"Charles Goldfarb","startTime":1779.68,"endTime":1783.36,"body":"therapy is super expensive."},{"speaker":"Charles Goldfarb","startTime":1779.68,"endTime":1783.36,"body":"We're using it for, you know,"},{"speaker":"Charles Goldfarb","startTime":1783.36,"endTime":1786.54,"body":"obviously for cancer. There's"},{"speaker":"Charles Goldfarb","startTime":1783.36,"endTime":1786.54,"body":"been some work done with sickle"},{"speaker":"Charles Goldfarb","startTime":1786.54,"endTime":1791.52,"body":"cell, and, you know, it's going"},{"speaker":"Charles Goldfarb","startTime":1786.54,"endTime":1791.52,"body":"to be arthritis, etc, etc. So"},{"speaker":"Charles Goldfarb","startTime":1791.52,"endTime":1794.4,"body":"maybe CMC arthritis doesn't"},{"speaker":"Charles Goldfarb","startTime":1791.52,"endTime":1794.4,"body":"exist anymore with gene therapy,"},{"speaker":"Charles Goldfarb","startTime":1794.4,"endTime":1797.64,"body":"but, but I think Gene therapy"},{"speaker":"Charles Goldfarb","startTime":1794.4,"endTime":1797.64,"body":"will, will, will change the way"},{"speaker":"Charles Goldfarb","startTime":1797.64,"endTime":1800.66,"body":"we think about congenital"},{"speaker":"Charles Goldfarb","startTime":1797.64,"endTime":1800.66,"body":"conditions and. Smart enough to"},{"speaker":"Charles Goldfarb","startTime":1800.66,"endTime":1803.0,"body":"know exactly what that means,"},{"speaker":"Charles Goldfarb","startTime":1800.66,"endTime":1803.0,"body":"but I don't think we'll be"},{"speaker":"Charles Goldfarb","startTime":1803.0,"endTime":1806.48,"body":"treating the same volume and in"},{"speaker":"Charles Goldfarb","startTime":1803.0,"endTime":1806.48,"body":"15 years that we are today."},{"speaker":"Charles Goldfarb","startTime":1806.96,"endTime":1807.2,"body":"That's"},{"speaker":"Chris Dy","startTime":1807.2,"endTime":1809.96,"body":"exciting, but the"},{"speaker":"Chris Dy","startTime":1807.2,"endTime":1809.96,"body":"problems that we're producing so"},{"speaker":"Chris Dy","startTime":1809.96,"endTime":1813.32,"body":"many congenital hand surgeons."},{"speaker":"Chris Dy","startTime":1809.96,"endTime":1813.32,"body":"Everybody wants to do"},{"speaker":"Chris Dy","startTime":1813.32,"endTime":1816.68,"body":"congenital. I just read every"},{"speaker":"Chris Dy","startTime":1813.32,"endTime":1816.68,"body":"fellowship application that we"},{"speaker":"Chris Dy","startTime":1816.68,"endTime":1819.26,"body":"received. I mean the number of"},{"speaker":"Chris Dy","startTime":1816.68,"endTime":1819.26,"body":"people that want to do pizza and"},{"speaker":"Chris Dy","startTime":1819.26,"endTime":1822.64,"body":"congenital like Good God, do we"},{"speaker":"Chris Dy","startTime":1819.26,"endTime":1822.64,"body":"need another congenital hand"},{"speaker":"Chris Dy","startTime":1822.64,"endTime":1823.24,"body":"surgery?"},{"speaker":"Charles Goldfarb","startTime":1824.98,"endTime":1827.74,"body":"News flash, we"},{"speaker":"Charles Goldfarb","startTime":1824.98,"endTime":1827.74,"body":"probably don't, but maybe I need"},{"speaker":"Charles Goldfarb","startTime":1827.74,"endTime":1831.94,"body":"to retire so, so there's space,"},{"speaker":"Charles Goldfarb","startTime":1827.74,"endTime":1831.94,"body":"there's room. Um, so"},{"speaker":"Chris Dy","startTime":1831.94,"endTime":1835.36,"body":"quick, quick question."},{"speaker":"Chris Dy","startTime":1831.94,"endTime":1835.36,"body":"Do you think Gene therapy for"},{"speaker":"Chris Dy","startTime":1835.36,"endTime":1840.6,"body":"arthritis will be ready before"},{"speaker":"Chris Dy","startTime":1835.36,"endTime":1840.6,"body":"an accepted thumb CMC implant in"},{"speaker":"Chris Dy","startTime":1840.6,"endTime":1842.76,"body":"the United States. I think"},{"speaker":"Charles Goldfarb","startTime":1842.76,"endTime":1846.96,"body":"it might be. I"},{"speaker":"Charles Goldfarb","startTime":1842.76,"endTime":1846.96,"body":"think it might be. And the work"},{"speaker":"Charles Goldfarb","startTime":1846.96,"endTime":1850.8,"body":"that our colleague and our"},{"speaker":"Charles Goldfarb","startTime":1846.96,"endTime":1850.8,"body":"partner, Fauci like doing in"},{"speaker":"Charles Goldfarb","startTime":1850.8,"endTime":1854.64,"body":"regards to osteoarthritis and"},{"speaker":"Charles Goldfarb","startTime":1850.8,"endTime":1854.64,"body":"treatment is unbelievable for"},{"speaker":"Charles Goldfarb","startTime":1854.64,"endTime":1858.3,"body":"those of you, and I can't speak"},{"speaker":"Charles Goldfarb","startTime":1854.64,"endTime":1858.3,"body":"eloquently about it, but the"},{"speaker":"Charles Goldfarb","startTime":1858.3,"endTime":1861.68,"body":"work being done in the lab for"},{"speaker":"Charles Goldfarb","startTime":1858.3,"endTime":1861.68,"body":"our osteoarthritis and treatment"},{"speaker":"Charles Goldfarb","startTime":1861.68,"endTime":1865.16,"body":"for it is unbelievable. We're"},{"speaker":"Charles Goldfarb","startTime":1861.68,"endTime":1865.16,"body":"not that far away. To Chris's"},{"speaker":"Charles Goldfarb","startTime":1865.16,"endTime":1868.04,"body":"point, yes, I'm voting for gene"},{"speaker":"Charles Goldfarb","startTime":1865.16,"endTime":1868.04,"body":"therapy, but I think"},{"speaker":"Chris Dy","startTime":1868.04,"endTime":1870.92,"body":"Gene therapy will get"},{"speaker":"Chris Dy","startTime":1868.04,"endTime":1870.92,"body":"there before a thumb CMC implant"},{"speaker":"Chris Dy","startTime":1870.92,"endTime":1873.62,"body":"is widely adopted in the United"},{"speaker":"Chris Dy","startTime":1870.92,"endTime":1873.62,"body":"States. Now, patients, I have to"},{"speaker":"Chris Dy","startTime":1873.62,"endTime":1876.38,"body":"answer that question a lot. I"},{"speaker":"Chris Dy","startTime":1873.62,"endTime":1876.38,"body":"mean, like my whole spiel about"},{"speaker":"Chris Dy","startTime":1876.38,"endTime":1878.72,"body":"arthritis is that we have no"},{"speaker":"Chris Dy","startTime":1876.38,"endTime":1878.72,"body":"cure for it, but they're working"},{"speaker":"Chris Dy","startTime":1878.72,"endTime":1882.16,"body":"on it in WashU. I mean, Fauci"},{"speaker":"Chris Dy","startTime":1878.72,"endTime":1882.16,"body":"received the largest grant in"},{"speaker":"Chris Dy","startTime":1882.16,"endTime":1885.94,"body":"Washington history. It's an"},{"speaker":"Chris Dy","startTime":1882.16,"endTime":1885.94,"body":"incredible amount of money. So"},{"speaker":"Chris Dy","startTime":1885.94,"endTime":1889.48,"body":"yeah, see, they're working very"},{"speaker":"Chris Dy","startTime":1885.94,"endTime":1889.48,"body":"hard on on fixing that. One"},{"speaker":"Chris Dy","startTime":1889.48,"endTime":1892.3,"body":"other question before we close,"},{"speaker":"Chris Dy","startTime":1889.48,"endTime":1892.3,"body":"do you ever think that there"},{"speaker":"Chris Dy","startTime":1892.3,"endTime":1895.72,"body":"will be in utero surgery for"},{"speaker":"Chris Dy","startTime":1892.3,"endTime":1895.72,"body":"congenital hand issues?"},{"speaker":"Charles Goldfarb","startTime":1896.8,"endTime":1900.96,"body":"So there"},{"speaker":"Charles Goldfarb","startTime":1896.8,"endTime":1900.96,"body":"currently is, theoretically, the"},{"speaker":"Charles Goldfarb","startTime":1900.96,"endTime":1906.36,"body":"problem today is the risk of"},{"speaker":"Charles Goldfarb","startTime":1900.96,"endTime":1906.36,"body":"like, if you have a constriction"},{"speaker":"Charles Goldfarb","startTime":1906.36,"endTime":1910.32,"body":"band around the forearm or upper"},{"speaker":"Charles Goldfarb","startTime":1906.36,"endTime":1910.32,"body":"arm, that's severe. I think our"},{"speaker":"Charles Goldfarb","startTime":1910.32,"endTime":1914.64,"body":"general surgery colleagues would"},{"speaker":"Charles Goldfarb","startTime":1910.32,"endTime":1914.64,"body":"potentially treat that in utero."},{"speaker":"Charles Goldfarb","startTime":1914.82,"endTime":1920.46,"body":"But most of the other stuff is"},{"speaker":"Charles Goldfarb","startTime":1914.82,"endTime":1920.46,"body":"the risk benefit ratio is off. I"},{"speaker":"Charles Goldfarb","startTime":1920.46,"endTime":1923.36,"body":"don't know how that changes. I'm"},{"speaker":"Charles Goldfarb","startTime":1920.46,"endTime":1923.36,"body":"just not that knowledgeable."},{"speaker":"Charles Goldfarb","startTime":1923.48,"endTime":1926.78,"body":"But, yeah, I think that'll"},{"speaker":"Charles Goldfarb","startTime":1923.48,"endTime":1926.78,"body":"increase as well I do. Okay,"},{"speaker":"Charles Goldfarb","startTime":1928.1,"endTime":1932.72,"body":"yeah, good. One important one,"},{"speaker":"Charles Goldfarb","startTime":1928.1,"endTime":1932.72,"body":"how many hand surgery podcasts"},{"speaker":"Charles Goldfarb","startTime":1932.72,"endTime":1933.74,"body":"will there be in 2030"},{"speaker":"Chris Dy","startTime":1936.26,"endTime":1939.68,"body":"so I, interestingly"},{"speaker":"Chris Dy","startTime":1936.26,"endTime":1939.68,"body":"enough, I did look a lot last"},{"speaker":"Chris Dy","startTime":1939.68,"endTime":1942.94,"body":"week. I was, I can't remember"},{"speaker":"Chris Dy","startTime":1939.68,"endTime":1942.94,"body":"what prompted me to do it. There"},{"speaker":"Chris Dy","startTime":1942.94,"endTime":1945.76,"body":"are a couple other hand surgery"},{"speaker":"Chris Dy","startTime":1942.94,"endTime":1945.76,"body":"podcasts that have a limited run"},{"speaker":"Chris Dy","startTime":1945.76,"endTime":1950.08,"body":"of episodes. I can't say that"},{"speaker":"Chris Dy","startTime":1945.76,"endTime":1950.08,"body":"anybody has, you know, five"},{"speaker":"Chris Dy","startTime":1950.08,"endTime":1954.34,"body":"years in a game like others, but"},{"speaker":"Chris Dy","startTime":1950.08,"endTime":1954.34,"body":"it's crazy. We're going up on"},{"speaker":"Chris Dy","startTime":1954.34,"endTime":1957.16,"body":"our five year anniversary next"},{"speaker":"Chris Dy","startTime":1954.34,"endTime":1957.16,"body":"month. Who would I feel like it?"},{"speaker":"Chris Dy","startTime":1957.28,"endTime":1958.42,"body":"I feel like you owe me a gift."},{"speaker":"Charles Goldfarb","startTime":1960.04,"endTime":1961.02,"body":"This is your"},{"speaker":"Charles Goldfarb","startTime":1960.04,"endTime":1961.02,"body":"gift."},{"speaker":"Chris Dy","startTime":1963.84,"endTime":1966.78,"body":"But, yeah, no, I"},{"speaker":"Chris Dy","startTime":1963.84,"endTime":1966.78,"body":"don't, I don't know. Maybe I"},{"speaker":"Chris Dy","startTime":1966.78,"endTime":1969.06,"body":"don't know if there'll be one"},{"speaker":"Chris Dy","startTime":1966.78,"endTime":1969.06,"body":"hand surgery podcast in five"},{"speaker":"Chris Dy","startTime":1969.06,"endTime":1972.96,"body":"years. We'll see You're awful,"},{"speaker":"Chris Dy","startTime":1969.06,"endTime":1972.96,"body":"you're awful busy,"},{"speaker":"Charles Goldfarb","startTime":1973.68,"endTime":1974.28,"body":"so"},{"speaker":"Chris Dy","startTime":1975.42,"endTime":1978.48,"body":"funny. I don't know."},{"speaker":"Chris Dy","startTime":1975.42,"endTime":1978.48,"body":"And, you know, I think that who"},{"speaker":"Chris Dy","startTime":1978.48,"endTime":1981.68,"body":"knows what the next educational"},{"speaker":"Chris Dy","startTime":1978.48,"endTime":1981.68,"body":"kind of venue is going to be. I"},{"speaker":"Chris Dy","startTime":1981.68,"endTime":1985.04,"body":"mean, I think that fortunately,"},{"speaker":"Chris Dy","startTime":1981.68,"endTime":1985.04,"body":"we were, I wouldn't say, ahead"},{"speaker":"Chris Dy","startTime":1985.04,"endTime":1987.44,"body":"of the curve. We were timed"},{"speaker":"Chris Dy","startTime":1985.04,"endTime":1987.44,"body":"appropriately, I think with"},{"speaker":"Chris Dy","startTime":1987.44,"endTime":1991.22,"body":"that, with the upper hand, but"},{"speaker":"Chris Dy","startTime":1987.44,"endTime":1991.22,"body":"who knows where it's going to"},{"speaker":"Chris Dy","startTime":1991.22,"endTime":1991.7,"body":"go. Yeah,"},{"speaker":"Charles Goldfarb","startTime":1991.7,"endTime":1993.44,"body":"for those of"},{"speaker":"Charles Goldfarb","startTime":1991.7,"endTime":1993.44,"body":"you listen, we're grateful for"},{"speaker":"Charles Goldfarb","startTime":1993.44,"endTime":1996.62,"body":"our listeners. This is a labor"},{"speaker":"Charles Goldfarb","startTime":1993.44,"endTime":1996.62,"body":"of love. We do enjoy it, for"},{"speaker":"Charles Goldfarb","startTime":1996.62,"endTime":2000.54,"body":"sure. What's been fascinating"},{"speaker":"Charles Goldfarb","startTime":1996.62,"endTime":2000.54,"body":"for me, and that goes to the"},{"speaker":"Charles Goldfarb","startTime":2000.54,"endTime":2003.42,"body":"listeners who are still tuned in"},{"speaker":"Charles Goldfarb","startTime":2000.54,"endTime":2003.42,"body":"and haven't dropped off yet. You"},{"speaker":"Charles Goldfarb","startTime":2003.42,"endTime":2007.56,"body":"know, most of you listen in the"},{"speaker":"Charles Goldfarb","startTime":2003.42,"endTime":2007.56,"body":"audio only format, but our"},{"speaker":"Charles Goldfarb","startTime":2007.56,"endTime":2010.56,"body":"YouTube viewership, why people"},{"speaker":"Charles Goldfarb","startTime":2007.56,"endTime":2010.56,"body":"want to see Chris and me sit"},{"speaker":"Charles Goldfarb","startTime":2010.56,"endTime":2013.86,"body":"here and talk? I do not know."},{"speaker":"Charles Goldfarb","startTime":2010.56,"endTime":2013.86,"body":"But our YouTube viewership is"},{"speaker":"Charles Goldfarb","startTime":2013.86,"endTime":2016.26,"body":"going through the roof. I mean,"},{"speaker":"Charles Goldfarb","startTime":2013.86,"endTime":2016.26,"body":"I think we had six or 700"},{"speaker":"Charles Goldfarb","startTime":2016.56,"endTime":2018.24,"body":"recently. It's really"},{"speaker":"Charles Goldfarb","startTime":2016.56,"endTime":2018.24,"body":"remarkable. I"},{"speaker":"Chris Dy","startTime":2018.66,"endTime":2021.5,"body":"think it's just easier"},{"speaker":"Chris Dy","startTime":2018.66,"endTime":2021.5,"body":"to pull stuff up on your on your"},{"speaker":"Chris Dy","startTime":2021.5,"endTime":2024.44,"body":"computer or your phone on"},{"speaker":"Chris Dy","startTime":2021.5,"endTime":2024.44,"body":"YouTube, maybe just like, let it"},{"speaker":"Chris Dy","startTime":2024.44,"endTime":2027.56,"body":"roll. That might be it. Or they"},{"speaker":"Chris Dy","startTime":2024.44,"endTime":2027.56,"body":"just, I mean, they love seeing"},{"speaker":"Chris Dy","startTime":2027.56,"endTime":2028.88,"body":"your dome. It's great."},{"speaker":"Charles Goldfarb","startTime":2029.72,"endTime":2032.72,"body":"I got a kind"},{"speaker":"Charles Goldfarb","startTime":2029.72,"endTime":2032.72,"body":"of shortcut. What happens"},{"speaker":"Chris Dy","startTime":2034.52,"endTime":2038.06,"body":"looking good? Well, I"},{"speaker":"Chris Dy","startTime":2034.52,"endTime":2038.06,"body":"wish you the best holiday season"},{"speaker":"Chris Dy","startTime":2038.12,"endTime":2041.62,"body":"and a great end to your 2024,"},{"speaker":"Chris Dy","startTime":2038.12,"endTime":2041.62,"body":"Chuck. It is always fun to do"},{"speaker":"Chris Dy","startTime":2041.62,"endTime":2045.22,"body":"this together, and I look"},{"speaker":"Chris Dy","startTime":2041.62,"endTime":2045.22,"body":"forward to another another year"},{"speaker":"Chris Dy","startTime":2045.22,"endTime":2051.4,"body":"of it, hopefully every dude,"},{"speaker":"Chris Dy","startTime":2045.22,"endTime":2051.4,"body":"happy holidays. Happy holidays."},{"speaker":"Chris Dy","startTime":2051.4,"endTime":2051.88,"body":"Take care."},{"speaker":"Charles Goldfarb","startTime":2053.08,"endTime":2055.06,"body":"Hey, Chris,"},{"speaker":"Charles Goldfarb","startTime":2053.08,"endTime":2055.06,"body":"that was fun. Let's do it again"},{"speaker":"Charles Goldfarb","startTime":2055.06,"endTime":2056.62,"body":"real soon. Sounds"},{"speaker":"Chris Dy","startTime":2056.62,"endTime":2059.02,"body":"good. Well, be sure to"},{"speaker":"Chris Dy","startTime":2056.62,"endTime":2059.02,"body":"email us with topic suggestions"},{"speaker":"Chris Dy","startTime":2059.02,"endTime":2061.44,"body":"and feedback. You can reach us"},{"speaker":"Chris Dy","startTime":2059.02,"endTime":2061.44,"body":"at hand, podcast@gmail.com"},{"speaker":"Charles Goldfarb","startTime":2063.12,"endTime":2065.28,"body":"and remember,"},{"speaker":"Charles Goldfarb","startTime":2063.12,"endTime":2065.28,"body":"please subscribe wherever you"},{"speaker":"Charles Goldfarb","startTime":2065.28,"endTime":2066.3,"body":"get your podcast,"},{"speaker":"Chris Dy","startTime":2066.72,"endTime":2069.54,"body":"and be sure to leave a"},{"speaker":"Chris Dy","startTime":2066.72,"endTime":2069.54,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":2069.54,"endTime":2071.16,"body":"word out. Special,"},{"speaker":"Charles Goldfarb","startTime":2071.159,"endTime":2073.199,"body":"thanks to"},{"speaker":"Charles Goldfarb","startTime":2071.159,"endTime":2073.199,"body":"Peter Martin for the amazing"},{"speaker":"Charles Goldfarb","startTime":2073.199,"endTime":2073.679,"body":"music."},{"speaker":"Chris Dy","startTime":2074.339,"endTime":2076.619,"body":"And remember, keep the"},{"speaker":"Chris Dy","startTime":2074.339,"endTime":2076.619,"body":"upper hand come back next time"},{"speaker":"Chris Dy","startTime":2076.619,"endTime":2076.739,"body":"you"}]}