Baylor College of Medicine

Compassion in Practice





Erik: And we're here.

Juan: Yes we are.

Erik: This is the Baylor College of Medicine Resonance Podcast. I am one of your hosts, Erik Anderson.

Juan: I am another host, Juan Carlos Ramirez.

Karl: And my name is Karl Lundin. I was the writer for this episode.

Erik: Yeah and so today we're going to be talking with Dr. Fields-Gilmore about her experience as a family medicine practitioner and Karl

Karl: So yes, we are going to be talking today to Dr. Joanna Fields-Gilmore, one of the wonderful faculty members we have here at Baylor College of Medicine. Dr. Fields-Gilmore is a family medicine specialist. Family medicine is a very important field; when people think of the classic community doctor, that's a family medicine doctor. They do it all: they take care of adults, they take care of kids, they take care of pregnant ladies and babies and all that stuff so really kind of the jack of all trades type doctor. So it’ll be cool, we'll get a chance to talk to her and get some sort of insight into that particular field of medicine and what it's like to be kind of integrated in the community as a physician. We'll also get to know Dr. Fields-Gilmore more personally, kind of hear about some of her background and what brought her to Baylor which will be really cool stuff. And we'll also get to hear about the course that she recently took on as the director of which is Compassion and the Art of Medicine. It's a really cool elective course offered to first-year medical students in the fall every year, and then also second-year medical students kind of come in as sort of small group facilitators for the class. So it's kind of a fun time.

Juan: It’s a great course. I took it actually. It's more a lot along the lines of just understanding people a little more. It's not just like their illness, systemic issues you know just problems that are going on in the world that affect people's health even here in Harris County. I remember some of the speakers that came over to talk to us like directors of homeless shelters and stuff like that. It's really good, kind of like an eye-opening experience too and I think you take a lot away from that. It’s a big slice of humble pie too.

Karl: Yeah. I think it kind of once again gets to sort of a part of our medical education that we sometimes don't think of; you know a lot of it is focused on book knowledge, on learning these various scientific and medical facts and problem solving skills and all that is very important to the practice of medicine, but another important thing about medical practice is the relationship you can build with your patients and with the community and how you can really learn from your patient how to best care for your patient. And so Compassion and the Art of Medicine was really, I also took the course, really valuable in sort of offering a chance for us to expand our perspective and develop some of those compassion and empathy skills. Because when you have a patient come into the room and you talk to them, they're bringing a whole lot of experiences of life with them and it's important for you to be able to reach out and try to learn and understand that patient so that you can best treat them and best manage their care. And we're going to get into her vision for the course, kind of what the course is all about and some of the cool stuff involved around that too. So it should be a good conversation.

Erik: Yeah, yeah definitely. Well, without further ado, Dr. Fields-Gilmore.

Karl: Well Dr. Fields-Gilmore, thank you for joining us for the podcast today. We appreciate you working through some technical issues because we are actually recording this, for those of you that don't know, during the Covid 19 sort of social isolation period of time, so we're having to do this virtually. But we appreciate you joining us today.

Dr. Fields-Gilmore: Thank you for having me.

Karl: We're glad to have you. So we thought we would just start off by asking you to tell us a little bit about your background, your education, where you grew up, all that sort of stuff.

Dr. Fields-Gilmore: Well I'm a native Houstonian. I was born and reared in Houston, and then I went off to Nacogdoches, Texas to do my first stint of college. So I got my bachelor's there and then in Indianapolis, Indiana for the for my second graduate degree and medical degree and then off to California for residency training. So I've been a couple of places. I've also been to Africa, did some work there while I was a fourth-year med student and also with one of the professors that I worked with when I was doing one of my graduate degrees. And my experience after residency, I was a national health corps scholar and in that experience you have to do four years of service time and no, they don't pay any student loans while you're doing that service time, which I'm doing in rural areas. And so I was in Laredo, Texas, which is right across the street from Nuevo Laredo, and if you know anything about that and the drug cartels and those kinds of things that were going on. Just a really interesting experience so far, because everything has been with underserved but just a lot of different areas and a lot of different regions that I've worked in. So it's been interesting.

Karl: Yeah, it sounds like you had a lot of different experiences in a lot of different places. Sounds kind of cool, you know lots of opportunities. Just out of curiosity, how long were you in Africa and what were you doing there more specifically?

Dr. Fields-Gilmore: So at Indiana University School of Medicine you had the opportunity to go to Kenya to do some work. And for me, I did not end up going to the traditional place that they go to in Kenya for Indiana University School of Medicine. I ended up doing missionary work so I ended up doing an Africa inland mission and I was in Kajabe. So Kajabe is an hour outside of Nairobi up in the mountains, and I went there right after they had their internal unrest. It was kind of like a civil war, if you will, where the largest group the Kikuyu was warring with the another group because of the election that they just had. This was in 2000, between 2008 and 2009. And so I went there right after they had that. It was kind of iffy whether or not I was going to be able to go because it was so dangerous. And so that was a different experience because the people that we saw were people who were coming in from having been internally displaced: what you would call refugees but they called them “internally displaced people” while I was there. And I went and we gave medical care to the people in the internally displaced camps, but they also made their way up to the mission hospital that I was a student physician at.

Karl: Wow. How do you feel like that kind of informed your subsequent experiences in your practice as a doctor?

Dr. Fields-Gilmore: You know, I'm going to tell you when you are a fourth year medical student you’re, I mean throughout your whole experience, even now I'm an attending I've been out of residency for a while and I didn't, you know, I've been working for a while and you still don't know everything. So when you're up for the amazing… it's scary, it's exciting, it can be fun and if you go to a different country and you get some down time you're able to explore. You get to know a different culture; hopefully you learn a little bit of the language, but when it comes to the medicine you're a fourth year med student and you know, you have a lot more responsibility in that situation than you do when you're here doing your clinicals in America. 

Erik: I'm curious, what ended up making you want to come back to Texas eventually? Or did you always want to come back to Texas?

Dr. Fields-Gilmore: You know, I had no plans to come back to Texas. I was going to stay in California. I came back because of family. I helped my family: we had some illnesses and some people passing away, and I came back to help my mom and ended up staying here for a whole lot of reasons that had nothing to do with wanting to stay for medicine. So I'm here. I mean I just bought a house.

Erik: So was there anything particular about Baylor that made you want to come and become a faculty here?

Dr. Fields-Gilmore: I'm going to tell you this: I have always wanted to be in the Baylor family. I wanted to go to Baylor's undergrad, I wanted to go to Baylor for med school, and I wanted to do residency at Baylor. So when I was finishing up my service as a national health corps scholar, I was looking around and I had an opportunity to be a partner for a clinic, which is scary in and of itself because you got to put a bunch of money in. You have to decide whether or not, you know, do you think this clinic is going to thrive or die? You know, lifestyle. So lots of decisions and Baylor looked like they had an opening, so I said, “Ha ha ha ha, I'm gonna try,” because I hadn't been accepted by Baylor up until now so I was like, “Ah, this is just, you know, a formality; I'm just gonna fill this out.” And I went for the interview and everything and actually I had got no emails that they picked another candidate. And so I said, “Okay, well well…” And me being the kind of person I am, I always want to know well if I didn't get that position then I want to know what would make my application stronger. And I think that this is something that anybody can learn from: if you don't get it the first time, then find out what makes you a stronger candidate so that if you want to try again then you can try again right. So you need to do more volunteer work, you need to do this that and the other… And I emailed and I got the email back and it said, “Oh no we wanted you! You got the email on mistake! We want you to start.” And I said, “Wow! I've got the job!” And so all the other, if I had at least two or three other opportunities, I said, “Okay, I'm going to go with Baylor because I'd always wanted to be a part of that. 

Karl: Oh that's very nice, that's very nice. In terms of the field you chose: you're a family medicine doctor right which we were just wondering first of all, what interested you in family medicine? And then what do you feel some of the unique opportunities you have and challenges in that field? Because it's kind of like, I'd say personally for me, my perception of family medicine is you are the closest interacting with the community as a whole. 

Dr. Fields-Gilmore: So I have a master's in public health, and I earned my master's in science and my master's in public health. I earned it before medical school. So when I got to medical school, I was older; I was non-traditional because I had two math degrees prior to that and worked and everything before that. I love public health! Absolutely hands down, a lot of public health and programming was my area, and I just really enjoyed it. And so for me, as I was going to medical school I knew that I wanted to do something that kept me involved with the community, okay, and would allow me to have that interaction with the community. So family medicine was one of those, one of the three or four on my list of what I wanted to do as far as matching was concerned. And so my because my personal mission statement was to serve the underserved and affect positive change in any community in which I served, so that's where I wanted to be because I wanted to continue to be able to do the public health things, do a program right, and try to make some mass changes. Not just one-on-one change, but do some programming and things that would hopefully help a whole community.

Karl: Yeah so do you feel like, what are some of the more unique opportunities or kind of the unique aspects of a family medicine doctor's position that allow them to do that in the community?

Dr. Fields-Gilmore: So over the years, because I'm not just going to focus on the Baylor experience, it has been helpful when you're, when physicians, especially family medicine and internal medicine, when they're able to do different types of programs that meet the needs of the community. So if you go into a community and you see that there's a lot of one type of disease, and it may be some lack of education knowledge or access to a resource. And if you can improve upon that to then improve that area, then that's what makes the job as exciting. To wake up in the morning and to continue to do, you know. And so that's a positive aspect of family medicine is being able to have that. With Baylor it's quality improvement projects, it's working with the students, and when the students have projects to work on with the community residents as well. So that is what the opportunity is, and that's what makes it good. 

Erik: It used to be more of a tradition to have actually in-house visits from physicians, and I could see, you know, where you'd actually go into people's homes and see them rather than coming to the clinic. As a family medicine physician, is that something that you would want to see come back, or do or do you think the current way that we do things where, you know, people come to us is the best way to do it?

Dr. Fields-Gilmore: I think that having a mixed bag is good. So when I was in medical school, there was one doctor… What’s her name? It was doctor… Obeime! Mercy Obeime, and she's big time in Indianapolis. I worked under her and shadowed her and was a student of hers for a long time, and she had an, I don't know what her position was… She was a medical director and a bunch of other titles and stuff. But she had the doctor's bag, she had an old school doctor's bag, and one of the things that she did amongst all the other things that she did was she went to people's homes. And so she had a clinic, she had her own clinic, it was thriving, she had mid-levels and she had another physician who worked with her. She was affiliated with the hospital; like I said, she was a medical director, she did a bunch of volunteer type of programming, she even had a foundation, they would go to Africa. So she had a lot of stuff going on and she did some home visits. When I was training in residency, we did home visits. So I think that them coming to the clinic is good because you have a more controlled environment and it's safer actually, because sometimes you never know what you're gonna walk into. But also going to see where someone lives, because we did that and I think… I can't remember… I think we did a home visit in medical school, but I know we did it in residency, especially for our diabetic patients; we went to their homes, we looked in refrigerators, you know. We did their foot exam there, we did all of that. So it's something that is done, you know. It can be done.

Erik: Well that's good to hear, and the fact that you were doing it, I guess maybe I just don't understand it enough; it seems to me that it's always just clinic visits and the home visit is being phased out, but maybe it's not. Would you say that it's not actually as gone as maybe like, for instance, I might think?

Dr. Fields-Gilmore: I think that because you're at an institution right now, the area where you are in your training, you're not seeing it then it doesn't seem like it exists. But you got to remember that you have a whole life ahead of you in this, and you will see a lot of different things you know like, “Oh they never did that there, but they do that here.” And now you know I tell people I switched around a lot. I didn't stay in one spot, and I know some people there they are successful when they go from undergrad to medical school to residency and they stay in one spot. If you can move around and if it's good for you and if it's successful and it makes you know, your curriculum vitae look good and all that, move around because you're going to have different experiences. And I think that that's it.

Erik: Yeah actually Karl and I both took a number of years off, so I think we both agree a lot with that sentiment.

Karl: Definitely. So a little bit of a change of topic, but one of the reasons I reached out to you to schedule this interview is because I actually took your Compassion and the Art of Medicine course my first year in med school, and I enjoyed it a lot. I understand you recently took over that, and we were just interested to ask you some things about that. Like what interested you in the course?

Dr. Fields-Gilmore: So I applied for the course because I had done the Healer's Art with Dr. Michelle Barrett, and she's a UT physician pediatrician, but the healer's art course has both Baylor and UT students. And you know what you guys experience in residency, in medical school is completely, completely different than what we experienced. We experienced a lot of the things that you guys now are able to report on; if somebody does something you can anonymously report. And so we endured that. And so when I was invited to do Healers Art, I was like, “Wow, they have something where you can actually just, you know, get some things off of your chest and you're not gonna get in trouble for it,” and I could be a facilitator for that. And I was actually really scared to be a faculty facilitator, but it ended up being wonderful. So then when I saw the Compassion and the Art of Medicine course director position opened up, I was like, “I could probably do that,” and I was chosen. So that's what made me do it, because this type of thing, it was not even in the stratosphere of the universe for medical schools to be thinking about how people, how the physicians feel, how they're training trainers. They didn't get somebody to ask you how you felt; you get up and you go to go do what you got to do and, you know, make sure you get your grades. Nobody asked you how you felt and how did it feel when somebody that, you know, as a student you cared for died or something. Nobody. Yeah you just kept going, and so I was like, “This is awesome that Baylor's doing this.” I just was really excited about the fact that this was being offered to the students because it wasn't offered for when I was training.

Erik: And do you want to explain what it is just in case there are people that are listening, or either one of you I guess. Just a brief synopsis.

Dr. Fields-Gilmore: Karl, you do it.

Karl: Yeah yeah; it did occur to me that we should probably provide some context. So Compassion and the Art of Medicine, it's basically a really neat course they offer at Baylor where first year students come in, and there are second year students that also come in and they facilitate actually, but the first year students they come in and basically there will be different guest speakers talking on different topics. And they all kind of have to do with, I guess what you call like the “softer side” of medicine, right. Not so much about like facts and figures and scientific data on patient treatment, and more about how to treat a patient as a human being, how to treat each other as human beings, as physicians, as other health care providers, and how we can sort of keep in mind our interconnectedness and have a holistic approach to the way we conduct ourselves in a medical environment. So, for example, we had a speaker come in, a doctor who talked about his own experiences as a parent of a child with a certain, like I guess you call it like developmental and health issues. I think she was deaf-mute, was that the correct um expression? And just kind of getting insight into what that family's experience was like and what we can do as physicians to help people in that situation and provide the best care in that situation. And I'd say really more than anything it's about developing your empathy, right? Not just your clinical acumen, which we're learning in other areas. But here we're learning how to be an empathic doctor and a doctor that really knows how to reach people where they are and be with them in their struggles. 

Dr. Fields-Gilmore: So that's my view, and the one thing that I emphasize, because I don't know whether or not it was emphasized before I became the director, is because in medicine all of our brethren, we have been trained and we are often trained to ignore ourselves. And now that we're in this pandemic with covid-19 and you see all of our brethren who are passing away who are not getting their protective personal equipment and things of that nature, it's important, it is paramount, and Karl knows I say this, you have got to take care of yourself because if you don't give yourself compassion, you cannot give compassion to your patients. And so that's the thing that I bring to the table which I know for a fact has not been something that has been trained into physicians is, you know, don't be the martyr. Yeah, the reason why you can be a hero is because first you be a hero to yourself, take care of yourselves. If you, you know, go take a walk, I tell them go call the grandmom, if the grandma's still alive. Walk the dog. Those kinds of things. Do that self-care, because then you're able to be in the present and be in tune for the patients of what they need. So it's very important that we take care of ourselves.

Erik: Yeah that is, yeah. Do you have any, and you mentioned already how important it is, especially during this time, because, you know, of what's going on. Have you found it harder because of that, or do you like, maybe just because I'm sure many people are working longer hours now too?

Dr. Fields-Gilmore: I think that just like everything, everybody else and every other position, we're all on edge and so to be aware of that and to be aware of your own anxiety, to be aware of your own concerns, is really important for your health, for if you have family to take care of and then for you to be able to take care of the patient that you see. Also, to be a positive advocate so that you are protected to be able to do the job. Be smart about the job and be an advocate to be able to get the things that you need so you can do the job, so you can live to do the job. It's very important.

Erik: Okay, yeah. No I agree. So we kind of already covered this, but what would you kind of summarize is the kind of experience you want students to get out of the Compassion and the Art of Medicine course?

Dr. Fields-Gilmore: You know every year, I think it ends up being different because it takes, actually it takes a life of its own. As far as the theme, I start off with saying I think I want y'all to do to talk about each speaker, and then for some reason they all end up having a theme that goes together. And they don't talk to each other. I've said this before, I'm like, they don't talk to each other, they just ended up, that year ends up being about; this last year we ended up talking about homelessness a lot. So basically, for the course I talk to the speakers and I just, I go to them and I ask them to talk about different thinking for as far as what they, where they're coming from. So if it's a clinician, you know talk about these types of experiences. If it's, if it's, because sometimes we don't have just physicians, we have different types of people in the community coming in, and I ask them just kind of because you want people to talk about what they're good at. And that's how I approach the course each year, and it ends up being just really good. Because I don't, I try not to, I try not to control too much of what they're gonna say. I mean of course I say, you know you can't be saying a whole bunch of stuff that you're not supposed to say. You know, these are students! Don't be unprofessional, but, and because you know that’s what is so great: we all want to talk about compassion, we all want to talk about the stories, the antidote to stories that we have about our experiences with these, with our patients, and with the people that we interact with in the community. We all want to do that, and we don't really often have a chance to. And I'm not sure if a lot of people are able to talk about these things at home. You know, you gotta adhere to HIPAA, but you don't really have an opportunity to talk about that too much. You just keep doing the job, and so a lot of doctors and a lot of people in healthcare love talking about their experiences and imparting that wisdom. So I guess that's kind of a lesson in and of itself: the approach, instead of like having a set agenda, you kind of let the speakers to a certain extent help bring the agenda in the same way you should probably act with a patient. You don't just come in and say this is how this is going to be, you kind of see where they're at and let them help participate in the encounter. 

Erik: Okay, that’s very good. Well, to switch gears a little bit, to more generally talking about health care, we were curious if you have any thoughts on the contrast between private and public health care? Yeah, and just what your experiences have been in those spheres.

Dr. Fields-Gilmore: In private healthcare you have a lot more leeway than in public. Because you have some limited resources, you kind of have to make decisions and decisions are made for you about what can be done because of the limited resources of limited funding. Both if you're serving the underserved, you're serving the same population, okay same population the private sector. And like when I was working as a national health corps scholar and I was in the rural areas, they didn't have access to the gold card in Harris Health, right? They didn't have access to the Harris Health system because things like the Harris Health system exists in a lot of major cities. There's the, I think John Peter Smith or something like that in Dallas. So you've got that in a lot of major cities, right? Where the underserved can have access to care and they don't pay very much at all, but in the rural areas they're resilient. When I was in Laredo, when people needed procedures and things they would have bake sales.

Karl: That's great! I love that!

Dr. Fields-Gilmore: Yeah, they have bake sales to pay for that cholecystectomy or something like that, you know. And it's a different approach, the population, depending on how they get, how they have to go about getting what they need, you're gonna have a different type of mindset in your patient, right? And so you if you think about that, because if you have access to something, you're always able to get lab work and images and health care, and you don't really have to pay for it as opposed to, in order to get that lab work you have to find the money, you got to ask family members, you gotta have a bake sale, you gotta, you know, go to the church. So it's just, it was different experiences. Public health and public access to care and private, but both, I was serving both in both areas.

Karl: So would you say it's kind of like, for the underserved population specifically in kind of the public health system, you can not worry as much about the cost for basic kind of care things, but maybe you don't have as much freedom, whereas in the private the main concern is, “How are we going to pay for this?” but we can kind of do whatever I think is going to work best? Does that kind of make sense?

Dr. Fields-Gilmore: A little bit, but not, you know that might be five to ten percent. Because you're still worrying about money, okay. You, with the patients worry about the cost of things either way, okay. Because again, because in the public sector there's no, there's not a lot of funding. There's not a lot that they're going to get, right? This is what you get, and so then they end up having to figure out what are they going to, how can they get the money to get what they need. And then who do they access. Because they're so used to having this system where they have this access, this easy access to this; now they got to figure out, “Well who in the private sector can they contact?” Do they have a sliding scale? Are they going to work with them financially? And all of this other kind of stuff. So those are those challenges. And then they start thinking about, “Let me have a bake sale.” 

Erik: Are they the same? I mean, I guess this is probably going to depend on obviously each private and public hospital or clinic you're working at, but do you find a similar amount of like patient load in each one?

Dr. Fields-Gilmore: Yeah, you do. It's just a lot of people who need, a lot of people who are in need either way. 

Erik: Yeah okay.

Karl: I guess this is another thing we touched on a little bit, but just and kind of in general, how do you feel uniquely as a doctor we have power to impact the local community in a way that maybe somebody in any other position in the community doesn't?

Dr. Fields-Gilmore: I think that if you know and you learn and you're training how to make those connections, and you learn how to not just think about going to work. So that's why in the course, I try to have different types of people come and speak different perspectives. Because if you're not careful, you as a training physician will only think about, you'll have tunnel vision basically; like this is when you have a lot of different ways in which to get some things done. You can collaborate with a lot of different types of people and just have a lot of different connections and have a broader network. And so that's really important in order to get stuff done that you want to get done, that you need to get done, and then when things come about that you see need to be done in a community or with people and patients, then you have that network and connection and you can hopefully make it happen. I mean, and that's why I tell y'all in the class, sometimes it's not gonna work out right. Do not take that home and let that eat you up, because you know we're only human and you do the best that you can with what you have. But if you work really well at making connections with people, then you'll have more access as a physician and then hopefully you can get some things done when the time comes. 

Karl: And I guess that kind of ties back in with the concept of self-care…

Dr. Fields-Gilmore: Right!

Karl: And making sure you're taking care of yourself, because if you take care of yourself you're going to be more likely to love your job, enjoy your job, have the energy to make those connections, just do those initiatives to really push to get things done for your patients in the community. 

Dr. Fields-Gilmore: You're gonna care! 

Karl: Yeah exactly. Yeah little thing called burnout we're trying to avoid.

Dr. Fields-Gilmore: Exactly.

Karl: So I guess we're getting close to the end of the interview, doctor. We really do thank you for your time, but we do have one last kind of big, broad question for you which is: just how do you think we can most effectively demonstrate compassion  in our daily lives towards patients, towards the people we interact with in the medical field, and just in general? Like, what is compassion to you and how can we demonstrate that to others most effectively?

Dr. Fields-Gilmore: I think the most important thing to have to be able to demonstrate that compassion and to have it there at your fingertips is to always reflect that upon yourself, your family, your own experience. Think outside of yourself, think outside of your family, think outside of your own experience, and then say, “What if that were my mom, my son, my daughter, my, you know, what if that were me?” And then go from there, because you know, you, like I say in the class, you're gonna be tired, especially as a training resident. You're gonna be really tired and you're gonna have a lot to get done in a short amount of time and somebody's gonna be trying to give you their whole life story sometimes. And you're going to have to take the take a seat and take a moment, and you may not be able to sit there, listen to the whole story. But like they tell you when you're training, the history is the most important thing, right? You got to listen and even if you don't get the whole story right then and there, at some point you're going to have to listen. And sometimes you don't want to listen, because listening is the hardest thing to do. And then when you're really tired, you really don't want to listen you, just want to get it done. You just want to get the labs on, you want to get the images done, you want to figure it out, but sometimes you can't figure it out from the labs and images because you hadn't even sat down to talk to the patient. So just remembering that if it were you how would you want to feel, and I think it's also important the more experiences you have. I've been a patient, you've been a patient, you know, you were a kid, you were, you know, a pediatric patient, you'll be a patient as you grow older, and as you grow older you're going to have more experiences with the health care system because that's just the nature of growing older. And I think that's one of the reasons why a lot of your older doctors typically show more compassion, because they have more experience with the healthcare system as a patient. I think that's something that we all need to remember, and it's really hard if you don't have experience with healthcare as a patient. It's hard to understand when I'm talking to my students at residency, and there'll be something like, I had a preceptorship, I was precepting a resident and this patient's legs were like swollen and when your legs are swollen, yeah they hurt, I mean. And if you've never experienced that, you don't know that. So if, you know, my residents are like, “Oh we're just going to do this and just send them home,” and I'm like, “Have you ever had your leg swelling like that!? That is painful!” Like no, we're not just gonna do that. So that's important, to just think, “If I had this situation happening with me or if it was happening to my mom or my grandmother or my brother, you know, how would I, what else could I make you do?” You know, and one of the things is just asking more questions outside of just the health questions, you know, “How are you feeling?” That's “How are you feeling?” like “What's your pain level?” But “How are you feeling,” right? One of the things that I am learning consistently is with patients, it's not how you make them feel but how you make them feel. Yeah okay, so patients remember that they remember how you make them feel, because our goal is to get those numbers right. Our goal is to get those labs right. Our goal is to, you know, if you're a surgeon, you're going to fix it, but how do you make them feel? 

Karl: I mean I've already seen that a couple times in my very limited clinical experiences where sometimes it's like, doctor, in your example, “My legs hurt,” right? And yeah, they want you to stop their legs from hurting, but they also just want to feel like you actually care about them, you actually are empathizing or sympathizing. You're there with them in the struggle, and yeah. I get what you're saying when it's not about how they feel, it's about how they feel, you know.

Dr. Fields-Gilmore: Yeah. Exactly.

Erik: Well, I think that's really great advice for anybody, for everybody that's practicing medicine. I think we could all work on being a little bit more empathic. And so we really appreciate you taking the time to talk with us, because we know that you're busy right now. So yeah.

Karl: Please stay safe, you know. We appreciate what you’re doing.

Dr. Fields-Gilmore: Yeah yeah. Y'all stay safe. Y'all keep learning and listen, we're going to get through this Covid 19 pandemic. And we're going to have so much more information, it's kind of, I mean it sounds, it's kind of interesting to learn all this stuff, and we're learning things every single day. So that's what we kind of as scientists and physicians and, you know, and if we like that kind of stuff, but we don't like it the way it's happening, okay? We would rather not it be happening this way. So we're going to get through this. We are, so just stay safe, and you know, take care of yourself. Take a walk, do some exercise, drink plenty of water, and get some sleep.

Erik: Exactly. Well thank you.

Karl: Thank you very much. 

Dr. Fileds-Gilmore: Alright bye-bye.