1
00:00:15,067 --> 00:00:17,603
>> THANK YOU, IT'S GOOD TO
SEE 

2
00:00:17,603 --> 00:00:23,175
EVERYONE, WELCOME TODAY TWO OF 

3
00:00:23,175 --> 00:00:25,410
THE SYMPOSIUM.  IT'S A PLEASURE 

4
00:00:25,410 --> 00:00:27,679
TO BE INTRUSION THIS MORNING 

5
00:00:27,679 --> 00:00:31,750
NIH'S DEPUTY DIRECTOR DR. AMY 

6
00:00:31,750 --> 00:00:33,385
KELLEY WHO WILL PROVIDE 

7
00:00:33,385 --> 00:00:35,154
PRERECORDED REMARKS.  WAS 

8
00:00:35,154 --> 00:00:37,256
APPOINTED AS DIRECTOR OF THE NIA

9
00:00:37,256 --> 00:00:40,325
IN SEPTEMBER 2022.  PRIOR TO 

10
00:00:40,325 --> 00:00:45,330
THIS WAS A PROFESSOR AND VICE 

11
00:00:45,330 --> 00:00:48,367
CHAIR OF HEALTH IN THE 

12
00:00:48,367 --> 00:00:50,536
DEPARTMENT OF GERIATRICS AND 

13
00:00:50,536 --> 00:00:52,171
SENIOR ASSOCIATE DEAN FOR GENDER

14
00:00:52,171 --> 00:00:54,606
EQUITY IN RESEARCH AFFAIRS AT 

15
00:00:54,606 --> 00:00:57,843
THE ICON SCHOOL OF MEDICINE IN 

16
00:00:57,843 --> 00:01:03,849
MOUNT SINAI IN NEW YORK.  SHE 

17
00:01:03,849 --> 00:01:06,418
FOCUSED ON SERIOUSLY ILL ADULTS 

18
00:01:06,418 --> 00:01:09,454
AND WAS SUPPORTED BY THE NIA 

19
00:01:09,454 --> 00:01:12,457
THROUGH MULTIPLE GRANTS, THE 

20
00:01:12,457 --> 00:01:13,559
NATIONAL PALLIATIVE CARE 

21
00:01:13,559 --> 00:01:14,993
RESEARCH CENTER AMONG OTHERS.  

22
00:01:14,993 --> 00:01:17,996
IS A TWO TIME ICON SCHOOL OF 

23
00:01:17,996 --> 00:01:20,332
MEDICINE AND A CLINICIAN OF THE 

24
00:01:20,332 --> 00:01:23,168
YEAR HONOREE AND IS RECOGNIZED 

25
00:01:23,168 --> 00:01:29,408
FOR EXEMPLARY WORK INCLUDED FOR 

26
00:01:29,408 --> 00:01:31,176
JAR REE YAT RISK SOCIETY.  SHE 

27
00:01:31,176 --> 00:01:36,448
SENDS HER REPORTS FOR  -- HER 

28
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REGRETS FOR NOT BEING ABLE TO 

29
00:01:39,151 --> 00:01:40,352
PARTICIPATE IN-PERSON BY WILL BE

30
00:01:40,352 --> 00:01:43,155
JOINING US VIRTUALLY.  THANK 

31
00:01:43,155 --> 00:01:43,922
YOU.

32
00:01:43,922 --> 00:01:44,723
>> GOOD MORNING.  AND
WELCOME 

33
00:01:44,723 --> 00:01:48,694
TODAY TWO OF THE NIH PAIN 

34
00:01:48,694 --> 00:01:50,362
CONSORTIUM SYMPOSIUM FOCUSED ON 

35
00:01:50,362 --> 00:01:52,364
SEX AND GENDER DIFFERENCES MY 

36
00:01:52,364 --> 00:01:57,402
NAME IS AMY KELLEY I AM THE 

37
00:01:57,402 --> 00:02:00,639
DEPUTY DIRECTOR OF NIA WOULD 

38
00:02:00,639 --> 00:02:03,008
HAVE BEEN THE 20 INSTITUTES HERE

39
00:02:03,008 --> 00:02:05,310
AND I AM SO SORRY I AM UNABLE TO

40
00:02:05,310 --> 00:02:06,979
BE HERE WITH YOU IN-PERSON 

41
00:02:06,979 --> 00:02:09,548
TODAY.  TODAY'S TOPIC SPEAKS TO 

42
00:02:09,548 --> 00:02:11,483
ME BOTH PERSONALLY AND 

43
00:02:11,483 --> 00:02:12,317
PROFESSIONALLY.  I'M A 

44
00:02:12,317 --> 00:02:14,853
PRACTICING JAR YA TRIGS AS WELL 

45
00:02:14,853 --> 00:02:17,256
AS A RESEARCHER AND I WORKED FOR

46
00:02:17,256 --> 00:02:20,259
DECADES TO IMPROVE THE LIVES OF 

47
00:02:20,259 --> 00:02:21,660
PEOPLE WITH SERIOUS ILLNESS AND 

48
00:02:21,660 --> 00:02:25,631
PAIN I WILL BE SURE TO CATCH THE

49
00:02:25,631 --> 00:02:27,833
RECORDING LATER ON AND TODAY 

50
00:02:27,833 --> 00:02:29,034
JUST WANTED TO TELL YOU A LITTLE

51
00:02:29,034 --> 00:02:32,604
BIT ABOUT NIA'S CONNECTION WITH 

52
00:02:32,604 --> 00:02:37,743
THE NIH PAIN CONSORTIUM.  WE'VE 

53
00:02:37,743 --> 00:02:39,845
BEEN A PROUD MEMBER OF THE 

54
00:02:39,845 --> 00:02:42,681
CONSORTIUM FOR AWHILE AND IN 

55
00:02:42,681 --> 00:02:44,583
THIS ROLE WE HAVE BEEN CHARGED 

56
00:02:44,583 --> 00:02:45,751
WITH STUDYING PAIN MANAGEMENT 

57
00:02:45,751 --> 00:02:47,753
SPECIFICALLY IN OLDER ADULTS.  

58
00:02:47,753 --> 00:02:48,654
IT'S AN UNDERSTUDIED POPULATION 

59
00:02:48,654 --> 00:02:52,357
WITH UNIQUE AND COMPLEX 

60
00:02:52,357 --> 00:02:53,558
CONSIDERATIONS.  SO AT LEAST 40%

61
00:02:53,558 --> 00:02:56,328
OF OLDER AMERICANS REPORT LIVING

62
00:02:56,328 --> 00:02:58,797
WITH CHRONIC PAIN, OFTEN IN 

63
00:02:58,797 --> 00:03:00,732
MULTIPLE BODY SITES AND OFTEN 

64
00:03:00,732 --> 00:03:02,768
WITH MULTIPLE TYPES OF PAIN.  

65
00:03:02,768 --> 00:03:04,469
THE LEADING CAUSES OF CHRONIC 

66
00:03:04,469 --> 00:03:07,973
PAIN IN OLDER ADULTS INCLUDE 

67
00:03:07,973 --> 00:03:09,841
MUSCULOSKELETAL CONDITIONS, 

68
00:03:09,841 --> 00:03:12,077
NEUROPATHIES, CANCER RELATED 

69
00:03:12,077 --> 00:03:13,912
PAIN AND HEADACHES.  

70
00:03:13,912 --> 00:03:14,713
ADDITIONALLY, TREATMENT OF PAIN 

71
00:03:14,713 --> 00:03:18,350
IN LATER LIFE IS OFTEN 

72
00:03:18,350 --> 00:03:19,284
COMPLICATED BY ADDITIONAL 

73
00:03:19,284 --> 00:03:21,153
CONSIDERATIONS THAT INCLUDES A 

74
00:03:21,153 --> 00:03:23,955
PERSON'S COMORBIDITIES AND THE 

75
00:03:23,955 --> 00:03:25,424
SIMULTANEOUS USE OF MULTIPLE 

76
00:03:25,424 --> 00:03:30,696
OTHER MEDICINES FOR THESE 

77
00:03:30,696 --> 00:03:36,735
CONDITIONS.  ASEAT MET -- ASEAT 

78
00:03:36,735 --> 00:03:39,871
MET FIN AND ATYPICAL ANALGESICS 

79
00:03:39,871 --> 00:03:42,741
ARE THE MAINSTAYS HOWEVER 

80
00:03:42,741 --> 00:03:47,746
THERE'S RISKS OF ADVERSE AFFECTS

81
00:03:47,746 --> 00:03:49,514
LIMITING THEIR USE.  FURTHERMORE

82
00:03:49,514 --> 00:03:50,749
IT CAN BE DIFFICULT FOR 

83
00:03:50,749 --> 00:03:51,650
PHYSICIANS AND FAMILIES TO EVEN 

84
00:03:51,650 --> 00:03:53,952
KNOW IF AN OLDER ADULT IS IN 

85
00:03:53,952 --> 00:03:56,788
PAIN, PARTICULARLY IF THAT 

86
00:03:56,788 --> 00:03:58,156
PERSON HAS COGNITION OR 

87
00:03:58,156 --> 00:03:59,358
COMMUNICATIONS PROBLEMS THAT 

88
00:03:59,358 --> 00:04:03,829
MIGHT HAVE BEEN CAUSED BY A 

89
00:04:03,829 --> 00:04:06,131
STROKE, DEMENTIA OR ANOTHER 

90
00:04:06,131 --> 00:04:08,667
HEALTH CONDITION, GIVEN THESE 

91
00:04:08,667 --> 00:04:11,203
COMPLEXITIES, NIA HAS A 

92
00:04:11,203 --> 00:04:12,170
LONG-STANDING INTEREST IN 

93
00:04:12,170 --> 00:04:14,339
RESEARCHING THE MEASUREMENT, AND

94
00:04:14,339 --> 00:04:17,943
THE MANAGEMENT OF PAIN WITH 

95
00:04:17,943 --> 00:04:21,680
AGING.  OVER THE YEARS NIA AS 

96
00:04:21,680 --> 00:04:22,781
ISSUED SEVERAL PAIN FOCUSED 

97
00:04:22,781 --> 00:04:25,083
OPPORTUNITIES THIS HAS INCLUDED 

98
00:04:25,083 --> 00:04:25,817
AN ACTIVE NOTICE OF SPECIAL 

99
00:04:25,817 --> 00:04:27,152
INTEREST FOR RESEARCH 

100
00:04:27,152 --> 00:04:29,988
APPLICATIONS THAT FOCUS ON 

101
00:04:29,988 --> 00:04:31,189
IMPROVING OUR UNDERSTANDING OF 

102
00:04:31,189 --> 00:04:33,825
MECHANISMS THAT UNDERLINE A PAIN

103
00:04:33,825 --> 00:04:35,727
EXPERIENCE WITH AGING.  THAT 

104
00:04:35,727 --> 00:04:37,596
ENHANCE THE ASSESSMENT, THE 

105
00:04:37,596 --> 00:04:38,630
PREVENTION AND MANAGEMENT 

106
00:04:38,630 --> 00:04:41,233
STRATEGIES FOR PAIN IN OLDER 

107
00:04:41,233 --> 00:04:42,667
ADULTS.  AND ALSO, IMPORTANTLY, 

108
00:04:42,667 --> 00:04:46,104
IMPROVING HEALTH EQUITY OF AGING

109
00:04:46,104 --> 00:04:49,307
POPULATION SUFFERING WITH PAIN. 

110
00:04:49,307 --> 00:04:50,075
ADDITIONALLY JUST THIS PAST 

111
00:04:50,075 --> 00:04:53,378
APRIL IN COLLABORATION WITH THE 

112
00:04:53,378 --> 00:04:56,581
NATIONAL 

113
00:04:56,581 --> 00:04:57,015
NATIONAL CENTER FOR 

114
00:04:57,015 --> 00:04:57,616
COMPLEMENTARY AND INTEGRATIVE 

115
00:04:57,616 --> 00:04:59,184
HEALTH NIH PUBLISHED A FUNDING 

116
00:04:59,184 --> 00:04:59,718
OPPORTUNITY TO SUPPORT A 

117
00:04:59,718 --> 00:05:00,952
CLINICAL TRIALS NETWORK THAT 

118
00:05:00,952 --> 00:05:02,888
WILL COLLECT SAFETY AND EARLY 

119
00:05:02,888 --> 00:05:06,291
EFFICACY DATA ON THE USE OF 

120
00:05:06,291 --> 00:05:07,359
PSYCHEDELIC ASSISTED THERAPY IN 

121
00:05:07,359 --> 00:05:08,760
OLDER ADULTS LIVING WITH 

122
00:05:08,760 --> 00:05:09,761
SPECIFIC CHRONIC PAIN CONDI

123
00:05:09,761 --> 00:05:14,566
CONDITIONS.  FURTHERMORE, NIA 

124
00:05:14,566 --> 00:05:17,769
SUPPORTS A GREAT DEAL OF 

125
00:05:17,769 --> 00:05:18,837
RESEARCH IN PALLIATIVE CARE AND 

126
00:05:18,837 --> 00:05:21,306
IN ADDITION TO THIS, WE HAVE 

127
00:05:21,306 --> 00:05:23,909
RECENTLY PARTNERED WITH ICS 

128
00:05:23,909 --> 00:05:26,978
ACROSS NIH TO RELEASE A NEW 

129
00:05:26,978 --> 00:05:28,847
NOTICE OF A FUNDING OPPORTUNITY 

130
00:05:28,847 --> 00:05:30,682
FOR APPLICATIONS TO THE 

131
00:05:30,682 --> 00:05:32,117
PALLIATIVE CARE RESEARCH 

132
00:05:32,117 --> 00:05:34,019
CONSORTIUM.  THIS FOCUSES ON 

133
00:05:34,019 --> 00:05:37,823
PROVIDING RESOURCES.  

134
00:05:37,823 --> 00:05:44,596
EXPERTISE.  AND COORDINATION FOR

135
00:05:44,596 --> 00:05:45,831
THOSE LIVING WITH SERIOUS 

136
00:05:45,831 --> 00:05:47,933
ILLNESSES ACROSS THE FULL LIFE 

137
00:05:47,933 --> 00:05:49,367
SPAN.  THE IDEA IS THE 

138
00:05:49,367 --> 00:05:51,603
CONSORTIUM WILL LEVERAGE THE 

139
00:05:51,603 --> 00:05:53,205
SYNERGIES, COORDINATE THE 

140
00:05:53,205 --> 00:05:53,939
EFFORTS AND DEVELOP THE 

141
00:05:53,939 --> 00:05:55,173
SCIENTIFIC WORKFORCE THAT WILL 

142
00:05:55,173 --> 00:05:57,843
ADDRESS THE REMAINING GAP IN 

143
00:05:57,843 --> 00:05:59,177
PALLIATIVE CARE RESEARCH THAT 

144
00:05:59,177 --> 00:06:01,980
WILL ENCOMPASS EVERYTHING FROM 

145
00:06:01,980 --> 00:06:02,714
ALZHEIMER'S AND RELATED 

146
00:06:02,714 --> 00:06:04,916
DEMENTIAS TO CANCER AND A RANGE 

147
00:06:04,916 --> 00:06:11,089
OF OTHER SERIOUS ILLNESSES AND 

148
00:06:11,089 --> 00:06:12,257
POPULATIONS.  AN IMPORTANT FOCUS

149
00:06:12,257 --> 00:06:13,058
WILL BE TO CONDUCT RESEARCH TO 

150
00:06:13,058 --> 00:06:15,827
BETTER UNDERSTAND AND TO ADDRESS

151
00:06:15,827 --> 00:06:18,230
THE DISPARITIES SEEN IN ACCESS, 

152
00:06:18,230 --> 00:06:19,764
QUALITY AND THE USE OF 

153
00:06:19,764 --> 00:06:22,033
PALLIATIVE CARE SERVICES FOR 

154
00:06:22,033 --> 00:06:25,170
HEALTH DISPARITY'S POPULATIONS. 

155
00:06:25,170 --> 00:06:26,338
ADDRESSING HEALTH DISPARITIES 

156
00:06:26,338 --> 00:06:28,573
INCLUDING THOSE RELATED TO SEX 

157
00:06:28,573 --> 00:06:30,575
AND GENDER DIFFERENCES IN 

158
00:06:30,575 --> 00:06:31,776
PALLIATIVE CARE AND PAIN 

159
00:06:31,776 --> 00:06:33,345
TREATMENT ARE OF UTMOST 

160
00:06:33,345 --> 00:06:37,148
IMPORTANT TO ME.  NIA IS DEEPLY 

161
00:06:37,148 --> 00:06:39,818
COMMITTED TO CLARIFY SEX AND 

162
00:06:39,818 --> 00:06:43,154
GENDER DIFFERENCES IN 

163
00:06:43,154 --> 00:06:43,855
AGE-RELATED CONDITIONS AND OUR 

164
00:06:43,855 --> 00:06:45,824
BROAD ISSUES ARE THOSE THAT 

165
00:06:45,824 --> 00:06:48,426
DRIVE THE DIFFERENCES, THAT 

166
00:06:48,426 --> 00:06:49,761
OPERATE DIFFERENTLY IN SEX AND 

167
00:06:49,761 --> 00:06:51,663
GENDER SPECIFIC MANNERS AND THE 

168
00:06:51,663 --> 00:06:55,166
FACTORS OF INTEREST INCLUDE 

169
00:06:55,166 --> 00:06:57,068
BIOLOGICAL, BEHAVIORAL, SOCIAL, 

170
00:06:57,068 --> 00:06:57,836
PSYCHOLOGICAL AND HEALTH CARE 

171
00:06:57,836 --> 00:07:01,039
SYSTEM RELATED FACTORS.  MANY OF

172
00:07:01,039 --> 00:07:04,242
MY TOP GOALS AS NIA'S CHIEF 

173
00:07:04,242 --> 00:07:06,077
DIVERSITY OFFICER REVOLVE AROUND

174
00:07:06,077 --> 00:07:09,114
IMPROVING HEALTH EQUITY WHICH 

175
00:07:09,114 --> 00:07:10,916
INVOLVES UNDERSTANDING AND 

176
00:07:10,916 --> 00:07:12,083
MITIGATING THE LIFELONG HEALTH 

177
00:07:12,083 --> 00:07:15,153
IMPACT OF SOCIAL EXPERIENCES AND

178
00:07:15,153 --> 00:07:16,821
PERSONAL BACKGROUNDS SO TODAY, 

179
00:07:16,821 --> 00:07:19,157
WE'LL HEAR FROM INDIVIDUALS WITH

180
00:07:19,157 --> 00:07:20,592
LIVED EXPERIENCE AND THEN A 

181
00:07:20,592 --> 00:07:21,826
SCIENTIFIC PANEL THAT WILL FOCUS

182
00:07:21,826 --> 00:07:22,861
ON APPROACHES TO PAIN MANAG

183
00:07:22,861 --> 00:07:26,097
MANAGEMENT.  YOU KNOW, I KNOW 

184
00:07:26,097 --> 00:07:28,500
FROM MY PROFESSIONAL EXPERIENCE 

185
00:07:28,500 --> 00:07:29,534
AS YOU KNOW FROM YOUR EXPERIENCE

186
00:07:29,534 --> 00:07:32,337
OF PEOPLE LIVING WITH PAIN, AS 

187
00:07:32,337 --> 00:07:34,272
CAREGIVERS AND CARE PARTNERS, AS

188
00:07:34,272 --> 00:07:36,942
RESEARCHERS AND ADVOCATES, YOU 

189
00:07:36,942 --> 00:07:38,176
KNOW HOW UNIQUE A PERSON'S 

190
00:07:38,176 --> 00:07:41,246
EXPERIENCE CAN BE.  AND THE 

191
00:07:41,246 --> 00:07:42,380
IMPORTANCE OF CONTINUED 

192
00:07:42,380 --> 00:07:44,416
ADVANCEMENT IN PAIN RESEARCH.  

193
00:07:44,416 --> 00:07:46,585
SO YOUR INPUT DURING THIS 

194
00:07:46,585 --> 00:07:48,219
SYMPOSIUM WILL HELP TO INFORM 

195
00:07:48,219 --> 00:07:50,355
FUTURE RESEARCH.  SO I DO WANT 

196
00:07:50,355 --> 00:07:52,190
TO EXPRESS MY GRATITUDE TO ALL 

197
00:07:52,190 --> 00:07:55,660
OF TODAY'S SPEAKERS, TO THE 

198
00:07:55,660 --> 00:07:56,595
AUDIENCE MEMBERS OF THE 

199
00:07:56,595 --> 00:07:58,964
SYMPOSIUM AND TO THE ORGANIZERS 

200
00:07:58,964 --> 00:08:01,299
WHO I KNOW PUT IN COUNTLESS HOUR

201
00:08:01,299 --> 00:08:02,634
TO MAKE THIS MEETING HAPPEN.  

202
00:08:02,634 --> 00:08:04,569
THANK YOU FOR COMING TODAY.  WE 

203
00:08:04,569 --> 00:08:06,071
WILL DO THE WORK NECESSARY TO 

204
00:08:06,071 --> 00:08:08,139
ENSURE THE FUTURE OF PAIN 

205
00:08:08,139 --> 00:08:09,341
RESEARCH MEETS THE NEEDS OF ALL 

206
00:08:09,341 --> 00:08:12,344
SO PLEASE DO ENJOY THE REMAINDER

207
00:08:12,344 --> 00:08:16,481
OF THE EXCITING SYMPOSIUM AHEAD 

208
00:08:16,481 --> 00:08:26,825
OF YOU.  THANK YOU.

209
00:08:35,567 --> 00:08:43,141
>> GOOD MORNING.  THIS
ONE?  MY 

210
00:08:43,141 --> 00:08:47,112
NAME EDNA AND IT'S MY PLEASURE 

211
00:08:47,112 --> 00:08:48,480
TO INTRODUCE THE NEXT PANEL.  

212
00:08:48,480 --> 00:08:52,617
BUT BEFORE I DO THIS, I WANT TO 

213
00:08:52,617 --> 00:08:55,053
HIGHLIGHT THE CRUCIAL IMPORTANCE

214
00:08:55,053 --> 00:08:56,621
OF INCLUDING PERSPECTIVES OF 

215
00:08:56,621 --> 00:09:00,892
PEOPLE WITH LIVE EXPERIENCE IN 

216
00:09:00,892 --> 00:09:02,260
RESEARCH.  ESPECIALLY IN PAIN 

217
00:09:02,260 --> 00:09:05,130
RESEARCH.  NIH HAS EMBRACED THIS

218
00:09:05,130 --> 00:09:07,165
IN A NUMBER OF INITIATIVES AND 

219
00:09:07,165 --> 00:09:08,533
THE RESEARCH AND ULTIMATELY 

220
00:09:08,533 --> 00:09:12,671
HEALTH CARE WILL BE BETTER FOR 

221
00:09:12,671 --> 00:09:15,507
IT.  THE HEEL INITIATIVE HELPING

222
00:09:15,507 --> 00:09:17,809
TO END ADDICTION LONG-TERM HAS 

223
00:09:17,809 --> 00:09:20,045
LED THE WAY. 

224
00:09:20,045 --> 00:09:23,548
WITH THE HEAL COMMUNITY PARTNERS

225
00:09:23,548 --> 00:09:25,950
COMMUNITY.  HEAL PUTS A PRIORITY

226
00:09:25,950 --> 00:09:29,587
ON PATIENT AND COMMUNITY 

227
00:09:29,587 --> 00:09:30,522
PERSPECTIVES IN RESEARCH AND 

228
00:09:30,522 --> 00:09:33,224
REALLY WILL DRIVE SCIENTIFIC 

229
00:09:33,224 --> 00:09:35,827
SOLUTIONS FOR COMPLEX, 

230
00:09:35,827 --> 00:09:37,062
MULTIFACETED CONDITIONS, LIKE 

231
00:09:37,062 --> 00:09:39,631
PAIN THAT CANNOT BE EFFECTIVE 

232
00:09:39,631 --> 00:09:43,168
WITHOUT KNOWING IF, HOW, AND HOW

233
00:09:43,168 --> 00:09:45,537
WELL THEY HELP REAL PEOPLE WITH 

234
00:09:45,537 --> 00:09:48,773
PAINFUL CONDITIONS.  CONNECTING 

235
00:09:48,773 --> 00:09:50,709
WITH AFFECTED INDIVIDUALS IS 

236
00:09:50,709 --> 00:09:52,444
ALSO IMPORTANT FOR CHOOSING 

237
00:09:52,444 --> 00:09:55,080
MEANINGFUL RESEARCH OUTCOMES.  

238
00:09:55,080 --> 00:09:57,348
FOR EXAMPLE, LOOKING FOR 

239
00:09:57,348 --> 00:10:00,185
EFFECTIVE TREATMENT ON HOW PAIN 

240
00:10:00,185 --> 00:10:03,254
AFFECTS DAILY FUNCTION AND LIFE 

241
00:10:03,254 --> 00:10:05,223
SATISFACTION.  SO, THE HEAL 

242
00:10:05,223 --> 00:10:06,758
COMMUNITY PARTNERS COMMITTEE WAS

243
00:10:06,758 --> 00:10:11,062
ESTABLISHED IN 2021.  TO PROVIDE

244
00:10:11,062 --> 00:10:12,363
INPUT TO HEAL ON KEY ISSUES 

245
00:10:12,363 --> 00:10:15,166
FACED BY INDIVIDUALS AFFECTED BY

246
00:10:15,166 --> 00:10:17,402
PAIN CONDITIONS.  OR OPIOID USE 

247
00:10:17,402 --> 00:10:21,840
DISORDER TO ENSURE THE 

248
00:10:21,840 --> 00:10:23,141
RELEVANCE, AND PRACTICALITY OF 

249
00:10:23,141 --> 00:10:25,343
HEAL SUPPORTED RESEARCH.  INPUT 

250
00:10:25,343 --> 00:10:27,479
FROM THE COMMITTEE, WHICH 

251
00:10:27,479 --> 00:10:29,581
INCLUDES PATIENTS, ADVOCATES, 

252
00:10:29,581 --> 00:10:31,716
AND FAMILY MEMBERS OF PEOPLE 

253
00:10:31,716 --> 00:10:34,686
WITH PAIN AND ADDICTION IS USED 

254
00:10:34,686 --> 00:10:37,989
BY HEAL TO IDENTIFY, REFINE, AND

255
00:10:37,989 --> 00:10:39,824
PRIORITIZE PATIENT AND COMMUNITY

256
00:10:39,824 --> 00:10:41,993
ENGAGEMENT ACTIVITIES THAT WILL 

257
00:10:41,993 --> 00:10:44,529
ENSURE THE GREATEST RELEVANCE 

258
00:10:44,529 --> 00:10:47,799
AND IMPACT OF HEAL RESEARCH.  SO

259
00:10:47,799 --> 00:10:50,902
HERE ARE JUST A FEW EXAMPLES OF 

260
00:10:50,902 --> 00:10:54,606
PATIENT ENGAGEMENT IN HEAL 

261
00:10:54,606 --> 00:10:57,375
STUDIES.  IN THE HEAL FUNDED 

262
00:10:57,375 --> 00:10:59,177
HEMODIALYSIS OPIOID PRESCRIPTION

263
00:10:59,177 --> 00:11:03,148
EFFORT OR HOPE STUDY, PATIENTS 

264
00:11:03,148 --> 00:11:05,984
HAVE DESIGNED MATERIALS FOR 

265
00:11:05,984 --> 00:11:07,452
RECRUITMENT, PARTICIPATED IN THE

266
00:11:07,452 --> 00:11:11,156
WRITING OF INFORMED CONSENT 

267
00:11:11,156 --> 00:11:15,160
DOCUMENTS, AND DESIGN AND 

268
00:11:15,160 --> 00:11:18,496
PARTICIPATED IN INTRODUCTORY 

269
00:11:18,496 --> 00:11:19,631
VIDEOS TO PRESENT THE STUDY TO 

270
00:11:19,631 --> 00:11:21,833
POTENTIAL PARTICIPANTS.  ANOTHER

271
00:11:21,833 --> 00:11:25,336
EXAMPLE IS IN THE BACK PAIN 

272
00:11:25,336 --> 00:11:27,472
CONSORTIUM OR BACKPACK, 

273
00:11:27,472 --> 00:11:31,142
COMMUNITY MEMBERS IN ANN ARBOR 

274
00:11:31,142 --> 00:11:32,677
MICHIGAN ARE WORKING WITH HEAL 

275
00:11:32,677 --> 00:11:35,146
SCIENTIST TO GROUND RESEARCH IN 

276
00:11:35,146 --> 00:11:39,384
REALITY.  BASED ON COMMUNITY 

277
00:11:39,384 --> 00:11:39,651
FEEDBACK. 

278
00:11:39,651 --> 00:11:41,052
THE BACKPACK TEAM CONDUCTED 

279
00:11:41,052 --> 00:11:43,555
SEVERAL APPROACHES SUCH AS BEING

280
00:11:43,555 --> 00:11:45,590
OPEN ON WEEKENDS AND IN 

281
00:11:45,590 --> 00:11:46,191
LOCATIONS BEYOND UNIVERSITY 

282
00:11:46,191 --> 00:11:48,827
HOSPITALS OR CLINICS, PROVIDE 

283
00:11:48,827 --> 00:11:50,094
TRANSPORTATION TO STUDY LOCATION

284
00:11:50,094 --> 00:11:51,229
FOR PARTICIPANTS.  PARTNERING 

285
00:11:51,229 --> 00:11:56,367
WITH COMMUNITY MEMBERS TO CREATE

286
00:11:56,367 --> 00:11:57,035
FRIENDLY ENVIRONMENTS AND 

287
00:11:57,035 --> 00:11:57,836
DISCUSSION BETWEEN RESEARCHERS 

288
00:11:57,836 --> 00:12:01,739
AND COMMUNITY MEMBERS.  AND 

289
00:12:01,739 --> 00:12:03,842
ASSEMBLING COMMUNITY ADVISORY 

290
00:12:03,842 --> 00:12:05,343
BOARDS AFTER FIRST CONDUCTING 

291
00:12:05,343 --> 00:12:07,011
COMMUNITY FOCUS GROUPS ON HOW TO

292
00:12:07,011 --> 00:12:11,149
DO IT.  AND THE BACKPACK TEAM 

293
00:12:11,149 --> 00:12:12,584
ALSO CREATED TWO IMPORTANT 

294
00:12:12,584 --> 00:12:14,719
POSITIONS STAFFED BY COMMUNITY 

295
00:12:14,719 --> 00:12:18,122
MEMBERS.  A COMMUNITY RESEARCH 

296
00:12:18,122 --> 00:12:21,125
FACILITATOR AND A RECRUITMENT 

297
00:12:21,125 --> 00:12:23,161
LIAISON.  SO, IN THIS CONTEXT, I

298
00:12:23,161 --> 00:12:26,564
AM VERY HAPPY TO INTRODUCE OUR 

299
00:12:26,564 --> 00:12:29,200
PANEL MEMBERS FOR TODAY'S 

300
00:12:29,200 --> 00:12:29,934
DISCUSSION OF PERSPECTIVES OF 

301
00:12:29,934 --> 00:12:33,471
PEOPLE WITH LIVED EXPERIENCE.  

302
00:12:33,471 --> 00:12:35,173
SO, TWO OF THEM WILL BE ON ZOOM 

303
00:12:35,173 --> 00:12:35,773
AND TWO OF THEM WILL BE HERE 

304
00:12:35,773 --> 00:12:46,217
TODAY.  FIRST, EDEN BUELL 

305
00:12:49,787 --> 00:12:51,155
GRADUATED AND WAS A TRAINEE WITH

306
00:12:51,155 --> 00:12:55,159
A JUSTICE INVOLVED AND EMERGING 

307
00:12:55,159 --> 00:13:03,001
ADULT POPULATION OR JIEAP 

308
00:13:03,001 --> 00:13:05,136
INITIATIVE AT WHICH HE IS NUT 

309
00:13:05,136 --> 00:13:07,739
HEALTH SYSTEMS INSTITUTE.  EDEN 

310
00:13:07,739 --> 00:13:09,841
IS A DEDICATED MEMBER OF HEAL'S 

311
00:13:09,841 --> 00:13:11,175
CONNECTION.  LEVERAGING HER 

312
00:13:11,175 --> 00:13:13,177
PERSONAL EXPERIENCES TO 

313
00:13:13,177 --> 00:13:15,747
EFFECTIVELY SERVE AS ONE OF THE 

314
00:13:15,747 --> 00:13:19,150
FACILITATORS FOR THE HEAL'S 

315
00:13:19,150 --> 00:13:19,884
CONNECTIONS LIVED EXPERIENCE 

316
00:13:19,884 --> 00:13:24,589
PANEL.  HER INSIGHTS ARE 

317
00:13:24,589 --> 00:13:25,890
ESPECIALLY VALUABLE GIVEN HER 

318
00:13:25,890 --> 00:13:29,260
BACKGROUND AS AN AFRO LATINA WHO

319
00:13:29,260 --> 00:13:31,129
HAS GRAPPLED WITH MULTIPLE PAIN 

320
00:13:31,129 --> 00:13:31,462
CONDITIONS.  

321
00:13:31,462 --> 00:13:36,067
SINCE THE AGE OF 11.  EDEN 

322
00:13:36,067 --> 00:13:39,170
RECOGNIZES THE URGENT NEED FOR 

323
00:13:39,170 --> 00:13:41,572
EQUITABLE HEALTH CARE, 

324
00:13:41,572 --> 00:13:43,141
REGARDLESS OF IDENTITY AND SHE 

325
00:13:43,141 --> 00:13:45,810
HOPES TO BUILD A CAREER IN 

326
00:13:45,810 --> 00:13:47,478
RESEARCH ESPECIALLY FOCUSING ON 

327
00:13:47,478 --> 00:13:50,148
RECOVERY SUPPORT SERVICES, 

328
00:13:50,148 --> 00:13:51,549
HEALTH CARE DISPARITIES, STIGMA 

329
00:13:51,549 --> 00:13:53,685
AND DISCRIMINATION.  WITH A FIRM

330
00:13:53,685 --> 00:13:56,554
COMMITMENT TO ADDRESSING THESE 

331
00:13:56,554 --> 00:13:59,023
ISSUES.  EDEN STANDS AS A 

332
00:13:59,023 --> 00:14:00,325
DEDICATED ADVOCATE, POISED TO 

333
00:14:00,325 --> 00:14:01,926
MAKE LASTING IMPACT IN THE FIELD

334
00:14:01,926 --> 00:14:04,529
OF RESEARCH THROUGH THE LENS OF 

335
00:14:04,529 --> 00:14:09,534
HER LIVED EXPERIENCE.  NEXT, IS 

336
00:14:09,534 --> 00:14:12,670
CHARIS HILL WHO I BELIEVE IS 

337
00:14:12,670 --> 00:14:15,807
ONLINE.  OKAY.  IS A DISABILITY 

338
00:14:15,807 --> 00:14:19,143
ACTIVIST, WRITER, AND SPEAKER 

339
00:14:19,143 --> 00:14:24,048
LIVING WITH AXIAL RESPONSE DID I

340
00:14:24,048 --> 00:14:27,018
LOW ARTHRITIS, MAJOR DEPRESSIVE 

341
00:14:27,018 --> 00:14:28,653
DISORDER, ANXIETY AND 

342
00:14:28,653 --> 00:14:30,254
POST-TRAUMATIC STRESS DISORDER 

343
00:14:30,254 --> 00:14:33,725
IN THEIR WORK CHARIS USES 

344
00:14:33,725 --> 00:14:35,159
NARRATIVE ENGAGEMENT TO ADVANCE 

345
00:14:35,159 --> 00:14:38,596
SOCIAL JUSTICE FOR THOSE WITH 

346
00:14:38,596 --> 00:14:39,864
MULTIPLE DISABILITIES.  CHARIS 

347
00:14:39,864 --> 00:14:44,335
WRITES FOR VARIOUS MEDIA OUTLETS

348
00:14:44,335 --> 00:14:47,271
INCLUDING HEALTH CENTRAL, HEALTH

349
00:14:47,271 --> 00:14:51,843
LINE, BUSINESS INSIDER, AN KILO 

350
00:14:51,843 --> 00:14:53,978
RESPONSE DID I LYSIS NET AND 

351
00:14:53,978 --> 00:14:55,446
THIS LIFE AND HAS HAD COVER 

352
00:14:55,446 --> 00:14:57,915
STORIES FOR ARTHRITIS TODAY AND 

353
00:14:57,915 --> 00:15:01,386
RESPONSE DID I LIGHTS MAGAZINE. 

354
00:15:01,386 --> 00:15:03,154
CHARIS GRADUATED FROM MEREDITH 

355
00:15:03,154 --> 00:15:04,889
COLLEGE WITH A BA IN PSYCHOLOGY 

356
00:15:04,889 --> 00:15:10,962
IN WOMEN'S STUDIES.  CHARIS IS 

357
00:15:10,962 --> 00:15:11,295
D 

358
00:15:11,295 --> 00:15:13,164
DEEPLY INVOLVED IN LEGISLATIVE 

359
00:15:13,164 --> 00:15:15,066
CAMPAIGN TO IMPROVE RESPONSE DID

360
00:15:15,066 --> 00:15:16,501
I LIGHTS AND DISABILITY 

361
00:15:16,501 --> 00:15:16,801
EDUCATION.  

362
00:15:16,801 --> 00:15:21,839
FUNDING AND ACCESS TO TREATMENT.

363
00:15:21,839 --> 00:15:26,611
SHE WORKED -- IN 2021, THEY 

364
00:15:26,611 --> 00:15:29,113
WORKED WITH CONGRESSWOMAN DORIS 

365
00:15:29,113 --> 00:15:31,682
MAT SUE WEE AND THE SHON DID I 

366
00:15:31,682 --> 00:15:33,851
LIGHTS ASSOCIATION OF AMERICA TO

367
00:15:33,851 --> 00:15:37,155
INTRODUCE RESOLUTION 135 WHICH 

368
00:15:37,155 --> 00:15:40,425
IF PASSED WILL DECLARE MAY AS 

369
00:15:40,425 --> 00:15:41,759
RESPONSE DID I LOW LIGHTS 

370
00:15:41,759 --> 00:15:43,094
AWARENESS MONTH. 

371
00:15:43,094 --> 00:15:44,929
CHARIS WAS AWARDED THE PROGRESS 

372
00:15:44,929 --> 00:15:46,964
IN POLICY AWARD BY THE ARTHRITIS

373
00:15:46,964 --> 00:15:48,699
FOUNDATION FOR EFFORTS IN 

374
00:15:48,699 --> 00:15:50,835
STATEWIDE AND NATIONAL 

375
00:15:50,835 --> 00:15:51,836
LEGISLATIVE ADVOCACY EFFORTS AND

376
00:15:51,836 --> 00:16:02,580
WAS RECOGNIZED IN 2021 ASSE AS 

377
00:16:03,915 --> 00:16:06,751
ADVOCACY VOLUNTEER OF THE YEAR. 

378
00:16:06,751 --> 00:16:10,288
WE HAVE ALSO SONYA WHO IS THE 

379
00:16:10,288 --> 00:16:12,690
AUTHOR OF BOOKS, ESSAYS AND 

380
00:16:12,690 --> 00:16:14,725
ARTICLES, TEACHES AT FAIRFIELD 

381
00:16:14,725 --> 00:16:17,562
UNIVERSITY AND IN FAIRFIELD 

382
00:16:17,562 --> 00:16:20,398
RESIDENCY FMA PROGRAMS HER WORK 

383
00:16:20,398 --> 00:16:21,999
BEFORE ACADEMIA INCLUDE THE WORK

384
00:16:21,999 --> 00:16:24,001
IN THE NONPROFIT SECTOR AS WELL 

385
00:16:24,001 --> 00:16:27,171
AS JOURNALISM AND SOCIAL WORK.  

386
00:16:27,171 --> 00:16:30,541
SHE RECEIVED A KIPLINGER 

387
00:16:30,541 --> 00:16:34,278
FELLOWSHIP IN PUBLIC INTEREST 

388
00:16:34,278 --> 00:16:37,115
JOURNALISM AND IN FMA IN 

389
00:16:37,115 --> 00:16:39,117
CREATIVE WRITING WITH THE OHIO 

390
00:16:39,117 --> 00:16:39,717
STATE UNIVERSITY.  HER BOOKS 

391
00:16:39,717 --> 00:16:43,154
INCLUDE COVER ME, A HEALTH 

392
00:16:43,154 --> 00:16:45,490
INSURANCE MEMOIR AND PAIN WOMAN 

393
00:16:45,490 --> 00:16:48,259
TAKES YOUR KEYS AND OTHER ESSAYS

394
00:16:48,259 --> 00:16:50,495
FROM A NERVOUS SYSTEM.  HER 

395
00:16:50,495 --> 00:16:51,362
ESSAYS HAVE APPEARED IN THE NEW 

396
00:16:51,362 --> 00:16:54,265
YORK TIMES, CREATIVE NONFICTION,

397
00:16:54,265 --> 00:16:56,100
BREVITY IN WASHINGTON POST, THE 

398
00:16:56,100 --> 00:16:59,003
ATLANTIC AND OTHER OUTLETS.  SHE

399
00:16:59,003 --> 00:17:03,341
RECEIVED A 2012 CREATIVE 

400
00:17:03,341 --> 00:17:05,510
NONFICTION AWARD FROM TUR RAIN 

401
00:17:05,510 --> 00:17:09,580
AND HER ESSAYS WERE NOTABLE IN 

402
00:17:09,580 --> 00:17:11,349
BEST AMERICAN ESSAYS MANY TIMES.

403
00:17:11,349 --> 00:17:17,855
SONYA IS ALSO A DISABILITY 

404
00:17:17,855 --> 00:17:19,323
ADVOCATE AND HAS BEEN ACTIVE FOR

405
00:17:19,323 --> 00:17:20,558
TREATMENTS AND SUPPORT FOR 

406
00:17:20,558 --> 00:17:23,161
CHRONIC PATIENTS.  SHE WAS THE 

407
00:17:23,161 --> 00:17:24,929
COFOUNDER OF THE ACTIVIST 

408
00:17:24,929 --> 00:17:27,165
NETWORK IN COLUMBUS, OHIO AND 

409
00:17:27,165 --> 00:17:31,102
MOST RECENTLY FOUNDED THE 2017 

410
00:17:31,102 --> 00:17:32,003
ONLINE DISABILITY MARCH 

411
00:17:32,003 --> 00:17:34,405
CURRENTLY SERVED AS A COMMUNITY 

412
00:17:34,405 --> 00:17:36,440
BOARD MEMBER FOR THE NATIONAL 

413
00:17:36,440 --> 00:17:42,747
PAIN ACTION CENTER AND FINALLY, 

414
00:17:42,747 --> 00:17:44,215
SHAREE TURPIN SEEKS OUT STORIES 

415
00:17:44,215 --> 00:17:45,883
THAT NO ONE WANTS, HER PASSIONS 

416
00:17:45,883 --> 00:17:47,418
ARE FOR THE ARTS, PUBLIC HEALTH 

417
00:17:47,418 --> 00:17:51,155
AND MEDICINE.  BUT EVERY NOW AND

418
00:17:51,155 --> 00:17:54,792
THEN FINDS A STORY ON HOW BOTH 

419
00:17:54,792 --> 00:17:56,727
COLLIDE.  AS A GRADUATE OF NEW 

420
00:17:56,727 --> 00:17:58,829
HOUSE AT SYRACUSE UNIVERSITY SHE

421
00:17:58,829 --> 00:18:02,767
HAS BEEN GIVEN THE CHANCE TO 

422
00:18:02,767 --> 00:18:05,403
INTERVIEW CURTIS BLOW. 

423
00:18:05,403 --> 00:18:09,040
GODFATHER OF HIP HOP, FRANK 

424
00:18:09,040 --> 00:18:11,175
MARSHALL, HOLLYWOOD'S FAVORITE 

425
00:18:11,175 --> 00:18:17,248
PRODUCE OF FILMS SUCH AS  JURY 

426
00:18:17,248 --> 00:18:19,150
RAS SICK PARK, SHE IS KNOWN FOR 

427
00:18:19,150 --> 00:18:20,952
HER ADVOCACY FOR SICKLE CELL 

428
00:18:20,952 --> 00:18:21,519
DISEASE. 

429
00:18:21,519 --> 00:18:24,355
AS A PATIENT OF THE DISEASE HER 

430
00:18:24,355 --> 00:18:24,956
SHAREE KNOWS THE TRICKS AND 

431
00:18:24,956 --> 00:18:28,226
HIDDEN DOORS IT TAKES TO SURVIVE

432
00:18:28,226 --> 00:18:31,062
DEALING WITH A CHRONIC ILLNESS 

433
00:18:31,062 --> 00:18:32,463
IN THE HEALTH CARE SYSTEM 

434
00:18:32,463 --> 00:18:33,631
SOMETIMES DOES NOT ACKNOWLEDGE 

435
00:18:33,631 --> 00:18:35,833
HER EXISTENCE.  SHE CURRENTLY 

436
00:18:35,833 --> 00:18:39,503
WORKS AS A PATIENT NAVIGATOR AT 

437
00:18:39,503 --> 00:18:41,973
THE CHILDREN'S HOSPITAL IN 

438
00:18:41,973 --> 00:18:42,907
ROCHESTER NEW YORK, SUPPORTING 

439
00:18:42,907 --> 00:18:45,076
CHILDREN AND FAMILIES AFFECTED 

440
00:18:45,076 --> 00:18:47,144
BY SICKLE CELL.  SO AS YOU CAN 

441
00:18:47,144 --> 00:18:51,148
SEE, WE HAVE QUITE A PANEL.  AND

442
00:18:51,148 --> 00:18:54,151
WE ARE VERY EXCITED TO HAVING 

443
00:18:54,151 --> 00:18:55,653
THIS VERY, VERY IMPORTANT 

444
00:18:55,653 --> 00:18:57,154
DISCUSSION SO WELCOME FOR THE 

445
00:18:57,154 --> 00:18:58,823
TWO OF YOU ONLINE AND THE TWO OF

446
00:18:58,823 --> 00:18:59,457
YOU HERE IN-PERSON TODAY.  THANK

447
00:18:59,457 --> 00:19:09,567
YOU.

448
00:19:33,924 --> 00:19:37,962
>> THANK YOU SO MUCH FOR
HAVING 

449
00:19:37,962 --> 00:19:39,196
ME, AFTER BEING INTRODUCED LIKE 

450
00:19:39,196 --> 00:19:41,098
THAT I FEEL VERY, VERY SPECIAL. 

451
00:19:41,098 --> 00:19:43,167
I WANT TO TAKE A MOMENT TO SEE 

452
00:19:43,167 --> 00:19:45,069
THAT I AM AN INDIVIDUAL WITH 

453
00:19:45,069 --> 00:19:47,004
LIVED EXPERIENCE.  I HAVE TWO 

454
00:19:47,004 --> 00:19:49,507
PAIN CONDITIONS.  ONE IS VERY 

455
00:19:49,507 --> 00:19:52,209
GENDER SPECIFIC.  I HAVE 

456
00:19:52,209 --> 00:19:53,577
ENDOMETRIOSIS.  I'VE HAD THAT 

457
00:19:53,577 --> 00:19:54,945
SINCE 11 AND THAT MEANS I'VE HAD

458
00:19:54,945 --> 00:19:59,483
IT FOR 24 YEARS SO JUST SUPER 

459
00:19:59,483 --> 00:20:02,720
AGED MYSELF.  AND I AM ALSO AN 

460
00:20:02,720 --> 00:20:04,422
INDIVIDUAL THAT WAS RECENTLY 

461
00:20:04,422 --> 00:20:05,723
DIAGNOSED WITH LUPUS AND I'M 

462
00:20:05,723 --> 00:20:08,526
STILL LEARNING WHAT THAT LOOKS 

463
00:20:08,526 --> 00:20:11,162
LIKE, HOW TO NAVIGATE THAT AND 

464
00:20:11,162 --> 00:20:14,198
JUST KIND OF MAKING MY WAY.  BUT

465
00:20:14,198 --> 00:20:16,467
JUST KIND OF HOW MY BIO SAID, I 

466
00:20:16,467 --> 00:20:18,636
AM -- I WISH I WAS HERE TO 

467
00:20:18,636 --> 00:20:19,437
REALLY TALK ABOUT MYSELF BUT THE

468
00:20:19,437 --> 00:20:21,872
REALITY IS I AM A PATIENT 

469
00:20:21,872 --> 00:20:22,707
ADVOCATE THROUGH AND THROUGH.  

470
00:20:22,707 --> 00:20:25,576
AND I AM HERE TO TALK ABOUT MY 

471
00:20:25,576 --> 00:20:29,246
GIRL, MY MOM.  HER NAME IS 

472
00:20:29,246 --> 00:20:30,848
KELLEY RIVERA, SHE WAS A DOUBLE 

473
00:20:30,848 --> 00:20:35,152
LEG AMPUTEE ON DIALYSIS.  AND I 

474
00:20:35,152 --> 00:20:38,456
AM A POSTBAC LAUREATE TRAINEE SO

475
00:20:38,456 --> 00:20:41,258
I LIKE TO TELL PEOPLE I'VE TAKEN

476
00:20:41,258 --> 00:20:43,094
THE SCENIC ROUTE TO COLLEGE AND 

477
00:20:43,094 --> 00:20:44,328
THROUGHOUT MY COLLEGE CAREER I 

478
00:20:44,328 --> 00:20:45,763
HAD THE PRIVILEGE OF PROVIDING 

479
00:20:45,763 --> 00:20:47,698
CARE FOR HER AND TAKING CARE OF 

480
00:20:47,698 --> 00:20:50,768
HER UNTIL SHE PASSED ON.  

481
00:20:50,768 --> 00:20:55,139
MY MOM WAS A WARRIOR.  SHE WAS 

482
00:20:55,139 --> 00:21:00,344
DEFINITELY AN INDIVIDUAL THAT 

483
00:21:00,344 --> 00:21:03,013
KEPT FIGHT.  SHE HAD NINE 

484
00:21:03,013 --> 00:21:08,252
REVISIONARY SURGERIES ON HER 

485
00:21:08,252 --> 00:21:10,054
LEG.  SHE HAD MULTIPLE FISTULAS 

486
00:21:10,054 --> 00:21:12,089
AND HEART ATTACKS AND THE PAIN 

487
00:21:12,089 --> 00:21:14,158
SHE HAD TO ENDURE IS SOMETHING 

488
00:21:14,158 --> 00:21:16,761
THAT I WOULD NEVER WANT TO GO 

489
00:21:16,761 --> 00:21:18,929
THROUGH.  BUT I ADMIRED HER 

490
00:21:18,929 --> 00:21:23,167
STRENGTH AND HER WILL TO KEEP 

491
00:21:23,167 --> 00:21:25,803
GOING.  AND WHEN WE -- WE DID 

492
00:21:25,803 --> 00:21:27,905
EVERYTHING WE COULD TO KEEP HER 

493
00:21:27,905 --> 00:21:31,475
AROUND.  SHE WAS 52 WHEN SHE 

494
00:21:31,475 --> 00:21:35,179
PASSED AND WE HAD A BUMP IN THE 

495
00:21:35,179 --> 00:21:38,015
ROAD CALLED CALENDAR SI FEW LACK

496
00:21:38,015 --> 00:21:41,085
SIS.  IT'S WHEN YOUR CAPILLARIES

497
00:21:41,085 --> 00:21:43,521
FILL WITH CALCIUM SO WE'RE AT A 

498
00:21:43,521 --> 00:21:45,689
STANDSTILL, WE'RE NOT GOING TO 

499
00:21:45,689 --> 00:21:47,625
WIN.  AND MY MOM, BEING A 

500
00:21:47,625 --> 00:21:49,593
PATIENT THAT SHE WAS, IN 

501
00:21:49,593 --> 00:21:51,862
HOSPITAL, KNEW SOMETHING WAS 

502
00:21:51,862 --> 00:21:54,365
WRONG.  SHE KNEW THAT THIS ISN'T

503
00:21:54,365 --> 00:21:57,835
THE NORMAL NORMAL THAT SHE'S 

504
00:21:57,835 --> 00:22:01,305
TAKEN IN THE HOSPITAL BEFORE AND

505
00:22:01,305 --> 00:22:05,910
WIZ  WAS REALLY CONFUSED ON WHAT

506
00:22:05,910 --> 00:22:08,212
WAS GOING ON WITH HER. 

507
00:22:08,212 --> 00:22:09,847
WHILE ON THE HOSPITAL BED SHE 

508
00:22:09,847 --> 00:22:11,949
WROTE AN AMAZING POEM THAT SPEAK

509
00:22:11,949 --> 00:22:13,684
TO THE PATIENT EXPERIENCE THAT I

510
00:22:13,684 --> 00:22:14,985
HOPE THAT EVERYONE AT SOME POINT

511
00:22:14,985 --> 00:22:16,687
CAN HEAR BECAUSE IT'S AMAZING 

512
00:22:16,687 --> 00:22:18,389
THAT THIS INDIVIDUAL WHO HAS 

513
00:22:18,389 --> 00:22:20,257
FOUGHT SO HARD CAN WRITE 

514
00:22:20,257 --> 00:22:22,393
SOMETHING SO BEAUTIFUL AND IF I 

515
00:22:22,393 --> 00:22:23,994
COULD I'D LIKE TO SHARE THAT 

516
00:22:23,994 --> 00:22:26,430
WITH YOU ALL RIGHT NOW IS POEM 

517
00:22:26,430 --> 00:22:30,701
IS TITLED UNRELIABLE AND WRITTEN

518
00:22:30,701 --> 00:22:35,239
BY KELLIANNE RIVERA. 

519
00:22:35,239 --> 00:22:37,308
I TELL YOU WHAT'S HAPPENED.  

520
00:22:37,308 --> 00:22:38,843
WHAT ISN'T QUITE RIGHT.  WHAT 

521
00:22:38,843 --> 00:22:41,011
I'M EXPERIENCING, MY FEARS, MY 

522
00:22:41,011 --> 00:22:45,382
PAINS, MY STRAINS, WHAT MAKES ME

523
00:22:45,382 --> 00:22:48,085
UNRELIABLE.  WHAT MAKES ME 

524
00:22:48,085 --> 00:22:49,186
UNTRUSTWORTHY.  UNBELIEVABLE.  

525
00:22:49,186 --> 00:22:53,057
CAN YOU FEEL MY FEELINGS?  MY 

526
00:22:53,057 --> 00:22:54,725
EXPERIENCES?  MY TREMORS?  DO 

527
00:22:54,725 --> 00:22:55,860
YOU HAVE ENOUGH EMPATHY TO KNOW 

528
00:22:55,860 --> 00:22:59,196
WHAT I SEE IS REAL?  THAT MY 

529
00:22:59,196 --> 00:23:02,066
PAIN IS REAL.  THAT MY FEARS, 

530
00:23:02,066 --> 00:23:06,003
RIGHT OR WRONG, ARE REAL.  I ASK

531
00:23:06,003 --> 00:23:13,010
YOU AS A HUMAN NOT AS A TITLE, 

532
00:23:13,010 --> 00:23:15,880
AN RN, TO LISTEN AND HEAR, GIVE 

533
00:23:15,880 --> 00:23:17,114
ME THE BENEFIT OF THE DOUBT.  

534
00:23:17,114 --> 00:23:20,885
LOOK AT ME AS A PERSON, NOT AS A

535
00:23:20,885 --> 00:23:23,153
PATIENT.  CHART.  ILLNESS.  JUST

536
00:23:23,153 --> 00:23:25,823
ANOTHER CASE.  LOOK AT ME AS A 

537
00:23:25,823 --> 00:23:29,093
FIGHTER, A SURVIVOR, AS A PERSON

538
00:23:29,093 --> 00:23:31,161
WHO DIDN'T GIVE UP.  ONE WHO 

539
00:23:31,161 --> 00:23:33,597
ROLLS WITH THE PUNCHES YET STILL

540
00:23:33,597 --> 00:23:36,333
FINDS A WAY TO KEEP A SMILE ON 

541
00:23:36,333 --> 00:23:38,802
MY FACE AND MAYBE IF GIVEN THE 

542
00:23:38,802 --> 00:23:41,105
CHANCE I COULD PUT ONE ON YOURS 

543
00:23:41,105 --> 00:23:43,140
TOO.  LOOK AT ME, KELLEY, THE 

544
00:23:43,140 --> 00:23:46,310
MOTHER, GRANDMOTHER, WIFE, 

545
00:23:46,310 --> 00:23:48,379
DAUGHTER, FRIEND, LOOK AT ME AND

546
00:23:48,379 --> 00:23:53,918
THEN DECIDE IF I AM UNRELIABLE. 

547
00:23:53,918 --> 00:23:57,688
MY MOM WOULD PASS A FEW MONTHS 

548
00:23:57,688 --> 00:24:06,897
AFTER THIS.  AND IT JUST GOES TO

549
00:24:06,897 --> 00:24:09,400
SHOW THAT WE'RE A PEOPLE.  WE'RE

550
00:24:09,400 --> 00:24:11,001
TALKING ABOUT ILLNESSES AND PAIN

551
00:24:11,001 --> 00:24:12,369
AND GENDER WHICH IS GREAT BUT AT

552
00:24:12,369 --> 00:24:14,204
THE END OF THE DAY THERE'S A 

553
00:24:14,204 --> 00:24:16,473
HUMAN ELEMENT THAT WE ALL HAVE 

554
00:24:16,473 --> 00:24:18,175
TO KIND OF BLOCK OFF TO KIND OF 

555
00:24:18,175 --> 00:24:19,143
KEEP GOING.  BUT IT'S SOMETHING 

556
00:24:19,143 --> 00:24:23,147
THAT MY MOM WANTED TO REMIND US 

557
00:24:23,147 --> 00:24:28,619
ALL AND SO THAT IS BEEN THE 

558
00:24:28,619 --> 00:24:30,187
MESSAGE THAT I HOPE TO CONTINUE 

559
00:24:30,187 --> 00:24:33,857
ON, CONTINUE TO LIVE THROUGH HER

560
00:24:33,857 --> 00:24:36,293
AND SPREAD HER MESSAGE THAT 

561
00:24:36,293 --> 00:24:38,062
WE'RE HUMANS AND NOT PATIENTS 

562
00:24:38,062 --> 00:24:41,966
AND CHARTS.  SO THAT'S ALL, 

563
00:24:41,966 --> 00:24:52,076
THANK YOU.

564
00:24:52,076 --> 00:24:56,046
>> THANK YOU, EDEN, I AM 

565
00:24:56,046 --> 00:24:57,881
WONDERING IF YOU CAN SHARE A 

566
00:24:57,881 --> 00:24:59,917
LITTLE BIT.  THERE THE PAST YOU 

567
00:24:59,917 --> 00:25:02,119
SHARED WHY SHE WAS REACTING TO 

568
00:25:02,119 --> 00:25:03,554
THAT.  WHY SHE WAS FEELING 

569
00:25:03,554 --> 00:25:05,889
PEOPLE THOUGHT SHE WAS 

570
00:25:05,889 --> 00:25:06,557
UNRELIABLE.  WHAT WAS THE WHOLE 

571
00:25:06,557 --> 00:25:07,157
STORY BEHIND THAT?

572
00:25:07,157 --> 00:25:09,693
>> YEAH, THANK YOU.  I
WASN'T 

573
00:25:09,693 --> 00:25:11,528
ABOUT TO CRY UP HERE, YA'LL.  SO

574
00:25:11,528 --> 00:25:15,165
I HAD TO THINK.  SO WHAT 

575
00:25:15,165 --> 00:25:18,769
HAPPENED IS, WHEN MY MOM, I 

576
00:25:18,769 --> 00:25:21,705
FOUND OUT THAT MY MOM HAD 

577
00:25:21,705 --> 00:25:24,742
CALENDAR SI IF A LACK SIS BEFORE

578
00:25:24,742 --> 00:25:31,181
SHE DID.  AND I KNEW WHAT WAS 

579
00:25:31,181 --> 00:25:33,183
GOING ON AND THE DIAGNOSIS.  AND

580
00:25:33,183 --> 00:25:34,518
AT THE SAME TIME AS I'M GOING TO

581
00:25:34,518 --> 00:25:36,620
COLLEGE AND LEARNING ABOUT HEAL 

582
00:25:36,620 --> 00:25:40,457
HEALTH CARE DISPARITIES AND 

583
00:25:40,457 --> 00:25:41,358
INEQUITIES I AM EXPERIENCING 

584
00:25:41,358 --> 00:25:43,160
THEM IN REALTIME WITH MY MOM AND

585
00:25:43,160 --> 00:25:47,831
SO WE CAME TO THIS CROSS ROAD OF

586
00:25:47,831 --> 00:25:49,867
WHAT IS GOING ON, EDEN AND I 

587
00:25:49,867 --> 00:25:51,902
SAID, IT'S ABOVE MY PAY GRADE, 

588
00:25:51,902 --> 00:25:56,006
MOM.  WE ALWAYS HAD THIS REALLY 

589
00:25:56,006 --> 00:26:03,113
FUNNY RELATIONSHIP AND WHEN SHE 

590
00:26:03,113 --> 00:26:05,449
NEW SOMETHING WAS GOING ON AND 

591
00:26:05,449 --> 00:26:07,084
NOBODY WANTED TO TELL HER.  NOT 

592
00:26:07,084 --> 00:26:11,021
EVEN HER DAUGHTER COULD COME AND

593
00:26:11,021 --> 00:26:14,992
TELL HER.  IT WAS REALLY HARD 

594
00:26:14,992 --> 00:26:16,627
FOR HER AND I REALLY THANK YOU 

595
00:26:16,627 --> 00:26:18,028
FOR BRINGING THIS UP BECAUSE ONE

596
00:26:18,028 --> 00:26:20,297
OF THE MOST PARTS OF THIS WHOLE 

597
00:26:20,297 --> 00:26:24,268
STORY IS THE AMAZING PCP MY MOM 

598
00:26:24,268 --> 00:26:26,837
HAD AND AND A NURSE CARE 

599
00:26:26,837 --> 00:26:27,905
NAVIGATOR WHO WAS TREMENDOUS, 

600
00:26:27,905 --> 00:26:30,107
LIKE IN KEEPING HER ALIVE FOR AS

601
00:26:30,107 --> 00:26:32,910
LONG AS WE DID AND KEEPING HER 

602
00:26:32,910 --> 00:26:35,879
AS HEALTHY AS WE COULD FOR AS 

603
00:26:35,879 --> 00:26:37,481
LONG AS WE DID.  AND THEY CAME 

604
00:26:37,481 --> 00:26:40,918
TO HER BEDSIDE TO TELL HER THAT 

605
00:26:40,918 --> 00:26:42,820
SHE HAD CALENDAR SI FEW LACK SIS

606
00:26:42,820 --> 00:26:45,389
SO IT WASN'T GOING TO BE SOME 

607
00:26:45,389 --> 00:26:47,558
DOCTOR THAT HAD MET HER FOR FIVE

608
00:26:47,558 --> 00:26:49,827
MINUTES OR FIFTEEN MINUTES A 

609
00:26:49,827 --> 00:26:50,894
DAY.  IT WAS GOING TO BE HER 

610
00:26:50,894 --> 00:26:53,931
PRIMARY CARE BUT LEADING UP TO 

611
00:26:53,931 --> 00:26:57,434
THAT MOMENT SHE JUST FELT LIKE 

612
00:26:57,434 --> 00:26:58,802
SHOW WASN'T TRUSTWORTHY THOUSAND

613
00:26:58,802 --> 00:27:00,304
KNOW WHAT WAS GOING ON WITH HER 

614
00:27:00,304 --> 00:27:03,874
AND HER OWN BODY.  SHE WOULD SEE

615
00:27:03,874 --> 00:27:06,410
YOU MAY KNOW THE BODY BUT I KNOW

616
00:27:06,410 --> 00:27:09,079
MY BODY AND SHE FELT SO UNWORTHY

617
00:27:09,079 --> 00:27:10,481
OF BEING TOLD WHAT WIZ GOING ON 

618
00:27:10,481 --> 00:27:11,148
IN A WAY THAT SHE COULD 

619
00:27:11,148 --> 00:27:17,788
UNDERSTAND.  AND I'M LUCKY I WAS

620
00:27:17,788 --> 00:27:19,156
ABLE TO LIKE KIND OF HELP HER 

621
00:27:19,156 --> 00:27:21,625
NAVIGATE THIS CRAZY WORLD OF 

622
00:27:21,625 --> 00:27:22,659
MEDICINE, RIGHT?

623
00:27:22,659 --> 00:27:25,028
BUT INDIVIDUALS OUT THERE, THEY 

624
00:27:25,028 --> 00:27:27,231
DON'T HAVE ALWAYS, LIKE A JUDY 

625
00:27:27,231 --> 00:27:31,668
OR A DR. ALISON TO GET THEM 

626
00:27:31,668 --> 00:27:35,139
THROUGH STUFF.  SO, YEAH, THAT'S

627
00:27:35,139 --> 00:27:39,143
PART OF THAT EXPERIENCE.

628
00:27:39,143 --> 00:27:41,411
>> THANK YOU I THINK WE
HAVE A 

629
00:27:41,411 --> 00:27:43,080
Q&A AT THE END AND I'M SURE
YOU 

630
00:27:43,080 --> 00:27:43,947
HAVE PROBABLY MORE TO SEE DURING

631
00:27:43,947 --> 00:27:47,151
THAT Q&A.  IF YOU'RE ONLINE
YOU 

632
00:27:47,151 --> 00:27:50,187
CAN SEND AN E-MAIL QUESTIONS IN 

633
00:27:50,187 --> 00:27:53,123
AND WE CAN VOICE THEM.  NEXT I 

634
00:27:53,123 --> 00:27:55,025
THINK WE'RE GOING IN 

635
00:27:55,025 --> 00:27:56,693
ALPHABETICAL ORDER BY LAST NAME 

636
00:27:56,693 --> 00:28:01,665
SO I HAVE THE PRIVILEGE OF 

637
00:28:01,665 --> 00:28:03,167
INTRODUCING OUR NEXT SPEAKER WHO

638
00:28:03,167 --> 00:28:08,806
IS A REALLY COOL NAME OF ALL 

639
00:28:08,806 --> 00:28:10,207
THEIR OTHER ACCOMPLISHMENTS 

640
00:28:10,207 --> 00:28:12,376
CHARIS AND THEY GAVE US AN EASY 

641
00:28:12,376 --> 00:28:15,145
WAY TO REMEMBER THEIR NAME WHICH

642
00:28:15,145 --> 00:28:23,153
IS I THINK KARMA, CHARIS AND 

643
00:28:23,153 --> 00:28:25,622
WITH THAT I WILL INTRODUCE 

644
00:28:25,622 --> 00:28:25,956
CHARIS.

645
00:28:25,956 --> 00:28:27,157
>> THANK YOU, GOOD
MORNING, 

646
00:28:27,157 --> 00:28:29,426
EVERYONE, I AM IN CALIFORNIA SO 

647
00:28:29,426 --> 00:28:34,264
IT'S VERY EARLY FOR ME.  I LIKE 

648
00:28:34,264 --> 00:28:35,165
KARMA.  BUT IT'S ACTUALLY 

649
00:28:35,165 --> 00:28:39,169
CHARISMA IS WHAT I SHARED.  

650
00:28:39,169 --> 00:28:41,772
EITHER'S FINE.  SO I THANK YOU 

651
00:28:41,772 --> 00:28:43,807
FOR HAVING ME HERE WITH YOU 

652
00:28:43,807 --> 00:28:45,409
TODAY.  IT'S AN HONOR TO BE ABLE

653
00:28:45,409 --> 00:28:48,946
TO SPEAK WITH YOU ALL TO JOIN A 

654
00:28:48,946 --> 00:28:52,816
GREAT PANEL OF PEOPLE.  I AM 

655
00:28:52,816 --> 00:28:55,152
HERE TODAY AS SOMEONE WHO HAS 

656
00:28:55,152 --> 00:28:56,854
CHRONIC PAIN.  I HAVE HAD 

657
00:28:56,854 --> 00:29:00,557
CHRONIC PAIN SINCE I WAS A KID. 

658
00:29:00,557 --> 00:29:03,160
SINCE BEFORE I WAS A TEENAGER.  

659
00:29:03,160 --> 00:29:06,763
BUT I'M ALSO HERE TODAY AS A 

660
00:29:06,763 --> 00:29:09,166
TRANS PERSON.  AND AS SOMEONE 

661
00:29:09,166 --> 00:29:11,635
WHO LIVES IN FORCED POVERTY ON 

662
00:29:11,635 --> 00:29:15,138
SOCIAL SECURITY DISABILITY.  SO 

663
00:29:15,138 --> 00:29:20,711
I RELY ON TWELVE HUNDRED DOLLARS

664
00:29:20,711 --> 00:29:23,080
A MONTH TO LIVE.  SO AND ALL OF 

665
00:29:23,080 --> 00:29:26,483
THOSE THINGS INTERSECT IN HOW I 

666
00:29:26,483 --> 00:29:30,220
APPROACH AND RECEIVE MY CARE.  I

667
00:29:30,220 --> 00:29:33,557
WILL SHARE A LITTLE BIT ABOUT MY

668
00:29:33,557 --> 00:29:36,927
DIAGNOSIS STORY SO I WAS 

669
00:29:36,927 --> 00:29:39,162
ASSIGNED FEMALE AT BIRTH.  MY 

670
00:29:39,162 --> 00:29:41,498
DAD HAD A DISEASE THAT I 

671
00:29:41,498 --> 00:29:42,833
COULDN'T REMEMBER THE NAME OF 

672
00:29:42,833 --> 00:29:46,236
BUT IT WAS A MAN'S DISEASE SO I 

673
00:29:46,236 --> 00:29:51,541
WASN'T GOING TO GET IT TURNS OUT

674
00:29:51,541 --> 00:30:01,485
I GOT IT.  BUT IT TURNED OUT 

675
00:30:01,485 --> 00:30:03,887
THAT MY DELAYED DIAGNOSIS WAS 

676
00:30:03,887 --> 00:30:05,756
OVER 13 YEARS -- PARTIALLY 

677
00:30:05,756 --> 00:30:07,157
BECAUSE OF THAT -- PARTLY 

678
00:30:07,157 --> 00:30:09,860
BECAUSE I INTERNALIZED MY PAIN. 

679
00:30:09,860 --> 00:30:11,962
BECAUSE WHEN YOU'RE A KID, YOU 

680
00:30:11,962 --> 00:30:13,497
KNOW, YOU WANT TO BE LIKE YOUR 

681
00:30:13,497 --> 00:30:15,499
PEERS AND MY PEERS WEREN'T 

682
00:30:15,499 --> 00:30:17,434
COMPLAINING ABOUT PAIN, YOU 

683
00:30:17,434 --> 00:30:18,735
KNOW, THEY WEREN'T SEEING OH, 

684
00:30:18,735 --> 00:30:21,104
I'M CRYING MYSELF TO SLEEP 

685
00:30:21,104 --> 00:30:22,005
BECAUSE OF MY PAIN EVERY NIGHT 

686
00:30:22,005 --> 00:30:24,608
AND SO I PRETENDED THAT I WAS 

687
00:30:24,608 --> 00:30:26,610
FINE.  AND I THOUGHT THAT THAT 

688
00:30:26,610 --> 00:30:28,378
WAS NORMAL.  YOU KNOW, CHRONIC 

689
00:30:28,378 --> 00:30:31,481
PAIN IS JUST THE WAY EVERYBODY 

690
00:30:31,481 --> 00:30:33,617
LIVES.  AND I WAS ALSO AN 

691
00:30:33,617 --> 00:30:35,419
ATHLETE, I PLAYED COLLEGE 

692
00:30:35,419 --> 00:30:36,853
SOCCER.  I PLAYED ALL OF THE 

693
00:30:36,853 --> 00:30:41,258
SPORTS GROWING UP.  AND JUST MY 

694
00:30:41,258 --> 00:30:42,592
NORMAL WAS IT'S PAIN.  IF IT'S 

695
00:30:42,592 --> 00:30:45,829
PAIN YOU PUSH THROUGH IT.  AND 

696
00:30:45,829 --> 00:30:47,497
SO THAT WAS ALL THOSE 

697
00:30:47,497 --> 00:30:51,868
CONTRIBUTED TO A DELAY IN 

698
00:30:51,868 --> 00:30:53,370
DIAGNOSIS.  I WAS FINALLY 

699
00:30:53,370 --> 00:30:56,807
DIAGNOSED AT THE AGE OF 26.  

700
00:30:56,807 --> 00:30:59,943
THAT WIZ MY FIRST OFFICIAL 

701
00:30:59,943 --> 00:31:02,079
DIAGNOSIS.  AND FROM THEN YOU 

702
00:31:02,079 --> 00:31:06,016
KNOW I PROGRESSIVELY GOT MORE 

703
00:31:06,016 --> 00:31:08,185
DIAGNOSES.  AS DIFFERENT PAIN 

704
00:31:08,185 --> 00:31:09,619
CONDITIONS JUST POPPING UP 

705
00:31:09,619 --> 00:31:11,254
EVERYWHERE.  I CALL IT MY ABCS 

706
00:31:11,254 --> 00:31:21,798
OF CONDITIONS.  I WAS GETTING TO

707
00:31:28,372 --> 00:31:30,640
KNOW NEW PEOPLE AND FIGURING OUT

708
00:31:30,640 --> 00:31:32,542
JOBS I DID NOT HAVE HEALTH CARE 

709
00:31:32,542 --> 00:31:34,644
AND IT JUST TURNED MY WORLD 

710
00:31:34,644 --> 00:31:37,180
UPSIDE DOWN.  I WAS AN ATHLETE 

711
00:31:37,180 --> 00:31:42,619
AND THEN SUDDENLY I WAS LARGELY 

712
00:31:42,619 --> 00:31:44,755
BEDRIDDEN.  AND I STARTED 

713
00:31:44,755 --> 00:31:45,856
POSTING ONLINE ABOUT WHAT I WAS 

714
00:31:45,856 --> 00:31:49,793
GOING THROUGH.  BECAUSE I NEEDED

715
00:31:49,793 --> 00:31:52,929
VALIDATION FOR WHAT I WAS GOING 

716
00:31:52,929 --> 00:31:58,869
THROUGH.  SO I DIDN'T REALIZE 

717
00:31:58,869 --> 00:31:59,436
THAT SHARING MY OWN STORY 

718
00:31:59,436 --> 00:32:02,339
BECAUSE I NEEDED PEOPLE TO 

719
00:32:02,339 --> 00:32:03,473
VALIDATE ME WAS ACTUALLY GIVING 

720
00:32:03,473 --> 00:32:05,409
OTHER PEOPLE PERMISSION TO SHARE

721
00:32:05,409 --> 00:32:08,612
THEIR STORIES WITH ME.  AND SO 

722
00:32:08,612 --> 00:32:09,746
JUST BY TALKING ABOUT WHAT I WAS

723
00:32:09,746 --> 00:32:12,549
GOING THROUGH FROM A SELFISH 

724
00:32:12,549 --> 00:32:15,585
STANDPOINT, I WAS BEING AN 

725
00:32:15,585 --> 00:32:17,988
ADVOCATE AND I WAS CATAPULTED 

726
00:32:17,988 --> 00:32:22,392
INTO THIS ADVOCACY STAGE.  WHERE

727
00:32:22,392 --> 00:32:23,994
I WAS RAISING A BUNCH OF MONEY 

728
00:32:23,994 --> 00:32:25,128
FOR THE ARTHRITIS FOUNDATION 

729
00:32:25,128 --> 00:32:29,132
JUST BY SHARING MY STORY.  I WAS

730
00:32:29,132 --> 00:32:33,870
INVITED TO BE -- TO DO ADVOCACY 

731
00:32:33,870 --> 00:32:35,806
ON CAPITOL HILL WITHIN A YEAR OF

732
00:32:35,806 --> 00:32:40,644
MY DIAGNOSIS.  I HAD STARTED A 

733
00:32:40,644 --> 00:32:42,379
SUPPORT GROUP FOR PEOPLE WITH MY

734
00:32:42,379 --> 00:32:45,715
CONDITION.  I HAD SPOKEN IN A 

735
00:32:45,715 --> 00:32:46,983
CALIFORNIA STATE HEALTH SENATE 

736
00:32:46,983 --> 00:32:49,753
HEALTH COMMITTEE HEARING ABOUT A

737
00:32:49,753 --> 00:32:52,722
BILL.  I JUST, LIKE, MY WHOLE 

738
00:32:52,722 --> 00:32:54,391
IDENTITY LIKE SHIFTED FROM 

739
00:32:54,391 --> 00:33:01,665
ATHLETE TO ADVOCATE.  I FOUND A 

740
00:33:01,665 --> 00:33:02,799
NEW IDENTITY IN THAT.  IN THE 

741
00:33:02,799 --> 00:33:09,172
LAST 2011.  SO FOR THE LAST 12, 

742
00:33:09,172 --> 00:33:10,907
MY MATH IS NOT GOING TO WORK 

743
00:33:10,907 --> 00:33:14,077
TODAY.  FOR THE LAST 12-13 YEARS

744
00:33:14,077 --> 00:33:15,712
THAT HAS BEEN MY IDENTITY.  SO 

745
00:33:15,712 --> 00:33:19,149
IT WENT FROM ATHLETE TO ADVOCATE

746
00:33:19,149 --> 00:33:23,386
AND ACTIVIST.  SO THAT'S LIKE MY

747
00:33:23,386 --> 00:33:26,723
PERSONAL STORY BUT WHAT I'M 

748
00:33:26,723 --> 00:33:29,292
INVOLVED IN PROFESSIONALLY NOW 

749
00:33:29,292 --> 00:33:33,029
IS ELEVATING MY LIVED EXPERIENCE

750
00:33:33,029 --> 00:33:34,431
INTO STUFF THAT YOU ALL MAY BE 

751
00:33:34,431 --> 00:33:39,603
DOING IN TERMS OF, LIKE, THE 

752
00:33:39,603 --> 00:33:41,505
HEAL INITIATIVE PAIN YOU'RE 

753
00:33:41,505 --> 00:33:43,874
ENGAGED IN PUTTING ON CMES WHICH

754
00:33:43,874 --> 00:33:48,378
I'VE BEEN INVOLVED IN.  PERHAPS 

755
00:33:48,378 --> 00:33:50,080
TURNING DOCUMENTS FROM CLINICAL 

756
00:33:50,080 --> 00:33:53,383
TRIALS INTO PLAIN LANGUAGE 

757
00:33:53,383 --> 00:33:56,520
RESOURCES.  SOME OF THE OTHER 

758
00:33:56,520 --> 00:33:59,156
THINGS I'VE BEEN INVOLVED IN IS 

759
00:33:59,156 --> 00:34:01,057
CREATING THE GLOBAL HEALTHY 

760
00:34:01,057 --> 00:34:03,126
LIVING FOUNDATION.  THE SOCIAL 

761
00:34:03,126 --> 00:34:09,199
MEDIA AND RESEARCH TOOLKIT OR 

762
00:34:09,199 --> 00:34:11,868
SMART WHICH WAS A PE COREY 

763
00:34:11,868 --> 00:34:14,070
FUNDING PROJECT.  I HAD HELPED 

764
00:34:14,070 --> 00:34:15,872
LEAD FOCUS GROUP RESEARCH THAT 

765
00:34:15,872 --> 00:34:20,076
IS COMPLETELY PATIENT-LED FROM 

766
00:34:20,076 --> 00:34:26,850
BEGINNING TO END.  I FEEL I'M 

767
00:34:26,850 --> 00:34:28,418
RAMBLING AT THIS POINT.  I AM 

768
00:34:28,418 --> 00:34:30,487
INVOLVED ACROSS THE BOARD I 

769
00:34:30,487 --> 00:34:32,422
BRING A LOT WITH ME.  LIKE EDEN 

770
00:34:32,422 --> 00:34:33,823
WAS SEEING WE ARE PEOPLE, WE ARE

771
00:34:33,823 --> 00:34:36,359
HUMAN.  SO I WANT TO ADD THAT I 

772
00:34:36,359 --> 00:34:39,162
AM A CAT PERSON.  I HAVE FOUR 

773
00:34:39,162 --> 00:34:42,966
CATS AND I TAKE CARE OF MATERIAL

774
00:34:42,966 --> 00:34:47,170
CATS IN MY BACKYARD, I AM A 

775
00:34:47,170 --> 00:34:54,744
GLARD GARDENER.  I THINK I WILL 

776
00:34:54,744 --> 00:34:57,247
STOP THERE AND I CAN ANSWER ANY 

777
00:34:57,247 --> 00:35:02,953
QUESTIONS LATER OR EXPAND NOW.

778
00:35:02,953 --> 00:35:05,088
>> THANK YOU, CHARIS,
EVERY TIME

779
00:35:05,088 --> 00:35:05,956
I TALK WITH YOU I LEARN 

780
00:35:05,956 --> 00:35:07,591
SOMETHING NEW.  IT'S REALLY 

781
00:35:07,591 --> 00:35:09,793
GREAT TO HEAR YOU NOW.  I THINK 

782
00:35:09,793 --> 00:35:12,462
AT DURING THE Q&A YOU'LL
HAVE AN

783
00:35:12,462 --> 00:35:15,165
OPPORTUNITY TO ADD ANYTHING 

784
00:35:15,165 --> 00:35:17,601
WE'VE MISSED.  WITH THAT I WILL 

785
00:35:17,601 --> 00:35:19,135
INTRODUCE THE NEXT SPEAKER I 

786
00:35:19,135 --> 00:35:29,045
BELIEVE SONYA IS SPEAKING NEXT

787
00:35:29,045 --> 00:35:31,715
>> HI, EVERYONE, I
PREPARED 

788
00:35:31,715 --> 00:35:33,216
SHORT REMARKS BECAUSE I WAS 

789
00:35:33,216 --> 00:35:34,184
NERVOUS BUT THEY'RE UNDER TEN 

790
00:35:34,184 --> 00:35:36,753
MINUTES SO MY STORY OF CHRONIC 

791
00:35:36,753 --> 00:35:39,256
PAIN ACTUALLY STARTS WITH HASH 

792
00:35:39,256 --> 00:35:42,859
SHOW MODO'S THIGH ROY DIETS AND 

793
00:35:42,859 --> 00:35:43,927
IT SEEMS THAT EVERYONE I KNOW 

794
00:35:43,927 --> 00:35:47,230
THAT GETS THAT GETS PAIN AND 

795
00:35:47,230 --> 00:35:49,599
THEN I GOT RHEUMATOID ARTHRITIS 

796
00:35:49,599 --> 00:35:51,067
WITHIN A FEW MONTHS AND WHAT I 

797
00:35:51,067 --> 00:35:53,603
WANT TO TALK ABOUT IS CHRONIC 

798
00:35:53,603 --> 00:35:55,605
STRESS.  THIS ALL HAPPENED SIX 

799
00:35:55,605 --> 00:35:59,175
MONTHS AFTER A DIFFICULT 

800
00:35:59,175 --> 00:36:02,612
DIVORCE.  AFTER ENDING A NINE 

801
00:36:02,612 --> 00:36:03,713
YEAR RELATIONSHIP THAT HAD BEEN 

802
00:36:03,713 --> 00:36:06,116
ABUSIVE ON MULTIPLE LEVELS I 

803
00:36:06,116 --> 00:36:07,217
ENTERED INTO THE RELATIONSHIP 

804
00:36:07,217 --> 00:36:09,853
BECAUSE CHAOS FELT LIKE HOME.  

805
00:36:09,853 --> 00:36:12,622
AND I GREW UP MANY IN THE 

806
00:36:12,622 --> 00:36:14,658
CONTEXT OF MULTIPLE GENERATIONS 

807
00:36:14,658 --> 00:36:19,162
OF FAMILY ISSUES AND SUBSTANCE 

808
00:36:19,162 --> 00:36:20,330
ABUSE.  WHILE IN THE 

809
00:36:20,330 --> 00:36:21,865
RELATIONSHIP I HAD A SON THE JOY

810
00:36:21,865 --> 00:36:24,067
OF MY LIFE BUT WE WERE 

811
00:36:24,067 --> 00:36:25,435
FINANCIALLY IN SERIOUS TROUBLE 

812
00:36:25,435 --> 00:36:27,871
AND HE AND I WERE SO LUCKY TO BE

813
00:36:27,871 --> 00:36:30,373
ON THE PUBLIC HEALTH PROGRAM IN 

814
00:36:30,373 --> 00:36:32,809
OHIO.  AND ON WIC AND OTHER 

815
00:36:32,809 --> 00:36:36,046
SOCIAL PROGRAMS ALL OF WHICH 

816
00:36:36,046 --> 00:36:39,649
SAVED MY LIFE.  IN MANY WAYS 

817
00:36:39,649 --> 00:36:43,153
HOWEVER I BROKE THE MOLD I HAD 

818
00:36:43,153 --> 00:36:48,858
ALSO GOT A TON OF THERAPY AND 

819
00:36:48,858 --> 00:36:52,996
TWO GRADUATE DEGREES AND AS THE 

820
00:36:52,996 --> 00:36:54,864
MARRIAGE WAS DEINTEGRATING AND 

821
00:36:54,864 --> 00:36:57,634
BECAME A DOMESTIC VIOLENCE CASE 

822
00:36:57,634 --> 00:37:00,470
IN GEORGIA I WORKED AS AN 

823
00:37:00,470 --> 00:37:01,604
ASSISTANT PROFESSOR AND 

824
00:37:01,604 --> 00:37:02,806
PUBLISHED MY FIRST BOOK. 

825
00:37:02,806 --> 00:37:05,709
IN THAT SAME YEAR I ASKED FOR A 

826
00:37:05,709 --> 00:37:07,410
DIVORCE AND WE HAD TO BEGIN 

827
00:37:07,410 --> 00:37:13,850
SUPERVISED EXCHANGES OF MY SON. 

828
00:37:13,850 --> 00:37:17,220
MY HUSBAND WHO WAS TRAUMATIZED 

829
00:37:17,220 --> 00:37:19,956
BY HIS VETERAN ALCOHOLIC FATHER 

830
00:37:19,956 --> 00:37:20,990
CONTINUED TO CAUSE STRESS SO IT 

831
00:37:20,990 --> 00:37:23,159
WAS THEN THAT NEXT FAIL THAT I 

832
00:37:23,159 --> 00:37:26,529
STARTED EXPERIENCING PAIN AND 

833
00:37:26,529 --> 00:37:29,833
EXHAUSTION.  AND THE HA SHOW 

834
00:37:29,833 --> 00:37:33,403
MODOS WAS EASY TO IDENTIFY 

835
00:37:33,403 --> 00:37:35,138
BECAUSE THERE WAS A CLEAR BLOOD 

836
00:37:35,138 --> 00:37:41,845
TEST.  MY NUMBERS WERE WAY UP SO

837
00:37:41,845 --> 00:37:44,114
IT WAS EASY TO DIAGNOSIS ME WITH

838
00:37:44,114 --> 00:37:46,149
RA.  BUT IN TRYING TO SEEK A 

839
00:37:46,149 --> 00:37:50,019
SPECIALIST IN RURAL GEORGIA TO 

840
00:37:50,019 --> 00:37:50,687
BEGIN THE BIOLOGICS THAT MIGHT 

841
00:37:50,687 --> 00:37:54,257
HAVE PUT ME INTO REMISSION I 

842
00:37:54,257 --> 00:37:56,659
ENCOUNTERED A HAZE OF DIFFICULTY

843
00:37:56,659 --> 00:37:57,894
AS MANY PEOPLE HAVE NOT BEING 

844
00:37:57,894 --> 00:38:03,166
ABLE TO GET MY INSURANCE TO 

845
00:38:03,166 --> 00:38:03,867
COVER DIAGNOSTIC PROCEDURES OR 

846
00:38:03,867 --> 00:38:05,602
SOMEONE JUST LOOKING AT ME AND 

847
00:38:05,602 --> 00:38:07,137
TELLING ME I COULDN'T HAVE RA, 

848
00:38:07,137 --> 00:38:09,873
JUST LOOKING AT MY FACE.  AND 

849
00:38:09,873 --> 00:38:12,542
THAT I NEED TO REDUCE STRESS, 

850
00:38:12,542 --> 00:38:15,445
THAT I WAS ON TOO MANY PAIN 

851
00:38:15,445 --> 00:38:20,083
PILLS.  MY INFLAMMATION LEVELS 

852
00:38:20,083 --> 00:38:21,751
WENT DOWN BUT THE PAIN I 

853
00:38:21,751 --> 00:38:22,652
CONTINUE TO HAVE WAS CRUSHING 

854
00:38:22,652 --> 00:38:25,622
AND I LEARNED THAT I ALSO HAD 

855
00:38:25,622 --> 00:38:29,426
NOW A DIAGNOSIS OF PTSD.  I WAS 

856
00:38:29,426 --> 00:38:33,363
PRESCRIBED TRAUMA DOLL, A MILD 

857
00:38:33,363 --> 00:38:34,330
OPIOID.  NEVER KNOWING THAT FOR 

858
00:38:34,330 --> 00:38:36,733
THE NEXT EIGHT YEARS I'D BE 

859
00:38:36,733 --> 00:38:38,735
TREATED ADDS THOSE I WAS DRUG 

860
00:38:38,735 --> 00:38:41,337
SEEKING WHICH WAS PAINFUL AS I 

861
00:38:41,337 --> 00:38:43,072
HAD COME THROUGH THE ADDICTIONS 

862
00:38:43,072 --> 00:38:47,177
OF OTHERS.  SO I SWORE OFF ANY 

863
00:38:47,177 --> 00:38:50,447
FURTHER OPIOID USE BECAUSE IT 

864
00:38:50,447 --> 00:38:52,148
WAS TOO TRAUMATIC.  I BELIEVE MY

865
00:38:52,148 --> 00:38:54,651
BODY BROKE DOWN DUE TO STRESS.  

866
00:38:54,651 --> 00:38:57,387
TRIGGERING A GENETIC 

867
00:38:57,387 --> 00:38:59,322
PREDISPOSITION.  I ENCOUNTERED 

868
00:38:59,322 --> 00:39:03,159
THEN SO MUCH MORE STRESS IN 

869
00:39:03,159 --> 00:39:08,698
TRYING TO SEEK TREATMENT.  WHAT 

870
00:39:08,698 --> 00:39:09,866
I'M INTERESTED IN TALKING WITH 

871
00:39:09,866 --> 00:39:11,167
YOU TODAY IS TO TALK A LITTLE 

872
00:39:11,167 --> 00:39:15,138
BIT ABOUT HOW TAKING PATIENT 

873
00:39:15,138 --> 00:39:17,340
HISTORIES CAN INCLUDE NOT JUST A

874
00:39:17,340 --> 00:39:19,042
SNAPSHOT OF THE PAIN THAT WE'VE 

875
00:39:19,042 --> 00:39:21,177
EXPERIENCED OVER THE PAST WEEK 

876
00:39:21,177 --> 00:39:23,012
OR THE PAST MONTH.  BUT HOW 

877
00:39:23,012 --> 00:39:29,219
THERE MIGHT BE A WAY TO INCLUDE 

878
00:39:29,219 --> 00:39:31,855
THE STRESS THAT IS LIVED 

879
00:39:31,855 --> 00:39:33,690
EXPERIENCE THAT MIGHT EVEN IN 

880
00:39:33,690 --> 00:39:36,793
MANY CASES TOUCH OFF THIS PAIN. 

881
00:39:36,793 --> 00:39:39,162
I'M THE THIRD GENERATION IN MY 

882
00:39:39,162 --> 00:39:44,067
FAMILY THAT HAD TO CARE FOR MY 

883
00:39:44,067 --> 00:39:46,169
FAMILY WHILE BEING THE SOLE 

884
00:39:46,169 --> 00:39:47,670
BREAD WINNER.  I WAS READING 

885
00:39:47,670 --> 00:39:49,906
ABOUT WHAT PROLONGED STRESS AND 

886
00:39:49,906 --> 00:39:52,475
CORTISOL DO TO THE BODY CREATING

887
00:39:52,475 --> 00:39:57,280
AN ALLOSTATIC LOAD 

888
00:39:57,280 --> 00:39:59,182
CONCEPTUALIZED AS THE WEAR AND 

889
00:39:59,182 --> 00:40:06,122
TEAR OR MULTIPLE ORGANS AND 

890
00:40:06,122 --> 00:40:08,224
TISSUES TO THE ONGOING 

891
00:40:08,224 --> 00:40:09,893
ENVIRONMENTAL DEMANDS AND THAT 

892
00:40:09,893 --> 00:40:11,194
INCLUDES EVERYTHING FROM BLOOD 

893
00:40:11,194 --> 00:40:13,630
PRESSURE, CARDIOVASCULAR 

894
00:40:13,630 --> 00:40:16,232
SYSTEMS, TO THE PARASYMPATHETIC 

895
00:40:16,232 --> 00:40:21,704
NERVOUS SYSTEM AND TO MENTAL 

896
00:40:21,704 --> 00:40:23,039
HEALTH.  I AM STILL NEGATIVE BUT

897
00:40:23,039 --> 00:40:29,779
I FINALLY HAVE A GREAT 

898
00:40:29,779 --> 00:40:31,014
RHEUMATOLOGIST WHO SAID TO ME 

899
00:40:31,014 --> 00:40:32,215
WHAT NO OTHER DOCTOR SAID BEFORE

900
00:40:32,215 --> 00:40:33,049
WHICH IS THAT THEY JUST DON'T 

901
00:40:33,049 --> 00:40:35,151
HAVE THE RIGHT TESTS YET TO SEE 

902
00:40:35,151 --> 00:40:43,159
WHAT'S CAUSING MY PAIN.  HAPPILY

903
00:40:43,159 --> 00:40:45,261
I'M NOW A TENURED PROFESSOR IN 

904
00:40:45,261 --> 00:40:46,696
CONNECTICUT AND ENDED UP WITH A 

905
00:40:46,696 --> 00:40:49,532
GREAT PARTNER AND BECAUSE I LIKE

906
00:40:49,532 --> 00:40:51,868
A CHALLENGE I THEN GOT COVID 

907
00:40:51,868 --> 00:40:54,070
THAT TURNED INTO LONG COVID IN 

908
00:40:54,070 --> 00:40:56,306
MARCH 2020 SO I'M AN EARLY 

909
00:40:56,306 --> 00:40:57,707
ADOPTER.  SO I JUST WANT TO 

910
00:40:57,707 --> 00:40:59,175
CLOSE WITH THE FACT THAT I THEN 

911
00:40:59,175 --> 00:41:03,146
BECAME PART OF WHAT I THINK IS A

912
00:41:03,146 --> 00:41:04,247
MODEL FOR COLLABORATION BETWEEN 

913
00:41:04,247 --> 00:41:06,549
PATIENT RESEARCHERS AND THE 

914
00:41:06,549 --> 00:41:08,985
MEDICAL COMMUNITY I WAS PART OF 

915
00:41:08,985 --> 00:41:10,653
THE VAST PATIENT LED RESEARCH 

916
00:41:10,653 --> 00:41:13,856
NETWORK THAT CREATED LONG COVID.

917
00:41:13,856 --> 00:41:15,358
WE SUMMONED IT FROM OUR 

918
00:41:15,358 --> 00:41:18,227
EXPERIENCE IN REALTIME.  WHEN I 

919
00:41:18,227 --> 00:41:21,230
WAS TOLD MY RACING HEART WAS 

920
00:41:21,230 --> 00:41:24,033
PTSD I KNEW THAT WASN'T TRUE 

921
00:41:24,033 --> 00:41:27,170
BECAUSE I KNEW WHAT MY PTSD FELT

922
00:41:27,170 --> 00:41:28,338
LIKE AND EVENTUALLY I WOULD 

923
00:41:28,338 --> 00:41:30,740
LEARN THAT MY BLOOD WAS PUMPING 

924
00:41:30,740 --> 00:41:33,743
TOO HARD AND IT GAVE ME AN 

925
00:41:33,743 --> 00:41:37,480
AORTIC ANEURYSM.  WE RESEARCHED 

926
00:41:37,480 --> 00:41:39,749
DEEPLY, TRADED INFORMATION IN 

927
00:41:39,749 --> 00:41:42,151
SLACK GROUPS COMING UP WITH OUR 

928
00:41:42,151 --> 00:41:43,486
OWN TREATMENT PROTOCOLS IT TOOK 

929
00:41:43,486 --> 00:41:45,421
ME A YEAR TO REGAIN 

930
00:41:45,421 --> 00:41:46,456
FUNCTIONALITY FROM LONG COVID 

931
00:41:46,456 --> 00:41:49,192
BUT I WORKED THROUGH ALL OF IT. 

932
00:41:49,192 --> 00:41:51,861
I AM NONBINARY AND I AM NOW 

933
00:41:51,861 --> 00:41:53,529
WATCHING PATIENTS TRY TO PUT 

934
00:41:53,529 --> 00:41:55,298
TOGETHER WHY TRANS AND NONBINARY

935
00:41:55,298 --> 00:41:57,567
PEOPLE HAVE COLLECTED A HIGHER 

936
00:41:57,567 --> 00:42:01,437
INCIDENCE OF LONG COVID AND WHY 

937
00:42:01,437 --> 00:42:03,172
OUR CONNECTIVE TISSUE SEEMS 

938
00:42:03,172 --> 00:42:04,540
WEAKER MAYBE BECAUSE WE'RE 

939
00:42:04,540 --> 00:42:06,142
SOCIALLY VULNERABLE IT ALL MAKES

940
00:42:06,142 --> 00:42:09,879
SENSE IN A WAY THAT WE JUST NEED

941
00:42:09,879 --> 00:42:17,787
MEDICINE TO PIT  -- PUT A NAME 

942
00:42:17,787 --> 00:42:20,356
ON AND SADLY I WAS CONFIRMED AND

943
00:42:20,356 --> 00:42:21,991
I KNEW MY BODY WAS WORKING SO 

944
00:42:21,991 --> 00:42:22,291
HARD. 

945
00:42:22,291 --> 00:42:23,893
I AM INTERESTED -- I KNOW 

946
00:42:23,893 --> 00:42:25,628
THERE'S CURRENT RESEARCH GOING 

947
00:42:25,628 --> 00:42:29,565
ON ON LOOKING INTO NOT JUST 

948
00:42:29,565 --> 00:42:31,167
INTERLEUKIN 6 BUT A BUNCH OF THE

949
00:42:31,167 --> 00:42:33,202
DIFFERENT INTERLEUKINS TO TRY TO

950
00:42:33,202 --> 00:42:37,073
SEE WHAT MIGHT ALIGN TO RA.  

951
00:42:37,073 --> 00:42:45,448
AND I AM INTERESTED FINALLY IAL 

952
00:42:45,448 --> 00:42:47,583
HIDING BEHIND THESE SOURCES OF 

953
00:42:47,583 --> 00:42:48,751
INFLAMMATION AND HOW WE ARE 

954
00:42:48,751 --> 00:42:50,219
UNITED ACROSS OUR CONDITIONS, 

955
00:42:50,219 --> 00:42:52,355
ALL OF THE FOLKS WHO ARE THE -- 

956
00:42:52,355 --> 00:42:55,792
THE WONDERFUL FOLKS ON THIS 

957
00:42:55,792 --> 00:42:57,794
PANEL.  I HOPE THAT NO -- OTHER 

958
00:42:57,794 --> 00:43:00,530
DOCTOR EVER TELLS ME TO REDUCE 

959
00:43:00,530 --> 00:43:02,165
STRESS.  BECAUSE STRESS IS 

960
00:43:02,165 --> 00:43:03,499
SOCIALLY CREATED AND OFTEN PUT 

961
00:43:03,499 --> 00:43:08,037
ON US AS CAREGIVERS AND -- AND 

962
00:43:08,037 --> 00:43:09,872
OFTENTIMES MAINSTAYS OF OUR 

963
00:43:09,872 --> 00:43:15,144
FAMILIES.  I ASK YOU TO THINK OF

964
00:43:15,144 --> 00:43:17,513
STRESS AS PART OF OUR HISTORIES 

965
00:43:17,513 --> 00:43:18,214
AND EMBEDDED NOT IN OUR MINDS 

966
00:43:18,214 --> 00:43:19,515
BUT IN OUR BODIES.  THANK YOU SO

967
00:43:19,515 --> 00:43:29,625
MUCH.

968
00:43:31,227 --> 00:43:34,297
>> THANK YOU.  OUR NEXT
SPEAKER 

969
00:43:34,297 --> 00:43:35,131
IS SHAREE.

970
00:43:35,131 --> 00:43:38,101
>> HELLO.  A LITTLE
CLOSER.  

971
00:43:38,101 --> 00:43:40,436
THERE'S A FEW THINGS I DID NOT 

972
00:43:40,436 --> 00:43:42,205
WANT TO FORGET SO I DID WRITE MY

973
00:43:42,205 --> 00:43:43,106
DOWN BUT THANK YOU SO MUCH FOR 

974
00:43:43,106 --> 00:43:47,944
BEING HERE AND LISTENING.  IN 

975
00:43:47,944 --> 00:43:50,713
2022, I BRITTANY HIGH TOWER A 

976
00:43:50,713 --> 00:43:52,415
22-YEAR-OLD IN HOUSTON, TEXAS 

977
00:43:52,415 --> 00:43:53,983
WAS GIVEN THE OPTION OF LEAVING 

978
00:43:53,983 --> 00:43:55,017
IN PAIN OR BE ARRESTED FOR 

979
00:43:55,017 --> 00:44:00,556
TRESPASSING.  DAYS LATER SHE 

980
00:44:00,556 --> 00:44:01,991
DIED FOR A CHOICE THAT SHE 

981
00:44:01,991 --> 00:44:03,159
SHOULD HAVE NEVER BEEN GIVEN 

982
00:44:03,159 --> 00:44:06,662
THIS TRIGGERED A MEMORY OF MINE 

983
00:44:06,662 --> 00:44:10,967
AT AGE 17. 

984
00:44:10,967 --> 00:44:14,570
A TYPICAL ED VISIT SHAPED MY 

985
00:44:14,570 --> 00:44:20,543
ENTIRE JOURNEY.  I HAD ACUTE 

986
00:44:20,543 --> 00:44:21,077
SYNDR

987
00:44:21,077 --> 00:44:23,112
SYNDROME.  I WAS PLACED ON A 

988
00:44:23,112 --> 00:44:27,150
STRETCHER, TUCKED IN A CORNER OF

989
00:44:27,150 --> 00:44:29,819
A HALL WEI FORGOTTEN ABOUT.  I 

990
00:44:29,819 --> 00:44:32,255
WAS TOLD BY A NURSE TO SHIT UP 

991
00:44:32,255 --> 00:44:39,228
WHEN I WAS SCR-- TOLD TO SHUT U 

992
00:44:39,228 --> 00:44:40,763
THIS IS FREQUENT WITH PATIENTS 

993
00:44:40,763 --> 00:44:43,166
OF SICKLE CELL WE CALL EACH 

994
00:44:43,166 --> 00:44:44,667
OTHER WARRIORS AS MUCH AS IT 

995
00:44:44,667 --> 00:44:45,868
DESCRIBES OUR RESILIENCE ALSO 

996
00:44:45,868 --> 00:44:47,570
REMINDS US OF THE NEVER ENDING 

997
00:44:47,570 --> 00:44:51,307
FIGHTS WE TAKE PART IN.  WE 

998
00:44:51,307 --> 00:44:53,676
FIGHT THIS BEAST OF AN ILLNESS 

999
00:44:53,676 --> 00:45:01,784
CALL SICKLE CELL AND A  -- ARE 

1000
00:45:01,784 --> 00:45:03,853
ATTACHED AS DRUG SEEKERS. 

1001
00:45:03,853 --> 00:45:06,189
IN MY MOST VULNERABLE TIME WITH 

1002
00:45:06,189 --> 00:45:07,990
A PAIN SCALE OF 10 MY THOUGHT 

1003
00:45:07,990 --> 00:45:09,692
WAS NOT WHICH HOSPITAL AM I 

1004
00:45:09,692 --> 00:45:11,794
GOING TO.  IT'S HOW QUICK CAN I 

1005
00:45:11,794 --> 00:45:13,496
SHOWER AND GROOM MYSELF SO I 

1006
00:45:13,496 --> 00:45:15,031
DON'T LOOK LIKE THE ADDICT THEY 

1007
00:45:15,031 --> 00:45:17,633
ALREADY THINK I AM.  EVEN THE 

1008
00:45:17,633 --> 00:45:19,435
MAINSTREAM MEDIA HAS TAKEN 

1009
00:45:19,435 --> 00:45:25,541
SICKLE CELL AS A TOPIC MORE  -- 

1010
00:45:25,541 --> 00:45:27,877
TOPIC FOR COMEDIC RELIEF. 

1011
00:45:27,877 --> 00:45:30,813
I HAVE TAKEN EVERY UNEXPLAINED 

1012
00:45:30,813 --> 00:45:33,049
LAB RESULT AND EACH BIAS I HAVE 

1013
00:45:33,049 --> 00:45:35,151
MET WITH AND ORGANICALLY BECAME 

1014
00:45:35,151 --> 00:45:38,154
AN ADVOCATE FOR MYSELF AND MY 

1015
00:45:38,154 --> 00:45:40,456
COMMUNITY.  IN MY WORLD, MY PAIN

1016
00:45:40,456 --> 00:45:43,893
HAS TO BE VALIDATED BEFORE IT'S 

1017
00:45:43,893 --> 00:45:45,595
RELIEVED AND AS MUCH AS IT IS A 

1018
00:45:45,595 --> 00:45:47,330
PHYSICAL PAIN THERE IS A 

1019
00:45:47,330 --> 00:45:49,165
WELL-ESTABLISHED MENTAL PAIN 

1020
00:45:49,165 --> 00:45:51,200
THAT ACCOMPANIES IT.  SINCE THE 

1021
00:45:51,200 --> 00:45:53,636
SYMPOSIUM IS FOCUSED ON SEX AND 

1022
00:45:53,636 --> 00:45:54,503
GENDER IT'S IMPORTANT TO NOTE 

1023
00:45:54,503 --> 00:46:01,911
WHAT I AM NOW SEEING AS A 

1024
00:46:01,911 --> 00:46:03,346
PATIENT NAVIGATOR.  YOUNG MALES 

1025
00:46:03,346 --> 00:46:05,448
CHOOSE TO STAY HOME, DISENGAGE 

1026
00:46:05,448 --> 00:46:07,149
FROM SOCIAL ACTIVITIES AND IF 

1027
00:46:07,149 --> 00:46:09,485
HOME TUMORING IS NOT AVAILABLE 

1028
00:46:09,485 --> 00:46:14,790
TODAY DROP OUT OF SCHOOL. 

1029
00:46:14,790 --> 00:46:19,528
FEMALES EXPERIENCING MENSTRUAL 

1030
00:46:19,528 --> 00:46:21,864
TRIGGER PAINS THAT ARE 

1031
00:46:21,864 --> 00:46:24,300
HEIGHTENED.  WE MUST DISCONTINUE

1032
00:46:24,300 --> 00:46:26,502
A LIFE SAVING DRUG IF WE PLAN TO

1033
00:46:26,502 --> 00:46:27,069
HAVE CHILDREN. 

1034
00:46:27,069 --> 00:46:29,639
I ONCE HEARD THAT SICKLE CELL 

1035
00:46:29,639 --> 00:46:31,874
PAIN IS A WINDOW TO ALL PAIN 

1036
00:46:31,874 --> 00:46:33,809
BECAUSE OF ITS COMPLEXITIES BUT 

1037
00:46:33,809 --> 00:46:39,148
EVEN AS THE MOST COMMON INHE

1038
00:46:39,148 --> 00:46:42,351
INHERITED PAIN IN THE U.S. I 

1039
00:46:42,351 --> 00:46:44,120
HEAR DOCTORS AND PATIENTS SEE 

1040
00:46:44,120 --> 00:46:46,889
HOW LONG HAVE I HAD SICKLE CELL.

1041
00:46:46,889 --> 00:46:56,732
IF IT TOOK TIME TO HAVE SOMEONE.

1042
00:46:56,732 --> 00:47:00,937
TODAY I GIVE YOU ALL WITH YOUR 

1043
00:47:00,937 --> 00:47:02,305
BRILLIANCE, AND INTEREST 

1044
00:47:02,305 --> 00:47:03,673
PERMISSION TO HELP CHANGE THE 

1045
00:47:03,673 --> 00:47:04,307
NARRATIVE OF SICKLE CELL, THANK 

1046
00:47:04,307 --> 00:47:13,349
YOU.

1047
00:47:13,349 --> 00:47:17,520
>> THANK YOU.  I THINK WE
NOW 

1048
00:47:17,520 --> 00:47:19,422
FOR QUESTIONS FOR THE PANELISTS 

1049
00:47:19,422 --> 00:47:21,857
AND MORE OF A DISCUSSION FROM 

1050
00:47:21,857 --> 00:47:23,225
THE PANELISTS.  EACH TIME WE 

1051
00:47:23,225 --> 00:47:24,994
TALK THESE SUBJECT MATTER 

1052
00:47:24,994 --> 00:47:26,228
EXPERTS HAVE MORE INTERESTING 

1053
00:47:26,228 --> 00:47:28,631
QUESTIONS THAN I THINK WE HAVE. 

1054
00:47:28,631 --> 00:47:31,334
SO PLEASE DO SPEAKERS, JUMP IN 

1055
00:47:31,334 --> 00:47:32,001
AND SHARE ANYTHING YOU DIDN'T 

1056
00:47:32,001 --> 00:47:37,506
SHARE OR QUESTIONS.  CHARIS I 

1057
00:47:37,506 --> 00:47:39,075
THINK HAS UNMUTED.  IS THAT 

1058
00:47:39,075 --> 00:47:41,444
RIGHT?  OH, SORRY, IT LOOKED 

1059
00:47:41,444 --> 00:47:43,179
LIKE FROM THE WAY YOU POPPED UP 

1060
00:47:43,179 --> 00:47:46,449
THAT YOU UNMUTED.  SO IF -- 

1061
00:47:46,449 --> 00:47:47,850
WHILE THE AUDIENCE HAS SOME TIME

1062
00:47:47,850 --> 00:47:50,486
TO COME TO THE MIC, IF YOU HAVE 

1063
00:47:50,486 --> 00:47:53,956
A QUESTION, I'LL START OUT WITH 

1064
00:47:53,956 --> 00:47:59,195
A FIRST QUESTION.  YOU'RE ALL 

1065
00:47:59,195 --> 00:48:04,633
HERE BECAUSE OF YOUR EXPERIENCE 

1066
00:48:04,633 --> 00:48:07,169
WITH PAIN.  YOU DECIDED TO USE 

1067
00:48:07,169 --> 00:48:08,137
YOUR PERSONAL STORIES OF ONE 

1068
00:48:08,137 --> 00:48:11,607
PIECE OF YOUR ADVOCACY FOR YOUR 

1069
00:48:11,607 --> 00:48:13,409
COMMUNITIES SO IT'D BE NICE TO 

1070
00:48:13,409 --> 00:48:14,677
HEAR A LITTLE BIT ABOUT HOW YOU 

1071
00:48:14,677 --> 00:48:21,317
FEEL ABOUT THAT CHOICE.  IS IT 

1072
00:48:21,317 --> 00:48:21,717
DRA

1073
00:48:21,717 --> 00:48:24,086
DRAINING?  IS IT EMPOWERING?  

1074
00:48:24,086 --> 00:48:25,654
WHAT SHOULD RESEARCHERS BE AWARE

1075
00:48:25,654 --> 00:48:27,156
OF WHEN DOING WHAT YOU'RE DOING 

1076
00:48:27,156 --> 00:48:31,193
AND LEVERAGING YOUR EXPERIENCES 

1077
00:48:31,193 --> 00:48:41,637
AT THE SCIENTIFIC TABLE?

1078
00:48:42,071 --> 00:48:44,173
>> I GUESS I COULD SHARE. 
I WAS

1079
00:48:44,173 --> 00:48:45,975
GETTING READY TO LOG ONTO ZOOM 

1080
00:48:45,975 --> 00:48:49,512
AND I WAS SO NERVOUS AND I 

1081
00:48:49,512 --> 00:48:52,148
REALIZED THAT WHAT I WAS REALLY 

1082
00:48:52,148 --> 00:48:54,417
NERVOUS ABOUT WAS, LIKE, I 

1083
00:48:54,417 --> 00:48:56,919
JUST -- NORMALLY DON'T EVEN 

1084
00:48:56,919 --> 00:48:58,954
CHOOSE TO SHARE MY -- ANYTHING 

1085
00:48:58,954 --> 00:49:02,758
OF MY STORY WITH DOCTORS WHO ARE

1086
00:49:02,758 --> 00:49:04,960
TREATING ME.  IT'S REALLY AN 

1087
00:49:04,960 --> 00:49:05,661
AMAZING OPPORTUNITY TO BE WITH 

1088
00:49:05,661 --> 00:49:07,797
YOU IN THIS SITUATION WHERE WE 

1089
00:49:07,797 --> 00:49:09,899
CAN.  BUT I HAVE, YOU KNOW, I AM

1090
00:49:09,899 --> 00:49:13,402
A PUBLIC SPEAKER FOR MY LIVING 

1091
00:49:13,402 --> 00:49:15,171
AND THIS MAKES -- THIS MADE ME 

1092
00:49:15,171 --> 00:49:17,206
VERY NERVOUS BECAUSE IT'S A 

1093
00:49:17,206 --> 00:49:18,307
DIFFERENT KIND OF PUBLIC 

1094
00:49:18,307 --> 00:49:19,775
SPEAKING.  I THINK IT'S SO -- 

1095
00:49:19,775 --> 00:49:29,051
IT'S HIGHLY CHARGED SO YEAH TO 

1096
00:49:29,051 --> 00:49:30,519
ANSWER YOUR QUESTION, IT'S A 

1097
00:49:30,519 --> 00:49:33,856
GREAT OPPORTUNITY BUT AT THE 

1098
00:49:33,856 --> 00:49:36,792
SAME TIME IT'S AN INTERFACE 

1099
00:49:36,792 --> 00:49:37,893
WHERE THERE'S BEEN SO MUCH 

1100
00:49:37,893 --> 00:49:39,161
STRESS IN MY LIFE SO I DO IT 

1101
00:49:39,161 --> 00:49:45,534
DESPITE THAT ANXIETY.

1102
00:49:45,534 --> 00:49:48,971
>> I CAN JUMP IN TOO.  I
AM VERY

1103
00:49:48,971 --> 00:49:52,274
LUCKY BECAUSE I HAVE AMAZING 

1104
00:49:52,274 --> 00:49:54,310
MENTOR, ASHLEY AND I ALSO HAVE 

1105
00:49:54,310 --> 00:50:00,616
AN AMAZING MENTOR AND I GET TO 

1106
00:50:00,616 --> 00:50:02,351
WORK WITH JESS, AWESOME AND WHAT

1107
00:50:02,351 --> 00:50:03,886
I LEARNED ABOUT SHARING MY LIVED

1108
00:50:03,886 --> 00:50:07,156
EXPERIENCE IN THIS FIELD IS THAT

1109
00:50:07,156 --> 00:50:08,891
SOMETIMES YOU CAN ALMOST 

1110
00:50:08,891 --> 00:50:16,665
ACCIDENTLY BE TOKENIZED AND 

1111
00:50:16,665 --> 00:50:18,300
THAT'S NOT BASED ON A SKIN 

1112
00:50:18,300 --> 00:50:20,336
COLOR, USING THE STORY AS A 

1113
00:50:20,336 --> 00:50:23,372
TOKEN.  SOMETIMES CAN FEEL 

1114
00:50:23,372 --> 00:50:26,609
REALLY BAD.  SO I JUST HOPE 

1115
00:50:26,609 --> 00:50:29,345
THAT, YOU KNOW, AS INDIVIDUALS 

1116
00:50:29,345 --> 00:50:31,780
WHO ARE -- FOR MYSELF, TRYING TO

1117
00:50:31,780 --> 00:50:33,883
BECOME A RESEARCHER, I HOPE THAT

1118
00:50:33,883 --> 00:50:35,818
WHEN YOU'RE LEARNING FROM THESE 

1119
00:50:35,818 --> 00:50:37,653
INDIVIDUALS WITH LIVED 

1120
00:50:37,653 --> 00:50:39,054
EXPERIENCE THAT YOU ARE DOING 

1121
00:50:39,054 --> 00:50:42,958
WHAT MY MENTOR DOES AND TRIES TO

1122
00:50:42,958 --> 00:50:47,129
KIND OF GIVE BACK TO YOUR 

1123
00:50:47,129 --> 00:50:48,597
MENTEES.  MAKE SURE THAT THESE 

1124
00:50:48,597 --> 00:50:50,032
PEOPLE WITH LIVED EXPERIENCE ARE

1125
00:50:50,032 --> 00:50:53,636
LIFTED UP AND NOT JUST 

1126
00:50:53,636 --> 00:50:57,273
TOKENIZED.  SO THAT'S ALL.

1127
00:50:57,273 --> 00:50:59,475
>> I'LL ADD THAT I
EXPERIENCED 

1128
00:50:59,475 --> 00:51:03,045
BOTH.  THERE'S A FULFILLMENT 

1129
00:51:03,045 --> 00:51:06,815
THAT COMES WITH I'M ABLE TO NOW 

1130
00:51:06,815 --> 00:51:09,485
LITERALLY HELP NAVIGATE THESE 

1131
00:51:09,485 --> 00:51:10,553
FAMILIES AND CHILDREN LIVING 

1132
00:51:10,553 --> 00:51:12,354
WITH SICKLE CELL BECAUSE I'VE 

1133
00:51:12,354 --> 00:51:14,757
DONE IT.  BUT IT ALSO CAN BE 

1134
00:51:14,757 --> 00:51:16,559
DRAINING BECAUSE EVEN IF I CLOCK

1135
00:51:16,559 --> 00:51:18,527
OUT I STILL HAVE SICKLE CELL.  

1136
00:51:18,527 --> 00:51:19,895
I'M STILL EXPERIENCING WHAT THEY

1137
00:51:19,895 --> 00:51:21,997
WILL SO IF I DON'T MAKE IT 

1138
00:51:21,997 --> 00:51:24,133
BETTER FOR MYSELF, THAT MEANS 

1139
00:51:24,133 --> 00:51:25,801
THE ONES TO COME ARE JUST GOING 

1140
00:51:25,801 --> 00:51:27,536
TO FOLLOW THE PATTERN THAT I'VE 

1141
00:51:27,536 --> 00:51:28,804
HAD TO UNFORTUNATELY LIVE 

1142
00:51:28,804 --> 00:51:33,776
THROUGH.  SO, I EXPERIENCED BOTH

1143
00:51:33,776 --> 00:51:34,310
FULFILLMENT AND TRAINING 

1144
00:51:34,310 --> 00:51:38,647
SOMETIMES.

1145
00:51:38,647 --> 00:51:45,354
>> I'LL ADD.  THIS IS
CHARIS, I 

1146
00:51:45,354 --> 00:51:48,290
AM EXHAUSTED.  I'LL JUST SEE IT.

1147
00:51:48,290 --> 00:51:51,894
I MEAN, I WANT TO BRING IN THE 

1148
00:51:51,894 --> 00:51:55,864
FACT THAT ALL FOUR OF US ON THIS

1149
00:51:55,864 --> 00:51:59,468
PANEL ARE DEALING WITH OUR OWN 

1150
00:51:59,468 --> 00:52:03,906
LIVED EXPERIENCE WHILE 

1151
00:52:03,906 --> 00:52:05,541
ADVOCATING.  WE OFTEN BARELY 

1152
00:52:05,541 --> 00:52:07,343
HAVE THE ENERGY TO DEAL WITH OUR

1153
00:52:07,343 --> 00:52:09,912
OWN PAIN AND PAIN IMPACTS EVERY 

1154
00:52:09,912 --> 00:52:15,351
SINGLE ASPECT OF LIFE.  AND IT'S

1155
00:52:15,351 --> 00:52:20,456
GETTING HARDER TO ACCESS PAIN 

1156
00:52:20,456 --> 00:52:21,890
CARE THAT'S EQUITABLE WHILE 

1157
00:52:21,890 --> 00:52:27,830
WE'RE ADVOCATING.  SO 

1158
00:52:27,830 --> 00:52:30,432
PERSONALLY, I AM 

1159
00:52:30,432 --> 00:52:31,667
IMMUNOCOMPROMISED I CAN'T 

1160
00:52:31,667 --> 00:52:32,701
EQUITABLY ACCESS HEALTH CARE AT 

1161
00:52:32,701 --> 00:52:34,236
ALL RIGHT NOW BECAUSE THERE ARE 

1162
00:52:34,236 --> 00:52:37,273
NO MASKS IN HEALTH CARE SETTINGS

1163
00:52:37,273 --> 00:52:39,141
ANYMORE MUCH LESS FEEL 

1164
00:52:39,141 --> 00:52:41,010
COMFORTABLE ADVOCATING FOR 

1165
00:52:41,010 --> 00:52:43,145
OPIOID ACCESS BECAUSE THAT IS A 

1166
00:52:43,145 --> 00:52:47,149
MEDICATION I RELY ON.  PLUS I'M 

1167
00:52:47,149 --> 00:52:50,119
TRANS.  SO NAVIGATING WHEN I ASK

1168
00:52:50,119 --> 00:52:52,788
MY DOCTORS TO PLEASE USE MY 

1169
00:52:52,788 --> 00:52:56,525
CORRECT PRONOUNS AND, YOU KNOW, 

1170
00:52:56,525 --> 00:52:59,795
STOP MISGENDERING ME TO MY FACE 

1171
00:52:59,795 --> 00:53:03,265
OR IN MY CHART.  ALL OF THESE 

1172
00:53:03,265 --> 00:53:06,635
THINGS, LIKE, INTERACT WITH EACH

1173
00:53:06,635 --> 00:53:09,238
OTHER AND THEN WE, I FEEL THE 

1174
00:53:09,238 --> 00:53:11,073
RESPONSIBILITY FOR MY COMMUNITY 

1175
00:53:11,073 --> 00:53:12,941
TO SHOW UP FOR THINGS LIKE THIS 

1176
00:53:12,941 --> 00:53:15,144
AND IT'S REALLY IMPORTANT TO ME.

1177
00:53:15,144 --> 00:53:18,380
I AM REALLY GLAD TO DO IT BUT I 

1178
00:53:18,380 --> 00:53:20,249
DON'T WANT IT TO BE THOUGHT OF 

1179
00:53:20,249 --> 00:53:21,984
AS THIS IS THE JOB WE SHOW UP 

1180
00:53:21,984 --> 00:53:23,919
FOR AND IT'S COMPLETELY SEPARATE

1181
00:53:23,919 --> 00:53:25,688
FROM THE REST OF OUR LIVES 

1182
00:53:25,688 --> 00:53:26,889
BECAUSE IT'S NOT.  LIKE WE'RE 

1183
00:53:26,889 --> 00:53:29,158
SHOWING UP FOR THIS.  WE'RE 

1184
00:53:29,158 --> 00:53:31,093
GETTING PAID TO BE HERE.  BUT 

1185
00:53:31,093 --> 00:53:33,896
WE'RE ALSO LIVING IT.  LIKE OUR 

1186
00:53:33,896 --> 00:53:35,164
LIVES ARE OUR WORK AND OUR WORK 

1187
00:53:35,164 --> 00:53:37,599
IS OUR LIFE.  WE CAN'T HAVE A 

1188
00:53:37,599 --> 00:53:40,502
VACATION FROM THAT AND SO I 

1189
00:53:40,502 --> 00:53:42,671
THINK THINKING ABOUT US HERE 

1190
00:53:42,671 --> 00:53:43,639
TODAY AS PROFESSIONALS, 

1191
00:53:43,639 --> 00:53:46,575
ALONGSIDE WITH YOU, WE ARE YOUR 

1192
00:53:46,575 --> 00:53:48,377
PEERS.  BUT WE ALSO DON'T LEAVE 

1193
00:53:48,377 --> 00:53:50,679
THIS WORK.  WHEN WE LEAVE TODAY.

1194
00:53:50,679 --> 00:53:58,654
WE LIVE IT.  AND SO WE'RE 

1195
00:53:58,654 --> 00:54:00,422
EXHAUSTED.  WELL, I'M EXHAUSTED,

1196
00:54:00,422 --> 00:54:03,158
I CAN'T SPEAK FOR EVERYONE ELSE.

1197
00:54:03,158 --> 00:54:05,294
ANYWAY, I JUST WANTED TO SHARE 

1198
00:54:05,294 --> 00:54:05,494
THAT.

1199
00:54:05,494 --> 00:54:09,898
>> THANKS, CHARIS, I HAVE
A 

1200
00:54:09,898 --> 00:54:10,566
QUESTION.  SPECIFICALLY FOR YOU 

1201
00:54:10,566 --> 00:54:12,401
BECAUSE IT WAS KIND OF 

1202
00:54:12,401 --> 00:54:15,871
HIGHLIGHTED IN YOUR BIO.  BUT I 

1203
00:54:15,871 --> 00:54:16,972
THINK OTHERS PROBABLY MAY BE 

1204
00:54:16,972 --> 00:54:21,377
ABLE TO JUMP IN AND ANSWER TOO. 

1205
00:54:21,377 --> 00:54:27,783
SO IN YOUR BIO IT HIGHLIGHTS THE

1206
00:54:27,783 --> 00:54:31,420
YOUR WORK WITH MULTIPLY 

1207
00:54:31,420 --> 00:54:32,221
MARGINALIZED DISABLED PEOPLE AS 

1208
00:54:32,221 --> 00:54:33,822
PARTNERS OF RESEARCH AND I 

1209
00:54:33,822 --> 00:54:34,723
WONDER IF THERE'S ANYTHING THAT 

1210
00:54:34,723 --> 00:54:37,893
YOU CAN SHARE OR TALK ABOUT THAT

1211
00:54:37,893 --> 00:54:39,128
RESEARCHERS NEED TO KNOW TO WORK

1212
00:54:39,128 --> 00:54:41,163
WITH MULTIPLE MARGINALIZED 

1213
00:54:41,163 --> 00:54:42,865
DISABLED PEOPLE AS PARTNERS IN 

1214
00:54:42,865 --> 00:54:45,334
RESEARCH TO MAKE THE SCIENCE 

1215
00:54:45,334 --> 00:54:47,636
BETTER, MORE ACCURATE OR MORE 

1216
00:54:47,636 --> 00:54:48,103
IMPACTFUL.

1217
00:54:48,103 --> 00:54:51,907
>> YEAH.  IT'S A REALLY
GOOD 

1218
00:54:51,907 --> 00:54:53,308
QUESTION.  AND I COULD GO ALL 

1219
00:54:53,308 --> 00:54:55,711
DAY ON THIS BUT I WILL JUST PICK

1220
00:54:55,711 --> 00:54:58,480
ONE, LIKE CONCRETE TANGIBLE 

1221
00:54:58,480 --> 00:55:02,251
THING.  AND THAT'S THAT -- SO --

1222
00:55:02,251 --> 00:55:05,421
I SOMETIMES WILL GIVE FEEDBACK 

1223
00:55:05,421 --> 00:55:09,892
ON PLAIN LANGUAGE CLINICAL TRIAL

1224
00:55:09,892 --> 00:55:13,362
SUMMARIES.  AND I AM ALWAYS 

1225
00:55:13,362 --> 00:55:15,631
REMINDED THAT GENDER, FOR 

1226
00:55:15,631 --> 00:55:18,033
CLINICAL TRIALS IS STILL BINARY.

1227
00:55:18,033 --> 00:55:21,170
AND SO AS A TRANS PERSON WHO IS 

1228
00:55:21,170 --> 00:55:23,138
NONBINARY WHEN I AM GIVING -- 

1229
00:55:23,138 --> 00:55:26,842
WHEN I'M LOOKING AT THESE 

1230
00:55:26,842 --> 00:55:27,843
CLINICAL TRIAL SUMMARY RESULTS 

1231
00:55:27,843 --> 00:55:30,012
I'M REMIND THAT HAD RESEARCH IS 

1232
00:55:30,012 --> 00:55:35,150
STILL BINARY WHEN IT COMES TO 

1233
00:55:35,150 --> 00:55:36,785
GATHERING DATA ABOUT GENDER.  

1234
00:55:36,785 --> 00:55:39,154
WHICH MEANS I AM NOT GATHERED.  

1235
00:55:39,154 --> 00:55:43,492
MY DATA IS NOT GATHERED.  SO 

1236
00:55:43,492 --> 00:55:45,327
THERE -- AS SONYA WILL PROBABLY 

1237
00:55:45,327 --> 00:55:46,862
BE ABLE TO BACK ME UP BECAUSE 

1238
00:55:46,862 --> 00:55:50,065
WE'VE TALKED ABOUT THIS WITH OUR

1239
00:55:50,065 --> 00:55:52,501
INVOLVEMENT ON THE NATIONAL PAIN

1240
00:55:52,501 --> 00:55:55,170
ADVOCACY COUNCIL THERE IS SO 

1241
00:55:55,170 --> 00:55:59,441
LITTLE RESEARCH THAT INCLUDES 

1242
00:55:59,441 --> 00:56:04,546
TRANS DATA.  THAT, LIKE, WHERE 

1243
00:56:04,546 --> 00:56:08,851
DO I FIT?  YOU KNOW.  SO I THINK

1244
00:56:08,851 --> 00:56:10,786
IT IS ABSOLUTELY VITAL FOR 

1245
00:56:10,786 --> 00:56:11,320
PEOPLE WHO ARE MULTIPLY 

1246
00:56:11,320 --> 00:56:15,724
MARGINALIZED WHO ARE TRANS AND 

1247
00:56:15,724 --> 00:56:17,292
DISABLED, WHO ARE BLACK AND 

1248
00:56:17,292 --> 00:56:19,228
DISABLED, WHO ARE IMPOVERISHED 

1249
00:56:19,228 --> 00:56:21,063
AND DISABLED AND ALL OF THE 

1250
00:56:21,063 --> 00:56:24,032
ABOVE MIXED TOGETHER ARE 

1251
00:56:24,032 --> 00:56:27,903
INVOLVED BECAUSE THESE SEEMINGLY

1252
00:56:27,903 --> 00:56:28,937
SMALL DETAILS ARE ACTUALLY 

1253
00:56:28,937 --> 00:56:31,139
REALLY IMPORTANT BECAUSE THEY 

1254
00:56:31,139 --> 00:56:35,511
IMPACT US DIRECTLY.  I DON'T 

1255
00:56:35,511 --> 00:56:37,880
WANT TO BE DISINCLUDED FROM 

1256
00:56:37,880 --> 00:56:39,882
RESEARCH AND SO I'M HOPING WE 

1257
00:56:39,882 --> 00:56:41,416
CAN COMPLETELY REWRITE THE 

1258
00:56:41,416 --> 00:56:42,684
SYSTEM AND FIX THAT AND I LOOK 

1259
00:56:42,684 --> 00:56:44,353
FORWARD TO HEARING WHAT ANY OF 

1260
00:56:44,353 --> 00:56:45,888
THE OTHER PANELISTS HAVE TO SEE 

1261
00:56:45,888 --> 00:56:51,260
ABOUT THAT  -- HAVE TO SAY ABOUT

1262
00:56:51,260 --> 00:56:51,660
THAT.

1263
00:56:51,660 --> 00:56:53,262
>> I CAN ACTUALLY JUMP IN
ON 

1264
00:56:53,262 --> 00:56:53,562
THAT TOO. 

1265
00:56:53,562 --> 00:56:57,366
A LOT OF WORK I DO IS COMMUNITY 

1266
00:56:57,366 --> 00:56:59,368
BASED PARTICIPATORY RESEARCH 

1267
00:56:59,368 --> 00:57:05,574
WHERE WE PARTNER WITH 

1268
00:57:05,574 --> 00:57:06,341
COMMUNITIES.  SAME THING WITH 

1269
00:57:06,341 --> 00:57:08,110
HEAL CONNECTIONS.  THESE PEOPLE 

1270
00:57:08,110 --> 00:57:08,944
ARE PARTNERS AND SOMETIMES WE 

1271
00:57:08,944 --> 00:57:13,115
FORGET THAT IN THE RESEARCH 

1272
00:57:13,115 --> 00:57:15,150
WORLD.  THAT WHILE WE WANT TO 

1273
00:57:15,150 --> 00:57:16,985
INCLUDE THE VOICE OF LIVED 

1274
00:57:16,985 --> 00:57:18,220
EXPERIENCE AND INCLUDE THESE 

1275
00:57:18,220 --> 00:57:19,187
THINGS WE HAVE TO REMEMBER 

1276
00:57:19,187 --> 00:57:20,455
PARTNERSHIP IS KEY.  BECAUSE 

1277
00:57:20,455 --> 00:57:21,990
THERE'S BEEN A LOT OF -- 

1278
00:57:21,990 --> 00:57:23,926
OBVIOUSLY WE ALL KNOW THERE'S 

1279
00:57:23,926 --> 00:57:26,662
BEEN A LOT OF TRUST ISSUES WITH 

1280
00:57:26,662 --> 00:57:28,530
PARTICULAR COMMUNITIES.  AND SO 

1281
00:57:28,530 --> 00:57:33,101
IF YOU START TO VIEW PEOPLE AS 

1282
00:57:33,101 --> 00:57:35,671
HUMANS AND THEIR PARTNERS HOW 

1283
00:57:35,671 --> 00:57:39,141
CAN YOU BE INEQUITABLE IS KIND 

1284
00:57:39,141 --> 00:57:49,418
OF HOW I FEEL.

1285
00:57:53,121 --> 00:57:54,623
>> THANK YOU TO ALL OF YOU
FOR 

1286
00:57:54,623 --> 00:57:55,791
SHARING YOUR EXPERIENCES.  I 

1287
00:57:55,791 --> 00:57:57,526
REALLY APPRECIATE IT.  WE KNOW 

1288
00:57:57,526 --> 00:57:59,194
THAT A NUMBER OF PAIN 

1289
00:57:59,194 --> 00:58:01,029
RESEARCHERS ARE REALLY WANTING 

1290
00:58:01,029 --> 00:58:03,565
TO INCLUDE PEOPLE WITH LIVED 

1291
00:58:03,565 --> 00:58:05,033
EXPERIENCE.  THROUGHOUT THE 

1292
00:58:05,033 --> 00:58:06,201
RESEARCH PROCESS.  AND SO BASED 

1293
00:58:06,201 --> 00:58:09,137
ON YOUR EXPERIENCES WORKING WITH

1294
00:58:09,137 --> 00:58:10,639
RESEARCHERS, I WAS HOPING THAT 

1295
00:58:10,639 --> 00:58:11,974
MAYBE YOU COULD GIVE SOME ADVICE

1296
00:58:11,974 --> 00:58:13,542
ON WHAT ARE SOME OF THE 

1297
00:58:13,542 --> 00:58:14,810
ENGAGEMENTS THAT HAVE GONE WELL.

1298
00:58:14,810 --> 00:58:15,877
WHAT ARE SOME THINGS THAT 

1299
00:58:15,877 --> 00:58:18,113
HAVEN'T GONE WELL.  SO WHAT ARE 

1300
00:58:18,113 --> 00:58:19,348
SOME CONCRETE ADVICE THAT YOU 

1301
00:58:19,348 --> 00:58:21,083
CAN GIVE TO PEOPLE THAT ARE 

1302
00:58:21,083 --> 00:58:21,984
WANTING TO INCORPORATE PEOPLE 

1303
00:58:21,984 --> 00:58:24,252
WITH LIVED EXPERIENCE IN THEIR 

1304
00:58:24,252 --> 00:58:26,521
RESEARCH STUDIES MOVING FORWARD?

1305
00:58:26,521 --> 00:58:27,022
THANK YOU.

1306
00:58:27,022 --> 00:58:28,890
>> I, I'M SORRY, I COULD
JUMP IN

1307
00:58:28,890 --> 00:58:31,727
AGAIN JUST BECAUSE I DO A LOT OF

1308
00:58:31,727 --> 00:58:34,863
THIS IN VPR I KNOW ENGAGEMENT IS

1309
00:58:34,863 --> 00:58:36,665
IMPORTANT AND IT'S MEETING THE 

1310
00:58:36,665 --> 00:58:38,600
INDIVIDUALS WHERE THEY ARE IS 

1311
00:58:38,600 --> 00:58:39,501
CRITICAL.  ALSO ASKING 

1312
00:58:39,501 --> 00:58:41,370
QUESTIONS, WHAT THEY NEED.  WHAT

1313
00:58:41,370 --> 00:58:43,171
THEY WANT.  KIND OF WHAT THEY 

1314
00:58:43,171 --> 00:58:47,409
NEED OUT OF THE -- LIKE 

1315
00:58:47,409 --> 00:58:48,810
PARTNERSHIP, RIGHT?  

1316
00:58:48,810 --> 00:58:51,146
PARTNERSHIP'S NOT ONE SIDED.  SO

1317
00:58:51,146 --> 00:58:53,915
IF YOU WANT TO GENUINELY 

1318
00:58:53,915 --> 00:58:55,083
ACTIVELY PAIR WITH INDIVIDUALS 

1319
00:58:55,083 --> 00:59:00,188
IN THE COMMUNITY, JUST REALLY 

1320
00:59:00,188 --> 00:59:03,692
BEING AUTHENTIC AND GOING BEYOND

1321
00:59:03,692 --> 00:59:06,928
WHAT YOU WANT OUT OF IT.  MAKING

1322
00:59:06,928 --> 00:59:09,264
SURE IT'S -- THERE'S RECIPROCITY

1323
00:59:09,264 --> 00:59:10,232
IN THAT PROCESS.  AND I JUST 

1324
00:59:10,232 --> 00:59:15,170
WANT TO SEE ONE MORE THING.  

1325
00:59:15,170 --> 00:59:17,372
JESS HAS THIS GREAT THING ABOUT 

1326
00:59:17,372 --> 00:59:18,507
SEVEN TOUCHES AND IT'S JUST 

1327
00:59:18,507 --> 00:59:20,676
LIKE, YOU KNOW, ONCE IN AWHILE 

1328
00:59:20,676 --> 00:59:23,145
REACHING OUT, ASKING HOW YOU'RE 

1329
00:59:23,145 --> 00:59:27,149
DOING, AGAIN, BUILDING TRY 

1330
00:59:27,149 --> 00:59:34,890
PARTNERSH

1331
00:59:34,890 --> 00:59:35,190
PARTNERSHIP.

1332
00:59:35,190 --> 00:59:38,827
>> I'LL ADD A FEW THINGS. 
I 

1333
00:59:38,827 --> 00:59:40,562
APPRECIATED GETTING THAT FROM 

1334
00:59:40,562 --> 00:59:44,733
THE NATIONAL PAIN AND ADVOCACY 

1335
00:59:44,733 --> 00:59:47,469
COUNCIL AND I HAVE APPRECIATED 

1336
00:59:47,469 --> 00:59:51,673
SPECIFICALLY WHERE, YOU KNOW, IN

1337
00:59:51,673 --> 00:59:55,177
SIGNING ONTO GIVE COMMENTS TO 

1338
00:59:55,177 --> 00:59:57,612
HAVE EVERYTHING VERY CLEAR, 

1339
00:59:57,612 --> 01:00:00,182
LIKE, YOU KNOW, WHAT WE'RE 

1340
01:00:00,182 --> 01:00:02,050
ASKING YOU TO DO, WHEN WE MIGHT 

1341
01:00:02,050 --> 01:00:03,552
WANT YOUR COMMENTS BECAUSE WITH 

1342
01:00:03,552 --> 01:00:05,454
EVERYTHING ELSE PLUS THE PAIN I 

1343
01:00:05,454 --> 01:00:07,489
GET A LITTLED A LED AND THAT'S 

1344
01:00:07,489 --> 01:00:09,291
REALLY NICE AND CLEAR. 

1345
01:00:09,291 --> 01:00:14,629
AND AS WAS JUST SHARED, I REALLY

1346
01:00:14,629 --> 01:00:15,897
APPRECIATED ON A BIG STUDY THAT 

1347
01:00:15,897 --> 01:00:19,167
I PARTICIPATED IN RECENTLY TO BE

1348
01:00:19,167 --> 01:00:21,536
ASKED AT SORT OF MULTIPLE POINTS

1349
01:00:21,536 --> 01:00:23,138
IS THERE ANYTHING WE'RE MISSING?

1350
01:00:23,138 --> 01:00:24,239
IS THERE ANYTHING YOU NOTICE 

1351
01:00:24,239 --> 01:00:25,707
THAT HAD HASN'T BEEN CAPTURED 

1352
01:00:25,707 --> 01:00:27,509
IN, YOU KNOW, THE QUESTIONS 

1353
01:00:27,509 --> 01:00:29,277
WE'VE ASKED ABOVE?  WHAT ARE 

1354
01:00:29,277 --> 01:00:30,979
YOUR CONCERNS OR ANYTHING YOU'D 

1355
01:00:30,979 --> 01:00:33,648
LIKE TO EXPAND?  THAT'S BEEN 

1356
01:00:33,648 --> 01:00:35,951
SUPER HELPFUL AND THEN, YOU 

1357
01:00:35,951 --> 01:00:38,854
KNOW, ANY KIND OF COMPENSATION 

1358
01:00:38,854 --> 01:00:39,921
IS SUPER HELPFUL ESPECIALLY, YOU

1359
01:00:39,921 --> 01:00:42,157
KNOW, EVEN IF IT'S LIKE, YOU 

1360
01:00:42,157 --> 01:00:44,159
KNOW, A SMALL AMAZON GIFT CARD 

1361
01:00:44,159 --> 01:00:47,796
OR ANYTHING LIKE THAT.  LIKE, 

1362
01:00:47,796 --> 01:00:52,934
IT'S JUST -- IT'S IT GOES A LONG

1363
01:00:52,934 --> 01:00:55,971
WAY COMMUNICATING THAT OUR TIME 

1364
01:00:55,971 --> 01:00:57,906
IS WORTHWHILE AND YOU KNOW JUST 

1365
01:00:57,906 --> 01:01:04,212
HELPS A LITTLE BIT.

1366
01:01:04,212 --> 01:01:06,314
>> I'LL JUST ADD FOUR
SHORT 

1367
01:01:06,314 --> 01:01:08,917
THINGS TO ADD ONTO WHAT SONYA 

1368
01:01:08,917 --> 01:01:13,455
SAID, PAY US, PAY US PAY US. .  

1369
01:01:13,455 --> 01:01:17,425
AND I WILL AND I WILL SEE PLEASE

1370
01:01:17,425 --> 01:01:19,828
PAY US EVENING WIT BLICHLT EVEN 

1371
01:01:19,828 --> 01:01:21,930
IF WE MAY NOT HAVE LETTERS 

1372
01:01:21,930 --> 01:01:24,800
BEHIND OUR NAMES THAT MEANS WE 

1373
01:01:24,800 --> 01:01:26,067
HAVE LIVED EXPERIENCE.  THAT 

1374
01:01:26,067 --> 01:01:27,536
MEANS WE HAVE STUFF YOU DON'T 

1375
01:01:27,536 --> 01:01:29,171
HAVE NECESSARILY.  WE ARE 

1376
01:01:29,171 --> 01:01:30,739
PROFESSORS, WE ARE IN THE ROOM 

1377
01:01:30,739 --> 01:01:33,108
AND SECOND POINT, PUT US IN THE 

1378
01:01:33,108 --> 01:01:35,477
PAPER.  PUT OUR NAMES ON THE 

1379
01:01:35,477 --> 01:01:39,014
PAPER.  WE NEED TO BE PUBLISHED 

1380
01:01:39,014 --> 01:01:42,984
IF WE'RE PART OF IT.  THE THIRD 

1381
01:01:42,984 --> 01:01:46,655
AND FOURTH ARE KIND OF PAIRED.  

1382
01:01:46,655 --> 01:01:49,791
SO WE'RE DISABLED A LOT OF US 

1383
01:01:49,791 --> 01:01:50,992
ARE IMMUNOCOMPROMISED, MAKE 

1384
01:01:50,992 --> 01:01:54,196
VIRTUAL AN OPTION, DON'T REMOVE 

1385
01:01:54,196 --> 01:01:55,564
THAT FROM US.  AND PAIR WITH 

1386
01:01:55,564 --> 01:01:57,899
THAT, THIS IS A REALLY UNIQUE 

1387
01:01:57,899 --> 01:02:01,703
POINT BUT CONGRESS RECENTLY 

1388
01:02:01,703 --> 01:02:03,872
DEFUNDED THE AFFORDABLE 

1389
01:02:03,872 --> 01:02:05,740
CONNECTIVITY PROGRAM AND SO I 

1390
01:02:05,740 --> 01:02:08,043
MIGHT LOSE INTERNET AND SO 

1391
01:02:08,043 --> 01:02:11,546
PAIRED WITH HYBRIDIZATION, 

1392
01:02:11,546 --> 01:02:14,983
KEEPING HYBRIDIZATION PERHAPS 

1393
01:02:14,983 --> 01:02:20,889
BUILD IN SOME SORT OF WAY TO 

1394
01:02:20,889 --> 01:02:22,858
COMPENSATE WHAT COSTS WILL BE 

1395
01:02:22,858 --> 01:02:23,992
FOR ACCESSING THAT.  SO, AND 

1396
01:02:23,992 --> 01:02:25,460
PEOPLE ARE WELCOME TO REACH OUT 

1397
01:02:25,460 --> 01:02:27,295
TO ME IF YOU WANT TO CHAT ABOUT 

1398
01:02:27,295 --> 01:02:32,500
DIFFERENT IDEAS FOR THAT.

1399
01:02:32,500 --> 01:02:33,435
>> THANK YOU, I'LL
DEFINITELY 

1400
01:02:33,435 --> 01:02:35,170
REACH OUT.  THAT'S REALLY 

1401
01:02:35,170 --> 01:02:36,671
INTERESTING.  I THINK WE HAVE 

1402
01:02:36,671 --> 01:02:37,372
THE NEXT QUESTION.

1403
01:02:37,372 --> 01:02:39,708
>> SURE, YEAH, I JUST
WANTED TO 

1404
01:02:39,708 --> 01:02:41,009
BRIEFLY SEE THANK YOU FOR HAVING

1405
01:02:41,009 --> 01:02:43,111
THE COURAGE TO SHARE THE STORIES

1406
01:02:43,111 --> 01:02:44,980
AND TRUSTING US TO LISTEN TO 

1407
01:02:44,980 --> 01:02:47,883
THEM.  I WANTED TO ASK, FOR 

1408
01:02:47,883 --> 01:02:50,719
EVERYBODY ON THE PANEL, 

1409
01:02:50,719 --> 01:02:52,621
EVERYBODY SHARED PRETTY POIGNANT

1410
01:02:52,621 --> 01:02:54,089
EXPERIENCES INTERACTING WITH THE

1411
01:02:54,089 --> 01:02:55,657
HEALTH CARE SYSTEM.  AND I JUST 

1412
01:02:55,657 --> 01:02:57,125
WANTED TO ASK IF YOU COULD THINK

1413
01:02:57,125 --> 01:03:00,562
OF MAYBE ONE OR A FEW THINGS YOU

1414
01:03:00,562 --> 01:03:01,196
WISH SOMEBODY WOULD HAVE ASKED 

1415
01:03:01,196 --> 01:03:11,740
YOU ALONG THE WAY.  WHILE YOU'RE

1416
01:03:13,174 --> 01:03:14,309
INTERACTING WITH HEALTH CARE.

1417
01:03:14,309 --> 01:03:17,345
>> BUILDING THOSE
RELATIONSHIPS 

1418
01:03:17,345 --> 01:03:19,047
WITH PHYSICIANS WITH HEALTH CARE

1419
01:03:19,047 --> 01:03:21,883
WORKERS IT'S MORE WHAT I WISH 

1420
01:03:21,883 --> 01:03:25,420
THEY WOULD SAY.  I WISH THEY 

1421
01:03:25,420 --> 01:03:27,622
WOULD SAY I DON'T KNOW.  I WISH 

1422
01:03:27,622 --> 01:03:29,224
THEY WOULD SAY LET ME GO ASK 

1423
01:03:29,224 --> 01:03:31,426
SOMEONE WHO DOES.  OR I NEED 

1424
01:03:31,426 --> 01:03:33,795
HELP.  BECAUSE IN THOSE MOMENTS 

1425
01:03:33,795 --> 01:03:35,730
WHERE THEY'RE GUESSING OR TRYING

1426
01:03:35,730 --> 01:03:38,333
TO PROVE A POINT, FIGURING OUT 

1427
01:03:38,333 --> 01:03:39,935
SICKLE CELL OR WHAT I MAY NEED, 

1428
01:03:39,935 --> 01:03:42,270
THOSE ARE THE MOMENTS WHERE I 

1429
01:03:42,270 --> 01:03:43,905
HAVE COME CLOSE TO DEATH OR LIKE

1430
01:03:43,905 --> 01:03:47,642
I JUST HAD A BAD EXPERIENCE SO I

1431
01:03:47,642 --> 01:03:50,078
JUST WISH -- IT IS OKAY TO SEE 

1432
01:03:50,078 --> 01:03:51,846
YOU DON'T KNOW AND TO FIND THE 

1433
01:03:51,846 --> 01:03:55,850
SOURCE OF SOMEONE WHO DOES KNOW 

1434
01:03:55,850 --> 01:04:06,661
OF MY ILL NENESILLNESS.

1435
01:04:08,830 --> 01:04:10,665
>> I HAD ADDED THIS WHEN I
SPOKE

1436
01:04:10,665 --> 01:04:14,069
BUT JUST TO ASK, ARE THERE -- 

1437
01:04:14,069 --> 01:04:17,872
HAVE THERE BE MAJOR SOURCES OF 

1438
01:04:17,872 --> 01:04:20,442
FAMILY STRESS IN THE HISTORY OF,

1439
01:04:20,442 --> 01:04:22,744
YOU KNOW, SINCE ONSET OR BEFORE 

1440
01:04:22,744 --> 01:04:27,248
ONSET.  SOME WAY TO CAPTURE THE 

1441
01:04:27,248 --> 01:04:33,355
KIND OF STRESS THAT CAN'T BE 

1442
01:04:33,355 --> 01:04:35,156
REDUCED.  AND I MEAN, I JUST -- 

1443
01:04:35,156 --> 01:04:38,226
I ALSO JUST HAD MY WONDERFUL NEW

1444
01:04:38,226 --> 01:04:39,894
RHEUMATOLOGIST ASK ME, LIKE, 

1445
01:04:39,894 --> 01:04:44,666
WHAT HAVE YOU NOTICED ABOUT THE 

1446
01:04:44,666 --> 01:04:45,934
PROGRESSION OF YOUR CONDITION?  

1447
01:04:45,934 --> 01:04:48,503
WHICH SORT OF BLEW ME AWAY BUT 

1448
01:04:48,503 --> 01:04:51,706
THAT'S AMAZING.  YOU KNOW, GOING

1449
01:04:51,706 --> 01:04:54,576
ALONG WITH CHARIS'S POINT ABOUT,

1450
01:04:54,576 --> 01:04:57,912
YOU KNOW, THE LIVED EXPERIENCE 

1451
01:04:57,912 --> 01:05:08,256
WE'VE ACCUMULATED.

1452
01:05:08,656 --> 01:05:14,162
>> I LOVE YOUR POINT ABOUT

1453
01:05:14,162 --> 01:05:17,232
SAYING I DON'T KNOW.  I LOVE 

1454
01:05:17,232 --> 01:05:20,368
SAYING I DON'T KNOW.  BECAUSE 

1455
01:05:20,368 --> 01:05:21,469
YOU DON'T KNOW IT DOESN'T MEAN 

1456
01:05:21,469 --> 01:05:26,241
WE'RE NOT HAVING REAL PROBLEMS. 

1457
01:05:26,241 --> 01:05:30,945
THAT'S REAL IMPORTANT IF YOU SAY

1458
01:05:30,945 --> 01:05:33,982
I DON'T KNOW HOW CAN YOU 

1459
01:05:33,982 --> 01:05:36,851
DISCREDIT I DON'T KNOW.

1460
01:05:36,851 --> 01:05:37,352
>> NEXT QUESTION.

1461
01:05:37,352 --> 01:05:40,855
>> YEAH, HI, I JUST WANT
TO 

1462
01:05:40,855 --> 01:05:42,557
FIRST OF ALL THANK EVERYONE FROM

1463
01:05:42,557 --> 01:05:44,559
THE PANEL FOR BEING SO AUTHENTIC

1464
01:05:44,559 --> 01:05:47,862
AND TELLING YOUR STORIES.  I 

1465
01:05:47,862 --> 01:05:50,265
KNOW EDEN BECAUSE SHE'S DONE A 

1466
01:05:50,265 --> 01:05:53,568
GREAT JOB ON THE HEAL PANEL THAT

1467
01:05:53,568 --> 01:05:56,037
I AM INCLUDED ON.  SO THAT'S 

1468
01:05:56,037 --> 01:05:57,572
TERRIFIC AND YOUR POEM WAS 

1469
01:05:57,572 --> 01:05:59,207
BEAUTIFUL AND SONYA, YOU 

1470
01:05:59,207 --> 01:06:01,409
ACTUALLY SPOKE AT MY PAIN GROUP 

1471
01:06:01,409 --> 01:06:03,878
I'VE BEEN RUNNING FOR 24 YEARS 

1472
01:06:03,878 --> 01:06:06,848
WITH THE AMAZING BOOK THAT YOU 

1473
01:06:06,848 --> 01:06:08,950
WROTE THAT PEOPLE REALLY 

1474
01:06:08,950 --> 01:06:11,686
ENJOYED.  BUT I WANTED TO SAY 

1475
01:06:11,686 --> 01:06:13,688
I'M A PERSON WITH PAIN.  I LIVE 

1476
01:06:13,688 --> 01:06:15,890
WITH BACK PAIN, I WAS CRUSHED IN

1477
01:06:15,890 --> 01:06:17,459
AN ACCIDENT.  I'M ALSO THE 

1478
01:06:17,459 --> 01:06:19,561
POLICY DIRECTOR FOR THE U.S. 

1479
01:06:19,561 --> 01:06:20,662
PAIN FOUNDATION AND ONE OF THE 

1480
01:06:20,662 --> 01:06:22,730
THINGS TO ANSWER THE QUESTION 

1481
01:06:22,730 --> 01:06:27,135
ABOUT WHAT RESEARCHERS COULD DO.

1482
01:06:27,135 --> 01:06:30,672
IS UNDERSTAND THAT PEOPLE WITH 

1483
01:06:30,672 --> 01:06:32,941
PAIN HAVE A LOT OF PHYSICAL NEED

1484
01:06:32,941 --> 01:06:35,510
AND WHEN I WENT TO THE HEAL 

1485
01:06:35,510 --> 01:06:39,147
SCIENTIFIC CONFERENCE I SPOKE UP

1486
01:06:39,147 --> 01:06:43,051
TO SAY I CAN'T SIT UP FOR MORE 

1487
01:06:43,051 --> 01:06:45,553
THAN AN HOUR OR DO ANYTHING FOR 

1488
01:06:45,553 --> 01:06:49,290
MORE THAN AN HOUR AND KNEAD  

1489
01:06:49,290 --> 01:06:53,595
NEED TO LAY DOWN AND GOT ME A 

1490
01:06:53,595 --> 01:06:55,763
SOFA IN THE BACK BUT THERE WERE 

1491
01:06:55,763 --> 01:06:57,799
PEOPLE WITH PAIN THAT I SAW 

1492
01:06:57,799 --> 01:06:58,933
STRUGGLING AND NO ONE ASKED WHAT

1493
01:06:58,933 --> 01:07:00,969
COULD BE DONE TO ACCOMMODATE ALL

1494
01:07:00,969 --> 01:07:02,437
THOSE PEOPLE.  WHEN U.S. PAIN 

1495
01:07:02,437 --> 01:07:06,141
HAS A CONFERENCE, WE HAVE, LIKE 

1496
01:07:06,141 --> 01:07:10,578
15 BEDS AND COTS OUT FOR PEOPLE 

1497
01:07:10,578 --> 01:07:15,150
WITH PAIN.  WE HAVE MORE BREAKS.

1498
01:07:15,150 --> 01:07:17,652
SO PEOPLE WITH PAIN CAN TAKE 

1499
01:07:17,652 --> 01:07:19,154
MORE BREAKS.  EVERYONE THAT IS 

1500
01:07:19,154 --> 01:07:22,757
LIVING WITH PAIN, NO MATTER WHAT

1501
01:07:22,757 --> 01:07:26,861
THEIR CONDITION HAS LIMITS AND 

1502
01:07:26,861 --> 01:07:27,896
THEY JUST NEED TO LEARN AS ONE 

1503
01:07:27,896 --> 01:07:29,831
OF THE WAYS TO MANAGE THEIR PAIN

1504
01:07:29,831 --> 01:07:32,700
HOW TO LIVE WITHIN THOSE LIMITS.

1505
01:07:32,700 --> 01:07:34,736
AND WE TELL PEOPLE THAT ALL THE 

1506
01:07:34,736 --> 01:07:36,404
TIME.  IT MIGHT BE THAT IF YOU 

1507
01:07:36,404 --> 01:07:38,273
HAVE MIGRAINES, FOR EXAMPLE, TOO

1508
01:07:38,273 --> 01:07:41,609
MUCH NOISE AND TOO MANY LIGHTS. 

1509
01:07:41,609 --> 01:07:43,411
SO IF PEOPLE CAME TO A 

1510
01:07:43,411 --> 01:07:45,380
CONFERENCE WITH MIGRAINE YOU 

1511
01:07:45,380 --> 01:07:46,748
WOULDN'T HAVE THESE BRIGHT 

1512
01:07:46,748 --> 01:07:48,650
SPOTLIGHTS HERE IN THIS ROOM AND

1513
01:07:48,650 --> 01:07:50,818
IF YOU AS RESEARCHERS WERE 

1514
01:07:50,818 --> 01:07:52,287
TRYING TO ACCOMMODATE FOR PEOPLE

1515
01:07:52,287 --> 01:07:53,454
WITH PAIN IT WOULDN'T BE HAVING 

1516
01:07:53,454 --> 01:07:55,590
THIS CONFERENCE IN THIS 

1517
01:07:55,590 --> 01:07:56,758
AUDITORIUM BECAUSE THE ONLY 

1518
01:07:56,758 --> 01:07:59,194
PLACE I CAN LAY DOWN AND STILL 

1519
01:07:59,194 --> 01:08:02,297
STAY IN THE AUDITORIUM IS IN THE

1520
01:08:02,297 --> 01:08:05,033
BACK WHERE THEY'VE TAKEN OUT TWO

1521
01:08:05,033 --> 01:08:07,168
SEATS.  AND SO I'VE BEEN COMING 

1522
01:08:07,168 --> 01:08:09,804
TO THIS CONFERENCE FOR AT LEAST 

1523
01:08:09,804 --> 01:08:12,540
FIFTEEN YEARS, LINDA KNOWS, I 

1524
01:08:12,540 --> 01:08:15,143
HAVE THAT LITTLE SPOT BACK 

1525
01:08:15,143 --> 01:08:16,511
THERE.  BUT IF ANYONE ELSE HAD 

1526
01:08:16,511 --> 01:08:18,913
TO LAY DOWN, THERE WOULD BE 

1527
01:08:18,913 --> 01:08:22,584
NOWHERE IN THIS ROOM FOR THEM TO

1528
01:08:22,584 --> 01:08:25,920
LAY DOWN AND STILL PARTICIPATE 

1529
01:08:25,920 --> 01:08:29,557
SO IN  IF YOU WANT TO BE 

1530
01:08:29,557 --> 01:08:30,091
INCLUSIVE AS RESEARCHERS. 

1531
01:08:30,091 --> 01:08:33,895
YOU REALLY NEED TO PROVIDE MORE 

1532
01:08:33,895 --> 01:08:36,097
ACCOMMODATIONS FOR PEOPLE WITH 

1533
01:08:36,097 --> 01:08:38,900
PAIN.  A WHEELCHAIR, PEOPLE GET,

1534
01:08:38,900 --> 01:08:42,370
PEOPLE DON'T GET WHEN I NEED TO 

1535
01:08:42,370 --> 01:08:45,206
LAY DOWN AND I GET YELLED OUT 

1536
01:08:45,206 --> 01:08:49,077
FOR PUTTING MY MAT ON THE FLOOR 

1537
01:08:49,077 --> 01:08:50,511
SOMEWHERE.  AND SO THAT IS -- 

1538
01:08:50,511 --> 01:08:51,613
IT'S INCREDIBLY EMBARRASSING TO 

1539
01:08:51,613 --> 01:08:54,249
DO THE THINGS WE NEED TO DO TO 

1540
01:08:54,249 --> 01:08:57,285
LAY DOWN ON COTS BUT IN ORDER TO

1541
01:08:57,285 --> 01:08:59,854
PARTICIPATE WE NEED TO DO THAT. 

1542
01:08:59,854 --> 01:09:02,056
ONE THING THAT'S GREAT IS HAVING

1543
01:09:02,056 --> 01:09:03,157
ZOOM.  BECAUSE TRAVELING FOR 

1544
01:09:03,157 --> 01:09:04,826
SOME PEOPLE WITH PAIN IS 

1545
01:09:04,826 --> 01:09:07,028
INCREDIBLY DIFFICULT AND IT MAY 

1546
01:09:07,028 --> 01:09:10,231
HAVE MADE IT EASIER FOR SONYA 

1547
01:09:10,231 --> 01:09:14,202
AND CHARIS TO BE HERE BUT THOSE 

1548
01:09:14,202 --> 01:09:16,304
ARE I THINK REALLY IMPORTANT 

1549
01:09:16,304 --> 01:09:17,639
THINGS.  AND THEN IN ANSWER TO 

1550
01:09:17,639 --> 01:09:19,674
THE QUESTION THAT THE PERSON 

1551
01:09:19,674 --> 01:09:22,043
JUST SAID BEFORE THAT WAS UP 

1552
01:09:22,043 --> 01:09:27,048
HERE AND SAID HOW CAN DOCTORS BE

1553
01:09:27,048 --> 01:09:29,384
MORE, YOU KNOW, ACCOMMODATING 

1554
01:09:29,384 --> 01:09:31,552
FOR PEOPLE WITH PAIN?  ONLY ONE 

1555
01:09:31,552 --> 01:09:33,921
DOCTOR IN MY ENTIRE LIFE WHO 

1556
01:09:33,921 --> 01:09:37,191
REALLY HELPED ME THE MOST SAID 

1557
01:09:37,191 --> 01:09:39,927
TO ME, YOU HAVE CHRONIC PAIN, 

1558
01:09:39,927 --> 01:09:43,698
THERE'S NO CURE.  I WILL HELP 

1559
01:09:43,698 --> 01:09:48,736
YOU MANAGE IT.  I WILL BE A 

1560
01:09:48,736 --> 01:09:50,905
PARTNER IN YOU WITH HELPING YOU 

1561
01:09:50,905 --> 01:09:53,875
MANAGE IT.  PEOPLE IN PAIN FEEL 

1562
01:09:53,875 --> 01:09:55,710
SO ALONE IN THEIR PAIN.  BECAUSE

1563
01:09:55,710 --> 01:09:56,878
THEY'VE GONE FROM DOCTOR TO 

1564
01:09:56,878 --> 01:10:00,214
DOCTOR TO DOCTOR.  THEY GET 

1565
01:10:00,214 --> 01:10:03,151
DISMISSED.  THEY GET CALLED DRUG

1566
01:10:03,151 --> 01:10:04,585
SEEKER, THEY SEE YOU'RE FAKING 

1567
01:10:04,585 --> 01:10:05,953
IT IF THEY CAN'T HELP BUT THE 

1568
01:10:05,953 --> 01:10:07,155
ONE THING THEY CAN DO EVEN IF 

1569
01:10:07,155 --> 01:10:10,958
THEY DON'T HAVE THE ANSWERS IS 

1570
01:10:10,958 --> 01:10:14,095
PARTNER WITH THE PERSON, SUPPORT

1571
01:10:14,095 --> 01:10:22,904
THEM.  AND WHEN THEY HAVE YOU 

1572
01:10:22,904 --> 01:10:26,040
TRY THINGS.  TRY HYDROTHERAPY, 

1573
01:10:26,040 --> 01:10:28,509
TRY THAT AND IF IT WORKS LET US 

1574
01:10:28,509 --> 01:10:30,845
KNOW.  SOME WILL DISMISS THEM.  

1575
01:10:30,845 --> 01:10:32,046
IF IT DOESN'T WORK.  I CAN'T 

1576
01:10:32,046 --> 01:10:33,648
HELP YOU.  BUT JUST BEING THERE 

1577
01:10:33,648 --> 01:10:36,984
AS A PARTNER, MEANS A LOT TO 

1578
01:10:36,984 --> 01:10:38,519
PEOPLE WITH PAIN.  SO SORRY FOR 

1579
01:10:38,519 --> 01:10:40,455
THE LONG REMARKS BUT I WANTED TO

1580
01:10:40,455 --> 01:10:43,157
ANSWER THOSE QUESTIONS.

1581
01:10:43,157 --> 01:10:46,327
>> THANK YOU, CINDY.

1582
01:10:46,327 --> 01:10:48,363
>> BEFORE I GO TO THE NEXT

1583
01:10:48,363 --> 01:10:51,065
QUESTION I WANTED TO ASK THE 

1584
01:10:51,065 --> 01:10:52,467
PANELISTS IF YOU HAD ANYTHING TO

1585
01:10:52,467 --> 01:11:03,010
ADD TO THAT.  OKAY.  I'LL GO TO 

1586
01:11:03,211 --> 01:11:11,152
THE NEXT QUESTION.

1587
01:11:11,152 --> 01:11:12,086
>> THANK YOU SO MUCH TO
ALL OF 

1588
01:11:12,086 --> 01:11:13,921
YOU FOR YOUR INFORMATIVE AND 

1589
01:11:13,921 --> 01:11:17,425
INSPIRING COMMENTS.  I HAVE A 

1590
01:11:17,425 --> 01:11:20,328
SPECIFIC QUESTION FOR SONYA.  

1591
01:11:20,328 --> 01:11:23,931
I -- YOU DESCRIBE VERY 

1592
01:11:23,931 --> 01:11:24,465
ELOQUENTLY THE IMPORTANT 

1593
01:11:24,465 --> 01:11:27,802
RELATIONSHIP BETWEEN STRESS AND 

1594
01:11:27,802 --> 01:11:30,805
PAIN.  AND ALSO YOU SAID 

1595
01:11:30,805 --> 01:11:31,706
SOMETHING I THINK THAT IS 

1596
01:11:31,706 --> 01:11:33,975
IMPORTANT FOR US TO HEAR YOU 

1597
01:11:33,975 --> 01:11:35,743
SAID YOU HOPE NOBODY EVER ASKS 

1598
01:11:35,743 --> 01:11:38,045
YOU TO REDUCE YOUR STRESS.  NOW 

1599
01:11:38,045 --> 01:11:39,680
I AM CURIOUS, AND WONDERING 

1600
01:11:39,680 --> 01:11:42,950
ABOUT YOUR ADVICE.  AS TO WHAT 

1601
01:11:42,950 --> 01:11:45,887
WOULD BE HELPFUL FOR EITHER 

1602
01:11:45,887 --> 01:11:49,857
PROVIDERS OR RESEARCHERS TO ASK 

1603
01:11:49,857 --> 01:11:51,159
ABOUT STRESS, FOR EXAMPLE, WOULD

1604
01:11:51,159 --> 01:11:55,263
IT BE HELPFUL TO SAY -- TO ASK 

1605
01:11:55,263 --> 01:11:57,865
HOW YOU MANAGE YOUR STRESS?  

1606
01:11:57,865 --> 01:12:00,902
WHAT OTHER QUESTIONS YOU THINK 

1607
01:12:00,902 --> 01:12:02,003
WE SHOULD BE ASKING?

1608
01:12:02,003 --> 01:12:03,938
>> I THINK, THANK YOU, SO
MUCH 

1609
01:12:03,938 --> 01:12:08,176
FOR ASKING THAT QUESTION.  YEAH,

1610
01:12:08,176 --> 01:12:10,411
WELL, I WILL START BY JUST 

1611
01:12:10,411 --> 01:12:12,180
SEEING WHEN A DOCTOR TELLS ME I 

1612
01:12:12,180 --> 01:12:15,149
HAVE TO REDUCE STRESS USUALLY I 

1613
01:12:15,149 --> 01:12:18,853
JUST WALK AWAY AND LAUGH 

1614
01:12:18,853 --> 01:12:20,922
BECAUSE, YOU KNOW, IF IT WAS 

1615
01:12:20,922 --> 01:12:22,990
THAT EASY I THINK I WOULD HAVE 

1616
01:12:22,990 --> 01:12:26,694
TRIED IT BEFORE NOW BUT I THINK 

1617
01:12:26,694 --> 01:12:29,297
WHEN I'VE BEEN ASKED THAT, IT'S 

1618
01:12:29,297 --> 01:12:39,774
SORT OF IMPLIES THAT IT'S A 

1619
01:12:40,107 --> 01:12:42,777
SIMPLE MATTER OF ADDING OR 

1620
01:12:42,777 --> 01:12:44,779
TAKING SOMETHING AWAY OR 

1621
01:12:44,779 --> 01:12:45,580
BUILDING TIME FOR MYSELF DURING 

1622
01:12:45,580 --> 01:12:49,150
THE DAY.  I THINK A LOT OF 

1623
01:12:49,150 --> 01:12:50,051
STRESS BUILT UPON INDIVIDUAL 

1624
01:12:50,051 --> 01:12:53,821
BODIES IS SYSTEMIC.  SO, YEAH, 

1625
01:12:53,821 --> 01:12:55,156
THERE'S A WAY IN WHICH I THINK 

1626
01:12:55,156 --> 01:12:58,292
IF WE TRY TO MAKE IT JUST AN 

1627
01:12:58,292 --> 01:12:59,827
INDIVIDUAL PROBLEM WE'RE MISSING

1628
01:12:59,827 --> 01:13:02,763
WHERE A LOT OF IT COMES FROM 

1629
01:13:02,763 --> 01:13:04,599
WHICH IS, YOU KNOW, RACE AND 

1630
01:13:04,599 --> 01:13:08,369
GENDER, INEQUALITY, OTHER FORMS 

1631
01:13:08,369 --> 01:13:12,240
OF OPPRESSION, ECONOMIC STRESS. 

1632
01:13:12,240 --> 01:13:15,142
SO I MEAN, I THINK IT MIGHT HELP

1633
01:13:15,142 --> 01:13:18,312
TO JUST SAY ARE THERE SOURCES OF

1634
01:13:18,312 --> 01:13:22,383
STRESS IN YOUR LIFE THAT YOU, 

1635
01:13:22,383 --> 01:13:25,753
YOU KNOW, THAT HAVE IMPACTED 

1636
01:13:25,753 --> 01:13:27,955
YOUR QUALITY OF LIFE?  AND SORT 

1637
01:13:27,955 --> 01:13:30,324
OF, YOU KNOW, LEAVE THE QUESTION

1638
01:13:30,324 --> 01:13:32,260
OF HOW WE MIGHT GET RID OF THEM 

1639
01:13:32,260 --> 01:13:37,064
OR HOW WE MIGHT MANAGE THEM TO, 

1640
01:13:37,064 --> 01:13:39,934
LIKE, FURTHER IN THE 

1641
01:13:39,934 --> 01:13:41,435
RELATIONSHIP.  I THINK IT CAN BE

1642
01:13:41,435 --> 01:13:43,170
OVERWHELMING ON TOP OF HAVING A 

1643
01:13:43,170 --> 01:13:45,172
MEDICAL ILLNESS TO HAVE A DOCTOR

1644
01:13:45,172 --> 01:13:48,309
TELL YOU, YOU KNOW, TAKE ALL 

1645
01:13:48,309 --> 01:13:50,711
THESE THINGS AND ALSO HERE'S AN 

1646
01:13:50,711 --> 01:13:52,380
ASSIGNMENT TO REDUCE STRESS IN 

1647
01:13:52,380 --> 01:13:54,515
YOUR LIFE.  IT ACTUALLY ADDS 

1648
01:13:54,515 --> 01:13:56,784
MORE STRESS.  SO, YEAH, I WOULD 

1649
01:13:56,784 --> 01:13:58,219
SEE, YOU KNOW, THAT THE SIMPLE 

1650
01:13:58,219 --> 01:14:00,421
QUESTION OF, YOU KNOW, IF YOU 

1651
01:14:00,421 --> 01:14:03,958
WANT TO SHARE ANY MAJOR STRESSES

1652
01:14:03,958 --> 01:14:05,726
YOU'VE HAD MAYBE EVEN THAT YOU 

1653
01:14:05,726 --> 01:14:08,529
FEEL LIKE MAY HAVE AGGRAVATED 

1654
01:14:08,529 --> 01:14:09,730
YOUR CONDITION, OR HOW MUCH 

1655
01:14:09,730 --> 01:14:19,740
STRESS DOES YOUR CONDITION ADD 

1656
01:14:19,740 --> 01:14:22,410
TO YOUR LIFE?  I THINK JUST THAT

1657
01:14:22,410 --> 01:14:24,445
QUESTION.  AND THEN MAYBE 

1658
01:14:24,445 --> 01:14:26,747
ALLOWING A CONVERSATION TO 

1659
01:14:26,747 --> 01:14:28,516
CONTINUE AS TRUST BUILDS OVER 

1660
01:14:28,516 --> 01:14:31,519
TIME AND THE RELATIONSHIP 

1661
01:14:31,519 --> 01:14:32,620
EVOLVES.  BUT I THINK OTHER 

1662
01:14:32,620 --> 01:14:33,254
FOLKS MIGHT HAVE GOOD THINGS TO 

1663
01:14:33,254 --> 01:14:36,657
SHARE TOO.

1664
01:14:36,657 --> 01:14:38,960
>> YEAH, I JUST -- I
WANTED TO 

1665
01:14:38,960 --> 01:14:42,229
SHARE AS WELL REALLY QUICK.  YOU

1666
01:14:42,229 --> 01:14:44,365
KNOW, FOR ME, SOMETIMES WHEN A 

1667
01:14:44,365 --> 01:14:45,866
DOCTOR TELLS ME, THIS IS WHAT 

1668
01:14:45,866 --> 01:14:47,134
YOU HAVE TO DO AND I DON'T HAVE 

1669
01:14:47,134 --> 01:14:49,470
THE RESOURCES TO DO IT.  THAT 

1670
01:14:49,470 --> 01:14:50,504
ADDS STRESS AND SHAME.  SO THEN 

1671
01:14:50,504 --> 01:14:53,407
I COME BACK TO YOU AND I'M LIKE 

1672
01:14:53,407 --> 01:14:55,643
I DIDN'T DO IT AND YOU'RE 

1673
01:14:55,643 --> 01:14:57,878
NONCOMPLIANT AT THAT TIME AND 

1674
01:14:57,878 --> 01:15:02,350
IT'S KIND OF CHARACTERLY WHAT 

1675
01:15:02,350 --> 01:15:05,453
 -- EXACTLY WHAT SONYA IS 

1676
01:15:05,453 --> 01:15:05,987
SEEING. 

1677
01:15:05,987 --> 01:15:08,556
YOU HAVE TO TAKE THE STRESS 

1678
01:15:08,556 --> 01:15:11,325
LEVEL AND THE RESOURCES 

1679
01:15:11,325 --> 01:15:12,193
AVAILABLE INSTEAD OF THE BLAME 

1680
01:15:12,193 --> 01:15:15,162
ON WHAT WE CAN DO.

1681
01:15:15,162 --> 01:15:24,605
>> I'LL ADD SOMETHING.  SO
MY 

1682
01:15:24,605 --> 01:15:27,141
PERSPECTIVE OF MY RELATIONSHIPS 

1683
01:15:27,141 --> 01:15:29,644
WITH CLINICIANS IS IT'S MY 

1684
01:15:29,644 --> 01:15:33,180
RELATIONSHIP

1685
01:15:33,180 --> 01:15:36,217
RELATIONSHIPS WITH THEM.  THEIR 

1686
01:15:36,217 --> 01:15:38,719
CONVERSATION TO NAVIGATE HOW TO 

1687
01:15:38,719 --> 01:15:41,022
MAINTAIN A HEALTHY -- AS HEALTHY

1688
01:15:41,022 --> 01:15:42,323
AS POSSIBLE RELATIONSHIP WITHIN 

1689
01:15:42,323 --> 01:15:43,157
THE CONFINES OF THE U.S. EHEALTH

1690
01:15:43,157 --> 01:15:48,262
CARE  SYSTEM. 

1691
01:15:48,262 --> 01:15:50,197
NOTHING'S PERFECT EXCUSE ME.  

1692
01:15:50,197 --> 01:15:51,632
AND SO I LIKE THE APPROACH OF 

1693
01:15:51,632 --> 01:15:55,670
TREATING IT LIKE A LONG-TERM 

1694
01:15:55,670 --> 01:15:57,004
RELATIONSHIP WHERE YOU ASK EACH 

1695
01:15:57,004 --> 01:15:58,906
OTHER IS THIS WORKING?  HOW IS 

1696
01:15:58,906 --> 01:16:02,877
IT WORKING?  AND ON THE TOPIC OF

1697
01:16:02,877 --> 01:16:05,279
STRESS.  AND NOT ADDING STRESS. 

1698
01:16:05,279 --> 01:16:09,183
BUT TRYING TO BE PROACTIVE.  

1699
01:16:09,183 --> 01:16:09,984
ASKING A QUESTION LIKE WHAT 

1700
01:16:09,984 --> 01:16:12,019
SUPPORT SYSTEMS DO YOU HAVE IN 

1701
01:16:12,019 --> 01:16:12,953
PLACE AND IS THERE SOMETHING 

1702
01:16:12,953 --> 01:16:15,156
THAT I CAN DO TO INCREASE THOSE 

1703
01:16:15,156 --> 01:16:18,159
SUPPORT SYSTEMS THAT CAN HELP 

1704
01:16:18,159 --> 01:16:20,928
REDUCE ANY STRESS THAT CAN BE 

1705
01:16:20,928 --> 01:16:22,096
REDUCED, LIKE, RATHER THAN 

1706
01:16:22,096 --> 01:16:25,533
PUTTING THE ONUS ON THE PATIENT 

1707
01:16:25,533 --> 01:16:27,935
TO DO THEMSELVES BEING AN ACTIVE

1708
01:16:27,935 --> 01:16:32,740
CARE PARTNER IN THAT.  AND 

1709
01:16:32,740 --> 01:16:34,341
SAYING HOW CAN I BE A PART OF 

1710
01:16:34,341 --> 01:16:36,077
REDUCING THE STRESS?  BECAUSE 

1711
01:16:36,077 --> 01:16:38,412
SOMETIMES IT IS RELATED TO THE 

1712
01:16:38,412 --> 01:16:41,115
CARE BEING RECEIVED.  IT'S NOT 

1713
01:16:41,115 --> 01:16:45,953
JUST THE LIFE OUTSIDE THE EXAM 

1714
01:16:45,953 --> 01:16:50,825
ROO

1715
01:16:50,825 --> 01:16:51,025
ROOM.

1716
01:16:51,025 --> 01:16:52,026
>> ALL RIGHT SO I WROTE
THIS 

1717
01:16:52,026 --> 01:16:53,961
DOWN BECAUSE THERE'S A LOT THAT 

1718
01:16:53,961 --> 01:16:55,162
I WANTED TO SHARE SO FIRST I 

1719
01:16:55,162 --> 01:16:57,732
WANT TO THANK YOU FOR SHARING 

1720
01:16:57,732 --> 01:17:00,067
YOUR STORY.  FOR BEING 

1721
01:17:00,067 --> 01:17:02,169
ADVOCATES.  I IMAGINE IT'S NOT 

1722
01:17:02,169 --> 01:17:03,304
EASY LIVING WITH A CAN AND 

1723
01:17:03,304 --> 01:17:06,273
HAVING TO EDUCATE PEOPLE ON THAT

1724
01:17:06,273 --> 01:17:07,675
CONDITION ON TOP OF THAT SO 

1725
01:17:07,675 --> 01:17:09,577
THANK YOU.  APPRECIATE YOUR 

1726
01:17:09,577 --> 01:17:11,145
PRESENCE HERE TODAY.  WE ALL 

1727
01:17:11,145 --> 01:17:13,914
KNOW THAT PAIN IS A COMPLEX 

1728
01:17:13,914 --> 01:17:15,950
CONDITION AND THEN WE ADD 

1729
01:17:15,950 --> 01:17:18,385
MULTIPLE LAYERS OF COMPLEXITY 

1730
01:17:18,385 --> 01:17:21,622
BASED ON EVERYTHING YOU SHARE 

1731
01:17:21,622 --> 01:17:29,330
TODAY FROM PATIENT EXPERIENCE 

1732
01:17:29,330 --> 01:17:31,165
LACK OF DIAGNOSIS.  BEING 

1733
01:17:31,165 --> 01:17:34,602
STIGMATIZED AND THE LIST GOES ON

1734
01:17:34,602 --> 01:17:36,704
AND ONTO WHAT I BELIEVE IS A 

1735
01:17:36,704 --> 01:17:37,671
SYSTEMATIC ISSUE SO TODAY WE 

1736
01:17:37,671 --> 01:17:39,740
SHARE A VERY SPECIAL MOMENT.  WE

1737
01:17:39,740 --> 01:17:43,144
HAVE PATIENTS WITH LIVED 

1738
01:17:43,144 --> 01:17:45,412
EXPERIENCES, CLINICIANS, 

1739
01:17:45,412 --> 01:17:48,415
RESEARCHERS AND LEADERS OF THE 

1740
01:17:48,415 --> 01:17:50,084
NIH IN THE SAME PLACE AND I WANT

1741
01:17:50,084 --> 01:17:54,221
TO ASK EACH ONE OF YOU, I KNOW 

1742
01:17:54,221 --> 01:17:56,657
IT'S A COMPLEX PROBLEM.  BUT 

1743
01:17:56,657 --> 01:17:57,958
WHERE DO WE START?  IF YOU COULD

1744
01:17:57,958 --> 01:17:59,627
NAME ONE THING THAT YOU WANT TO 

1745
01:17:59,627 --> 01:18:01,395
SHARE WITH ALL OF THESE PEOPLE 

1746
01:18:01,395 --> 01:18:03,964
TODAY, AND I KNOW ONE THING 

1747
01:18:03,964 --> 01:18:07,034
WON'T SOLVE ALL OF THE PROBLEMS 

1748
01:18:07,034 --> 01:18:09,003
BUT WHAT IS A -- THE PRACTICAL 

1749
01:18:09,003 --> 01:18:10,404
STEP THAT WE COULD TAKE TODAY 

1750
01:18:10,404 --> 01:18:13,474
THAT WOULD MAKE YOUR LIVED 

1751
01:18:13,474 --> 01:18:23,818
EXPERIENCE BETTER?

1752
01:18:31,826 --> 01:18:33,460
>> I'D HAVE TO STEP IN
YOUR 

1753
01:18:33,460 --> 01:18:35,162
WORLD.  WHEN I SEE YOURS, I MEAN

1754
01:18:35,162 --> 01:18:37,798
THE PHYSICIANS.  I ALWAYS HAVE 

1755
01:18:37,798 --> 01:18:39,733
TO STEP INTO THEIR WORLD TO GET 

1756
01:18:39,733 --> 01:18:42,203
THEM TO UNDERSTAND MINE.  WHEN I

1757
01:18:42,203 --> 01:18:45,973
SEE THAT I MEAN, DEFINITIONS OF 

1758
01:18:45,973 --> 01:18:49,143
SIMPLE TERMS.  YOU KNOW, I AM 

1759
01:18:49,143 --> 01:18:50,277
SOMEONE WHO JUST LOVES TO 

1760
01:18:50,277 --> 01:18:52,179
RESEARCH ON MY OWN AND FIND OUT 

1761
01:18:52,179 --> 01:18:55,282
THE DEFINITIONS BUT I SHOULDN'T 

1762
01:18:55,282 --> 01:18:58,452
HAVE HAD TO DONE THAT.  SO IF 

1763
01:18:58,452 --> 01:19:01,889
YOU CAN JUST BREAK THINGS DOWN 

1764
01:19:01,889 --> 01:19:04,859
EASIER FOR ME TO UNDERSTAND OR 

1765
01:19:04,859 --> 01:19:10,097
US TO UNDERSTAND.  AND JUST 

1766
01:19:10,097 --> 01:19:11,265
REALIZE WE DON'T HAVE THE 

1767
01:19:11,265 --> 01:19:13,467
MEDICAL DEGREE BUT THAT DIDN'T 

1768
01:19:13,467 --> 01:19:15,135
NECESSARILY MEAN WE WON'T 

1769
01:19:15,135 --> 01:19:18,339
UNDERSTAND SO I WOULD JUST SEE 

1770
01:19:18,339 --> 01:19:21,041
COMING INTO OUR WORLD AND NOT 

1771
01:19:21,041 --> 01:19:23,177
HAVING THIS SENSE OF, I'M JUST 

1772
01:19:23,177 --> 01:19:27,147
GOING TO RUN OFF ALL THESE 

1773
01:19:27,147 --> 01:19:29,149
DIAGNOSIS AND BLOOD LAB RESULTS 

1774
01:19:29,149 --> 01:19:31,986
AND OF COURSE THEY UNDERSTAND.  

1775
01:19:31,986 --> 01:19:34,154
THEY'VE BEEN PATIENTS FOR YEARS,

1776
01:19:34,154 --> 01:19:36,724
OBVIOUSLY THEY'LL UNDERSTAND.  

1777
01:19:36,724 --> 01:19:38,492
STEP INTO OUR WORLD AND THAT WE 

1778
01:19:38,492 --> 01:19:39,159
HAVE TO SEE YOUR BRAIN AND WHAT 

1779
01:19:39,159 --> 01:19:43,163
YOU SEE.

1780
01:19:43,163 --> 01:19:45,499
>> I GUESS IF I HAD TO
SHARE ONE

1781
01:19:45,499 --> 01:19:47,134
THING IT'S TO STAY HUMBLE.  WE 

1782
01:19:47,134 --> 01:19:50,738
KNOW YOU'RE EDUCATED.  YOU'RE 

1783
01:19:50,738 --> 01:19:53,707
HIGHLY EDUCATED INDIVIDUALS AND 

1784
01:19:53,707 --> 01:19:56,110
BECAUSE WE ASK QUESTIONS AS 

1785
01:19:56,110 --> 01:19:57,244
PATIENTS OR DON'T FEEL IT'S 

1786
01:19:57,244 --> 01:19:59,179
QUITE RIGHT SOMETIMES WE'RE FOOT

1787
01:19:59,179 --> 01:20:01,649
REALLY VALIDATED BECAUSE OUR 

1788
01:20:01,649 --> 01:20:03,550
EDUCATION ISN'T AS HIGH AS 

1789
01:20:03,550 --> 01:20:03,984
YOURS. 

1790
01:20:03,984 --> 01:20:07,154
SO STAY SUMMABLE BECAUSE THE 

1791
01:20:07,154 --> 01:20:08,656
SMARTEST MAN IN THE WORLD 

1792
01:20:08,656 --> 01:20:10,557
DOESN'T KNOW EVERYTHING AND HE 

1793
01:20:10,557 --> 01:20:13,494
KNOWS.  SOMETIMES WE KNOW OUR 

1794
01:20:13,494 --> 01:20:15,162
BODIES, SOMETIMES YOU'LL WE KNOW

1795
01:20:15,162 --> 01:20:16,597
YOU'LL GET BLOOD FROM AND 

1796
01:20:16,597 --> 01:20:18,866
SOMETIMES YOU DON'T LISTEN.  

1797
01:20:18,866 --> 01:20:21,936
STAY HUMBLE IS WHAT I WOULD SEE.

1798
01:20:21,936 --> 01:20:25,139
>> I'LL GO.  THIS IS
CHARIS.  SO

1799
01:20:25,139 --> 01:20:29,343
I -- THAT IS SUCH A GREAT 

1800
01:20:29,343 --> 01:20:31,912
QUESTION.  AND PUTTING THIS ALL 

1801
01:20:31,912 --> 01:20:33,347
INTO CONTEXT OF THE ENVIRONMENT 

1802
01:20:33,347 --> 01:20:38,419
WE'RE IN TODAY.  SO THANK YOU.  

1803
01:20:38,419 --> 01:20:39,320
I THINK IT'S REALLY IMPORTANT 

1804
01:20:39,320 --> 01:20:43,157
FOR ME TO SHARE THAT I OPERATE 

1805
01:20:43,157 --> 01:20:45,626
REALLY STRONGLY UNDER THE TEN 

1806
01:20:45,626 --> 01:20:49,063
PRINCIPLES OF DISABILITY JUSTICE

1807
01:20:49,063 --> 01:20:52,900
AND YOU CAN FIND THOSE ON SINS 

1808
01:20:52,900 --> 01:20:55,169
INVALID.  THAT'S A NONPROFIT IN 

1809
01:20:55,169 --> 01:20:59,173
THE BAY AREA.  AND ONE OF THOSE 

1810
01:20:59,173 --> 01:21:01,308
LEADING PRINCIPLES IS THAT THOSE

1811
01:21:01,308 --> 01:21:05,813
WHO ARE MOST IMPACTED LEAD THE 

1812
01:21:05,813 --> 01:21:10,684
CHARGE.  SO IF YOU ARE -- IF YOU

1813
01:21:10,684 --> 01:21:13,487
HAVE A PERSONAL STAKE IN THE 

1814
01:21:13,487 --> 01:21:14,955
OUTCOME, IN TERMS OF WHERE WE 

1815
01:21:14,955 --> 01:21:18,292
ARE TODAY, THAT MEANS PEOPLE 

1816
01:21:18,292 --> 01:21:20,260
LIVING IN PAIN.  THEN YOU ARE 

1817
01:21:20,260 --> 01:21:21,962
LEADING THE CHARGE, YOU ARE THE 

1818
01:21:21,962 --> 01:21:26,133
HEAD OF THE TABLE AND THAT 

1819
01:21:26,133 --> 01:21:28,969
DOESN'T MEAN WE'RE TAKING OVER. 

1820
01:21:28,969 --> 01:21:31,171
I MEAN, I WOULD BE OKAY IF PAIN 

1821
01:21:31,171 --> 01:21:33,207
PATIENTS TOOK OVER THE WORLD BUT

1822
01:21:33,207 --> 01:21:36,143
BEING LIKE FULLY EQUAL THAT 

1823
01:21:36,143 --> 01:21:39,279
MEANS FROM VERY START OF CONCEPT

1824
01:21:39,279 --> 01:21:43,384
OF THE RESEARCH TO CREATING THE 

1825
01:21:43,384 --> 01:21:47,221
OBJECTIVE TS TO RECRUITING THE 

1826
01:21:47,221 --> 01:21:49,656
PARTICIPANTS OF THE STUDY. 

1827
01:21:49,656 --> 01:21:53,660
AND TO DISSEMINATION.  O  ALL OF

1828
01:21:53,660 --> 01:21:55,562
THAT WE NEED TO BE EQUAL 

1829
01:21:55,562 --> 01:21:57,097
PARTNERS OF THE TABLE. 

1830
01:21:57,097 --> 01:21:59,666
NOT AS PEOPLE YOU BRING IN AS 

1831
01:21:59,666 --> 01:22:00,701
CONTRACTORS OR LIKE -- ONE 

1832
01:22:00,701 --> 01:22:04,938
PERSON FOR THIS, YOU KNOW, ONE 

1833
01:22:04,938 --> 01:22:06,573
SURVEY.  WE NEED TO BE PART OF 

1834
01:22:06,573 --> 01:22:10,878
THE TEAM AS EQUALS.  CREATING, 

1835
01:22:10,878 --> 01:22:14,148
DEVELOPING, DISSEMINATING AND 

1836
01:22:14,148 --> 01:22:17,584
THAT'S REALLY THE ONLY WAY THAT 

1837
01:22:17,584 --> 01:22:20,921
THOSE WHO ARE MOST IMPACTED WILL

1838
01:22:20,921 --> 01:22:23,057
BENEFIT THAT THE PRIMARY TAKE 

1839
01:22:23,057 --> 01:22:26,260
HOLDERS WHO ARE PAIN PATIENTS 

1840
01:22:26,260 --> 01:22:28,996
WHO WILL GET PAIN CARE THAT IS 

1841
01:22:28,996 --> 01:22:32,699
EQUITABLE, THAT IS MEANT FOR US.

1842
01:22:32,699 --> 01:22:35,135
>> YEAH.  I DEFINITELY,
YOU 

1843
01:22:35,135 --> 01:22:38,705
KNOW, ECHO WHAT EVERYONE HAS 

1844
01:22:38,705 --> 01:22:44,545
SAID.  ALREADY.  I THINK THE ONE

1845
01:22:44,545 --> 01:22:48,082
THING THAT I THINK COULD MAKE A 

1846
01:22:48,082 --> 01:22:51,018
DIFFERENCE IS I'M SORT OF 

1847
01:22:51,018 --> 01:22:54,188
DESPERATE TO REDUCE THE PAIN IN 

1848
01:22:54,188 --> 01:23:00,961
MY LIFE AND SO I'M ALWAYS 

1849
01:23:00,961 --> 01:23:01,628
READING AND TRYING EVERYTHING.  

1850
01:23:01,628 --> 01:23:03,163
THERE ARE A NUMBER OF TREATMENTS

1851
01:23:03,163 --> 01:23:04,665
THAT I BROUGHT TO MY 

1852
01:23:04,665 --> 01:23:06,033
RHEUMATOLOGISTS OR BROUGHT TO 

1853
01:23:06,033 --> 01:23:09,336
OTHER DOCTORS TO SEE IF WE COULD

1854
01:23:09,336 --> 01:23:15,075
TRY.  SO I THINK, YOU KNOW, KIND

1855
01:23:15,075 --> 01:23:16,977
OF GOING OFF OF WHAT CHARIS HAD 

1856
01:23:16,977 --> 01:23:19,146
SAID, LIKE THAT WE HAVE GOOD 

1857
01:23:19,146 --> 01:23:23,150
IDEAS FOR WHAT TO LOOK INTO 

1858
01:23:23,150 --> 01:23:27,621
NEXT.  AND THEN I THINK AS FAR 

1859
01:23:27,621 --> 01:23:31,158
AS CLINICIANS, SOMEONE TO JUST 

1860
01:23:31,158 --> 01:23:33,961
LOOK AT US AND FIRST ASK HOW WE 

1861
01:23:33,961 --> 01:23:37,464
ARE.  YOU KNOW, WITH EYE 

1862
01:23:37,464 --> 01:23:39,166
CONTACT, BEFORE STARTING TO TYPE

1863
01:23:39,166 --> 01:23:44,271
BY,  BUT YEAH I'M EXCITED ABOUT 

1864
01:23:44,271 --> 01:23:45,906
A FEW THINGS THAT ARE WORKING 

1865
01:23:45,906 --> 01:23:46,640
FOR ME. 

1866
01:23:46,640 --> 01:23:48,642
THAT, YOU KNOW, MIGHT BE A 

1867
01:23:48,642 --> 01:23:49,510
MEDICAL STUDIES AND I DON'T 

1868
01:23:49,510 --> 01:23:52,479
KNOW, FIVE TEN YEARS.  AND SO I 

1869
01:23:52,479 --> 01:23:55,149
WOULD LIKE SOME SORT OF 

1870
01:23:55,149 --> 01:24:02,322
OPPORTUNITY TO SHARE THOSE IDEAS

1871
01:24:02,322 --> 01:24:06,226
AS SITES FOR FUTURE RESEARCH.  

1872
01:24:06,226 --> 01:24:06,426
YEAH.

1873
01:24:06,426 --> 01:24:08,595
>> I JUST WANTED TO ADD 

1874
01:24:08,595 --> 01:24:13,233
SOMETHING TO CHARIS' POINT AS 

1875
01:24:13,233 --> 01:24:15,435
FAR AS INDIVIDUALS WHO IN THE 

1876
01:24:15,435 --> 01:24:17,638
ENTIRE PROCESS HAVE A LIVED 

1877
01:24:17,638 --> 01:24:18,805
EXPERIENCE.  MEMBER CHECKING IS 

1878
01:24:18,805 --> 01:24:21,575
SO CRITICAL.  MAKE SURE YOU HAVE

1879
01:24:21,575 --> 01:24:24,178
IT RIGHT.  AS A MENTEE OR -- I 

1880
01:24:24,178 --> 01:24:25,612
WOULD NEVER JUST PUT SOMETHING 

1881
01:24:25,612 --> 01:24:27,014
OUT THERE WITHOUT CHECKING WITH 

1882
01:24:27,014 --> 01:24:28,549
MY MENTOR, MAKING SURE THAT WE 

1883
01:24:28,549 --> 01:24:30,284
DID IT RIGHT.  WE EDIT THINGS 

1884
01:24:30,284 --> 01:24:33,253
OVER AND OVER AGAIN.  SO MEMBER 

1885
01:24:33,253 --> 01:24:37,191
CHECKING IS REALLY CRITICAL AND 

1886
01:24:37,191 --> 01:24:38,825
ALSO JUST MAKING SURE THAT 

1887
01:24:38,825 --> 01:24:39,993
YOU'RE COMING BACK AND YOU'RE 

1888
01:24:39,993 --> 01:24:41,628
SHOEING THEM WHAT YOU DID.  

1889
01:24:41,628 --> 01:24:44,198
LIKE, WHAT ALL THE WORK THAT YOU

1890
01:24:44,198 --> 01:24:45,732
DID.  IT'S -- HOW MANY TIMES 

1891
01:24:45,732 --> 01:24:47,467
HAVE WE HEARD YOU JUST WALK 

1892
01:24:47,467 --> 01:24:49,603
AWAY, THAT'S IT, RESEARCH IS 

1893
01:24:49,603 --> 01:24:51,138
DONE, YOU'RE GONE.  YOU HAVE TO 

1894
01:24:51,138 --> 01:24:52,506
COME BACK BECAUSE THESE PEOPLE 

1895
01:24:52,506 --> 01:24:55,075
INVEST THEIR LIVES, THEIR TIME, 

1896
01:24:55,075 --> 01:24:56,243
THEIR ENERGY, AND INTO DOING 

1897
01:24:56,243 --> 01:24:59,179
THIS AND THEN YOU WALK AWAY AND 

1898
01:24:59,179 --> 01:25:00,013
YOU DON'T EVEN KNOW WHAT 

1899
01:25:00,013 --> 01:25:09,590
HAPPENED TO IT.  SO, YEAH.

1900
01:25:09,590 --> 01:25:15,062
>> I HAVE AN E- - -Q.  --
QUEST 

1901
01:25:15,062 --> 01:25:16,897
I WONDER IF YOU CAN SHARE YOU 

1902
01:25:16,897 --> 01:25:18,065
WERE EXPERIENCE OF BEING BOTH 

1903
01:25:18,065 --> 01:25:19,433
WITH YOUR PAIN, BEING BOTH A 

1904
01:25:19,433 --> 01:25:29,743
CHILD AND HAVING A DISORDER THA 

1905
01:25:29,743 --> 01:25:30,344
I WONDER IF YOU CAN SHARE YOU 

1906
01:25:30,344 --> 01:25:30,944
WERE EXPERIENCE OF BEING BOTH 

1907
01:25:30,944 --> 01:25:31,545
WITH YOUR PAIN, BEING BOTH A 

1908
01:25:31,545 --> 01:25:33,280
CHILD AND HAVING A DISORDER THAT

1909
01:25:33,280 --> 01:25:36,049
IS DEFINED BY HAVING A UTERUS OR

1910
01:25:36,049 --> 01:25:39,219
YOUR ANCESTRY AND HOW YOU FELT 

1911
01:25:39,219 --> 01:25:43,457
THAT COMPROMISED ANY PART OF THE

1912
01:25:43,457 --> 01:25:53,667
EXPERIEN

1913
01:26:02,609 --> 01:26:02,843
EXPERIENCE?

1914
01:26:02,843 --> 01:26:05,979
>> I HAD A WALL IN MY
UTERUS.  

1915
01:26:05,979 --> 01:26:07,547
AND FOR MONTHS AND MONTHS AND 

1916
01:26:07,547 --> 01:26:09,216
MONTHS I KEPT TELLING PEOPLE I 

1917
01:26:09,216 --> 01:26:12,986
WAS IN PAIN.  AND NOBODY 

1918
01:26:12,986 --> 01:26:16,990
COULD -- NOBODY KNEW WHY.  I WAS

1919
01:26:16,990 --> 01:26:18,692
KIND OF IGNORED FOR AWHILE AND 

1920
01:26:18,692 --> 01:26:22,529
WAS CALLED PAIN SEEKING AT 11.  

1921
01:26:22,529 --> 01:26:24,998
MEDICATION SEEKING AT 11.  AND 

1922
01:26:24,998 --> 01:26:27,167
IT WASN'T UNTIL A DOCTOR SAID, 

1923
01:26:27,167 --> 01:26:29,303
OH, LET'S DO A SONOGRAM THAT 

1924
01:26:29,303 --> 01:26:32,339
THEY FOUND I HAD A MASS INSIDE 

1925
01:26:32,339 --> 01:26:34,574
MY UTERUS.  I WAS MISSING A 

1926
01:26:34,574 --> 01:26:37,344
KIDNEY AND I HAD A FALLOPIAN 

1927
01:26:37,344 --> 01:26:38,745
TUBE WRAPPED AROUND THE OTHER 

1928
01:26:38,745 --> 01:26:41,448
ONE AND FOR ME AS A CHILD IT 

1929
01:26:41,448 --> 01:26:43,150
IMMEDIATELY KIND OF DREW THIS 

1930
01:26:43,150 --> 01:26:46,386
LINE OF TRUST.  RIGHT?  I NEEDED

1931
01:26:46,386 --> 01:26:49,723
HELP.  I COULDN'T WALK.  BECAUSE

1932
01:26:49,723 --> 01:26:51,325
THIS MASS WAS PUSHING ON MY 

1933
01:26:51,325 --> 01:26:53,160
BLADDER, ON MY INTESTINES, I 

1934
01:26:53,160 --> 01:26:55,195
COULDN'T PEE OR POOP.  I WAS 

1935
01:26:55,195 --> 01:26:58,899
HUNCHED OVER.  AND CALLED PAIN 

1936
01:26:58,899 --> 01:27:02,769
SEEKING.  OR MEDICATION SEEKING.

1937
01:27:02,769 --> 01:27:05,572
AT 11.  SO I THINK AS AN ADULT, 

1938
01:27:05,572 --> 01:27:07,007
I ADVOCATE STRONGLY, INDUSTRIAL,

1939
01:27:07,007 --> 01:27:10,677
MY MOM IS PASSED AND I STILL 

1940
01:27:10,677 --> 01:27:15,148
ADVOCATE FOR HER, BUT WHEN IT 

1941
01:27:15,148 --> 01:27:20,354
COMES TO ADVOCATING FOR MYSELF 

1942
01:27:20,354 --> 01:27:22,556
AND HOW LITTLE I FELT THAT HAS 

1943
01:27:22,556 --> 01:27:25,225
TRANSCENDED TO ME AS AN ADULT SO

1944
01:27:25,225 --> 01:27:27,160
SOMETIMES WHEN I HAVE A FLARE 

1945
01:27:27,160 --> 01:27:30,263
AND I CAN'T WALK I DON'T ASK FOR

1946
01:27:30,263 --> 01:27:32,499
HELP, I DON'T NEED THE JUDGMENT.

1947
01:27:32,499 --> 01:27:34,201
I THINK THAT EXPERIENCE AS A 

1948
01:27:34,201 --> 01:27:37,404
CHILD REALLY IMPACTED ME AND 

1949
01:27:37,404 --> 01:27:39,973
ALSO BEING -- HAVING SUCH A 

1950
01:27:39,973 --> 01:27:41,241
GENDER SPECIFIC ILLNESS WHERE 

1951
01:27:41,241 --> 01:27:43,877
IT'S LIKE, OH, YOU GET A PERIOD 

1952
01:27:43,877 --> 01:27:45,178
EVERY MONTH, YOU'RE SUPPOSED TO 

1953
01:27:45,178 --> 01:27:48,949
BE IN PAIN.  YOU KNOW, I DON'T 

1954
01:27:48,949 --> 01:27:51,151
ASK FOR HELP.  I BEACH MYSELF ON

1955
01:27:51,151 --> 01:27:53,220
A COUCH AND I TELL EVERYBODY YOU

1956
01:27:53,220 --> 01:27:54,388
KNOW WHAT TIME IT IS JUST LEAVE 

1957
01:27:54,388 --> 01:27:56,857
ME ALONE FOR THREE DAYS, I'M 

1958
01:27:56,857 --> 01:28:00,460
JUST GOING TO STAY THERE AND I 

1959
01:28:00,460 --> 01:28:04,664
JUST THINK WE'RE GETTING MORE 

1960
01:28:04,664 --> 01:28:09,102
EXPOSURE TO ENDOMETRIOSIS AND 

1961
01:28:09,102 --> 01:28:11,138
WHAT WOMEN GO THROUGH MONTHLY.  

1962
01:28:11,138 --> 01:28:16,810
ONE IN TEN WOMEN WILL HAVE 

1963
01:28:16,810 --> 01:28:19,112
ENDOMETRIOSIS AND IT IS A VERY 

1964
01:28:19,112 --> 01:28:21,648
PAINFUL THING THAT STARTS AT A 

1965
01:28:21,648 --> 01:28:22,015
VERY YOUNG AGE.

1966
01:28:22,015 --> 01:28:25,752
>> FOR ME THERE'S SO MUCH
I 

1967
01:28:25,752 --> 01:28:29,356
DIDN'T KNOW ABOUT MY ILLNESS 

1968
01:28:29,356 --> 01:28:32,325
UNTIL I WAS AN ADULT.  THINKING 

1969
01:28:32,325 --> 01:28:33,960
THAT THIS DISEASE ONLY AFFECTED 

1970
01:28:33,960 --> 01:28:36,530
BLACK PEOPLE OR AFRICAN 

1971
01:28:36,530 --> 01:28:38,331
AMERICANS.  SO NOT KNOW THAT ALL

1972
01:28:38,331 --> 01:28:40,834
RACES CAN EXPERIENCE OR LIKE 

1973
01:28:40,834 --> 01:28:46,006
HAVE SICKLE CELL.  I SHOULD HAVE

1974
01:28:46,006 --> 01:28:47,908
KNOWN THAT EARLIER.  I FELT 

1975
01:28:47,908 --> 01:28:49,943
ALONE.  IN MY OWN COMMUNITY I 

1976
01:28:49,943 --> 01:28:52,512
WAS ONE OF NONE.  LIKE I JUST 

1977
01:28:52,512 --> 01:28:57,918
WAS SO OSTRACIZED NOT KNOWING 

1978
01:28:57,918 --> 01:29:00,320
MUCH ABOUT MY ILLNESS AT A 

1979
01:29:00,320 --> 01:29:03,156
YOUNGER AGE WHEN THEN I WOULD 

1980
01:29:03,156 --> 01:29:06,593
ALSO SEE DIFFERENT TREATMENT OF 

1981
01:29:06,593 --> 01:29:09,129
HOW MY DIAGNOSIS WAS HANDLED 

1982
01:29:09,129 --> 01:29:10,764
DIFFERENTLY IN THE HOSPITAL THAN

1983
01:29:10,764 --> 01:29:12,098
OTHER DIAGNOSIS.  THEY KNEW SO 

1984
01:29:12,098 --> 01:29:15,168
MUCH MORE ABOUT.  BUT STILL I 

1985
01:29:15,168 --> 01:29:17,938
FELT THEY STILL DIDN'T KNOW MUCH

1986
01:29:17,938 --> 01:29:20,407
ABOUT MINE.  EVEN AS A CHILD I 

1987
01:29:20,407 --> 01:29:21,708
WITNESSED, YOU KNOW, NO ONE 

1988
01:29:21,708 --> 01:29:24,077
REALLY CARES ABOUT YOUR ILLNESS.

1989
01:29:24,077 --> 01:29:28,448
THEY DON'T KNOW ABOUT IT.  

1990
01:29:28,448 --> 01:29:28,949
SO....

1991
01:29:28,949 --> 01:29:31,985
>> THANK YOU SO MUCH.  I
HAVE 20

1992
01:29:31,985 --> 01:29:32,986
MORE QUESTIONS AT LEAST AND 

1993
01:29:32,986 --> 01:29:35,922
LUCKILY I HAVE YOUR E-MAILS SO I

1994
01:29:35,922 --> 01:29:37,724
CAN FOLLOW UP.  BUT IF ANYBODY 

1995
01:29:37,724 --> 01:29:39,993
ELSE WANTS TO FOLLOW UP AND HAS 

1996
01:29:39,993 --> 01:29:48,001
QUESTIONS.  MY ENA-ME-MAIL.  PL 

1997
01:29:48,001 --> 01:29:49,803
FEEL FREE TO REACH OUT TO ME AND

1998
01:29:49,803 --> 01:29:52,038
I CAN FIND OUT HOW TO CONNECT 

1999
01:29:52,038 --> 01:29:54,441
WITH THESE PEOPLE IN A NON 

2000
01:29:54,441 --> 01:29:56,810
EXHAUSTING WAY.  

2001
01:29:56,810 --> 01:30:02,682
THANK YOU SO MUCH, THIS HAS BEEN

2002
01:30:02,682 --> 01:30:02,916
AMAZING.

2003
01:30:02,916 --> 01:30:13,159
>> THANK YOU.

2004
01:31:09,349 --> 01:31:11,084
>> ALL RIGHT.  GOOD
MORNING.  

2005
01:31:11,084 --> 01:31:13,219
I'M ANDREW MANNES, I'M CHIEF OF 

2006
01:31:13,219 --> 01:31:15,155
THE DEPARTMENT HERE AT THE 

2007
01:31:15,155 --> 01:31:15,789
NATIONAL INSTITUTES OF HEALTH 

2008
01:31:15,789 --> 01:31:17,290
WE'RE NOW AT THE HOMESTRETCH 

2009
01:31:17,290 --> 01:31:18,625
THIS IS THE LAST PANEL OF THE 

2010
01:31:18,625 --> 01:31:21,294
DAY.  THE CONFERENCE.  AND I'LL 

2011
01:31:21,294 --> 01:31:23,029
JUMP RIGHT INTO THE -- WITH -- 

2012
01:31:23,029 --> 01:31:24,965
INTO THE INTRODUCTION FOR OUR 

2013
01:31:24,965 --> 01:31:27,067
FIRST PANELIST.  I THINK WE'RE 

2014
01:31:27,067 --> 01:31:30,403
GOING HAVE THE QUESTION AND 

2015
01:31:30,403 --> 01:31:32,439
ANSWER AT THE END.  I HAVE THE 

2016
01:31:32,439 --> 01:31:34,441
PLEASURE OF INTRODUCING OUR 

2017
01:31:34,441 --> 01:31:38,912
FIRST PANELIST TODAY, DIANE 

2018
01:31:38,912 --> 01:31:41,881
HOFFMAN.  WHO IS THE JACOB A. 

2019
01:31:41,881 --> 01:31:43,183
FRANCE PROFESSOR AT HEALTH LAW 

2020
01:31:43,183 --> 01:31:46,019
AT THE UNIVERSITY OF MARYLAND, 

2021
01:31:46,019 --> 01:31:47,153
CARRIE SCHOOL OF LAW, 

2022
01:31:47,153 --> 01:31:49,289
DISTINGUISHED UNIVERSITY 

2023
01:31:49,289 --> 01:31:50,724
PROFESSOR AND DIRECTOR OF THE 

2024
01:31:50,724 --> 01:31:52,626
SCHOOL'S LAW AND HEALTH CARE 

2025
01:31:52,626 --> 01:31:54,394
PROGRAM.  SHE RECEIVED HER LAW 

2026
01:31:54,394 --> 01:31:57,697
DEGREE FROM HARVARD AND RECEIVED

2027
01:31:57,697 --> 01:31:59,499
HER MASTER'S FROM THE SAME 

2028
01:31:59,499 --> 01:32:00,700
INSTITUTION.  AND ONE OF THE 

2029
01:32:00,700 --> 01:32:05,138
PRIMARY AUTHORS OF THE HEALTH 

2030
01:32:05,138 --> 01:32:06,172
CARE ACT WHICH ESTABLISHES 

2031
01:32:06,172 --> 01:32:07,774
PROCEDURES AT THE END OF LIFE 

2032
01:32:07,774 --> 01:32:09,175
WHO LACK DECISION-MAKING 

2033
01:32:09,175 --> 01:32:10,310
CAPACITY.  SHE SERVED AS THE 

2034
01:32:10,310 --> 01:32:12,979
MEMBER OF A NUMBER OF ETHICS 

2035
01:32:12,979 --> 01:32:13,613
COMMITTEES INCLUDING THOSE AT 

2036
01:32:13,613 --> 01:32:14,914
THE UNIVERSITY OF MARYLAND 

2037
01:32:14,914 --> 01:32:16,216
MEDICAL SYSTEM.  AND ALSO HERE 

2038
01:32:16,216 --> 01:32:18,985
AT THE CLINICAL CENTER AT THE 

2039
01:32:18,985 --> 01:32:19,853
NATIONAL INSTITUTES OF HEALTH.  

2040
01:32:19,853 --> 01:32:22,389
DR. HOFFMAN WAS THE ACTING STAFF

2041
01:32:22,389 --> 01:32:23,857
DIRECTOR AT THE SENATE SUB 

2042
01:32:23,857 --> 01:32:25,959
COMMITTEE ON AGING, SERVED AS A 

2043
01:32:25,959 --> 01:32:27,727
MEMBER OF THE BOARD OF DIRECTORS

2044
01:32:27,727 --> 01:32:30,964
AT THE AMERICAN SOCIETY OF LAW, 

2045
01:32:30,964 --> 01:32:32,732
MEDICINE AND ETHICS.  SHE 

2046
01:32:32,732 --> 01:32:34,668
CURRENTLY CHAIRS THE MARYLAND 

2047
01:32:34,668 --> 01:32:35,235
STEM CELL MISSION AND IS 

2048
01:32:35,235 --> 01:32:37,570
CO-CHAIR OF THE U.S. ASSOCIATION

2049
01:32:37,570 --> 01:32:41,207
OF THE STUDY OF PAIN ADVOCACY 

2050
01:32:41,207 --> 01:32:43,176
COMMITTEE.  HAS PUBLISHED 

2051
01:32:43,176 --> 01:32:45,679
NUMEROUS ARTICLES ON PAIN ISSUES

2052
01:32:45,679 --> 01:32:47,414
IN LEADING SCIENTIFIC JOURNALS A

2053
01:32:47,414 --> 01:32:48,615
SIGNIFICANT AMOUNT OF HER 

2054
01:32:48,615 --> 01:32:51,685
SCHOLARSHIP FOCUSED ON LEGAL 

2055
01:32:51,685 --> 01:32:52,419
OBSTACLES FOR THE TREATMENT OF 

2056
01:32:52,419 --> 01:32:55,155
PAIN AND INCLUDES PAIN 

2057
01:32:55,155 --> 01:32:57,223
MANAGEMENT IN TER RAH OF MANAGED

2058
01:32:57,223 --> 01:33:00,627
CARE.  THE ROLE OF THE MEDICAL 

2059
01:33:00,627 --> 01:33:01,828
BOARDS.  REGULATION OF MEDICAL 

2060
01:33:01,828 --> 01:33:05,098
MARIJUANA.  CRIMINAL PROSECUTION

2061
01:33:05,098 --> 01:33:07,167
OF PHYSICIANS FOR 

2062
01:33:07,167 --> 01:33:08,668
OVERPRESCRIBING OF OPIATES AND 

2063
01:33:08,668 --> 01:33:10,670
MOST IMPORTANTLY FOR TODAY, IS A

2064
01:33:10,670 --> 01:33:12,172
BIAS AGAINST WOMEN IN THE 

2065
01:33:12,172 --> 01:33:13,840
TREATMENT OF PAIN.  TODAY'S TALK

2066
01:33:13,840 --> 01:33:16,342
IS THE DISPARITY AND PAIN 

2067
01:33:16,342 --> 01:33:19,145
TREATMENT BASED ON SEX.  

2068
01:33:19,145 --> 01:33:29,389
DR. HOFFMAN.

2069
01:33:33,593 --> 01:33:35,195
>> GOOD MORNING, EVERYONE,
IT'S 

2070
01:33:35,195 --> 01:33:36,362
A PLEASURE TO BE HERE AND TO 

2071
01:33:36,362 --> 01:33:37,430
HAVE THE OPPORTUNITY TO SPEAK 

2072
01:33:37,430 --> 01:33:39,165
WITH YOU TODAY.  SO YOU HEARD 

2073
01:33:39,165 --> 01:33:42,235
I'M NOT A SCIENTIST, I'M A LAW 

2074
01:33:42,235 --> 01:33:44,170
PROFESSOR, BY I HAVE DONE A 

2075
01:33:44,170 --> 01:33:46,039
SIGNIFICANT AMOUNT OF RESEARCH 

2076
01:33:46,039 --> 01:33:50,510
ON THE TOPICS OF DISPARITIES IN 

2077
01:33:50,510 --> 01:33:52,045
THE TREATMENT OF PAIN BASED ON 

2078
01:33:52,045 --> 01:33:53,780
SEX AND IN MY SHORT TIME THIS 

2079
01:33:53,780 --> 01:33:55,148
MORNING I WOULD LIKE TO SHARE 

2080
01:33:55,148 --> 01:33:56,783
WITH YOU THE STORY OF THE 

2081
01:33:56,783 --> 01:33:58,952
EVOLUTION OF MY WORK IN THIS 

2082
01:33:58,952 --> 01:34:02,088
AREA.  SO IN 2001 I PUBLISHED AN

2083
01:34:02,088 --> 01:34:03,890
ARTICLE CALLED THE GIRL WHO 

2084
01:34:03,890 --> 01:34:07,193
CRIED PAIN A BIAS AGAINST WOMEN 

2085
01:34:07,193 --> 01:34:11,598
IN THE TREATMENT OF PAIN AND 

2086
01:34:11,598 --> 01:34:15,168
MOST OF MY WRITING BEFORE THAT 

2087
01:34:15,168 --> 01:34:21,508
WAS ON FINANCIALING INGOBSTACLE 

2088
01:34:21,508 --> 01:34:22,542
WHILE I WAS DOING THE RESEARCH I

2089
01:34:22,542 --> 01:34:24,778
CAME ACROSS AN ARTICLE ABOUT 

2090
01:34:24,778 --> 01:34:27,147
LOOKING AT HOW MEN AND WOMEN 

2091
01:34:27,147 --> 01:34:29,415
WERE TREATED FOR THEIR PAIN 

2092
01:34:29,415 --> 01:34:32,252
AFTER CORONARY ARTERY BYPASS 

2093
01:34:32,252 --> 01:34:34,621
GRAFT SURGERY AND MEN WERE MORE 

2094
01:34:34,621 --> 01:34:36,489
LIKELY TO BE GIVEN ANALGESIA AND

2095
01:34:36,489 --> 01:34:38,491
WOMEN FOR LIKELY TO BE GIVEN 

2096
01:34:38,491 --> 01:34:44,464
SEDATIVES AND I WAS TROUBLED BY 

2097
01:34:44,464 --> 01:34:46,599
THAT RESULT BUT I WANTED TO SEE 

2098
01:34:46,599 --> 01:34:48,802
HOW WIDESPREAD THE TREATMENT WAS

2099
01:34:48,802 --> 01:34:49,803
BUT BEFORE THEY NEEDED TO LEARN 

2100
01:34:49,803 --> 01:34:52,038
MORE ABOUT WHAT WAS AT THE TIME 

2101
01:34:52,038 --> 01:34:53,106
ABOUT HOW MEN AND WOMEN 

2102
01:34:53,106 --> 01:34:54,674
EXPERIENCE AND REPORT PAIN AND 

2103
01:34:54,674 --> 01:34:55,475
WHETHER THERE WERE DIFFERENCES 

2104
01:34:55,475 --> 01:34:59,746
IN THE BIOLOGICAL AND 

2105
01:34:59,746 --> 01:35:01,915
PSYCHOSOCIAL BASES OF PAIN 

2106
01:35:01,915 --> 01:35:03,583
BETWEEN MEN AND WOMEN.  BASED ON

2107
01:35:03,583 --> 01:35:07,153
A LITERATURE REVIEW MY COAUTHOR 

2108
01:35:07,153 --> 01:35:08,688
AND I FOUND THAT WOMEN WERE MORE

2109
01:35:08,688 --> 01:35:11,124
LIKELY THAN MEN TO EXPERIENCE AT

2110
01:35:11,124 --> 01:35:13,493
LEAST, OR AT LEAST REPORT A 

2111
01:35:13,493 --> 01:35:15,528
NUMBER OF CHRONIC PAIN 

2112
01:35:15,528 --> 01:35:17,931
CONDITIONS AND IN ADDITION, IN 

2113
01:35:17,931 --> 01:35:21,901
EXPERIMENTAL SETTINGS, WOMEN HAD

2114
01:35:21,901 --> 01:35:23,536
LOWER THRESHOLDS, LOWER PAIN 

2115
01:35:23,536 --> 01:35:24,671
TOLERANCE THAN MEN.  THESE ARE 

2116
01:35:24,671 --> 01:35:27,407
THINGS THAT WE ALL KNOW NOW.  

2117
01:35:27,407 --> 01:35:30,343
BUT DESPITE THE DIFFERENCES IN 

2118
01:35:30,343 --> 01:35:31,578
PAIN EXPERIENCE, SEVERAL STUDIES

2119
01:35:31,578 --> 01:35:34,848
AT THE TIME ALSO INDICATED THAT 

2120
01:35:34,848 --> 01:35:37,650
WOMEN WERE MORE LIKELY TO BE 

2121
01:35:37,650 --> 01:35:38,284
INADEQUATELY TREATED FOR THEIR 

2122
01:35:38,284 --> 01:35:43,022
PAIN AND SO WE ATTRIBUTED THAT 

2123
01:35:43,022 --> 01:35:48,628
FINDING TO HEALTH CARE PROVIDERS

2124
01:35:48,628 --> 01:35:51,464
WHO WERE MORE LIKELY TO DISCOUNT

2125
01:35:51,464 --> 01:35:52,565
WOMEN'S VERBAL REPORTS AND GAVE 

2126
01:35:52,565 --> 01:35:54,734
MORE IMPORTANCE TO BIOLOGICAL 

2127
01:35:54,734 --> 01:35:57,303
PAIN CONTRIBUTORS THAN EMOTIONAL

2128
01:35:57,303 --> 01:35:59,172
OR PSYCHOLOGICAL CONTRIBUTORS.  

2129
01:35:59,172 --> 01:36:03,142
THE ARTICLE TO MY SURPRISE 

2130
01:36:03,142 --> 01:36:07,146
THOUGH STRUCK A CHORD WITH H

2131
01:36:07,146 --> 01:36:11,251
HIM -- WOMEN AND JOURNALISTS. 

2132
01:36:11,251 --> 01:36:12,652
THE NEW YORK TIMES POSTED A 

2133
01:36:12,652 --> 01:36:15,154
THREE PAGE ARTICLE BASED LARGELY

2134
01:36:15,154 --> 01:36:17,557
ON OUR ARTICLE AND POSSIBLY AS A

2135
01:36:17,557 --> 01:36:19,926
RESULT, THE ARTICLE HAS BEEN 

2136
01:36:19,926 --> 01:36:21,628
CITED MANY, MANY TIMES. 

2137
01:36:21,628 --> 01:36:24,097
AND OVER THE SUBSEQUENT 20 YEARS

2138
01:36:24,097 --> 01:36:25,098
I RECEIVED MANY CALLS FROM 

2139
01:36:25,098 --> 01:36:27,066
JOURNALISTS AND REPORTERS WHO 

2140
01:36:27,066 --> 01:36:29,469
WANTED TO TALK TO ME ABOUT MY 

2141
01:36:29,469 --> 01:36:30,670
FINDINGS AND WANTED TO KNOW 

2142
01:36:30,670 --> 01:36:33,640
WHETHER IT WAS STILL THE CASE 

2143
01:36:33,640 --> 01:36:34,974
THAT THERE WERE THESE TREATMENT 

2144
01:36:34,974 --> 01:36:36,276
DISPARITIES AND AFTER AWHILE I 

2145
01:36:36,276 --> 01:36:38,311
WOULD SEE TO THEM I REALLY DON'T

2146
01:36:38,311 --> 01:36:40,680
KNOW THE ARTICLE WAS PUBLISHED 

2147
01:36:40,680 --> 01:36:41,948
MANY YEARS AGO AND I DON'T KNOW 

2148
01:36:41,948 --> 01:36:43,383
IF THINGS WERE THE SAME SO I 

2149
01:36:43,383 --> 01:36:45,785
DECIDED TO WRITE A FOLLOW UP 

2150
01:36:45,785 --> 01:36:48,454
ARTICLE DESCRIBING BOTH WHAT 

2151
01:36:48,454 --> 01:36:51,157
RESEARCHERS HAD LEARNED OVER THE

2152
01:36:51,157 --> 01:36:53,860
LAST 20 YEARS ABOUT THE CAUSES 

2153
01:36:53,860 --> 01:36:56,029
AND EXPERIENCE OF CHRONIC PAIN 

2154
01:36:56,029 --> 01:36:59,198
FOR MEN AND WOMEN.  ALONG WITH 

2155
01:36:59,198 --> 01:37:02,669
WHETHER DISPARITIES IN TREATMENT

2156
01:37:02,669 --> 01:37:05,371
STILL EXISTED SO THE SECOND 

2157
01:37:05,371 --> 01:37:12,345
ARTICLE WAS CALLED THE WOMAN WHO

2158
01:37:12,345 --> 01:37:14,013
CRIED PAIN AND THAT WAS 

2159
01:37:14,013 --> 01:37:23,122
PUBLISHED IN 2022.  THIS WAS 

2160
01:37:23,122 --> 01:37:27,160
COAUTHORED WITH ROGER WHO WE 

2161
01:37:27,160 --> 01:37:29,595
HEARD FROM YESTERDAY.  AND 

2162
01:37:29,595 --> 01:37:31,130
KRISTIN VEEZLY THE DIRECTOR OF 

2163
01:37:31,130 --> 01:37:33,499
THE CHRONIC PAIN RESEARCH 

2164
01:37:33,499 --> 01:37:34,801
ALLIANCE.  THIS ARTICLE LIKE THE

2165
01:37:34,801 --> 01:37:36,002
ORIGINAL FIRST DESCRIBED WHAT WE

2166
01:37:36,002 --> 01:37:39,138
KNOW ABOUT DIFFERENCES IN 

2167
01:37:39,138 --> 01:37:40,039
BIOLOGY.  

2168
01:37:40,039 --> 01:37:41,574
AND PSYCHOSOCIAL FACTORS BETWEEN

2169
01:37:41,574 --> 01:37:45,078
MEN AND WOMEN THAT LEAD TO 

2170
01:37:45,078 --> 01:37:46,045
DIFFERENCES IN THEIR PAIN AND 

2171
01:37:46,045 --> 01:37:47,880
THEN REPORTED ON THE STUDIES 

2172
01:37:47,880 --> 01:37:49,482
THAT LOOKED AT WHETHER MEN AND 

2173
01:37:49,482 --> 01:37:51,150
WOMEN ARE TREATED DIFFERENTLY.  

2174
01:37:51,150 --> 01:37:53,720
FOR THEIR PAIN.  AND WHETHER 

2175
01:37:53,720 --> 01:37:55,455
THAT INFLUENCE MIGHT BE DUE TO 

2176
01:37:55,455 --> 01:37:57,790
IMPLICIT BIAS OR OTHER REASONS. 

2177
01:37:57,790 --> 01:38:00,360
OUR ARTICLE FOCUSED ON SEX 

2178
01:38:00,360 --> 01:38:02,695
THOUGH AS A BINARY 

2179
01:38:02,695 --> 01:38:04,063
CHARACTERISTICS BASED ON 

2180
01:38:04,063 --> 01:38:05,031
REPRODUCTIVE ORGANS AND 

2181
01:38:05,031 --> 01:38:07,633
FUNCTIONS ASSIGNED BY CHROMOSOME

2182
01:38:07,633 --> 01:38:10,036
COMPLEMENT.  ALTHOUGH WE 

2183
01:38:10,036 --> 01:38:14,674
RECOGNIZE THAT THAT CONCEPTS 

2184
01:38:14,674 --> 01:38:16,175
WERE OUTMODED THE CONCEPTS WSH 

2185
01:38:16,175 --> 01:38:19,145
NOT CATEGORIZING INTO OTHER 

2186
01:38:19,145 --> 01:38:19,912
GENDER-BASED CATEGORIES. 

2187
01:38:19,912 --> 01:38:22,048
AND I'M SO EXCITE THAT HAD THIS 

2188
01:38:22,048 --> 01:38:22,982
CONFERENCE THAT PEOPLE THAT 

2189
01:38:22,982 --> 01:38:29,155
PEOPLE ARE LOOKING AT THAT AS

2190
01:38:29,155 --> 01:38:29,655
RESEARCHERS. 

2191
01:38:29,655 --> 01:38:31,824
BUT MY FOCUS WAS LOOKING AT THE 

2192
01:38:31,824 --> 01:38:33,026
LITERATURE ON DIFFERENCES IN 

2193
01:38:33,026 --> 01:38:35,161
PAIN TREATMENT.  OVER THE LAST 

2194
01:38:35,161 --> 01:38:38,197
TWO DECADES.  SO ALTHOUGH 

2195
01:38:38,197 --> 01:38:39,932
ANECDOTAL REPORTS HAD FUELLED 

2196
01:38:39,932 --> 01:38:42,368
ASSERTIONS OF DISPARITIES AND 

2197
01:38:42,368 --> 01:38:43,770
PAIN TREATMENT BASED ON SEX A 

2198
01:38:43,770 --> 01:38:45,805
REVIEW OF THE LITERATURE 

2199
01:38:45,805 --> 01:38:46,773
REVEALED THERE WERE REALLY NOT 

2200
01:38:46,773 --> 01:38:48,207
THAT MANY WELL DESIGNED AND 

2201
01:38:48,207 --> 01:38:50,743
SUFFICIENTLY POWERED STUDIES 

2202
01:38:50,743 --> 01:38:52,245
THAT LOOKED AT WHETHER WOMEN AND

2203
01:38:52,245 --> 01:38:54,247
MEN WERE TREATED OR DIAGNOSED 

2204
01:38:54,247 --> 01:38:55,715
DIFFERENTLY FOR THEIR PAIN THOSE

2205
01:38:55,715 --> 01:38:57,450
THAT HAD BEEN CONTRADICTED CAN 

2206
01:38:57,450 --> 01:38:58,484
BE CATEGORIZED INTO THREE 

2207
01:38:58,484 --> 01:38:59,185
GROUPS. 

2208
01:38:59,185 --> 01:39:02,121
THOSE THAT FOCUSED ON 

2209
01:39:02,121 --> 01:39:03,056
DIFFERENCES IN TREATMENT OR 

2210
01:39:03,056 --> 01:39:05,558
DIAGNOSIS BETWEEN MEN AND WOMEN 

2211
01:39:05,558 --> 01:39:07,460
FOR SPECIFIC MEDICAL CONDITIONS 

2212
01:39:07,460 --> 01:39:10,696
THAT WERE NOT JUST PAIN. 

2213
01:39:10,696 --> 01:39:15,501
THINGS LIKE CORONARY DISEASES OR

2214
01:39:15,501 --> 01:39:23,142
CONDITIONS OR STROKE.  SECOND 

2215
01:39:23,142 --> 01:39:26,979
WERE STUDIES IN PAIN IN THE 

2216
01:39:26,979 --> 01:39:27,613
EMERGENCY SETTINGS AND THIRD WAS

2217
01:39:27,613 --> 01:39:29,949
UNIQUE TO WOMEN.  SO AN EXAMPLE 

2218
01:39:29,949 --> 01:39:32,585
OF THE LATTER, IS A STUDY 

2219
01:39:32,585 --> 01:39:35,955
CONDUCTED BY HARLOW AND STEWART 

2220
01:39:35,955 --> 01:39:44,931
OF WOMEN WITH CHRONIC AS A RULE 

2221
01:39:44,931 --> 01:39:47,066
VAR PAIN.  SIMILARLY ARTICLES 

2222
01:39:47,066 --> 01:39:51,537
FOUND THAT 50% OF WOMEN WITH 

2223
01:39:51,537 --> 01:39:52,538
ENDOMETRIOSIS SAW AT LEAST FIVE 

2224
01:39:52,538 --> 01:39:54,707
HEALTH CARE PROVIDERS BEFORE 

2225
01:39:54,707 --> 01:39:56,042
RECEIVING A DIAGNOSIS AND A 

2226
01:39:56,042 --> 01:39:56,309
REFERRAL. 

2227
01:39:56,309 --> 01:39:59,178
AND A FEW STUDIES HAD LOOKED AT 

2228
01:39:59,178 --> 01:40:00,980
SEX BASED TREATMENT OR 

2229
01:40:00,980 --> 01:40:03,082
DIAGNOSTIC DISPARITIES FOR 

2230
01:40:03,082 --> 01:40:07,320
STROKE AND CARDIAC CASES WHERE 

2231
01:40:07,320 --> 01:40:08,087
PATIENTS MAY PRESENT WITH PAIN 

2232
01:40:08,087 --> 01:40:13,493
IN A STUDY TO ASSESS MISSED 

2233
01:40:13,493 --> 01:40:15,161
STROKES IN THE EMERGENCY 

2234
01:40:15,161 --> 01:40:22,068
DEPARTMENT, NEWMAN SAW 187,000 

2235
01:40:22,068 --> 01:40:25,872
RECORDS OF STROKE ADMISSIONS 

2236
01:40:25,872 --> 01:40:27,540
WITH DISCHARGE FROM OVER ONE 

2237
01:40:27,540 --> 01:40:29,609
THOUSAND HOSPITALS IN NINE 

2238
01:40:29,609 --> 01:40:31,144
STATES.  THEY FOUND THE TWO MOST

2239
01:40:31,144 --> 01:40:34,147
COMMON PRESENTING SYMPTOMS FOR 

2240
01:40:34,147 --> 01:40:35,948
STROKE MISDIAGNOSIS IN THE 

2241
01:40:35,948 --> 01:40:36,883
EMERGENCY DEPARTMENT WERE 

2242
01:40:36,883 --> 01:40:37,717
DIZZINESS AND HEADACHE.  AND 

2243
01:40:37,717 --> 01:40:40,052
THAT WOMEN WERE MUCH MORE LIKELY

2244
01:40:40,052 --> 01:40:45,892
TO BE MISDIAGNOSED THAN MEN.  

2245
01:40:45,892 --> 01:40:46,993
WHEN ASSESSING PATIENTS FOR 

2246
01:40:46,993 --> 01:40:49,362
STROKE THEY SHOULD BE MORE 

2247
01:40:49,362 --> 01:40:50,596
ATTENTIVE TO THE SYMPTOMS OF 

2248
01:40:50,596 --> 01:40:52,732
WOMEN AS WELL AS YOUNGER AND 

2249
01:40:52,732 --> 01:40:54,634
NONWHITE PATIENTS AND THAT 

2250
01:40:54,634 --> 01:40:56,335
FUNDING AGENCIES SHOULD SUPPORT 

2251
01:40:56,335 --> 01:40:59,172
STUDY TO EXAMINE DISPARITIES IN 

2252
01:40:59,172 --> 01:41:01,507
MISDIAGNOSIS BASED ON SEX, AGE, 

2253
01:41:01,507 --> 01:41:03,142
RACE OR ETHNICITY BUT MOST OF 

2254
01:41:03,142 --> 01:41:06,212
THE STUDIES THAT I FOUND WERE IN

2255
01:41:06,212 --> 01:41:08,781
THE PRE -- WE ACTUALLY IN THE 

2256
01:41:08,781 --> 01:41:11,150
PREEMERGENCY DEPARTMENT AND 

2257
01:41:11,150 --> 01:41:12,585
EMERGENCY DEPARTMENT SETTING.  

2258
01:41:12,585 --> 01:41:14,754
WHERE PATIENTS OFTEN PRESENT 

2259
01:41:14,754 --> 01:41:17,490
WITH PAIN AND INTERESTINGLY THE 

2260
01:41:17,490 --> 01:41:23,162
RESULTS FOR MIXED.  SO ONE STUDY

2261
01:41:23,162 --> 01:41:27,833
BY MICHAEL LOOKED AT HOW HIGH 

2262
01:41:27,833 --> 01:41:28,734
EMERGENCY MEDICINE PERSONNEL 

2263
01:41:28,734 --> 01:41:30,836
RESPOND TO PATIENT COMPLAINTS OF

2264
01:41:30,836 --> 01:41:34,073
PAIN BY PATIENT SIX.  THIS WAS A

2265
01:41:34,073 --> 01:41:36,943
RETROSPECTIVE STUDY OF 

2266
01:41:36,943 --> 01:41:37,710
ELECTRONIC MEDICAL RECORDS, 

2267
01:41:37,710 --> 01:41:38,344
APPROXIMATELY ONE THOUSAND CASES

2268
01:41:38,344 --> 01:41:40,546
WERE INCLUDED IN THE STUDY.  THE

2269
01:41:40,546 --> 01:41:42,615
AUTHORS FOUND THAT WOMEN WERE 

2270
01:41:42,615 --> 01:41:44,217
SIGNIFICANTLY MORE LIKELY TO 

2271
01:41:44,217 --> 01:41:47,153
RECEIVE LESS ANALGESIA IN 

2272
01:41:47,153 --> 01:41:49,555
ISOLATED EXTREMITY INJURIES IN 

2273
01:41:49,555 --> 01:41:50,756
THE PREHOSPITAL SETTING EVEN 

2274
01:41:50,756 --> 01:41:52,091
WHEN CONTROLLING FOR PAIN 

2275
01:41:52,091 --> 01:41:54,060
INTENSITY AND CONCLUDED THAT 

2276
01:41:54,060 --> 01:41:56,295
FURTHER INQUIRIES NEEDED TO 

2277
01:41:56,295 --> 01:41:57,597
DETERMINE WHILE CERTAIN 

2278
01:41:57,597 --> 01:41:59,165
POPULATIONS SUCH AS WOMEN 

2279
01:41:59,165 --> 01:42:03,569
RECEIVED DISPROPORTIONATELY LESS

2280
01:42:03,569 --> 01:42:06,005
ANALGESIA AND IN A PROSPECTIVE 

2281
01:42:06,005 --> 01:42:10,743
STUDY OF 981 ADULTS THAT 

2282
01:42:10,743 --> 01:42:14,080
PRESENTED WITH ABDOMINAL PAIN 

2283
01:42:14,080 --> 01:42:17,383
FOUND THAT DESPITE SIMILAR PAIN 

2284
01:42:17,383 --> 01:42:19,151
SCORES WOMEN WERE LIKELY TO 

2285
01:42:19,151 --> 01:42:23,789
RECEIVE NO ANALGESIA AND LESS 

2286
01:42:23,789 --> 01:42:26,726
LIKELY TO RECEIVE OPIATES AND 

2287
01:42:26,726 --> 01:42:31,163
THIS WAS WHEN GENDER SPECIFIC 

2288
01:42:31,163 --> 01:42:34,066
DIAGNOSIS WAS EXCLUDE AND AFTER 

2289
01:42:34,066 --> 01:42:36,068
INCLUDING RACE, WOMEN WERE STILL

2290
01:42:36,068 --> 01:42:40,139
LESS LIKELY THAN MEN TO RECEIVE 

2291
01:42:40,139 --> 01:42:45,711
OIP OIP YOIT ANALGESIA. 

2292
01:42:45,711 --> 01:42:47,146
BUT IN ADDITION, WOMEN ALSO 

2293
01:42:47,146 --> 01:42:49,282
WAITED LONGER TO RECEIVE THEIR 

2294
01:42:49,282 --> 01:42:51,984
ANALGESIA.  THE MEDIAN TIME WAS 

2295
01:42:51,984 --> 01:42:56,022
65 MINUTES FOR WOMEN VERSUS  49 

2296
01:42:56,022 --> 01:42:59,158
MINUTES FOR MEN.  THE RESULTS 

2297
01:42:59,158 --> 01:43:01,460
MAY BE DUE TO GENDER BIAS. 

2298
01:43:01,460 --> 01:43:03,195
HOWEVER OTHER STUDIES IN THE 

2299
01:43:03,195 --> 01:43:05,398
EMERGENCY DEPARTMENT HAVE HAD 

2300
01:43:05,398 --> 01:43:07,366
DIFFERENT RESULTS IN A 

2301
01:43:07,366 --> 01:43:09,268
RETROSPECTIVE STUDY IN THE 

2302
01:43:09,268 --> 01:43:15,741
RECORDS OF 868 PATIENTS PROT 

2303
01:43:15,741 --> 01:43:21,247
PRESENTING WITH MUS CUE KOE -- 

2304
01:43:21,247 --> 01:43:27,153
MUS CUE KOE SKELETAL PAIN IT WAS

2305
01:43:27,153 --> 01:43:29,555
UNDER GENDER. 

2306
01:43:29,555 --> 01:43:32,958
IN A MULTICENTER STUDY OF 16 

2307
01:43:32,958 --> 01:43:34,060
EMERGENCY DEPARTMENTS, THE 

2308
01:43:34,060 --> 01:43:35,961
INFLUENCE OF BOTH PROVIDER AND 

2309
01:43:35,961 --> 01:43:39,131
PATIENT R PATIENT GENDER OR SEX 

2310
01:43:39,131 --> 01:43:40,533
OF AN ANALGESIC ADMINISTRATION 

2311
01:43:40,533 --> 01:43:43,102
WITH PATIENTS FROM MODERATE TO 

2312
01:43:43,102 --> 01:43:45,338
SEVERE PAIN TREATED WITH OVER 

2313
01:43:45,338 --> 01:43:47,006
120 PERIOD.  842 PATIENTS 

2314
01:43:47,006 --> 01:43:50,376
PARTICIPATED IN THIS STUDY.  THE

2315
01:43:50,376 --> 01:43:51,277
BASELINE PAIN SCORES WERE 

2316
01:43:51,277 --> 01:43:54,814
SIMILAR FOR BOTH SEXES.  RATES 

2317
01:43:54,814 --> 01:43:55,781
FOR NOT SIGNIFICANTLY DIFFERENT 

2318
01:43:55,781 --> 01:43:57,717
FROM FEMALE AND MALE PATIENTS.  

2319
01:43:57,717 --> 01:43:59,185
BUT FEMALE PATIENTS WERE 

2320
01:43:59,185 --> 01:44:02,955
SLIGHTLY MORE LIKELY TO RECEIVE 

2321
01:44:02,955 --> 01:44:04,423
OPIOIDS THAN MALE PATIENTS.  

2322
01:44:04,423 --> 01:44:06,125
THERE HAVE BEEN ALSO BEEN SOME 

2323
01:44:06,125 --> 01:44:07,460
STUDIES IN THE LAST DECADE THAT 

2324
01:44:07,460 --> 01:44:09,161
INDICATE THAT HEALTH CARE 

2325
01:44:09,161 --> 01:44:11,597
PROVIDERS ARE MORE LIKELY TO 

2326
01:44:11,597 --> 01:44:14,200
PRESCRIBE PSYCHE TROPHIC 

2327
01:44:14,200 --> 01:44:15,234
MEDICATIONS THAN MEN WHEN BOTH 

2328
01:44:15,234 --> 01:44:16,802
PRESENT WITH THE SAME SYMPTOMS. 

2329
01:44:16,802 --> 01:44:19,405
IN TWO RELATED STUDIES PUBLISHED

2330
01:44:19,405 --> 01:44:24,944
IN 2013-14 THE AUTHOR USED 

2331
01:44:24,944 --> 01:44:27,913
CLINICAL PAIN VIGNETTE TO ASSESS

2332
01:44:27,913 --> 01:44:29,915
PROVIDER TREATMENT PREFERENCES. 

2333
01:44:29,915 --> 01:44:31,150
FEMALE WERE SIGNIFICANTLY MORE 

2334
01:44:31,150 --> 01:44:32,885
LIKELY TO RECEIVE 

2335
01:44:32,885 --> 01:44:35,054
RECOMMENDATIONS FOR 

2336
01:44:35,054 --> 01:44:35,488
ANTIDEPRESSANTS AND 

2337
01:44:35,488 --> 01:44:36,222
PSYCHOLOGICAL TREATMENT THAN 

2338
01:44:36,222 --> 01:44:38,591
MALES IN BOTH CASES, MALE AND 

2339
01:44:38,591 --> 01:44:40,526
FEMALE PATIENTS HAD SIMILAR 

2340
01:44:40,526 --> 01:44:42,194
SYMPTOMS.  AND FACIAL 

2341
01:44:42,194 --> 01:44:44,430
EXPRESSIONS.  AND THOSE SAME 

2342
01:44:44,430 --> 01:44:47,166
STUDIES MEN WERE MORE LIKELY TO 

2343
01:44:47,166 --> 01:44:48,501
BE PRESCRIBED ANALGESICS THAN 

2344
01:44:48,501 --> 01:44:50,102
WOMEN.  THEN WE ALSO REVIEWED 

2345
01:44:50,102 --> 01:44:53,873
THE LIT CHERATURE WHAT MIGHT 

2346
01:44:53,873 --> 01:44:55,841
ACCOUNT FOR DIFFERENCES IN 

2347
01:44:55,841 --> 01:44:56,876
TREATMENT.  AND ONE SIGNIFICANT 

2348
01:44:56,876 --> 01:44:57,877
SUGGESTION THAT CAME UP SEVERAL 

2349
01:44:57,877 --> 01:45:01,447
TIMES HAS BEEN IMPLICIT BIAS OR 

2350
01:45:01,447 --> 01:45:03,149
UNCONSCIOUS BIAS THAT OPERATES 

2351
01:45:03,149 --> 01:45:06,385
OUTSIDE OF THE PERSON'S 

2352
01:45:06,385 --> 01:45:10,122
AWARENESS AND CAN BE A DIRECT 

2353
01:45:10,122 --> 01:45:12,391
CONTRADICTION TO THEIR ESPOUSED 

2354
01:45:12,391 --> 01:45:15,127
BELIEFS.  ALTHOUGH THERE MAY NOT

2355
01:45:15,127 --> 01:45:16,829
HAVE BEEN MANY STUDIES IN 

2356
01:45:16,829 --> 01:45:18,731
DIFFERENCES IN ACTUAL TREATMENT 

2357
01:45:18,731 --> 01:45:21,167
OF PAIN MEDICATION BASED ON SEX 

2358
01:45:21,167 --> 01:45:21,867
THERE HAVE BEEN STUDIES LOOKING 

2359
01:45:21,867 --> 01:45:27,139
AT HEALTH CARE PROVIDER IMPLICIT

2360
01:45:27,139 --> 01:45:29,308
BIAS.  WHEN TREATING PATIENTS 

2361
01:45:29,308 --> 01:45:33,979
PRESENTING WITH PAIN.  A NUMBER 

2362
01:45:33,979 --> 01:45:40,019
OF THESE STUDIES USED AVATARS TO

2363
01:45:40,019 --> 01:45:42,621
ASSESS THE PROVIDER 

2364
01:45:42,621 --> 01:45:49,395
DECISION-MAKING.  OTHERS USED A 

2365
01:45:49,395 --> 01:45:50,796
QUESTIONNAIRES.  FOR EXAMPLE, 

2366
01:45:50,796 --> 01:45:54,533
HIRSCH EXPOSED 54 NURSES TO 

2367
01:45:54,533 --> 01:45:56,569
VIGNETTES OF VIRTUAL PATIENTS 

2368
01:45:56,569 --> 01:45:58,103
AFTER SURGERY AND THE VIRTUAL 

2369
01:45:58,103 --> 01:46:00,873
PATIENTS DIFFERED BY SEX, AGE, 

2370
01:46:00,873 --> 01:46:02,575
RACE AND FACIAL EXPRESSION.  THE

2371
01:46:02,575 --> 01:46:04,076
NURSES MADE ASSESSMENTS OF 

2372
01:46:04,076 --> 01:46:06,445
PATIENT PAIN AND RENDERED 

2373
01:46:06,445 --> 01:46:09,181
TREATMENT DECISIONS AND WERE 

2374
01:46:09,181 --> 01:46:10,349
THEN ASKED TO INDICATE WHAT 

2375
01:46:10,349 --> 01:46:13,552
INFORMATION THEY RELIED ONTO 

2376
01:46:13,552 --> 01:46:17,056
MAKE THEIR DECISIONS.  AND NONE 

2377
01:46:17,056 --> 01:46:20,226
INDICATED THAT THE PATIENT'S 

2378
01:46:20,226 --> 01:46:21,126
DEMOGRAPHIC INFORMATION 

2379
01:46:21,126 --> 01:46:23,162
INFLUENCED THEIR DECISIONS WHEN,

2380
01:46:23,162 --> 01:46:25,264
IN FACT, STATISTICAL MODELING 

2381
01:46:25,264 --> 01:46:28,767
INDICATED THAT 28-54% USED 

2382
01:46:28,767 --> 01:46:30,236
PATIENT DEMOGRAPHIC CUES 

2383
01:46:30,236 --> 01:46:34,073
INCLUDING SEX TO MAKE THEIR 

2384
01:46:34,073 --> 01:46:38,077
DECISIONS.  BIAS MAY BE COMMON 

2385
01:46:38,077 --> 01:46:39,845
IN PRACTITIONER DECISION-MAKING 

2386
01:46:39,845 --> 01:46:41,647
ABOUT PAIN BUT THE PROVIDERS 

2387
01:46:41,647 --> 01:46:44,416
HAVE MINIMAL AWARENESS AND/OR A 

2388
01:46:44,416 --> 01:46:46,352
LACK OF WILLINGNESS TO 

2389
01:46:46,352 --> 01:46:48,888
ACKNOWLEDGE THAT BIAS.  IN A 

2390
01:46:48,888 --> 01:46:51,056
SUBSEQUENT STUDY, USING SIMILAR 

2391
01:46:51,056 --> 01:46:52,091
METHODS MEDICAL TRAINEES WERE 

2392
01:46:52,091 --> 01:46:55,160
ASKED TO REVIEW VIGNETTES OF 16 

2393
01:46:55,160 --> 01:46:57,730
VIRTUAL PATIENTS WITH CHRONIC 

2394
01:46:57,730 --> 01:47:00,199
LOW BACK PAIN.  WHO DIFFERED BY 

2395
01:47:00,199 --> 01:47:03,168
RACE AND SEX AND MADE TREATMENT 

2396
01:47:03,168 --> 01:47:04,069
DECISIONS INCLUDING WHETHER THEY

2397
01:47:04,069 --> 01:47:07,706
WOULD PROVIDE OPIOIDS, 

2398
01:47:07,706 --> 01:47:08,807
ANTIDEPRESSANTS OR PHYSICAL 

2399
01:47:08,807 --> 01:47:10,843
THERAPY.  THE TRAINEES WERE 

2400
01:47:10,843 --> 01:47:12,711
ASKED TO INDICATE THE FACTORS 

2401
01:47:12,711 --> 01:47:14,146
THAT INFLUENCED THEIR 

2402
01:47:14,146 --> 01:47:15,080
DECISION-MAKING.  THE RESEARCH 

2403
01:47:15,080 --> 01:47:17,283
FOUND THAT 30% OF PARTICIPANTS 

2404
01:47:17,283 --> 01:47:20,152
WERE RELIABLY INFLUENCED BY THE 

2405
01:47:20,152 --> 01:47:23,255
PATIENT'S SEX AND 15% BY THE 

2406
01:47:23,255 --> 01:47:25,591
PATIENT'S RACE.  HOWEVER, WELL 

2407
01:47:25,591 --> 01:47:27,159
DURING FOLLOW UP INTERVIEWS THE 

2408
01:47:27,159 --> 01:47:30,696
STUDY AUTHORS NOTED, SOME 

2409
01:47:30,696 --> 01:47:32,831
PARTICIPANTS ENDORSED 

2410
01:47:32,831 --> 01:47:34,066
STEREOTYPICAL BELIEVERS ABOUT 

2411
01:47:34,066 --> 01:47:38,070
FEMALE PATIENTS SUCH AS WOMEN 

2412
01:47:38,070 --> 01:47:40,072
WOULD HAVE LESS OCCUPATIONAL 

2413
01:47:40,072 --> 01:47:42,541
IMPAIRMENT DIE TO PAIN AND THERE

2414
01:47:42,541 --> 01:47:44,944
WOULD BE LESS IN MEN.  THESE 

2415
01:47:44,944 --> 01:47:47,479
VIEWS THE AUTHORS SAID FIT WITH 

2416
01:47:47,479 --> 01:47:50,115
EVIDENCE THAT PROVIDERS OFTEN 

2417
01:47:50,115 --> 01:47:53,085
ATTRIBUTE FEMALE PATIENTS' PAIN 

2418
01:47:53,085 --> 01:47:55,154
TO PSYCHOLOGICAL FACTORS 

2419
01:47:55,154 --> 01:47:57,690
PARTICULARLY WHEN THERE'S NO 

2420
01:47:57,690 --> 01:47:59,425
OBSERVABLE PAIN PATHOLOGY.  AND 

2421
01:47:59,425 --> 01:48:00,859
BELIEVE THAT WOMEN HAVE HIGHER 

2422
01:48:00,859 --> 01:48:03,195
PAIN TOLERANCES THAN MEN.  SOME 

2423
01:48:03,195 --> 01:48:04,630
OF THESE ATTITUDES MAY BE 

2424
01:48:04,630 --> 01:48:07,166
LEARNED BY MEDICAL STUDENTS 

2425
01:48:07,166 --> 01:48:09,735
DURING THEIR MEDICAL EDUCATION. 

2426
01:48:09,735 --> 01:48:13,672
ACCORDING TO RICE THERE IS 

2427
01:48:13,672 --> 01:48:17,943
EVIDENCE THAT MEDICAL STUDENTS' 

2428
01:48:17,943 --> 01:48:20,346
ATTITUDES GET PROGRESSIVELY 

2429
01:48:20,346 --> 01:48:22,081
WORSE AS THEY GO THROUGH MEDICAL

2430
01:48:22,081 --> 01:48:24,383
SCHOOL IN A STUDY OF MEDICAL 

2431
01:48:24,383 --> 01:48:27,152
STUDENTS AND RESIDENTS THE 

2432
01:48:27,152 --> 01:48:34,093
AUTHORS FOUND TRAINEES VIEWED 

2433
01:48:34,093 --> 01:48:43,135
CHRONIC PAIN MANAGEMENT ON BE TS

2434
01:48:43,135 --> 01:48:46,572
LEFT THEM CONFUSED AND HOW TO 

2435
01:48:46,572 --> 01:48:50,776
PROVIDE CARE AND THEIR 

2436
01:48:50,776 --> 01:48:52,378
PRECEPTORS HAVE INDICATED THESE 

2437
01:48:52,378 --> 01:48:54,246
PATIENTS HAD LITTLE EDUCATIONAL 

2438
01:48:54,246 --> 01:48:56,882
VALUE.  HEALTH CARE PROVIDERS, 

2439
01:48:56,882 --> 01:48:58,517
EVEN EARLY STAGE PRACTITIONERS 

2440
01:48:58,517 --> 01:49:01,887
MAY HAVE IMPLICIT BIAS WHEN IT 

2441
01:49:01,887 --> 01:49:04,490
COMES TO THEIR ATTITUDES AS 

2442
01:49:04,490 --> 01:49:05,858
TREATING PATIENTS AS WELL AS 

2443
01:49:05,858 --> 01:49:07,126
WOMEN AND THEIR PAIN ANOTHER 

2444
01:49:07,126 --> 01:49:07,860
REASON I WANTED TO MENTION THAT 

2445
01:49:07,860 --> 01:49:10,129
HAS COME UP THAT MAY ATTRIBUTE 

2446
01:49:10,129 --> 01:49:11,797
IT TO DIFFERENCES IN PAIN 

2447
01:49:11,797 --> 01:49:16,035
TREATMENT BY SEX IS DIFFICULTY 

2448
01:49:16,035 --> 01:49:20,606
OF DIAGNOSIS.  MANY OF THE PAIN 

2449
01:49:20,606 --> 01:49:24,009
RELATED CONDITIONS, CHRONIC 

2450
01:49:24,009 --> 01:49:26,345
FATIGUE SYNDROME MUST BE 

2451
01:49:26,345 --> 01:49:28,881
DIAGNOSED BY EXCLUSION.  THERE'S

2452
01:49:28,881 --> 01:49:32,051
NO DIAGNOSTIC TEST FOR THEM.  

2453
01:49:32,051 --> 01:49:38,824
FOR EXAMPLE, IN  AN ARTICLE 

2454
01:49:38,824 --> 01:49:41,393
ABOUT FIBROMYALGIA STATED THE 

2455
01:49:41,393 --> 01:49:46,098
DIAGNOSIS MANAGEMENT AND 

2456
01:49:46,098 --> 01:49:48,500
STREEMENT  TREATMENT IS A 

2457
01:49:48,500 --> 01:49:50,636
CHALLENGE FOR HEALTH CARE 

2458
01:49:50,636 --> 01:49:52,971
PROFESSIONALS AND PATIENTS. 

2459
01:49:52,971 --> 01:49:55,040
MAINLY DUE TO UNKNOWN SYMPTOM 

2460
01:49:55,040 --> 01:49:58,110
OVERLAP AND A LACK OF OBJECTIVE 

2461
01:49:58,110 --> 01:50:00,079
DIAGNOSTIC TECHNIQUES.  VERY 

2462
01:50:00,079 --> 01:50:02,047
OFTEN THERE'S NONUNIFORMITY IN 

2463
01:50:02,047 --> 01:50:04,083
SYMPTOM EXPERIENCE AMONG 

2464
01:50:04,083 --> 01:50:06,618
PATIENTS.  MANY OF THE PAINFUL 

2465
01:50:06,618 --> 01:50:09,555
CONDITIONS THAT PLAGUE WOMEN ARE

2466
01:50:09,555 --> 01:50:10,789
ALSO POORLY UNDERSTOOD.  PERHAPS

2467
01:50:10,789 --> 01:50:14,693
IN PART BECAUSE THE FEDERAL AND 

2468
01:50:14,693 --> 01:50:20,766
PRIVATE INSTITUTIONS THAT FUND 

2469
01:50:20,766 --> 01:50:27,139
RESEARCH INTO CHRONIC PAIN 

2470
01:50:27,139 --> 01:50:30,175
DISORDERS REMAINS INCOMMISERATE 

2471
01:50:30,175 --> 01:50:32,878
IN THEIR SOCIETAL BURDEN.  WE 

2472
01:50:32,878 --> 01:50:34,413
KNOW LITTLE ABOUT THE CAUSES AND

2473
01:50:34,413 --> 01:50:36,014
EFFECTIVE TREATMENTS FOR THESE 

2474
01:50:36,014 --> 01:50:36,315
CONDITIONS. 

2475
01:50:36,315 --> 01:50:38,050
SO IF YOU CAN GO BACK TO THE 

2476
01:50:38,050 --> 01:50:40,753
LAST SLIDE, SO WHAT CAN WE DO 

2477
01:50:40,753 --> 01:50:43,889
ABOUT THESE CHALLENGES AND 

2478
01:50:43,889 --> 01:50:45,324
RESULTING DISPARITIES? WHAT 

2479
01:50:45,324 --> 01:50:46,959
WE -- AND MY COAUTHORS 

2480
01:50:46,959 --> 01:50:50,329
RECOMMENDED IS FIRST, THERE 

2481
01:50:50,329 --> 01:50:52,097
NEEDS TO BE MORE IMPLEMENTATION 

2482
01:50:52,097 --> 01:50:54,266
RESEARCH, FUNDING, THE CHRONIC 

2483
01:50:54,266 --> 01:50:55,234
PAIN CONDITIONS THAT ARE MORE 

2484
01:50:55,234 --> 01:50:56,969
COMMON TO WOMEN PARTICULARLY 

2485
01:50:56,969 --> 01:50:58,504
THOSE THAT ARE MORE DIFFICULT TO

2486
01:50:58,504 --> 01:51:01,306
DIAGNOSE AND TREAT.  SECOND, WE 

2487
01:51:01,306 --> 01:51:02,841
NEED ADDITIONAL LARGE 

2488
01:51:02,841 --> 01:51:05,444
WELL-DESIGNED STUDIES 

2489
01:51:05,444 --> 01:51:07,012
INVESTIGATING WHETHER THERE ARE 

2490
01:51:07,012 --> 01:51:07,880
DISPARITIES IN THE TREATMENT OF 

2491
01:51:07,880 --> 01:51:09,915
MEN AND WOMEN FOR PAIN.  THIRD 

2492
01:51:09,915 --> 01:51:11,683
MORE RESEARCH NEEDS TO BE DONE 

2493
01:51:11,683 --> 01:51:17,656
ON HOW BIOLOGICAL CULL CHAURL --

2494
01:51:17,656 --> 01:51:19,158
CULTURAL FACTORS COMBINE FOR MEN

2495
01:51:19,158 --> 01:51:21,360
AND WOMEN.  FOURTH WE SAID THERE

2496
01:51:21,360 --> 01:51:23,162
NEEDS TO BE BETTER EDUCATION OF 

2497
01:51:23,162 --> 01:51:25,430
MEDICAL STUDENTS AND PHYSICIANS 

2498
01:51:25,430 --> 01:51:29,134
ABOUT HOW TO DIAGNOSE AND TREAT 

2499
01:51:29,134 --> 01:51:30,302
ACUTE AND CHRONIC PAIN 

2500
01:51:30,302 --> 01:51:32,504
CONDITIONS, ABOUT STEREOTYPES, 

2501
01:51:32,504 --> 01:51:37,242
ABOUT SEX BASED PAIN, AND THE 

2502
01:51:37,242 --> 01:51:47,052
NEED TO TREAT THESE PATIENTS AND

2503
01:51:47,052 --> 01:51:48,453
MORE TRAINING FOR STUDENTS TO 

2504
01:51:48,453 --> 01:51:50,556
IDENTIFY AND REDUCE IMPLICIT 

2505
01:51:50,556 --> 01:51:52,457
BIAS RELATED TO THE TREATMENT OF

2506
01:51:52,457 --> 01:51:54,126
WOMEN FOR CHRONIC PAIN AND WITH 

2507
01:51:54,126 --> 01:51:55,194
THAT, I'LL END AND THANK YOU SO 

2508
01:51:55,194 --> 01:51:57,329
MUCH FOR YOUR TIME AND 

2509
01:51:57,329 --> 01:51:58,130
ATTENTION.  AND TAKE QUESTIONS 

2510
01:51:58,130 --> 01:52:08,540
IN THE Q&A.  THANK YOU.

2511
01:52:15,214 --> 01:52:17,449
>> OUR SECOND SPEAKER. 
DR. SARA

2512
01:52:17,449 --> 01:52:19,151
JANE WARD IS THE TENURED 

2513
01:52:19,151 --> 01:52:22,120
ASSOCIATE PROFESSOR IN THE 

2514
01:52:22,120 --> 01:52:23,155
DEPARTMENT OF NEURAL SCIENCES IN

2515
01:52:23,155 --> 01:52:26,758
THE CENTER FOR SUBSTANCE ABUSE 

2516
01:52:26,758 --> 01:52:28,894
RESEARCH AT TEMPLE UNIVERSITY 

2517
01:52:28,894 --> 01:52:30,796
SCHOOL OF MEDICINE.  SHE EARNED 

2518
01:52:30,796 --> 01:52:34,099
HER PH.D. IN NEUROSCIENCE AND 

2519
01:52:34,099 --> 01:52:37,336
HER POST-DOCTORAL RESEARCH WAS 

2520
01:52:37,336 --> 01:52:40,239
WITH ELLEN WALKER AND FOCUSED ON

2521
01:52:40,239 --> 01:52:44,977
THE CANNABINOID SYSTEMS AND 

2522
01:52:44,977 --> 01:52:47,145
COCAINE REINFORCEMENT AND WORKS 

2523
01:52:47,145 --> 01:52:50,082
WITH THE THERAPEUTIC POTENTIAL 

2524
01:52:50,082 --> 01:52:54,987
OF THESE USEN ANIMAL MODELS OF 

2525
01:52:54,987 --> 01:52:57,322
PAIN INFLAMMATION AND SUBSTANCE 

2526
01:52:57,322 --> 01:52:58,090
USE DISORDER. 

2527
01:52:58,090 --> 01:53:02,227
AND THIS COMBINES THE EFFECTS OF

2528
01:53:02,227 --> 01:53:06,465
CANNABINOIDS AND THIS WORKS WITH

2529
01:53:06,465 --> 01:53:13,505
THE CBD IN RODENT MODEL OF 

2530
01:53:13,505 --> 01:53:15,140
CHEMOTHERAPY AND PAIN.  AND HAS 

2531
01:53:15,140 --> 01:53:18,377
INSPIRED THE IMPLEMENTATION OF 

2532
01:53:18,377 --> 01:53:20,012
AT LEAST TWO CLINICAL TRIALS IN 

2533
01:53:20,012 --> 01:53:25,150
THE AREA.  SHE COLLABORATES WITH

2534
01:53:25,150 --> 01:53:26,752
OTHER ACADEMIC LABORATORIES TO 

2535
01:53:26,752 --> 01:53:29,521
STUDIES THE MODELS OF SUBSTANCE 

2536
01:53:29,521 --> 01:53:32,524
USE DISORDERS.  SPINAL CORD 

2537
01:53:32,524 --> 01:53:34,593
INJURY, STROKE AND AGING.  THE 

2538
01:53:34,593 --> 01:53:37,129
TITLE OF HER TALK IS CONSIDERING

2539
01:53:37,129 --> 01:53:38,797
PRECLINICAL SEX DIFFERENCES IN 

2540
01:53:38,797 --> 01:53:40,632
THE CONTEXT OF NEUROPATHIC PAIN 

2541
01:53:40,632 --> 01:53:48,407
AND THERAPEUTIC USE OF KA NAB 

2542
01:53:48,407 --> 01:53:50,108
 -- CANNABINOIDS.

2543
01:53:50,108 --> 01:53:50,742
>> THANK YOU SO MUCH FOR
THAT 

2544
01:53:50,742 --> 01:53:52,911
INTRODUCTION.  THANK YOU FOR THE

2545
01:53:52,911 --> 01:53:55,147
INVITATION TO PRESENT AT THE NIH

2546
01:53:55,147 --> 01:53:56,815
PAIN CONSORTIUM, I'VE BEEN 

2547
01:53:56,815 --> 01:53:57,649
ATTENDING THE CONFERENCE FOR 

2548
01:53:57,649 --> 01:54:04,756
MANY YEARS AND IT'S REALLY A 

2549
01:54:04,756 --> 01:54:06,558
THRILL TO PRESENT TO YOU ALL.  I

2550
01:54:06,558 --> 01:54:10,095
WOULD LIKE TO THANK THE NICH FOR

2551
01:54:10,095 --> 01:54:13,131
THEIR SUPPORT OF THE 

2552
01:54:13,131 --> 01:54:14,900
INVESTIGATION OF CANNABIS FOR 

2553
01:54:14,900 --> 01:54:16,969
THE TREATMENT OF PAIN.  THE 

2554
01:54:16,969 --> 01:54:18,370
SESSIONS YESTERDAY AND TODAY 

2555
01:54:18,370 --> 01:54:20,772
HAVE JUST BEEN FANTASTIC AND I 

2556
01:54:20,772 --> 01:54:22,174
ALMOST WANT TO APOLOGIZE FOR 

2557
01:54:22,174 --> 01:54:25,811
BREAKING THIS BEAUTIFUL TREND OF

2558
01:54:25,811 --> 01:54:27,546
TALKING ABOUT PATIENT CARE AND 

2559
01:54:27,546 --> 01:54:29,815
SWITCHING GEARS AWAY FROM HUMANS

2560
01:54:29,815 --> 01:54:31,883
AND TALKING ABOUT RATS AND MICE 

2561
01:54:31,883 --> 01:54:34,119
BY HOPEFULLY I CAN CONVINCE YOU 

2562
01:54:34,119 --> 01:54:40,759
THAT IT'S ALSO INTERESTING TO 

2563
01:54:40,759 --> 01:54:43,161
INCLUDE RATS AND MICE IN OUR 

2564
01:54:43,161 --> 01:54:44,830
CONVERSATION I'M A BEHAVIORAL 

2565
01:54:44,830 --> 01:54:47,032
PHARMACOLOGIST AND I USE RODENT 

2566
01:54:47,032 --> 01:54:50,035
MODELS OF YOUR PATHIC PAIN 

2567
01:54:50,035 --> 01:54:53,305
MOSTLY TO TRY TO UNDERSTAND THE 

2568
01:54:53,305 --> 01:54:55,140
POTENTIAL AND SAFETY MARGINS OF 

2569
01:54:55,140 --> 01:54:58,510
USING CANNABINOID BASED 

2570
01:54:58,510 --> 01:54:59,177
THERAPIES.  

2571
01:54:59,177 --> 01:55:02,347
AND SO I DO WANT TO GIVE YOU A 

2572
01:55:02,347 --> 01:55:04,449
BRIEF INTRODUCTION INTO THE 

2573
01:55:04,449 --> 01:55:06,018
TOPIC BY TALKING A LITTLE BIT 

2574
01:55:06,018 --> 01:55:08,353
ABOUT WHAT IS KNOWN FROM THE 

2575
01:55:08,353 --> 01:55:10,055
HUMAN LITERATURE REGARDING 

2576
01:55:10,055 --> 01:55:12,190
POTENTIAL SEX DIFFERENCES IN THE

2577
01:55:12,190 --> 01:55:14,226
EFFECTS OF CANNABIS.  SO I WILL 

2578
01:55:14,226 --> 01:55:16,128
TOUCH UPON THAT.  AND THEN I 

2579
01:55:16,128 --> 01:55:18,864
WILL SEGWAY INTO THE PRECLINICAL

2580
01:55:18,864 --> 01:55:20,799
RESEARCH THAT I'VE BEEN DOING. 

2581
01:55:20,799 --> 01:55:22,134
FOR THE LAST FIFTEEN YEARS 

2582
01:55:22,134 --> 01:55:26,471
LOOKING AT THE EFFECTS OF NIGH 

2583
01:55:26,471 --> 01:55:28,707
TO CANNABINOIDS.  AND THEN I 

2584
01:55:28,707 --> 01:55:31,443
WILL GET TO MY MOST CURRENT DATA

2585
01:55:31,443 --> 01:55:35,147
WHICH ADDRESSES THE POTENTIAL OF

2586
01:55:35,147 --> 01:55:37,682
SEX DIFFERENCES IN THE ACTUAL 

2587
01:55:37,682 --> 01:55:40,685
MODEL OF CHEMOTHERAPY INDUCED 

2588
01:55:40,685 --> 01:55:43,055
NEUROPATHIC PAIN THAT WE USE IN 

2589
01:55:43,055 --> 01:55:48,360
THE LABORATORY AND HIGH -- HOW 

2590
01:55:48,360 --> 01:55:50,695
THAT CAN BE A FACTOR WHEN WE 

2591
01:55:50,695 --> 01:55:53,465
LOOK AT THE THERAPEUTIC EFFECTS.

2592
01:55:53,465 --> 01:55:55,233
AND SO IN ORDER TO GET YOU 

2593
01:55:55,233 --> 01:55:58,437
INTERESTED IN MY RODENT DATA I 

2594
01:55:58,437 --> 01:56:00,238
HOPE TO CONVINCE YOU THAT IT'S 

2595
01:56:00,238 --> 01:56:02,641
INTERESTING TO LOOK AT THE 

2596
01:56:02,641 --> 01:56:05,177
POTENTIAL SEX DIFFERENCES IN 

2597
01:56:05,177 --> 01:56:08,580
HUMANS IN REGARDS TO THE EFFECTS

2598
01:56:08,580 --> 01:56:10,082
OF CANNABIS AND CANNABINOIDS.  

2599
01:56:10,082 --> 01:56:16,088
AND SO THE USE OF CANNABIS HAS 

2600
01:56:16,088 --> 01:56:17,289
BEEN, YOU KNOW, STEADILY ON THE 

2601
01:56:17,289 --> 01:56:20,392
RISE IN THIS COUNTRY.  AS WELL 

2602
01:56:20,392 --> 01:56:21,726
AS CHANGES IN LEGISLATION THAT 

2603
01:56:21,726 --> 01:56:24,896
ARE BOTH A RESPONSE TO THAT AS 

2604
01:56:24,896 --> 01:56:26,832
WELL AS A CAUSE OF THAT 

2605
01:56:26,832 --> 01:56:28,333
INCREASE.  ALONG WITH THE 

2606
01:56:28,333 --> 01:56:29,901
INCREASE IN USE OF CANNABIS IS 

2607
01:56:29,901 --> 01:56:34,106
AN INCREASE IN THE PASSAGE OF 

2608
01:56:34,106 --> 01:56:36,007
LEGISLATION REGARDING MEDICAL 

2609
01:56:36,007 --> 01:56:38,510
CANNABIS AND IN REGARD TO 

2610
01:56:38,510 --> 01:56:41,680
MEDICAL CANNABIS ONE OF THE 

2611
01:56:41,680 --> 01:56:42,747
PRIMARY REASONS THAT PEOPLE 

2612
01:56:42,747 --> 01:56:43,849
REPORT USING MEDICAL CANNABIS IS

2613
01:56:43,849 --> 01:56:46,118
FOR THE TREATMENT OF PAIN AND AS

2614
01:56:46,118 --> 01:56:49,221
YOU ARE ALL INTERESTED IN THE 

2615
01:56:49,221 --> 01:56:49,754
TREATMENT OF PAIN YOU'RE 

2616
01:56:49,754 --> 01:56:51,723
PROBABLY FAMILIAR WITH THE FACT 

2617
01:56:51,723 --> 01:56:56,061
THAT MANY FOLKS USE CANNABIS FOR

2618
01:56:56,061 --> 01:56:59,164
THIS PURPOSE AND SO IN THE 

2619
01:56:59,164 --> 01:57:02,734
UNITED STATES, IN 2020, NEARLY 

2620
01:57:02,734 --> 01:57:06,738
50 MILLION PEOPLE, ABOUT 18% OF 

2621
01:57:06,738 --> 01:57:09,274
THE POPULATION, AGE 12 OR OVER 

2622
01:57:09,274 --> 01:57:11,143
WERE ESTIMATED TO HAVE USED 

2623
01:57:11,143 --> 01:57:13,578
CANNABIS.  THERE'S LOTS OF FOLKS

2624
01:57:13,578 --> 01:57:16,381
USING CANNABIS FOR A MIX OF 

2625
01:57:16,381 --> 01:57:18,250
RECREATIONAL AND MEDICAL 

2626
01:57:18,250 --> 01:57:19,151
PURPOSES.  HISTORICALLY THIS 

2627
01:57:19,151 --> 01:57:20,752
POPULATION HAS BEEN 

2628
01:57:20,752 --> 01:57:22,554
PREDOMINANTLY MALES.  AS 

2629
01:57:22,554 --> 01:57:24,389
COMPARED WITH FEMALES BUT WITH 

2630
01:57:24,389 --> 01:57:27,159
THIS RISE OF THE USE OF CANNABIS

2631
01:57:27,159 --> 01:57:27,726
BOTH RECREATIONALLY AND 

2632
01:57:27,726 --> 01:57:29,794
MEDICALLY IN THIS COUNTRY, THERE

2633
01:57:29,794 --> 01:57:32,164
HAS BEEN A DRASTIC INCREASE IN 

2634
01:57:32,164 --> 01:57:35,267
THE RATE OF USE AMONG FEMALES.  

2635
01:57:35,267 --> 01:57:37,702
FEMALES MAKE UP THE FASTEST 

2636
01:57:37,702 --> 01:57:41,573
GROWING CONSUMER DEMOGRAPHIC.  

2637
01:57:41,573 --> 01:57:43,141
AND IT'S BEEN REPORTED THAT 

2638
01:57:43,141 --> 01:57:45,443
PERHAPS SOME OF THE REASONS THAT

2639
01:57:45,443 --> 01:57:48,480
FEMALES USE CANNABIS MAY BE 

2640
01:57:48,480 --> 01:57:49,848
DIFFERENT THAN REASONS ENDORSED 

2641
01:57:49,848 --> 01:57:51,983
BY MALES.  SO THIS A REALLY 

2642
01:57:51,983 --> 01:57:55,687
ACTIVE AREA OF RESEARCH 

2643
01:57:55,687 --> 01:57:58,690
CURRENTLY.  IN OUR UNDERSTANDING

2644
01:57:58,690 --> 01:58:01,026
OF WHAT POTENTIAL SEX 

2645
01:58:01,026 --> 01:58:03,028
DIFFERENCES ARE A RESULT OF 

2646
01:58:03,028 --> 01:58:04,829
USING CANNABIS, MOST OF THE 

2647
01:58:04,829 --> 01:58:07,165
RESEARCH IN THIS AREA IS FOCUSED

2648
01:58:07,165 --> 01:58:08,867
ON THE ADVERSE EFFECTS AS MOST 

2649
01:58:08,867 --> 01:58:11,169
OF THE HUMAN RESEARCH TO DATE OF

2650
01:58:11,169 --> 01:58:14,005
THE EFFECTS OF CANNABIS HAVE 

2651
01:58:14,005 --> 01:58:19,010
FOCUSED MORE ON ADVERSE EFFECTS 

2652
01:58:19,010 --> 01:58:19,511
AS OPPOSED TO POTENTIAL 

2653
01:58:19,511 --> 01:58:20,145
THERAPEUTIC EFFECTS SO WE'LL 

2654
01:58:20,145 --> 01:58:21,880
TALK A LITTLE BIT ABOUT WHAT HAS

2655
01:58:21,880 --> 01:58:24,182
BEEN REPORTED FOR ADVERSE 

2656
01:58:24,182 --> 01:58:27,118
EFFECTS AND THEN SEGWAY INTO 

2657
01:58:27,118 --> 01:58:30,388
POTENTIAL ANALGESIC EFFECTS IN 

2658
01:58:30,388 --> 01:58:37,963
SEX DIFFERENCES.  SO THE TITLE 

2659
01:58:37,963 --> 01:58:38,930
OF THIS SLIDE IS INTERESTING 

2660
01:58:38,930 --> 01:58:41,399
GIVEN THE TALK THIS MORNING.  

2661
01:58:41,399 --> 01:58:46,638
I'VE SEEN SEVERAL REPORTS IN THE

2662
01:58:46,638 --> 01:58:56,081
LITERATURE OF THE USE OF THE 

2663
01:58:56,081 --> 01:58:58,116
CANNABIS IS PROBLEMATIC AND 

2664
01:58:58,116 --> 01:59:00,852
MAYBE A LOADED TERM.  AND TALK 

2665
01:59:00,852 --> 01:59:02,387
ABOUT THE SUBSTANCE USE OF 

2666
01:59:02,387 --> 01:59:04,122
FEMALES VERSUS MALES BUT JUST TO

2667
01:59:04,122 --> 01:59:05,824
GIVE YOU SOME CONTEXT HERE.  

2668
01:59:05,824 --> 01:59:07,859
MALES DO INITIATE CANNABIS USE 

2669
01:59:07,859 --> 01:59:12,130
AT A YOUNGER AGE.  USE MORE 

2670
01:59:12,130 --> 01:59:15,634
CANNABIS THAN FEMALES AND ALSO 

2671
01:59:15,634 --> 01:59:16,968
MORE OFTEN MEET THE CRITERIA FOR

2672
01:59:16,968 --> 01:59:20,705
CANNABIS USE DISORDER OR CUD.  

2673
01:59:20,705 --> 01:59:25,010
BUT, AGAIN, CANNABIS USE AS WELL

2674
01:59:25,010 --> 01:59:26,778
AS DIAGNOSIS OF CANNABIS USE 

2675
01:59:26,778 --> 01:59:29,781
DISORDER IS ON THE RISE IN 

2676
01:59:29,781 --> 01:59:30,715
FEMALES.  RESEARCH HAS SHOWN 

2677
01:59:30,715 --> 01:59:33,852
SIMILAR TO OTHER SUBSTANCES OF 

2678
01:59:33,852 --> 01:59:36,288
ABUSE SUCH AS ALCOHOL, PSYCHO 

2679
01:59:36,288 --> 01:59:37,555
STIMULANTS AND OPIOIDS THERE 

2680
01:59:37,555 --> 01:59:39,524
ALSO SEEMS TO BE A QUICKER 

2681
01:59:39,524 --> 01:59:41,593
PROGRESSION FROM RECREATIONAL 

2682
01:59:41,593 --> 01:59:43,995
USE TO DIAGNOSIS OF CANNABIS USE

2683
01:59:43,995 --> 01:59:45,530
DISORDER IN FEMALES AS COMPARED 

2684
01:59:45,530 --> 01:59:45,864
WITH MALES. 

2685
01:59:45,864 --> 01:59:49,934
GOING ALONG WITH THIS CONCEPT OF

2686
01:59:49,934 --> 01:59:53,705
TELESCOPING IN FEMALES.  AND 

2687
01:59:53,705 --> 01:59:55,140
THEN THERE'S A GROWING 

2688
01:59:55,140 --> 01:59:58,143
LITERATURE SUGGESTING THAT 

2689
01:59:58,143 --> 02:00:00,645
FEMALES INDUCE MORE WITHDRAWAL 

2690
02:00:00,645 --> 02:00:04,149
SYMPTOMS AND ARE MORE LIKELY TO 

2691
02:00:04,149 --> 02:00:06,918
REPORT COMORBID ANXIETY, 

2692
02:00:06,918 --> 02:00:08,586
MISDISORDERS AND SUICIDE DALT 

2693
02:00:08,586 --> 02:00:11,489
RELATED TO MALES BUT I ALSO IN 

2694
02:00:11,489 --> 02:00:13,658
RESPONSE TO THESE ARTICLES FOUND

2695
02:00:13,658 --> 02:00:15,393
OTHER COMMENTARY SUGGESTING THAT

2696
02:00:15,393 --> 02:00:16,795
THERE IS A BIAS TOWARD FEMALES 

2697
02:00:16,795 --> 02:00:19,931
AND THE WAY IN WHICH THEY 

2698
02:00:19,931 --> 02:00:23,368
DESCRIBE THEIR CANNABIS USE 

2699
02:00:23,368 --> 02:00:25,236
DISORDER AND THEIR WITHDRAWAL 

2700
02:00:25,236 --> 02:00:26,104
SYMPTOMS THAT MAY BE SKEWING 

2701
02:00:26,104 --> 02:00:28,139
THIS.  FOLKS ARE INTERESTED IN 

2702
02:00:28,139 --> 02:00:29,374
THIS POTENTIAL BIAS.  THIS IS AN

2703
02:00:29,374 --> 02:00:30,608
INTERESTING AREA TO START 

2704
02:00:30,608 --> 02:00:35,146
LOOKING AT IN THE LITERATURE.  

2705
02:00:35,146 --> 02:00:37,549
SO TURNING AWAY FROM SO-CALLED 

2706
02:00:37,549 --> 02:00:39,584
ADVERSE EFFECTS AND FOCUSING 

2707
02:00:39,584 --> 02:00:44,789
MORE ON CANNABIS AND CANNABINOID

2708
02:00:44,789 --> 02:00:46,157
ASSOCIATED ANALGESIA, THERE IS 

2709
02:00:46,157 --> 02:00:49,361
AN EMERGING FIELD OF FOLKS 

2710
02:00:49,361 --> 02:00:50,528
STUDYING WHETHER THERE IS A SEX 

2711
02:00:50,528 --> 02:00:52,230
DIFFERENCE IN RESPONSE TO THE 

2712
02:00:52,230 --> 02:00:53,865
ANALGESIC PROPERTIES OF CANNABIS

2713
02:00:53,865 --> 02:01:03,141
MOST OF THIS WORK IS LED DOCTORS

2714
02:01:03,141 --> 02:01:05,777
MEG, COOPER AND RYAN.  IN THIS 

2715
02:01:05,777 --> 02:01:07,145
WORK THEY REPORT WHAT THEY HAVE 

2716
02:01:07,145 --> 02:01:09,547
SEEN SO FAR IS REALLY VARIABLE. 

2717
02:01:09,547 --> 02:01:11,015
AND THIS CAN BE DUE TO MANY 

2718
02:01:11,015 --> 02:01:12,717
REASONS, MANY FOLKS HAVE ALREADY

2719
02:01:12,717 --> 02:01:14,719
TOUCHED UPON THE DIFFERENT 

2720
02:01:14,719 --> 02:01:16,154
REASONS WHY YOU CAN GET 

2721
02:01:16,154 --> 02:01:19,157
DISPARATE EFFECTS WHEN LOOKING 

2722
02:01:19,157 --> 02:01:20,558
AT POTENTIAL ANALGESIC RESPONSES

2723
02:01:20,558 --> 02:01:22,560
IN MEN AND WOMEN.  YOU ADD ON 

2724
02:01:22,560 --> 02:01:25,196
TOP OF THIS, SORT OF THE 

2725
02:01:25,196 --> 02:01:26,097
COMPLEXITIES OF CANNABIS.  AND 

2726
02:01:26,097 --> 02:01:28,933
THE FACT THAT CANNABIS IS NOT 

2727
02:01:28,933 --> 02:01:30,668
ONE PARTICULAR SUBSTANCE BUT IS 

2728
02:01:30,668 --> 02:01:32,771
USED WITH MANY DIFFERENT ROUTES 

2729
02:01:32,771 --> 02:01:34,973
OF ADMINISTRATION AND IS 

2730
02:01:34,973 --> 02:01:36,975
COMPRISED BY ONES OF DIFFERENT 

2731
02:01:36,975 --> 02:01:39,144
CHEMICALS THIS IS A VERY NASCENT

2732
02:01:39,144 --> 02:01:42,547
FIELD IS AND THE RESULTS COMING 

2733
02:01:42,547 --> 02:01:44,816
OUT OF IT ARE PRETTY VARIABLE.  

2734
02:01:44,816 --> 02:01:48,420
SO IN ONE STUDY THAT WAS LOOKING

2735
02:01:48,420 --> 02:01:50,722
AT LOW TO MODERATE FREQUENCY OF 

2736
02:01:50,722 --> 02:01:53,958
CANNABIS USE DID REPORT THAT 

2737
02:01:53,958 --> 02:01:54,926
THERE WERE STRONGER DRUG EFFECT 

2738
02:01:54,926 --> 02:01:58,163
RATINGS IN FEMALES COMPARED TO 

2739
02:01:58,163 --> 02:01:59,130
MALE PARTICIPANTS SO PERHAPS 

2740
02:01:59,130 --> 02:02:00,799
THAT THE FEMALES WERE MORE 

2741
02:02:00,799 --> 02:02:04,169
SENSITIVE TO THE SUBJECTIVE 

2742
02:02:04,169 --> 02:02:09,140
EFFECTS OF CANNABIS.  BUT 

2743
02:02:09,140 --> 02:02:10,575
LOOKING AT CANNABIS ANALGESIA 

2744
02:02:10,575 --> 02:02:13,011
THERE ARE TWO REPORTS THAT IT 

2745
02:02:13,011 --> 02:02:15,046
MAY BE MORE POTENT IN MALE 

2746
02:02:15,046 --> 02:02:17,916
PATIENTS OR MALE USERS VERSUS 

2747
02:02:17,916 --> 02:02:20,385
FEMALES SO IN A POPULATION OF 

2748
02:02:20,385 --> 02:02:24,088
CANNABIS SMOKERS MALE REPORTED 

2749
02:02:24,088 --> 02:02:31,129
GREATER ACUTE ANALGESIA COMPARED

2750
02:02:31,129 --> 02:02:35,834
TO FEMALES.  THESE WERE IN A 

2751
02:02:35,834 --> 02:02:37,769
COLD PRESSOR TEST.  IN AN ACTUAL

2752
02:02:37,769 --> 02:02:40,305
PATIENT SETTING IN CANCER 

2753
02:02:40,305 --> 02:02:42,640
PATIENTS, THAT WERE ALL 

2754
02:02:42,640 --> 02:02:43,541
REPORTING SIGNIFICANT PAIN 

2755
02:02:43,541 --> 02:02:45,543
RELIEF WITH USING CANNABIS 

2756
02:02:45,543 --> 02:02:48,213
BETTER PAIN RELIEF WAS REPORTED 

2757
02:02:48,213 --> 02:02:49,747
IN MEN AS COMPARED TO WOMEN SO 

2758
02:02:49,747 --> 02:02:52,150
THIS IS AN EMERGING FIELD AND IF

2759
02:02:52,150 --> 02:02:54,853
YOU'RE INTERESTING IN THESE 

2760
02:02:54,853 --> 02:02:56,221
POTENTIAL SEX DIFFERENCES IN 

2761
02:02:56,221 --> 02:02:57,889
HUMANS I WOULD DIRECT YOU FIRST 

2762
02:02:57,889 --> 02:03:02,994
TO THIS REVIEW THAT TALKS ABOUT 

2763
02:03:02,994 --> 02:03:04,562
THESE STUDIES.  I ALSO FOUND 

2764
02:03:04,562 --> 02:03:09,934
THERE IS AN EHER YENS -- 

2765
02:03:09,934 --> 02:03:11,002
EMERGENCE OF GENDER BASED 

2766
02:03:11,002 --> 02:03:12,036
STUDIES AS WELL. 

2767
02:03:12,036 --> 02:03:14,706
SO THE FIELD IS INCORPORATING 

2768
02:03:14,706 --> 02:03:16,007
GENDER AS WELL AS SEX.  NOW TO 

2769
02:03:16,007 --> 02:03:17,609
TURN MORE INTO MY WORLD OF 

2770
02:03:17,609 --> 02:03:19,844
STUDYING THIS USING RODENT 

2771
02:03:19,844 --> 02:03:22,113
MODELS.  YOU KNOW, ONE OF THE 

2772
02:03:22,113 --> 02:03:24,816
REASONS TO USE RATS AND MICE IN 

2773
02:03:24,816 --> 02:03:27,151
THIS RESEARCH IS TO TRY TO 

2774
02:03:27,151 --> 02:03:28,119
DECREASE THE AMOUNT OF 

2775
02:03:28,119 --> 02:03:30,355
VARIABILITY AND HAVE MORE 

2776
02:03:30,355 --> 02:03:31,456
CONTROL OVER THE 

2777
02:03:31,456 --> 02:03:33,091
EXPERIMENTATION, POSSIBLY TO 

2778
02:03:33,091 --> 02:03:35,159
START TO GET AT MORE OF THE 

2779
02:03:35,159 --> 02:03:37,529
PHARMACOLOGICAL AND BIOLOGICAL 

2780
02:03:37,529 --> 02:03:40,164
UNDERPINNINGS OF SEX 

2781
02:03:40,164 --> 02:03:41,199
DIFFERENCES.  BUT AS WE KNOW 

2782
02:03:41,199 --> 02:03:47,005
THERE ARE STILL BIASES IN RODENT

2783
02:03:47,005 --> 02:03:48,139
RESEARCH AND OTHER THINGS THAT 

2784
02:03:48,139 --> 02:03:49,841
WE NEED TO CONSIDER THAT I WILL 

2785
02:03:49,841 --> 02:03:51,676
TOUCH UPON.  THE LEADER IN THE 

2786
02:03:51,676 --> 02:03:53,344
FIELD OF LOOKING AT SEX 

2787
02:03:53,344 --> 02:03:57,515
DIFFERENCES FOR CANNABINOIDS IS 

2788
02:03:57,515 --> 02:03:59,817
DR. REBEKAH, MOST OF THE 

2789
02:03:59,817 --> 02:04:01,519
PRECRITICAL LITERATURE COMES OUT

2790
02:04:01,519 --> 02:04:04,155
OF HER LABORATORY AND LOOKING AT

2791
02:04:04,155 --> 02:04:13,364
ANIMAL MODELS OF ACUTE .  IT 

2792
02:04:13,364 --> 02:04:16,167
LOOKS LIKE THEY ARE MORE POTENT 

2793
02:04:16,167 --> 02:04:17,835
IN FEMALE ROW DENS VERSUS MALE 

2794
02:04:17,835 --> 02:04:20,004
AND THERE IS A LITERATURE DIVING

2795
02:04:20,004 --> 02:04:22,073
INTO SOME OF THE RECEPTOR BASED 

2796
02:04:22,073 --> 02:04:24,809
MECHANISMS UNDERLYING THIS 

2797
02:04:24,809 --> 02:04:26,344
INCREASED POTENCY OF 

2798
02:04:26,344 --> 02:04:29,647
CANNABINOIDS IN FEMALE VERSUS 

2799
02:04:29,647 --> 02:04:31,716
MALE RODENTS.  SO WHAT REMAINS 

2800
02:04:31,716 --> 02:04:33,818
UNKNOWN?  WELL A WHOLE HECK OF A

2801
02:04:33,818 --> 02:04:36,487
LOT REMAINS TO BE INVESTIGATED 

2802
02:04:36,487 --> 02:04:38,856
IN THIS AREA AS YOU CAN IMAGINE.

2803
02:04:38,856 --> 02:04:40,258
SO THE FIRST BULLET POINT THAT I

2804
02:04:40,258 --> 02:04:41,993
THINK IS VERY IMPORTANT IS THAT 

2805
02:04:41,993 --> 02:04:44,762
THE MAJORITY OF THESE STUDIES IN

2806
02:04:44,762 --> 02:04:47,165
HUMANS AS WELL AS IN ANIMALS TO 

2807
02:04:47,165 --> 02:04:55,139
DATE AS FOCUSED ON ACUTE ANTI 

2808
02:04:55,139 --> 02:04:57,275
KNOW SIS RECEPTIVE IN HUMANS 

2809
02:04:57,275 --> 02:04:59,177
THAT DO NOT HAVE A CHRONIC PAIN 

2810
02:04:59,177 --> 02:05:01,846
CONDITION.  SO I THINK IT'S 

2811
02:05:01,846 --> 02:05:02,714
IMPORTANT TO UNDERSTAND WHETHER 

2812
02:05:02,714 --> 02:05:05,149
THERE ARE POTENTIAL SEX 

2813
02:05:05,149 --> 02:05:07,018
DIFFERENCES IN THE THERAPEUTIC 

2814
02:05:07,018 --> 02:05:09,387
EFFECTS OF CANNABINOIDS IN 

2815
02:05:09,387 --> 02:05:10,788
CHRONIC FLIER PATHIC AND/OR 

2816
02:05:10,788 --> 02:05:12,323
INPOLICEMAN STORY PAIN.  AND 

2817
02:05:12,323 --> 02:05:14,993
THEN WHAT MY LABORATORY FOCUSES 

2818
02:05:14,993 --> 02:05:16,160
ON AS WELL. 

2819
02:05:16,160 --> 02:05:19,130
IS IN THESE ANIMAL MODELS OF 

2820
02:05:19,130 --> 02:05:23,134
CHRONIC PAIN WHAT ARE THE 

2821
02:05:23,134 --> 02:05:30,842
POTENTIAL THERAPEURAPEUTIC EFFEF

2822
02:05:30,842 --> 02:05:32,076
CANNABINOIDS DEVOID OF EFFECTS. 

2823
02:05:32,076 --> 02:05:34,512
I AM A PAIN RESEARCHER AND MOST 

2824
02:05:34,512 --> 02:05:38,149
OF MY WORK DOES NOT FOCUS ON 

2825
02:05:38,149 --> 02:05:44,055
DELTA-9 THC OR CANNABINOID 

2826
02:05:44,055 --> 02:05:46,524
COMPOUNDS THAT INCLUDE ACTIVITY 

2827
02:05:46,524 --> 02:05:48,559
I'M INSTEAD IN OTHER 

2828
02:05:48,559 --> 02:05:49,761
CONSTITUENTS OF THE PLANT OR 

2829
02:05:49,761 --> 02:05:51,863
CHEMICALS THAT ARE SYNTHESIZED 

2830
02:05:51,863 --> 02:05:54,098
TO BE DEVOID OF PSYCHO ACTIVITY 

2831
02:05:54,098 --> 02:05:56,768
AND ABUSED LIABILITY.  THE 

2832
02:05:56,768 --> 02:06:02,106
PRIMARY CANNABINOID THAT I STUDY

2833
02:06:02,106 --> 02:06:06,044
IN MY LABORATORY IS CBD THAT HAS

2834
02:06:06,044 --> 02:06:07,779
SOME CHARACTERIZED 

2835
02:06:07,779 --> 02:06:09,447
ANTI-INFLAMMATORY PROPERTIES SO 

2836
02:06:09,447 --> 02:06:18,656
OUR LAB RAH  RARE -- LABORATORY.

2837
02:06:18,656 --> 02:06:20,758
THERE ARE OTHER FIE TO 

2838
02:06:20,758 --> 02:06:23,795
CANNABINOIDS THAT ARE NOW 

2839
02:06:23,795 --> 02:06:26,497
EMERGING IN THE LITERATURE.  ONE

2840
02:06:26,497 --> 02:06:27,598
IS QANA BEST OF MY KNOWLEDGE 

2841
02:06:27,598 --> 02:06:29,534
ROLL OR CBG. 

2842
02:06:29,534 --> 02:06:32,070
WE HAVE DONE TO INVESTIGATE THIS

2843
02:06:32,070 --> 02:06:34,305
IN THE LABORATORY AS WELL AND 

2844
02:06:34,305 --> 02:06:36,140
THERE IS ALMOST NOTHING KNOWN 

2845
02:06:36,140 --> 02:06:38,276
ABOUT THE POTENTIAL SEX 

2846
02:06:38,276 --> 02:06:40,611
DIFFERENCES THAT ARISE FROM CBD,

2847
02:06:40,611 --> 02:06:43,648
WHICH IS FASCINATING GIVEN THE 

2848
02:06:43,648 --> 02:06:47,719
MASSIVE NUMBER OF PEOPLE NOW WHO

2849
02:06:47,719 --> 02:06:52,156
ARE USING CBD AND OTHER HEMP 

2850
02:06:52,156 --> 02:06:53,991
DERIVED PRODUCTS FOR A VARIETY 

2851
02:06:53,991 --> 02:06:57,061
OF REASONS INCLUDING THE 

2852
02:06:57,061 --> 02:07:03,134
POTENTIAL TREATMENT OF PAIN SO 

2853
02:07:03,134 --> 02:07:04,168
I'M JUST GOING TO TALK ABOUT THE

2854
02:07:04,168 --> 02:07:05,937
WORK WE'VE DONE IN THE PAST, 

2855
02:07:05,937 --> 02:07:08,206
FOCUSING ON TESTING CBD AND OUR 

2856
02:07:08,206 --> 02:07:13,745
MOUSE MODEL OF CIPN OR 

2857
02:07:13,745 --> 02:07:16,013
MECHANICAL SENSITIVITY AND SO 

2858
02:07:16,013 --> 02:07:17,648
WE'VE BEEN DOING THIS RESEARCH 

2859
02:07:17,648 --> 02:07:20,551
FOR OVER FIFTEEN YEARS NOW.  WE 

2860
02:07:20,551 --> 02:07:23,087
WERE THE FIRST LABORATORY TO 

2861
02:07:23,087 --> 02:07:24,889
DEMONSTRATE THAT IF WE 

2862
02:07:24,889 --> 02:07:28,059
ADMINISTER CBD TO MICE WE CAN 

2863
02:07:28,059 --> 02:07:29,560
PREVENT THE DEVELOPMENT OF THIS.

2864
02:07:29,560 --> 02:07:32,864
THERE IS A RODENT MODEL THAT IS 

2865
02:07:32,864 --> 02:07:35,466
SIMILAR TO THE DATA THAT BRIAN 

2866
02:07:35,466 --> 02:07:36,968
SHOWED YOU YESTERDAY AND SO WE 

2867
02:07:36,968 --> 02:07:39,036
FOUND THAT CBD CAN COMPLETELY 

2868
02:07:39,036 --> 02:07:42,073
PREVENT THE DEVELOPMENT OF CIPN 

2869
02:07:42,073 --> 02:07:44,876
IN MICE.  WE STARTED THIS 

2870
02:07:44,876 --> 02:07:49,947
RESEARCH IN FEMALE MICE.  TAXOL 

2871
02:07:49,947 --> 02:07:52,150
IS A THERAPEUTIC AGENT USED FOR 

2872
02:07:52,150 --> 02:07:54,318
BREAST CANCER SO WE THOUGHT THAT

2873
02:07:54,318 --> 02:07:56,320
FEMALES WERE A RELEVANT SEX TO 

2874
02:07:56,320 --> 02:07:57,588
STUDY IN OUR MOUSE MODEL.  SO 

2875
02:07:57,588 --> 02:08:03,161
OUR FIRST TWO PUBLICATIONS WERE 

2876
02:08:03,161 --> 02:08:07,932
DONE EXCLUSIVELY IN FEMALE MICE.

2877
02:08:07,932 --> 02:08:10,868
I GOT THE MEMO LATE.  THE EARLY 

2878
02:08:10,868 --> 02:08:12,770
WORK WAS NOT DONE TO ASSESS 

2879
02:08:12,770 --> 02:08:15,006
POTENTIAL SEX DIFFERENCES.  BUT 

2880
02:08:15,006 --> 02:08:17,575
IN THE FEMALE MICE WE DETERMINED

2881
02:08:17,575 --> 02:08:22,146
THAT PACK LA TAXOL REDUCES 

2882
02:08:22,146 --> 02:08:22,480
SENSITIVITY. 

2883
02:08:22,480 --> 02:08:26,551
AND THIS CAN BE DONE BY 

2884
02:08:26,551 --> 02:08:28,653
PRETREATMENT OF QANA WHAT DIAL. 

2885
02:08:28,653 --> 02:08:30,588
A FURTHER STUDY WHEN I MOVED 

2886
02:08:30,588 --> 02:08:32,757
FROM THE SCHOOL OF PHARMACY TO 

2887
02:08:32,757 --> 02:08:33,391
THE SCHOOL OF MEDICINE, 

2888
02:08:33,391 --> 02:08:35,159
DIFFERENT LABORATORY, DIFFERENT 

2889
02:08:35,159 --> 02:08:37,328
SIDE OF BROAD STREET IN 

2890
02:08:37,328 --> 02:08:37,662
PHILADELPHIA. 

2891
02:08:37,662 --> 02:08:39,864
DIFFERENT FOLKS IN MY LAB DOING 

2892
02:08:39,864 --> 02:08:41,566
THE EXPERIMENTATION, BUYING THE 

2893
02:08:41,566 --> 02:08:43,167
MICE FROM A DIFFERENT VENDOR, 

2894
02:08:43,167 --> 02:08:44,969
ALL KINDS OF THINGS CHANGING 

2895
02:08:44,969 --> 02:08:47,805
INCLUDING THE SEX OF THE ANIMALS

2896
02:08:47,805 --> 02:08:51,809
BUT CBD STILL WORKED.  SO PACKLY

2897
02:08:51,809 --> 02:08:53,678
TACK SOME PRODUCES SENSITIVITY 

2898
02:08:53,678 --> 02:08:56,581
AND CBD PREVENTS THAT SO I COULD

2899
02:08:56,581 --> 02:08:58,883
SEE FROM THESE DATA THAT CBD 

2900
02:08:58,883 --> 02:09:00,184
WORKS IN MALES AND FEMALES BUT 

2901
02:09:00,184 --> 02:09:03,154
AS WE ALL KNOW THAT'S REALLY NOT

2902
02:09:03,154 --> 02:09:04,155
THE PROPER WAY TO EXAMINE SEX 

2903
02:09:04,155 --> 02:09:08,826
DIFFERENCES.  SO WE HAVE NOW 

2904
02:09:08,826 --> 02:09:11,162
MOVED ONTO DIRECTLY COMPARING 

2905
02:09:11,162 --> 02:09:14,899
THE EFFECTS OF PACLITAXEL AND 

2906
02:09:14,899 --> 02:09:18,636
FIE TO CANNABINOIDS IN FEMALE 

2907
02:09:18,636 --> 02:09:22,139
AND MALE MICE LOOKING AT THE 

2908
02:09:22,139 --> 02:09:23,074
INFLAMMATORY CONSEQUENCES.  SO 

2909
02:09:23,074 --> 02:09:24,942
I'M GOING TO SHOW YOU MOST OF 

2910
02:09:24,942 --> 02:09:27,545
THE WORK THAT WE ARE NOW DOING 

2911
02:09:27,545 --> 02:09:32,917
WITH SEX DIFFERENCES WE'VE 

2912
02:09:32,917 --> 02:09:34,151
DECIDED TO START THE SOLE AND 

2913
02:09:34,151 --> 02:09:40,157
EXCLUSIVE DIFFER-- SEX DIFFEREN 

2914
02:09:40,157 --> 02:09:41,859
WORK WITH THE OTHER DRUG.  

2915
02:09:41,859 --> 02:09:43,361
AN INTERESTING PAPER CAME OUT 

2916
02:09:43,361 --> 02:09:46,697
FROM MICHELE SEXTON'S GROUP 

2917
02:09:46,697 --> 02:09:48,900
DEMONSTRATING THAT IN PATIENTS 

2918
02:09:48,900 --> 02:09:50,568
WHO ARE USING MEDICAL CANNABIS 

2919
02:09:50,568 --> 02:09:53,871
PRODUCTS TO TREAT THEIR 

2920
02:09:53,871 --> 02:09:54,672
NEUROPATHIC PAIN THOSE PATIENTS 

2921
02:09:54,672 --> 02:09:56,007
THAT ENDORSED THE MOST 

2922
02:09:56,007 --> 02:09:57,208
SUCCESSFUL TREATMENT OF THEIR 

2923
02:09:57,208 --> 02:10:00,278
PAIN WERE USING CANNABIS 

2924
02:10:00,278 --> 02:10:01,579
CULTIVARS THAT WERE 

2925
02:10:01,579 --> 02:10:05,516
SIGNIFICANTLY HIGHER IN THIS FIE

2926
02:10:05,516 --> 02:10:07,018
TO CANNABINOID CBG. 

2927
02:10:07,018 --> 02:10:09,420
SO FOLKS ARE INTERESTING IN 

2928
02:10:09,420 --> 02:10:14,292
EXPLORING THE EFFECTS OF CBG.  I

2929
02:10:14,292 --> 02:10:15,860
ALSO WANTED TO HIGHLIGHT HERE OF

2930
02:10:15,860 --> 02:10:17,695
MY LAB BYES WHO HAVE BEEN 

2931
02:10:17,695 --> 02:10:20,698
WORKING ON TESTING CBG IN OUR 

2932
02:10:20,698 --> 02:10:22,166
MOUSE MODEL OF CIPN. 

2933
02:10:22,166 --> 02:10:24,001
AND NOT ONLY DID I WANT TO SHOW 

2934
02:10:24,001 --> 02:10:25,536
A PICTURE OF THEM BECAUSE THEY 

2935
02:10:25,536 --> 02:10:29,440
BOTH DESERVE A LOT OF CREDIT BUT

2936
02:10:29,440 --> 02:10:32,743
BECAUSE HUM BOW IS A FEMALE 

2937
02:10:32,743 --> 02:10:36,113
INVESTIGATOR AND SHAUN IS A MALE

2938
02:10:36,113 --> 02:10:38,082
INVESTIGATOR AND I CAN TELL YOU 

2939
02:10:38,082 --> 02:10:40,217
THAT TO SUPPORT THE WORK THAT 

2940
02:10:40,217 --> 02:10:41,986
JEFF AND ROB PUBLISHED THAT WAS 

2941
02:10:41,986 --> 02:10:44,388
SO FASCINATING THESE TWO 

2942
02:10:44,388 --> 02:10:46,090
INVESTIGATORS DO GET DIFFERENT 

2943
02:10:46,090 --> 02:10:47,792
EFFECTS FROM MALE VERSUS FEMALE 

2944
02:10:47,792 --> 02:10:51,696
MICE IN THE C IPN MODEL TO THIS 

2945
02:10:51,696 --> 02:10:54,699
ADDS AN EXTRA LAYER OF 

2946
02:10:54,699 --> 02:10:55,967
COMPLEXITY IN TESTING THE 

2947
02:10:55,967 --> 02:10:57,568
POTENTIAL OF DIFFERENCES. 

2948
02:10:57,568 --> 02:10:59,170
SO ALL OF THE DATA I'M GOING TO 

2949
02:10:59,170 --> 02:11:02,139
SHOW YOU ARE THE DATA CLICKED BY

2950
02:11:02,139 --> 02:11:06,644
HIM BOW IN THE LABORATORY AND  

2951
02:11:06,644 --> 02:11:08,612
SHE'S BEEN WORKING ON THE 

2952
02:11:08,612 --> 02:11:10,481
PROJECT FOR THE LAST TWO YEARS. 

2953
02:11:10,481 --> 02:11:12,817
HERE ARE THE BEHAVIORAL DATA 

2954
02:11:12,817 --> 02:11:14,785
LOOKING AT MALES VERSUS FEMALES 

2955
02:11:14,785 --> 02:11:16,854
THAT HAVE BEEN TREATED WITH 

2956
02:11:16,854 --> 02:11:18,956
PACLITAXEL SO I'M A BEHAVIORAL 

2957
02:11:18,956 --> 02:11:21,459
PHARMACOLOGIST I LIKE TO GIVE 

2958
02:11:21,459 --> 02:11:24,195
LOTS OF DOSES OF DIFFERENT DRUGS

2959
02:11:24,195 --> 02:11:25,162
TO LOOK AT THE RESPONSE 

2960
02:11:25,162 --> 02:11:27,565
RELATIONSHIP.  YOU CAN SEE IN 

2961
02:11:27,565 --> 02:11:30,601
BOTH FEMALE AND MALE MICE AT 17 

2962
02:11:30,601 --> 02:11:33,137
AND 14 DAYS THERE IS A DOSE 

2963
02:11:33,137 --> 02:11:35,873
DEPENDENT INCREASE IN MECHANICAL

2964
02:11:35,873 --> 02:11:37,842
SENSITIVITY.  IF YOU OVERLAY 

2965
02:11:37,842 --> 02:11:39,477
THESE GRAPHS, YOU CAN SEE THAT 

2966
02:11:39,477 --> 02:11:42,546
ON DAY SEVEN, WE SEE A 

2967
02:11:42,546 --> 02:11:45,049
SIGNIFICANT SEX DIFFERENCE WHERE

2968
02:11:45,049 --> 02:11:47,118
THE MALES ARE SENSITIVE AT A 

2969
02:11:47,118 --> 02:11:49,387
LOWER DOSE THAN THE FEMALES ARE.

2970
02:11:49,387 --> 02:11:51,722
AND AT DAY 14, WE SEE A LITTLE 

2971
02:11:51,722 --> 02:11:54,492
BIT OF A CROSSOVER WHERE WE GET 

2972
02:11:54,492 --> 02:11:57,261
MALES THAT ARE MORE SENSITIVE AT

2973
02:11:57,261 --> 02:11:58,562
THE EARLY DOSES AND FEMALES AT 

2974
02:11:58,562 --> 02:12:01,732
THE LATER DOSES.  SO WE'RE 

2975
02:12:01,732 --> 02:12:03,167
SEEING SOME INTERESTING SEX 

2976
02:12:03,167 --> 02:12:10,174
DIFFERENCES IN THE BEHAVIOR.  SO

2977
02:12:10,174 --> 02:12:12,143
WHAT I WANTED TO DO FROM THIS 

2978
02:12:12,143 --> 02:12:15,146
DATA IS TO EXAMINE IF WE SEE ANY

2979
02:12:15,146 --> 02:12:17,748
NEUROINFLAMMATORY CORRELATES.  

2980
02:12:17,748 --> 02:12:20,851
ANOTHER SHOUT-OUT TO JEFF AND 

2981
02:12:20,851 --> 02:12:23,087
ROB AND SOME OF THE FANTASTIC 

2982
02:12:23,087 --> 02:12:24,889
WORK THAT THEY'VE DONE WE KNOW 

2983
02:12:24,889 --> 02:12:26,257
THAT THERE ARE POTENTIAL 

2984
02:12:26,257 --> 02:12:27,358
NEUROINFLAMMATORY SEX 

2985
02:12:27,358 --> 02:12:28,559
DIFFERENCES THAT CAN EXPLAIN 

2986
02:12:28,559 --> 02:12:31,095
SOME OF THESE DIFFERENTIAL 

2987
02:12:31,095 --> 02:12:33,197
RESPONSES TO PAIN.  IN FEMALE 

2988
02:12:33,197 --> 02:12:34,665
VERSUS MALE RODENTS.  SO WE 

2989
02:12:34,665 --> 02:12:39,136
WANTED TO SEE WHETHER WE WOULD 

2990
02:12:39,136 --> 02:12:45,943
SEE DIFFERENT PATTERNS OF YOUR 

2991
02:12:45,943 --> 02:12:47,812
IN -- NEUROINFLAMMATION. 

2992
02:12:47,812 --> 02:12:51,882
THIS WAS AN RTPCR EXPERIMENT 

2993
02:12:51,882 --> 02:12:53,717
USING BOTH MALE AND FEMALE MICE 

2994
02:12:53,717 --> 02:12:57,421
FROM TACONIC WITH HUM BOAZ THE 

2995
02:12:57,421 --> 02:12:57,755
INVESTIGATOR. 

2996
02:12:57,755 --> 02:13:03,160
WE HAD THE TWO DIFFERENT TIME 

2997
02:13:03,160 --> 02:13:07,164
POINTS, TISSUE HARVESTED 

2998
02:13:07,164 --> 02:13:10,167
FOLLOWING PACK LOW TACK SILL 

2999
02:13:10,167 --> 02:13:10,501
INFLAMMATION. 

3000
02:13:10,501 --> 02:13:12,870
AND SOMEBODY ASKED A QUESTION 

3001
02:13:12,870 --> 02:13:16,006
YESTERDAY ABOUT PERHAPS WHERE IN

3002
02:13:16,006 --> 02:13:18,142
THE PAIN PATH WEI SEX 

3003
02:13:18,142 --> 02:13:21,312
DIFFERENCES MIGHT BE ABLE TO BE 

3004
02:13:21,312 --> 02:13:23,147
IDENTIFIED.  WE LOOKED AT THE 

3005
02:13:23,147 --> 02:13:23,981
CENTRAL SITE. 

3006
02:13:23,981 --> 02:13:27,151
THE PERRY AC WE DUCTAL GRAY 

3007
02:13:27,151 --> 02:13:27,718
WHICH IS IMPORTANT IN PAIN 

3008
02:13:27,718 --> 02:13:38,863
SIGNALLING.  AND SO LOOK AT ALL 

3009
02:13:39,497 --> 02:13:41,999
VARIABLES THAT GAVE US OVER 50 

3010
02:13:41,999 --> 02:13:44,935
DIFFERENT GRAPHS.  ONE OF THE 

3011
02:13:44,935 --> 02:13:46,170
REVIEWERS IS LIKE YOU'RE LOOKING

3012
02:13:46,170 --> 02:13:47,138
AT TOO MANY DIFFERENT THINGS AND

3013
02:13:47,138 --> 02:13:49,773
THEY SEEMED DISTURBED BY THAT 

3014
02:13:49,773 --> 02:13:52,176
BUT I FELT LIKE I COULD HAVE 

3015
02:13:52,176 --> 02:13:55,679
GONE ON BUT WE ACTUALLY DID LOOK

3016
02:13:55,679 --> 02:14:01,085
AT MORE THAN THIS.  BUT I FELT 

3017
02:14:01,085 --> 02:14:02,920
TO GET A BEGINNINGSES OF THE 

3018
02:14:02,920 --> 02:14:04,188
CLEAR PICTURE THAT WE REALLY HAD

3019
02:14:04,188 --> 02:14:06,790
TO LOOK AT ALL OF THESE 

3020
02:14:06,790 --> 02:14:08,292
DIFFERENT THINGS.  SO I AM NOT 

3021
02:14:08,292 --> 02:14:10,127
GOING TO SHOW YOU 56 GRAPHS.  

3022
02:14:10,127 --> 02:14:12,696
I'M GOING TO SHOW YOU A SUMMARY 

3023
02:14:12,696 --> 02:14:13,330
TABLE IF YOU'RE INTERESTED, I 

3024
02:14:13,330 --> 02:14:15,566
HAVE THE CITATION OF THE 

3025
02:14:15,566 --> 02:14:19,136
PUBLICATION DOWN ON THE BOTTOM 

3026
02:14:19,136 --> 02:14:20,905
THERE.  BUT TWO OF THE REALLY 

3027
02:14:20,905 --> 02:14:22,940
INTERESTING THINGS THAT EMERGED 

3028
02:14:22,940 --> 02:14:27,111
WAS DAY EIGHT IN THE DORSAL ROOT

3029
02:14:27,111 --> 02:14:29,914
GANGLION WE SAW SEVERAL SEX 

3030
02:14:29,914 --> 02:14:32,349
DIFFERENCES IN THE PAIN AND 

3031
02:14:32,349 --> 02:14:33,817
INFLAMMATION THAT WERE DECREASED

3032
02:14:33,817 --> 02:14:36,420
IN MALES OVER FEMALES AND IN 

3033
02:14:36,420 --> 02:14:37,688
GENERAL, MORE INFLAMMATION 

3034
02:14:37,688 --> 02:14:41,892
MEASURED IN THE DRG ON DAY EIGHT

3035
02:14:41,892 --> 02:14:44,361
IN MALES.  IN DAY FIFTEEN, WE 

3036
02:14:44,361 --> 02:14:48,632
STARTED TO SEE THE EMERGENCE OF 

3037
02:14:48,632 --> 02:14:49,466
CHANGES IN NEUROINFLAMMATORY 

3038
02:14:49,466 --> 02:14:53,270
MARKERS IN THE PERIAQUEDUCTAL 

3039
02:14:53,270 --> 02:14:55,139
GRAY SO ALMOST LIKE THE 

3040
02:14:55,139 --> 02:14:56,774
INFLAMMATION IS MOVING BUT BY 

3041
02:14:56,774 --> 02:15:00,678
DAY FIFTEEN IN THE PAG MORE OF 

3042
02:15:00,678 --> 02:15:02,379
THIS NEUROINFLAMMATION WAS 

3043
02:15:02,379 --> 02:15:04,181
PRESENT IN THE FEMALES AS 

3044
02:15:04,181 --> 02:15:09,653
COMPARED TO THE MALES IF YOU 

3045
02:15:09,653 --> 02:15:10,955
WANT THE GESTALT OF THE 

3046
02:15:10,955 --> 02:15:13,057
EXPERIMENT THAT WAS THE MOST 

3047
02:15:13,057 --> 02:15:15,159
INTERESTING TREND IN OUR DATA.  

3048
02:15:15,159 --> 02:15:21,966
ONE OF THE MORE COME -- COM

3049
02:15:21,966 --> 02:15:24,702
COMPELLING SIX DIFFERENCES THAT 

3050
02:15:24,702 --> 02:15:27,238
WE DID SEE WAS THE CXCL 9. 

3051
02:15:27,238 --> 02:15:28,539
THERE'S AN INTERESTING 

3052
02:15:28,539 --> 02:15:33,544
LITERATURE EMERGING WITH CXCL 9 

3053
02:15:33,544 --> 02:15:35,145
IN PAIN.  TWO OTHER MARKERS THAT

3054
02:15:35,145 --> 02:15:39,149
I THOUGHT WERE INTERESTING IN 

3055
02:15:39,149 --> 02:15:42,119
THE PERIAQUEDUCTAL GRAY WERE TRL

3056
02:15:42,119 --> 02:15:44,088
4 WHERE WE SAW INCREASES IN 

3057
02:15:44,088 --> 02:15:47,925
FEMALES AND NOT IN MALES.  

3058
02:15:47,925 --> 02:15:50,995
SO THAT'S ALL JUST PACLITAXEL, 

3059
02:15:50,995 --> 02:15:54,298
WHAT HAPPENS WITH CBG?  CBG 

3060
02:15:54,298 --> 02:15:56,333
PRODUCED A BEHAVIORAL EFFECT 

3061
02:15:56,333 --> 02:15:59,169
TREATMENT WITH CBG PREVENTED THE

3062
02:15:59,169 --> 02:16:01,372
DEVELOPMENT OF MECHANICAL 

3063
02:16:01,372 --> 02:16:03,807
SENSITIVITY ASSOCIATED WITH 

3064
02:16:03,807 --> 02:16:06,410
PACLITAXEL AND ALSO DECREASED 

3065
02:16:06,410 --> 02:16:07,845
ANY NEUROINFLAMMATION ANYWHERE 

3066
02:16:07,845 --> 02:16:11,148
IN EITHER SEX.  SO WE SAW LOTS 

3067
02:16:11,148 --> 02:16:13,117
OF INTERESTING SEX DIFFERENCE 

3068
02:16:13,117 --> 02:16:15,052
PATTERNS EMERGING IN MICE 

3069
02:16:15,052 --> 02:16:18,188
TREATED WITH PACLITAXEL AND ALL 

3070
02:16:18,188 --> 02:16:21,058
OF THOSE WERE AMELIORATED WITH 

3071
02:16:21,058 --> 02:16:23,127
PRETREATMENT WITH CBG.  SO TAKE 

3072
02:16:23,127 --> 02:16:27,164
HOME MESSAGES, MY TAKE HOME 

3073
02:16:27,164 --> 02:16:27,831
MESSAGE IS ALMOST ALWAYS IT'S 

3074
02:16:27,831 --> 02:16:30,334
REALLY COMPLICATED.  THAT'S SORT

3075
02:16:30,334 --> 02:16:32,403
OF A COPOUT, BUT JUST TO 

3076
02:16:32,403 --> 02:16:34,238
HIGHLIGHT SOME OF THE THINGS 

3077
02:16:34,238 --> 02:16:38,142
THAT ARE REALLY CRITICAL IN THIS

3078
02:16:38,142 --> 02:16:38,842
RESEARCH, IT'S DEPENDENT 

3079
02:16:38,842 --> 02:16:41,378
PROBABLY ON THE SEX OF THE 

3080
02:16:41,378 --> 02:16:43,480
INVESTIGATOR EVEN IN RODENT 

3081
02:16:43,480 --> 02:16:45,182
STUDIES.  IT'S DEPENDENT ON THE 

3082
02:16:45,182 --> 02:16:49,119
DOSE OF PACLITAXEL.  ON THE 

3083
02:16:49,119 --> 02:16:50,087
NEUROANATOMICAL SITE, ON THE 

3084
02:16:50,087 --> 02:16:51,889
TIME YOU'RE LOOKING AT AND ON 

3085
02:16:51,889 --> 02:16:56,160
THE AN LITE AND THAT IS JUST FOR

3086
02:16:56,160 --> 02:16:59,797
THE PACLITAXEL DATA ITSELF. 

3087
02:16:59,797 --> 02:17:01,799
BUT ONE POTENTIAL TAKE HOME 

3088
02:17:01,799 --> 02:17:03,901
MESSAGE TO ADDRESS SOMETHING 

3089
02:17:03,901 --> 02:17:06,170
THAT WAS MENTIONED YESTERDAY AS 

3090
02:17:06,170 --> 02:17:08,505
WELL IS PERHAPS THE SEX 

3091
02:17:08,505 --> 02:17:12,109
DIFFERENCES IN THE DISEASE OF 

3092
02:17:12,109 --> 02:17:14,511
CIPN MAY STILL BOTH BE 

3093
02:17:14,511 --> 02:17:16,180
RESPONSIVE IN BOTH SEXES TO 

3094
02:17:16,180 --> 02:17:19,149
CERTAIN TREATMENTS SUCH AS FIE 

3095
02:17:19,149 --> 02:17:20,951
TO CANNABINOIDS. 

3096
02:17:20,951 --> 02:17:23,420
SO THESE FIE TO CANNABINOIDS ARE

3097
02:17:23,420 --> 02:17:31,161
EMERGING AS WHAT I HAVE  CALL 

3098
02:17:31,161 --> 02:17:32,730
THESE EFFECTS. 

3099
02:17:32,730 --> 02:17:35,566
SO THERE MAY BE A SEX DIFFERENCE

3100
02:17:35,566 --> 02:17:38,736
IN THE DISEASE, BUT IF THE FIE 

3101
02:17:38,736 --> 02:17:40,170
TO CANNABINOIDS ARE ACTIVE AT 

3102
02:17:40,170 --> 02:17:42,806
BOTH OF THESE MECHANISMS 

3103
02:17:42,806 --> 02:17:44,475
UNDERLYING THE SEX DIFFERENCES 

3104
02:17:44,475 --> 02:17:46,910
THAT PERHAPS WE WON'T REALLY SEE

3105
02:17:46,910 --> 02:17:48,979
A MEANINGFUL SEX DIFFERENCE IN 

3106
02:17:48,979 --> 02:17:49,913
WE GET TO THE CLINIC WITH THESE 

3107
02:17:49,913 --> 02:17:53,283
COMPOUNDS.  SO THANK YOU VERY 

3108
02:17:53,283 --> 02:17:54,952
MUCH FOR YOUR ATTENTION AND I 

3109
02:17:54,952 --> 02:17:58,188
HOOK FORWARD TO ANSWERING 

3110
02:17:58,188 --> 02:18:08,599
QUESTIONS AT THE PANEL.

3111
02:18:13,670 --> 02:18:16,140
>> THE THIRD AND FINAL
SPEAKER 

3112
02:18:16,140 --> 02:18:19,109
FOR TODAY THIS IS DR. TAMARA 

3113
02:18:19,109 --> 02:18:22,179
SOMERS IS AN ASSOCIATE PROFESSOR

3114
02:18:22,179 --> 02:18:27,117
IN THE DEPARTMENT OF PSYCHOLOGY 

3115
02:18:27,117 --> 02:18:32,322
AT DUKE UNIVERSITY.  SHE IS A 

3116
02:18:32,322 --> 02:18:35,192
FACULTY MEMBER OF AT THE DUKE 

3117
02:18:35,192 --> 02:18:43,133
CANCER INSTITUTE.  DR. SOCCER --

3118
02:18:43,133 --> 02:18:46,036
DR. SOCCER USES MOBILE HEALTH 

3119
02:18:46,036 --> 02:18:48,705
MODALITIES TO IMPROVE PATIENT 

3120
02:18:48,705 --> 02:18:48,939
ACCESS. 

3121
02:18:48,939 --> 02:18:50,774
SHE HAS SEVERAL GRANTS TO 

3122
02:18:50,774 --> 02:18:52,176
PROMOTE THIS WORK AND 

3123
02:18:52,176 --> 02:18:54,278
COLLABORATES BOTH NATIONALLY AND

3124
02:18:54,278 --> 02:18:55,979
INTERNATIONALLY WITH 

3125
02:18:55,979 --> 02:18:59,183
INVESTIGATORS INTERESTED IN 

3126
02:18:59,183 --> 02:19:03,120
DEVELOPING NOVEL APPROACHES TO 

3127
02:19:03,120 --> 02:19:04,188
BEHAVIORAL AND PSYCHOSOCIAL 

3128
02:19:04,188 --> 02:19:05,222
MANAGEMENT FOR PATIENTS WITH 

3129
02:19:05,222 --> 02:19:06,590
CANCER AND OTHER DISEASES.  

3130
02:19:06,590 --> 02:19:09,626
DR. SOMERS FOUNDED AND CODIRECTS

3131
02:19:09,626 --> 02:19:13,864
THE CLINICAL PSYCHOLOGY AND 

3132
02:19:13,864 --> 02:19:15,599
INTERNSHIP ROTATION PROVIDING 

3133
02:19:15,599 --> 02:19:18,569
TRAINING AND RESEARCH MENTORSHIP

3134
02:19:18,569 --> 02:19:21,371
TO NUMEROUS JUNIOR 

3135
02:19:21,371 --> 02:19:25,375
INVESTIGATORS.  SHE HAS MENTORED

3136
02:19:25,375 --> 02:19:27,177
SEVERAL NIH CAREER FACULTY 

3137
02:19:27,177 --> 02:19:31,148
MEMBERS.  HER TITLE TODAY IS 

3138
02:19:31,148 --> 02:19:33,050
COGNITIVE BEHAVIORAL STRATEGIES 

3139
02:19:33,050 --> 02:19:36,253
CONSIDERING SEX DIFFERENCE AND 

3140
02:19:36,253 --> 02:19:46,563
ACCESS.  WELCOME.

3141
02:19:48,165 --> 02:19:53,103
>> IT'S AN HONOR TO BE
HERE WITH

3142
02:19:53,103 --> 02:19:55,138
YOU TODAY TO FINISH OUT THE 

3143
02:19:55,138 --> 02:19:56,974
TALKS.  SO SOME OF YOU CAN 

3144
02:19:56,974 --> 02:19:58,041
ANSWER THIS QUESTION IN YOUR 

3145
02:19:58,041 --> 02:20:00,511
SLEEP BUT FOR THOSE OF YOU WHO 

3146
02:20:00,511 --> 02:20:02,646
NEED A REFRESHER COGNITIVE 

3147
02:20:02,646 --> 02:20:04,014
BEHAVIORAL THERAPY USES THEORY 

3148
02:20:04,014 --> 02:20:06,617
BASED PRINCIPLES TO HELP 

3149
02:20:06,617 --> 02:20:07,217
INDIVIDUALS LEARN TO MANAGE 

3150
02:20:07,217 --> 02:20:12,890
THEIR PAIN, OUR GROUP AND OTHERS

3151
02:20:12,890 --> 02:20:15,192
CALL THIS PAIN SKILLS BEHAVING. 

3152
02:20:15,192 --> 02:20:17,628
THIS WAS DEVELOPED IN THE 60S TO

3153
02:20:17,628 --> 02:20:19,129
HELP PEOPLE RECOGNIZE AND CHANGE

3154
02:20:19,129 --> 02:20:21,632
NEGATIVE THOUGHT PATTERNS, 

3155
02:20:21,632 --> 02:20:23,100
BEHAVIORS AND FEELINGS.  THESE 

3156
02:20:23,100 --> 02:20:24,334
PROTOCOLS HAVE BEEN APPLIED TO 

3157
02:20:24,334 --> 02:20:26,236
SEVERAL PATIENT POPULATIONS WITH

3158
02:20:26,236 --> 02:20:27,971
BOTH ACUTE AND CHRONIC PAIN.  

3159
02:20:27,971 --> 02:20:30,173
HERE'S HOW IT CAN WORK.  ONE 

3160
02:20:30,173 --> 02:20:31,942
MIGHT HAVE THE THOUGHT THAT THIS

3161
02:20:31,942 --> 02:20:34,444
PAIN IS TERRIBLE.  AND THERE IS 

3162
02:20:34,444 --> 02:20:36,380
NOTHING AT ALL THAT CAN I DO 

3163
02:20:36,380 --> 02:20:38,048
ABOUT IT.  THIS THOUGHT MIGHT 

3164
02:20:38,048 --> 02:20:41,251
RESULT IN NEGATIVE BEHAVIOR SUCH

3165
02:20:41,251 --> 02:20:43,153
AS BEING GROUCHY WITH OTHERS, 

3166
02:20:43,153 --> 02:20:44,621
STAYING ON THE BED AND THE COUCH

3167
02:20:44,621 --> 02:20:46,189
ALL DAY LONG AND OBVIOUSLY THESE

3168
02:20:46,189 --> 02:20:50,127
TWO THINGS CAN LEAD TO NEGATIVE 

3169
02:20:50,127 --> 02:20:51,628
FEELINGS.  PATIENTS CAN OFTEN 

3170
02:20:51,628 --> 02:20:53,597
FIND THEMSELVES CAUGHT IN THIS 

3171
02:20:53,597 --> 02:20:55,632
CYCLE.  AND EACH OF THESE START 

3172
02:20:55,632 --> 02:20:59,036
TO INFLUENCE EACH OTHER IN A 

3173
02:20:59,036 --> 02:21:02,539
NEGATIVE WAY.  PAIN COPING CAN 

3174
02:21:02,539 --> 02:21:04,207
IMPROVE THOUGHTS THAT CAN CHANGE

3175
02:21:04,207 --> 02:21:07,144
THIS NEGATIVE CYCLE.  THE GOAL 

3176
02:21:07,144 --> 02:21:12,983
OF PAIN COPING SKILLS (READING).

3177
02:21:12,983 --> 02:21:15,185
SO THEY CAN IMPROVE THEIR OWN 

3178
02:21:15,185 --> 02:21:17,254
PAIN MANAGEMENT SO HERE YOU CAN 

3179
02:21:17,254 --> 02:21:19,523
SEE A MENU OF SOME OF THE MOST 

3180
02:21:19,523 --> 02:21:22,192
COMMON SKILLS TAUGHT IN THESE 

3181
02:21:22,192 --> 02:21:22,826
PROTOCOLS.  SOME OF THESE WILL 

3182
02:21:22,826 --> 02:21:25,362
BE FAMILIAR, OTHERS MAY NOT.  

3183
02:21:25,362 --> 02:21:27,931
THERE'S PROGRESSIVE MUSCLE 

3184
02:21:27,931 --> 02:21:38,475
RELAXATION.  (READING).  THESE 

3185
02:21:38,775 --> 02:21:40,210
SKILLS ARE TAUGHT THROUGH THE 

3186
02:21:40,210 --> 02:21:42,446
USE OF PSYCHOSOCIAL PAIN, 

3187
02:21:42,446 --> 02:21:45,282
EDUCATION, RATIONALE, TEACHING 

3188
02:21:45,282 --> 02:21:48,151
SKILL DIDACTICS, AND THEN WITH A

3189
02:21:48,151 --> 02:21:53,724
LARGE EMPHASIS ON HOME PRACTICE.

3190
02:21:53,724 --> 02:21:54,825
COGNITIVE BEHAVIORAL COGNITIVE 

3191
02:21:54,825 --> 02:21:57,494
BEHAVIORAL PROTOCOLS HAVE 

3192
02:21:57,494 --> 02:21:58,195
TRADITIONALLY BEEN -- HAVE BEEN 

3193
02:21:58,195 --> 02:21:59,730
DELIVERED IN WEEKLY SESSIONS 

3194
02:21:59,730 --> 02:22:01,698
WHERE MULTIPLE SKILLS ARE 

3195
02:22:01,698 --> 02:22:02,733
TAUGHT.  THESE SESSIONS ARE 

3196
02:22:02,733 --> 02:22:04,368
OFTEN AT THE MEDICAL CENTER, CAN

3197
02:22:04,368 --> 02:22:06,136
BE INDIVIDUAL OR GROUP BASED, 

3198
02:22:06,136 --> 02:22:08,672
CAN BE AN HOUR OR LONGER AND 

3199
02:22:08,672 --> 02:22:10,440
WERE DESIGNED AND DELIVERED 

3200
02:22:10,440 --> 02:22:13,310
OFTEN BY PEOPLE WITH A HIGH 

3201
02:22:13,310 --> 02:22:15,212
LEVEL OF TRAINING.  SO SPOILER 

3202
02:22:15,212 --> 02:22:17,214
ALERT FOR WHAT I WILL TALK ABOUT

3203
02:22:17,214 --> 02:22:19,950
IN A BIT IS THAT THESE FEATURES 

3204
02:22:19,950 --> 02:22:22,219
CAN REALLY LIMIT PATIENT ACCESS 

3205
02:22:22,219 --> 02:22:25,722
PARTICULARLY FOR PATIENTS WITH 

3206
02:22:25,722 --> 02:22:26,390
DISEASE-RELATED PAIN.  THERE ARE

3207
02:22:26,390 --> 02:22:28,892
A NUMBER OF STUDIES THAT HAVE 

3208
02:22:28,892 --> 02:22:30,227
SHOWN THAT THESE IN-PERSON EIGHT

3209
02:22:30,227 --> 02:22:33,497
OR MORE SESSION PROTOCOLS ARE 

3210
02:22:33,497 --> 02:22:35,132
EFFICACIOUS FOR DIFFERENT PAIN 

3211
02:22:35,132 --> 02:22:40,203
POPULATIONS.  THERE'S AN EARLY 

3212
02:22:40,203 --> 02:22:45,275
STUDY ON KNEE ARTHRITIS, KNEE 

3213
02:22:45,275 --> 02:22:47,177
REPLACEMENT SURGERY.  SO NOW I 

3214
02:22:47,177 --> 02:22:49,713
WILL SHARE WHAT WE KNOW WHICH 

3215
02:22:49,713 --> 02:22:51,548
ISN'T AS MUCH AS I THOUGHT IT 

3216
02:22:51,548 --> 02:22:54,084
WOULD BE ABOUT SEX DIFFERENCES 

3217
02:22:54,084 --> 02:22:55,152
AND COGNITIVE BEHAVIORAL THERAPY

3218
02:22:55,152 --> 02:22:56,286
FOR PAIN.  WHEN WE THINK ABOUT 

3219
02:22:56,286 --> 02:22:59,356
PAIN COPING SKILLS FOR PAIN IT'S

3220
02:22:59,356 --> 02:23:00,157
IMPORTANT TO RECOGNIZE PAST WORK

3221
02:23:00,157 --> 02:23:01,658
THAT PROVIDES INFORMATION ON HOW

3222
02:23:01,658 --> 02:23:04,127
MALES AND FEMALES MIGHT APPROACH

3223
02:23:04,127 --> 02:23:05,629
COPING WITH PAIN DIFFERENTLY.  

3224
02:23:05,629 --> 02:23:07,097
WORK HAS SHOWN THAT MALES ARE 

3225
02:23:07,097 --> 02:23:09,433
MORE LIKELY TO USE BEHAVIORAL 

3226
02:23:09,433 --> 02:23:11,368
DISTRACTION IN PROBLEM FOCUSED 

3227
02:23:11,368 --> 02:23:12,502
COPING WHEN EXPERIENCING PAIN WE

3228
02:23:12,502 --> 02:23:14,304
KNOW THAT FEMALES ARE MORE 

3229
02:23:14,304 --> 02:23:16,239
LIKELY TO USE POSITIVE SELF 

3230
02:23:16,239 --> 02:23:20,243
STATEMENT, EMOTION FOCUSED 

3231
02:23:20,243 --> 02:23:22,245
TECHNIQUES, COGNITIVE 

3232
02:23:22,245 --> 02:23:23,280
RESTRUCTURING, AND SOCIAL 

3233
02:23:23,280 --> 02:23:24,915
SUPPORT.  THIS INFORMATION CAN 

3234
02:23:24,915 --> 02:23:27,150
PROVIDE SOME HYPOTHESIS ABOUT 

3235
02:23:27,150 --> 02:23:29,453
WHAT COGNITIVE BEHAVIORAL SKILLS

3236
02:23:29,453 --> 02:23:30,921
MIGHT BE MOST EFFECTIVE FOR 

3237
02:23:30,921 --> 02:23:32,689
MALES AND FEMALES.  

3238
02:23:32,689 --> 02:23:33,423
INTERESTINGLY TO MY KNOWLEDGE 

3239
02:23:33,423 --> 02:23:36,093
THERE HAVE NOT BEEN STUDIES THAT

3240
02:23:36,093 --> 02:23:38,662
TRIED TO MATCH SEX BASED COPING 

3241
02:23:38,662 --> 02:23:40,997
STRATEGIES IN PAIN COPING SKILLS

3242
02:23:40,997 --> 02:23:42,432
PROTOCOLS.  SO HERE'S THE MENU 

3243
02:23:42,432 --> 02:23:44,334
THAT I SHOWED YOU EARLIER.  WHAT

3244
02:23:44,334 --> 02:23:46,036
MIGHT MAKE MORE SENSE IS TO 

3245
02:23:46,036 --> 02:23:50,040
APPLY THEM IN THIS WAY.  PERHAPS

3246
02:23:50,040 --> 02:23:52,242
MALES WOULD FIND BENEFIT IN 

3247
02:23:52,242 --> 02:23:54,344
BEHAVIORAL RELAXATION SKILLS.  

3248
02:23:54,344 --> 02:23:56,146
WHILE FEMALES MIGHT PARTICULARLY

3249
02:23:56,146 --> 02:23:58,215
BENEFIT FROM A GROUP BASED 

3250
02:23:58,215 --> 02:24:02,886
THERAPY FOCUSING ON COGNITIVE 

3251
02:24:02,886 --> 02:24:03,553
RESTRUCTURING AND RELATED SKILLS

3252
02:24:03,553 --> 02:24:08,325
WITH IMAGERY.  THERE'S OTHER 

3253
02:24:08,325 --> 02:24:09,960
GOOD INFORMATION FROM THE 

3254
02:24:09,960 --> 02:24:10,961
PSYCHOSOCIAL PAIN LITERATURE 

3255
02:24:10,961 --> 02:24:13,196
THAT CAN HELP US THINK ABOUT HOW

3256
02:24:13,196 --> 02:24:14,564
MALES AND FEMALES MIGHT RESPOND 

3257
02:24:14,564 --> 02:24:18,135
TO COGNITIVE BEHAVIORAL THERAPY 

3258
02:24:18,135 --> 02:24:19,136
PROTOCOLS DIFFERENTLY.  THERE'S 

3259
02:24:19,136 --> 02:24:21,371
A LOT OF EVIDENCE THAT PAIN 

3260
02:24:21,371 --> 02:24:23,140
MANAGEMENT ARE TWO OF THE 

3261
02:24:23,140 --> 02:24:24,941
LEADING PSYCHOSOCIAL VARIABLES 

3262
02:24:24,941 --> 02:24:27,878
THAT IMPACT PAIN OUTCOMES.  

3263
02:24:27,878 --> 02:24:30,046
SELF-EFFICACY FOR PAIN 

3264
02:24:30,046 --> 02:24:32,082
MANAGEMENT IS THE DEGREE OF 

3265
02:24:32,082 --> 02:24:33,150
CONFIDENCE, WHICH ONE WHERE THEY

3266
02:24:33,150 --> 02:24:35,018
CAN CONTROL THE PAIN WITHOUT 

3267
02:24:35,018 --> 02:24:37,921
ADDITIONAL MEDICATION, AND PAIN 

3268
02:24:37,921 --> 02:24:40,223
CATASTROPHIZING REFERS TO ONE 

3269
02:24:40,223 --> 02:24:42,492
TENDENCY SO THINK ONE IS 

3270
02:24:42,492 --> 02:24:43,994
HELPLESS IN PAIN AND ASSUME THE 

3271
02:24:43,994 --> 02:24:47,097
WORST POSSIBLE OUTCOMES.  WE 

3272
02:24:47,097 --> 02:24:49,466
KNOW THAT FEMALES HAVE LESS PAIN

3273
02:24:49,466 --> 02:24:53,170
AND HIGHER LEVELS OF PAIN 

3274
02:24:53,170 --> 02:24:55,505
CATASTROPHIZING.  THUS 

3275
02:24:55,505 --> 02:25:01,812
INCREASING SELF I HAVE IF-- 

3276
02:25:01,812 --> 02:25:02,546
SELF-EFFICACY AND MAY BE 

3277
02:25:02,546 --> 02:25:04,247
PARTICULARLY IMPORTANT TO PAY 

3278
02:25:04,247 --> 02:25:10,220
ATTENTION TO IN PROTOCOL IN 

3279
02:25:10,220 --> 02:25:14,324
FEMALES.  SO AS WE FORWARDED I 

3280
02:25:14,324 --> 02:25:17,427
WOULD LIKE YOU TO KEEP THE 

3281
02:25:17,427 --> 02:25:20,330
STATISTIC IN MIND.  IT SHOWS 

3282
02:25:20,330 --> 02:25:22,065
THAT 510 CLINICAL TRIALS ON 

3283
02:25:22,065 --> 02:25:26,303
CHRONIC PAIN NOT RELATED TO 

3284
02:25:26,303 --> 02:25:26,937
PSYCHOSOCIAL INTERVENTION 

3285
02:25:26,937 --> 02:25:28,638
FEMALES WERE OVERREPRESENTED.  

3286
02:25:28,638 --> 02:25:29,973
FOR THE REST OF THE WORK I WILL 

3287
02:25:29,973 --> 02:25:30,941
PRESENT I MADE A POINT TO 

3288
02:25:30,941 --> 02:25:33,977
INCLUDE THE STATISTICS ON MALE 

3289
02:25:33,977 --> 02:25:35,145
AND FEMALE PARTICIPANTS AND YOU 

3290
02:25:35,145 --> 02:25:37,247
SEE IT IS MIXED SOME OF THEM 

3291
02:25:37,247 --> 02:25:39,149
CERTAINLY HAVE MORE FEMALES OR 

3292
02:25:39,149 --> 02:25:42,152
ARE FEMALE FOCUSED BUT SOME OF 

3293
02:25:42,152 --> 02:25:45,288
THEM HAVE A PRETTY EVEN SEX 

3294
02:25:45,288 --> 02:25:47,157
DISTRIBUTORS.  SO BASED ON THAT,

3295
02:25:47,157 --> 02:25:49,159
IT'S GOOD NEWS THAT IT LACKS 

3296
02:25:49,159 --> 02:25:51,595
LIKE FEMALES ARE MORE LIKELY TO 

3297
02:25:51,595 --> 02:25:54,431
HAVE IMPROVED PAIN OUTCOMES IN 

3298
02:25:54,431 --> 02:25:56,833
RESPONSE TO COGNITIVE BEHAVIORAL

3299
02:25:56,833 --> 02:25:58,235
THERAPY PROTOCOLS FOR PAIN.  

3300
02:25:58,235 --> 02:25:59,402
THERE'S ALSO WORK SUGGESTING 

3301
02:25:59,402 --> 02:26:01,204
THAT MALES MIGHT RESPOND BETTER 

3302
02:26:01,204 --> 02:26:04,040
TO COGNITIVE BEHAVIORAL THERAPY 

3303
02:26:04,040 --> 02:26:05,642
PROTOCOLS THAN OTHER BEHAVIORAL 

3304
02:26:05,642 --> 02:26:10,247
OR OTHER PSYCHOSOCIAL PAIN 

3305
02:26:10,247 --> 02:26:14,251
APPROACHES.  SO WITHIN THIS 

3306
02:26:14,251 --> 02:26:16,219
CONTEXT WE WILL LOOK AT HOW TO 

3307
02:26:16,219 --> 02:26:20,390
IMPROVE ACCESS FOR ALL PATIENTS.

3308
02:26:20,390 --> 02:26:21,625
I PRESENTED EARLIER THE 

3309
02:26:21,625 --> 02:26:23,493
TRADITIONAL APPROACH TO 

3310
02:26:23,493 --> 02:26:24,327
COGNITIVE BEHAVIORAL THERAPY 

3311
02:26:24,327 --> 02:26:26,763
PAIN PROTOCOLS.  AGAIN, THESE 

3312
02:26:26,763 --> 02:26:30,100
ARE SEVERAL SESSIONS, OFTEN AT A

3313
02:26:30,100 --> 02:26:31,134
MEDICAL CENTER THEY INCLUDE 

3314
02:26:31,134 --> 02:26:32,836
TRAVEL, COST ASSOCIATED WITH 

3315
02:26:32,836 --> 02:26:35,138
TRAVEL AND PARKING, WALKING INTO

3316
02:26:35,138 --> 02:26:37,107
THE MEDICAL CENTER AND ARE OFTEN

3317
02:26:37,107 --> 02:26:38,608
DELIVERED BY HIGHLY TRAINED 

3318
02:26:38,608 --> 02:26:40,243
THERAPISTS WHILE THESE PROTOCOLS

3319
02:26:40,243 --> 02:26:42,212
APPEAR TO WORK MUCH OF THE TIME 

3320
02:26:42,212 --> 02:26:44,814
THE PROBLEM IS THAT THESE 

3321
02:26:44,814 --> 02:26:45,682
DELIVERY STRATEGIES LEAD TO 

3322
02:26:45,682 --> 02:26:49,352
PERSISTENT ACCESS BARRIERS 

3323
02:26:49,352 --> 02:26:50,253
PARTICULARLY FOR PATIENTS WITH 

3324
02:26:50,253 --> 02:26:51,388
PAIN.  THESE CAN BE EXPENSIVE 

3325
02:26:51,388 --> 02:26:54,090
AND COSTLY.  THEY REQUIRE 

3326
02:26:54,090 --> 02:26:56,459
ADDITIONAL TRIP TO THE MEDICAL 

3327
02:26:56,459 --> 02:26:58,228
CENTER AND IT CAN BE HARD TO 

3328
02:26:58,228 --> 02:27:00,597
FIND SOMEONE TRAINED TO DO THESE

3329
02:27:00,597 --> 02:27:02,399
INTERVENTIONS.  SO AS WITH MANY 

3330
02:27:02,399 --> 02:27:04,301
PIECES OF OR WORLD FOR BETTER OR

3331
02:27:04,301 --> 02:27:06,803
WORSE, LONGER PROTOCOLS ARE 

3332
02:27:06,803 --> 02:27:08,605
BEING SEEN LESS OFTEN IN MOBILE 

3333
02:27:08,605 --> 02:27:11,107
AND SHORTER PROTOCOLS ARE BEING 

3334
02:27:11,107 --> 02:27:11,975
SEEN MORE OFTEN BUT IT'S 

3335
02:27:11,975 --> 02:27:15,145
IMPORTANT TO THINK ABOUT HOW 

3336
02:27:15,145 --> 02:27:19,916
THESE WORK AND IF THEY WORK.  AS

3337
02:27:19,916 --> 02:27:24,654
OUR GROUP INDULGED IN THE 

3338
02:27:24,654 --> 02:27:26,389
ZEITGEIST WE WERE THINKING HARD 

3339
02:27:26,389 --> 02:27:28,224
ABOUT PATIENTS WITH CANCER.  OUR

3340
02:27:28,224 --> 02:27:31,962
FIRST STRATEGY WAS SPURRED BY A 

3341
02:27:31,962 --> 02:27:33,063
TECHNOLOGICAL ADVANCE IN 2010 

3342
02:27:33,063 --> 02:27:34,331
WHILE THE FIRST TABLET COMPUTER 

3343
02:27:34,331 --> 02:27:37,400
WAS INTRODUCED IN 1989 THE IPAD 

3344
02:27:37,400 --> 02:27:40,070
CAME OUT IN 2010 SO IT IS AT 

3345
02:27:40,070 --> 02:27:43,840
THIS TIME THAT PERSONAL TABLET 

3346
02:27:43,840 --> 02:27:45,608
COMPUTERS REALLY BECAME POPULAR 

3347
02:27:45,608 --> 02:27:46,576
FOR INDIVIDUALS AND THAT PEOPLE 

3348
02:27:46,576 --> 02:27:48,678
WERE LIKELY TO HAVE THEM IN 

3349
02:27:48,678 --> 02:27:50,080
THEIR HOMES SO REMOTE DELIVERY 

3350
02:27:50,080 --> 02:27:52,082
USING VIDEO CONFERENCING SEEMED 

3351
02:27:52,082 --> 02:27:52,882
LIKE IT MIGHT BE A POTENTIAL WAY

3352
02:27:52,882 --> 02:27:55,885
TO INCREASE ACCESS TO THESE 

3353
02:27:55,885 --> 02:27:56,519
INTERVENTIONS.  ALSO IMPORTANT 

3354
02:27:56,519 --> 02:28:01,391
TO REMEMBER THIS WAS 2010, TEN 

3355
02:28:01,391 --> 02:28:01,791
GRE

3356
02:28:01,791 --> 02:28:03,493
YEARS BEFORE THE COVID-19 

3357
02:28:03,493 --> 02:28:05,128
PANDEMIC.  SO WE LOOKED TO SEE 

3358
02:28:05,128 --> 02:28:06,396
IF WE COULD GET THE INTERVENTION

3359
02:28:06,396 --> 02:28:08,131
AT OUR OFFICE TO A HOUSE AT THE 

3360
02:28:08,131 --> 02:28:11,835
END OF THE ROAD THAT LOOKED LIKE

3361
02:28:11,835 --> 02:28:14,838
THIS.  THE OTHER STRATEGY THAT 

3362
02:28:14,838 --> 02:28:16,239
WE AND OTHERS WERE WORKING ON AT

3363
02:28:16,239 --> 02:28:18,808
THE SAME TIME WAS LOOKING AT THE

3364
02:28:18,808 --> 02:28:19,642
LITERATURE AND CLINICAL 

3365
02:28:19,642 --> 02:28:21,911
EXPERIENCES TO REDUCE PROTOCOLS 

3366
02:28:21,911 --> 02:28:23,813
TO THE SKILLS THAT MIGHT BE MOST

3367
02:28:23,813 --> 02:28:25,815
LIKELY TO BE EFFECTIVE AND TO 

3368
02:28:25,815 --> 02:28:28,084
KEEP PHONE CALLS BRIEF.  THESE 

3369
02:28:28,084 --> 02:28:29,185
ARE THE SKILLS THAT WE HAVE 

3370
02:28:29,185 --> 02:28:30,854
LANDED ON WITH MOST OF THE 

3371
02:28:30,854 --> 02:28:31,721
PROTOCOLS THAT WE'VE DONE AND 

3372
02:28:31,721 --> 02:28:33,490
YOU'LL SEE IN A MOMENT SOMETIMES

3373
02:28:33,490 --> 02:28:35,358
WE DO REALLY BRIEF PROTOCOLS AND

3374
02:28:35,358 --> 02:28:37,093
SOMETIMES WE DO PROTOCOLS THAT 

3375
02:28:37,093 --> 02:28:43,166
ARE MORE LIKE 4-6 SESSIONS.  IN 

3376
02:28:43,166 --> 02:28:45,769
A STUDY BY DARNELL THEY EXAMINED

3377
02:28:45,769 --> 02:28:49,239
WHETHER TWO HOUR SINGLE SESSION 

3378
02:28:49,239 --> 02:28:50,540
PAIN MANAGEMENT PROTOCOL 

3379
02:28:50,540 --> 02:28:54,411
DELIVERED IN AN IN-PERSON GROUP 

3380
02:28:54,411 --> 02:28:55,045
FORMAT WOULD BE NONINFERIOR TO 

3381
02:28:55,045 --> 02:29:01,618
AN EIGHT SESSION COGNITIVE 

3382
02:29:01,618 --> 02:29:02,919
BEHAVIORAL PROTOCOL.  WHAT THEY 

3383
02:29:02,919 --> 02:29:04,888
FOUND WAS THE SINGLE PAIN 

3384
02:29:04,888 --> 02:29:05,622
MANAGEMENT CLASS RESULTED IN 

3385
02:29:05,622 --> 02:29:07,857
SIGNIFICANT IMPROVEMENTS ON PAIN

3386
02:29:07,857 --> 02:29:10,060
AND MANY PAIN RELATED OUTCOMES 

3387
02:29:10,060 --> 02:29:12,595
AND THAT THIS WAS NONINFERIOR TO

3388
02:29:12,595 --> 02:29:14,164
THE EIGHT SESSION PROTOCOL AT 

3389
02:29:14,164 --> 02:29:16,232
THREE MONTHS.  OUR GROUP HAS 

3390
02:29:16,232 --> 02:29:18,868
ALSO COMPLETE SEVERAL PILOT 

3391
02:29:18,868 --> 02:29:20,203
TRIALS FINDING THAT THESE BRIEF 

3392
02:29:20,203 --> 02:29:22,505
ROT KOLS ARE FEASIBLE AND 

3393
02:29:22,505 --> 02:29:23,907
ACCEPTABLE AND REALLY POINT TO 

3394
02:29:23,907 --> 02:29:27,010
HAVING GOOD BENEFITS FOR 

3395
02:29:27,010 --> 02:29:29,712
PATIENTS THAT ENGAGE IN THEM WE 

3396
02:29:29,712 --> 02:29:32,449
DID A STUDY TO DETERMINE A 

3397
02:29:32,449 --> 02:29:34,584
LARGER TRIAL IF A VIDEO 

3398
02:29:34,584 --> 02:29:37,120
CONFERENCING WOULD SHOW HIGH 

3399
02:29:37,120 --> 02:29:38,655
ACCEPTABILITY IN A LARGE TRIAL 

3400
02:29:38,655 --> 02:29:40,190
AND WHETHER IT WOULD BE AS GOOD 

3401
02:29:40,190 --> 02:29:41,458
AS AN IN-PERSON PROTOCOL THIS 

3402
02:29:41,458 --> 02:29:43,893
PATIENT IN THE TOP IMAGE HERE IS

3403
02:29:43,893 --> 02:29:45,862
WHAT AN IN-PERSON CONDITION 

3404
02:29:45,862 --> 02:29:48,965
MIGHT LOOK LIKE.  HE MAY HAVE 

3405
02:29:48,965 --> 02:29:51,167
HIS HEAD IN HIS HANDS AFTER THE 

3406
02:29:51,167 --> 02:29:53,069
HASSLE OF GETTING TO PARKING.  

3407
02:29:53,069 --> 02:29:55,772
THE BOTTOM IMAGE SHOWS WHAT AN 

3408
02:29:55,772 --> 02:29:57,540
AT HOME APPOINTMENT CAN LOOK 

3409
02:29:57,540 --> 02:30:02,445
LIKE FOR A PATIENT.  THE 

3410
02:30:02,445 --> 02:30:04,047
PATIENTS HAD MIXED CANCERS.  

3411
02:30:04,047 --> 02:30:05,648
THERE WAS AN AVERAGE AGE OF 57 

3412
02:30:05,648 --> 02:30:09,119
AND ABOUT TWELVE MONTHS OUT FROM

3413
02:30:09,119 --> 02:30:10,220
THEIR CANCER DIAGNOSIS.  

3414
02:30:10,220 --> 02:30:12,789
PARTICIPANTS RANDOMIZED BOTH OF 

3415
02:30:12,789 --> 02:30:14,791
THESE CONDITIONS HAD FOUR MEANT 

3416
02:30:14,791 --> 02:30:16,226
TO BE WEEKLY PAIN COPING SKILLS 

3417
02:30:16,226 --> 02:30:18,094
TRAINING SESSIONS SO THE 

3418
02:30:18,094 --> 02:30:20,997
FEASIBILITY RESULTS SHOWED THAT 

3419
02:30:20,997 --> 02:30:24,934
THERE WAS ALMOST TWICE AS MUCH 

3420
02:30:24,934 --> 02:30:27,003
ATTRITION IN THE IN-PERSON 

3421
02:30:27,003 --> 02:30:28,238
CONDITION.  FURTHER THOSE THAT 

3422
02:30:28,238 --> 02:30:30,306
DID COMPLETE THE IN-PERSON 

3423
02:30:30,306 --> 02:30:31,975
CONDITION HAD SIGNIFICANTLY 

3424
02:30:31,975 --> 02:30:33,276
LOWER ADHERENCE TO STUDY 

3425
02:30:33,276 --> 02:30:35,145
PROCEDURES SO THEY WEREN'T 

3426
02:30:35,145 --> 02:30:36,646
GETTING THE INTERVENTION AS IT 

3427
02:30:36,646 --> 02:30:38,148
WAS INTENDED TO BE DELIVERED.  

3428
02:30:38,148 --> 02:30:43,153
SO DAYS TO COMPLETION OF THE 

3429
02:30:43,153 --> 02:30:44,888
INTERVENTION WERE MORE THAN 

3430
02:30:44,888 --> 02:30:47,123
TWICE AS MUCH.  IT TOOK 65 DAYS 

3431
02:30:47,123 --> 02:30:49,025
TO GET THEM BACK INTO THE 

3432
02:30:49,025 --> 02:30:51,161
MEDICAL CENTER FOUR TIMES WHERE 

3433
02:30:51,161 --> 02:30:52,929
THE VIDEO CONFERENCING DID THIS 

3434
02:30:52,929 --> 02:30:55,165
IN ABOUT 27 DAYS AND AGAIN THIS 

3435
02:30:55,165 --> 02:30:58,234
IS FOUR SESSIONS SO IDEALLY IT 

3436
02:30:58,234 --> 02:31:01,838
WOULD BE 28 AND NO MORE THAN 40 

3437
02:31:01,838 --> 02:31:12,348
DAYS FROM BEGINNING TO END.  

3438
02:31:18,521 --> 02:31:20,223
THIS TRIAL INCLUDED BOTH MALES 

3439
02:31:20,223 --> 02:31:21,691
AND FEMALES AND ALLOWED US TO 

3440
02:31:21,691 --> 02:31:23,593
LOOK AT SOME SEX DIFFERENCES 

3441
02:31:23,593 --> 02:31:26,262
GIVEN THAT ONLY 28% OF THE 

3442
02:31:26,262 --> 02:31:29,399
SAMPLE WERE MALE THIS SHOULD BE 

3443
02:31:29,399 --> 02:31:32,268
SEEN AS DATA.  MALES WERE LESS 

3444
02:31:32,268 --> 02:31:34,237
LIKELY TO ENROLL IN THIS TRIAL 

3445
02:31:34,237 --> 02:31:37,273
THAN WOMEN WHILE ONLY A TREND 

3446
02:31:37,273 --> 02:31:38,808
TOWARD STATISTICAL SIGNIFICANCE 

3447
02:31:38,808 --> 02:31:41,110
THE DROPOUT RATE FOR MALES WERE 

3448
02:31:41,110 --> 02:31:42,078
HIGHER THAN FOR WOMEN.  I THINK 

3449
02:31:42,078 --> 02:31:43,146
ONE OF THE INTERESTING THINGS 

3450
02:31:43,146 --> 02:31:47,317
THAT WE LOOKED AT WAS THE 

3451
02:31:47,317 --> 02:31:50,420
ATTRITION BY SEX AND BY 

3452
02:31:50,420 --> 02:31:52,222
CONDITION.  SO WHAT YOU'RE 

3453
02:31:52,222 --> 02:31:54,357
SEEING HERE IS IT'S ALL ABOUT 

3454
02:31:54,357 --> 02:31:55,625
THE SAME EXCEPT WHEN YOU ASK 

3455
02:31:55,625 --> 02:32:00,029
WOMEN TO COME BACK INTO THE 

3456
02:32:00,029 --> 02:32:02,298
CANCER CENTER YOU SEE A MUCH 

3457
02:32:02,298 --> 02:32:04,067
HIGHER DROPOUT RATE THAN AT HOME

3458
02:32:04,067 --> 02:32:05,468
AND THIS MAY COME BACK TO THOSE 

3459
02:32:05,468 --> 02:32:07,704
ISSUES I TALKED ABOUT IN TERMS 

3460
02:32:07,704 --> 02:32:08,938
OF BURDEN OF TRANSPORTATION, 

3461
02:32:08,938 --> 02:32:10,073
OTHER RESPONSIBILITIES.  SO I 

3462
02:32:10,073 --> 02:32:12,208
THINK THIS IS A REALLY IMPORTANT

3463
02:32:12,208 --> 02:32:14,677
PIECE TO HIGHLIGHT IS THAT IT 

3464
02:32:14,677 --> 02:32:15,712
LOOKS LIKE IF WE GIVE WOMEN MORE

3465
02:32:15,712 --> 02:32:17,847
ACCESS TO THESE INTERVENTIONS 

3466
02:32:17,847 --> 02:32:22,252
THEY'RE MUCH MORE LIKELY TO 

3467
02:32:22,252 --> 02:32:23,853
ENGAGE AND FIND BENEFIT.  SO FOR

3468
02:32:23,853 --> 02:32:25,655
MALES AND FEMALES THAT COMPLETED

3469
02:32:25,655 --> 02:32:28,224
THERE WERE CLEAR BENEFITS AND 

3470
02:32:28,224 --> 02:32:29,359
THERE WERE SOME INTERESTING 

3471
02:32:29,359 --> 02:32:31,227
BETWEEN SEX DIFFERENCES THAT WE 

3472
02:32:31,227 --> 02:32:33,763
SAW.  SO THIS IS A PAIN 

3473
02:32:33,763 --> 02:32:34,430
INTERFERENCE MEASURE.  THE BLUE 

3474
02:32:34,430 --> 02:32:38,234
LINE IS THE MALES.  MALES 

3475
02:32:38,234 --> 02:32:39,335
DECREASED IN PAIN INTERFERENCE 

3476
02:32:39,335 --> 02:32:41,504
FROM PRE TO POST INTERVENTION AT

3477
02:32:41,504 --> 02:32:45,074
38% WHILE FEMALES DECREASED IN 

3478
02:32:45,074 --> 02:32:49,746
PAIN INTERFERENCE AT 13%.  PAIN 

3479
02:32:49,746 --> 02:32:51,047
SEVERITY WAS ABOUT THE SAME.  AN

3480
02:32:51,047 --> 02:32:54,684
INTERESTING THING TO HEAR ABOUT 

3481
02:32:54,684 --> 02:32:56,419
THE PAIN INTERFERENCE AND IN 

3482
02:32:56,419 --> 02:32:57,754
BOTH MALES AND FEMALES HAD ABOUT

3483
02:32:57,754 --> 02:33:00,356
THE SAME INCREASE IN 

3484
02:33:00,356 --> 02:33:01,424
SELF-EFFICACY FOR PAIN 

3485
02:33:01,424 --> 02:33:02,158
MANAGEMENT WHICH BECOMES REALLY 

3486
02:33:02,158 --> 02:33:02,859
IMPORTANT BECAUSE WE KNOW THAT 

3487
02:33:02,859 --> 02:33:04,694
THIS IS ONE OF THE THINGS THAT 

3488
02:33:04,694 --> 02:33:08,231
DRIVES BETTER OUTCOMES IF WE CAN

3489
02:33:08,231 --> 02:33:11,534
CONVINCE PEOPLE THAT THEY CAN 

3490
02:33:11,534 --> 02:33:13,169
MANAGE THEIR PAIN WE KNOW THAT 

3491
02:33:13,169 --> 02:33:15,905
THEIR OUTCOMES ARE LIKELY TO BE 

3492
02:33:15,905 --> 02:33:18,074
BETTER.  AND THEN THIS IS 

3493
02:33:18,074 --> 02:33:19,242
SELF-REPORTED MEDICATION USE.  

3494
02:33:19,242 --> 02:33:23,146
IN MALES VERSUS FEMALES SO MALES

3495
02:33:23,146 --> 02:33:24,514
DECREASE FROM PRE TO 

3496
02:33:24,514 --> 02:33:26,082
POSTTREATMENT AT ABOUT A DAY PER

3497
02:33:26,082 --> 02:33:28,251
WEEK AND FEMALES DECREASED LESS 

3498
02:33:28,251 --> 02:33:30,086
THAN HALF A DAY A WEEK SO SEEING

3499
02:33:30,086 --> 02:33:31,688
A LITTLE BIT OF DIFFERENCES 

3500
02:33:31,688 --> 02:33:34,223
THERE IN THIS EARLY DATA TO LOOK

3501
02:33:34,223 --> 02:33:36,125
AT THIS.  SO IN ADDITION TO 

3502
02:33:36,125 --> 02:33:37,560
INCREASING OUR EYES OF MOBILE 

3503
02:33:37,560 --> 02:33:40,129
HEALTH DECREASES IN REMOTE 

3504
02:33:40,129 --> 02:33:41,397
DELIVERY WE WERE EXAMINING -- 

3505
02:33:41,397 --> 02:33:43,166
WE'VE BEEN EXAMINING HOW BRIEF 

3506
02:33:43,166 --> 02:33:44,801
WE CAN GET THESE INTERVENTIONS 

3507
02:33:44,801 --> 02:33:46,035
AND STILL HAVE THEM BE 

3508
02:33:46,035 --> 02:33:49,205
EFFICACIOUS AND PROVIDE BENEFIT.

3509
02:33:49,205 --> 02:33:54,811
SO NIH FUNDED SEQUENTIAL TRIAL. 

3510
02:33:54,811 --> 02:33:58,247
WE RECRUITED 327 WOMEN WITH 

3511
02:33:58,247 --> 02:34:01,551
BREAST CANCER THAT REPORTED AT 

3512
02:34:01,551 --> 02:34:03,152
LEAST MODERATE PAIN AND GAVE 

3513
02:34:03,152 --> 02:34:05,588
THEM TWO DOSES OF PAIN TRAINING.

3514
02:34:05,588 --> 02:34:07,090
WOMEN HAD EITHER ONE SESSION OR 

3515
02:34:07,090 --> 02:34:10,259
FIVE SESSIONS.  THE ONE SESSION 

3516
02:34:10,259 --> 02:34:12,795
PROTOCOL INCLUDED THE PSYCHO 

3517
02:34:12,795 --> 02:34:15,164
EDUCATION AND RATIONALE AND ALSO

3518
02:34:15,164 --> 02:34:17,166
RELAXATION AND IMAGERY AND THEN 

3519
02:34:17,166 --> 02:34:19,669
LOTS OF ENCOURAGEMENT FOR HOME 

3520
02:34:19,669 --> 02:34:21,704
PRACTICE.  IF THEIR PAIN REDUCED

3521
02:34:21,704 --> 02:34:25,208
BY 30% OR MORE WE RERANDOMIZED 

3522
02:34:25,208 --> 02:34:27,143
THEM TO MAINTENANCE OR NOTHING 

3523
02:34:27,143 --> 02:34:29,312
AND IF THEIR PAIN DID NOT REDUCE

3524
02:34:29,312 --> 02:34:35,151
THEY WERE RERANDOMIZED TO MORE 

3525
02:34:35,151 --> 02:34:45,695
TRAINING OR MAINTENANCE DOSE.  

3526
02:34:46,195 --> 02:34:52,268
SO WHILE THE ONE SESSION WENT 

3527
02:34:52,268 --> 02:34:55,138
INTO A REDUCTION OF 15%.  ONE OF

3528
02:34:55,138 --> 02:34:57,340
THE INTERESTING FIND SGS IS WE 

3529
02:34:57,340 --> 02:34:58,474
FOUND THAT SPRIJ PATIENTS THAT 

3530
02:34:58,474 --> 02:35:00,042
ACHIEVED AT LEAST A PAIN 

3531
02:35:00,042 --> 02:35:05,515
REDUCTION OF 30% IN BOTH GROUPS,

3532
02:35:05,515 --> 02:35:07,016
WERE A SIGNIFICANT NUMBER SO WE 

3533
02:35:07,016 --> 02:35:09,285
FOUND THAT 53 BANK ACCOUNT OF 

3534
02:35:09,285 --> 02:35:11,154
THE WOMEN THAT HAD THE PROPERTY 

3535
02:35:11,154 --> 02:35:13,689
COAL REDUCED THEIR PAIN BY 35% 

3536
02:35:13,689 --> 02:35:15,458
IN FIVE WEEKS AND STILL 42% OF 

3537
02:35:15,458 --> 02:35:17,160
THE WOMEN HAD THE SAME 

3538
02:35:17,160 --> 02:35:18,895
REDUCTION.  SO THIS IS 

3539
02:35:18,895 --> 02:35:20,463
SUGGESTING THAT SOME PEOPLE ARE 

3540
02:35:20,463 --> 02:35:22,265
GETTING BENEFIT FROM THIS BRIEF 

3541
02:35:22,265 --> 02:35:25,168
PROTOCOL.  PRETTY QUICKLY.  WE 

3542
02:35:25,168 --> 02:35:26,636
ALSO PERFORM COST ANALYSES IN 

3543
02:35:26,636 --> 02:35:29,105
THE STUDY AND FOUND THAT THE 

3544
02:35:29,105 --> 02:35:31,073
FIVE SESSIONS COST ABOUT 573 

3545
02:35:31,073 --> 02:35:34,243
DOLLARS AND THE ONE SESSION WAS 

3546
02:35:34,243 --> 02:35:41,651
161 DOLLARS.  BASED ON RESPONSE,

3547
02:35:41,651 --> 02:35:44,887
AGAIN THEY WERE RERANDOMIZED TO 

3548
02:35:44,887 --> 02:35:46,155
EARLY A MAINTENANCE DOSE OR 

3549
02:35:46,155 --> 02:35:47,824
NOTHING.  WHAT WE FOUND THAT A 

3550
02:35:47,824 --> 02:35:49,725
THIRD ASSESSMENTINGS, SO THEY 

3551
02:35:49,725 --> 02:35:52,261
WERE RERANDOMIZED, HAD MORE 

3552
02:35:52,261 --> 02:35:55,698
INTERVENTION OR NOTHING HERE.  

3553
02:35:55,698 --> 02:35:56,799
WAS THAT THERE WERE NO 

3554
02:35:56,799 --> 02:35:57,900
SIGNIFICANT DIFFERENCES BETWEEN 

3555
02:35:57,900 --> 02:35:59,669
THESE EIGHT CONDITIONS.  AND ALL

3556
02:35:59,669 --> 02:36:00,970
OF THE CONDITIONS HAD 

3557
02:36:00,970 --> 02:36:03,139
SIGNIFICANT REDUCTIONS FROM 

3558
02:36:03,139 --> 02:36:04,841
BASELINE.  SO THIS SUGGESTS THAT

3559
02:36:04,841 --> 02:36:07,143
PERHAPS GIVING PEOPLE WHAT THEY 

3560
02:36:07,143 --> 02:36:08,744
NEED REALLY OPTIMIZING TO THE 

3561
02:36:08,744 --> 02:36:11,047
PERSON PUTS EVERYONE ON A MORE 

3562
02:36:11,047 --> 02:36:13,015
EVEN PLAYING LEVEL.  WHEN 

3563
02:36:13,015 --> 02:36:14,183
LOOKING AT LONGER TERM OUTCOMES 

3564
02:36:14,183 --> 02:36:15,918
ABOUT TEN MONTHS FOLLOWING 

3565
02:36:15,918 --> 02:36:18,988
BASELINE THIS WORK FOUND IN MOST

3566
02:36:18,988 --> 02:36:20,756
CONDITIONS GAINES HAD BEEN 

3567
02:36:20,756 --> 02:36:21,691
MAINTAINED IN REGRESSION TO THE 

3568
02:36:21,691 --> 02:36:23,226
MEAN WHICH IS TYPICAL AND 

3569
02:36:23,226 --> 02:36:30,199
BEHAVIORAL WORK WAS MINIMIZED.  

3570
02:36:30,199 --> 02:36:32,068
WHILE WE KNOW THIS CAN BE 

3571
02:36:32,068 --> 02:36:33,970
CHALLENGING ANYWHERE.  EVEN IN 

3572
02:36:33,970 --> 02:36:36,372
ACADEMIC MEDICAL CENTERS, WE'RE 

3573
02:36:36,372 --> 02:36:38,808
SURE ALSO THAT IT'S IMPOSSIBLE 

3574
02:36:38,808 --> 02:36:40,910
TO ACCESS THESE INTERVENTIONS 

3575
02:36:40,910 --> 02:36:43,913
FOR PATIENTS FOR THOSE RECEIVING

3576
02:36:43,913 --> 02:36:45,348
ONCOLOGY CARE IN MEDICALLY 

3577
02:36:45,348 --> 02:36:46,682
UNDERSERVED AREAS.  ONLY ABOUT 

3578
02:36:46,682 --> 02:36:50,520
3% OF ONCOLOGISTS PRACTICE IN 

3579
02:36:50,520 --> 02:36:53,222
RURAL AREAS SO IT IS NOT HARD TO

3580
02:36:53,222 --> 02:36:55,525
TRANSLATE THE UNAVAILABILITY OF 

3581
02:36:55,525 --> 02:36:57,460
COGNITIVE BEHAVIORAL OR PAIN 

3582
02:36:57,460 --> 02:36:58,861
THERAPISTS THAT WOULD BE 

3583
02:36:58,861 --> 02:37:01,230
AVAILABLE IN THESE AREAS.  SO IF

3584
02:37:01,230 --> 02:37:03,766
THE SMART DESIGN MADE YOU DIZZY 

3585
02:37:03,766 --> 02:37:05,034
AT ALL YOU MIGHT WELCOME THE 

3586
02:37:05,034 --> 02:37:07,703
SIMPLE TWO ARM RANDOMIZED 

3587
02:37:07,703 --> 02:37:09,138
CONTROL CONTROL EXAMINING THE 

3588
02:37:09,138 --> 02:37:10,940
EFFICACY OF FOUR SESSIONS OF 

3589
02:37:10,940 --> 02:37:13,309
PAIN, COPING SKILLS, COMPARED TO

3590
02:37:13,309 --> 02:37:15,077
FOUR SESSIONS OF THE CONTROL 

3591
02:37:15,077 --> 02:37:16,178
GROUP IN WOMEN WITH BREAST 

3592
02:37:16,178 --> 02:37:18,180
CANCER AND PAIN RECEIVING THEIR 

3593
02:37:18,180 --> 02:37:18,748
ONCOLOGY CARE IN MEDICALLY 

3594
02:37:18,748 --> 02:37:24,887
UNDERSERVED AREAS.  SO IN THIS 

3595
02:37:24,887 --> 02:37:27,156
TRIAL WE HAVE SET UP VIDEO 

3596
02:37:27,156 --> 02:37:28,024
CONFERENCING KIOSKS AND WOMEN 

3597
02:37:28,024 --> 02:37:30,226
COME INTO THE CLINIC TO COMPLETE

3598
02:37:30,226 --> 02:37:32,328
THE VIDEO CONFERENCING SESSION 

3599
02:37:32,328 --> 02:37:34,597
WITH A THERAPIST THAT'S AT DUKE.

3600
02:37:34,597 --> 02:37:36,999
SO HERE YOU CAN SEE ARE THREE OF

3601
02:37:36,999 --> 02:37:40,136
OUR EIGHT CLINICS, THEY'RE MUCH 

3602
02:37:40,136 --> 02:37:42,171
SMALLER.  THAN THE ACADEMIC 

3603
02:37:42,171 --> 02:37:44,206
MEDICAL CENTERS IN MOST OFTEN IN

3604
02:37:44,206 --> 02:37:45,341
VERY SMALL TOWNS OR EVEN IN 

3605
02:37:45,341 --> 02:37:47,143
RURAL AREAS.  SO WE JUST 

3606
02:37:47,143 --> 02:37:48,878
FINISHED RECRUITMENT FOR THIS 

3607
02:37:48,878 --> 02:37:50,112
TRIAL AND ARE ABOUT TO GET 

3608
02:37:50,112 --> 02:37:51,147
EVERYONE THROUGH THE 

3609
02:37:51,147 --> 02:37:51,781
INTERVENTION SO WE'LL HAVE 

3610
02:37:51,781 --> 02:37:54,984
OUTCOME DATA SOON BUT WE'RE 

3611
02:37:54,984 --> 02:37:58,054
HOPING THAT THIS PAIN COPING 

3612
02:37:58,054 --> 02:38:00,122
SKILLS TRAINING THAT'S HIGHLY 

3613
02:38:00,122 --> 02:38:01,591
ACCESSIBLE WILL BE EFFICACIOUS 

3614
02:38:01,591 --> 02:38:06,529
AS WELL FOR THESE WOMEN.  SO 

3615
02:38:06,529 --> 02:38:08,631
FINALLY I WANT TO SHARE ONE LAST

3616
02:38:08,631 --> 02:38:11,634
PILOT STUDY LED BY SARA IN OUR 

3617
02:38:11,634 --> 02:38:13,669
GROUP.  THIS IS LOOKING AT 

3618
02:38:13,669 --> 02:38:16,038
FEASIBILITY OF A FULLY 

3619
02:38:16,038 --> 02:38:18,341
STANDALONE APP FOR PATIENTS WITH

3620
02:38:18,341 --> 02:38:21,477
COLO RECK CALENDAR CANCER.  THIS

3621
02:38:21,477 --> 02:38:22,945
STUDY RANDOMIZED PATIENTS TO 

3622
02:38:22,945 --> 02:38:26,816
PAIN PACK, A STAND ALONE APP OR 

3623
02:38:26,816 --> 02:38:28,884
FOUR WEEKLY SESSION -- VIDEO 

3624
02:38:28,884 --> 02:38:29,986
CONFERENCING SESSIONS WITH A 

3625
02:38:29,986 --> 02:38:32,088
THERAPIST SO IT'S COMPLETELY ON 

3626
02:38:32,088 --> 02:38:33,956
THEIR OWN OR VIDEO CONFERENCING 

3627
02:38:33,956 --> 02:38:38,327
WITH A THERAPIST.  WE CURRENTLY 

3628
02:38:38,327 --> 02:38:40,262
RECRUITED 45 PARTICIPANTS WITH 

3629
02:38:40,262 --> 02:38:42,698
62 BEING FEMALE.  OUR ATTRITION 

3630
02:38:42,698 --> 02:38:44,300
HAS BEEN -- YOUR ATTRITION RATE 

3631
02:38:44,300 --> 02:38:46,602
HAS BEEN LOW TO DATE.  ONE OF 

3632
02:38:46,602 --> 02:38:48,404
THESE HAS BEEN FEMALE AND TWO IS

3633
02:38:48,404 --> 02:38:50,473
MALE.  WHAT WE'RE HOPING WITH 

3634
02:38:50,473 --> 02:38:52,008
PAIN PACK IS AT LEAST FOR 

3635
02:38:52,008 --> 02:38:53,309
SOME -- AND SOME PATIENTS THAT 

3636
02:38:53,309 --> 02:38:56,846
THIS IS A REALLY HIGHLY 

3637
02:38:56,846 --> 02:38:58,247
ACCESS

3638
02:38:58,247 --> 02:39:00,182
ACCESSIBLE INTERVENTION THAT 

3639
02:39:00,182 --> 02:39:01,751
WILL HAVE LOW COST AND WE'LL BE 

3640
02:39:01,751 --> 02:39:03,152
ABLE TO DISSEMINATE IT VERY 

3641
02:39:03,152 --> 02:39:07,156
WIDELY.  SO IN SUMMARY HERE, 

3642
02:39:07,156 --> 02:39:09,692
JUST SOME AREAS FOR FUTURE 

3643
02:39:09,692 --> 02:39:11,694
STUDY, CONTINUED OPTIMIZATION OF

3644
02:39:11,694 --> 02:39:13,663
COGNITIVE BEHAVIORAL THERAPY, 

3645
02:39:13,663 --> 02:39:15,698
PROTOCOLS FOR PAIN, IMPROVED 

3646
02:39:15,698 --> 02:39:17,566
ACCESS, RIGOROUS EXAMINATION OF 

3647
02:39:17,566 --> 02:39:19,435
SEX DIFFERENCES IN COGNITIVE 

3648
02:39:19,435 --> 02:39:21,971
BEHAVIORAL THERAPY FOR PAIN 

3649
02:39:21,971 --> 02:39:22,605
MANAGEMENT.  OPTIMIZATION OF 

3650
02:39:22,605 --> 02:39:26,042
THESE BRIEF PAIN COPING SKILLS, 

3651
02:39:26,042 --> 02:39:27,276
PROTOCOLS TARGETING SEX 

3652
02:39:27,276 --> 02:39:28,444
DIFFERENCES AND PURPOSEFULLY TO 

3653
02:39:28,444 --> 02:39:30,646
RECRUIT AND ENROLL IN THESE 

3654
02:39:30,646 --> 02:39:33,449
TRIALS CONSIDERING SEX 

3655
02:39:33,449 --> 02:39:35,151
DIFFERENCES IN RESPONSE TO PAIN 

3656
02:39:35,151 --> 02:39:38,921
COPING SKILLS OR COGNITIVE 

3657
02:39:38,921 --> 02:39:39,755
BEHAVIORAL THERAPY FOR PAIN 

3658
02:39:39,755 --> 02:39:40,589
MANAGEMENT.  THANK YOU AGAIN FOR

3659
02:39:40,589 --> 02:39:41,724
HAVING ME AND LISTENING ABOUT 

3660
02:39:41,724 --> 02:39:43,159
THE WORK THAT WE'VE BEEN DOING 

3661
02:39:43,159 --> 02:39:46,262
AND THANK YOU TO OUR FUNDERS, MY

3662
02:39:46,262 --> 02:39:48,097
LONG-TERM MENTORS PROVIDED THE 

3663
02:39:48,097 --> 02:39:51,067
FOUNDATION FOR THIS WORK AND AN 

3664
02:39:51,067 --> 02:39:54,070
AWESOME RESEARCH TEAM THAT KEEPS

3665
02:39:54,070 --> 02:40:04,380
THIS ALL MOVING.

3666
02:40:32,074 --> 02:40:33,909
>> WELCOME, WE'RE READY
FOR 

3667
02:40:33,909 --> 02:40:34,710
QUESTIONS.  I WILL LEAD OFF H

3668
02:40:34,710 --> 02:40:39,381
HERE.  DR. HOFFMAN.  FABULOUS 

3669
02:40:39,381 --> 02:40:42,585
SET OF ARTICLES.  THE GIRL WHO 

3670
02:40:42,585 --> 02:40:44,320
CRIED PAIN AND THEN WENT ONTO 

3671
02:40:44,320 --> 02:40:46,255
THE WOMEN WHO CRIED PAIN I 

3672
02:40:46,255 --> 02:40:48,124
REALLY HIGHLY RECOMMEND THAT TO 

3673
02:40:48,124 --> 02:40:49,992
ANYBODY AT THIS CONFERENCE HERE.

3674
02:40:49,992 --> 02:40:52,261
I'M GOING TO GIVE THOSE TO MY 

3675
02:40:52,261 --> 02:40:54,797
FUTURE STUDENTS WHO COME IN.  

3676
02:40:54,797 --> 02:40:56,298
WHAT IS THE BOTTOM LINE ON THE 

3677
02:40:56,298 --> 02:40:58,567
STATE OF DISPARITIES BASED ON 

3678
02:40:58,567 --> 02:40:59,502
SEX AND THE TREATMENT OF PAIN 

3679
02:40:59,502 --> 02:41:01,237
AND WHAT DO YOU CONCLUDE AFTER 

3680
02:41:01,237 --> 02:41:04,573
REVIEWING ALL THE LITERATURE?

3681
02:41:04,573 --> 02:41:07,943
>> SO THAT'S THE QUESTION
I GET 

3682
02:41:07,943 --> 02:41:09,812
FROM REPORTERS AND JOURNALISTS 

3683
02:41:09,812 --> 02:41:12,715
WHEN THEY TALK TO ME.  SO I 

3684
02:41:12,715 --> 02:41:16,986
GUESS I WOULD SEE NOW THAT THERE

3685
02:41:16,986 --> 02:41:20,589
IS STILL, I WOULD -- SIGNIFICANT

3686
02:41:20,589 --> 02:41:21,257
DISPARITIES IN THE TREATMENT OF 

3687
02:41:21,257 --> 02:41:24,260
WOMEN FOR PAIN.  AND I THINK OF 

3688
02:41:24,260 --> 02:41:26,262
MOST CONCERN OF THE MOST RECENT 

3689
02:41:26,262 --> 02:41:28,631
RESEARCH THAT WE'VE DONE IS THE 

3690
02:41:28,631 --> 02:41:33,435
STUDIES ON BIAS.  IMPLICIT BIAS 

3691
02:41:33,435 --> 02:41:35,004
BECAUSE USING THOSE AVATARS AND 

3692
02:41:35,004 --> 02:41:37,039
VIRTUAL HUMANS YOU CAN JUST 

3693
02:41:37,039 --> 02:41:40,576
MODIFY A SINGLE VARIABLE LIKE 

3694
02:41:40,576 --> 02:41:43,445
SEX.  AND REALLY SEE DOES THAT 

3695
02:41:43,445 --> 02:41:45,848
INFLUENCE DECISION-MAKING.  BUT 

3696
02:41:45,848 --> 02:41:47,349
I WOULD ALSO SEE THAT THERE WERE

3697
02:41:47,349 --> 02:41:51,153
TWO VERY SIGNIFICANT STUDIES, 

3698
02:41:51,153 --> 02:41:53,856
ONE THAT AT SIXTEEN DIFFERENT 

3699
02:41:53,856 --> 02:41:55,191
HOSPITALS IN THE U.S. AND THREE 

3700
02:41:55,191 --> 02:42:00,663
IN CANADA THAT SHOWED NO 

3701
02:42:00,663 --> 02:42:03,866
DIFFERENCE IN THE TREATMENT OF 

3702
02:42:03,866 --> 02:42:05,167
WOMEN AND MEN.  I THINK THERE 

3703
02:42:05,167 --> 02:42:06,435
ARE PLACES THAT ARE DOING A 

3704
02:42:06,435 --> 02:42:08,571
BETTER JOB.  I THINK A NEXT STEP

3705
02:42:08,571 --> 02:42:10,339
IN RESEARCH THAT WILL BE VERY 

3706
02:42:10,339 --> 02:42:11,607
INTERESTING WILL BE TO GO BACK 

3707
02:42:11,607 --> 02:42:14,109
TO THOSE HOSPITALS AND SEE, YOU 

3708
02:42:14,109 --> 02:42:16,312
KNOW, HAVE THEY FOCUSED, HAVE 

3709
02:42:16,312 --> 02:42:18,747
THEY DONE ANY KIND OF MORE 

3710
02:42:18,747 --> 02:42:21,784
TARGETED EDUCATION AND 

3711
02:42:21,784 --> 02:42:23,152
INCREASING AWARENESS ON THE PART

3712
02:42:23,152 --> 02:42:27,156
OF HEALTH CARE PROVIDERS ABOUT 

3713
02:42:27,156 --> 02:42:29,091
TREATMENT OF WOMEN AND MEN FOR 

3714
02:42:29,091 --> 02:42:30,292
PAIN?  SO THAT'S WHAT I WOULD 

3715
02:42:30,292 --> 02:42:30,459
SEE.

3716
02:42:30,459 --> 02:42:32,728
>> OKAY.  THANK YOU.  I 

3717
02:42:32,728 --> 02:42:34,063
APOLOGIZE THAT -- I DON'T HAVE A

3718
02:42:34,063 --> 02:42:34,930
METHOD I GUESS OF CHECKING 

3719
02:42:34,930 --> 02:42:35,664
WHETHER QUESTIONS ARE COMING IN 

3720
02:42:35,664 --> 02:42:42,338
FROM ONLINE.  TO DR. WARD, HIGH 

3721
02:42:42,338 --> 02:42:45,140
DOES THE MECHANISM OF ACTION, 

3722
02:42:45,140 --> 02:42:47,142
THE FIE TO CANNABINOIDS THAT YOU

3723
02:42:47,142 --> 02:42:49,345
STUDY IN THE LAB RELATE TO SEX 

3724
02:42:49,345 --> 02:42:53,315
DIFFERENCES IN THE RODENT MODELS

3725
02:42:53,315 --> 02:42:57,920
OF PAIN?

3726
02:42:57,920 --> 02:42:58,988
>> THANK YOU FOR THE
QUESTION.  

3727
02:42:58,988 --> 02:43:00,656
ON THE ONE HAND I MENTIONED IN 

3728
02:43:00,656 --> 02:43:02,458
THE CONCLUSION SLIDE THAT MANY 

3729
02:43:02,458 --> 02:43:05,227
OF US THINK OF THESE FIE TO 

3730
02:43:05,227 --> 02:43:08,898
CANNABINOIDS AS BEING SORT OF 

3731
02:43:08,898 --> 02:43:10,165
PAN ANTI-INFLAMMATORY AND SO 

3732
02:43:10,165 --> 02:43:11,500
PERHAPS EVEN IN THE MODEL WHERE 

3733
02:43:11,500 --> 02:43:13,702
THERE'S A SEX DIFFERENCE THAT 

3734
02:43:13,702 --> 02:43:14,803
THE CANNABINOIDS MAY BE 

3735
02:43:14,803 --> 02:43:17,539
EFFECTIVE BUT WITH CBD WHICH I 

3736
02:43:17,539 --> 02:43:21,176
DIDN'T TALK ABOUT AS MUCH AT THE

3737
02:43:21,176 --> 02:43:23,145
END OF MY PRESENTATION ONE OF 

3738
02:43:23,145 --> 02:43:24,914
THE OBSERVATIONS FROM THE 

3739
02:43:24,914 --> 02:43:26,248
LITERATURE AS WELL AS FROM MY 

3740
02:43:26,248 --> 02:43:28,784
LABORATORY IS THAT THERE SEEM TO

3741
02:43:28,784 --> 02:43:31,654
AB MORE PREDOMINANT EFFECT OF 

3742
02:43:31,654 --> 02:43:34,490
CBD ON T-CELL ACTIVATION THAN ON

3743
02:43:34,490 --> 02:43:37,393
MICRO GLIAL ACTIVATION AND SO 

3744
02:43:37,393 --> 02:43:41,163
GIVEN THE WORK OF JEFF MOGUL AND

3745
02:43:41,163 --> 02:43:42,898
ROB S. AND SOME OF THE FOLLOW UP

3746
02:43:42,898 --> 02:43:44,700
STUDIES FROM OTHER FOLKS THERE 

3747
02:43:44,700 --> 02:43:48,871
IS A POTENTIAL THAT CBD WITH ITS

3748
02:43:48,871 --> 02:43:51,140
REALLY PROFOUND EFFECTS ON 

3749
02:43:51,140 --> 02:43:54,543
T-CELL ACTIVITY MAY BE 

3750
02:43:54,543 --> 02:43:55,377
ESPECIALLY EFFICACIOUS IN 

3751
02:43:55,377 --> 02:43:59,682
FEMALES AGAIN, IF MANY OF THESE 

3752
02:43:59,682 --> 02:44:02,084
NEUROPATHIC PAIN CONDITIONS IN 

3753
02:44:02,084 --> 02:44:04,253
FEMALES HAVE A T-CELL DOMINANT 

3754
02:44:04,253 --> 02:44:06,455
PAIN SIGNATURE.  SO THAT'S 

3755
02:44:06,455 --> 02:44:07,623
SOMETHING THAT I'M PARTICULARLY 

3756
02:44:07,623 --> 02:44:08,257
INTERESTED IN SEEING FOLKS 

3757
02:44:08,257 --> 02:44:13,862
FOLLOW UP ON.

3758
02:44:13,862 --> 02:44:15,965
>> THANK YOU.  DR. SOMERS
YOUR 

3759
02:44:15,965 --> 02:44:16,799
PRESENTATION, YOU ACTUALLY 

3760
02:44:16,799 --> 02:44:18,634
PRESENTED ON POTENTIAL SEX 

3761
02:44:18,634 --> 02:44:20,836
DIFFERENCES IN RESPONSE TO 

3762
02:44:20,836 --> 02:44:22,037
COGNITIVE BEHAVIORAL STRATEGIES 

3763
02:44:22,037 --> 02:44:23,138
FOR PAIN MANAGEMENT.  WHAT MIGHT

3764
02:44:23,138 --> 02:44:26,108
BE A STRATEGY FOR DEVELOPING AN 

3765
02:44:26,108 --> 02:44:29,278
INTERVENTION TARGETED AT EITHER 

3766
02:44:29,278 --> 02:44:30,813
MALES OR FEMALES?

3767
02:44:30,813 --> 02:44:33,716
>> I MEAN, THAT'S A GOOD
YES.  I

3768
02:44:33,716 --> 02:44:34,883
ACTUALLY AM REALLY SURPRISE TO 

3769
02:44:34,883 --> 02:44:37,052
DO THINK THAT WE ARE TO SEE THAT

3770
02:44:37,052 --> 02:44:39,154
WE HADN'T THOUGHT MORE ABOUT 

3771
02:44:39,154 --> 02:44:41,190
THAT.  WE HAVE CLUES FROM THE 

3772
02:44:41,190 --> 02:44:42,891
LITERATURE THAT THERE'S CERTAIN 

3773
02:44:42,891 --> 02:44:43,959
SKILLS OR COPING STRATEGIES THAT

3774
02:44:43,959 --> 02:44:46,095
GENERALLY APPLY TO MALES OR 

3775
02:44:46,095 --> 02:44:47,363
FEMALES THAT MAP ONTO THE SKILLS

3776
02:44:47,363 --> 02:44:49,198
THAT WE TEACH IN PAIN COPING 

3777
02:44:49,198 --> 02:44:53,969
SKILLS TRAINING.  SO I THINK 

3778
02:44:53,969 --> 02:44:56,205
THAT WE COULD TEST WHETHER 

3779
02:44:56,205 --> 02:44:57,573
PROTOCOLS THAT HAVE THOSE 

3780
02:44:57,573 --> 02:44:58,574
SPECIFIC SKILLS IN THEM MIGHT BE

3781
02:44:58,574 --> 02:45:02,211
MORE, YOU KNOW, I THINK THE BIG 

3782
02:45:02,211 --> 02:45:05,014
THING IS BEING ACCEPTABLE SO 

3783
02:45:05,014 --> 02:45:06,615
THAT CAN WE GREAT MAYBE 

3784
02:45:06,615 --> 02:45:07,483
PARTICULARLY MALES TO CONTINUE 

3785
02:45:07,483 --> 02:45:08,784
WITH THESE INTERVENTIONS AND TO 

3786
02:45:08,784 --> 02:45:11,520
SEE THE BENEFITS.  AND ANOTHER 

3787
02:45:11,520 --> 02:45:14,656
OBVIOUS ONE SEEMS TO BE GROUP 

3788
02:45:14,656 --> 02:45:16,258
BASED THERAPIES FOR FEMALES 

3789
02:45:16,258 --> 02:45:18,660
PERHAPS MIGHT BE MORE RELEVANT 

3790
02:45:18,660 --> 02:45:19,261
AND INDIVIDUAL THERAPIES FOR 

3791
02:45:19,261 --> 02:45:20,929
MALES.

3792
02:45:20,929 --> 02:45:25,200
>> OKAY.  THANK YOU. 
AGAIN, THE

3793
02:45:25,200 --> 02:45:30,572
QUESTION FOR DR. HOFFMAN,  --

3794
02:45:30,572 --> 02:45:32,041
>> THERE'S PEOPLE IN THE 

3795
02:45:32,041 --> 02:45:32,307
AUDIENCE.

3796
02:45:32,307 --> 02:45:33,976
>> THERE ARE, I SEE, LET'S
TAKE 

3797
02:45:33,976 --> 02:45:35,644
A FIRST QUESTION THEN.

3798
02:45:35,644 --> 02:45:37,813
>> THANK YOU FOR GREAT 

3799
02:45:37,813 --> 02:45:38,747
PRESENTATIONS, THIS QUESTION'S 

3800
02:45:38,747 --> 02:45:40,616
FOR THE WHOLE PANEL.  WHAT ROLE 

3801
02:45:40,616 --> 02:45:44,553
DO THERAPY PETS OR SERVICE PETS 

3802
02:45:44,553 --> 02:45:47,156
HAVE IN A MULTIDISCIPLINARY 

3803
02:45:47,156 --> 02:45:47,790
APPROACH TO CHRONIC PAIN 

3804
02:45:47,790 --> 02:45:53,429
MANAGEMENT?

3805
02:45:53,429 --> 02:45:55,831
>> I CAN ANSWER.  TALK A
LITTLE 

3806
02:45:55,831 --> 02:45:59,435
BIT ABOUT THAT.  I THINK THERE'S

3807
02:45:59,435 --> 02:46:00,836
SOME EVIDENCE THAT THEY'RE 

3808
02:46:00,836 --> 02:46:03,138
CERTAINLY HELPFUL, DEFINITELY, 

3809
02:46:03,138 --> 02:46:05,340
FOR EMOTIONAL/BEHAVIORAL PIECES 

3810
02:46:05,340 --> 02:46:07,142
THAT INFLUENCE CHRONIC PAIN.  

3811
02:46:07,142 --> 02:46:10,646
WE'RE DOING SOME WORK WITH 

3812
02:46:10,646 --> 02:46:11,346
INVESTIGATORS AT NORTH CAROLINA 

3813
02:46:11,346 --> 02:46:13,115
STATE THAT WE'RE TRYING TO 

3814
02:46:13,115 --> 02:46:14,349
ANSWER THAT QUESTION SO WE HAVE 

3815
02:46:14,349 --> 02:46:17,820
THERAPY DOGS IN THE CANCER 

3816
02:46:17,820 --> 02:46:23,158
CENTER.  AND WE KNOW CLINICALLY 

3817
02:46:23,158 --> 02:46:25,794
THAT PATIENTS LOVE WHEN THEY 

3818
02:46:25,794 --> 02:46:28,197
COME.  PARTICULARLY THE 

3819
02:46:28,197 --> 02:46:29,898
PEDIATRIC PATIENTS SO WE'RE 

3820
02:46:29,898 --> 02:46:30,933
LOOKING AT THE RESPONSE WHEN WE 

3821
02:46:30,933 --> 02:46:32,401
HAVE DOGS IN THE ROOM AND MY 

3822
02:46:32,401 --> 02:46:33,969
INTEREST IS PAIN OUTCOMES 

3823
02:46:33,969 --> 02:46:35,270
PARTICULARLY AROUND PROCEDURES 

3824
02:46:35,270 --> 02:46:36,171
SO WE KNOW A LITTLE BIT BUT NOT 

3825
02:46:36,171 --> 02:46:38,507
A LOT BUT I THINK IT'S A REALLY 

3826
02:46:38,507 --> 02:46:40,008
PROMISING AREA.

3827
02:46:40,008 --> 02:46:41,543
>> DO YOU EXPECT THERE
WOULD BE 

3828
02:46:41,543 --> 02:46:43,946
A SEX DIFFERENCE IN TERMS OF THE

3829
02:46:43,946 --> 02:46:46,915
IMPACT ON OXYTOCIN LEVELS OR KOR

3830
02:46:46,915 --> 02:46:47,216
SOL LEVELS?

3831
02:46:47,216 --> 02:46:48,684
>> I DON'T KNOW IF I KNOW
ENOUGH

3832
02:46:48,684 --> 02:46:51,153
TO ANSWER THAT.  DOES ANYONE 

3833
02:46:51,153 --> 02:46:57,192
ELSE HAVE A THOUGHT ABOUT THAT

3834
02:46:57,192 --> 02:46:59,094
>> NO, BUT I WILL ADD THAT
I 

3835
02:46:59,094 --> 02:47:00,863
THINK -- THINKING ABOUT THOSE 

3836
02:47:00,863 --> 02:47:04,266
TYPES OF THINGS AND A 

3837
02:47:04,266 --> 02:47:05,701
POTENTIALLY, YOU KNOW, 

3838
02:47:05,701 --> 02:47:08,437
TRANSLATIONALLY TO MODEL THAT IN

3839
02:47:08,437 --> 02:47:10,272
RODENTS, SOMETIMES PEOPLE HAVE 

3840
02:47:10,272 --> 02:47:14,042
RODENTS AS PETS BUT WE DON'T 

3841
02:47:14,042 --> 02:47:15,144
NECESSARILY THINK OF RODENTS AS 

3842
02:47:15,144 --> 02:47:17,246
HAVING THOSE KINDS OF COMPANIONS

3843
02:47:17,246 --> 02:47:20,115
BUT I THINK SOME OF THE DATA 

3844
02:47:20,115 --> 02:47:23,352
THAT JEFF SHOWED YESTERDAY 

3845
02:47:23,352 --> 02:47:26,688
SHOWING SEX DIFFERENCES IN 

3846
02:47:26,688 --> 02:47:28,257
WHETHER ANIMALS DISPLAY PAIN 

3847
02:47:28,257 --> 02:47:31,093
LIKE BEHAVIOR ALONE VERSUS 

3848
02:47:31,093 --> 02:47:32,895
SOCIALLY WE CAN MODEL SOCIAL 

3849
02:47:32,895 --> 02:47:34,696
ACTIVITY AND ACCESS TO SOCIAL 

3850
02:47:34,696 --> 02:47:37,032
ACTIVITY OR OTHER PLEASURABLE 

3851
02:47:37,032 --> 02:47:39,067
ACTIVITY IN RODENTS SO THAT 

3852
02:47:39,067 --> 02:47:40,269
COULD BE SOMETHING THAT, YOU 

3853
02:47:40,269 --> 02:47:46,275
KNOW, IF YOU'RE TALKING ABOUT 

3854
02:47:46,275 --> 02:47:47,643
BIOLOGICAL SEX DIFFERENCES AND 

3855
02:47:47,643 --> 02:47:50,012
WHETHER CERTAIN TYPES OF 

3856
02:47:50,012 --> 02:47:52,814
ACTIVITIES MAY BE PLEASURABLE 

3857
02:47:52,814 --> 02:47:55,150
AND DECREASE BEHAVIOR.  THAT'S A

3858
02:47:55,150 --> 02:47:57,920
NEAT IDEA.

3859
02:47:57,920 --> 02:48:00,022
>> THANK YOU.

3860
02:48:00,022 --> 02:48:02,257
>> THANK YOU, ALL, FOR THE
GREAT

3861
02:48:02,257 --> 02:48:05,227
TALKS.  I'M A CLINICAL 

3862
02:48:05,227 --> 02:48:09,665
PSYCHOLOGIST AS WELL.  AT 

3863
02:48:09,665 --> 02:48:12,000
COGNITIVE BEHAVIORAL THERAPY SO 

3864
02:48:12,000 --> 02:48:13,468
MY QUESTIONS ARE MORE FOR 

3865
02:48:13,468 --> 02:48:14,603
DR. SOMERS.  I HAVE TWO 

3866
02:48:14,603 --> 02:48:15,504
QUESTIONS.  QUESTION NUMBER ONE,

3867
02:48:15,504 --> 02:48:18,907
IT SEEMS PERSONALLY, TO AMERICA 

3868
02:48:18,907 --> 02:48:25,948
IT SEEMS COUNTERINTUITIVE THAT 

3869
02:48:25,948 --> 02:48:27,983
ADHERENCE WAS LOWER AND I AM 

3870
02:48:27,983 --> 02:48:30,285
CURIOUS AS TO WHY YOU THINK THAT

3871
02:48:30,285 --> 02:48:32,921
WAS AND QUESTION TWO WHEN YOU 

3872
02:48:32,921 --> 02:48:34,990
TESTED THE SKILLS FOR BRIEF 

3873
02:48:34,990 --> 02:48:37,726
THERAPIES HAVE YOU FOUND ANY 

3874
02:48:37,726 --> 02:48:39,127
COMBINATION THAT WAS -- THAT 

3875
02:48:39,127 --> 02:48:40,762
WORKED SURPRISINGLY WELL LIKE IF

3876
02:48:40,762 --> 02:48:43,899
WE ONLY HAVE TWO SESSIONS WITH 

3877
02:48:43,899 --> 02:48:45,801
SOMEONE, WHAT TWO SKILLS WOULD 

3878
02:48:45,801 --> 02:48:47,636
YOU KIND OF INTRODUCE?

3879
02:48:47,636 --> 02:48:49,171
>> GREAT QUESTIONS. 
THINGS THAT

3880
02:48:49,171 --> 02:48:50,505
WE'RE THINKING ABOUT A LOT SO I 

3881
02:48:50,505 --> 02:48:52,274
THINK THE ANSWER TO YOUR FIRST 

3882
02:48:52,274 --> 02:48:53,675
QUESTION'S REALLY ABOUT ACCESS. 

3883
02:48:53,675 --> 02:48:56,678
SO, YOU KNOW, HOW I THINK ABOUT 

3884
02:48:56,678 --> 02:49:03,151
THE WOMEN BEING MORE AD  

3885
02:49:03,151 --> 02:49:05,921
ADHERENT TO THE VIDEO 

3886
02:49:05,921 --> 02:49:06,255
CONFERENCING. 

3887
02:49:06,255 --> 02:49:08,223
IS THEY'RE JUGGLING FAMILY AND 

3888
02:49:08,223 --> 02:49:08,423
WORK. 

3889
02:49:08,423 --> 02:49:10,292
AND THEY HAVE OTHER 

3890
02:49:10,292 --> 02:49:14,062
RESPONSIBILITIES TO, YOU KNOW, 

3891
02:49:14,062 --> 02:49:15,864
THAT THEY ARE MORE LIKELY TO BE 

3892
02:49:15,864 --> 02:49:18,333
ABLE TO LIKE SET UP -- YOU KNOW,

3893
02:49:18,333 --> 02:49:19,868
WE HAD OUR THERAPIST AVAILABLE 

3894
02:49:19,868 --> 02:49:21,503
AT 8 O'CLOCK AT NIGHT IF THAT'S 

3895
02:49:21,503 --> 02:49:23,138
WHEN THEY COULD DO THEIR 

3896
02:49:23,138 --> 02:49:25,073
SESSIONS SO THEY'RE MORE ABLE TO

3897
02:49:25,073 --> 02:49:27,142
FIND SOME TIME ALONE TO DO IT AT

3898
02:49:27,142 --> 02:49:29,344
THAT TIME.  SO I -- DOES THAT 

3899
02:49:29,344 --> 02:49:30,379
KIND OF GET AT YOUR FIRST 

3900
02:49:30,379 --> 02:49:32,447
QUESTION?  MAYBE ANSWERED IT?  

3901
02:49:32,447 --> 02:49:34,283
YOU WOULD EXPECT THEM TO BE MORE

3902
02:49:34,283 --> 02:49:37,386
AD HEERNT TO THE IN-PERSON.

3903
02:49:37,386 --> 02:49:39,921
>> I THINK I
MISUNDERSTOOD.  I 

3904
02:49:39,921 --> 02:49:41,923
THOUGHT YOU MEANT ADHERENT TO 

3905
02:49:41,923 --> 02:49:43,158
ACTUALLY LIKE DOING THE HOMEWORK

3906
02:49:43,158 --> 02:49:44,826
PRESCRIPTIONS BUT YOU'RE TALKING

3907
02:49:44,826 --> 02:49:46,561
ADHERENT LIKE THEY ATTENDED THE 

3908
02:49:46,561 --> 02:49:48,163
SESSIONS.  GOT YOU.  OKAY.

3909
02:49:48,163 --> 02:49:49,631
>> GREAT QUESTION SO
ADHERENCE 

3910
02:49:49,631 --> 02:49:51,233
IN THIS CASE WE MEASURED AS 

3911
02:49:51,233 --> 02:49:54,803
SESSION ATTENDANCE AND THEN ALSO

3912
02:49:54,803 --> 02:49:58,740
AS COMPLETING STUDY PROCEDURES.

3913
02:49:58,740 --> 02:50:00,676
>> I MISUNDERSTOOD THAT
THEN.  

3914
02:50:00,676 --> 02:50:01,076
THANK YOU.

3915
02:50:01,076 --> 02:50:03,745
>> AND I THINK WITH SKILLS
THE 

3916
02:50:03,745 --> 02:50:05,414
THING THAT WE ALWAYS DO FIRST IS

3917
02:50:05,414 --> 02:50:07,149
SOME SORT OF RELAXATION SO IF WE

3918
02:50:07,149 --> 02:50:08,183
HAVE ONE SESSION WE DO A LITTLE 

3919
02:50:08,183 --> 02:50:10,252
BIT OF PSYCHO EDUCATION, KIND OF

3920
02:50:10,252 --> 02:50:12,754
PRESENT THE COGNITIVE BEHAVIORAL

3921
02:50:12,754 --> 02:50:15,123
THERAPY MODEL WHERE THOUGHTS AND

3922
02:50:15,123 --> 02:50:17,592
FEELINGS INTERACT WITH PAIN AND 

3923
02:50:17,592 --> 02:50:20,395
AS WELL AS BEHAVIORS AND KIND OF

3924
02:50:20,395 --> 02:50:25,033
GIVE SOME FUN EXAMPLES TO THHEL 

3925
02:50:25,033 --> 02:50:26,802
THEM THINK ABOUT IT AND DO 

3926
02:50:26,802 --> 02:50:28,303
RELAXATION ALONG WITH THAT.  

3927
02:50:28,303 --> 02:50:33,475
WE'VE DONE THESE VERY BRIEF AND 

3928
02:50:33,475 --> 02:50:34,810
FOUR SESSION WOULD BE OUR NEXT 

3929
02:50:34,810 --> 02:50:36,278
BRIEF SO THERE'S A LOT TO 

3930
02:50:36,278 --> 02:50:38,747
UNDERSTAND WHAT SKILL MIGHT WORK

3931
02:50:38,747 --> 02:50:41,116
BEST FOR SOME PEOPLE THAN OTHERS

3932
02:50:41,116 --> 02:50:42,617
AND TWO OR THREE MIGHT WORK 

3933
02:50:42,617 --> 02:50:44,286
BETTER THAN ONE.  WE'RE DOING 

3934
02:50:44,286 --> 02:50:46,321
WORK IN THAT AREA TRYING TO SEE 

3935
02:50:46,321 --> 02:50:47,989
BUT GOOD QUESTION.

3936
02:50:47,989 --> 02:50:49,591
>> ALL RIGHT.  THANK YOU. 

3937
02:50:49,591 --> 02:50:54,129
DR. HOFFMAN, YOU HAD MENTIONED 

3938
02:50:54,129 --> 02:50:55,664
THAT PHYSICIAN GENDER MADE A 

3939
02:50:55,664 --> 02:50:58,300
DIFFERENCE ON HOW PEOPLE WERE 

3940
02:50:58,300 --> 02:51:00,469
TREATED AND JUST WAS WONDERING 

3941
02:51:00,469 --> 02:51:01,837
IF YOU COULD EXPOUND UPON THAT.

3942
02:51:01,837 --> 02:51:05,273
>> YEAH, SO SOME OF THE
STUDIES 

3943
02:51:05,273 --> 02:51:07,776
LOOK BOTH AT PATIENT AND 

3944
02:51:07,776 --> 02:51:09,111
PHYSICIAN SEX AND AT LEAST ONE 

3945
02:51:09,111 --> 02:51:16,184
OF THE LARGER STUDIES FOUND THAT

3946
02:51:16,184 --> 02:51:18,653
FEMALE PHYSICIANS WERE MORE 

3947
02:51:18,653 --> 02:51:20,222
LIKELY TO ADMINISTER ANALGESIA 

3948
02:51:20,222 --> 02:51:22,424
THAN MALE OVERALL AND WITH 

3949
02:51:22,424 --> 02:51:26,194
RESPECT TO OPIOIDS FEMALE 

3950
02:51:26,194 --> 02:51:31,133
PHYSICIANS WERE MORE LIKELY TO 

3951
02:51:31,133 --> 02:51:33,135
ADMINISTER OPIOIDS TO FEMALE 

3952
02:51:33,135 --> 02:51:35,036
PATIENTS AND MALE TO MALE.  THEY

3953
02:51:35,036 --> 02:51:37,339
DIDN'T REALLY SPECULATE WHY.

3954
02:51:37,339 --> 02:51:41,576
>> WAS THERE AN AGE
FACTOR.

3955
02:51:41,576 --> 02:51:42,177
>> WITH RESPECT TO THE 

3956
02:51:42,177 --> 02:51:42,944
PHYSICIANS I DON'T THINK THAT 

3957
02:51:42,944 --> 02:51:45,013
CAME OUT AS SIGNIFICANT.  IT WAS

3958
02:51:45,013 --> 02:51:47,783
THE SEX OF THE PHYSICIAN THAT 

3959
02:51:47,783 --> 02:51:52,020
WAS MOST SIGNIFICANT.  THAT'S 

3960
02:51:52,020 --> 02:51:54,055
ANOTHER INTERESTING AREA I THINK

3961
02:51:54,055 --> 02:51:56,391
FOR FUTURE RESEARCH.  I KNOW 

3962
02:51:56,391 --> 02:51:58,093
THERE IS GENERALLY ON OTHER 

3963
02:51:58,093 --> 02:51:59,161
KINDS OF MEDICAL TREATMENT 

3964
02:51:59,161 --> 02:51:59,661
BUT --

3965
02:51:59,661 --> 02:52:01,763
>> SO AMONG ALL YOUR OTHER

3966
02:52:01,763 --> 02:52:07,135
CONCERNS YOU HAVE TO WONDER OF 

3967
02:52:07,135 --> 02:52:08,970
THE GENDER OF THE PHYSICIAN 

3968
02:52:08,970 --> 02:52:10,138
THAT'S TREATING YOU.  WHETHER 

3969
02:52:10,138 --> 02:52:11,139
YOU'LL GET THE MEDICATION.

3970
02:52:11,139 --> 02:52:13,008
>> SEEMS TO BE THE CASE.

3971
02:52:13,008 --> 02:52:16,511
>> ONE LAST QUESTION.  DR.
WARD.

3972
02:52:16,511 --> 02:52:18,780
WHAT HAVE YOU FOUND TO BE THE 

3973
02:52:18,780 --> 02:52:19,915
BIGGEST CHALLENGE IN STUDYING 

3974
02:52:19,915 --> 02:52:22,317
SEX DIFFERENCES IN YOUR FIELD OF

3975
02:52:22,317 --> 02:52:22,584
RESEARCH?

3976
02:52:22,584 --> 02:52:28,323
>> YEAH.  SO HONESTLY, IT
HAS 

3977
02:52:28,323 --> 02:52:29,891
BEEN THE CONTINUITY OF THE 

3978
02:52:29,891 --> 02:52:31,293
PERSON IN MY LABORATORY THAT IS 

3979
02:52:31,293 --> 02:52:34,930
DOING THE RESEARCH.  SO THESE 

3980
02:52:34,930 --> 02:52:36,131
NEUROPATHIC PAIN MODELS AND THE 

3981
02:52:36,131 --> 02:52:39,134
WAY IN WHICH WE MEASURE THE PAIN

3982
02:52:39,134 --> 02:52:40,669
RESPONSE, ALTHOUGH WE DON'T WANT

3983
02:52:40,669 --> 02:52:44,639
IT TO BE, CAN BE PRETTY 

3984
02:52:44,639 --> 02:52:46,575
SUBJECTIVE.  AND SO THE 

3985
02:52:46,575 --> 02:52:48,610
RESEARCHER HAS TO BE 

3986
02:52:48,610 --> 02:52:51,146
WELL-TRAINED AND EVEN WHEN THE 

3987
02:52:51,146 --> 02:52:52,314
RESEARCHER IS WELL-TRAINED THERE

3988
02:52:52,314 --> 02:52:55,150
ARE DIFFERENCES ACROSS FOLKS IN 

3989
02:52:55,150 --> 02:52:58,186
MY LAB EVEN WITHIN SEX.  SO THEY

3990
02:52:58,186 --> 02:53:02,624
RATE THE BEHAVIORS VERY 

3991
02:53:02,624 --> 02:53:03,258
CONSISTENTLY, YOU KNOW, WITHIN 

3992
02:53:03,258 --> 02:53:08,063
THEIR OWN STUDIES.  BUT THEN IF 

3993
02:53:08,063 --> 02:53:10,732
SOMEONE -- SO I WORK AT AN 

3994
02:53:10,732 --> 02:53:12,934
ACADEMIC INSTITUTION.  WE HAVE 

3995
02:53:12,934 --> 02:53:14,503
STUDENTS.  I -- MOST OF MY 

3996
02:53:14,503 --> 02:53:15,237
RESEARCHERS ARE STUDENTS SO 

3997
02:53:15,237 --> 02:53:17,172
THEY'LL COME IN FOR A SEMESTER 

3998
02:53:17,172 --> 02:53:21,977
OR A YEAR OR TWO YEARS AND THEN 

3999
02:53:21,977 --> 02:53:23,078
THEY'LL LEAVE AND SOMEONE ELSE 

4000
02:53:23,078 --> 02:53:24,613
WILL COME IN.  THAT CAN BE 

4001
02:53:24,613 --> 02:53:25,413
CHALLENGING.  IT'S VERY, VERY 

4002
02:53:25,413 --> 02:53:26,548
IMPORTANT TO PAY ATTENTION TO 

4003
02:53:26,548 --> 02:53:28,383
THOSE KINDS OF THINGS IN THIS 

4004
02:53:28,383 --> 02:53:30,852
AREA OF RESEARCH.  I THINK 

4005
02:53:30,852 --> 02:53:33,088
THERE'S A COUPLE OF WAYS THAT 

4006
02:53:33,088 --> 02:53:35,757
ARE NEW PROCEDURES IN PAIN 

4007
02:53:35,757 --> 02:53:37,325
RESEARCH TO AUTOMATE BEHAVIORAL 

4008
02:53:37,325 --> 02:53:39,761
RESPONSES TO PAIN.  SO THERE ARE

4009
02:53:39,761 --> 02:53:44,366
SOME FOLKS THAT ARE NOW -- SO WE

4010
02:53:44,366 --> 02:53:46,401
POKE THE MOUSE'S PAW AND WE 

4011
02:53:46,401 --> 02:53:48,003
MEASURE THEIR WITHDRAWAL 

4012
02:53:48,003 --> 02:53:51,139
RESPONSE SO WE HAVE COLLEAGUES 

4013
02:53:51,139 --> 02:53:53,909
WHO ARE VIDEOTAPIING THE ANIMAL 

4014
02:53:53,909 --> 02:53:55,644
AND DOING A COMPUTER ANALYZED 

4015
02:53:55,644 --> 02:53:58,313
MICRO STRUCTURAL ANALYSIS OF THE

4016
02:53:58,313 --> 02:54:00,982
RESPONSE WHICH TAKES THE PERSON 

4017
02:54:00,982 --> 02:54:02,417
OUT OF IT.  AND HELPS WITH 

4018
02:54:02,417 --> 02:54:03,318
CONTINUITY AND I WAS THINKING 

4019
02:54:03,318 --> 02:54:05,086
THAT THAT COULD ALSO BE, I DON'T

4020
02:54:05,086 --> 02:54:06,955
KNOW IF ANYONE YET HAS APPLIED 

4021
02:54:06,955 --> 02:54:09,791
THAT TO SEX DIFFERENCES OF THE 

4022
02:54:09,791 --> 02:54:13,795
ANIMAL BECAUSE THE MALE AND THE 

4023
02:54:13,795 --> 02:54:15,163
FEMALE MICE BEHAVE DIFFERENTLY 

4024
02:54:15,163 --> 02:54:17,732
WHEN WE PUT THE MOUSE IN THE 

4025
02:54:17,732 --> 02:54:21,436
LITTLE CUBBY TO STUDY THEM THEY 

4026
02:54:21,436 --> 02:54:27,609
ALSO BEHAVE.  I THINK  -- YOU 

4027
02:54:27,609 --> 02:54:29,477
CAN TELL THE DIFFERENCE. 

4028
02:54:29,477 --> 02:54:31,880
THAT IS SOMETHING THAT MAY SOUND

4029
02:54:31,880 --> 02:54:34,215
A SMALL DETAIL, CAN BE REALLY 

4030
02:54:34,215 --> 02:54:39,454
CHANNEL -- CHALLENGING IN 

4031
02:54:39,454 --> 02:54:40,956
MEASURING SEX DIFFERENCES. 

4032
02:54:40,956 --> 02:54:43,058
BUT THERE'S WAYS TO IMPROVE IT.

4033
02:54:43,058 --> 02:54:46,161
>> I SEE NO OTHER
QUESTIONS, 

4034
02:54:46,161 --> 02:54:47,095
AGAIN, I WANT TO THANK THE 

4035
02:54:47,095 --> 02:54:48,496
SPEAKERS AGAIN TODAY FOR THEIR 

4036
02:54:48,496 --> 02:54:58,773
PRESENTATIONS.

4037
02:55:24,566 --> 02:55:28,336
>> WHAT A GREAT COUPLE OF
DAYS. 

4038
02:55:28,336 --> 02:55:31,506
I CERTAINLY LEARNED A LOT.  A 

4039
02:55:31,506 --> 02:55:33,308
LITTLE OVERWHELMED BY THE WORK 

4040
02:55:33,308 --> 02:55:36,011
WE NEED TO DO BUT THAT'S WHY 

4041
02:55:36,011 --> 02:55:37,112
WE'RE HERE IS TO CHART A PATH TO

4042
02:55:37,112 --> 02:55:38,947
THE FUTURE.  I WANT TO JUST 

4043
02:55:38,947 --> 02:55:45,553
START OFF BY THANKING FOLKS.  

4044
02:55:45,553 --> 02:55:47,155
PARTICULARLY DEVON AND DAVID 

4045
02:55:47,155 --> 02:55:51,159
THOMAS FOR THE CO-CHAIRING THE 

4046
02:55:51,159 --> 02:55:55,130
CONSORTIUM MEETING THIS YEAR.  I

4047
02:55:55,130 --> 02:55:59,968
WANT TO ALSO THANK LEAH FOR 

4048
02:55:59,968 --> 02:56:02,003
COORDINATING THE -- AND 

4049
02:56:02,003 --> 02:56:04,139
ORGANIZING THE MEETINGS.  THE 

4050
02:56:04,139 --> 02:56:06,141
MODERATORS, THE PANELISTS, THEY 

4051
02:56:06,141 --> 02:56:08,309
DID A FANTASTIC JOB.  CLEARLY A 

4052
02:56:08,309 --> 02:56:12,580
LOT OF ENERGY, A LOT OF 

4053
02:56:12,580 --> 02:56:16,317
COMPASSION, AND A LOT OF 

4054
02:56:16,317 --> 02:56:19,154
PERSISTENCE ON WHAT WE HEARD 

4055
02:56:19,154 --> 02:56:21,623
TODAY TO GET ANSWERS FROM PEOPLE

4056
02:56:21,623 --> 02:56:22,824
SUFFERING FROM PAIN.  I ALSO 

4057
02:56:22,824 --> 02:56:24,259
WANT TO THANK THE CONTRACTORS 

4058
02:56:24,259 --> 02:56:26,828
AND THE EVENTS STAFF AND A BIG 

4059
02:56:26,828 --> 02:56:28,797
CONGRATULATIONS TO THE JUNIOR 

4060
02:56:28,797 --> 02:56:30,265
INVESTIGATORS WHO PRESENTED THE 

4061
02:56:30,265 --> 02:56:38,006
AWARD AND TO KARLA AND PATTERSON

4062
02:56:38,006 --> 02:56:39,874
WHO WON THAT CONTEST BUT THEY'RE

4063
02:56:39,874 --> 02:56:42,010
ALL WINNERS IN MY BOOK.  I JUST 

4064
02:56:42,010 --> 02:56:44,179
WANTED TO MENTION A COUPLE OF 

4065
02:56:44,179 --> 02:56:47,048
THINGS IN CLOSING.  THE PAIN 

4066
02:56:47,048 --> 02:56:52,921
CONSORTIUM HAS BEEN BRINGING 

4067
02:56:52,921 --> 02:56:54,956
TOGETHER THE MULTIPLE WORK WHO 

4068
02:56:54,956 --> 02:56:56,725
ALL HAVE PORTFOLIOS IN PAIN, 

4069
02:56:56,725 --> 02:56:58,326
BRINGING THEM TOGETHER, 

4070
02:56:58,326 --> 02:56:58,927
COORDINATING THEIR ACTIVITIES 

4071
02:56:58,927 --> 02:57:00,161
AND IT'S REALLY THAT WORK THAT 

4072
02:57:00,161 --> 02:57:03,131
WENT ON OVER THE YEARS, 

4073
02:57:03,131 --> 02:57:04,232
DEVELOPING RELATIONSHIPS THAT I 

4074
02:57:04,232 --> 02:57:07,135
THINK ALLOWED THE HEAL 

4075
02:57:07,135 --> 02:57:11,206
INITIATIVE TO BE AS SUCCESSFUL 

4076
02:57:11,206 --> 02:57:14,109
AS IT HAS TO HELP END ADDICTION.

4077
02:57:14,109 --> 02:57:16,344
WAS SET UP BY DR. COLLINS, IT'S 

4078
02:57:16,344 --> 02:57:20,615
A JOINT EFFORT OF MULTIPLE 

4079
02:57:20,615 --> 02:57:24,786
INSTITUTES.  WITH A MAJOR FOCUS 

4080
02:57:24,786 --> 02:57:27,922
IN REDUCING SUBSTANCE USE 

4081
02:57:27,922 --> 02:57:35,130
DISORDERS LED BY NIGH TA AND 

4082
02:57:35,130 --> 02:57:39,134
REDUCED THE RISK OF ADDICTION 

4083
02:57:39,134 --> 02:57:41,136
LED BY 14 INSTITUTES AND 

4084
02:57:41,136 --> 02:57:43,905
SENATORS ARE INVOLVED IN THE 

4085
02:57:43,905 --> 02:57:44,539
PAIN PROGRAM.  

4086
02:57:44,539 --> 02:57:47,041
THE THING THAT HAPPENED I THINK,

4087
02:57:47,041 --> 02:57:48,643
THE PAIN CONSORTIUM AS I 

4088
02:57:48,643 --> 02:57:50,879
MENTIONED BROUGHT THE INSTITUTES

4089
02:57:50,879 --> 02:57:51,980
TOGETHER, THE HEAL INITIATIVE 

4090
02:57:51,980 --> 02:57:54,516
BECAUSE IT CAME WITH FUNDING, 

4091
02:57:54,516 --> 02:58:01,856
REALLY ALLOWED THE GROUP IN THE 

4092
02:58:01,856 --> 02:58:03,324
PAIN CONSORTIUM TO HAVE GROUPS 

4093
02:58:03,324 --> 02:58:04,359
THEY NEVER COULD DO PREVIOUSLY. 

4094
02:58:04,359 --> 02:58:06,327
THESE ARE ALL FOCUSED ON 

4095
02:58:06,327 --> 02:58:08,630
IMPROVING THE MANAGEMENT OF PAIN

4096
02:58:08,630 --> 02:58:10,298
AND DECREASING THE RISK OF 

4097
02:58:10,298 --> 02:58:12,567
ADDICTION.  DEVELOPING NON 

4098
02:58:12,567 --> 02:58:16,671
ADDICTIVE MEDICATIONS AND TO DO 

4099
02:58:16,671 --> 02:58:19,874
THE CROSSCUTTING PROJECTS THAT 

4100
02:58:19,874 --> 02:58:21,442
ARE INVOLVED AND THAT CUT ACROSS

4101
02:58:21,442 --> 02:58:23,711
ALL THE PORTFOLIOS THAT NO ONE 

4102
02:58:23,711 --> 02:58:26,981
INSTITUTE COULD DO BY 

4103
02:58:26,981 --> 02:58:28,116
THEMSELVES.  SOME INTERESTING 

4104
02:58:28,116 --> 02:58:30,185
EXAMPLES ARE THINGS LIKE WE 

4105
02:58:30,185 --> 02:58:32,954
HEARD TODAY ABOUT GETTING PEOPLE

4106
02:58:32,954 --> 02:58:35,723
WITH LIVED EXPERIENCE IN PAIN TO

4107
02:58:35,723 --> 02:58:38,259
COME TOGETHER TO GIVE INPUT TO 

4108
02:58:38,259 --> 02:58:40,328
THE RESEARCHERS, TO THE 

4109
02:58:40,328 --> 02:58:43,131
LEADERSHIP HERE AT NIH AND ALSO 

4110
02:58:43,131 --> 02:58:45,233
TO INCORPORATE THEM INTO THE 

4111
02:58:45,233 --> 02:58:47,135
LEADERSHIP THEMSELVES.  WE ALSO 

4112
02:58:47,135 --> 02:58:51,139
HAVE MAJOR PROGRAMS IN TRAINING 

4113
02:58:51,139 --> 02:58:55,143
IN DEVELOPING PAIN RESEARCHES 

4114
02:58:55,143 --> 02:58:57,579
FOR THE FUTURE AND WE HAVE 

4115
02:58:57,579 --> 02:58:59,781
PROGRAMS ONGOING BUILDING A DATA

4116
02:58:59,781 --> 02:59:02,183
INFRASTRUCTURE FOR PAIN 

4117
02:59:02,183 --> 02:59:04,319
RESEARCH.  SO REALLY I THINK A 

4118
02:59:04,319 --> 02:59:08,056
VERY IMPACTFUL PROGRAM FOR PAIN 

4119
02:59:08,056 --> 02:59:12,894
ACROSS THE COUNTRY.  THIS YEAR'S

4120
02:59:12,894 --> 02:59:15,163
MEETING WAS REALLY POIGNANT IN 

4121
02:59:15,163 --> 02:59:19,100
TERMS OF POINTING OUT THE 

4122
02:59:19,100 --> 02:59:23,271
COMPLEXITY OF PAIN.  WE HEARD 

4123
02:59:23,271 --> 02:59:25,740
ABOUT EXPERIMENTS DONE IN 

4124
02:59:25,740 --> 02:59:28,076
ANIMALS LOOKING AT SEX 

4125
02:59:28,076 --> 02:59:30,311
DIFFERENCES BUT WE ALSO HEARD 

4126
02:59:30,311 --> 02:59:32,080
THAT IT'S REALLY THE PAIN 

4127
02:59:32,080 --> 02:59:34,315
EXPERIENCE INFLUENCED BY SO MANY

4128
02:59:34,315 --> 02:59:38,887
THINGS IN A PERSON'S IDENTITY IN

4129
02:59:38,887 --> 02:59:42,290
THEIR SOCIAL CONTEXT, I THINK 

4130
02:59:42,290 --> 02:59:48,796
WE -- THE STORIES ABOUT THE 

4131
02:59:48,796 --> 02:59:51,132
REFUGEE CHILDREN, FOR INSTANCE, 

4132
02:59:51,132 --> 02:59:54,869
CAN ONLY IMAGINE HOW THEIR PAPER

4133
02:59:54,869 --> 03:00:00,575
EXPERIENCES INFLUENCED BY THEIR 

4134
03:00:00,575 --> 03:00:01,743
CONTEXT.  BUT I THINK THAT 

4135
03:00:01,743 --> 03:00:05,313
HAPPENS TO ALL OF US.  OUR PAIN 

4136
03:00:05,313 --> 03:00:06,714
EXPERIENCE IS OUR INTERWOVEN 

4137
03:00:06,714 --> 03:00:09,250
INTO WHO WE ARE AND SO TRYING TO

4138
03:00:09,250 --> 03:00:11,319
DEVELOP BETTER THERAPIES, BETTER

4139
03:00:11,319 --> 03:00:13,888
WAYS OF MANAGING PAIN, I THINK 

4140
03:00:13,888 --> 03:00:17,125
ALL THAT HAS TO BE TAKEN INTO 

4141
03:00:17,125 --> 03:00:19,160
CONTEXT.  WE HAVE TO KIND OF 

4142
03:00:19,160 --> 03:00:21,296
EXPLORE THE SEX DIFFERENCES THAT

4143
03:00:21,296 --> 03:00:23,598
WE CAN IN THE ANIMALS AND 

4144
03:00:23,598 --> 03:00:24,165
CERTAINLY WE'RE GOING FIND 

4145
03:00:24,165 --> 03:00:25,566
THINGS AND HOPEFULLY SOME OF 

4146
03:00:25,566 --> 03:00:27,135
THOSE ARE GOING TO BE ACTIONABLE

4147
03:00:27,135 --> 03:00:29,804
IN TERMS OF DEVELOPING BETTER 

4148
03:00:29,804 --> 03:00:34,309
MEDICATIONS OR BETTER WAYS OF 

4149
03:00:34,309 --> 03:00:36,077
MODULATING PAIN SYSTEMS.  BUT 

4150
03:00:36,077 --> 03:00:38,680
ALSO THE NONPHARMACOLOGICAL 

4151
03:00:38,680 --> 03:00:39,981
MANAGEMENT OF PAIN AS WE HEARD 

4152
03:00:39,981 --> 03:00:43,117
PARTICULARLY IN THE SESSIONS 

4153
03:00:43,117 --> 03:00:46,321
TODAY NEED TO TAKE INTO 

4154
03:00:46,321 --> 03:00:48,489
CONSIDERATION THE CONTEXT IN 

4155
03:00:48,489 --> 03:00:52,327
WHICH A PERSON'S COMING TO YOU 

4156
03:00:52,327 --> 03:00:55,163
WITH THEIR INDIVIDUAL PAIN 

4157
03:00:55,163 --> 03:00:59,167
EXPERIENCE AND I THINK I WOULD 

4158
03:00:59,167 --> 03:01:01,836
LIKE TO MAKE A PLEA TO TRY TO 

4159
03:01:01,836 --> 03:01:03,905
UNDERSTAND WHAT OUTCOMES ARE THE

4160
03:01:03,905 --> 03:01:07,809
BEST ONES TO MEASURE?  TAKING 

4161
03:01:07,809 --> 03:01:09,410
IN, WHAT WE HEARD TODAY WOULD 

4162
03:01:09,410 --> 03:01:11,512
CERTAINLY BE SO IMPORTANT IF WE 

4163
03:01:11,512 --> 03:01:13,648
HAD SOME MEASURES OF FUNCTION, 

4164
03:01:13,648 --> 03:01:15,383
OF QUALITY OF LIFE, BECAUSE 

4165
03:01:15,383 --> 03:01:17,518
THAT'S ACTUALLY WHAT WE'RE GOING

4166
03:01:17,518 --> 03:01:19,253
TO BE TRYING TO MOVE AND IMPROVE

4167
03:01:19,253 --> 03:01:21,656
ON PARTICULARLY IN PEOPLE WHO 

4168
03:01:21,656 --> 03:01:23,157
HAVE PAIN THAT WE CAN'T MAKE GO 

4169
03:01:23,157 --> 03:01:26,160
AWAY.  SO IN TERMS OF MANAGING 

4170
03:01:26,160 --> 03:01:29,430
THEIR PAIN EITHER WITH MEDICINES

4171
03:01:29,430 --> 03:01:31,766
OR NOT IT'S GETTING PEOPLE TO 

4172
03:01:31,766 --> 03:01:33,368
THEIR BEST QUALITY OF LIFE IS 

4173
03:01:33,368 --> 03:01:35,837
WHAT WE SHOULD BE THINKING ABOUT

4174
03:01:35,837 --> 03:01:38,873
DOING.  THE FIELD ALSO SUFFERS 

4175
03:01:38,873 --> 03:01:40,308
FROM THE INABILITY TO ACTUALLY 

4176
03:01:40,308 --> 03:01:42,877
DOSE PAIN.  WE DON'T HAVE THE 

4177
03:01:42,877 --> 03:01:45,613
PAIN O METER TO BE ABLE TO 

4178
03:01:45,613 --> 03:01:48,282
NORMALIZE THE SUBJECTS THAT COME

4179
03:01:48,282 --> 03:01:51,152
IN IN TERMS OF THEIR DEGREE OF 

4180
03:01:51,152 --> 03:01:51,519
PAIN. 

4181
03:01:51,519 --> 03:01:54,222
PERHAPS HOWEVER WE CAN DO BETTER

4182
03:01:54,222 --> 03:01:57,125
IN THAT SPACE.  LIKE BEING A 

4183
03:01:57,125 --> 03:01:59,660
LITTLE BIT MORE CLEVER.  IN 

4184
03:01:59,660 --> 03:02:01,329
UNDERSTANDING HOW TO MAKE THOSE 

4185
03:02:01,329 --> 03:02:04,032
ASSESSMENTS.  PARTICULARLY IF WE

4186
03:02:04,032 --> 03:02:07,168
CAN CORRELATE THEM WITH QUALITY 

4187
03:02:07,168 --> 03:02:10,304
OF LIFE OR FUNCTION.  SO I THINK

4188
03:02:10,304 --> 03:02:14,208
THERE'S A GREAT DEAL TO DO.  I 

4189
03:02:14,208 --> 03:02:16,310
THINK ALL HAVE A LOT TO LEARN 

4190
03:02:16,310 --> 03:02:19,914
AND WE LEARNED A LOT FROM THE 

4191
03:02:19,914 --> 03:02:22,283
DIFFERENT FOLKS TODAY AND 

4192
03:02:22,283 --> 03:02:23,151
YESTERDAY.  AND IN TERMS OF 

4193
03:02:23,151 --> 03:02:26,988
THAT, I WANTED TO MENTION THAT 

4194
03:02:26,988 --> 03:02:30,925
THE HEAL INITIATIVE ON THE PAIN 

4195
03:02:30,925 --> 03:02:35,129
SIDE IS GOING TO INSTITUTE A 

4196
03:02:35,129 --> 03:02:36,798
VERY INTENSIVE STRATEGIC 

4197
03:02:36,798 --> 03:02:38,800
PLANNING PROCESS, SO PROBABLY GO

4198
03:02:38,800 --> 03:02:42,537
OVER THE NEXT YEAR.  AND IT'S TO

4199
03:02:42,537 --> 03:02:44,338
INFORM THE WORK OF THE HEAL 

4200
03:02:44,338 --> 03:02:45,940
INITIATIVE WHICH IS NOT ALL OF 

4201
03:02:45,940 --> 03:02:48,409
THE PAIN AT NIH BUT IT IS THIS 

4202
03:02:48,409 --> 03:02:52,313
KIND OF CENTRAL FOCUS NOW AS I 

4203
03:02:52,313 --> 03:03:02,857
MENTIONED BEFORE.  AND SO OVER 

4204
03:03:04,792 --> 03:03:06,627
TIME THERE'LL BE GROUPS, 

4205
03:03:06,627 --> 03:03:08,629
MULTIPLE WORKSHOPS, GETTING 

4206
03:03:08,629 --> 03:03:10,598
INPUT FROM PEOPLE WITH LIVED 

4207
03:03:10,598 --> 03:03:12,567
EXPERIENCE, FROM PEOPLE IN THE 

4208
03:03:12,567 --> 03:03:14,836
PAIN AND CANCER FIELD, REALLY 

4209
03:03:14,836 --> 03:03:17,271
TRYING TO REACH OUT AND 

4210
03:03:17,271 --> 03:03:19,574
UNDERSTAND HOW -- WHAT IS THE 

4211
03:03:19,574 --> 03:03:20,741
ROADMAP FOR THE HEAL INITIATIVE 

4212
03:03:20,741 --> 03:03:25,213
MOVING FORWARD.  AS MENTIONED.  

4213
03:03:25,213 --> 03:03:26,247
IT DOESN'T -- THE HEAL 

4214
03:03:26,247 --> 03:03:28,816
INITIATIVE DOESN'T SUBSTITUTE 

4215
03:03:28,816 --> 03:03:30,885
FOR WHAT ALL THE INSTITUTES DO 

4216
03:03:30,885 --> 03:03:32,553
FOR PAIN BUT IT IS A CONVENING 

4217
03:03:32,553 --> 03:03:35,022
PROGRAM THAT BRINGS THEM 

4218
03:03:35,022 --> 03:03:37,325
TOGETHER TO ACHIEVE THIS GOAL OF

4219
03:03:37,325 --> 03:03:39,360
GETTING BETTER PAIN MANAGEMENT, 

4220
03:03:39,360 --> 03:03:41,262
BETTER NON ADDICTIVE THERAPIES 

4221
03:03:41,262 --> 03:03:44,232
AND DECREASING THE RISK OF 

4222
03:03:44,232 --> 03:03:45,266
ADDICTION.  SO LOOK FORWARD TO 

4223
03:03:45,266 --> 03:03:48,169
THAT, LOOK FORWARD TO YOUR 

4224
03:03:48,169 --> 03:03:50,037
INPUT.  THERE'LL BE LOTS OF 

4225
03:03:50,037 --> 03:03:51,239
OPPORTUNITIES OVER THE LAST 

4226
03:03:51,239 --> 03:03:52,840
YEAR.  RIGHT NOW WE'RE JUST 

4227
03:03:52,840 --> 03:03:55,076
DEVELOPING THE COMMITTEE, WE'LL 

4228
03:03:55,076 --> 03:03:57,345
PROBABLY BREAK UP INTO 

4229
03:03:57,345 --> 03:03:58,312
SUBCOMMITTEES.  WORKSHOPS WILL 

4230
03:03:58,312 --> 03:04:00,815
BE HELD ON DIFFERENT TOPICS.  

4231
03:04:00,815 --> 03:04:04,252
AND THEN FINALLY, A ROADMAP WILL

4232
03:04:04,252 --> 03:04:05,686
BE BROUGHT BACK TO THE DIFFERENT

4233
03:04:05,686 --> 03:04:08,956
COUNCILS PARTICULARLY FOR US, 

4234
03:04:08,956 --> 03:04:11,692
THE NIDS COUNCIL FOR APPROVAL.  

4235
03:04:11,692 --> 03:04:13,528
AND THIS WILL THEN INFORM THE 

4236
03:04:13,528 --> 03:04:16,164
HEAL INITIATIVE GOING FORWARD IN

4237
03:04:16,164 --> 03:04:20,868
THE NEXT HOPEFULLY FIVE TO TEN 

4238
03:04:20,868 --> 03:04:24,138
YEARS.  SO WITH THAT I JUST 

4239
03:04:24,138 --> 03:04:25,206
WANTED TO THANK EVERYONE ONCE 

4240
03:04:25,206 --> 03:04:26,707
AGAIN AND CLOSE THE MEETING.  I 

4241
03:04:26,707 --> 03:04:28,876
THINK EVERYONE LEARNED A LOT AND

4242
03:04:28,876 --> 03:04:31,145
LOOK FORWARD TO WORKING WITH YOU

4243
03:04:31,145 --> 03:04:41,689
AGAIN IN THE FUTURE.  TAKE CARE.