Morning, everyone. Can you guys hear me? All right. So this is a big morning. One I've been looking forward to since I was in the second row eager to hear these two guys talk. Today I have the pleasure of introducing my two senior fellows, Patrick Della Plain, who is going to start off. I'll introduce both of them at the start here. So Patrick attended the University of Nevada Reno for undergrad, measured in biochemistry and psychology and then went to the University of Nevada school of medicine for his MD. He did residency at California, University of California Irvine. And during residency, he also, as you all well know, completed a surgical critical care fellowship here. And then a research fellowship at Children's Hospital Los Angeles. During all of his years of research time, he made a lot of contributions in the areas of particularly trauma, CDH, ECMO, as well as infectious disease, which is a continued interest of his, at least through conversations in the fellow's office. After graduation, he's going to be going to Houston to start his career at Texas Children's Hospital, with a particular focus in colorectal surgery. His co-fellow, RN Medansee, he obtained the first of his many degrees at Harvard and undergrad, during in history and literature, and then got his MD from University of Michigan. Then he came back to Boston, completed his training at Brigham and did also a similar way of critical care fellowship here, as well as a research fellowship, and earned a lot of extra letters after his name during throughout that process, including his MPH, his SM, which is Harvard for a Master's degree in science and bio stats, which is also something we all have learned a lot from him then. Then his PhD also from Harvard, who are the focus on epidemiology. He has also been a prolific researcher. The most, probably have an outdated version of the CV, because there was probably a few days old, so might not catch all of his papers. Many articles, presentations, which has shown his position and also has maintained his position as a visiting scientist at Harvard School of Public Health, which is impressive given by staying busy in his surgical fellowship here. After graduation, he's going to be staying on here, as we all know, particularly working in surgical oncology as well as many other areas. On a personal and level from my perspective, the two of them have been awesome senior fellows to learn from. It's particularly honored to be here to speak to them and to present them and speak on their behalf. They both have played a really crucial role from day one, really getting me through my first year. I owe a lot to both of you guys. At first glance, they look, they seem like they might be the same, they even kind of look the same. They're both excellent clinicians, excellent surgeons, but on a personal level, as we all know, they're extremely different. Arrin is quite low key as an understated approach, and it really helped me early on in fellowship, when I felt over my head fairly regularly, he would provide spoken runs on spoken reassurance that things were going to be fine, even though sometimes they were not going to be fine. Patrick has a slightly different approach, a little more fast-paced, energetic, but Patrick is the one that sort of keeps you on task and makes sure that you're really not cut in corners and that you have a good, helps me think through a lot of the challenging problems and make sure we're thinking through things logically and with a good evidence base. So I'm really eager to hear both of them providing them sure, continued different perspectives on their last two years of fellowship. So that's for the due, Patrick. Thanks. Okay. Good morning, everyone. I'm not 100% sure what the topic of this is supposed to be, because last year, WUZ was just this very thoughtful hit everyone individually about a very personal experience, and that's not what this is going to be about. So I'm going to just try and figure it out as we go, but I'm pretty sure I'm supposed to justify the time that I've spent here, both to my family and to you. So I'll try and do that and explain what exactly I've been up to. So to start off, let's just say that this isn't Tina, my first rodeo. We have a somewhat atypical marriage structure. We spent 11 months together and missed our first anniversary so that I could come here and do the ICU fellowship. So one year together, one year apart, then we spent two years together, and this is the end of two years apart. So at least for the next three years, we're planning to spend that time together. But honestly, this was way easier because last time I was here was 2019, 2020. And so the COVID pandemic kind of got in the way of our successful long distance relationship. So I wanted to share kind of a breakdown of cases that I had over the last few years. And I was happy to see that my top three are really the three things that I'm most passionate about, anorectal malformations, EA's and CBL's. The next kind of runner up group is exactly what you'd expect from a well-rounded fellowship. I have some gastroestemies, appendicitis, ECMO cannulations, tracheopathies, exactly what you'd expect to see among any kind of graduating fellow. And then just in case people are wondering, I was actually doing other things too. I did some CDHs. I have some oncology cases, some collodocal stuff, and biliratrija, fatoblastoma, as wellms, tumors, and valesial gastroskises. And I am the winner in terms of three fellows in terms of most liver transplants, 16. The next thing that I did a breakdown on is when you break down my case volume by attending, there's not really any pattern here that's recognizable. So I think you can just kind of glance over it, but I did do a quarter of my cases in fellowship with Dr. Dickey. Almost twice as many as anybody else, followed by doctors in the day. And then if you add Dr. Nondevada in there, it's almost like a third of my cases with Dr. Nondevada and Dr. Dickey. So speaking of my very first case here was also with Dr. Dickey. I actually don't even think that I had a badge. I just showed up, nothing was done, and it was like, oh, this will be a great case for you. Let's get you in and you can do a laparoscopic nissen, which is great because as far as I can tell, I think there must have been a moratorium on baby nissen after this case because I have not seen another one outside of the EA room since here. So I was good that I got that experience early on. My second day of fellowship, I scrubbed a rope, a lobe with Dr. Lilla High and his protege Dr. Demiri. They do a lot of, they do everything together. So it's not surprising that they're here together in this also. So I would go on to learn a lot of pulmonary anatomy from these two, but I think the most important thing that I learned this day is, do you see that? So my loops came with a headband to attach my light to. I wore it for this case and it continually rode up. Like it just kept going up. I never wore this again. I think that was the most important thing that I learned this case was to just attach them to your loops because this weird headband thing that it comes with is horrible for the OR. So it went to the trash after that. Okay. So I want to transition to something a little bit more serious now. When I worked in Dr. Ford's lab, he had these sains that we were supposed to kind of have a buy-by and they're actually adopted from an autobiography by Dr. Arnold Beckman. Besides Dr. Jack, Jacksafe, does anyone who know who Dr. Beckman is? Does Dr. Jacksa know who Dr. Beckman? No. Oh. So he is actually one of the probably the foremost chemists of the 19th century or the 20th century. The pH meter and the spectrophotometer. And so these sains came from an autobiography that Dr. Ford had read. And his first rule was that there's no satisfactory substitute for excellence. And at the time when I got the advice, it was in the setting of being in the lab. But when I came here, it really took on a different meaning, I think. And I think that the one that you hear around here, which I believe is a saying from Dr. Feins, is sometimes you just have to be good. And that, so this isn't O-shoot kind of x-ray. We knew this baby was going to be small. We knew that they were going to have CDH. We knew that they were going to have a soft agilatresia. Those were all things that we had kind of prepared for prenatally. But we were hoping with the microgastrian polyhydramios that it wasn't going to be at types. And that we would maybe have some time to not have to intervene on them right away. So there was a couple of surprises. One is air in the bowel, so type C is op agilatresia. And you can't pass the NG2. Number two, there are 1.9 kilos. And number three, they have imperfect anus. So it really created an urgency to get things done. And step one was we needed to likeate the fistula. And that all went tolerably well, like very stressful. And we're getting ready to transport the baby back to the MSICU and then have a pulmonary hypertensive crisis. And we're having to make the decision to basically crash a 1.9 kilo baby onto everyone. And we did get out of the operating room. We got on to repair the CDH a few days later. But I think this is one of those very humbling moments in fellowship. I realized that someday it was going to be me that was going to have to get someone through getting a 1.9 kilo baby, emergently onto ECMO. And at the end of an already taxing night, like at 3 o'clock in the morning. And I really wasn't up to the task at that time. You know, even though I had been here, even though I was helped to get you guided through it. But I think that it really showed me that like you just have to be good enough to do these things. And I hope that now I would be good enough to do this. So aren't and I always found time to agree on things and work on projects together. And one thing that we were definitely all in on Dooderm House. When we heard about Dooderm House, we actually like every single patient that had even the smallest and valescent we were there, night or day. You can't hear the audio here, but you can probably picture it. And the bickering here is actually like not as bad as it normally is. But we, this was one of our earliest iterations of Dooderm House. And this was actually one of our earliest patients. I'd like to, from this point forward, take full credit for these binder clips. I think it's the Patrick addition to this strategy. But we were able to get several babies fully closed, short period of time with the Dooderm House. I don't think that we fully understand the science behind the binder clip. But I think it's like a critical part of actually being able to facilitate this technique. So I hope that it doesn't go away. But then I got to wondering, is there any significant limitation to Dooderm? Is there anything that we can't do with it? And I really didn't think that there was anything that we couldn't do with it. And so I'd like to go through all of the different iterations that we tried. So we started off with something simple, then went to kind of like advanced diaper, then to diaper with a thin, then to more like a sumo type diaper, then diaper with an ostomy bag. But at the end of it, we actually built abdominal domain. And we were able to do this OAS case, like both the early stages, stage one and stage two with abdominal closure by increasing the intra-addominal domain. And so it actually did work despite having to re-vise it kind of on a daily basis. This unfortunately was not fixable by Dooderm. But I want to show just kind of some of the complexity of what we do. I'm not sure that anyone still really knows what the nature of this defect is. And or what to do with a completely formed anus that's off midline. So this was, but like normal sphincter complex, everything else, it's just off midline. There's no reason to reposition it necessarily because the sphincter is just in the wrong place. And kind of due to some persistence between Dr. Wiley and Dr. Dickie, this patient was recently back for to get a GJ tube and abdominal closure and really went from this to this and over the course of about two years, the two years I was in fellowship. The final thing is, or the final thing talking about abdominal wall defects is I still can't believe that this works. Like it's one of those things that you just have to see it to believe it. You put all this stuff back in. Then you have this little ancho v of a desiccated cord that you just throw on top. And this baby went on to feed normally to we didn't have to do any other operations. We just put it back in and put the cord on top and it works. I also weirdly in fellowship had three kids with three different people come in with non specific obstructive symptoms who are subsequently discovered intraoperatively. I have some kind of congenital mesenteric defects. So this first case that I did with doctors in days, and you can actually see, this is a parodied anal hernia. You can actually see the bowel in this hernia defect that is up in the right upper quadrant. This is another one that I did with Dr. Buckmiller. And then finally, this is a retrocholic behind the secum defect that I did with Dr. Kim. So three congenital mesenteric defects. And then Arna, I did have a chance to do a few cases together. I think it went as well as you would probably expect it to go. So here we are doing an abdominal closure after doing a nervous house. In this case, I took on the role of nagging and he took on the role of primary surgeon. And FROC was there to laugh at us. And I think FROC has been a good portion this year just laughing at me in general. And I think this was like no exception. This case, we decided to flip roles. And so this time, I took on the role of operating surgeon and Arna took on the role of gently nagging me. And so this is a congenital diaphragmatic hernia that we did together. Where I think about half the U-stitches are on one side and half are on the other side because we kept arguing with each other about which way they were supposed to go. But this maybe actually did just fine. And again, there's FROC making fun of us. Does anyone recognize this case? Oh yeah, we got to get a gastrophicus in here again. I told you I've milked this. This is like third or fourth time I've presented this. I already have the slides made so I just threw them in here because I've needed some filler. But essentially this is a case of a kid who was congenitaly missing their esophagus. And the stomach was literally attached to the pharynx in the neck. I'm not going to show too many because this is not jokingly. This is the third or fourth time I've shown these exact same things. But they're good. They're producing everything into the abdomen through the diaphragmatic defect. And this is us celebrating that everything is actually still profused. Well, there we go. Including this plane. So I will get everything out of the chest. One of the other things that you learn in pediatric surgery fellowship is that you need to constantly be vigilant for kind of subtle signs that something's wrong or for subtle exam findings that will help lead you to a diagnosis. And because sometimes babies can be subtle and sometimes when they show up to the emergency room, you don't necessarily know what's going on or what the diagnosis is. And so I want to see if you guys will notice this kind of subtle finding. It was very astute of all the caregivers to notice that there was something that was a miss. But it is subtle. Babies, they say babies whisper. They don't always tell you what's going on. But this was a persistent phalamasenteric duct, which was a fun, quick fix that I did with Dr. Nondevada. So somewhere along the way, Dr. Dickie and I started recording all of our cases together. And it culminated in submitting a video to IPAG that was accepted. And I'm just going to skim through this just because it's like five minutes long and we don't have the much time. But it's a nice little demonstration of how Dr. Dickie does lapisistic cloacas or UG separations. And it's been fun because to go back and also review how I did these cases as well. Let me ensure this in a different way because I think I'm having trouble with it. We have to do that. Rest is a chalk talk. It looks like. All right, I want to give him to your time too much. So after doing this, it kind of, I got the idea of why couldn't we do this for more of the stuff that we've done together. That was too big. Anyways, you get the picture. We made some videos together. Let me see if I did have some like, I wonder if I can actually get beyond the videos. So these are what we have so far. So all of these hopefully will be ready for anyone to kind of review and look at. And this is just kind of how we do our color rectal experience here. And I'm hoping to make a couple more with videos that I have. The other thing that we've kind of decided to use with them is. We have, I'm joining Dr. Dickie for a mission trip in Vietnam in the fall and it will be helpful to have actual videos. Because one of the things that they kind of identified is that the English portion may be difficult to kind of convey. And so if we can have these videos and get them transcribed into Vietnamese, then they'll, it may be easier to kind of teach some of the technique stuff that we're trying to do. So I'm, we're working on getting these transcribed into Vietnamese also so that we'll have that available. Okay. Here's another, does anyone know what this screenshot is from? So this screenshot is from our recruitment video on the website. And this is me at the end of being here probably 24 hours had just had a like horrible ECPR case. And I came to find someone to decompress to. So I found Arn and Wu in the video cameras for the people that were here recording the. So this is my theory I do decompression in the middle of fellowship that is forever memorialized in our recruitment issue. It's just a short segment and unless you knew the circumstances of it, I'm not sure that you've noticed, but I, I definitely remember it. One thing that my wife and I both share is we're both horrible remembering to take pictures and that's like has been true for the last two years. These are all of the pictures that I could find of people spending time with people over the last two years like, like, this is it. This is my entire social memory of the last two years. But I still do not have a single good picture of me and Dr. Dickey. This is the best picture of me and Dr. Nandavada. I'm actually here, but not in this picture. I don't know where I was there. This is the one of two or three times that Arn and I hung out outside of fellowship. We covered so that we could go to a hockey game. It was a shark sprue and game and he was gracious enough to sit next to me in my shark's gear and in the garden. I also, so I got in the habit last year of I always wanted to thank Arn and Wu for covering for me when I was like spending time with my wife or doing anything. I had it of taking a selfie to send to Arn and Wu just to thank them for covering for me. And so these are all the photos that I took over the time that Arn and Wu and Brian covered for me over the last two years so I could spend time with my wife. Bringing it back, so the fifth rule in the Beckman Ford one was to never take yourself too seriously. And I think that's one thing that I can definitely say that I do well. I don't know if I'm good, but I definitely don't take myself too seriously. And thankfully no one else takes me too seriously either. So my next steps are I am going to Texas Children's in the fall. And there's not like a specific name for this specialty that I'm going to be doing, but it's going to be specifically a non-surrosalized portions of the interact is going to be the main thing that I'm going to be doing there. So thank you and all looks like I'm just about around time. Sometimes he has trouble with technology so I'll just get this uploaded. It's just on the screen. We're going to bring out the chocolate. Thanks everyone for coming. It's amazing to be here at the end of the year. Thank you. She's responsible for all my good quality. So, yeah, what have I been doing for the last two years, basically. So similarly I wanted to share where I came from, my history and then how far I've come. I went along distance from residency from the Brigham across the street across the bridge over here to Children's Hospital. And so it makes you wonder, well, why the rodeo theme for our change party. And so we're both cobweights and we're always, you know, wearing our boots and I go into the saloon. But in fact, both of us are from the Southwest and so I'm from the beautiful Sonoran Desert and two center Arizona. And the desert you learn to be very resourceful. And so I think that's something that. I've tried to bring to fellowship, but we've also had to become resourceful at home. And so with limited resources with my wife being a trauma surgeon, being frequently on call and just making everything work for the help from my mom, her really doing the lion's share of everything at home. And so, but this picture is our son Emory and he has also adopted this dual personality of the Boston Fire Department had these put over a cowboy hat. And then he just on his own did this last week and so I thought that what's up fitting for that for this slide. So. Well, I've not been home this is what I've been doing. This is a summary of who I've worked with. And it's been really fairly even across the board. I've had the privilege and pleasure of working with all the surgeons in our department. And I'm also a host of all doctors and they asked Dr. Dickey, Dr. Kim, Dr. while. And so, but thanks everyone for for teaching me and working with me and continuing to work with me. So the ACGME categories for fellowship are are lumped into seven categories and the cases that I didn't know I spit in these categories and they weren't always. For the expected categories and so I'm also a thoracic, but I just wanted to share some of my experiences and most memorable cases from from each of these categories. So. Starting with the soft, you know, Tricia team. We just have an incredible thoracic experience here. And some of my most memorable and favorite cases. In particular, all the redo and soft, you know, Tricia cases, baby type sees that. And I always worried about doing those strangely enough, like as I got months and months in fellowship and then you realize it is as Ben and broken small say so much easier than than the cases that they do routinely the redo, redo chest. So and then I'm also one of my favorite case the anterior tracheopaxi and they were the best he would just lovely and. This was my first type to you with some all that I still remember and thank for for doing with me and a beautiful and asthmosis I love these pictures this five pictures at the end of the case it's like you made it to the finish line you achieved your goal like we always get that one shot with with things. Looking nice. And then later in the year. Actually earlier in the year attraction system for for one process, minimally and basically with the E 18. And just an amazing thing when you're first thinking about it to put these babies on traction and just to be able to even do a minimally and basically watch the suffrage girl was just incredible. And so the best things were case that I learned a lot from in terms of minimally invasive approach in the chest from Dr. DeMerry Dr. Lilahai and Dr. Buckfeller picture of Dr. Buckfeller and I. And so just the precision with poor placement the precision with movement the thoughtfulness about the approach. I really learned a lot from from all due in particular with these cases and the repetition and doing them lucky to be able to participate in that. And then chest wall deformities was a real pleasure as well. So not only did we do a lot of minimally invasive practice and again with Dr. Lilahai and Dr. DeMerry and really paying attention to free operative planning was what I took most from this. And we'll see on the next slide. A defect was a minimally invasive. Nuts procedure. We've now gone from one bar to two bar to three bars. And at times. And so this has been real joy to participate in a record of participating in these cases in the future. This was a very memorable case practice archid bottom, which is a different type of defect that can't be fixed for those kind of bars and. And so we can see the end result on the right and and a real cosmetic win for this young man, I think. And so and we went from Dr. Schamberger as well, which was. Proble to be able to operate with him as well. And so, I think that's not the only thing that I've learned so much from Dr. Dickie and Dr. Zleska, so Dr. DeMerry about really the critical care management and we around nightly with the CDH team. And we were able to do it like, in a minute, with them and the critical care team and it's just the everything matters, every move matters. And I and these, these taking care of these units is really hard and really taxing emotionally and I really appreciated. Especially Dr. Zleska's. For helping me with that part of it as well. So I think about Dr. Schamberger, Dr. Zleska, Dr. Schamberger, Dr. Woldent, Dr. Woldent, Dr. Schamberger. And so I've been able to work with Dr. Schamberger and Dr. Woldent, Dr. Schamberger, Dr. Schamberger, Dr. Schamberger, Dr. Schamberger, Dr. Woldent. I started with menial tumors. This is a recent case of cystic trauma. It was towards the end of the year. And this was a case where I really felt like, things were coming together. And I'm really understanding how did these operations and this was a very interesting case that I wanted to share. Overing tumors, this was an interesting one that I talked at Nazim with Dr. Wolland, Dr. Walden about, even as a resident. I'm thinking about these tumors and how to manage them, how to free up, or do the appropriate thing based on free up planning. And so we had several of these operations that we had to consider what the right thing to do was and I execute that plan. We did three metabolically active tumors. Pragging, we almost feel almost like I'm a very memorable movie in drop-to-management. This is one where we're fortunate to have Dr. Holzman, who will come and collected the entire time for a laparoscopic resection of a metabolic active paragangium. And then finally, some more unusual things. I did a resection, inucleation of, I think that a kid mass, solitude papillary tumor with Dr. Kim, and just a really fascinating case to be able to see this plan for this preoperatively and then take out this tumor. Fatico resections were a big learning point during fellowship and I really appreciate Dr. Kwanke and Dr. Kim and Dr. Lee for really taking me through these cases, being patient with me as I learned that really new part of the body, new approach and careful approach. This is on the left of the screen as an example of a patient that we did a rate haptic test for. This was a memorable patient of Dr. Kwanke who had an intrapatocleid and was in the ICU for a long time and really very sick. So she recovered and we were able to do this resection. This is a new procedure on the right. We called the shark as a procedure. Had Dr. Kim and I completed and for kind of unique reasons, the right thing to do was multiple partial epitectomies. My most memorable patient is one that I shared with Dr. DeMerry and a number of other faculty members and I really have to thank him as well as Dr. Chan and Dr. Muhammad and Dr. Mohdi for helping me manage this patient. This was just over one kilo baby, X-Premi, just a few weeks old who came with an necroticinoclitus is still in the hospital now and we did five iterations of operations for her to get her to the point that she's at now, trying to spare as much value as possible and just having these discussions, figuring out what to do, really feeling like, this was my patient and really taking ownership out of over her care was a really formative experience. I have to thank Dr. DeMerry for that for helping me through that and everyone's support because it was really a departmental patient, we had to go back to the reoperate multiple times and so I really thank everyone for doing that. We ultimately put together several segments of bowel over Brovia, those were able to be an estimate list and then she was left with 44 centimeters of bowel and hopefully more since she's still growing and she's excavated, recovering in a necute and on a reasonable amount of feeds. Domino wall team, core members, you saw earlier but I have some other ones to add, big send you patch up to each of those. So this was another one that we added to our repertoire. This was a patient of Dr. Tens in mind and this was a patient with a huge traumatic flank charnia and we pulled our faculty education conference. I talked to the Brigham faculty. I came back to the indications conference and asked for more advice and we collaborated with one of the plastic surgeons to do a really challenging repair for this young man and it's so far held but he had just shorn off of his Iliakis, the his whole flank musculature and rectus musculature and we ended up spending all day in the offering room but having a really nice result for him and he's active and I think we really helped him and helped prevent a long-term problem for him. I hope that similarly Patrick's Chipclip in the middle and this was another example of the duo dream process that you can see here and I'm just still amazed every time I look at these photos I just thinking naively, you know, how can we be able to do this and really reduce that amount of abdominal contents both there and here as examples and reduce that down to flat and then close and get this outcome in just a few days and thanks to our faculty who Patrick and I have convinced me on this charnia with us often a sod or unsuspecting sod or sal, who we've taken along. Then these weren't able to be really categorized for CBT codes accounted for fellowship but I've done seven Porto Stemic Shunts with Dr. Kim and six magic or synthetic operations with this team and these were just all day affairs that taught me a lot about the anatomy that I'm hoping to apply to my practice in terms of operating in the retroferenium during the right maneuvers to for me and then get a little bit of a room to be able to do this for rotations and getting create exposure. Can you see the magic vessel here which is an aorta area 5S to help with mediotic syndrome with the kidney and a blood flow which is a picture of us hard at work. And then this is an example of a patient who we've made a Porto Systemic Shunt to help with bleeding and we always had to be creative. A little bit with preoperative planning I think on our feet and that was something that I learned in particular from Dr. Kim and this is a patient with a left-sided IVC and so it was a very convenient target for us and we used that and had a nice result on the follow up CT. I can safely say that was the only fellow in our class who did back-to-back KSI operations in the same day. It was in October of my first year and I just couldn't imagine that this was actually happening. And so we did two operations for Bili Artesia I've done four total in fellowship and that was just an incredible experience to be able to see sort of two different versions of the same pathology and how we fix it or are evaluated in the same day. And that was an example of a Spi-Fi-A portal plate this year which is a portion not a whole lot of bile, visible and green and then this is a really nice picture that I took recently at the portal plate and so. I had done a number of other compatibility cases hepatic cysts, exigenose memorable, Dr. Quenca and I think six or seven collodocal cysts together and so these were really fun operations and Dr. Quenca told me I had a fun time in the operating room yesterday and I think that's very clear. We, these are just one after doing the first few and getting the hang of them, they're just really joy to do and wonderful times. So thanks for teaching me. And this also didn't fit into a clear category. This was a memorable case. We excised over Dr. Fishman and I and Claire Ostertag excised over 100 lesions spending 28 hours in the operating room together and that's one picture that we have. So then I mind, I thought, well how do I deal with such long cases, 28 hours in the operating room and the people who really come to mind are of our scrubs and circulators and operating room staff in particular, Oleshink Christine, a really taking care of us. You can see that Christine always ends either right instrument. We'll go get you something no matter where it is in the hospital. She does the same for my kid. She got him these, this dyno fork and dyno excavator fork. So he can have to write instruments. Yeah, he liked them so much, she got more. Just like how it goes in the eA room, if it goes well with one thing, we get more of us. We also, she implemented the Feed the Fellows program. So this is a collage of really just Christine taking care of us and we really appreciated that. Thank you. What else? The other thing was knowing that the MPs and have the impatience just walked down on the floor. Like we never had to worry about anything. I really appreciate all the communication, the care for the patients and they taught me even more than that. Tell me how to make sourdough bread. We're fly a crew, shout out to the fly a crew in the sourdough bread crew. So, but no, just knowing that everything was fine and that they'd find us a thing. That's no, it was nothing to, your mind wasn't in four places while we were operating was a huge relief. And then of course, my co-fills, when I came here, I thought, I'm gonna be offering these guys all the time. We're gonna be doing, you know, call bladders, raffes, I'm sure there'll be time to do TAK cases together when we're on the stage there. And so you saw on a picture of Patrick and I operating. It was exactly how Patrick said. The only difference was I think we didn't really trade off like the nagging and dickering part from case to case one, it was sort of just a constant thing, but the patients had great outcomes. So I think that's just the price of our perfection. But what I realized in looking at this was that these are the cases that I operated on my co-fellows. We did decide operation, neonatal bowel, re-operated neonatal bowel, giant lymphocles and then ECPRs. Just the most straightforward, random butter cases that you can do with your co-fellows. So thanks to the faculty for teaching us and letting us have those experiences. I'm feeling like we're ready for them. So then finally we get to the other category, which is kind of a hodgepodge of head and neck, undercreen, GU and interactive malformations. I won't show more videos and ARIM experiences and Patrick covered that, but I did want to thank Dr. Dickey and Dr. Nandibata for taking me through those really subtle cases. But I will mention OB experience that was part of my fellowship. I was with Dr. Kim. We were just, there was a talker who had a ruptured operatial, actrogenic injury. We're just in the operating room and I got a page and I found out that my wife was in labor, so I rushed home and we, as many of you know, we had an unplanned home delivery and thankfully everything was fine and everything is well, but still remember rushing home to the, now we have this little guy who's grown up big and is doing great. But really thanks for everyone for letting me get home to my kids, mostly Patrick and Brian and just helping out with, you know, when we have so much going on, I just couldn't have done this without you guys. First call when I went home and we delivered a memory was to Jody who's here. That's her, do I need to do anything with this little guy? I see you, you see, okay, I'm just in our room. And she reassured me and told me everything was okay and then we came out of the house. Most importantly, thanks to my family and friends for just understanding that I haven't been all that available these two years and really before that as well. But it's been a long path to training for all of us. And so thanks for understanding. My mom takes care of our kids a lot. It is a museum with them. This is my grandmother, with Emory at home in Tucson, who will be here at the Chains party this week and so on my dad. I'm gonna keep that stuff. But thank you. So our kids, they look like lovely little guys. I'm looking forward to getting to know them. They look like they're really thriving. So I spend as much time as I possibly can with them and they're really doing great. You can see this is Julian, Pick and Strawberries at Catherine Mooney's local farm and race plan baseball. And then most of all, thanks to my wife, Kristen. She's also like I said, a trauma surgeon on call all the time doing the same stuff that we I see you call back and forth meetings, everything. So despite that, she's managed to just really take care of everything at home, make sure our kids are doing great. And I really owe her a lot and I'm looking forward to sort of a more normal seeing spending time together. So thanks, Kristen. Everything, thank you everyone. Wow. Every year we do this and many of you have been here and many of us have been there. Some are gonna be. And it really does highlight for us. It's impossible in 30 minutes each to really say what you've been doing for the last two years, but you guys have done a remarkable job of giving a flavor of it. Unless you've done it and been through it's impossible to understand the experience. I hope that the two of you have thought it to be the pinnacle of your training. An honor to be able to take so many children. It's certainly been our honor to have you do it for us and with us and with all these families and our extraordinary team. We say during our interviews to try to attract next class that the fellowship is a centerpiece to our department. And I certainly believe that to be true. And I think it's self-evident that the two of you have done it with the greatest of expertise, a plumb and fun. We've all had the opportunity to appreciate the most incredible partnership of Banta. We won't ask who, well, we know who won the back end in tournament. Patrick's looking at the count. Do you have the count on your watch? And for those who don't know, Aaron may be a world class chess master, but Patrick is a world class back end champion. And we'll have more opportunity in a couple of days to hear from Brian to let us know how things really went this last couple of years. And we're looking forward to that. To the family members who are here and not here. You really can't appreciate what they have been doing for the last two years or 10, 12. But it's been extraordinary. We're so proud. I know Dr. Modi feels this way. With both of you have accomplished and what you're going to accomplish. I have heard from two of the people that Patrick will be collaborating with most closely as colleagues that text us children's, both through who happen to be close friends of mine and former research fellows of mine who are over the moon at having him join them, both in the non-sourcialized, I love the description, as well as in the care of the sick as patients, which nobody does a better. And we're thrilled that the school public health is willing to share Aaron with us to remain our faculty. I've had the pleasure of getting to meet the chair of epidemiology. Being in the room alone with the chair of epidemiology school public health and Aaron is a highly intimidating experience. I didn't understand where they were talking about. And but we're extraordinary extraordinary blessed that spend this time with us. And there's no way they're honored than having to join us. Like to say, Brian, it's all you now, but fortunately it's not. We were welcomed in the next class. Everybody will have a chance to meet our new fellows. Mostly mead. But for those who haven't done Dr. Mark Fleming is joining us. He prefers to go by Markey. And for those who haven't met this new person, Dr. Liza Lee, who will be joining us in our fellowship class. And I think Brian will agree that he couldn't have a better start to his chief here to have them as his teammates. I remember sitting in, I was way back there. I didn't have a good sitting second row and say, wow, I was like totally intimidated. I wanted to walk out. This is like 33 years ago. Exactly. And but the opportunity is extraordinary. And we have every confidence in the company of excellence. And we very much need you guys to understand what it takes to do that. And also what it takes to do what we hope to see Friday night. Because that's actually the most important part of first year fellowship is to figure out how to roast your senior. No pressure, Brian. I don't know if Dr. Moni, if you'd like to comment. Thank you. And no, I don't want to take too much more time, but you know, extraordinary two years to great surgeons, great clinicians, great people. We could not be proud of you two guys and really look forward to what I expect to be really amazing career ahead. I look forward to celebrating you guys on Friday.
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