Ep. 34 | Patrick Murrah, MD, Cardiothoracic Surgeon, SGMC Health

Transcript

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- Welcome to another episode of What Brings You in Today.

- I'm Erika Bennett.

- And I'm Taylor

- Fisher. And we just wanna thank you for tuning in and liking subscribing, sharing with your friends and family, and just taking interest to everything that we have going on here at SGMC Health.

- And if you have any questions or topics you'd like to hear more about, you can submit those at sgmc.org/podcast.

- Alright, today we are here with Patrick Murrah, MD and cardiothoracic surgeon. So, Dr. Murrah, what brings you in today?

- Well, I, it's a Friday and I, I didn't have a case this morning. My partner, Joe Johnson's doing a really tough one.

- Oh.

- That helped him get started. And I didn't have a lot to do. I thought I'd come in here and tell you about all the good things we're doing. And then our team here at SGMC Health.

- All right. I'm here for it. So, Dr. Johnson's getting his hands dirty this morning. Yeah. He's cardiothoracic surgery for the people that don't understand, what is that?

- Well, it is heart cardio, being heart, so, so heart surgery, anything really above the diaphragm. Okay. So mostly heart surgery, but we're doing a lot of exciting things in thoracic surgery also. We have some really good tools we'll

- Talk about. And thoracic is lung, right? And

- That's, that's thoracic? Well, it's thoracic being just above the diaphragm. You can have the esophagus.

- Okay.

- The lung and, and the heart. But just thoracic is kind of a general term, the thorax. But cardiothoracic is just basically people that do heart and lung surgery and occasional esophageal surgery. Not much, but some.

- All right.

- So anything in there in the chest?

- Well, tell us about yourself first. Give us a little background. What led you to your career and how did we get you in this seat today?

- Well, I think people kind of do what they do for, you know, sometimes you don't know why you do things, but you do things 'cause those are the things you maybe gravitate towards. I became a heart surgeon. It's, it's like going down a long tunnel. You get to where you, maybe you get almost the end of the tunnel and you really can't. That's about all you can do. So I, it's a long training process, I guess I was, I liked sports as a kid and I was fairly competitive and, and I always, it would appeal to me in medical school that the, the nature of surgery, The ability to, to fix things and more, more so you, you manage things, but a lot of times uniquely in, in surgery and in cardiac surgery, you can really fix things. So it's, that's a, that's a very gratifying thing. So I, and it's a challenge. And that's, you know, probably in some ways you, you create your own misery. You just say, all right, I'm gonna tell, I'm gonna try to do the hardest thing. It was a long, it was a long process that, but my wife and I, my wife Allison and I of 35 years, the 10 years of residency and going through that whole process, she's just as much a part of it.

- So, yeah, absolutely.

- So we sort of chose it together and did it. And so,

- Well what did, what made you decide to be a doctor? A physician in general?

- I was actually, I played golf as a kid. I, I was gonna be a little golfer and do my thing, and I was pretty, and I grew up in Titusville, Florida. My dad worked for nasa Oh. In, on the east coast there with the Kennedy Space Center. And I, I liked golf, I be a golfer. But then you figured you could play golf and be a doctor. My mom was a nurse when I was there. There was when I beca went to college as a third person going to college. So my mom went to school to become a nurse to be able to pay for college. So, so that was, and so that was inspiring. I thought that was, I remember seeing, going to the ICU one time and she's up there in, in in Titusville and, and somebody was on the ventilator. And I, I think it was, must have been, I don't know. I guess I was, I was pretty young, but, but it was, and, and, and the guy was sick. And I, and I remember thinking that that's not fair.

- Yeah.

- And that, that guy had got sick and he was not doing well. I was like, well, I just, it didn't, and I, I guess as a child, the way you approach things, maybe when you get older, you, you don't think, you know, there's not a, like a fairness committee me on your behalf. But when you're young and you're like, wow, that's real. That person's really in despair and, and really, I guess that's inspiring,

- But - You can help that person. That's pretty helpless.

- Wow. That's a cool story.

- So, yeah, I just remember feeling that way.

- Yeah.

- It's interesting,

- Huh? Well, so you mentioned going into cardio thoracic surgery, wanting to do the things that are hard. Tell us about what it's like. We have not had a heart surgeon on our pod cast yet. Yeah. So what is that like performing a heart surgery?

- It, it is, if it's, if it's hard to do, then you probably need to do some more training.

- Okay.

- Yeah. Yeah. That's true. That's true.

- But you, I mean, I mean, it's hard. It's hard. I mean, and it is, it's taxing, but you need to be ready to go. So, you know, 'cause you got, you know, somebody counting on you,

- Right? Yeah.

- So you really need to pay the upfront price and get all the training done. So you're just sort of going through the,

- It's

- A

- Big deal process training big that you're doing that a trust you not, so Yeah. But you're, you're, it. So that, the big thing I, I always thought is I wanted to try to take the hard road in training

- So - That when it comes to that person who's having their one op open heart surgery, that you're the, you're the best option for them. But it's, it, there's a sense of responsibility that you feel I've occasionally had to operate on friends or family and friends and that, and that feels a little different. Yeah. And which, you know, you never, but you Well you got, that's what you do. So you

- Yeah.

- You do that. But I, I was in, I was in a, I was in a couple college towns where they had famous football coaches and I was hoping I would not have to do their

- Operations. Oh yeah. Yeah. But

- That would not happen because they were getting up there in, in years. I was in Athens for a while and I was also in Tallahassee where they all loved their football coach. And so there, there, there were times when you, that would've made me a little uncomfortable. I think.

- You don't wanna be responsible

- Pressure or find a friend, but, but I, I don't know. But it's a, it's a, it's a really gratifying feeling. We, where there's a process, working with a team is great. It feels good to get, to get a, to get things done.

- Tell us about the team that's in the, or whenever you're doing a surgery. 'cause it's more than just the surgeons. Absolutely. While you have tell us. Because nobody gets to see that. So

- Yes. It's, it's, it's really the, there, there's a whole lot to it. And there's any little moving part that's gotta be right of much like my dad's space shuttle doing that there who the solid rocket boosters and the, and the external tank and the orbiter and the, all the things you do to go through that process. And, and the, and the o-rings were bad on the challenger one time. Yeah. They had its thing. So you always, so attention to detail is so important. And having people engaged, I'm very, and I, I know other people are as well, but focusing on what you're doing

- Is - Really, I mean, some people play music and all, and you can do that, but, but I really think it's not at the expense of people focusing on what they're doing and paying attention to every detail. And there's a little saying in heart surgery that there's a snake under every rock,

- Which

- Is wise. Yeah. So you don't think of that way. And that's a,

- Well that makes me me think about our organization has gone, or is undergoing is on its journey for the high reliability organization. Yes. And this upcoming year, we'll be getting ISO rated, which is like the highest safety within a organization, but it is on that preoccupies preoccupation patient. Is that preoccupation Right. Preoccupation with failure. Like how can something go wrong and how can we prevent anything from going wrong and really making sure that everything is just as safe as it can be.

- Right. And I think it's very also important just in you, you study performance that people are relaxed. The people that you're working with, you don't have them worried about you biting them or getting after 'em and getting, you know, getting in, in that. They feel like they can, the people perform their best when they're generally

- Relaxed. Yeah. I feel,

- And they also have a, there's a, there's a process called Team steps that was a, a process that was based on an accident in the airline industry. And they, they looked at the how mistakes happen and you want people to feel free to say, Hey, that doesn't seem the same way. I may just be the person clean up the room, but this part is outta place.

- Yeah.

- And that everybody gets listened to and everybody has that freedom to, to,

- To voice if something is a concern

- Or to really Yes. It's

- A raise a flag if

- They're not without repercussions.

- Yeah. - So, so I think people perform better when they're not re not trying to, they're not worried about Yeah. Whether they should say that or not. And that's an important part of doing things right. So everybody on our team is, they're relaxed, they're not uptight, but they're focused, I think is the best way to perform.

- Yeah. I think that goes for every department, not just surgery. I mean, we all have to have that kind of environment that we, you know,

- An environment where you feel freedom to voice concerns. Yes. And you feel psychologically safe

- Right.

- And supported. Yes.

- Yes.

- And I think that helps in any Yeah. Any atmosphere. Absolutely. But particularly in high risk

- Situations. Yes. I think that's very true. So that's, that's, and but so the environment, the people that we have there are outstanding. They come from all walks of life and towns around South Georgia.

- Tell me the different professionals you have in the room.

- We have an anesthesia team. One or two, usually a nurse practitioner or a CRNA will be in there, in a, in a staff person will have someone running the trans esophageal echo that looks at the heart and, and how that looks pre and post procedure. So you have an anesthesia team of two or three people. We have a heart lung machine person and they, they'll usually one of those, they'll be running the, running that machine, which is really makes it possible to do what we do. And I have a scrub nurse to my right and an assistant across. And then there's a circulator going around the room, answering my phone and answering phone calls and then helping out and sort of moving things to about 10 people in general. But it's a really, it's a fascinating thing. You're used to it, but it's when someone walks in and looks and, and they're like, wow, there's a lot of stuff going on.

- Yeah. - But it's all in, in concert and working well and people communicate well. That's why it's important I think to everybody that, that they're focused on what, on the patient remembering that this is their only operation. This may be my 5000th.

- Right.

- But that's their heart surgery and that and that. I'll occasionally, sometimes you'll have somebody come in and they're maybe a medical student or somebody's visiting and then they'll start talking

- And

- Then I'll stop and I'll say, you know, this is, this guy's, yeah. Pardon us. We're doing this guy's heart surgery and is their only operation and we all wanna focus. But I don't have to do that very often. That's gonna

- Yeah. Yeah.

- But, but, but it's, but it's, it is important to, to really remember that, that this is, we want to do our, do our best. Definitely sounds very serious.

- What type of surgeries do you do? So you say heart surgery, but what are the most common procedures that you perform when you're having to do heart

- Surgery? Most, most what we do is, Joe and I do, and we all do things a little differently in terms of our specialties that we, that we focus on. But we both do coronary bypass operations,

- Which is,

- It is, it is for blockages in the coronary arteries. Okay. So from too much Velv, Vita and Crisco. Or, or maybe, or maybe you may not help me understand, do you remember what Crisco did y'all y'all know Crisco is, do they still have that? I'm,

- I'm sure they still do. They for you, they still sell it. Some

- Of that and velv vita, you know, but, and also family history can contribute to that, to coronary disease. But so treating coronary artery blockages, but medical therapy most of the time you can do that for coronary artery disease stenting, which we have a great team of interventional cardiologists that do that. And if they can't get that done, then we're sort of the last resort. So a lot of coronary bypass operations. Joe does a great job with, with the atrial fibrillation of maze procedure

- And

- Is very aggressive and, and does a really good job with that. And I think we manage atrial fibrillation here just as well as any, any place in the southeast.

- Very good. And tell us why atrial fibrillation is,

- It's just an irregular heartbeat. Okay. It is where you have an atrium and a ventricle against the camera, but dink dink dink dink AFib is where this is dinking too much. And it's so the flow through the heart's not good. And it's associated with strokes. Yeah. So it's something that we can manage now with a procedure called the maze procedure intraoperatively. And Joe does great work with that. I do that as well. But he's done some real pioneering work with that. We also collaborate with Dr. Hannah,

- Our

- Electrophysiologist and do some mentally invasive AFib things. But AFib is sort of what happens as you get older.

- Yeah. - It's interesting. I was at a meeting with Dr. Hannah down in Miami. We were really struggling at that meeting to go to Miami. But the, it was talking about AFib, so the irregular heartbeat, the, that it's not really, don't think of it as a disease as, as you would think of gray hair as a disease. Ah. It's just a a it's something that happens. It's just what happens when you get old. There's about 10 million people

- Yeah.

- In America that have that. And so it's the way you manage the AFib. So, so that's what we do. We do, we do coronary surgery, we do ma procedures. I like mitral valve repairs. I'm very interested in that. That's a really good procedure to do. And, and you can avoid replacing the mitral valve. And so we did one last week on a lady who was doing great. That's a nice procedure to do. There's some new techniques in mitral valve repair. Aortic valve replacement is, is something we have done a lot of the real exciting stuff. The young great Dr. Alt and his team have done with the structural heart program is really a big driver in the whole hospital because it really is a new treatment that's better than what I do. If, if I have a small lady that has a very small aorta, then I know that a TAVR procedure's much better. And I would want that if I was 75 years old and I had a aortic problem where I would have to go have surgery by me and I would have to open up your chest. But, but the aortic valve things that we're doing are very exciting. We have Mondays where we all work together

- Doing that. So that's done through the structural heart center. Yeah.

- Right. - That Dr. Bol and you are a part of. Yeah. And basically you can evaluate your candidates to see if they are or evaluate your patients to see if they're a candidate for that versus the open heart surgery. And that is where he takes that catheter

- Yeah.

- Up and replaces the valve.

- Right.

- Minimally.

- And we're fi we're finding most of that's done through the groin and they're just under sedation, which is which, amazing. They can get home in a day or two. And there's, we've done some alternative access cases now going through the carotid arteries. We're doing one next Monday

- When you first first started, which

- Is really exciting. It's a team effort. That's Colby Ruiz.

- Yeah. - Vascular surgery. We'll do that together on

- Monday. But when you first started, did you imagine that people would be able to have that procedure done in that manner?

- I'm glad it happened.

- Yeah. No, but did you envision it? Like I

- Didn't think about that. No, I didn't. And I think it's a really, it's a huge advance. No, I didn't and I was,

- I mean, it's amazing to be able to do.

- So I'm, and I got out when I was 36, so that was 24 years ago.

- The,

- And when I got out of Emory and no, it wasn't even close. That's, that's only been going on about 10 years.

- Yeah. That's very,

- So it's very cool. So it's a really dramatic good thing.

- I was gonna ask And we're

- Doing it right here. That's the best we,

- Yeah.

- Really. We have

- A

- Young great person doing it, leading that team, and we're all really excited about it.

- Well, you kind of hit on it, but I was gonna ask what you think makes our heart program, you know, all the different programs stand out in this region.

- I th the thing I really, really like and I've seen different heart and vascular programs is that the vascular surgeons, the cardiologists and the cardiac surgeons are all on the same page. They're all, we're all working for the same team. And in that there's no, and so it's just one team that Monday will be an example of that, that we're working together. Dr. Ruiz and myself and Dr. Alt will be doing a, an alternative access case. And that, so just, I think having that just synergistically working together is a, that that is a big deal.

- Yeah.

- I think we've recruited a lot of good young talent here. And there's a, there's a fairly scarce supply of heart surgeons nowadays. 'cause nobody wants to do the, the 10 year re and get out when you're 36. And, and, and so it's a it is. And we've a, we have a new, and I'll, just so I can remember, we have a new person coming, Dr. Guillermo. And he is coming in mid August and as a star. Yeah. Not just a good heart. He's a topnotch big recruit that the day that he accepted SGMC Health, he had an offer from Gainesville. He had an offer from in Phoenix, Arizona. And he's a very sought after heart surgeon who's coming here to be with his friend Colby Ruiz.

- Yeah.

- And we have, and we've given him the environment to, to bring him. Here's, so I feel like we've reached it. That's awesome. Colby. And I feel like, and, and Dr. Hardy, like we've reached a critical mass to where we've got good young people with a up and coming program, very progressive leadership and just so people are coming.

- And the way Dr. Ruiz explained it to me, 'cause I said, well how can I explain like what y'all do, what type of procedures you do and what the benefit is? And he said, well, we're in the vascular world. He's like, we're the A so we can offer this, this, this, this, this. We can offer all these options. Whereas some people can only option offer one option. And so they may lend to try to force that one option on a patient because that's the only option they have. And when you have options or when you have access to all these other options, then you're truly doing what's best for the patient.

- Yes. - And not just trying to pigeon the patient into what you can do.

- Right. - And I thought that was a good way to put it. And it reminds me of what you're saying with having access to all the specialists is that you can truly do the workup, the evaluation and see what makes the best sense. And you have all the people already here that can do these things.

- And sometimes the best answer is not to do anything. There's something called the mom test, which has served me well over many years. Would I want my mother to have this? I wouldn't operate on my mom. But the, but it would be is this, is this something sound and are we just doing this? 'cause we can do it.

- Yeah.

- And a lot of times the the real in, in this place, you need to know what, what's appropriate for that We need to do here. Most things we, we, we don't send out much as in the heart program. But, but does anything need to be done at all? There's a, there's a lot to be said for medical therapy. Yeah. There's a lot to be said for and, and understanding also when you're getting consent on these procedures that they understand all the risk benefits and alternatives. Right. And that's, it's really not just having them sign a consent, but understand that these are the options. So getting really, but giving them the fancy procedure if it's appropriate. A lot of times trying medical therapy works, works really well in coronary disease. So you can eat some more Crisco and some avita. But chuva no. And go off.

- No. Are there any, you've been doing this for a while, so there have to be some patient stories or patient families that have kind of stuck out to you. Is there anything that,

- There's a lot

- Comes to mind.

- I did. I, and full disclosure, y'all did give me a couple the list of the questions. So that's, maybe it's not fair. They get the questions asked. So I thought about a few, I was thinking of some, there's a just that really come to mind. There's maybe a couple, there was a young girl who had, it's not really a cardiac surgery, it's more of a collaboration with vascular surgery. She had something called superior Vena Cava syndrome. She was in Tallahassee when I spent a lot of my career there. She had a, a young child, a single mother, but had had sickle cell disease and had her superior vena cava didn't work. So she had this horrible swelling in her upper extremities in her head. Horrible headaches. And she's trying to raise a child by herself.

- Hmm.

- And Dr. Kalin and, and I did a series of operations over several years to decompress that. Then it would shut down. We'd do another try. We'd go in the chest, we'd try this way, but we also, we decompressed her enough and got her through and got that child raised and through college.

- Wow.

- And that was very gratifying. So that just came to mind. It's not really a heart surgery case, it's more of

- A

- Collaboration with vascular people. I thought about that as one.

- Yeah. And that's probably rare to do so many, you know, procedures on one patient. You are. Yeah,

- It is. But but, but just, but I think the importance that I tell my kids this is you don't have to be the smartest person. You just, but you need to be the most persistent and like, persistence and you just do the right thing and work hard. And then, and really being persistent, that's a very powerful thing. Yeah. To be persistent. So that, that case came up, I had a, my perfusionist that runs a heart lung machine in Tallahassee was in his yard and the tree people were cutting down a tree and a stick came down and went through his neck.

- Oh my gosh.

- And through his trachea and then to his left chest. So he was impaled like a, you know, something from

- Wow.

- From bra fart.

- Yeah.

- And so he, then he pulled it out and then came, he came, no, come on. He should've breathe. Breathe. No, that's true story. And so, so he, so he came into the emergency room and he was, it was my friend, he's a heart lung machine guy. He's a good guy. And he's blowing air outta the side of his neck. Wow. And his trache had been severed. And, and, and we fixed that. And that was a, that was a a thing talking about operating on your friends.

- Yeah.

- But my, my buddy David Saint was who had been here before was, was not in town. So I was like, me and another guy and, and I went to fix it, put a patch on it, put the, the breathing tube passed the repair. And it was the middle of the night. So I went back, I was gonna go have my stress meal at McDonald's and I'm halfway there and they said we can't ventilate him in, in the anesthesia friend of mine advanced the tube a little bit past the repair again, had moved back and we could ventilate him again. And I left him on the, paralyzed it on the ventilator, chemically paralyzed on purpose for about a week. And then we've woke him up and slowly got the tube out and Wow. And he's, he's lives down at the beach now and he's doing awesome. So he's a that was a big deal. I I just remember that. It's just an odd case. But that, that one sticks out

- With a lot of your surgeries being, I mean, well I guess it varies as far as being a emergent or, you know, being able to be evaluated over time Yes. And scheduled. But how do you handle, like what, how do you prepare for that emergency situation? And I mean, I know you do and, and I'm sure it takes, you just experience over the, but how did the, in the team, how do they, you

- You need to, everybody needs to be calm. Yeah. You need to be not, not just focusing on what you're doing. Yeah. And being calm, you know, have a job to do. It helps others. You ain't got a job to do and you do it and you treat everybody the same. And you, and you're, and you, you do it right. And you have a process and you just continue that process. And I think that's a, that's really important that again, that for performance, that people feel relaxed and they do their job and, and, and they're, they're not worried about one thing, about the freaking out heart surgeon over here. The, that he's calm and that or she is calm and can perform better. So that thing just, and knowing what you're doing is important. And that's, again, the training and going through it and paying the upfront price, which is Right. What you do.

- And speaking of training, what are your thoughts on, we have a lot of exciting things happening in the medical space here at SGMC Health, with our partnership with Mercer, all the resident.

- Huge big programs.

- Huge, huge.

- It makes us better. And, you know, the, the model of private doctors is okay, but, but now you have a lot more eyes and ears on the patient and it's just fantastic. It really raises the bar. I remember when I was at Emory, Dr. Guyton was my chairman there saying that kinda under his breath, we had something going. It was actually a thing that was kind of related to what something a resident had done. And he was just sort of talking to himself in the middle of the night and he's going, well on the balance, it's much better to have the residents around 'cause they keep eyes on me. He was just justifying he was. But but, but he was, but he was always right. Yeah. Dr. Guy was a brilliant man. He was the chief at Emory for many years. But he, and I think that's true. There's such a, to have more eyes and ears on the patient is a, is a big deal. And so it makes us all better

- Having that

- Affiliation. It's kinda

- Like competition naturally makes you better too. Because if you have competition in any kind of business, you makes you evaluate what you're doing and are you performing the way you should. And while most people don't like it Right, it does naturally like elevate your performance and think that,

- I mean Yeah. Are you acting in a way, are you that, that you would want this person that's watching you, how you respond? Yeah. Are you, you know, you

- Culture, you've

- Being a good example

- For that. And speaking of what, I mean, what are your thoughts on the physician culture here at SGMC Health? 'cause I feel like it's definitely improved leaps and bounds over the last years, specifically having such a influx of new physicians to the medical staff. Not necessarily new to their careers, but new to SGMC health and their openness and excitement and willing to bring in new things.

- Yes. - I, I think we're, and engagement, I guess

- I do, I think we have a lot of good young people. I don't count myself as one of the youngsters, but I, I feel young, but, but they, I think we have a lot of good young talent and I think that's all they're, they're optimistic, they're energetic. I think that there's good accountability, which is very important in any organization. So we've got that. I think there's a great spirit. I I, we went yesterday, Colby and Dr. Ruiz and, and Dr. Hardy myself went over to take a guy to, to dinner. He was interviewing from Pittsburgh, university of Pittsburgh. He's a critical specialist and, and infectious disease, which is an interesting combination. But he was, he has a fiance and he, they're looking at us and we're able to say, Hey, we got some, got some momentum going here

- And,

- And we all, we like each other. We're sitting here, you know, we're not, you know,

- We're right.

- And we, we do stuff together and the vascular surgeons and the heart surgeons, we, we work together and, and they see that. And I think, and so I think we've really reached a, a great momentum point where we can, you can bring other recruits in

- And that great. It helps with your quality of recruits you get Absolutely. As

- Well. Absolutely. It does. Absolutely. So I think things are

- Good. Yeah. Well, switching gears just a little bit, is there anything that you think that people can do to be proactive so they don't end up maybe necessarily on your operating table? Don't buy the Crisco or the Velv Vito, when

- You get stressed out, don't go to McDonald's. That's for eggs here,

- Say not as that day.

- That's right. No, yeah, that's right. Yeah. I think, I think the really important thing is to, you know, a big thing I see a lot of is, is insulin resistance because there's so much food you get now and it's, and they, there's a lot of things the way that they, they they get you hooked and it's, it's very, I think just being, knowing what your hemoglobin A1C is and they, it is not diabetic. Not diabetic. There's a continuum. So you're, so you're on the, on the, on the scale there. And I, I go see, oh gosh, Hayes, Dr. Hayes, I go to the doctor and he's, he's, he runs the residency program. He's fantastic. Yeah. And he's my doctor, so he checks my hemoglobin A1C and then, and getting that and then, and that's such an important thing that I think there's a big problem with obesity in our society. And, and, and it's hard. Yeah. It's really, it's a hard, I think one day they're going, they're gonna really get on that the way they've did with alcoholism there other things where you're, you know, addiction to food.

- Yeah. - You know, I think they ought to treat it the same way 'cause it has such

- Health. We've actually, repercussions actually had Dr. La Guana who specialized in obesity medicine. Yeah. And that was the same thing too. I mean, it is a disease. Yeah. Correct. Like it is an addiction.

- Right.

- In some sort. And

- So, so I think there, I think getting after that and making sure you're with your doctor and that you, you know what your hemoglobin A1C is and you're staying active. And, and those are important things I think. I think there's a lot of that out there.

- Definitely. Well, my last question is about foods. So maybe that wasn't the best segue for me to do, but so at the end of every episode we ask our physicians, our guests what their favorite thing to eat is here in our food services. So, but,

- But in the question you said specifically the All Spice Cafe

- Cafeteria or allspice of either one. Either one.

- Because that was hard. That's a hard one. 'cause I, there's a, there's a thing called a Bang Bang. I, i, I go to the

- Never heard of that. I go

- To the doctor's lounge and then you, it's just

- In the doctor's lounge.

- And then so you go there and you get your, get your gravy or whatever. And then I would have to come up, if I went over the All Spice, that that would constitute a bang, bang. I rarely can make it over there. But the, I would have to say that's the bang bang is you, you hit location. It's when you go out, you go out one restaurant and then into another one. That's the call a bang bang. That's, it's, it's,

- You

- Learned some and my, my kids and that was sort of like an eating challenge with my kids. See here, I got, we're just talking about Hemoglobin A one Cs.

- I know, but

- Do as I say. No.

- And and you have not told us what the favorite food item is. I

- Don't know. I just, I I I, I know I usually get an orange juice or something over there. 'cause I've already, I haven't, they have a pretty good made to order thing in the corner. Like get a

- Oh yeah. Your sandwiches and stuff.

- Yeah. A little chicken sandwich over there.

- Yeah. Or wrap Pretty good and stuff.

- Pretty solid. My my favorite thing though, I don't know if you were here, is the What's Cooking Hotline?

- Oh, you do you

- Know about that?

- Yeah. It, it still exists.

- It it is hilarious. It is. I kept that number. It still exists. And I sent it to some of my friends in Atlanta. I says they would call the What's Cooking hotline It is. And then maybe the vegetable bar was the hot dog bar or something. They

- Would say, oh my

- Goodness. And that lady was, and she, she's really cute.

- Yeah. So this was a number you could call on. You could hear the, what's what's Cooking hotline. I still have it on my phone. You know, this was kind of before computers became such a big deal where you could look at the menu online. Yeah. We have it on hotline. We do still have the hotline. So,

- And it's funny, they say that the vegetable bar is the hot dog bar is kind of, today we're just sort of lapping the hot

- Dogs. Yeah. We don't do that anymore. That's definitely an old

- School thing. I'm sorry. Yeah. But it is excellent food. The food is excellent and it is very, very good. But that's, that's the deal. I think they spoil us though with the food and the Yeah. Doctor's license too. That's dangerous. You gotta kind of, they need to cut off my card there,

- So. Okay. That's okay. Well, you can, you can always just give us your card and we will take your meal, get you want. We'll

- Get paid that for a little while. But I, but anyway. No, I'm just, but just in general, I'm very, very proud to be here. And this is such a great

- Organization. Well, I know you were talking about those top recruits and we felt the same way when we were able to land you to come back here

- Anyway,

- So I'm glad, glad that you're here. Glad here. Yeah.

- Very glad to be here. And y'all do the three of you. I think you're pretty outstanding.

- Well, thank you. Thank you.

- I think you really are, you really represent things well.

- Y'all make our job easy. Yeah. Yeah. So, all right, well thank you for coming in. Thank you. And we'll get you back on again later and hear about all the next steps and new advancements. I'm sure you'll have by the time we circle back around.

- Okay.

- Alright.

- Thank,

- Thank you.

- That's good. Thank you everyone for listening today. And if you have any questions, you can submit those sgmc.org/podcast. And don't forget to like and subscribe.