Ep. 10 | James Davis, MD, General Surgeon, SGMC Health
Surgery can be scary, but James Davis, MD, is here to calm your fears! Dr. Davis is a board-certified General Surgeon who specializes in endocrine surgery, caring for diseases of the thyroid, parathyroid, adrenal glands, and pancreas. Dive into his surgical playbook, where he eases patients' worries and answers all of their questions from the notorious Dr. Google. Dr. Davis shares his expertise alongside some great one-liners that you don't want to miss!
Transcript
- Welcome to another episode of What Brings You in Today.
- I'm Erika Bennett.
- And I'm Taylor Fisher.
- And we just wanna start off by thanking everyone for tuning in today and to listening to all of our episodes. Be sure to follow us and like and subscribe and of course you can always leave a review as well.
- And also if there's any topics you would like to hear our guests talk about, you can go to our website, sgmc.org/podcast and you can submit your topics there.
- Alright, well, today we are joined by James Davis, MD, General Surgeon, but also fellowship trained and endocrine surgery. So Dr. Davis, what brings you in today?
- I was hoping, I watched a few of these podcasts and I thought it was a good strategy to kind of bring some updates to SGMC surgery as well as the practices in endocrine surgery as we go into the new year. So, yeah.
- Alright, well, tell us a little bit about what made you pursue kind of your journey in your medical career and what led you to becoming a surgeon in endocrine surgery?
- Yeah, so I, I was not the standard. I wanna be a doctor kind of kid growing up. So it was more of a, I went to college and kind of nerded out in some of the sciences, specifically physics and chemistry. But I didn't really see a future in that I didn't know what I was gonna do with a physics degree. And I had a mentor that was married to a physician and she encouraged me as a chemistry professor. She encouraged me to say, Hey, why don't you take an mcat? Why don't you try to go the medical route? And it was as simple as that. I had a, my, my father's best friend was a general surgeon, so I, to shadowed him a little bit, I kind of liked that part. I shadowed a few more years in undergrad and then I took the MCAT and pursued it on. And then as far as endocrine, when I left medical school, I didn't even know what endocrine surgery was. I knew I was going into general surgery. I anticipated a career doing broad-based general surgery, hernias, colons, all that. And then about my third year of general surgery training is when I recognized the need for specialty training in certain areas of the body. There were certain organ systems that you really need to be proficient at, you need to be high volume at in order to be really good. And it makes sense I think to most things. If you're gonna have a Whipple done, you want somebody that's doing 50 whipples a year, you don't want somebody that's like, ah, I did three last. It's just not what you want. It's not what you want for your loved ones. Yeah, makes sense. So that was kind of where my thought process went with endocrine. As I said, I wanna be really proficient and do a lot of thyroids, a lot of parathyroids, a lot of adrenal surgery. And I recognized a need in South Georgia. So when it came time to look for a job, I recognized there really wasn't a lot of high volume surgeons below Atlanta doing this kind of stuff. And that was attractive to me for a job and it allowed me, SGMC allowed me to continue to do general surgery practices so far as hernias, colons, everything like that, and practice one of my best friends and also bring endocrine surgery to South Georgia. So.
- Very cool. So you mentioned Whipple or Whipple and I don't know what that is, but you don't have to tell me what that is, but I do need to, we do need to know what thyroid endocrine. Okay. Thyroid, you said para parathyroid, there's different, what is that and what does it mean to the person's health?
- Yeah, so probably the number one and number two complaints that p patients are wishing are related to that thyroid is fatigue and hair loss,
- Weight loss. Oh, weight loss. I thought weight loss. Well,
- Weight loss is right there too, right? Number three. But a lot of people will come in my office and they're gonna mention hoping, kind of crossing their fingers that they're, they're losing their hair and it's related to the thyroid or you know, something along their energy levels is gonna be related to the thyroid. And I am too because I can fix that. Yeah. It's awkward when I say your thyroid looks like it's functioning great. I have no quick fix for your hair loss. All right. I don't have a fix for my hair loss, you know? Right. So these are, these are things that, you know, you, you see on a day-to-day basis. And then the weight is definitely up there as a, as a common complaint. But really what you're looking for with the thyroid as far as surgical needs are, is the gland over functioning? Is it got a nodule that's causing compression of other areas in the neck? Or is the nodule have suspicious characteristics? So thyroid cancers, graves disease, toxic multinodular, gorders and then big large gorders that we see down here that are kind of substernal, these really, really big gorders that we end up sometimes having to open the chest just to get it out. So these are, these are typical pathologies that I deal with with endocrine surgery.
- So a goer is literally just like a big black, not
- I, I tell people, and it is a term that's thrown around very loosely. So a lot of people say, I've got a goer and I look at the dimensions of their thyroid and I say, no, your thyroid's just slightly enlarged. Not bad, but a true goer's enlargement of that thyroid gland. And you've got multiple nodules most of the time that are kind of compressing other things in your neck that lead to that development of symptoms. And the typical symptoms we look for are trouble swallowing, maybe some voice changes when they lay down at night, a fullness on their neck, they turn their head a certain way, they feel that fullness or weight kind of pushing. It's not so much pain in the neck. That's kind of a atypical finding when it's truly causing pain. But usually that swallowing is the first couple things they develop or they look in the mirror, they're brushing their teeth and they go, what the heck is that? Yeah. And they see something kind of popping up in their neck Yeah. When they swallow. So,
- So what exactly is the thyroid's purpose in the
- Body? So it, it serves all kinds of systems across your body. It doesn't get a lot of street cred like other things because we have a medicine, you never heard about it to take its place, which is Synthroid or levothyroxine. And the most common reason you end up on that medicine is because as we age, sometimes our thyroid just burns out. Okay. And it's something that your primary care doctor's gonna pick up on their routine labs or check in on you once a year. That thyroid function test starts to show that it's, it's out and then they replace it with Synthroid or levothyroxine. And that typically does the trick. The second most common reason you end up on that medication is me. And that's when we take the thyroid out for one of those reasons we mentioned earlier with the pathology. But it serves all kinds of purposes across your body as far as your sleep wake cycle, your energy throughout the day, your weight, your fluctuation, even your, your blood pressure. So it helps lots of other systems work really, really well and fine tune those systems
- Well in. So thyroid surgery, I know you do da Vinci surgery and I'd like to get, you know, talk a little bit about robotic surgery, but in regards to the thyroid, is that like a major procedure or what type of
- Risk
- Level are those?
- So I define a major procedure as any procedure done on my body that is major. Okay. And, and I treat the patients the same way. So I, it is a, it is, it is always a situation where you wanna be there with 'em from the time they go off to sleep and they're intubated because it is scary, it is nerve wracking to them. Although we're doing them multiple of these per day, you know, to them it's their one and only time they're having thyroid surgery and it is a big deal. But as far as the cosmetics and all, we try to hide it in a natural skin line. My goal is a year down the road to not be able to see that scar unless I'm rarely squinting and really looking closely at their neck. But the neck itself, great vascular supply, not much tension on the neck. So usually you get a good cosmetic result as long as you can put the tissue planes back together decently.
- Yeah. Well I do like the comment you made about specializing in something. I mean that kind of resonated me. I didn't really think about that until you said it, especially when it comes to surgeries within your body. You know, having somebody that does a multitude of the same procedure over and over and over so that you really get that skillset. So that's pretty cool. And I'm sure you're, we can talk about that with Da Vinci. So robotic surgery, that's the biggest trend now. I mean, it's been around for a while, but tell us about the benefits, kind of what surgeries you're able to do with the Da Vinci robot and kind of where you can see that trending.
- Yeah, so, so we've got the latest developments in the robot right here at South Georgia Medical Center. We've got a Da Vinci XXI robot. We're talks and probably gonna be rumored to be getting another one within the next year. So our, our procedures and the case logs that we're doing that, that production continues to ramp up for robotics. So, and, and that's just what patients are desiring. They want the mentally invasive approach. They want you to fix their hernia, but they want you to do it through small incisions. They don't want a big cut across their abdomen. They want, and again, I, I want the same thing. I want, it's a lot of pride to be able to know that they can put a bathing suit on again and, and they don't know I was there. You know, so it's a kind of a stealthy move type procedure. And, and that's attractive as far as their recovery process as far as the cosmesis, everything. And so as long as you can offer them the same type of surgery as the open and that's what the Da Vinci robot allows. So it's laparoscopic surgery with better visualization and wristed instruments. So it's more natural motion versus the traditional laparoscopic surgery. And, and I, and it really has, I've kind of watched it from when it first started and watching some of the guys that were training me have to have a learning curve and come on board with Da Vinci and general surgery was one of the places that really caught on later. You know, it wasn't, it wasn't grabbing it up front, it was really holding back and kind of Heisman the, the approach. It eventually caught up with it and said, yeah, I think there's a place in general surgery for this, you know, technology. And really where I find it advantageous is for gut cases and then down the pelvis. And then when you've got your morbidly obese patients that have these really, really small hernias, I mean, to have a patient who's pushing over 250 pounds with this really, really small hernia but symptomatic hernia to go and make this big cut on that individual, you're, you know, from a cosmetic standpoint, not gonna make a new friend, you're going to increase your chances of a surgical site infection and of course the postoperative pain will be worse. Those are really attractive options for that robot. And that's what I use it for, for my practice. And so when I came to town, it really, there wasn't anybody doing high volume for gut surgery here. And so that's where I just kind of waved my hand and said, I'm willing to do hidal hernias and nissin and those type procedures. And sure enough it, it kind of pushed my way. So I see my office is a lot of kind of colons and for gut cases and hernias and it's a good, good breadth of general surgery. So my day is never boring. And then of course the endocrine practice keeps coming too. So, but I, I do think the robot has a place in general surgery. I think we've swung that pendulum all the way to where I kind of, if anything harp that we, maybe we use it too much sometimes, you know, there are cases that you probably don't need that technology for. And I think right now, especially among service lines, adding urology, OB GYN that uses it, cardiothoracic that uses as well as general surgery, we really have to kind of play nice in the sandbox and say these are appropriate cases for that robot. These are cases I can get done traditionally in a laparoscopic fashion or better served open. And I think that judgment or being able to have that, that toolbox where I can use all three options on a patient's certainly attractive. So
- Are there any like disease specific surgeries or related from certain diseases that are prevalent in our area that you're seeing? I
- See a, a lot of big hidal hernias, a lot of big hidal hernias. And
- What is, what's the hernia? So,
- So the hernias all over your body. Hernia just means whole, that's all that means is a whole. And so the kind of classic hernias you hear about are umbilical hernias. So that belly button protrusion or a groin hernia. So that inguinal approach and that's the two most common. And I treat those as well as my partners. But then the hiatal hernia is that natural defect from your esophagus as it turns into your stomach below the diaphragm. That opening, that opening right there that allows the esophagus to enter into the stomach as it widens up the stomach likes to slide up into the chest and that's a classified as a diaphragmatic hernia or a hidal hernia or a paraesophageal hernia. The terms that get tossed around with that. And so I end up fixing a lot of those and the robot is definitely the way to go. I will never do one traditionally laparoscopic rigid. It's just the flexibility of those wristed instruments, the visualization looking up, being able to see not only the abdomen but looking up into the chest cavity and you're doing it all through eight millimeter little cuts, which is certainly better than the old school open approach. Yeah,
- Those things are so cool. We got to kind of test them when they were here in the lobby and I just, you know, I'm not a surgeon but I was like trying to get the hang of it just to pick up these rings and I just can't imagine it's a day almost still a game. Yeah, it was almost like a game. Yeah.
- Yeah. So I mean it's, it's the same thing that the visualization is certainly impressive. Yeah. That you get to sit down and you know, even the techs that are helping or assisting at the bedside on the individual, when I sit down at the robot, there are things that they're seeing on their 2D monitor that look very different when I'm looking through that console, that robot. And there are things I can almost look around the corner and they go, ah, how does he know to see that? You know, because they're, they've got a 2D lens. Whereas I'm looking through there and it's almost, it really is truly 3D approach that I'm getting to see up into that, that hiatus. So
- Sneakers, yeah, when we looked at it, the representative I guess from Da Vinci had a penny in there and she is said, you know, or maybe it was a dollar, I think it was a penny though. It was like a,
- It was a dollar and they hit the nose on George Washington with the pen. You Yeah.
- Well I don't know about that, but what the one I did, you could zoom in and you could actually see like the words like on something that you would've never seen. I think it was the penny and it was something the, maybe I'm thinking
- Of something from a TV
- Show. But anyway, it was just, I would've never even been able to see that with the naked eye. So that's crazy. Yeah,
- I think that was on Grace's Anatomy. Okay.
- Maybe, I dunno
- For those that, so a lot of people are scared of surgery, right? I mean it's, it is. You're going under most of the time. And so you're really putting, patients are putting their trust in the surgery team and their surgeon. So what do you tell patients? How do you, so
- I try to do my homework most of the time. If you're seeing me in the clinic, I've done my homework on you the night before. So when I'm popping my head in to meet you for the first time, I kind of know what the imaging looks like. I know the story from the physician. So most of my approach is essentially sitting down just like we're doing right now and kind of hearing the patient's perspective of it. 'cause that's what I don't have yet. That's the gap I don't have for my, for my documentation is what is their side of the story. Why are you here? And that's a common question of what I'll start with. And it kind of throws 'em back like, don't you already know? Yeah. Well yeah I know what the doctor's telling you here for, but you tell me your side of the story. And so that gets me that subjectiveness so I can truly understand are their symptoms going to match up with the disease process? Because if they're not, I can do the best hernia repair in the world. But if they came in and their symptoms don't truly match up with the hernia, they're gonna be disappointed with that result. Yeah. And so I'll spend most of my time just kind of talking and hearing their side of the story and then I'll spend another five or 10 minutes looking for snakes under rocks. You know, where's that, where's that snake? Where's the blood thinner that's gonna stop me. Where's the irregular heart rate? You know, something along those lines. And then we kind of talk about the surgery for the rest of it and we'll say, all right, this is what I think you need. I recommend this operation. And I try to use picture diagrams because I, I do ramble as I do now. I will ramble in that clinic appointment with the patient. And so I'll use a lot of picture diagrams so it kind of makes sense to the individual, this is the organ we're going after, this is the approach we're gonna use. If you don't like that we have other options. And I'll bring those into the conversation. And then after that part, because remember most of the days the patient is also coming in having done some homework and Dr. Google is not their friend. Yeah. We talk about that a lot. Okay. And so Dr. Google has already given them some information. Yeah. And so the last part of it is really after I've gone through what I think we ought to do, whether it's surgery or hold off, it's what questions do you have based on your homework from Dr. Google? And some of it's accurate, some of it isn't. But we try to dispel that part for the, the final part of it. And then any additional questions are answered. And then usually at that point you've got the patient pretty comfortable, you've got them understanding their process, what what are true, realistic expectations and if they're comfortable, I let 'em meet my scheduler that same day. So we try to be as efficient if I need labs, we draw labs that same day. So we get 'em through that process as quickly as possible. But also I think most of my patients will leave that office having learned something that day, feeling comfortable with it. And and sometimes you end that conversation with just saying, Hey, I've given you some information. I've given you some stuff to think about. Let give you a buzz tomorrow. Yeah. You head out today, you talk to family and stuff like that. 'cause there's, there's, that's one thing I love about this place is you're gonna get some different opinions, you know, and people leave that office, they're gonna, they they know Dr. So-and-so and they wanna talk to them. Yeah. Or hey, my aunt's a nurse in, in this hospital. And I was like, that's great, go talk to 'em. I'll give you buzz tomorrow. Let's finalize the plan that way. So yeah,
- I think that's great that it's, yeah, we talk about the Dr. Google a lot 'cause we know that now more than ever Yeah, people have a choice of where, I mean they even do this with their choice of their hospital. They're Googling, they're looking at reviews or they're talking, I'm in the marketing field, but word of mouth is always still gonna always be your number one referral tool. Yes. So do you have any particular story, a patient story that you found like particularly rewarding or interesting that, I mean obviously not sharing patient information, but Yeah.
- Yeah, so I mean I, the couple come to mind. So in surgery, one of the reasons a lot of people go into surgery is this instant gratification. We get to fix a problem right there on the spot. So if it's a gallbladder attack, they come in with pain in that right of a quadrant. You take the gallbladder out, you're their hero right there. So it's instant gratification. You fix that problem. And so that kind of comes with the territory. But just thinking about patients that have kind of popped in my head recently was a kind of a cool, interesting zebra case was something called a pheochromocytoma cytoma. And that's a neat tumor that involves the adrenal gland. So think with the adrenal gland kind of adrenaline, that surge of hormone. And this was a young athletic individual, healthy otherwise that was showing up in the ER with kind of panic attacks. Blood pressure was uncontrolled, shortness of breath and chest pain, like truly having chest pain with this. And they found this tumor by doing a, they stumbled upon it by doing a PE protocol ct. So they got a CAT scan of her chest trying to rule out a blood clot based on her symptoms. And a CAT scan of the chest always goes just low enough to capture that adrenal gland, which sits right on top of the kidney. And so it went low enough, it caught this thing and it was a huge tumor. It was like a seven centimeter adrenal mass, which is large for the adrenal and classically lit up hypervascular. And they said, Hmm, we've got to enter, do we gotta at least entertain this, this opportunity to get this over to the endocrine surgery guy? And right away, as soon as I looked at the images, like this is gonna be a fiat, you look at her symptoms and all this, she's surging this adrenaline hormone into her system. Wow. And that's what's happening. This was a, you know, a 30 5-year-old female. Wow. This was someone that shouldn't have uncontrolled hypertension as of yet. She was running and walking every day until this tumor took over until it's causing fatigue. And she was like, if I try to run right now, my heart rate goes through the roof, I get excruciating headaches, I can't even exercise. So that was kind of a, a cool case to be able to remove that tumor and give her back life instantly. Yeah. Because the minute you clamp the vein on that tumor, blood pressure returns to normal. It's a really, really cool case to do. It kind of makes anesthesia panic a little bit because the whole case, they're preparing to block those hormones so that you don't see a systolic blood pressure of two 50. Yeah. And then the minute you clamp that vein and you get control, I do a little happy dance while I'm scrubbed in, but the blood pressure immediately drops and you're pounding that patient right there on the table with fluids. You're trying to get them hydrated back up because you've just switched tracks. Now you've got a patient who's hypotensive and you're dropping that blood pressure because you just cured 'em of all that disease. And that's a really, really cool case. And I got to see that individual for a, a follow up recently. And she's doing great and I was very, very obviously happy. She's off all blood pressure medication, she's back to exercising and, and return of her normalcy. Her, her life is back. And that's a, that's a cool finding back at work. And all the, the other case if you got time is go ahead. I wanna give a little shout out to a family doctor in town. So what we do is, is obviously a lot of fun and being a doctor is great and it's a lot of stress. There's days I come home and my wife can see on my face that I'm wearing my work, I'm bringing it home with me. She can tell my brain's still stuck in clinic and, and that that comes with I think being a decent provider for our system. But a newer family doctor to our system caught breast lesion recent recently a breast cancer. And that was, that was because she listened to her patient. The same thing I was talking about earlier was this, this patient was seeing a, a doctor and was telling her, I've got a mass, I found something, I need some help. Breast exam wasn't even performed by that provider. The patient thought fortunately was wise enough, say, I'm gonna go check out a different provider, I'm gonna get me a new family doctor. This one doesn't seem to be listening to me. That was her words, this one's not listening to me. So she met up with a new family doctor in town, Dr. Harris who I don't even know that well yet. We like her but I hear nothing but good things. But Dr. Harris got to establish care with this individual. Dr. Harris immediately listened to her, did the physical exam, found the breast cancer, and then got that patient over to our clinic for care for breast cancer. And so a little bit of, like I said, these patients, if you just sit down with 'em, spend some time, why are you here? What's the deal? You don't, they're gonna give you that talk, they're gonna tell you everything. So it's not always rocket science and it's not always the intelligence factor for physicians. It's a little bit of just being able to absorb and listen to your patients. And I think hat off to Dr. Harris, that case popped in my brain a little bit.
- You're almost a little bit of a counselor in some ways. You know, they might open up to you and tell you something they haven't told anyone else. Some
- Something's too much, some things. And you have to kinda stay in your space a little bit. What I love about my job is there's some things they'll tell me. Uhuh not your guy for that. You know, no, we gotta
- Get you to that person. That's something think it probably is such a balance because you have some people that totally overshare or maybe really did so much homework. So then you gotta know like when to tune in to what, 'cause I could, I could see as just a person, not a physician, where you could tend to be like zone, you know, kind of tuning out some things just for those. I mean, I'm just thinking of when I have somebody that overshare with me, I'm like, okay, you start drifting off. But really you have to engage and make sure you're getting down to the root of everything. You, you gotta look
- Snake. Yeah. Yeah. The, the females do great. The males, it's like pulling teeth bet to get to that really nitty gritty stuff. Like, you gotta tell me this part man. Don't hide anything I need to know. Yeah. You know, so the the best part is when the, the men will bring their wives to that appointment. Oh bet. As long as I got the CEO in the room with 'em, they will tell you the truth. Okay.
- So yes, the wives will tell, they can tell all the, all the symptoms. No, you started complaining about this actually a week earlier than that. That's correct.
- That's correct. Yeah. I have to do that with my dad. Yeah. Yeah.
- So
- It's, I have to be in the room.
- It is always nice when the husbands bring their wives or significant others to those appointments because Yes. He'll, the, the inevitably us men and we are genetically flawed with that timeline. So it's been going on for about a week. She like at least a year, you know. Yeah, yeah. So completely different stories.
- Well, I mean this has very, definitely been really insightful for me. Anything like any common misconceptions people have about surgery or anything you hear frequently that you'd wanna dispel? No,
- I, I think, I think there's a, at least when I came, you know, there's a little bit of a stereotype that goes with being a surgeon that you're this mean cold-hearted individual. And I don't think that's the case. I do think we are, most of us are incredibly stereotyped, correctly with hardworking. We, we spend a lot of time at this hospital. We spend a lot of time for our patients and, and we do care. And so some days you may catch us very tired, very overworked some days because yeah, there's, there's several of us that we will carry this work home with us. We're always thinking about that. And that's, that's part of it. So I I think hopefully you recognize at least what we're trying to build with South Georgia medical Center's surgery is that you're building compassionate individuals that truly are hardworking and want this place to succeed. And I, I think that's only gonna get better. We're trying to start with our general surgery department and kind of core it out and you're seeing specialty care. So since we've come here, we've added colorectal surgery, we've, we're adding bariatric surgery, you know, so expanding on different realms of vascular surgery and bringing in new CT surgeons and all this stuff. So it's just getting each, each realm is getting more and more in depth and you're adding these little specialty cases to surgery and that's, that's what the patient's desire, that's what they're Googling. So if they need a Whipple Yeah. They need to go see that surgeon, you know, and so they, they're smart enough to recognize that and so we've just gotta make sure to keep up with the times. Yeah. You know, and there is a lot of word of mouth. And I do love that part about South Georgia. You know, one of the best things about a small town is everybody knows you. One of the worst things about a small town, everybody knows you. Yeah. Okay. So that's still true in this town, but we've gotta make sure that we're keeping up and, and treating our patients with the, the latest and greatest in technology as well as the type of physician that's gonna be introduced to them. So,
- Yeah. Well I know you serve on our medical executive committee and as well as our quality improvement committee and probably other ones that I don't, I don't even know of, but we appreciate your service to doing that. Yeah. 'cause that's, you know,
- I, I like wearing these different hats on there because I do think I wanna be around for the future and I do think I wanna be part of that development process for the next several decades so that when you do, you know, it, it'd be nice to, to be able to see that out for several years. But bringing in bariatrics, I'm excited about that. That's a new service line that our, our area needed. So to bring that in, and again, looking toward the future with other subspecialties, surgical oncology, all these different fields, this is the wave and this is what's gonna be expected of this place. So. Cool.
- I feel like I need to know what a Whipple is now. 'cause you've said it like three times. Pancreatic
- Cancer. Sorry. I'm sorry. Sorry. Pancreatic cancer. It's a big pancreatic cancer operation.
- Yeah, well hopefully it's like one of those things you don't need to know, you know, you don't know unless you know somebody. I was just curious.
- No, no, no. So it, it's, it's just, it's well described in the literature. Certain organs and, and the pancreas being one of them. High volume surgeon, high volume surgeons. So thyroid's kinda like, that's got a lot of literature out there. Most thyroid surgeons, if you're gonna get an operation, you need to be doing at least 50 to a hundred per year. And parathyroid, same thing. Adrenal certain things. So there's these numbers out there and patients are wise enough to kind of find them and they go find and seek out those high volume surgeons. So.
- Alright, well, we got it. Last question. This one's the hardest question. One last question.
- Oh boy.
- I don't, I didn't include it in your talking point.
- Oh gosh. Okay. We
- Just always ask everybody, since we know all of our physicians and most, you know, nurses, people spend so much time here. What is your favorite thing to eat? Oh, all right. And our cafeteria or all size?
- Great question. All right. So I'm a, I'm a big foodie and I'll try anything, but we just started doing these smash burgers in the spice. They're really good. Do pepper jack, add onions to it and get all the sides. It's fantastic. So yes, I, I enjoy eating smashburger if I'm ever gonna be home late. I know the spice has me covered, so Yes.
- Somebody else said that too, I feel like, but yeah, I haven't tried one. I'll have to try
- One. I I had one the first day that they started, I was like, I'll, I'll try. I'm like you, I'll try anything. Anything's good. And I like to keep a variety and so, yeah. You know what's
- Up. They, they do it well, they do it well. Alright,
- Well we thank you and we know thank y'all. Like you said, you, our physicians spend a lot of time here and a lot of time with their patients and are truly our unsung heroes. Just dedicating your lives to improving the health of our community. So this part of our podcast was really to give our community a chance to hear a little bit from our physicians to know more, get to know them, get to know them on a more intimate basis. So I just appreciate you taking time with us today.
- Yes, definitely.
- No, thank y'all. So I, I, I, I'm a big fan. I watched several podcasts, but this was cool to be part of one, so thank you.
- All right, well thank you all very much for tuning in and be sure to like and subscribe. I always feel like my little sun, wouldn't I say that because one time he pretended he had a YouTube channel and he always said like, and subscribe. So I feel really awkward saying it. I'm just throwing that out there. But I still say it. So like, and subscribe.
- And also, know, Erika has a really big office. I just learned that. So I'm looking around. I was like, man, she's got a really spacious office, so it's great.
- I had to find somewhere to, we'd have no more room left in the hospital. No, because we're growing so much. So I had to make my own space. But anywho, all right. Thank you for tuning in. We'll catch you next time.