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Welcome to "I'm Dying to Tell You," where we shine a light on resilience and hope. In this special episode, we're celebrating six years of I AM ALS, an organization created for patients, by patients.Why is this so important? Because for far too long, those most impacted by ALS weren't leading the charge in our collective mission for a cure. But I AM ALS changed the game. By putting patients at the forefront, they are not only better equipped to serve the ALS community, but we're operating on the ALS clock—pushing for accelerated progress every single day.Today, I'm thrilled to chat with four incredible volunteers, Tim Abeska, Randy Gregory Jr., Cristy Hardin & Deb Winters about how I AM ALS continues to be driven by patient voices, advocating, empowering, and fighting to make ALS a thing of the past. We'll dive into the work of the I AM ALS Community Teams, their ongoing efforts, and how YOU can get involved in this powerful movement.So, listen in and be inspired to join these teams of patients, caregivers, and advocates who prove that the impossible is possible—every single day. Thank you for sharing this celebration. Hugs, LorriFollow and see what's coming next: Instagram, Facebook, Twitter, TikTok, LinkedIn.
Brian Wallach's life changed when he was diagnosed with ALS at just 37. He and his wife, Sandra Abrevaya, used their political skills from the Obama White House to begin advocating for the cause. Katie Couric is one of the executive producers for a documentary featuring the couple, "For Love & Life: No Ordinary Campaign."
Donald Trump is forced to remove a video promising "a unified Reich" as Joe Biden and Kamala Harris go on the attack against Trump's latest nod to Nazi language. Dan and Addisu Demissie discuss how Democrats should capitalize on Trump's mistakes, including an interview where Trump left the door open to bans on contraception. Then, Jon chats with friends of the pod Brian Wallach, Sandra Abrevaya, and Katie Couric about their new documentary on turning Brian's ALS diagnosis into an opportunity to organize, advocate, and push for a cure.
In this week's episode, influencer Brooke Eby joins Brain & Life co-host Dr. Katy Peters. Brooke discusses her experience living with amyotrophic lateral sclerosis (ALS) and why she chooses to share it with the world on social media. Then, Dr. Peters is joined by Dr. Richard Bedlack, an associate professor of medicine/neurology at Duke and director of the Duke ALS Clinic. He explains ALS and what hopeful research is on the horizon. Additional Resources What is ALS? Activist Ady Barkan and Actor Bradley Whitford Works to Reform Health Care A Marathoner on a Quest to End ALS Inside Nanci Ryder's Battle with ALS Other Brain & Life Podcast Episodes on These Topics Finding Strength in ALS Advocacy with Podcaster Lorri Carrey The Campaign to Cure ALS with Brian Wallach and Sandra Abrevaya Hop on a Cure for ALS with John Driskell Hopkins We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? · Record a voicemail at 612-928-6206 · Email us at BLpodcast@brainandlife.org Social Media: Guests: Brooke Eby @limpbroozkit Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD
In this week's episode, Brain & Life Podcast co-hosts Dr. Daniel Correa and Dr. Katy Peters introduce their pets and answer a listener question about ALS. Then, Dr. Peters discusses neurologic disorders in pets with Dr. Ann Tilton. With more than 30 years of experience as a pediatric neurologist, Dr. Ann Tilton is a Professor of Neurology and Pediatrics at LSU Health New Orleans. She has also loaned her expertise to other species! She tells stories from her time diagnosing pangolins and monkeys at the zoo and shares her insights and experiences with neurologic disorders in pets. Additional Resources Can Pets Have Neurologic Disorders? Pets May Be Good for Brain Health Phineas the Cat Spreads Awareness of a Rare Neurologic Disorder I am ALS Other Brain & Life Podcast Episodes on These Topics Finding Strength in ALS Advocacy with Podcaster Lorri Carey Hop on a Cure for ALS with John Driskell Hopkins The Campaign to Cure ALS with Brian Wallach and Sandra Abrevaya We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? · Record a voicemail at 612-928-6206 · Email us at BLpodcast@brainandlife.org Social Media: Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD
This week Dr. Daniel Correa speaks with podcaster and advocate Lorri Carey. Lorri shares her story of being diagnosed with amyotrophic lateral sclerosis (ALS) and how her family has joined advocacy efforts for people in the community living with the condition. Next Dr. Correa sits down with returning medical expert, Dr. Stephen Goutman, an assistant professor in the Department of Neurology and director of the Pranger Amyotrophic Lateral Sclerosis Clinic and associate director of the ALS Center of Excellence at Michigan Medicine. Dr. Goutman discusses the different types of ALS and offers advice on approaching the conversation of possible treatments for someone living with ALS. Additional Resources I'm Dying to Tell You Podcast with Lorri Carey ALSUntangled® I Am ALS Learn more about ALS Brain & Life: A Marathoner on a Quest to End ALS Other ALS Brain & Life Podcast Episodes Hop on a Cure for ALS with John Driskell Hopkins The Campaign to Cure ALS with Brian Wallach and Sandra Abrevaya We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? Record a voicemail at 612-928-6206 Email us at BLpodcast@brainandlife.org Social Media: Guests: Lorri Carey @LorrisPodcast (Twitter); Michigan Medicine @umichmedicine Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD
Andrea Goodman, the CEO of I AM ALS, joins Charity Talks. I AM ALS was founded by Brian Wallach and his wife Sandra after he was diagnosed with ALS in 2017. ALS is a terminal neurodegenerative disease that robs people of their ability to move, speak, eat, and breathe, usually in less than five years. Brian and Sandra founded I AM ALS to find a way to empower people who are living with ALS to be a part of finding the solution for their disease. As Andrea and Brooke discuss, I AM ALS is a patient-led community that provides critical support and resources to those living with ALS, caregivers and their loved ones. It also empowers advocates to raise mainstream awareness and lead the revolution against ALS in driving the development of cures. I AM ALS is infusing hope in so many who are suffering from this disease. (0:30). Website: https://iamals.org/
Six years ago when former Obama staffer Brian Wallach was diagnosed with Amyotrophic Lateral Sclerosis - ALS - a rare neurological disease that kills most people who contract it within a few years, he and his wife Sandra Abrevaya quickly got to work. They launched a non-profit advocacy group I am ALS and a battle to try and fight for increased funding and research that they hoped would lead to a cure for the disease.Since then Wallach and Abrevaya have changed the face of medical advocacy in the country, helping secure legislation that President Biden signed in 2021 that funds $100 million worth of ALS initiatives each year. NPR's Juana Summers spent time with Wallach and Abrevaya to hear about their fight for a cure for ALS.In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community.Email us at considerthis@npr.org.
This week Dr. Daniel Correa sits down with amyotrophic lateral sclerosis (ALS) advocates and I AM ALS co-founders, Brian Wallach and Sandra Abrevaya. Brian—who was diagnosed with ALS in 2017 at 37 years old—and his wife and care partner Sandra share their family's experience with ALS and how they have utilized their skills from working on legislation and political campaigns to become effective advocates and raise awareness about this neurodegenerative disease. Next, Dr. Correa speaks with Dr. Jinsy Andrews, neurologist and associate professor of neurology in the Division of Neuromuscular Medicine and director of Neuromuscular Clinical Trials at Columbia University. Dr. Andrews discusses the advances in treatment for ALS, the evolution of clinical trials in recent years, and how these trials benefit research for other neurodegenerative conditions. Learn more about Brian and Sandra's advocacy work and find out how you can watch their documentary No Ordinary Campaign by visiting www.NoOrdinaryCampaign.com. Additional Resources Learn more about ALS Brain & Life Books series: Navigating Life with Amyotrophic Lateral Sclerosis (ALS) Read more about ALS on Brandandlife.org: at Musician John Driskell Hopkins Turned an ALS Diagnosis into a Mission to Help Others Listen to the Brain & Life Podcast: Hop on a Cure for ALS with John Driskell Hopkins https://www.synapticure.com/ https://iamals.org/ We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? Record a voicemail at 612-928-6206 Email us at BLpodcast@brainandlife.org Social Media: Guest(s): Brian Wallach @bsw5020 (Twitter); Sandra Abrevaya @sabrevaya (Twitter); Synapticure @synapticure (Twitter); I AM ALS @iamalsorg (Twitter)
Dr. Jason Crowell discusses the film, "No Ordinary Campaign", which follows the story of Brian Wallach, a former Obama staff member diagnosed with ALS. The showing is scheduled for Tuesday, April 25th, at 3:30 p.m. Eastern Time. Please find more details at https://www.aan.com/MSA/Public/Events/Details/16429.
Here I chat with Brian Wallach and his wife Sandra Abrevaya, co-founders of I AM ALS and Synapticure. At 37, Brian was diagnosed with ALS—on the same day he and he and Sandra brought their second daughter home from the hospital. In an instant, everything changed. They went from being a couple only a few years removed from both working at the White House to not knowing if Brian would live to see his 40th birthday. An otherwise healthy former college athlete, Brian expected to find a system built to help him and Sandra deal with this new reality. Instead, they found a broken and failed system in which doctors told patients to “get their affairs in order and get ready to die.” In this episode, we talk about what happened next which was to do what they do best, put hope into action. In 2019 they founded and built a patient-led revolution called I AM ALS, which is now a community of over 50,000. Next they completed a documentary film, No Ordinary Campaign. The film follows them in real time as they fight for their own future while seeking to build a brighter one for thousands of others. Recently they started, Synapticure, a telemedicine health care company for people living with ALS. We catch up on all that and talk about how they do all this while living with a terminal illness and raising two daughters 5 and 7. Today, there is no cure for ALS. There are no treatments available to save lives. As Brian puts it, you have two choices in a situation like this: curl up into a ball or act. Listen in and hear how Brian and Sandra chose to act. Thanks for sharing with a friend and leaving a review to help others join our fight to end ALS. Hugs, Lorri
When a former Obama campaign staffer was diagnosed with the progressive neurodegenerative disease ALS, he was given six months to live. But five years later, with his wife's help, Brian Wallach is still fighting the disease and raising awareness in hopes of one day finding a cure. Reporter Brandis Friedman has this story from PBS station WTTW in Chicago. PBS NewsHour is supported by - https://www.pbs.org/newshour/about/funders
When a former Obama campaign staffer was diagnosed with the progressive neurodegenerative disease ALS, he was given six months to live. But five years later, with his wife's help, Brian Wallach is still fighting the disease and raising awareness in hopes of one day finding a cure. Reporter Brandis Friedman has this story from PBS station WTTW in Chicago. PBS NewsHour is supported by - https://www.pbs.org/newshour/about/funders
Her Story - Envisioning the Leadership Possibilities in Healthcare
Meet the Guests:Since her diagnosis with ALS at age 32, Gwen Petersen has poured her energy into advancing the science of her disease. Gwen is not the stereotypical ALS face; thus, she does a lot of media work to dispel the myth that ALS is an older white man's disease. Prior to her diagnosis, Gwen worked as a Recruiter for one of the top ten medical centers in the country. Leah Stavenhagen is a globetrotter who began a career in management consulting in Paris at 26. At the same time, she learned that she had ALS. Almost five years after the onset of symptoms, she focuses her energy on advocacy work, having launched Her ALS Story in 2021 to create a network for young females with ALS. Alexandra Cavaliere spent her 20's establishing her career as an attorney working in corporate law. When at the age of 28 she was diagnosed with ALS, she began shifting her focus to family, friends, and advocacy. She now devotes her time to and her work with the women of Her ALS Story. Key Insights:This episode features three women who are diagnosed with ALS. The conversation is powerful, heartfelt, and inspiring. They share the stories behind their diagnosis, advocacy work, and vision for the future of ALS. No One-Size-Fits-All Solution. ALS is a heterogeneous disease, and so is the experience of the symptoms, progression, and effective therapies for patients. These women share their unique stories in their advocacy to emphasize the dynamic approach law makers and healthcare need to take regarding ALS treatment. Her ALS Story. These women have a group where they can provide support, openly ask for advice, and motivate themselves and each other. All three women share that their advocacy work and the support group gives them purpose. Hope-focused. Sometimes framing around terminal diseases can be depressing, but these leaders want their message to be centered around hope. Hope helps patients find their voice and purpose. And there is reason to be hopeful, including the FDA's recent approval of a third ALS drug. This episode is hosted by Sandra Abrevaya. She is a member of the Advisory Council for Her Story and the co-founder and CEO of synaptic care as well as the o-founder of I AM ALS. Relevant Links:Learn more about I AM ALSWatch the I AM ALS episode with Sandra Abrevaya and Brian Wallach on The Gary Bisbee Show
Here I chat with ALS advocate and boa flouncer Katrina Byrd about her experience as a caregiver and what led her to write, "The Language of Forgiveness." Katrina is a writer, playwright and ALS advocate, of Jackson, Mississippi. She's an inspiration to many as she is a perfect example of courage, love, acceptance and forgiveness. Katrina is legally blind and is no stranger to life obstacles of her own. Yet, she cared for her partner, Dora Robertson who died from ALS just 76 days after being diagnosed with the disease. Katrina also goes by "The Boa Flouncer" to help others going through a grief journey. Fully aware of the devastating impacts of the journey of ALS, Katrina is honored to use her alter ego, "The Flouncer" which Dora helped to develop, to recognize others who advocate, educate and create ALS awareness. She co-leads the Many Shades of ALS Community Team at I AM ALS which brings attention to and provides resources for the mental, physical and social health of people of color living with and impacted by ALS. This time, we are flouncing our boat at you, Katrina. Hugs, Lorri
Meet Brian Wallach, J.D. and Sandra Abrevaya, J.D.:In 2017, Brian Wallach, J.D. learned that he was diagnosed with ALS. He and his wife Sandra Abrevaya, J.D. are dedicating their remaining time together to help ALS patients everywhere. They founded I AM ALS, a non-profit organization that successfully advocated for millions in research through major legislation. Brian and Sandra also launched Synapticure, a care platform for ALS patients, with the backing of GV and other investors. They are on a mission to reshape our understanding and treatment of ALS.Key Insights:Brian and Sandra are truly inspirational, revealing how a family can go forward with a devastating diagnosis and what two people can accomplish in such a short amount of time.Founding I AM ALS. Sandra and Brian founded the non-profit I AM ALS to create policy change. Their advocacy facilitated the passage of Act for ALS, which allocates $100 million annually over five years for research and expands treatment options for patients. I AM ALS also provides a platform for patients and caregivers to get support and share their stories, and for volunteers to take “micro actions” that advocate for patients. (12:32)Founding Synapticure. Synapticure provides ALS patients a care coordinator that helps manage the administrative burden of coordinating between the patient's entire care team. It also facilitates access to cutting-edge and personalized testing and treatment; ALS is a heterogeneous disease with many sub-types that respond differently to targeted therapies. Sandra and Brian founded this company to create the continuity of care they wished they had during their treatment experience. (21:28)Power in the Purpose. Brian gets his energy from the knowledge that he and Sandra can change the course of ALS with their advocacy. He is driven partially by necessity, but also the belief that he can make a difference, and potentially save his life and 1000's of others. (31:00)This episode is hosted by Gary Bisbee, Ph.D. He is the Founder, Chairman, and CEO of Think MediumRelevant Links:Learn more about I AM ALS and how to take actionLearn more about SynapticureRead “I am Brian Wallach” Read “I am Sandra Abrevaya and Brian Wallach”
Meet Brian Wallach and Sandra Abrevaya:In 2017, Brian Wallach learned that he was diagnosed with ALS. He and his wife Sandra Abrevaya are dedicating their remaining time together to help ALS patients everywhere. They founded I AM ALS, a non-profit organization that successfully advocated for millions in research through major legislation. Brian and Sandra also launched Synapticure, a care platform for ALS patients, with the backing of GV and other investors. They are on a mission to reshape our understanding and treatment of ALS.Key Insights:Brian and Sandra are truly inspirational, revealing how a family can go forward with a devastating diagnosis and what two people can accomplish in such a short amount of time.Founding I AM ALS. Sandra and Brian founded the non-profit I AM ALS to create policy change. Their advocacy facilitated the passage of Act for ALS, which allocates $100 million annually over five years for research and expands treatment options for patients. They also have reframed the narrative around ALS to focus on hope. (14:00)Creating Better Care for ALS Patients. Synapticure facilitates coordinated care and gives ALS patients access to cutting-edge and personalized testing and treatment. Sandra and Brian founded this company to create the continuity of care they wished they had in their treatment experience. (23:06)Power in the Purpose. Brian gets his energy from the knowledge that he and Sandra can change the course of ALS with their advocacy. He is driven partially by necessity, but also the belief that he can make a difference, and potentially save his life and 1000's of others. (32:38)Relevant Links: Learn more about I AM ALS and how to take actionLearn more about SynapticureRead “I am Brian Wallach”Read “I am Sandra Abrevaya and Brian Wallach”
Listen in and hear how thousands of people have come together to better the lives of those living with ALS. In this episode, I celebrate I AM ALS turning 3. Here I chat with Mandi Bailey, Tony Rosello & Sandy Morris and hear how their involvement with the ALS patient-led group I AM ALS has showed them the power of a unified community. Each of them are driven by their heart to end ALS and celebrate the progress over the past 3 years. Listen in to their personal testimonies of why they continue to fight for a world without ALS. I AM ALS was created to not only cure ALS but to unlock critical breakthroughs that will help defeat Parkinson's, Alzheimer's, Frontotemporal Dementia, and beyond. You can join this fight here: https://iamals.org/. Thanks for listening, sharing with a friend and leaving a review to help others find I AM ALS! Hugs, LorriFollow: https://bit.ly/ImDyingToTellYouInstagram
Mass casualty events are rare and thus the mistakes made and lessons learned are often repeated, over and over. In this episode, emergency physician and former Special Forces medic Mike Shertz, MD walks us through the steps on how to be an effective first receiver of mass casualty victims and shares the lessons written in blood from previous events. Listen on: iTunes Spotify Stitcher Guest Bio: Mike Shertz MD is an emergency physician who spent 13 years as a Green Beret and a Special Forces medic. He is the founder and purveyor of Crisis Medicine which teaches and trains first responders in tactical casualty care. Check out this video that we did together in 2019 on how to place and remove a tourniquet and this one on how to pack a gunshot wound with combat gauze. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We Discuss: The First Receiver who is in a singularly unique position as it applies to a mass casualty [03:55]; The difference between a hospital's surge capacity and mass casualty preparedness [05:30]; What you might expect from EMS during a mass casualty as compared with a normal day [08:20]; The mindset of the medical provider after receiving a patient from EMS [10:32]; The value of a field triage score which is a simple way to stratify casualties [12:50]; How the success of a mass casualty event for the first receiver has to do with organization, throughput, and saving lives [16:15]; Lessons learned from the Christchurch, New Zealand mass shooter incident [29:45]; How your response to a mass casualty differs if you're unsure about the safety of your facility (as was the case in the 2020 Beirut explosion) [41:15]; One of the sayings of the Special Forces: ‘All lessons are written in blood' [43:27]; The question Shertz thinks people should ask of their hospital disaster planners [45:45]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
Mass casualty events are rare and thus the mistakes made and lessons learned are often repeated, over and over. In this episode, emergency physician and former Special Forces medic Mike Shertz, MD walks us through the steps on how to be an effective first receiver of mass casualty victims and shares the lessons written in blood from previous events. Listen on: iTunes Spotify Stitcher Guest Bio: Mike Shertz MD is an emergency physician who spent 13 years as a Green Beret and a Special Forces medic. He is the founder and purveyor of Crisis Medicine which teaches and trains first responders in tactical casualty care. Check out this video that we did together in 2019 on how to place and remove a tourniquet and this one on how to pack a gunshot wound with combat gauze. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We Discuss: The First Receiver who is in a singularly unique position as it applies to a mass casualty [03:55]; The difference between a hospital's surge capacity and mass casualty preparedness [05:30]; What you might expect from EMS during a mass casualty as compared with a normal day [08:20]; The mindset of the medical provider after receiving a patient from EMS [10:32]; The value of a field triage score which is a simple way to stratify casualties [12:50]; How the success of a mass casualty event for the first receiver has to do with organization, throughput, and saving lives [16:15]; Lessons learned from the Christchurch, New Zealand mass shooter incident [29:45]; How your response to a mass casualty differs if you're unsure about the safety of your facility (as was the case in the 2020 Beirut explosion) [41:15]; One of the sayings of the Special Forces: ‘All lessons are written in blood' [43:27]; The question Shertz thinks people should ask of their hospital disaster planners [45:45]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
The emergency mind is cool under pressure. But how do you get there? For most us, it's not an innate skill. Dan Dworkis MD, PhD lays out the path: graduated pressure, deliberate training, tired moves, and acknowledging the suboptimal. Listen on: iTunes Spotify Stitcher Guest Bio: Dan Dworkis MD, PhD is an emergency physician who is a clinical professor of emergency medicine at USC Keck School of Medicine. He's also host of the Emergency Mind podcast that focuses on helping individuals and teams perform better under pressure and the author of The Emergency Mind: Wiring Your Brain for Performance Under Pressure. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We discuss: Deploying psychological countermeasures when you're under stress and dealing with uncertainty [05:40]; Whether the approach to managing pressure is universal for all stressful situations [11:15]; Different modes of thought: system 1, system 2, and the recognition-primed decision-making model [15:50]; The deliberate path to becoming an expert (beyond just repetition) [20:00]; The value of training with an idea of graduated pressure [21:45]; What it means to borrow pressure from other events to succeed in something that's unrelated [25:50]; The Yerkes–Dodson law [28:45]; Why sangfroid is a good thing and how you do it [35:20]; The path to excellence which goes far beyond mastery of a specific skill [38:30]; How acknowledging the suboptimal nature of a situation when something goes wrong can help you “regroup, recover, and evolve out of any crisis” [41:50]; What does it mean to train your “tired moves” [42:55]; Dan's challenge for the Stimulus audience [52:44]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
The emergency mind is cool under pressure. But how do you get there? For most us, it's not an innate skill. Dan Dworkis MD, PhD lays out the path: graduated pressure, deliberate training, tired moves, and acknowledging the suboptimal. Listen on: iTunes Spotify Stitcher Guest Bio: Dan Dworkis MD, PhD is an emergency physician who is a clinical professor of emergency medicine at USC Keck School of Medicine. He's also host of the Emergency Mind podcast that focuses on helping individuals and teams perform better under pressure and the author of The Emergency Mind: Wiring Your Brain for Performance Under Pressure. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We discuss: Deploying psychological countermeasures when you're under stress and dealing with uncertainty [05:40]; Whether the approach to managing pressure is universal for all stressful situations [11:15]; Different modes of thought: system 1, system 2, and the recognition-primed decision-making model [15:50]; The deliberate path to becoming an expert (beyond just repetition) [20:00]; The value of training with an idea of graduated pressure [21:45]; What it means to borrow pressure from other events to succeed in something that's unrelated [25:50]; The Yerkes–Dodson law [28:45]; Why sangfroid is a good thing and how you do it [35:20]; The path to excellence which goes far beyond mastery of a specific skill [38:30]; How acknowledging the suboptimal nature of a situation when something goes wrong can help you “regroup, recover, and evolve out of any crisis” [41:50]; What does it mean to train your “tired moves” [42:55]; Dan's challenge for the Stimulus audience [52:44]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
The phrase “too much on my plate” and word “busy” are pervasive in modern discourse. But does it have to be so? We certainly didn't start out that way as children! In this episode, Dr. Christina Shenvi walks us through the path to clear our ‘schedule plates' and open space in our lives, get un-busy, and conquer the email inbox. Listen on: iTunes Spotify Stitcher Guest Bio: Christina Shenvi MD, PhD is an emergency physician at the University of North Carolina, Chapel Hill where she is the director of the UNC Office of Academic Excellence and the newly appointed president of the Association of Professional Women and Medical Sciences. A frequent guest on Stimulus, Dr. Shenvi is a world class time managment coach www.timeforyourlife.org where her goal is to help busy professionals find more peace with their schedules, feel less stressed, and use their time more effectively.. Her most recent Stimulus episodes were on Procrastination and Habits. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We discuss: The insidious path of getting to the point of having too much on your plate [02:00]; A framework for deciding whether to say “yes” or “no” to things [05:45]; The 4 pillars Rob uses to help guide “yes” or “no” decisions [08:30]; Why it's problematic to think of life as a zero sum game makes [10:20]; The Japanese concept of Ikigai [13:30]; Becoming more efficient by shrinking the amount of time you spend on things that are on your plate [15:45]; The 5 Whys technique for understanding the fundamental bedrock of your motivation [19:30]; Self worth theory, which helps explain both why we overwork/overcommit as well as why we sometimes procrastinate [25:00]; The concept of Stoic meditation and the Ozymandias exercise [30:10]; The constant struggle of determining if your work is aligning with your values and using Stoic indifference to suspend self-judgement [32:00]; Choosing to do things vs. “I should” [33:40]; Reframing the notion of being too busy [40:44]; Deep work [43:30]; The importance of creating a system for shallow work [46:15]; The freedom gained from managing your email inbox [51:50]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
The phrase “too much on my plate” and word “busy” are pervasive in modern discourse. But does it have to be so? We certainly didn't start out that way as children! In this episode, Dr. Christina Shenvi walks us through the path to clear our ‘schedule plates' and open space in our lives, get un-busy, and conquer the email inbox. Listen on: iTunes Spotify Stitcher Guest Bio: Christina Shenvi MD, PhD is an emergency physician at the University of North Carolina, Chapel Hill where she is the director of the UNC Office of Academic Excellence and the newly appointed president of the Association of Professional Women and Medical Sciences. A frequent guest on Stimulus, Dr. Shenvi is a world class time managment coach www.timeforyourlife.org where her goal is to help busy professionals find more peace with their schedules, feel less stressed, and use their time more effectively.. Her most recent Stimulus episodes were on Procrastination and Habits. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We discuss: The insidious path of getting to the point of having too much on your plate [02:00]; A framework for deciding whether to say “yes” or “no” to things [05:45]; The 4 pillars Rob uses to help guide “yes” or “no” decisions [08:30]; Why it's problematic to think of life as a zero sum game makes [10:20]; The Japanese concept of Ikigai [13:30]; Becoming more efficient by shrinking the amount of time you spend on things that are on your plate [15:45]; The 5 Whys technique for understanding the fundamental bedrock of your motivation [19:30]; Self worth theory, which helps explain both why we overwork/overcommit as well as why we sometimes procrastinate [25:00]; The concept of Stoic meditation and the Ozymandias exercise [30:10]; The constant struggle of determining if your work is aligning with your values and using Stoic indifference to suspend self-judgement [32:00]; Choosing to do things vs. “I should” [33:40]; Reframing the notion of being too busy [40:44]; Deep work [43:30]; The importance of creating a system for shallow work [46:15]; The freedom gained from managing your email inbox [51:50]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
Sandra Abrevaya shares what it's like to care for her husband, Brian Wallach, who was diagnosed with amyotrophic lateral sclerosis (ALS), four years ago. She also discusses the mission of I Am ALS, the nonprofit the couple founded to provide hope for others with ALS -- and to help find a cure.
Sandra Abrevaya is the co-founder of I AM ALS and a caregiver to her husband, Brian Wallach, who was diagnosed with ALS in 2017. Jennifer invites Sandra on the show to discuss her family's journey post-diagnosis, explaining the disease to her two daughters, launching their successful patient-led nonprofit organization, navigating the isolating effects of COVID, and maintaining hope through the discomfort and difficulties of caregiving. Sandra also explains why now is the time to join the fight against ALS. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com See acast.com/privacy for privacy and opt-out information.
Sandra Abrevaya is the co-founder of I AM ALS and a caregiver to her husband, Brian Wallach, who was diagnosed with ALS in 2017. Jennifer invites Sandra on the show to discuss her family's journey post-diagnosis, explaining the disease to her two daughters, launching their successful patient-led nonprofit organization, navigating the isolating effects of COVID, and maintaining hope through the discomfort and difficulties of caregiving. Sandra also explains why now is the time to join the fight against ALS. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Scott Weingart is arguably one of the most influential and polarizing physicians on the planet. He is not one to mince words and often comes across as definitive in how he describes his practice of medicine. What people don't realize, he says, is that his clinical care is often guided by fear, not bravado, ego, or machismo. In this episode, Scott breaks down his five fears when it comes to medical practice and thinks that those who seek to follow his advice should take these fears into account before acting. Listen on: iTunes Spotify Stitcher Guest Bio: Scott Weingart is an emergency physician who went on to complete fellowships in Trauma, Surgical Critical Care, and ECMO at the Shock Trauma Center in Baltimore. He is currently chief of the Division of Emergency Critical Care at Stony Brook Hospital and a tenured professor of emergency medicine at Stony Brook Medicine. He is best known for his podcast on Resuscitation and ED Critical Care called the EMCrit Podcast; it currently is downloaded > 400,000 times per month. Scott is the author of multiple books including Emergency Medicine Decision Making and the Resuscitation Crisis Manual. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We discuss: The distinction between carrying fear and being afraid [06:50]; Delayed sequence intubation (DSI) as an example for how healthy fear can keep things safe in the emergency department [09:30]; The importance of embracing the idea that sick patients don't take a joke [13:40]; Scott's fear number one: lawyers [15:15]; A common fear that Scott does not personally experience: being an imposter [21:00]; Fear of Monday morning quarterbacking [28:10]; Fear of procedural complications [33:15]; How Scott Weingart is not a jerk. He's an acquired taste. [41:35]; Scott's final fear: a patient dying on his watch [46:55]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
Scott Weingart is arguably one of the most influential and polarizing physicians on the planet. He is not one to mince words and often comes across as definitive in how he describes his practice of medicine. What people don't realize, he says, is that his clinical care is often guided by fear, not bravado, ego, or machismo. In this episode, Scott breaks down his five fears when it comes to medical practice and thinks that those who seek to follow his advice should take these fears into account before acting. Listen on: iTunes Spotify Stitcher Guest Bio: Scott Weingart is an emergency physician who went on to complete fellowships in Trauma, Surgical Critical Care, and ECMO at the Shock Trauma Center in Baltimore. He is currently chief of the Division of Emergency Critical Care at Stony Brook Hospital and a tenured professor of emergency medicine at Stony Brook Medicine. He is best known for his podcast on Resuscitation and ED Critical Care called the EMCrit Podcast; it currently is downloaded > 400,000 times per month. Scott is the author of multiple books including Emergency Medicine Decision Making and the Resuscitation Crisis Manual. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We discuss: The distinction between carrying fear and being afraid [06:50]; Delayed sequence intubation (DSI) as an example for how healthy fear can keep things safe in the emergency department [09:30]; The importance of embracing the idea that sick patients don't take a joke [13:40]; Scott's fear number one: lawyers [15:15]; A common fear that Scott does not personally experience: being an imposter [21:00]; Fear of Monday morning quarterbacking [28:10]; Fear of procedural complications [33:15]; How Scott Weingart is not a jerk. He's an acquired taste. [41:35]; Scott's final fear: a patient dying on his watch [46:55]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
Most of us don't give a lot of thought to how and when we listen to podcasts. But like most of life, an intentional approach can reap benefits. In this episode, Josh Russell walks us through: strategies for maximizing retention, listening based on brain state, new data on listening while driving, the value of silence. Listen on: iTunes Spotify Stitcher Guest Bio: Joshua Russell, MD is clinician, writer, and educator. Since completing residency training in Emergency Medicine, Dr. Russell has had a varied career including supervising PAs and NPs as a medical director for a regional Urgent Care network, contributing to various Hippo Education podcasts, and serving as the Editor-in-Chief of the Journal of Urgent Care Medicine (JUCM). Most recently, he has completed fellowship training in Hospice and Palliative Medicine at the University of Chicago Medical Center. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We discuss: Strategies for maximizing retention of podcast content [04:20]; How your working memory is like the RAM of your brain [08:40]; Why Josh prefers to listen to podcasts in the morning as this is when he is best able to focus [10:20]; The importance of using your brain for tasks that are appropriate for the state that it's in [12:45]; The fact that not every interstitial moment needs to be occupied by something educational or entertaining [15:55]; How Rob consumes podcasts [17:10]; A recent study which evaluated the knowledge gained from listening to podcasts while driving compared to that gained from undistracted listening [20:40]; The value of silence [24:10]; A functional MRI study which shows that listening to a story-based podcast lights up huge areas of the brain [28:35]; A study in mice which found that 2 hours of silence per day led to neurogenesis whereas background or white noise didn't [29:00]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
Most of us don't give a lot of thought to how and when we listen to podcasts. But like most of life, an intentional approach can reap benefits. In this episode, Josh Russell walks us through: strategies for maximizing retention, listening based on brain state, new data on listening while driving, the value of silence. Listen on: iTunes Spotify Stitcher Guest Bio: Joshua Russell, MD is clinician, writer, and educator. Since completing residency training in Emergency Medicine, Dr. Russell has had a varied career including supervising PAs and NPs as a medical director for a regional Urgent Care network, contributing to various Hippo Education podcasts, and serving as the Editor-in-Chief of the Journal of Urgent Care Medicine (JUCM). Most recently, he has completed fellowship training in Hospice and Palliative Medicine at the University of Chicago Medical Center. This episode is in support of the I AM ALS. I AM ALS was founded by Brian Wallach and his wife Sandra shortly after his diagnosis at the age of 37. He was given 6 months to live, and now 4 years later he is leading a revolution to find a cure. People often refer to ALS as rare, which is not really so. The lifetime risk is around 1 in 300. Since Lou Gehrig was diagnosed 80 years ago, available treatments have been shown to extend life a mere 3 months. I AM ALS supports research, legislation to fast track therapies, and provides critical resources to patients and caregivers. ALS is relentless, and so are they. The question is no longer if we'll find a cure for ALS, but when. This is an underfunded disease and every little bit makes a difference. We will match donations to I AM ALS up to $5000 -- get started here on our Stimulus Donation Page. And for your daily dose of positivity, follow Brian on Twitter. We discuss: Strategies for maximizing retention of podcast content [04:20]; How your working memory is like the RAM of your brain [08:40]; Why Josh prefers to listen to podcasts in the morning as this is when he is best able to focus [10:20]; The importance of using your brain for tasks that are appropriate for the state that it's in [12:45]; The fact that not every interstitial moment needs to be occupied by something educational or entertaining [15:55]; How Rob consumes podcasts [17:10]; A recent study which evaluated the knowledge gained from listening to podcasts while driving compared to that gained from undistracted listening [20:40]; The value of silence [24:10]; A functional MRI study which shows that listening to a story-based podcast lights up huge areas of the brain [28:35]; A study in mice which found that 2 hours of silence per day led to neurogenesis whereas background or white noise didn't [29:00]; And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
Listen in as I talk to Leah Stavenhagen, 28, about her ALS journey and the "In Her ALS Shoes" movement she created. "I was an active 26-year-old so why did I feel like my feet couldn’t quite keep up? She couldn’t find my knee-jerk reflex and suggested that I visit a neurologist. Naively, I didn’t understand why I was being referred to a neurologist over a podiatrist. This quickly changed. I learned that I had ALS and a 2-5 year life expectancy." That is from my guest, Leah. In this episode, hear Leah share what it was like learning she had ALS, how it changed her perspective on life and how she's empowering other young women. Leah is leading a movement called "In Her ALS Shoes" where women who were diagnosed with ALS under the age of 35 are teaming up to support each other and to raise awareness that ALS can affect anyone. Please consider supporting this movement by sharing this episode. If you were diagnosed under the age of 35, share your story https://iamals.org/action/in-her-als-shoes/ here. Detailing your ALS story will help other young women feel connected, relatable and less lonely. Thank you for listening and sharing with a friend. Hugs, LorriFollow: https://bit.ly/ImDyingToTellYouInstagram and https://bit.ly/ImDyingToTellYouTwitterIf it's in your heart to rate and review this episode, please do. It really helps new listeners find this special community. Thank you.
In 2017, Sandra Abrevaya and Brian Wallach had it all. She was the president of Thrive Chicago, a non-profit in her hometown aimed at bettering the lives of the city's young people, he had his dream job as an Assistant US Attorney, and together they had two beautiful little girls. Then, on the day they brought their second daughter home from the hospital, Brian went to the doctor for a nagging cough. During the appointment he shared other strange symptoms he'd been having, most notably difficulty grasping a pen. The doctor eventually said he thought Brian had ALS and as little as six months to live. Over the next many months, Brian and Sandra, who met while working on Barack Obama's 2008 presidential campaign, realized there was a void in the ALS advocacy sector, and they could fill it. They founded I Am ALS, an organization that in just two years has propelled $83 million in federal money toward ALS research and treatments and, through its website, www.iamals.org, has given ALS patients and their families a place to go to find community, support and answers. This is a story of hope against the odds, of creating the change you want to see and of pressing on even as Brian's ALS has almost completely robbed him of his ability to speak and walk.