Podcasts about serious news

In June's VermontBiz, we take a close look at Rutland. From one side of the county to the other, its communities are buzzing with renewed energy and enthusiasm. Our conversations with community leaders indicate that the county's economy is steady and providing new opportunities but organizations are braced for federal funding cuts and potential losses. In Environmental news, Vermont missed its emissions goals, despite a drop in fossil fuel use and pollution levels. And a verdict is expected soon in the tree cutting case in Green Mountain National Forest. VermontBiz also gets into the summer spirit with a “Scoop” on Prouty's Parlor - a new mother-daughter owned and operated Ice-Cream shop located in Merchant's Row in Rutland! And don't miss our special SBA insert featuring Small Business Persons and Small Business of the year awards! All this and more is in the June issue of VermontBiz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In May's VermontBiz, meet the writer behind the profiles that we've been featuring since 2002! Our own Joyce Marcel has explored everything from the unexpected success of croutons to the cutting edge technology of electric airplanes. After writing more than 200 cover stories, she is putting away her pencil looking forward to retirement. VermontBiz reports on the economic upheaval for agricultural producers in Vermont caused by the Trump administration's tariffs. We also shed some light on the 8 farm workers in Berkshire detained by armed agents of US Border Patrol. And don't miss our special Best of Business AWARDS section! The 9th annual BOB Awards honor over 120 Vermont business “treasures” identified by over 66,000 readers during our survey in early 2025. Who are the winners? Pick up an issue and find out! All this and more is in the May Issue of VermontBiz – Celebration more than 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In April's edition of VermontBiz we take a close look at Killington Mountain Resort, which is set to undergo a metamorphosis to solidify its reputation as a world-class, four-season destination. We discuss this public private partnership with Michael Sneyd,[snaid] president of the Resort Residential Division for Great Gulf, who is spearheading the project. At the University of Vermont, an academic from out West, Dr. Marlene Tromp,comes East to be UVM's 28th president. In Vermont Biz Construction Industry news: 2024 ended on a high note and the industry anticipates similar results this construction season, despite the Trump administration's threatened tariffs on goods from Canada and Mexico. And don't miss our special insert in partnership with the Vermont Chamber announcing the 19th annual Best Places to Work in Vermont! All this and more is in the April Issue of VermontBiz - Celebrating more than 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In March's VermontBiz we turn the spotlight on Windsor County. Restaurants and retail businesses had one of their best years in 2024 -and saw their bottom lines increase as the pandemic finally moved to the rearview. At long last, some dreams are becoming visible. We also look at what it takes to create a tech focused business ecosystem in Springfield. The Black River Innovation Campus recipe includes surrounding entrepreneurs in a supportive network of training, community, and housing. VermontBiz details concerns about the Waterbury Dam facelift: Officials say the dam needs repairs if it's to withstand more of the catastrophic floods that have recently hit the area. And Governor Scott's proposed massive changes to school district size and call for the creation of local advisory councils, to “promote high levels of community engagement,” is baffling local education officials statewide. All this and more is in the March Issue of VermontBiz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In February's VermontBiz we bring you a profile of Corinne Prevot, the young owner, founder and designer of the proudly made-in-Vermont outdoors accessories brand Skida. Learn how this Pennsylvania native's entrepreneurial spirit and passion for the outdoors turned a high school hobby into a thriving Vermont business. VermontBiz's Economic Report focuses on Lamoille county: preparing for growth, infrastructure and the future. Can careful planning birth a region that serves full-time residents,second-home owners and tourists? In a tale of transformation: Emily and Justin Rose converted the former IGA in North Ferrisburgh into The Piano Gallery. The sales floor — once the grocery department — showcases new and refurbished pianos, while the old stockroom is now a workshop for in-house repairs. Finally — VermontBiz is pleased to honor outstanding business of the year: Union Mutual Insurance! All this and more is in the February Issue of VermontBiz, Serious Business...Serious News! For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In our most anticipated issue of the year, January's VermontBiz brings you Vermont's top 111 companies ranked by sales revenue. And this 38th edition is packed with charts showing Vermont's fastest growing companies from last year to 36 years ago, with profiles of Vermont Smoke and Cure, Connor Contracting, Ivy Computer and others. Plus, we identify firms to keep your eye on for their growth and innovation over the last 5 years, including Fluency, Mamava, Champlain Housing Trust, 89 North and Twincraft. After his overwhelming victory in the fall elections, VermontBiz has an exclusive interview with Governor Phil Scott as he begins his 5th term. He still has quite a bit of “unfinished business…” And we get a sneak peek at the revitalized Waybury Inn, a beloved East Middlebury landmark (now under new ownership) All this and more is in the January Issue of VermontBiz. Celebrating more than 50 Years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In December's VermontBiz, we profile a pilot program that helps individuals with bachelor's degrees attain their teaching certification while earning a salary and gaining classroom experience. Can it solve Vermont's teacher shortage crisis? We also speak to Matthew Vaughan, chief scientist at the Lake Champlain Basin Program, and Rebecca Diehl, a research assistant professor at UVM, to learn how Lake Champlain scientists are prepping for future floods. In Health care news, OneCare Vermont, a pioneering accountable care organization committed to enhancing Vermont's health care system, has announced its intention to cease operations at the end of 2025. And VermontBiz is celebrating the holidays by supporting local nonprofits in our annual holiday giving guide, featuring Vermont based organizations. Please consider not only giving monetarily to these nonprofits but also volunteering your time and talent. All this and more is in the December Issue of VermontBiz — Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

November's VermontBiz profiles Lisa Keysar - President and CEO of Montpelier's Union Mutual of Vermont. This year the company celebrates its 150th anniversary and Keysar is the 15th person to be the company's CEO and the first woman to lead the firm since it was founded in 1874. A Migrant Justice study spotlights the numerous challenges faced by immigrant workers on dairy farms throughout the state, including low wages, unsafe working conditions, substandard housing and discrimination. And Frontier Airlines is coming back to the 802! Burlington International Airport is anticipating even further growth, and plans a $50 million dollar upgrade! Make sure to check out VermontBiz' special section on the 15th annual Rising Stars Class of 2024, highlighting the top 40 new leaders in Vermont under 40 years of age. All this and more is in the November Issue of VermontBiz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

Woodsy reveals the item he stole from one of his former clubs, Peter V'Landys joins us and Liz Hayes remembers the late George Negus   See omnystudio.com/listener for privacy information.

In September's VermontBiz, we profile Janice St St. Onge, a true pioneer in the investment community who has been working quietly to improve the economy for several decades. In 2011, she created the for profit Flex Fund - providing flexible risk capital for young companies in Vermont's food system, forestry and clean technology spaces We also look at the Construction industry which is having a tremendous year! Building projects may not be as visible as they were a few years ago. The most obvious construction today involves infrastructure. VermontBiz' economic report focuses on Franklin County – which continues to sit on the three-legged stool of agriculture, manufacturing and tourism. Finally - it's award time! We celebrate the 25 fastest-growing companies in Vermont over the past five years. All this and more is in the September Issue of VermontBiz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

August's VermontBiz profiles Joyce Judy, the longtime president of Community College of Vermont. During her tenure at CCV, Judy has transformed the college into a leader in innovation and creativity — qualities not typically associated with community colleges. In many ways CCV is reinventing what a college can be! In more sobering news, the Green Mountain Care Board reports that the state health care system is in crisis. They warn that unless immediate action is taken to transform Vermont's health care system it will be financially unsustainable by 2030. And on a more optimistic note: on the heels of yet another recent flood event in July, the state is reporting some stubborn gains in reducing Greenhouse gas emissions as it embarks on an ambitious plan to create a Clean Heat Standard and Climate Superfund. All this and more is in the August Issue of VermontBiz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

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THREEHUNDRED-TACULAR!!!!! We give a new spin on our 91 headlines, Then get into our weekly racing updates. Finally for our 300th episode we're talking about why we do this?.... Like, Comment, and Subscribe! Follow Us: @ninetyoneoctane ​ Email Us: info@ninetyoneoctane.com Website: https://www.ninetyoneoctane.com - Use Code "JACKSTANDS" for 10% Off & Free Shipping on Orders Over $35 Discount Codes - 5% off at Advanced Sim Racing: Use code NINETYONEOCTANE or visit https://www.advancedsimracing.com/ninetyoneoctane - 5% off at APEX Sim Racing: Use our code NINETYONEOCTANE or visit https://www.apexsimracing.com/29085 - 5% off at SimSportGadget Sim Racing: Use our code NINETYONEOCTANE or visit https://www.simsportgadget.com/ninetyoneoctane Affiliates - MOZA Racing: https://mozaracing.com/?ref=ninetyoneoctane - Fanatec: https://shorturl.at/ajFKV - Trakracer: https://shorturl.at/uL0R5 Thank you, your purchases help us keep this content going!  

Holmberg's Morning Sickness - Monday June 17, 2024 Learn more about your ad choices. Visit megaphone.fm/adchoices

Holmberg's Morning Sickness - Monday June 17, 2024 Learn more about your ad choices. Visit megaphone.fm/adchoices

In June's VermontBiz, we profile Ann and Ben Clark of Ann Clark Limited - a company that broke the mold by creating the mold! This mother-son cookie-cutter endeavor based in Rutland holds up to 75% of the US Cookie Cutter market! VermontBiz also looks at the revitalization of Rutland County's economy — which may hinge on infrastructure — but not just roads, bridges and utilities. Rewriting the regional plan, fostering connections at co-working spaces and supporting volunteers and cultural institutions are equally vital to creating a vibrant community that attracts new residents and businesses. In Environmental news, the rollout of new fast-charging stations offers relief to Vermont's EV drivers and 14 more new sites may soon be on the way! And don't miss our special SBA insert featuring Small Business Person and Small Business of the year awards! All this and more is in the June issue of VermontBiz. Celebrating over 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

Your patient was in a terrible car crash and is currently intubated with multiple traumatic injuries that will need surgery. Family has just arrived and all they've heard is that he has a broken leg. How do you share this serious news with family? What do you do when they become angry, cry or bombard you with questions that you don't have answers to? Join the surgical palliative care team from the University of Washington as we role play a difficult conversation with a standardized patient. We will identify common challenges that arise and discuss key skills to navigate these situations. Hosts:  Dr. Katie O'Connell (@katmo15) is an assistant professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is a PGY7 current palliative care fellow at the University of Washington, formerly a UW general surgery resident and Parkland trauma/critical care fellow.  Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY5 general surgery resident and current surgical oncology research fellow at the University of Washington. Dr. Virginia Wang is a PGY2 general surgery resident at the University of Washington. Learning Objectives: ·      Identify common pitfalls encountered during difficult conversations ·      Learn how to synthesize complex medical information and construct a succinct headline statement to deliver a digestible take-home message ·      Develop skills to respond to emotional cues using empathetic statements References: ·      “Responding to Emotion.” Vitaltalk. Accessed March 4, 2024. https://www.vitaltalk.org/guides/responding-to-emotion-respecting/ ·      “Serious News.” Vitaltalk. Accessed March 4, 2024. https://www.vitaltalk.org/guides/serious-news/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In May's VermontBiz, meet the team behind Fluency Inc - a privately held, self-funded, successful and still-growing company founded by former executives from Dealer.com. Learn their back story and why these Startup founders say a mutual interest in each other's well-being is key to their success. VermontBiz reports on the private meetings held to replace Dick Mazza after the Senate veteran's sudden resignation catches even his closest supporters by surprise. Our Windham Country Economic Report indicates that the overall outlook has improved - with several established businesses changing hands to serve a new generation. And don't miss our special Best of Business AWARDS section! The 8th annual BOB Awards honor over 120 Vermont business “treasures” identified by over 79,000 readers during our survey in early 2024. Who are the winners? Pick up an issue and find out! All this and more is in the May Issue of VermontBiz. Celebrating more than 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

Welcome to episode 196.We felt we've been silly long enough, time to be mature journalists and bring you hard-hitting news covered with tact and compassion.TWD Tip of the Week: Diversify carefully and invest often and early. Your older self will thank you.

Has the job market finally flipped? Throughout most of the pandemic, it seemed that any and every worker was a hot commodity. Job-hopping was the new norm as businesses outbid each other to get the best talent. Now, thanks to rising interest rates, a slower economy, and a return to the office, it seems that employees don't have the same negotiating power they did just a couple of years ago, and the new jobs numbers are showing this. Welcome to a new type of format on the BiggerPockets Money podcast—a headlines show! We're taking some of the top news stories from the world of personal finance and the overall economy and giving you our takes so you can make better money decisions. First, a strong jobs report comes in, but unemployment still rises as Americans find it harder and harder to get the job they want. Are employers back in control after years of workers owning the market? Then, we'll touch on the latest inflation numbers and why costs are rising even as work becomes less available. Student loan borrowers receive a huge win as getting their debt discharged during bankruptcy becomes even easier. This could cause significant ripple effects for which degrees become financeable in the future! Finally, a 529 plan update that now gives parents a HUGE reason to invest in their child's future education. Click here to check the full show notes: https://www.biggerpockets.com/blog/money-512   Interested in learning more about today's sponsors or becoming a BiggerPockets partner yourself? Email us: moneymoment@biggerpockets.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In March's VermontBiz we profile Jean Giard, President and CEO of Vermont Federal Credit Union. Credit unions may look like banks and act like banks, but they are, in reality, nonprofit membership-driven financial cooperatives - and under her leadership, Giard has plans to make this Vermont's Credit Union. Check out the Vermont Biz feature on the progress of CityPlace development in downtown Burlington! After 15 Months of construction, the $200 million-dollar project will have 350 apartments, 2 hotels, retail space and is on pace to be completed by its target date of summer 2026! And our Windsor County economic report shows that businesses are back on good solid ground. After the pandemic's upheaval and summer floods that left communities playing a form of economic pick-up sticks, “good and solid” are a reprieve. All this and more is in the March Issue of VermontBiz. Celebrating more than 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In February's Vermont Biz we bring you a profile of Lindsay DesLauriers, CEO and President of Bolton Valley Ski Resort. Founded and developed by her father Ralph in the 1960s, this is as much a story of a family as it is of a business. In an era of consolidated ski resorts owned by out-of-state corporations, a family- run ski resort is a treasured rarity. Attention rail lovers - An increase in federal funding could mean the addition of 2 more Amtrak routes! Vermont Biz's Economic Report focuses on Lamoille county - The economy is strong, and good things are happening but living here is beyond the means of many. And we take a closer look at Lamoille County projects in progress, including Johnson Light Industrial Park, Smuggler's Notch Natural Resources and Parking and the Wolcott community wastewater system. Finally - we are pleased to honor outstanding business of the year: Bourne's Energy! All this and more is in the February Issue of Vermont Biz, Celebrating over 50 Years of Serious Business...Serious News! For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In December's VermontBiz, we learn more about Alejandro Hernandez, the new president of Champlain College. He has secured million-dollar grants, rejuvenated the curriculum and overseen a record fundraising year - all in his first 18 months! We also speak to Mike Lane, Co-founder and CEO of Fluency, the Vermont based business recently named one of the fastest growing companies in America by Inc. Magazine. Learn about his wild ride!! Our healthcare report looks at soaring health care costs, lack of affordable housing and how they continue to hinder the state's post-pandemic recovery efforts. And VermontBiz is celebrating the holidays by supporting local businesses in our annual holiday gift guide, featuring Vermont made products! From Flannel Pet Jackets to Pebble Art … you'll find all you need for the holidays all in one place. All this and more is in the December Issue of VermontBiz - celebrating over 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe

November's VermontBiz profiles Maura Collins, the executive director of the Vermont Housing Finance Agency, which was recently awarded $50 million to try and make a dent in the housing shortage. From building loans to building infrastructure, this brilliant and compassionate woman is up to the challenge. We also look at the Washington County Economic report: After adapting to the post-pandemic economy, Washington County now has to adapt to the consequences of climate change - call it “washing away the new normal…” Also - what's going on in Vermont transportation now? Are there new incentives business owners can offer employees? How did the summer flooding affect transportation around the state? Has a full recovery been made? We'll let you know! And VermontBiz has a special section on the 14th annual Rising Stars Class of 2023, highlighting the top 40 new leaders in Vermont under 40 years of age. All this and more is in the November Issue of VermontBiz. Celebrating over 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In October's VermontBiz we profile Green Mountain Power's president and CEO Mari McClure, who is positioning the company to stand on the revolutionary edge of our energy future. Under McClure's leadership, GMP is transitioning from a traditional utility into a technology company. VermontBiz focuses on Travel and Tourism with a look at vacationing in Vermont. The industry weathered this year's storms and looks forward to a brighter future, starting with fall foliage. Read to find out why many are bullish on this season's prospects. Our Economic Report on Bennington County shows all indications are…optimistic! Despite shortages in housing and childcare, and flooding over the summer, this community's spirit is undampened! We also introduce you to the friends who started a business as they searched for a way to connect with their loved ones diagnosed with dementia. Their solution? It's all in the cards… All this and more is in the October Issue of VermontBiz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In September's VermontBiz, we profile Patrick Boyle - a globe-trotting Scotsman with an Irish name who is the perfect choice to take over the Vermont Manufacturing Extension Center. We also look at the Construction industry which is going full tilt! There's a lot of work to do following the pandemic and recent floods. With ongoing workforce issues, most planned projects will experience a six to nine month lag time. VermontBiz' economic report focuses on Franklin County – with a long history of agriculture including dairy and maple syrup. Tourism, manufacturing, healthcare and small retailers round out the area's business landscape. Finally - it's award time! We celebrate the 25 fastest-growing companies in Vermont over the past five years. The growth rate for these companies range from 69% to an incredible 1,400%. All this and more is in the September Issue of VermontBiz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

August's VermontBiz profiles Adeline Druart, the rising CEO of Lawson's Finest Liquids. As the former president of Vermont Creamery, she is shifting from butter and cheese to beer! In 2003 Druart experienced what the French call a coup de foudre when she fell in love with her husband, and then with Vermont. Will lightning strike yet again? VermontBiz's economic feature focuses on Addison County, home to hard cider makers as well as Middlebury College and Porter Medical Center. While new developments offer an exciting outlook, many businesses are still struggling to regain their footing. Is the mood overburdened or optimistic? Finally, following the flooding of July 7-12, FEMA has sent more than 400 personnel to help with housing and infrastructure recovery and the SBA is making loans available in the counties hit hardest. Vermont Biz will keep you up to date on the recovery efforts and the impact on businesses. All this and more is in the August Issue of VermontBiz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In July's VermontBiz we profile the Jewel in UVM's Crown - Provost and senior Vice President Patricia Prelock who has been shining in her new roles for the past 4 years. And for the past 4 years, the University has been experiencing an exceptional run of successes. Coincidence? Read to find out! Sadly, Vemont's Maple Syrup producers had a less than stellar year, with production down 20% after a record high value of $84.5 million in 2022. Even with this roller coaster of a year, Vermont's sugar makers managed to roll with the weather and produce the signature maple syrup that Vermont is known for. And Vermont Biz' technology section reveals that the 130 year old Fairbanks Museum is on the cutting edge! Aligned with the Fairbanks' commitment to decarbonization, their new addition is the first in the world to use regional hemlock in cross-laminated timber construction! All this and more is in the July Issue of Vermont Biz. Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In June's VermontBiz, we profile Thomas Dee, CEO of the Southwestern Vermont Health Center. At 6'6, he is arguably at the height of his career - and faced with the tall order of shepherding the merger of SVHC with Dartmouth Hitchcock Medical Center. For this hospital administrator, leadership truly starts at the top! VermontBiz also looks at Rutland County: as Vermont's second most populated county, Rutland has tremendous opportunity - matched only by the attendant challenges of growth seen in the rest of our state. In Environmental news, Vermont has issued more than 16,000 solar permits over the last 6 years, bringing over 292,000 kilowatts of energy to the grid. (Great news, right?) Learn why our soaring solar spree is trickier than you might think! And don't miss our special SBA insert featuring Small Business Persons and Small Business of the year awards! All this and more is in the June issue of VermontBiz. Celebrating over 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

KKOB guest host Darren White calls from the US/Mexican border to discuss Title 42's expiration and what is going on down there with TJ on News Radio KKOBSee omnystudio.com/listener for privacy information.

In May's VermontBiz we have a rather “sketchy” profile of Vermont's 4th Cartoonist Laureate, Richard Veitch, who has been penning his comics for over half a century. Find out how this self described “delinquent kid from Bellows Falls” became a revered comics master! Our Agriculture section highlights expert's warnings for hikers to stay away from high elevation trails (for now) to protect natural areas from erosion and further damage. Learn what steps you can take to keep these trails in tip top shape for future generations. And don't miss VT Biz' s special Best of Business AWARDS section! The 7th annual BOB Awards honor over 100 Vermont business “treasures” identified by over 81,000 readers during our survey in early 2023. Who are the winners? Pick up an issue and find out! All this and more is in the May Issue of VermontBiz. Celebrating more than 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

In December's VermontBiz, we learn more about the woman who made history in November's Elections. Becca Balint, a former state senator is the first woman and the first gay person to represent Vermont in the US House of Representatives. She is ready to write the next chapter. In our economic profile of the Northeast Kingdom we ask: Could the region continue its comeback, given its small population, long-time economic challenges and a slowdown in pandemic funding? The answer is a yes, and then some! The VermontBiz healthcare report looks at Williston based Garnett Healthcare - a company who sees the cracks in Vermont's Healthcare System as a growth opportunity! And Vermont Biz is celebrating the holidays by supporting local business in our annual holiday gift guide, featuring Vermont made products! From Craft Nut Butter to Custom made glass to freeze dried candy … you'll find all you need for the holidays all in one place. All this and more is in the December Issue of VermontBiz - celebrating 50 years of Serious Business...Serious News. For asubscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

November's VermontBiz profiles Dr. John Brumstead, retiring president and CEO of University of Vermont Health Network. He reflects on his 30 year career - all of which he spent here in Vermont and the evolution of how medical care is delivered in the Green Mountain State. We also look at the Washington County Economic report - celebrating wins (like the growing diversity of businesses and vibrant downtowns) and acknowledging challenges: finding workers (and housing) is still tough! In our transportation focus we look at the resumption of passenger service on Amtraks Vermont Trains - The expansion of the New York City to Rutland route brought a ridership boost of 51% in August. And VermontBiz has a special section on the 13th annual Rising Stars Class of 2022, highlighting the top 40 new leaders in Vermont under 40 years of age. Finally - Woman Saves Dog...and starts business! Read about the genesis of Houndstooth and learn about canine couture!) All this and more is in the November Issue of VermontBiz . Celebrating 50 years of Serious Business...Serious News. For a subscription, call 802-863-8038 or go to vermontbiz.com/subscribe.

Peter Sagal, host of NPR's Wait Wait...Don't Tell Me!, reflects on how the show deals with serious issues in a funny way, and why that's important.

0:00 Intro 3:40 Serious News 21:53 Alaska 45:25 Other Topics  56:45 Vaccines For more updates, visit: http://www.brighteon.com/channel/hrreport NaturalNews videos would not be possible without you, as always we remain passionately dedicated to our mission of educating people all over the world on the subject of natural healing remedies and personal liberty (food freedom, medical freedom, the freedom of speech, etc.). Together, we're helping create a better world, with more honest food labeling, reduced chemical contamination, the avoidance of toxic heavy metals and vastly increased scientific transparency. ▶️ Every dollar you spend at the Health Ranger Store goes toward helping us achieve important science and content goals for humanity: https://www.healthrangerstore.com/ ▶️ Sign Up For Our Newsletter: https://www.naturalnews.com/Readerregistration.html ▶️ Brighteon: https://www.brighteon.com/channels/hrreport ▶️ Join Our Social Network: https://brighteon.social/@HealthRanger ▶️ Check In Stock Products at: https://PrepWithMike.com

Breaking Geek Radio: The Podcast is about analyzing geekdom and the things we like: an in-depth examination of movies, television, and culture. Expect reviews, a look at entertainment controversies, and other fun content! This Podcast is a once a week release coming out every Friday.   (00:00)- Intro & Jammer Complains About Internet Stuff (06:40)- Pinocchio Trailer Reaction (12:47)- Devotion Trailer Reaction (16:09)- The Bad Batch Season 2 Trailer Reaction (20:52)- 8 Minutes Of Us Not Knowing Star Wars (28:32)- Moses Ingram Faces Racism For Kenobi Role (37:13)- National Treasure 3 Is Happening (47:54)- Depp And Heard Trial Is Over And The After Effects Discussed (01:01:11)- Top Gun: Maverick Gives Tom Cruise A New Record (01:08:20)- Quentin Tarantino's New Book (01:17:49)- Who Watches: Obi-Wan Kenobi (SPOILERS Episodes 1-3) (01:32:21)- Stranger Things 4 Part 1 (SPOILER FREE) (01:35:30)- Final Thoughts And Random Talk We know how much more fun Breaking Geek Radio: The Podcast is when the entire Ladtastic 4 are able to assemble, but this we are down a Danny (@dannykbartlett). The three remaining lads, Jonesy (@sirjonesiest), Jammer (@JAMtheWriter and Nick (@geekyNICKDOLL) are hear to discuss the racism aimed at Obi-Wan Kenobi's Moses Ingram and the results of the Amanda Heard and Johnny Depp trial. The Triforce of Geekdom has happier news to discuss as well. From the return of National Treasure 3 to Top Gun: Maverick being the first Tom Cruise film to open about $100 million domestical. Crazy, huh? Also, Tarantino is writing another book? Is he done with filmmaking? We also have plenty of trailers to discuss including Devotion, Star Wars: The Bad Batch's new trailer, and the teaser for Pinocchio with Tom Hanks? Will it be better than the typical Disney live-action remake fare? Finally, we discuss the first three episodes of Obi-Wan Kenobi and Nick gives a short, spoiler free review of Stranger Things 4. What did you think of Stranger Things 4? Please sound off in the comments below or our lovely, lovely Discord! Thanks to everyone who has listened and commented over the years. We do this for you just as much as for each other. We certainly wouldn't be the premiere or flagship podcast without your support. Thank you. PRODUCER: Kyle Malone (@ThatKyleMalone) Join our Discord: discord.gg/G2bzcpDtqC Producer Kyle: twitter.com/ThatKyleMalone Visit our websites: www.lrmonline.com www.genreverse.com Follow us on twitter: twitter.com/LRM_Exclusive twitter.com/TheGenreVerse

Podcast Topics- How do I get started as an artist?- Does having followers really matter?- 3 Tulsa Artists That Don't Get Enough Credit- Tulsa's love/hate relationship w/ Bash The Rappa?- If I managed OTS JHuncho1. How do I get started as an artist?- Record a song & put it out- Get rid of nervousness and procrastination- Do a music video- Contact Sol Ray, 2Peece, Wallace Production for Recording SOngs- Contact King Spencer, Dre JSPH, Wallace Production for music videos.2. Does having followers really matter?- Could be very riskySubscribe/Like/Share/Comment/Follow3. Artists That I Dont Think Get Enough Credit4. @BashTheRappaSubscribe/Like/Share/Comment/Follow- If I managed OTS JhunchoSupport this podcast at — https://redcircle.com/tulsa-progression-podcast/exclusive-content

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0:00 Intro 10:00 Serious News 32:00 Food Shortage 54:45 Ammunition Prices For more updates, visit: http://www.brighteon.com/channel/hrreport NaturalNews videos would not be possible without you, as always we remain passionately dedicated to our mission of educating people all over the world on the subject of natural healing remedies and personal liberty (food freedom, medical freedom, the freedom of speech, etc.). Together, we're helping create a better world, with more honest food labeling, reduced chemical contamination, the avoidance of toxic heavy metals and vastly increased scientific transparency. ▶️ Every dollar you spend at the Health Ranger Store goes toward helping us achieve important science and content goals for humanity: https://www.healthrangerstore.com/ ▶️ Sign Up For Our Newsletter: https://www.naturalnews.com/Readerregistration.html ▶️ Brighteon: https://www.brighteon.com/channels/hrreport ▶️ Join Our Social Network: https://brighteon.social/@HealthRanger ▶️ Check In Stock Products at: https://PrepWithMike.com

In the second of this two-part ASCO Education Podcast episode, Drs. Stephen Berns (University of Vermont), Tyler Johnson (Stanford Medicine), and Katie Stowers (Oregon Health & Science University) continue their discussion about what it takes to deliver serious news to people with cancer effectively and compassionately. If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.   TRANSCRIPT [MUSIC PLAYING]   STEVE BURNS: Hello, and welcome to the second part of ASCO's Education Podcast focused on clinician-patient communication in the context of delivering serious news to patients and families. My name is Steve Burns. I'm an internist, hospice, and palliative care physician and associate professor of medicine at the University of Vermont College of Medicine. Once again, I'm joined by Katie Stowers, a hospice and palliative care physician and assistant professor of medicine at the Oregon Health Science University, and Tyler Johnson, a medical oncologist and clinical assistant professor of medicine at Stanford University. In our previous episode, we spoke about what constitutes serious news, the best modalities for delivering serious news particularly in the wake of COVID, who might be the best person to deliver it, and the importance of the care team as a whole. We left off on the question, how do we prepare for delivering serious news? Let's continue the conversation. [MUSIC PLAYING]   TYLER JOHNSON: Katie was talking about how we need to be realistic about the way that a conversation is going to impact us in addition to the way that it's going to impact the patient. And one thing that I have realized is that a headline, for those who maybe haven't had evals of training, is just a concise summary statement of sort of the big picture of what's going on, just like buying a newspaper article. And what I have recognized is that oftentimes, I have this almost visceral reaction against giving a headline. And if I drill down just a little bit, what I find is I don't want to give the headline because then I'm really going to have to say things the way that they are, right? If I give a five minute disquisition on creatinine and edema and chemotherapy, immunotherapy, therapeutic options and whatever, right? Then, I can just like talk a cloud around things and never actually say what it is that I'm trying to say, which then gives me the advantage of feeling like I said it, but actually sort of knowing that I never actually said it, right? And so I think the thing that the headline does is it forces me to say the thing. And then once the thing is out in the open, then we can talk about, if necessary and appropriate, some of the other nuances and whatever. But all of that is to say that often, the greatest barrier to doing that is an unwillingness to be real with myself about the information that I'm really trying to convey. KATIE STOWERS: I think this is another really great opportunity where when partners go in together, it's easier to get into the moment if you get the opportunity. Someone with a little bit of accountability, but also somebody to help you. Maybe you're able to get out the facts and they're able to tie-in the meaning. Or you end up going bigger than your headline and they're able to say, I think what you were trying to say was dah-dah-dah-dah-dah, and help really get back to that core. STEVE BURNS: It does say that we all, before we share serious news, making sure whoever you're going in with, you're on the same page. And having a pre-meeting is so important. And what I often do with my pre-meetings is I come up with the headline as the group, right? So we're all clear about what is that headline so that when we go in, we can, in some ways, also hold each other accountable for that headline. KATIE STOWERS: I think also, a little bit of who's going to say it too. Like, is that something that you feel comfortable saying, or would it be easier for somebody else to say? Are there parts of it, and then parts of it that I can do, I think, can be really helpful. TYLER JOHNSON: Yeah. It's funny, because sometimes, even though I'm pretty tuned into these things and I try really hard to do them well, I still find that there are times as a medical oncologist when the palliative care doctor who is unfailingly ever so nice and gracious about it, ends up being like the real human translator for my medical leads. So I, like, say some word cloud. And then the palliative care doctor, like Katie just said, is like, if I can say that what Dr. Johnson was trying to say right there is something in normal human English speak. And then, as soon as they do that, I'm like, oh. But that can actually be really helpful. And again, I think it's obviously not meant to slight me. It's not meant as an affront, right? It's just sometimes, it's just kind of hard to quite get there, right, and to quite say the thing. And sometimes, having someone to help. Like, you get 80% of the way there, and then having somebody else get the other 20% is really, really meaningful. And it also, in a strange way, kind of allows us to share the emotional burden a little bit, right? So that it doesn't feel like, oh my gosh, this is just me saying this thing. There's something about having other members of the team there to kind of hold your arms up as you're doing that that's really meaningful. KATIE STOWERS: I worry that part of this conversation is saying like, oh. Some people are really good at this. Some people aren't. I don't think that this is a palliative care physician's good the whole time. I think this is a normal human experience. This just happened to me. This week in clinic where my patient was like, you just told me like a five minute story of things I already know. And I still don't know any more information. And I was like, oh, that wasn't really clear at all, was it? So I mean, I think it's when our nerves pop up. When we are uncertain or unclear about what it is that we want to say or just really nervous about doing it, like, I think this is our normal human default to go back to beating around the bush. But it definitely, as Steve mentioned, is a skill that we can learn and continue to practice. And it's also really helpful to have somebody there who can hold your feet to the fire and help you in the moment. STEVE BURNS: Katie, I'm so glad you mentioned that. I just think about even for us as palliative care physicians, who do serious illness conversations all the time, catching ourselves doing some things because we are being affected by the conversation and our well-being. I remember a couple of weeks ago, how hard it was for me to say dying and death. And I know. I've been teaching my learners say the D word. It's OK. It's direct. It's straightforward. And then all of a sudden, I was in the middle of the conversation and I noticed I was struggling saying death. And so again, just to say we are human, that these conversations affect us. And having team support is so helpful in the moment. Because the chaplain who I was with said, what we're saying is we're worried that she's dying. And I was like, oh thank god. She said it. TYLER JOHNSON: And the other thing too, right, is that I think it's helpful in a sense to recognize that the difficulty with giving a headline or with saying death or dying or whatever is an impulse borne of human compassion. I mean, it's not because we're bad people. It's because we have good hearts and because short of maybe clergy members, there's really nobody else in the way that human ecosystems are set up that does this, right? It's just a hard thing to do. And recognizing that it's hard and recognizing that we ourselves are having a hard time with it, is not some failing of doctoring. I would say that actually, this is one of those weird instances where having that consistent struggle, that should be a tension that should define part of how we doctor. Because if the tension goes away, that's actually more worrisome than if the tension continues to be there, though we have to find productive ways to engage with it. STEVE BURNS: Yeah. We did a study in 2016, the Vermont Hospice Study, and similar to actually, what Cambia Health Foundation found, why people don't engage in serious illness conversations. And one of the biggest reasons was taking away hope or hurting people's feelings and in causing emotional distress. We also know with the literature that most patients, up to like 90%, 95%, want to know the truth because it helps them better make decisions. And I think we can deliver prognosis in a compassionate way. And I think practicing that in the kind and caring way that's person-centered, asking them, what do you know? Is it all right if we talk about this right now? Delivering in a headline and responding to emotion can help make that a more compassionate conversation. Although it still doesn't take away the human feeling that I'm worried I'm going to hurt someone in this conversation. TYLER JOHNSON: Almost always in my experience, patients who have metastatic disease, or for some other reason, disease that is known from the get-go to be incurable, in one of our first discussions, they will ask some version of the question of how long do I have, or what are things going to look like going down the road? There's good evidence to demonstrate, and it has also been my personal experience, that we're really bad at answering that question at the time of diagnosis, right? Because we don't know anything about the biology of the tumor, the response of chemotherapy, what the molecular markers are. There's a whole host of things that just make it so we almost always cannot answer the question accurately even if we try. And so what I will usually do is I will tell patients, I'll say, when they ask some version of that question, I'll say, look. I need you to know that, first of all, I can't answer that question right now. I'm not obfuscating. It's just, I would be lying if I gave you an answer because we just don't know. But I want to let you know that what is true is that I can usually tell when things are starting to go in the wrong direction. And unless you ask me specifically to do otherwise, I promise you, the patient, that as soon as I recognize that things are heading in a direction that I'm concerned about, I will tell you that in so many words so that you understand what I'm talking about. And then we will have a discussion about where to go from there. And then, when we get to that point, whether it's six weeks later or six months later, or sometimes six years later, I will say-- because I do this with all my patients-- I'll say, do you remember when I made you that promise way back when or a few months ago, whatever it is? And then I'll say, I hope that I'm wrong here. But I'm concerned that we may now be in that place. And I want to tell you why, and then I want to talk about where to go from there. Because that then situates this difficult discussion in the context of this relationship of trust that we've been building over however long I've known the patient. And I have found that that provides a trusting context within which to have the more difficult conversation that has been really helpful. STEVE BURNS: Noticing the time, I'm curious, how does the task of delivering bad news affect your own well-being? TYLER JOHNSON: Just to remind people, we said this before, but I just think it's important to recognize that this being a heavy thing is normal. And recognizing that is normal and that it really is-- I mean, there's some degree to which you can do this well and that will lighten the burden to some degree. But you have to make sure that you're filling your own reservoir, right? You can't pour empathy out of an empty reservoir. And so I think you have to make sure that you're filling that in whatever the ways are that you do. KATIE STOWERS: I just think I was thinking about that too, Steve. One other thing that I wanted to build off of, this fear and this worry that we bring to these conversations, that I'm going to send them into a tailspin of depression. Or I'm going to take away all of their hope. I think there is the other part of this that I get to see as a palliative care physician, which is the high degrees of distress that often come from not knowing this information, that's really helpful in preparing and planning for the future and almost this sense of relief. Even when it's unfavorable, even when it's not what they wanted to hear, there's a relief in knowing and being able to do something with it. So that limbo and uncertainty. the idea that something terrible is out there or they can't prepare for it can be really distressing. And so to some degree, we're helping to heal by being able to move into some planning. STEVE BURNS: Yeah, I totally agree that it's such an important thing to minimize the stress of uncertainty. And the other piece that I think about is these are really sacred moments where we can really connect with our patients, share the news, find out how they're doing with it, and then find out what really matters in their lives. I think that really helps be my north star when it comes to continuing the care that I'll provide for them in their families. TYLER JOHNSON: Yeah. You know, there's a really harrowing, in some ways, but beautiful moment. And many of you will probably have read the book Just Mercy, which is written by this lawyer who's fighting for justice, particularly racial justice, for people who have been unfairly treated by the justice system in the deep South. And there's this moment towards the end of the book where a person who he had been fighting for who was on death row has just finally been executed. And he goes home and sort of just collapses crying. And then he writes really beautifully about how this moment of sort of shared vulnerability, where he kind of recognized that the reason that this was so hard was because even though he was vulnerable and broken in different ways than the person who had just been executed, it was still sort of a shared sense of vulnerability. It was what made his work hard, but also what made his work beautiful. And I think that in a similar fashion, when we have these really difficult discussions, I think that while there is a real moral weight and difficulty to it, there is also just as you said, they also end up being some of the most meaningful, memorable, and beautiful moments. STEVE BURNS: As a clinician, what have you learned over the years regarding communication with patients that may help others navigate scenarios where they can deliver serious news? I was just on service with a trainee. The team was delivering serious news. It was serious news around lung cancer. And the team's like, this patient's just not getting it. And we tried to explain it over and over again. And they're not getting it. And then my trainee went in and attempted and said, yes. Here's your diagnosis. We're concerned it's incurable. And you likely will die in the next year or so. And the patient said, no. I'll be fine. So we hypothesized before going in the room with me, like, what it would be. And what it came out is maybe it's not they're not understanding it. Maybe it's emotion. So we went back in. And sure enough, my trainee did wonderful and responded to emotion and said. It must be really hard hearing this news. And the patient immediately got sad and said, I'm really scared. And we unpacked that a little bit. And when we left the room, he said to me, yeah. That was emotion. He totally gets it. He's just upset. And so I just want to reiterate the idea, sometimes, it's not that they're not understanding it. It's that it's a lot to process. And there's a lot of feelings behind it. KATIE STOWERS: Building on that, one of the things that I see happen a lot around emotion is the health system is not set for people to process and to come to terms with these hugely life things and life-altering things. There's not time for people to process what this means for their life to term and process that emotion. And we're constantly pushing. And sometimes it almost could feel like badgering, really trying to get a decision to come where, with some degree of autonomy and some degree of time, allowing them to really process. People, a lot of times, get to where they need to go. But it's a process of really being able to deal with. STEVE BURNS: Yeah. TYLER JOHNSON: Yeah, the only thing that I will add is that these conversations, when they need to happen, work best when I have been mindful of laying the groundwork for the conversation over the entire arc of the illness. Rather than thinking of, oh, this is the thing that I do right when someone is getting close to dying. Because if you've never laid the groundwork and then you try to have the discussion, then when the person is really, really sick and in the hospital or whatever, of course, there's still a better and a worse way to do that. But even the best conversation if it's that isolated incident, in my experience, is nowhere near as good as if we have been transparent and building trust and building a sort of a shared vocabulary with the patient over the course of the illness. So that then, when they get to having to have quote, "the discussion" unquote, it becomes just one part of this longer chain rather than an isolated happening. And that really gets to what I was saying earlier about the promise that I make my patients when they first ask that sort of big picture question. That even though I'm not in a good place to talk about it right then, that I promise them that when it comes time, I will talk with them about that with candor. That makes an enormous amount of difference. I know I had a trainee who was with me one time who was a continuity fellow with me and had heard me make that promise to a number of patients and the first time he was with that same patient when it came time to have that discussion. And I said, well, you remember that promise that I made the first time I met you? And he could, for the first time, see all of the dots connect over the arc of the illness. It was like, whoa. Like, there's just really this power that comes. But you have to have been building it piece by piece over time. STEVE BURNS: I think both of you are highlighting for me two reminders that I want to keep in mind every day when I'm delivering serious news. One is sort of having an agenda but being flexible with my agenda. And I remember during my training, one of my mentors said, keep your agenda out the door. Don't force your agenda on the patient, as Katie mentioned. And yet, have a plan and still go in with that plan. The other piece that Tyler, you're reminding me of, is the importance of the arc of the conversation and how continuity. Because we build off of conversations from visit to visit. And yet, sometimes, someone else is taking over for us or they end up in a hospital or they end up in a nursing home. And it reminds me how important documentation is to convey what happened in that encounter. What was said, what was the headline that was shared, how did the patient respond, and then what was the plan. And far too often, we usually just write the results of the conversation. TYLER JOHNSON: Yeah. One last thing that I want to put a specific plug in that I have found to be enormously important, I think all of us would agree that amidst all the conversations that we might have as part of taking care of a patient, this is the one where shared decision-making matters the most. And yet, if you ask most people, even experienced doctors, how do you engage in shared decision-making around this kind of question? That's really tricky, right? Because I think what often ends up happening is that we either default to being very prescriptive where we go in and say, well, you should do this or shouldn't do this. Or we default to being waiters with the menu. Like, well. OK, so would you like some intubation on the side of CPR? And so, I think that both of those models are equally problematic and that the tool, the specific tool that has helped me really learn about how to do shared decision-making and even provides the specific words, is what's called the Serious Illness Conversation Guide from the Ariadne group at Harvard, which is the group founded by Atul Gawande and his colleagues. And I think that that gives a very brief script which, I mean, you can literally almost just read. You can get a little card that you can carry in your pocket or whatever. And it gives-- and the entire conversation in most cases, takes maybe 10 or 12 minutes. But it gives you the point-by-point things to say and really allows you to meaningfully engage in shared decision-making so that you spend the first half of the conversation listening to the patient's priorities and values, and then the last maybe third of the conversation, using that to make meaningful recommendations. And so again, it's called the Serious Illness Conversation Guide. And I would really recommend to listeners that they look it up. STEVE BURNS: That's a really great segue to what training and resources are there for clinicians and oncology trainees to improve their communication skills. The three resources that I can think about are Vital Talk, the Serious Illness Conversation Program out of Harvard and Ariadne Labs, and then they have a rich program which is from the American Academy of Communication of Health Care. All three are different ways of approaching communication skills training. I always think about the Serious Illness Conversation Programs about raising the floor to make sure that we hit the basics. And then Vital Talk is if you want to flex your muscles or flex your skills when it comes to how do I respond to really intense emotion, or if someone's avoiding the conversation, what do I do? They train with raising the ceiling or their goals to raise the ceiling. And Vital Talk actually came out of oncology conversations first with OncoTalk almost 20 years ago. And really thinking about not didactic-based, but practice and skills-based training. And I certainly have found it rewarding and life-changing for me, where I could actually label the things that I do every day, give myself some feedback, and then teach my trainees. TYLER JOHNSON: And I will just add, as a medical oncologist who has both taken the Vital Talk course and now is trained and teaching Vital Talk courses, that this is not just for palliative care doctors. And I think that it is particularly-- I mean, you may not have the interest or passion to want to become a Vital Talk trainer, which is understandable if you're a medical oncologist, either a busy practice or a heavy research portfolio. But it's just to say that they offer 1 and 2 and various iterations of courses, depending on how intensely you want to study these things. But it's just to say that the skills that they teach are concrete. This is not some sort of head in the clouds theoretical exercise. I mean, they're taught very concrete skills that you can wake up the next morning and employ you in your practice. And that I think to a point that is often counterintuitive to us, I think that we are almost afraid, as oncologists, to know about this because we think, oh my gosh. I didn't have time to engage in these long discussions. There's no way. But my experience has actually been what this does at the end, is it actually makes you more efficient. I know that seems counterintuitive, but we spend so much time sort of beating around the bush around this stuff that we actually end up making ourselves take longer. And having really concrete skills for how to have these discussions can actually make your practice more efficient for things that otherwise can really eat up a lot of time. KATIE STOWERS: I do a lot of teaching in Vital Talk incentives. It sounds like both of you do as well. But the piece of feedback that I hear from trainees that come take courses-- and I do a lot with oncologists and oncology fellows as well-- is oh, these are the things that I've seen in conversations at work that I never had a name for. Like, you're putting a name on something that I've seen. And maybe I've done a couple of times, but I didn't know that I was doing it this way. And especially for my colleagues who are practicing providers who teach others, they really love having a name and a framework for being able to teach these skills to others. It's not some magic fairy dust that you either have or you don't. It's actually, here's a skill that I can pass on to you and you can practice. And I can watch for, and we can have some feedback about. And I have seen that being a really enjoyable part of doing this framework. We have that, right, for almost every other part of medicine. But because communication is something that's so innate and personal, that hasn't always been the case around communication. And so I really love that about Vital Talk, that they've taken these pieces and put names on them. Because this is how you give communication clearly, information clearly, is the headline. This is how you show someone that you care about them. These are empathic statements. And that's something that we can use as a third language when we're going into team meetings together or when we're teaching a trainee. STEVE BURNS: It's one of the most important skills that we do every day, and probably the most important procedure that we do on a regular basis in all of our fields. TYLER JOHNSON: And I think you can tell from the way that the three of us have discussed delivering a headline during this podcast, that this is not like a thing that we learned seven years ago and then just sort of left in a drawer somewhere, right? Like, this is something that we're actively thinking about as we actually take care of patients every day, which is to say that it really is very applicable. STEVE BURNS: I feel like that's the time for today. This has been a really great conversation. Thanks so much for both of your insights and participation in this episode of the ASCO Educational Podcast. KATIE STOWERS: Thanks for inviting us. It's been great to be here. TYLER JOHNSON: Thanks so much. It's been a pleasure. [MUSIC PLAYING]   SPEAKER 1: Thank you for listening to the ASCO Education Podcast. To stay up to date with the latest episodes, please click Subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive education center at Education.ASCO.org. SPEAKER 2: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

In part one of this two-part ASCO Education Podcast episode, Drs. Stephen Berns (University of Vermont), Tyler Johnson (Stanford Medicine) and Katie Stowers (Oregon Health & Science University) chat candidly about what it takes to deliver serious news to people with cancer effectively and compassionately. Subscribe: Apple Podcasts, Google Podcasts | Additional resources: education.asco.org | Contact Us Air Date: 2/16/22   TRANSCRIPT Steve Burns (Dr. Burns):  Hello. My name is Steve Burns. And I am a Hospice and Palliative Care Specialist and Associate Professor of Medicine at the Larner College of Medicine in Vermont. I'm pleased to moderate this episode of the ASCO Education Podcast focused on clinician patient communication in the context of delivering serious news to patients and family. I am joined Katie Stowers, a Hospice and Palliative Care Physician and Assistant Professor of Medicine at Oregon Health & Science University and Tyler Johnson, a Medical Oncologist and Clinical Assistant Professor of Medicine at Stanford University. Well, this is a serious discussion on delivering difficult news to patients and families. It is an extremely important one that I'm glad to be having. Let's first start with our question, what is bad news? I'm delighted to answer the question first mostly because I have an issue with calling it bad news. It really comes down to some of the training that I had as a palliative care physician when one of my attending said, don't assume it's bad. And I remember an example that I had for one of my first couple of patients, where the patient, when we were explaining that she had metastatic cancer and that she was likely going to die from this illness, she said, “Oh my gosh. I'm so relieved because I've been looking for an answer for months.” So what made me realize during that moment and also what my palliative care attending reminded me of is don't assume. And this is consistent with a study that came out, I think, by Anthony Balkin like 2011 where they did a qualitative review of patients encounters with serious news and bad news. And patients actually gave feedback that said, “We don't want the physicians to judge our news.”  Again, sort of reframing that, it's better to call it serious news rather than bad news. Dr. Tyler Johnson (Dr. Johnson):   I'll build off of that and just say that I think it's also important that we recognize that sometimes when we call something bad news, what that's actually reflecting is what our experience is going to be or what we anticipate that our experience is potentially going to be, which is totally fair. It's absolutely valid to say having to share this news is going to be a difficult part of my day. And therefore, I think of this as sharing bad news. In fact, I think that recognition is important and can lead to important reflection and even to self-compassion. We should be candid about the fact that this is a hard part of our jobs. I mean, who likes to share life-changing, sometimes devasting news with patients?  Nobody wants to do that. That's never going to be a fun part of your day. I think, though, that it is important to recognize that that's a different question from how the news is going to land to the patient.  Sometimes those things will match up and sometimes they won't. And it's important for us to be circumspect and careful in the way that we think about both how the news is going to impact us and how the interaction is going to impact us and also how it's going to impact the patient. Dr. Burns:  I'll move to the second question, which is what is the ideal circumstance or modality, in person or video call or telehealth, to deliver serious news to patients? Dr. Katie Stowers (Dr. Stowers):  I was actually struck on reflecting on that question about the ideal modality. I think COVID has actually really changed the way that I think about that question. Pre-COVID, I would have said hands down, everybody sitting in the same room being able to reach out and touch someone or be able to see them. But COVID has actually changed that. The people who need to be there aren't always able to be there because of hospital visiting restrictions. And being in the same room often means three layers of PPE between you and the people you're trying to talk to when they can actually see your face. I found some really meaningful encounters of delivering serious news that's been able to happen virtually in a way that I think I would have really surprised about pre-pandemic. I just had a patient in clinic with me a couple weeks ago who we were sitting there face-to-face, but visitor restrictions in our cancer center still wish she couldn't have anyone with her in the clinic. And so we were sitting there together and she wanted information. She wanted to review information that her oncologist had given her about prognosis. And so we were going to start to talk about that, and immediately she became overwhelmed and well, let's get my family on the phone. And I would really like somebody else to hear this information. And ultimately we realized after trying to get people on and not being able to contact them that actually the best way to do this was going to be a virtual visit where she was home with her sister, with her dog in her lap, her aunt in New Mexico and her uncle in Alaska were all able to come on. We were all able to share this information together. And it was this really lovely moment where she had all of the things that she needed, and it had nothing to do with being in clinic. In fact, clinic brought a whole different set of stressors. And so I think the way I've looked at this really is different and it's what does this person actually need? Do they need me to be able to physically touch them or do they need their support system? Do they need to be able to see my face without a mask? What is it that this individual needs? And I think that's more of how I go in and approach thinking about the ideal circumstance now. Dr. Johnson: Yeah. I think that there is a lot of truth to that and because we are so constrained and clinic often now.  The one thing that I will mention as a practicing oncologist that I have recognized is really important, though, if you're going to try to leverage the advantages that can come with technology is that it's really, really important to make sure that the patient is tuned in to the kind of conversation that you're going to be having before you launch into a discussion where you're going to be talking about serious news. Because what we have found is that often when people are coming to see us, it's part of a multi-hour half day or even a full day. They come in and see us. Then they get their labs drawn. They go to the waiting room. Then they go to get their chemo. Then they have to sit for a minute and be monitored afterwards. And sometimes it can be six or seven or eight hours. The reason I mentioned that is to say that what we have found is that many of our patients, for instance, are now having video visits with us, where we can tell them. They're like in the car driving in to get their labs done. And they love that because they're able to save an hour or two of time instead of sitting in our waiting room, they're doing the visit in the car. But as wonderful as that is for efficiency for somebody who's riding the chemo train, that's not the place that you want to be having this kind of serious discussion. And so I think that if you know that you're going to be having a visit that is going to involve sharing serious news, it's really important to say, “Hey, I just want to let you know that this is going to be a particularly important discussion. Can you make sure that you're in a quiet place where you can really focus here and have whatever family members or friends or whatever, your support that you want there so that they're keyed in a little bit?” Because if they're in clinic, we talk about preparing the right space. It's better to do this in a private room in the hospital than in an Emergency Department with 27 things going on you. So by the same token, I think we have to give them the opportunity to sort of prepare the environment to allow them to have the best experience. Dr. Burns:  I agree with both you Katie and Tyler. I think about most of my work's done in the inpatient setting and just thinking about even in the inpatient setting, making sure that even though a patient has their own private room, sometimes they don't and they have a neighbor that they're sharing it with and thinking about how do we create that privacy for them? How do we incorporate their loved ones, whether that's actually using now a iPad that rolls in where you can now have a Zoom conference with their loved ones across the country or across the globe. But the other piece is really thinking about not tacking it on to the end of your rounds, but really setting aside some time to do that. And that's even physically having someone hold your pager, silencing your phone so that you can be present for that conversation, just like how Tyler described that in the outpatient setting. Dr. Johnson: Yep. Totally agree. Dr. Burns: Well, thinking about who should be involved in the conversations, do you discuss as a team, which member of the cancer care team will deliver bad news to the patient and family? Dr. Johnson: I can maybe address this one first and then you guys can add on. I think I come at this with a slightly different perspective because I'm actually a practicing medical oncologist. I'm not a palliative care doctor. I actually think that there are important points to be made on two ends of a spectrum here. What I mean by that is that one thing that I is important is to recognize that there is more kinds of healthcare providers can be involved in these discussions than we sometimes may think. So for instance, Manali Patel, who's a health services researcher here at Stanford, has done a lot of really interesting work lately with lay health workers being able to help have the first parts of these discussions in terms of exploring the values and priorities and needs of the patients.  And basically what she's shown is that while there was initially a lot of skepticism, how can a layperson be involved in those discussions. After some training, these people actually do wonderfully well. I think by the same token, there are many members of the healthcare team that can help with that part. Having said that, I do think that there is also then a part of it that most patients appreciate coming from one of their primary healthcare workers. I think that as oncologists, we're here talking to the American Society of Clinical Oncology audience, I think it's important that oncologists recognize that there are certain things that patients really want to hear directly from you. And I think that in particular, some of the harder things to say, like we really don't have other meaningful treatment options left, that phrase I don't think land in quite the same way if it comes anywhere but from the treating oncologist because there's always going to be this thought in the back of the patient's mind that maybe my oncologist has something else in line or I need to talk to them later or what have you. I think that while on the one hand, we should broaden the spectrum of people who can be involved in these discussions, I do think on the other hand that it's important to recognize that there are some parts of this that really are most effective when coming from the treating oncologist. Dr. Burns:  Tyler, I think you hit on the importance of the relationship of the oncologist and the oncologist team with the patient and their loved ones. I often think of out this tide of care cartoon. I think it's almost like a far side cartoon where it's a physician who's sharing news to a patient and says I have some really bad news. So I'm going to get someone else to say it for me. I often feel like, as a palliative care physician, I sometimes am thrown into the mix. Am I the one delivering this news? What I really enjoy is partnering with the oncologist and even joining together when we can or for me to check in with a patient after the news is delivered, just because of how important that relationship is between the patient and their oncologist. The only other thing that I would add is I love having a team with me during those meetings. And so if I can in the outpatient center or inpatient setting, having a nurse or a social worker or a chaplain join me because sometimes I misstep and I say more than I should or I don't notice emotion. And I think having the other interprofessional lens there to watch and observe can interrupt me, give some feedback in the moment and/or take a step back so that we make sure that patients understand on what's going on. Dr. Stowers: I think, Steve, the part that I love about delivering news with the team is all the things you said. And when I notice my own emotions or I feel stuck on what to say, there's somebody there who can kick the ball and run with it for a bit so I'm able to catch back up. I wanted to add on to something else that you were saying, Tyler, about this relationship between patient and oncologist. And I see that a lot where patients will come to me and they're not ready to talk about things until they've heard it from the oncologist first. I just have got this morning this guy who got discharged from the hospital and hospice had been brought up in his visit, but he sees his oncologist on Friday and there was no way he was going there with me and how he's able to talk to his oncologist rightly so. I also see the flip side of it not too infrequently where the relationship that the patient has with their oncologist is they're the gatekeepers to life prolonging treatments. And they see any discussion of worries or fears as a weakness that maybe will make it less likely for them to get those treatments. And so I also see that patient population where they see me as the place as a palliative care provider where they can talk about some of those things that they're not ready to talk about with the oncologist. They need the oncologist to be positive treatment focused and they need another place that's not the oncologist to talk about those things. Dr. Burns:  Yeah, Katie, I just actually had a case like this last week where a patient says that she is really tired of the chemotherapy she was getting. She has a head and neck cancer, but she was afraid to bring it up with her oncologist because, she says, “I need to be brave in front of her.” And I just thought how interesting that was. And so every time she's in the room with the oncologist, everything's fine, everything's great. And then when she's speaking to me, she's like not everything's fine and not everything's great. And so I just think that the illustration of, yes, it would be great as a team, sometimes when we individually approach it, people do feel comfortable saying something differently outside of their oncology visit. Dr. Johnson: I think that one thing that this all gets to that I think is what all of us are saying, but it's worth articulating is that, Steve alluded to that cartoon at the beginning of this part of the discussion. The sort of underlying message from that is this idea that we as medical oncologists involve palliative care doctors if we don't know how to do something or we're not interested in doing it. And of course there may be times when the patient is better off with a skilled palliative care doctor doing the conversation that maybe a less skilled oncologist doesn't know how to do so well. But that's certainly not the optimal outcome. The optimal outcome is that there is teamwork and a partnership between medical oncology and palliative care. I think that teamwork creates a synergy where, because you're right, that the patient may have one face that they put on for the oncologist and a different face that they put on for their palliative care doctor. And I know there are times when I can sense as the oncologist that there is something just below the surface that they're not quite ready to bring up to me. And sometimes in those cases, I will say at the end of the visit, “I think this would be a really good time to touch base with the palliative care team.” And what I'm really thinking is because there's clearly something else you need to talk about that's not going to come out right here. So I want it to come out when you get to meet with them. Then of course, especially in those kinds of cases, having a little bit of back channels communication after the visit with me so that I can prep the palliative care doctors and let them know that I feel that there is something else there to be addressed, I think is really important. Dr. Burns:  One question to think about is how do we prepare? How do you prepare for delivering serious news? I think I will say that the first thing I like to do is do my biopsy of the situation. I know that's quite medical to use as analogy, but I like to know who are the players? What is the prognosis? And what I need to do is do a really thorough check-in with the specialist. So oncologist or if there's a radiation oncologist involved to check in with them and to actually check in with the patient about information preferences and/or who would like to be in the room or who they would want to be in the room. I think all of that helps prepare it. I always use the analogy with my trainees, like a good, serious illness discussion or a good delivering of serious news is a lot of preparation, just like how we learn to put in central lines. A lot of it's the prep and then the central line when you place it is pretty quick. And so I certainly think about delivering serious news in the same way. Dr. Stowers: I think the part of preparing for serious news that we probably don't think about as much is the part about preparing ourselves for giving this serious news. And Tyler, you alluded to that earlier on in the conversation of what am I bringing to this conversation? I, through a series of tough experiences when I was a new palliative care physician in a busy outpatient practice, really found myself losing the empathy that I really prided myself on having in my clinical encounters. And I walk in and be like looking at the clock, like tapping my foot as this person's crying in front of me and like, holy smokes, what's going on here? And I realized that I was not prepared to give this kind of news. And so really started instituting before I knock on the door and go into the office or click the virtual visit now as it, I'm making sure how am I? Have I gone to the bathroom? Have I eaten? Am I hot? Am I cold? Like how does this patient make me feel. What are the emotions that I'm bringing up? What are the biases that I'm bringing to this about what outcomes do I really want from this conversation and doing this little mini-checklist of how am I and what am I bringing to this conversation has really helped me get a lot more centered before I walk into their room. And so I think that that should absolutely be on that checklist that we do as we're preparing for these conversations. Dr. Johnson: I'll say two things building off of those great points. One is that I think, to Katie's point, I think it's important that we put a plug in here for a holistic evaluation of your own wellness as a doctor in the big picture perspective. And obviously, I have my own bags under my own eyes after the last two years of the pandemic. You can choose if I'm the pot or the kettle, but I recognize that I struggle with this just as much as anybody.  But it's just to say that if you're not eating well and you're not sleeping well and you're not getting some exercise and you're not taking time for yourself and you don't have a sense of self compassion, it's very difficult to fake empathy. It's very difficult to pretend to be present. And if you try, it usually just doesn't really work. I mean, you kind of either are present or you're not. But the issue is that you can't summon self-care in the moment that you need it. You can maybe try to do that for a couple of days. I think that largely is what burnout is. It's trying to magically materialize self-care as if you can do that the moment before you walk into a room and that's just not how the human psyche works. So that's thing number one. The other point that I would make is that, and I feel like this is one of those things that I just have to learn a thousand times over the course of being a clinician, because no matter how many times I learn it, then I forget it and it blows up in my face and I think, oh, well, yeah, I forgot that lesson again is how important it is that the first thing I do when I get in with a patient and I'm preparing to have one of these discussions is to talk with them about what they already understand about what's going on. Because you have some patients who you're surprised to find that you know that they're on end of line chemotherapy and they have overwhelming disease burden, etc., and then you ask them what's going on. And they say, “Well, I'm just really excited for the next chemo because doc, you said that the next chemo was going to be the one that was going to make the difference.” when of course you probably think you didn't say that. But the point is just to say, that's very different than if you ask the patient and they say, “You know, Doc, I so much appreciate everything you've done. If I'm really honest, I kind of feel like I'm dying. I think that's where I am.” Well, those are two totally different discussions. And if you come in assuming either of those things and it's actually the other one, then you're either going to waste a phenomenal amount of time or it's just going to be a terrible encounter. And I've made mistakes on both ends of that spectrum, which just reemphasizes for me the importance of figuring out where the patient is before I start saying anything. Dr. Burns:  And Tyler, I also think about the efficiency of these conversations. Often we are so worried it's going to take so much time. And when you start with, what have you been told or what do you understand or what's been going on with the big picture of your cancer, it does save time. So you don't actually have to repeat from the top. And I will say I've also watched people still and I caught myself a couple times where we still ask, what do you understand? And then we still repeat the whole story. And so I certainly encourage all of us to think like if they heard it, totally fine to move forward, but the other efficiency piece and I know all of us have been vital talk trained thinking about a headline in like a big picture. What is the big message? I always think about a headline is what is sort of the summary of the medical information and what is the impact on the future of this person's health?   Knowing that we often are pretty good with the summary of the medical information but a little less good at the impact. I always find that that helps them better understand their big picture and be able to then share the same information with their loved ones. They could easily have that catchphrase or a two-liner that they can say, guess what? The oncologist has shared this with me. I think that's so helpful when they're thinking about their overall care and helps them inform their goals and priorities and helps us better understand their goals and priorities.  That concludes part one of our conversation on delivering serious news. In part two, we will continue the conversation on how the care team can prepare for delivering serious news. Useful resources and more. Thank you so much to all of our listeners for tuning into this episode of the ASCO Education Podcast. Speaker 1: Thank you for listening to this week's episode. To make us part of your weekly routine, click subscribe. Let us know what you think by leaving a review. For more information, visit the Comprehensive eLearning Center at elearningdotasco.org. Speaker 2: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

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0:00 Intro 4:25 Serious News 18:50 Steve Kirsch Interview 41:08 Australia 59:00 Main Story For more updates, visit: http://www.brighteon.com/channel/hrreport NaturalNews videos would not be possible without you, as always we remain passionately dedicated to our mission of educating people all over the world on the subject of natural healing remedies and personal liberty (food freedom, medical freedom, the freedom of speech, etc.). Together, we're helping create a better world, with more honest food labeling, reduced chemical contamination, the avoidance of toxic heavy metals and vastly increased scientific transparency. ▶️ Every dollar you spend at the Health Ranger Store goes toward helping us achieve important science and content goals for humanity: https://www.healthrangerstore.com/ ▶️ Sign Up For Our Newsletter: https://www.naturalnews.com/Readerregistration.html ▶️ Brighteon: https://www.brighteon.com/channels/hrreport ▶️ Join Our Social Network: https://brighteon.social/@HealthRanger ▶️ Check In Stock Products at: https://PrepWithMike.com

Hi I'm a very serious news reporter. The Russians are controlling our thoughts with Facebook memes and scrambling our brains with invisible ray gun attacks. In other news, capitalism is working fine and our wars defend freedom and democracy. The government never lies. Here's Bob with the weather. Reading by Tim Foley.

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The fact that the mass media continually seek out expert foreign policy analysis from warmongers who've been consistently wrong about everything for decades is by itself enough reason to fully dismiss them. Reading by Tim Foley.

God has given every person a choice. The choice is between God and self; between Jesus Christ and self. This choice determines a person's eternal destiny: heaven or hell. God created man into His own image and likeness. He gave man a free will. The first person God created was given the choice. The two […] The post Jesus is God; the Greatest News…the Most Serious News…Jesus is Alive! Amen! appeared first on Wonder & Reality.

God has given every person a choice. The choice is between God and self; between Jesus Christ and self. This choice determines a person's eternal destiny: heaven or hell. God created man into His own image and likeness. He gave man a free will. The first person God created was given the choice. The two […] The post Jesus is God; the Greatest News…the Most Serious News…Jesus is Alive! Amen! appeared first on Wonder & Reality.

Today’s NewsPotential organic salt detection from Curiosity yields further evidence for past organics on MarsLink: https://www.nasaspaceflight.com/2021/05/curiosity-organic-salts-mars/Aliens: US Senator 'can't imagine' sighted UFOs came from EarthLink: https://www.express.co.uk/news/weird/1439738/aliens-ufo-sighting-us-senator-martin-heinrich-pentagon-ufo-report-space-evgPAC Launched To Press Feds To Release More Info On UFOsLink: https://www.forbes.com/sites/jackbrewster/2021/05/20/pac-launched-to-press-feds-to-release-more-info-on-ufos/?sh=4aa109331868UFOPacLink: www.Ufopac.orgHow UFO sightings went from joke to national security worry in WashingtonLink: https://www.washingtonpost.com/dc-md-va/2021/05/23/ufo-report-sightings-search/Podcast StuffFacebook: The Dark Horde - https://www.facebook.com/thedarkhordellcFacebook: The Tempest Universe - https://www.facebook.com/thetempestuniverseFacebook: Manny’s Page - https://www.facebook.com/MannyPodcastTwitter: The Tempest Universe - https://twitter.com/ufobusterradioTwitter: The Dark Horde - https://twitter.com/HordeDarkDiscord Group - https://discord.com/channels/679454064890871869/679454064890871875Mail can be sent to:The Dark Horde LLCPO BOX 769905San Antonio TX 78245Tel: (972) 591-8880

Today's News Potential organic salt detection from Curiosity yields further evidence for past organics on Mars Link: https://www.nasaspaceflight.com/2021/05/curiosity-organic-salts-mars/ Aliens: US Senator 'can't imagine' sighted UFOs came from Earth Link: https://www.express.co.uk/news/weird/1439738/aliens-ufo-sighting-us-senator-martin-heinrich-pentagon-ufo-report-space-evg PAC Launched To Press Feds To Release More Info On UFOs Link: https://www.forbes.com/sites/jackbrewster/2021/05/20/pac-launched-to-press-feds-to-release-more-info-on-ufos/?sh=4aa109331868 UFOPac Link: www.Ufopac.org How UFO sightings went from joke to national security worry in Washington Link: https://www.washingtonpost.com/dc-md-va/2021/05/23/ufo-report-sightings-search/ Podcast Stuff Facebook: The Dark Horde - https://www.facebook.com/thedarkhordellc Facebook: The Tempest Universe - https://www.facebook.com/thetempestuniverse Facebook: Manny's Page - https://www.facebook.com/MannyPodcast Twitter: The Tempest Universe - https://twitter.com/ufobusterradio Twitter: The Dark Horde - https://twitter.com/HordeDark Discord Group - https://discord.com/channels/679454064890871869/679454064890871875 Mail can be sent to: The Dark Horde LLC PO BOX 769905 San Antonio TX 78245 Tel: (972) 591-8880

Today's News Potential organic salt detection from Curiosity yields further evidence for past organics on Mars Link: https://www.nasaspaceflight.com/2021/05/curiosity-organic-salts-mars/ Aliens: US Senator 'can't imagine' sighted UFOs came from Earth Link: https://www.express.co.uk/news/weird/1439738/aliens-ufo-sighting-us-senator-martin-heinrich-pentagon-ufo-report-space-evg PAC Launched To Press Feds To Release More Info On UFOs Link: https://www.forbes.com/sites/jackbrewster/2021/05/20/pac-launched-to-press-feds-to-release-more-info-on-ufos/?sh=4aa109331868 UFOPac Link: www.Ufopac.org How UFO sightings went from joke to national security worry in Washington Link: https://www.washingtonpost.com/dc-md-va/2021/05/23/ufo-report-sightings-search/ Podcast Stuff Facebook: The Dark Horde - https://www.facebook.com/thedarkhordellc Facebook: The Tempest Universe - https://www.facebook.com/thetempestuniverse Facebook: Manny's Page - https://www.facebook.com/MannyPodcast Twitter: The Tempest Universe - https://twitter.com/ufobusterradio Twitter: The Dark Horde - https://twitter.com/HordeDark Discord Group - https://discord.com/channels/679454064890871869/679454064890871875 Mail can be sent to: The Dark Horde LLC PO BOX 769905 San Antonio TX 78245 Tel: (972) 591-8880

We reminisce about the days of freedom before COVID. Cody dives into his new segment: Serious News... Murder corner. Seth chats about his first experience watching RuPaul's Drag Race. And of course, as always, there is much talk about dicks. 

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Kristine Lazar is an Emmy award winning investigative reporter for CBS 2 and KCAL 9 News in Los Angeles. She started her news career 20 years ago in Northern Wisconsin, where she juggled forecasting the weather while shooting and editing her own news stories. Flash forward to 2017, when she helped launch a consumer justice franchise, 2 On Your Side. Kristine is the epitome of a journalist who has maintained career success while keeping personal goals.

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Gabriel and Caleb are back at it again. Jesse is gone. Still. So Gabriel and Caleb begin talking about a topic near and dear to our teenage hormonally beating hearts: Food. The Walgreen's weed man, 3300 calorie science Olympiad splurge. Raisin' Canes vs. Zaxbys. And in their inexperienced minds, we find it OK to speak about our experiences with confidence, and our increasing attractiveness to wamen and our inexperiences with that. Ready for some deep convos that aren't that entertaining? Listen in, children as your dad takes your lunchables....

1. Uncovering the weekend's biggest issue 2. Old Town Road: AFL Edition 3. AFL Scandal Museum 4. Serious News 

RU Unfunny Serious News for June 20th 2019 1. Southern California Earthquake rise 2. Amtrack power outage 3.Mexicos Immigration problem 4.Hackers extort florida 5.Americans hate mornings 6. European Comet interceptor 7.Drunk on a plane 8.Nude Instagram Protest 9.6.4 earthquake in Tokyo 10.Russian Warship 11.Melissa Rycroft 12.Trum  13.Coleman Hughes 14.hope Hicks 15.Interest Rates 16.Elizabeth Warren 17.Iran Tough Talks 18.Campaign fundraising 19.Brett Favre 20. Jennifer Morrison 21. Bradley Cooper 22. Piers morgan , Sophie Turner 23.Bella Thorne 24.Jennifer Lawrence 25.Lindsay Lohan 26.Angelina Jolie 27.Carrie Underwood 28.R.Kelly 29.Kevin Spacey 30. Richard Tyson 31. Pilot Jones 32. Meghan Markle 33. Kate Middelton  

Trial of daily news release 1.Facbook new Crypto Currency  2.Nebraska School district testing for Nicotine in Jr High and High School Students 3.16.5 ton Cocaine bust 4.UN predicts world population Flatline 5.Meth attack Squirle 6.Google Calendar failure 7. Boeing Back in production of Death trap 8. DJ Official , Officially dead 9.Trump announces 2020 Campaign 10.Bernie Sanders to dismantle large corporations 11.AOC claims boarder holding facilities are equal to Nazi Concentration Camps 12.Fox new dominates the ratings 13.Trump tweet for deportation 14. Patrick Shanahan is out for Secretary of Defense 15.Jersey shore come back 16.lola Consuelos scarred for life 17.Honey Boo Boo wont go home 18.Bill Cosby gi ves life advice 19.90210 feud myth busted 20.Ashton Kutcher getting Punk'ed 21.who is Dewan and Kazee 22.

Tips on using the SPIKES protocol for delivering serious or important news.

Jose Mourinho petitions for a new job, the lads bring you some Serious News, and talk Crew and Cincy results. The CCL might be over, but it is OPEN CUP TIME! We pick some lower division teams and wrap things up with Hell is Horny, with a surprise entrant.

Jose Mourinho petitions for a new job, the lads bring you some Serious News, and talk Crew and Cincy results. The CCL might be over, but it is OPEN CUP TIME! We pick some lower division teams and wrap things up with Hell is Horny, with a surprise

Episode 1449 of The Goin' Deep Show includes Halloween party pic search but all we seem to find is more of our moonshine. This, of course, makes it way harder to find anything.  Kid gets concerned that his browser knows what he wants even when he doesn't even know. We review the After Porn series on Netflix which features a tattoo covered Bonnie Rotten Kid expresses his disappointment in not going to see two legends in porn industry that visited the area then dives straight into an annoying scene involving Peter North and Christy Canyon. ADDITIONAL TOPICS OF DISCUSSION BELOW Tittie fucking scenarios How nobody wants to see a guys face when he gets off A hat tip to the women who put up with fucking us. Mr. Crowley makes his directorial debut with some raw footage Lady smelly parts and trimmed vag The gooch piercing Wally throws his 2 cents in Meeting a girl on Craigslist who is into golden showers Poop vs Pee and whats off limits  Serious News vs Porn Sound FX Go Deep.  

1. AFL Scandal Updates 2. Cult heroes 3. Melbourne Falcons 4. Serious News: 50 Cent 5. SAUSAGE 

1. Brutal Grand Final 2. Collingwood's Banner 3. Magpie's Grand Final Dinner 4. Serious News 5. Social Media Watch 

1. Making Boring Games Exciting 2. Hall Of Fame 3. LAWYER UP 4. Serious News 5. Feedback

1. Footy Stat City 2. Time To Lawyer Up 3. Serious News 4. Etihad Seagull Update 5. Facebook Marketplace Competiiton

1. Winter Olympics 2. Jordan De Goey in trouble again 3. AFLX 4. Howard X 5. Serious News

Podcast only edition of the show! 1. Mayne Dog's Twitter Account 2. Get Behind the Storm 3. Shit Brownlow questions submissions 4. Serious News 5. Crumpet Ad  6. AFL Meme's stolen by Albanian hackers

Matthew 18:5-14 Matthew Reality Santa Barbara

Matthew 18:5-14 Matthew Reality Santa Barbara

Jeffy is tired of serious news, and decides that he's going to have some fun, 6 ways to a longer life for men.Follow Jeffy on Twitter: @JeffyMRALike Jeffy on Facebook: www.facebook.com/JeffFisherRadioFollow Jeffy on Instagram: @jeffymra Learn more about your ad choices. Visit megaphone.fm/adchoices