all right so well good
afternoon I think it is
jeremy in your time zone
and it's uh eight thirty in
the morning my time here so
got a little bit of a time
differential so I'll
probably have different uh
Hunger personalities and
those kinds of things going
on today with our show.
But super excited to have
you joining us at our AOMT
conference this year and
getting a chance to bring
you over to the United States,
bring you to sunny and
hopefully not too humid and
sticky Orlando, Florida.
But I wanted to get an
opportunity to get the
attendees that will be
showing up or maybe those
that are considering coming
to conference a chance to
get to know you before you
actually present our
keynote and also our
pre-conference course to
our attendees by doing this show.
So thank you very much for
joining us today.
It's my absolute pleasure
and it's a great honor for me.
Yeah, yeah, no, we're super excited.
I know a lot of the people
that I've talked to that
are going to conference are
really pumped to get to
hear from you as well as
the other keynote presenters.
So, you know,
I know a lot of people
probably they know your work.
They obviously know your
work is probably in the
shoulder and that sort of thing.
But can you give our
listeners a little bit
about your journey that
kind of led you to
down your career path, if you will.
I'm sure you've given this quite a bit,
and you have a little bit
of an elevator pitch,
but just your journey that
got you to this point.
Well, each time I get asked to do this,
I give a completely
different story because I'm
just trying to keep one
step ahead of everybody else,
but I'll try and be consistent.
So I was originally born in New Zealand,
grew up in New Zealand,
had a wonderful childhood,
moved to Australia as a teenager,
struggled to try and work
out what I wanted to do as a career,
eventually settled on physio.
Ten years after I finished
undergraduate training,
I did the one year
manipulative manual therapy training.
Jeff Malan was one of our teachers,
so a great privilege of
learning from him.
And then a year after that,
I did a one year sports
physiotherapy course in
Western Australia and
twenty four years ago moved
to the United Kingdom.
The plan was to move here for a year.
but really enjoyed living
here and finished here
another diploma in biomechanics.
The scope of practice in the
United Kingdom when I got
here was rapidly changing.
And soon after I got here, physios,
physical therapists were allowed to
refer patients for any
imaging blood tests etc
then we were allowed to
train to do injections soft
tissue and joint injections
I did an extra year or so
to become a to be able to
use diagnostic ultrasound
in clinical practice I
don't use diagnostic
ultrasound so much for
diagnosis but I do use it
for ultrasound guided
injections for frozen
shoulders which is clinical
interest research interest
And, uh, I believe it was,
they changed the law again
with an extra almost years training.
We were allowed to prescribe
any medicine that there was
an evidence base for that
could support clinical practice.
So it's been a really
interesting evolution.
I still firmly believe that
the most important, um,
management that I can
provide with patients with
non-traumatic
musculoskeletal shoulder
problems is the traditional physiotherapy,
physical therapy interventions.
It certainly, from a risk point of view,
a harms point of view, it's much safer,
probably more effective
than injection therapy and pharmacology.
So I don't think we're in
any way offering second
best treatment with what we offer.
So that's more or less what I do.
I do two and a half days a week clinically,
and I work two and a half
days a week in research,
doing my own research and
supporting ten PhD students
around the world.
And I also have the
privilege of teaching a shoulder course,
which I've just come back
from teaching in Korea, Hong Kong,
Kuala Lumpur, and two courses in India.
So please excuse the black under my eyes.
It's jet lag and my voice is gone as well.
So please excuse that.
No, that is totally okay.
I understood.
Maybe I don't understand
because I don't quite have
that same level of a travel
and teaching schedule for sure.
But, you know,
it's interesting that you...
You're a lucky man.
You know,
fascinating background and
fascinating history.
It's interesting, too.
I think we could probably
have a lot of conversations,
side conversation,
just in terms of scope of practices,
differences,
and I'm sure that you've seen
it in your travels throughout the world,
you know, what certain physios can do.
in certain countries.
And that probably impacts a
little bit of the way that
you teach and manage.
But I really appreciate that
you mentioned that you
firmly believe our
traditional methods of physical therapy,
you know,
are really what matters the most.
But it'd be fascinating to
just even hear like at some point,
not necessarily today, but, you know,
just how that scope of
practice looks in the UK,
because I know the United
States certainly is
leaning into a lot of those
sort of advanced practice
skill sets within our own
industry that it's
obviously met with a lot of resistance,
but that would be a fascinating topic.
So I'm curious,
and then I'm super excited
also that you know,
you you learn from Jeff Maitland,
I know that that will ring, you know,
true to a lot of our attendees.
at AOMP conference.
But more importantly, I was curious,
how did you end up in the shoulder?
I think everybody kind of has their ways.
They may end up with low
back as kind of their focus.
Some people end up in the foot,
in the neck.
You ended up in the shoulder.
How did you get there?
It's sort of a bit like that movie,
I don't know if you've seen it,
the one with Gwyneth Paltrow,
I forgot the name of it actually,
but Sliding Doors,
you might not have seen it.
It's sort of, it's a movie where a person,
half the movie is a person
goes into the sliding door
of an underground train in
London and the other half
is she doesn't meet the
quite make the draw.
So what happens in her life
when you go down these two
different opportunities
separated by a few milliseconds, really?
I wanted actually to
specialize in an area.
At the point in time when I
was about to start my PhD,
everybody was doing low back pain.
Everybody was doing knee pain, hip pain.
So I thought I'd go as far
south as I could.
and try and become as expert
as I could managing feet problems.
But I was really interested
in the concept of posture
and I was also very
interested in the concept
of subacromial impingement syndrome.
So I decided my great
contribution to the world
would be to demonstrate how
posture causes subacromial
impingement and how when we
improve posture,
it reduces or alleviates the symptoms.
and um three years later I'm
uh probably my most
confused person on the
planet thinking that well
there's absolutely no
evidence for postural
theory that we follow so
strongly and there's no
such condition as
subacromial impingement
syndrome and I think that
uh subsequent our
subsequent research and
research and many others
has has demonstrated that's
the case that um the the
postural beliefs we have in
our profession um we're
probably just disabling people
by telling them how bad poor
their posture is, their muscle imbalances,
and, you know,
asking them if they're
related to Quasimodo.
So, you know,
so I think my PhD sort of
blew that out of the water.
And also it confused me
knowing that this condition
that everybody was saying
is the most common
condition of the shoulder,
impingement syndrome,
probably didn't exist.
And I guess as a consequence of that,
I tried to,
think, well, okay, well,
my first plan didn't work,
but just stay with the
shoulder and see what I can
contribute with clinical
knowledge and research knowledge.
And that's where I got to.
That's where I am.
That's great.
So,
so the things like upper cross syndrome
probably drive you nuts at
this point now.
I think what we're doing by
perpetuating some of these
clinical beliefs is just
continuing to disable
people who are seeking care
and by telling them they've
got impingement or telling
them they've got
subacromial pain syndrome,
which is a meaningless, in my opinion,
a meaningless diagnosis
because then people ask, well,
what what's the subacromion
and then you talk about the
structures in it and then
you talk about well what
could be causing harm or
damage those structures I
think that's another
meaningless term we you
give to patients and you're
sort of asking or who's
benefiting from labeling a
term like that and to me it
makes as as nonsensical as
superhumeral pain syndrome so um
So I think, you know,
labeling people with
pathoanatomical diagnosis
is very harmful and telling
people poor posture,
and it makes it easy for us
to explain symptoms.
But the truth is,
we've got really no basis
for a lot of what we say in
clinical practice.
And I love medical, I love history,
and I love medical history.
And I've always tried to
make an effort to go back to
where some of these theories
started from and how they
snowballed or avalanched or
how they perpetuated.
And very often it's just, I guess,
a couple of people had a
couple of vodkas and had a thought
or whatever the favorite tipple was,
the drink was at that stage
and came up with an idea
and it just snowballed.
That's probably what
happened with postural
theory sort of starting in Germany,
a hundred and fifty years ago.
It just sort of became existentially,
that's the wrong word,
but it became very
increasingly a sort of myth
build upon myth, build upon myth.
And then it became fact.
And I think that's the same
for many medical, many
conditions such as
impingement syndrome as well.
Because if you go back to
the original paper in
nineteen seventy two,
Charles Near's original
paper and you read it today, you'd say,
well, hang on a second.
This is just reading like a blog.
This isn't a scientific paper.
This is an opinion piece.
This is what I've been doing.
This is what I'm believing.
This is what I'm suggesting.
But I guess in the nineteen seventies,
there was no such thing as
a blog and it became a fact.
But because of that blog,
millions of people around
the world and probably
many thousands of people around the world,
including in your country
and in the United Kingdom
and many others today,
are having a subacromial decompression,
which
has clearly shown not to
outperform placebo surgery
and clearly shown with
ten-year follow-ups not to
outperform an exercise
manual therapy approach.
It's just adding expense to healthcare,
reducing its sustainability,
but it was started by basically a blog.
And, yeah, so...
And I think a lot of the
elective surgery that
happens on the shoulders,
whether it's rotator cuff repairs,
whether it's type two slap lesions,
biceps tenodesis,
so much of it is these
elective surgeries that we
think we're fixing problems
with are clearly not
outperforming placebos.
And we have to ask ourselves,
in whose best interest are
these procedures being performed for?
And, you know, follow the money sometimes.
Yeah, you know,
and I really appreciate all
those thoughts.
Actually, the history behind it,
I'm going to have to go and look at that.
Because obviously we
resource that quite a bit.
When I talk to PTs, you know,
I think one of the things
that always frustrates, you know,
a physical therapist.
So the example I give is.
what do you do when a
patient comes in and they say,
I've got a herniated disc
and it's causing my low back pain?
Well, as a physical therapist,
we're quick to jump in and say, well,
it can't be your disc.
There's so many people that
are healthy that have healthy discs.
There's people that are
unhealthy that don't have healthy,
so on and so forth.
And so we jump onto that bandwagon.
Yet, a few minutes later,
we're quick to say
something along the lines of, well,
your posture is this.
It's like,
So almost like the physios
version of a herniated disc, right?
So like kind of talking
about both sides of our mouths, which,
you know,
I certainly understand it's hard
to get those, it's hard to, you know,
untangle some of that mess
that has been provided to
us over the course of time.
But yeah.
Yeah,
that's such an interesting reflection.
You're a hundred percent right.
You know, we, we,
think that some of the
medical diagnoses that are
given are just so ridiculous,
but then we just label
people with other
ridiculous diagnoses or
explanations for symptoms.
And I think one of the worst
things we can do is just to
confuse people seeking care
more by denigrating somebody else's
I'd never say to a patient, you know,
it's ridiculous you've been
given a diagnosis of impingement syndrome,
or it's ridiculous that
you've been told your
symptoms are coming from your tear.
This thing that's cruel to
people seeking care, you know,
that we all need to speak with one voice,
but the one voice we speak
with needs to be an honest voice.
And I'm not sure that's
happening in
musculoskeletal practice
around the world.
Yeah,
and I think there's a lot more we
could be doing within our
profession and between professions,
reminding ourselves that
the most important person
in healthcare is not the
physio or the doctor, it's the patient.
And if we're not working to that ideal,
that goal,
it's questionable whether we're
offering best healthcare.
Yeah, no kidding, definitely.
All right,
so I want to take a little bit
of a deviation here since
we're getting to meet you in Orlando.
So without giving away too much,
because we don't want you
to give away too much,
we want people to come to the conference,
but can you share a few
takeaways that our audience
will gain from hearing your keynote?
Okay, well, I'm going to,
if it's okay with you, Derek,
actually work backwards.
I'm giving a fifteen-minute lecture,
I think,
in the morning of the night
after a pub crawl.
So I guess it's going to be
me and the sound engineer
in the lecture hall.
No, the physios come back.
They bounce back really fast.
You're going to be surprised.
They're going to be a full audience.
Yeah, OK.
Do you want to bet ten dollars on this?
Yes.
Virtual handshake?
All right.
So anyway,
so that lecture is going to be entitled,
What Teaching in Iceland
and Building a Shed Taught
Me About Manual Therapy.
And so that's the title of
the short lecture,
which I'm sure some people
are going to find as
somewhat as challenging as
what I've been talking
about with posture.
I'm totally into touch therapy.
I totally think as a profession,
we should be doing
manual therapy, touch therapy,
touching therapies,
but I think we maybe need
to reframe it slightly,
and I'm sure that's going
to upset some people.
I think there's ridiculous
debates that are happening
on social media about hands-on, hands-off,
so irrelevant in terms of
the important things we
should be talking about
delivering quality healthcare.
We should absolutely be
including touch therapy in our treatments,
but maybe we should be
thinking how we discuss them
or explain them to patients
and ourselves in different ways.
So that's the second lecture.
The keynote is going to be
looking at what I would
prefer to call my umbrella
term for what people have
called impingement syndrome,
subacromial pain syndrome,
partial full thickness tears
of the rotator cuff.
Because in truth,
we do not know for the
majority of people if the
symptoms are coming from
those pathoanatomical diagnoses.
And I think they should be consigned to
this is what we used to
think and we need to come
up with a
non-pathoanatomical explanation
for patient symptoms and
I'm totally against the
idea of calling it you've
got simple shoulder pain or
non-specific shoulder pain.
I think that's derogatory for patients.
People need, people who write about pain,
people who are in pain
write about the need for,
who tell us that the worst
pain is an unexplained pain
and they also tell us that pain
that if a treatment doesn't make,
if the explanation for
their symptoms isn't clear,
then no treatment will make
sense and they won't engage with it.
So we need to provide, in my opinion,
a non-pathoanatomical diagnosis.
I've been promoting and
pushing a term I came up
with in twenty sixteen to
replace all those other terms,
rotator cuff related shoulder pain.
So the keynotes about
rotator cuff related shoulder pain.
And I'm going to try and make a case that
we need to be thinking way
beyond a bit of exercise
and manual therapy if we as
a profession believe that a
bit of exercise bit of
manual therapy can make a
difference to this
condition in the presence
of someone who's smoking
not sleeping well not
exercising well um and with
poor nutrition where where
fooling ourselves in a very
large way we're being very
naive and I'm going to try
and make a case in the
keynote that this could
become a golden time for
our profession because so
much of the elective
surgery that's occurring
for trying to fix the pain
are not fixes they're not
fixing the pain at all
they're not outperforming
placebos or non-surgical
intervention as I mentioned earlier
But what I think we should be doing,
and our competition
shouldn't be with another profession.
It should be within our own profession.
How do we do a better job?
And what I truly believe we
need to be doing in our
profession is stopping this
ridiculous debate about hands on,
hands off,
and trying to work out how we
become experts in assessing
lifestyle factors and
supporting people through,
in a nonjudgmental way,
supporting people through
the process of behavioral change,
which means we have got to
put as much emphasis on
assessing sleep quality,
nutritional quality,
general exercise participation,
smoking behaviours, drinking behaviours,
et cetera, as we do with anything else.
And we need to think more
holistically about the care
we offer for all
musculoskeletal conditions.
We have to stop telling
people we can fix them
because the evidence would
suggest that we can't and
the orthopaedic surgeons can't.
we need to just try and work
out ways to restore people
back to their valued
activities and it's naive
of us to think that a bit
of exercise a bit of manual
therapy can achieve that in
the presence of other
lifestyle factors so I'm
going to talk about this at
a cellular level how
lifestyle factors can
impact upon the health of
tendon cells tenocytes um and um
you know,
it's not going to be only that
that will send people to sleep,
but we need to think more
in terms of a Venn diagram
than we can thinking that, you know,
focusing in on what we tend
to have focused in on for
the last fifty or so years
is probably naive.
And maybe that's one of the
reasons the outcomes that
we're getting are less than desirable.
So that's going to be my
pitch in the keynote.
But there'll be hopefully
lots of good takeaway
messages that people will value.
And I hope it will also
stimulate some robust
conversation discussion.
Be interesting to hear what people can
how people react to that.
No, I'm super excited for that.
And I, you know,
thank you a lot for putting
something like that together.
I think, you know,
it resonates beyond
obviously just the shoulder,
but obviously it'll have
the consequence with the shoulder.
But, you know, I think that a lot of the,
progression and movement is toward that.
I think you're going to have
an audience that'll be very
engaged and interested in that as well.
And I'm going to win ten dollars.
You're going to have a full
house in the morning.
It depends who's most competitive.
I might be prepared to pay a
thousand dollars for people
not to come just so that I
don't lose face.
All right.
Well,
I think that the topic title of
itself is going to be interesting,
especially, yeah.
The people love those fifteen-minute talks,
too.
Those are fantastic.
So the next question I have for you is,
you know, and I think you actually,
you kind of have said this already,
so I don't even know if I
want to ask a question,
but I'll ask a question
anyway because it may just
generate a different thought.
You know,
you've already mentioned how
management of shoulder pain
has changed since you
started and you've been
kind of responsible for
looking at some of those
different ways about it.
But, you know,
how do what do you see in the next five,
ten years?
You kind of mentioned,
I think it's I think I know
where your answer is going
to go a little bit with this.
But, you know,
in the management of shoulder pain itself,
like how do you see it?
I guess for lack of a better
way of putting it,
what keeps you excited
about researching the
shoulder going forward in the next five,
ten plus years or whatever it might be?
Right.
I think if I realistically
got ten years left.
So the things that I would
like to look at in the next
ten years are I'm really
interested in mechanisms.
Why exercise therapy and
maybe behavioral change,
lifestyle change could
influence symptoms.
I think we have to move away from
uh structural explanations
we know that the surgery
isn't repairing the tendon
and even if it does that's
not related to the reasons
why people feel better so
then we've got a whole lot
of pain people coming and
saying it must be just
something that's going on
in the brain but I think
that's too far a leap
forwards I think you know
some of the evidence for
some of the pain neuro
educations pain beliefs is
is on less stable grounds
than some of the evidence
for manual therapy
What I'm really interested
in is how exercise may
change the biochemistry and
may reduce some of the
pro-inflammatory cytokines,
the positively charged
neuropeptides such as
substance P may change
their concentration in
pain-sensitive structures
in the shoulder.
and seeing how is that the
mechanism that white people
many people come back and
say I'm better not
completely better but I'm
better and it would also
then make sense that when
we add lifestyle factors to
it do we even get a better
uh restore restoration of
homeostasis of the pain
biochemistry around the
tissues that may um uh that
may help to explain why some people
report improvement and maybe
a lack of change in the
biochemistry explains why
others might not.
So that's one thing.
I'm also interested in how
do we support people to
participate in exercise
programs and how do we mess
with their brains in legal
ways that they're not frightened to move?
So I've got three PhD
students at the moment who
are looking at the role of
virtual reality
um in the management of
shoulder problems and from
my own clinical experience
um of course you know
there's a bias when a
person talks about their
clinical experience but um
I'm so excited about the
potential of this technology in terms of
improving the adherence of
people to an exercise program,
helping people graduate
through an exercise program,
but also in a legal way,
messing with their brain to
maybe reduce the fear of movement.
And we've had some spectacular failures,
but we've also had some
really spectacular positive
changes in people who have
not moved their shoulder for nine months,
two years,
that in a few minutes are
moving normally and maintain that.
well after the treatment and
the initial treatment.
And so I tend to divide my
rehabilitation into three phases.
The first phase is
restoration of movement.
Second phase is improvement
of muscle performance.
And the third phase is
restoration of function.
And so for me,
virtual reality is a very exciting
motor technology on the
horizon it's here but it's
going to become a bigger
part of what we do I
believe in assessment and
management we just need
more research on it so
those those keep me excited
I've got some research on
frozen shoulders got some
research on education and a
bit of research on
lifestyle so that will keep
me occupied for the next ten years
Yeah, well, good.
I hope that you stick around
for more than ten years
then because we've got a
lot of questions to answer.
The mechanisms is very interesting.
I think that that's coming
back in terms of in play in
regards to research as well.
So that'll be interesting,
especially when we don't
know at this point.
Yeah.
So I have a,
this question is actually very
relevant because you just
were a part of a
publication that I think a
lot of people are really interested in,
in JOSBT.
And that was the, you know,
advice paper that just came out,
I think ahead of publication.
And so the,
the question that I was going
to ask you is, you know,
for those that are, you know,
either just entering
physical therapy right now, you know,
they're in PT school or
maybe they're newly
graduated and they're kind
of thinking about what they want to do.
you know, coming off that article there,
what's some advice that you
would give the new professional?
Read the article.
It's all there.
Yeah.
So it was a great team.
Jared Powell,
who's a PhD student in
Australia coming to the end of his PhD,
led on it.
And it was co-authors were
Chad Cook and Karen McCreish,
who was another PhD student who's now,
way surpassed me in her
knowledge and her research skills,
as Gerard will any minute now as well.
So yes, it was a great team.
And I think we had all
slightly different ideas,
but it came together in
quite a hopefully useful
way for new grads.
And I think one of the big
things that I've noticed
that's changed is
originally in my career, you'd go to the,
after work on Friday,
you'd go to the pub in
Australia and you'd sit
around all these manual therapy,
physiotherapy experts and
listen to their
achievements of the week
and you'd sort of say, well, my gosh,
I'd like to be like them and, you know,
I want to become the
greatest fixer in the world,
which I know a lot of
people of my generation wanted to do.
And so, you know, you apply for all these
very difficult to get into
postgraduate courses.
And then you realise that
maybe the reality doesn't
live up to the expectation
of those courses.
And I think that's been replaced now,
the Friday night pub, to a large extent,
it's been replaced by social media.
And, you know,
you get these influencers in
social media who are making
ridiculous claims about
what we should and shouldn't be doing.
and to some extent bullying
people and to some extent, you know,
asking... And I think what
we try to do in the paper
is to try and balance that
a little bit and hopefully give people,
like we try to give patients,
confidence to manage...
..to clinically reason, to problem-solve,
to work things out for themselves.
And I guess that was, for me,
an important part of the paper and...
you know,
don't listen to people who are so
adamant about the only way forwards is.
And, you know,
that was definitely part of the paper.
But there's a lot more to it,
and I strongly recommend
that everyone get a hold of
it and have a read of it
and comment on it, what was good,
what could have been better.
Yeah, and the nice thing,
we may even be able to link
this in with this podcast,
but it's open access at
this point as well, too.
So it should be able to be
readable for everybody.
I appreciate it.
And obviously teaching in an
entry-level PT program,
it's important that we...
retain and keep people
excited about you know this
profession you know I I see
a lot of things on social
media where like man it's
like anything like even
with my kids you know
they're not um you know
like they can be influenced
by so much and a lot of it
is not necessarily positive
building or confidence
building and some of my
research area is actually looking at
burnout in physical therapy.
And I do think that that's
part of the consequence of
some of these things that we see.
And certainly that what you
mentioned there,
the confidence going forward,
I think that definitely
helps people with regards to, you know,
staying in this profession, being excited,
hopefully about it.
Yeah, I think that's,
I'm aware of what you're doing.
And I think that's,
it's such a valuable contribution.
And I wonder if, you know,
if we also changed our
belief system from an I can
fix you model to I can work
with you model to try and
restore you to the greatest,
highest level of function possible.
And maybe we can stop
burnout to some extent by
by not going to work
thinking I'm failing
because I'm not fixing
people the way that people
on social media are claiming we can,
or people in the past in
pubs have claimed that they can.
And maybe if we go back more
to the nineteen fifties,
which I think was one of
the golden times of our profession,
where if you think about
your country in America,
when there was the polio
epidemic before Jonas Salk
came up with the vaccine for polio,
people in our profession
were not trying to fix
people with polio but
trying to work out how can
we restore them to the
highest level of function
possible and and obviously
that needs to be exercised
but like I said in the
earlier part of this
conversation it has to be
through lifestyle factors
as well and I wonder if we
reduce burnout by um
by actually changing our
belief system and maybe
making it more honest with
moving away from the I can
fix you to I can work with
you in a non-judgmental way
in a supportive way you
know and we can just take
this as far as you want
um you know sort of like
trying to help someone with
depression or help someone
with diabetes that there's
so much we can do we can't
fix these problems but we
can reduce the long-term
disability um you know it's
it's interesting isn't it
that so much not so many
non-communicable disorders
diabetes high blood
pressure depression asthma
no one goes in and says you
know I want to be fixed of
course we want to but no
one's got a noble prize for
medicine for that but what
we can do is we can put together
a package of care that
involves educating why
smoking is maybe not the great idea,
why nutrition is important,
why good sleep, hygiene,
health is important,
why a general exercise
program is important.
And by doing that,
we can often reduce the disability,
but when that patient's not fixed,
but the disability is
reduced and we can also
work out ways to try and
maintain that for as long as possible.
help people problem solve if
there's a flare up in blood
sugars or there's a flare
up in the depression,
but we're always there if
they can't help manage the flare up.
And of course,
all that can be supported by
medicines as well.
But I just wonder if we took
that approach with our
musculoskeletal practice,
if we would be offering,
we're definitely offering
more honest care and maybe
less burnout for people as well.
And that's to me more important than
a lot of the crazy debates
that happen on social media
at the moment that used to
happen in the pubs, you know,
back in the time when there
was no social media in my life.
Yeah, no, no, it's great.
No, I appreciate it.
So Jeremy, I want to respect your time.
I want to respect our
listeners' time because I
think people's attentions
are around thirty minutes
or so and we're getting to
about that point.
And I'm going to leave a lot
on the line because I want
our listeners hopefully to
come to Orlando, hear you speak,
get a chance to meet you
and see me win a ten dollar bet.
All right.
Well,
I'm going to get out a crispy ten
dollar bill and just in
case I do lose because I'll stick to it.
But we'll see.
I'm pretty sure that it will
be quite an empty hall the
night after what is
advertised as a pub crawl.
I don't know.
All right, Jeremy.
Well,
thank you very much for your time and
have a great day.
Thank you, Derek.
It was a great pleasure.
Looking forward to catching
up in person next month.
All right.
We'll see you.