1 00:00:00,160 --> 00:00:02,560 This is Alan Condon with the Becker's Healthcare 2 00:00:02,560 --> 00:00:05,120 Podcast, and I'm delighted to to be joined 3 00:00:05,120 --> 00:00:08,419 today by doctor Ravi Bashial, director of outpatient 4 00:00:08,639 --> 00:00:11,939 hip and knee replacement surgery at Endeavor Health. 5 00:00:12,154 --> 00:00:13,755 Ravi, a pleasure to have you back on 6 00:00:13,755 --> 00:00:15,914 the podcast with us today. For any of 7 00:00:15,914 --> 00:00:17,914 our listeners who might be as as acquainted 8 00:00:17,914 --> 00:00:19,754 with you or Endeavor Health, can you take 9 00:00:19,754 --> 00:00:20,795 a moment to give us a little bit 10 00:00:20,795 --> 00:00:22,494 more insight into your role and your background? 11 00:00:23,675 --> 00:00:25,500 Absolutely, Alan. A great pleasure to be on 12 00:00:25,500 --> 00:00:26,400 and thank you 13 00:00:26,780 --> 00:00:28,940 to the entire Becker's team and Scott Becker 14 00:00:28,940 --> 00:00:30,539 for hosting us. You guys do a great 15 00:00:30,539 --> 00:00:33,579 job with disseminating information, which is just really 16 00:00:33,579 --> 00:00:34,079 critical. 17 00:00:34,620 --> 00:00:36,940 As you mentioned, my name is Ravi Vishal. 18 00:00:36,940 --> 00:00:38,320 I'm a hip and knee surgeon, 19 00:00:38,620 --> 00:00:39,920 with Endeavor Health, 20 00:00:40,225 --> 00:00:42,884 specializing in minimally invasive hip and knee replacement. 21 00:00:43,344 --> 00:00:45,664 I run our outpatient program, here at Endeavor 22 00:00:45,664 --> 00:00:48,144 Health, which is a large multi hospital, multi 23 00:00:48,144 --> 00:00:51,024 specialty group in the Chicagoland area, performing an 24 00:00:51,024 --> 00:00:53,424 extremely high volume of total joints as a 25 00:00:53,424 --> 00:00:53,905 system, 26 00:00:54,545 --> 00:00:55,364 as a whole. 27 00:00:56,520 --> 00:00:58,700 Fantastic. Thank you so much for the brief 28 00:00:58,760 --> 00:01:02,679 intro. So really important topic. A fascinating story 29 00:01:02,679 --> 00:01:04,280 that I wanted to pick your brains on 30 00:01:04,280 --> 00:01:04,780 today. 31 00:01:05,560 --> 00:01:07,400 I know for many years, you've been making 32 00:01:07,400 --> 00:01:10,674 a mission trip to Nepal with fellow Endeavor 33 00:01:10,674 --> 00:01:11,734 Health team members. 34 00:01:12,275 --> 00:01:13,635 Would love to dive a little bit more 35 00:01:13,635 --> 00:01:14,615 into this story, 36 00:01:15,155 --> 00:01:17,875 this initiative. First and foremost, could you tell 37 00:01:17,875 --> 00:01:19,795 us a little bit about what inspired you 38 00:01:19,795 --> 00:01:21,954 and the Endeavor Health team to partner with 39 00:01:21,954 --> 00:01:24,055 Operation Walk for these missions in Nepal? 40 00:01:25,229 --> 00:01:25,969 Yeah. Absolutely. 41 00:01:26,269 --> 00:01:28,929 It's been this really interesting organic journey, 42 00:01:29,629 --> 00:01:31,890 for both myself and many of the Endeavor, 43 00:01:33,069 --> 00:01:35,009 team members, that I travel with. 44 00:01:35,390 --> 00:01:37,729 Operation Walk Chicago is an organization 45 00:01:38,030 --> 00:01:40,245 that was started by Victoria Brander and doctor 46 00:01:40,405 --> 00:01:41,225 David Stahlberg, 47 00:01:42,185 --> 00:01:45,784 to travel to initially sort of envision as 48 00:01:46,005 --> 00:01:48,405 an opportunity to travel to parts of the 49 00:01:48,405 --> 00:01:50,405 world that were less served and provide hip 50 00:01:50,405 --> 00:01:51,305 and knee replacements 51 00:01:51,605 --> 00:01:53,545 for free to those in need. 52 00:01:54,109 --> 00:01:57,150 The mission to Nepal began about 15 years 53 00:01:57,150 --> 00:01:57,650 ago, 54 00:01:58,109 --> 00:02:00,129 prior to me joining Endeavor Health, 55 00:02:00,590 --> 00:02:02,670 and they had just started to go to 56 00:02:02,670 --> 00:02:03,170 Nepal 57 00:02:03,629 --> 00:02:05,390 and had made an introduction at the Nepal 58 00:02:05,390 --> 00:02:08,110 Orthopedic Hospital. I think they'd gone on an 59 00:02:08,110 --> 00:02:09,164 introductory trip, 60 00:02:09,805 --> 00:02:12,044 at which point, I became involved with the 61 00:02:12,044 --> 00:02:12,544 organization 62 00:02:13,245 --> 00:02:15,745 soon after I completed my training in 2011. 63 00:02:16,604 --> 00:02:18,764 And it truly was an organic story. As 64 00:02:18,764 --> 00:02:21,389 it turns out, my father is from Nepal. 65 00:02:21,389 --> 00:02:23,169 He was born in Nepal in the 1930s 66 00:02:23,310 --> 00:02:25,550 and immigrated to the United States in the 67 00:02:25,550 --> 00:02:27,229 60s. And I was born here in the 68 00:02:27,229 --> 00:02:29,629 U. S. In the late 70s. So, it 69 00:02:29,629 --> 00:02:31,009 became sort of this serendipitous 70 00:02:31,629 --> 00:02:35,330 meeting where we had myself, a Nepalese American, 71 00:02:35,550 --> 00:02:36,525 being able to work 72 00:02:37,004 --> 00:02:39,104 with the group that traveled to Nepal. 73 00:02:39,485 --> 00:02:40,544 And over the past, 74 00:02:41,164 --> 00:02:43,805 now 13 to 14 years, this has really 75 00:02:43,805 --> 00:02:45,185 developed into an amazing 76 00:02:45,724 --> 00:02:48,064 opportunity for us to interact. And it's changed 77 00:02:48,525 --> 00:02:49,025 from 78 00:02:49,860 --> 00:02:51,860 an opportunity to just go and perform hip 79 00:02:51,860 --> 00:02:52,759 and knee replacements, 80 00:02:53,139 --> 00:02:55,379 and then leave to really working with the 81 00:02:55,379 --> 00:02:57,560 hospital and with the doctors in Nepal, 82 00:02:57,939 --> 00:02:59,620 to train them to be experts in hip 83 00:02:59,620 --> 00:03:01,780 and knee replacement. And we've now gotten to 84 00:03:01,780 --> 00:03:03,854 a point where we are still going on 85 00:03:03,854 --> 00:03:06,414 an annual basis performing these charity hip and 86 00:03:06,414 --> 00:03:07,155 knee replacements, 87 00:03:07,615 --> 00:03:09,134 but have really gotten to the stage where 88 00:03:09,134 --> 00:03:11,455 the doctors there are able to perform these 89 00:03:11,455 --> 00:03:13,474 procedures for those who can afford it, 90 00:03:13,854 --> 00:03:15,455 when we are not there. And when we 91 00:03:15,455 --> 00:03:17,055 are there, we are really focused on the 92 00:03:17,055 --> 00:03:17,610 charity side 93 00:03:18,729 --> 00:03:20,490 side of the mission and being able to 94 00:03:20,490 --> 00:03:21,490 provide these for free to those in need 95 00:03:21,490 --> 00:03:22,270 who could otherwise 96 00:03:22,569 --> 00:03:23,310 not afford it. 97 00:03:24,330 --> 00:03:26,889 I mean, it's such an important mission. And 98 00:03:26,889 --> 00:03:28,569 no doubt in terms of taking care of 99 00:03:28,569 --> 00:03:30,250 some of these patients that needed care in 100 00:03:30,250 --> 00:03:32,925 the orthopedic area, but also training that next 101 00:03:32,925 --> 00:03:35,264 generation of Nephilim Providers as well. 102 00:03:35,805 --> 00:03:37,564 Before we get to that, could you talk 103 00:03:37,564 --> 00:03:39,884 just a little bit about the challenges that 104 00:03:39,884 --> 00:03:43,324 you typically encounter when performing surgeries in a 105 00:03:43,324 --> 00:03:45,485 setting like La Pal compared to your work 106 00:03:45,485 --> 00:03:46,844 in the US? And how do you overcome 107 00:03:46,844 --> 00:03:47,585 these challenges? 108 00:03:48,590 --> 00:03:51,229 Yeah, absolutely. You know, I think anybody that's 109 00:03:51,229 --> 00:03:52,689 ever played a sport understands, 110 00:03:52,990 --> 00:03:55,789 what home court advantage is, where you're used 111 00:03:55,789 --> 00:03:56,030 to, 112 00:03:57,150 --> 00:03:59,069 playing in your own field, you're staying at 113 00:03:59,069 --> 00:04:01,185 your own house and any time you transport 114 00:04:01,324 --> 00:04:02,384 that there's challenges. 115 00:04:03,004 --> 00:04:03,745 In Nepal 116 00:04:04,525 --> 00:04:05,025 particularly, 117 00:04:06,044 --> 00:04:09,025 there are some significant challenges when we've traveled. 118 00:04:09,485 --> 00:04:11,104 The operating rooms are not 119 00:04:11,564 --> 00:04:13,104 at the same sort of 120 00:04:14,525 --> 00:04:16,930 level of technology that we have here. 121 00:04:17,230 --> 00:04:18,610 We often are forced to 122 00:04:19,470 --> 00:04:21,949 work through logistical issues. But at the end 123 00:04:21,949 --> 00:04:23,790 of the day, our goal is to provide 124 00:04:23,790 --> 00:04:25,389 the same high level of care that we 125 00:04:25,389 --> 00:04:27,550 provide in the United States. So, we don't 126 00:04:27,550 --> 00:04:29,629 do that by compromising on what we do. 127 00:04:29,629 --> 00:04:31,875 We do that by identifying what the challenges 128 00:04:31,875 --> 00:04:33,395 are and then making sure that we have 129 00:04:33,395 --> 00:04:36,035 the infrastructure and support in place in order 130 00:04:36,035 --> 00:04:38,835 to provide high quality joint replacement for those 131 00:04:38,835 --> 00:04:41,175 in need. And that includes bringing over 132 00:04:42,990 --> 00:04:44,829 using state of the art technology in the 133 00:04:44,829 --> 00:04:47,870 operating room. And through close partnerships with many 134 00:04:47,870 --> 00:04:49,949 of our corporate donors, we're able to achieve 135 00:04:49,949 --> 00:04:51,870 that. So, we don't really have to compromise 136 00:04:51,870 --> 00:04:53,550 care, but instead are able to bring that 137 00:04:53,550 --> 00:04:54,769 same level of care, 138 00:04:55,149 --> 00:04:57,564 to Nepal. But certainly, there's some things that 139 00:04:57,564 --> 00:04:59,165 are out of our control. I've been in 140 00:04:59,165 --> 00:05:01,404 the operating room when the power has gone 141 00:05:01,404 --> 00:05:03,324 off and the hospital has a generator, but 142 00:05:03,324 --> 00:05:04,604 if you're in the middle of a case, 143 00:05:04,604 --> 00:05:06,125 you may not have any lights for a 144 00:05:06,125 --> 00:05:07,725 minute or 2 while that kicks on. And 145 00:05:07,725 --> 00:05:10,310 I can remember many occasions where we've operated 146 00:05:10,310 --> 00:05:11,449 by the light of an iPhone, 147 00:05:12,629 --> 00:05:14,150 kind of keeping going with the case while 148 00:05:14,150 --> 00:05:15,589 we're waiting for the lights to come back 149 00:05:15,589 --> 00:05:18,550 on. So certainly, these places present their own 150 00:05:18,550 --> 00:05:20,710 unique challenges, but we do our very best 151 00:05:20,710 --> 00:05:23,504 to overcome those and provide the same high 152 00:05:23,504 --> 00:05:25,105 level of care that we provide to our 153 00:05:25,105 --> 00:05:26,725 patients here in the United States. 154 00:05:27,425 --> 00:05:28,865 Yeah. Yeah. I love that. I guess, sounds 155 00:05:28,865 --> 00:05:31,205 like you really happen to be flexible, sometimes 156 00:05:31,264 --> 00:05:33,824 maybe thinking on the fly while also not 157 00:05:33,824 --> 00:05:36,180 sacrificing that that high quality care that you're 158 00:05:36,180 --> 00:05:38,500 no doubt providing to those Napoli patients as 159 00:05:38,500 --> 00:05:39,000 well. 160 00:05:40,259 --> 00:05:42,500 Ravi, could you talk about obviously, there's 2 161 00:05:42,500 --> 00:05:45,220 key components of this mission. It's balancing can 162 00:05:45,220 --> 00:05:47,779 you talk a little bit about providing balancing 163 00:05:47,779 --> 00:05:50,134 providing care for patients in need in Nepal, 164 00:05:50,435 --> 00:05:53,714 while also training that next generation of Nepali 165 00:05:53,714 --> 00:05:54,214 providers? 166 00:05:55,475 --> 00:05:56,535 Yeah, absolutely. 167 00:05:56,995 --> 00:05:59,154 And some of this, also goes back to 168 00:05:59,154 --> 00:06:01,334 your prior question about challenges. So 169 00:06:02,110 --> 00:06:04,449 if the disease that we see in Nepal 170 00:06:04,590 --> 00:06:06,750 is often far different than what we see 171 00:06:06,750 --> 00:06:07,970 in the United States, 172 00:06:08,509 --> 00:06:10,910 one particular case comes to mind. I literally 173 00:06:10,910 --> 00:06:12,430 just got back last night, so I hope 174 00:06:12,430 --> 00:06:14,084 these are very fresh in my mind. But, 175 00:06:14,805 --> 00:06:16,725 on this trip, I happened to have taken 176 00:06:16,725 --> 00:06:17,704 care of a 177 00:06:18,004 --> 00:06:20,404 young 24 year old female who had juvenile 178 00:06:20,404 --> 00:06:22,644 rheumatoid arthritis. And by the time we saw 179 00:06:22,644 --> 00:06:25,365 her, her left knee was essentially fused and 180 00:06:25,365 --> 00:06:26,990 her right knee wasn't far behind. 181 00:06:27,529 --> 00:06:30,410 And, certainly, juvenile rheumatoid arthritis exists in the 182 00:06:30,410 --> 00:06:32,990 United States, but in most cases, patients 183 00:06:33,449 --> 00:06:34,670 are able to be treated, 184 00:06:35,769 --> 00:06:36,589 and certainly, 185 00:06:37,290 --> 00:06:39,769 they most likely end up with needing some 186 00:06:39,769 --> 00:06:42,024 sort of intervention later in life. But to 187 00:06:42,024 --> 00:06:44,204 do a bilateral total knee on a patient 188 00:06:44,345 --> 00:06:46,504 with knees that are essentially fused at age 189 00:06:46,504 --> 00:06:47,004 24 190 00:06:49,064 --> 00:06:50,745 is a unique disease state that we don't 191 00:06:50,745 --> 00:06:52,745 really see frequently in the United States. And 192 00:06:52,745 --> 00:06:54,584 even aside from that example, many of the 193 00:06:54,584 --> 00:06:56,970 deformities that we see are so far advanced 194 00:06:56,970 --> 00:06:58,810 because they have not been able to access 195 00:06:58,810 --> 00:07:01,050 care. So, while we are doing the same 196 00:07:01,050 --> 00:07:03,050 operation as we do here, we're often doing 197 00:07:03,050 --> 00:07:05,870 them on much more complex patients. And that 198 00:07:06,410 --> 00:07:09,050 translates into our training as well. And it's 199 00:07:09,050 --> 00:07:11,529 important to remember that joint replacement doesn't live 200 00:07:11,529 --> 00:07:13,314 in a vacuum. It's not just the surgeons 201 00:07:13,314 --> 00:07:15,314 knowing how to do the surgery. It's the 202 00:07:15,314 --> 00:07:18,034 entire spectrum of care. Anesthesia has to be 203 00:07:18,034 --> 00:07:20,034 on board with the plan, physical therapy, the 204 00:07:20,034 --> 00:07:22,675 nursing staff. And we've really been blessed with 205 00:07:22,675 --> 00:07:23,175 a 206 00:07:23,634 --> 00:07:25,794 large and diverse group of volunteers that has 207 00:07:25,794 --> 00:07:26,694 helped us train 208 00:07:28,310 --> 00:07:29,449 all of these various stakeholders 209 00:07:30,550 --> 00:07:33,110 in joint arthroplasty. So, we've had leaders from 210 00:07:33,110 --> 00:07:35,910 therapy, leaders from nursing, leaders from anesthesia join 211 00:07:35,910 --> 00:07:38,389 us in order to be able to provide 212 00:07:38,389 --> 00:07:39,129 these protocols 213 00:07:39,509 --> 00:07:40,704 and best practices 214 00:07:41,245 --> 00:07:43,004 in order to have these patients have the 215 00:07:43,004 --> 00:07:45,404 best possible outcome. So again, it's not just 216 00:07:45,404 --> 00:07:47,165 teaching the surgeons, but sort of setting up 217 00:07:47,165 --> 00:07:47,824 a system 218 00:07:48,285 --> 00:07:50,925 in the entire hospital. On our first trip, 219 00:07:50,925 --> 00:07:53,245 there wasn't even really a proper post operative 220 00:07:53,245 --> 00:07:55,670 unit set up for these patients, and we 221 00:07:55,670 --> 00:07:57,350 had to work on that with the Nepalese 222 00:07:57,350 --> 00:07:59,029 and our donors to build that. And the 223 00:07:59,029 --> 00:08:00,389 best way I can put it is that 224 00:08:00,389 --> 00:08:02,710 you need hardware and software. So, some of 225 00:08:02,710 --> 00:08:03,930 these needs are intrinsically 226 00:08:04,310 --> 00:08:04,810 material. 227 00:08:05,110 --> 00:08:07,125 You need the implants, the beds, 228 00:08:08,004 --> 00:08:08,985 the physical technology. 229 00:08:09,444 --> 00:08:11,125 And that's half the battle. But the other 230 00:08:11,125 --> 00:08:12,985 half is really the software, which is, 231 00:08:13,605 --> 00:08:15,625 if we want to continue on that analogy, 232 00:08:16,084 --> 00:08:18,404 downloading the protocols and the knowledge in order 233 00:08:18,404 --> 00:08:19,949 to be able to use the hardware in 234 00:08:19,949 --> 00:08:22,670 the appropriate manner. And, again, it extends beyond 235 00:08:22,670 --> 00:08:24,930 just the surgeons to the therapists, the nurses, 236 00:08:25,310 --> 00:08:27,089 and the anesthesia teams as well. 237 00:08:28,110 --> 00:08:31,149 Yeah. It's fascinating work. And, again, hats off 238 00:08:31,149 --> 00:08:33,809 to you and your team, also in partnership 239 00:08:33,870 --> 00:08:36,584 with Operation WA Chicago. Like you said, Endeavour 240 00:08:36,584 --> 00:08:38,584 Health, previously NorthShire have been involved with this 241 00:08:38,584 --> 00:08:39,804 for many, many years, 242 00:08:40,264 --> 00:08:42,845 as have you. Last question on this before 243 00:08:42,985 --> 00:08:45,384 we wrap up, Ravi. I guess what do 244 00:08:45,384 --> 00:08:48,184 you hope the younger medical professionals or the 245 00:08:48,184 --> 00:08:51,459 next generation of surgeons take away from really 246 00:08:51,459 --> 00:08:52,759 participating in these 247 00:08:53,299 --> 00:08:54,759 important missions in the past? 248 00:08:55,539 --> 00:08:57,539 Thanks, Alan. I think that's a really important 249 00:08:57,539 --> 00:08:59,539 question. I think that when we look at 250 00:08:59,539 --> 00:09:01,440 the value of doing these trips, the initial 251 00:09:01,440 --> 00:09:01,813 reaction is to the patients we are helping, 252 00:09:01,860 --> 00:09:02,679 which is 253 00:09:03,415 --> 00:09:04,215 the initial reaction is to the patients we 254 00:09:04,215 --> 00:09:04,875 are helping, 255 00:09:05,415 --> 00:09:08,934 which is absolutely fundamental. We are changing the 256 00:09:08,934 --> 00:09:10,535 lives of some of these folks. In the 257 00:09:10,535 --> 00:09:12,615 United States, when we do hip or knee 258 00:09:12,615 --> 00:09:13,115 replacement, 259 00:09:13,495 --> 00:09:15,090 we take care of patients in need. My 260 00:09:15,170 --> 00:09:17,250 patients are grateful, and I'm grateful to have 261 00:09:17,250 --> 00:09:19,029 the pleasure of taking care of them. 262 00:09:20,050 --> 00:09:21,970 But for the most part here with the 263 00:09:21,970 --> 00:09:24,129 diseases states that we're seeing, we're changing their 264 00:09:24,129 --> 00:09:26,129 lifestyle and their quality of life, them being 265 00:09:26,129 --> 00:09:27,570 able to get back to the things that 266 00:09:27,570 --> 00:09:29,504 they want to be able to do. In 267 00:09:29,504 --> 00:09:32,384 Nepal, we are literally changing lives. And I 268 00:09:32,384 --> 00:09:33,524 always make that 269 00:09:33,904 --> 00:09:35,745 analogy. In the United States, hip and knee 270 00:09:35,745 --> 00:09:37,044 replacement changes lifestyles, 271 00:09:37,345 --> 00:09:38,784 but when we go to Nepal, it changes 272 00:09:38,784 --> 00:09:41,559 lives. We take people who are unable to 273 00:09:41,700 --> 00:09:44,340 sort of move forward physically or socially. I'll 274 00:09:44,340 --> 00:09:46,100 use that 24 year old girl as an 275 00:09:46,100 --> 00:09:48,899 example again. Her knees being fused prevented her 276 00:09:48,899 --> 00:09:51,620 from walking normally, a very physical attribute, but 277 00:09:51,620 --> 00:09:53,540 they also prevented her from being able to 278 00:09:53,540 --> 00:09:55,894 move forward with her life. We actually took 279 00:09:55,894 --> 00:09:58,214 care of another 20 something year old last 280 00:09:58,214 --> 00:10:01,355 year who, because of her, juvenile rheumatoid arthritis, 281 00:10:01,815 --> 00:10:04,054 wasn't able to go to school, wasn't able 282 00:10:04,054 --> 00:10:05,414 to do the things that she wanted to 283 00:10:05,414 --> 00:10:07,830 do within her family, and was socially a 284 00:10:07,830 --> 00:10:09,129 little bit viewed differently. 285 00:10:09,750 --> 00:10:11,190 By fixing her knees, we did see her 286 00:10:11,190 --> 00:10:12,870 back for her 1 year follow-up. She's now 287 00:10:12,870 --> 00:10:14,629 been able to go to school, move forward, 288 00:10:14,629 --> 00:10:16,490 and and really has changed her whole life 289 00:10:16,629 --> 00:10:18,789 aside from just the physical walking side of 290 00:10:18,789 --> 00:10:21,254 things. So number 1 is our patients. Number 291 00:10:21,254 --> 00:10:23,095 2, as you've alluded to, is training the 292 00:10:23,095 --> 00:10:26,054 next generation. Nepal Orthopedic Hospital, where we've been 293 00:10:26,054 --> 00:10:28,554 going consistently now for about 15 years, 294 00:10:29,175 --> 00:10:31,894 now does more joint replacements than any other 295 00:10:31,894 --> 00:10:34,870 single hospital in Nepal. And to us, that's 296 00:10:34,870 --> 00:10:37,209 really meaningful. These folks are really able 297 00:10:37,669 --> 00:10:39,669 to provide best in class care for their 298 00:10:39,669 --> 00:10:41,909 patients. But the side that's often missed that 299 00:10:41,909 --> 00:10:43,769 I often think is the most important 300 00:10:44,230 --> 00:10:46,389 is how we change the volunteers that go 301 00:10:46,389 --> 00:10:47,370 on this trip. 302 00:10:48,884 --> 00:10:50,404 We often have a meeting with our volunteers, 303 00:10:51,605 --> 00:10:53,545 before we go and I say to them, 304 00:10:53,764 --> 00:10:56,105 as sad as it is, if you're born 305 00:10:56,245 --> 00:10:58,325 the child of a shoeshiner on the streets 306 00:10:58,325 --> 00:10:59,465 of Kathmandu, Nepal, 307 00:11:00,004 --> 00:11:02,745 you're most likely going to die a shoeshiner 308 00:11:02,850 --> 00:11:04,769 on the streets of Kathmandu. There's not a 309 00:11:04,769 --> 00:11:07,250 lot of room for mobility and for change. 310 00:11:07,250 --> 00:11:08,470 And for those folks, 311 00:11:09,089 --> 00:11:11,569 they have a very difficult life. And while 312 00:11:11,569 --> 00:11:13,329 we in the United States face our own 313 00:11:13,329 --> 00:11:15,409 set of challenges, I think going on a 314 00:11:15,409 --> 00:11:15,689 trip like this really gives people perspective. They 315 00:11:15,689 --> 00:11:16,870 can see, how the other half lives and 316 00:11:30,480 --> 00:11:30,980 people 317 00:11:32,240 --> 00:11:34,639 or them not trying hard enough. It's sort 318 00:11:34,639 --> 00:11:36,320 of the luck of where you're born. And 319 00:11:36,320 --> 00:11:36,820 for 320 00:11:37,360 --> 00:11:37,759 those of us that do live in the 321 00:11:37,759 --> 00:11:40,159 United States of America or other developed nations, 322 00:11:41,120 --> 00:11:44,559 we really have an advantage just by where 323 00:11:44,559 --> 00:11:46,125 we were born. And I think with that 324 00:11:46,125 --> 00:11:46,625 advantage 325 00:11:47,004 --> 00:11:48,684 comes an obligation to give back. And I 326 00:11:48,684 --> 00:11:51,324 think that's really what these volunteers learn, and 327 00:11:51,324 --> 00:11:53,245 when they come back, they become agents for 328 00:11:53,245 --> 00:11:55,884 change. I think they become better Americans, 329 00:11:56,284 --> 00:11:57,884 for those that live here in the United 330 00:11:57,884 --> 00:11:59,565 States. It really allows us to be more 331 00:11:59,565 --> 00:12:00,065 compassionate, 332 00:12:00,600 --> 00:12:02,940 more understanding, and more giving back to our 333 00:12:03,159 --> 00:12:03,659 fellow 334 00:12:04,919 --> 00:12:05,419 man 335 00:12:05,799 --> 00:12:08,279 in terms of other people that are around 336 00:12:08,279 --> 00:12:09,639 us. And I think it gives really a 337 00:12:09,639 --> 00:12:10,539 unique perspective. 338 00:12:11,079 --> 00:12:12,519 And I think that's really one of the 339 00:12:12,519 --> 00:12:14,539 biggest benefits of a trip like this. 340 00:12:15,455 --> 00:12:17,294 So Ravi, it sounds like you've trained the 341 00:12:17,294 --> 00:12:19,855 surgeon, you and your team exceptionally well. Can 342 00:12:19,855 --> 00:12:21,375 you give us a little bit more insight 343 00:12:21,375 --> 00:12:24,115 into the barriers that they're looking to overcome, 344 00:12:24,735 --> 00:12:26,735 in places like Nepal, which are a little 345 00:12:26,735 --> 00:12:27,475 bit disadvantage 346 00:12:27,855 --> 00:12:29,615 compared to what we might experience in the 347 00:12:29,615 --> 00:12:30,115 US? 348 00:12:31,399 --> 00:12:33,399 Yeah. Thanks, Alan. Yeah, I do think that 349 00:12:33,399 --> 00:12:35,319 the surgeons, the therapists, and the nurses have 350 00:12:35,319 --> 00:12:36,779 been trained very well. 351 00:12:37,399 --> 00:12:40,519 The biggest barrier for marginalized populations is that 352 00:12:40,519 --> 00:12:42,440 they cannot afford the cost of the implant. 353 00:12:42,440 --> 00:12:44,839 So there is no nationalized insurance that will 354 00:12:44,839 --> 00:12:46,575 pay for their implant or their surgery. 355 00:12:47,054 --> 00:12:48,995 So, that's been the biggest barrier. However, 356 00:12:49,375 --> 00:12:51,455 really pleased to announce that on this trip, 357 00:12:51,455 --> 00:12:52,835 we were able to inaugurate, 358 00:12:54,495 --> 00:12:57,235 the Pritzker, arthroplasty fund through the generosity, 359 00:12:57,934 --> 00:13:00,254 of Tom and Margo Pritzker, who are Chicago 360 00:13:00,254 --> 00:13:03,690 based. They provided a significant donation that is 361 00:13:03,690 --> 00:13:06,409 going to be used to fund the cost 362 00:13:06,409 --> 00:13:07,309 of the implant, 363 00:13:07,929 --> 00:13:10,730 for disadvantaged and marginalized folks. So now, we 364 00:13:10,730 --> 00:13:11,230 have 365 00:13:12,409 --> 00:13:14,250 the software in place with the surgeons and 366 00:13:14,250 --> 00:13:15,850 the team at the hospital, but now, we 367 00:13:15,850 --> 00:13:18,024 have a resource by which to provide the 368 00:13:18,024 --> 00:13:19,245 hardware, in this case, 369 00:13:19,625 --> 00:13:20,845 the implants themselves, 370 00:13:21,144 --> 00:13:23,465 even when we're not there and using donated 371 00:13:23,465 --> 00:13:23,965 implants, 372 00:13:24,424 --> 00:13:26,745 again, through this Pritzker arthroplasty fund that was 373 00:13:26,745 --> 00:13:29,565 generously donated by Tom and Margo Pritzker. 374 00:13:31,039 --> 00:13:33,199 Got it. And Ravi, such an important mission. 375 00:13:33,199 --> 00:13:34,480 Thank you so much for taking the time 376 00:13:34,480 --> 00:13:36,240 out of your busy schedule to educate us 377 00:13:36,240 --> 00:13:38,319 on this. Is there any last notes or 378 00:13:38,319 --> 00:13:39,919 final words that you'd like our audience to 379 00:13:39,919 --> 00:13:40,740 know about this? 380 00:13:41,519 --> 00:13:43,120 Yeah. You know, I'd really like to thank 381 00:13:43,120 --> 00:13:45,615 the the groups that helped enable this. This 382 00:13:45,615 --> 00:13:48,894 includes Operation Walk Chicago, obviously, which is the 383 00:13:48,894 --> 00:13:50,574 group that I'm a board member on and 384 00:13:50,574 --> 00:13:52,274 near and dear to my heart that organizes 385 00:13:52,334 --> 00:13:52,995 this trip. 386 00:13:53,534 --> 00:13:55,855 Tom and Margo Pritzker, who again provided the 387 00:13:55,855 --> 00:13:58,195 arthroplasty fund that we're going to use for 388 00:13:58,414 --> 00:14:00,034 implant use in marginalized 389 00:14:00,480 --> 00:14:02,879 folks going forward. And I'd also like to 390 00:14:02,879 --> 00:14:06,339 thank, Endeavor Health for providing a lot of 391 00:14:07,679 --> 00:14:09,360 the human resource that went on this trip. 392 00:14:09,360 --> 00:14:11,600 We had numerous members of our Endeavor Health 393 00:14:11,600 --> 00:14:14,159 team, including 2 of my joint arthroplasty fellows 394 00:14:14,159 --> 00:14:16,575 that are training with us, anesthesia and other 395 00:14:16,575 --> 00:14:19,375 subspecialties that helped, really make this mission a 396 00:14:19,375 --> 00:14:21,774 success. And I think it falls in line 397 00:14:21,774 --> 00:14:23,934 with the credo of endeavor and what we 398 00:14:23,934 --> 00:14:25,695 try to do in helping our patients here 399 00:14:25,695 --> 00:14:28,159 every day. Being able to extend that 400 00:14:28,539 --> 00:14:31,740 to marginalized populations overseas is very important as 401 00:14:31,740 --> 00:14:33,820 well. And I'd also like to acknowledge Smith 402 00:14:33,820 --> 00:14:36,000 and Nephew who provided all of our implants 403 00:14:36,379 --> 00:14:38,620 at no charge to us, which is the 404 00:14:38,620 --> 00:14:41,154 single biggest barrier in terms of cost. So, 405 00:14:41,154 --> 00:14:43,174 Smith and Nephew provided all of the implants. 406 00:14:43,715 --> 00:14:46,595 Neck Science provided all of the irrigation that 407 00:14:46,595 --> 00:14:48,754 we use, the same high-tech irrigation that we 408 00:14:48,754 --> 00:14:50,754 use in the United States. And I'd also 409 00:14:50,754 --> 00:14:51,815 like to thank Heraeus 410 00:14:53,370 --> 00:14:56,350 USA, which provided the same high quality palakos 411 00:14:56,410 --> 00:14:58,330 cement that we use here. So, kind of 412 00:14:58,330 --> 00:15:00,910 to my earlier point, through these generous donations, 413 00:15:01,769 --> 00:15:03,690 we were able to use the same standard 414 00:15:03,690 --> 00:15:05,924 of care equipment that we use here, 415 00:15:06,404 --> 00:15:07,764 and again, would not have been able to 416 00:15:07,764 --> 00:15:10,245 do it without these generous donations. We do 417 00:15:10,245 --> 00:15:11,764 fund a lot of the travel and the 418 00:15:11,764 --> 00:15:14,404 lodging. But without the donations of this equipment 419 00:15:14,404 --> 00:15:16,565 and and implant, we would not have been 420 00:15:16,565 --> 00:15:17,924 able to do it. So really want to 421 00:15:17,924 --> 00:15:20,105 acknowledge those sponsors as well. 422 00:15:21,610 --> 00:15:23,529 Absolutely. Thank you so much, Ravi, for taking 423 00:15:23,529 --> 00:15:25,290 time to speak with us today. Very, very 424 00:15:25,290 --> 00:15:26,970 important to wrap up. And again, big, big 425 00:15:26,970 --> 00:15:28,750 thank you to Operation Walk Chicago, 426 00:15:29,210 --> 00:15:31,370 yourself and the excellent providers and team members 427 00:15:31,370 --> 00:15:33,210 that you work with at Andeavor Health with 428 00:15:33,210 --> 00:15:33,950 this mission. 429 00:15:35,047 --> 00:15:36,886 Thank you, Alan. It's been a great pleasure 430 00:15:36,886 --> 00:15:38,326 and really the honor of my life to 431 00:15:38,326 --> 00:15:39,787 be able to do this every year.