Part 2 - Dr. Bill Bestic, Ex-special Forces Operator Turned Trauma Physician Talks Human Performance In Medicine & Aviation

TK: I could share with you a little bit of feedback from what we’re trying to do with Dicerra, which is something similar. People can voice up, hey, I did this and it didn’t work out, and it’s very non punitive. So we protect, we make sure there’s a level of content moderation, where we can trap people and prevent somebody’s name from being thrown to the wolves. And we thought, you know, AB testing with a few hundred folks across North America to get input. And we thought maybe, we need to demonstrate what a healthy culture looks like to people who haven’t seen it before. So we’ll interleave some aviation posts from people who are very familiar with this culture already. And we’ll combine our two platforms so that when you first log on, you know, every second post is an aviator, saying, here’s all the dumb stuff I did. As a way of showing like, it’s okay to share and it actually makes everyone better. I’m not sure that we’re going to continue with the model of keeping the aviation interleaved with the healthcare because we’ve also had some feedback that people just, you know, not interested in the other profession. But I do, I 100% think that that’s an awesome path forward, I share your perspective on even the catharsis for an individual if just being able to share it and know that you’re not going to be blamed for it. Because we are human. And one thing that I will give to healthcare over aviation is often they’re compared and contrasted as being very similar. We want to learn borrow techniques from one and, and kind of overlay it on the other as though it’s a perfect match. But healthcare is much more and you’ll know this better than anybody, being a helicopter pilot and a physician. Healthcare seems significantly, an order of magnitude more complex. And when we talk about simulation, in aviation, we have a cockpit that is an absolute replica of the aircraft that you’re gonna fly with visuals that are close to what you can expect to see. And you will run over an emergency in a really controlled manner. Probably almost exactly the way it would be represented in the aircraft. But human body is a lot more complex than that. And, you know, you can use simulation training. But I imagine you’ve probably got first hand experience that sometimes symptoms are not well presented in one patient as compared with another with exactly the same problem and sometimes there’s abnormalities within the human body where you’re trying to react to an issue and whatever procedure you have in place for the 99% doesn’t work on the 1%. And then a million other very complex variables that make healthcare much more difficult. So maybe, you know, going back to the point, you mentioned earlier about the difference in mentality when you’re you have that immediate SOP that immediate action, and then you have to make a decision as a doctor, and you’re drawing from maybe an experience you had 10 years ago, and some advice you had from somebody else five years ago, and you’re seeing this condition for the first time. Maybe ever. How, how do you deal with the complexity? And how do you deal with, you know, what we would call proficiency or lack of proficiency in aviation, where if you haven’t practised a manoeuvre for a long time, you have to go back and do it in the sim, or practice at airborne. And you don’t have that luxury in healthcare, you might be doing a procedure once, you know at a blue moon. And when you have to execute, it has to go well. How do you deal with that as a physician? Is there anything that you can borrow from aviation? Or is it really so different? That you have to take a different approach?

BESTIC: There’s a lot we can borrow from aviation that we don’t. One of is the approach to training and something I noticed coming out of the military. Military is pretty good at training. The military’s got a lot of problems. But one thing it does well is train, because most of the military, when I was in sort of warfighting roles, you spend more time training than you do, actually doing your job. In later years in a conflict in Afghanistan, they will probably soldiers spent more time fighting than training. But certainly when I joined, there weren’t a lot of wars going on. And we spent a lot of time training. So we’re very good at organising training, determining what the training needs, we’re good at saying and they will hold courses on training needs analysis. Noncommissioned officers went to this course on how to develop training. You were taught how to run training as part of the officer training. Okay, what’s the competency that I need to what level of that competency? Is it just understanding? Is it competency or is it unconscious competence? And then you work it back to the terminal, the test the build up to the test, you know, if it’s counterterrorism you say, right, the endpoint needs to be I need an individual to enter a room and be able to put two bullets through the brainstem in an instinctive manner, I need that person to have instinctive levels of shooting. So they need to start with learning how the weapon works. And then dry firing, then live firing. And then weeks on the range just getting used to instinctive shooting. And then in fully immersive, live firing with lots of people in the room and noise going off and lights and light and dark. And for months at a time till it becomes instinctive. I go to medical school, there is no list of competencies. It’s just a general sense that you’ll spend a few years tooling around University and the hospital learning stuff. And at the end of it, there’s no, there’s an exam. But you just sort of drift into the job with a gentle understanding that, wow, it’s a vocation you learn on the job. You go to specialty training, same kind of deal. It’s, there’s a terrible expression in medicine called See One, Do One, Teach One. It’s a bit tongue in cheek, but it’s actually really common. So I remember, as an intern, I needed to do a lumbar puncture, put a needle into someone’s back to get a sample of cerebral spinal fluid. I hadn’t done one before. So I said to my registrar, hey, the patient needs a lumbar puncture. And she went “sure, we’ll do it,” “yep, I haven’t done one.” So in the corridor, she tries to explain to me how to do it. “Well, it’s not that hard, you just sort of feel across the top of the pelvis and sort of draw an imagined line there and then feel between the bones and then just keep poking the needle until the fluid comes back.” I said, “Sure, can you show me ?” “Like you know, people under pressure, we got lots of patients.” So she comes in, she sort of horribly shows me how to do it. Okay, good. So that’s you qualified now, because you’ve seen one, that’s the most training you’re gonna get in sticking the needle in someone’s back. The next time you do it, you can now teach someone else. Now, think of all the things that might not have been taught properly. Think of primacy of learning, think if, you know, were you ever interested that you’re doing it, and no one will ever see you do that again potentially. It’s completely autonomous practice. So the system around training is there is no system of training.

TK: Is there an expectation, maybe a cultural one, that once you achieve a certain level of education, that that instinctively makes you just a good instructor or a good, a good teacher? A great lecture without needing any additional training.

BESTIC: Absolutely. And this sort of moves on to your second question around, so the first question is around training there really isn’t any. And the notion around training is not really there. There’s not a system that says, “Okay, we need people to learn how to intubate, put a bit of  plastic into their trachea, we must be able to break this down into steps and run it as a formal course with a mannequin, and then some supervised training in a very structured way by by people who are trained to instruct. And then you would set an exam, a course, a practical assessment, you’d be sign up, but it’s almost like medicine says, well, there’s far too many skills for us to do that. Actually, there wouldn’t be you could absolute, I mean, Christ, look at flying a fighter jet, you don’t start on day one, by getting put into the jet. I assume. You’re, you’re built up through years. With, that’s the endpoint. So of course, you can break it down into steps. There’s no skill that can be broken into steps to track, but that’s not the culture. So. And in medicine, when I finished my anaesthetic training to be a consultant, there’s no final, there’s an exam of my theoretical knowledge. But there’s no practical assessment. You know, when I get my licence to be a helicopter pilot, I can examine it from Kassar. You know, we have an hour in his office with him q&a, me. And then we go flying for three hours. Where we do everything, and all the emergencies. And I mean, it’s exhausting, right. I mean, check flights, you’ve been there. 

TK: Yeah.

BESTIC: And but at the end of it, there’s a sense that right, I’ve met the standard. In medicine, there’s not that same level. The general culture is you have to do a lot of it. So this comes back to some of these fatigue rules. As a consultant, I look back at the trainees and go “Well, if you’re going to get to do half the hours, the training might need to be twice as long. So instead of taking five years, especially training, maybe it needs to be 10. Because in that level of fatigue, I’ve done hundreds of those procedures because I was in the hospital so much. You’ve done dozens of that procedure. So you haven’t yet run into the problems that you should have, because you haven’t done enough.” So there is, that’s this part of why as senior clinicians, we’re like, well, it’s fine just to say safe workouts but we have a general sense that you need to do a certain amount of stuff, find the practice to be good at it. But no one’s really defined that either. So there’s no real sense of what good training should look like. Now, in terms of how we cope with complexity, my experience has been actually, the more complex something is, the more I’m using my human factors training, then my technical knowledge and my experience. I’ve reached the point now, if I’m team leading a, the most complex trauma that we can get, we get horrendously complex trauma, and we’re doing more and more and more patients now than we’ve ever done in the past. So I might have, I think, last time, we counted 25 people in operating here from four different surgical teams, and you’re running all of that. The more experience I get, the more I actually keep my brain empty. And I got that concept from a helicopter pilot instructor who said to me on one flight, “Bill 30% of your working memory should be free at all times for the unexpected emergency. 30% of your brain needs to be empty all of the time that you’re flying.” What a concept. So he said, “you probably didn’t notice it, but you just gave your callsign right in the wrong order. Instead of Alpha Bravo, Charlie, you gave Charlie Bravo Alpha, did you realise that?” I went  “Oh, no, I didn’t.” “Because that’s a sign to yourself that you’re getting protected, you need to pick up on the signs when you’re a single pilot. So recognize that it’s happened, recognize why it’s happened, and start to cognitively offload because your brain is full. So when the engine goes quiet, you’re not gonna be able to cope with it because your brains too full of all the other stuff. Maybe offload tasks to ATC, maybe, if you’ve got a passenger give them a map. It might look unprofessional, but you have to rapidly cognitive offload.” So I’ve applied this in this sort of Team Leader setting where I go, someone will hand me a blood test result for the patient. And I think I don’t need to interpret that there’s tons of doctors in the room that can do that. So I’ll just hand it to someone else, I delegate absolutely everything. Because I don’t need to fly the plane as such, I’ve got enough people that can do that. I can actually stand back from all of it, and be A) available to information B) maintain situational awareness because I’m not diving into a task. And I actively keep my brain into it. I mean, it sounds kind of ridiculous. But it’s this, it’s very counter to the way medicine is taught. If it is a cognitive aid, I’ll use it. You think about the way we teach medicine, we our first experiences of being a doctor or standing at a bedside with our ties on and feeling very sweaty and nervous, with our shiny new stethoscopes around our necks and our bundles of notes and pens, and a very senior professor of something with a bow tie or some such thing in front of a patient. And it’s just training by humiliation, you’re basically “Mr. Bestwick? Is it ? (As I look at your ID card) Why don’t you tell me the differentials of a gentleman with crackles in the lower left base? Come on, you should know this.” And when you don’t know it, you are put down and someone else, “Oh, excuse me, sir, excuse me, I know this.” So the culture is if you don’t have all the knowledge in your head, you’re going to be a bad doctor. Now imagine if the ward round said “if you don’t know this, I’ll wait, you can Google it. Because this is exactly what you’re going to do, when you’re a junior doctor. You’re going to google it. So why don’t you Google it? And then I’ll tell you whether that resource is actually right or not. Why don’t you set up some cognitive aids in your phone, because you’re going to carry a phone. It’s a walking computer, you can have cognitive aids for everything. But your challenge is going to be how to access the right aid, at the right time. Because if you pick the wrong aid, it’ll, you’ll become, you’ll get confirmation bias and you’ll be down the wrong pathway. So we should be being taught how to use the aid not, you’re not allowed to use the aid. So the training culture is different, you know, how do I cope with complexity? I use all the non medical stuff I’ve learned not the medical stuff I’ve learned.

TK: I wonder if that culture comes from you know, that comes from a time pre smartphone and the doctor had to carry around as much knowledge through rote memorization and experience as possible. Of course now we have these extra tools and you can probably increase the safety care and the quality of care because you can access this new tool, so don’t deprive yourself of those tools, use them, like you said, leverage them to the best of your ability. And I wonder as well, you know, you’re talking about stepping back and keeping your situational awareness, by being able to delegate to team members, I wonder how much of that has come from your background in soft as well, where, you know, as a, from a command perspective, you don’t want to be too far down in the weeds. Because you need perspective, you don’t want your bucket to be full, you want to have additional capacity, you want to have your bubble way, way, way out in front to be able to think about all the what ifs and that requires effective delegation. And then it requires trust that the people you’re delegating to a competent, and then they can do what you’ve asked them to do, which I assume, especially in soft, you have a little more of a flat hierarchy, perhaps than elsewhere in the military, where even down to the lowest levels, people are trusted to be highly, highly competent, especially in a small team. So do you credit some of the way that you’re approaching scenarios like you just described as well to some of your military background?

BESTIC: Oh, definitely. I think I’ve been through a transition where I came out of the military, and was and tried to lead in the military way. And it doesn’t work. You know, of course, it doesn’t work. The language is one part, you can’t be dropping F bombs and C bombs, during the brief, which is quite normal in the military. People don’t bat an eyelid, all of a sudden, people’s eyes are getting wider and wider while you’re just chatting. And you’re thinking why they’re looking at me like that. It’s like, oh, people don’t talk like that. Okay, I get it. I mean, that’s one it. The others that we use direct language, we are trained from the start that things work better once when someone’s in charge. So we subscribe to the model, that having a leader means a better outcome than actually having a not great leader, it’s still better than not having any leadership at all. So we kind of buy into that. So that if, and we were out rank openly, we know who’s in charge, we can look around the room and go, who’s in charge me, because I’m the most senior rank until the next senior rank walks in. Now in the civilian worlds and medical thing, there’s actually the same hierarchy, but no one overtly wears the rank, but everyone understands the hierarchy, sort of. So what I found was, I would come in and generally make assumptions that people would accept that I’m in charge and running. But that’s a dangerous way to start something. So I had to modify the leadership to almost get permission to lead. And that frustrated me initially, because in a time critical situation, I’m a big subscriber to authoritative leadership, you know, we’re taught Steve Adairs, models of leadership of participative, and free reign authority, and you’ve got the time for participative leadership is over, you will do what I tell you. And you’ll do it when I tell you to do it, or you’ll leave the room. Now, that’ll get you through that particular situation. And you can get, you’ve got all the skills to get louder and more forceful, and use your brave voice, if you have to, right? You can really dominate from that military training. But good luck doing it the next time. Because people are going to turn off that style really quickly. So I’ve got started to get feedback that, you know, my style was not working, was inappropriate, was too forceful, too intimidating. And in a culture where, you know, people aren’t loving that kind of white male approach to things, it’s time to recognize that the room has changed, and that you need to modify that.

TK: When you say getting permission from the, to lead, what kind of soft skills are you alluding to there?

BESTIC: Someone told me very early on in my officer training, he was a Vietnam veteran. And he said, in a crisis, people look to the leader that physically look at the leader. And that may not be you, even though you’re the platoon commander, but you’ll know who the leader is. And the first time I was involved in a real gunfight I remember crouching in the jungle and hearing shots going off and being worried for my own safety. And I, it was very confusing. It wasn’t like we did in training, where it was very clear what the problem was. We didn’t train enough for confusion and actually having to lead when you have no idea what to do. You know the military training was kind of you work out what to do, then you do it. But I think in real time combat situations, you actually spent a long period of time making decisions and the total absence of really knowing what’s even going on, but you have to keep making those decisions. You can’t just be stunned. And you actually fall back on these Maxim’s that you used to think were a joke, but are actually quite useful. Things like when you’re not sure what to do, move towards the sound of gunfire and kill everything you find. They empower you to do something. Okay, can’t use these analogies in a medical setting, right? Doesn’t, doesn’t wash it as well.

TK: It doesn’t translate, 

BESTIC: Maybe you can modify it, move towards the sound of people dying and save all the people in your path, I don’t know, there’s probably an analogy. But I remember crabs in the jungle. And I had some soldiers left and right of me. And I looked to my left, and they were looking at me. And I thought they were looking at something else. And I looked to my right, and they were looking at me. And I had that moment where I thought, Oh, they’re waiting for me to make a decision. So I just made a decision to go that way. I don’t know if that was the right thing to do. I don’t know if it’s the right direction. But it got us moving instead of doing nothing. And at that time, that’s what needed to happen, we’d lost momentum. So A)recognizing that if you want to be a good leader in the workplace, every time you interact with someone, or do something, it’s setting the conditions for that moment. You bring history to the room. In a good and a bad way. If you’ve got a history of being a collaborative, thoughtful, caring leader, that kind of knows their shit, then guess what people want you in the room, and when you turn up, they’re going to be glad that you arrived. That’s what we all want. But if you’re kind of a dick, or you’re really mean to people, or actually a bit incompetent, people aren’t going to want you in the room. If you don’t have insight into your own performance and how to improve it, then you’re never going to get better. We’re a highly critical society and environment, you’re never going to get everybody on side. And it’s dealing with which part of this criticism is just someone being mean and which part is actually important. That great concept that feedback is a gift. If I can get feedback about my performance, it might not be packaged in the way I want to hear it. But there’s a reason someone saying that to me, I’ve got to fix something. So I did a lot more of, instead of me internalising everything, and then giving the direction which would work in the military, I don’t need to justify my decision to my soldiers in a combat situation, I tell them to do something and they do it. If they don’t like it, afterwards, we’ll have it out. But they won’t question it at the time. Because there’s, we believe in the system of leadership and the military, we subscribe to that. We agree we’ve all agreed on that set of rules. Medical people haven’t agreed on those sets of rules. They have never even been explicitly discussed. Leadership’s never taught or even discussed, it’s, there was mentioned that coroner’s report that there was a lack of leadership, but that’s as far as it went. In fact, with a really good leader, it might have gone just fine, because everyone had the skills in the room. But they weren’t harnessed. There was no one keeping their brain free. They were all engaged in an activity, and they got cognitively loaded. But that’s not a system, not even a coroner can work out. But that’s probably the biggest problem in the room. So dealing with that complexity, I found keep it simple, keep dragging it back to doing this simple stuff well, because in our efforts to be too good and too sharp and too clever, we’re gonna miss the simple stuff. And the simple stuff is what kills people.

TK: Really, like you comment there on you bring your history with you into the room. I think that’s a really interesting way of looking at it, because people need to understand that their reputation will follow them. And the flip side of that, I suppose, is, it needs to be nurtured over a period of time. So you need to earn your leadership daily. And if you falter, all that history and goodwill that you’ve built up over, it doesn’t matter anymore. Everything you’ve done, everything you’ve built, it can fall away, so so quickly. Really, really interesting way of putting that. And I want to we’re running a little bit short on time. So we’ll make this the last question and we can kind of you know, we can see where it goes for 15 minutes. You mentioned when people are looking to you as the leader and in a situation that you gave before in a gunfight where you have to do something you don’t want to be in decision paralysis. So in a medical context, I assume That decision paralysis could come maybe from two different ends of the spectrum. Could come from not enough information, or it could come from having way too much information and then being paralyzed and not knowing what to do. How do you balance between those two ends of the spectrum when you’re trying to make the right decision, and then impart that upon your team?

BESTIC: Yeah, this happens a lot, actually, particularly in severe trauma, you don’t get any, more frequently, patients come directly to the operating theatre from the helipad, or, or screaming from the air, we bring the ambulance stretcher directly into the theatre, we bypass the emergency department completely. So the patient arrives, straight off the injury. They might have to scoop then run, put them on a stretcher, board them and that person might be in pieces. So you don’t know the extent of their injury. There’s lots of noise in the room, nurses are pulling open surgical packs, surgeons are arriving, people are crashing into there. And we don’t even know everyone. Everyone’s stress, you don’t even know their names, they’ve got masks on. You don’t know if that’s a surgeon, or a scrub nurse or an orderly. Those are situations where I find I immediately start to feel overwhelmed. I’m worried about my own performance, I’ve got fear that I’m going to make an error, that I’m going to miss something really important, that the patient is going to die and afterwards someone will go, “You miss that? Really? How do you miss that?” Because always in that hindsight, retrospective scope, it’s really obvious what the problem was. So I find in those situations, I’ve got to take a breath, you know, the first pulse you take is your own, you control yourself before you control the environment. I’m acute, it’s like I leave my body. I imagine what everyone else sees when they look at me. And I need to give them what they need to see, I need to look like I’m calm. I want to take a minute to control my voice. I learned a lot of this from, more from yes, the military, but also from aviation. When we speak, when we transmit, when we’re flying, that’s a very considered statement. We don’t press the transmit button and just start talking, we have thought about what we’re going to say in the way that we’re going to say. And if it’s an emergency, we also want to make sure we sound cool. Because we don’t want our last transmission to us whaling like a baby on transition, right? So these are the rules of Special Forces: one know your shit, two look cool. Three, if you don’t know your shit look cool anyway. So we get quite accustomed to taking a breath. And then delivering it in a very, you know, we’ve got obviously strict phraseology as well, but we give consideration to how we’re transmitting. So if I take a breath and give a thought to the first thing out of my mouth and how I deliver it, it’s going to set a tone. It doesn’t matter whether I’ve, my heads still spinning, but I have to give the impression that it’s not. So I’m faking it a bit. But people need to see that someone is in charge, otherwise, it will unravel. And then I think right and I dropped back to airway, breathing circulation, I just go, if I dumb it down to the simplest possible things. I don’t try to overreach. I even say to myself 80% solution on time is better than 100% late. It’s better that I do the basics well and miss something rare and complex that they die off, then pursue the most awesome, amazing kickass resuscitation, but miss the fact that we didn’t even put the tube in the right place. So calm down, let the situation play, listen to the noise, listen to the room, get it to really tap into your environment. And don’t over control it. Yeah, there has to be a level of noise. There might be times we get everyone to be quiet. But those moments that you transmit, how you say it isn’t important as what you say. It’s got to be short and sharp and directed. And there’ll be afterwards it’ll never make your own standard. There’s no time I do something where I feel, yeah man there was nothing to fix there. And that’s when I defaulted controlling with 14 and two squadrons in New Zealand on the Inaki and Skybell. And then we’ll take ourselves flying. And what really struck me about those fighter squadrons is how critical they are of each other. The debrief is longer than the flight. And there is nothing that’s not picked up. But it’s never taken personally. It’s always an understanding that this is important if we want to be better at what we do, and we do want to be better at what we do. So yes, yeah, we can be our own worst enemy. And sometimes when I’ve gone to mentors, they’re like “You’re overthinking mate, you did a good job, let it go.” But it still burns you. I don’t want to make that error again. And that’s why I think we took that standard about performance. And perhaps the aviation medical model, people are getting a bit worn out of that model. So you can look to other fields, the All Blacks or or any, pick any high performing sports team, they have all these cultures, they know that fatigue, they’re not going to keep the team out the night before the game. They’re going to make sure they’ve got a quiet, temperature controlled environment to sleep, they’re going to control their diet, they’re going to control their attitude, their stress, all of that if they want a good performance. So it’s like if you want to be a high performer, well guess what fighter pilots do and all blacks do and special forces do, they all have exactly the same approach to performance. And the beauty of it is that it’s highly learnable. All of us have the ability to do it. Most of us are not innately talented at things, some of us are better at things than others. Most of us get there, just through hard graft and application. You got insight into your performance and you want to get better, you don’t have to do much to be a lot better. But the highest yield is actually around human factors, not technical ability. Medicine’s very bad for this, we put huge emphasis on how good I am at a technical procedure, can I put a cannula and can I intubate? Can I do a lumbar puncture, without having five goes at it. But we don’t put any metric on that, actually speak to the patient. When I asked them why they’re having surgery, and they said, they only got told last week, they’ve got cancer and start crying. There’s no metric for saying you are a compassionate human when they started crying. The metric starts with the procedure. So junior doctors, if they’re being watched by senior doctor will want to be really good at their procedure, because that’s what they’re most stressed about. The more cognitive space they’ve got, the more there’ll be a human to the patient. That’s the doctor you and I want. I’m not actually fast, if the doctor misses the candle only three times, as long as I know, they’re highly professional. And they have my interests at heart and all the rest of it, right. So it’s switching the metric. And I think all of us have the ability to tap into this Goldmine, where the highest yield once you’ve learned your basic trade. Really, it’s attitude, and insight, that’s going to make you really, really good. And you don’t have to be amazing at any job, you’ve only got to be good enough.

TK: That is an excellent point that I think we can wrap up on. Really, really thrilled to have had you join us for this podcast. And I think I’d like to have you back because there were 100 questions that are constantly going through my head that we could have pursued. So many different avenues, you’ve got a ton to offer. And we only just scratched the absolute surface, just the tip of the iceberg. So, you know, we’ll reach out again and try and coordinate a time that works for you as well. But I want to give the last words to you. Any parting thoughts that you want our viewers and our listeners to take away from this episode?

BESTIC: I want to really acknowledge and commend you for what you’re doing. You know, I’ve probably at risk of feeling overwhelmed by my frustration with things not being as good as they could be. And my response has been to become increasingly siloed. But I’m really encouraged and motivated by people like yourself, who see that as a challenge to take it on and make it better. And if we don’t have people like you doing that, it won’t ever get better. And I think Dicerra’s a great start to actually starting that conversation. Because there’s probably a whole lot of like minded people out there. We just don’t really have a voice. And we feel a bit silenced. So I think what you’re doing is commendable. You know, if I finish with a bit of an anecdote that I read about a book I read, he’s a war surgeon. And he’s travelling the world operating in far flung places. And he’s also a pilot, a commercial pilot. So I loved it. It’s a great book called War Doctor, I think. And he’s on a helicopter, and he’s flying over this massive refugee camp in the Middle East somewhere. And there’s something like a million people in refugee camp or something like that incredible number, right? And the guy he happens to be sitting next to he doesn’t know, and he says to the civilian next to him through the headset, I’ve been operating near this refugee camp, and I reckon there’s at least 20, 25 people that I managed to save through my surgery. And the guy next to him went, Oh, that’s fantastic. That’s great. And the surgeon says to the guy, what are you doing? He goes I’m a water engineer, we just put fresh water into that refugee camp. He thinks he’s probably just saved half a million people with one water pipe. And I’d save 20. And it made him reflect on, if I really want to do the most good for the most people, I’d be a water engineer. So in actual fact, solving malaria, fixing mosquito problems, solving poverty, save far more people than the one at a time that I might be doing in the operating theatre. So what you’re doing is, has a far greater impact on actually saving lives by even just fatigue. If we just solve the fatigue issue, and approach fatigue in a different way in the healthcare industry, millions of lives would be saved every year. So what you’re doing and is actually having a far greater impact and it’s and we just need to keep hearing that message.

TK: Thanks So much, Bill. I really appreciate it. Thanks for joining us and I can’t wait to talk to you again soon.

BESTIC: Thanks for the invite. Appreciate it. See ya. 

TK: Cheers.


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