SIRKO Paper Cut

00:00:00 10 minutes.

00:00:00 10 minutes.

00:00:04 Okay, 10 minutes unfortunately. We're running late. We'll see what control we get.

00:00:14 We'll go up around a little bit here. They're all looking at you. Laura. Unfortunately, he said we only have 10 minutes. We must be running behind schedule. Where are you guys from? Los Angeles or Dallas? Oh, hey. Oh, hey. How are you doing? You're all right. You're all right. Thank you. What brings you here? We're going to put some... *phone rings*

00:01:22 - Thank you. - Thank you. - Thank you. - Take care. - Take care. - Don't miss it. - Don't miss it.

00:01:30 - We won't. - Cheers. - Yeah, we only have a few minutes.

00:01:38 - Oh, where'd Laura go? - Laura went inside to grab your food. - Let's at least try to look at this church here.

00:01:58 So normally, oh here it is, here's a nice picture right here. I'm gonna walk through this shot, we'll come back to you.

00:02:09 Oh yeah.

00:02:42 So, here's that, I assume it's a church, there's crosses on top, but we could go underneath to walk around, that's the little market where I'd say we could buy more stuff, but the

00:02:53 dude said we only have 10 minutes, so. So, do you want to, yeah, let's go back.

00:03:00 Okay.

00:00:00 Anyway

00:00:00 I think he just sent a text about the latest attack.

00:00:30 Russia tried out a strike with a guided aerial bomb on Kamiatsky in the Nitro-Petrovsk region. About 150 kilometers from Nitro. Massive column of smoke rose over the city. Mr. Kiersey can talk to me. Yeah, I need people to care. Yikes. We can have him do it again with.

00:00:59 2.5 inches. A different conductor.

00:01:23 Yeah, because that guy wasn't playing ball with us. nice so where was it neat about 150 cloud or somewhere we're going you're nervous about going here that you want to wait until the train yeah yeah editorially

00:01:42 if the train is stopped.

00:01:49 Yeah, that's going to be the whole background theme. I like to have an opening with that though. That's a great idea. The sound.

00:02:00 Yeah, and I think I texted you. I actually, you know, what I do when I'm here is I kind of text pictures and things and some videos to the people back home, you know, the residents and respecters that we work with. And I did that and I said, this is what it was like all night long. We got the window it's black you just hear the the wheels rolling on the tracks. You want to get his laces here?

00:02:24 Alright. Yeah. We can wait until you get it. Yeah, that was disappointing. It was always something you look forward to on this trip. Pretty much shortly after we run through this town, it starts getting dark. Yeah, we had a little more time, but certainly don't want to miss the...

00:02:53 Yeah, see, the guy lied to us.

00:02:59 We probably have 20 minutes. Yeah, guy. We're going to sit here forever and hear his name. Yeah. Oh, well. I was talking to a Mediterranean cruise, so it didn't suck, but I was talking to one of the people that worked there and they were telling me that they were on a ship when an

00:00:00 somebody or do something but no so yeah um it was uh i was talking to a hospital administrator

00:00:00 once and i said you know the stupid things that humans do is job security for people administrator positions because there's always problems to solve and headaches to deal with he laughed and he said sometimes i could use a little less job security

00:00:21 oh that's too bad that we didn't get more uh there too bad but that's okay i get that you

00:00:27 guys are pretty flexible with this whole thing oh yeah i mean i'm impressed you guys are like launching this big documentary project you've never even been there yeah you don't know what

00:00:37 you're getting yourselves into well i mean both logan and i have been in situations where it's just You roll with what happens. But also, we've done this together enough that I... Well, I certainly... I rarely tell him what to do. Yeah.

00:01:04 So is Laura out there? Laura's out there, yes. So you guys are both only in your early 20s? No, he's 30. Oh, I thought you were older than that. But still, it's pretty young. You seem to know your way around pretty well. I've been working with him since he was 23, so that gives you...

00:00:00 thing is that by being there with the guy the whole time you know you're you're you're you're

00:00:00 outraged because you know how he was you were risking your life just in in your imagination with him as you go through this and so you know it was a pretty intense thing but like they had a theatrical run and then it was released by frontline so that was circled back and and and so So like, you know, I wouldn't know, but I'm assuming the more lucrative would be like an HBO type thing. But the most lucrative could be the theatrical run. So we'll try that first. Logan, I'm just asking him, how does the revenue from this work? I have no idea. I do this thing and I don't know how it works. He just knows much more about that than me. Yes. Oh, you can see in the background that building right there to the church. They were fading away, leaving Colville.

00:00:56 Logan, now I'm self-conscious you didn't hear that when they announced the award for best series, they used our documentary. Was this for Pony? No, it was actually for Boz. Oh, that's cool. the clip for the series was Brian and his son in the storage unit. So, which, um, Logan, I don't like the way it's shot, so there's a reason we're here. Anyway, so, uh, oh, here's another church. Oh, yeah. So, Alex, I have this theory or this response to you, and I want you to hear it and either refute it or go into what it makes you think. I've been talking about this film and the service aspect of it, and I have said that I feel like it's not that you're driven by your faith to do this, but the same thing that

00:01:55 Does that make sense to you like that? There's it's it's part and parcel of the same thing. It's not like oh I am I am I am I have this faith. I must do something with it. I think it feels combined it feels like intrinsic You know, I think you're thinking about this a lot more than I am I mean I'm a surgeon right so a lot of people think surgeons are mouth breathing knuckle draggers. It's very simple. I mean this is something, this is a horrible evil

00:02:41 that's being committed. I mean not only is it a tyrannical state attacking a democratic state in Europe of all places, but it's also just good versus evil. I mean no one mentions anymore every day their war crimes being committed. You know the Russians are bombing children's hospitals and and kindergartens and churches and supermarkets and village squares and apartment blocks. We used to talk about the Geneva Conventions and rules of war and all that stuff has gone way out the window. And like no one cares anymore. They just mentioned every day on the news podcast I listened to, they talk about how many hundreds of drones and missiles the Russians have launched and how many got shot down, how many made it through, how many people died. And it's kind of like that's

00:03:30 the way it is now. No one even says that's right or wrong. You know when we met, Irina came with you, right? And she said her class, that people from her class were like, "Oh, I didn't know the war was still going on." Yeah, that was when, after I gave that talk at the University of Dallas, they thought that oh, they were surprised that the Russians are deliberately targeting non-combatant targets, you know, civilian targets. They thought, oh, that was just the occasional stray drone

00:04:00 or missile or something like that. It wasn't active? No, it's a deliberate campaign. The amazing thing is despite the hundreds of drones and missiles and glide bombs and things that are launched every day, every death is tragic. But if only five or six Ukrainians are killed and more injured, that's not a very good return on the investment if you're trying to demoralize the infrastructure. And of course, the more Ukrainians get attacked, what would the U.S. do if somebody were attacking the U.S.? Like, what happened on 9/11? Did we just turn tail and run? Of course not. That was one of the few things that brought the country together and everybody was pretty pissed off and everybody fought back. Ukrainians doing the exact same thing. You know, they're amazingly brave and resilient people. You know, you and I are of an age, but I'm of an age still, but

00:04:48 that we know that Ukraine voluntarily gave up its nuclear weapons. Yeah, the Budapest wars. Yeah, 1994, I think it was. And in return, they were going to be protected and guaranteed security. Which is so funny in a not humorous sense that now everyone's saying, "Well, part of the ending of the war, Ukraine's going to need security guarantees." That didn't work too well for them in 1994. I have a friend who says to me that he believes that most of the world's suffering is because of broken agreements.

00:05:37 You could say that's true at both the individual level, the organizational level, and the international level. Do you want to hit that light? Yeah, interesting. We're going to turn off. Oh. It just came on. earlier yeah no I think yeah yeah so I think it was just they they've started out at nighttime it's gotten late in the day yeah the power on air oh yeah so Logan is it better if these lights are on or we turn them off yeah look at that got that figured out So, who should talk more about Andre? What can we talk about Andre Circo? Well, tell me about him. So, Andre Circo is the, I think he's a cataclyphalist director of the Center for Shiropril Neurosurgery at Shiropril Hospital.

00:06:28 So, by, before the war started, in 2014, he was, and he used to be an excellent tumor surgeon. primarily tumors of the skull base, kind of the bottom part of the brain where there are a lot of cranial nerves that come off and do critical functions like help your face move, you control your vision, your eye movements, things like that. And a lot of the arteries coming up from below to feed the brain. So definitely tiger country in terms of places to operate and he is a master at that. And he was able to transfer that skill set over to victims of the Russian attack who've had shrapnel primarily, or called penetrating brain injury.

00:07:13 And of course it can go anywhere in the brain, but the ones that kind of come from below and maybe go through your eye socket, your frontal lobes up into the brain, or the bottom of the skull up into the brain,

00:00:00 Just kind of weird I think

00:00:00 Get some sound sync See here Where's my phone? Alright, one more to go up here

00:00:18 All right.

00:00:28 So what did you want to talk about? Hang on one second and then we'll get there. All right. Let me just put this on. Also, do I need to be sitting or doing something different? Am I okay with this thing?

00:00:52 I feel like I'm in a cave here. It's fine, it adds to the ambiance. What's next? Do you set a...

00:01:00 Yeah. Let's do it for me. One more thing.

00:01:24 So I remember giving an interview once, getting ready to talk to someone. We had a really great media person in the hospital. "What should I do with my hands?" She sent me this clip from this movie Talladega Nights. You ever seen it with... What do I do with my hands? Yeah, I guess it's kind of funny. Yeah, Will Ferrell, he's giving his hands, because he was asking about it ahead of time, so the audience was ready for this. And they're interviewing his hands were like all over the place, just gonna move it. - I'm just getting the one thing above me. - Every time I've asked if Dad's seen a movie, he always says yes. - Well, you know, I haven't seen-- - That is Will Ferrell, yeah. - I haven't seen as many as most of the recent ones, because there came a time in my life

00:02:16 and uh um yeah are these are these colors matching yours or are we good you're probably good right but it's like 3d4 for the gender but it's a later problem okay again that's right keep looking at you there yes you should and that's why i got it right here yeah so uh no i uh i'll tell when we're not rolling i'll talk i mean i don't mind it being out there but we're wasting time yeah yeah talking about it i'll tell you in a second um but uh

00:02:45 let me do that there you go you know the light's good for you guys it is pretty dark in here yeah

00:02:54 man okay color quit it yeah that's in the mood that's funny is the camera isn't even facing you

00:03:00 Oh there it is, there we go. That's too dark but what are you going to do?

00:03:13 Just going to have any of you. This one doesn't look good. Oops sorry.

00:03:27 I'm going to work. Alright, let's do that and...

00:03:58 Is that magnetic?

00:04:04 Yeah. That's very cool. Yeah, there you go. Oh shit, I just moved it. No, it's okay. Just put it up like that. Okay. Just like that. That's good. It's okay. It's getting sync sound, so that's why I have it rolling. Which means, you know, anyway, the sound is going to it. So that's just why I was making sure to get it on. It's not, it's nothing, it's a little,

00:04:30 a little claustrophobic.

00:04:35 - So, you know, this is an interesting example of what it's like in Ukraine right now. I mean, we're sitting here having this conversation on a train, it's normal countryside, and theoretically at any second now, there could be a drone or a missile coming. And that's how these people live in their lives. You know, you can't just stop living because what's going on here. So they're having birthday parties and celebrations. They go to work every day. Knowing in the back of their minds that it could end very badly sometime today. It's amazing, their strength and resilience. And you also have to wonder what the long-term toll line that's going to be, especially on the kids growing up in this. This has been going on for closer to four years now, three and a half years. Have you gotten to talk to Andre about his son growing up in this? Or have you actually talked to Sviatolab?

00:05:34 Sviatolab. I need a porter to say it. Yeah. Andre's mentioned how when they have to go in the middle of the night to their shelter in the basement of their building, sometimes he gets pretty upset and wondering if he's

00:05:47 going to die. He is in his early or mid teens right now. And obviously he's not the only one. There are millions of kids in Ukraine doing the same thing. Growing up like that, you hope kids are resilient enough

00:06:00 to overcome that, but you gotta think that to a certain extent they never will. - What have you learned about

00:06:16 Okay, first, what does, what do people, what surprises people the most when you tell them about your experience doing this?

00:06:28 Good question. What surprises me is the fact that some of them are only peripherally aware that the war in Ukraine is still going on, which may be understandable if you live in America where there's always a 24 hour news cycle, people have very short memories and currently everything seems to be driven by Donald Trump, right? Everything he does, the left wing opposes the right wing defends and that's what consumes 90% of the media. But you get outside the US or even look at other news sources, not surprising people in Europe are very much concerned about what's going on. So that's one thing is how little it is on the public's radar screen. is most people do the kind of thing, so thank you for going there, it's a great thing you're

00:07:18 doing. It's kind of like every time you meet someone in the military, you say thank you for your service. But there are some who genuinely think it's a stupid thing, like why would you do that? You're not accomplishing anything. And I try to explain to them why I think it

00:07:33 is important to go. You know, that could be argued about a lot of things. Why do it? Because one person doesn't accomplish much on their own, but all the one people have to do it to make a difference.

00:07:48 Well, I always remind people of the quote that's attributed to Edmund Burke, and I don't think he ever said this, but the basic idea is that the only thing necessary for the triumph of evil is for good men to do nothing. And of course, that was stated a couple hundred years ago, so you have to update it to say good men and women. But that's a perfect example of how if the U.S. had been more aggressive early on, I've read that a lot of people think Russia could actually have been defeated in 2022. But we didn't. We kept saying we're not going to do this. We kept gradually raising the stakes and dragging it out so long that we didn't intervene. And now, as we're recording this, you know that somewhere between 19 or 21 or so drones went into Poland, depending on which source you read.

00:08:39 They went into Romanian airspace, the Russian went into Romanian airspace for 12 minutes. They crossed into Estonian airspace. I heard just a day or two ago they crossed into Lithuanian airspace. All these drones over airports in Europe, no one's doing anything. Everyone's talking about it and everyone's saying, "Oh, this is really bad," but no one just stepped up to stop. So, does it really make a difference though for one or two people like Rocco and me to go over there? Once you've been over there, once you've become friends with them, you realize how big of an impact it has for them to see that Americans still care

00:09:24 and there are people in the West who still support them and are willing to take the time to go over there there and try to help out and also help publicize what they're doing. You know, not only in an academic sense about publishing technical neurosurgical articles about the management of these types of penetrating brain injury and trying to give those talks at academic meetings, but just to the the wider public about the amazing work that's happening over there and the incredible injustices that are being done every day.

00:09:58 What do you do to spread the message? You had that talk at UD. How else have you gotten the word out?

00:10:05 Well, I've tried to give talks at pretty much any venue that will listen, whether it's my own institution, giving departmental grand rounds, which is kind of the weekly conference that medical departments have, or at other groups. Some meetings I normally don't go to, they're not on my regular calendar, but if people want you to talk about Ukraine, I said, yeah, I'm happy to do that. You know, various newsletters and things, they're not so much technically oriented, but more, you know, kind of sociopolitical publications from medical journals. And Rocco is very well positioned. He knows a couple of reporters from ABC, because he helped take care of Bob Woodruff when he was injured.

00:10:54 So he knows Bob Woodruff pretty well. And I'm blanking on her name.

00:11:00 Who's their Sunday morning talk host? Her name is an M. It's a tip of my tongue. She's been to Ukraine a couple of times. She's a friend of Rocco's. I know who you're talking about. Yeah, okay, this is embarrassing. It's okay. It's okay. You're fine. We're not going to play that. So that's a much, again, Rocco's the ultimate extrovert. So he's pretty well connected in those worlds. whatever he can to get the word out to.

00:11:30 So let's let's.

00:11:36 You asked me earlier about Andre Circo, what makes him so remarkable. And I've thought about that a lot. And somewhere on my list of things to do is to try to write another article with Rocco. That would just talk about something along the lines of leadership under fire. and just try to briefly describe what makes Andre Circo such a remarkable leader. Because he's an expert at his craft, which is neurosurgery, but he's an expert at organization and motivating his team, very active on social media to try to get the word out there. He's incredibly detail-oriented and organized, and yet, unlike a lot of those people, he can also turn on a dime. you know when all those plans just fall apart he can roll with it and he's a genuinely good person he doesn't yell at people or demean them that's the kind of thing you could write up for a harvard

00:12:26 business review article or some management journal or things like that

00:12:31 well you uh so when we're just filming a second ago you you were talking about what he had been I mean he still is one of the world's foremost surgeons in, but like the... The elective practice, yeah.

00:12:50 The technical term is neuro-oncology, which means tumors in the nervous system. So he's been an expert in that for a while, and unfortunately he's had to become the world's expert on penetrating brain injury and surgical management of it.

00:13:00 And that's what you do as well?

00:13:09 Yeah, my main area of interest is neuro trauma, neurocritical care. So that's right in my wheelhouse. But I, whenever I go there, I probably learn a lot more than I I don't know what it would be like the first time I went. Because when a lot of neurosurgeons from the west go to other places, it's generally places with very little neurosurgical presence or infrastructure. So places like Sub-Saharan Africa or Latin America, you kind of drop in, do some surgeries and leave. But there it's very different because they have excellent people in Ukraine. the problem at least at Mexico hospital is just the sheer volume is a big challenge for you know they don't have a lot of the resources that we have so trying to do high quality work with

00:13:57 tremendous value uh knowing you have constrained resources is uh is an art and he's an expert at that so that's why i kind of learned some techniques from him and bring them back and

00:14:09 teach some of my residents so uh you know the statement is it's not brain surgery Is brain surgery really that hard or?

00:14:21 The residency is seven years long. So it may be hard, but if you devote seven years of your life to studying it, you can pretty much learn almost anything. As a surgeon of any kind, how does it affect your ego?

00:14:38 At least when you're younger.

00:14:46 I feel like I'm in a courtroom. Can you explain the question, please? I just mean that, like, you have a life-saving skill, and that's what you do. Or a life-altering, improving.

00:15:02 What you do directly affects people's existence. Does that, at least when you're younger, give you a self-importance? Or, you know, what does it do? Or you never thought of it this way?

00:15:19 From what I've seen, the doctors of any type who think that they're important are probably not the best doctors. You know, what you do is you just get so involved in the daily work. I have a kind of a regular number of young students, you know, college students, so they haven't gotten their bachelor's degree yet, who are interested in going into medicine or neurosurgery. And they reach out and ask if they can do some shadowing. And I say, "Sure, the hospital has some, you can understand some fairly strict processes to go through so they can do that." And I think what amazes them the most is that it's not like TV with all the drama and stuff like that.

00:16:00 It's like, on the one hand, we're doing brain surgery, but that's kind of over here. What the daily life is about is, okay, Mr. Smith, you know, is he ready for surgery? Has he had his MRI scans? Does his blood work okay? You know, or Mrs. Jones was admitted overnight through the emergency department. She's having trouble walking for a few months, and this is what they found. You know, her spinal cord is being compressed. And you start figuring out, does she need surgery? What kind of surgery? You know, you get lost in the details of it.

00:16:30 And every once in a while, maybe you realize that what we do is pretty cool. But you can't run around thinking how great you are. So a great story about that. Once when I was in another institution and we were rounding in the morning. And early morning rounds, the people who were in the hospital were kind of explaining to the crew coming out what happened overnight and trading off patients and things like that. And they mentioned that there was a 9-year-old kid who had come in with an epidural hematoma, which is a blood clot under the skull, but it was rapidly enlarging and pushing on the brain. And the kid was going into a coma. So they took him to the OR and operated. The kid's doing great. And the casket next morning looked great. So we were talking on rounds, and the incoming resident said, oh, you did a nine-year-old kid? Yeah. And they said, that's pretty cool. And then we moved on. We had to talk about the next patient. What's the hardest thing about being a neurosurgeon, being a brain surgeon? A lot of things we can't help, unfortunately.

00:17:30 I mean, we've made a lot of advances in a lot of areas, but two of the most things that still are very difficult to treat are malignant brain tumors. Having to tell families that's what they have. And then on the other hand, there's the kind of the emergencies of people with really bad strokes or really bad brain injuries or spinal cord injuries that, despite your best efforts, unfortunately, you have to give the family some very bad news. The thing about that, what's interesting though, is in some ways what's worse than the bad news is the not knowing. When families or patients are kind of waiting to see whether the biopsy results come back malignant tumor or not. Or, you know, we just operated on this man, he was in a car wreck, is he going to wake up and be okay or not?

00:18:20 That's the worst, you know, not knowing. I think people can often eventually come to grips with some kind of bad news, but twisting in the wind is terrible. I just, I can't imagine how hard it is to say there's nothing we can do. Yeah, sometimes you have to say that or you say, listen, we did everything we could and it's still not good enough.

00:18:52 So I know in studying for this, that a lot of issues formerly in Ukraine with tumors, etc.,

00:19:00 is that there had been a lack of testing so that a lot of the tumors were a lot further along than they needed to be in terms of like if you had the earlier testing and techniques. Is that still the case? So is Andre seeing like more advanced than you would see in the U.S.?

00:19:28 Yeah, that's a great question, but when you're asking about any particular surgeon like Andre, you got to realize he has been doing this thing in one institution for a long time, and he has a very good reputation, very well-deserved. So the kind of cases he would see might be different than the ones that someone just starting out or at a smaller place might see. So that's a great question and I don't have any direct knowledge of that, but at least from what I've seen, cases aren't necessarily any further along than they would be in the United States. I mean, for example, I spend a lot of time at what's called the safety net hospital, you know, county hospital, where we see a lot of people who have no health insurance. You know, people may not be in a country legally.

00:20:14 And of course we take care of them, but a lot of them show up with incredibly advanced tumors. And I mean they're going blind that kind of thing. Yeah, going blind or just literally things growing out of people's heads.

00:20:30 You know, you have to wonder why, what took them so long to decide to come to the hospital. And the other question is why did you come in now? You've had this going on for a while. What was it about today or tonight that made you decide to finally come in? So tell me again what you just called the county hospital. A safety net hospital? You ever heard that term before? I haven't. It's kind of for people who don't have health insurance or no other place to go. You can't afford to go to some large private hospital. It's a place that's supposed to kind of be there for those who have no other recourse.

00:21:08 So, as if I didn't know, tell me about Ukraine and tell me about what's going on.

00:21:15 In what sense?

00:21:26 That Russia invaded. Yes.

00:21:30 Sovereign nation. Yeah, Russia. And just as you're speaking about it, feel it and think about the meaning of what you're... So let me ask you for documentary purposes, though.

00:21:41 Do we want to get this much into the politics of the Russian attack? It's not really going to be that we get much into the politics.

00:21:47 What I'm really asking you for is when you're telling about this, that you might say something about the nuance of it that fits into it.

00:21:55 So this current war actually started in 2014, which a lot of people aren't aware of, with

00:22:00 Russia's illegal annexation of Crimea. And they had what was called little green men. You have people in military uniforms, but without any insignia on them. So you didn't know what country they were coming from. And I think everybody knew what was going on. But the West pretty much said, "Oh, we're not going to do anything, because everyone's afraid of the Russian bear." So large parts of Ukraine were annexed back then. And Andrei Tsierko with them would see a relatively small number of casualties coming up from the constant fighting down in front of me. And towards the end of calendar year 2021, in January 2022, Russia started building up a lot of troops on Ukrainian border.

00:22:48 And pretty much anyone with half a brain could figure out they were going to attack and invade. And I still remember these endless discussions under news every day about what's going to happen.

00:23:00 I still remember waking up one morning and, you know, the day the invasion started on February 22nd. No, I was going to get the day, February 24th, the year of 2022, when they just rolled in. And everyone said, well, you know, Ukraine is hoes, right? Because Russia's got a huge army and Ukraine's getting it rolled over. And there was that great quote from Ukrainian President Volodymyr Zelenskyy when the West, I think the U.S. had offered him, you know, a way out. But he said something along the lines of, I don't need a ride, I need ammunition.

00:23:30 And the amazing thing is how ill-prepared the Russian army was and how they had no idea how to run a war. And the Ukrainians are incredibly resilient and very smart. So they figured out that Russian generals are using their own cell phones, their own civilian cell phones, not secure military communications to communicate with each other. And immediately the Ukraine started killing the Russian generals. You know, the Russian tanks kind of got stopped in this huge column. I forget if they ran out of gas or got stuck in the mud or stupid reasons like that. And they were just sitting ducks for the Ukrainians. And basically, Ukraine repelled a lot of the attack. You know, if you look at the map of Ukraine, and you can still see roughly 19, maybe 20% or so of the country in the south and east is still occupied by Russia. But then look at the areas that were taken over by Russia in 2022, with the Ukraine captured back. It's a lot of real estate.

00:24:24 So Russia being Russia, the way they seem to always fight their wars is get their butts kicked early on, but they just have such a big population. You know, they can sacrifice people and keep on fighting. The war has essentially been in a stalemate for many, many months now, if not years. You know, Russia may advance a few hundred meters one day, maybe Ukraine pushes back. But there's, it's not going to end anytime soon. And Russia keeps throwing its own people at it. And now they have North Korea and Cuba and others sending them soldiers. And the other thing that's happened, you know, getting back to Medchikov Hospital, is that Dnipro is the biggest city close to where the fighting is happening, to the south and east of Dnipro. And as a result, a lot of people are evacuating those areas and going

00:25:19 up to Dnipro. And in just a year and a half or so that I've been going to Ukraine, I've noticed that cities seem more crowded, you know, more traffic, more cars. Ander Sirko's clinic for his elective patients, you know, the tumors and other things that the general population has that require neurosurgeons, you know, andeurism, spine disease, all that. The number of those patients has increased too. So it's not just the unending number of combat casualties, but a larger volume of the non-combat related neurosurgical needs. When about 30% or more of the workforce in Dnipro, in Meshachikov, has left.

00:26:00 You know, some doctors either left Ukraine altogether, or went to other parts of the country or join the military. So you're doing they have to do a lot more work with a lot fewer people. And the same is the same personnel at Menshikov who've been dealing with this increased value and daily attacks while they're working they're worried about their families getting blown up at home. They've been doing this for for literally for 11 years now and counting since 2014 and it's especially wrapped up since 2022. That's very different than what the U.S. has been doing or what the U.S. was doing in Afghanistan and Iraq in which the medical personnel would rotate in and out for a defined period. So maybe 12 months

00:26:49 or so plus minus was the average rotation. And even though it sucked to be over there, you knew there was an end date for it. You can go back home. They don't have that luxury at Medjokhov hospital. They're there for the duration. There's no other home for them to go to. So again, that psychological stress is terrible on that, but you also really get to see their resilience, their determination, their bravery. They're fighting even harder. not giving up. And from an academic point of view, a byproduct of that is they have this intensive immersive experience and this huge number of combat related injuries. So they are the world's experts now in understanding the natural history of the disease and how

00:27:38 to treat it. And remember, no one else in the world ever has had to fight the kind of war they're fighting. Because when this war started, it was just another traditional war with tanks on some fields in the eastern part of Europe. And this is not an artillery or armor fight anymore. It's a drone war, which no one's ever figured out how to deal with before. And Ukrainians are the world's leaders in developing drone technology and fighting against that. Also, learning how to treat the people injured by this new kind of weapon. - So, some of these questions you know,

00:28:20 I know the answer to, but I assume I don't. Well, likewise, you heard me say this before. Of course, of course. Well, it's always tough telling someone for the second time. No, I know a little bit how they gave us.

00:28:30 So are my answers good? Do I need to be more emotive? Do I need to be more like Rocco? No, you're fine. No, no, I mean, like, because I don't know what we're going to use from this. I mean, like, this is just sort of all a precursor.

00:28:43 So maybe let's think about that. And it's just like, what do you feel when you look at the countryside? And maybe tell us about the first time you went and were you afraid the first time?

00:29:00 So before I even went, when I got to talking to Rocco about this at this meeting, I may have mentioned we're at September of 2023. And at that time, like every other American, my experience of combat had been people in a desert, right? are you know people living inside the wire and the figured military thing i even asked him like sleeping in tents somewhere in a cot he said no this is like fighting in an urban city i mean pick any big city in america and imagine that drones could take it out at any moment it's it's crazy it's it's not like urban warfare or an insurgency it's like this is real live war on your doorstep So it was a surprise to me to realize, oh, this is just like going to a country in Europe,

00:29:45 staying at a decent hotel, walking five or ten minutes to a big hospital. And the other thing is I was so ignorant about drones. Because you heard, this is back when drones were kind of first being used. And back then, they would use these cute little quadcopter drones that you see, you know, that people use when a building inspector comes to your house that looks at your roof and stuff like that. And they were using those to drop grenades on troops at the front line. So I thought I'm going to have to be looking over my head the whole time, making sure there's going to be no drone. Of course, that's not going to happen in a big city. But the drone technology and the drone weaponry has advanced so much since then. I have a much better understanding about it, too,

00:30:30 since I've been paying more attention and listening to podcasts about this and trying to read more about this. And again, I had no idea. I thought this was gonna be like a traditional kind of neurosurgical mission trip when you go to some underserved part of the world and all these patients with horrible diseases, they've been kind of lining up for the surgeons from America or from the western country to operate on. Now this is different. You know, those guys know what they're doing. And, you know, Rocco has the term reciprocal learning. We learn from each other. He also calls it a cultural exchange. We learn how they take care of patients and we teach them how we do it. As a spin-off of that, the ICU people especially had a lot of questions about how we do this. So we set up a monthly neurocritical care conference with them for that same purpose.

00:31:17 We alternate months, one month we present cases, one month they do.

00:31:22 Let's hold for a second while he repositions and deep cut hairs. Are you sure you got enough light?

00:31:29 I'm looking at this little thing. It's starting to get dark in here. I mean, you got to do an overhead light? No, because it won't match. Should I lean forward a little bit? No, that doesn't sound good either. If you scoot a little bit closer, I'll know that better. Hey, there you go. Anything you want to change about this, Logan?

00:00:00 comes into play is my eyesight. And then my brain plays tricks.

00:00:00 You're good like that, Logan? Yeah, I'm good for a little bit. I'll move around a bit. Thank you. So what are you talking about? I don't know, but the leaves are changing. Just mention that. So you asked me earlier about the thoughts on Ukraine. I mean, here's a really nice countryside. What's interesting is that as we're riding along here, I noticed that But these leaves in this part of the country are already further along in the autumn process here. There are more yellows and oranges and browns than it were just a little while ago. It's a beautiful country. It really is. And that is actually why, or part of why, it's been in such an important sort of region over the centuries of the thousands of years of mankind being in the European area.

00:00:51 So it sounds pretty stupid to say that we are lucky in America because we're protected by two oceans. You know, if you grow up in the United States, you live there your whole life, you don't even think about being attacked or invaded. But when you're actually physically here, you know, almost anywhere in Europe, but especially kind of in Eastern Europe like this, you really realize that there's nothing stopping any invading army or invading horde of barbarians throughout history coming from any direction. north, south, east or west. Just a big flat plain. There's no natural barriers. It makes you realize how vulnerable these people are. But isn't this a center for agriculture? I mean like... Oh yeah. Yeah. Ukraine is one of the world's bread baskets, right? That was a big problem. All the wheat they need to export through

00:01:42 the Black Sea was under threat for a while. And if that's under threat, then a lot of people in the Tell me again when you got your Lithuanian citizenship. I think it was a couple of years, 2020, late 2022, early 2023. And when did you go to? June of 2023, just a couple of months before I talked to Rocco about this. So I was kind of preconditioned to come for a couple of reasons. We talked about my wife and her volunteering with the Red Cross, which I've always thought was cool. Then I talked about the fact that I kind of seen the former KGB headquarters and, you know, walked the places where they executed people there. So those were swirling My children are grown and they've left the house, so we're empty nesters.

00:02:42 So perfect timing. Are you excited to be heading back? I am because we talked earlier about some of the reasons to do this. Because it's trying to help defend a free democratic state against its tyrannical state's invasion.

00:03:00 a more fundamental notice good versus evil but that was personal because they're my friends and they're my friends who are going through some hard times and so the first time I went was just kind of get the lay of the land right then I thought how can I up my game for my second visit so I I spent more time in the ICU because I'm actually certified in neurocritical care as well and I have A lot of interest in that part of the hospital. And then my third visit, I actually spent a few nights taking call in the hospital at night. And I kept thinking, how am I going to up things for my next visit?

00:03:45 And I realized I don't have to. Because just by showing up, it is such a big shot in the arm for them. Yeah, you bring little gifts as a sort of a gesture of friendship. But it's not because of the gifts or anything like that. It's just seeing someone from America who's willing to make the journey. And sure, there's some risk there, obviously. But I'm surprised that more people from America aren't going all the way to eastern Ukraine, to Medchikov Hospital. If you're interested in trauma, this is the institution that's leading the development of trauma for future conflicts. And those lessons, of course, translate immediately to civilian trauma care. But I mean like the so you're talking about double-legged sword on one side you want to tell people that like hey the

00:04:34 We're still going on but like but no you can go go near it. Yeah, so it's it's sort of a tough thing Right, you know because you both want to like Say the people to be aware, but also like well the you're right, but we're not going to the front line Right the front line is a disaster. There's no longer a front line in traditional sense It's kind of this long gray zone and it's hard to tell who's in charge of different pieces of land. This thing can be kilometers in thickness. You know, it's not just a thin line on a map. But we're not going anyplace over there. We're going to a large city that has a good missile defense system. And especially the area near the hospital is particularly well defended.

00:05:21 The place we're staying at and the hospital itself, they have shelters in the basement. So, there's usually enough of an advanced notice. If something really bad is happening, you can get to the shelter, but it's unlikely because all the defenses are on the hospital. So, yeah, the risk is not zero, but, you know, if you're an infectious disease doctor and you're interested in Ebola and you go to Africa to study Ebola, well, yeah, there's a risk there, right? Or maybe malaria might be a better example, right? You want to go to a place where there's malaria so you can study it. You might catch malaria, but you know, you kind of put up with certain risks. You're a long haul truck driver, you can get in an accident, fall asleep behind the wheel. There's a risk crossing the street.

00:06:08 Yeah. What about brain surgery or neurosurgery? How did you end up in your journey? Like when did you know that this is what you wanted to do? Yeah, that's a good question. I know some people don't make up their minds till late, but it was always something I was very interested in. So for me, medical school was more looking at other specialties to make sure I wasn't missing anything. You know, neurosurgery was always my number one thing, but let's look twice at this or that to make sure maybe there's not something else I'd rather do, because I know a couple of classmates of mine who are dead set on surgery, and they had had this revelation in second or third year of med school that they really don't want to

00:06:53 go into surgery. So they went into other fields. I developed pretty early on an interest in neuro trauma and neuro critical care. And when I was talking to my advisor in medical school about that interest, he's the one who recommended me, recommended that I should do my residency places are strong in that. I'm struck by the statement you just made earlier and like we're going to a city with a strong missile defense whatever whatever you said. It's just like that's just not something we have to think about in the

00:07:30 U.S. you know? Yeah I think it would be well obviously I'm biased but yeah I I think we've become too insular in the United States with this breathless reporting. I mean, I love when the fact that you have some news story that's maybe 18, 24 hours old and have like a live reporter, you know, who's in some other part of the world. So they're awake at 3 a.m. local time or something talking to the evening news in the United States. You don't need a live reporter there. You know, you always see a reporter standing out in the middle of a hurricane, broadcasting about the hurricane. We don't need this kind of stuff like that. I think if we take a step back and think about what's really important, I mean, this conflict going on has redefined how war is going to be fought forevermore.

00:08:16 The future of Europe is at stake, and if Europe's affected, it's certainly going to affect the U.S. People in the U.S. may not want to think that way, but it will. It'll affect the rest of the world as well. How much do you think about the people that you couldn't say or couldn't, whether not operating at all or operating and it wasn't successful, how much does that stay Sometimes, sometimes you think about it at random moments or sometimes when you see a patient with, who shows up with the same kind of injury or same kind of disease or illness that a patient whom you treated had and the one you treated didn't do well.

00:09:02 You know, you think, "Oh, okay, I remember this because this patient over here had this and didn't do well." You just try to do your best to make sure it doesn't happen again. You know, the best surgeons I know, and I work a lot with residents, especially the upper-level residents, who are going to be independently in practice in a year or two. And if they're involved in a case that doesn't go well, they choose them up sometimes. And I know they're going to be the best ones. You know, you have to have several conversations with them and reassure them that you didn't do anything wrong. Or, God forbid, they didn't make a mistake. They learn from it. you sit down with them and make sure they understand what happened again and usually they're well aware of that. Usually if you're most lines of work if like 99% is pretty good you're happy

00:09:52 with that. The problem is that 1% isn't good and that's not good enough if you're in the medical field especially a surgical field. When you see something similar are you are you frightened or excited about the opportunity to do something different or is it a little bit of both? I don't think there's any, there's not that kind of emotion about, it's more like problem solving. It's like okay we need to approach this tumor this way or approach the spine problem this way and you're thinking about this other patient who had a complication and didn't do well, you just, you'll learn from your mistakes but hopefully you learn more from other people's mistakes that you've read about or discuss the conferences. So you don't have to repeat those same mistakes.

00:10:40 Tell me about Metzikov at night. It can be pretty variable but on any one day just on the circle alone will get one to eight cases of penetrating traumatic brain injury which again that means that someone has had usually shrapnel. In the United States when you talk about penetrating brain injury, it's usually a gunshot wound to the head. But in war, it's usually shrapnel from explosions, a piece of metal or brick or pavement or whatever is in someone's head. So they do anywhere from one to eight of those cases, an average of about three per day, just for that disease entity alone. Not to mention the other types of injury or trauma, and then not to mention

00:11:28 and all the other surgeries they do for brain tumors and you know, chronic artery disease, spine disease and all the other branches of neurosurgery. They can be pretty busy at night. And that's when the people are brought in from the front. Yeah, generally it's, we talked about how the so-called rules of war got thrown out the window. It used to be a pretty sacred thing not to attack a medical facility, right? Because theoretically, those doctors and nurses and healthcare workers could be taking care of one of your side's injured soldiers as well as the enemy's injured But that's unfortunately a very naive way to look at things now, which shocked me when I started looking at this. So, of course, ambulances with the big medical symbol on them that used to mean off limits.

00:12:18 No, now they're targets for the Russian drones. They'll go after them. And Ukraine, they have these kind of stabilization centers, which are usually the first place an injured soldier or civilian may get to as they're trying to get them stabilized and move them further away from the line. But again, those have become targets now. So I've been reading how a lot of those are now kind of being hidden or placed underground or not advertised as such. medical symbol used to be kind of like a garlic for a vampire, you know, it keeps away the drones and things. Now it's a magnet, unfortunately.

00:13:00 So we were there when Andre talked about this, but as if we weren't, tell me about Andre talking about his surname and talking about Ivan Sirko. You'll have to talk to him more about that. I know Ivan or Ivan Sirko was a great Cossack leader. I don't know, is he a general, a military leader? And yeah, Andres descended from him. So if you talk about the tradition of service running in his family, it doesn't get much better than that, as witnessed by the fact that his older son is a neurosurgeon. He has finished training and starting his career. His younger son still has a ways to go in his education, of course, but even he is

00:13:48 leading more towards a medical field. Last time I talked to him he was thinking more about trauma surgery. I think because of part of the older son's training he had done a stint that's kind of like a little different than in the United States but like a neurosurgeon who can also do stuff on the other part of the body. So I think the younger son was kind of thinking about that model but knowing Andre I think that by the time his younger son is finished his school the younger son will be a and you're a surgeon too. So there's very strong family traditions dating all the way back to Ivan Sirko. - Wow, I didn't pick up that he was descended from him. I picked up like how, you know, the legendary figure. - No, I thought he's a descendant of him. - Oh, what do you mean? - Yeah, we can clarify when we're there. - I just, for me, he was just talking about having a name that he had to live up to, like, because he is named Sirko,

00:14:44 can't leave people look to him as you know for for the strength that that the Sirko name carries that's what I was a very strong thing you know that I took from it. You're exactly right yeah it's not only his his own personal leadership but he's again unlike in the United States these people do think back to prior generations in their family heritage Talk to me about passion. So I got to tell you that my ancestors come from northern Europe.

00:15:31 So we tend to be a little more stoic and not that emotive. Kind of like the Ukrainians, you know, it struck me in clinic. I mean, either circle would have these conversations with patients, give them very bad news. they're very stoic about it at least they're you know I'm sure when they go home and choose them up yeah we're I'm just not as passionate as someone from the southern part of Europe you know your Greeks or Italians people like Rocco who are much more passionate and articulate about these things but we still have the same drive no question we may express it different ways but Andre Rocco and I I have formed this team, alliance, brotherhood, where we're talking every day on WhatsApp. And we're all very different, which makes us a better team, right?

00:16:20 We all have different strengths that complement each other's weaknesses, different styles. But we're all united by this idea about trying to help Ananday do the best possible job he can to take care of these horrible casualties that he gets every day and try to educate the rest of the world what's happening in Ukraine. Describe being driven, have that drive. You know, it's funny. You asked me to describe that. It was like you asked me to describe, like, why do I go? You know, it's just something I do. I mean, my wife has given up on me because, you know, I pretty much don't have any hobbies. trying to work all the time. You know even on this trip knowing that we wouldn't have very good internet trying to line up the work and things to do on this long train ride that wouldn't require internet.

00:17:11 So it just, well I will say this though, um, you know they used to call people uh workaholics which don't hear much anymore but the idea about working all the time and I've been blessed in my career to hold a lot of leadership positions and organize neurosurgery and be able to give back to the specialty a lot in that way but I think that what I'm doing here now in Ukraine it's a whole order magnitude bigger and not to disparage any of the other you know committee work leadership things I've done or the people who are currently doing those things because it's important but we're talking about a war here I mean literally you know it's not just committee meetings and trying to reconfigure organizations and things like that. Then even trying to improve the way the

00:18:01 specialty is practiced the understates. This is like life and death for a lot of people. So the whole workaholic drive thing, just the innate desire to keep working, I think is important. But you know we all know people who work all the time and they're busy counting their paper clips, you know rearranging the rubber bands and things like that. Think back to my wife. You know, she didn't have to volunteer for the Red Cross. Just someday, one day years ago, she said she's gonna do that. And she stuck with it. I think that's very commendable. It's interesting. What I call passion, you call drive. Yeah. It's funny because I think of myself as actually being a very passionate, driven, hardworking person. And

00:18:54 I know these um they're still in college who are shattering me she said Dr. Black are you always so calm and I that struck me I guess maybe on the outside people think I'm calm but I don't think of myself that being away on the inside. Logan before we lose light completely um are there some topics that uh um you think we should hit in this uh

00:00:00 like we want to get with Alex oh yeah probably be nice to get someone like

00:00:00 like Alex right yeah yeah exactly okay or so I'm walking around the crane but also just sitting yeah yeah okay so so welcome to the Ukrainian train we are on our way to Dnipro which is in central Ukraine but in terms of the where the front line is it's only an hour from the front line so to get here I live in Dallas and I try to be as efficient as I can with my travel to minimize the time I'm away from work. So the cycle I've gotten into is leave Dallas on a Thursday evening, connect somewhere in Western Europe like London or Frankfurt and get into Warsaw, spend the night there which is Friday night, then Saturday

00:00:46 morning catch a 6:40 a.m. train from Warsaw to the Polish border. That ride is two hours, 45 minutes or something like that. And then an hour later, catch a train that leaves from Helm, the border town, and goes all the way to Nitro, which will get us in at Sunday morning. So if you leave U.S. Central time Thursday night, you get in Sunday morning, you lose eight hours with the time zone change. I know some people take even longer routes, but this is, trust me, I spent a lot of time on Google trying to figure this out. This is the most time efficient way. So when I am out of Dallas on these trips,

00:01:30 I'm out of Dallas for 10 nights, only five of those nights are actually spent sleeping in Dnipro. The other five are spent sleeping on planes or trains or airport hotels in Warsaw or hotels by the train station. - Is it worth it? - Absolutely. Yeah, I think what's happening over there is incredibly overlooked in the West. It's so important, I think, to support the incredibly brave, resilient people over there and the work that they're doing.

00:02:00 It's important to learn from them. We've published several articles in the medical literature with many more in the works on how to take care of these patients. But more importantly, just to not only deal with the medical audience, but the audience at large. People are always really curious about why I go over there. That's something that they never thought anybody would do. So explain to them what it's like, why the war is important. And maybe the best thing of all now is it's most important thing I should say is that it's personal for me now, because I'm friends with these people there. And we've operated on tough cases together. We've done CPR together in the ICU. We've taken care of patients in the ICU who are critically ill. I'm very, very concerned about them and want to do whatever I can to support them.

00:02:50 And making the effort going all this way, all this time and money and effort to get there and just show support for them is a

00:03:00 huge morale booster for them. Because some of them have been doing this, most of them have been doing this for the entire 10 years of the war, even though significant percentage of their colleagues have left and even though they don't get a break. So I think it's absolutely worth it. This is why I spend my vacation time doing this. I mean, I can't imagine. Like, from what you do and get out of it, I can't imagine a better way to spend your vacation time. Seriously. I mean, I have to be careful not to involve my employer in any of this. So I take vacation time. I pay my own travel. You have to buy your own health insurance here in Ukraine because the policies I have at home don't cover us in a war zone, apparently. So all these things kind of insulate my employer.

00:03:47 So I do this on my own time and on my own dollar. And no second thoughts at all. I just wish I could do more. I think that's probably a good way to end our conversation.

00:00:00 Oh yeah, look at that, Wi-Fi. Get some of these messages sent real quick. So should I be talking about this or is there going to be a silent part where I'm just playing with the computer? How about you just feel it out? Like just do your work and comment if you feel... Okay.

00:00:30 Oops. Oh no.

00:00:37 I just lost my Wi-Fi. Oh well. All right. Go back to doing something else. What was that statement you told me about a surgeon only touching an email? Yeah, just in general, the business efficiency thing is only touch an email once. Don't look at it and say, "I'll get back to it." Just try to get rid of it right away. But that's the rights. Like I said, I got some things I can do just on word here. Matter of fact, one of the things I need to do is another draft of an article we've been working on with Andre. He just sent it back to me, so I need to kind of start working on that one too. That's my next project. focusing on his series of penetrating injuries to the lateral skull base, you know, kind of in this area here. He and Rocco published one on the anterior skull base before I got involved.

00:01:28 And the numbers that Andre has seen from this just dwarf anything else that's ever been published. And unfortunately, I should say sadly, Andre has some incredible illustrations of how horrible these injuries are. I was smart enough to download this onto my hard drive before I left. The new internet would be sketchy here. Do you want me to stare out the window periodically and think deep about?

00:02:30 You do whatever feels. I don't know for you. I'm looking for this one. Clutter here. Yeah, we're very cluttered. E aí

00:00:00 And you go for it, Alex.

00:00:00 So, Andre just sent this to Vrakko and me. About a strike in the Nitro-Petrosk region. So here's the city of Dnipro. And this is the city that got hit. And this is where it came from. In Russian territory, about 150 kilometers. And Kiev also got hit. You can see how the smoke there. This is just another day in Kiev and in Ukraine. This stuff happens every day. It's terrible. Did you get the big call in the smoke? I did. Oh yeah, this is something...

00:00:58 Oh shit, I don't want to do that. Yeah, I don't have Facebook or WhatsApp or any of that stuff. We have WhatsApp. Yeah. Stop creating account. Yeah, it shows this woman just kind of standing here that she gets blown up. Oh, here we go. You getting this? Yep. This is from the VBC. ご視聴ありがとうございました

00:01:55 - What else do I need to get, Logan?

00:02:30 - I think I'm good. - You're good, yeah.

00:00:00 This documentary goes through here to follow a neurosurgeon from the United States.

00:00:00 As he goes and volunteers his time at the hospital in Newbro. He does this twice a year. And he broke. Newbro. Newbro, yeah. And the hospital there has seen 45,000 wounded since February 2022. And this is still going open. The hospital has seen 45,000 wounded since 2022. And there have been 2,500 brain surgeries.

00:00:47 So he's a brain surgeon who goes, he's one of two Americans who goes twice a year. So, he and another surgeon who comes another time during the year, they do this and end up traveling for as many days as they're on the ground in Nipro. So we want to open the documentary with a few of the rails because that's how we're entering

00:01:34 into the film. I don't know how I got to play with more.

00:01:46 I'm going to

00:02:15 [RUS] [Subtitles by DimaTorzok]

00:00:00 There's a documentary about all the Ukrainian children who Russia kidnapped and tried to brainwash.

00:00:00 There's a documentary about all the Ukrainian children who Russia kidnapped and tried to brainwash. Wow. That's a documentary.

00:00:10 That's one of the very few topics that Republicans and Democrats agree on.

00:00:15 Don't brainwash kids? Yeah, Russia's militarizing Ukrainian children who occupied territory. It's free to watch everything you can share.

00:00:24 Free to watch on YouTube? Yeah, that's what it says here. It's terrible. Yeah, so the guy who owns the sound company that I met with last night, he had been doing a documentary on surrogate mothers in Ukraine.

00:00:00 Everybody needs to read about the colonoscopies.

00:00:00 Everybody needs to read about the colonoscopies. It's morning, right? It's like morning coffee.

00:00:11 And here's a... We'll see if there's a great person. If they're... If they're parents? Yeah, yeah, of course. I can... I can move.

00:00:27 It's like, um, yeah, it's not rocket science. So, you know, uh, Alex, I grew up with a lot of anxiety and depression and stress and all this kind of stuff. And like one of the reasons why... You're a bit typical American. Yes. Well, one of the big reasons that, like, um, you know, I am against, uh, gun ownership I just feel like something like that opioid, if it's around, you have it.

00:01:00 And I don't mean like using it on somebody else. So it's interesting because, um, you know, going under some, you know, pretty charged topic, I don't know if this is true, or just like in Ukraine, usually they have a piece from the US, and then when you're in a restaurant, they're starting to get it. Right, right, right. Yeah, exactly. Well that's, you know, like the, our Constitution says, we want a well-organized, well something, well-show. So it's like, you know, gun ownership works. So yeah, the wrangling says that of course, it was a government that was told that they went way too far,

00:01:47 There's restrictions and things like that. Right. So that's why we need weapons. Right. With the left-wing, they're getting a million. Trump is going to be a dictator. That's what they need. That's what they need. Right, exactly.

00:02:00 A friend of mine from China was actually doing a fellowship here, and I took it to a shooting range once. I said, you know, the difference is that in China, the people fear the government. Right. In America, the government should fear the people. Right. What I don't get is like, we set up something that was supposed to be a government for, and people buy them. And like, it's too much, you know, I don't know, too much feeling of separation. Oh yeah. So we have a better idea than that sometimes, our country's history, we have a lot of polarization, right?

00:03:09 - It's gonna be Yeah, sorry, what are you on the side that hasn't sun? No, it's not.

00:00:00 So what should I do with my hands?

00:00:00 So what should I do with my hands? You know, she sent me this clip from this movie, Talladega Nights. - Yeah. - You ever see it with-- - What do I do with my hands? - Yeah, and I guess he's kinda funny. Yeah, Will Ferrell, he's giving his hand, 'cause he was asking about it ahead of time, so the audience was ready for this. And they're in the interview with his hands were like all over the place, just gonna move it.

00:00:20 - I'm just getting the one thing above me. - Every time I've asked if Dad's seen a movie, he always says yes. - Well, you know, I happen to-- - That is Will Ferrell, yeah.

00:00:30 I haven't seen as many as most of the recent ones because there came a time in my life when... Are these colors matching yours? Are we good? You're probably good. Right. I feel like it's a reading more of a gentleman's a leader problem. Okay. Keep looking at you there. Keep looking at you there. Yes, you should. And that's why I got it right here. Yeah, so, uh, no, I, uh, I'll tell, when we're not rolling, I'll, I'll, I'll, I mean, I, I don't mind it being out there, but we're wasting time, so, with me talking about it, I'll tell you in a second, um, but, uh, uh, let me do that, there you go, alright. The light's good for you guys, it's just pretty dark in here. Yeah, man, okay. It's still dark, but it's, you know. That's in the mood. That's funny. The camera isn't even facing you, is it? Oh, there it is. There we go.

00:01:30 Amazing. That's too dark, but what are you going to do? I just don't have any idea. I just want those up to you. Oh, sorry.

00:01:44 Oh, sorry. 4 all right let's do that and is that like that it yeah that's very cool yeah there you go oh shit i just moved it no it's okay just just put it up no no no just put it up like that

00:02:32 okay just like that that's good it's okay it's it's it's getting sync sound so that's why i have it rolling which means it's yeah anyway the sound is going to it so that's just

00:02:43 why I was making sure to get it on it's not nothing it's a little a little claustrophobic so anyway this is an example of what it's like in Ukraine right now I mean we're we're sitting here having this conversation on a train it's normal countryside and theoretically at any second now there could be a drone or a missile coming. And that's how these people are living their lives. You know, you can't just stop living because of what's going on here. So they're having birthday parties and celebrations. They go to work every day. Knowing in the back of their minds that could end very badly sometime today. It's amazing. Their strength and resilience. And you also have to wonder

00:03:29 what the long-term toll line is going to be, especially on the kids growing up in this. been going on for closer to four years now three and a half years have you uh we've gotten to talk to uh um Andre about um his son growing up in in this or you actually talked to

00:03:55 i need i need water to say yeah um i think he's mentioned how um When they have to go in the middle of the night to the shelter in the basement of their building, sometimes he gets pretty upset and wondering if he's going to die. He is in his early or mid-teens right now. And obviously he's not the only one. There are millions of kids in Ukraine doing the same thing. Growing up like that, you know, you hope kids are

00:04:21 resilient enough to overcome that, but you got to think that to a certain extent they never will. what um what what what have you learned about uh okay first what does what do people what what surprises people the most when you tell them

00:04:45 about your experience doing this good question um what surprises me is the fact that some of them are only peripherally aware that the war in ukraine is still going on. Which may be understandable if you live in America where there's always a 24-hour news cycle of people who have very short memories. Currently everything seems to be driven by Donald Trump, right? Everything he does, the left-wing opposes the right-wing defense and that's what consumes 90% of the media. But you get outside the U.S. or even look at other news sources, not surprisingly, people in Europe are very much concerned about what's going on. So that's one thing is how little it is on the public radar screen.

00:05:35 Another is most people do the kind of thing, "Thank you for going there. It's a great thing you're doing." It's kind of like every time you meet someone in the military, you say, "Thank you for your service." But there are some who genuinely think it's a stupid thing. "Why would you do that? You're not accomplishing anything."

00:05:55 I try to explain to them why I think it is important to go. You know that could be argued about a lot of things. Why do it? Because you're not accomplishing anything. Any one person doesn't accomplish much on their own, but all the one people have to do

00:06:12 it to make a difference. Well, I always remind people of the quote that's attributed to Edmund Burke, and I don't think he ever said this, but the basic idea is that the only thing necessary for the triumph of evil is for good men to do nothing. And of course that was stated a couple hundred years ago, UCF held data to say good men and women. But that's a perfect example of how, if the U.S. had been more aggressive early on, I've read that a lot of people think Russia could actually have been defeated in 2022. But we didn't. We kept saying we're not going to do this. We kept gradually raising the stakes and dragging out so long that we didn't intervene. And now, as we're recording this, you know that somewhere between 19 or 21 or so drones went into Poland,

00:07:08 depending on which source you read, that when it's a Romanian airspace, the Russian went into a Romanian airspace for 12 minutes, they crossed into Estonian airspace. I heard just a day or two ago, they crossed into Lithuanian airspace. All these drones over airports in Europe, no one's doing anything. Everyone's talking about it and everyone's saying, "Oh, this is really bad," but no one

00:07:30 has stepped up to stop. So does it really make a difference, though, for one or two people like Rocco and me to go over there? Once you've been over there, once you've become friends with them, you realize how big of an impact it has for them to see that Americans still care and there are people in the West that still support them and are willing to take the time to go over there and try to help out and also help publicize what they're doing. You know, not only in an academic sense about publishing technical neurosurgical articles about the management of these types of penetrating brain injury and trying to give those talks at academic meetings, but just to the wider public about the amazing work that's happening

00:08:13 over there and the incredible injustices that are being done every day. What do you do to spread the message? You had that talk at UD. How else have you gotten the word out?

00:08:30 Well, I've tried to give talks at pretty much any venue that will listen, whether it's my own institution, giving the Parmental Grand Rounds, which is kind of the weekly conference that medical departments have. Or at other groups, some meetings I normally don't go to, they're not on my regular calendar, but if people want you to talk about your current, they say, "Yeah, I'm happy to do that." Various newsletters and things, they're not so much technically oriented, but more kind of sociopolitical publications from medical journals. And Rocco is very well positioned. He knows a couple of reporters from ABC, because he helped take care of Bob Woodruff when he was injured so he knows uh bob would rip pretty well and um i'm blanking in her name who's their

00:09:21 their sunday morning tacos uh that's the tip of my tongue she's been to ukraine a couple times

00:09:30 she's a friend of rocco's um i yeah i know who you're talking about yeah this is embarrassing

00:09:36 it's okay it's okay we'll you're fine we're not gonna play that so that's a much again rocco is the ultimate extrovert so he's pretty well connected in those worlds and he does whatever um so uh let's let's let's you know you asked me earlier about andres circo what makes him so remarkable and i find about that a lot that somewhere on my list of things to do is to try to write another article with Rocco that would just talk about something along the lines of leadership under fire and just try to briefly describe what makes Andres Sirko such a remarkable leader because he's an expert at his craft which is neurosurgery but he's an expert at

00:10:23 organization and motivating his team very active on social media to try to get the word out there

00:10:30 you know he's incredibly detail-oriented and organized and yet unlike a lot of those people he can also turn on a dime you know when all those plans just fall apart he can roll with it and he's genuinely a good person he doesn't yell at people that can mean that

00:10:46 that's the kind of thing you could write up for a harvard business review article or some management journal or things like that well you uh so when we're just filming a second ago you you were talking about what he had been I mean he still is a one of the world's foremost

00:11:05 surgeons in but like they tell me again you practice yeah yeah it's hasn't sort of a neuro oncology which means tumors in the nervous system so he's been an expert in that for a while unfortunately he's had to become the world's expert on penetrating brain injury and surgical management and that's what you do as well. Yeah, my main area of interest is neuro trauma and neurocritical care. So that's right in my wheelhouse. But yeah, I, I, whenever I go there, I probably learn a lot more than I teach, to be honest. I don't know what it would be like the first time I went. Because when a lot of neurosurgeons from the West go to other places, it's generally places with very little

00:11:52 neurosurgical presence or infrastructure. So places like Sub-Saharan Africa or Latin America, you kind of drop in, do some surgeries and leave. But there is very different because they have excellent people in Ukraine. The problem, at least at Mexico hospital, is just the sheer volume is a big challenge. They don't have a lot of the resources that we have. So trying to do high quality work with tremendous value uh knowing you have constrained resources is uh

00:12:24 is an art and he's an expert at that so that's why i kind of learned some techniques from him and bring them back and teach some of my residents so uh you know the statement is it's not brain

00:12:37 surgery uh is brain surgery uh really that hard or the residency is seven years long so It may be hard, but if you devote seven years of your life to studying it, you can pretty

00:12:51 much learn almost anything. As a surgeon of any kind, how does it affect your ego?

00:13:03 Or at least when you're younger. I feel like I'm in a courtroom. Can you explain the question, please? I just mean that you have a life-saving skill, and that's what you do.

00:13:19 Or a life-altering, improving. What you do directly affects people's existence. Does that, at least when you're younger, give you a self-importance? Or what does it do? Or you never thought of it this way?

00:13:40 From what I've seen, the doctors of any type who think that they're important are probably not the best doctors. What you do is you just get so involved in the daily work. I have a kind of a regular number of young students, college students, so they haven't got their bachelor's degree yet, who are interested in going into medicine or neurosurgery, and reach out and ask if they could do some shadowing and I say sure you the hospital has some you can understand some fairly strict processes to go through so they can do that and I think what amazes them the most is that it's not like TV with all the drama and stuff like that it's like on one hand you're

00:14:25 doing brain surgery but that's kind of over here what the daily life is about is okay Mr. Smith you know is he ready for surgery is he had his MRI scans his blood work okay. You know, or Mrs. Jones was admitted overnight through the emergency department. She's having trouble walking for a few months and this is what they found, you know, her spine cord is being compressed. And you start figuring out does she need surgery, what kind of surgery. You know, you get lost in the details of it. And every once in a while maybe you realize that what we do is pretty cool, but you can't run around thinking how great you are. So a great story about that. Once when I was in another institution and we were rounding in the morning and the early morning rounds the people who are in the hospital are kind of explaining to the the crew coming out what happened overnight and you know

00:15:12 trading off patients and things like that. And they mentioned that there was a nine-year-old kid who had come in with an epidural hematoma which is a blood clot under the skull but it was rapidly enlarging and pushing on the brain the kid was going into a coma. So they took him to the OR and operated. The kids knew him great. And the casket the next morning looked great. So we were talking around and the incoming residents said, "Oh, you did a nine-year-old kid?" "Yeah." And they said, "That's pretty

00:15:38 cool." And then we moved on. We had to talk about the next patient.

00:15:43 What's the hardest thing about being a neurosurgeon, being a brain surgeon? A lot of things we can't help, unfortunately. We've made a lot of advances in a lot of areas but two of the most things that still are very difficult to treat are malignant brain

00:16:00 tumors. Having to tell families that's what they have. And then on the other hand there's the kind of the emergencies of people with really bad strokes or really bad brain injuries or spinal cord injuries that despite your best efforts unfortunately you have to give the family some very bad news. The thing about that what's interesting though is in some ways what's worse than the bad news is the not knowing. When families or patients are kind of waiting to see what the biopsy results come back on ligand tumor or not or you'll be just operated on this man who's in a car wreck Is he gonna wake up and be okay or not? That's the worst, not knowing. I think people can often eventually come to grips with some kind of bad news, but twisting in the wind is terrible.

00:17:00 - I just, I can't imagine how hard it is to say there's nothing we can do. - Yeah, sometimes you have to say that or you say, "Listen, we did everything we could." it's still not good enough. So I know in studying for this, that a lot of issues formerly in Ukraine with tumors, etc., is that there had been a lack of testing, so that a lot of the tumors were a lot further along than they needed to be in terms of, like, if you had the earlier testing and techniques. Is that still the case or is Andre seeing like more advanced than you would see in the US?

00:17:51 Yeah, that's a great question. But when you're asking about any particular surgeon like Andre, you got to realize he has been doing his thing in one institution for a long time.

00:18:00 And he has a very good reputation, very well deserved. So the kind of cases he would see might be different than the ones that someone just starting out or in a smaller place might see. So that's a great question and I don't have any direct knowledge of that, but at least from what I've seen, cases aren't necessarily any further along than they would be in the United States. I mean, for example, I spend a lot of time at what's called the safety net hospital, you know, county hospital, where we see a lot of people who have no health insurance, you know, people who may not be in the country illegally. And of course we take care of them, but a lot of them show up with incredibly advanced

00:18:38 tumors.

00:18:43 And I mean, going blind, that kind of thing? Yeah, going blind is literally things growing out of people's heads. You have to wonder why, what took them so long to decide to come to the hospital? And the other question is, why did you come in now? You've had this going on for a while. What was it about today or tonight that made you decide to come in?

00:19:06 So tell me again what you just called the county hospital. Safety net hospital? You ever heard that term before? It's kind of for people who don't have health insurance or no other place to go. It's kind of for people who don't have health insurance or no other place to go.

00:19:21 You can't afford to go to some large private hospital.

00:19:25 It's a place that's supposed to kind of be there for those who have no other recourse. So, as if I didn't know, tell me about Ukraine and tell me about what's going on. In what sense? That Russia invaded, that sovereign nation, you know. And just as you're speaking about it, feel it and think about the meaning of what you're... So let me ask you for documentary purposes, do we want to get this much into the politics of the Russian attack? It's not really going to be that we get much into politics. What I'm really asking you for is when you're telling about this, that you might say something about the nuance of it, you know, that fits into it.

00:00:00 and they had what was called little green men.

00:00:00 and they had what was called little green men. You have people in military uniforms, but without any insignia on them. So you didn't know what country they were coming from. And I think everybody knew what was going on, but the West pretty much said, "Oh, we're not gonna do anything, 'cause everyone's afraid of the Russian bear." So, large parts of Ukraine were annexed back then, and Andrei Sierko with them would see a relatively small number of casualties coming up the constant fighting down in front of the uh um and towards the end of calendar year 2021 and in january 2022 russia started building up a lot of troops on ukrainian border and pretty much anyone with half a brain could figure out they were going to attack and invade and i still remember these

00:00:47 endless discussions under news every day but what's going to happen and i still remember waking up one morning and you know the day the invasion started and uh February 22nd no actually the day 24th year 2022 when they just rolled in and um everyone said well you know Ukraine is hosed right because Russia's got a huge army and Ukraine's gonna get rolled over and there was that great quote from uh Ukrainian president Vladimir Zelensky when uh the west I think the U.S. had offered him you know a way out he said something along the lines of i don't need a ride i need ammunition and the amazing thing is how ill prepared the russian army was and how they had no idea how

00:01:33 to run a war and the ukrainians are incredibly resilient and very smart so they figured out the russian generals are using their own cell phones or civilian cell phones not secure military communications to communicate with each other. And immediately Ukraine started killing the Russian generals. You know, the Russian tanks kind of got stopped in this huge column. And I forget if they ran out of gas or get stuck in the mud or stupid reasons like that. And they were just sitting ducks with the Ukrainians. And basically Ukraine repelled a lot of the attack. You know, if you look at the map of Ukraine, and you can still see roughly 19, maybe 20% or or so in the country in the south and east is still occupied by Russia. But then look at the areas that were taken over by Russia in 2022

00:02:19 with the Ukraine capture back. It's a lot of real estate. So Russia being Russia, the way they seem to always fight their wars is get their butts kicked early on. But they just have such a big population, you know, they can sacrifice people and keep on fighting. The war has essentially been in a stalemate for many, many months now, if not years. Russia may advance a few hundred meters one day, maybe Ukraine pushes back. But it's not going to end any time soon. And Russia keeps throwing its own people at it, and now they have North Korea, Cuba, and others sending them soldiers. And the other thing that's happened, getting back to Metzhenikov Hospital, is that Dnipro is the biggest city close to where the fighting is happening to the south and east of Dnipro.

00:03:11 And as a result, a lot of people are evacuating those areas and going up to Dnipro. And in just a year and a half or so that I've been going to Ukraine, I've noticed that the city's seen more crowded, you know, more traffic, more cars. Adesirko's clinic for his elective patients, you know, the tumors and other things that the general population has that require neurosurgeons, you know, andurism, spine disease, all that. The number of those patients is increased too. So it's not just the unending number of combat casualties, but a larger volume of the non-combat related neurosurgical needs. when about 30% or more of the workforce in Dnipro and Medchikov has left.

00:03:57 Some doctors either left Ukraine altogether or went to other parts of the country or joined the military. So they have to do a lot more work with a lot fewer people. And it's the same personnel at Medchikov who have been dealing with this increased value and daily attacks while they're working, they're worried about their families getting blown up at home. They've been doing this for literally for 11 years now and counting since 2014. And it's especially wrapped up since 2022. That's very different than what the US has been doing or what the US was doing in Afghanistan and Iraq in which the medical personnel rotate in and out for a defined period. So maybe 12 months or so, plus/minus was the average rotation.

00:04:48 And even though it sucked to be over there, you knew there was an end date for it. You can go back home. They don't have that luxury, I mentioned Cuff Hospital. They're there for the duration. There's no other home for them to go to. So again, that psychological stress is terrible, that man, but you also really get to see their, their resilience, their determination, their bravery. They're fighting even harder. They're not giving up. And from an academic point of view, a byproduct of that is they have this intensive, immersive experience, and this huge number of combat related injuries. So they are the world's experts now in understanding the natural history of the disease and

00:05:33 how to treat it. And remember, no one else in the world, ever, has had to fight the kind of war they're fighting. Because when this war started It was just another traditional war with tanks at some fields in the eastern part of Europe. And this is not an artillery or armor fight anymore. It's a drone war, which no one's ever figured out how to deal with before. And Ukrainians are the world's leaders in developing drone technology and fighting against that.

00:06:04 Also learning how to treat the people injured by this new kind of weapon.

00:06:09 So, some of these questions you know I know the answer to, but I assume I don't.

00:06:14 Likewise, you've heard me say this before. Of course, of course. It's always tough telling someone for the second time.

00:06:21 I know a little bit how they gave this. So, are my answers good? Do I need to be more emotive? Do I need to be more like Rocco? No, you're fine. No, no, I mean, because I don't know what we're going to use from this.

00:06:33 I mean, this is just sort of all a precursor. So maybe let's think about that. Let's just like, what do you feel when you look at the countryside?

00:06:49 And like, maybe tell us about the first time you went and whether you were you afraid the first time? So before I even went, when I got to talking to Rocco about this at this meeting, I may have mentioned we're at September of 2023. And at that time, like every other American, my experience of combat had been people in a desert, right? Or people living inside the wire and the military thing. I even asked him, are you sleeping in tents somewhere in a cot? He said, no, this is like fighting in an urban city. I mean, pick any big city in America and imagine that drones could take it out at any moment. It's crazy. It's not like urban warfare or an insurgency. like this is real live war on your doorstep so it was a surprise to me to realize oh this is just

00:07:40 like going to a you know a country in europe you know staying at a decent hotel walking five or ten minutes to a big hospital and the other thing is i was so ignorant about drones because you you heard this is back when drones were kind of first being used and back then they would use these these cute little quadcopter drones that you see you know that people use when a building inspector comes to

00:08:00 your house that looks at your roof and stuff like that. And they were using those to drop grenades on troops at the front line. So I thought I'm going to have to be looking over my head the whole time, making sure there's going to be no drone. Of course, that's not going to happen in a big city. But the drone technology and the drone weaponry has advanced so much since then. I have a much better understanding about it, too, since I've been paying more attention and listening to podcasts about this and trying to read more about this. And again, I had no idea.

00:08:30 I thought this was going to be a traditional kind of neurosurgical mission trip when you go to some underserved part of the world. And all these patients with horrible diseases, they've been kind of lining up for the surgeons from America or from the Western country to operate on. Now this is different. Those guys know what they're doing. And Rocco has the term reciprocal learning. We learn from each other. He also calls it a cultural exchange. We learn how they take care of patients. and we teach them how we do it. There's a spin-off of that. The ICU people especially had a lot of questions about how we do this. So we set up a monthly neurocritical care conference with them for that same purpose. We alternate months, one month we present cases, one month they do. - Let's hold for a second while he repositions. And you-- - Are you sure we got enough light?

00:09:21 - It's starting to get dark in here. - It's starting to get dark in here. I mean, are you gonna do an overhead lights? - No, 'cause it won't match. Yeah. No, I mean... Should I lean forward a little bit? I know there's one. If you scoot a little bit towards the window, that would... Hey, there you go. Anything you want to change about this, Logan?

00:09:39 For a... Go. Just watch this focus. Keep those cells stable there. Here, I'm going to swap this car. Okay. Yeah, I feel like we are kind of approaching towards the end of our light here. choice of a new generation. Pepsi. Zero sucro. I was too busy losing my lens filter. It's funny because it's the it's the one filter we're going to use on on this camera. I have two of them so luckily it does this anamorphic thing which basically So it just squeezes the image so you get more information on the sides.

00:10:31 Anyway, it provides it this intriguing look that makes up for the fact that it's... And this, by the way, we're not necessarily going to even use. I'm just getting it because it's literally synced up to your mic.

00:10:48 So it'll... So I'm starting to understand, is this part of why post-production is so expensive?

00:10:54 You have to take all these different kind of live streams of info and sync them perfectly? Right, yeah, exactly. And so that's why what I was doing last night was a big thing, was getting the sync boxes, because you can, it's so much easier when you have matching timecode. um yeah yeah and so like to match it precisely you uh um there are different techniques but you know like that's that's um that's why you know that they use the slate right the clapper board if you you've seen that like in in a film before you know yeah yeah so that's that's just matching you know primarily usually one camera to one piece of sound but uh and i mean the other thing

00:11:40 is that like you can do this and and have it all you know lined up perfectly at the same time but that takes a lot of money because you got to have all kinds of gear so it's all going into one you know one one unit so but but then like just think about like um we're sitting here rolling on this this uh this journey is going to be very brief in the film right and so they like the the the job of the editor is then you know and the post people is to you know watch all of this and and i'll watch a lot of it but you know they they they'll go through it all and um they will

00:12:33 eventually we want to leave that door open or close it open it's not too bad for sound so it definitely helps with the fill level it gives us a little bit more um so like like the the titanic

00:12:45 film they shot more hours of footage than the journey lasted

00:12:56 so i'll look at you know look at more uh more yellow leaves here brown leaves let's see if i can know different part of the country yeah we're gonna do leaf peeping this is now a leaf peeping tour well no it's amazing that uh gosh my when i i can deal with sleep deprivation uh these days much better than i used to be able to the one place where it comes into play is is my eyesight

00:13:30 that's it uh you know and then my brain plays tricks that uh yeah i'm good for a little bit

00:13:42 i don't know but the leaves are changing to just mention that yeah so you asked me earlier about the thoughts on ukraine i mean here's a really nice countryside what's interesting is that that is riding along here, I noticed that these leaves in this part of the country are already further along in the autumn process here. There are more yellows and oranges and

00:14:03 browns than there were just a little while ago. It's a beautiful country. It really is. And that is actually why, or part of why, it's been in such an important sort of region

00:14:19 over the centuries of the thousands of years of mankind being in the European area. So it sounds pretty stupid to say that we are lucky in America because we're protected by two oceans. You know, if you grow up in the United States, you live there your whole life, you don't even think about being attacked or invaded. But when you're actually physically here, almost anywhere in Europe, but especially in Eastern Europe like this, you really realize that there's nothing stopping any invading army or invading horde of barbarians throughout history coming from any direction you know north south east or west just a big flat plane

00:14:58 there's no natural barriers um it makes you realize how vulnerable these people are

00:15:05 but isn't this uh center for agriculture i mean like oh yeah yeah yeah yeah yeah Ukraine is one of the world's bread baskets right that was a big problem all the wheat they need to export through the Black Sea was under threat for a while and if that's under threat

00:15:18 then a lot of people in the world go hungry in Africa and other places. So when did you tell me again when you got your Lithuanian citizen trip? I think it was a couple of years 2020, late 2022, early 2023.

00:15:34 And when did you go to? June of 2023, just a couple of months before I talked to Rocco about this. So I was kind of preconditioned to come for a couple of reasons. We talked about my wife and her volunteering with the Red Cross, which I've always thought was cool. Then we talked about the fact that I'd kind of seen the former KGB headquarters and, you know, walked the places where they executed people there. So those were swirling around the back of my head. And then I met this guy who had been to eastern Ukraine and trying to help there. And I said, I can do that too. Why can't I? My children are grown and they've left the house, so we're empty nesters. It's a perfect timing.

00:16:20 Are you excited to be heading back? I am because we talked earlier about some of the reasons to do this. Because it's trying to help defend a free democratic state against a tyrannical state's invasion. a more fundamental notice, good versus evil. But that was personal because they're my friends. And they're my friends who are going through some hard times. And so the first time I went was just kind of get the lay of the land, right? Then I thought, how can I up my game for my second visit? So I spent more time in the ICU because I'm actually certified in neurocreditable care as well. And I'm a lot of interested in that part of the hospital.

00:17:07 And then my third visit, I actually spent a few nights taking call in the hospital at night. And I kept thinking, how am I going to up things for my next visit? And I realized I don't have to. Because just by showing up, it is such a big shot in the arm for that. You bring little gifts as sort of a gesture of friendship. But it's not because of the gifts or anything like that. It's just seeing someone from America who's willing to make the journey. But sure, there's some risk there, obviously. But I'm surprised that more people from America aren't going all the way to eastern Ukraine, to Bechikov Hospital. If you're interested in trauma, this is the institution that's leading the development of trauma for future conflicts.

00:17:57 And those lessons, of course, translate immediately to civilian trauma here. But I mean, like, so you're talking a double leg short. On one side, you want to tell people that, like, hey, the war's still going on. But, like, but no, you can go near it. So it's sort of a tough thing, right? So it's sort of a tough thing, right? You know, because you both want to, like, say people to be aware, but also, like...

00:18:23 Well, you're right, but we're not going to the front line, right? The front line is a disaster. There's no longer a front line in a traditional sense. It's kind of this long gray zone and it's hard to tell who's in charge of different pieces of land. This thing could be kilometers in thickness. You know, it's not just a thin line on a map, but we're not going any place over there. We're going to a large city that has a good missile defense system. And especially the area near the hospital is particularly well defended. Um, the, the place we're staying at and the hospital itself, they have shelters in the basement. So there's usually enough of an advanced notice. If something really bad is happening, you can get to the shelter, but it's unlikely because all the defenses are on the hospital. So yeah, the risk is not zero, but if you're an infectious disease doctor and you're interested

00:19:15 in Ebola and you go to Africa to study Ebola, well, there's a risk there, right? Or maybe malaria might be a better example, right? You want to go to a place where there's malaria, so you can study it. You might catch malaria, but you can put up with certain risks.

00:19:32 You're a long-haul truck driver, you can get in an accident and fall asleep behind the wheel.

00:19:36 There's a risk crossing the street. Yeah.

00:19:42 What about brain surgery or neurosurgery? How did you end up in your journey?

00:19:50 When did you know that this is what you wanted to do? That's a good question. people don't make up their minds till late but it was always something I was very interested in. So for me medical school was more looking at other specialties to make sure I wasn't missing anything. You know, neurosurgery was always my number one thing but let's look twice at this or that to make sure maybe there's not something else I'd rather do because I know a couple of classmates of mine who are dead set on surgery and they had this revelation in second or third year of med school that they really don't want to go into surgery so they went into other fields.

00:20:30 The one, I developed pretty early on an interest in neuro trauma and neurocritical care and when I was talking to my advisor in medical school about that interest, he's the one who recommended me, recommended that I, you know, where should I do my residency for places that are strong

00:20:46 in that. I'm struck by the statement you just made earlier. We're going to a city with a strong missile defense, whatever you said.

00:20:59 It's just like, that's just not something we have to think about in the U.S. You know? Yeah, I think it would be, well, obviously I'm biased, but yeah, I think we've become too insular in the United States with this breathless reporting. I mean, I love when the fact that you have some news story that's maybe 18, 24 hours old, and have like a live reporter, you know, who's in some other part of the world. So they're awake at 3 a.m. local time or something, talking to the evening news in the United States. You don't need a live reporter there. You know, you always see a reporter standing out in the middle of a hurricane, broadcasting about the hurricane. You know, we don't need this kind of stuff like that. I think if we take a step back and think about what's really important, I mean, this conflict going on,

00:21:46 has redefined how war is going to be fought forevermore. The future of Europe is at stake, and if Europe's affected, it's certainly going to affect the US. People in the US may not want to think that way, but it will affect the rest of the world as well.

00:22:03 How much do you think about the people that you couldn't save, or couldn't-- whether not operating at all or operating and it wasn't successful? How much does that stay with you? - Sometimes. Sometimes you think about it in random moments, or sometimes when you see a patient who shows up with the same kind of injury or same kind of disease or illness

00:22:30 that a patient whom you treated had and the one you treated didn't do well. You know, oh, okay, I remember this because this patient over here had this and didn't do well. You just try to do your best to make sure it doesn't happen again. the best surgeons I know and I work a lot with residents especially the upper level residents who are going to be independently in practice in a year or two and if they're involved in a case that doesn't go well choose them up sometimes and I know they're going to be the best ones you have to have several conversations with them and reassure them that you didn't do anything wrong or God forbid they didn't make a mistake they learn from it you sit

00:23:13 down with them and make sure they understand what happened again and usually they're well aware of that.

00:23:19 What's the... Usually, if you know most lines of work, if like 99% is pretty good, you're happy with that. The problem is that 1% isn't good and that's not good enough if you're in the medical field,

00:23:32 especially the surgical field. When you see something similar, are you frightened or excited about the opportunity to do something different?

00:23:44 Or is it a little bit of both? I don't think there's any, there's not that kind of emotion about the problem solving. Like, okay, we need to approach this tumor this way or approach this spine problem this way. And you're thinking about this other patient who had a complication or didn't do well. You just, you learn from your mistakes, but hopefully you learn more from other people's mistakes that you've read about or discussed at conferences. So you don't have to repeat those same mistakes. Tell me about Metzhenkoff at night. It can be pretty variable, but on any one day, just Andres Serco alone will get one to to eight cases of penetrating traumatic brain injury, which again, that means that someone has had,

00:24:32 usually shrapnel. In the United States, when you talk about penetrating brain injury, it's usually a gunshot wound to the head. But in war, it's usually shrapnel from explosions, a piece of metal or brick or pavement or whatever is in someone's head. So they do anywhere from one to eight of those cases, an average of about three per day. just for that disease entity alone. Not to mention the other types of injury or trauma,

00:25:00 and then not to mention all the other surgeries they do for brain tumors and chronic artery disease, spine disease, and all the other branches of neurosurgery.

00:25:10 They can be pretty busy at night. - And that's when the people are brought in from the front, right? - Yeah, generally, we talked about how the so-called

00:25:21 rules of war got thrown out the window. It used to be a pretty sacred thing not to attack a medical facility, right?

00:25:30 Because theoretically, those doctors and nurses, healthcare workers could be taking care of one of your size injured soldiers as well as the enemy's injured soldiers. But that's unfortunately a very naive way to look at things now, which shocked me when I started looking at this. So of course, ambulances with the big medical symbol on them, that used to mean off limits. No, now they're targets for the Russian drones. They'll go after them. And Ukraine, they have these kind of stabilization centers, which are usually the first place an injured soldier or civilian may get to as they're trying to get them stabilized and move them further away from the line. But again, those have become targets now. So, you know, I've been reading how a lot of those are now kind of being hidden or placed underground or not advertised as such.

00:26:23 You know, that medical symbol used to be kind of like a garlic for a vampire. You know, it keeps away the drones and things. Now it's a magnum, unfortunately.

00:26:36 So we were there when Andre talked about this, but as if we weren't. Tell me about Andre talking about his surname and talking about Ivan Sirko.

00:26:47 You'll have to talk to him more about that. Ivan Ivan Sirko was a great Cosset leader. Was he a general, a military leader? And yeah, Andres descended from him. So if you talk about the tradition of service running in his family, it doesn't get much better than that. As witnessed by the fact that his older son is a neurosurgeon. He's finished training and starting his career. His younger son still has a ways to go in his education, of course, but even he is leading more towards the medical field. Last time I talked to him, he was thinking more about trauma surgery. I think because of part of the older son's training, he had done a stint that's kind of like a little different than in the United States, but like a neurosurgeon who can also

00:27:37 do stuff on the other part of the body. So I think the younger son was kind of thinking about that model, but knowing Andre, I think by the time his younger son is finished his school the younger son will be a neurosurgeon too

00:27:48 so there's very strong family traditions dating all the way back to uh uh i've been sitting home

00:27:55 wow i didn't pick up that it that he that he was descended from him i i picked up like how you know

00:28:01 it was a legendary figure yeah i thought he's a descendant though oh wait i mean yeah we can clarify yeah but i just for me he was just talking about how i the having a name that he had to live up to like because he because he is named Sirko he can't leave people look to him as you know

00:28:21 for for the strength that that the Sirko name carries that's what I was a very strong thing you know that I took from it. You're exactly right yeah it's not only his his own personal leadership but these again unlike in the United States these people do think back to prior generations in their

00:28:41 their family heritage.

00:28:47 Talk to me about passion. So I gotta tell you that my ancestors come from Northern Europe. So we tend to be a little more stoic and not that emotive. Kind of like the Ukrainians. you know, it struck me in clinic. I mean, I would have these conversations with patients, you have the very bad news and they're very stoic about it, at least there. You know, I'm sure when they go home, they choose them out. Yeah, I'm just not as passionate as someone from the southern part of Europe, you know, you're Greeks, you're Italians, people like Rocco,

00:29:30 who are a bunch more passionate and articulate about these things. But we still have the same drive, No question. We may express it different ways, but Andre Rocco and I have formed this team, alliance, brotherhood, where we're talking every day on WhatsApp. And we're all very different, which makes us a better team, right? We all have different strengths that complement each other's weaknesses, different styles. But we're all united by this idea about trying to help Andre do the the best possible job he can to take care of these horrible casualties that he gets every

00:30:06 day and try to try to educate the rest of the world what's happening in Ukraine.

00:30:16 Describe being driven to have that drive. You know it's funny that's asking me to describe that it's like you asked me to describe like Why do I go? It's just something I do. I mean, my wife was giving up on me because, you know, pretty much don't have any hobbies. You're trying to work all the time. Even on this trip knowing that we wouldn't have very good internet, trying to line up work and things to do on this long train ride, it wouldn't require an internet. So it just, well, I will say this though. You know, they used to call people workaholics, which you don't hear much anymore. the idea about working all the time and I've been blessed in my career to hold a lot of leadership positions and

00:31:02 organizing or surgery and be able to give back to the special team on in that way. But I think that what I'm doing here now in Ukraine, it's a whole order magnitude bigger. And not to disparage any of the other, you know, community work leadership things I've done or the people who are currently doing those things because it's important. But we're talking about a war here. I mean literally. You know it's not just committee meetings and trying to reconfigure organizations and things like that. And even trying to improve the way the specialty is practiced in the understate. This is like life and death for a lot of people. So the whole workaholic drive thing, just the innate desire to keep working I think is important. But we all know people who work all the time and they're busy counting their paper clips, rearranging the rubber bands and things like that. Think about big picture, what can you do to maybe have a larger impact. I keep going back to my wife.

00:32:00 She didn't have to volunteer for the Red Cross. Just someday, one day years ago, she said she's gonna do that. She stuck with it. I think that's very commendable.

00:32:13 It's interesting.

00:32:17 What I call passion, you call drive. Yeah. It's funny because I think of myself as actually being a very passionate, driven, working person. And yet one of these young students I know, they're still in college, who are shattering me. She said, Dr. Falk, are you always so calm? And that struck me. I guess maybe on the outside people think I'm calm, but I don't think of myself being a way I did.

00:32:43 - That's a... - Logan, before we lose light completely, are there some topics that you think we should hit in this?

00:32:54 - Oh, you know, yeah, I was starting to think that. I mean, I think we got a bunch of stuff. - I know. - I wonder if maybe, you know,

00:00:00 to get there and just show support for them is a huge morale booster for them.

00:00:00 to get there and just show support for them is a huge morale booster for them. Some of them have been doing this, most of them have been doing this for the entire 10 years of the war, even though significant percentage of their colleagues have left, and even though they don't get a break. So I think it's absolutely worth it. This is why I spent my vacation time doing this. I mean, I can't imagine, like, from what you do and get out of it, I can't imagine a better way to spend your vacation time? Seriously. I mean, I have to be careful not to involve my employer in any of this. So I take vacation time, I pay my own travel. You have to buy your health insurance here in Ukraine because the policies I have at home don't cover us in a war zone, apparently. So all these things kind of insulate my employer. So I do this on my

00:00:49 own time and on my own dollar. And no second thoughts at all. I just wish I could do more. I think that's probably a good way to end our conversation.

00:01:00 Yeah. And so Alex, Logan, what do you, what, what do you want to get with, And so Alex, Logan, what do you, what, what do you want to get with,

00:01:11 he'll, he'll direct you here for a second, you know. Wait, do you want to try, I definitely want to get more on the train too. A little bit. A little bit.

00:00:00 Oh yeah, look at that, Wi-Fi. Oh yeah, look at that, Wi-Fi.

00:00:15 So should I be talking about this or just the silent part where I'm just playing with a computer? How about you just feel it out? just do your work and comment if you feel okay compelled to oh no i just lost my wi-fi

00:00:43 what was that statement you told me about uh uh surgeon only only touching an email and yeah general business efficiency thing is only touch an email once don't look at it and say i'll get back to it just try to get rid of it right away but that's the right i said i got some things i can do just on word here matter of fact one of the things i need to do is another draft of an article we've been working out with andre and he just sent it back to me so i need to kind of start I'm going to start working on that one too. That's my next project. That's focusing on histories of penetrating injuries to the lateral skull base, you know, kind of in this area here. Ian Rockwell published one on the anterior skull base before I got involved.

00:01:33 And the numbers that I've ever seen from this just warp anything else that's ever been published. Unfortunately, I should say sadly, there's some incredible illustrations of how horrible these injuries are. I was smart enough to download this onto my hard drive before I left. I knew it had to be sketchy here.

00:02:25 Do you want me to stare at the window periodically? You do whatever it feels comfortable for you. Clutter here. Yeah, we're very cluttered. バター

00:03:40 Wrocław Did the Polish train seem a little less rocky to you than this one? Yeah, this one is getting increasingly... Yeah, I've noticed that too, how fluid the Polish train was.

00:00:00 Am I closed or?

00:00:12 Am I closed or? Oh, keep it open for now actually. So I need to send some stuff on what stuff. Can you see this now or? One second. I'll see the side. And go for it. I can see it. Oh, this is from Terry. So this is Keeve after Russia's attacks overnight.

00:00:54 Oh, lost the internet. This is... Yeah, not too far from the metro. Got attacked. Where's this gonna settle? Hey, it's not there? Hey, it's not there? No, no, it's out. It's what? Did you leave it back here? It might be. Where are we looking for it? The little bag thing that I was looking for. - Trusting the camera. - Yeah, let me vanish.

00:01:43 - Ooh, she's from Hebrew. So we lost the internet? Let's try again, just look at some of the videos.

00:02:00 This might take a long time to download it.

00:02:06 Yeah, unfortunately.

00:02:15 That's a trade movie. Russia there's another attack in the Neatropa Troves. This is all the fire you can see there.

00:02:52 A huge column of smoke in the city. Now do me a favor. I'll keep doing it. but like uh now try and see me in the reflection of the phone we see the camera at least well i i'm not seeing that that well yeah it's okay well i got where you're looking at so it's let's see where are you yeah i can't i can't see that far can you see your face yeah and then tilt it a little this way I can't see you either so it's like it's all good

00:03:34 and see the screen yeah the screen looks great here's the path of the missile strike 150 kilometers from Russian territory to there.

00:03:58 Dnipro is right there. Point it out again.

00:04:05 So this is the Russian territory here to this city about 150 kilometers. And here's Dnipro at the top right. So not too far from Dnipro. Oblast, which is the same province or state that Diko is in, Diko Petrosk province. We gathered aerial bomb. So far, two dead and ten injured. Oh, this is in Keeve, two dead and ten injured in Keeve. I hope or not.

00:04:53 Yeah, useful clouds. I almost got him. I almost got him. No. You want to look at that again? You want to look at that again? No, you're fine. Let me just... Well, yeah, hold it on the black screen and move your front thumb.

00:05:15 Let me see if I can... I'm not going to be able to get it. It's okay, I can. Let's see if I can get the explosion on this camera. Yeah, I'll do it. Do you want a different lens on it? Uh-huh. I'll take that lens.

00:00:00 Braco and me.

00:00:00 Braco and me. We got a strike in the Nikopetrovsk region. So here's the city of Nitro. This is the city that got hit. This is where it came from. In the Russian territory of 150 kilometers. And Kiev also got hit. You can see how the smoke there.

00:00:30 The sad thing is, this is just another day in Kiev and in Ukraine.

00:00:34 This stuff happens every day. It's terrible. Did you get the big column of smoke? I did.

00:00:53 Oh yeah, this is something.

00:00:58 Yeah, I don't have a Facebook or a WhatsApp.

00:01:04 Oh yeah, but WhatsApp. Yeah, it shows this woman just standing here. I think she gets blown up. Oh, here we go. You getting this?

00:01:30 Yep. This is from the VVC. Dzień dobry.

00:02:25 I think I'm good. I think we're good, yeah.

00:00:00 We have a little less go here, I'm going to wait to look at the interesting background. We have a little less go here, I'm going to wait to look at the interesting background.

00:00:51 Wrocław

00:01:00 That's where the vampires come from I was gonna say, Logan Mane was a great player They're talking about, uh Some of these stories by vampires came from The main and the kind of inspired over a A thousand years ago It's getting dark pretty soon Just saying

00:01:37 Going back and then maybe trying to build a little more light. Let's do that and maybe we'll try to get one of those super stable. Let's try the lenses out. Just have Alex walk right following him back. Seems like they don't appear that we're here. Yeah, now that we've explained ourselves a little. She's very nice. I mean, there's something very interesting about how like, squirrely and like, out of focus. And like, you know, just crazy it looks. So I don't necessarily hate that. But... No, I mean, it's just, uh... It's the energy of this Soviet-era train.

00:02:32 All right.

00:00:00 Speaker 1: Just to make sure.

00:00:00 Speaker 1: Just to make sure. Speaker 1: What were you saying? Speaker 1: We are going to be crossing the border in just a few seconds from Poland into Ukraine. Speaker 1: I guess 15 seconds based on this. Speaker 1: Okay, getting ready to cross the border. Speaker 1: Google Maps, Neverod.

00:00:45 Speaker 1: We're crossing the river. Speaker 1: Welcome to Ukraine. [VO CANDIDATE]

00:00:54 Speaker 1: We're in. Speaker 2: Love it.

00:01:00 Speaker 2: I did not have, I was not set up. Speaker 1: Yeah, I didn't think about it. Speaker 1: It's just, uh... Speaker 2: That video was on yesterday. Speaker 1: Hey Logan! Logan! Speaker 1: We're now in Ukraine. Speaker 1: Well, I guess there's no customs today. Speaker 1: Yeah, that was weird. Speaker 1: So here's the border right here. Speaker 1: We are going just across the...

00:01:25 Speaker 2: I didn't have the ND on this because I couldn't find the filter I was looking for. Speaker 2: He was at least the biggest thing I could grab. Speaker 2: He was telling us he was crossing the border. Speaker 2: Didn't really get it, but hey, it's okay. Speaker 2: Even if I had gotten it with this, you know, it wouldn't be fantastic.

00:01:50 Speaker 2: At least now I got it. Speaker 1: Ukrainian water. Speaker 1: Uh huh. Speaker 1: What are these? Speaker 1: Ukrainian passport.

00:02:13 Speaker 2: Do they have to leave passports again? Speaker 2: I guess there are passports to leave. Speaker 2: I guess there are passports to leave. Speaker 2: Passports to leave. Speaker 2: Hold it. Speaker 2: And then passports to enter in Ukraine. Speaker 1: Okay. Speaker 1: Boy, I don't remember it being this long last time. Speaker 1: Yeah.

00:02:31 Speaker 1: Yeah, but we also spent, I don't mind, we spent like half an hour or something. Speaker 1: like 25 minutes in key, you know, so if you get there late they can always just leave a room.

00:05:59 Speaker 1: Good morning.

00:07:31 Speaker 1: Do you have AT&T? Speaker 1: No, I have ATTN's global plan every time you cross into a new country.

00:07:38 Speaker 1: So now I'm getting a green welcome to Ukraine. Speaker 2: Mine does similar except it didn't do it this last time. Speaker 2: Oh, you know why? Because I've got, probably had a VPN on or something. Speaker 1: I think it may be something like that. Speaker 2: But yeah, I didn't do it this time, but it's normally what happens.

00:08:22 Speaker 2: Thank you.

00:09:10 Speaker 1: Now they're going to do it. Speaker 1: Yeah. Speaker 1: Yeah.

00:09:49 Speaker 1: Okay, so I need some internet.

00:10:50 Speaker 2: I'm not filming right now, I'm just checking my settings.

00:11:17 Speaker 1: The dogs. Speaker 2: Yay. Speaker 1: These don't look like working dogs. Speaker 1: These look like farm wild dogs.

00:11:25 Speaker 1: I've done it right there. Speaker 1: I've done it right there. Speaker 2: Look at that. Speaker 2: Look at that. Speaker 2: That's that. Speaker 1: Yeah, those ain't no Speaker 1: bomb sniffing or drug sniffing dogs.

00:11:37 Speaker 2: Those guys got the day off. Speaker 2: Yes. Speaker 2: So I'm missing this filter for the little cameras.

00:12:26 Speaker 2: Hello. Speaker 1: Did he just walk right by a little bit more? Speaker 1: That was the customs dispatcher. Speaker 1: Yeah, he just looked at us. Speaker 1: If he walked by, then we're good. Speaker 1: I think so.

00:12:55 Speaker 2: He did. Speaker 2: Yeah. Speaker 2: There you go. Speaker 2: *Sigh*

00:13:55 Speaker 2: What?

00:14:00 Speaker 1: Is this thing on? Speaker 1: Yeah. Speaker 2: Yeah. Speaker 2: Yeah. Still recording. Speaker 2: That one's... Speaker 2: This one's blinking, that means it's on. Speaker 2: This one means it's recording. Speaker 2: So, with this, Speaker 2: you'll have smaller ones than this

00:14:18 Speaker 2: for you in Speaker 2: the future. Speaker 2: And you can either... Speaker 2: we can put another mic Speaker 2: into it you know or it's just like plug it in and you use this magnet here Speaker 2: just have it there inside your shirt it still picks up yeah yeah um what i was hoping to do Speaker 2: yeah what i was hoping to do was i was hoping to get um Speaker 2: ukraine flags you know for this so you know that's what would show up there but Speaker 2: But, I couldn't get it done in time.

00:15:21 Speaker 2: And then it's also got a clip, so like, you know, you prefer... Speaker 2: But like, you'll see a lot of content creators use this exact microphone, and they'll just be talking like this, and I'm like, you can put it on. Speaker 2: But it does look a little goofy when it's like that big one right there, you know? Speaker 2: And I have the next iteration of these, which is about this size, so I've got them with me too. Speaker 2: This one was the one that I knew was charged and ready. Speaker 2: Or I expected. Speaker 2: That'll work. Speaker 2: I suspected was charged and ready. Speaker 1: Okay.

00:16:00 Speaker 1: So.

00:16:00 Speaker 1: So. Speaker 2: Like when we. Speaker 2: When we really get close to filming. Speaker 2: We'll get that on you. Speaker 2: You know on your shirt or whatever. Speaker 2: So I think. Speaker 2: So I think. Speaker 1: So G local says I have Wi-Fi. Speaker 1: Why can't my computer see it?

00:16:25 Speaker 1: Come on guys. Speaker 3: Okay.

00:16:43 Speaker 1: Oh, look at that. Speaker 1: I do have Wi-Fi.

00:16:49 Speaker 2: Use it while you can. Speaker 2: I don't know.

00:17:00 Speaker 2: Oh, boy. Speaker 2: Where else this would be?

00:17:21 Speaker 2: So, let's go. Speaker 1: so you know we're not even in uh at halloween yet it's cold out there these guys are walking Speaker 1: around heavy clothes yeah and we left dallas it was what 82 or something like that yep

00:17:49 Speaker 1: yep everything's better in texas there you go Speaker 2: I love it. Speaker 2: You know what? Speaker 2: Okay, thank you. Speaker 2: So, let's go.

00:19:00 Speaker 2: So, let's go.

00:19:45 Speaker 1: Yep.

00:20:59 You're sniffing dogs, you're having a fight out there. Speaker 1: You're sniffing dogs, you're having a fight out there.

00:22:53 Speaker 1: Thank you.

00:25:00 Speaker 1: *Loud noise* Speaker 3: Woah Speaker 3: I love you.

00:26:04 Speaker 3: I'm going to go ahead and put it on the back.

00:27:17 Speaker 3: *Makes a little bit* Speaker 2: They're talking next to her. Speaker 2: Hello? Speaker 2: Hey. Speaker 2: Okay, it's good. Speaker 1: Because she's talking. Speaker 2: Not anymore. Speaker 2: I just heard Speaker 2: an American doctor. Speaker 2: an American doctor. Speaker 2: He said that. Speaker 2: Not about himself, I don't think. Speaker 2: Oh, okay. Speaker 2: He was traveling. Speaker 2: But we do Speaker 2: call each other doctor. Speaker 2: So we do. Speaker 2: It's not a joke.

00:28:12 Speaker 2: Hey. Speaker 2: Hey. Speaker 2: Yeah. Speaker 2: Alright, so... Speaker 2: Thank you.

00:29:56 [RUS] Speaker 2: To be continued...

00:00:00 2 o'clock already? Speaker 1: 2 o'clock already? Speaker 1: We just lost an hour crossing the border. Speaker 2: I guess so. Speaker 1: Fucking A. Speaker 2: Crazy. Speaker 1: It doesn't seem like it. Speaker 2: No, it doesn't. Speaker 2: Oh, so we're an hour and a half from that stop, apparently.

00:00:50 Speaker 1: Koval, yeah. Speaker 1: Where is that? Speaker 1: Let's see exactly where it is.

00:01:02 Speaker 1: yeah Speaker 2: means the pressure is on Speaker 2: for me to get finished Speaker 2: I've started to organize by type of gear. Speaker 2: I've started to organize by type of gear.

00:01:26 Speaker 2: So for this is my toiletries. Speaker 1: Well, I'm going to get to crash with somebody. Speaker 1: I could crash up there. Speaker 2: I can close this as soon as you're ready to crash. Speaker 2: If you're ready as soon as we leave here, then you can crash here. Speaker 1: I'm just waiting for the slowest internet connection in the world. Speaker 1: Don't complain, right? Speaker 1: Nothing. Speaker 1: Nothing.

00:02:02 Speaker 2: Check the lenses. Speaker 2: Megs. Speaker 2: Power, power.

00:03:03 Speaker 2: Thank you. Speaker 2: Sound. Speaker 2: Sound. Speaker 2: You're just waiting for us to leave the crash?

00:03:47 Speaker 1: No, I'm waiting. Speaker 1: I think this... Speaker 1: I have to go online and finish this book we're editing Speaker 1: and do some proof. Speaker 1: The friggin' authors for the individual chapters Speaker 1: wouldn't do their thing, so I just have to Speaker 1: do it myself, which is fine.

00:04:00 Speaker 1: But I think if I wait long enough, Speaker 1: this will go through. Speaker 1: It's like, you know, the old days, Speaker 2: remember dial-up and that, stuff like that? Speaker 1: Even though I've allegedly got three bars here. Speaker 2: Yeah, we can wait all night for everything, anything to download.

00:04:23 Speaker 2: All right, okay. Speaker 2: So.

00:04:38 Speaker 1: We'll wait a while and see what happens. Either it'll go through or it'll time out. Speaker 1: Thank you.

00:05:48 Alright, let's try this again.

00:06:13 Speaker 1: Alright, let's try this again. Speaker 2: Hmm.

00:07:36 Speaker 2: ... Speaker 2: So, let's go.

00:09:50 Speaker 2: I'm going to go.

00:11:47 Speaker 2: Thank you. Speaker 1: the intellectual side of me, Speaker 1: saying just forget the internet, Speaker 1: work on other stuff, Speaker 1: I can take care of this, Speaker 1: get the other stuff. Speaker 1: I just wanna fucking finish this, Speaker 1: and cross it off my list. Speaker 2: - I know that feeling, Speaker 2: it's just, Speaker 2: it's gonna gnaw you. Speaker 1: - Yeah. Speaker 1: 'Cause you know, Speaker 1: people talk about the way to be efficient, Speaker 1: they only touch an email once. Speaker 1: "Oh, I'll get back to it," Speaker 1: "Oh, I'll get back to it,"

00:12:30 Speaker 1: and then you gotta redo your train of thought. Speaker 2: - Right. Speaker 1: this freaking thing out. Speaker 1: this freaking thing out. Speaker 2: - I don't touch an email once, Speaker 2: That wouldn't help. Speaker 1: Yeah, we're so dependent on Wi-Fi.

00:12:45 Speaker 1: You know, I'm trying to remember if this whole thing took... Speaker 1: I guess this must have taken this long in the past. Speaker 1: I don't know if you can buy that. Speaker 2: Yeah. Speaker 1: Because there was a... Speaker 1: What's-her-face, Irina, even said me, Speaker 1: and they can get us a driver and, like, a mini bus or something to take us. Speaker 1: And that would be about 13 or 14 hours or something. Speaker 1: And I said, oh, it might save us. Speaker 1: Yeah, it was from Helm. Speaker 1: Right. Speaker 1: I said, well, they might save us a little time, but I don't know how we sleep on that. Speaker 2: Right. Speaker 2: Right. Speaker 1: And trying you can get up and walk around some, you know, so it's not quite as painful as sitting in a friggin' car seat. Speaker 2: Right. Speaker 1: But now I guess that makes sense. Speaker 1: It's rough. Speaker 1: If you subtract all this time we're waiting, then it's about the same. Speaker 2: Mm-hmm. Speaker 1: But I'm sure it could be border crossings if we did that, too, so I don't know.

00:14:00 Speaker 1: *Sigh* Speaker 1: I'm going to throw out some of my accumulated trash. Speaker 1: Okay. Speaker 1: Hit it real quick.

00:14:52 Speaker 1: *Gasp*

00:17:04 Speaker 1: Thank you.

00:18:06 Speaker 2: I'm not going to get to the point, but Speaker 2: I'll show you what it looks like.

00:18:53 Speaker 2: It looks like this. Speaker 2: Okay.

00:19:55 Speaker 2: I'm about to close this up. Speaker 1: Yeah, because Laura is sacking out of the top bunk. Speaker 1: Yeah, because Laura is sacking out of the top bunk. Speaker 1: We better use a top bunk for store. Speaker 1: Probably better use a top bunk for store. Speaker 2: Yeah. Let me just... Speaker 2: Put all of these... Speaker 1: Yeah, let me turn around here. Speaker 1: Expans again. Speaker 1: Don't worry about it. Speaker 1: Oh, geez. This is like $10,000 equipment. Speaker 2: Yeah, no, no, no. It's fine. Speaker 2: Fine. Speaker 2: I got the cheap stuff with me. Speaker 2: Or cheaper stuff. Speaker 1: Well, you know, it's funny you mention that. Speaker 1: Because I was thinking, yeah, to be honest, Speaker 1: these aren't my best pair of clothes and all that stuff. Speaker 1: Because you never know. Speaker 2: Right. Speaker 2: Right. Speaker 1: We're not exactly going to see the queen. Speaker 1: Yeah. Speaker 1: Okay. Speaker 1: What's that? Speaker 2: Okay. Speaker 2: Okay. Speaker 2: Get her up here. Speaker 1: Do this so I don't knock everything over again.

00:20:50 Speaker 2: These two things.

00:20:56 Speaker 1: so the best idea we've ever had is to get us two bunks each i don't know you guys are bringing so

00:21:00 Speaker 2: many cameras and things yeah i don't know how uh i don't know how i'm getting home with one uh Speaker 1: one bunk no you have two okay i think you have i'm pretty sure yeah you do you do i need your Speaker 1: tickets i mean to be honest i i i you know i hate the sound high maintenance i'm dealing with Speaker 1: but I've told Irene that two bumps really make things much easier. Speaker 1: Right. Yeah. Speaker 1: So if you come back with, I mean, in all honesty, if you come back with

00:21:27 Speaker 1: rock hotel or like, you know, somehow

00:21:31 Speaker 2: each of us get a... Speaker 1: three or something like that, or divide Speaker 1: and throw you up in a three compartment or a rock hotel, you know, something like that. Speaker 1: You definitely need all the money.

00:21:45 Speaker 1: Okay, this is a passports. Speaker 2: Okay. Speaker 2: This, this and this. Speaker 2: Boom, right. Speaker 2: Close this down. Speaker 1: Yeah, very disappointed in the internet here. Speaker 1: Thought I'd solve that problem. Speaker 2: Well, uh, sternly worded letter. Speaker 1: You won't be giving them a five star review?

00:22:21 Speaker 2: No.

00:22:26 Speaker 1: Have you seen Scarface with Al Pacino? Speaker 1: The problem is, yeah, you and I are too old. Speaker 1: The problem is, yeah, you and I are too old. Speaker 1: That's the residents. Speaker 1: But I always quote. Speaker 1: But I always quote. Speaker 1: I said, there's a line you can quote from Scarface, Speaker 1: apply to any medical situation. Speaker 1: And my favorite, the answer is no. Speaker 1: Fuck no. Speaker 2: Oh, man. Speaker 2: Classic. Speaker 1: I'm a 20-man-tona. Speaker 1: Political person from Cuba. Speaker 1: Now I'm at fucking human rights. Speaker 1: President Henry Carter, you see I got fucking human rights. Speaker 2: Oh, man. Speaker 2: So I just finished a film on Fidel Castro's daughter. Speaker 2: Oh yeah, yeah. Speaker 2: Oh yeah, yeah. Speaker 2: Yeah, so we have a little clip of that in there. Speaker 2: Oh, Scarface? Speaker 1: That's awesome. Speaker 1: That's awesome. Speaker 2: Yeah.

00:23:17 Speaker 2: Do you want one of these bunks down? Speaker 1: Yeah, let's figure out how to do this. Speaker 1: Get this out of the way. Speaker 1: Get this stuff out of here before I hurt myself.

00:23:36 Speaker 1: And, uh, here. Speaker 2: I can put this under the air. Speaker 2: Oh no, there's no room. Speaker 2: Under your bum, though? Speaker 2: Yeah, that could work. Speaker 2: Oh, now that we have that out of the way, I can put it right there. Speaker 2: Okay. Speaker 1: There's a pillow hiding here. Speaker 2: We need the sheets up there. Speaker 1: Yeah, we have them. Speaker 1: See if it matters which side goes up.

00:24:07 Speaker 1: I'll come down. Speaker 1: Maybe downside? Speaker 1: Yeah. Speaker 1: Okay, let's just let me get a... Speaker 1: Yeah, you want to put that up here right now? Speaker 2: Yep. Speaker 1: Here's a little packet. Speaker 1: Oh, maybe the other way wheels in so we don't kill ourselves. Speaker 1: That's a good point. Speaker 1: Alright. Speaker 1: Watch your stuff. Speaker 1: Perfect. Speaker 1: Alright, let's get to work on this.

00:25:09 Speaker 1: Yes. Speaker 1: Or is it okay over there? Speaker 1: Or is it okay over there? Speaker 1: Can you hand it to me? Speaker 1: Can you hand it to me? Speaker 1: Here. Speaker 1: It's probably more expensive than fancy surgical instruments.

00:25:21 Speaker 1: It's decently expensive. Speaker 2: I'll just do that.

00:25:30 Speaker 2: There we go. Speaker 1: That one maybe could stay there.

00:25:39 Speaker 1: I'm afraid of kicking stuff and breaking it. Speaker 2: No problem. Speaker 1: You should be filming me making my bed on the train. Speaker 2: I know. Speaker 2: What are we doing?

00:26:26 Speaker 2: Okay. Speaker 2: Okay. Speaker 2: Laura wasn't joking about that producer credit.

00:26:47 Speaker 2: That actual producing. Speaker 1: Alright. Speaker 1: Making progress.

00:27:06 Speaker 2: Oh, you're napping. Speaker 2: Never mind, he was making his bed. Speaker 2: Oh, it was just, uh, Alex was making the bed. Figured it was a good beat, but I've got it. Speaker 2: Alright.

00:27:28 Speaker 2: Okay, no worries. Speaker 1: Alright, we're good to go.

00:27:55 Speaker 1: All right, you got that? Speaker 2: Now I can get my stuff out of the way here. Speaker 2: Now I can get my stuff out of the way here. Speaker 1: No, no, it's perfect.

00:28:00 Speaker 1: Is that a real $100 bill? Speaker 2: It is. Speaker 1: Dude. Speaker 2: I don't Speaker 2: I don't Speaker 2: I don't ever carry cash Speaker 2: but the funny thing is Speaker 2: I've been selling gear Speaker 2: as you've overheard Speaker 2: because I Speaker 2: have more than Speaker 2: I normally use Speaker 2: and Speaker 2: and Speaker 2: some people pay cash Speaker 1: so I Speaker 1: Yeah, almost every place will take, like, out-of-pay or something, you know, use your phone.

00:28:41 Speaker 1: But there's, I may have mentioned, right across the street from the hotel is this, kind of, Speaker 1: indoor, sort of a higher-end market. Speaker 1: You can, it's a seafood place, a butcher shop, they have pastries, they have fruits and veggies, Speaker 1: chocolate and all that stuff. Speaker 1: Most of the fruit, you know, I usually try to go get some apples or oranges or peaches or something. Speaker 1: But some of them don't take, you know, they only take cash. Speaker 1: But some of them don't take, you know, they only take cash. Speaker 1: So I have, I gave Logan and Laura a little bit of walking around money. Speaker 1: So I have, I gave Logan and Laura a little bit of walking around money.

00:29:11 Speaker 1: It's like $100, $500, which sounds like a lot. Speaker 1: It's about $12.5. Speaker 1: It's about $12.5. Speaker 1: In case they ever run into a place that doesn't take cash. Speaker 2: There you go. Speaker 1: Yeah, I keep doing that too.

00:29:37 Speaker 2: You still fighting the internet? Speaker 1: Yeah, I'm just wondering. Speaker 1: Usually there's something on there that says like Ukraine rail. Speaker 1: You know, when it lists your available networks. Speaker 1: Yeah. Speaker 1: Maybe it's on my phone. Speaker 1: It's okay, I've got other ways to use the time.

00:30:05 Speaker 1: Do they stop offering it? Speaker 2: Maybe. Speaker 2: Maybe it's only when they're rolling.

00:30:16 Speaker 2: Yeah, that's a good thought. Speaker 1: You're right. Speaker 1: Yeah, because the lights aren't working.

00:30:24 Speaker 1: Somewhere up here there are switches for the overhead lights. Speaker 2: Over here? Speaker 1: Yeah, yeah.

00:30:30 Speaker 1: Yeah. Speaker 1: That must be the one there. Speaker 2: Yeah. Speaker 2: That's probably the issue. Speaker 2: Alright, let me... Speaker 1: I'll see if I can sack out even just a few minutes. Speaker 2: Oh, there it's moving now.

00:00:27 *Click* Speaker 1: I'm going to try to do a language lesson. Speaker 1: Please do! Speaker 1: Sometimes it has to be to repeat sentences. Speaker 1: You're good.

00:00:53 Speaker 2: Let's put this inside your... Speaker 2: Let's put this inside your...

00:01:22 Speaker 1: You can open it or if I just want to bother people out in the hallway.

00:01:27 Speaker 1: Alright, let's see.

00:01:53 Speaker 3: Yes. Speaker 1: Saturday, okay. Speaker 1: Oh no, there's no Wi-Fi. Speaker 1: It's taking a long time to load.

00:02:25 Speaker 1: Yeah, shit.

00:02:32 Speaker 2: Well. Speaker 1: Well... Speaker 2: You getting out of here? Speaker 1: I don't know if it's gonna work.

00:03:23 Speaker 4: There she is. Speaker 1: Oh, okay.

00:03:49 Speaker 1: Would it be better if I took these things off? Speaker 2: Yeah, actually. Speaker 2: Would be great. Speaker 2: You don't have to worry about bothering me. Speaker 2: We're here for you. Speaker 2: Logan is out shooting. Speaker 2: I should get him. Speaker 1: What is he shooting? Speaker 2: He's shooting the train tracks. Speaker 1: Oh, that's cool.

00:04:39 [RUS] Speaker 1: Distribution

00:04:40 Speaker 1: It's not hearing me. Speaker 1: Yake dosvid robita bu mayata. Speaker 1: Yake dosvid robita bu mayata. Speaker 1: Robita. Speaker 1: Yake dosvid robita. Speaker 1: Wow. Speaker 2: You need to put your headphones in, does that mean? Speaker 1: I think it'll make a difference. Speaker 1: I think it'll make a difference.

00:05:29 Speaker 1: *Layne Speaker 1: I could say I can't speak right now. Speaker 1: Yakidosvid robita vumayata. Speaker 1: Yakidosvid robita vumayata. Speaker 1: It's not here. Damn. Speaker 1: Not working well at all.

00:06:02 Speaker 1: Let me turn off my VPN. Speaker 5: Yep.

00:06:16 Speaker 1: Okay, so that's working.

00:06:41 Speaker 3: Presentation. Speaker 1: This is gonna be hard. Speaker 1: Um...

00:06:50 Speaker 6: Who-one. Speaker 6: Nothing. Speaker 6: But... Speaker 6: Police. Speaker 6: But... Speaker 6: Nothing. Speaker 6: but Speaker 1: you disk a kidalia okay

00:07:40 Speaker 6: *EUR*

00:08:10 [UKR] Speaker 5: Why didn't you go anywhere in the winter?

00:08:13 Speaker 3: You. Speaker 6: You.

00:08:17 [UKR] Speaker 6: Nowhere.

00:08:18 [RUS] Speaker 5: Why didn't you go anywhere?

00:08:20 Speaker 5: Why did you go anywhere?

00:08:29 Speaker 6: I went to the night. Speaker 2: Hey. Speaker 2: He's doing his Duolingo. Speaker 7: Yeah, we were, we just set up, we just walked through the train. Speaker 7: Yeah, we were, we just set up, we just walked through the train. Speaker 2: Okay, gotcha. Speaker 7: Yeah. Speaker 7: Yeah. Speaker 7: We tried to go out the back, but they all looked at us. Speaker 2: Oh, wow. Speaker 1: You walked through the whole, are all the cars like this one? Speaker 7: No, the ones in the front are, they seem more modern.

00:08:59 Speaker 7: Really? Speaker 7: Really?

00:09:00 Speaker 7: Yeah. Speaker 1: I'll have to do that. Speaker 1: Yeah, I've never done that before. Speaker 7: Yeah, well, I don't know if we're supposed to do that. Speaker 7: Some of the people give us weird looks, but I don't know. Speaker 1: Yeah, they seem to do that a lot when people walk by. Speaker 1: I've actually gone in the middle between train cars. Speaker 1: I've had to make phone calls back home because you don't want to talk so loudly. Speaker 1: You're bothering all the people in the compartment. Speaker 1: Oh, you guys are brave. Speaker 7: Well, I know. Speaker 1: Uh... Speaker 1: -Rynek. -Markets. Speaker 1: Nishtone. Nobody. Speaker 1: -Ftosh. -Some body.

00:09:47 Speaker 8: -Tarima, like, right where all this bag is, Speaker 8: -Tarima, like, right where all this bag is,

00:09:51 Speaker 2: we... Speaker 2: we, uh... Speaker 2: just zipit up.

00:10:05 Speaker 8: Yeah, that's what Laura was saying. Speaker 8: The window. Speaker 8: I knew the only one that would work is one back there, and he yelled at us when we opened

00:10:12 Speaker 8: the door, but I wonder if, about that, maybe you could smooth talk him.

00:10:16 Speaker 1: Can you tell him you're press? Speaker 8: Yeah, well, I don't think it's anything super good. Speaker 8: The guy was like a detective. Speaker 1: The what? Speaker 8: What's that? Speaker 1: Oh, it's the conductor guy? Speaker 8: The one who's like the attendant of the car. Speaker 8: The conductor of this car. Speaker 8: Maybe if we went and talked to him. Speaker 8: We didn't have the camera. We just like poke our heads in there. Speaker 8: Yeah.

00:10:41 Speaker 1: Yeah, we could try. Show them the press pass. Speaker 1: Yeah, maybe. Speaker 1: Well, actually, we're on schedule. Speaker 1: Looks like we are. We're going to be stopping in a few minutes Speaker 2: I'll just look back through here.

00:11:07 Speaker 1: Oh no, did I lose my place? Speaker 8: Oh! Speaker 8: Sorry, Alex, I threw you up. Speaker 1: No! Speaker 1: All that hard work. Speaker 1: Oh well. Speaker 1: That's weird.

00:11:22 Speaker 1: See, I had to-- it's taken a long time to load. Speaker 1: I had to kill my VPN to get access to it. Speaker 1: We're going to close this so we don't bother people. Speaker 1: The damn thing's not loading. Speaker 1: Oh, see, it's because this-- yeah, Speaker 1: I lost my internet connection with this thing. Speaker 1: Let's see if I can use cellular data.

00:11:53 Speaker 1: Well, at least you got a few minutes of it. Speaker 2: We did. Speaker 2: We'll come back.

00:12:00 Speaker 1: Oh, here we go. Speaker 1: OK, we got something. Speaker 1: That's interview. Speaker 1: That's interview. Speaker 1: Oh, boy. Speaker 1: Let's see. Speaker 1: See, it's not making the sound. Speaker 1: It's anybody. Speaker 1: Somebody. Speaker 1: Not anywhere. Speaker 1: So it's strange. Speaker 1: You're supposed to make a sound every time I click on the word. Speaker 1: Oh, shit. Speaker 1: Yeah, we're not getting any kind of signal here.

00:12:53 Speaker 1: Oh, sorry guys. Speaker 1: Yeah, we have no, but we're getting close to a town, there should be Wi-Fi soon. Speaker 1: You know, see, red light. Speaker 1: No cell signal here. Speaker 8: Mine didn't have any either. Speaker 1: Hmm? Speaker 8: Mine didn't have any either. Speaker 1: Very spotty. Speaker 1: It usually is better in your towns, though. Speaker 1: And according to Google Maps, Speaker 1: yeah, we are almost in Colville. Speaker 1: Just a few miles. Speaker 1: So the signal should pick up soon.

00:13:48 Speaker 1: Yeah, that's where we're getting out and walk around for a little bit, because we have a Speaker 1: 20 minute rest stop, the longest one of the trip, except for Keeve in the middle of the Speaker 1: night, when we're all going to be asleep.

00:14:23 Speaker 1: Okay, we may be getting something here. Speaker 8: Dad, have you guys been talking about where we are, like the train or where we're going? Speaker 8: Yeah, yeah. Speaker 8: Yeah? Speaker 8: Yeah? Speaker 2: No. Speaker 2: No. Speaker 2: We've gotten a little, like, been telling me about, like, that we were getting close to the border,

00:14:50 Speaker 2: stuff like that. Speaker 2: If I'm talking to them, what's going to look better, me being right next to you? Speaker 2: Yeah, probably. Speaker 2: Yeah, right. Speaker 1: So, do the Shreye be looking at the camera or looking at Thad? Speaker 8: I feel like a person like this, you're probably looking at you, Thad, right? Speaker 2: Yeah, for sure. Speaker 2: I think what we're going to do is... Speaker 2: Like, make some noise eventually, but... Speaker 2: I mean, I think that, like...

00:15:19 Speaker 2: I think it's okay if he's taking me through his adventure, you know, as the audience, you know?

00:15:27 Speaker 1: You hear that? It finally said something in for a long delay.

00:15:30 Speaker 8: You can go back and do it if you want. Speaker 1: No, if you want. Speaker 1: Yeah, okay. Speaker 1: Yeah, okay. Speaker 8: Do it a little bit. Speaker 3: They love listening to music, but they don't listen to music. Speaker 1: They love listening to music, but they don't listen to music. Speaker 1: They don't listen to music. Speaker 1: Music. Speaker 1: They don't like me. Speaker 1: Okay, let's try this again. Speaker 1: Okay. Speaker 1: Yeah, no Wi-Fi, it's not... Speaker 1: It's not hearing me. Speaker 1: Oh well. Speaker 1: So do you want to talk a little bit? Speaker 1: Sure. Speaker 2: So, you've...

00:16:31 Speaker 2: Hang on, let me fix that. Speaker 2: Just get it a little farther in. Speaker 2: Put some tape over that.

00:16:49 Speaker 1: Well, maybe it looks like some sort of logo or something. Speaker 1: Well, maybe it looks like some sort of logo or something. Speaker 2: Let me see if I have it right here. Speaker 1: Yeah, we should be getting up and train in a few minutes. Speaker 1: You guys want to keep me wired while we're walking around? Speaker 1: Yes. Speaker 1: Oh, okay. Speaker 7: Sure. Speaker 1: Oh, man, I just woke up. Speaker 1: You know, Logan, we don't have much hair left. Speaker 1: You got to take good care of the survivors.

00:17:28 Speaker 2: I have green tape, but that's going to call attention to it. Speaker 2: We'll survive for now. Speaker 2: We'll get it-- Speaker 2: Yeah. Speaker 2: And if it's annoying on this one, then. Speaker 2: So, what were you working on earlier? Speaker 1: Trying to do my Duolingo Ukrainian lesson.

00:17:52 Speaker 2: Well, even before that, like trying to get an email to go out? Speaker 1: Yeah, trying to do some internet-based work. Speaker 1: And I've learned that Wi-Fi and Cell are pretty sketchy here. Speaker 1: So I planned for some work I could get done without Wi-Fi, you know, like editing Word documents.

00:18:09 Speaker 1: things like that. Speaker 2: But you were frustrated with the one particular thing that you needed to know.

00:18:16 Speaker 1: I bought one of these things which essentially is supposed to help provide like a local Wi-Fi Speaker 1: network when there's cell access. Speaker 1: It makes things a little bit better, but not much. Speaker 2: How are you doing in your Duolingo? Speaker 1: Well after working on Ukrainian for probably over a year or two, I think I've almost got

00:18:35 Speaker 1: the alphabet figured out. Big step forward.

00:18:41 Speaker 2: Where's your drive to be of service come from? Speaker 1: I don't know. When I got to talking to Rocco, this was 25 months ago, September 23, and Speaker 1: We were at this meeting of a bunch of us putting together guidelines for penetrating TBI, Speaker 1: and he started talking about his experience, how he had actually been to eastern Ukraine. Speaker 1: And I thought, yeah, how did you first do that? Speaker 1: And the light bulb went off in my head, like, you know, I could try to do this too. Speaker 1: My wife has volunteered with the Red Cross for a long time, Speaker 1: and I've always thought that was pretty cool. Speaker 1: You know, she's going to the fires and floods and things like that.

00:19:30 Speaker 1: But a neurosurgical skill set is probably not what you need when you're in that kind of far forward environment. Speaker 1: So that was always percolating in the back of my mind. Speaker 1: And another thing that came into play was summer of 2023 when we went to visit Vilnius in Lithuania for the first time Speaker 1: after I became a Lithuanian citizen and got a Lithuanian passport. Speaker 1: It was a great trip, but part of that visit that was not so great was visiting what was called the KGB Museum, Speaker 1: which is the former headquarters at the KGB in Vilnius. Speaker 1: And although the top part is a pretty interesting museum of what the Soviet occupation was like,

00:20:15 Speaker 1: in the bottom you actually see the prison where they would cram 20 to 30 people in these tiny cells with no seats or chairs or anything. Speaker 1: You saw the torture chamber that still has the padding and the walls to muffle the screams. Speaker 1: And then you go in the sub-basement where it's estimated that a thousand people were killed between, I believe, 1945 and 1952. Speaker 1: And you realize the same kind of stuff is still happening in a lot of countries in the world today. Speaker 1: It's a very disturbing place to visit. Speaker 1: So between kind of my wife's history of volunteering and then realizing there's a lot of horrible stuff still happening in the world that's happening in Ukraine right now.

00:21:01 Speaker 1: And here's a guy who had actually gone and done that. Speaker 1: I thought, you know, that's a perfect thing for me to do because although my skill set isn't really tailored towards helping my wife,

00:21:12 Speaker 1: these sort of Red Cross disasters, it is pretty well suited to this.

00:21:18 Speaker 2: Because you saw your wife doing it? Was it proving your masculinity, your manhood, that you could do the same?

00:21:26 Speaker 1: No, nothing quite so dramatic. More just trying to make myself useful somehow.

00:21:32 Speaker 2: What? Speaker 1: I may have told you that I was president of the American Association of Psychological Surgeons in the year that ended in 2018. Speaker 1: And the president has to choose a theme for their annual meeting and give the presidential address at the end of the year.

00:21:49 Speaker 1: And for my theme, I chose a privilege of service.

00:21:54 Speaker 2: Why? What did you have to say? Speaker 1: I just talked about ways we can try to give back, we as neurosurgeons, but perhaps speaking to a wider audience. Speaker 1: And whether it's serving in some small local way in your community, in your local hospital, Speaker 1: doing roles a lot of neurosurgeons don't like to do, like administrative roles are often Speaker 1: crucial, although we'd rather be in the OR, you know, someone's got to make the right decisions Speaker 1: about running the place. Speaker 1: But it talks a lot about altruism also, and just paying back somehow, in big ways or small.

00:22:32 Speaker 2: What excites you about your neurosurgery? Speaker 2: What exciting things have you done recently Speaker 2: back in Dallas in the neurosurgery world?

00:22:44 Speaker 1: - So back home, I've only been in my current job Speaker 1: a few years, so I feel like I'm still getting Speaker 1: to know my way around, but we're able to integrate Speaker 1: pretty well with the residency program, Speaker 1: the training program, with the hospital, Speaker 1: and do some good clinical work and try to bring Speaker 1: some new programs aboard, and also beefing up research, primarily in neurocritical care Speaker 1: or traumatic brain injury. Speaker 1: Trying to think outside the box a little bit, new ways to solve some of these problems Speaker 1: that have been bothering mankind for thousands of years, Speaker 1: if you read the Edward Smith papyruses from ancient Egypt.

00:23:18 Speaker 1: In some ways, not a whole lot has changed since back then.

00:23:23 Speaker 2: What role are you in in this Dallas hospital? Speaker 1: I'm a faculty member of my med school and I'm the chief of service at the hospital. Speaker 2: What does chief of service mean? Speaker 1: It means I go to a lot of meetings and get a lot of complaints. Speaker 1: All right, we got to go. We got 20 minutes. Speaker 1: All right. Speaker 1: So I'm going to hide stuff. Speaker 1: All right, the clock is ticking, guys. Speaker 1: All right. Speaker 1: Yeah, let me get the Google Translate up real quick and ask him.

00:24:00 Speaker 1: Ready to go? Speaker 1: Yeah, we got to go outside now. Speaker 1: Otherwise, we'll be cooped up here all day. Speaker 1: Let me check with the dude. Speaker 1: You want to get a jacket? Speaker 1: You're okay? Speaker 8: We're only here for 20 minutes, I'll be fine. Speaker 1: Yeah, let me ask him. Speaker 1: Hey, no way.

00:24:33 Speaker 1: Oh, there he is.

00:24:39 Speaker 4: You have 10 minutes. Speaker 1: 10 or 20? Speaker 4: 10 minutes. Speaker 1: OK. Speaker 1: OK. Speaker 1: OK, 10 minutes, unfortunately. Speaker 1: We're running late. Speaker 8: We'll see. Speaker 1: Yeah. Speaker 1: So 1532. Speaker 1: All right. Speaker 1: We can walk around a little bit here. Speaker 1: They're all looking at you. Speaker 1: Laura. Speaker 1: Here, let's walk this way. Speaker 1: Unfortunately, he said we only have 10 minutes. Speaker 1: We must be running behind schedule. Speaker 4: Where are you from? Speaker 4: Where are you from? Speaker 1: Huh? Speaker 4: Where are you from? Speaker 1: Los Angeles and Dallas. Speaker 4: New York. Speaker 4: How are you doing? Speaker 4: How are you doing? Speaker 1: Doing all right.

00:25:30 Speaker 1: Welcome.

00:25:30 Speaker 1: Welcome. Speaker 4: Thank you. Speaker 1: What brings you here? Speaker 4: We're going to put some logistical hub. Speaker 1: For what? Speaker 4: Drain warehouse. Speaker 1: Oh, so all the bread and butter stuff. Speaker 4: Oh, that's great. Speaker 1: Here in Cobalt? Speaker 1: Oh, that's great. Speaker 1: Yeah, we're headed to Dnipro to Metricot Hospital. Speaker 4: When are you going back home? Speaker 4: You're flying back from Warsaw? Yeah, we're going from Warsaw

00:26:00 Speaker 1: to Dnipro now and going back home about a week and a half. Speaker 4: I will be there probably, we'll be back home in November.

00:26:07 Speaker 4: Thanksgiving, that's for sure. Oh, that's a long time. Well, good. Well, nice meeting you. Speaker 1: Same here. Take care. Thank you. Thanks. We out. Speaker 1: Yeah, we only have a few minutes.

00:26:21 Speaker 1: Oh, where did Laura go? Speaker 8: Laura went inside to grab.

00:26:27 Speaker 1: So let's at least try to look at this church here. Speaker 1: Yeah, so normally, oh, here it is. Speaker 1: Here's a nice picture right here. Speaker 2: Yeah.

00:27:26 Speaker 1: So here's that... Speaker 1: I assume it's a church. There's crosses on top. Speaker 1: But we can go underneath to walk around. Speaker 1: That's the little market where I say we can buy more stuff. Speaker 1: But the dude said we only have 10 minutes. Speaker 2: So do you want to... Speaker 1: Yeah, let's go back. Speaker 1: Okay.

00:27:53 [RUS] Speaker 1: To be continued...

00:28:20 Speaker 1: Is this okay? Speaker 1: Just me walking around? Speaker 1: What's that? Speaker 1: Just me walking around? Speaker 1: You okay with that? Speaker 8: We're just walking. Speaker 1: Yeah, I'm just getting back on the train. Speaker 1: Yeah, I'm just getting back on the train. Speaker 1: It's a long walk otherwise. Speaker 1: This is a building where you go inside in the basement, Speaker 1: and there's some signs in Ukrainian that I can't read, Speaker 1: but you can see the word Starlink. Speaker 1: So I think you're giving love to Elon Musk Speaker 1: for providing Starlink to him. Speaker 1: Oh yeah, you can see. Speaker 1: I don't know if you can see those. Speaker 1: See to the bottom right of that clock, that thing on the wall? Speaker 1: It says Starlink on that little wall poster that's kind of white circled there. Speaker 1: It's pretty cool.

00:29:22 Speaker 1: Let's see. Speaker 1: Yeah, this is our car, right? Speaker 1: Yeah, this is number 10. Speaker 1: Sorry. Speaker 1: Yeah, we used to be in the end. Speaker 1: Oh, you just want to get me going back on the train? Speaker 1: Yeah, we get to go back. Speaker 1: Alright.

00:29:50 Speaker 1: Well, sorry, that's kind of a bust. Speaker 8: That's all good. Speaker 1: Oh, well.

00:30:08 Speaker 3: Yeah, this is us. Speaker 3: Okay.

00:30:24 Speaker 5: Oh, okay.

00:00:00 Speaker 1: Oh yeah, I noticed that stuff.

00:00:00 Speaker 1: Oh yeah, I noticed that stuff. Speaker 2: Where is he changing the lines?

00:00:08 Speaker 2: Oh, I'm not changing the lines. Speaker 3: See the lady walking around right there with a glass of champagne?

00:00:23 Speaker 3: Where's she got that from? Speaker 2: Who knows? Speaker 2: Shadow nose. Speaker 4: Whoa. Speaker 2: You ready? You're up, okay.

00:01:13 Speaker 3: Yeah, still no Wi-Fi. Speaker 3: It's pretty annoying. Speaker 3: I think they just sent a text about the latest attack. Speaker 3: The rush strike tried out a strike with a guided aerial bomb on Kamiatsky in the Nitro-Petrovsk region.

00:02:00 Speaker 3: About 150 kilometers from Dnipro. Speaker 3: A massive column of smoke rose over the city. Speaker 2: Let's see if you can touch me. Speaker 3: Yeah, you can take a look here. Speaker 3: Yikes. Speaker 2: We can have him do the Kenwood. Speaker 3: Two dead and five injured.

00:02:27 Speaker 1: Okay. Speaker 1: We'll see.

00:02:34 Speaker 1: Another chance to access to.

00:02:39 Speaker 3: A different conductor? Speaker 1: Yeah, because that guy wasn't really involved with us. Speaker 3: Yeah, he's not very nice.

00:02:47 Speaker 2: So, where was it? Speaker 3: Dnipro, Petrovsk region, about 150 kilometers to where we're going.

00:02:57 Speaker 1: Are you ever nervous about going? Speaker 1: Here, uh, Dad, do you want to wait until the train is coming? Speaker 1: Yeah, let's wait, yeah, let's do that. Speaker 1: That'd be better, better visual, yeah. Speaker 1: Editorially, if the train is... Speaker 1: Exactly, still. Speaker 1: True. Speaker 3: Yeah, that's going to be the whole background theme. Speaker 3: I like to have an opening with that, though. Speaker 3: That's a great idea. Speaker 3: That's a great idea. Speaker 2: The sound? Speaker 2: Yeah, I think I texted you. Speaker 3: I actually, you know, what I do when I'm here is I kind of text pictures and things,

00:03:24 Speaker 3: some videos to the people back home, you know, the residents and nurse practitioners we work Speaker 3: with. Speaker 3: And I did that, and I said, "This is what it was like all night long."

00:03:33 Speaker 3: Look out the window, it's black, you just hear the wheels rolling on the tracks. Speaker 2: You want to get his laces here? Speaker 2: Oh, he...

00:03:56 Speaker 3: All right. Speaker 1: Yeah, we can wait until you...

00:04:00 Speaker 3: Yeah, that was disappointing. Speaker 3: There's always something to look forward to on this trip. Speaker 3: You know, kind of pretty much shortly after we run through this town, it starts getting dark. Speaker 2: Yeah, we had a little more time, but, you know, certainly don't want to miss the... Speaker 3: Yeah, see, I think I lied to us. Speaker 3: Yeah, we probably have 20 minutes. Speaker 2: Yeah, guy. Speaker 2: We're going to sit here forever and curse his name. Speaker 3: Oh, well. Speaker 3: Oh, well. Speaker 2: I was talking to a Mediterranean cruise, so it didn't suck, but I was talking to one of the people that worked there, and they were telling me that they were on a ship when an internet creator, a YouTuber, got left behind because he wanted to film the boat leaving.

00:04:50 Speaker 3: Okay. Speaker 2: Sounds like something I would do. Speaker 2: Yeah. Speaker 3: So did they go back again or did they say you're on your own? Speaker 2: I think they said you're on your own. Speaker 2: Like he thought that they would send somebody or do something, but no.

00:05:04 Speaker 2: So, yeah. Speaker 3: I was talking to a hospital administrator once, and I said, you know, the stupid things that humans do is job security for people in administrator positions, Speaker 3: because there's always problems to solve and headaches to deal with. Speaker 3: He laughed and he said, sometimes I could use a little less job security.

00:05:29 Speaker 2: That's too bad that we didn't get more there. Speaker 2: Too bad. Speaker 3: That's okay. Speaker 3: I get that you guys are pretty flexible with this whole thing. Speaker 2: Oh, yeah. Speaker 3: I'm impressed you guys are launching this big documentary project. Speaker 3: You've never even been there. Speaker 3: You don't know what you're getting yourselves into. Speaker 2: Well, I mean, both Logan and I have been in situations where it's just you roll with what happens.

00:05:54 Speaker 2: But also, we've done this together enough that I, well, I certainly, I rarely tell him what to do.

00:06:07 Speaker 3: So is Laura out there? Speaker 1: Laura's out there, yes. Speaker 3: So you guys are both only in your early 20s? Speaker 4: No, he's 30. Speaker 3: Oh, I thought you were older than that, but still, that's pretty young. Speaker 3: You seem to know your way around pretty well. Speaker 2: I've been working with him since he was 23, so that's giving you an idea.

00:06:27 Speaker 3: So another question, and again, this is totally outside my world, but you guys have both won Emmys, right? Speaker 3: I don't know, honestly, is that like a big deal? Speaker 3: Or does everybody get an Emmy? Speaker 3: Because I always thought it was a big deal. Speaker 2: It is a big deal, but... Speaker 3: And now, like, everyone's got one. Speaker 3: You two guys have one. Speaker 2: But, like, it depends on what you... Speaker 3: And she's got one, too, right? Speaker 3: Jeez. Speaker 3: Jeez. Speaker 3: So now I'm feeling bad. Speaker 3: I don't have my own on here to brag about. Speaker 2: We can get you one. Speaker 2: We can get you one. Speaker 2: That's what we're here for. Speaker 2: No, I'm... Speaker 2: But, no, no, so, like, everybody gets an Emmy when something wins.

00:07:07 Speaker 2: Logan's is particularly impressive because it's for cinematography, Speaker 2: specifically for the cinematography work he did. Speaker 2: So it's not like, I mean, I think his fellow,

00:07:19 Speaker 2: the other shooter got one too. Speaker 1: Right, yeah, because I couldn't get into COVID, Speaker 1: or to Canada at the time due to COVID. Speaker 1: So someone shot a week or something of work up there. Speaker 1: But him and I were the only people that got that. Speaker 1: Like even Todd didn't get it for, Speaker 2: this director didn't get it for the cinematography. Speaker 2: Right. So and then I got mine for so I'll mine. I mean, I feel like I feel like our film was honored.

00:07:48 Speaker 2: So so the second 30 for 30, I had won an Emmy for best, you know, best documentary series.

00:08:02 Speaker 2: And when they announced it, they had our film playing.

00:08:10 Speaker 2: Yeah. Speaker 2: Yeah. Speaker 3: No suspense there. Speaker 3: I know. Speaker 2: But, like, have you seen Brian and the Boss? Speaker 2: Have you seen either? Speaker 3: I've heard about that. Speaker 3: I know who Brian Basworth is, of course. Speaker 3: You know, I, unfortunately, I don't do a whole lot of watching a video. Speaker 3: I mean, I don't subscribe to Netflix or Amazon Prime or any of those things. Speaker 2: No, that's okay. Speaker 3: I'm not. Speaker 3: My thought is one day if I ever retire, that's all I'll do in my spare time. Speaker 3: catch up on all the things I've been missing. Speaker 2: Yeah. Speaker 2: Well, you know, Speaker 2: so in Brian and the Boz, Speaker 2: so you remember the Boz. Speaker 2: He was kind of a jerk, right? Speaker 2: He was kind of a jerk, right? Speaker 2: And so when I heard, Speaker 2: when they were asking me for advice, Speaker 2: they, Speaker 2: they, Speaker 2: my first thought was like, Speaker 2: my first thought was like,

00:09:00 Speaker 2: I don't know if I even want to see a movie about the boss, right? Speaker 2: Like, don't we know that story? Speaker 2: He was a jerk that got most coming to him. Speaker 2: And then I, you know, so anyway, first they were just asking me advice. Speaker 2: One week later, I talked to them again, and they were like, Speaker 2: well, how would you like to direct this? Speaker 2: And I was like, hmm, well, if I direct it, I know I'd want to see it, Speaker 2: so let's see. Speaker 2: But actually, they had told me the week before that they had the blessing Speaker 2: of the University of Oklahoma, and they had a million dollars. Speaker 2: And my thought was like, how much money did you say you had? Speaker 3: Yeah, did you need to shift that decimal point a little bit? Speaker 2: Yeah, exactly. Speaker 2: Well, anyway, I later told their investor that it was not a good investment, Speaker 2: especially if they wanted it on ESPN, because it's just like ESPN knows the stature they have.

00:09:50 Speaker 2: So it's like, unless you pay for the whole thing, but still, you're not going to make much Speaker 2: on a sports doc because there's a lot of other things payment-wise, whatever that goes into Speaker 2: Anyway, I told them just put in money. Speaker 2: Anyway, I told them just put in money. Speaker 3: And so where does revenue come from? Speaker 3: I mean, how do they make money on any kind of documentary? Speaker 2: So the people that make money on the ESPN documentaries are ESPN because their model is

00:10:19 Speaker 3: But something like the one we're working on now. Speaker 3: But something like the one we're working on now. Speaker 2: So what's going to happen is we're going to, at least as it's going, we're going to privately

00:10:28 Speaker 2: finance the whole thing and then we'll sell the uh we'll sell the film you know and so then you

00:10:35 Speaker 2: hopefully you sell it to to uh theatrical just because it'd be great to see it you know have a Speaker 3: theatrical run but um it could be netflix so selling it means someone yeah someone like netflix or one

00:10:46 Speaker 3: of the big studios will buy it just like so just like they're cranking out superhero films all the Speaker 2: time that kind of stuff yeah and now it might be like a um a um a mix because like two of the Speaker 2: recent and probably many more but two of the recent oscar winners and documentary um uh were Speaker 2: released by pbs um but i think they were they had theatrical runs before um so like um 20 days Speaker 2: at mary opel oh yeah i've heard about that i've not seen it but it's it's one of the the two films Speaker 2: that I think are like Speaker 2: prequels, if you will, to this film. Speaker 2: That one's about an AP Speaker 2: or it's Speaker 2: about himself, basically. Speaker 2: Not really, but he Speaker 2: and other AP reporters are Speaker 2: in Mariupol during the invasion Speaker 2: and then eventually the city Speaker 2: gets overrun. During the siege Speaker 2: he was there? Yeah, exactly. Speaker 3: Yeah, that was a horrible place. Speaker 2: Yeah, and they were fun. Speaker 2: It was. Speaker 2: And a lot of the stuff they filmed, they filmed at hospitals. Speaker 2: So it's, and that was like, at times, the safer place.

00:11:57 Speaker 2: But, you know, it was a great sort of lesson in combating fake news in the sense of, like, you're with this, so you're seeing the world through this guy's camera. Speaker 2: You know, he's going around, and he's a Ukrainian guy. Speaker 2: And so at the end, he does this voiceover to walk you through, right? Speaker 2: And you see what he's capturing. Speaker 2: And at one point, they don't have a car again, and they're moved or they're being moved. Speaker 2: And they happen on this hospital that just had been hit.

00:12:44 Speaker 2: And it was a maternity. Speaker 2: actually I think the whole hospital was with her. Speaker 3: - Oh, I've heard it, yeah. Speaker 3: I remember hearing about that. Speaker 2: - Yeah, and so then these women are being taken out. Speaker 2: And you know, one of them is just completely shell-shocked. Speaker 2: And then you see this one like literally Speaker 2: seeming like she was about to give birth Speaker 2: and she's clearly injured with blood on her, Speaker 2: like holding her stomach, and they're wheeling her out. Speaker 2: And it's these awful images that the world needs to see, right? Speaker 2: So the idea is you're the AP reporter there. Speaker 2: You have to film this so the world can see what's going on there, right?

00:13:29 Speaker 2: And so then after you film it, you have to get it uploaded. Speaker 2: And there's no Internet's working, right? Speaker 2: And so they, like, go to one spot in town where they can get Internet, Speaker 2: and, like, he's uploading at 10 seconds a clip. Speaker 2: And a very effective thing that they do in it is, or he, as the director does, is they cut to the broadcasts using his footage. Speaker 2: So it's like, so you hear these international broadcasts, like voices you know, and they use the footage there, like this, on the ground in Mariupol, you know, and they do this.

00:14:10 Speaker 2: So they show his coverage of the...

00:14:14 Speaker 3: Yeah, we had 20 minutes. Speaker 2: Yeah, they show his coverage of the...

00:14:23 Speaker 2: of the victims of the maternity...

00:14:30 Speaker 3: The hospital attack? Speaker 3: Yeah, yeah. Speaker 2: And then, just a little bit later, Speaker 2: so you see that and you see it contextualized Speaker 2: by the network anchors, etc.

00:14:42 Speaker 2: But then, soon thereafter, you see Russian commentators and the Russian representative Speaker 2: of the UN calling it fake news. Speaker 2: Of course.

00:15:00 Speaker 2: Right.

00:15:00 Speaker 2: Right. Speaker 2: They were trained. Speaker 2: Marya Poole has become a Hollywood set, is what they said. Speaker 2: And so the super effective thing is that by being there with the guy the whole time, you know, Speaker 2: you're outraged because you know how he was... Speaker 2: you were risking your life just in your imagination with him as you go through this. Speaker 2: And so, you know, it was a pretty intense thing. Speaker 2: But like they had a theatrical run and then it was released by Frontline. Speaker 2: So that was circled back. Speaker 2: And so, like, you know, the-- Speaker 2: I mean, I wouldn't know, but I'm assuming Speaker 2: the more lucrative would be like an HBO type thing.

00:15:47 Speaker 2: But the most lucrative could be the theatrical run. Speaker 2: So we'll try that first. Speaker 3: Logan, I was just asking him, how does the revenue Speaker 3: from this work, you know, the business side of all this? Speaker 3: I do this thing, and I don't know how it works. Speaker 1: He knows much more about that than me.

00:16:00 Speaker 1: Yes. Speaker 3: Oh, there you can see in the background that building right there to the church. Speaker 3: They were fading away, leaving Colville.

00:16:10 Speaker 2: Logan, now I'm self-conscious. You didn't hear that when they announced the award for best series, they used our documentary. Speaker 2: Was this for Pony? Speaker 2: No, it was actually for Bob. Speaker 1: Oh, that's cool. Speaker 2: Yeah, so like they like the clip for the series was Brian and his son in the storage unit. Speaker 2: So, which, um, Logan, I don't like the way it's shot. Speaker 2: So, there's a reason we're here.

00:16:41 Speaker 2: Anyway, so, oh, here's another church.

00:16:46 Speaker 3: Oh, yeah. Speaker 2: So, Alex, I have this theory or this response to you, and I want you to hear it and either refute it or go into what it makes you think. Speaker 2: So, Alex, I have this theory or this response to you, and I want you to hear it and either refute it or go into what it makes you think. Speaker 2: I've been talking about this film and the service aspect of it, and I have said that I feel like it's not that you're driven by your faith to do this, but the same thing that drives your faith is the same thing that drives you to do this. Speaker 2: Does that make sense to you? Speaker 2: It's part and parcel of the same thing. Speaker 2: It's not like, oh, I have this faith.

00:17:34 Speaker 2: I must do something with it. Speaker 2: I think it feels combined. Speaker 2: It feels like intrinsic.

00:17:44 Speaker 3: You know, I think you're thinking about this a lot more than I am. Speaker 3: I mean, I'm a surgeon, right? Speaker 3: So a lot of people think surgeons are mouth-breathing knuckle draggers. Speaker 3: It's very simple. Speaker 3: I mean, this is something, this is a horrible evil that's being committed. Speaker 3: I mean, not only is it a tyrannical state attacking a democratic state in Europe of all places, Speaker 3: but it's also just good versus evil. Speaker 3: I mean, no one mentions anymore every day that are war crimes being committed. Speaker 3: You know, the Russians are bombing children's hospitals and kindergartens Speaker 3: and churches and supermarkets and village squares and apartment blocks. Speaker 3: We used to talk about the Geneva Conventions and rules of war, and all that stuff has gone way out the window.

00:18:29 Speaker 3: And no one cares anymore. Speaker 3: They just mention every day on the news podcast I listen to, they talk about how many hundreds of drones and missiles the Russians have launched, Speaker 3: and how many got shot down, how many made it through, how many people died. Speaker 3: And it's kind of like that's the way it is now. Speaker 3: No one even says that's right or wrong. Speaker 2: You know, when we met, Irina came with you, right? Speaker 2: And she said her class, that people from her class were like, "Oh, I didn't know the war was still going on."

00:19:00 Speaker 3: Yeah, that was when I, after I gave that talk at the University of Dallas, Speaker 3: they thought that, "Oh, they were surprised that the Russians are deliberately targeting non-combatant targets, Speaker 3: you know, civilian targets." They thought, "Oh, that was just the occasional stray drone or missile," Speaker 3: or something like that. Speaker 3: That wasn't active? Speaker 3: No, it's a deliberate campaign. Speaker 3: The amazing thing is despite the hundreds of drones and missiles and glide bombs and things that are launched every day, Speaker 3: every death is tragic. Speaker 3: But if only five or six Ukrainians are killed and more injured, Speaker 3: that's not a very good return on the investment if you're trying to demoralize the infrastructure. Speaker 3: And, of course, the more Ukrainians get attacked, what would the U.S. do if somebody were attacking the U.S.? Speaker 3: Like, what happened on 9-11? Speaker 3: Did we just turn tail and run? Speaker 3: Of course not. Speaker 3: That was one of the few things that brought the country together, and everybody was pretty pissed off and everybody fought back.

00:19:54 Speaker 3: Ukraine's doing the exact same thing. Speaker 3: They're amazingly brave and resilient people. Speaker 2: You know, you and I are of an age, but I'm of an age still, but we know that Ukraine voluntarily gave up its nuclear weapons. Speaker 3: Yeah, the Budapest Awards. Speaker 3: Yeah, 1994, I think it was. Speaker 3: And in return, they were going to be protected and guaranteed security, which is so funny Speaker 3: in a not humorous sense that now everyone's saying, well, part of the ending of the war

00:20:30 Speaker 3: of Ukraine's going to need security guarantees. Speaker 3: That didn't work too well for them in 1994.

00:20:39 Speaker 2: I have a friend who says to me that he believes that most of the world's suffering is because

00:20:47 Speaker 2: of broken agreements. Speaker 3: You could say that's true at both the individual level and the organizational level and the

00:20:56 Speaker 3: international level. Speaker 2: Do you want to hit that light?

00:21:00 Speaker 2: Yeah, we were playing with it earlier.

00:21:09 Speaker 3: Yeah, okay, so maybe they just turned it on at night time or something. Speaker 1: It's gotten late in the time of day. Speaker 1: The power on here. Speaker 1: The power on here. Speaker 3: Oh, yeah. Speaker 3: So Logan, is it better if these lights are on or not? Speaker 1: I want to turn them off.

00:21:24 Speaker 3: Yeah, look at that. Speaker 3: We got that figured out. Speaker 3: We got that figured out.

00:21:30 Speaker 3: So we should talk more about Andre. Speaker 3: What can we talk about Andre Sirko? Speaker 1: Well, tell me about him. Speaker 3: So Andre Sirko is the-- Speaker 3: I think his exact title is director of the Center Speaker 3: for cerebral neurosurgery in Metrenicove Hospital. Speaker 3: So by, before the war started in 2014, Speaker 3: he was and continues to be an excellent tumor surgeon. Speaker 3: Primarily tumors of the skull base, Speaker 3: kind of the bottom part of the brain

00:22:00 Speaker 3: where there are a lot of what we call cranial nerves Speaker 3: that come off and do critical functions Speaker 3: like help your face move, control your vision Speaker 3: and your eye movements, things like that. Speaker 3: and a lot of the arteries coming up from below to feed the brain. Speaker 3: So definitely tiger country in terms of places to operate. Speaker 3: And he is a master at that. Speaker 3: And he was able to transfer that skill set over to victims Speaker 3: of the Russian attack who've had shrapnel primarily

00:22:30 Speaker 3: or called penetrating brain injury. Speaker 3: And of course, it can go anywhere in the brain. Speaker 3: But the ones that kind of come from below and maybe go through your eye socket and your frontal lobes up into the brain or bottom of the skull up into the brain, that's a major reconstructive effort. Speaker 3: And he has learned from that. Speaker 3: I think his hospital has seen right now over 2,500 cases since the war started. Speaker 3: So obviously they've learned a lot. Speaker 3: And Andre is a very detail-oriented, very hardworking guy. Speaker 3: So he catalogs their results and what they've done. Speaker 3: And some of the techniques that he's developed Speaker 3: have become the new way to do this. Speaker 3: He has rewritten the textbooks. Speaker 3: See, the interesting thing about this war Speaker 3: compared to when the US was fighting in the Middle East Speaker 3: is that if somebody were injured in the Middle East, Speaker 3: it was pretty reasonably good evacuation Speaker 3: because we had air superiority. Speaker 3: And they were able to go from Iraq, Afghanistan, Speaker 3: eventually get to Landstuhl in Germany,

00:23:30 Speaker 3: and then get to Walter Reed, but that was a third of the world away or half a world away, Speaker 3: you know, a long flight over the ocean. Speaker 3: Here, as Rocco Armando always says, imagine having Walter Reed, like right there, Speaker 3: just 100 kilometers, 60 miles from the front line. Speaker 3: So you have all the capabilities of a major medical center, Speaker 3: and you don't have to have the delay of transporting patients across an ocean Speaker 3: to get the benefits of that care. Speaker 3: So I think it's probably helped improve the outcome of a lot of the patients he sees. Speaker 3: And sadly, a lot of them are civilians. Speaker 3: They're not just the war fighters, the military personnel, but Speaker 3: a lot of the elderly people who are totally not military threats at all.

00:24:15 Speaker 3: They get injured by the drones and the bombs. Speaker 2: Logan, we only have a little light left. Speaker 2: Do you want to get one of your lenses on one of my cameras or something like that? Speaker 1: Yeah, let me change this battery. Speaker 2: Right. Or I can... Speaker 1: Let me just get you the FF. Speaker 2: Yeah, that's what I was going to say.

00:24:41 Speaker 3: I see your screen. Speaker 3: I see your screen. Speaker 3: I see your screen. Oh, look, it's hearing me. Speaker 3: Oh, look, it's hearing me. Speaker 3: Okay, good.

00:24:53 Speaker 3: Staff meeting is... The word for staff meeting sounds like the word for boring. Speaker 3: The word for staff meeting sounds like the word for boring.

00:25:40 Speaker 3: Yeah, whatever works for you. Speaker 1: Presentation.

00:25:48 Speaker 1: No one.

00:25:54 Speaker 1: Here. Speaker 1: Oh, here we go. Speaker 1: Oh, here we go. Speaker 1: Yes. Speaker 1: That's like tighter than probably. Speaker 2: Yeah. Speaker 2: I mean, I can give you whatever. Speaker 2: That's fine, but that's kind of the angle you're getting. Speaker 1: Yeah.

00:26:22 Speaker 2: Can you do me a favor and let me see if the light's still on here?

00:26:26 Speaker 2: blinking that's good right yeah that's on right Speaker 1: okay

00:26:54 [RUS] Speaker 3: You guys ready to go?

00:27:00 [RUS-NEEDS] Крисусы [RUS-NEEDS] Что? [RUS-NEEDS] Ничего

00:27:15 [RUS-NEEDS] Колыны?

00:27:18 You guys ready to go?

00:27:26 I think so. I'm just trying to bang out my daily lesson here. Speaker 3: I'm just trying to bang out my daily lesson here. No dish.

00:27:37 Okay, then record button on the handle, well here I'll try this one, okay? Speaker 2: Okay, then record button on the handle, well here I'll try this one, okay? Speaker 2: It wasn't working on the handle, but it ended up working. Speaker 2: So talk to me again about, let me make sure I get a little bit of this camera to my side. Speaker 2: By the way, Laura, you can actually see that this sound is running here on this thing.

00:28:27 Speaker 2: I'm going to do one more thing. Speaker 1: Actually, I'm going to go 32 parts. Speaker 1: Actually, I'm going to go 32 parts. Speaker 1: I'm going to go more different than that. Speaker 1: Okay. Marco. Speaker 1: Okay. Marco.

00:28:47 [RUS-NEEDS] Не будь. [RUS-NEEDS] Парку.

00:29:02 [RUS] Speaker 5: To the park. [RUS] Speaker 5: Yesterday. [RUS] Speaker 5: One. [RUS] Speaker 5: Thousand.

00:29:34 [RUS] Speaker 1: Children.

00:29:37 Speaker 1: Read.

00:29:38 [RUS-NEEDS] Книги.

00:29:40 [RUS] Speaker 1: Books.

00:29:44 Speaker 2: What? Speaker 2: Sound sync. Speaker 2: Let's see here. Speaker 2: Where's my phone?

00:29:53 Speaker 5: It's nothing. Speaker 3: Just... Speaker 3: Alright, one more to go here. Speaker 3: Oh, damn. Speaker 3: Alright.

00:30:15 Speaker 3: So what did you want to talk about? Speaker 2: Hang on one second and then we'll get there. Speaker 2: All right. Speaker 2: Let me just put this on.

00:30:27 Speaker 3: Also, do I need to be sitting or doing something different? Speaker 3: Am I okay with this thing? Speaker 3: I feel like I'm in a cave here. Speaker 2: It's fine. Speaker 2: It adds to the ambiance.

00:30:40 Speaker 2: I'm gonna sit next to you though. Speaker 2: Yeah. Speaker 2: Yeah, let's do it. Speaker 2: Come in.

00:00:00 One more thing.

00:00:13 Speaker 1: One more thing. Speaker 2: So I remember giving an interview once, getting ready to talk to someone.

00:00:30 Speaker 2: We had a really great media person in the hospital. Speaker 2: And I said, what should I do with my hands? Speaker 2: She sent me this clip from this movie Talladega Nights. Speaker 2: You ever seen it with... Speaker 1: What do I do with my hands? Speaker 2: Yeah, and I guess it's kind of funny. Speaker 2: Yeah, Will Ferrell, he's giving his talk with his hands Speaker 2: because he was asking about it ahead of time. Speaker 2: So the audience was ready for this. Speaker 2: And during the interview, his hands were like all over the place. Speaker 2: He's just going to move it. Speaker 1: I'm just getting the one thing above me.

00:00:56 Speaker 2: Every time I've asked if Thad seen a movie, he always says yes.

00:01:00 Speaker 1: Well, you know, I haven't seen as many as most of the recent ones, because there came a time in my life when... Speaker 1: Are these colors matching yours? Are we good? Speaker 1: You're probably good. Speaker 1: Right. Speaker 1: Das ist eine Probleme. Speaker 2: Again, should I keep looking at you? Speaker 1: Yes, you should. Speaker 1: And that's why I got it right here. Speaker 1: Yeah, so, you know, I...

00:01:30 Speaker 1: I'll tell you when we're not rolling, I'll tell you. Speaker 1: I mean, I don't mind it being out there, but we're wasting time. Speaker 1: Yeah, yeah, yeah. Speaker 1: I'll tell you in a second. Speaker 1: But... Speaker 1: Let me do that. Speaker 2: The light's good for you guys. Speaker 2: The light's good for you guys. Speaker 2: It's just pretty dark in here. Speaker 1: Yeah, man. Speaker 2: Okay. Speaker 1: Dark. Speaker 1: That's the mood. Speaker 1: That's funny.

00:02:00 Speaker 1: There it is. Speaker 1: There we go. Speaker 1: That's too dark. Speaker 1: What are you going to do? Speaker 1: Oops, sorry.

00:02:48 Speaker 1: Alright, let's do that and...

00:02:54 Speaker 2: Is that magnetic? Speaker 2: That's very cool. Speaker 2: That's very cool. Speaker 2: Yeah. Speaker 1: There you go.

00:03:00 Speaker 2: Oh shit, I just moved it. Speaker 1: Just put it up like that. Speaker 1: Just put it up like that. Speaker 1: Just like that. Speaker 1: Just like that. Speaker 1: That's good. Speaker 1: It's okay. Speaker 1: It's getting sync sound, so that's why I have it rolling. Speaker 1: Which means, you know, anyway, the sound is going to it. Speaker 1: So that's just why I was making sure to get it on. Speaker 1: It's not something. Speaker 1: It's a little claustrophobic.

00:03:27 Speaker 2: So, you know, this is an interesting example of what it's like in Ukraine right now. Speaker 2: I mean, we're sitting here having this conversation on a train. Speaker 2: It's a normal countryside. Speaker 2: And theoretically, at any second now, there could be a drone or a missile coming. Speaker 2: And that's how these people are living their lives. Speaker 2: You know, you can't just stop living because of what's going on here. Speaker 2: So they're having, you know, birthday parties and celebrations. Speaker 2: They go to work every day. Speaker 2: Knowing in the back of their minds that, you know, Speaker 2: it could end very badly sometime today. Speaker 2: It's amazing their strength and resilience. Speaker 2: And you also have to wonder what the long-term toll line that's going to be, Speaker 2: especially on the kids growing up in this. Speaker 2: This has been going on for closer to four years now, three and a half years.

00:04:12 Speaker 1: Have you gotten to talk to Andre about his son growing up in this? Speaker 1: Or have you actually talked to Spiazalow? Speaker 1: Spiazalow. Speaker 1: Spiazalow. Speaker 1: I need water to say it. Speaker 2: Andre's mentioned how when they have to go in the middle of the night to their shelter Speaker 2: Andre's mentioned how when they have to go in the middle of the night to their shelter

00:04:37 Speaker 2: in the basement of their building, sometimes he gets pretty upset, wondering if he's going Speaker 2: to die. Speaker 2: He is in his early or mid-teens right now. Speaker 2: And obviously he's not the only one. Speaker 2: There are millions of kids in Ukraine doing the same thing. Speaker 2: Growing up like that, I mean, God, you hope kids are resilient enough to overcome that.

00:04:56 Speaker 2: But you got to think that to a certain extent, they never will. Speaker 1: What have you learned about—okay, first, what does—what do people—what surprises

00:05:17 Speaker 1: people the most when you tell them about your experience doing this? Speaker 2: Good question. Speaker 2: What surprises me is the fact that some of them are only peripherally aware that the war

00:05:30 Speaker 2: Ukraine is still going on, which may be understandable if you live in America, where there's always Speaker 2: a 25-hour news cycle when people have very short memories. Speaker 2: And currently, everything seems to be driven by Donald Trump, right? Speaker 2: Everything he does, the left-wing opposes, the right-wing defends, and that's what consumes Speaker 2: 90 percent of the media. Speaker 2: But when you get outside the U.S. or even look at other news sources, not surprisingly, Speaker 2: people in Europe are very much concerned about what's going on. So that's one thing, is how Speaker 2: little it is on the public's radar screen. Another is most people do the kind of thing, Speaker 2: so you know, thank you for going there, it's a great thing you're doing. It's kind of like every

00:06:17 Speaker 2: time you meet someone in the military, you say thank you for your service. But there are some who Speaker 2: genuinely think it's a stupid thing, like why would you do that? You know, you're not accomplishing

00:06:26 Speaker 2: anything. And I try to explain to them why I think it is important to go. Speaker 1: You know, that could be argued about a lot of things. Why do it? Because you're not Speaker 1: accomplishing anything. And any one person doesn't accomplish much on their own, but all

00:06:44 Speaker 1: the one people have to do it to make a difference. Speaker 2: Well, I always remind people of the quote that's attributed to Edmund Burke, and I don't Speaker 2: thing necessary for the triumph of evil is for good men to do nothing. And of course, Speaker 2: that was stated a couple hundred years ago, so you have to update it, it's good men and Speaker 2: women. But that's a perfect example of how if the U.S. had been more aggressive early on, Speaker 2: I've read that a lot of people think Russia could actually have been defeated in 2022. Speaker 2: But we didn't. We kept saying we're not going to do this. We kept gradually raising the stakes and Speaker 2: out so long that we didn't intervene. Speaker 2: And now, as we're recording this, you know that somewhere between 19 or 21 or so drones

00:07:38 Speaker 2: went into Poland, depending on which source you read. Speaker 2: They went into Romanian airspace, the Russian went into Romanian airspace for 12 minutes. Speaker 2: They crossed into Estonian airspace. Speaker 2: I heard just a day or two ago they crossed into Lithuanian airspace. Speaker 2: these drones over airports in Europe and no one's doing anything. Everyone's talking about

00:08:00 Speaker 2: it and everyone's saying, "Oh, this is really bad," but no one just stepped up to stop. Speaker 2: So it doesn't really make a difference, though, for one or two people like Rocco and me to Speaker 2: go over there. Once you've been over there, once you've become friends with them, you realize Speaker 2: how big of an impact it has for them to see that Americans still care and there are people Speaker 2: in the West that still support them and are willing to take the time to go over there and Speaker 2: try to help out and also help publicize what they're doing. Speaker 2: You know, not only in an academic sense about publishing technical neurosurgical articles Speaker 2: about the management of these types of penetrating brain injury and trying to give those talks Speaker 2: at academic meetings, but just to the wider public about the amazing work that's happening

00:08:46 Speaker 2: over there and the incredible injustices that are being done every day. Speaker 1: What do you do to spread the message? Speaker 1: You had that talk at UD.

00:09:00 Speaker 1: How else have you gotten the word out? Speaker 2: Well, I've tried to give talks at pretty much any venue that will listen, Speaker 2: whether it's my own institution, giving departmental grand rounds, Speaker 2: which is kind of the weekly conference that medical departments have, Speaker 2: or at other groups. Speaker 2: Some meetings I normally don't go to, Speaker 2: they're not on my regular calendar, Speaker 2: but if people want you to talk about Ukraine, Speaker 2: I said, yeah, I'm happy to do that. Speaker 2: Various newsletters and things, Speaker 2: they're not so much technically oriented,

00:09:30 Speaker 2: but more kind of sociopolitical publications Speaker 2: for medical journals. Speaker 2: And Rocco is very well positioned. Speaker 2: He knows a couple of reporters from ABC Speaker 2: because he helped take care of Bob Woodruff when he was injured. Speaker 2: So he knows Bob Woodruff pretty well. Speaker 2: And I'm blanking on her name. Speaker 2: Who's their Sunday morning talk host? Speaker 2: Her name is an M. Speaker 2: It's the tip of my tongue. Speaker 2: She's been to Ukraine a couple of times. Speaker 2: She's a friend of Rocco's. Speaker 1: I know who you're talking about. Speaker 1: Yeah, okay, this is embarrassing. Speaker 1: It's okay. Speaker 1: It's okay. Speaker 1: You're fine. Speaker 1: We're not going to play that. Speaker 2: So that's a much, again, Rocco is the ultimate extrovert, so he's pretty well connected in

00:10:19 Speaker 2: those worlds, and he does whatever he can to get the word out, too.

00:10:26 Speaker 1: So let's, let's. Speaker 2: Oh, you had asked me earlier about Andre Sirko, what makes him so remarkable, and I've thought Speaker 2: about that a lot, and somewhere on my list of things to do is to try to write another article Speaker 2: with Rocco that would just talk about something along the lines of leadership under fire and just Speaker 2: try to briefly describe what makes Andres Sirko such a remarkable leader because he's an expert Speaker 2: at his craft, which is neurosurgery, but he's an expert at organization and motivating his team, Speaker 2: very active on social media to try to get the word out there. He's incredibly detail-oriented Speaker 2: and organized and yet unlike a lot of those people he can also turn on a dime Speaker 2: you know when all those plans just fall apart he can roll with it and he's a

00:11:15 Speaker 2: genuinely good person he doesn't yell at people or demean them that's the kind of Speaker 2: thing you could write up for a Harvard Business Review article there's some Speaker 2: management journal or things like that

00:11:27 Speaker 1: when you so when we're just filming a second ago you you were talking about what

00:11:32 Speaker 1: he had been I mean he still is a one of the world's foremost surgeons in but like the Speaker 2: the elective practice yeah like the technical term of neuro oncology which means tumors of the Speaker 2: nervous system so he's been an expert in that for a while and unfortunately he's had to become the Speaker 2: world's expert on penetrating brain injury and the surgical management of it and that's what you do

00:12:00 Speaker 2: as well. Yeah, my main area of interest is neuro trauma and neurocritical care. So that's Speaker 2: right in my wheelhouse. But, you know, I, I, whenever I go there, I probably learn a lot Speaker 2: more than I teach, to be honest. I don't know what it would be like the first time I went. Speaker 2: Because when a lot of neurosurgeons from the West go to other places, it's generally places Speaker 2: with very little neurosurgical presence or infrastructure. Speaker 2: So places like Sub-Saharan Africa or Latin America, Speaker 2: you kind of drop in, do some surgeries, and leave. Speaker 2: But there is very different, Speaker 2: because they have excellent people in Ukraine. Speaker 2: The problem, at least at Medchikov Hospital, Speaker 2: is just the sheer volume is a big challenge.

00:12:47 Speaker 2: They don't have a lot of the resources that we have. Speaker 2: So trying to do high-quality work with tremendous volume, Speaker 2: knowing you have constrained resources is an art. Speaker 2: And he's an expert at that. Speaker 2: So that's why I kind of learned some techniques from him Speaker 2: and bring them back and teach some of my residents.

00:13:07 Speaker 1: So, you know, the statement is, it's not brain surgery. Speaker 1: Is brain surgery really that hard?

00:13:15 Speaker 1: Or-- Speaker 2: The residency is seven years long. Speaker 2: So it may be hard, but if you devote seven years Speaker 1: life to studying it you can pretty much learn almost anything as a surgeon of any kind how does

00:13:31 Speaker 1: it affect your ego uh or at least when you're younger i feel like i'm in a courtroom can you Speaker 1: explain the question please i just mean that like um you have a a life-saving um skill and that's Speaker 1: what you do or a life altering, improving, what you do directly affects people's existence.

00:14:00 Speaker 1: Does that at least when you're younger give you a self-importance or what does it do or

00:14:09 Speaker 1: you never thought of it this way? Speaker 2: From what I've seen, the doctors of any type who think that they're important are probably Speaker 2: not the best doctors. Speaker 2: What you do is you just get so involved in the daily work. Speaker 2: I have a kind of a regular number of young students, college students, so they haven't Speaker 2: gotten their bachelor's degree yet, who are interested in going into medicine or neurosurgery. Speaker 2: And they reach out and ask if they could do some shadowing. Speaker 2: And I say, sure, the hospital has some, you can understand some fairly strict processes Speaker 2: to go through so they can do that. Speaker 2: And I think what amazes them the most is that it's not like TV with all the drama and stuff

00:14:55 Speaker 2: It's like, on one hand, we're doing brain surgery, but that's kind of over here. Speaker 2: It's like, on one hand, we're doing brain surgery, but that's kind of over here. Speaker 2: What the daily life is about is, okay, Mr. Smith, you know, is he ready for surgery? Speaker 2: Has he had his MRI scans? Speaker 2: Is his blood work okay? Speaker 2: Or Mrs. Jones was admitted overnight through the emergency department. Speaker 2: having trouble walking for a few months and this is what they found you know her Speaker 2: spinal cord is being compressed and you start figuring out does she need surgery Speaker 2: what kind of surgery you know you get lost in the details of it and every once Speaker 2: in a while maybe you realize that what we do is pretty cool but you can't run Speaker 2: around thinking how great you are so a great story about that once when I was in Speaker 2: another institution and we were rounding in the morning and the early morning Speaker 2: rounds of people who are in the hospital are kind of explaining to the the crew

00:15:43 Speaker 2: coming out what happened overnight and you know trading off patients and things Speaker 2: like that and they mentioned that there was a nine-year-old kid who had come in Speaker 2: with an epidural hematoma which is a blood clot under the skull but it was Speaker 2: rapidly enlarging and pushing on the brain and kid was going into a coma so they Speaker 2: took him to the OR and operated the kid's doing great and the casket next Speaker 2: one he looked great so we were talking around and the incoming residents said oh Speaker 2: He did a nine-year-old kid. Speaker 2: Yeah. Speaker 2: And he said, that's pretty cool. Speaker 2: And then we moved on. Speaker 2: We had to talk about the next patient. Speaker 1: What's the hardest thing about being a neurosurgeon, being a brain surgeon? Speaker 2: A lot of things we can't help, unfortunately. Speaker 2: I mean, we've made a lot of advances in a lot of areas, but two of the most things that still are very difficult to treat are malignant brain tumors.

00:16:34 Speaker 2: Having to tell families that's what they have. Speaker 2: And then on the other hand, there's the kind of the emergencies of people with really bad Speaker 2: strokes or really bad brain injuries or spinal cord injuries that, despite your best efforts, Speaker 2: unfortunately, you have to give the family some very bad news. Speaker 2: The thing about that, what's interesting, though, is in some ways what's worse than the bad news Speaker 2: is the not knowing. Speaker 2: families or patients are kind of waiting to see whether the biopsy results come back malignant Speaker 2: tumor or not. Or, you know, we just operated on this man, he was in a car wreck, is he going to Speaker 2: wake up and be okay or not? That's the worst, you know, not knowing. I think people can often

00:17:24 Speaker 2: eventually come to grips with some kind of bad news, but twisting in the wind is terrible.

00:17:33 Speaker 1: I just, I can't imagine how hard it is to say there's nothing we can do.

00:17:42 Speaker 2: Yeah, sometimes you have to say that or you say, listen, we did everything we could and it's still not good enough. Speaker 1: So I know in studying for this, that a lot of issues formerly in Ukraine with tumors, etc., is that there had been a lack of testing, so that a lot of the tumors were a lot further along than they needed to be in terms of like if you had the earlier testing and techniques. Speaker 1: Is that still the case? Speaker 1: Is Andre seeing more advanced than you would see in the U.S.?

00:18:23 Speaker 2: That's a great question, but when you're asking about any particular surgeon like Andre, Speaker 2: you've got to realize he has been doing his thing at one institution for a long time, Speaker 2: and he has a very good reputation, very well-deserved. Speaker 2: So the kind of cases he would see might be different than the ones that someone just starting out Speaker 2: or at a smaller place might see. Speaker 2: So that's a great question, and I don't have any direct knowledge of that, but at least from what I've seen, Speaker 2: cases aren't necessarily any further along than they would be in the United States. Speaker 2: I mean, for example, I spend a lot of time at what's called the safety net hospital, you know, county hospital, Speaker 2: where we see a lot of people who have no health insurance, you know, people who may not be in the country legally.

00:19:06 Speaker 2: And, of course, we take care of them, but a lot of them show up with incredibly advanced tumors.

00:19:16 Speaker 1: And I mean, going blind, that kind of thing? Speaker 2: Yeah, going blind or just literally things growing out of people's heads, you know, and Speaker 2: you have to wonder why, what took them so long to decide to come to the hospital? Speaker 2: And the other question is, why'd you come in now? Speaker 2: You've had this going on for a while. Speaker 2: What was it about today or tonight that made you decide to finally come in? Speaker 1: So tell me again what you just called the county hospital. Speaker 2: A safety net hospital? Speaker 2: You ever heard that term before? Speaker 2: It's kind of for people who don't have health insurance or no other place to go. Speaker 2: You can't afford to go to some large private hospital.

00:19:58 Speaker 2: It's a place that's supposed to kind of be there for those who have no other recourse.

00:20:06 Speaker 1: So as if I didn't know, tell me about Ukraine and tell me about what's going on.

00:20:16 Speaker 2: In what sense? Speaker 1: That Russia invaded. Speaker 1: Yeah, so. Speaker 1: So a sovereign nation, you know. Speaker 1: Yeah, Russia. Speaker 1: And just as you're speaking about it, feel it and think about, you know, the meaning of what you're. Speaker 2: So let me ask you for documentary purposes, though, do we want to get this much into the politics of the Russian attack? Speaker 1: It's not really going to be that we get much into the politics. Speaker 1: What I'm really asking you for is when you're telling about this, that you might say something about the nuance of it that fits into it.

00:20:50 Speaker 2: So this terror war actually started in 2014, which a lot of people aren't aware of, with Russia's illegal annexation of Crimea. Speaker 2: when they had what was called little green men, Speaker 2: the people in military uniforms but without any insignia on them, Speaker 2: so you didn't know what country they were coming from. Speaker 2: And I think everybody knew what was going on, Speaker 2: but the West pretty much said, oh, we're not going to do anything Speaker 2: because everyone's afraid of the Russian bear. Speaker 2: So large parts of Ukraine were annexed back then, Speaker 2: and Andrei Sirko and them would see a relatively small number of casualties Speaker 2: is coming up from the constant fighting down in Crimea. Speaker 2: And towards the end of calendar year 2021, in January 2022,

00:21:37 Speaker 2: Russia started building up a lot of troops Speaker 2: on the Ukrainian border. Speaker 2: And pretty much anyone with half a brain Speaker 2: could figure out they were going to attack and invade. Speaker 2: And I still remember these endless discussions Speaker 2: on the news every day about what's going to happen. Speaker 2: And I still remember waking up one morning Speaker 2: And, you know, the day the invasion started on February 22nd, no, I forget the days, February 24th, the year 2022, when they just rolled in. Speaker 2: And everyone said, well, you know, Ukraine is hosed, right, because Russia's got a huge army and Ukraine's going to get rolled over. Speaker 2: And there was that great quote from Ukrainian President Volodymyr Zelenskyy when the West, I think the U.S., kind of offered him, you know, a way out. Speaker 2: He said something along the lines of, "I don't need a ride, I need ammunition."

00:22:26 Speaker 2: And the amazing thing is how ill-prepared the Russian army was and how they had no idea how Speaker 2: to run a war. And the Ukrainians are incredibly resilient and very smart. So they figured out the Speaker 2: Russian generals are using their own cell phones, their own civilian cell phones, not secured military Speaker 2: communications, to communicate with each other. And immediately the Ukraine started killing the Russian Speaker 2: generals. You know, the Russian tanks kind of got stopped in this huge column. I forget if they ran Speaker 2: out of gas or got stuck in the mud or stupid reasons like that. And they were just sitting Speaker 2: ducks for the Ukrainians. And basically, Ukraine repelled a lot of the attack. You know, if you look Speaker 2: at the map of Ukraine, and you can still see roughly 19, maybe 20 percent or so of the country

00:23:11 Speaker 2: in the south and east is still occupied by Russia. But then look at the areas that were Speaker 2: taken over by Russia in 2022, Speaker 2: with then Ukraine captured back, Speaker 2: it's a lot of real estate. Speaker 2: So, Russia being Russia, Speaker 2: the way they seem to always fight their wars Speaker 2: is get their butts kicked early on, Speaker 2: but they just have such a big population. Speaker 2: You know, they can sacrifice people Speaker 2: and keep on fighting. Speaker 2: The war's essentially been in a stalemate Speaker 2: for many, many months now, Speaker 2: if not years. Speaker 2: You know, Russia may advance Speaker 2: a few hundred meters one day, Speaker 2: maybe Ukraine pushes back. Speaker 2: But there's -- it's not going to end any time soon. Speaker 2: And Russia keeps throwing its own people at it, Speaker 2: and now they have North Korea and Cuba Speaker 2: and others sending them soldiers. Speaker 2: And the other thing that's happened, Speaker 2: getting back to Metzhakov Hospital, Speaker 2: is that Dnipro is the biggest city close

00:24:06 Speaker 2: to where the fighting is happening, Speaker 2: to the south and east of Dnipro. Speaker 2: And as a result, a lot of people are evacuating those areas Speaker 2: going up to Dnipro, and in just a year and a half or so that I've been going to Ukraine, Speaker 2: I've noticed that the city seems more crowded. Speaker 2: You know, more traffic, more cars. Speaker 2: Andres Sirko's clinic for his elective patients, you know, the tumors and other things that the Speaker 2: general population has that require neurosurgeons, you know, andeurism, spine disease, all that. Speaker 2: The number of those patients has increased, too. Speaker 2: is not just the unending number of combat casualties, but a larger volume of the non-combat-related Speaker 2: neurosurgical needs, when about 30 percent or more of the workforce in Dnipro and Meshikov

00:24:56 Speaker 2: has left. Speaker 2: You know, some doctors either left Ukraine altogether or went to other parts of the country Speaker 2: or joined the military. Speaker 2: So they have to do a lot more work with a lot fewer people. Speaker 2: It's the same personnel at Metzikov who have been dealing with this increased volume and daily attacks. Speaker 2: While they're working, they're worried about their families getting blown up at home. Speaker 2: They've been doing this literally for 11 years now and counting, since 2014. Speaker 2: And it's especially wrapped up since 2022. Speaker 2: That's very different than what the U.S. has been doing or what the U.S. was doing in Afghanistan and Iraq in which the medical personnel would rotate in and out for a defined period.

00:25:44 Speaker 2: So maybe 12 months or so, plus minus, was the average rotation. Speaker 2: And even though it sucked to be over there, you knew there was an end date for it. Speaker 2: You can go back home. Speaker 2: They don't have that luxury at Medjlyakov Hospital. Speaker 2: They're there for the duration. Speaker 2: there's no other home for them to go to. Speaker 2: So again, that psychological stress is terrible on that, Speaker 2: but you also really get to see their resilience, Speaker 2: their determination, their bravery. Speaker 2: They're fighting even harder, they're not giving up. Speaker 2: And from an academic point of view, Speaker 2: a byproduct of that is they have this Speaker 2: intensive, immersive experience, Speaker 2: and this huge number of combat-related injuries. Speaker 2: So they are the world's experts now in understanding the natural history of the disease and how to treat it.

00:26:34 Speaker 2: And remember, no one else in the world ever has had to fight the kind of war they're fighting. Speaker 2: Because when this war started, it was just another traditional war with tanks on some fields in the eastern part of Europe. Speaker 2: And this is not an artillery or armor fight anymore. Speaker 2: It's a drone war, which no one's ever figured out how to deal with before. Speaker 2: And Ukrainians are the world's leaders in developing drone technology and fighting against Speaker 2: that. Speaker 2: Also, we're learning how to treat the people injured by this new kind of weapon.

00:27:10 Speaker 1: So some of these questions you know I know the answer to, but I assume I don't.

00:27:14 Speaker 1: Well, likewise. Speaker 2: You've heard me say this before. Speaker 1: Of course. Speaker 1: It's always tough telling someone for the second time. Speaker 2: I know a little bit how they gave us. Speaker 2: So are my answers good? Speaker 2: Do I need to be more emotive? Speaker 2: Do I need to be more like Rocco? Speaker 1: - No, you're fine. Speaker 1: No, no, I mean, 'cause, 'cause, Speaker 1: I don't know what we're gonna use from this. Speaker 1: I mean, like, this is just, Speaker 1: this is sort of all a precursor. Speaker 1: So maybe let's think about that. Speaker 1: Let's just, like,

00:27:45 Speaker 1: what is, Speaker 1: what do you feel when you look at the countryside Speaker 1: and, like, maybe tell us about the first time you went Speaker 1: And were you afraid the first time?

00:27:56 Speaker 2: So before I even went, when I got to talking to Rocco about this at this meeting,

00:28:00 Speaker 2: I may have mentioned we're at September of 2023. Speaker 2: And at that time, like every other American, my experience of combat had been people in a desert, right? Speaker 2: Or people living inside the wire and the figured military thing. Speaker 2: I even asked him, are you sleeping in tents somewhere in a cot? Speaker 2: He said, no, this is like fighting in an urban city. Speaker 2: I mean, pick any big city in America and imagine that drones could take it out at any moment. Speaker 2: It's crazy. Speaker 2: It's not like urban warfare or an insurgency. Speaker 2: It's like this is real-life war on your doorstep. Speaker 2: So it was a surprise to me to realize, oh, this is just like going to a country in Europe, Speaker 2: staying at a decent hotel, walking five or ten minutes to a big hospital.

00:28:47 Speaker 2: And the other thing is I was so ignorant about drones Speaker 2: because you heard this is back when drones were kind of first being used. Speaker 2: And back then they would use these cute little quadcopter drones that you see, Speaker 2: you know, that people use when a building inspector comes to your house Speaker 2: and looks at your roof and stuff like that. Speaker 2: And they were using those to drop grenades on troops at the front line. Speaker 2: So I thought I'm going to have to be looking over my head the whole time, Speaker 2: making sure there's going to be no drone. Speaker 2: Of course, that's not going to happen in a big city. Speaker 2: But the drone technology and the drone weaponry has advanced so much since then. Speaker 2: I have a much better understanding about it too since I've been paying more attention and listening to podcasts about this and trying to read more about this. Speaker 2: And again, I had no idea.

00:29:30 Speaker 2: I thought this was going to be like a traditional kind of neurosurgical mission trip when you go to some underserved part of the world. Speaker 2: And all these patients with horrible diseases, they've been kind of lining up for the surgeons from America or from the Western country to operate on. Speaker 2: Now, this is different. Speaker 2: You know, those guys know what they're doing. Speaker 2: And Rocco has the term reciprocal learning. Speaker 2: We learn from each other. Speaker 2: He also calls it a cultural exchange. Speaker 2: We learn how they take care of patients, and we teach them how we do it. Speaker 2: As a spin-off of that, the ICU people especially had a lot of questions about how we do this. Speaker 2: So we set up a monthly neurocritical care conference with them for that same purpose.

00:30:12 Speaker 2: We alternate months, one month we present cases, one month they do. Speaker 1: Let's hold for a second while he repositions. Speaker 1: And you've cut here. Speaker 2: Are you sure you've got enough light? Speaker 2: Because I'm looking at this little thing. Speaker 1: It's starting to get dark in here. Speaker 2: I mean, you want to do an overhead light? Speaker 1: No, because it will match. Speaker 1: Yeah. Speaker 2: Should I lean forward a little bit? Speaker 2: Should I lean forward a little bit? Speaker 2: No, that doesn't look good either. Speaker 1: You scoot a little bit towards the one. Speaker 1: Hey, there you go. Speaker 1: Anything you want to change about this, Logan? Speaker 1: For a... Speaker 1: Go. Speaker 1: Focus.

00:00:00 Speaker 1: uh swap this car going back in a minute

00:00:00 Speaker 1: uh swap this car going back in a minute Speaker 1: so yeah are kind of approaching towards the end of our light here choice of a new generation Speaker 2: pepsi zero sucro no sugar Speaker 1: i was too busy losing my lens filter uh it's funny because it's the it's the one filter we're going to Speaker 1: use on this camera, I have two of them, so luckily it does this anamorphic thing which Speaker 1: basically just squeezes the image so you get more information on the side. Speaker 1: Anyway, it provides it this intriguing look that sort of makes up for the fact that it's,

00:00:49 Speaker 1: This, by the way, we're not necessarily going to even use. Speaker 1: I'm just getting it because it's literally synced up to your mic.

00:01:00 Speaker 2: So I'm starting to understand. Speaker 2: Is this part of why post-production is so expensive? Speaker 2: You have to take all these different kind of live streams of info and sync them perfectly?

00:01:08 Speaker 1: Right, yeah, exactly. Speaker 1: And so that's why what I was doing last night was a big thing, Speaker 1: getting the sync boxes because you can it's so much easier when you have matching time code yeah Speaker 1: yeah yeah and so like to match it precisely you there are different techniques but you know like Speaker 1: that's that's that's why you know that they use the slate right the clapper board if you you've Speaker 1: seen that like in a film before you know yeah yeah so that's that's just matching you know Speaker 1: primarily usually one camera and one piece of sound but uh and I mean the other thing is is that Speaker 1: like you can do this and and have it all you know lined up uh perfectly at the same time but that

00:02:03 Speaker 1: takes a lot of money because you gotta have all kinds of gear so it's all going into one you know Speaker 1: yeah one unit so but then like just think about like we're sitting here Speaker 1: rolling on this this this journey is gonna be very brief in the film right and Speaker 1: so they like the the job of the editor is then you know and the post people is to

00:02:30 Speaker 1: you know watch all of this and and I'll watch a lot of it but you know they they Speaker 1: they certainly they'll go through it all and they will eventually leave that door Speaker 1: open or close

00:02:52 Speaker 1: So like the Titanic film, they shot more hours of footage than the journey lasted. Speaker 2: Oh, look at more yellow leaves here and brown leaves.

00:03:13 Speaker 2: Different part of the country. Speaker 1: We're going to do leap peeping. Speaker 1: This is now a leap peeping tour. Speaker 2: Well, it's amazing that...

00:03:30 Speaker 1: When I... Speaker 1: I can deal with sleep deprivation these days much better than I used to be able to. Speaker 1: The one place where it comes into play is my eyesight. Speaker 1: It's... Speaker 1: You know, and then my brain plays tricks. Speaker 2: Okay, you're good like that, Lou? Speaker 1: Yeah, I'm good for... Speaker 2: So what were we talking about? Speaker 1: I don't know, but the leaves are changing. Speaker 1: Just mention that. Speaker 2: You asked me earlier

00:04:00 Speaker 2: about the thoughts on Ukraine. Speaker 2: Here's a really nice countryside. Speaker 2: What's interesting is Speaker 2: that as we're riding along here, I noticed Speaker 2: that these leaves in this part of the country are already Speaker 2: further along in the autumn process Speaker 2: here. There are more yellows and oranges Speaker 2: and browns than there were just a little while ago. Speaker 2: But it's Speaker 2: a beautiful country. It really is.

00:04:22 Speaker 1: And that is actually why, or part of why, it's been in such an important sort of region

00:04:29 Speaker 1: over the centuries of the thousands of years of mankind being in the European area. Speaker 2: So it sounds pretty stupid to say that we are lucky in America because we're protected Speaker 2: by two oceans. Speaker 2: You know, if you grow up in the United States, you live there your whole life, you don't even Speaker 2: think about being attacked or invaded. Speaker 2: But when you're actually physically here, almost anywhere in Europe, but especially kind of in Eastern Europe like this, Speaker 2: you really realize that there's nothing stopping any invading army or invading horde of barbarians throughout history Speaker 2: coming from any direction, north, south, east, or west. Speaker 2: Just a big flat plain. There's no natural barriers.

00:05:11 Speaker 2: And it makes you realize how vulnerable these people are. Speaker 1: But isn't this a center for agriculture? Speaker 1: Oh yeah. Speaker 2: Yeah, Ukraine is one of the world's bread baskets, right? Speaker 2: That was a big problem. Speaker 2: All the wheat they need to export through the Black Sea was under threat for a while. Speaker 2: And if that's under threat, then a lot of people in the world go hungry in Africa and other places.

00:05:34 Speaker 1: So when did you tell me again when you got your Lithuanian citizenship?

00:05:38 Speaker 2: I think it was a couple of years, late 2022, early 2023.

00:05:45 Speaker 1: And when did you go to? Speaker 2: June of 2023, just a couple of months before I talked to Rocco about this. Speaker 2: So I was kind of preconditioned to come for a couple of reasons. Speaker 2: We talked about my wife and her volunteering with the Red Cross, which I've always thought was cool. Speaker 2: Then we talked about the fact that I'd kind of seen the former KGB headquarters and, you know, Speaker 2: walked the places where they executed people there. Speaker 2: So those were swirling around the back of my head. Speaker 2: But then I bet this guy who had been to Eastern Ukraine and trying to help there, I said, Speaker 2: I can do that too. Speaker 2: Why can't I? Speaker 2: My children are grown and they've left the house. Speaker 2: We're empty nesters. Speaker 2: It's a perfect timing.

00:06:30 Speaker 1: Are you excited to be heading back? Speaker 2: I am because we talked earlier about some of the reasons to do this. Speaker 2: because it's trying to help defend a free democratic state against a tyrannical state's invasion Speaker 2: and a more fundamental, no just good versus evil. Speaker 2: But that was personal because they're my friends, Speaker 2: and they're my friends who are going through some hard times. Speaker 2: And so the first time I went was just kind of get the lay of the land, right? Speaker 2: Then I thought, how can I up my game for my second visit? Speaker 2: So I spent more time in the ICU because I'm actually certified in neurocritical care as well, Speaker 2: and I have a lot of interest in that part of the hospital.

00:07:18 Speaker 2: And then my third visit, I actually spent a few nights taking call in the hospital at night. Speaker 2: And I kept thinking, how am I going to up things for my next visit? Speaker 2: And I realized I don't have to because just by showing up, it is such a big shot in the arm for them. Speaker 2: You bring little gifts as a sort of a gesture of friendship, but it's not because of the gifts or anything like that. Speaker 2: It's just seeing someone from America who's willing to make the journey. Speaker 2: And sure, there's some risk there, obviously. Speaker 2: But I'm surprised that more people from America aren't going all the way to eastern Ukraine to Medchikov Hospital. Speaker 2: If you're interested in trauma, this is the institution that's leading the development of trauma for future conflicts.

00:08:07 Speaker 2: And those lessons, of course, translate immediately to civilian trauma care. Speaker 1: But I mean, like, so you're topicing a double-edged sword. Speaker 1: On one side, you want to tell people that, like, hey, the war's still going on. Speaker 1: But no, you can go near it. Speaker 1: So it's sort of a tough thing, right? Speaker 1: So it's sort of a tough thing, right? Speaker 1: You know, because you both want to, like, say people to be aware, but also, like...

00:08:34 Speaker 2: Well, you're right, but we're not going to the front line, right? Speaker 2: The front line is a disaster. Speaker 2: There's no longer a front line in a traditional sense. Speaker 2: It's kind of this long gray zone, and it's hard to tell who's in charge of different pieces of land. Speaker 2: This thing can be kilometers in thickness. Speaker 2: You know, it's not just a thin line on a map. Speaker 2: But we're not going anyplace over there. Speaker 2: We're going to a large city that has a good missile defense system. Speaker 2: And especially the area near the hospital is particularly well defended. Speaker 2: The place we're staying at and the hospital itself, they have shelters in the basement. Speaker 2: So there's usually enough of an advanced notice. Speaker 2: If something really bad is happening, you can get to the shelter. Speaker 2: But it's unlikely because all the defenses are on the hospital.

00:09:20 Speaker 2: So, yeah, the risk is not zero. Speaker 2: But if you're an infectious disease doctor and you're interested in Ebola and you go to Africa to study Ebola, there's a risk there.

00:09:30 Speaker 2: Or maybe malaria might be a better example. Speaker 2: You want to go to a place where there's malaria so you can study it, you might catch malaria, but you can kind of put up with certain risks.

00:09:42 Speaker 2: You're a long-haul truck driver, you can get in an accident, fall asleep behind the wheel.

00:09:46 Speaker 1: There's a risk crossing the street. Speaker 2: Yeah. Speaker 1: What about brain surgery or neurosurgery? How did you end up in your journey? When did you know that this is what you wanted to do? Speaker 2: Yeah, that's a good question. I know some people don't make up their minds till late, but it was always something I was very interested in. Speaker 2: So for me, medical school was more looking at other specialties to make sure I wasn't missing anything. Speaker 2: Neurosurgery was always my number one thing, but let's look twice at this or that to make sure maybe there's not something else I'd rather do. Speaker 2: Because I know a couple of classmates of mine who are dead set on surgery.

00:10:31 Speaker 2: And they had this revelation in second or third year of med school that they really don't want to go into surgery. Speaker 2: So they went into other fields. Speaker 2: I developed pretty early on an interest in neurotrauma and neurocritical care. Speaker 2: And when I was talking to my advisor in medical school about that interest, he's the one who Speaker 2: recommended me, recommended that I, you know, where I should do my residency for places that

00:10:56 Speaker 2: are strong in that.

00:11:00 Speaker 1: I'm struck by the statement you just made earlier, like, we're going to a city with a strong missile Speaker 1: defense, whatever you said. Speaker 1: And it's just like, that's just not something we have to think about in the U.S., you know? Speaker 1: And it's just like, that's just not something we have to think about in the U.S., you know?

00:11:17 Speaker 2: Yeah, I think it would be, well, obviously I'm biased, but yeah, I think we've become Speaker 2: too insular in the United States with this breathless reporting. Speaker 2: I mean, I love when the fact that you have some news story that's maybe 18, 25 years old Speaker 2: and have like a live reporter, you know, who's in some other part of the world. Speaker 2: So they're awake at 3 a.m. local time or something talking to the evening news in the United States. Speaker 2: You don't need a live reporter there. Speaker 2: You know, you always see a reporter standing out in the middle of a hurricane. Speaker 2: Broadcasting about the hurricane. Speaker 2: You know, we don't need this kind of stuff like that. Speaker 2: I think if we take a step back and think about what's really important, Speaker 2: I mean, this conflict going on has redefined how war is going to be fought forevermore.

00:12:00 Speaker 2: The future of Europe is at stake, and if Europe's affected, it's certainly going to affect the U.S. Speaker 2: People in the U.S. may not want to think that way, but it will. Speaker 2: It'll affect the rest of the world as well.

00:12:14 Speaker 1: How much do you think about the people that you couldn't save or couldn't, whether not operating at all or operating and it wasn't successful?

00:12:25 Speaker 1: How much does that stay with you? Speaker 2: Sometimes.

00:12:30 Speaker 2: Sometimes you think about it at random moments, Speaker 2: or sometimes when you see a patient who shows up Speaker 2: with the same kind of injury or same kind of disease or illness Speaker 2: that a patient whom you treated had, Speaker 2: and the one you treated didn't do well. Speaker 2: You know, you think, oh, OK, I remember this Speaker 2: because this patient over here had this and didn't do well. Speaker 2: You just try to do your best to make sure it doesn't happen again. Speaker 2: You know, the best surgeons I know, and I work a lot with residents,

00:13:00 Speaker 2: especially the upper-level residents who are going to be independently in practice in a year or two. Speaker 2: And if they're involved in a case that doesn't go well, choose them up sometimes. Speaker 2: And I know they're going to be the best ones. Speaker 2: You know, you have to have several conversations with them and reassure them that you didn't do anything wrong. Speaker 2: Or, God forbid, they didn't make a mistake. Speaker 2: They learn from it. Speaker 2: And you sit down with them and make sure they understand it won't happen again, and usually Speaker 2: they're well aware of that. Speaker 2: Usually if, you know, most lines of work, if like 99% is pretty good, you're happy with Speaker 2: that. Speaker 2: The problem is that 1% isn't good, and that's not good enough if you're in the medical field,

00:13:42 Speaker 2: especially the surgical field. Speaker 1: When you see something similar, are you frightened or excited about the opportunity to do something

00:13:54 Speaker 1: different or is it a little bit of both? Speaker 2: I don't think there's any—there's not that kind of emotion involved.

00:14:00 Speaker 2: It's more like problem solving. Speaker 2: It's like, "Okay, we need to approach this tumor this way or approach this spine problem Speaker 2: this way," and you're thinking about this other patient who had a complication or didn't Speaker 2: do well. Speaker 2: You'll learn from your mistakes, but hopefully you'll learn more from other people's mistakes

00:14:17 Speaker 2: that you've read about or discussed at conferences, so you don't have to repeat those same mistakes.

00:14:25 Speaker 1: Tell me about Metrotop at night. Speaker 2: It can be pretty variable, but on any one day, just Andres Sirko alone, Speaker 2: we'll get one to eight cases of penetrating traumatic brain injury, Speaker 2: which, again, that means that someone has had usually shrapnel. Speaker 2: In the United States, when you talk about penetrating brain injury, Speaker 2: it's usually a gunshot wound to the head. Speaker 2: But in war, it's usually shrapnel from explosions, Speaker 2: so a piece of metal or brick or pavement or whatever is in someone's head.

00:15:00 Speaker 2: So they do anywhere from one to eight of those cases, Speaker 2: an average of about three per day, just for that disease entity alone. Speaker 2: Not to mention the other types of injury or trauma, and then not to mention all the other surgeries they do for brain tumors and carotid artery disease and spine disease and all the other branches of neurosurgery.

00:15:20 Speaker 2: They can be pretty busy at night.

00:15:24 Speaker 1: And that's when the people are brought in from the front. Speaker 2: Yeah, generally, we talked about how the so-called rules of war got thrown out the window. Speaker 2: It used to be a pretty sacred thing not to attack a medical facility, right? Speaker 2: Because theoretically, those doctors and nurses, health care workers, Speaker 2: could be taking care of one of your side's injured soldiers as well as the enemy's injured soldiers. Speaker 2: But that's unfortunately a very naive way to look at things now, Speaker 2: which shocked me when I started looking at this. Speaker 2: So, of course, ambulances with the big medical symbol on them that used to mean off limits. Speaker 2: No, now they're targets for the Russian drones. Speaker 2: They'll go after them. Speaker 2: And Ukraine, they have these kind of stabilization centers,

00:16:12 Speaker 2: which are usually the first place an injured soldier or civilian may get to Speaker 2: as they're trying to get them stabilized and move them further away from the line. Speaker 2: But, again, those have become targets now. Speaker 2: So, you know, I've been reading how a lot of those are now kind of being hidden

00:16:30 Speaker 2: or placed underground or not advertised as such. Speaker 2: You know, that medical symbol used to be kind of like a garlic for a vampire. Speaker 2: You know, it keeps away the drones and things. Speaker 2: Now it's a magnet, unfortunately.

00:16:46 Speaker 1: So we were there when Andre talked about this, but as if we weren't.

00:16:51 Speaker 1: Tell me about Andre talking about his surname and talking about Ivan Sirko. Speaker 2: You know, you'll have to talk to him more about that.

00:17:00 Speaker 2: Ivan Ivan Sirko was a great Cossack leader. Speaker 2: I don't know, was he a general, a military leader? Speaker 2: And, yeah, Andres descended from him. Speaker 2: So if you talk about the tradition of service running in his family, Speaker 2: it doesn't get much better than that, Speaker 2: as witnessed by the fact that his older son is a neurosurgeon. Speaker 2: He has finished training and starting his career. Speaker 2: His younger son still has a ways to go in his education, of course, Speaker 2: but even he is leading more towards the medical field. Speaker 2: Last time I talked to him, he was thinking more about trauma surgery. Speaker 2: I think because of part of the older son's training, Speaker 2: he had done a stint that's kind of like a little different than in the United States,

00:17:45 Speaker 2: but like a neurosurgery who could also do stuff on the other part of the body. Speaker 2: So I think the younger son was kind of thinking about that model. Speaker 2: But knowing Andre, I think that by the time his younger son is finished his school, Speaker 2: the younger son will be a neurosurgeon, too. Speaker 2: So there's very strong family traditions dating all the way back to Ivan Sirko.

00:18:05 Speaker 1: Wow, I didn't pick up that he was descended from him.

00:18:09 Speaker 1: I picked up like how, you know, he was a legendary figure.

00:18:13 Speaker 2: No, I thought he's a descendant of him. Speaker 1: Oh, well, you mean. Speaker 2: Yeah, we can clarify when we're there. Speaker 1: But I just for being he was just talking about how I Speaker 1: Having a name that he had to live up to like because he because he is named Sirko Speaker 1: He can't leave people look to him as you know for for the strength that the Sirko name carries

00:18:38 Speaker 1: That's a very strong thing you know that I took from it Speaker 2: You're exactly right. Yeah, it's not only his his own personal leadership, but he

00:18:47 Speaker 2: Again, unlike in the United States, these people do think back to prior generations and their family heritage. Speaker 1: Talk to me about...

00:19:02 Speaker 1: ...action. Speaker 2: So I got to tell you that my ancestors come from Northern Europe. Speaker 2: So we tend to be a little more stoic and not that emotive. Speaker 2: Kind of like the Ukrainians, you know, it struck me in clinic. Speaker 2: I mean, I'd have these conversations with patients. Speaker 2: You have them very bad news, and they're very stoic about it. Speaker 2: At least there. Speaker 2: I'm sure when they go home, it chews them up. Speaker 2: Yeah, I'm just not as passionate as someone from the southern part of Europe. Speaker 2: You know, you're Greeks or Italians, people like Rocco, Speaker 2: who are much more passionate and articulate about these things. Speaker 2: But we still have the same drive, no question.

00:19:48 Speaker 2: We may express it different ways, but Andre Rocco and I have formed this team, alliance, brotherhood, Speaker 2: where we're talking every day on WhatsApp, and we're all very different, which makes us a better team. Speaker 2: We all have different strengths that complement each other's weaknesses, different styles.

00:20:07 Speaker 2: But we're all united by this idea about trying to help Andrade do the best possible job he can to take care of these horrible casualties that he gets every day and try to educate the rest of the world what's happening in Ukraine.

00:20:26 Speaker 1: Describe being driven, have that drive. Speaker 2: You know, it's funny. Speaker 2: You asked me to describe that. Speaker 2: You asked me to describe, like, why do I go? Speaker 2: It's just something I do. Speaker 2: I mean, my wife has given up on me because, you know, I pretty much don't have any hobbies. Speaker 2: You're trying to work all the time. Speaker 2: You know, even on this trip, knowing that we wouldn't have very good internet, trying to Speaker 2: line up the work and things to do on this long train ride, it wouldn't require internet. Speaker 2: So it just--well, I will say this, though.

00:21:00 Speaker 2: You know, they used to call people workaholics, which you don't hear much anymore. Speaker 2: But the idea about working all the time, and I've been blessed in my career to hold a lot of leadership positions Speaker 2: and organize neurosurgery and be able to give back to the specialty a lot in that way. Speaker 2: But I think that what I'm doing here now in Ukraine, it's a whole order of magnitude bigger. Speaker 2: And not to disparage any of the other, you know, Speaker 2: community work leadership things I've done or the people who are currently doing those things, Speaker 2: because it's important, but we're talking about a war here. Speaker 2: I mean, literally. Speaker 2: You know, it's not just committee meetings and trying to reconfigure organizations Speaker 2: and things like that. Speaker 2: And even trying to improve the way the specialty is practiced in the United States. Speaker 2: This is like life and death for a lot of people.

00:21:51 Speaker 2: So the whole workaholic drive thing, just the innate desire to keep working, Speaker 2: I think is important, but we all know people who work all the time and they're busy counting

00:22:00 Speaker 2: their paper clips and rearranging the rubber bands and things like that. Speaker 2: Think about big picture. Speaker 2: What can you do to maybe have a larger impact? Speaker 2: I keep going back to my wife. Speaker 2: She didn't have to volunteer for the Red Cross. Speaker 2: Just one day years ago, she said she's going to do that, and she stuck with it.

00:22:18 Speaker 2: I think that's very commendable. Speaker 1: It's interesting.

00:22:28 Speaker 1: What I call passion, you call drive.

00:22:30 Speaker 2: Yeah. Speaker 2: It's funny because I think of myself as actually being a very passionate, driven, hardworking person. Speaker 2: And yet one of these young students I know, they're still in college, who are shattering me, Speaker 2: she said, "Dr. Black, are you always so calm?" Speaker 2: And that struck me. Speaker 2: I guess maybe on the outside people think I'm calm, but I don't think of myself being away on the inside.

00:22:55 Speaker 1: Logan, before we lose light completely, are there some topics that you think we should hit in this?

00:23:05 Speaker 1: You know, yeah, I was starting to think that. I mean, I think we got a bunch of stuff. Speaker 3: I know. I wonder if maybe, you know, maybe we should tee up kind of like just in layman's terms,

00:23:17 Speaker 3: like the train from Warsaw, you know, in a few succinct kind of pieces. Speaker 1: Oh, that's a good idea. Speaker 1: It's like, what are we doing here? Speaker 1: Where are we going? Speaker 1: Yeah. Speaker 1: Where are we going through? Speaker 1: You know, yes. Speaker 2: That's a good idea. Speaker 2: That's a good idea. Speaker 1: Let him get a little set. Speaker 3: Yeah, because I'd love to shoot some out the window and some other stuff. Speaker 1: I was going to say if there's anything like we want to get with Alex. Speaker 1: I was going to say if there's anything like we want to get with Alex. Speaker 1: Oh, yeah, it'd probably be nice to get some like stoic Alex. Speaker 1: Right. Speaker 1: Yeah, exactly. Or even walking around the train, but also just sitting.

00:23:50 Speaker 1: Yeah. Speaker 2: Okay, so welcome to the Ukrainian train. Speaker 2: We are on our way to Dnipro, which is in central Ukraine, Speaker 2: but in terms of where the front line is, it's only an hour from the front line. Speaker 2: So to get here, I live in Dallas, and I try to be as efficient as I can with my travel Speaker 2: to minimize the time I'm away from work. Speaker 2: So the cycle I've gotten into is leave Dallas on a Thursday evening, Speaker 2: connect somewhere in Western Europe like London or Frankfurt, Speaker 2: and get into Warsaw, spend the night there, which is Friday night.

00:24:30 Speaker 2: Then Saturday morning, catch a 6.40 a.m. train from Warsaw to the Polish border. Speaker 2: That ride is about two hours, 45 minutes or something like that. Speaker 2: And then an hour later, Ketutraña leaves from Helm, the border town, and goes all the way to Dnipro, which will get us in at Sunday morning. Speaker 2: So if you leave U.S. Central time, Thursday night, you get in Sunday morning, you lose eight hours with the time zone change. Speaker 2: I know some people take even longer routes, but this is, trust me, I spent a lot of time on Google trying to figure this out. Speaker 2: This is the most time efficient way. Speaker 2: So when I am out of Dallas on these trips, I'm out of Dallas for 10 nights.

00:25:15 Speaker 2: Only five of those nights are actually spent sleeping in Dnipro. Speaker 2: The other five are spent sleeping on planes or trains or airport hotels in Warsaw

00:25:26 Speaker 2: or hotels by the train station.

00:25:30 Speaker 3: Is it worth it? Speaker 2: Absolutely. Speaker 2: Yeah, I think what's happening over there is incredibly overlooked in the West. Speaker 2: It's so important, I think, to support the incredibly brave, resilient people over there Speaker 2: and the work that they're doing. Speaker 2: It's important to learn from them. Speaker 2: We've published several articles in the medical literature with many more in the works on how Speaker 2: to take care of these patients. Speaker 2: But more importantly, just to not only deal with the medical audience, but the audience Speaker 2: at large. Speaker 2: I mean, people are always really curious about why I go over there, and it's something that Speaker 2: they never thought anybody would do. Speaker 2: So explain to them what it's like, why the war is important. Speaker 2: And maybe the best thing of all now is it's, well, most important thing I should say,

00:26:16 Speaker 2: is that it's personal for me now because I'm friends with these people there. Speaker 2: And we've operated on tough cases together. Speaker 2: We've done CPR together in the ICU. Speaker 2: We've taken care of patients in the ICU who are critically ill.

00:26:30 Speaker 2: I'm very, very concerned about them and want to do whatever I can to support them. Speaker 2: And making the effort going all this way, all this time and money and effort to get there Speaker 2: and just show support for them is a huge morale booster for them. Speaker 2: Because some of them have been doing this, most of them have been doing this for the entire Speaker 2: 10 years of the war, even though significant percentage of their colleagues have left, Speaker 2: and even though they don't get a break. Speaker 2: So I think it's absolutely worth it.

00:27:00 Speaker 2: This is why I spent my vacation time doing this.

00:27:04 Speaker 1: I mean, I can't imagine, like, from what you do and get out of it, I can't imagine a better way to spend your vacation time. Speaker 2: Seriously. I mean, you have to be careful not to involve my employer in any of this. Speaker 2: So I take vacation time, I pay my own travel. Speaker 2: You have to buy your own health insurance here in Ukraine because the policies I have at home don't cover us in a war zone, apparently. Speaker 2: So all these things kind of insulate my employer. Speaker 2: So I do this on my own time and on my own dollar. Speaker 2: and no second thoughts at all. Speaker 2: I just wish I could do more.

00:27:39 Speaker 1: I think that's probably a good way to end our conversation. Speaker 1: Okay, and so Alex, Logan, what do you want to get with?

00:27:53 Speaker 1: He'll direct you here for a second. Speaker 3: I definitely want to walk around the train too a little bit.

00:28:00 Speaker 3: I'm going to go to the corner here. Speaker 3: Maybe we can just start looking out the window for a minute. Speaker 2: Looking profound and thoughtful? Speaker 3: Yeah, thinking about you, Grant. Speaker 3: Yeah, you're good. Speaker 3: You're fine. Speaker 1: Is that recording? Speaker 1: It's just out here. Speaker 1: It's just out here. Speaker 1: A little up. Speaker 1: A little up. Speaker 1: Oh, there you go. Speaker 1: Oh, there you go. Speaker 1: Oh, at least it was in the camera. Speaker 3: All right. Speaker 3: All right. Speaker 2: You got the wire in front? Speaker 3: I was actually pulling away. Speaker 3: I'm going to have you sit in the corner. Speaker 2: Oh, all the way in the corner.

00:28:30 Speaker 2: Okay. Speaker 2: You know, Dad, before we, we'd spend a long time making sure we don't lose all our things.

00:28:39 Speaker 2: You and I have things scattered all over the place here. Speaker 1: Yeah. Speaker 1: We'll make sure we…

00:28:47 Speaker 2: Are you sure this looks good? Speaker 2: I feel like I'm getting claustrophobic when I look up. Speaker 1: Do you not normally have it down like that? Speaker 2: No, usually it's down, but usually I'm not sitting. Speaker 2: Usually I sit like this when I work it, but I don't lean back.

00:29:00 Speaker 1: it's a different experience. I mean you can also do some work or what not. Speaker 2: Okay, yeah definitely. Okay, well that's... yeah.

00:29:11 Speaker 2: Are you going to complain about the internet? Speaker 1: I should check your mic. Can you just open your shirt so I can see if the light's still on? Speaker 1: Yeah, red light? Speaker 1: Yeah, good, right. Speaker 2: Alright, where's my mouse? Speaker 1: Logan, should I just roll from here? Speaker 1: There. Speaker 1: There.

00:29:41 Speaker 2: Alright, so we're good right here? Speaker 3: Yeah. Speaker 3: See what you're excited about that? Speaker 2: Yeah, let's see. Speaker 2: Okay. Speaker 2: We have, actually we have Wi-Fi for a few seconds, I think.

00:29:53 Speaker 2: Let me check. Speaker 2: Oh yeah, look at that, Wi-Fi. Speaker 2: Some of these messages sent real quick.

00:30:10 Speaker 2: So should I be talking about this or is there going to be a silent part where I'm just playing with the computer? Speaker 1: How about you just feel it out? Speaker 1: Just do your work and comment if you feel...

00:30:23 Speaker 2: Okay.

00:00:00 Speaker 1: Don't look at it and say I'll get back to it.

00:00:00 Speaker 1: Don't look at it and say I'll get back to it. Speaker 1: Just try to get rid of it right away. Speaker 1: But that's the right. Speaker 1: Like I said, I got some things I can do just on word here. Speaker 1: Matter of fact, one of the things I need to do is another draft of an article we've been working on with Andre. Speaker 1: And he just sent it back to me, so I need to kind of start working on that one too. Speaker 1: That's my next project. Speaker 1: That's focusing on his series of penetrating injuries to the lateral skull base, you know, Speaker 1: kind of in this area here. Speaker 1: He and Rocco published one on the anterior skull base before I got involved. Speaker 1: And the numbers that Andre has seen from this just dwarf anything else that's ever been published.

00:00:48 Speaker 1: Yeah, here it is. Speaker 1: And unfortunately, I should say sadly, Andre has some incredible illustrations of how horrible Speaker 1: these injuries are. Speaker 1: And I was smart enough to download this onto my hard drive before I left. Speaker 1: The new internet would be sketchy here.

00:01:31 Speaker 1: Do you want me to stare out the window periodically and think deep thoughts? Speaker 2: You do whatever feels. Speaker 2: Alright.

00:01:44 Speaker 2: Clutter here. Speaker 1: Yeah, we're very cluttered.

00:03:04 Speaker 1: Did the Polish train seem a little less rocky to you than this one?

00:03:09 Speaker 2: Yeah, this one is getting increasingly... Speaker 1: Yeah, I've noticed that too, how smooth the Polish train was.

00:03:18 Speaker 1: Yeah, I'm trying to do some cutting and pasting here.

00:04:09 Speaker 3: I need to hear those bottles. Speaker 3: Oh, yeah, thank you. Speaker 1: Yeah, all the food and stuff here. Speaker 3: No, you're fine. This one is these that we didn't want to see. Speaker 3: More? Speaker 3: I think we're good.

00:05:08 Speaker 3: Thank you.

00:05:29 Speaker 2: Yeah. Speaker 3: You want to give me a try? Speaker 3: Alex, we're going to try and get your reflection on the computer screen as you're working. Speaker 3: Alex, we're going to try and get your reflection on the computer screen as you're working.

00:05:52 Speaker 3: What you can do is just kind of rotate the screen until you see the camera. Speaker 2: That's the easiest way of... Speaker 2: It's a pretty aggressive sheet.

00:06:02 Speaker 1: I can't even see the reflection at all. Speaker 1: I have one of those polarized screen protectors. Speaker 2: Yeah. Speaker 3: Well, then we can find you. Speaker 3: Yeah.

00:06:17 Speaker 2: Oh, that was close. Speaker 2: I don't know if I can get it because he's got the polarizer.

00:06:24 Speaker 3: Yeah, I have to keep going back to the window. Yeah, no worry. Sorry about that. No, don't don't don't don't sweat it Speaker 3: You know, we can do is Speaker 3: At some point you can look on your phone Speaker 1: Unless you have a full right here on your phone. No, okay

00:06:43 Speaker 3: I mean Speaker 1: So let's see actually I just got a text from my daughter

00:06:56 Speaker 1: Can you see that? Speaker 2: No, I didn't. Speaker 1: Is this good for you? Speaker 2: Uh, sorry, once I got a battery here.

00:07:07 Speaker 3: Yeah. Speaker 3: Well, we would like to see you getting the text from your daughter and responding.

00:07:13 Speaker 3: I think that's a good one. Speaker 1: Ha, okay. Speaker 3: Good moment. Speaker 3: One second.

00:07:51 Speaker 1: Oh, actually, maybe, uh, oh, Andre sent a bunch of stuff, too, on WhatsApp. Speaker 3: Alright. Speaker 3: We can get some of that.

00:08:12 Speaker 2: Do I close, or...? Speaker 1: So Andre just sent some stuff on WhatsApp. Speaker 1: So can you see this now? Speaker 2: One second, real quick here. Speaker 2: And go for it, I can see it. Speaker 1: Oh, this is from Terry. Speaker 1: I don't know how do I have to say. Speaker 1: I don't know how do I have to say. Speaker 1: So this is Kiev after Russia's attacks overnight. Speaker 1: Oh, lost internet.

00:09:03 Speaker 1: And this is... Speaker 1: Yeah, not too far from Nitro, got attacked.

00:09:09 Speaker 3: Is that it's not there? Speaker 2: No, no, that one's... Speaker 1: That's what? Speaker 2: Did you leave it back here? Speaker 1: What are you looking for? Speaker 2: The little bag thing that I was resting the camera on.

00:09:21 Speaker 2: Vanished. Sorry. Speaker 1: Uh, it's not back here? Speaker 2: No, no, it says your backpack. Speaker 1: Oh, man, look at all this stuff here.

00:09:38 Speaker 1: So the fixtures name is Anastasia? Speaker 2: Yes. Speaker 2: She's from Newport.

00:09:52 Speaker 2: You said we lost internet? Speaker 1: Let's try again. Look at some of those videos. Speaker 1: Oops. Speaker 1: Oh, this might take a long time to download. Speaker 1: Yeah, unfortunately. Speaker 1: they kill my VPN.

00:10:14 Speaker 1: Maybe this will help. Speaker 2: You just saw him? Oh, here he is.

00:10:42 Speaker 1: Russia, there's another attack in Nitro-Petrovsk.

00:10:49 Speaker 1: This is all the fire you can see there a huge column of smoke in the city.

00:11:00 Speaker 3: Now do me a favor. Keep doing that.

00:11:06 Speaker 3: Now try and see me in the reflection of the phone.

00:11:11 Speaker 1: I'm not seeing that that well. Speaker 3: well unfortunately. It's okay. I got where you're looking at. Speaker 1: Let's see. Where are you? Yeah, I can't see that far. Speaker 3: Can you see your face? Yeah. And then tilt it a little this way. I can't see either. Speaker 3: So it's like a little good. How's that? Speaker 3: Can you see the screen? Yeah, the screen looks great. Speaker 3: That's terrible. Yeah, it is.

00:11:49 Speaker 1: Here's the path of the missile strike. Speaker 1: About 150 kilometers from Russian territory to there.

00:11:59 Speaker 1: Nipro is right there. Speaker 3: Point it out again.

00:12:07 Speaker 1: So this is the Russian territory here to this city, about 150 kilometers. Speaker 1: And here's Dnipro at the top right. Speaker 1: So not too far from Dnipro. Speaker 1: And the same Oblast, which is the same province or state that Dnipro is in. Speaker 1: The Nitro-Petrovsk province. Speaker 1: The guided aerial bomb. Speaker 1: So far, two dead and ten injured. Speaker 1: Oh, this is in Kyiv. Two dead and ten injured in Kyiv overnight.

00:12:54 Speaker 1: Yeah, huge smoke clouds.

00:13:06 Speaker 3: I almost got him. Speaker 3: I almost got him. Speaker 1: No. Speaker 1: You wanna look at that again? Speaker 3: No, you're fine. Speaker 3: Let me just, well, yeah. Speaker 3: Hold it on the black screen and move your front thumb. Speaker 3: Let me see if I can... Speaker 3: I'm not gonna be able to get it. Speaker 2: It's okay, I can't. Speaker 2: Let me see if I can get the, um... Speaker 2: with the explosion on this camera. Speaker 2: - Yeah, do it. Speaker 2: Do you want to get a different lens on it? Speaker 2: - Uh huh. Speaker 2: - Yeah, I'll take it. Speaker 2: - I'll take it out. Speaker 2: - Okay.

00:14:00 Speaker 2: Yeah.

00:14:04 Speaker 3: I think the explosion is a good thing to get and then move on.

00:14:09 Speaker 1: Then the vampires come out. Speaker 3: Right. Speaker 1: Romania, Ukraine are the part of the world where vampire legends came about a thousand Speaker 1: years ago. Speaker 3: That's where my family is from as far as I've gone back to the Matula family.

00:14:23 Speaker 2: One quick second. Speaker 1: So Andre just sent this to Braco and me. Speaker 1: About a strike in the Nitro-Petrovsk region. Speaker 1: So here's the city of Dnipro. Speaker 1: And this is the city that got hit. Speaker 1: And this is where it came from in Russian territory about 150 kilometers. Speaker 1: And Kiev also got hit. Speaker 1: You can see a column of smoke there.

00:15:10 Speaker 1: The sad thing is this is just another day in Kiev and in Ukraine. [VO CANDIDATE] Speaker 1: This stuff happens every day. [VO CANDIDATE]

00:15:17 Speaker 1: It's terrible. Speaker 2: Did you get the big column of smoke? Speaker 2: I did.

00:15:33 Speaker 1: Oh yeah, this is something... Speaker 1: Oh shit, I don't want to do that. Speaker 1: Yeah, I don't have Facebook or WhatsApp or any of that stuff. Speaker 3: We have a WhatsApp. Speaker 1: Yeah. Speaker 1: It's not creating a account. Speaker 1: Yeah. Speaker 1: It shows this woman just kind of standing here that she gets blown up. Speaker 1: Oh, here we go. Speaker 1: You getting this? Speaker 2: Yep. Speaker 1: This is from the VVC.

00:17:04 Speaker 1: Alright, what else do you got, Logan? Speaker 3: I think I'm good. Speaker 3: I think I'm good, yeah. Speaker 3: There's sun setting over there. Speaker 1: Do you ever see, you probably saw the original Omega Man with Charlton Heston?

00:17:16 Speaker 1: Oh. Speaker 1: Oh. Speaker 3: Maybe I haven't. Speaker 1: Well, you saw the Will Smith remake, right? Speaker 1: I Am Legend? Speaker 3: Oh, yeah, I saw that one, yes. Speaker 1: It's getting dark. Speaker 1: They'll be coming out soon. Speaker 3: Right, right. Speaker 3: Get out of the way of view for you. Speaker 3: Oh, that's great.

00:17:35 Speaker 2: It's more like woodsy than I thought it was going to be. Speaker 2: I thought we were going to see a lot more like fields.

00:17:42 Speaker 1: This is pretty much it. Speaker 1: If you close your eyes you're going to be hearing this all night long. Speaker 1: Especially if you have your window open. Speaker 1: Is Laura getting some sleep? Speaker 1: Yeah, she's sleeping in the house. Speaker 2: I came back to the woods. Speaker 1: There's a little lake over there. Speaker 1: There's that one. Speaker 1: See, that's beautiful. One of those little houses right there on the small hill overlooking the lake.

00:18:10 Speaker 1: Oh, sorry. Speaker 3: I'm gonna grab this too. Speaker 3: Oh, wow.

00:18:26 Speaker 1: Now that's not gonna be too dark for you? Speaker 2: No. Speaker 2: Yeah, cause otherwise you can kinda just lose the sky. Speaker 2: You can kinda find the little middle ground right here.

00:19:55 Speaker 2: *Ball's phone* Speaker 3: We're gonna try and talk him into getting the shot out of the back. Speaker 3: Hey, you got your breath pass? Speaker 3: Yeah, I got it. Speaker 3: Yeah. Speaker 3: Yeah. Speaker 1: Cool. Speaker 3: So, we'll see what we can get. Speaker 1: Alright.

00:20:28 Speaker 3: You know, I should take my clothes so I can translate.

00:20:30 Speaker 1: Mhm. Speaker 3: Where to go right here. Speaker 3: Thank you.

00:21:17 Speaker 3: Thank you.

00:23:32 Speaker 3: *Sigh*

00:24:55 1. スイッチ

00:25:43 2.

00:26:34 おやすみなさい。 Oh, fuck me.

00:27:29 Speaker 3: Oh, fuck me. Speaker 3: *Sigh*

00:00:00 Hey. Speaker 1: Hey. Speaker 1: Hey. Speaker 1: At some point, maybe you want to come all the way back here. Speaker 1: We're all the way at the end, and we might get you just Speaker 1: watching at the end. Speaker 1: So turn right out of the compartment? Speaker 1: So turn right out of the compartment? Speaker 1: Okay, all right, I'm right there. Speaker 1: All right. Speaker 1: Sorry, you're going that way. Speaker 1: Thank you.

00:00:55 Speaker 1: Oh, shit.

00:00:59 Speaker 1: Oh, shit. Speaker 2: Oh, hey. Speaker 2: Oh, hey.

00:01:34 Speaker 3: So no filming? Speaker 3: No filming?

00:01:41 Speaker 1: So what happened? Speaker 1: Hey.

00:01:50 Speaker 3: So I told her we were following a surgeon. Speaker 3: So if you have Google Translate, you can... Speaker 3: Tell her that and we can ask her if she... Speaker 3: Tell her that and we can ask her if she... Speaker 3: Oh, yeah, you didn't get in position, did you? Speaker 3: You're good.

00:02:19 Speaker 3: I think she wants to... Speaker 4: Oh, okay. Speaker 4: She's going out? Speaker 4: Okay, go.

00:02:41 Speaker 3: - No, dude. Speaker 1: - No. Speaker 1: Did you show your press badge? Speaker 1: I did, yeah. Speaker 2: Yeah. Speaker 2: You're a doctor. Speaker 2: Yeah. Speaker 1: Yeah, yeah. Speaker 1: Yeah, yeah. Speaker 1: Yeah. Speaker 1: Yeah. Speaker 1: Yeah. Speaker 2: New York. Speaker 1: Oh, Dallas, Texas. Speaker 1: Texas. Speaker 1: America.

00:03:27 Speaker 1: So can they -- can they film or she said no? Speaker 3: No, we're allowed to film.

00:03:30 Speaker 1: Oh, okay. Speaker 1: Oh, I thought you said she wouldn't let you film. Speaker 1: No, no. Speaker 3: Oh, she wouldn't let us film her screen. Speaker 1: Oh, I see. I misunderstood. Speaker 5: I was waiting for the train to get back up to speed. Speaker 1: Alright, I misunderstood. Speaker 1: Look at those little kids running across. Speaker 1: It's so funny. You have kids are the same everywhere. Speaker 1: Can you get the longer shot? Speaker 1: Maybe lift up the camera a little bit?

00:04:24 Speaker 1: She seems a lot nicer than I got. Speaker 5: Yeah, definitely.

00:04:30 Speaker 1: I didn't realize. Speaker 1: There's a whole different kind of sleeping car, is there? Speaker 1: Wow. Speaker 4: I guess a lot of people are in the teens. Speaker 4: So I wonder if it's... Speaker 1: A military thing? Speaker 1: Yeah, it's interesting they entered this car on Speaker 1: when we were at Speaker 1: Hobo Speaker 1: Trying to brace low good here. Speaker 1: Put sandbags on the other side. Speaker 3: Is this doing anything for you? Speaker 3: You getting something? Alright. I mean us.

00:05:33 Speaker 5: We're on the last one. Speaker 5: We'll be able to run in for this one probably. Speaker 5: Just gonna let it go for like minutes. Speaker 5: Okay, stop it. Speaker 5: No, I'll stop it.

00:05:52 Speaker 3: I should have one of my little ones, but obviously it's not gonna be.

00:06:00 Speaker 3: That's a bad one, that's a bad one. Speaker 3: I'll go get one of my little ones. Speaker 3: - It's okay. Speaker 3: - It's okay? Speaker 3: - Right. Speaker 3: - Right. Speaker 3: - Yeah, we wouldn't use it. Speaker 3: Okay. Speaker 3: So Alex, the idea was that we were going to try and reverse this shot, but with those

00:06:50 Speaker 3: leaves kicking up right there, that was amazing. Speaker 3: Alright, that might be it. Speaker 3: That might be it. Speaker 3: Yeah, I might be able to get a little more stable in this position. Speaker 3: Can you hear Laura? Speaker 3: Yeah. Speaker 3: I'm gonna do that one. Speaker 3: Where are you?

00:07:37 Speaker 1: I wonder if this swaying back and forth will actually convey itself on the screen.

00:07:44 Speaker 3: It will a little bit. Speaker 1: That'll be cool.

00:07:57 Speaker 5: I think we've got something here. Speaker 3: Yeah, I think so. Speaker 3: Yeah, I think so.

00:08:00 Speaker 3: Alright. Speaker 3: We'll get a little of them walking back just because... Speaker 3: But which lens do you want? Speaker 3: But which lens do you want? Speaker 1: Did you want to get me looking out the window too? Speaker 3: Sure. I was actually just trying to get you back here. Speaker 3: Oh, okay. Alright. That's cool. Speaker 3: But yeah, I mean like... Speaker 3: You know what you should do is like...

00:08:26 Speaker 3: I don't know... Speaker 1: Yeah, one house is at this, uh... Speaker 1: It's like a city. Speaker 5: Here, we have one last go here. I'm gonna wait until we can look at an interesting background. Speaker 1: Oh, this is my little church? Speaker 1: Yeah.

00:09:21 Speaker 1: Good day.

00:09:38 Speaker 1: Oh, that's where the vampires come from. Speaker 6: I was going to say, "Locum, there was a graveyard that we passed it."

00:09:46 Speaker 1: They were talking about how allegedly, stories by vampires came from Romaine and Ukraine, Speaker 1: this part of the world, what, a thousand years ago or something? Speaker 1: It's getting dark pretty soon. Speaker 1: Just saying.

00:10:15 Speaker 5: I wonder if it's worth going back and then maybe trying to build the building with a Speaker 5: little more light. Speaker 5: Let's do that and maybe we'll try to get one of those super stable. Speaker 5: Let's try the lenses up. Speaker 5: So that one's going to fall in back. Speaker 5: Yep.

00:10:38 Speaker 3: Yeah, now that we've explained ourselves a little. Speaker 1: Well she's very nice. Speaker 1: I wish she were in our car.

00:10:51 Speaker 3: There's something very interesting about how squirrely and out of focus and like, you know, Speaker 3: just crazy it looks so I don't necessarily think of that but it's just the energy of the Soviet era train

00:11:17 Speaker 3: Alex, let me just get my lens on so I'm not walking around trying to, but then we're going to follow you Speaker 1: Oh, walking back? Speaker 1: Yeah. Speaker 3: We're gonna suddenly follow you.

00:11:35 Speaker 3: Let me know you're good, Dad. Speaker 3: Yeah, you guys can go. Speaker 3: Okay, you follow. Speaker 3: Yeah, go ahead. Speaker 4: Just walk and you're following me? Speaker 4: Just walk and you're following me? Speaker 4: Yeah, I'll just follow you. Speaker 4: There we go. Speaker 4: Got it. Speaker 4: Okay. Speaker 4: Alright. Speaker 4: Okay. Speaker 1: Alright, Jackie. Speaker 2: Good luck, sir. Speaker 2: Thank you.

00:12:51 Speaker 2: *Sigh*

00:13:02 Speaker 4: I'm going to go ahead and do this.

00:13:15 Speaker 3: That shot of you walking through is pretty cool. Speaker 1: I had never seen that car like that before. Speaker 1: Wow, I didn't realize. Speaker 1: Yeah, we're complaining about this situation here. Speaker 3: Yeah, I was just like, when I saw that, I was like, we gotta have them walk through this.

00:13:31 Speaker 3: We gotta have you walk through it. Speaker 3: We gotta have you walk through it. Speaker 3: I was like, there's no way we're, no way we're missing that. Speaker 3: I was like, there's no way we're, no way we're missing that.

00:15:17 Speaker 3: Thank you. Speaker 3: *Groan*

00:16:07 Speaker 3: I don't see it. Speaker 1: What does it look like? Speaker 3: It's just a little Allen wrench. Speaker 1: Oh, boy. Speaker 1: You know what? Speaker 1: This might help. Speaker 1: This might help. Speaker 1: We have the technology. Speaker 1: We have, yes. Speaker 1: Um. Speaker 1: Um.

00:16:30 Speaker 1: Wow. Speaker 3: Some light on the situation. Speaker 1: Fire. Speaker 3: So they're busy building the other camera and they can better cope with this, uh, um,

00:16:46 Speaker 3: what we need out of the motion or the view. Speaker 1: You want a little air for a little bit? Speaker 1: Please. Speaker 3: We should ask her to call the front of the train. Speaker 1: Yeah. Speaker 1: Yeah. Speaker 3: Let's do that. Speaker 3: Let me-- Speaker 1: Did she have to call somebody to get permission? Speaker 3: No. Speaker 3: No. Speaker 3: So I was just thinking that she's been a lot more attentive to us.

00:17:29 Speaker 3: She was a lot more open to what we were doing. Speaker 3: I'll just take this. Speaker 3: Cool.

00:18:00 There it is.

00:18:36 Speaker 3: There it is. Speaker 1: Oh, cool. Speaker 1: Let's go. Speaker 1: Oh, that's just a SIM card. Speaker 1: Yeah, it's for this thing that's supposed to be my Wi-Fi, which is Speaker 1: it's nice of them to include it, but really just a little Speaker 1: pin or needle would do it. Yeah, but you obviously

00:19:26 Speaker 1: know what it is. As I said, you've been around the block.

00:19:30 Speaker 1: I figure it's inevitable that I'm going to lose them. Speaker 3: I've lost something that's going to be a big help.

00:19:44 Speaker 3: I mean, I guess maybe I set it down in this grocery store as we were going.

00:19:50 Speaker 1: Oh, yeah. Speaker 3: Because I was trying to put it away and I didn't have enough hands.

00:21:20 Speaker 1: So is this what you call a pilsner glass? Speaker 3: Yes, I would call it that. Speaker 1: Meets your definition? Speaker 3: Yeah, that meets the definition. Speaker 3: Oops. Speaker 3: Yeah. Speaker 3: I'll kill this line again. Speaker 3: Just for a second. Speaker 3: I think it's a good idea. Speaker 3: Maybe...

00:22:40 Speaker 3: Do you want the light back on? Speaker 1: No, no, I'm good. Speaker 1: Yeah, just helping you with your search. Speaker 1: Yeah, just helping you with your search.

00:22:47 Speaker 3: Oh no, I found it. You helped me indeed.

00:22:52 Speaker 3: I'm just wondering where my hat went to. Speaker 1: Oh, I saw it somewhere. Speaker 1: Yeah, you can turn the light back on.

00:23:00 Speaker 1: You were wearing it earlier.

00:23:06 Speaker 3: Did you start to cross behind all this? Speaker 1: Oh boy, I hope not. Speaker 3: No, no. Speaker 3: Okay.

00:24:52 Speaker 3: That was pretty crazy. I'm not seeing it anywhere.

00:24:58 Speaker 1: Did you leave it next door? Speaker 3: I just checked. Speaker 1: Huh.

00:25:23 Speaker 1: Yeah, I'll help you in one sec. Speaker 1: I gotta get to comply to this.

00:25:41 Speaker 3: Where did my phone go? Speaker 3: This is crazy. I just set my phone up there. Speaker 3: I was pulling out the bag.

00:26:08 Speaker 3: Any chance it got put in? Speaker 1: No, no. Speaker 1: Oh, there's nothing under there. Speaker 3: Nothing under there. Speaker 1: It's not under there? Speaker 1: Nope. Speaker 1: Maybe in the back, you should look behind those bedrolls.

00:26:22 Speaker 1: Oh shit.

00:26:31 Speaker 3: Nope. Speaker 4: Okay.

00:27:05 Speaker 3: Maybe it's in the bag. I closed it pretty quickly.

00:27:13 Speaker 3: I'll look for that after I go back. Speaker 1: Let's see. Speaker 3: The bag is in the other room. Speaker 1: You look for your hat everywhere. Speaker 1: Where have you not looked? Speaker 3: I think it's going to be in the bag in the other room. Speaker 1: In the bag?

00:27:30 Speaker 1: about it let me go to the back okay I seen it you know maybe it was yesterday or earlier

00:27:35 Speaker 3: no no it was so what I think I did is I um all right well if you're helping me out yeah Speaker 1: huh Speaker 1: yeah you've got all this

00:27:50 Speaker 3: so what I'm thinking is I slammed this closed to get uh

00:27:55 Speaker 3: Logan a sitting space so maybe it's got slam clothes in here

00:28:10 Speaker 1: let's see so you've looked all over here right so Speaker 3: Right. Speaker 3: I don't see it smashed in here. Speaker 3: I've seen it by now. Speaker 3: This is in here. Speaker 3: Right. Speaker 3: Okay, well. Speaker 3: Okay, well.

00:29:14 Speaker 3: Yeah, it must have been when we were rushing to get out of the grocery store. Speaker 7: But you didn't... Speaker 7: But you didn't... Speaker 3: Yeah. Speaker 7: Were you wearing it in the grocery store? Speaker 7: Were you wearing it when you were walking? Speaker 3: Oh, there we go.

00:29:30 Speaker 7: I was gonna say. Speaker 3: Now if only we could find the... Speaker 3: The little filter. Speaker 3: I'm gonna put this back in there, room light. Speaker 3: I'll find it. Speaker 3: I'll find it. Speaker 3: At least I can look the part. Speaker 3: Alright, I'm going to go find them. Speaker 3: I'll be back.

00:30:32 Speaker 1: So I usually send some pictures and things to my residents and nurse practitioners and

00:30:39 Speaker 1: just trying to send a few things and can't be delivered, no signal.

00:30:44 Speaker 3: Alright, well I'm going to go get a picture out the back.

00:00:00 I'm going to go back Speaker 1: I'm going to go back

00:01:44 おやすみなさい

00:04:10 The Speaker 1: The

00:06:16 [RUS] Speaker 1: To be continued...

00:07:09 Speaker 1: Thank you.

00:08:51 [RUS] Speaker 1: To be continued...

00:10:16 [RUS] Speaker 1: To be continued...

00:10:54 Speaker 1: Good day.

00:11:25 [RUS] Speaker 1: To be continued...

00:12:43 [RUS] Speaker 1: To be continued...

00:18:16 Speaker 1: E aí

00:19:30 I'm going to go ahead and Speaker 1: I'm going to go ahead and

00:20:46 [RUS] Speaker 1: To be continued...

00:22:02 Speaker 1: I'm sorry.

00:23:14 おやす *clicks*

00:24:00 Speaker 1: *clicks* おやすみなさい。

00:25:08 おやすみなさい。

00:27:10 エビを切り取ります。

00:27:34 [RUS] [To be continued...]

00:28:12 [RUS] Speaker 1: To be continued...

00:28:35 Speaker 2: Hey. Speaker 2: Are you cold? Speaker 2: You're wearing gloves. Speaker 3: No, no, I'm okay. Speaker 2: No, I thought you were not gloves. Speaker 3: You can take your own seat. Speaker 3: I was sitting in as you. Speaker 2: Oh, okay, yeah. Speaker 2: This is our cabin. Speaker 2: Do we have Wi-Fi yet? Speaker 2: Yeah, we'll switch places to be here, Alex. Speaker 2: Huh? Speaker 4: We're just going to shoot your reflection. Speaker 4: It's kind of interesting with the trees out there. Speaker 4: You can barely see them. Speaker 4: Do you want me to sit in until you see what it looks like? Speaker 4: Oh, I'll be in the track and come there, right? Speaker 4: You'll be over here. Speaker 4: I'll have you to sit as close to the window. Speaker 2: Oh, right now? Oh, okay. Speaker 2: Okay, so you want me to do what? Just like this? Speaker 1: Yeah.

00:29:31 Speaker 2: This one is mine. Speaker 2: Yeah, I got mine over here. Speaker 2: Yeah, I got mine over here. Speaker 2: Okay. Speaker 2: Yeah, you can sit. Speaker 2: Okay, so do you want me to do this? Speaker 2: Is that light back in the hallway good? Speaker 4: Yeah, that's good.

00:29:58 Speaker 4: Can we hold that? Speaker 4: You can come back there. Speaker 4: You want farther back? No, no, that's good.

00:00:00 I'll probably just grab a few more shots of Alex and work in. Speaker 1: I'll probably just grab a few more shots of Alex and work in. Speaker 1: Yeah, just have it. Speaker 1: Yeah, just have it. Speaker 1: Yeah. Speaker 2: Yeah, we're going to sit closer or? Speaker 1: You're all good. Speaker 1: I can use mine. Speaker 3: Here, you want me to turn your flashlight off? Speaker 1: There. Speaker 1: There. Speaker 3: Right here. Speaker 1: Oh, I just want to see your flashlight.

00:00:53 Speaker 1: Alright, I will step out. Speaker 1: Oh!

00:01:52 Thank you. Speaker 1: Thank you. Speaker 1: I'm sorry.

00:03:08 Speaker 1: Thank you. Speaker 1: Thank you.

00:06:13 By the way, you did see the lines in the bathroom, no drinking water out of the sinks there? Speaker 2: By the way, you did see the lines in the bathroom, no drinking water out of the sinks there? Speaker 2: Yeah. Speaker 2: Bohdan was trying to explain to me once, it's something to do with, I guess, the water doesn't Speaker 2: circulate as frequently through the sterilization system, so you can just build up some crud. Speaker 3: Yeah, I mean, I've seen it on planes. Speaker 2: Yeah, and even at Metricon Hospital, don't drink the water out of the pipes. Speaker 2: They have these big bottled water dispensers everywhere that you'll see.

00:07:02 Speaker 3: Alright, we may get a couple more things, but we got a lot.

00:07:08 Speaker 3: Here we go. Cheers. Speaker 1: Okay. Speaker 1: Alright.

00:07:16 Speaker 1: That's not a bad shot.

00:07:26 Speaker 3: I feel how hot this... Speaker 2: Oh man.

00:07:30 Speaker 2: Been working that little puppy.

00:07:30 Speaker 2: Been working that little puppy. Speaker 3: Right. Speaker 2: Okay, so I need a word attachment for that. Speaker 2: Okay, so I need a word attachment for that.

00:07:40 Speaker 2: Yeah, I think I told you, I'm a morning person, so I'm getting ready to pretty much shut down Speaker 2: my brain and sit back and do some reading or something. Speaker 3: Yeah, I was about to ask you, when are you going to sleep? Speaker 3: Do I have like 15 minutes to decompress before I start getting ready?

00:07:56 Speaker 2: Yeah, even when you want, I mean, trust me, I can, you know. Speaker 3: Yeah, you're a surgeon, you can sleep anywhere, right?

00:08:03 Speaker 2: Yeah, plus, like I said, you sort of get in the mindset. Speaker 2: I mean, look, if I'm going to complain about you, you complain about me, Speaker 2: just think about that car over there. Speaker 2: I know. Speaker 2: You know, we got nothing to complain about. Speaker 3: I got, yeah. Speaker 2: So we can kind of regulate this window a little bit.

00:08:23 Speaker 2: Open a lot, open a little. Speaker 3: Well, eventually we got some really good stuff.

00:08:30 Speaker 3: Well, we got some really good, not eventually, we got some good stuff the whole time. Speaker 3: That was great. Speaker 3: But like, we had that with, I guess you weren't there, yeah, you weren't there for the very Speaker 3: end. Speaker 3: Logan got the other camera that can do these stabilized shots and all this kind of stuff. Speaker 3: Oh, so you went back to the... Speaker 3: Yeah, yeah. Speaker 3: And it just kept not working. Speaker 3: And then finally he got it to work and then he went back and got the other camera again and got a few more. Speaker 3: Good. Speaker 3: So I'm about to hop on my laptop and I'll show you some of the stuff at least that I got. Speaker 3: So I'm about to hop on my laptop and I'll show you some of the stuff at least that I got. Speaker 3: I can show you. Speaker 3: I can show you. Speaker 2: So give me feedback on the interview. Speaker 2: I mean, was I coming across kind of stiff, or was I OK on that? Speaker 3: You were great. Speaker 3: I mean, so here's the deal.

00:09:18 Speaker 3: These are good questions, but it's like the-- Speaker 3: one of the things that I can do a better job of,

00:09:30 Speaker 3: but this is not a complaint towards you, Speaker 3: but I like to do this when we're in interviews Speaker 3: and not have a camera where I'm just trying to figure out Speaker 3: what the shot is, you know, Speaker 3: 'cause it's much easier on the person that's talking

00:09:43 Speaker 3: to have an attentive-- Speaker 2: - Oh yeah, that's much more natural. Speaker 3: - Yeah, so, you know, so,

00:09:51 Speaker 3: I think that like when we do this again, Speaker 3: I'll be a lot more like, you know, here, Speaker 3: instead of like trying to get a shot too, you know? Speaker 2: - It's really, yeah. Speaker 2: - It's really, yeah. Speaker 2: And like I said, I mean, Rocco just comes across very good at camera and stuff like that. Speaker 2: So it would be good to get all three of us, Rocco, Andre, and me. Speaker 3: I think so, too. Speaker 3: I mean, because I think that, like, the dynamic there is just, it's really interesting.

00:10:21 Speaker 2: Well, you know that L.A. was the first time that three of us were ever in the same place together. Speaker 2: That's crazy. Speaker 2: That's fun. Speaker 2: That's fun. Speaker 2: Because Rocco's been here by himself and I've been here by myself.

00:10:30 Speaker 3: Wow. Speaker 2: Yeah. Speaker 2: But at the same time, Rocco and I have, I told you, we've been acquaintances forever. Speaker 2: But we really kind of got much closer with this Ukraine experience. Speaker 2: And, yeah, Andrei is Andrei. Speaker 2: You know what's fascinating is you're going to meet an anesthesia resident, Nick, who speaks pretty good English. Speaker 3: And he's the one that's, no, Nikita is the surgeon.

00:10:53 Speaker 2: Yeah, it's the same name, but different guys. Speaker 3: He speaks pretty good English. Speaker 2: But Nick, the anesthesia buddy, I mean, I have his contact info on WhatsApp.

00:11:03 Speaker 2: He has never met Rocco. Speaker 2: So how can that be? Speaker 2: So how can that be? Speaker 2: Wow. Speaker 2: Yeah, I guess Nick has been doing rotations elsewhere or something. Speaker 2: And, you know, I think you mentioned somewhere, or maybe in the promo stuff, Speaker 2: that Rocco and I kind of go at different times to maximize our impact. Speaker 2: And he only goes once a year. Speaker 2: So if Nick's out of town for that year, you know, he misses him. Speaker 2: So if Nick's out of town for that year, you know, he misses him. Speaker 3: It's, yeah, you know, like, anything that I got wrong in that, it's not really going to matter because it's not going to be public-facing, per se. Speaker 3: It's just for fundraising. Speaker 2: I get it. Speaker 2: I get it. Speaker 3: But still, I appreciate knowing, you know, for myself, that it's just once a year, you know, for him. Speaker 2: Yeah, it's funny. Speaker 2: So, Inside Dirt, I asked him because he is usually Martha Raddatz.

00:11:51 Speaker 2: That was the lady's name, which I remember. Speaker 2: She's been there a couple times for the anniversary of the invasion. Speaker 2: I thought Rocco would just go on around February 24th. Speaker 3: He said, no, the real reason he wants to go is his birthday. Speaker 2: February 19th is Rocco's, Andre's birthday. Speaker 2: And he always throws a big bash. Speaker 2: So who knew? Speaker 3: Yeah. Speaker 3: I should have gotten that, you talking about that. Speaker 3: But it's okay. Speaker 3: We may have gotten Yanni. Speaker 2: Also, Andre can show you pictures of his 50th birthday party. Speaker 2: It was like in the past year or so. Speaker 2: Oh, wow. Speaker 2: You know, he's interesting. Speaker 2: He knows you need to have a lot of these celebrations. Speaker 2: Some people will say, how can you do that? Speaker 2: You're at war. Speaker 2: But he gets you need to kind of give good for morale

00:12:30 Speaker 2: and let people realize there's still a life out there. Speaker 2: You can't let these big events pass. Speaker 3: You know, and if he's descended from Ivan Sirko

00:12:42 Speaker 3: or just the last name, Speaker 3: the idea was like, you know, one of the things either he said Speaker 3: or I read, no, I think he said it, Speaker 3: was that armies would parade Ivan's arm in front of them. Speaker 1: - Yeah, yeah, yeah.

00:13:00 Speaker 3: - So, I mean, I think he understands Speaker 3: that there's a role he needs to play, Speaker 3: and not to say that he wouldn't do it otherwise, Speaker 3: but I think he's, like, I really got the idea

00:00:00 おやすみなさい

00:00:30 Do we want to move? Yeah. Alex, this side looks better. If we could move you where Laura is sitting or do you... Sure. It's about a thousand times we're going to do this. Right. You're doing you can even you can take all your Take this you got it all right

00:01:18 You may take your mouse right yeah, I'll get it there we go

00:01:40 - No, you put your baby in a corner. - Yes, yes. - Sorry, Alex. - You're welcome. - There we go. I'll just sit down here.

00:03:18 So, I have a moment of time response with an email from a number of UTRs that we've So, I have a moment of time response with an email from a number of UTRs that we've I'm just going to show you why I sit for that apartment. I'm going to go over the Christmas tree. Which is fine. It's just a happy new project. I hope it is a little busy on the road here. So, hopefully we can sit out for a seat and then we'll follow up and get back.

00:04:13 We have a lot of Wi-Fi in the car.

00:04:27 request? Like, where do you typically have people? Not unusual. There's a steady triple. My name lists me on some sort of list or something where people randomly reach out. Usually people from the Atlas where I live who want to do something over there on Christmas break or summer break. And the interesting thing is they're all very, very smart. And at least 90 plus percent of them are women, Indian ancestry. So that's the future of American Neurosurgery.

00:01:11 東京都道路線の中で、東京都道路線の中で、東京都道路線は、東京都道路駅となります。

00:01:41 so do you want me to be like doing anything no you're just doing your work yeah you're just gonna do your work i like what you were saying a second ago i don't know how much we're gonna use of you like just randomly talking but like um but i'll later get a mic on you so like when you do say that stuff like that,

00:02:00 we'll pick it up. Like, I mean, I may have picked it up on this, but that's not. Yeah, plus a lot of background noise. Yeah, exactly. Yeah, but I'd say, like, overall, looking for a film, you know, probably just think of a lot of time. Right, exactly. Like, you know, don't feel like you need to say anything. So Arthur Circle, at one point Arthur Circle, So Arthur Circle, at one point Arthur Circle,

00:02:19 I texted me and just kind of said, "He realizes he doesn't know what you're about, but all I could do is, I'm a very boring person. I get up and I work, getting up trying to squeeze in some exercise once in a while. Is that you saying? Yeah, yeah. Yeah, yeah. Yeah. So, you know, we're empty nesters and kids are over. Right? Well, look, it's, I wouldn't feel any pressure.

00:02:41 I mean, like, the whole thing is that, like, the audience is going to be able to enter this world through you. and it's not about your, what you say, or, it's just this, it's the visual journey, right? It's the arrival, it's the, it's, so it's, you know, they'll have the ability to sort of paint upon you their own emotions, if that makes any sense. So, it's, uh... Like there's no pressure on you to do anything other than what you are doing normally.

00:03:27 No pressure to entertain. Yeah, you do not need to entertain. You're already doing it.

00:03:53 Yeah, the other thing. Yeah. Laura. Laura, Logan.

00:04:00 Look around. Sometimes on this train I've actually seen people who have, you see them on the train, then you see them in the grocery store, you know, and then you see them on the train and you pray. Trying to find some people that are... Yeah, might be kind of interesting. You guys should ask them what's their story. Right. For sure.

00:04:32 Can you just hand me my phone? I'll wait. Yeah, you're good. And the camera as well. And the camera as well. I'll take the little one while you're doing. Thank you. 大阪市駅

00:00:39 so

00:01:00 Express. They also gave us two. I'm not sure. Is this that's you? Is this that's you?

00:01:17 I actually brought a couple readers that can read those. I mean, sure, they gave you readers, but just they're extras. Okay. I guess that you might know this. So they gave us two CFexpress cards, they gave us two SD cards.

00:01:32 Is there a difference on this camera in terms of what you can do capacity-wise with an SD Is there a difference on this camera in terms of what you can do capacity-wise with an SD

00:01:38 card? I don't think so. I think it's just the speed of the read after. Okay. Okay. This is kind of coming up to you see this church and it's called Coal. Yeah.

00:01:57 Yeah, this is like a little village square kind of thing, shopping area. Right. Oh yeah, there was some guy who brought a dog or something at the train. This is the train from going to be at us in a couple hours. Wow. And every time they send me something via WhatsApp, it goes to my photo.

00:02:18 He's always sending this was the Prime Minister of Germany. Right. I have a little video of this. Anyways, we can bring a camera or something. Right. We'll have to kind of run out real quick and go back when the train leaves. Obviously. So is this, are we still in Poland?

00:02:38 No, no, it's just in Ukraine. So are we already in Ukraine? Actually, we'll be there at about 3.30 or so. 15.32. Oh, that's on the other train. Yeah, we'll get off at home. Yeah, we'll get off at home. We'll have an hour or so to kill.

00:02:54 I've been trying to get the internet here for about the last 10 minutes.

00:00:09 東京都道路線

00:00:56 Oh wow.

00:01:00 That's a documentary. That's one of the very few topics that I think Republicans and Democrats have re-owned. Don't brainwash kids. Yeah, Russia's military. The Ukrainian is looking like a military. It's free to watch on the YouTube channel. Free to watch on the YouTube channel? Yeah, it's terrible.

00:01:22 Yeah, so the guy who owns the sound company that I met with last night, He had been doing a documentary on like surrogate mothers in Ukraine. Like people from foreign lands buying these... Buying somebody's uterus. Right, yeah, exactly. Exactly. I don't know what the end-all, be-all of the dock was supposed to be.

00:01:53 So, you know the downside of how if you run statistics or something you can find most anything? There's a big one.

00:02:00 It's a urinary tract infection. Yeah, I think we can scan it out. Yeah, I think so. Yeah. Is this a... This is the American Medical Academy. Remember, they set out this daily. I just usually put the head on, so it's pretty funny. If you make patients pay less, they're gonna follow up better. If you make patients pay less, they're gonna follow up better. I mean, you know, everybody needs to read about colonoscopies each morning, right?

00:00:00 If their parents have...

00:00:00 If their parents have... Yeah. Of course. Well, like, you need me to move. You can. It's like... Yeah, it's not rockin' surface. So, you know, Alex, I grew up with a lot of anxiety and depression and stress and all this kind of stuff.

00:00:23 And like one of the reasons... You're basically a typical American. Yes. Well, one of the big reasons that, like, you know, I am against gun ownership is I just feel like something like that opioid, if it's around, you have it, you know? And I don't mean, like, using it on somebody else. So it's interesting because gun ownership is a pretty charged topic. I don't know if this is to ever just start here that Ukraine used the enemies of the street gun laws that when the Russians rolled it, they just started giving guns to everybody who's going to fight. Yeah, exactly. Well, that's, you know, like our Constitution says, like, what, a well-organized, well-something militia?

00:01:13 So it's like you can, you know, gun ownership groups. So, you know, the right wing says that, of course, you look at the government, they didn't be coping. They went way too far, all these restrictions and things like that. They went way too far, all these restrictions and things like that.

00:01:30 So that's why we need weapons to prevent them from doing that.

00:01:30 So that's why we need weapons to prevent them from doing that. Right. Look at the left wing. They're pretty hitting it. The Trump is doing this. He's going to be a dictator. That's why they need their weapons. That's why they need their weapons. Right, exactly. Yeah. A friend of mine from China was actually doing a fellowship here and I took it to a shooting range once. He said, you know, the difference is that in China, the people fear the government.

00:01:52 In America, the governments are for the people. Right, right. Well, what I don't get is like, we set up something that was supposed to be a government for the people, by the people. and like it's too much you know i don't know too much feeling of separation

00:02:14 oh yeah so we probably got better than i do there but sometimes in our country system we've had a lot of polarization right but we managed to come back together

00:02:25 one of the big differences now is social media i mean you could generate a flash do we need him

00:02:30 not talking to me here for a second you guys okay okay you can generate a flash mob at 67th right now you know, people out there and killing each other and fighting, which never used to happen before. Maybe that's going to be the thing that pushes us over the edge. Maybe that's going to be the thing that pushes us over the edge. Maybe.

00:02:50 I don't know. I mean, it's just, yeah.

00:03:03 Yes, sorry we put you on the side that has the sun. No, it's not actually nice. I'll probably shout out to you. I'll be back to where you were and I'm on the Bollywood part right now. No, I'm good. I can say if you guys are good. Either way. We probably shot enough here, right? Yeah, of course. So I definitely want to put a mic on you, Alex, when we get to the next train. Right. Because I feel like probably all the sound that is unused. I agree. I agree. Unfortunately.

00:03:30 Well, not. I don't want to have like two hours of conversations here and then burn it. And if we listen to this, we can't hear anything because all the way here is a train noise.

00:03:40 Yeah, I mean I was planning on getting all that set up in the next, but I could probably pop one out here. Wait, wait, wait, wait, wait, wait, that might be better, right? Of course. Yeah. Are you trying to keep these seating arrangements? No, you can... If you want to go back, that's better. No, I'm easy, whatever. Whatever way for you, we're going to be just settling in over there. Do you guys need to talk business though? No, no, we're well, you know.

00:04:13 Laura, you ready to get in this corner and just crash a little bit? No, okay. You look kind of bleary-eyed there.

00:04:27 All right. All right.

00:04:30 All right. Alex is going to move back to his...

00:04:45 Oh, I got my... Perfect timing. Remember we're going to get on the train, then we're going to ride maybe half an hour or something. Then we stop and actually do the water crossing stuff. Okay. Okay. So I don't know, I think we might be keeping it, Bill. It's more like how much cocaine is it to carry?

00:05:31 Mm-hmm. Like a little slow step too much. Yeah. If... If... If...

00:05:46 If... Oh here yeah let me I can do that.

00:00:00 No, don't worry. It's internal.

00:00:00 No, don't worry. It's internal.

00:00:04 I could always twist her arm. Well, it could be a bonus feature.

00:00:13 You're not just a plain old mate thing. You're the bonus thing. Right, yeah. Exactly.

00:00:23 It's interesting. We have not as many people we are in the line here.

00:00:28 1950年

00:00:58 so

00:01:00 - You never played some old, like I said, did you ever hear that song, "California Dreamer"? - Of course, I love it. - He said, "He never heard that song." He said, "Dude." - He had never heard that song? - It's perfect, beautiful, whether they're here or the leaves are just there. - I know. All the leaves are green. - All the leaves are green. - And the sky is gray. - How could he not have, was he not from the US?

00:01:26 - That's a good point, I think you can bring it there. Right.

00:01:30 Any other great song?

00:01:30 Any other great song? Is it never Raid in California? He never heard that one. He never heard that one. Oh, geez.

00:01:39 Crazy. It was, uh, I'm so glad that I got to meet your wife, and I'm so glad that I got to meet Tatiana and Sviatoslav. Yeah, I think that's right. Yeah, Sviatoslav. It was so funny at these social media watching, Patty and Tatiana, to me they came here, you know, Google Translate. Right? Yeah. They have one of these bags, Patty sent some gifts for her, so... I love it. I love it. Yeah, it's a very big thing on turn. Yeah, yeah. So I may, while we're in Dnipro, I may get a computer monitor that I would gift to maybe

00:02:30 Swiatislav. You know, I would use it this time and then maybe in February if we come back. So that's one gift, but there were other gifts I was going to bring if we come back next time. I think Rokko would be great. Yeah. Yeah, I know it's a big hassle if you guys don't get it. Yes, there is that, but it's not so much the hassle, it's just sort of like the fluidness of the situation and you know, we'll just see. I'm planning on coming back.

00:03:03 I'm planning on it. Also, as a backup, I already blocked out the dates out coming at the end of March. So for some reason, I think the Rock will go through, or you want to come back for even more. Right, right, exactly. Maybe it's just me. Did you send me a YouTube? Did I send you a YouTube? Yeah. Oh, no. Sorry.

00:03:30 I saw your name. I think you just sent me something. Action.

00:03:40 He always sends me stuff like Instagram, Facebook, Instagram, social media.

00:03:48 Well, I do, so he'll have to get mine. Well, you need it in your line of work. I know. I know. You know that talk that started this whole thing that Greg Roper saw me giving. I haven't watched the talk yet. I haven't watched the talk yet. It is on YouTube. Yeah. Yeah. I've got a lot of force you guys. I was part of it. I've got to get fewer slappings to talk some more. I've got pressure to get through all of them.

00:04:30 Well, I think that, like, when you watch it on video, you're more likely to be, and it's you, you're going to be more critical of yourself. I'm sure that, like, as an audience, they were just, like, amazed about the story and whatnot, you know? So, yes, watch and sort of take it in and be able to like, "Hey, next time I'm going to do this."

00:04:56 But don't stress about the delivery or how it came out because what they're going to remember is just like the journey in the story.

00:05:06 The man who said, they don't remember what you said, they remember how you made them feel.

00:05:10 Yeah, exactly, exactly. I just texted you guys an article that is based on presidential address, national president of A&S, 2018. Yeah. In A&S, it's one of those associations where the president is really complicated,

00:05:32 and he's used to meet him in the meeting and all that other things. Right. and you have to give a big address in your feed, and you have to write it up as an article that the journalier's written up.

00:05:43 Right. So my theme was the privilege of service. Oh, wow. And, uh, yeah. Well, and you sent us that. You forgive my brain. You have to give your credit. Well, no, but you said you sent that? Just a few minutes ago. For a self-service service. Well, you know, you know, I mean the... The idea but behind you and and Rocco as like characters is this idea of service of extreme service, you know? I'm gonna have to show...

00:06:47 このような感じがします。 Oh, you're getting ready. Okay. I was about to show you. What's up? I was showing you that there's good stuff to be had. What is that? Um, what I'm currently filming. Oh, not at all.

00:07:16 Yeah, I was just confirming he'll be here. He goes up tomorrow at 7:00. Gotcha. Not quite as dynamic as it was just a minute ago, but with the light.

00:07:28 Yeah, there's the light and stuff.

00:07:30 Yes, exactly.

00:00:00 I'm getting ready to cross the border. I'm getting ready to cross the border. Google Maps, never wrong. We're crossing the river. Man, I wish we had... Welcome to Ukraine.

00:00:30 There we go. Love it.

00:00:34 I did not have... I was not set up for that.

00:00:38 Yeah, I just think about it. Yeah. That video is unusable.

00:00:43 Hey, Logan. Logan. We're now in Ukraine. Oh, I guess there's no customs. Yeah, that was weird. I don't know what's going on, but here's the... So here's the border right here. We are going. We've just crossed it. Yep. Yep. Yeah, I didn't have the ND on this because I couldn't find the filter I was looking for

00:01:04 and he was, at least, it was the quickest thing I could grab as he was telling us he was crossing So, didn't really get it, but hey, you know, it's okay. So, didn't really get it, but hey, you know, it's okay.

00:00:00 Alright, one more to go here. Alright, one more to go here.

00:00:20 Oh fuck. All right.

00:00:33 So what did you want to talk about? Hang on one second and then we'll get there. Let me just put this on. Let me just put this on.

00:00:45 Also, do I need to be sitting or doing something different? Or am I OK with this thing? I feel like I'm in a cave here. It adds to the ambiance. It adds to the ambiance.

00:00:57 Let's sit next. Yeah.

00:01:00 Let's do it. Come in. All right.

00:01:21 One more thing. So I remember giving an interview once, getting ready to talk to someone. We had a really great media person in the hospital, and I said, what should I do with my hands? She sent me this clip from this movie Talladega Nights. You ever seen it with... What do I do with my hands? Yeah, and I guess it's kind of funny. Yeah, Will Ferrell, he's giving his hands because he was asking about it ahead of time. So the audience was ready for this. And they're in the interview with his hands. They're like all over the place. He's just going to move it.

00:02:00 I'm just getting the one thing above me.

00:02:04 Every time I've asked if Dad sees a movie, he always says yes. Well, you know, I haven't seen as many as most of the recent ones because there came a time in my life when... Are these colors matching yours? Are we good? You're probably good. It's like reading more for Jim. It's like reading more for Jim. It's a later problem. Okay.

00:02:30 Should I keep looking at you there? Yes, you should. And that's why I got it right here. Yeah, so... When we're not rolling, I mean, I don't mind it being out there, we're wasting time yeah I'll tell you in a second but uh

00:02:52 you do that there you go you know what the lights good for you guys it is pretty

00:02:56 dark in here yeah man okay

00:03:02 that's the mood it's funny Oh there it is. There we go. Amazing. That's too dark. What are you going to do?

00:03:16 Just put this one out of here.

00:00:00 is that magnetic yeah that's very cool yeah yeah there you go is that magnetic yeah that's very cool yeah yeah there you go

00:00:09 oh i just moved it no it's okay just just put it up no no just put it up and like that okay just like that that's good it's okay it's it's it's getting sync sound so that's why i have it rolling which means it's you know anyway the sound is going to it so that's just why i was uh

00:00:26 making sure to get it on. It's not something, it's a little, a little claustrophobic. So, you know, this is an interesting example of what it's like in Ukraine right now. I mean, we're sitting here having this conversation on a train, it's normal countryside, and theoretically, at any second now, there could be a drone or a missile coming. And that's how these people are living their lives. You know, you can't just stop living because what's going on here. So they're having birthday parties and celebrations. They go to work every day. Knowing in the back of their minds that this could end very badly sometime today. It's amazing their strength and resilience. And you also have to wonder what the long-term toll line that's going to be, especially on the

00:01:13 kids growing up in this. This has been going on for closer to four years now, three and a half years. Have you gotten to talk to Andre about his son growing up in this? Or have you actually talked to Spiazakal? Spiazakal. I need water to say it. Yeah. Andre's mentioned how when they have to go in the middle of the night to their shelter in the basement of their building,

00:01:47 sometimes he gets pretty upset, wondering if he's going to die. He is in his early or mid-teens right now. And obviously he's not the only one. There are millions of kids in Ukraine doing the same thing. Growing up like that, I mean, God, you hope kids are resilient enough to overcome that, but you gotta think that to a certain extent, they never will.

00:02:15 - What have you learned about

00:02:21 Okay, first, what does, what do people, what surprises people the most when you tell them about your experience doing this? Good question. What surprises me is the fact that some of them are only peripherally aware that the war in Ukraine is still going on. Which may be understandable if you live in America, where there's always a 24-hour news cycle when people have very short memories. And currently, everything seems to be driven by Donald Trump, right? Everything he does, the left-wing opposes, the right-wing defends, and that's what consumes 90% of the media. But when you get outside the U.S. or even look at other news sources, not surprisingly, people in Europe are very much concerned about what's going on.

00:03:09 So that's one thing is how little it is on the public's radar screen. Another is most people do the kind of thing, so, you know, thank you for going there. It's a great thing you're doing. It's kind of like every time you meet someone in the military, you say thank you for your service. But there are some who genuinely think it's a stupid thing. Like, why would you do that? You know, you're not accomplishing anything. And I try to explain to them why I think it is important to go.

00:03:41 You know, that could be argued about a lot of things. Why do it? Because you're not accomplishing anything. And any one person doesn't accomplish much on their own,

00:03:51 but all the one people have to do it to make a difference. Well, I always remind people of the quote that's attributed to Edmund Burke, and I don't think he ever said this, but the basic idea is that the only thing necessary for the triumph of evil is for good men to do nothing. And, of course, that was stated a couple hundred years ago, so you have to update it, say, good men and women. But that's a perfect example of how, if the U.S. had been more aggressive early on, I've read that a lot of people think Russia could actually have been defeated in 2022.

00:04:30 But we didn't. We kept saying we're not going to do this. We kept gradually raising the stakes and dragging it out so long that we didn't intervene. And now, as we're recording this, you know that somewhere between 19 or 21 or so drones went into Poland, depending on which source you read. They went into Romanian airspace. The Russian went into Romanian airspace for 12 minutes. They crossed into Estonian airspace. I heard just a day or two ago they crossed into Lithuanian airspace. All these drones over airports in Europe. No one's doing anything. Everyone's talking about it and everyone's saying, oh, this is really bad. But no one just stepped up to stop. So it doesn't really make a difference, though, for one or two people like Rocco and me to go over there.

00:05:23 Once you've been over there, once you've become friends with them, you realize how big of an impact it has for them to see that Americans still care.

00:05:30 And there are people in the West who still support them and are willing to take the time to go over there and try to help out and also help publicize what they're doing. You know, not only in an academic sense about publishing technical neurosurgical articles about the management of these types of penetrating brain injury and trying to give those talks at academic meetings. But just to the wider public about the amazing work that's happening over there

00:05:56 and the incredible injustices that are being done every day. What do you do to spread the message? You had that talk at UD.

00:06:09 How else have you gotten the word out? Well, I've tried to give talks to pretty much any venue that will listen, whether it's my own institution, giving departmental grand rounds, which is kind of the weekly conference that medical departments had. Or at other groups, some meetings I normally don't go to,

00:06:30 they're not on my regular calendar, but if people want you to talk about Ukraine, I said, yeah, I'm happy to do that. Various newsletters and things, they're not so much technically oriented, but more kind of sociopolitical publications for medical journals. And Rocco is very well positioned. He knows a couple of reporters from ABC because he helped take care of Bob Woodruff when he was injured. So he knows Bob Woodruff pretty well.

00:07:00 And I'm blanking on her name. Who's their Sunday morning talk host? Her name is an M. It's the tip of my tongue. She's been to Ukraine a couple of times. She's a friend of Rocco's. I know who you're talking about. Yeah, okay, this is embarrassing. It's okay. It's okay. You're fine. We're not going to play that. So that's a much, again, Rocco is the ultimate extrovert, so he's pretty well connected in those worlds.

00:07:28 And he does whatever he can to get the word out, too.

00:07:35 So, let's... You had asked me earlier about Andre Sirko, what makes him so remarkable. And I've thought about that a lot. somewhere on my list of things to do is to try to write another article with Rocco that would just talk about something along the lines of leadership under fire and just try to briefly describe what makes Andre Sirko such a remarkable leader because he's an expert at his craft, which is neurosurgery, but he's an expert at organization and motivating his team, very active on social media to try to get the word out there. He's incredibly detail-oriented and organized, and yet, unlike a lot of those people, he can also turn on a dime. When all those plans just fall apart, he can roll with it.

00:08:23 He's a genuinely good person. He doesn't yell at people or demean them. That's the kind of thing you could write up for a Harvard Business Review article

00:08:30 or some management journal or things like that.

00:08:36 So when we were just filming a second ago, you were talking about what he had been, I mean he still is one of the world's foremost surgeons in, but like the... The elective practice, yeah. The technical term of neuro-oncology, which means tumors of the nervous system.

00:08:58 So he's been an expert on that for a while and unfortunately he's had to become the world's expert on penetrating brain injury and the surgical management of it.

00:09:08 And that's what you do as well. Yeah, my main area of interest is neuro trauma and neurocritical care. So that's right in my wheelhouse. But yeah, I, I, whenever I go there, I probably learn a lot more than I teach, to be honest. I don't know what it would be like the first time I went. Because when a lot of neurosurgeons from the West go to other places, it's generally places with very little neurosurgical presence or infrastructure. So places like Sub-Saharan Africa or Latin America, you kind of drop in, do some surgeries, and leave. But there it's very different because they have excellent people in Ukraine. The problem, at least at Medchikov Hospital, is just the sheer volume is a big challenge. They don't have a lot of the resources that we have. So trying to do high-quality work with tremendous volume,

00:10:02 knowing you have constrained resources is an art. And he's an expert at that. So that's why I kind of learned some techniques from him and bring them back and teach some of my residents.

00:10:15 So, you know, the statement is it's not brain surgery. Is brain surgery really that hard? Or? The residency is seven years long. So it may be hard, but if you devote seven years your life to studying it, You can pretty much learn almost anything. As a surgeon of any kind, how does it affect your ego?

00:10:44 Or at least when you're younger. I feel like I'm in a courtroom. Can you explain the question, please? I just mean that you have a life-saving skill, and that's what you do.

00:11:00 or a life altering, improving, what you do directly affects people's existence. Does that, at least when you're younger, give you a self-importance, or what does it do?

00:11:17 Or have you never thought of it this way? - From what I've seen, the doctors of any type who think that they're important probably not the best doctors. You know, what you do is you just get so involved in the daily work. I have a kind of a regular number of young students, you know, college students, so they haven't gotten their bachelor's degree yet, who are interested in going into medicine or neurosurgery. And they reach out and ask if they could do some shadowing. And I say, "Sure, the hospital has some, you can understand some fairly strict processes to go through so they can do that. And I think what amazes them the most is that it's not like TV with all the drama and stuff like that.

00:12:04 It's like, on one hand, we're doing brain surgery, but that's kind of over here. What the daily life is about is, okay, Mr. Smith, you know, is he ready for surgery? Has he had his MRI scans? Is his blood work okay? You know, or Mrs. Jones was admitted overnight through the emergency department. She's having trouble walking for a few months, and this is what they found. You know, her spinal cord is being compressed. And you start figuring out, does she need surgery? What kind of surgery? You know, you get lost in the details of it. And every once in a while maybe you realize that what we do is pretty cool. But you can't run around thinking how great you are. So a great story about that. Once when I was at another institution and we were rounding in the morning. And early morning rounds, the people who were in the hospital were kind of explaining to the crew coming out.

00:12:52 what happened overnight and trading off patients and things like that. And they mentioned that there was a nine-year-old kid who had come in with an epidural hematoma, which is a blood clot under the skull, but it was rapidly enlarging and pushing on the brain. The kid was going into a coma. So they took him to the OR and operated. The kid's doing great. And the CAT scan next morning looked great. So we were talking around, and the incoming resident said, oh, you did a nine-year-old kid? And they said, that's pretty cool. And they said, that's pretty cool. And then we moved on. You know, to talk about the next patient. What's the hardest thing about being a neurosurgeon, being a brain surgeon? A lot of things we can't help, unfortunately. I mean, we've made a lot of advances in a lot of areas, but two of the most things that still are very difficult to treat are malignant brain tumors.

00:13:43 Having to tell families that's what they have. And then on the other hand, there's the kind of the emergencies of people with really bad strokes or really bad brain injuries or spinal cord injuries that, despite your best efforts, unfortunately, you have to give the family some very bad news. The thing about that, what's interesting, though, is in some ways what's worse than the bad news is the not knowing. When families or patients are kind of waiting to see, will the biopsy results come back malignant tumor or not? Or, you know, we just operated on this man. He was in a car wreck. Is he going to wake up and be okay or not? That's the worst, you know, not knowing.

00:14:30 I think people can often eventually come to grips with some kind of bad news,

00:14:35 but twisting in the wind is terrible.

00:14:41 I just, I can't imagine how hard it is to say there's nothing we can do.

00:14:51 Yeah, sometimes you have to say that or you say, listen, we did everything we could and it's still not good enough. So I know in studying for this, that a lot of issues formerly in Ukraine with tumors, etc., is that there had been a lack of testing so that a lot of the tumors were a lot further along than they needed to be in terms of like if you had the earlier testing and techniques. Is that still the case? Is Andre seeing more advanced than you would see in the U.S.?

00:15:32 That's a great question, but when you're asking about any particular surgeon like Andre, you've got to realize he has been doing his thing at one institution for a long time, and he has a very good reputation, very well-deserved. So the kind of cases he would see might be different than the ones that someone just starting out or at a smaller place might see. So that's a great question, and I don't have any direct knowledge of that, but at least from what I've seen, cases aren't necessarily any further along than they would be in the United States. I mean, for example, I spend a lot of time at what's called the safety net hospital, you know, county hospital, where we see a lot of people who have no health insurance, you know, people who may not be in the country legally.

00:16:15 And of course we take care of them, but a lot of them show up with incredibly advanced tumors.

00:16:25 And, I mean, going blind, that kind of thing? Yeah, going blind or just literally things growing out of people's heads, you know, and you have to wonder why, what took them so long to decide to come to the hospital? And the other question is, why did you come in now? You've had this going on for a while. What was it about today or tonight that made you decide to finally come in? So tell me again what you just called the county hospital. A safety net hospital? You ever heard that term before? It's kind of for people who don't have health insurance or no other place to go. You know, you can't afford to go to some large private hospital.

00:17:06 It's a place that's supposed to kind of, you know, be there for those who have no other recourse.

00:17:14 So, as if I didn't know, tell me about Ukraine and tell me about what's going on.

00:17:24 In what sense? That Russia invaded. Yeah, so.

00:17:30 The sovereign nation, you know. And just as you're speaking about it, feel it and think about, you know, the meaning of what you're... And just as you're speaking about it, feel it and think about, you know, the meaning of what you're... So let me ask you for documentary purposes, though, do we want to get this much into the politics of the Russian attack? It's not really going to be that we get much into the politics. What I'm really asking you for is when you're telling about this, that you might say something about the nuance of it that fits into it.

00:17:59 So this terror war actually started in 2014, which a lot of people aren't aware of, with Russia's illegal annexation of Crimea. when they had what was called little green men. The people of military uniforms, but without any insignia on them. So you didn't know what country they were coming from. And I think everybody knew what was going on. But the West pretty much said, oh, we're not going to do anything because everyone's afraid of the Russian bear. So large parts of Ukraine were annexed back then. And Andrei Sirko and them would see a relatively small number of casualties coming up from the constant fighting down in front of the... And towards the end of calendar year 2021, in January 2022, Russia started building up a lot of troops on the Ukrainian border.

00:18:49 And pretty much anyone with half a brain could figure out they were going to attack and invade. And I still remember these endless discussions on the news every day about what's going to happen. And I still remember waking up one morning and, you know, the day the invasion started on February 22nd. No, I was going to get the days, 24, the year 2022, when they just rolled in. And everyone said, well, Ukraine is hosed, right? Because Russia's got a huge army and Ukraine's going to get rolled over. And there was that great quote from Ukrainian President Volodymyr Zelenskyy when the West, I think the U.S., had offered him a way out. He said something along the lines of, I don't need a ride, I need ammunition.

00:19:35 And the amazing thing is how ill-prepared the Russian army was and how they had no idea how to run a war. And the Ukrainians are incredibly resilient and very smart. So they figured out the Russian generals are using their own cell phones, their own civilian cell phones, not secured military communications, to communicate with each other. And immediately the Ukraine started killing the Russian generals. You know, the Russian tanks kind of got stopped in this huge column. I forget if they ran out of gas or got stuck in the mud or stupid reasons like that. And they were just sitting ducks for the Ukrainians. And basically, Ukraine repelled a lot of the attack. You know, if you look at the map of Ukraine, and you can still see roughly 19, maybe 20% or so of the country in the south and east is still occupied by Russia.

00:20:23 But then look at the areas that were taken over by Russia in 2022, and then Ukraine captured back. It's a lot of real estate. Russia being Russia, the way they seem to always fight their wars is get their butts kicked early on, but they just have such a big population. They can sacrifice people and keep on fighting. The war has essentially been in a stalemate for many, many months now, if not years. Russia may advance a few hundred meters one day, maybe Ukraine pushes back, but it's not going to end anytime soon. And Russia keeps throwing its own people at it. And now they have North Korea and Cuba and others sending them soldiers. And the other thing that's happened, you know, getting back to Medchikov Hospital, is that Dnipro is the biggest city close to where the fighting is happening,

00:21:17 to the south and east of Dnipro. And as a result, a lot of people are evacuating those areas and going up to Dnipro. And in just a year and a half or so that I've been going to Ukraine, I've noticed that the city seems more crowded, you know, more traffic, more cars. Ander Sirko's clinic for his elective patients, you know, the tumors and other things that the general population has that require neurosurgeons, you know, andeurism, spine disease, all that. The number of those patients has increased, too. So it's not just the unending number of combat casualties, but a larger volume of the non-combat-related neurosurgical needs. when about 30% or more of the workforce in Dnipro, in Medchikov, has left.

00:22:05 You know, some doctors either left Ukraine altogether, or went to other parts of the country, or joined the military. So you're doing, they have to do a lot more work with a lot fewer people. And the same, it's the same personnel at Medchikov who've been dealing with this increased value and daily attacks. While they're working, they're worried about their families getting blown up at home.

00:22:30 They've been doing this for literally for 11 years now and counting since 2014. And it's especially wrapped up since 2022. That's very different than what the U.S. has been doing or what the U.S. was doing in Afghanistan and Iraq in which the medical personnel would rotate in and out for a defined period. So maybe 12 months or so, plus minus, was the average rotation. And even though it sucked to be over there, you knew there was an end date for it. You can go back home. They don't have that luxury at Medsha Cup Hospital. They're there for the duration. There's no other home for them to go to. So again, that psychological stress is terrible on that. But you also really get to see their resilience, their determination, their bravery.

00:23:23 they're fighting even harder. They're not giving up. And from an academic point of view, a byproduct of that is they have this intensive, immersive experience on this huge number of combat-related injuries. So they are the world's experts now in understanding the natural history of the disease and how to treat it. And remember, no one else in the world ever has had to fight the kind of war they're fighting. Because when this war started, it was just another traditional war with tanks on some fields in the eastern part of Europe. And this is not an artillery or armor fight anymore. It's a drone war, which no one's ever figured out how to deal with before. And Ukrainians are the world's leaders in developing drone technology and fighting against that.

00:24:12 Also, learning how to treat the people injured by this new kind of weapon. So a lot of some of these questions, you know, I know the answer to but assume I don't. Well likewise you heard me say this before

00:24:24 Of course, of course. Well, it's it's always tough telling someone for the second time. I know I Know a little bit how they gave us, but so Are my answers good? Do I need to be more emotive? Do I need to be more like Racco?

00:24:36 No, you're fine. No, I mean like because I don't know what we're gonna use from this. I mean like this is this is just This is sort of all a precursor. So maybe let's think about that. Let's just like, what do you feel when you look at the countryside?

00:24:58 And like, maybe tell us about the first time you went and were you afraid the first time? So before I even went, when I got to talking to Rocco about this at this meeting, I may have mentioned we're at September of 2023. And at that time, like every other American, my experience of combat had been people in a desert, right? Or, you know, people living inside the wire and the figured military thing. I even asked him, are you like sleeping in tents somewhere in a cot? He said, no, this is like fighting in an urban city.

00:25:30 I mean, pick any big city in America and imagine that drones could take it out at any moment. It's crazy. It's not like urban warfare or an insurgency. It's like this is real-life war on your doorstep. So it was a surprise to me to realize, oh, this is just like going to a country in Europe, staying at a decent hotel, walking five or ten minutes to a big hospital. And the other thing is I was so ignorant about drones. Because you heard, this is back when drones were kind of first being used. And back then, they would use these cute little quadcopter drones that you see, you know, that people use when a building inspector comes to your house and looks at your roof and stuff like that. And they were using those to drop grenades on troops at the front line.

00:26:16 So I thought I'm going to have to be looking over my head the whole time, making sure there's going to be no drone. Of course, that's not going to happen in a big city. But the drone technology and the drone weaponry has advanced so much since then. I have a much better understanding about it, too, since I've been paying more attention and listening to podcasts about this and trying to read more about this. And again, I had no idea. I thought this was gonna be a traditional kind of neurosurgical mission trip when you go to some underserved part of the world and all these patients with horrible diseases, they've been kind of lining up for the surgeons from America or from the Western country to operate on. Now this is different. You know, those guys know what they're doing. And Rocco has the term reciprocal learning.

00:27:00 We learn from each other. He also calls it a cultural exchange. We learn how they take care of patients and we teach them how we do it. As a spin-off of that, the ICU people especially had a lot of questions about how we do this. So we set up a monthly neurocritical care conference with them for that same purpose.

00:27:20 We alternate months, one month 3% cases, one month they do.

00:27:24 Let's hold for a second while he repositions this F and we've cut here. Are you sure you got enough light? Because I'm looking at this little thing.

00:27:30 Yeah, it's starting to get dark in here. I mean, you got to do an overhead light? - No, because it will match. - Yeah. - Okay, so I lean forward a little bit? No, that doesn't look good either. - If you scoot a little bit towards the one. - Hey, hey, there you go. Anything you wanna change about this, Logan?

00:27:47 For a go.

00:00:00 I'm going to swap this car the way back in a minute. I'm going to swap this car the way back in a minute.

00:00:08 So yeah, we are kind of approaching towards the end of our light here. Choice of a new generation. Pepsi. Zero sucre. No sugar. I was too busy losing my lens filter. It's funny because it's the one filter we're going to use on this camera. I have two of them. So luckily it does this anamorphic thing, which basically just, you know, squeezes the image so you get like more information on the side. Anyway, but it provides it this intriguing look that sort of makes up for the fact that

00:00:53 And this, by the way, we're not necessarily going to even use. I'm just getting it because it's literally synced up to your mic.

00:01:02 So it'll... So I'm starting to understand. Is this part of why post-production is so expensive? You have to take all these different kind of live streams of info and sync them perfectly?

00:01:13 Right, yeah, exactly. And so that's why what I was doing last night was a big thing, was getting the sync boxes because you can, it's so much easier when you have matching time code. - Yeah, yeah, yeah. - And so like to match it precisely, there are different techniques, but you know, like that's why, you know, they use the slate, right? The clapperboard, you've seen that like in a film before,

00:01:46 you know? - Yeah, yeah. So that's just matching, you know, primarily usually one camera to one piece of sound.

00:01:55 And I mean, the other thing is that, like, you can do this and have it all, you know, lined up perfectly at the same time. But that takes a lot of money because you've got to have all kinds of gear so it's all going into one, you know, one unit. But then, just think about, we're sitting here rolling on this. This journey is going to be very brief in the film, right? And so, the job of the editor and the post people is to watch all of this.

00:02:39 And I'll watch a lot of it, but they... Yeah, sit down here. They'll go through it all and they will eventually...

00:02:49 Do we want to leave that door open or close it? We'll keep it open. Okay, not too bad for sound. It's definitely helping them. Yeah, it gives us a little bit more. So like the Titanic film, they shot more hours of footage than the journey lasted.

00:03:07 Tough. Oh look at you know, look at more yellow leaves here and brown leaves.

00:03:19 Different part of the country. We're gonna do leaf peeping. This is now a leaf peeping tour. Well, it's amazing that... when I I can deal with sleep deprivation these days much better than I used to be able to one place where it comes into play is my eyesight it You know and then my brain plays tricks Okay, you're good like that? So what were we talking about? I don't know but the leaves are changing

00:04:00 Just mention that. Oh, yeah, so you asked me earlier I'll give up the thoughts on Ukraine. I mean, here's a really nice countryside. And what's interesting is that as we're riding along here, I noticed that these leaves in this part of the country are already further along in the autumn process here. There are more yellows and oranges and browns than there were just a little while ago. But it's a beautiful country. It really is.

00:04:27 And that is actually why, or part of why,

00:04:31 It's been in such an important sort of region over the centuries of the thousands of years of mankind being in the European area. So it sounds pretty stupid to say that we are lucky in America because we're protected by two oceans. You know, if you grow up in the United States, you live there your whole life, you don't even think about being attacked or invaded. But when you're actually physically here, you know, almost anywhere in Europe, but especially kind of in Eastern Europe like this,

00:05:00 you really realize that there's nothing stopping any invading army or invading horde of barbarians throughout history coming from any direction. You know north, south, east or west. Just a big flat

00:05:13 plain. There's no natural barriers. And it makes you realize how vulnerable these people are.

00:05:20 But isn't this a center for agriculture? I mean like... Oh yeah. Yeah. Ukraine is one of the world's bread baskets, right? That was a big problem. All the wheat they need to export through the Black Sea

00:05:30 I was under threat for a while. And if that's under threat, then a lot of people in the world go hungry in Africa and other places. So when did you tell me again when you got your Lithuanian system trip?

00:05:43 I think it was a couple of years, 2020, late 2022, early 2023.

00:05:50 And when did you go to? June of 2023, just a couple of months before I talked to Rocco about this. So I was kind of preconditioned to come for a couple of reasons.

00:06:00 We talked about my wife and her volunteering with the Red Cross, which I've always thought was cool. Then we talked about the fact that I'd kind of seen the former KGB headquarters and, you know, walked the places where they executed people there. So those were swirling around the back of my head. And then I met this guy who had been to eastern Ukraine and trying to help there. I said, I can do that, too. Why can't I? You know, my children are grown and they've left the house. So we're empty nesters. It's a perfect timing. Are you excited to be heading back? I am because we talked earlier about some of the reasons to do this, you know, because it's trying to help defend a free democratic state against a tyrannical state's invasion.

00:06:53 And a more fundamental note, just good versus evil. But that was personal because they're my friends. And they're my friends who are going through some hard times. And so the first time I went was just kind of get the lay of the land, right? Then I thought, how can I up my game for my second visit? So I spent more time in the ICU because I'm actually certified in neurocritical care as well. And I have a lot of interest in that part of the hospital. And then my third visit, I actually spent a few nights taking call in the hospital at night. and I kept thinking, how am I going to up things for my next visit? And I realized I don't have to, because just by showing up, it is such a big shot in the arm for them.

00:07:39 Yeah, you bring little gifts as a sort of a gesture of friendship, but it's not because of the gifts or anything like that. It's just seeing someone from America who's willing to make the journey. And sure, there's some risk there, obviously, But I'm surprised that more people from America aren't going all the way to eastern Ukraine, to Medchikov Hospital. If you're interested in trauma, this is the institution that's leading the development of trauma for future conflicts.

00:08:12 And those lessons, of course, translate immediately to civilian trauma care. But I mean, like, so you're topicking a double leg short. On one side, you want to tell people that, like, hey, the war's still going on. But, like, but no, you can go near it. Yeah. So it's sort of a tough thing, right? You know, because you both want to, like, say people to be aware, but also, like.

00:08:38 Well, you're right, but we're not going to the front line, right? The front line is a disaster. There's no longer a front line in a traditional sense. It's kind of this long gray zone, and it's hard to tell who's in charge of different pieces of land. This thing can be kilometers in thickness. You know, it's not just a thin line on a map. But we're not going anyplace over there.

00:09:00 We're going to a large city that has a good missile defense system, and especially the area near the hospital is particularly well defended. The place we're staying at and the hospital itself, they have shelters in the basement. So, you know, there's usually enough of an advanced notice. If something really bad is happening, you can get to the shelter, but it's unlikely because all the defenses are on the hospital. So, yeah, the risk is not zero, but, you know, if you're an infectious disease doctor and you're interested in Ebola and you go to Africa to study Ebola, well, there's a risk there, right? Or maybe malaria might be a better example, right? You want to go to a place where there's malaria so you can study it. You might catch malaria, but you kind of put up with certain risks.

00:09:47 You're a long-haul truck driver. You can get in an accident. Fall asleep behind the wheel. There's a risk crossing the street. Yeah.

00:09:57 What about brain surgery or neurosurgery? How did you end up in your journey?

00:10:05 When did you know that this is what you wanted to do? Yeah, that's a good question. I know some people don't make up their minds till late, but it was always something I was very interested in. So for me, medical school was more looking at other specialties to make sure I wasn't missing anything. You know, neurosurgery was always my number one thing, but let's look twice at this or that to make sure maybe there's not something else I'd rather do.

00:10:30 because I know a couple of classmates of mine who are dead set on surgery, and they had this revelation in second or third year of med school that they really don't want to go into surgery, so they went into other fields. And I developed pretty early on an interest in neurotrauma and neurocritical care, and when I was talking to my advisor at medical school about that interest, sees the one who recommended me, recommended that I, you know, where I should do my residency

00:11:00 for places that are strong in that. I'm struck by the statement you just made earlier. Like, we're going to a city with a strong missile defense, whatever you said. Yeah. It's just like, that's just not something we have to think about in the U.S., you know?

00:11:22 Yeah, I think it would be, well, obviously I'm biased, but yeah, I think We've become too insular in the United States with this breathless reporting. I mean, I love when the fact that you have some news story that's maybe 18, 24 hours old and have like a live reporter, you know, who's in some other part of the world. So they're awake at 3 a.m. local time or something talking to the evening news in the United States. You don't need a live reporter there. You know, you always see a reporter standing out in the middle of a hurricane, broadcasting about the hurricane. You know, we don't need this kind of stuff like that. I think if we take a step back and think about what's really important, I mean, this conflict going on has redefined how war is going to be fought forevermore. The future of Europe is at stake, and if Europe's affected, it's certainly going to affect the

00:12:11 U.S. People in the U.S. may not want to think that way, but it will. It'll affect the rest of the world as well.

00:12:19 How much do you think about the people that you couldn't save or couldn't, whether not operating at all or operating and it wasn't successful?

00:12:30 How much does that stay with you? Sometimes. Sometimes you think about it at random moments, or sometimes when you see a patient who shows up with the same kind of injury or same kind of disease or illness that a patient whom you treated had, and the one you treated didn't do well. You think, oh, okay, I remember this because this patient over here had this and didn't do well. You just try to do your best to make sure it doesn't happen again. You know, the best surgeons I know, and I work a lot with residents, especially the upper-level residents who are going to be independently in practice in a year or two. And if they're involved in a case that doesn't go well, choose them up sometimes.

00:13:16 And I know they're going to be the best ones. You know, you have to have several conversations with them and reassure them that you didn't do anything wrong. Or, God forbid, they didn't make a mistake. They learn from it. You sit down with them and make sure they understand it won't happen again, and usually they're well aware of that. Usually, in most lines of work, if 99% is pretty good, you're happy with that,

00:13:42 the problem is that 1% isn't good, and that's not good enough if you're in the medical field, especially the surgical field. When you see something similar, are you frightened or excited about the opportunity to do something different?

00:13:59 Or is it a little bit of both? I don't think there's any, there's not that kind of emotion involved. It's more like problem solving. It's like, okay, we need to approach this tumor this way or approach this spine problem this way. And you're thinking about this other patient who had a complication or didn't do well. You just learn from your mistakes, but hopefully you learn more from other people's mistakes

00:14:22 that you've read about or discussed at conferences, so you don't have to repeat those same mistakes.

00:14:30 Tell me about Metrotob at night. It can be pretty variable, but on any one day, just Andres Sirko alone, we'll get one to eight cases of penetrating traumatic brain injury, which, again, that means that someone has had usually shrapnel. In the United States, when you talk about penetrating brain injury, it's usually a gunshot wound to the head. But in war, it's usually shrapnel from explosion, so a piece of metal or brick or pavement or whatever is in someone's head. So they do anywhere from one to eight of those cases, an average of about three per day, just for that disease entity alone. Not to mention the other types of injury or trauma, and then not to mention all the other surgeries they do for brain tumors and

00:15:19 you know, chronic artery disease and spine disease and all the other branches of neurosurgery.

00:15:25 They can be pretty busy at night. And that's when the people are brought in from the front.

00:15:32 Yeah, generally it's, we talked about how the so-called rules of war got thrown out the window. So it used to be a pretty sacred thing not to attack a medical facility, right? Because theoretically, those doctors and nurses, healthcare workers, could be taking care of one of your side's injured soldiers as well as the enemy's injured soldiers. But that's unfortunately a very naive way to look at things now, which shocked me when I started looking at this. So, of course, ambulances with the big medical symbol on them that used to mean it's off limits. No, now they're targets for the Russian drones. They'll go after them. And Ukraine, they have these kind of stabilization centers,

00:16:17 which are usually the first place an injured soldier or civilian may get to as they're trying to get them stabilized and move them further away from the line. But again, those have become targets now.

00:16:30 So, you know, I've been reading how a lot of those are now kind of being hidden or placed underground or not advertised as such. You know, that medical symbol used to be kind of like a garlic for a vampire. You know, it keeps away the drones and things. Now it's a magnet, unfortunately.

00:16:51 So we were there when Andre talked about this picture. But as if we weren't, tell me about Andre talking about his surname

00:17:00 and talking about Ivan Sirko. You know, you'll have to talk to him more about that. Ivan Ivan Sirko was a great Cossack leader. I don't know, was he a general, a military leader? And yeah, Andres descended from him. So if you talk about the tradition of service running in his family, it doesn't get much better than that, as witnessed by the fact that his older son is a neurosurgeon. He has finished training and starting his career. His younger son still has a ways to go in his education, of course, but even he is leading more towards the medical field. Last time I talked to him, he was thinking more about trauma surgery. I think because of part of the older son's training, he had done a stint that's kind of

00:17:47 like a little different than in the United States, but like a neurosurgeon who can also do stuff on the other part of the body. So I think the younger son was kind of thinking about that model, but knowing Andre, I think by the time his younger son has finished his school the younger son will be a neurosurgeon too

00:18:04 so there's very strong family traditions dating all the way back to uh uh ivan sirko wow i didn't pick up that he was descended from him i i picked up like how you know he's a legendary figure no i thought he's a descendant of him yeah we can we can clarify when we're there but i just for me he he was just talking about having a name that he had to live up to. Because he is named Sirko, he can't leave. People look to him as for the strength that the Sirko name carries.

00:18:42 That's a very strong thing that I took from it. You're exactly right. Yeah, it's not only his own personal leadership, but he's, again, unlike in the United States,

00:18:53 these people do think back to prior generations and their family heritage.

00:19:03 Talk to me about passion. So I got to tell you that my ancestors come from Northern Europe, so we tend to be a little more stoic and not that emotive. Kind of like the Ukrainians, you know, it struck me in clinic. I mean, you, I'd have these conversations with patients, give them very bad news and they're very stoic about it. At least there, you know, I'm sure when they go home, it chews them up. Yeah, we're, I'm just not as passionate as someone from the southern part of Europe, you know, you're Greeks or Italians, people like Rocco, who are much more passionate and and articulate about these things. But we still have the same drive, no question.

00:19:53 We may express it different ways, but Andre Rocco and I have formed this team, alliance, brotherhood, where we're talking every day on WhatsApp. And we're all very different, which makes us a better team, right? We all have different strengths that complement each other's weaknesses, different styles. We're all united by this idea about trying to help Andrade do the best possible job he can to take care of these horrible casualties that he gets every day and try to educate the

00:20:26 rest of the world what's happening in Ukraine.

00:20:31 Describe being driven, have that drive. You know, it's funny. You asked me to describe that. It was like, you asked me to describe, like, why do I go? You know, it's just something I do. I mean, my wife has given up on me because, you know, pretty much don't have any hobbies. You're trying to work all the time. You know, even on this trip, knowing that we wouldn't have very good internet, trying to line up the work and things to do on this long train ride, it wouldn't require internet.

00:21:00 So it just... Well, I will say this, though. You know, they used to call people workaholics, which you don't hear much anymore. But they have to be about working all the time. And I've been blessed in my career to hold a lot of leadership positions and organize neurosurgery and be able to give back to the specialty a lot in that way. But I think that what I'm doing here now in Ukraine, it's a whole order of magnitude bigger.

00:21:30 And not to disparage any of the other, you know, committee work leadership things I've done or the people who are currently doing those things because it's important, but we're talking about a war here. I mean, literally. You know, it's not just committee meetings and trying to reconfigure organizations and things like that. And even trying to improve the way the specialty is practiced in the United States. This is like life and death for a lot of people. So the whole workaholic drive thing, just the innate desire to keep working,

00:22:00 I think it's important, but we all know people who work all the time and they're busy counting their paper clips and rearranging the rubber bands and things like that. Think about big picture. What can you do to maybe have a larger impact? Like, keep going back to my wife. She didn't have to volunteer for the Red Cross. Just one day, years ago, she said she's going to do that. And she stuck with it. I think that's very commendable. It's interesting that what I call passion, you call drive. Yeah. It's funny because I think of myself as actually being a very passionate, driven, hardworking person and yet one of these young students I know, they're still in college, who is shattering

00:22:47 me, she said, "Dr. Black, are you always so calm?" But that struck me. I guess maybe on the outside people think I'm calm, but I don't think of myself being away on the inside.

00:23:00 Logan, before we lose light completely, are there some topics that you think we should hit in this? You know, yeah, I was trying to think that. I mean, I think we've got a bunch of stuff. I wonder if maybe we should tee up kind of like just in layman's terms.

00:23:22 terms like the train from Warsaw, you know, in a few succinct kind of pieces.

00:23:26 Oh, that's a good idea. It's like, what are we doing here? Where are we going? Yeah.

00:23:30 Where are we going through? You know, yes. That's a good idea. That's a good idea. Let him get a little set. Yeah, because I'd love to shoot some out the window and some other stuff. Yeah, I know. And like, I was going to say, if there's anything like we want to get with Alex. Oh yeah, it'd probably be nice to get some like, like, stoic Alex. Right. Exactly. Or walking around the train, but also just sitting. Yeah. Yeah. Okay. So welcome to the Ukrainian train. We are on our way to Dnipro, which is in central

00:24:06 Ukraine, but in terms of where the front line is, it's only an hour from the front line. So to get here, I live in Dallas, and I try to be as efficient as I can with my travel to minimize the time I'm away from work. So the cycle I've gotten into is leave Dallas on a Thursday evening, connect somewhere in Western Europe like London or Frankfurt and get into Warsaw, spend the night there, which is Friday night, then Saturday morning catch a 6:40 a.m. train from Warsaw to the Polish border. That ride is about two hours, 45 minutes or something like that. And then an hour later, Ketutraini leaves from Helm, the border town, and goes all the

00:24:53 way to Dnipro, which will get us in at Sunday morning. So if you leave U.S. Central Time Thursday night, you get in Sunday morning, you lose

00:01:35 All right.

00:01:47 All right. He's maybe in the bathroom.

00:01:52 Yeah. Okay, please. Let's try to see if I can get it.

00:02:00 Oh, let me turn on. Hey, Bub? I feel like now we can get it.

00:02:09 Reflection. We can. We can. Whew. I'll sit in for him. Yeah. If you turn on that guy. If you turn on that guy. Yeah. Oh, I know how. I've done it. So. Let me act as if I'm stealing important secrets here. The secrets of surgery.

00:03:22 Can we get him reflected in the... This one is trying to line up the end. Oh yeah, and I can see my reflection.

00:03:30 Let me try and see if I can see my reflection in the... Ow! Okay. Oh yeah. I can't believe that.

00:04:35 I need light on me. So. You can take your own seat. I was sitting in as you. Yeah. Yeah. Do you have Wi-Fi yet?

00:05:01 Yeah, we'll get more to see you there, Alex. - It's gonna shoot your reflection. - It's kinda interesting with the things out there. - Yeah. - You can barely see them. - Do you want me to sit in so you see what it looks like? - All right, all right. - Oh, I'll be in the shot. I'm there, right? - Yeah. - Yeah. - All right. - I'll tell you if you sit as close to the window as you can. - Oh, yeah. - Oh, yeah. - Oh, yeah. - Okay. - Okay, so you want me to do what? - This?

00:05:30 - Yeah. Is this my phone over here? This one is mine. This one is mine. Okay. Then I'm like, yeah, I got mine over here. Then I'm like, yeah, I got mine over here. That's great. I'm using your set. Okay, I'm going to do this. You need to hold that. You want it farther back? No, no, it's good. Okay.

00:06:31 So, we're going to go.

00:06:58 Hang on one second. I'll probably just grab a few more shots of Alex to work in. Yeah, just have it. Yeah. All right. All right.

00:07:33 Do you guys see the closer? You're all good. Here. I can use mine with it here. Do you want me to turn your flashlight off? There. There. All right. All right, I will step out. Oh, look at my... There we go. The

00:08:45 *door opens* Oh yeah yeah okay Logan you might want to we might need to slip in so she can person go through oh okay she's not all right sorry sorry about that

00:09:31 open it.

00:10:23 *Burge sounds* you try and get his reflection see if I can get out of the way

00:11:31 so *click*

00:13:23 *Sigh*

00:13:30 did see the lines in the bathroom no drinking water out of the sticks there yeah yeah i i bob done was trying to explain to you once it's something to do with like is the water doesn't circulate as frequently through this sterilization system yeah i know it doesn't cry you know yeah i mean i've yeah i've seen it on trains and even at mexico possible don't drink the water out of the

00:13:50 pipes okay they'll only bottle they have these big like bottled water dispensers everywhere you'll see all right that was uh we may we may get a couple more things but we got a lot there we go cheers yep that's not a bad shot

00:00:00 [RUS] Speaker 1: The fibers completely bend.

00:00:00 [RUS] Speaker 1: The fibers completely bend. [RUS] Speaker 1: - And there it shows us. [RUS] Speaker 1: This is us leaking from the frame.

00:01:13 Speaker 1: more hot-flavored

00:01:40 Speaker 2: She said, "Did we have a first stage somewhere?" Speaker 3: I'm gonna get in the shot, but yeah, I am in the shot. Speaker 3: We're gonna go get a photo, but it's okay. Speaker 3: I always like getting selfies, I do A, prove I'm there, but B,

00:02:09 Speaker 3: Because I know I can get a shot that will have energy and be present.

00:02:38 Speaker 4: Yes. Speaker 1: here's warriors being kind of unruly, difficult to manage. Speaker 1: You know, that's for all the swords and bows and arrows. Speaker 1: That was the guy who showed you, excuse me, the first one.

00:03:20 Speaker 1: Yeah. Speaker 4: This one is Easter.

00:03:30 Speaker 4: Easter, is he sex prepare for Easter for holidays? Speaker 4: Yes, yes, in each family create this painting. Speaker 4: Yes, yes, in each family create this painting.

00:03:45 Speaker 1: It's not a big thing, it's the same thing. Speaker 1: It's not a big thing, it's the same thing. Speaker 1: You put an egg in a solid color of eastern and each really color. Speaker 1: So, I'll give you a photo.

00:04:30 Speaker 1: - Speaker 4: thank you thank you let me get one more photo of this one one more photo

00:04:55 Speaker 4: here you go

00:05:00 Speaker 3: oh nice and one more one more here we go finally Speaker 4: I documented it. It happened. Speaker 4: The Ukrainian tribe. Speaker 4: Oh, yeah.

00:05:34 Speaker 1: So can you, when you get a second, ask Andre and White, Speaker 1: some flags have the tribes in the US. Speaker 1: The tribe is a symbol of the military. Speaker 1: Okay. Speaker 1: No. Speaker 2: This is really a symbol of the military. Speaker 2: It's a symbol of Ukraine. Speaker 2: It's one of the symbols of Ukraine. Speaker 1: I thought it was one of the symbols of the Ukrainian military specifically. Speaker 1: No. Speaker 2: No. Speaker 1: That's what I'm writing on the internet. Speaker 1: Is it used? Great.