Nichole McCaffrey and Daniella Sinay

00:01 Alright, Daniella whenever you're ready. Hi, I'm Daniella sinay. And today is Monday, August 30th, and I am recording for my home in Northeast, Portland, Oregon. And I'm going to be talking to my co-worker in the Pediatric ICU, Nicole.

00:20 And my name is Nichole McCaffrey and it is August 30th. Monday, and I am recording from my home and Happy Valley, Oregon. And speaking to my friend and colleague in the Pediatric ICU, Daniela.

00:39 So now I'm supposed to ask, sorry.

00:46 You're waiting on me that I have worked with you for a long time. But I really don't know what your background was before you found his ankle therapy. Tell me a little bit about like where you're born and raised. And I'm just curious. What, what kind of a child are you actually? I don't know if this is a shock to you. But yes, which is a pretty nice job since I was about 15 years old, I grew up on the East Coast. So maybe that's why I'm originally from New York City. And then when I have a twin brother and a sister who's like barely 2 years younger than us. And when we all became school-age, my parents moved out to the suburbs, but I think we never really left that New York City mentality, and we were all so close in age. So there's a lot of like

01:45 Fighting for like, this is how I want to play this game and or we have to go to this park, like me, and my siblings are all really close and close to me. So, I think we all realize. Really that if we wanted something, we have to speak up together and both my parents worked and I work really hard. So again, it was a lot of like, if I want you, no attention for Mom and Dad, and they're busy working and also making dinner. It's like you got to kind of yell. I can sort of figure it out really early on that. You know, if I want to. Like, I think that's my personality to that. Like I want something, I want to get it. So I always got really good grades and I always worked really hard. I think like the best way, a good anecdote to describe myself. When my brother and I were in the first grade, we really wanted to have a party at our house and we rode out in the hay.

02:45 I can read em and weep a small out to her classmates and said the date and the time. And then this, I think Friday night before the party. My parents are to getting all these calls from parents being like rain. We're going to drop your kids off at your house tomorrow and my parents were like, what are you talkin about, six year olds did this. So we've been organizing for a while. So everyone out that my parents were really creepy about it and talk to you. But I've always kind of been that way like organizing and kind of creating events for people and I always had an interest in science and medicine. I think that a lot of people in my family are nurses and I always going to solve the impact that. Had and I love people, I'm a hundred percent an extroverted people person. So I was kind of knew that I wanted to help people and be around people. And then when I was 15, I had an injury, I tore my AC

03:45 And I really got to see the, you know, medicine from step one to step 10. I went to the emergency room and I interact with the nurses and the doctors there. And then I went to the orthopedic clinic tonight and, you know, interacting with the doctor there and the anesthesiologist, and the people after surgery. And then I went to physical therapy in my first day after surgery and he made such an impact on me. I went into his office. And first of all, he saw me less than 12 hours after surgery, which was amazing. And I sat in his office and I was 16 and I couldn't walk, and I've never experienced any sort of injury. I've never had surgery before and he asked me to move my toes. My toes and I couldn't get up, was crying. I have my crutches, and he was just so calm. And he talked about how your brain controls your muscles, and how, you know,

04:45 Your your brain is always in control of your body and kind of talked me through what muscles do what, and how to get my toes to move and how to get my knee to bend. And I immediately called me down and it was amazing and he helped me pay my first steps again, which was wild especially at 16, you know, I was, I never had dealt with anything that, you know, took me off my feet, and I recovered so fast and he had such an amazing protocol to get me back on my feet. I think I was running again in six months, which you noticed that 16 was the most important thing to me, you know, to be able to get back to playing sports and getting back to myself. And it was also one of the first opportunity that I had to experience, you know, being on the other side. I think that is a practitioner. Now, it's hard to imagine yourself in the shoes of someone who is sick or a parent of a, of a sick child. And it was my first experience and I always go back to that has like what? It felt

05:45 Like to have an injury or have an illness and what it what it must feel like, for all of our patients and he was so kind and patient and he had all this time with me, which I think it's something that really attracted me to physical therapy. You know, the doctor spent maybe 15 minutes with me. The anesthesiologist. I saw as I was, you know, looping into sedation and he really made just such an impact on me. And so I really have with him and I think he kind of saw my interest and he asked me to stay on as a Helper and I helped him with you. No logging information for insurance and getting no calling patients and cleaning at the clinic. And then he started to teach me a little bit and then I started to be his right-hand lady and I spent the summer there with him as well. It was really transformative again at an age where I was like

06:41 You know, super young and just looking to soak up information. And then after that, I was a junior. And I knew applying to colleges that I wanted to give the symbols are pissed and I didn't surprise anybody. Who knows me? Because again, I think I had like a 10-year plan when I was five and I just worked really hard to get there. When I, when I decided to go, it had just do not judge, but it had changed from a master's to a doctoral program. So a lot of prerequisites and it's a lot of extra school and all that extra class says, I'm so you definitely maybe missed out on a lot of things that 16 or 17 or 18 year old kids do probably to my parents.

07:29 Elation like I was not the kid who was out late. I didn't ever got in trouble. And it's funny. I was telling my husband not like I really hope our kids are like the hospital who are ATV accidents and you know, I like was in a book reading and planning for my future. And that's how I knew, what a really early age that I wanted to get into that kind of helped a little bit more. I don't know. I always had this, like, spark inside me that, like, I'm grateful for it. You know, I'm really lucky. I graduated PT school at 25, you know, none of my classmates were. Young and I was really, you know, lucky to get a paycheck at that age and know what I wanted to do and feel driven in that way. So I think,

08:29 I don't like how you see me at work or I'm pretty Taipei is true for how I was as a child and how I got to where I am, I guess.

08:42 Thank you for sharing that. I'm not surprised to hear that. You've always been a terrible person because he just really excel at what you do. And I think that empathy that comes from having lived, a little bit really makes per

08:58 Just that greatness at the at the bedside, like you've been through it. So you have done that a theme that you're bringing to the work that you do. I'm curious if you really specialize in working with infants. And how did that evolve over time? It was working with adults. When I, I went to school in New York and my first job was out there at NYU. And I worked at a specialty clinic for adult recovering from a neurological disorder. So, I saw a lot of strokes and spinal cord injuries and I love that type of work. And anyone who's had any sort of neurological injury isn't able to really advocate for themselves, you know, so I really found it in powering to be able to speak for those who maybe have a TBI, and they can't really

09:55 Say what they want or what they need and no one's there to advocate for, you know, for them and for the things that are important to them. And that's why I really enjoy what I do, you know, I don't have to worry about medication and sedation and a plan moving forward. Like I really at the physical therapist have to worry about. How can I make this person comfortable setting her up, going to the bathroom, getting into their home, especially working in New York City. It was like, okay, how do I get this paraplegic man up to his fourth Storey apartment in New York City because finding another home was not an option, you know, and there's no elevator in the Walk of the he lives in. So, how do I get him home to his home? Where he wants to go to it? You know, I've always kind of found it a special place in my heart for people who can't speak up for themselves. And then when I moved to Oregon, I was initially working in adults, as well. I was working in the Premier League in the emergency room and the trauma.

10:55 Center as well as Orthopedics. And it kind of lost that a bit of like, people get out of the gate for themselves on the ortho unit. And I kind of was struggling with, like, finding like my likes park there and the pediatric department just needed help. They had, they were short-staffed, and they were asking for people to help stop over there. So I said, why not? I'll go help over there and when I have been in school, I had traded a little bit in Pediatrics. I worked at the NIH in DC. That was my last clinical rotation and I had to work with Pediatrics there, but I left that thing. I'll never do pediatrics. It's too sad. And so I had a few know for your crew with adults, but I said he had a little bit of experience. Let me try working in Peds and it was exactly. It was like, you know, kids who can't verbalize what they need actually in since, you know, so I came over and started working with kids.

11:55 I realized no one had been specialize in the 12 months and under population, or the woman who had had just gone on maternity leave and never came back. So I talked about this woman who, you know, works for 12 months and Under 12 months and under, but she was gone, and no one was really there. So,

12:15 You know, in my experience, over in Doernbecher for the short. Of time that I would, you know, how it started raining over there. That was like the Lost population. You know, I would do my rounds in the pick you and see all the big kids and even the toddlers, whose parents are right by their side. And then I see the room. So, you know, the open heart, you know, cardiac surgery babies, and, you know, maybe there are no parents there or there on a smile, when your parents are too scared to be in the room and no one's there. I'd be kidding for them or for their needs. And I just kind of fell in love with that population. I just started taking classes. I remember with him like the first couple months that I've been training in Pediatrics, I flew to LA and took a neonatal class. I became a member of nant, which is the Antonio needle therapist Association and was taking, like, I couldn't stop taking online classes, about feeding. Ty never done. I don't have any kids and there are you babysit my

13:15 So I just heard of eating, you know, eating up all this information, how babies brains work and what they do process and that everything they're processing in the ICU affects them later in life. I'll never forget. I read an article really early on in my training. About NICU babies have a higher likelihood of being to Walker's because when they get heal pokes, that's how we draw blood from Nikki baby's not sensory input of getting poked on your heel over and over again translates, later in life. So they have a significantly increased chance of walking on their toes. When are toddlers, which to me just like blew my mind, you know, like everything that's happening to them. They're processing and their reign is remembering and their body is remembering. And so I just wanted to be helpful. I wanted to let you know be the person who had the interest and I was like ready to jump in there and I just wanted to like give up

14:15 Are patients, who didn't have a voice? And I think that like we do as, you know, one of the higher-level pick use and Nick use in the state with a lot of babies who don't have parent Advocates at their side, you know, there's a lot of abuse who I work with in the NICU. Who's, you know, they're born in their parents are addicted to drugs or they are helpless. And so they're really really their voice list, you know, and I was just wanted, I wanted to help in any way that I could and I love a challenge. So, you know, there was a hole I wanted to kind of see if I could be the person to help out until that hole and

14:57 You know, finding a niche. So I think it was just by observing where the need was, you know, and who, who really needed to help the most? And like I said, I just took all of the classes and did a lot of training and then ended up getting trained in the NICU as well, which really helps I think with our continuity of care. I see a lot of babies who starred in the NICU and they need surgery or, you know, they make their way down to the Pediatric ICU. So, I've really seen an opportunity for continuance of care. Being the person who knows, best, who knows this kid from day one of life. We just had a patient who spent months in her. Pediatric ICU who you know, came without parents and now she has an amazing Foster family, but I'm at heard they want his wife in the NICU, without any parents work with her in the NICU, work with her in the pic you and then to see her, you know, get this amazing Foster family.

15:57 Google home with them and then she just came back for second surgery and to see her driving was like, it's the best. You know, it's the best feeling to know that like you were there for someone when they needed, you know, they needed it the most.

16:13 So what? Yeah, I find it. I found that there was a hole and I found that I absolutely love it.

16:21 Yeah, it's like a population that we don't think about and it and I also think when I tell people what I do, like, what would a physical therapist do for a baby and it's so fun to be able to explain like so much. They're so much. Develop a m, their brain is, you know, absorbing all of this. Just like Howard two-month-old at home is absorbing sound and light and you know, being held and you know, the compression that you know, being swaddled in held by parents, what it does for their bones and their joints, and their muscle elasticity, you know, babies who are on their back and I see you don't get all of that. And that's really important. So I think it's been really fun for me to learn like a whole new aspect of my trade and

17:06 Yeah, well, I think one of the greatest things about you specialize in that you have all this knowledge and now you're sharing. I feel like I have learnt. So all these things about babies in their development and understanding and that and I'll just being shared in the picu. I'm sure in the NICU as well. So it doesn't grows exponentially and I'm sorry. I'm so distracted. There's a fly. That is like. So Danielle what patient story in your time, as a physical therapist, like

17:48 Really sticks out in your mind. And what do you think it is about that experience? That was so impactful. Yeah. I love working with cardiac patients. Did you know that Nicole like I love getting in with them because they're so fragile and like everything is, you know, on the line there and the way that I look at it. It's like how can I make this person the most comfortable in like, the hardest situation will probably ever be in their life and they don't even know it right there, like 3 days old and so there's a specific. There's a couple of cardiac patients that I have in mind specifically and two of my anecdotes one has a happy ending and one has not such a happy ending, but they both kind of have the same message.

18:41 When I first started and this is going to be long-winded to, you know, long story to a short story. When I first started working in the picu with neonate. I remember seeing a cardiac patient on ECMO and I asked one of my colleagues who have been there for years. Like what is that machine and like what's going on there? She's like, oh, that's an ECMO machines, the heart-lung machine. It's keeping that child to live. Like we don't go into those rooms. There's nothing that we could do there. And obviously I said, well, why not? I can always do something. I can always make myself useful. I can always find a way to make a patient more comfortable. To check their joint positioning to make sure that they're getting range of motion. Like. Big machine, doesn't scare me. Like, why don't we go in there? And I remember Joyce was the nurse and she's also up for everything and anything and

19:41 Can I come in and just make sure that you know, the The Joint positioning of this patient is? Okay. Can I just make sure that like they're not getting any sort of skin irritation. Can I make sure that there are soft blankets around that patient and connect make sure that their hands, you know are in a good position and Joyce said of course you can come in and I think that was just like the perfect moment of like me being brave and like not letting something scare me because at the end of what the other end of that machine is a human, the little person who is probably in some sort of pain or is needing a little bit of help in some way. You know, I can't imagine what it feels like to be on a mower to be sedated and that way but

20:29 I believe that like everything we process with her. We are sitting it or conscious stays with us, you know, there's like an energy in us that like feels everything. He hears everything. And so, if I could go in there and just make sure that like that piece of energy is being nourished than like, why not, you know, and so, I just, you know, didn't touch anything and just make sure that the kids in hands and skin looks good. And then I went home and like, washed videos on YouTube. I think for the 3 hours and try to figure out, like, what the really important pieces of the machine are in, what I absolutely shouldn't touch and what are the dangers and you know, what does it do? And then I feel really lucky because all of the nurses in the pic, you gave me all of that education as well, you know, they all of you. All of the nurses in the pic, you are amazing. And you guys have so much going on, and you have so much to do.

21:29 Whenever I ask questions, everybody answers my questions. And everybody takes the time to explain to me and look what the machines do and what the purpose is. And, you know, I remember seeing that the PTA dialysis and I was like, why are you pushing you know, why are you pushing fluid every 11 minutes? And I think with all of her was doing it and he explained it to me, exactly, which makes my job so much easier to do and I understand the mechanics behind it. So anyway, I became obsessed with going to act more rooms and helping those patients out. And I can think of a specific patient that was on a koala that I got in with probably like day two or three of life. And I worked with him really closely really, really closely. I watched him come off aphmau. I was really concerned about his hips and, you know, yelled at the ortho doctor that I think he has hip dysplasia, and everyone kept telling

22:29 That's the last thing we need to worry about right now. He's on a heart and lung machine. We're not worried about his head, but I was worried about the tips because that's going to have ramifications later on in life. And I can't imagine that that's comfortable to sit with dislocated hips, and I, you know, maybe the doctors weren't as concerned with it. But all of the nurses were, which was, you know, amazing, to, to see other people, who care as much as you do. And so it works really closely with the nurses to make sure that his hips were comfortable, and that he wasn't getting turned on to that side because I can't imagine that. That would be comfortable. I always made sure that he had something super soft over there on on that hip. I talked to parents a lot about what that's going to look like later on in life.

23:17 And I remember after that piece got taken off X bottle, getting him on his belly for the first time after, you know, heart surgery and how good that must feel to come off of, you know, you're not lying on your back for weeks and weeks how uncomfortable or help. You know how that must feel for your skin. So, I remember doing and this was, you know, Weeks Later doing massage the back with the dad there, for this pigeon, who is really really sick, you know, and the dad was like, I never thought we would do tummy time, you know, like it's so exciting to do tummy time with my baby and tell her things out like that patient, didn't make it, but I think that

24:03 I think that the time that we spent together with his parents was so meaningful of like to be able to come into a room where a patient is so sick and to be able to talk about it or not, blood pressure, and not medication and sedation. But to be able to talk about massage and Joint compression and positioning for anybody help later on in life, never happen. Like, it was so powerful to be able to talk about later on in life without parent. And, you know, give him a little bit of like, this is my child. I think of all the times we get you have this is a patient who needs to be done. This type of medication to be maintained sedation and I really try to look at it holistically and bring parents in to look at this, you know, and I think parents sometimes we'll ask the questions about like the right this second and I'm like, let's talk about what his brain is doing and how that's going to impact his ability to crawl in a few months and

25:03 In a few months looks like look for your picture, even though that might never happen. I think it like, gives parents this like deep breath of like, yeah. This is my child. And like, you know, these are like a little moments of like how many time were, you know, massage to take us out of this medical model, which can be really powerful. So and then I'm on the other side. I had a I had a cardiac babe who kind of same course, but she made it out of the pick, you and went home. And I did follow up Clinic with her hidden. I have like a secret follow-up Clinic that I do not available to the public that I like, save my Tuesday, afternoons, for sick, patients in and taken to a room so that I can do follow-up care, with babies, who spent a long time in the pic you because a lot of times, these babies will be in the ICU for month.

26:03 The time and then they go home and turns or like how do we work on sitting? And how do we work on walking and they have this terrible aversion to being on their belly because they have this huge incision and they had a wound VAC in and they weren't on their belly for the first three months of life. So, I know I have a really special place in my heart for those kids and I do follow up with them. And I also think it's unfair for another physical therapist like that. That's what I do is so foreign. I would say to 99% of physical therapist, you know, they are getting the type of care that, that they need. And I work for this kiddo up until she was a year old. And she was crawling and cruising and she was off of oxygen at home and she was eating by now. And the mom was just like, I cannot believe how far we've come. And I couldn't believe, you know, like the little peanut who I met intubated after heart surgery with a

27:03 Back and, you know, everything like is cruising and eating and you know, making noises like. Tammy, looks a little fight. Like the little little humans that we see on those machines. Like, there's something inside their, you know, they're not just like little people who we put tubes in and IVs in like they have brains and they have energy and like that. Develops, you know, and how we Foster that is really important. So seeing her come at the end of her journey with me was like, I'll never forget. It was incredible to see, you know, a one-year-old cruising and Crawling After, you know, that traumatic experience was it's all it like keeps me going always.

27:52 Well, it's is really powerful listening to you. Talk about like this to

27:58 Stories that, you know, obviously ended in different ways and I'm like, the old choked up, listening to you talk about it, but just

28:06 The way that you're always, remembering that Humanity, which is hard. Sometimes, all those machines attached to this oncology, this baby that had cancer that I took care of, you know, years ago and has brand new nursing is really hard watching his

28:30 You know, watching his little body fight until

28:34 I was really calm with one time. When his mom had said to me in the mail tonight. Like there's always room for Hope and that stuck with me forever because it's interesting that those two kids like, you know started out kind of the same way and obviously it ended so differently and that's something that I think I'll carry with me for the rest of my heard that in.

28:58 In talking.

29:01 Sorry, you just talk to me. I said Daniel. So my next question is a lot of conflicting challenges. We're short-staffed. You guys are all short-staffed like you talked about, you were in the middle of this pandemic that has changed our world. What keeps you going? I mean, and you're you're doing your work. Well, you know, I'm growing in it. So so what is keeping you going in these hard times? I think it's kind of what led me to specialize in neonatal care in the first place. Like these patients. Don't have a voice. So somebody has to be there for them. You know, I think that it's hardest for me and waking up really early. Like, when my alarm goes off at 6, and I have to like Russia make my coffee and pay for parking and like,

30:01 Do all of the things leading up to getting to work or the harder part. And then once I do step onto the unit and I have my hands on a patient like then everything else melt away, you know, it's for me. It's just about the patients, like they don't get to stop being sick or stop fighting because there's a pandemic or because I had to wake up early, you know, like they are. I always think about this. Like, I get to leave, like I get to go home at the end of the day and, you know, all these kids can. And I always think that like, I got to go home and I have people who love me and a lot of our patients, you know, don't have that yet. And so I think that like, especially the patients who are there on their own, you know, the babies who are born and their parents aren't able to be involved and provide them with the support that they need. Like

30:58 I want to do that for the short amount of time that they're with us. Like I want to provide that support and it doesn't matter if it's hailing outside and nobody else has to go to work, you know, like they're still there. So somebody else has to be there to help them, you know, and I think that it's been really hard piano with the short staffing, like we've taken on so many more rolls than we used to, and then, of course, you know, you're burnt out and your life, but that will kind of goes away for me. I don't know if you feel that way, but when I'm just working with a patient, the perspective is while you know, like you realize that

31:40 Some of the things that we think are super hard or not. As hard as like being sedated in a crib with an open chest, you know, so I try to just really be grateful for the things that I do have and I always try to put myself in my patience position and you know, like who would I want to be there? And who would I want, you know, like I'd want someone there fighting for me. I'd want someone they're advocating for me and making sure. I mean like, putting myself in like a baby brain. Like making sure that like, I had a pacifier readily available. If you know making sure that like my toes aren't cold and making sure that like my hands are comfortable. That's what I just try to remember is that and I and I know that like there are so many other people who do amazing work, but I I feel like somebody has to do it and I'm there. So, like I might as well do it, you know, like I might as well be there in and help because all of the hard things are

32:40 Going to be there when you leave work. I also think that like, we're so lucky like the nurses that I work with, like, you and Oliver and your wife want to come to work, you know, like having our conversations in the morning and it makes such a difference. Like, I think we're so lucky. My team. The rehab team that I work with is so supportive and amazing. I think that we are really lucky to work at a place where everybody is so passionate about what they do and not like drives me, you know, that really makes me feel like we are an empowered Workforce there, you know, like we all care so much about what we do and we love what we do. We love our patients and like that. Why were all there in the middle of this Insanity of the fires were happening last year and it was like the apocalypse, you know, like the world felt like it was ending but

33:40 Are you going to work and like it's a tunnel, you know, like you're focused on something really like greater than yourself and the world around you, you know.

33:52 Very relatable to me. It's like I just the band with this almost gone some days, but I agree with you. I feel like it's really simple for me. Sometimes as providing the absolute best care. I can those 12 hours that I'm there, you know, despite the challenges. I became a nurse for a reason, and that is really rewarding, aren't you grateful to have work? That's like, so rewarding like that. I feel like honestly, the luckiest person to be able to

34:33 Do something that I love that. Like filled my cup in that way. You know, that I'm not sitting at a computer all day long. Like I'm not doing anything with spreadsheets. Like I did too go have human interactions where I hopefully like make somebody feel better. You know, like what else would you want to do with your day? Or I wouldn't want to do anything else with my day, you know, and to get a paycheck out of it is like

35:00 Pretty amazing.

35:03 That's great.

35:05 If you could go back in time and talk to your twenty-year-old self. What advice would you give to her? I'm down that you have plenty of time. I think that I was really in a rush to get somewhere and I was like, you have this plan if I wanted to go to school and I wanted to become this and I wanted to make sure, you know, and I did miss out like I never took a study abroad when I was in college because I was way too busy and I couldn't possibly miss a semester of labs and I spend every summer taking, you know, the extra prerequisite courses and I still kind of hard time now, like slowing down and not being in a rush to accomplish whatever it is that I want to accomplish. So I would probably tell myself back then and I continue to tell myself now just to

35:57 Relaxing, you know, try to like not worry so much about getting everything done, you know. Again, like the type a person in me wants everything to be done perfectly in the time that I think is necessary. So, probably just take a deep breath and that you have time.

36:21 That's great, Nicole. What keeps you going? What keeps you coming to work every day. Well, one big piece of it is that I love the people that I work with it, like, on the daily lately this last year, like way we can do this work. We didn't like it. You didn't like each other because some of my greatest friends I've had in my entire life and I've had a lot of good friends, but truly some of the greatest most authentic relationships I've ever had in my life came from work and then

36:54 You know, again, it's

36:56 I became a nurse because I wanted to help people, you know, I grew up. I want to be a pediatrician and then I kind of lost my way a little bit in my early twenties. And when I had my daughter, when my youngest daughter was born,

37:11 That was the first time I personally have been in the hospital and been taking. I was taking care of by nurses and my eyes are open to wet nurses. Really do. And I had this aha moment was like

37:23 I was looking at this child that I love so much and I knew like, I needed to provide the best life I could for her and at the same time.

37:36 Those nurses were just amazing. And so I

37:42 I guess it's the sort of intersection of those two things. I also feel so grateful for the work that I would do. It's really rewarding. People. Tell me all the time. I don't know how you do, what you do, not to downplay that.

37:55 Yeah, I'd like a lot of myself with a lot of patients over the years but it is such a rewarding work. I love it. Some days, I try to talk myself into doing something else, that's less stressful, but I truly love the work. Now. I'm at a point in my career where I feel like I have a lot of knowledge to share with.

38:13 Younger nurses too. And so

38:17 It's the patient's people around me. I think I'm really, really grateful.

38:28 Yeah. Yeah, I think we like we are really lucky. You know, the the picu is a pretty special place with the all of the people who work there. And yeah, it makes coming to work feel like

38:42 Special.

38:44 So thank you. Well Danielle, this is been like I feel really honored that you shared this time with me. I mean, you're so great at what you do and that's do, you know, I wanted to sit down and talk to you about this but it's it's nice having the the background of who you are and how you found yourself here and thank you for the time. Thank you. I feel so honored that you asked me to do that. So, you know, I think that it's so important to get that feedback and this whole process is like really rejuvenated me, you know, sometimes you run around and you're doing all these things and it's like, you know, does anyone even is anyone notice, or does anyone see you? And it feels really good to be seen. Thank you so much. It's meant so much to me and I forgive, you know, for people that want to listen and be able to say like hey, I appreciate your your your role here.

39:44 So much to me, so, thank you.

39:46 Yeah, that makes me happy.