An Empowered Person with Cancer - What's That?

You're live. Good day and welcome to Medicine Health with Dr. Paul Anderson. That's me, I'm Dr. Paul. And today we're here in Seattle, Washington. I actually have some sun outside, which is a nice change and brightens up everyone's day. And so today, as advertised, we want to talk about empowerment, but specifically empowerment for patients with cancer. And really, because cancer is never a lone entity, meaning we always have somebody or some people in our life who are intimately affected by things that happen to us, if we're the cancer patient, it affects everybody around us, especially those closest to us. So one of the reasons that today's topic came up is the release a few weeks ago of my new book, Cancer, and it's just called The Journey from Diagnosis to Empowerment. And most people really get the diagnosis part. They know, okay, we, you know, that's when you get diagnosed with cancer. Um, but why a journey and why the idea of empowerment? Now, one of the things that's been, uh, very cool, um, didn't, you never know how these things are going to go, especially when you launch something like a book or any new endeavor, but, um, the book itself, uh, it, Hit 3 number 1 spots on Amazon's list for its launch, its first week. And one was in oncology, and then it was a couple other related areas. And so we're really happy with that. We've got a lot of feedback about the book and a lot of questions about people asking, well, you know, how is it available? And so right now, Amazon in Canada or the US, you can get it. Yeah. printed version, you can get a Kindle version, and we'll be recording the audio version that'll be on any of the, the audio outlets like, you know, Apple Play or Audible and all the, you know, 100 other audiobook versions. That's coming up. That probably won't be ready till about the beginning of next year though because of the production involved. But a lot of the questions came in And they were asking, well, so if if it's you know journey from diagnosis to empowerment, what do you mean by empowerment? And how does that affect you know me as a cancer patient or me as someone supporting or being the partner of or in any other way you know connected to a cancer patient? So it's a big part of the book obviously because the subtitle. Literally says what the trajectory of the book is. The beginning of the book talks about you know what what's normal when you get diagnosed with cancer as far as the way you feel inside. What's normal if it's your loved one who gets diagnosed? What do you normally default to when you get these sort of you know not wonderful news, bad news, et cetera? What are the most common sort of human emotions that happen there? And then what can we do to oppose human nature, which is to stay there and, you know, stay in whatever emotional state that we're in because it, you know, it's somewhat comforting to feel the way that you feel when you get something disturbing like a diagnosis like cancer. But the important part, and really the point of the book, is that based on what I've seen working with cancer patients for decades now and watching them, watching their families, etc., the more you move from the shock of the diagnosis over to a place where you are actually empowered as the cancer patient, or you are supporting the cancer patient and being empowered, or if it's someone very close to you, you actually really need to become empowered in your role in the world of the cancer patient. So the journey over to being empowered is important. And the biggest purpose of the book is to say it's normal and it's okay to start where you start. We all feel very, you know, and you can fill in a lot of emotions here, confused, dismayed, angry, upset, et cetera, et cetera, when we get the diagnosis, but how do we get to a place where we're sort of in a different mindset around the diagnosis? Because one of the stark realities of any diagnosis, but especially diagnosis of cancer is, well, it's, unless it's a mistaken diagnosis, which happens, but not that often, it's there. And you can't really do anything about the part Of, of your life that is the diagnosis of cancer. What you can do something about is the internal journey that you are now embarking on, whether you want to embark on it or not, of going from being confused and thrown off your feet and angry and dismayed, etc., etc., to a place where you are the opposite of that and you're really on top of that within Your own mind. The other point of the book is that let's say, you know, you are the support person for somebody who has cancer. So you don't have cancer yourself, but you're their partner, their spouse, their best friend, their family member, you know, whatever it is. What does that look like for you in that role where you're not the cancer patient, but This world, your world has been changed because now you have somebody very, very close to you who is the cancer patient. So there's really 2 jobs on the side of the person who is the support person, the partner, the spouse, or, you know, what have you. Those 2 jobs really are, number one, what do I do to be the most empowering to the cancer patient? How do I support them through the journey? And then the other side of the coin is you have to work on your own stuff, if you will, around all of that. Because when we look at the relationships that go on, and the closer the relationship is, the more impactful it is on the person with cancer. But when we look at the relationships that go on, whether they're, say, family, loved ones, people, whatever, they have a giant impact on the person who has cancer. One of the biggest stumbling blocks— this is something we go through in the book because the book is really written for both parties. It's written for the cancer patient first, but also the caregiver, loved one, et cetera. One of the biggest stumbling blocks, just like it is for the patient to get to that place where you have a more on top of it, more empowered sort of feeling going on is dealing with your own stuff around the diagnosis that your friend or loved one has got. And so I've seen people where, you know, say it's a support person who's really close, maybe it's, you know, a partner, a spouse, you know, somebody who lives with the person. And so, you know, they're physically close, but they're also emotionally close, et cetera. And I've seen where the cancer patient's actually doing not too bad. They're kind of progressing along, they're getting on top of things, and they're feeling more empowered. And then you see the support person kind of get stuck in a certain place. Now, this can happen to either party, but if you're the support person— and normally the support person, it's— this is not something you're trying to do, it's just the way that things work out, the way our brains and our emotions work— but if you are the support person, the thing that you want to keep in mind is that Um, you have to go through all of the same, uh, internal issues, etc., and deal with your own feelings and your own emotions around this diagnosis of cancer, even though you didn't get the diagnosis, someone you care about did. And so the same process and the same steps are critical to either party as they go along. But one of the things I've seen is if the person who is supporting is having a harder time getting beyond, you know, their normal human nature of being shocked and dismayed by the diagnosis, and they're not moving forward, they can actually inadvertently— and normally they don't mean to— be a detriment to the mental-emotional health and space that the patient with cancer is trying to achieve. And so it is critically important that both sides of the equation kind of go through these things. If you think about it, let's say, you know, we'll stick with the support person, loved one, etc., for just a moment. Let's say, you know, a support person, you don't have cancer, you don't have the diagnosis, but it's a diagnosis that you've always thought about in your head and thought, gee, I hope, you know, I hope I never get that one, right? Most people do. Most people don't want to get a diagnosis of cancer, so Let's say that goes on and you, you know, you don't think about it every day, but when you do think about being diagnosed with cancer, you think that's probably one of the worst things that could happen. And then suddenly your loved one is diagnosed with cancer. Well, you can go into the same spiral that the patient does, but you go into it in your own way. So, for example, some of the most common things that I've seen, whether it's a patient or a loved one becoming, you know, getting diagnosed first and then moving on. The most common things are, of course, shock. I mean, we're not expecting it usually. There are people who, you know, have an idea because they've been sick for a while and they're not sure why they've been sick, and there's some things that don't add up, and they get a diagnosis of cancer and they don't like the diagnosis, but it makes the things that were going on make sense at least. So a lot of times, you know, you'll have people who aren't as shocked. They're dismayed and— displeased with the diagnosis. But most of the time, the caregiver loved one is in a space where it hits them, you know, really as a blindside. Can hit anyone as a blindside. But usually the person who it's been going on in their own body, there's a percentage of people who kind of have an inkling it might be something not great. So for the person who's the caregiver, a lot of times there's a shock component that really Is the same as triggering a fight-or-flight response. So the, the normal, you know, sympathetic nervous system running away from, you know, an attacker sort of a response. And what that response does in your brain is it connects immediately to not only your physiologic, you know, efforts to run away from an attacker, and there is no attacker there, so your body just goes into the state, but Neurologically and emotionally, the memories and the thoughts that are triggered cannot make a lot of sense for a lot of people. And so suddenly, the shock of the diagnosis— and this could be either party, but a lot of times this is the support person— the shock of the diagnosis sends them to a place emotionally that they don't even, you know, you can't verbalize it. But of course, it feels very, very bad, but it can feel then like a lot of different things depending on what old memories or what thoughts it brings up. For example, I've seen people where their biggest fear, you know, was developing a diagnosis of cancer, which again, nobody really wants that. But the fear is rooted in the fact that they watched their mother or their father go through an extended battle with cancer. And it was very traumatic for them, you know, or a brother or a sister or somebody very close, spouse, somebody very close to them. And so they have this very, very heavily entrenched memory that is extremely negative and obviously presses all the wrong buttons on the inside. And so that person, without even knowing it, usually goes right to those feelings. Now, they may not even go to the memories of it other than a little bit fleeting through, but the feelings will all come up. Same thing can happen if you're the patient with cancer as well. So wherever your brain goes, the first thing we say in the book is that's okay. Everything's basically okay. Everything that occurs is okay because that's you and that's your human nature. The point is we have to assess that and say, well, I understand where this is coming from. Maybe I need to talk to somebody to talk through it or whatever. We talk about that, getting help and stuff like that, but The bottom line is it's okay to start there. That's where you're starting. But the important thing to keep in mind as you go along is that might trigger 2 totally different reactions in you, the cancer patient, and then the other person who is your support person, closest person maybe in the world. Because you have different experiences and your brain processes your experiences differently. We've all probably seen this, or if you think about it, you can probably think of examples that you've seen in families where, let's say it's the example of a parent who goes through a protracted ordeal with cancer and it is a lot of treatment, they get very ill. And eventually they pass away and it's very traumatic. And, you know, let's say that there's, you know, 3 children. who all go through this, walk through it with the parent, they can have 3 very, very different impressions mentally and emotionally of that experience. And so let's say all 3 of them now are dealing with someone else close to them with a cancer diagnosis. Their bodies and their mental-emotional state will go to 3 totally different places. Same thing with you and your loved one who has cancer. So One of the things to be just mindful of is, A, it's okay wherever you start, B, it's normal because it's human nature, and C, it's gonna be different for everybody. So for some people I've seen where one person is more purely depressed, again, a very normal emotional response to a bad diagnosis, but they have this sort of pure down dark depression. The other person reacts in a more angry, violent manner. And I don't mean necessarily physically violent, but it's just this upheaval. Well, when you start pushing on those places deeper in the mind where these feelings that I say are human nature come from, the reason two people get totally different experiences and feelings is that the mind has these impressions and dredges them up, and you don't get really a choice of it initially. That's why it feels so. So weird. But also, Person A can be totally just in a dark place about it, and Person B can be very angry and agitated about it, and they're experiencing the same thing. It comes from the same place. So the first part about moving towards being empowered really is to look at what does it take for me to get off square one which is a disempowered place around the diagnosis, and to not just move on and, you know, be empowered and all of this stuff, but to walk through the steps that are required for you to process those things as an individual. And if you're doing this as a family or a couple or, you know, or some other fairly close-knit group, you're going to walk through it together, but you need to know you're all gonna have a different experience So as the book unfolds, there's sort of 2 things that I did when writing it. And again, it all comes, you know, from my experience and also putting together, you know, the science around both processing negative emotions and also becoming empowered. But, you know, so there's, there's a method to it, of course. But the point of the book really, and it's a, it's a It's a quick, easy read that just gets right to the main points and then gives you resources if you need deeper resources. But the point of the book is, you want to validate wherever you're starting, because the worst thing that you can do is to say, oh, I shouldn't feel this way, I'm bad to feel this way, or any other negative thing. Now, that's you. You got bad news, and that's how it's hitting you. Okay, the important part is to not stay there. Okay, we all have the experience of something negative, but we all also have the ability mentally and emotionally to even ever so slightly rise above it and look at it and say, this is something that's happening to me. In no way do I like it. In no way do I want to participate in it. But this is what's going on. I now, as a human, have the power and the opportunity to choose how I want to perceive this bad thing happening to me. So through the book, there's expression and explanation of the different phases that most people will experience. And again, some people more or less of each one, and some people recycle and all that. It's all normal. So that helps just with identifying where you're at, but also looking at a progression from, oh no, I've got this and this is a bad place to be, to actually being empowered. But the other thing is just some personal examples. And what I did is I picked 2 people who, of course, are, you know, not identified, they're fictitious names, and I changed circumstances and things, so no one could ever figure out who they are. But they're real people, and they're real people that I thought exemplified 2 different trajectories for dealing with their cancer. One was a person who decided that this, this is no good, I don't like it, etc. And they had some trouble kind of in the beginning, but they really put in the work to become an empowered patient and be— and we'll talk about empowerment, what that means and stuff— but basically to be in charge of their life and in charge of the way it happens and to engender the best quality of life. The other person— and again, I say in the book, this was their decision, and it's totally your decision is your decision. And I also say in the book, if you're reading the book, you're probably not like this person because they would never read a book like this, but Their choice was to get shocked, then angry, and they just became more and more angry. And they stayed angry and alienated everyone around them until they passed away. Now, when it comes to moving towards being empowered, whether you're the support caregiver, loved one, or patient with cancer, The most important reason for that, and the reason that I wrote the whole book, was it's so critical for the quality of life for the patient with cancer, for their loved ones, their family, their network. The quality of life is completely different when you're trying to move towards a place of being on top of it and being empowered than it is if you get stuck in your in. Or you're stuck in anger, or you're stuck in disbelief or denial, or, you know, any of the other things that can happen. And that's not only borne out in the science that I mentioned some of, but it's also been borne out in all of the patients I've ever seen. Quality of life, if it really comes down to it, is the first goal that patients with cancer have. You know, usually their first goal is a request to say, could you take the cancer away? And I wish I could, but no, that's— I always tell people that's above my pay grade. But if you get past that, and we do see things happen where cancer does go away, but that's just, that's, you know, not, uh, not something that's usually part of the initial plan. But what they normally are interested in beyond that then is, then how do I have the very best quality of life and hopefully quantity of life while I'm here? Because in reality, and it just changes with cancer because now you have a diagnosis that's potentially life-threatening, but we all only have so much time here. Now, some of us have longer times than others, but none of us get to know how long that is. When you have a diagnosis like cancer, you're just suddenly going to be faced with the fact that somewhere on a spectrum, you're going to have a longer or shorter average survival. Now, the averages are averages. You might be longer or shorter yourself. But really what matters for all of us, but especially somebody with cancer, is what can I do so that I have the very best quality of life and hopefully longer quantity And being empowered is one of those things. It's the big why around why would you go through the trouble of processing your feelings and emotions and, you know, all of the hurt that you feel or anger or disbelief or, you know, any of the other things. Why would I process that and go through all that to become empowered and be on top of things? Well, it's really quality of life, and I would argue quantity of life as well. Now, one of the things that comes up is when you're thinking about empowerment, empowerment really is looking at how you as a person have autonomy, so you are in charge and What degree are you self-determined? So being self-determined and having autonomy are relative because you can have, you know, a child with cancer. We have a special chapter and sections on children with cancer, which is different, where, you know, you're young enough where you still rely on your parents for some of your determination and circumstances and all that. So it makes the parents' role in the cancer, you know, really, really extra heavy. And there's a lot to do as the parent. Or you can be somebody who is already pretty self-determined and autonomous, and you've got those skills, and you're, you know, you can kind of work through your emotional stuff and get over to, you know, the empowered, self-determined place. And then there's a lot of people where they just sort of floating around somewhere, and life kind of is happening to them. And, you know, there's nothing wrong with that. We all get to live our lives the way we live our lives. But you get pushed on by something like cancer. And suddenly you realize, well, maybe I don't have as much life as I thought I was going to have. Now I'm sick, and I'm dealing with, you know, all of this stuff I never thought I would have to deal with. And you suddenly realize, I'm actually not a very autonomous or self-determined person. I just sort of let life happen to me. So one of the questions that came up with some of the feedback and really good stuff was, is part of being empowered, you know, not letting life just happen to you? And to a degree, that's very, very true. So if you think of cancer as something that is happening to you, And you think of your cancer treatment and, you know, work that you're going through and everything as something that's happening to you, you are less likely to reach this place of being self-determined and autonomous, etc., because a self-determined autonomous person doesn't really believe that things are just happening to them. Now, of course, Getting a diagnosis is something that, you know, is external, but pretty soon it has to become internalized. And how you look at it is where you become either self-determined or just sort of, well, I'm a victim of this and this is what's going on. One of the things, kind of like some of the earlier parts that we talked about around this trip over to being empowered that we talk about in the book is Being a victim is something that we often look at and say, well, you know, we don't want to have victim mentality. We want to be empowered and self-determined, all this stuff. And that's very, very true. The other side of the coin, though, is it's very normal for many people's personalities to feel victimized by cancer because they didn't ask for it. They didn't want it, and it seemed to come out of nowhere. And so in a sense, they feel like, just like if you were minding your own business and somebody, you know, runs into you in a car, you didn't ask for it, you weren't planning on it, etc. You're a victim of that circumstance. That's actually fine because you are. All of those things fit. But just like being depressed or angry or whatever, we have to realize that once we get past the idea that, well, that did happen and that's a point in time, the, the part about being self-determined and empowered is now what do I do with the rest of my time after that? So I have this moment in time where, yes, I was seemingly the victim of a diagnosis, or my loved one was. Uh, and I got down or I got angry or I was in denial, whatever. Okay, I see that. I can't live that way and become and be empowered. That's, that's really the key. Now, if the purpose of being empowered is to have this autonomy and self-determination, and the real purpose of being empowered and having all that is so that we have better quality of life and probably quantity of life, and generally what I've seen is your, your cancer therapy seems to work better, the more empowered you are as well, because you're actually in charge. So if it's not being a victim, you know, then what is it? You know, what is this other end? What's the goal? Diagnosis to empowerment. Well, the idea of being empowered is to be completely as honest as you possibly can be with yourself, your emotions, your feelings, And then letting that flow through to your actions as possible in a way that processes all the negative junk that comes along and all the normal human nature stuff that we all go through every day in our mind. Cancer just adds a whole other layer to it. Processing that, but getting to the place where you stay in this honest position with you, your diagnosis, how it's feeling, or you, your loved one's diagnosis, how that makes you feel and How that affects your relationship and everything else. You stay honest about it, but you stay honest about it, looking at it as something that you actually have control over. Yes, you may have less control over the cancer process itself, but you do have control over your brain, your mind, your emotions, your spirit, and where that takes you. That's the important part. It's a difficult, difficult thing. One of the people that I quote early on a couple times in the book is Dr. Viktor Frankl. Most people know Dr. Viktor Frankl as a physician who was a psychiatrist who survived the Nazi death camps during World War II. And he wrote Um, a great deal about that, but he also— one of the core things that he decided in being in the death camps was that the only thing that they really couldn't do to him or take away or add was his response to what went on. He had no control over what happened to him, uh, what was going to go on, and whether or not he would live or die and how he was treated. But he decided that the one thing that he did have that no one could take away was his ability to react to it and his choice over how he reacted. Now, one of the most difficult things is having something horrible happening to you, and cancer is one of those things, and having somebody say, well, you know, you have the power to rise above it and Choose a different way to feel and all that. Nobody really likes that sort of advice. The hard reality of it is, though, is that if you want to move towards being empowered, you have to come to peace with the idea that you are in many ways mentally and emotionally actually separate from what's happening to you, and you do have a choice to decide this is. This is not good what's going on. I don't have to like it, but I can respond to it differently. So the counterpoint would be if my initial response was to become very depressed, totally reasonable and normal, or my initial response was to get angry and lash out, you know, and ask why me, totally normal, reasonable. I can now decide that that was fine. That was a place I was at. It's totally understandable. But I need to move to a place where I have to live the rest of my life, however much time it is, whether it's days or months or years. And I need to reset my internal meter on how I look at this diagnosis, whether it's happening to me or a loved one. Every day I have to, I have to reset, and there's going to be better days and worse days. often deal with, with people who are moving to this place of trying to be empowered in cancer and other chronic diseases is this idea that how I feel today does not have to be the only predictor of how I feel mentally and emotionally. So physically, I might be having a bad day. There are many of those. If you're going through cancer, you're going to have either treatment-related things that make you feel pretty bad, or You know, physical things that go on, or energy drains, or other you know all manner pain, all manner of other things. Your response to that, and it's it's a learned response to rise above it and decide that you get to decide how you feel regardless of how your body is feeling today. The more you do it, the easier it gets and the better it gets. Not easy; it's a hard trip. That's why I wrote the book is to. Outline the trip. And it's a practice that you do every day. But what I've seen over and over without any exception is the people who are on the trip and trying to get there and trying to stay, you know, self-determined and empowered are able to put things in perspective every day, live their life within whatever parameters they have. And their quality of life takes big leaps and jumps. When they're able to do that, they're able to not have an absence of problems, not have an absence of pain or feeling bad or tired or reacting to medications or whatever, but they're reacting to the situation mentally and emotionally, right? Lets them actually rise above it. And that's a very important critical factor to remember. Now, why have I talked so much? Because the title was about the patient with cancer, and I'm certainly talking about that, but I've also talked a lot about the loved ones, caregivers, support people, family, etc. The book is for them as well, because let's say the patient with cancer is really working on this and trying, you know, through The hardship of cancer and all of the things going on to be, you know, self-determined and empowered. If you— because you can't get past your own stuff and your own, you know, depression or anger or dismay about the diagnosis your loved one has— if you can't get beyond that and you now feel like a victim of your loved one's cancer, and that's a totally normal thing to feel. But if you can't move through the same thing, you actually become an anchor in a negative way to the person who has cancer. This could go both ways, but often it's the support person who's dealing with it. Because although it's extremely hard to deal with this when it's your own body and you have an illness and you're trying to be separate from the illness and rise above and be empowered, it's difficult in a whole other way to do it when you are the loved one or support person of a person with cancer, because it's actually not happening in your body. What you're dealing with is your internal emotional turmoil that you have, because we don't want our friends and loved ones to have cancer. We don't want them to go through all this stuff. It's, it's a supreme, you know, bummer to have that happen, and it's very upsetting. So what we are rising above as the support people is usually our response to someone we love and care about having a diagnosis we don't want them to have. So it's 2 different risings above, but really it's the same process because both of us get shocked, both go through, you know, the negative emotions and process and all that, and eventually get to a place. Of hopefully empowerment. The other side of that coin is really when you can be an empowered caregiver, loved one, support person, it takes you from being an anchor in a negative way to the patient with cancer to being someone who can lift them up and someone who can support them truly mentally and emotionally, or mentally and emotionally and spiritually, whatever way you like to divide that up. for the other person. And so we want to keep in mind some things. So being empowered, you know, having autonomy and self-determination, all this, it's not being, you know, Pollyanna about stuff. There's some very real things about cancer that are, you know, unpleasant and things that we, you know, don't want to look at for good reason. It's also not ignoring the fact that there is a problem. There's a physical, physiological, pathological problem going on in the person or that you love or yourself. And it's not saying, oh no, no big deal, it's just cancer or whatever. The other thing which I've had patients really struggle with is, well, does it mean I just give in, you know, and just say, oh well, there's nothing I can do about it? No, because giving in and giving up, that's being a victim. That's the opposite of being empowered. So we're really going for here Is someone who is, as I said earlier, in a place where they get to a realistic assessment of wherever they are in the process. They see what they need to do to get to the next step, and they're working towards it. And they realize they're going to have some great days, and they're going to fall backwards on some days, and they're going to recycle some, you know, stages and all that. But it's the process of getting there. That makes you empowered. And it's the muscle, if you will, that you are exercising that brings the empowerment. Because every day you're going to feel different about the situation. Body's going to feel different if you're the patient. And every day you get to decide, probably a lot of times during the day, okay, that's happening today, but I still am in charge of how I think and feel about it. And that's really the point of the whole book is to get through that. Now, one of the things that comes up, and I talk about this in kind of the middle, the middle of the book, if you will, chapter 5 says, what does modern science say about empowerment? And one of the things that I tried to not do was use terms that didn't have some basis in a fairly large amount of history, in the world of psychology, psychiatry, emotional, emotional studies, maturation, etc., and also, you know, research. But one of the things, as recently as less than a year ago, they published a review about empowerment. And it goes— and you can read it in the book, but, you know, essentially what it goes through is The factors that are involved in us rising above and feeling like we're in charge, and one of the things that you know that they saw in looking at the idea of empowerment in people who are ill, etc., is it's it's not so much your direct control over your disease state, although you do have control over your disease state in many ways. But you're maybe not choosing all of the therapies you get; you're not doing the. Therapies to yourself. You know, there's parts you're not controlling. What they were saying in this very recent paper was, it's not so much that that leads to empowerment, but it's your, really your participation in your ability to control what you can and understanding which things are within and without your control. And there's some other ones that I go through and talk about in the book that go through things such as empowerment empowerment actually affecting your ability to have pain managed. And certainly pain management and pain is important for many, many reasons and many people. There's also things around being empowered and the interpersonal relationships that we're all involved in. This is why the book is really written for the cancer patient and everyone in their circle, because we all need to, if we care about the person with cancer, we need to be moving to be Being an empowered caregiver or loved one, and the person with cancer needs to move to being empowered around their disease, their diagnosis, and literally rising above it. Well, we're just about out of time for today, so I really appreciate everyone listening. I appreciate those who asked questions and all. As I said, you can get the book Cancer: The Journey from Diagnosis to Empowerment by me, Dr. Paul Anderson, anywhere books are sold online. You can get the Kindle version, you can get a book version, paper version. As I said, we're working on the audio version, which will be on all the audio platforms, whether it's Apple Play or Google or Audible and all of the other ones that I don't know about, but the people who make these do. And we're going to have some other things coming out around it as well. in the future. But we are winding down for the day. So, oh, somebody also asked, just because I got 30 seconds. So I saw this, I know it's on Amazon. Are there other outlets? So Barnes Noble is one. If you want to do a really great solid for a local, a big local bookseller, Powell's Books, big— I'm from Portland, Oregon, they were huge there. They're now a big, huge presence online, Powell's Books. And they're You know, a way you can do it for— it's really a mom-and-pop operation still. But really anywhere you order books online, you can get the book. But that leads us to the end, and I want to thank you for being here. I'm Dr. Paul Anderson with Medicine Health. I'll see you all next week on the radio.