Dr. Isabel Newton: Centering humanity in all aspects of healthcare

In this episode, host Grant Oliphant sits down with Dr. Isabel Newton, a distinguished physician-scientist and passionate mentor, whose work is transforming how patients and medical professionals engage with the healthcare system. Her multifaceted career spans research, clinical care, education, and community connection, all rooted in the belief that everyone deserves access to the same quality of care. 

The conversation delves into Dr. Newton’s work in patient advocacy, where she empowers individuals to take an active role in their health decisions. As co-founder and chair of the Interventional Initiative, she provides education on Minimally Invasive, Image-guided Procedures that can significantly improve recovery times. She talks about their numerous resources, including the docu-series Without a Scalpel, which provides an in-depth look into the direct impact of these procedures on patients and efforts to make them available worldwide.

Dr. Newton's commitment to equity in healthcare also focuses on healthcare workers. She and Grant discuss the profound impact of mentorship. She shares how mentors influenced her journey, how she is mentoring aspiring medical professionals, and how diverse voices lead to more innovation. 

Learn how Dr. Isabel Newton is making strides in healthcare by championing equity, nurturing future leaders, and advocating for the universal right to high-quality care. 

Credits:

This is a production of the Prebys Foundation.

Hosted by Grant Oliphant

Co-Hosted by Crystal Page

Co-produced by Crystal Page and Adam Greenfield

Engineered by Adam Greenfield

Production Assistance by Tess Karesky

The Stop & Talk Theme song was created by San Diego’s own Mr. Lyrical Groove.

Recorded at the Voice of San Diego Podcast Studio

Download episodes at your favorite podcatcher or visit us at StopAndTalkPodcast.org

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Episode Transcript

Grant Oliphant (00:10):
Hey, Crystal.

Crystal Page (00:11):
Hello, Grant.

Grant Oliphant (00:12):
How you doing?

Crystal Page (00:14):
I am having an excellent day in part because
our guest today is one of theLeaders in Belonging, one of our
awardees.

Grant Oliphant (00:21):
I love this interview. So we're going to be
talking here with IsabelleNewton, a one of our 5
recipients of the inauguralLeaders in Belonging prize, a
cancer researcher, a practicingdoctor, somebody who's on a
mission to educate people aboutalternatives to invasive

(00:45):
surgical procedures, really anan exceptional individual.

Crystal Page (00:51):
And in addition to the studying of liver cancer, I
have to say when we did ouraward ceremony, she brought her
3 kids and her spouse. So thefact that she can do all these
amazing things and then somehowis a gracious mother and this
amazingly kind and humble human.I just can't wait to hear the
conversation and what you takeaway from that.

Grant Oliphant (01:13):
Yeah. And I well and I think that's such an
important point that this is aninterview with a whole human
being who, who brings her wholeself to her work and to her
conversation, and what aninteresting person she is. I
think it is,a wonderful part of our Leaders in Belonging

(01:34):
prize that a medical researcherand clinician was included in
this in this set of, inauguralrecipients, and it makes so much
sense. If we think about a partof life where people often end
up being excluded or not givingaccess or being othered in
strange ways. Medicine is justone of those places and so is

(01:57):
medical research, And doctorIsabel Newton is in so many ways
modeling the antidote to that.
So let's talk to her.

Crystal Page (02:07):
Let's do it.

Grant Oliphant (02:12):
Doctor Isabel Newton, thank you so much for
being here with us.

Isabel Newton (02:15):
Thank you, Grant. It's certainly a pleasure.

Grant Oliphant (02:18):
Yeah. It is a it's a huge pleasure for me. You
and I met really by phone only afew months ago when I called you
to let you know that you'd wonone of our Leaders in Belonging
prizes. And I I remember I thinkyou were on vacation somewhere,
and you were trying to wrap yourhead around what I was telling

(02:39):
you. You've had a lot of timesince then to sort of process
it.
And we're gonna touch on theLeaders in Belonging a little
bit later, but I'm I'm curiousto know what that award meant to
you and why why you thought itfelt appropriate and and good
for you.

Isabel Newton (02:58):
You are absolutely right. I was shocked,
and I don't know if that shockhas really dissipated. I'm still
surprised to be among the 5 thatyou selected. I'm in awe of what
they are doing in the communityand the impact that they have
had. And so to be among them is,humbling to say the least and

(03:18):
awe inspiring as well.
I derive a lot of inspirationfrom the work that they're
doing. And I think when you whenyou told me that, it was at a
point where, you know, we haddone so much striving in the
darkness, both through thenonprofit work that we do and
through our research. And it wasthe first glimmer of light. And
it's not simply that, you know,to be recognized because that

(03:42):
feels good. But for me, it was amoment where I was no longer
feeling like, you know, mycompatriots and I were doing
good work in the darkness alone,but that it had been seen and
there was some light brought toit, and with that light comes
opportunity.
And so for me, it was anopportunity to connect within my

(04:02):
community in a substantive waywith other people doing good
things to broaden and deepen theimpact of these works and to
make sure that this strivingamounts to something impactful
and important for everyone inour community.

Grant Oliphant (04:18):
I so appreciate that answer, and I am what
strikes me in it is the image ofstriving in the darkness,
because I think most peoplewould assume you're a celebrated
researcher at a celebratedinstitution, that you have

(04:38):
access to people and resources,that it wouldn't feel like
striving in the darknessnecessarily. That might surprise
people. And yet, you weretelling me this before we
started even that in research,it often feels like that. Can
you say a little bit more aboutwhy that is?

Isabel Newton (04:58):
Well, research in its nature is it it's something
you don't do if you are weak ofheart, because there's more
failure in it, more, periods offeeling lost and disoriented
than there are the wins. Andyou're not really chasing the
wins like you would somebodywho's addicted to winning, like
going to a lottery or to, youknow, gambling or anything like

(05:20):
that. It's more this, like,insatiable passion to find out
what the truth is, and you keepstriving, keep yearning towards
something. And I think that'swhat, is common of everyone who
pursues science in a fundamentalway. But when you add on top of
that the fact that, I'm aclinician in a field that's

(05:42):
relatively new, So I'm aninterventional radiologist.
And for most of your listeners,that means nothing, and they are
not alone because most peopledon't know what interventional
radiology is. It was invented inthe mid sixties, and it is a
field where we use radiologypictures to do procedures deep
inside the body through pinholesin the skin. And that means

(06:05):
people go home. They can bewhole.
They can return to their livesfaster. And we do things all
over the body from bleeding toinfection to cancer treatment,
which is what I do.
And so when you overlay the fact that you have
this relatively anonymous fieldof medicine, and I'm trying to
do research in it to convincethe bodies that, make decisions

(06:29):
about funding, that this is theright way to go, and we're on
the cusp of the cutting edge,and they haven't many times
heard of what we're doing orreally appreciate its value in
terms of, synergizing withexisting and emerging therapies,
it becomes a very difficultthing to, get headway in. And so
the way that our fundingagencies are structured, they

(06:52):
don't really wanna take bigrisks for big potential gains.
So a lot of that striving in thedarkness was related to that as
well.

Grant Oliphant (07:00):
Where do you think that interest in minimally
invasive procedures came from?You know, why was that important
to you?

Isabel Newton (07:08):
So I, I have a a PhD in neuroscience, and I knew
I was gonna be a scientistbefore I ever knew I was going
to be a clinician, you know, adoctor. And that came from being
really little and always beingcurious and wanting to know more
about the the world around me,my own body, the universe, all

(07:29):
of those things. And when I wentto college, I knew I was gonna
do research, but I did notrealize how difficult it is for
researchers to maintain a aconstant flow of funding and all
of those other uncertaintiesthat surround it. You could be
doing an amazing experiment andthen your entire experiment gets

(07:51):
contaminated by somethingoutside of your control and you
start over. It takes a lot of,strength and focus and gumption
really to pursue a career inresearch.
And at the time, my family wasgoing through bankruptcy, and so
I knew also, you know, how am Igoing to support myself? I'm
coming out. So I started toexplore other, avenues, and I

(08:13):
realized I could get an MD and aPhD together, and I would fund
myself. And that way, my backupplan would be medicine.

Grant Oliphant (08:21):
So you were your own entrepreneurial plan?

Isabel Newton (08:23):
In a way, yes. And, also, I'm a classic person
who wants to leave all the doorsopen, and I'm always very
curious. And so by doing this, Ihad, more opportunities to
pursue interests. And in theprocess, I found out I loved
medicine. And above all things,I really loved procedural
medicine, like surgery, which iswhat most people understand to

(08:46):
be procedural medicine.
I didn't realize thatinterventional radiology even
existed, and so I sort of backedinto it through radiology, which
I had been convinced to do bythe husband of my, my boss when
I got my PhD, my PI. He was aradiologist, and he said, you'll

(09:06):
love radiology. You'll have alot of time, you know, to do
research and all kinds of stuff.And when I started radiology, I
actually, had a rotation oninterventional radiology, and I
was immediately hooked. And forsomebody like me who, loves the
combination of hands on, offixing a problem, of creativity,

(09:29):
of innovation, and of finding away, it's just this incredibly
fulfilling and stimulating,field within medicine, and one
that I am excited to do everysingle day.

Grant Oliphant (09:41):
Yeah. I wanna pick up on on your backstory
before we move forward with therest of this. So your family was
going through bankruptcy, youhad to support yourself, you
decided to go to medical schoolas well as being a researcher.
You already knew you wanted togo down this path, difficult

(10:02):
path of being a researcher,which by the way for those of us
who like to cheat by going tothe synopsis of a movie and
figuring out what the ending is,is probably not a good career
choice for us.
So you you had to make some hardchoices in life. What was it
that made you interested inmedicine and research and health
in general? Was there somethingabout in your background that

(10:25):
led you to be curious?

Isabel Newton (10:27):
It's funny that you asked that because, there
are people I think who strive tofind their passion, and then
there are people like me whostrive to choose among their
passions, and I becomepassionate about most anything
I'm really, you know, into. AndI love art. I love poetry and,
literature. I do I can

Grant Oliphant (10:49):
Can I put you on your spot on the spot and ask
who your favorite poet is?

Isabel Newton (10:52):
Well, it's funny because, my mother, is a
literary critic, so I grew upwith a lot of different poets.
And lately, or just recently, Iwas looking at the poetry again
of Federico Garcia Lorca, and mymom is a specialist in, in his
poetry. But there's a lot ofdifferent poems and poetry that
I that I love, and it kind ofspans the gamut and has had an

(11:15):
interesting resurgence in mycareer now as we have integrated
the humanities in some of theworks that that I'm doing now.

Grant Oliphant (11:22):
Okay. So we're gonna come back to that.

Isabel Newton (11:23):
We'll get to that. But

Grant Oliphant (11:24):
yeah. So how- you had choose among your
passions.

Isabel Newton (11:27):
So when I was in college, there was a literary
critic there, Elaine Showalter,and I knew about her when I was
a high school student becausewe, had to do a critical reading
of a text that we chose, and Ichose The Awakening, by Kate
Chopin. She was one of theliterary critics that I quoted,

(11:48):
and I became a fan of hers,which is kind of, in retrospect,
rather nerdy of me, but I huntedher down in college and I,
signed up for her class And theyassigned me to a small group
that didn't include her, and Icame up with some reason to be
put into her small group. And soI was able to study with her.
And after small group one day, Iasked her, I said, how did you

(12:11):
know that you wanted to doEnglish? Because I'm so
interested in this, but I'm alsoso interested in science And she
quipped, well, because herhusband's name is English
Showalter.
She goes, if you find a man named molecular
biology, you will know.
And I thought that was really funny, but then
what I realized is, science isnot something I can do as a

(12:33):
hobby . But I might be able tosatisfy a lot of my my, artistic
and literary, interests on theside. So I really wanted to do
the thing that was going to bemost impactful. I've always been
driven by a desire to leave theworld better than how I found it
and and contribute as much aspossible, and that's that was

(12:54):
what what showed me is, youknow, I'd be able to do so.

Grant Oliphant (12:57):
A lot of women in the have have talked about
how difficult it is to be awoman in the sciences and in
research in particular, Andwe've had on this program,
Svasti Haricharan, who's lookedat the challenges that women
face in getting a fair share ofresources and access for their
research. That pivotal momentwhere you were asking the

(13:22):
question about which of thesepaths should I take, the more
conventional decision would havebeen to go with English. And you
chose science anyway. What wasit in you do you think that made
you make that harder choice?

Isabel Newton (13:39):
So now I'm a mother of 3 children, and so I
look at, you know, how theyinteract with their peers and
whatnot. And I thought mydaughter was gonna be kind of
how I was, which was utterlyoblivious. I did not know you
were supposed to be embarrassedabout answering questions or
that you were supposed to dressa certain way or, or any of that
until kinda too late. I wasalready set in my ways. And in

(14:01):
some ways, my daughter is muchmore aware of the fashions and
whatnot, which, you know, meansshe always looks better than I
would have ever looked at herage.
But part of me wishes she hadthat obliviousness because it
became my superpower. And lateron, you know, I just took risks
and did things thinking, I'mjust I'll figure it out when I
get there because I always did,and I always have. And so I

(14:25):
didn't really worry about thesethings. And, also, you know, I'm
approaching 50, and so I fall inthis group of women where there
were really strong, amazingwomen who paved, paths before us
and did so, you know, having tobe tough and like men and
sometimes harsher than men. Someof my mentors were like, don't

(14:47):
apologize to them.
You know, you be strong and allthis kind of stuff. And then
there are women after us who arefully women unapologetically,
you know, and aren't afraid ofappearing weak or being
dismissed in the same way thatwe did. And so those of us who
kind of fall in between, we tryto be invisible. So we really
just try to blend in and, be,you know, not different from the

(15:13):
men. You know, my field ofinterventional radiology when I
joined, it was 7% women.
So the bathrooms are always, youknow, free at the conventions.
Like, you didn't have to wait inline, but you were often
mistaken for, you know, a a repfrom a company or something like
that. And it's funny what yousay because when I was asked, to

(15:34):
give a talk on women ininterventional radiology and in
medicine, my first response was,what is there to say? And then
when I started to really delveinto it, I started to understand
things that we had ignored,suppressed, or or intentionally
just sidelined. And I askedother women from different
generations about the samething, and I realized there's

(15:55):
been a lot of code switching, alot of, just, you know, sort of
not standing out too much.
And I've had a couple ofinstances with, funding and
things like that where I feltlike if I pushed too hard to
advocate what for what I knewwas right, I was going to be

(16:16):
seen as being overly aggressive

Grant Oliphant: A push woman, yeah. (16:21):
undefined

Isabel Newton (16:22):
Pushy, yeah, all of those things, the b word. You
know? And so I just it was veryunsettling, you know, and and
it's crazy making because it'sundermining you. You know what
you see and what you'reexperiencing, and yet you're
being made to to feel likeyou're not seeing an experience.

Grant Oliphant: Do you still experience that (16:39):
undefined
today?

Isabel Newton (16:42):
I that instance, which when I which I'm alluding
to is the worst one. Mhmm. I doat sometimes feel these these
kind of subterranean things, butsomething magical happens as a
woman approaches 50, and it'swhere you just stop caring so
much. And, also, you have,earned enough gravitas for the
power of these other, influencesto kind of start to, to

(17:08):
dissipate. I wouldn't say that,it's not there, but I still am a
product of my generation, so Istill make myself invisible.
I still code switch. I still dothe things where I make myself
be the nice guy even though I'mvery frank, you know, and that's
not necessarily how I would be,but I've learned politically how
to navigate some murky waters.

Grant Oliphant (17:27):
And code switching in this case for you
manifests as not appearing to betoo pushy, not being too
aggressive. Is that right?

Isabel Newton (17:38):
It goes in both directions. It's, you know, not
being pushy, but also actinglike a guy. You know? It, you
know, using the language of men,not being sensitive to, you
know, even cursing and thingslike that. Like, it's just you
go with the flow.

Grant Oliphant (17:53):
And what's your advice to young women today who
ask you, hey. How do I get towhere you are?

Isabel Newton (18:01):
That's you know, my number one advice to my
mentees is don't try to be theperson you think they want you
to be. You will be unhappy. Itis a surefire way to end up a
place that you don't want to be,and it's basically a
prescription for burnout. Butthe other side of it is if we

(18:21):
are looking for more diversemembers of teams, we want them
to come with the uniqueness thatthey bring, not the sameness
that they think that we want.
Even if we think that there's acertain type that would excel in
a role that we're looking for.When I was program director, of
our residency program ininterventional radiology, I was

(18:41):
always looking for the peoplewho came from the atypical roads
because innovation reallyderives from different
perspectives, and that wasimportant to me and has borne
out.

Grant Oliphant (18:55):
I just have to say how how fantastic I think
that is because I think so oftenin mentor mentee relationships,
the the thing the mentee islooking for is sort of the magic
formula. It's what's the what'sthe the secret key that gets me
into every room. Tell me how tobehave. Tell me what I have to

(19:19):
do. What your advice is is howto be more uniquely themselves,
and translate that into whateverenvironment that they need to be
in, which is great advice forlife by the way, but apparently
also great advice for futureresearchers because they'll
bring a unique perspective intothe room.

Isabel Newton (19:39):
Absolutely.

Grant Oliphant (19:39):
I'm curious where well, we can talk about
where that wisdom came from, butI'm I'm curious for your view of
being a mentor. Did you have aparticularly spectacular mentor
who helped you see that?

Isabel Newton (19:54):
I did, and I think it's not just one mentor.
So, when you're a woman,especially one pursuing both,
you know, research based kindaand clinician and and
interventional radiology, I callit a Frankenmentor. You end up
aggregating, you know, peopleacross different parts of your
life who have a significantimpact, and they go beyond being

(20:17):
a mentor to being a sponsor. Andsometimes and these are people,
like Judy Brenzo Bechtold, whowas my mentor for my PhD, who
modeled, grace, but also just aan unwavering dedication to
research into the truth, not thestory you want to tell, to
people who have plucked me andput me in situations where I may

(20:40):
not have had any business beingor maybe I didn't feel like I
did, like Steve Rose, my mentorfor interventional radiology,
and Anne Roberts, also my IRmentor, who, supported me in
doing some of these things thatlooked very outlandish at the
beginning. You know, I'm tellingthem, hey.
We're gonna go film adocuseries, and they're like, go
for it. Or I'm do you know, I'mtrying to integrate molecular

(21:02):
biology into interventionalradiology, and they I'm gonna
put you up on a stage to talkabout this to our field. And
these are things that catalyzeda lot of important opportunities
for me, and I think that mentorsacross the the spectrum have
this opportunity to kind of picksomebody up and move them far
ahead on the on the board gameof life. And sometimes it

(21:24):
doesn't take much effort ontheir part, and that's the kind
of mentor I'm trying to be. AndI even pick up mentees from
strange places, like, at onepoint, we had a a service where,
they would drive us aroundcampus before they built the
bridge between the VA and UCSD.
And so one of the young womenwho picked me up to take me over

(21:46):
to the campus, was this womanthat, was in science early in
science, and we started talking.And I just noticed in her this
fire, and she remains my menteeto today.

Grant Oliphant (21:56):
To this day.

Isabel Newton (21:57):
Yes. And she's, pursuing her PhD, and it's just
truly remarkable what she'sdone. But we just do these very
kind of infrequent but impactfultouch points. We're, you know,
navigating difficult situationsand talking about common ways
that we've we've gone throughthings. And what I've noticed is
my best mentees also become mymentors in a way.

(22:19):
I learn a lot aboutopportunities and to to better
myself and also to integrate,values into the work that I do.

Grant Oliphant (22:31):
I, I so appreciate your approach to
this, it was part of theconsideration that the committee
had as we were thinking aboutyour candidacy for becoming a
leader in belonging, and by theway, you didn't know, you didn't
know that you were beingconsidered for this, but it came
up that you were an eager andwilling mentor who would work

(22:55):
with people. Before we leavethis gender subject, and I and I
didn't really expect to go asdeep as we have on this, but
it's it's important, and Ireally appreciate your candor.
What do you what do you wish menin research would understand
that about about what it's liketo be a woman in research that

(23:17):
perhaps they still don't get?

Isabel Newton (23:20):
You know, I don't know if it's gendered in that
way because I think perpetratorsof misogyny, are of both
genders.

Grant Oliphant (23:28):
Interesting.

Isabel Newton (23:29):
I think it's more of a way that we think in our
society and perspectives thathave been normalized. So when I
give talks of this subject, onething that I say is when you
talk about, in improvinglatitude in terms of family
planning, that shouldn't begendered either. There are very
dedicated parents of any gender.Right? And and being a parent or

(23:53):
being a caregiver, whether it'sto a child or to a spouse or to
a parent, that is not at allrelated to what gender you are.
So when we talk about giving,you know, parental leave or
giving family leave, they alwayslike to center that around women
as if the burden falls all onwomen, and I think that's unfair

(24:14):
to to men and to other genders,nonbinary, whatever you are. So
that was one thing that that Iwould note. The other thing that
I think is important if you arein a position, you know, and I
won't name specifically whatthis would look like, but if you
are not minoritized in some way,it might be difficult to
understand what it's like to befrom a minoritized group, which

(24:36):
many times just to not rufflefeathers or make waves, you're
trying to make yourselfinvisible. And what it must feel
like if you are one of thosepeople who has to raise a valid
concern Or who makes a mistakeor who is legitimately angry or
who's just having a bad day.
You know, how how easy is it foryou to be someone where everyone

(24:59):
around you is assuming you'regoing to go ahead and do the
best and and be successful?Whereas these people are out,
they have to prove themselves,so you can't have a bad day. You
can't look unprofessional, orhave hair that doesn't look like
everyone else's. So I thinkthat's the wider message is
broaden your idea of whatsuccess looks like. Don't have

(25:20):
this very rigid, sense of whatsomebody who belongs looks like.
And I think that if you do that,your experience of the teams
that you're on and the groupsthat you belong to are is gonna
be a lot richer.

Grant Oliphant (25:34):
Yeah. Suddenly, I mean, what you're describing
is a formula for welcoming allthe unique perspectives that you
were describing earlier, andallowing more perspectives into
the room, and therefore, moreand better opinions in theory.
So as we think about your uniqueperspective, let's switch now

(25:56):
for a moment to what it's liketo be both a doctor and a
researcher.

Isabel Newton (26:00):
Mhmm.

Grant Oliphant (26:01):
How has being a physician, influenced your
understanding of research andvice versa?

Isabel Newton (26:09):
That's such a good question, and and when
you're learning to be both, it'sextremely difficult, because
they're almost at odds with eachother. On the research side,
you're taught to questioneverything and to be skeptical
about everything, and on themedicine side, you're taught to
learn, to memorize, toimplement, and to be decisive

(26:29):
because you have to be. And sowhat you learn to do is to
switch back and forth, and, it'ssomething where, you know, it's
a great opportunity to be ableto to be that sort of liaison,
that bridge, but it's verydifficult to do so. But I'll say
that, now that I have learned toreally walk both sides, and I

(26:50):
can switch many times within aday now, whereas in the in the
past, it'd be this verydifficult, alright. Now we're
going from research to medicine.
Okay. Now we're going frommedicine back to research. But
what it does is it, deepens thesense of urgency and, and value
of what we're doing. So forinstance, I treat liver cancer,

(27:12):
and that means I get to meet andknow and love people who are
suffering from and facing livercancer for a long time. And that
feeds the urgency to make itbetter because it's really not
acceptable, the options that wehave for patients now.
And so it personalizes it. Youknow, in the laboratory, you are

(27:34):
you're trying to pursue an ideaor the science, which is
incredibly fulfilling, you know,the idea of something or
mechanisms, like for those of uswho really love that kind of
stuff, but that doesn't addressthe part that makes us human,
and that's what being aclinician really brings to me.

Grant Oliphant (27:54):
I really appreciate that answer and the
way in which you talk aboutmelding these worlds. You
launched something called theinterventional initiative. Can
you tell us a little bit aboutwhat that is?

Isabel Newton (28:07):
Right. So in 2015, my cofounder, Susan
Jackson, and I recognized thefact that minimally invasive
image guided procedures arerelatively unknown to the public
and to people who would benefitfrom them. And the way that we
came to that realization is wehad actually been filming a

(28:28):
documentary. We thought it'd beone documentary about, we
thought it was gonna be thestart of, interventional
radiology. What it became was afew patients' interactions and
experience with interventionalradiology procedures and the
clinicians providing it.
And we realized this is notenough just to make a one off

(28:49):
documentary to educate thepublic. We need to have some
kind of longitudinal way wherewe address this problem because
at its heart, it's an accessproblem. If you don't know
something exists, you can'taccess it when you need it. And
so we began the interventionalinitiative, in 2015 to educate
and engage the public about thevalue of minimally invasive

(29:10):
image guided procedures. Andsince then, it has grown and
evolved quite a bit, but it'salways focused on this idea of
improving access to care throughminimally invasive procedures.

Grant Oliphant (29:23):
The name of the docuseries was Without a
Scalpel.

Isabel Newton (29:26):
That's right.

Grant Oliphant (29:26):
Is that right? And I very catchy title by the
way that I think most of uswould wanna learn more about,
but I'm curious as you talkabout minimally invasive
procedures, clearly, that's a agood in its own right in
medicine. Why is it also anequity issue?

Isabel Newton (29:47):
So first of all, health care is an equity issue
at its at its very core. Thismorning, we had a stunning grand
rounds by my mentor slashmentee, Peter Abraham, who's
published extensively on this,and we published together about
health equity and radiology andthe impact of of the pandemic.
But more fundamentally, whenyou're talking about some of

(30:10):
these very cutting edgeprocedures, there's not access
to them in sort of an even wayacross our country. So rural
areas suffer from lower accessto minimally invasive
procedures, and then the samegoes for the world. There are
areas of the world where thereis lower access to care simply

(30:30):
because they are very cuttingedge procedures that rely on
technology and advanced trainingto, practitioners to be able to
perform them.
And so what we did last May, isa group of us from the
interventional initiative joinedup with a sister organization
called Road to IR, and Road toIR is very cool because they

(30:52):
started a training program inSub Saharan Africa, at Muhimbili
National Hospital in Dar esSalaam, and they recognize if we
can train clinicians there, ifwe can train radiologists there
to do minimally invasiveprocedures, we can improve this
access issue. And so we jointhem as volunteers, but also as

(31:13):
storytellers because that's whatwe do is is really, put a name
to what they are accomplishing,and we filmed. So 1 week, we
just volunteered, and the secondweek, we filmed for what is
becoming episode 5 of without ascalpel, and it's called same
care everywhere.

Grant Oliphant (31:32):
I you know, as I'm as I as I listen to you talk
about that, I am I'm struck byhow often in conversations about
any kind of access or belongingor equity issue, the argument is
thrown up that this is aboutmarginalized groups, this is
about a particular subset of thepopulation. What I hear you

(31:56):
saying is this is actually aboutbetter care for everyone. Mhmm.
Is that how you talk about it?

Isabel Newton (32:01):
Yeah. Our mantra is same care everywhere. And
when we say that

Grant Oliphant (32:05):
I mean, that's what I mean, that that that
phrase struck me as, you know,to use a terrible analogy is,
like, the the concept ofStarbucks when they started was
that you'd get the same cup ofcoffee anywhere in the world.
Why wouldn't you expect the sameof your health care that you can
get the same quality of care nomatter where you go? So say more

(32:26):
about that.

Isabel Newton (32:28):
Well, I think, you know, if you're just gonna
look at underserved areas, Ithink in the past, the idea is
let's just send donations. Let'syou know, even if they're
expired donations, you know,whatever we can send is better
than nothing. And that thinkingis really changing too. Like,
why would you send these peopleany less quality, materials than

(32:52):
what you would give to your ownfamily, and so there's a real
change and a focus towards,providing the same quality of
care with the same quality ofmaterials and elevating all of
us because none of us are wellunless all of us are well, and
it takes a while to get there,but that should be the goal from
the outset, outset, not justgood enough. And so when we went

(33:14):
to Muhimbili National Hospital,we showed up with 7 suitcases of
donated materials, and they wereall brand new, but they were
donated materials, and even aswe were giving it to them, we
said, you know, this is notsustainable, And I met with the,
director of the hospital. Hesaid, we wanna purchase things.
We wanna be able to havesustainable access to these
consumable materials so that wecan develop, our practice. We

(33:39):
can stop sending patients tothey were sending patients to
India and to, China where we canbecome the hub where people come
for treatment, and we cansupport our own communities. And
so I have, through theinterventional initiative,
actually, become involved with agroup where we're kind of trying
to address those issues of howdo you provide sustainable

(34:01):
access to materials to, placesin the world that have not had
them.
You're basically paving newroads is what you're doing. And
so that's an exciting other sortof offshoot of our our goals
through the interventionalinitiative is that we're seeing,
this importance of improvingaccess, not simply being
something that is North Americaor even places where there's

(34:24):
well developed healthcare, butbeyond. And and that includes,
as I say, also rural Americabecause those are places where
you have sometimes relativedeserts of, cutting edge.

Grant Oliphant (34:35):
It's a hugely underserved population actually
in the United States.

Isabel Newton (34:39):
And the health outcomes are worse. I'm curious
how you view all of this. Soyou're a you're a medical
clinician, you're practicingmedicine and and caring for
people. You're doing research inthis minimally invasive
procedure area, Also studyingliver cancer. And you're you're

(35:03):
trying to figure out how toensure access for people in
ruralAmerica and around the world, which is kind of a social mission.
of your life, or do they allsomehow knit together in your
own mind?
Yeah. When people when I tellpeople what I do, it feels, like

(35:28):
I'm all over the place andchaotic, because you feel like
it's not

Grant Oliphant: It doesn't feel chaotic. It does (35:32):
undefined
feel like a lot.

Isabel Newton (35:33):
A lot. Yes.
It is a lot. But they they all sort of feed the
same purpose and the same goal.And the goal is, I love I love
patients. I want people to bewell.
And how do we how do we come atthat problem from different
areas? And so, you know, theresearch, make sure that we have

(35:55):
better procedures to offer, theinterventional initiative, make
sure that people understandtheir options so they can
connect with them when they needto. Also through the
interventional initiative, weare focusing on, shared decision
making through patient decisionaids and a curriculum to teach,
our clinicians how to talk topatients in a compassionate way

(36:18):
that, drives their values andand what they want to do. And
then there's also wellness. Sothere's another realm that we
haven't even talked about, but Ihave I served as wellness
director and, am quite attunedto, the issues, surrounding
burnout and wellness and makingsure that all of us who are

(36:39):
doing this work don't want toleave the work before we're
done, you know, before we'reready to retire.
So I think it is a lot. I'vealways been someone who likes
It's

Grant Oliphant (36:49):
Not a criticism, by the way. It's just
admiration, I think, morethan anything.

Isabel Newton (36:52):
But I think there there's there's something to be
said. You know? You can fillyour plate too much even if it's
full of stuff you love to eat.You know?
It can still be too much to tohandle, and I am, I am guilty of
that at times. But anytime alittle spot on my plate opens
up, I just put something rightback in it. So it's, it's
definitely a passion.

Grant Oliphant (37:10):
Why is it important to get patients'
voices more into theconversation?

Isabel Newton (37:18):
It's important on so many levels. What is
important to patients, theirvalues, their goals, that
impacts their outcomes, and wehave research that shows that.
So patients who are educated andmake informed decisions, they
actually do better than patientswho just sort of are buffeted
around or do whatever their teamtells them to do, but also,

(37:42):
anyone who's ever been on thepatient side, it's this
terrifying thing where even ifyou have people telling you,
yeah, you know, you're it's whatyou wanna do or whatever,
there's a tendency for mostpeople to kind of assume the
role of a lamb. Like, I'm justgoing to just tell me what to
do, doc, you know, and I alwaystry to encourage my patients to

(38:02):
become, I tell them at the VA,the captain of their own ship. I
say, I'm here to advise you.
Here we are all advisors, butlet's work together, and it's an
empowering thing. And I thinkthat actually supports better
wellness too, to not be theperson to which things are done,
but be the person who helpsdecide how I'm going to go
forward, and even when you havepatients who are at the end of

(38:24):
life, and especially thosepatients, that kind of agency
really communicates a sense ofgrace and also, peace to some
patients to be able to say, I'mchoosing the way that I go
forward.

Grant Oliphant (38:38):
You know, in our work, Isabelle, we've we've
borrowed the concept of wellnessto guide our thinking about
community, and we wanna beagents of community wellness.
But for you as a researcher anda physician who spends every day
talking with people about this.What does wellness mean in your

(38:59):
context?

Isabel Newton (39:01):
Well, people who treat patients, have higher
rates of burnout, than agematched people in the community.
So, clinicians, you know, it'sit's a kind of a recipe for
burnout in some ways becauseespecially those of us who deal
with patients, at the end oflife or patients with, chronic,

(39:24):
disease or serious illnesses,that sense of loss keeps
repeating itself, and it's veryundermining to one's wellness.
But other factors are at play,and that's the increased burden
of, the electronic medicalrecord, the introduction of
things that are meant to, youknow, make medicine better, but

(39:45):
just make it more bureaucratic,less efficient, and, decrease
the touch points, those humantouch points that were so
fulfilling. So all of theseforces are at play, and what's
happening is it is undermining,our ability to provide quality
care to the patients that we'reactually with in the moment. So
it's rare now to find aclinician who will sit down

(40:07):
without a computer in front ofthem, look you in the eye, and
have a conversation with you andmake you feel like they have
time.

Grant Oliphant (40:12):
Right.

Isabel Newton (40:12):
And it's not because they're bad people.
There are all kinds of pressuresthat are making it difficult to
do that, to practice medicine inthat way. And so now the, the
way that people are going is,alright, order as many tests as
possible so we, you know, canrule out as many things as
possible because then the otherend is that, oh, fear of this
litigious outcome. You know,someone's gonna sue you. And I

(40:35):
think this all goes down to theproblem in the US, which is
patients are consumers insteadof being patients.
You know, It is a business in the United States,
it's not like in other countriesor even in the VA, which is the
la la land where I practice. Youknow, we really can just do
what's right for patients. Idon't have to worry about can
they pay or not pay, or willinsurance pay for it or

(40:58):
whatever. I can just take careof the patient. And in terms of
moral injury, nothing's moreinjurious than on the outside
when you know you could dosomething right for a patient,
and yet they they don't won'thave access to it because they
cannot pay.

Grant Oliphant (41:13):
Wow. That's so powerful. I, we could have a
whole other program about that.And I, you know, but what I what
I'm really struck by is, you mayhave too much on your plate, but
there is a a very obviousthrough line in the things that
you're doing, which is, at leastto me, as an outsider, that you

(41:36):
are in every aspect of your workfocusing on how to put the human
at the center, and have a aperson's personhood be
recognized whether they're apatient or you're talking about
researching their disease ortalking about the clinician and
how they stay healthy and whole.Is that a fair way of thinking

(41:58):
about how you view your life'smission?

Isabel Newton (42:00):
Yeah.

Grant Oliphant (42:02):
Is there anything that you feel
particularly excited about atthe moment that you're working
on?

Isabel Newton (42:08):
I'm really

Grant Oliphant (42:09):
I mean, you're excited about it all, so I hope
people get the sense of passionthat you convey as you talk
about this work, but I'm justcurious if there is some new
project in the offing that hasreally got you fired up at the
moment.

Isabel Newton (42:23):
So, the CURE prize that that our laboratory
got, was to fund a new clinicaltrial to try to, address liver
cancer.
You know, the problem is liver cancer, even
with our best treatments, comesback in by some accounts, up to
85%. And in our laboratory,we've been able to show that
with a unique combination of 3different, strategies that,

(42:47):
attack the cancer immunitycycle. We're able to trick the
immune system to become ourallies in treating liver cancer,
and it has worked so beautifullyin our animal model that, we are
launching this phase oneclinical trial to demonstrate
safety and tolerability inhumans. And if this ends up
being safe, tolerable, andeffective, it could change the

(43:09):
way that we treat liver cancerof all stages, so that is really
getting me excited. And theother thing is is not just liver
cancer, but other cancers thatare immunologically cold or
silent, some breast cancers,some prostate cancers, some
brain cancers.
The same approach could be employed for these, and
we could offer an opportunity tosensitize more patients to some

(43:33):
of our immunotherapies that areout there, so it's really
exciting. So that's one thing,and then on the II side, the
interventional initiative side,I'm really excited for episode 5
to come out. I think it's gonnabe our best one yet. The imagery
is so stunning, and the thethemes that we're exploring
there are very compelling, andso to see it all come together,

(43:56):
the genius of our editor, OscarButcher, is just, you know, just
so exciting. He's been workingwith us the whole time across
all of the episodes.
So that too is is very exciting,and we're hoping to have it out
by this summer.

Grant Oliphant (44:11):
Thank you for sharing that. I think I should
probably ask you quickly aboutso the the Cure Prize is from
Cure Bound?

Isabel Newton (44:19):
Yes.

Grant Oliphant (44:22):
A really amazing San Diego institution Right. Is
focused on, intersectional workto address cures to cancer.
Mhmm. So congratulations onthat. And then you recently got
another recognition as well forthe lab.
Is that right?

Isabel Newton (44:38):
My collaborator, Nick Webster, so he and I do all
of our research together. He wasthe PI on a sister grant, which
is the targeted grant, just ahalf a $1,000,000 grant through
Cure Bound for, looking atprolonged nightly fasting in
patients with liver cancer tosee if it's safe and, and

(45:00):
tolerable. And the idea is inour animal models, we have
noticed, that fasting decreases,cancer growth. So if we can
combine that with some of theother things that we're doing,
we could really decrease therate of recurrence and empower
patients to do something fortheir own health. So we saw that

(45:22):
also in breast cancer.

Grant Oliphant (45:23):
Is that right?

Isabel Newton (45:24):
Yep.

Grant Oliphant (45:25):
And prolonged so the so is this what we all think
of in terms of intermittentfasting, or is this more?

Isabel Newton (45:33):
It is, and, you know, it's funny. Fasting has
become this faddish thing, butit's not new. Actually, part of
my thesis, in the brain was oncaloric restriction and its
impact on a part of the brainthat is involved in learning and
memory. So I've been in thisspace, this metabolic space for
a while. Nick Webster has beenas well, so we're a very natural

(45:54):
fit.
And, what we have seen is wecall it prolonged nightly
fasting because, of course,unless you wake up to eat in the
middle of the night, you don'teat during the night. Right?
When you stop eating and stoptaking in calories, there's a
period of time, and so, there'sdata that shows that at least 12
hours and up to 16 hours,depending on how you do it,
there are various ways, has,differential impacts on the

(46:17):
body, on the liver metabolism,on cancer development, and all
that kind of stuff. So in thisstudy that Nick Webster is
leading, it's called prolongednightly fastings. It's just
prolong that fast that younormally would do, and instead
of breaking it at 6 AM, don'tbreak it till 10 or 11 or or 12.
And there's some questionsbecause liver cancer patients,

(46:39):
there's this idea that they needto be eating all the time
Up until the minute they go tobed, so that they don't have
wasting because they loseprotein sometimes. So we have to
test that to see if it is indeedsafe, and it seems like it will
be safe based on all of ourstudies, but if so, it could be
something that could reallychange the microenvironment in

(47:00):
the liver. And right now, themicroenvironment of liver cancer
patients or patients withscarring in the liver, which we
call cirrhosis, is is really onethat promotes cancer
development. So if we can changethe tides and do something to
make that environment lesstumorigenic, then we'll have
fewer patients who are sufferingfrom this deadly disease.

Grant Oliphant (47:22):
Well, so many important and interesting
questions, and the reason Ibrought up the additional
recognition was earlier we hadtalked about, you know, at the
top we'd spoken about strivingin the dark, and it sounds like
you're encountering more andmore light. I know, speaking on
behalf of the Prebys Foundationand the Leaders in Belonging

(47:45):
Committee, we're delighted tohave been able to shed some
light on the work that you'redoing. It's extraordinary, and I
really appreciate what you'redoing to center people's
humanity in everything that thatyou're doing. And through the
research and your medicine, Ithink you're really making an

(48:07):
incredible mark for belonging inSan Diego. Thank you.

Isabel Newton (48:10):
Thank you so much. I appreciate this.

Grant Oliphant (48:11):
Pleasure being with you.

Isabel Newton (48:12):
It's been so nice. Thanks.

Crystal Page (48:18):
Wow. So much to take away from that interview.

Grant Oliphant (48:21):
What an extraordinary human being, And
I, you know, I do think thatthis piece we ended up with at
the end, Crystal, of of how ineverything she's doing, which is
so many different things, she isputting, people at the center
and their humanity at thecenter. It's really an

(48:41):
extraordinary model. I got apoem for you. Alright. So I I
did some quick research, whenwhen she walked out of the
studio before you and I recordedthis, on Federico Garcia Yorka,
who she mentioned early on asbeing one of her favorite poets.
So he wrote a poem called Dittyof First Desire, which goes in

(49:04):
English, in the green morning Iwanted to be a heart, a heart,
and in the ripe evening I wantedto be a nightingale, a
nightingale. Soul turned orangecolored, soul turned the color
of love. In the vivid morning, Iwanted to be myself, a heart,
and at the evening's end, Iwanted to be my voice a

(49:24):
nightingale. Soul turn orangecolored, soul turn the color of
love. It's a poem about havingto make deep hard choices in
life, whether to be your trueself or the heart or the
nightingale.
I think she told us the story ofhow she lived that choice,
having to choose between herlove for the arts and humanities

(49:47):
and having to choose her lovefor medicine and science. She
thinks she chose science. Ithink she chose both.

Crystal Page (49:55):
Oh, one, I should have known you were gonna go
straight for the poetry.

Grant Oliphant (49:59):
Of course. Yeah.

Crystal Page (49:59):
Should have known. But, yeah, she is so poetic in
the way she tells the story ofthe work and of the people, but
I think you're right. I makingthe decision to choose the
science because she knew sheneeded to be in a lab or doing
these things, but then she sayson the side, but you're right.
She wraps the humanities, whichis the reason for things like
STEAM instead of STEM now. Shewraps the humanities into her

(50:22):
work, and I think that allowsher to see the human struggle.
And those things drive her workin this noninvasive
intervention. Right?

Grant Oliphant (50:31):
Yeah. And I well, I, you know, I think one
of the takeaways for me fromthat was, how completely she
sees the challenges that sheengages in. It's not just about
solving a puzzle. It's aboutsolving a puzzle for people. And
and she has real because of themedicine that she does, she has

(50:54):
real people in mind.
And I that comes across ineverything that she talks about.
You know, the fact that that sheis through the, interventional
initiative trying to expandunderstanding of noninvasive
procedures and theiravailability to people
everywhere, and the ability andright of patients to ask for a

(51:18):
different type of care so thataccess is expanded for them no
matter who they are or wherethey're from. Her idea now of
same care everywhere, that youshould be entitled to the same
standard of care wherever youare in the world. And I, you
know, I meant I made thatterrible analogy with Starbucks,

(51:39):
but the but the reason is verysimple. You know?
We think that's okay or logicalfor there to be a sort of
standard cup of coffee you canget anywhere. Why shouldn't at a
minimum that be what we expectof medicine, that, that there be
the standard level of care, andshe's just opening up the doors
of better medicine and bettercare and better research for

(52:02):
everyone.

Crystal Page (52:03):
Well, in noninvasive care, it seems so
practical. The idea that youdon't have to be completely
opened up, get your surgery, andthen she said you recover
faster. The quality of life forsomeone who has that experience
versus having one of those bigcomplicated surgeries that often
has complications has to be lifechanging, especially if you're

(52:24):
someone struggling to make endsmeet. So the idea of saying care
everywhere, I just feel likethat should be the banner of
quality health care.

Grant Oliphant (52:31):
It should be. And as long as the banner is
also about quality, which forher, it clearly is.

Crystal Page (52:37):
Absolutely.

Grant Oliphant (52:38):
I'm curious what you thought of one of the themes
that left out from ourconversation for me as well is
how she has clearly lived themantra she teaches her mentees
about being uniquely yourself.How did that resonate for you?

Crystal Page (53:00):
You know, I happen to work at a place that talks
about bringing our whole selvesto work. I'm like, are you sure?
But I do think she's rightbecause what happens if you
aren't unapologetically yourselfor if you don't bring yourself
to things, you're not speakingup. You're not bringing your
best ideas, but even more sowhen you can bring the entirety

(53:21):
of yourself, you're bringingyour experience, your lens. It
makes for better science is whatI took away.
It makes for better science,better human connection. Like,
the fact that the person whotakes her in the shuttle from
the VA to UCSD or who used to,she started mentoring that
person because they were in theshuttle everywhere. Right? And
so relationships are built notjust based on shared identity,

(53:43):
but really knowing each other.

Grant Oliphant (53:45):
Mhmm.

Crystal Page (53:46):
So I think it lands with me. I think it's a
challenge, though, especiallyalso being a woman. I have been
in spaces where it's easier tokeep your mouth shut or it's
easier not to offer a differentway of thinking because it may
not be received. Actually, whenshe said the piece about going
to conventions, initially, womenwere 7% of the attendees. That's

(54:07):
probably why I was giggling was,thinking about the bathroom
lines being clear.
Sounds amazing. But that meanshow many opportunities are lost,
ideas from women, ideas frompeople who may be caregivers who
have more of a femaleexperience. There's all these
things that are lost when noteveryone's at the table. So I
think it resonated, but alsolots more to think about.

Grant Oliphant (54:29):
Yeah. Her I thought her discussion of that,
which was incredibly candid andcompletely devoid of any self
pity was, was exceptionallypowerful. You know, she talked
about how, as a woman researcherof her generation, which she's

(54:55):
young to me, but she, is feelingher wisdom at the same time.
She, clearly has had tonegotiate, being in a world
where at times she has felt likeshe's invisible, or needs to
stay invisible, or needs not torock the boat, or needs to code

(55:18):
switch so that she doesn'toffend people in the room who
might be offended or she mightnot be perceived a certain way.
I think that probably resonateswith anybody who's ever been
the, the minority in the roomand had to navigate, how to

(55:38):
adapt to a dominant culture inthat room.
What I also found powerful washow she is part of she sees
herself as part of agenerational shift in changing
that. You know, she paid tributeto the women who went before
her. She also paid tribute tothe women who have come after

(55:58):
her, who are much morecomfortable now in these spaces,
and very interesting perspectivefrom her about being in that
sort of pivot generation whereit's a transition from the one
to the other.

Crystal Page (56:15):
And I think that's the world that we're in now.
Right? We're in this transition.Having worked for several, folks
in government, women ingovernment, you see that
transition. We had these thesefierce women who are probably 60
plus now and then there's thistransition of wanting to be
invisible.
But I will tell you having beenin a room with doctor Newton,

(56:35):
she just keeps opening doors andspaces and invites you in and
makes you feel like a peer. Idon't know half of what she
knows, but, you know, she, makesyou feel like a peer. And she
talks about this the value ofthat mentorship. Right? How do
we make sure that the knowledgeand the experience and the doors
that she's open stay open forother people and then they open
other doors for other folks?

(56:56):
And so I think that there's asense of community or a vision
of, making improving upon whatthe past generation has given us
that I have great gratitude for.

Grant Oliphant (57:06):
And once again, I think we were treated to a
master class on why what youjust said is important, not just
on the face of it, not just forthe sake of the researchers or
scientists involved, but becauseit actually produces better

(57:27):
research and better medicine andbetter care for more people
everywhere regardless of whothey are. You know, this is a
this is a piece that gets solost in the current iterations
of conversation around how weinclude others, and how we
create a culture of belonging,but if we create a culture of

(57:49):
true belonging in medicine andhealthcare and health research,
what we are going to have isbetter better medicine and
better health care and betterhealth research for everyone.

Crystal Page (58:01):
And to go back to what you said on that and what
she said about minoritizedgroups. Right? There is this
whole piece of feelingcomfortable enough to be in a
space and and do things likeraise valid concerns. Right?

Grant Oliphant (58:14):
Right.

Crystal Page (58:15):
And so I just thought there was a value when
you asked her about, you know,what do men need to know in this
space, and she turned it aroundto here's what everyone needs to
know. Yeah.

Grant Oliphant (58:22):
I thought that was brilliant.

Isabel Newton (58:23):
Yeah. It

Crystal Page (58:24):
she's just like the queen of speaking as far as
I'm concerned. So good. Butyeah. What did you take away
from that that moment in time?

Grant Oliphant (58:31):
Well, first of all, I just found that very
powerful and what she is willingto do, which the best people
often are when they're whenthey're thinking about these
issues is, well, she's willingto challenge us all. That there
are behaviors and ways ofthinking that we all can expand
our minds around to make, forbetter outcomes. And that's
that's essentially what she wasdoing. Listen, I think, I think

(58:54):
doctor Isabel Newton this was a,a fantastic interview, and
here's my final takeaway abouther. She started off by talking
about striving in the darkness,and that is, you know, for
people like me who like to knowthe answers before the show is
done, that I just don't knowthat I could be a researcher the

(59:16):
way she is, and I'm so gratefulfor the striving that she and
her colleagues do, because theyare lighting the way for all of
us, and as simple as that.

Crystal Page (59:26):
I think that's the the place to end it. Alright.
Thank you, Grant.

Grant Oliphant (59:29):
Thank you, Crystal. This is a production of
the Prebys Foundation, hosted byGrant Oliphant and co hosted by
Crystal Page. The program is coproduced by Crystal Page and
Adam Greenfield, and it'sengineered by Adam Greenfield.

(59:50):
Production assistance isprovided by Tess Karesky. And
our new theme song is by misterLyrical Groove, a local San
Diego artist.
Download episodes at yourfavorite podcatcher or visit us
at stop and talk podcast.org. Ifyou like this show, and we

(01:00:11):
really hope you do, the best wayto support it is to share,
subscribe, and review ourpodcast. Thank you for your
support, your ideas, and most ofall, for listening. This program
has been recorded at The Voiceof San Diego Podcast Studio.