Welcome. Thank you all for coming. It's really a great pleasure to present the Pascual Chiagulia Memorial Lecture in Interventional Medicine to Christine Argento. For people who don't know, Pascual Chiagulia was the person who invented percutaneous tracheostomy, so a true interventionalist. And this honors a member of CHEST well known for their work in interventional medicine. Topic areas include state-of-the-art innovations, economic impact, invention, and interventional critical care research, or a host of other interesting facets of interventional medicine. It's really a pleasure to have Christine receive this award. I've been lucky enough to watch her and follow her career, which has had a few stops along the way. And when you see stops, sometimes you think people are just dissatisfied. But, you know, each of the stops in her career has been well planned, and it's always been for her to learn more, do more, and be in an environment where she could advance the field. And when I see those kinds of transfers as a sort of older guy, I get very excited because I know that's a person I want to keep my eye on. She's an associate professor and the director of bronchoscopy and interventional pulmonary at the Division of Pulmonary and Critical Care at Johns Hopkins. She has participated in development and implementation of bronchoscopy and thoracic ultrasound guided plural programs, and with the assistance of a CHESS grant, had the opportunity to develop an education course for bronchoscopy in Uganda. And, you know, it's hard enough to do bronchoscopy in the United States sometimes, but to develop a program and deliver it to an underserved community is really both a challenge and really tells you what kind of person has just won this award. She's currently a guideline panelist on two CHESS guidelines, serves as the bronchoscopy domain task force leader for CHESS and develops curriculum and didactic simulation courses also for CHESS. She serves on the editorial board of CHESS Physician. For her dedication to education and medicine and her involvement at CHESS, it's a pleasure to honor her today. Please join me in welcoming Dr. Christine Argento to present the Pasquale Tiaglia Memorial Lecture. All right, good morning. Thank you so much, everyone, for being here. I really appreciate it. My name's Christine Argento. If this was the talk that you came for, just so you know, I have switched it on you. This was not properly advertised. So I will not be talking about the physiology of ARDS. So if that's what you came for, sorry. But my real talk title is How to Make an Impact Beyond Our Technical Skills. I don't have any disclosures that will affect the contents of this talk. So a little bit about Pat Tiaglia. He enlisted in the Army right after completing surgical training during World War II. He served in England and France. And there he met his wife. And they were married for over 50 years. In his 70s, so not as a young gentleman, but as an older gentleman, he was concerned that surgical tracheostomy had a lot of complications. And he happened to see a colleague who was performing a percutaneous kidney stone removal procedure and noticed that he was using straight serial dilators using a Seldinger technique and thought, hey, maybe we can apply this to tracheostomy. And so he paired up with Cook Medical and developed the Blue Rhino kit that we use today. Interesting, he actually wrote an obit eulogy before he died. And interestingly there, it was written that he was proud of a very few things. And one was the fact that he never sent or he did not send unpaid patient bills to any collection agencies. And neither were the wages of a nonpaying patient ever garnished. I think that's something that really spoke to me in his obit eulogy. He also said, well I guess the numbers had to be put in, but on the 23rd day of the 5th month of 2000, Pat Cholley at age 88, somewhat reluctantly, returned to the eternal oblivion from whence he had come on February 18th, 1912. Jacqueline, his wife, was truly his better three-quarters and was the main reason he regretted leaving this life. And so I'm really absolutely humbled to receive this honor award. I've been thinking a lot about how I won. Why I won. And just what sort of makes my journey worthy. And so I really wanted to share my journey and see if you all think it fits. So, first off I just wanted to put up a slide that has several of my mentors. I'm a mentor collector, if people don't know. And so these are not even all of them, but they are most of my mentors. A lot of people in this room are on these slides. And they've all contributed to me and my path and my education in pretty specific ways. And I wouldn't be here without them. So just a couple that I wanted to point out. I don't know if you can see my pointer, but the guy in the middle with the glasses and the white coat is Zaza Cohen and the guy on the left is Kevin Fennelly. And they identified me as a medical resident and got me really interested in pulmonary critical care. They sort of shuffled me into all the pulmonary lectures and talks. And Zaza was really important. He was my first real sponsor. So Kevin really served as a mentor and Zaza really served as a sponsor. And they had significant impacts on my career. And I wouldn't have gone to fellowship at Yale if it weren't for those two. At Yale, I was lucky enough to be paired up with Lynn Tanoue, who's on the top right hand of the screen. She still serves as a mentor today. But I was randomly and haphazardly paired with her as a pulmonary fellow. And I learned innumerable things from her, Frank Detterbeck and John Paczalski was the IP attending there. He had just graduated from his IP fellowship. And despite being really junior, he introduced me to Dan Sterman, Colin Gillespie, who took me for a coffee as a first year pulmonary fellow and told me how I can strategize well to get into a career in IP. We later became partners and are still best friends to this day. And then now my partner's at Hopkins, so I have Lonnie Yarmus, Hans Lee, Jeff Thiboutot, Nadia Hansel, and Cindy Rand are also sort of part of the group that really mentor me at Hopkins and have served to really round out my career. So I just wanted to give a quick thank you to all of the people on the screen, but particularly to those. And you know you're old when you can actually fill a slide with your own IP fellow mentees. So this is how I know I'm old, but trying to sort of pay it forward. And I'm still learning and continue to learn about being both a good mentee, a good mentor, and how to sponsor people. And really, for me, I think this award talks about sort of how you've made an impact. And for me, I think one of my biggest impacts is on both my trainees and the people I come into contact with that I've helped get their feet in the door, that I've helped inspire them on how they can create a career that is maybe not super straightforward and not the typical career path of somebody in academics. So it got me thinking about what is your superpower? And Courtney Broadius, who works at UCSF, is well known to many here. When I spoke with her at one point, she barely knew me. She just sat there and said, I think you're a node, you're a connector. I was like, I have no idea what you're talking about. And she said, it's a personality trait where your strength is really sort of figuring out the people around you, figuring out their strengths, who's who, what's what, and you're able to connect people in various paths and various scenarios in your life, and you can get them all to the right people, all boats, as Carla would say. And so she said, that seems to be your superpower after she met me for 10 or 15 minutes or so. And I feel like I wasn't sure that I really fit that bill, but I've tried to sort of take that to heart and make that my mission and my goal to sort of realize what she thinks she saw in me. So I think to everybody here, I think as you're thinking about your career and whether you're in a place where you can do traditional research and randomized clinical trials, how you can have an impact may be something really small, like talking to people, mentoring them, showing them a path in life. And I think you just need to be honest with yourself about your strengths and try to apply them to a career. So how did I do it? I got involved. So I think one of the best things that people along my way showed me was to get involved with my different societies. And I think that's a really good way to make a pretty significant difference and impact is just by getting involved in your society. So clearly I've been involved with CHEST in several different facets. So I teach with them primarily as simulation faculty. I serve on guideline panels, obviously participate in meetings, and I think it has truly enriched my academic career. ATS, I do similar things with the Association of Interventional Pulmonary Program Directors. I am the incoming president this year, which I'm really excited about. And I'll talk to you a little bit more and focus on some of our work there, which I think is the stuff that I'm probably the most proud of in my career. I participate a lot with the Association of Bronchology and Interventional Pulmonary, and then WIP Strong. I hope most of you in this room know what that is, but it's the Women in Interventional Pulmonary group that, again, I'm really excited to be a part of. So for CHEST, as I mentioned, I think getting involved, becoming faculty really offers you so many benefits. You get to participate, you get to meet a lot of people, but you get involved in program development. They actually force, in a good way, you to get educated on how to educate. So you not only get to participate, but you also get to learn and you get to experience what it is to get a full education through CHEST, which I think has been invaluable. You get to participate in some of these scenarios. On the right-hand side of the screen, you see one of our interactive scenarios that we do during our EBIS course, and it's just a simple mat with an airway tree on the floor, which we've upgraded this year. I should have taken a new picture. But Mike Michuzak actually came up with a whole game where you're interactive, and on that mat, people serve as the different landmarks, the different lymph nodes and vessels and whatnot, and that sort of taught me a lot about being creative and just inserting a little bit of yourself every time you teach. I think, for me, that has been extremely instructive. And so I've taken a lot of these experiences, and one of the other things I'm proud of is I developed a hemoptysis simulation while I was at Northwestern. And we devised, we took a mannequin or a model, and we have altered it so that you have different IV tubing, basically, that can go into any of the segments of the airways. You have a little box that sort of keeps that a secret from the learner. But you can go in, and you can pump blood into any of the segmental airways, and they can practice how they would manage massive hemoptysis. So something that doesn't happen too often is extremely scary, and they should be practicing on sort of a regular basis. One of the other really important parts of this simulation protocol is that it's not just for fellows. So we actually have the nurses participate, the respiratory therapists, and the techs, and we do it in our Bronx suite. So it's actually in your area where all the things are where they're going to be when you're actually going to encounter this scenario in real life. And so we did it twice a year, and when I left, you started with a didactic, you ended up with your hands-on simulation. When I left, one of the fellows ended up taking it over and really formalizing it. So now there's pre-test questions, post-assessments, and they even do follow-up assessments later on. And so we're trying to really formalize this, validate it as a tool, and then now publish it so that it can be hopefully expanded to other institutions around the country. With WIP, I think it's something so interesting. I wasn't there for the very beginning. There were a few women, Cindy Ray, Carla Lamb, Colleen Chanick, and Gaetan Michaud really were the first four to come up with this idea of a support group for women, since there were so few of them. This was one of the earlier meetings I joined when I was just coming into IP, and we used to just meet informally at meetings, and now we have a president, a vice president, a secretary treasurer. We've become formalized, we have documents, and we really start to do things that I think are really important. One of the things that I helped to start is called the Welcome Home Session, which is a sounding board session and really rings true to the thought process behind the creation of WIP, which was a support group. So we come there and we talk about situations that are difficult, how we don't know how to manage, or we're not sure what to do, and the think tank of all the women of different ages and seniority levels come together to try and brainstorm about solutions to various people's problems. For me, that serves as a really nice support group and rings true to the mission of WIP. Through the AIPPD, we've done lots of things. Notably, this year, we're heading into ACGME accreditation. I had something to do with that, but I was lower in the ranks at that point, but I love this organization. It really serves well for program directors as well as fellows. It tries to help everybody in their career development. For program directors and fellows, every single year in December, we offer a career development conference and it's held separately. The program directors are treated separately from the fellows and then the program directors actually serve as faculty for the fellows, so it gives them another line item on their CV. It increases their visibility in the field and gives them some opportunities to speak and teach, which I think is really just a nice way to go about things. We sponsor lots of projects. We help out with boot camps and really are trying to get everybody to, again, raise their career status as much as they can. A couple of the projects that I've really been involved in have been in Uganda and Kenya. Going to Africa, I think, was really important for me and quite life-changing and really the bulk of what I wanted to talk about today. We went to the Malago National Specialized Hospital, which is in Kampala, Uganda, which is the capital of Uganda. This is the Lung Institute, so here's a close-up view of the two entrances to the Institute. They actually gave me a faculty position there, which is kind of amazing. As you enter, they have their vision statement right up on the wall where they're looking for an Africa with healthy lungs and their mission is to conduct high-quality lung health research that integrates disease prevention, clinical care and training in sub-Saharan Africa. They have pretty significant core values of innovation, excellence, integrity, care and effort. With that, they want to really start an educational program, but they couldn't do it unless they offered bronchoscopy as a core competency. They have all their paperwork and everything together. All they were missing was bronchoscopy. What we did was, in 2019, we went and set up this room, which is their bronchoscopy suite. I know it doesn't look like much, but it was a really big deal for them. We put in two beds, one for the patient actually getting their procedure and one as a recovery bed. They have a monitor, they have an Olympus tower with a few scopes, they have sterilization equipment and then they have a cart with all of their equipment for their cases. They are set up to do BALs and transbronchial biopsies. We had an engineer come into the room and make it negative pressure, which was also kind of a big deal. This is their suite and it's humble, but it really functions well and nice. These are some locals that were quite interested in visiting our bronch suite. They stop by almost every day. The setup at MLI is that you have all these individual little houses or places, so these institutes. The Lung Institute is, unfortunately, for the lung patients, three-quarters of the way up a pretty steep hill. It's connected with other, like the ID space, the oncology space, through these walkways that are open air. You can see patients walking back and forth between doctors, etc. You think about, as we're doing bronchoscopy, you want to think about your exit strategy. If anything goes wrong, where is my ICU located? Just in case. Hopefully it would never happen, but just in case. You think about how would I transport a patient who's in duress through these little walkways. Walkways don't seem so bad, but actually, the walkways don't go everywhere, and so most of them end. To get to the ICU, you actually have to take the walkway, end it here, and then go up this dirt-rock path uphill that you wouldn't be able to roll a stretcher or a cart on. You would have to carry the patient by hand if you really wanted to take them to the ICU. You can imagine if it was rainy, how that would be muddy and slippery and not ideal, especially if you're bagging a patient or having somebody who really deserves and needs an ICU. Once you walk up that path, then you have to go, this isn't the best picture, but it's actually quite a busy street. You have to go across the street and go down the hill to get to the ICU. It's about a 10-minute walk if you are just a normal person walking at a normal cadence or pace. You can imagine how it would be if you're actually carrying a stretcher with a person who's sedated on it, trying to bag them and get them to the intensive care unit. Thinking about doing bronchoscopy in this scenario is really more challenging than what you would expect in the U.S., where we have our ICUs in the same building, maybe just an elevator ride away at most, where it's nice and easy to just transport them one way or the other. This is something that you really have to think about. A little bit more about their situation. This is outside the hospital. You see lots of people there. It's not because it's an awesome place to be. It's because the family members of the patients who are hospitalized have to wash and provide clean clothes and bed sheets for their family members. The hospitals don't do that. They don't provide that. They all sort of stay on the hospital grounds, and they wash the sheets and the clothing every day for them. They're doing laundry all the time. You also see campfires intermittently because they don't provide food either. The families have to provide food for their loved ones while they're hospitalized. How did we do it? We provided didactic lectures for a day, and then we did a lot of hands-on simulation training, so we used low-fidelity models. We taught them about informed consent. We taught them about sedation. We taught them about using local anesthesia like lidocaine, and we taught them all their anatomy and their bronchoscopy skills, which was a lot of fun. We had them fishing out foreign bodies to help them learn their anatomy and develop their technical skills, which they really enjoyed. And then on the third day, we had them do some live cases, and we were proctoring them. So guiding them through, making sure they did the preoperative checks, they did the procedures correctly, and then we guided them through the postoperative care as well. They did a couple of patients. At one point, we didn't have enough patients, so that's actually me on the stretcher, and they're bronching me. I have really nice vocal cords, right? Those are mine. They look amazing. And the poor guy was sweating like crazy. He was a little nervous bronching me, but everything went well. I'm still here today. Christina McRosty actually was proctoring that one, so she was all over them to be perfect and good. So they got sort of didactic, hands-on practice, and then they got real-life practice with actual patients. Then the following day, again, we go through, and they don't have electronic medical records like we do. So this is Hitesh Batra going through the scans. Again, just making sure that if they're going to do a BAL or transbronchial biopsy, it's going to be in an appropriate location. So reviewing scans with them back up on the light boards like we used to do before the EMRs was around, that's still really standard there. Patients also come with their medical record in hand, so it's a paper chart that they bring with them to their procedures and everywhere they go with all their labs, all their testing, et cetera. So it just makes things a little bit logistically difficult, as you can imagine. But they all did really well, and afterwards, we sort of celebrated. This was our team with the folks from Kampala and us sort of celebrating the end of our teaching session. So what came out of that? So we actually looked at cost of training and setting up a bronchoscopy suite in a low and middle income country, and what that would look like, both for fixed startup costs as well as for variable costs to sort of continue ongoing efforts with bronchoscopy. It looks like it costs about $16,000 US to start it up. But then you just have to remember that they have to be able to sustain their efforts and maintain their supplies moving forward. So it depends what you want to teach them, and you have to be really thoughtful about what kind of bronchoscopy they're going to do, what kind of equipment they're going to need, and how they're going to set it up with what sort of support, physicians, nurses, techs, et cetera. But if you look at our first 14 patients, it showed that the bronchoscopies that we did actually really made a significant difference. So in nine of the 14 patients, or 64% of them, they had a significant change in management just based on BAL results. So most of these patients were being treated for tuberculosis and multidrug-related tuberculosis, and they had been given multiple courses of antibiotics without improvement in their symptoms. And because of a simple BAL, something that we take for granted as something easy and quick to accomplish, it really made a difference in this patient population. How did we do as far as teaching is concerned? Unfortunately, that COVID pandemic happened right in the middle of our sort of training for them. So our first year was 2019 in October. So you can see the blue bars, pre-didactic, post-didactic, and then their B-STAT scores. They did pretty well. So significant improvement from the pre-didactic to the post-didactic, and their B-STAT scores after a day of simulation training were just above 70%. When we went back in 2022, sort of after we felt it was safe to come back after the pandemic, they did retain some of their knowledge. So instead of at 30%, they're starting at 50% on their pre-didactic exams. But they didn't improve as much. And I think we started thinking about this as, how do we sustain a program with them? Obviously, going back once every few years is not good enough. They need sort of sustained and ongoing training. So thinking about creating some enduring materials and connecting with them virtually and trying to go back at least once a year, I think, is going to be really important. But it goes back to the sustainability, right? You can create one program, but can you expand this to really help create other programs in the country? It was interesting on my flight on the way here, I ran into this woman who does a lot of work in low-middle-income countries. And she tries to set up these sustainable programs, and she was showing me some of her data about which disease states really need some ongoing instruction, training, programs that are set up, and tuberculosis falls really high on that list. And then sort of what kind of programs really are worth investing in. And really, you need programs that are collaborative approaches to improvements with training, and they incorporate some QI into the program. And so I think that's what we're trying to build at this program before we can expand it to others, is trying to make sure that it's nice and sustainable. A slightly different program that we did was in Kenya. So we went to Nairobi at Kenyatta National Hospital, which is their largest tertiary care center, where they're already doing bronchoscopy. So they have an open and active bronchoscopy suite, unlike in Uganda, where this was the very first one, and they were just starting to do bronchoscopy. In Kenya, they're actually quite advanced and have been doing bronchoscopy, transbronchial biopsies for quite some time. They actually have an interventional person who does quite a bit of things. So they organized some really nice workshops for us to do this past year. So they did a bronchoscopy skills workshop from basic to advanced, and that was, again, a three-day course that was structured pretty similarly to that one in Uganda. And then we did a pleural disease and interventional pulmonary lecture, where Hans and I gave talks about medical thoracoscopy, pleural biopsies, thoras and chest tubes. And all of this was sponsored by the Respiratory Society of Kenya, which is really quite active. So actually, at our pleural disease lecture, we had about 70 people in person, and we had another 70 or 80 people online, virtually listening to this. So it just shows us that there's quite an appetite for this. They really want to learn, they're very engaged, and they're there to get as much information as possible for whoever's going to be willing to provide quality education. So I think this is really a good place to go. They set up a whole tent for us. You can see us giving some didactic lectures. This is Hitesh and Andrew, who's actually from Kenya and organized this event. We provided them with training certificates after the fact, if they completed all three days of training. Again, we used simulation. I got to be the guinea pig where they could practice putting lidocaine in for local anesthesia on me. That was not as fun as it looks. On the third day, again, we did live cases. And again, you can see how this has a really big impact. This is an N of 1, but this patient was a nine-year-old little girl who had been suffering for about six years, and they couldn't figure out why. The CT scan just showed some thickening in the bronchial tree, the right, like the BI, down to the lower lobe. And she'd been treated for tuberculosis again and again and again, recurrent respiratory infections, and she was being hospitalized for failure to thrive. She was losing weight. She wasn't eating anything. And when the pediatric bronchoscopist went down to look, we thought we were going to have to balloon dilate or something of that sort. And it turns out, you can see on the bottom picture, she actually has a foreign body stuck in her airways. And the thing is, they don't have the skills there to actually remove foreign bodies. So if they get a foreign body, most of those patients go for lobectomies. So we ended up just using forceps. I showed her how to remove a foreign body, and we took it out. The patient's actually doing great. I kind of kept in touch with her. So she's now eating again, starting to recover, and had gotten discharged from the hospital about a week or so later. So that was a big win, and it was an all-female team, just to be clear. So myself, the pediatric pulmonologist, and the nurse were all female, so that was really fun. But again, we had a nice big team here. Everybody was really engaged. They already have a pseudo-fellowship. It's not really formalized yet, but they are training people to do bronchoscopy, basic bronchoscopy. And they really want to advance their skills. And so I think, unlike Uganda, where we're really starting from the bottom and the baseline, in Kenya, we're taking something where they have a nice base and a good set of knowledge, and we're trying to advance them further. But again, it's not as straightforward as you would think here in the US. It's one thing, oh, give them E-bis. We should just start training them this way. But if they are not able to purchase the needles and the disposables and the equipment, then they're not able to sustain a program. So the thought has to be, how can we make something like this sustainable? And how can we make it a program that can then be expanded to other regions? And so actually, after, I should say, Hans, Hitesh, and I were given these blankets or shawls, and they told us that we were warriors. So we all had them on, and we were very excited about that. And clearly, we went for a safari after and saw all the animals that you can see in Kenya, because you should not go all that way and not see an animal. So ongoing research efforts there that are currently underway. So we are working on bronchoscopy competency. So trying to validate, again, opening and sustaining new programs in low and middle income countries. We're looking at how to train the physicians, as well as the nursing and support staff over there. We're underway with a sedation protocol, and I'll show you some preliminary results in a moment, where we're using topical lidocaine alone versus moderate sedation in these patients. And I know that sounds like we're increasing the disparities there, but it's actually by choice for them, and I'll talk about that in a second. And again, establishing a sustainable procedural training program. So we're trying to institute a train-the-trainer paradigm, where we're training the people who are actually proficient in bronchoscopy and trying to get them to then be able to propagate those skills. And ideally, what we're starting to pilot is an exchange program. So some of their trainees can come to the U.S. to learn, and some of our trainees can go there to learn. They do a lot of thoracoscopy, a lot of pleural biopsies, things that we are struggling to get our fellows and our trainees experience with. So I think having an exchange program might be a really worthwhile endeavor. So those things are in the works. So for the sedation for bronchoscopy protocol, we have patients who are undergoing BAL for a COPD study. And so far, we have 13 patients enrolled. And what we're doing is we offer them moderate sedation versus lidocaine, so topical only. And we ask them why they would pick whichever one they pick. To be fair, all 13 of them have chosen lidocaine only, which kind of surprised me. None of them wanted sedation. And then we sort of see how the procedure goes. So how long does it take to get through the vocal cords to the main carina? How long does it take to do your actual procedure? How much do they cough? How uncomfortable are they? How uncomfortable is it for both the patient as well as the proceduralist? And are you able to get done what you can do? I know this is really small, so you won't be able to read it. But we ask them about comfort, anxiety, and cough sort of before, during, and after the procedure. And then we ask them what was uncomfortable during the procedure. Most of them report nausea. By far and away, that's been the most common thing. But again, only 13 patients so far. And then a little bit as far as retention and runoff of secretions. So those are the things that seem to bother them the most. They've all picked no sedation, so just local lidocaine use. And most of them say that it's because they don't have somebody to accompany them home afterwards. So we're really trying to drill down on what are their preferences and why. Other reasons when we were there is because they want to go to work after. They don't want to stay for an extended recovery period. And I think it's a cultural thing, but they're a little bit nervous to actually get sedated. So they don't like that idea of having moderate sedation. Anyways, the numbers will bear out. We have a few hundred patients that we're going to be enrolling into this study. But the first 13, we just got the results two days ago. So here they are. But why it matters. So I think our work in Uganda really matters because just setting up a Bronx suite, which again was that sort of little room that didn't look like a lot, but took quite a bit of effort to put together, now enables them to actually open a pulmonary fellowship program. And to put it into context, if you wanted to be pulmonary trained in Uganda, you actually had to go to Ethiopia or South Africa to be trained. There was no other way to get training there. So this will actually open the first fellowship program. And we were actually training people in a neighboring five hours or so drive away, Barara. We were training them on bronchoscopy as well. So they are opening sort of a second bronchoscopy suite in the country. And hopefully that's going to lead to a second fellowship program. Ideally we'd introduce EBUS or other advanced skills to low middle income countries. So in Kenya, I think that's really the way to go. They already have a base with bronchoscopy, but it really makes a difference for their patients. And I think EBUS is the next step. They do see a lot of patients with lymphadenopathy that are concerning for cancer. But the question there is just how do we get them the equipment and make it a sustainable program for them? And I think there's so much opportunity as far as cooperation and global learning opportunities there. But ideally it's really to save patients' lives. And I think we showed that we can do that there. So I think this stuff really matters and is really truly important. Something that's pretty near and dear to my heart and something that, again, I think is so simple but has a pretty big impact overall. And then switching gears, the other thing that I'm going to put a shameless plug for is lung cancer. So the last thing that has nothing to do with global health but does affect everybody on the planet is lung cancer. And so one of the things I'm doing with a group of people that I'll show you in a moment is to do a social media challenge to raise awareness for lung cancer. I think that there's a lot of, there's not a lot of information in the general public about lung cancer overall. They have a lot of misconceptions. And there's a lot of things that they really don't know. So what we wanted to do was a fun way to sort of disseminate information to the masses. And we thought, why not model ourselves after the ALS Ice Bucket Challenge but make it, associate it with breathing, so to do with the lungs. And so our challenge is the One Breath Bubble Challenge where you blow a bubble with one breath and you post it on social media and tag, use our hashtags, and that will direct people to our website. You can challenge friends, hopefully, and have this propagate around. Once people come to our website, they'll have information about lung cancer to raise awareness and some resources for them as well. Throughout the Lung Cancer Awareness Month, which is November, so which is coming up in a couple of weeks, we will be sort of highlighting lung cancer survivors in our first week. We'll be talking about lung cancer in women, other disparities as it relates to lung cancer screening. We'll talk about new diagnostic techniques and new therapies out there for lung cancer. So throughout the month, a lot of really good and important information. We'll also have some fun facts and myth busters on that website that I think will be just a whole lot of really good information. I couldn't do it without a team, so I've put together, I don't know how I was able to convince this amazing group of people to join me, but Dr. Silvestri is on my team, Dr. Tanoue, Dr. Tanner, Dr. Patricia Rivera, and Dr. Aaron Gillaspie have all joined me as sort of my core group to help plan this. And then we have some people, well, everybody here probably knows Kim French, she's so involved in CHEST and she's an absolute force, so she's helping as well. And then some people from industry who have a lot of experience with marketing and social media, none of which I have, so they're helping with that on their own individual behalves, not on behalf of industry. And so this is what it looks like. We have a website that's going to raise awareness for lung cancer and we have several social media sites that are ready to be up and running. And so ideally we are launching this in a couple of weeks for November 1st for Lung Cancer Awareness Month. And then ideally we're going to have a few extra things throughout the year, so April is Minority Health Awareness Month, May is Women's Health Awareness Month, June is Men's Health Awareness Month, and then there's LGBTQIA plus Health Month as well. So we ideally are going to be planning different things for our campaign during that time of the year, so we're not just thinking about lung cancer only in November, but sort of little bits throughout the year. And although raising awareness is really the primary focus of that campaign, inevitably we hope to raise some money, and those funds will be directed towards the American Cancer Society and specifically to the National Lung Cancer Roundtable, where they will go to a subcommittee, the DEI subcommittee specifically that's run by Patricia Rivera, it's just being created and started, and we will work with her to put together a nice, to support a research grant in support of lung cancer through her subcommittee specifically. If there's enough money, we'd also like to fund an educational event for healthcare providers and provide some educational materials for patients and families who have been affected by lung cancer. And people have already started to do this, so we have some people who have already participated in the challenge, I have some bubbles here and some bubble gum if anybody wants to participate at the end of this, we'd be really happy to get your videos. This is a really good one to, as a good example, you can see Dr. Silvestri here with Jackie, and they are in a bubble off, I guess you would say. So here they go, the trash talking started, is now ended, and now they're about to blow their bubbles. Jackie's clearly winning, until now. And so that's how you do it. With that, I promised Hans, my partner, that I would throw in this sort of random video, but just to say thank you, I'm really honored to have won this award, the future is bright, and just think, if you have not followed a traditional path, and you do some sort of crazy out of the box thinking, you don't have to pick at scraps, you can soar on your own, you can win a Chalia award, and you can really have a career where I think you can make an impact that is beyond using your technical skills. And so with that, I'll say thank you so much for everyone for being here.

Dr. Christine Argento

Interventional Medicine

Education

Innovation

Bronchoscopy Suites

Underserved Communities

Lung Cancer

Global Healthcare