Tuesday, February 27, 2018

Youtube daily report Feb 27 2018

Do you want to rule?

Do you see the problems in your country and know how to fix them?

If only you had the power to do so.

Well, you've come to the right place.

But before we begin this lesson in political power

ask yourself:

why don't rulers see as clearly as you?

Instead acting in such

selfish, self-destructive, short-sighted ways.

Are they stupid

these most powerful people in the world?

Or

is it something else?

The throne looks omnipotent from afar

but it is not as it seems.

Take the throne to act

and the throne acts upon you.

Accept that or turn back now before we discuss

The Rules for Rulers.

*somber music*

No matter how bright the rays of any sun king:

No man rules alone.

A king can't build roads alone

can't enforce laws alone

can't defend the nation or himself, alone.

The power of a king is not to act but to get

others to act on his behalf

using the treasure in his vaults.

A king needs an army, and someone to run it.

Treasure and someone to collect it.

Law and someone to enforce it.

The individuals needed to make the necessary things happen are the

king's keys to power.

All the changes you wish to make

are but thoughts in your head

if the keys will not follow your commands.

In a dictatorship, where might makes right

the number of keys to power is small

perhaps only a dozen generals

bureaucrats

and regional leaders.

Sway them to your side and the power to rule is yours

but never forget:

Displease them...

and they will replace you.

Now all countries lie on a spectrum

from those where the ruler needs few key supporters

to those where the ruler needs many.

This foundation of power is why countries are different.

Yet many keys or few

the rules are the same:

First:

Get the key supporters on your side.

With them, you have the power to act

you have everything.

Without them

you have nothing.

Now in order to keep those keys to power, you must

Second:

Control the treasure.

You must make sure your treasure is raised and distributed to you

for all your hard work

and to the keys needed to keep your position.

This is your true work as a ruler:

figuring out how best to raise and distribute resources

so as not to topple the house of cards

upon which your throne sits.

Now you

aspiring benevolent dictator

may want to help your citizens

but your control of the treasure is what attracts rivals

so you must keep those keys loyal.

But there is only so much treasure in your vaults

so much wealth your kingdom produces.

So beware:

Every bit of treasure spent on citizens

is treasure not spent on loyalty.

Thus, doing the right thing

spending the wealth of the nation on the citizens of the nation

hands a tool of power acquisition to your rivals.

Treasure poured into

roads, and universities, and hospitals

is treasure a rival can promise to key supporters

if only they switch sides.

Benevolent dictators CAN spend THEIR take on the citizens

but the keys must get their rewards

for EVEN IF you have gathered the most loyal, angelic supporters

they have the same problem as you

just one level down.

Being a key to power is a position of power.

They too must watch out for rivals from below or above

thus the treasure they get must also be spent to maintain their position.

The loyal and dim may stay by your side no matter what.

But smart key supporters, will always watch the balance of power

ready to change allegiance if you look to be the loser

in a shifting web of alliances.

In countries where the keys are few

the rewards are great.

And when violence rules

the most ruthless are attracted

and angels that build good works will lose

to devils that don't.

So buy all the loyalty you can

because loyalty

in dictatorial organizations of all kinds

is everything.

For the ruler, anyway.

Thus, the dictatorship exposed:

A king who needs his court

to raise the treasure

to keep the court loyal

and keep raising the treasure.

This is the self-sustaining core of power.

All

outside

is secondary.

Now a king with many key supporters has real problems:

not just their expense

but also their competing needs and rivalries are difficult to balance.

the more complicated the social and financial web between them all

the more able a rival is to sway a critical mass.

The more key supporters a ruler has on average

the shorter their reign.

Which brings us to the third rule for rulers:

Minimize Key Supporters

If a key in your court becomes unnecessary

his skills no longer required

you MUST kick him out.

After a successful coup

the new dictator will purge some of those who helped him come to power

while working with the underlings of the previous dictator

which from the outside seems a terrible idea.

Why abandon your fellow revolutionaries?

Are the old dictator's supporters not a danger?

But the keys necessary to gain power

are not the same

as those needed to keep it.

Having someone on the payroll who was vital in the past

but useless now is the same as

spending money on the citizens:

Treasure

wasted

on

the irrelevant.

And by definition, a dictator that pulls off a coup

has promised greater treasure

to those switching sides.

The size of the vault has not changed

so the treasure must be split among fewer.

A dictator that sways the right keys

takes control of the treasure

cuts unnecessary spending

kills unnecessary keys

will have a long and successful career.

Seeing the structure unveiled

you might be excited to get started

and control a country to the benefit of you and your cronies

or you might be exhausted

wishing to do good but seeing the structural difficulties

now turn to democracy for salvation.

So let us discuss

Rulers as Representatives.

You again might have grand dreams of the utopia you wish to build.

But

No man rules alone.

And never more so than in democracy.

Presidents and Prime ministers

must negotiate with their

senates and parliaments and vice versa.

And they all have their own key supporters to manage.

In a well-designed democracy

power is fractured among many

and is taken not with force

but with words.

Meaning you must get thousands or millions of citizens to

if not like you on election day

at least like you better than the alternative.

With so many voters and such fractured power

it's impossible to

as a dictator would

follow these rules and buy loyalty.

Or is it?

Of course not.

Don't think of citizens as individuals with their individual desires

but instead as divided into blocs:

the elderly

or homeowners

or business owners

or the poor.

Blocs you can reward as a group.

Democracies have wildly complicated tax codes and laws

not as accident but as reward for the

blocs that get and keep the ruling representatives in power:

Farming subsidies, for example

have nothing to do with the food a nation needs

but entirely with how key the vote of the farming bloc is.

Countries where farmers' votes don't swing elections

don't have farming subsidies.

If a bloc doesn't vote

such as younger citizens

then no need to divert rewards their way.

Even if large in number

they are irrelevant to gaining power.

Which is good news for you:

one less bloc to sway

and the treasure you give to your key blocs has to come from somewhere.

If you want long years in office

rule three is your friend in a democracy

just as much as a dictatorship.

You can't eliminate those who don't vote for you

but there is still much you can do.

Once in power

make it easier for your key blocs to vote

and harder for others.

Establish voting systems that reduce the number of blocs you need to win

the more rivals you get

very handy indeed.

Draw election borders to predetermine the results for you or your cronies

and have party pre-elections with Byzantine rules

to determine who blocs even CAN vote for.

Mix and match the above for even better power perpetuation.

When approval ratings couldn't be lower

yet re-election rates couldn't be higher

you'll know you've succeeded.

Now, enough with thinking about the citizens.

Even in a democracy

there still are very influential individual key supporters

you need on your side

because their money

or influence

or favors

keeps you in power.

While you can't just promise to give them treasure directly...

as a dictator would

...you can create loopholes for their investments

pass laws that they've written

or print get out of jail free cards for their actions.

Not a wheelbarrow of gold to the door

but contracts for their business.

You as ruler do have roads to build

or computers to maintain

or buildings to reconstruct.

No man rules alone, after all.

Or you could take the moral path

and ignore the big keys.

But you'll fight against those who didn't.

Good luck with that.

Corruption is not some kind of petty crime

but rather a tool of power

in democracies and dictatorships

but more on that another time.

So, accept the favors

sway the key blocs

and you will get into power

ruling with actions that look contradictory and stupid

to those who don't understand the game

privately helping a powerful industry you publicly denounced

or passing laws that hurt a bloc that voted for you.

But your job isn't to have a consistent understandable ruling policy

but to balance the interests of your keys to power

big and small.

That is how you stay in office.

Now with all this headache of being a representative

you may wonder...

looking at rule three

Why couldn't you skip all this bloc-building, favor trading nonsense and

just bribe the army to take power?

We must finally turn to:

taxes and revolts.

You must understand rule two

and how the treasure is raised and used

to hold a country together.

If we graph the tax rate of countries vs the number of key supporters the ruler needs

there's a clear relationship.

More democracy

lower taxes.

If you're sitting comfortably in a cushy democracy

you may scoff at this

but your fellow citizens who don't earn enough

don't pay income taxes and get rebates.

Bringing the AVERAGE tax rate down.

In dictatorships

this doesn't happen.

Dictatorships often forgo tax paperwork in favor of just

taking wealth directly.

It's common for the dictator to force farmers to sell their produce to him for little

then turn around and sell it on the open market.

Pocketing the difference at an unthinkably high equivalent tax rate.

So taxes in democracies are low

in comparison to dictatorships.

But why do representatives lower their take?

Well, cutting taxes is a crowd pleaser.

Dictators have no need to please the crowds

and thus can take a large percentage from their poor citizens

to pay key supporters.

But representatives in a democracy can take a smaller percentage

from each to pay their key supporters

because their educated, freer citizens

are more productive than peasants.

For rulers in a democracy

the more productivity the better.

Which is why they build universities

and hospitals

and roads

and grant freedoms

not just out of the goodness of their hearts

but because it increases citizen productiveness

which increases treasure for the ruler and their key supporters

even when a lower percentage is taken.

Democracies are better places to live than dictatorships

not because representatives are better people

but because their needs HAPPEN to be aligned

with a large portion of the population.

The things that make citizens more productive

also make their lives better.

Representatives want everyone productive

so everyone gets highways.

The worst dictators are those whose incentives

are aligned with the fewest citizens.

Those who have the fewest keys to power.

This explains why the worst dictatorships have something in common.

Gold or oil or diamonds or similar.

If the wealth of a nation is mostly dug out of the ground:

it's a terrible place to live

because a gold mine can run

with dying slaves

and still produce great treasure.

Oil is harder

but luckily foreign companies can extract and refine it

without any citizen involvement.

With citizens outside this cycle

they can be ignored

while the ruler is rewarded

and the keys to power

kept loyal.

Thus we live in a world where the

best, smartest democracies are stable

the worst, richest dictatorships are stable

and in between

is a valley of revolution.

The resource-rich dictators build roads

only from their ports to their resources

and from their palace to the airport.

And the people stay quiet

not because

"this is fine"

or even because they're scared

but because the cold truth is:

starving, disconnected, illiterates

don't make good revolutionaries.

Now a middling dictator without resources must

as mentioned before

take a large amount of wealth

directly from his poor farmers and factory workers.

Thus two roads won't do

and so he must maintain

some minimums of life for the citizens.

But keeping the work-force SOMEWHAT connected

and SOMEWHAT educated

and SOMEWHAT healthy

makes them more able to

revolt.

Now understand:

the romantic image of the people storming the gates

and overthrowing their dictator

is mostly a fantasy.

If you run a middling dictatorship

the people only storm the palace when

the army LETS THEM

to remove you

because you lost control over your keys

and are being replaced.

This is why after

"popular revolts"

in middling dictatorships, the new ruler is often

the same as the old

if not worse.

The people didn't replace the king

the court replaced the king

using the peoples' protest

they let happen to do it.

The very things a benevolent dictator wants to build

to cross this valley

take treasure away from the keys to power

and make the citizens more able to revolt

often ending in a stronger ruler

less likely to build bridges

and more loyal to his keys.

On the other side, the best democracies are stable

not just because

the large number of keys and their competing desires

makes dictatorial revolt near-impossible to organize

but also because the revolt would destroy

the very wealth it intended to capture.

The high productivity of the citizens.

Plus: those helping the would-be dictator in a democracy

know he plans to cull key supporters once in power.

That's what's a coup is.

So potential key supporters must weigh the probability of surviving the cull

and getting the rewards

versus the risk of being on the outside of a dictatorship

they helped create.

In a stable democracy

that's a terrible gamble:

MAYBE you'll be incredibly wealthy

but PROBABLY you'll be dead

and have made the lives of everyone you know

worse.

The math says no.

Being on the right side of a coup in a dictatorship

means having the resources to get you and your family

what the peasants lack:

Health care, education, quality of life.

This is what make the competition for power so fierce.

But in a democracy most already have these things

so why risk it?

So the more the wealth of a nation comes from

the productive citizens of the nation

the more the power gets spread out

and the more the ruler must maintain the quality of life for those citizens.

The less

the less.

Now if a stable democracy becomes very poor

or if a resource that dwarfs the productivity of the citizens is found

the odds of this gamble change

and make it more possible for a small group to seize power.

Because if the current quality of life is terrible

or the wealth not dependent on the citizens

coups

are worth

the risk.

When democracies fall

these are usually the reasons.

*Conclusion*

These rules for rulers explain not only why

some men are monsters

and others are merciful

but EVERYTHING about politics:

from war

to foreign aid

to political dynasties

to corruption.

All of which, we can talk about at another time.

But for now

you aspiring ruler

may be disgusted by the world of politics

and have decided to avoid it entirely

but you cannot

for rulers come in many forms.

Yes, Kings

Presidents

and Prime Ministers

but also Deans, Dons, Mayors, Chairs, Chiefs.

These rules apply to all and explain their actions:

from the CEO of the largest global corporate conglomerate

whom must keep his board happy

to the chair of the smallest home owner's association

managing votes and spending membership fees.

You cannot escape structures of power.

You can only turn a blind eye to understanding them

…and

if you ever want the change you dream about

there is a zeroth rule you cannot ignore.

Without power

you

can affect

nothing.

You may not like these rules

but surely

better you on the throne than someone else.

And who knows

maybe you'll be different.

*somber piano music, slowly fading*

For more infomation >> Az Uralkodók Szabályai (CGP Grey fordítás) - Duration: 18:57.

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Brilliance, Baths, and a Rant - Vacation Vlog Part 1 - Duration: 10:50.

oh terrible lighting, terrible lighting

better lighting

hi everybody, I'm Amanda the G and I'm on vacation so

vacation vlog!

woooooooo

now you got sick

this is day one

it's Friday

and I actually went to work this morning, so it's like half of a day

but it's day one, we're going with it, day one!

I went

(dog claws clicking)

I went to the gym

(dog claws clicking)

I'm just gonna let him click

you're just gonna deal with it

who's crazy?

are you crazy?

then I filmed a video which I had wanted to film, but I was sick

and then

I went to Hobby Lobby, cause I thought I was gonna get stuff to recover this couch that I destroyed

in my basement

here's what I did

here's what I did to this couch

this is the couch that got stuck

up in the corner

when I was trying

to bring it down from upstairs

it's my old couch

that I hate

(quiet laughter) so

my plan was

to put more foam in it, make it like a double armed chaise lounge type of thing

and then recover the whole thing

and

I went to Hobby Lobby

because- oh god, don't die

um, went to Hobby Lobby because the fabric was on sale

it was like 30% off, and I was like, ok, I'll look at it

I'm not spending 70 bucks for frikin' fabric to recover a free couch

so instead, I got some stickers

and

I scheduled

to have my HVAC cleaned for the fall cleaning that I clearly postponed way too friggin long

to make sure it's not gonna kill me with carbon monoxide

ummmm so they're coming (laughing) this week

and

I also scheduled my home internet to come

so I'm going to actually have internet in my house again

which is weird cause I have not in years

but now

I'm gonna eat some food

and I'm gonna watch the Olympics

and I can't show you that

because I have a feeling if you broadcast the Olympics

even in a little bit, they're gonna be mad at you

day two and I have just gotten home, this lovely, lovely look

is brought to you by two hours at the gym followed by a walk in the rain

which wasn't raining at first, but now it's raining

so

yay good thing I wore my rain boots

and then I come home and I see this

and I'm reminded

of how much this closet sucks

there's shit everywhere

shit everywhere

in this closet

so now

I've decided that on my to do list

I'm gonna add fix that damn closet

and now you see why Amanda doesn't daily vlog

because one, my house is a fucking mess

and two

I don't do a lot of super fun shit (laughing)

my vacation is doing shit around the house

I'll see you guys after I take a shower cause this is gross

actually!

let's knock off the to do list

let's give the dog a bath

put the paws up, there you go, good boy

good boy, Ollie, good boy, mwah, mwah, mwah, good boy

good boy

that's a good boy, I know, I know

get the soap

good boy

good boy

good boy, good boy

who's a good boy?

who's a good boy?

who's a good doggie?

you're a good boy, yes you are

good boy

all done, water goes off

what a good doggie!

yes, you're good boy

yes you're a good boy, yes you are

oh what a good boy

believe it or not

that's like the least painful a bath has ever been

ever

and I've taken a shower now

clean

and we got one load of laundry in, and I'm about to do something that I consider brilliant

and hopefully you consider it brilliant too, and if you don't

oh well

it's not your house, it's not your stuff

deal with it

this comforter

is in a cover

and it keeps moving

and you have

sections of the cover

with no comforter in it

and sections where there's like a pile of frikin comforter

and also it's a pain in the butt to put in

and to figure out where things are going

so I've come up with what I consider a brilliant damn solution

I'm gonna put snaps in it

I'm gonna put em one way on the top

and another way on the bottom

and I'm gonna put a corresponding snap on the comforter on the inside

and then if I get a new cover, I just put four more snaps on the cover based on the top and bottom

and then I'll always be able to find the top and bottom

you just snap in all four corners

it should spread out easier

hopefully

that's the thought

and then it stays out, and then you have your comforter everywhere

instead of like my dog hogging all the comforter

yeah that's right, Ollie, I know what you do, you're a comforter hog

high 5

good boy!

that's his trick, he likes to high 5

you get a little pokey thing and this

and the pokey thing goes underneath

and this goes on top of the fabric

and then you hammer it on

snaps are on, laundry is in

and

second load of laundry is actually in now

and the first one's in the dryer

and hanging up in my bathroom because not all of it can be dried

and I am now going to eat

for the first time all day

and then I'm gonna edit

which is super thrilling

look

it's the Olympics- don't look!

it's classified

I'm just taking

my little

video file

and transferring it onto my computer from my SD card

it's super thrilling

(robot voice) robot vacuum take over world

the lighing is shit right now because it's, it's night time

I have my 6th

load of laundry in the frikin dryer (laughing)

because

I don't know, I waited too long to do all of this

but I'm gonna see

if my

plan

worked

cause now there's snaps on that

so

theoretically

you just put the mountains in the holes

since the mountains are on the top on the inner thing and the bottom on the outer thing

it should be easy

and there should just be simple

(music playing)

(maniacal laughter)

it's working!

it's all to each corner now

it's all to each side now

you just have to snap em and then fling it

it works!

day three

good morning, I have coffee

all the coffee is mine

I'm gonna wake up now

I'm gonna have coffee

and then

I'm gonna be super fun again and edit all day

(sizzling) breakfast yummmmmmmmmm

ok, now that I finished editing, I've moved that painting over there

just so I have room on my table

for insanity

also known as scrapbooking

I just finished 36 pages of scrapbooking

which if you scrapbook at all, you know how extensive that is

umm

that hacking is the dog

it's like

yeah, it's like almost 6 o'clock at night

um, this is the aftermath

on my table

which I clearly need to clean up

cause it's everywhere

and then there's more

um, more too

because there's never enough space

for all of this

day four

I'm exhausted

right now

because my alarm went off at 5:10

and I'm going to the gym

but

I planned on this

I planned on my alarm going off this early because I have to get

my run in

before

the internet people come

so we'll see how many

crazy people there are at the gym at this hour

also that's a Capri Sun

on my night table

because I got really thirsty in the middle of the night

and I didn't feel like getting a glass to get water

which I probably should've done, so instead

I got a Capri Sun that's in my fridge that was leftover

and it took me forever to get that stupid thing open

with that straw cause I didn't want to turn any lights on

I'm back from the gym, I just ran for like an hour

and then I went and stretched for a bit

so I did intervals, one on, er

one off, two on

whatever

um, and I just- I have my sock here because that's blood

um

I was like I think my foot's bleeding

about halfway through

yeah my foot's bleeding

in high school, my cross country coach used to get mad at us

and every time he did, he said that he would make us run until their feet bled

so Mr. Forbes

my foot is bleeding

it's like

seven o'clock in the morning

dog is still asleep

I gotta take a shower

and then get dressed and then move the TV

so that the internet people can get to the plugs back there

because for some reason in this house

the only place to plug in anything like a cable wire

or a cable for internet is behind where my TV is

three hours later, I finally have internet

well three hours after the guy got here

look my house looks actually kind of clean

but you wouldn't think that

because there was mud all over the place that I had to clean up

and then the guy asks for a towel to put under his shoes, and it's been raining

so it's like, ok, well I figured it'd be like water, it was caked in mud

so it's a good thing that I gave him a shit towel

that I don't really care as much about

but now

I still have to clean that towel

and I just did 7, 6? 6? 6 loads of laundry?

somethin' like that

the other day

and now I just made more laundry

so great

and I'm also kinda pissed off right now because

the guy

is talking to people his whole time he's here

which is fine

if you wanna talk to people on your little bluetooth headset, you go ahead and talk to people on your

little bluetooth headset when you're settin' shit up

but he's like trying to explain shit to me, and making phone calls, and trying to explain shit

and making phone calls, but just fucking deal with what we're dealin' with here, and then go make your goddamn phone call

also I heard him very loudly say outside and then

hush himself as he was coming in the door and then say very loudly in my basement

which by the way, sound carries like no other in this house

I can hear everything that happens

to complain

about the dog poop in my back yard

ok

first off

I work four jobs

I have no time

I'm taking a week off to stay at home to get laundry done

and cleaning done, you think I have time?

and then on top of that, it's fucking pouring rain

so I was gonna go out there and pick it up this mornin'

after I went to the gym

but it's fucking pouring down rain

I'm not doing it in the fucking pouring down rain

also, my dog just shits on the walkway because he's a jerk

so just go next to the walkway, it's fucking fine

and there's not even that much out there

he's like 'I'm gonna be sick'

blah, blah, blah

you wanna complain about me?

fucking complain about me, I don't care

complain about me all the fuck you want to

complain about my yard all the fuck you want to

but don't do it in my house

anyway

day four!

I have internet

and terrible lighting

and now I have to crochet more

and then get some other stuff done

and I have to go back to my to do list

back there

it's so hard to point

back there

and see what else I'm gonna do today

(music playing)

For more infomation >> Brilliance, Baths, and a Rant - Vacation Vlog Part 1 - Duration: 10:50.

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Romina Power e Al Bano Carrisi: Loredana Lecciso? "Sono giorni molto tristi…", parla Barbara d'Urso - Duration: 6:47.

For more infomation >> Romina Power e Al Bano Carrisi: Loredana Lecciso? "Sono giorni molto tristi…", parla Barbara d'Urso - Duration: 6:47.

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Anticipazioni l'Isola dei Famosi: naufraghi in arrivo in Honduras, ecco i nomi | M.C.G.S - Duration: 3:54.

For more infomation >> Anticipazioni l'Isola dei Famosi: naufraghi in arrivo in Honduras, ecco i nomi | M.C.G.S - Duration: 3:54.

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Grayhill Touch Encoder | Digi-Key Daily - Duration: 1:08.

Grayhill's Touch Encoder simplifies the design and implementation of attractive, robust,

highly functional HMIs for industrial, commercial kitchen, medical, off-road and other challenging

environments.

It supports tap, swipe, and turn gestures, making it an intuitive interface for users

that can save space by replacing multiple traditional inputs.

The Touch Encoder combines a PCAP high resolution touch screen and rotating encoder in an IP67

sealed, IK6 impact resistant, and chemical resistant package.

The tablet-based development platform has a library of customizable widgets to simplify

development, and the integrated memory can store hundreds of screens.

The Touch Encoder has 32 positions per revolution and is rated for 1 million cycles, and is

offered with either a USB or CAN interface and multiple knob styles.

For more infomation >> Grayhill Touch Encoder | Digi-Key Daily - Duration: 1:08.

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REINHARD HEYDRICH - WikiVidi Documentary - Duration: 23:28.

For more infomation >> REINHARD HEYDRICH - WikiVidi Documentary - Duration: 23:28.

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Cactus Coloring Book and Drawing for Children | Learn Colors for Toddlers - Duration: 4:44.

PINK

RED

YELLOW

PURPLE

PURPLE

ORANGE

PINK

PINK

BLUE

BLUE

GREEN

GREEN

YELLOW

YELLOW

For more infomation >> Cactus Coloring Book and Drawing for Children | Learn Colors for Toddlers - Duration: 4:44.

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Racing Sports Network

For more infomation >> Racing Sports Network

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TOME AGUA DURANTE LA MAÑANA EN AYUNAS POR 30 DIAS Y ESO SUCEDERÁ CON SU CUERPO! - Duration: 2:39.

For more infomation >> TOME AGUA DURANTE LA MAÑANA EN AYUNAS POR 30 DIAS Y ESO SUCEDERÁ CON SU CUERPO! - Duration: 2:39.

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BuildingNY:NYStories - Robert J. Cerfolio, MD - NYU Langone Health - Duration: 28:14.

♪ [THEME MUSIC] ♪

>> NORTH HALEDON, NEW JERSEY.

>> PATERSON, NEW JERSEY, OH, I

LIKE BASEBALL.

I LIKE SPORTS.

I LIKE COMPETITION. A LABOR

AT THE AGE OF TEN. SWEEPING?

I WILL BE A DOCTOR BECAUSE

YOU KNOW, I SPAYED MY DOG.

YOU KNOW?

I AM GOING TO FIND THIS PROGRAM

UP AT THE UNIVERSITY IN

ROCHESTER, 242, YOU KNOW, DAD

WANTED ME TO BE A UROLOGIST,

YOU KNOW?

MAYBE I WILL DO CARDIOTHORACIC.

THEN I AM GOING TO GO TO

MEMORIAL SLOAN, BUT NO, I AM

GOING TO WANT TO GO TO THE MAYO

CLINIC.

THE UNIVERSITY OF ALABAMA?

A BOY FROM NEW JERSEY?

THIS GUY IS NOT A UNIVERSITY OF

ALABAMA.

HE WRITES BOOKS.

HE LECTURES.

HE TRAVELS AROUND.

HE DONE 18,000 SURGERIES.

I HAVE THE CARDIOTHORACIC

SURGEON FROM NYU LANGONE-

>> DIRECTOR OF THE LUNG

CANCER CENTER.

A LOT OF FANCY TITLES.

DO YOU WANT TO GIVE THE LAST

NAME TOO? DOCTOR-

>> ROBERT CERFOLIO.

>> THANK YOU FOR BEING HERE.

>> THANK YOU.

>> SO TELL ME ABOUT YOUR

GRANDPARENTS. HOW THEY CAME

OVER HERE AND HOW THEY CREATED

THE NAME CERFOLIO.

>> WELL, FIRST OF ALL MICHAEL,

THANKS SO MUCH FOR THAT

INTRODUCTION. THAT WAS GREAT.

I HAVEN'T HEARD IT DONE THAT

WAY?

WELL, I THINK, EVERYTHING GOES

BACK TO YOUR ROOTS.

EVERYTHING GOES BACK TO YOUR

CULTURE AND WHAT HAS BEEN

INGRAINED IN YOU.

SO MY GREAT GREAT-GRANDFATHER

ON MY FATHERS

SIDE WAS AN ORPHAN

AND OSTENSIBLY, THE LEGEND HE

WAS LEFT AT THE ORPHANAGE AT FEW

DAYS OF AGE.

AND THERE IS SOME HERB FLOWER IN

ITALY THAT IS NAMED CERFOY

AND FROM THAT THEY MADE UP

CERFOLIO.

>> SO WHEN DOES GRANDPA

COME OVER TO AMERICA?

>> SO ON MY MOM'S SIDE.

MY MOM'S PARENTS WERE BORN HERE.

BUT HER PARENTS CAME OVER.

ON MY DADS SIDE.

MY DAD'S MOM WAS BORN HERE.

MY DAD'S FATHER CAME

OVERLOOKING FOR HIS FATHER.

>> NOW YOUR DAD'S FATHER FIRST

OF ALL I THINK HE WAS INVOLVED

WITH BUILDING BRIDGES?

>> HE WAS.

GEORGE WASHINGTON BRIDGE WAS

A LABORER BUT LIVED IN NORTH

HALDEN, NEW JERSEY. THEY HAD

BEAUTIFUL HOME IN A GARDEN.

GIGANTIC GARDEN.

I MEAN 1,000 TOMATO PLANTS,

APPLE ORCHARD, PEACH TREES,

40 OR 50 OF THESE. WHEN I WAS A

KID I REMEMBER GROWING UP,

CLIMBING ON THEM.

>> SUBSEQUENTLY FROM BEING A

LABORER, HE BECAME A FARMER.

>> HE DID. THEY STARTED SELLING

THEIR PRODUCE

AND THOUGHT IT WAS EASIER WAY

THAN TRAVELING TO THE FOUNDATION

AND DOING ALL OF THE LABOR WORK.

>> RIGHT.

YOU WERE ALSO SAYING TO ME WHAT

WAS INTERESTING IS THAT BOTH OF

THE GRANDFATHER AND THE

GRANDMOTHER DIDN'T HAVE ANY

FORMAL EDUCATION BUT THEY BECAME

BUSINESS PEOPLE.

>> THEY DID. THEY

HAD NO FORMAL EDUCATION TO

THE FIFTH OR SIXTH GRADE WAS

AS HIGH AS THEY WENT.

THEY COULD READ AND WRITE.

THEY HAD A GREAT WORK ETHIC AND

OF COURSE, THAT'S THE MOST

IMPORTANT THING.

>> TELL ME ABOUT YOUR DAD?

THEN TELL ME ABOUT MOM.

>> MY DAD WAS ONE OF FOUR.

HE HAD THREE SISTERS.

HE WAS BROUGHT UP IN THE HOME

WHERE THERE WAS A LOT OF HARD

WORK, GRASS ROOT TYPE OF

MENTALITY. HE WAS THE ONLY ONE

WHO REALLY WENT ON. ONE SISTER

WAS NURSE BUT HE WAS GOING

ON TO COLLEGE AFTER THAT THEN TO

MEDICAL SCHOOL.

>> HE GREW UP IN NEW JERSEY,

IN NORTH HALDEN.

>> RIGHT.

>> HE WENT TO-

HE WENT TO CHICAGO MEDICAL

SCHOOL.

THAT IS WHERE MET MY MOM WHO WAS

NURSE THERE.

THEN, HE TOOK HER BACK AND HE

DID HIS TRAINING AND KINGS

COUNTY IN BROOKLYN.

>> HOW DID DAD DECIDE HE WANTED

TO BECOME A UROLOGIST?

>> WELL, HE WAS IN THE NAVY AND

SO HE SAW SOME OF THE DOCTORS

AND SAID I THINK I'M JUST AS

SMART AS SOME OF THESE

GUYS AND I AM NOT SURE HOW

THE SURGICAL SUB SPECIALITY OF

UROLOGY INTERESTED HIM.

HE LIKED THE FACT THEY WERE

DOING A LOT OF THINGS IN THE

BELLY, IN MULTIPLE AREAS OF THE

BODY AND THAT ATTRACTED HIM.

>> SO THE NEW JERSEY RESIDENT

WHO WAS IN CHICAGO, NOW COMES TO

BROOKLYN TO KINGS COUNTY THEN

SUBSEQUENTLY HE GOES BACK TO

PATERSON, YOU SAID, RIGHT?

>> TYPICAL ITALIAN BOY WENT BACK

CLOSE TO HIS MOM AND DAD WENT TO

FRANKLIN LAKES WHICH IS TEN

MINUTES FROM NORTH HILL.

>> AND WAS IN WAYNE HOSPITAL

YOU WERE SAYING TO ME.

>> SO THEY BUILT- FIRST HE WAS

IN PATERSON.

THEY LIVED IN PATERSON AWHILE

FOR TEN YEARS AFTER THEY GOT

MARRIED. MY MOM AND DAD.

>> YOUR FATHER IS 91?

>> MY FATHER HAD HIS 91st

BIRTHDAY.

HAPPY BIRTHDAY DAD IF YOU ARE

WATCHING.

YESTERDAY, THE 13TH.

>> WONDERFUL.

>> MY MOM IS 87 VERY, VERY

HEALTHY.

YEAH.

SO THEY GOT MARRIED AND WENT TO

PATERSON.

HE WAS ON STAFF AT THE PATERSON

GENERAL HOSPITAL WHICH BECAME TO

WAYNE AND BECAME THE WAYNE

GENERAL HOSPITAL AND LEFT

PATERSON AND BUILT A HOME IN

FRANKLIN LAKES IN '64.

>> NOW YOU SAID TO ME, YOUR

DAD HAD A HOME OFFICE, RIGHT

>> HE DID. IN PATTERSON.

>> WHEN WERE YOU BORN?

>> WELL, THE INTERESTING

THING IS MY MOM RAN HIS OFFICE

FOR 35 YEARS.

>> DID TELL ME SHE WAS HIS

OFFICE MANAGER.

>> YEAH.

MY MOM AND DAD WORKED TOGETHER

EVERY DAY FOR 35-40 YEARS AND

CAME HOME AND YELLED AT EACH

OTHER ABOUT THE WORK THEY DID.

I WAS BORN IN 1962 AND THEN WE

MOVED TO FRANKLIN LAKES IN '64

SO MY LIFE WAS REALLY ONLY IN

FRANKLIN LAKES.

>> WE HAVE A NICE BABY PICTURE

OF YOU?

>> NOT SO NICE.

THAT IS ALL GOD GAVE ME.

>> OKAY.

LET'S TALK ABOUT GROWING UP IN

FRANKLIN LAKES.

WE'LL GET TO THE JOBS BUT YOU

SAID TO ME FROM THE BEGINNING,

YOU WERE ALWAYS ATHLETICALLY

INCLINED.

HOW DO YOU GET, WAS DAD INVOLVED

WITH COACHING AND BASEBALL TOO?

>> HE WAS.

IT IS A SIMILAR PARALLEL BETWEEN

ME AND MY CHILDREN. HE WAS THE

ASSISTANT COACH OF OUR BASEBALL

TEAM AND THE ALL STAR BASEBALL

TEAM AND HE ALWAYS LOVED SPORTS

ALL FOUR OF US.

I WAS THE THIRD OR FOUR CHILDREN

ALL PLAYED HOCKEY.

MY OLDER BROTHER PLAYED HOCKEY,

BASEBALL, FOOTBALL LIKE I DID.

MY OLDER SISTER PLAYED TENNIS

AND SWAM. MY YOUNGER SISTER

WAS A SWIMMER, IN

GYMNASTICS, ALL VERY, VERY

ACCOMPLISHED.

>> SO TELL ME ABOUT YOU

GROWING UP?

YOU WENT TO PRIVATE SCHOOL, TWO

PRIVATE SCHOOLS, RIGHT?

YOU STILL, EVEN THOUGH YOU

WENT TO PRIVATE SCHOOL, YOU

STILL PLAYED IN THE COMMUNITY

SPORTS YOU SAID TO ME.

>> CORRECT.

WENT TO KINDERGARTEN TO THIRD

GRADE IN ENGLEWOOD, NEW JERSEY

THEN WENT TO MONTCLAIR FROM

FIFTH GRADE TO 12th GRADE AND

GRADUATED IFROM THERE.

BUT YEAH.

I PLAYED IN THE LOCAL TOWN

BECAUSE I WAS IN FRANKLIN LAKES

WHICH A DISTANCE FROM ENGLEWOOD

AND MONTCLAIR SO I PLAYED

LOCALLY ON THE BASEBALL TEAMS

AND PLAYED TENNIS AND PLAYED

BASEBALL, PLAYED HOCKEY.

PLAYED 100 HOCKEY GAMES A YEAR

ON A COUPLE OF TRAVEL TEAMS.

VERY INTENSE SPORTS.

>> NOW YOU SAID DAD WANTED TO

YOU WORK EARLY SO YOU GOT

YOU A JOB SWEEPING?

>> I BECAME A LABOR FOR ONE OF

THE CONSTRUCTION FIRMS ACTUALLY

IN PATTERSON.

MY FATHER HAD OPERATED ON THE

OWNER AND PRESIDENT.

SO I WAS DOING JOBS FIRST

PAINTING THEN SWEEPING THEN

ACTUALLY GOING OUT WITH CRANES

AND DOING MORE DANGEROUS JOBS

AS I GOT OLDER.

I DID THAT FOR FOUR OR

FIVE SUMMERS UNTIL I STARTED MY

OWN BUSINESS.

>> WHICH WE'LL GET TO IN A

SECOND.

IN YOUR BOOK, OKAY,

SUPER PERFORMING, YOU TALK ABOUT

YOUR LIFE GROWING UP AND YOUR

DAD TALK ABOUT SOMETHING WHICH

PROBABLY MAY HAVE INFLUENCED YOU

TO BECOME A PHYSICIAN, THE

SPADING OF THE DOG.

>> YES. MY FATHER TOOK

WHAT MANY THINK INTO HIS OWN

HANDS AND I THINK THAT GOES TO

ACCOUNTABILITY AND THE LESSON

YOU LEARN FROM THAT.

OUR DOG, OUR BEAUTIFUL DOG, A

LITTLE BEAGLE, NEED A HIS

HYSTERECTOMY.

NEEDED TO BE SPADED. RATHER

THAN GO TO A VET SINCE WAS

OPERATING IN THAT PART OF THE

BODY EVERY DAY. HE SAID HE

WAS GOING TO DO IT HIMSELF.

I WAS 12.

WHAT DID I KNOW?

HE GAVE THE DOG HIS OWN

ANESTHETIC.

WE BUILT THE BOARD WITH STRAPS

FOR THE PAWS.

WE DID THIS INCREDIBLE

OPERATION.

I REMEMBER ASSISTING.

THAT DAY CHANGED MY LIFE.

I REMEMBER THAT LIKE IT WAS

YESTERDAY.

I THOUGHT THAT WAS THE MOST

INCREDIBLE THING TO SEE MY

FATHER WHO YOU CAN SEE TAKE THE

GARBAGE OUT, HIT THE GROUND

BALLS NOW WAS DOING IN THIS

CREDIBLE OPERATION ON AN ANIMAL

WE LOVED. THERE

WAS NOTHING MORE SPECIAL TO

US TO THAN OUR DOG AND WATCH THE

DOG FULLY RECOVER FROM THE

OPERATION AND DO GREAT.

ITS WITH AMAZING.

>> TELL ME ABOUT THE

SWIMMING POOL BUSINESS.

>> SO I REALIZED THAT MY FATHER

WAS MAKING ME WORK TO LEARN

THE LESSON.

>> THERE AREN'T THAT MANY

CARDIOTHORACIC LUNG SURGEONS

WHO COULD SAY THEY WERE IN

THE SWIMMING POOL BUSINESS.

>> LET'S HOPE NOT AT LEAST.

>> RIGHT.

>> I SAID, I GOT THE LESSON.

I WANT TO START MY OWN

BUSINESS.

I THOUGHT IT WOULD BE SOMETHING

THAT WOULD BE FINANCIALLY

BENEFICIAL AND ALSO I LEARNED A

LOT MORE.

SO MY MOM AND DAD WERE

TOTALLY AGAINST IT.

THEY SAID, OKAY.

WE'LL LET YOU BUY A PUMP AND

VACUUM $150 IF YOU CANNOT MAKE

THAT MONEY BACK IN TWO

WEEKS YOU GOT TO GO BACK TO

CONSTRUCTION.

IN TWO WEEKS, I HAD FOUR OR FIVE

ACCOUNTS AND I GAVE THEM THE

MONEY BACK IN FIVE DAYS.

THEN, FLASH FORWARD FIVE YEARS

LATER WE WERE CLEANING 400

POOLES A WEEK AND MAKING MORE

MONEY IN THREE MONTHS OVER

THE SUMMER WITH THE LAST COUPLE

OF SUMMER.

>> HOW DID YOU DECIDE TO

CONTINUE?

SOMETIMES WHEN YOU'RE AN

ENTREPRENEUR AND YOU DO THAT?

HOW DID YOU DECIDE TO BE

MOTIVATED TO CONTINUE TO GO

TO MEDICINE?

>> WELL, I DIDN'T WANT TO

SPEND THE REST OF

MY LIFE SUCKING DIRT OUT

OF A BOTTOM OF A POOL BUT I HAD

TEN PEOPLE AT ONE POINT, NINE

OR TEN PEOPLE WORKING AT FOR ME

WHEN REAL REALIZED MY DAD TOLD

ME TO PUT MONEY IN RETIREMENT

FUND AND DO OTHER THINGS

THAT SEEMED COMPLICATED.

I STILL LOVED MEDICINE.

I KNEW SURGERY IS WHAT I WANTED

TO DO.

I WAS DRIVEN TO DO THAT AND BE

THE BEST AT THAT.

SO I KNEW THE POOL

CLEANING BUSINESS WAS SOMETHING

THAT WAS GOING TO END.

>> A GOOD WAY FOR THE SUMMER

WHEN YOU WERE IN COLLEGE. LET'S

TALK ABOUT WITH REGARD TO THAT.

SO YOU WERE ALL AMERICAN

IN HIGH SCHOOL ON A VARIETY OF

TEAMS.

HOW DID YOU DECIDE TO GO TO

ROCHESTER?

>> SO,

I WAS ALL AMERICAN IN FOOTBALL.

IN HIGH SCHOOL I WAS ALL STATE

IN THOSE THREE SPORTS. I WAS ALL

AMERICAN IN FOOTBALL, BASEBALL

AND HOCKEY.

BUT GIVEN MY SIZE AND STRENGTH

BASEBALL WAS GOING TO BE

THE ONLY THING THAT I WOULD HAVE

A CHANCE TO PLAY AT A COLLEGIATE

LEVEL.

THE UNIVERSITY OF ROCHESTER

WAS INTERESTED IN BASEBALL BUT

WAS ONE OF THE FEW SCHOOLS I

LOOKED AT THAT HAD THE 242 YOU

MENTIONED IT.

IT IS EARLY SELECTION TO MEDICAL

SCHOOL AFTER TWO YEARS OF

COLLEGE.

SO YOU DON'T GET INTO IT UNTIL

YOU ARE A SOPHOMORE IN COLLEGE.

I WAS LUCKY ENOUGH TO GET THE

WRONG LETTER AND THEY ACCEPTED

ME IN A GOT INTO MEDICAL SCHOOL

EARLY.

>> YOU GOT INTO MEDICAL SCHOOL.

YOU SAID TO ME I DIDN'T HAVE

TAKE THE MCATS.

>> I DID NOT. BECAUSE I GOT INTO

MEDICAL SCHOOL AS A SOPHOMORE

IN COLLEGE, I DIDN'T HAVE TO

TAKE THE MCATS.

>> YOU REALLY WANTED

TO PLAY BASEBALL, RIGHT?

THEN YOU HAD ACCIDENT?

>> SO, NO, I WANTED TO PLAY

BASEBALL.

SO THE BEAUTIFUL THING IS

ROCHESTER THAT ALLOWED THE

DURING THE BASEBALL SEASON TO

TAKE LESS OF AN ACADEMIC LOAD

LIKE MY SON IS DOING NOW DURING

BASEBALL SEASON, A LITTLE LESS

ACADEMIC AND I COULD LOAD UP

DURING THE NON-SEASON.

>> ONE OF THE FEW PEOPLE WHO

PLAYED BASEBALL WHEN YOU WERE IN

MEDICAL SCHOOL.

>> OH, YEAH.

MY FRESHMAN YEAR, I GOT INJURED.

I HURT MY ANKLE. SO I HAD

FOUR YEARS OF ELIGIBILITY

THE YEAR AND I WAS FIRST TEAM

ACADEMIC ALL AMERICAN I WAS A

FIRST YEAR MEDICAL STUDENT SO I

GRADUATED IN COLLEGE IN 1984 BUT

I WAS A FIRST TEAM ACADEMIC ALL

AMERICAN BASEBALL PLAYER IN 1985

WHICH IS UNUSUAL.

WE HAD TO PETITION THE NCAA YOU

KNOW, THEY SAID IT WAS FINE.

>> SO YOU CONTINUE AT THE

UNIVERSITY OF ROCHESTER AND AS

WITH PLANS TO BE UROLOGIST.

>> MY DAD IS STILL THE MOST

INCREDIBLE MAN IN THE WORLD TO

ME.

I WANTED TO BE LIKE HIM.

I WANTED TO JOIN HIM IN HIS

PRACTICE.

HE HAD WAITED FOR ME AND PRIVATE

PRACTICE DURING DIFFICULT TIMES

FOR HIS SON TO COME JOIN HIM.

AND I MATCHED AT NEW YORK

HOSPITAL WITH THE NUMBER

ONE RANKED UROLOGY

PROGRAM IN THE COUNTRY

BACK THEN, I GUESS IT WAS 1988.

>> BUT THEN, AS OPPOSED TO

GO THERE, YOU FIND SOMETHING UP

AT HARTFORD.

WHAT HAPPENED? THIS LITTLE

HOSPITAL ST. FRANCIS.

>> YEAH.

THAT DECISION CHANGED MY LIFE

IN SO MANY WAYS.

SO YOU DO TWO YEARS OF GENERAL

SURGERY AND FOUR YEARS

UROLOGIC OF TRAINING IF YOU

GOING TO BE UROLOGIST BUT THE

FIRST TWO YEARS AT NEW YORK

HOSPITAL DID VERY LITTLE

SURGERY. DID A LOT OF PUSHING

PATIENTS AROUND.

I MADE AND ARGUMENT TO THE

DOCTOR THAT I WANTED TO GO

SOMEWHERE THAT I OPERATED A LOT

AND I FOUND THEY DID THE MOST

OPERATIONS AS PGY1 AND PGY2

INTERNS AND SECOND YEAR SURGICAL

RESIDENTS.

ST. FRANCIS HOSPITAL IN

HARTFORD, CONNECTICUT AND THAT

IS WHERE I CHANGED MY CAREER AND

MET MY WIFE.

>> LET'S TALK ABOUT HOW

YOU MET YOUR WIFE.

>> YEAH.

>> WHO WAS A NURSE. OKAY-

>> SHE WALKED IN THE CAFETERIA,

THAT IS ALL SHE NEEDED TO DO.

>> WE HAVE A PICTURE OF

YOU AND HER AT THE EARLY TIME

WHEN YOU MET.

>> RIGHT.

>> THEN HOW DID YOU DECIDE

TO LEAVE UROLOGY TO GET INTO

CARDIOTHORACIC SURGERY?

>> MY WIFE WE'LL TALK ABOUT

LATER. BUT

I KNEW DURING THOSE FIRST TWO

YEARS I FELL IN LOVE WITH

CARDIOTHORACIC SURGERY, I'D

NEVER BEEN EXPOSED TO IT.

I SIGNED A CONTRACT WITH

DR. VAUGHN AND THAT MEANT A

LOT TO ME AND I WAS GIVEN A

POSITION TO STAY THERE BECAUSE

I WAS DOING RELATIVELY WELL AT

HARTFORD HOSPITAL IN CONNECTICUT

VERY GOOD GENERAL SURGICAL

PROGRAM AND I WENT TO NEW YORK.

DID MY YEAR OF UROLOGY.

I FULFILLED MY CONTRACT AT NEW

YORK HOSPITAL AND

SLOAN-KETTERING.

I SPENT TIME IN BOTH PLACES

ACROSS THE STREET AS YOU KNOW.

SO THEN, AT THAT POINT, I WAS IN

TROUBLE BECAUSE I DIDN'T HAVE A

JOB IN GENERAL SURGERY. THEY

OFFERED ME TO STAY THERE BUT

I'D DO A YEAR OF RESEARCH.

I SAID, LISTEN.

WANT TO DO CARDIOTHORACIC

SURGERY. I THINK

THE MAYO CLINICS THE BEST PLACE

IN THE WORLD.

YOU READ THE STORY IN THE BOOK

WHERE I KEPT CALLING AND FINALLY

GOT INTERVIEW AT MAYO.

>> TALK ABOUT THAT.

WHAT HAPPENED WAS, YOU CALLED UP

AND YOU KEPT IN TOUCH FOR TWO

WEEKS WITH THE CHAIRMAN OF THE

DEPARTMENT AND FINALLY, HE

ACCEPTED YOU THAT YOU SHOULD GO

THERE.

>> I CALLED HIM EVERY DAY FOR

TWO WEEKS.

SAYING I WANT TO COME IN AS

PGY3.

HE KEPT SAYING WE HAVE NO

SPOTS FOR PGY3 BECAUSE I'D

DONE TWO YEARS OF

GENERAL SURGERY, ONE YEAR OF

UROLOGY.

AFTER CALLING HIS OFFICE EVERY

DAY OR TWO WEEKS HE FINALLY

SAID, YOU'RE NOT GOING TO GO

AWAY AND INTERVIEW KNOW SEE

WHAT YOU THINK.

AFTER THE INTERVIEW THEY GAVE ME

A SPOT AT PGY4 BECAUSE I HAD

DONE ENOUGH CASES IN MY FIRST

TWO YEARS MORE THAN MOST.

>> WHEN DID YOU GET MARRIED?

>> WELL I ASKED HER OUT.

SHE SAID I WON'T

GO OUT WITH DOCTORS

SO NOW THE CHALLENGE WAS DOWN.

WE GOT MARRIED IN NOVEMBER OF

1990.

>> AT THAT TIME, YOU WERE UP

AT THE MAYO CLINIC OR-

>> WE WERE ENGAGED.

MY FIRST SIX MONTHS IN NEW YORK

WE GOT MARRIED IN CONNECTICUT

THEN I DRAGGED HER TO ROCHESTER,

MINNESOTA, WHERE WE HAD TWO-

>> VERY WARM.

>> REALLY WARM.

>> SHE IS FROM CONNECTICUT.

I'M FROM NEW JERSEY.

I TOOK HER TO ROCHESTER,

MINNESOTA AND THEN BIRMINGHAM,

ALABAMA.

>> HOW DID THE JERSEY BOY

GET TO BIRMINGHAM, ALABAMA?

>> AT MAYO I DID MY LAST YEARS

OF GENERAL SURGERY,

THREE YEARS OF

CARDIOTHORACIC, SPENT FIVE

YEARS THERE. MY FIRST SON ROBBY,

MY MIDDLE ALEX WERE BORN.

WE WANTED SOMEPLACE WARM.

THERE IS A REAL CONNECTION

BETWEEN MAYO CLINIC AND THE

UNIVERSITY OF ALABAMA BECAUSE OF

A GUY NAMED JIM KIRKLAND, A

FAMOUS HEART SURGEON.

THAT IS WHERE I WENT.

>> YOU'RE 34, RIGHT?

>> ABOUT THAT.

PROBABLY ABOUT RIGHT.

>> HOW DO YOU BUILT THE

CARDIOTHORACIC SURGERY AND

THE LUNG-

>> I WAS VERY FORTUNATE.

THE UNIVERSITY OF ALABAMA IS

A WORLD CLASS HOSPITAL WITH

GREAT PEOPLE.

I SPENT 21 YEARS THERE.

THEY ARE AND ALWAYS WILL BE MY

FAMILY.

THEY GAVE ME A GREAT OPPORTUNITY

TO BUILD. THEY GAVE ME RESOURCES

AND WE WERE LUCKY ENOUGH TO

BUILD REALLY ONE OF THE BEST I

WOULD SAY THE BEST LUNG CANCER

PROGRAM IN THE COUNTRY. NOW IT

IS AT NYU BUT IT WAS THERE.

>> WHAT HAPPENS WHEN THEY,

WHEN YOU PERFORM THE

SURGERY AND YOU HEAR ABOUT

YOUR WIFE?

>> YEAH.

THE DAY MY WIFE WAS HAVING HER

MASTECTOMY.

I SCHEDULED NINE OR TEN

OPERATIONS WITH PEOPLE WITH

CANCER.

AND SO I HAD VISITORS EVERY DAY.

WE OPERATED YESTERDAY HERE.

I HAD VISITORS IN ALABAMA.

I HAD VISITORS THEN, THE BREST

SURGEON TOLD ME SHE HAD DONE THE

LUMPECTOMY BUT THE SET IN THE

LYMPH NODE WAS POSITIVE AND

I WAS OPERATING AT THE TIME,

WHEN I GOT THAT NEWS WHICH WAS

IN A WAY DEVASTATING.

I TALK ABOUT THAT IN THE

INTRODUCTION TO THE FIRST BOOK.

>> SO LET'S TALK ABOUT IT.

SO BECAUSE, I THINK PART OF THE

BOOK IS AN INSPIRATION TALKING

ABOUT YOU AND YOUR WIFE AND

YOUR CAREER.

HOW DID YOU DECIDE TO WRITE

THE BOOK?

>> AGAIN, IT IS ALWAYS

CHALLENGING FROM THE CHILDREN.

I ALWAYS TOLD MY CHILDREN, THAT

I DON'T WANT TO HEAR YOU CAN'T.

I DON'T WANT TO HEAR EXCUSES.

I THINK AT SOME POINT I SAID

YOU KNOW WHATI SHOULD WRITE A

BOOK. AND MY SON SAID, DAD,

DON'T TALK ABOUT IT. DO IT.

AND I SAID, YOU KNOW WHAT?

FINE. I WILL.

NOW I HAVE WRITTEN THREE.

>> LETS A TALK ABOUT THE

FIRST ONE WHICH WAS WRITTEN A

LITTLE AFTER YOUR WIFE PASSED

ON?

>> YEAH.

ACTUALLY IT WAS ALMOST REALLY

DONE BEFORE SHE PASSED AWAY.

>> YOU SAY IN THE BOOK,

THE LAST CHAPTER WOULD HAVE

BEEN DIFFERENT.

>> IT WAS SUPPOSED TO BE WE

LIVED HAPPILY EVER AFTER.

SHE WAS THE LOVE OF MY LIFE.

I MISS HER EVER SECOND OF EVERY

DAY.

SO I WAS WRITING THE BOOK REALLY

ABOUT THE PROCESS OF IMPROVEMENT

AND THAT IT'S ABOUT PROCESS OF

THAT OUTCOME AND PREPARATION,

REALLY, REALLY BEING ENGAGING

YOUR TEAMMATES HAVING TEAMMATES

ENGAGE AND ALIGN.

>> THINK I THE BOOK IS A

SELF-HELP BOOK.

>> IT IS A SELF-HELP BOOK.

INITIALLY IT WAS CALLED

THE ATHLETICISM OF SURGERY.

BUT THE PEOPLE WHO WERE

PUBLISHING IT THOUGHT IT

WOULD BE BETTER CALLED

SUPERFORMING AT WORK AND HOME TO

SELL NOT TO ATHLETES OR

EXECUTIVES BUT TO EVERYBODY.

IT IS A SELF HELP BOOK BUT THE

LAST TWO OR THREE CHAPTERS IS A

LOVE STORY ABOUT MY WIFE WHO HAD

BREAST CANCER AND GOT

CHEMOTHERAPY FOR IT AND THE

CHEMO CAUSED LEUKEMIA.

SHE DIED OF COMPLICATIONS FROM

THE CHEMO THAT CAUSED ACUTE

LEUKEMIA AND GOT CHEMO AGAIN

OVER FIVE MONTHS AND PASSED

AWAY IN APRIL OF 2013.

>> ALSO THE BOOK TALKS YOU

ABOUT BRINGING YOUR DAD AND YOUR

MOTHER TO ALABAMA.

YOUR FATHER ORIGINALLY THE MAYO

CLING.

>> CORRECT.

MY DAD HAD, WE WERE ICE SKATING

ON THE ICE ONE CHRISTMAS.

WE WERE GOING BACK SOME YEARS

NOW.

HE HAD CHEST PAIN THE NEXT DAY.

I WAS BACK IN ALABAMA.

IT TURNED OUT HE HAD SIGNIFICANT

CORONARY ARTERY DISEASE.

I FLEW HIM TO MAYO.

I WAS IN ONE OPERATING ROOM.

HE WAS IN ONE OPERATING ROOM AND

HE HAD A TRIPLE BYPASS AND HE'S

DONE GREAT FROM THAT.

>> AND MOM ALSO HAD ONE.

>> MOM HAD ONE DONE IN ALABAMA

SO WHEN SHE HAD A CORONARY

STENOSIS. I FLEW HER TO

ALABAMA BECAUSE I WANTED

TO MICROMANAGE THEIR CARE.

THAT'S MY PERSONALITY.

>> YOU KNOW IN THE BOOK YOU

TALKED ABOUT AND IT IS TODAY,

WHEN WE WERE TALKING IN GENERAL,

YOU KNOW, SURGERY WAS MANUALLY.

THE WORLD HAS BECOME, YOU KNOW,

IT IS A QUESTION OF HOW PEOPLE

ADAPT AND ADJUST AND YOU BECOME

ONE OF A LEADING ROBOTIC

SURGEONS.

TALK TO ME ABOUT HOW THE MANUAL

AND THE ROBOTIC TODAY.

>> IT IS A GREAT QUESTION.

I THINK WE HAVE TO EVOLVE.

NOT JUST TECHNICALLY BUT

EMOTIONALLY IN EVERYTHING WE DO.

WE NEED TO EVOLVE AS PARENTS,

AS CHILDREN, WE EVOLVE WITH

TIMES.

WE EVOLVE WITH NEW TECHNOLOGY

BUT SHOULD EMOTIONALLY EVOLVE

AND BECOME BETTER LEADERS SO

WHEN I SEE THE ROBOT WAS GOING

TO PROVIDE BETTER CARE FOR MY

PATIENTS AND I AM CONVINCED IT

DOES

I KNEW I NEEDED TO EVOLVE INTO

THAT ALTHOUGH IT WAS DIFFICULT

TO LEARN.

>> THE QUESTION, EVEN FOR THE

PATIENT, THE PATIENT WHEN YOU

SAY I AM GOING TO DO ROBOTIC

SURGERY.

THEY SAY, IT IS A SURGEON WITH

THE SURGEON'S HANDS.

WELL, OK.

BUT I MEAN, YOU ARE USING THE

HANDS BUT YOU ARE USING THE

HANDS ON THE ROBOT IN

ANOTHER ROOM-

>> CORRECT.

I LOVE WHEN THE PATIENT HEARS-

THE PATIENT HEARS ROBOT AND

THEY THINK OF LITTLE GUY IS

GOING TO DO THE OPERATION WE ARE

DRINKING A CUP OF COFFEE

AROUND THE CORNER.

NO, NO.

AND NO.

THE ROBOT IS JUST ARMS THAT

ARE PUT INTO THE PATIENT

THROUGH LITTLE INCISIONS AND

THEN WE SIT AT A CONSOLE

AND WE MOVE.

THE DEFINITION OF A ROBOT, AND

I HAVE WRITTEN A FEW PAPERS

ON THIS,

IT IS SOMETHING THAT COPIES IN A

SLAVE-LIKE MANNER YOU THOUGHTS

OR YOUR MOVEMENTS.

AND THAT'S WHAT HAPPENS. THE

ROBOT DOESN'T MOVE UNLESS WE

ARE MOVING.

>>THE TEAM, THE REST OF THE

TEAM IS IN THE OPERATING ROOM.

YOU ARE IN-

>> I AM IN THE OPERATING ROOM

BUT NOT AT THE BEDSIDE.

I AM A FEW FEET AWAY SITTING

AT CONSOLE.

TEN MAGNIFICATION, THE OF 3D,

THE MOST INCREDIBLE VIEW

YOU HAVE EVER SEEN.

MY ASSISTANT, THE NURSE OR

RESIDENTS,

THE RESIDENT IS TRAINING AT

ANOTHER CONSOLE.

SO THE NURSE, THE SCRUB NURSE

AND THE PHYSICIAN'S ASSISTANTS

OR SOME HOSPITALS USE NP'S

ARE AT THE BEDSIDE PUTTING

PUT INSTRUMENTS IN FOR US.

>> HOW DID YOU GO FROM

CARDIOTHORACIC TO MORE

LUNGS?

>> WELL, I ALWAYS HAD MORE OF AN

INTERESTS IN THE NONCARDIAC PART

OF CARDIOTHORACIC, THE LUNG,

ESOPHAGUS, THE STINUM. I THOUGHT

THERE WAS BIG OPENING THERE.

IT WAS NOT BEING DONE VERY WELL.

THERE WERE NOT A LOT OF PEOPLE

DOING.

I MOST PEOPLE WENT INTO

CARDIOTHORACIC SO THEY

COULD DO HEART SURGERY.

I WAS ATTRACTED TO THE OTHER

PART. I THOUGHT IT WAS

TECHNICALLY DIFFICULT IN A WAY.

IT WAS MORE, A GREATER

VARIETY AND

I LOVE SURGICAL VARIETY.

THE NECK, BELLY AND THE CHEST.

>> AFTER 21 YEARS IN ALABAMA,

YOU LOST YOUR WIFE.

ONE OF YOUR SONS.

>> MY OLDER SON ROBBIE

WENT TO YALE. LEFTY PITCHER

THE CAPTAIN OF THE YALE

PITCHING TEAM. DRAFTED BY THE

DODGER BUT HURT HIS ELBOW AND

NEVER PLAYED PROFESSIONAL

BASEBALL NOW IN THE FRONT OFFICE

FOR THE CLEVELAND INDIANS.

MY MIDDLE SON ALEX WENT TO THE

UNIVERSITY OF ALABAMA AND THE

HONOR'S COLLEGE THERE WHICH IS

PRESTIGIOUS.

GRADUATED WITH HONORS AND THEN,

HE JUST FINISHED THE FIRST

SCREENPLAY AND VERY

ACCOMPLISHED AS WELL.

MY YOUNGER SON MATTHEW IS A

FRESHMAN AT COLUMBIA.

THAT ANSWERS YOUR QUESTION

BECAUSE I WAS COMING HOME TO THE

HOUSE THAT I BUILT FOR MY

CHILDREN WHICH AS

YOU KNOW AS AN ATHLETIC

CATHEDRAL WITH MULTIPLE SPORTS

FIELD AND A TINY GOLF COURSE.

WHEN HE SIGNED WITH COLUMBIA

OVER PRINCETON TO PLAY BASEBALL

AND I AM COMING HOME TO A

HOUSE FOR MY WIFE WHO IS NO

LONGER THERE.

SHE PASSED AWAY THREE YEARS

EARLIER. MY MOM AND DAD ARE

IN NEW JERSEY WITH FAILING

HEALTH, MY SISTERS IN NEW YORK,

MY OTHER SISTERS IN BOSTON,

MY BROTHERS IN CALIFORNIA

AND THEN NYU IS JUST A

WORLD CLASS METRO SIZED HOSPITAL

THAT I SHARED THE CULTURE WITH.

JUST A EASY DECISION.

>> WHAT ABOUT THE CANCER

AT NYU?

WHAT IS THAT PROGRAM CALLED?

>> WHAT I LIKE ABOUT IT.

NOT JUST A MYOPIC

VIEW OF BEING A SURGEON

BUT TAKING CARE OF A PATIENT,

A DISEASE PROCESS.

WHETHER YOU ARE DOING SURGERY,

CHEMOTHERAPY, RADIATION. THE

DIRECTOR OF THE LUNG CANCER

CENTER IDEALLY IS SOMEONE THAT

IS LOOKING AT PATIENT OUTCOMES

NOT THE SURGEON.

ACADEMIC MEDICINE CENTERS

ARE SILOED. YOU HAVE THE

DEPARTMENT OF SURGERY AND

DEPARTMENT OF RADIATION

DEPARTMENT OF ONCOLOGY.

AND IT IS SUPPOSED TO BRIDGE

THOSE SILOS.

>> LETS TALK ABOUT THE SECOND

AND THIRD BOOK. ESPECIALLY

SINCE I HAVE READ THEM.

>> YOU'RE THE ONLY PERSON IN THE

WORLD WHO READ THE THIRD BOOK

"INSPIRE" YOU HAVE THE ONLY COPY

HERE.

>> TALK ABOUT "INSPIRE."

>> SO "INSPIRE" IS MY BEST

BOOK AND THE MOST

IMPORTANT BOOK TO ME BECAUSE IT

TALKS TO EVERYBODY ABOUT HOW TO

LEAD.

I AM CONVINCED THAT BUSINESSES

THAT DO WELL, HOSPITALS THAT DO

WELL, FAMILIES THAT DO WELL,

IS FROM THE LEADERSHIP AND THE

CULTURE THAT ARE INGRAINED AND

EVOLVED AND INSTILLED.

>> WE'LL CONTINUE ABOUT

"INSPIRE". ALSO TALKS ABOUT

THAT YOU CHANGED YOURSELF.

THAT MANY YEARS AGO WHICH

IS SIMPLE FOR MEDICINE BECAUSE

THE, THE SURGEONS ALWAYS

SCREAMED AT THE RESIDENTS AND

THE INTERNS, OKAY?

YOU HAVE LEARNED TO BE

ADAPTABLE.

>> I STILL GET GIVE THEM A HARD

TIME. MORE OF A COACH.

IT DEPENDS. IN THE BOOK WE TALK

ABOUT LOVE LANGUAGE.

I TALK ABOUT COACHABILITY

LANGUAGE.

EVERYBODY HAS DIFFERENT LANGUAGE

THAT THEY RESPOND TO BETTER FROM

THE COACH.

THE COACH SHOULD BE ABLE TO

CHANGE THAT COACHING STYLE

BASED ON, IT SHOULD BE

PERSONALIZED TO THE STUDENT.

SOME RESIDENTS DO REALLY WELL

WHEN YOU YELL AND WHIP

THEM, JUST LIKE SOME OF MY

CHILDREN AND SOME DO BETTER

WITH ENCOURAGEMENT.

>> LET'S TALK ABOUT THE THIRD

BOOK. THE THIRD BOOK IS CALLED?

>> THIRD BOOK IS SOLVING U.S.

HEALTHCARE CRISIS WHICH I WAS

CHARGED TO DO AND I WAS

TALKING ABOUT, I WAS

TIRED OF WATCHING HOW PATIENT

CARE WAS BEING POLITICIZED BY

REPUBLICAN AND DEMOCRATS ARGUING

OVER NONSENSE INSTEAD OF TAKING

CARE OF PEOPLE WHO ARE DYING.

>> SOME PEOPLE ARE GOING TO ASK

YOU WRITE THESE BOOK, SPEAK

AROUND THE WORLD,

WE HAVE PICTURES OF YOU IN

INDIA, CHINA AND OTHER PLACES.

THEN YOU DO EIGHT TO TEN

SURGERIES A DAY ALSO?

>> WELL, IN ALABAMA, I DID 1,000

OPERATIONS A YEAR FOR EIGHT

CONSECUTIVE YEARS.

I DON'T DO THAT NOW.

EVEN MY LAST FEW YEARS IN

ALABAMA I WAS MORE ABOUT GROWING

A TEAM AS OPPOSED TO DOING THAT

MUCH SURGERY.

BUT WE HAD THE HIGHEST QUALITY.

WHEN PEOPLE SAID YOU COULDN'T DO

THAT MUCH AND DO HIGH QUALITY.

THE DATA SHOWS THAT IS NOT TRUE.

>> WHAT IS REALLY GOOD IS THANK

GOD YOU LEFT BEING A LABOR.

YOU LEFT A SUCCESSFUL SWIMMING

POOL BUSINESS.

>> I MISSED IT.

>> YOU BECAME A WONDERFUL

SURGEON, IMPORTANT TO THE

COMMUNITY AND AS YOU SAY, PEOPLE

HAVE TO ADAPT AND PEOPLE HAVE TO

DECIDE THAT THIS IS THE NEXT

CAREER AND IN THE BOOK YOU ALSO

MENTIONED EVERY SEVEN YEARS IF

YOU HAVE THE POSSIBILITY YOU

SHOULD ALSO.

>> YOU SHOULD REINVENT

YOURSELF.

EVERY FIVE TO SEVEN YEARS.

I AM NOT SAYING YOU GET A NEW

JOB BUT YOU SHOULD DO A 360 TO

SEE WHAT YOU DO WELL AND WHAT

YOU DON'T DO WELL.

SO MANY THINGS I DON'T DO WELL

THAT I NEED TO IMPROVE THAT

I WILL WORK HARD ON THOSE TODAY

AND TOMORROW.

I WILL GET BETTER AT THOSE

THINGS THAT WILL TAKE ME DOWN TO

A DIFFERENT PATH TO HELP

MORE PEOPLE HOPEFULLY.

>> SO IN THIS CAREER AND IN THE

LIFE PORTION, I THINK THE NYU

LANGONE AND YOUR PARENTS

BEING NEARBY.

YOUR SISTER AND YOUR SONS.

THANKS FOR BEING HERE TODAY.

>> THANKS SO MUCH FOR YOUR TIME,

MICHAEL. THANK YOU.

♪ [THEME MUSIC] ♪

For more infomation >> BuildingNY:NYStories - Robert J. Cerfolio, MD - NYU Langone Health - Duration: 28:14.

-------------------------------------------

Cactus Coloring Book and Drawing for Children | Learn Colors for Toddlers - Duration: 4:44.

PINK

RED

YELLOW

PURPLE

PURPLE

ORANGE

PINK

PINK

BLUE

BLUE

GREEN

GREEN

YELLOW

YELLOW

For more infomation >> Cactus Coloring Book and Drawing for Children | Learn Colors for Toddlers - Duration: 4:44.

-------------------------------------------

Nous buvons cette boisson chaque jour sans nous douter qu'elle peut causer le cancer du sein - Duration: 6:44.

For more infomation >> Nous buvons cette boisson chaque jour sans nous douter qu'elle peut causer le cancer du sein - Duration: 6:44.

-------------------------------------------

Big Gummy Vs. Lil Gummy

For more infomation >> Big Gummy Vs. Lil Gummy

-------------------------------------------

cat_and_horse.mp4 - Duration: 0:41.

Hello there..

Why did tcha' active subtitles?

Turn them off.

Hello, What did i say?

TURN TH- o wait..

Umm... Ignore what you almost saw..

They're still spinning..

Now i'm sp- HEY, TURN TH- Ah.. you know what..

Screw it, i'm not saying anything.

...

...

bang bang bang

pfoo pfoo pfoo

Welp, bye horse..

r.i.p spinning horse will never be forgoten 1998 - 2020

For more infomation >> cat_and_horse.mp4 - Duration: 0:41.

-------------------------------------------

Republicans Stop Liberal Judges Dead In Their Tracks, Find Grounds For Impeachment - Duration: 2:36.

Republicans Stop Liberal Judges Dead In Their Tracks, Find Grounds For Impeachment.

Liberal judges in the past few years have taken unprecedented liberties.

Instead of making a decision based upon the rule of law, the U.S. Constitution, and the

Declaration of Independence, which is their sworn duty to uphold, they choose to make

up their own rules and regulations based upon their liberal agenda.

In the rust belt, liberal judges from a northeastern state supreme court made a horrendous decision

that directly attacks conservatives living there.

So Republicans there have had enough.

They have now found grounds for impeachment that should leave these judges stopped dead

in their tracks.

Philly.com passes along an example of how the party is doing just that.

Pennsylvania Republicans, furious that the state Supreme Court threw out the existing

congressional map and imposed one that stripped much of their partisan advantage, have been

talking about a stark response: impeaching the justices who ruled against them.

After a rank-and-file lawmaker, state Rep. Cris Dush of Jefferson County, raised the

idea a few weeks ago, the rhetoric has intensified.

This week, U.S. Rep. Ryan Costello of Chester County said the justices "should be impeached"

and U.S. Sen. Pat Toomey said the idea is worth discussing.

In short, the state's Democratic Party was feeling colicky about the prospect of having

their clocks cleaned in future elections.

To prevent that from happening, they changed the rules to ensure there would be nothing

resembling a fair fight.

State Republicans aren't going to take this one laying down, and they're hinting at

taking down these judges.

Talk about an epic response.

As of Thursday, no impeachment bill had been introduced.

But in the memo he circulated to fellow lawmakers, Dush contended the high court's ruling redrawing

the congressional map "blatantly and clearly contradicts the plain language of the Pennsylvania

Constitution."

We'll have to wait and see how this ultimately plays out, but it's at least encouraging

to see the GOP fighting back on this egregious overstep by Democrats.

Perhaps members of the GOP in the nation's capital can use this for some further inspiration

to do the same.

After all, they finally have a president in place that is more than happy to call out

blatant and ridiculous nonsense whenever he sees it.

what do you think about this?

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