Lake Doctor | A Lilly Center for Lakes and Streams Podcast

Lake Doctor | Strategic Health and Water Safety Insights with K21 Health Foundation

• Lilly Center for Lakes & Streams • Season 1 • Episode 3

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How do strategic health initiatives transform a community? Join us as Rich Haddad from the K21 Health Foundation shares his journey from Grace College to leading the K21 Health Foundation for nearly two decades. You'll learn about K21's mission, born from the sale of Kosciusko Community Hospital, and how it now champions health opportunities for Kosciusko County residents. Rich's analytical prowess and passion for community well-being have made K21 a powerhouse in local health projects, including vital partnerships with the Lilly Center for Lakes and Streams. Discover the behind-the-scenes efforts that are making a measurable difference in community health.

We also dive into our collaborative research on the presence of E. coli contamination at public swimming beaches in Warsaw and the impactful results of our community-driven research. Hear from experts Matt Burlingame and Morgan Sass as we answer questions about blue-green algae, also known as cyanobacteria: what they are, how to identify them, and the risks they pose to both humans and pets. Learn about the conditions that foster cyanobacterial blooms and the crucial steps being taken to monitor and mitigate their effects. This episode is packed with practical insights and critical information to help you stay informed about water safety and the health of our beloved lakes.

Learn more about the Lilly Center's work at https://lakes.grace.edu/.

Have a question we could answer on the podcast? Send an email to lakes@grace.edu or submit a comment below.

Help us improve the podcast by filling out this short survey: https://forms.gle/MzGSXHcnkEQC8T74A.


Speaker 1:

Thanks for listening to the Lake Doctor podcast. I'm your host, suzy Light, and I get to share some stories and talk about our beautiful lakes with my friend, dr Nate Bosch. Nate, you got your doctorate degree from the University of Michigan in limnology right.

Speaker 2:

Correct, suzy. Unlike oceanography, though, limnology is the study of freshwater aquatic systems. Limnology is the study of freshwater aquatic systems. On this podcast, we're gonna dive into lake science. We're gonna meet another person who's passionate about our lakes and have some fun together.

Speaker 1:

Super. You can learn more about the topics in this episode or support the Lilly Center's work by visiting our website lakesgraceedu.

Speaker 2:

In today's episode we're joined by Rich Haddad from the K21 Health Foundation. We're going to be focused on research and K21 has been a vital research partner with the Lilly Center.

Speaker 1:

We are so excited about today's episode. The doctor is in Welcome to the Like Doctor podcast. Today with us we have Rich Haddad from the K21 Health Foundation. Today, we're focused on research. Rich, we've known each other for 20 years.

Speaker 2:

A while.

Speaker 3:

A while.

Speaker 1:

But tell our listeners and viewers a bit about yourself, please.

Speaker 4:

Yeah, well, I go back in this community to the early 80s. I was a Grace College student, tried to play sports there. I would say I was okay.

Speaker 4:

Tennis player In my tennis golf and a little bit of basketball actually. So it was back when you could try to do multiple things. But that was part of enjoying. My experience at Grace is the team camaraderie, the competition and certainly the experience with Grace College. My memories are that the professors that taught me also invested in my life beyond the classroom and that is what made Grace special for me. After a few years in Indianapolis, our family relocated back here in 92. So we've been we're not native to our community, but certainly have been around long enough that I think people see me as a local. So it's been a great experience to not only raise a family here, invest our time here, active in our church all those wonderful things and to be an active person. Water sports, golf is now my main thing.

Speaker 1:

Boating on the lake.

Speaker 4:

Boating. Not a lot of exercise there, but certainly a lot of enjoyment. We love the waters. We're fortunate enough to have a place on Winona Lake and enjoy lake living here in Kosciuszko.

Speaker 1:

But you're on the Warsaw side of Winona Lake, aren't you? We are, yes, warsonians.

Speaker 4:

We're technically. There's a little sliver on the southwest side that's actually a county, and so we're kind of in between, technically, warsaw and Winona Lake, but our address is Warsaw, yeah.

Speaker 2:

Good. So you were at Grace College and we already had the environmental science program. Would you have gone? Environmental science rather than accounting and business?

Speaker 4:

absolutely, because I'm sure now wait a minute.

Speaker 2:

Rich, you are a numbers guy you're right, hey, we do a lot of numbers in environmental science. I said that for his benefit.

Speaker 4:

Yes, nate's such a compelling person and very motivating and inspirational. But no, in all seriousness, god created me a certain way and I'm very analytical. Numbers have always come easy to me, and so finding not only the education but then the career paths and opportunities to again education, but then the career paths and opportunities to again use those sort of skills to make a difference in the community is where clearly I landed.

Speaker 1:

Well, you know, you said something that I found really interesting. It was the professors at Grace College that really had an impact and still are pointing to your life and I imagine that Nate's students would be saying the same thing about him that you cultivate relationships, thank you, thank you for doing that to students. So you are now the head of the K21 Health Foundation.

Speaker 4:

Yes.

Speaker 1:

Would you tell us a bit about the mission of K21?

Speaker 4:

Sure.

Speaker 4:

So I've been fortunate enough to be leading that organization for 17 years now, so we've known each other probably a little longer than that.

Speaker 4:

But in your leadership at the Community Foundation and mine there, I loved being a colleague, a peer, an encourager and a partner with you and your team, so it's been a wonderful journey.

Speaker 4:

But K21 Health Foundation was birthed actually 25 years ago when Kosciuszko Community Hospital was sold as a nonprofit hospital to a for-profit system, and so the board of directors at that point said, well, we've got this big check, what do we do with it? And they essentially repurposed that nonprofit to become a foundation. And that's how K21 Health Foundation came to be, and pretty quickly. Then the mission was was defined as continuing to honor the original donors that helped to build the hospital and impact our, the county residents, kosciuszko County residents, in any way we could in health, and so it was really a health focus, because that's where the money originated. Now we have the opportunity as a grant maker to be a little broader than just a hospital operation, which is a wonderful blessing that we can continue to try to help the residents of our community have not only opportunities but remove a lot of the barriers of health and a healthy life that a lot of people face.

Speaker 1:

So K21 Health Foundation has granted funds to Lilly Center for Lakes and Streams, focused on research, and why did K21 Health Foundation feel that that was important?

Speaker 4:

Yeah, I'm again a pretty analytical and strategic guy and so when I came late in 2006 to the early years of K21 Health Foundation, we were doing a good amount of granting, but I was having a hard time figuring out how it was strategic or kind of intentional, strategic or kind of intentional. And so our board spent the next year a lot of off-site time to really say what does health mean to us as a foundation? How do we define health? Because it could mean a lot of things and a lot of people could ask for money for things that maybe it would be a stretch to be health, but you can justify it eventually. You know that, hey, this affects people. So we had to kind of define what health meant to us.

Speaker 4:

But one of the things that came out of that process over time was what we would call environmental health and, frankly, the early relationship with Nate helped, I would say, clarify that for us as we talked about. What does that mean? How broad could that term be? Right, nate? It's like okay, and so for us to honor our mission and purpose and be involved in environmental health needs or opportunities. It was. We kind of ran it through the lens of anything that would impact the human health of our residents Because ultimately I think the lens we try to make decisions on is is this affecting people who live? The residents live in Kosciuszko County? That's probably the bottom line strategy filter that we try to think through. The grant request and again, I think talking several times with Nate helped us process that and take that back to our board for kind of approval that that was a key area for us to be investing in.

Speaker 1:

Rich tell me some of the other ways K21 has worked with the Lilly Center.

Speaker 4:

Yeah, outside of kind of the ongoing, I would say, partnership in research, when Grace was going through their capital campaign to improve the facilities on campus, one of the big parts of their project was to expand and enhance the science center and to really create a permanent home for the Lilly Center.

Speaker 4:

Like you know the uniqueness of what they do and how they do it needed its own space and so we were approached to consider a capital grant to help fund that. And as our barge sat down and looked at that and it was a significant request, I think they concluded that the importance, the critical importance of the Lilly Center's work and Nate's leadership for our community almost needed to. We needed a bricks and mortar permanent home so that we were investing in their long-term role in our community. Obviously their work goes beyond Kosciuszko, but when the majority of the work is in Kosciuszko for Kosciuszko, we all win of our largest grants we've ever done to a specific organization so that a great facility could be built and expanded so that the Lilly Center could continue to grow in their work.

Speaker 1:

And I know that one of the grants you made was to help with the equipment that is at the Lilly Center. Tell us a bit about that.

Speaker 4:

Yeah, I think you know again, in the early grants and research, you know there was always a big cost for all the testing to be sent to a lab. And so you know, as we continue to interact with Nate and his team, it was like you know, that takes time, sometimes they're too busy and so it's delayed and very expensive. Part of the research was was the outside testing costs. And uh, so they approached us one of those cycles of and and added a request to say, look, I I think it's a win for everybody if we are trained and have the equipment to do uh, the lake testing in-house. It's, it's the students, we get our results way quicker and we're going to save a ton of money in those sort of kind of outsourcing costs if we can have you invest in the equipment being purchased and being trained on here. And so again our board was like, yes, this takes that research work to another level of effectiveness and efficiency.

Speaker 1:

And so they made that grant commitment to help bring that testing capability in-house for the Lilly Center. And I remember some time ago there was research that you did on E coli. That was fascinating research. Tell us both of you, tell me about that.

Speaker 4:

Yeah, I'll let Nate give the details on that.

Speaker 2:

But again, that was a wonderful way for us to invest in their work through the county health department, have been measuring E coli, which is another one of those human health threats at the seven public swimming beaches across the county, and two of those public swimming beaches, pike Lake and Center Lake, had abnormally high levels of E coli.

Speaker 2:

And what we were doing as a community is simply putting a sign out saying, hey, it's not safe to go in the water, but nobody was trying to figure out why is that the case and how can we fix it. And so, with K-21 support, we came in to figure out exactly what was causing this. And then we were able to make recommendations to the city of Warsaw in this case because they owned those two beaches, the part of their park system to fix that problem, and I remember we had a list of recommendations. We found most of the E coli was coming from the gulls. It had to do with the pier construction in those two areas as well and what the city was doing to kind of freshen up the beaches each morning before the swimmers would come in.

Speaker 1:

And those piers are still solid piers.

Speaker 2:

Yes.

Speaker 1:

Big concrete solids, so the water couldn't flow through them.

Speaker 2:

Right. It would create sort of a stagnant, sort of little elbow sort of area there where the E coli, everybody was swimming yeah.

Speaker 2:

And that happened to be the highest density of swimmers. Right in that area where there was the the E coli, everybody was swimming, yeah, and that happened to be the highest density of swimmers, right in that area where there was the most E coli. So we then went to the city with this list of recommendations. Mayor Talmer at the time decided not to start killing gulls, which is maybe a good political decision in our community. But the other two were much easier or maybe more feasible.

Speaker 2:

One is the re-engineering of those piers, and it's my understanding that that's already been figured out and those are being implemented now Already. Part of them have already been changed. And then the other was with how the sand would be managed each morning before the swimmers would come, and now there's an implement that's pulled behind their tractor that catches that kind of skims off the top and pulls all the waste of the gulls into a hopper and that's put into a dumpster, whereas before it was stirred into the beach sand kind of tilled in, and so the E coli source then was still there, even though you couldn't see it. And so with those changes now we've had a lot less E coli issues on those two beaches.

Speaker 1:

Did you? Did you have to DNA test the E coli?

Speaker 2:

We did, we had a poor student at the time who had to do what we would call positive controls, where we actually had to collect all those different types of waste because we were wondering if it was pets or people, or gulls or ducks or geese, and when you're talking waste, you're not talking like the hamburger wrapper on the beach, right no? You're talking about feces, feces, waste, yes, where E coli?

Speaker 5:

comes from yes, so you had a student. Have E coli comes from yes.

Speaker 1:

So you had a student have to go retrieve all of that.

Speaker 2:

Yes, yes, yeah, hey, research sometimes is not all fun and games. Not always glamorous. Yes, because we had to genetically determine where the E coli was coming from, not just look at proximity and what's around, but actually know for sure that this E coli is coming from this particular organism, so that we can minimize that threat in the future.

Speaker 1:

And it was gulls, not geese.

Speaker 2:

It was gulls yeah.

Speaker 1:

So one of the things that they did at the beach, they put signs up said don't feed the birds.

Speaker 2:

Yeah, that's another good step in the right direction as well.

Speaker 1:

Fascinating stuff you do.

Speaker 2:

Well, and one other thing I wanted to get back to that Rich just mentioned a couple minutes ago was talking about taking some of the analysis in-house. So we've done that for E coli, like what we're talking about right now, and so we can actually analyze all of our E coli samples, and so we're doing that same sort of almost kind of fingerprinting sort of work for a lot of our streams now around the county to determine where are some of these nutrients coming from and what can be done to minimize those nutrient sources.

Speaker 1:

So what's the turnaround time in the studies that you get to do in-house versus the testing, versus sending the samples out?

Speaker 2:

Yeah, so in the terms of E coli, it would be similar. We would get our results if we do it in-house within a day or two. If we'd send it out, maybe it'd be two or three days, but in the terms of algae toxins, it's a much different story. So before, when we would send those out, it was a laboratory in Ohio and if we were lucky, we would get results back in about four weeks. Now, when we do it in-house, we get our results back within 24 hours, and so that's a huge difference right.

Speaker 2:

It's not helpful to tell people on the lakes, hey, remember that water you were swimming in four weeks ago? You actually shouldn't have been in that water, whereas now we're able to say, hey, our samples just taken four weeks ago you actually shouldn't have been in that water, Whereas now we're able to say, hey, our samples just taken two days ago show this particular issue. You should probably stay out of the water or keep your pets out of the water until we come back and sample again in a few more days, and so that's a much better way to keep our community safe and healthy.

Speaker 4:

Yeah, susie, there was an example of an algae bloom that the research team went out and tested and it was very high, but within a couple days it had dissipated, you know, as water can do, but if we were waiting four weeks we would have never known how high that had spiked at the moment.

Speaker 1:

That was recent Right.

Speaker 4:

And so that sort of real-time or timely information so that action can be taken is really and I would say, a lot of our conversation is, yeah, we need to continue to learn and hopefully someday we'll get that revelation of what is actually causing it, that revelation of what is actually causing it. But we also knew that there was actionable or application to the research, and that was always a conversation we've had with Nate is how can this be applied to not only protecting people and pets on the lake, but responding when things you know test out in a dangerous way? And again, I think the timeliness of the testing was really critical to that next step of helping the community as those sort of threats came up.

Speaker 1:

So when a threat is identified let's just say suddenly there's a toxic bloom on Monona Lake who do you notify?

Speaker 2:

So we have a notification system which people can opt into. We also have relationships with all of the lake associations around the county, and so we can utilize their communication networks as well whenever there is a problem on one of our lakes.

Speaker 1:

So Rich. You've shared a bit about K21's mission. How do you give legs and feet to that mission? What are some of the things you do to help people live their healthiest lives?

Speaker 4:

Yeah, thanks, susie. There's probably two themes that I think we're always thinking about. One would be a healthy life looks different for different people and different interests, and so what's interesting is it's like how many different ways can we help build or improve opportunities for people to live their healthiest life? So, again, there's so many different ways. We have an amazing BMX track for kids and adults who love BMX biking. It's actually one of the best in Northern Indiana. It's a kind of a best kept secret. That would be a good example of like not everybody likes to BMX bike, but hopefully enough that might create an interest in them to be active in that way.

Speaker 4:

So we're constantly trying to look at how diverse of opportunities for people to make choices and live an active, healthy life based on different interests, can we help create for our community so that they have those choices? I think the other thing we really look closely at is are there people in our community that really are either limited or have barriers to those choices? So, whether that's economic or geographic or other ways, they are limited in having the choices and having the ability to be healthy. How do we remove those barriers? How do we create more access, whether that's, again, transportation, or there's certain healthcare services that aren't being provided in our community. How do we help bring those to our community?

Speaker 4:

And or again, there's people whether it's insurance or economic or other reasons. They have limitations that aren't in their control, and so we're constantly looking for ways to open doors and remove those barriers for everybody. And again, our goal is every person that calls Kosciuszko County home has has a again, a free path to making their best choices. It is definitely health is one of those. At the end of the day, we all can choose to make good, healthy choices or not. Some people actually are limited in having those choices, and so we want to give people every opportunity to make those good decisions. That, again, I'm challenged with too, but those are probably the two ways we try to look at continuing to build everybody's opportunity for healthy living.

Speaker 1:

So Rich.

Speaker 4:

Yes.

Speaker 1:

We've talked legacy stuff before and you've talked about your grandkids. What would be your legacy, particularly toward Winona Lake? What would be, your legacy.

Speaker 4:

Wow, that's a big, deep question. You know, I see my role at K21 Health Foundation. I use the term steward. This is the community's money. It's not my money, it's not the board's money. We're responsible for it but it's really, how do we best utilize this foundation and the community that's been blessed to have it reside here and do the most good with it? And so, to me, a lot of the, I would say. The ultimate legacy I hope for is that we continue to help evolve our community into every person in Kosciuszko County being able to live their healthiest life as they choose, as they understand and as they have opportunities to do it. And so, again, the natural assets of our lakes and streams is like there's no better place to bike and walk and jog and kayak and paddleboard and Swim.

Speaker 1:

Swim Ski, I mean it's Wakesurf jog, and kayak and paddleboard and swim, swim.

Speaker 4:

I mean it's right and so how do we maximize the beauty we've been blessed with so that every person has that opportunity to live a healthy life, to enjoy the lakes and streams and all the other things? So my legacy would be that we have advanced our culture in our community, that we're all living on our own accord a healthier lifestyle, that the culture changes you know so often in North of Indiana or the Midwest right. We kind of. Our history is that we like to hibernate in the winter like buckle down.

Speaker 4:

We'll you know, we'll catch up on our Netflix and we'll see you in the spring.

Speaker 5:

Right.

Speaker 4:

And so um, and and we always talk about if you ever want to visit us, visit us in the summer, cause it doesn't get any better than that. You know, my daughter, speaking of of lake experiences, is like I want to spend every 4th of July the rest of my life on Winona Lake. She's like there's nothing better and that's great. But we want to help create a culture where people are able to live an active, healthy life 12 months a year, not just three or four, because we kind of naturally are doing that, because it is pretty wonderful. But we want to continue to build a culture that each of us are able to again live our healthiest life year round.

Speaker 2:

Certainly, we've had a relationship of financial investment. You guys have invested in us, both operationally, to be ready to respond to certain issues that come up on our lakes, oftentimes unforeseen, to convene groups of people together to help really move the needle in how we manage our lakes and streams, as well as on the research side, like we've been talking more about here so far, and um, but it's been so much more than just financial investment. You and I have sat down many times and how do you, um, how do you manage a nonprofit organization, and uh, how do you partner well with other organizations and, um, you know, as a leader, how do you make decisions, and uh, and have your team members be in the places that are most beneficial for them and for the organization, and so I've really appreciated that mentorship as well.

Speaker 4:

Thank you. It's been mutual. It's been really great to, you know, have a professional relationship of ofmaker standpoint, but you and I again have been colleagues. We've learned from each other, hopefully encouraged each other to continue to grow and be better, and again, it's so that we can hopefully make the biggest impact that we're in a place to be able to make. So, yeah, it's been a good ride, hopefully not over.

Speaker 2:

Yeah, yeah, many more years.

Speaker 1:

So thank you very much for joining us today, rich, for the Lake Doctor podcast. We really appreciate you and K21's investment in health in our community, the work that you're doing with Nate and the support that the Lilly Center is getting. Thank you very much for joining us today for the Lake Doctor podcast. Stay tuned. We are going to have an exciting segment coming up with, maybe cyanobacteria.

Speaker 2:

Oh, you got the word right.

Speaker 1:

Yay, good job.

Speaker 2:

Good job.

Speaker 3:

Today we'll be answering the Internet's most frequently asked questions about cyanobacteria. I'm Morgan Sass, a lab assistant at the Lilly Center for Lakes and Streams.

Speaker 5:

And I'm Matt Burlingame, assistant director of research at the Lilly Center. Cyanobacteria is a big focus of our research. Here let's answer the most common questions about cyanobacteria. Question number one what is cyanobacteria? Cyanobacteria is a bacteria. It's composed of some different pigments like chlorophyll A, phycobilin and phycoerythrin, and these pigments allow cyanobacteria to photosynthesize like algae and they also help produce its blue-green color.

Speaker 3:

What is cyanobacteria bloom? Cyanobacteria bloom is what happens when cyanobacteria reproduces rapidly and causes a massive amount of algae.

Speaker 5:

Alright, causes a massive amount of algae, all right. Question number three what is cyanobacteria made of? Cyanobacteria aren't algae, they're bacteria and they're actually prokaryotes, and they do not have a nucleus or organ membrane, bound organelles which make them a little bit different than algae, green algae, which are true algae, is cyanobacteria algae.

Speaker 3:

Well, as matt said, it's actually a bacteria. So we call it an algae because it sort of photosynthesizes like algae and it's small like algae.

Speaker 5:

But it's actually a bacteria, all right morgan, do something crazy, go out of order here. It's actually a bacteria. All right, morgan, I'm gonna do something crazy. Go out of order here. So is cyanobacteria bad? Cyanobacteria is a naturally occurring organism in our lakes, so it's supposed to be there. So it's not necessarily bad. But like a lot of things, too much of it could be bad. So if there's a bloom and it produces toxin, then the cyanobacteria toxin can be detrimental to pets and people at certain levels.

Speaker 3:

I'll follow your lead. How to identify cyanobacteria. So cyanobacteria has a couple different things. It'll look sort of like a paint spill on the water. It'll be real thin and sort of floaty and if you stir a stick around in it it'll kind of stick to the stick, sort of like paint would.

Speaker 5:

It can also sometimes create a bad smell or sometimes we'll see fish kills that go along with it. All right. Next question what causes cyanobacteria? All right, so cyanobacteria again is naturally occurring. But what can cause a bloom? A lot of warm days in a row, so high temperatures extended for a couple of days, high sunlight concentrations, excess nutrients like nitrogen and phosphorus in the lake, even interactions with different organisms can cause cyanobacterial bloom.

Speaker 3:

Is cyanobacteria photosynthetic? Yes, so cyanobacteria has chlorophyll in it, and that makes it able to harness the sun's energy to make energy of its own.

Speaker 5:

If I can pull these apart. Oh, is cyanobacteria a blue-green algae? Cyanobacteria is called a blue-green algae, even though it's not algae. It's bacteria, as we said before. It's called blue-green because of the combination of pigments in the cyanobacteria can make it blue-green color and because it photosynthesizes and it's small and it's in the water, we call them algae, even though they're not algae. They're bacteria.

Speaker 3:

Why cyanobacteria is bacteria, so it's actually a completely different classification. Even though it behaves a lot like algae, cyanobacteria is actually smaller than algae most times and it doesn't contain some of the same organelles which are sort of like organs inside the body.

Speaker 5:

What cyanobacteria eats. So they don't swim around the lake and eat stuff like a fish does, but cyanobacteria consume nutrients such as nitrogen and phosphorus and some trace minerals, and that's what they need to grow, besides using energy from sunlight to photosynthesize and then taking up carbon dioxide and water in that process to create food to build their own biomass.

Speaker 3:

What cyanobacteria looks like. So I actually study cyanobacteria under the microscope and it can take a few different forms. We'll often see microcystis in small little circles, or we'll see some filamentous algae, which means they kind of look like a string of cells.

Speaker 5:

That's my last one, morgan, oh dear. Is cyanobacteria bad for dogs? It can be. Again, as we said a couple times, it's a naturally occurring organism, but at the right concentrations cyanobacteria can be harmful to pets. It typically affects dogs because a lot of times when you're not playing fetch with your Labrador retriever cat and she's not chasing the tennis ball out of the lake, but dogs go in the lake and I know my dog swims around and it's always biting at the water. And when it gets out, what's a dog do? He licks himself off to get the water off him and they end up ingesting a lot of water and then that, therefore, if there's toxin present from the cyanobacteria, that can cause harm to the pets.

Speaker 3:

All right, and I'll finish it out Does my lake have cyanobacteria? Yeah, all lakes have cyanobacteria, just like all lakes have algae. But unless there's a bloom or otherwise high levels, we're not going to see any toxin or harm from it. So as long as it's not in a bloom, it should be fine. Speaking of blooms, if you want our weekly toxin updates, they come out every Friday and you can find them at lakesgraceedu and they'll send you an email telling you a little bit about the lakes you live on. Thanks for joining us for.

Speaker 5:

Autocomplete FAQs.

Speaker 1:

Thanks for listening to this episode of the Lake Doctor podcast. Join us next time. It's bound to be fun.

Speaker 2:

Listening to this podcast is the first step to making your lake cleaner and healthier. Visit our website for full studies of our applied research and discover some tangible ways you can make a difference on your lake. Join us at lakesgraceedu.

Speaker 1:

We'll see you next time. The Doctor is In.