>>Good morning, everyone. Thank you, Johns Hopkins, for inviting me to speak here today and for your determination to cure cancer. By researching and
advancing the latest drugs in many clinical trials,
you’re helping me survive. A Woman’s Journey is the network needed to advocate for our health, to keep us connected with
other females and physicians, and to keep us strong
when life feels tough. A very special thank you to
my friend, Dorothy Blagrove, who joined me from Arlington, Virginia, my mother-in-law, Sonia
Lersten from Albuquerque, and Lillian Lindell,
her cousin from Tampa. It means a lot that
you’ve come here today. My oldest child, several
years back, was 12 years old and had just received an iPhone as a gift. And that was around the time of my advanced cancer diagnosis. It was a communication tool
that kept both of us going. I got a text one night that
said, “Mom, are you okay?” And I could have yelled to the
next room, “I’m just fine,” but I texted back (laughs), and I asked him if he wanted
to talk and he said, “Yes.” That moment still brings
tears to my eyes this day. We sat on the edge of the tub, and he cried, “I’m not
ready for you to die.” My three-year-old at that
time knew Mom had boo-boos, and my six-year-old never
wanted to talk about anything. And my nine-year-old,
interestingly he wanted to go to infusions and
learn more systemically how do you get rid of cancer? My husband, an amazing
soul, he was afraid. How could he raise four
young kids if I died? I wasn’t ready to leave them. It was profoundly sad. You can’t say everything
is going to be fine, but what you do is you hug tight and you say I’m giving this all I have. That was five years ago. I’m honored to be here today
in this beautiful city. We snuck over to Palm
Beach Island last night. It’s phenomenal. I’m a stage four melanoma
Mom surviving cancer. I’ve learned so much on this journey, and I will share with you
today the guiding principles that I believe have really driven me to be here with you
here today, to survive. My first principle is
listen to your gut instinct and act with a sense of urgency. My original diagnosis was in 2003 when I found a small
pinkish spot on my calf. It didn’t even look like a typical mole. And it was actually my mom who pushed me to the dermatologist when she noticed it changing. And the dermatologist didn’t
think it needed to be removed. But I thought it was ugly,
and I wanted it off my calf. So I insisted get it off. I was pregnant with my second child. We were living in the United
Arab Emirates in Dubai, and I flew to the U.S. for surgery. And at that time the surgeon told me that I had saved my life by
insisting the spot be removed because it had tested
for stage one melanoma. Vanity saved my life. I was told there was a 98% chance that I would never see cancer again. So fast-forward to a
Wednesday night in 2012. Nine years later. Nine years of nothing. Nine years after my stage
one melanoma diagnosis and several kids later, I was putting my then
three-year-old to bed and I found a lump near my groin. I went to my primary
physician that Friday, and it’s important to remember these dates because this has been part
of my drive to surviving. I went to the physician on a Friday who said it could be the
result of an ingrown hair. I did not think it was an ingrown hair. I remember crying alone with
my baby girl asleep that night, because I knew it was more. It felt like a marble, and it was on the same leg
of my original diagnosis, just higher up. At my insistence, I got
an immediate referral to an oncologist. And I met with him three
days later on a Monday. Do you know how hard it is to
get an oncologist appointment within a matter of days? The oncologist, who also
suspected something, I could just see it on his
face, recommended a surgeon who happened to be in
the same building as he, and I went straight to
the surgeon’s office. They told me the surgeon
was going on vacation and would not be able to
meet with me for three weeks. I was falling apart and I knew
I could not wait three weeks. My tears were real, and in front of 25 people
in that waiting room I lost it, I cried. I got in the door that moment. I’m not saying to cry your way in, but it definitely worked (laughs). And I just sat, I remember,
in the surgeon’s lunch area. I just was a wreck. I thought this is it. The surgeon agreed to do the
surgery before his vacation which was in two days. From the time I found
the lump on a Wednesday to meeting with the oncologist
and the surgeon on a Monday and having surgery two days later, the time that lapsed was seven days. Seven days. And on that seventh day,
I had one lump removed. I drove that very same
day to Boy Scouts camp to spend a few nights with one of my kids. I couldn’t get in the water, but I was there to be with my son. And it was at Boy Scouts Camp
when I got the call that said I had tested for melanoma, stage three. A few weeks later I had
22 lymph nodes removed from a phenomenal female surgeon, Dr. Lisa Jacobs at Johns Hopkins. All nodes were clear. Regardless of what the doctors
told me, an ingrown hair, or the front office staff
in the waiting room, “You can’t see the doctor
until three weeks,” I trusted my instincts. I forged ahead with a
strong sense of urgency. It was my life at stake. Trusting my gut and progressing with speed have always helped me get
closer to the finish line. With the beautiful Florida sun, if there are spots or moles
or something that seems off or odd-shaped or changing, go get checked. Taking action can save
your life like it has mine. My second principle is
leave no stone unturned. I work for the Department of Energy, the National Nuclear
Security Administration, and we are charged with
ensuring our nation’s nuclear security is second to none. That is the best. I’ve served in Russia
working to secure plutonium and highly-enriched uranium and helping consolidate the weapons from Belarus, Ukraine, and Kazakhstan. I had visited many Russian closed cities. The kind that are not on the maps, maybe they are today,
but they weren’t then, and I required special access to get into these closed cities. But sometimes I wonder, was
my cancer triggered there? I visited a lot of Russian
nuclear facilities. How much radiation was I exposed to? I also served as the
Department of Energy’s senior representative in the Middle East establishing key partnerships
in the oil and gas industry and trying to build
scientific partnerships to advance the U.S.
nuclear security agenda. When it comes to securing materials to prevent nuclear-related technology from spreading globally, when it comes to protecting America, no stone should be left unturned. And leaving no stone unturned
applies to my cancer. Learning I had cancer
shocked me to the core from the first stage
one diagnosis in 2003, when it returned and became
advanced cancer in 2012, when it came back in 2014 to
the liver, now stage four, when it returned to the liver in 2015, and when it reinserted its ugly head just last year outside of the colon wall, It felt like my life was over each time. It did not and was not
getting easier for me. And I cried and I cried and I cried so hard each time it came back. I’m really begin to think
I’m a crier (laughs). My four kids would not have a
mother, I thought each time. Why doesn’t it get easier with no evidence of disease windows? I would not see my children
go to prom, get married, have kids. Cancer was a death sentence, I thought. My advanced cancer time
frame 2012 to the present is an important time frame
for melanoma patients. In fact I’m told there is no better time to have melanoma (laughs). This is the great window. There were very few options to
treat melanoma prior to 2011 when the very first immunotherapy
drugs were introduced. Unlike chemotherapy, immunotherapy, It does not go after the cancer destroying the good cells and the bad. It revs up your immune
system to fight the cancer. Chemotherapy knocks people down. Immunotherapy drugs,
while not a cake walk, can be managed, I have found. Every time I’ve had a
recurrence I have had to listen, I had the choice to
listen to professionals and do simply what they said, or be proactive about my
care, taking initiative. And I chose the latter. I developed a plan A and a plan B, and I always have a backup plan. Asking questions along the way. Making decisions, sometimes challenging what the doctors recommended, and I’ll tell you more about that. And ultimately having enough information so that I could make an informed decision and feel good about it. When you’re on a cancer journey, the decisions you make
have to feel good to you. I insisted on more scans than
the doctor said I needed. I researched and traveled
all over the East Coast from D.C. up to New York. I ventured out to Texas and
visited the best oncology units. I delved into reading more about alternative medicinal practices. I said I wanted surgery when one doctor said stay on treatment. I searched desperately for
survivors across the country, and I reached out to them
for advice and guidance. I chose to develop my own
plan that worked for me. And as a result, I have
a team of oncologists who consult with one another. Dr. Evan Lipson from Johns
Hopkins, close to my home, knows I started my journey with Dr. Anna Pavlick in New York. When I saw Dr. Lipson recently, he volunteered that he would make sure Dr. Pavlick had the
latest scan information, even though I wasn’t
seeing Dr. Pavlick anymore, and I have this amazing
oncologist Dr. Lipson. You have got to meet him. He took the time to
call her, to email her, to share scan information, because it’s a very personal journey. He knew I felt an emotional
connection with her. What an amazing mindset. That is the type of doctor
that you want on your side, and I don’t have just one
doctor on my side, I have two. The team of surgeons. I have had seven different
surgeons operate on me. Four of those major surgeries: The first surgery, he
told me I save my life when I had the stage one diagnosis, the one local hospital surgeon, the one I cried my way into, one from New York, one from MD Anderson, and three from Hopkins. Dr. Marty Paul of Hopkins and then another amazing, amazing individual removed six inches of my colon. Brought me in on a Tuesday,
removed part of the colon, and I was out the next day. And in 10 days I was doing light yoga. He reinforced Dr. Lipson’s philosophy: I’ll share with anyone on your team. That’s the type of surgeon
you want on your side. My alternative team, a naturalist doctor provides me with mistletoe. The very mistletoe that you
hang during the holidays. Mistletoe has a history of medicinal use. The European varieties have been used in traditional
medicine to treat seizures, headaches, arthritis, hypertension, infertility and even cancer. I do mistletoe injections
regularly, injecting myself. I know it helps fight
cancer, builds immune system, builds the immune system and
it give me a ton of energy. I really don’t need Red Bull. My mistletoe is just great. The first ever mistletoe
trial in this country is underway at Johns Hopkins as I speak. That is incredible. I dial up and I dial
down on energy healing and juicing organic,
acupuncture and therapy. Therapy and cancer go
hand-in-hand, by the way. (laughs) Everyone needs a good therapist, right? I’ve had all the mercury
removed from my old dental work. Hired an alternative nutritionist, and I do meditation and yoga. But there’s one foundation
that never changes, and that’s God. God was not in my life very much before 2012 when I had
the advanced diagnosis. And I wasn’t embracing anything. We were living in Nicaragua
and were about to leave, in 2011, when a missionary from the church that we went
to came up to me and said, “I’m not sure why, but God
asked me to seek you out.” I thought it was very weird. So I had coffee with her and there were no light bulbs going off for either of us. But I think in a very odd
way, God knew I needed Him. I just didn’t know it. And when my love life fell
apart, with stage three in 2012, things happened and fell in place with my opening the door
a bit more to faith. To call on Him for healing and pray. And I’ve met so many
people around the country. I’ve been invited into a Bible study. I can’t tell you how many people I have praying for me around this country. And I have to pause and realize that strange, very strange
encounter in Nicaragua I believe was God’s way
of reaching out to me. My third principle is, put
your ego and humility aside. I stepped down from managing 250 people and overseeing a $10 billion budget. I needed time to get
better, to heal, to survive, to be with my family, that’s
all that really mattered. I literally was falling apart. I needed time to reflect, is this it? My agency, who I worked
for, has been so supportive and to this day allows
me to be an executive. I’m not managing hundreds of
people or billions of dollars. While I’m on this cancer journey, I have been able to remain an executive and I am so grateful for that. I feel like a shadow in the
distance at work sometimes, there’s no question. And I’ve had to put my ego aside. I’m okay with not being
at the leadership table. Because my core is my family. Putting everything I have into surviving and living each day is
sacred and above all else. I debated talking about
the ugly side of cancer, the ugly things it does to you. But I’m gonna take a moment
and just share something. And this has to do with ego
and more humility and dignity. I was traveling a lot to New York when I started my cancer journey and I did it all, trains, planes, buses anything to get up and back. And I was taking the bus
back with my sister one time and I was on an immunotherapy drug. And we got onto the bus and I told her I wasn’t feeling great. And I got sick and I passed out. Apparently with convulsion-like movements. And I came to, and I reminded my sister, “Oh, when I get sick I pass out.” It’s vasovagal syncope and,
for the doctors in this room, I’m probably not even sure
I’m saying that right. But it’s not a serious or
life-threatening condition. It’s an abnormal reflex thing. And I got sick several times on the bus and word had gotten to the driver that there was a gravely ill person passing out and convulsing up top. So we pulled over and the ambulance comes. I have to get off the bus and
I know people were irritated. I was holding them up. And those Washingtonians had
to get back to Washington. Not much patience there. And I just explained to the ambulance, “Oh it’s a reflex issue.” I left out the cancer part, because I thought I would really
be holding up that bus. (laughs) And so, I got back on the bus, and I moved downstairs,
and you should have seen, everyone just moved upstairs. And guess what, you get the drift. Things did not go well
the rest of the ride. And this time the bus pulled over again and off I went into an
ambulance, to who knows where. I had no idea where I was. In the middle of somewhere,
I think it was Maryland. There are many times when I’ve crawled to the bathroom on the floor. Where I went shopping
with my uncle and kids and had to throw all
the clothes in my arms, handing them over to my uncle
and racing out to the car because I couldn’t take it. I was not well. To step out of a big job, to have no control over your
body in front of dozens, pulling over while my kids are in the car, explaining to my youngest two, I’m going to get sick,
I’m going to pass out. I will be back in about 30 seconds. To lay down in the park, I
remember this so vividly, while my daughters had
to rush and go find help. I literally had to lay down in a park. That is ego, dignity,
humility and pride aside. That is cancer. But I’m still here today. My fourth principle is the importance of a strong network around you. Networks are vital to our success. Both personally and professionally. Those friends who just
make our days happier. These are the circle of people
who you want on your side, to help keep you positive,
to build up your confidence. To provide you with a lending
hand to accomplish your goals. And my goals were, and are, simple. It’s to live and to fill my
kids’ lives with memories. I’ve learned some networks fail you. But they either come around or you have enough of a network that you rely on those who truly back you. My 77-year-old dad has
never missed a surgery. This past one, he slept
on the couch in my room. And the one before that, in a chair. I am sure that chair was not comfortable, sleeping in all night long. When I mentioned that some
of my hair was coming out, on one of my treatments, and
mind you, on immunotherapy, I never experienced full hair
loss, like on chemotherapy. But my dad, when he heard, “Oh, some of her hair is falling out.” I really think he thought I
was going to lose all my hair. So, what does he do? My dad lives in Wyoming,
that is an important point. He shaves his entire head. And sent me the picture,
and I thought, oh boy. I cannot send him a photo,
or FaceTime or Skype with him for a while. (laughs) What the heck, he just shaved his head in the middle of a Wyoming winter. My dad is part of my foundational network. My mom comes out every surgery and is armed to cook
and get my weight back. My community has helped me and
made sure my family was fed. And my friends, many there, and some not. You lose some friends,
on a cancer journey. I didn’t expect that. I thought friends were
always thee for you. And my husband, who has
grown on this journey, he’s there for me every day. I’ve made sure that I have had,
and have a healthy network. Learning to ask for things,
so unlike my character. If you knew me, you’d be
like, “Oh, she does it all.” I have learned to ask for help. My network consists of people who will never take a break or
deviate from supporting me. Their feedback, honesty and dependability helped me grow and overcome
the challenges I faced. Because none of us can do it
alone, or at least effectively. My fifth principle is uncertainty
and staying on course. The fear, the anxiety,
that goes with each scan never gets easier. I’ve had almost 35 scans
in the last five years. Very three months, I go
through the cycle of, “Is the cancer back? “Why can’t it just go away?” and when it comes back,
like it did last March, (sighs) I was heartbroken. How in the world was I gonna
break it to the kids again? Life seemed to be getting back to normal and I had to tell them,
“Mom’s cancer is back.” And I won’t tell you the
words my 16-year-old son used. (laughs) The first time
I probably didn’t say, “Don’t use that language.” and with my work, I have so
much drive, but I wonder, should I step up again? But what happens if the cancer comes back? I wish I could say, “I’ve got this.” But I don’t. There are so many fears and
worries and the truth is, there’s many times when I’m
sad, I’m scared, I’m angry. And there’s many times
when I find myself okay. Right after a scan, if I
get the news it’s all clear, oh, I feel like celebrating. I feel that is the time
where you will catch me in my best mood ever. There are times when I do, I have courage. I have mental strength. And I simply think, I’ll
just do another surgery because I can. My melanoma has not proliferated to the point of interoperability. It’s been one tumor. So surgery is part of my game plan. There’s such great
uncertainty and challenges not just about the cancer unknowns, but about financing cancer. We’ve been out of network with some and in network and, I tell you, we have accumulated considerable debt. Debt that we are still paying off. And then you add in the
alternative treatments on top of that. There is no question, cancer is not cheap. But you do anything to survive. Because I have four kids. I have a family. A life that I am not done living. I don’t care what the cost is. I will pay what it takes to survive. And let me tell you why I’m still living. Much to do with my mental
courage and strength but also the latest,
incredible immunotherapy drugs. And I’m gonna spend just a couple minutes talking about them. Because many of them are
the way of the future. There are so many clinical
trials in immunotherapy drugs that John Hopkins os on top of, and is at the cutting edge point on, that it gives me such hope. Many trials that have been developed in drugs since 2011, 2011, and it’s allowed me to live hard and to live fairly normally. And I’ve been able to
manage the side effects, to spend quality time with my family. So shortly after that 2012
stage three diagnosis, and lymph node resection, I went on a clinical vaccine trial. Our family traveled to your
beautiful state of Florida. I think I want to retire here,
by the way, it’s beautiful. (laughs) We went to Disney
World several times. Our kids were so young. And other then flu-like
symptoms, fevers and chills for a couple of months, I was fine. I could deal with the flu
for a couple of months. You know how rotten you
feel when you have the flu? Just have it for a couple months. But I could deal with that. Almost 1 1/2 years of
no evidence of disease the cancer returned to the liver in 2014. And I have to tell you just, (sighs) I will never forget when
somebody told me that and it was not at Hopkins. But a physician aide came in and said, “Well the good news is, it
didn’t go to the brain.” and I just stopped
right there and thought, oh my God, well where did it go to? The bedside manner, it was horrific. It was not at Hopkins. So it returned to the liver in early 2014. And after a very tough liver
surgery, done robotically, I went on the drug Zelboraf. Zelboraf is a targeted therapy that blocks the function
of abnormal molecules to slow the growth of melanoma. My hair, that’s when it got super thin. No ounce of tolerance to the sun. Sunscreen is always essential, right? But on Zelboraf, if a single spot was left uncovered from sunscreen, I would develop this major
red, painful sunburn. I developed a rash all over my body. Not just a normal light rash. It was, yeah. They should have put me on an island and just kept me there isolated. And they had to reduce the
drug to the minimum level and I could not complete the full course due to the toxicity. But, while on Zelboraf,
and this is the fun part. While on these targeted drugs
and immunitherapy drugs, this time, summer 2014, we went to Iceland and the blue lagoon. Norway, visiting my sister
and husband in the fjords. And seeing my kids plunge
into the glacier water. And England to see more family, going to Charlie and the Chocolate Factory in London’s Theater District. Going to water buffalo
farms with Dorothy in Italy. Seeing 20 Maltese friends in Malta, who I studied with 25 years ago. And learning how to scuba dive there. And being at the very, very tip of the Italian boot in Sicily,
Susan, you gotta try it. All while on the
melanoma-targeted drug Zelboraf. I could live. I could manage. Another liver surgery, so there was another year of no evidence of disease, and then my cancer returned
again in early 2005. Another liver surgery, and a tough one. The liver just, ooph, tough surgery. I went on my first
immunotherapy drug Yervoy. I cannot say the way
the medical drug name, so forgive me, but like,
ipilimumab, something like that. The drug was the toughest one
and kept me closer to home because one wrong dietary choice, I was in an ambulance
recovering at the hospital. My diet consisted of
pasta, rice, eggs and meat. And resulted on about 20
pounds of weight loss. Who needs Jenny Craig? (laughs) Yervoy administered intervenously, was originally approved in 2011, to treat late stage melanoma. Yervoy works by allowing
the body’s immune system to recognize, target and attack melanoma cells, melanoma tumors. This drug gave me the largest window of no evidence of disease. 2015 to 2017. And for my 50th birthday, my girlfriends and I traveled to Peru. And we climbed the Salkantay peak, the back way into Machu Picchu. And reaching almost 16,000 on
our climb at the very peak. This was my first major mountain climb, on my cancer journey. Then I had another, that was the 2000, the two years of no evidence of disease, I thought I was out of the woods. Some say stage four melanoma patients will experience a 90% return. Dr. Lipson, from Hopkins, says it’s difficult to estimate
disease recurrence rates in patients with stage four
melanoma, largely because the response to the
therapies vary so widely. And in terms of the
five year survival rate, for patients stage four
melanoma, my situation, it was about 15% a few years ago. My survival rate, five years, is about 30% now, it’s doubled. So the cancer came back in March 2017, now outside of the colon area. And I tried Opdivo, the sister drug to what President Jimmy
Carter used for his melanoma, that had reached the brain. Opdivo works as a check point inhibitor, blocking a signal that would have prevented activated T cells
from attacking the cancer. That’s clearing the immune system, having the immune system
clear the cancer out. Opdivo did not work for me. I moved on to a clinical trial, Opdivo plus, called LAG-3. It’s a cell service molecule
expressed on activated T cells. And the hope was that this
combination would do the trick. So remember I had a four-inch tumor on the outside of my colon. While on this clinical trial, I was on a very strict
two-week infusion schedule. And my main side effect was exhaustion. But that did not stop me
from traveling to Japan with my eldest child
for a one-on-one trip. I told each of my kids, “When you’re 15, we’re
gonna do a one-on-one trip.” Because I figure after 15
you start losing them, right? They’re just like, “I don’t want mom.” So we went to Japan. And this was the same
child, four years earlier, who I sat on the edge of the
bathtub with, sharing tears. Because we didn’t know if
I was going to survive. I had an infusion on a Tuesday, got on a plane on Wednesday
and flew to Japan, climbed Mount Fuji, the
second major mountain, with cancer, and eight hours in the rain climbing that mountain, we reached the top at 4:00
a.m. and caught sunrise. My son’s first ever sunrise. And after 12 days, we returned to the US and I made my infusion the very next day, upon return from this most
incredible and memorable trip. As a result of our trip, my son wants to continue his Japanese studies
and move to Tokyo one day. Do you know what this
means to a mom with cancer? To see something sparked in your child, to know that they’ll have a future, they need their mom. But he will be okay. And after returning from Japan, the scan showed minimal tumor shrinkage. It was then that I
decided I wanted surgery. I had differing opinions. And I went with my gut. The medicine was not
showing astounding results. But perhaps I didn’t give it enough time. I was not willing to wait. And it’s okay, because for
me surgery was the way to go. And Dr. Lipson at
Hopkins recently told me, “Cindy, you do really well with surgery. “We need to keep that in mind
should there be recurrences.” He saw a different person
when that tumor came out. I recover quickly. I have had operable tumors. And so, as I’ve said, surgery
is just part of my plan. Yervoy, the drug I did, the
first immunitherapy drug, Opdivo, the second one, and LAG-3, all three of these drugs work by allowing the body’s immune system to recognize, target and attack
cells in melanoma tumors. And a major component of Johns
Hopkins research right now, involves discovering
which of these medications and others like them, are
effective in patients and why. So even though these drugs
didn’t provide a cure for me, or showed the significant
results that I wanted to see, I am relieved to know that
Johns Hopkins is examining why. Why do these drugs work
in some and not the other? The melanoma immunotherapy drugs have no doubt extended my life. And there are many
combinations of melanoma drugs, many clinical trials, that I haven’t done. So, while I’ve done the FDA
approved melanoma drugs, there’s different options. You can mix drugs, you can combine drugs. There are many things I
have in my back pocket. And my windows of no evidence of disease that allows for more time, for more drugs, to get to the FDA finish line. My December scans were clear. And my kids, now eight, 11, 13 and 16, still have a mom for them every day. I’m in a watch-and-see mode. And with my next PET
and CT scans in March, my care is ongoing and
that is just my life. But the longer I survive,
the more option I have. And all of us should remember that. So in conclusion, why did I get melanoma? Was it the baby oil sunning, tanning days? I know some of you out
there did it too. (laughs) The blistering sunburns in childhood, I used to go skiing in Steamboat, not an ounce of sunscreen on my face. Or is it genetic? My 53-year-old sister developed stage one melanoma two years ago. Actually I think it was three. And then just had a stage
one recurrence last year. No one can tell me exactly why. How does one live scan to scan, wondering if in a three month time frame that cancer’s coming back? I’ll be honest, it’s hard. And the nights, oh,
nights are hard for me. They’re quiet, they’re
scary, they’re lonely. The thoughts that pass
through my mind at nighttime, they’re chilling. There’s not one day that goes by when I don’t think about my health. And the chemotherapy ward, where you go for immunitherapy infusions, among the many sick,
receiving my infusion, I don’t feel like I belong
there but I am there. I don’t feel like I deserve this. I’ve learned so much. To love harder, to be kinder,
to be more compassionate to yell less, although my
kids still would disagree. I yell. But I try to yell less. I don’t feel my family deserves this, to have a mom or a wife who is sick. But we are in this space. I will live each day
with or without melanoma. I beat the odds five years ago. And when I thought cancer
was a death sentence, it was not. I treat it like a chronic illness. And I am wondering, what
mountain will I climb next. Thank you. (audience applauding)

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