 My name is Dr. Susan Joseph. I am an associate professor of medicine at the University of Maryland School of Medicine in Baltimore and I am section chief of advanced heart failure transplant and mechanical circulatory support. My goal for patients is to help restore as close to a normal or excellent quality of life as possible in spite of the fact that we still don't have a cure if you will for heart failure. So quality of life but also to live longer. The other thing I really enjoy is forming relationships that are that are long lasting over a period of years you know seeing patients get married and have babies or have grandbabies and travel or go back to work. So that's absolutely my goal for patients and for them to know that when you come and see me or a member of my team that they're seeing somebody who they can trust to be up to date on the latest medications the most current knowledge that they are getting a gold standard service and relationship with a doctor that they can trust. Advanced heart failure is absolutely an ever-evolving field not just because of the novel devices the ventricular assist devices and the the life support devices that we use in patients with a failing heart because of course the technology is always ever-evolving. So it's not just the technology that's exciting however there are also advances in medications I mean just in the past five years at least four new medications have been proven to improve the symptoms and the outcomes in patients with advanced heart failure. The best part about my job is improving patient lives and also the ability to participate in contributing to an ever-changing field because of being in a university setting with ability to collaborate with other investigators and and actually you know try to make that make that contribute to the treatments and the discovery behind heart failure treatments.