 I'm Richard Malarski. I'm a pulmonary, critical care, and palliative care doctor, and I also conduct research on lung and palliative care topics at the Kaiser Permanente Center for Health Research. When I was younger, my dad characterized me as a jack-of-all-trades, master of a few, and that sort of renaissance man style is, you know, really what persisted through my undergraduate and graduate years. I changed my major at least a dozen times, biochemistry, physics, math, you know, I even worked as a bioengineer and a quality engineer at Motorola before I finally settled on medical school. And I went to medical school really because it was the chance to allow me to have all of my passions around education and knowledge paired with actually doing some good in the world. I knew I wanted to do research, but I also wanted to practice medicine. So I came to Kaiser Permanente where I do research at the center, but spend half my time taking care of lung and ICU patients in our delivery system. Right now, most of my research is in COPD, chronic obstructive pulmonary disease, a slow progressive disease that destroys the lungs. As part of this work, I co-lead the Patient-Powered Research Network with the COPD Foundation. It's an endeavor where we really try to involve patients in the whole research enterprise so we can most understand what's most relevant to patients and their providers. I first became interested in palliative care research working with ICU patients, critically ill patients who accept life support for a chance to get better, but yet, 50s patients succumb to their illness and never leave the ICU. One of my favorite projects was a communication project, mostly with families of these patients using a mnemonic called value. Value says, value and appreciate what family members say, acknowledge their emotions, listen actively and empathetically, understand who the person really is, and then elicit questions from the family. An example of where the value tool really helped us was working with this young woman whose mom was dying in her ICU. Her lungs and kidneys were failing and the machines were barely able to keep her alive, yet every time one of the doctors or nurses started to broach the subject of letting her die, she just pulled back. She wasn't ready to have that conversation. So when I came on service, I first invited her to just join us in rounds and hear what the whole multidisciplinary team was doing with all the medical caring and had said, let's sit down later. So we sat down, she had her baby with her and she kind of spread out on a bench. So we really just listened to her, gave her a chance to tell her story, being a new mom how sad it would be for her to now be without her mother. As we talked and we cried together over time, she came to tell us, she understands how sick her mom is and we can't keep her on the life support. So the next morning, we let nature take its course and in many ways it was a really beautiful death with her family around telling stories, hugging and saying their goodbyes. One of the things that really helps with the emotional work that I do is having an amazing wife who's also a Kaiser doctor. We met in residency and the first month we were working together and we went on a mountain bike ride together and, you know, she was doing the switchbacks and didn't end over. A handlebars came up with a face full of mud and grass and a giant grin and I was just smitten. We were engaged five months later. Sometimes even at the dinner table with our kids, we're able to talk about our passions about quality and improving patient care. You know, I think that helps our kids, you know, be advocates and be more involved in, you know, their communities and really care about others.