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thank you for that kind reduction Jeff and I know each other for maybe seven eight years now since he was a medical student we worked on some projects together and I dare say that actually weamp;#39;re weamp;#39;re friends now is that right Jeff were you fair is that fair to say I think itamp;#39;s fair okay all right so we can disclose the disclose the truth so thank you all for coming Iamp;#39;m going to talk to you about how to keep up with medical information um hopefully we get into some interesting things Jeff said uh it was carte blanche to present you controversial stuff so weamp;#39;re going to have some of that in there too but hopefully you have some tips on how to keep up with reading the literature all right so this all starts with a case this is uh this is a real case this is really what happens in real life I was uh in clinic once and I was with my patient my patientamp;#39;s a 65 year old woman and she has multiple myeloma and she comes to the clinic visits with h