How a Young Guy from India Became A World Leading Surrogacy Physician

How a Young Guy from India Became A World Leading Surrogacy Physician


Dr. Said Daneshmand is an internationally recognized fertility specialist with extensive experience in providing third-party reproductive services. In his second year of studying medicine, he had a profound experience that changed his life forever.

Intro: You’re listening to the Australian Family and Fertility Law Podcast. Here’s your host, Stephen Page.

Stephen Page: Good day. I’m Stephen Page from Page Provan. And this is another podcast in our series, Australian Family and Fertility Law Podcast. And my guest today is Dr Said Daneshmand from San Diego Fertility Centre. You may have seen him recently in our webinar on Australian intended parents taking surrogacy in the US. Hi Said, how are you?

Said Daneshmand: Good day to you, Stephen. I’m doing well. It’s a Friday late afternoon here, so I’m excited for the weekend.

SP: And I’m spending my Saturday morning talking with you or a small portion of my Saturday morning. Tell me, you’ve been recognised by the American Society for Reproductive Medicine with an award I think for recollection, it’s a superstar.

SD: [laughs] Yes. It’s a Star Award. It’s actually an award that’s given to researchers who present original research at the Society for ten consecutive years. It’s a select group of researchers that have presented their papers, their original research at the Society for ten consecutive years. And really, it’s been an honour to have been awarded the Star Award now for several years. And it really just speaks to the dedication that we have here to research because it’s really through research that we can understand complex IVF cases more clearly, we can find solutions for the challenges that still exist in the few in vitro fertilisation, egg donation and surrogacy.

And it’s really a lot of fun to be able to perform research. And you almost act like Sherlock Holmes. You’re trying to discover something. And I think the more meticulous you are about really leaving no stone unturned, the more success you have. And I think that’s been reflected in the great successful rats that we’ve had.

SP: Well, let me just respond to that by saying, as you know, I’m a lawyer, not a doctor, which is always a good response when clients are asking about medical stuff. But it’s been around for 40 years now. Yes, it’s not as though it was embedded yesterday. Why do we need to do so much research?

SD: Well, you know, if you look at I’ve been in practice now 23 years. And when I started Practising IVF and started my career in the field of IVF, the pregnancy rates back then were somewhere in the order of 20-25% I mean, we were kind of getting closer the 30% mark. And these are with good quality eggs and embryo culture techniques that we had back then. Nowadays —

SP: Just to stop you there for a second. So that means that any woman coming to a clinic would have a three of four chance of not getting it?

SD: Exactly right. And IVF pregnancy rates have come a long way, and many of that has been a great deal to do with all the research that’s been done, all the publications of us, our colleagues, what we’ve really concentrated on is two aspects. Number one is, how do we maximise the quality of the eggs and the sperm that we use in the creation of embryos through our medication protocols, through the conduct of IVF, how do we select the sperm with the highest quality DNA so that it’s got the best chance of leading to a healthy delivery?

So that’s been one aspect of the research. And the second aspect is how do we make the uterus more receptive so that we’re transferring embryos into that window of implantation so that it has the best chance of implanting and developing into a healthy pregnancy? So when you now, we’ve concentrated the concentrated on these two aspects of IVF nowadays, with the transfer of a good quality embryo to an adequately prepared uterus, you’re looking at live birth rates of somewhere around 70% to 81%, a long way from those days of sort of 20% to 30% pregnancy and live birth rates.

SP: Well, that’s an extraordinary change, isn’t it?

SD: It is really.

SP: And it’s not, as you’ve said in receiving the award ten years in presentations about research that this is while research might go ahead in leaps and bounds, most of it is incremental step have to let this try that and keep trying so that you’re keeping innovating looking at new solutions for existing problems.

SD: Absolutely. Absolutely. I mean, and we’re trying to make also the IVF cycle for whether it’s for egg donors, for patients, easier to tolerate, with less risk, more safety and more efficacy. For example, one of the series of papers that we published was on the prevention of ovarian hyperstimulation syndrome, which can happen in patients who produce a significant number of eggs, typically in excess of 20. And it’s a complication that occurs in IVF and used to occur at a very regular rate in IVF. And through the series of papers that we published, we showed that using a different medication protocol to cause that final maturation of the eggs, we can actually prevent ovarian hyperstimulation syndrome.

And my last case of a very hyperstimulation syndrome, thankfully, was back in 2008.

SP: Because and what happens if a woman has ovarian hyperstimulation syndrome?

SD: Hyperstimulation syndrome can get serious because it’s really a sort of an accumulation of fluid within the abdomen. So this typically happens as early as about four to seven days after the retrieval of the eggs and they could be fluid accumulation within the abdomen. The patient can have problems with respiration. The ovaries are significantly enlarged. There’s something called intravascular volume depletion, which means that all of the sort of the volume of fluid within the vascular space pours out into the extra vascular space into that cavity of the abdomen.

So the patient actually almost becomes dehydrated and needs intravenous fluids. It could increase the risk of blood clots from forming. In very severe cases, patients can get hospitalised. It can damage their kidneys. It can cause kidney complications. So mild hyperstimulation syndrome tends to resolve quickly, but more moderate to severe. Patients can even get hospitalised. And this was something that didn’t occur infrequently before. And now it’s really rare because most clinics are using the protocols that we published on in regards to prevention.

SP: Wow. And you didn’t always live your life in San Diego?

Sd: No. No, I didn’t. Not in beautiful, sunny San Diego. You want me to talk about some sort of from the beginning from birth? [laughs]

SP: How did you end up there? Because no, now you’re with San Diego Fertility. You do. So this work, you help people have babies magical. But I’m sure, you know, you didn’t start there.

SD: I did not. And, you know, I’ve been really fortunate and blessed to have lived in three different continents, have been able to understand different cultures and really have a greater sensitivity to my patients and a greater bond with my patients. So I was born in Iran many, many years ago and lived there for the first 14 years of my life. And then right after the revolution there in Iran, we moved to England because my grandparents had lived there before. And so we moved over there and immigrated and lived there for several years.

And it was in England, really, that I’d learned how to speak English. And I was fortunate. I went to a great school. I remember guilt for a grammar school. And they also taught me German and French.

SP: Which I couldn’t learn. If you couldn’t learn English in England, I probably wouldn’t. [laughs]

SD: That’s exactly right. The Queen’s English in England. But my time in England was wonderful because it was again, a different culture. And, of course, initially was a culture shock because here I am not even speaking a word of English and get thrown into school in England. And Thankfully, I was able to learn English fairly quickly and really assimilate into the English culture fairly quickly. And before I came to the United States I had a very thick British accent, which I lost very quickly after emigrating to the United States.

So after having lived in England for a few years, we moved to Los Angeles, which at the time was sort of not as cultured a place as it is right now. There weren’t as many sort of cultural venues and as rich as they were back in England, I went to finish my high school there. And then when did my undergraduate studies at University of California in Los Angeles to UCLA. And it was at UCLA that I got a job making extra money. I worked in a research lab that did a lot of research on cardiac transplantation, heart transplantation.

SP: Just before you talk about that, when you went in to study medicine, did you have any idea that you would be doing what you’re doing now?

SD No. No idea at all. I fell in love with medicine in general in my undergraduate years, my University years. And then when I went to medical school, I met a fertility doctor and her bond with her patients and her ability to be able to help them have a family just completely inspired me. And it was at that moment I knew I wanted to be a fertility doctor. There was no doubt in my mind that’s what I wanted to do. And it was fairly early on the medical school.

In the second year of medical school, I had exposure to fertility. I felt that from a sort of a reproductive in technology and hormone perspective, it was really intellectually challenging. And then to be able to sort of give the gift of family to patients. That was amazing. What better profession can you be in where you have that bond with your patients and able to help them have their families? So that’s when I decided I wanted to be a fertility doctor and apply to different programmes, was able to actually get into UCLA.

I actually graduated from medical school, devout Victorian. My medical school class, which allowed me to really have my choice of where I wanted to go for my residency and fellowship and became a fertility doctor after spending six years training at UCLA and started my career in Las Vegas at the fertility centre in Las Vegas. And I moved there because there was sort of a posity of fertility care at that particular time in Vegas and the population was growing very rapidly. And also I met a colleague there that I felt was terrific in terms of his love for research and for academics.

And, you know, we really bonded and melded. Well, and then we became partners and I spent the next 17 years in Las Vegas is building a practice and then building an international practice, helping many, many intended parents around the world and in Australia and New Zealand and Europe and South America. So that’s where I sort of where my foray into the international world came about. It was in Vegas and indeed.

SP: In Vegas is Oracle. It at least one occasion your best man as well.

SD Yes. I had the honour of being your best man in Las Vegas when you and Mitch came in for your wedding. And that was a great honour. I mean, I never forget that day. Rich was there in Kim was there and then you and Mitch and it was a special day. And I never forget, actually, that as one of my gifts to you, I decided to sing a song for you. If you remember.

SP: Well, and it’s one of those surprising things. I didn’t know that you could sing up a that I have the singing skills of actually, not as good, of Homer. Simpson, if you sing in tune and I always forget to get the words that you have not only a passion for helping others, but somehow you have a musical side that was I knew nothing about until that special moment.

SD: Well, thank you. You’re very kind because, you know, I love to sing, but just usually typically in the shower, I don’t want to hurt anybody’s ears with my singing. But, you know, music has always been a solace. You know, for me growing up, I remember, you know, going through some tough times, you know, really financial hardship when we left for England and then from there to the United States, I think my parents had gone through a great deal of financial hardship because of this sort of the change is and in venues, and my dad wasn’t able to practise his dentistry.

So we were under a lot of pressure financially. And I always found that music was a great solace, great escape, a de-stressor, as it were. And then later on in life, I think when I would turn 40, I decided to play the guitar. I just always loved music. And I said, you know what? I haven’t learned an instrument. I really couldn’t afford to learn an instrument before. Let me learn how to play the guitar. And my daughter came to me and said, “Dad, and you’re too old to play the guitar.”

And I said, you know what? I’m gonna show you, because every time somebody tells me I can’t do something, it’s just that extra drive and energy and inspiration for me. So several years later, that same daughter, I was maybe 11:00 or 11:30 at night, and I was just practising my guitar. And it was just improvising and playing well at the time. And my daughter comes behind me goes, “Wow, you really know how to play.” I said, “Well, you inspired me to play. So that’s how I learned how to play the guitar.”

SP: If we just talk about what I saw from you, no doubt, wonderful guitar playing. If we talk about your work, you have a passion for helping people. This is what drives you day in, day out.

SD: Yes. Yeah, I really do. And I connect with my patients on a deep level, try to understand the suffering they’re going through as a result of infertility, as a result of not being able to have the family that they want. And for me, that drives me, it’s the spawn that you create. And, you know, being emotional to me helps because I can understand their emotions and having sort of grown up in different continents, being able to connect with different cultures, the greatest joy that I have are the days when the surrogates come in for their pregnancy tests and the pregnant test is positive.

I feel wonderful for the surrogates because they have achieved their goal of helping someone. And I feel wonderful for the intended parents. It’s just an incredible moment. And I have devoted my life, my career, to helping intended parents create their families. And that’s going to be my legacy. And I’m committed to it. I’m married to it. I’m devoted, and I enjoy it. It’s something that drives me. And it’s it’s something, according to my partner says, it’s one of the few really good things that you do.

SP: But two things that struck me about that. With what would you just said. That you, you at university when you are doing your medical degree, that you wanted to assist people to have children. And how come you knew that that was the course as opposed to, for example, being an orthopaedic surgeon or a neurologist, because they got people too?

SD: Of course, absolutely like to tell people I agree with you. I think it was just that bond that’s created when you help someone have a family, it’s sort of forever bond. There are many professions in medicine where you help someone with their, like you said, with their knee trouble with orthopaedic pain, and it’s a little bit more transient. But helping someone with a family is forever because I have intended parents who have parents who have 19, 20, 21-year-olds who I keep in touch with. And we know we share photos with one another, and I feel like I it’s just so emotional.

They send me notes and telling me that I’m in their hearts forever and I changed their lives forever. And you create the help create their children and help create uncles and grandparents. And they are in my heart. So I just felt that that bond and that connection with intended parents and with patients, it was going to be something that I was really going to enjoy. And having done it now for 23 years, I’m still as energised by it and as passionate for it as I ever was.

SP: Which is absolutely wonderful. I was thinking before, at least in my game, there are people who do the job as lawyers. They should really do something else. They’re unhappy with it, right? You should only do something you actually love doing. I love helping people have families. And of course, all I’m doing is guiding them in the right direction, making sure that the paperwork is done right, the laws are complied with, etc. But I’m not doing the magic in the lab that you do.

SD: It’s incredible. What you said is so poignant in regards to you’ve got to really be passionate about what you do. And you and I both help future parents in different ways. But really, what we’re doing is we’re creating a path for them to get to their dream of becoming parents. And as a father of three daughters, I understand the love of children, love of family. I mean, when I get a text from my 20-year-old who’s now in university, so my heart sings when I get a text from her and says, “Dad, I miss you. I love you. And call me later today. I want to just give you an update on what’s going on with me.” 

And it’s every phase of this journey as a parent is beautiful. And I want the same for my intended parents for my future parents. So I’m gonna work diligently and tirelessly to help them achieve that goal.

SP: As I say to my clients, heaven and Earth in him to get there. And the other thing that you’ve identified was pain, that there’s often this pain and sorrow for those who are going through this process because no one will ever want to go through IVF unless they absolutely have to, right?

SD: Absolutely. There is pain. It’s the pain of not being able to conceive, not be able to have your family. I think, yes, as a doctor, you are trained to use all your intellectual and sort of dextrous skills to be able to help your patients heal or help your patients and create their families. But I also think there’s an emotional component there. And I also want to be there for them to help them emotionally through the process as well, to give them hope, to tell them that, you know, here is we are going to do everything possible to help you reach your goal.

And success is our purpose, and we’re going to get there. There are going to be sort of times when we are going to have disappointments, but I just don’t want them to get discouraged because the overwhelming majority of intended parents of patients who start this journey are successful in having their families. And when they look back, they always tell me, “I’m so glad you didn’t let us give up. We’re glad that you were there supporting us. And you said, you know, we’re going to get there and we needed that hope in order to be able to move forward and take that other step rather than sort of give up on our dreams of having a family.”

SP: And that’s certainly what you say. What you say absolutely resonates with me because I’m certainly what I say to my clients is when, not if, you’ll become parents. Yes, it was a certain journey. And, of course, as a lawyer, I have to say, well, there are some exceptions, but there is some certainty of getting to the other end. And if things go right or if you are resilient, if you’re determined, you’ll get it.

SD: Absolutely. And that’s why you have to be committed as a doctor, as a lawyer, you have to as a physician, I feel that I have to do everything possible, direct all of my energy and my sort of intellectual energy into helping them find solutions to get to their goal of becoming parents. I owe it to them. This is a commitment that I’ve made. It’s an oath that I’ve taken, taken, and I’m always going to be there for them. And that’s why when I meet with intended parents, I let them know I’m available.

I give them my mobile number. I tell them if you want to reach me via WhatsApp, anytime, seven days a week, you can contact me because I want to be there for you. I know sometimes you need to have an answer more quickly. You need support. You need to be able to reach someone and please contact me. I’m gonna be there for you.

SP: One of the things you were talking about before is how success rates with IVF cycles have gone up. And earlier on, there was about a one in four chance of becoming pregnant through IVF. So. But as I said, three of four chances of not getting there.

Often with IVF there is. And it’s wonderful that there’s success rates are so much higher. But there is this roller coaster of emotions, isn’t there? Filled up your expectations. We’re going to get there are going to get there, and then you come crashing down the other side. I’ve certainly seen I think the highest number of IVF cycles I’ve heard about in Australia was 38 before the woman became pregnant. Right. And what I reflected upon when I heard that number was, these people are going to be roadkill.

They’ve gone through such a hard journey. And I wonder whether the doctor in question ever said to them, have you thought about doing it differently? Have you ever thought about surrogacy, for example, or egg donation, rather than using a, you know, the same approach of hitting your head against the wall and then wondering why your head hurts and not actually achieving anything?

SD: Absolutely. I think it’s so incumbent upon physicians, you know, the way I approach it as well as incumbent upon us to really look at and dissect the sort of the IVF journey and find out exactly what’s going on that’s preventing the patients from achieving success. Oftentimes when I consult with patients around the world, I ask them to send me all their medical records, you know, their IVF records, because many of them have gone through multiple IVF cycles, embryo transfers without success. And what I do is I go through those records in a meticulous fashion to find out exactly what the diagnosis is, because oftentimes it’s a patients are told, “We don’t know what’s wrong. Everything looks to be fine, but it’s just not working.”

SP: But that’s not good on, isn’t it? It’s common is now for doctors to say it’s undefined infertility, and it’s for my clients. This leaves them in a lot of pain because we’re told everything’s great until I try, and then nothing works and we’ll try this. We’ll try that. And again, nothing works.

SD: And really, Stephen, you’re so right. There always is a diagnosis. It’s just a matter of how meticulous you are in trying to find it. That’s why I love these Sherlock Holmes novels, and especially on the screen these days. It’s because you just have to dig deeper. You have to look further. You have to look at exactly all aspects of the IVF cycle and you will arrive at a diagnosis. If you have the background, the knowledge, the research, experience, then I feel confident that on every IVF cycle, I can arrive at a diagnosis as to why the patient was not successful.

And when you arrive at that diagnosis, then that’s the key to open that door to success. Otherwise, you’re just trying different things at random and hoping for a different result. You want to give the patients a clear diagnosis, a reason as to why the cycle is not working, and then find a solution and target that particular issue so that you can open that path to success.

SP: And for many years now your practice of IVF work if has been helped by surrogates.

SD: Yes.

SP: These magical women who enable other people to have children. Tell us about surrogates what it’s like to work with surrogates day in, day out.

SD: It’s really inspirational. I mean, I really tip off my hat when I do an embryo transfer to a surrogate, I just put my head down and I thank them and tell them how amazing they are, that they are sacrificing so much to be able to help someone or a couple have their dream of having a family. Surrogates are amazing women. They are women who look at the pain of intended parents and future parents of not being able to have children. And they look at themselves and say, you know, I have been blessed to be able to have healthy pregnancies, enjoy my pregnancies.

You know what if I could help someone else, and that’s the ultimate sacrifice in terms of being able to help a couple or help someone realise their goal of becoming parents? I have so much respect for Stargate. I take care of of them every day. And there’s not a day that passes in my life in my career that I’m not either doing a screening on a surrogate, doing a transfer on the surrogate, speaking to a surrogate on the phone. And I always tell them, you are amazing without you, this is not possible.

This journey is not possible. None of us can do what we do without your help. And my goodness, you have helped to create grandparents, parents and so many so much happiness with what you’re doing. So much respect their VIPs, their amazing, amazing women.

SP: Extraordinary women, aren’t they? Say that they find it easy to get pregnant. They have straightforward pregnancies and childbirth and then say, well, because I’m like that. And I know that there are always people who can’t have kids, that I’m going to go ahead there and help someone who can have kids.

SD: Yes, absolutely. And I think to that regard to sort of a similar extent to egg donors as well. I work with egg donors every day with egg retrievals, taking care of them, screening, monitoring them for their Follicular development during the IVF cycle. And I tell egg donors to you, you are helping create a family. Thank you. Thank you for what you’re doing. It’s not both of these actions.

SP: I’m sorry. Both of these amazing groups of women, and egg donors and targets potentially put their laws on the law and brothers.

SD: Yes, absolutely, absolutely. I mean, pregnancy, whilst in the overwhelming majority of instances is uncomplicated and proceeds smoothly. There are risks, and we always talk about those potential risk during pregnancy. And so they are putting their health at risk when they acquiesce to becoming surrogates. So I do think that there’s just so much respect and love admiration we have for surrogates and for egg donors as well.

SP: And one of the things that Australian policy make, as politicians have put forward, is a fear that egg donors and surrogates have been commodified in some ways. There seems to be this innate fear. And so as a result, in Australia, we have these very strict laws about surrogates and egg donors, and then it has the flow on effect that there aren’t enough surrogate and egg donors in Australia. So intended parents go somewhere else, such as the United States. What do you see? What do you see? Do you see that your surrogates and egg donors are commodified in any way?

SD: Not at all. You know, they are doing this. It’s a voluntary basis, meaning that surrogates seek out to become surrogates. They’re represented by attorneys. Their rights are represented. They’re given all the information about the risks of pregnancy, about the risks of every aspect of what they go through. They’re making personal choices, independent choices. They’re consulting with their partners to find out if their partners are supportive. You know, they have children. They talk to their children about what they want to do and how they want to help someone.

So I think that if you have a great deal of respect for surrogates, if you are taking care of them kindly, if they’re making their own decisions, independent decisions? Yes. They’re being compensated for the pain and suffering they go through as they go through the entire process. Many of them have to take time off from work because sometimes there are reasons for surrogates to have to have a bed rest or some time off from work when something happens during pregnancy, whether it’s high blood pressure or premature contractions.

So there’s a great deal of sacrifice and they’re compensated for it and for the expenses, and they have a compensation. But this is they are doing this from the goodness of their heart and independently. No one is forcing them to be surrogates. They are seeking out agencies and intended parents to be able to help them in a journey to becoming parents. There’s no duress involved, no Duress involved?

SP: No and they have their own lawyers on the way through.

SD: Yes. They have to have you know, if you’re in a legal structure in which the surrogate is represented independently from the intended parents, and there’s this very discipline and strict legal structure and you have it from a medical standpoint here discussing all the risks with a surrogate, then really they’re making informed decisions as to being a surrogate. I think in that environment, then no, there is no dress. There is no exploitation commodification. You have to just do it in a very structured, legally disciplined way from a talking from a legal point of view.

SP: Each surrogate who comes to see you, an egg donor who comes to see B or patient.

SD: Exactly right.

SP: Do you have a duty of care to them?

SD: Absolutely. Every egg donor, every surrogate. And I always tell my team, Eg, Doris and surrogates are VIP patients because they’re doing this for someone else. So absolutely, we take care. They’re my patients. I give my surrogate and Mic donors my mobile number and say, you reach me if you need me. If there’s any issues, you have questions, you have concerns. Give me a call. Send me a text. Call my team. There are patients and we have a duty to take care of them and make sure we ensure their health.

Part of it starts even with the screening process. We do because we want want to make sure that we’re not putting the surrogate’s health at risk. If there are underlying medical conditions that then caused a surrogate to have a higher risk of complications, then we let know that unfortunately, it’s just too risky for them to become pregnant. So that screening process, the more meticulous you are about screening them and reviewing their medical records to ensure that if they had a previous complication, there could be a recurrence.

And so perhaps that’s not the best idea for them to be pregnant. Again. We want to protect their health from the very beginning. If they’ve had uncomplicated pregnancies and they meet all the criteria of a healthy surrogate, then yes, they can move forward. Why? Because the risks then become minimised. But it all starts with screening. You want to make sure to protect their health. That’s of paramount importance.

SP: Some final words, final words of wisdom, because we’re running out of time and you have a very busy day and have other stuff to do. Some pearls of Wisdom for those who are looking at becoming parents, what would your pearls of wisdom be?

SD: I think my personal wisdom is you educate yourself about all aspects of this. Don’t hesitate to seek second opinions when you’re going through a particular treatment and it’s not working. The world has become much smaller. With all the video consultations and zooms and Skypes. You have access to the best health care providers, doctors, nurses around the world. Don’t hesitate to do your research and due diligence in achieving your dream of becoming parents. And then once you are parents, the Pearl of pearls of wisdom are educate yourself about how you can be the best parents that you can be.

Every phase of this journey of being parents is different. And for example, when my teenagers became teenagers, I try to read a few books on teenagers because there are changes that occur with them, and I want it to be more aware of the emotional changes and some of that sort of independent seeking behaviour that they have when they become a teenager. So do your research. Become as educated as parents as possible. And then also in your journey of IVF and becoming parents, leave no stone unturned.

You have access to the best physicians, best doctors around the world. So that’s why, I would say is education information. And certainly having had three teenagers, you can also give me a ring and I’ll give you my words.

SP: Thank you. Thank you for joining me today on The Australian Family and Fertility Law Podcast. Thank you very much.

SD:  It’s been my pleasure. Thank you, Stephen.

SP: Thanks, Dan. For me. This is great.

SD: Thanks. It was awesome.

SP: That was wonderful. And I was just thinking about you being an Iranian in England and having to learn English there. There was a Homer Simpson T-shirt ages ago. England would never have to. Why would I ever have to learn English? I never go to England because you learn English with an English accent and everything. And then hit the United States to go to La, of all places in this kind of.

SD: Exactly. Right. And I remember when the first actually was in the US in LA. I was in the elevator. I think I was moving something up to our apartment. And this girl came into the elevator and says, Hi. I said Hi, and I said Hi because the English way is not just you just start a conversation with someone who’s a stranger and to say Hi. What is you know, you say Hello. So that was my first foray and interaction with the American culture with the girl in the elevator who said Hi.

SP: Wow.

SD: These people are very warm and very welcoming.

SP: Well, you’re warm and welcoming. You have to do some more work, I presume I’ll go home.

SD: Well, it’s been lovely being with both of you and lovely questions. And I love the interaction. Sending lots of hugs to you, Stephen, and look forward to more working with you.

SP: Likewise, my friend, that I hope that before long, we actually see each other again.

SD: I hope so, too. Absolutely. I would love it.

Outro: Thanks for listening. If you have any questions, please don’t hesitate reaching out to Stephen at

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