Louisa Smith, MS is an epidemiology PhD student at Harvard who was diagnosed with stage 3 breast cancer at age 28. After a year of chemotherapy, surgery, and radiation, she now has no evidence of disease! On this episode, Louisa talks about her treatment, quantifying and graphing her own data, joining a randomized trial, and thinking about her future and how she wants to spend her time now. Louisa tells me about a Modern Epidemiology textbook-yearbook, an outhouse race she won, and choosing her PhD program based on the outcome of a basketball game. Louisa is delightful, and her story is so uplifting!
Louisa Smith, MS is an epidemiology PhD student at Harvard who was diagnosed with stage 3 breast cancer at age 28. After a year of chemotherapy, surgery, and radiation, she now has no evidence of disease! On this episode, Louisa talks about her treatment, quantifying and graphing her own data, joining a randomized trial, and thinking about her future and how she wants to spend her time now. Louisa tells me about a Modern Epidemiology textbook-yearbook, an outhouse race she won, and choosing her PhD program based on the outcome of a basketball game. Louisa is delightful, and her story is so uplifting!
Lisa Bodnar:
I'm Lisa Bodnar. Thanks for being here. Today, I'm really happy to share with you a conversation I had with Louisa Smith, an epi PhD student at Harvard. Louisa was incredibly generous to share her story of a diagnosis and treatment of breast cancer on this episode. If hearing about cancer is uncomfortable or triggering for you, maybe this isn't the episode for you. When Louisa learned about her breast cancer in February of 2018, she was only 28 years old. She was diagnosed with stage three breast cancer, which was ER+, meaning that it has estrogen receptors, PR-, which means it does not have progesterone receptors, and HER2+, which means it makes extra growth factor protein. The receptor status is important because although this subtype of breast cancer is particularly aggressive, it means that alongside standard chemotherapy, surgery, and radiation, it can also be treated with hormone blocking drugs, as well as newer targeted antibody therapies, which makes for a good prognosis.
Lisa Bodnar:
Louisa describes herself as an open book when it comes to her cancer. She describes in our conversation why sharing her story is important to her. I'll tell you that although this episode is largely about Louisa's cancer, it's really uplifting. She has such a positive outlook, and that translates into how she talks about her experience. Louisa allowed me to read a blog that she's written the past few years. It includes lots of photos and she is smiling and almost all of them, and I think it's safe to say that it's a genuine smile. She interlaced her stories with really funny tidbits, videos and photos. One was a slideshow of her hair loss and return, and below that was a series of her Bitmojis that she created that went along with these changes. It was hilarious and amazing. Today, Louisa has no evidence of disease and she's finishing up her dissertation. I hope you enjoy the show.
Lisa Bodnar:
Hi, Louisa.
Louisa Smith:
Hello.
Lisa Bodnar:
It's so great to meet you.
Louisa Smith:
Nice to meet you too.
Lisa Bodnar:
So, you wrote this wonderful blog during your treatment and even now, and you generously allowed me to read it to prepare for today. So, thank you for that trust.
Louisa Smith:
You're welcome.
Lisa Bodnar:
You've gone through so much in the last three years and you very succinctly quantified what happened to you in the last few years? Could you read it?
Louisa Smith:
Yeah. So, I made this list trying to capture a lot of the experiences that I had been through. I think I made it a year after my diagnosis, so it's not entirely up-to-date.
Lisa Bodnar:
We need an erratum.
Louisa Smith:
Yes, exactly. So, I went through 16 rounds of chemotherapy, two major surgeries, and two more minor surgeries. Over three weeks of daily radiation. I ended up having 17 antibody infusions in addition to the chemo. At the time I had gotten 13 hormone suppressing injections. These are things that I get every month. So, it was a year and a half ago, so more than that now.
Lisa Bodnar:
More.
Louisa Smith:
I kept track of all of my appointments on a special calendar and at this point, one year into it, it was up above 100, over 1,000 pills. And then, I also kept track of some of the more academic things that I was doing alongside of my treatment. Two written qualifying exams. I completed five classes as a student and two as a TA. I wrote two first author papers and then-
Lisa Bodnar:
That were published in Epidemiology, which is exciting.
Louisa Smith:
Oh yeah, that was included. Yes, it was very exciting. And then, the less exciting things where I counted at least four crying spells at school, in public, in my office, or in the classroom, or in the student lounge, and at least 20 naps on the floor, usually right behind my desk. I stole a bean bag from the student lounge to keep there. So, I ended up collecting a lot of data. I mean, obviously I'm a data nerd and epidemiology, but I've always enjoyed collecting data on myself. So, one reason I did this was to just keep track of my symptoms. So, alongside this list of numbers that I presented, I have kept track for example, of the hot flashes that I was having for a while, just installed a little button on my phone so I could keep track of those and graph those and present them to my doctors.
Lisa Bodnar:
Were they asking you to keep track of that or some of the symptoms?
Louisa Smith:
They asked me every time like, "Oh, how are your hot flashes? Are they getting better? Are they getting worse?" And I did start a drug to try to help make them better. And so, I wanted to see if that was actually working and have something to tell them.
Lisa Bodnar:
That's awesome.
Louisa Smith:
When you have surgery, certain types of surgery, and you need to have fluid drained after the surgery so it doesn't build up, they send you home with drains to drain that fluid. And so, they do ask you to keep track of the milliliters of fluid that drain off your body every six, 12 hours. So, they send you home with a little sheet and want you to hand write how many milliliters of fluid and maybe the color or something.
Lisa Bodnar:
You're like, "Dude."
Louisa Smith:
Yes.
Lisa Bodnar:
Dude.
Louisa Smith:
I don't hand write anything, that's too subject to error.
Lisa Bodnar:
Totally.
Louisa Smith:
It's all going inside R, where I can keep track of it and make some really pretty graphs and do some analysis of the change over time and see whether the slopes changing. So, I presented that to my doctor and that was much appreciated.
Lisa Bodnar:
Yeah. Was he like, "I've literally never had a patient like you."
Louisa Smith:
Yeah. Yeah. They may think I'm funny. I gave them to the assistant who was in charge of deciding whether or not to take out the drains first. And she was like, "I do not know what to do with this." They promised that they would take them out when it was, I think, under 20 milliliters per day or something. So, I just graphed the rolling average over a 24 hour period. Said look, "This drain is under 20 milliliters. Take it out of me."
Lisa Bodnar:
What were other things that you graphed?
Louisa Smith:
So, I went into my insurance account online and scraped the data for all my insurance claims. So in 2018, my hospital charged $639,000, of that my insurance company only paid 226,000. Luckily I did not have to pay the rest.
Lisa Bodnar:
So, how did keeping track of this data help you over the course of that year?
Louisa Smith:
It just gave me something to do and something to play with and something to learn more about. So, that was helpful, and that it was fun. I have forgotten some things that happened over the course of the past two and a half years, and I don't know whether that's due to my chemo brain or just time passing or to trauma or whatever it might be. But it is good, I think for me to look back and remember. I originally posted a bunch of these graphs on Twitter last year, around this time, because it's October, Breast Cancer Awareness Month. There has been a lot of backlash, especially from the metastatic breast cancer community about how we're pumping all this money into making sure that people are getting mammograms and there's not as much money in terms of research for prolonging people's lives. Putting my treatment experience into a more visual format helps people understand, even when we're looking at this big population problem, because breast cancer is a big population problem, this is how it can affect individuals’ lives. And so, I think that was a useful to way to share this experience.
Lisa Bodnar:
Has it affected your view of epidemiology, how you actually do your work?
Louisa Smith:
I do remember right after my diagnosis, looking at a survival curve and feeling a way about a survival curve that I never felt before. I've looked at a lot of survival curves academically and thinking of me being on that survival curve and where I might fall was definitely a different feeling. It's been interesting trying to balance my beliefs about population health with individual health. So, I'm in a group of young people with breast cancer, and a lot of times people will write in our Facebook group or advocate for the age at which to start mammograms to be a lot younger or, why are know why are these 30 year olds not getting mammograms? And I know epidemiologically, it makes absolutely no sense for us to give 30 year olds mammograms. That's just not an effective thing to do in terms of population health, but I also understand why on an individual level people would say, "Oh, my doctor denied me in a mammogram and then I turned out to have breast cancer a year later, why didn't they give me a mammogram a year ago?"
Lisa Bodnar:
You were in an RCT during your treatment. I think that every epidemiologist should be in an RCT at some point in their lives, the earlier the better, what was it like and what surprised you?
Louisa Smith:
So, it was a trial for radiation and my radiation oncologist is just wonderful. He does a lot of research. So, the way he explained it to me is that for lumpectomies, radiation is standard of care. So, you cut out the cancerous tumor and then you blast the breast with radiation to try to kill everything else around it. For people who have mastectomies, radiation is not standard of care if the cancer has not left the breast, because the idea is like, okay, if you just have a mastectomy, you cut out everything, it's gone, we're good. And studies have shown that lumpectomy with radiation and mastectomy have the same survival. So, due to the specifics of my tumor and how far it had it spread, I had to have a mastectomy and radiation.
Louisa Smith:
They have done studies of lumpectomies of two different treatment strategies. One is high dose radiation for fewer days, and the other one is lower dose radiation for longer days. And the traditional treatment in the US is lower dose radiation for longer days, and then in maybe Canada and the UK, it happens to be higher dose, shorter days. And so, they have done studies comparing these in lumpectomy patients, comparing survival, all great, they're basically the same, but also comparing aesthetics. Radiation can really damage the skin. It can shrink the breasts. It can do all these changes. So, they've done these studies in lumpectomies, but had not yet done them in mastectomies. So this trial was comparing a course of radiation that would last 25 days versus a course of radiation that would last 16 days. And the only difference basically would be that you'd get a higher dose in the 16 day one, which is not currently standard of care in the United States.
Louisa Smith:
If I didn't do the trial, I would have to do radiation for 25 days, which is really annoying. If I was randomized into the intervention arm, I would get to only do it for 16 days. So, I decided that was really what I wanted to do. And I remember he called me later that day and was like, "Great news, you've been randomized into the intervention arm." And I was like, "Oh, this is so exciting. I get to shorten my treatment. I get to try something new that will hopefully ..." You mean, hopefully the results from this trial are great and that this can be offered to more people because it's a huge inconvenience. And it's also just really annoying to go into the hospital every day and change your clothes and lie on this piece of metal and have these big radiation machines, I don't know the terminology, aiming at you.
Lisa Bodnar:
Does it take a long time, the procedure itself?
Louisa Smith:
No. It only takes like 15 minutes. Since my cancer is on my left side, it's right near my heart, so you have to do these special breathing things, which are really ... It's really scary, the idea that there's this something that you can't see that's aiming for something that could hit your heart but if you breathe in this certain, certain way, it won't hit your heart.
Lisa Bodnar:
Whoa. Wait a minute, how do they trust that people are going to breathe right?
Louisa Smith:
So, they have this thing on your chest, and different radiation facilities do this differently, that sees when your chest is up and down and then the technician guides you through it and says, "Okay, big breath in and then big breath out." So, they do only shoot it when you're breathing in the correct way.
But it's a little bit stressful being like, okay, if I just breathe out suddenly everything's going to go wrong.
Lisa Bodnar:
Or like, "Did I hear you right? Oh my gosh, did she say it? I missed it."
Louisa Smith:
And sometimes they kind of yell at you for doing it wrong and breathing too deeply or too shallowly, and I'm like, I can't even get this normal human thing right.
Lisa Bodnar:
And you were doing this so often, right?
Louisa Smith:
Yeah. Yeah. Exactly.
Lisa Bodnar:
It wasn't just once. You were like, "Oh my God, I screwed it up on minute eight before, I can't do that again."
Louisa Smith:
Yeah. And another reason to participate in this study is that they were giving a $50 gift card for each six month follow-up.
Lisa Bodnar:
Nice.
Louisa Smith:
So, I was like, nice, great, $200-
Lisa Bodnar:
I'm a student.
Louisa Smith:
Yep.
Lisa Bodnar:
Totally.
Louisa Smith:
Long story, I became ineligible for the trial after I'd already gone through it. So, my doctor was like, "Oh, do you want to just drop out?" And I was like, "No."
Lisa Bodnar:
No.
Louisa Smith:
You need to keep this data on me, it's still very important.
Lisa Bodnar:
You're like, "Do you know me at all?"
Louisa Smith:
Yeah, I'm not dropping out. Also, I want that $50 gift card.
Lisa Bodnar:
Totally. Did they have results?
Louisa Smith:
Not yet.
Lisa Bodnar:
You wrote in your blog about this amazing gift that your friends gave to you early in your treatment, right? Could you talk about it? This was so uplifting for me. It just made my heart sing.
Louisa Smith:
Yeah. So, this was pretty early after my diagnosis and I got this big box from my friends from Berkeley where I did my masters. And I opened it up and there are some socks and warm hats and just all these lovely comforting things. And then, digging a little deeper, there were some treats from the Berkeley Bowl, which is the best grocery store in Berkeley. And then, I get to the bottom and there's a copy of Modern Epidemiology.
Lisa Bodnar:
Which edition?
Louisa Smith:
Third.
Lisa Bodnar:
I feel like we need to clarify.
Louisa Smith:
Third.
Lisa Bodnar:
Third edition. Okay.
Louisa Smith:
I mean, I already own Modern Epi, version three. So I was like, what is going on? Do they think I don't own this? And at the time I had been complaining that I wasn't studying ... Or not complaining, but just pointing out that I wasn't studying for my qualifying exams because this diagnosis had happened right after I had started studying. And so I was like, Oh, they're really worried for me, and really want to encourage me to study, and think that sending me this book will make me do it. And then, so I noticed that there were little sticky notes poking out of some of the pages. And I was like, okay, these are the things I'm going to have to memorize for the qualifying exam, and then I open it up and it's this really sweet kind of yearbook that they've written for me.
Louisa Smith:
Some of my friends there had ... Both people that I know and went to school with, as well as some of the new students who don't even know me, the administrator that I knew, people signed this and had really a lot of nice things to say, just letting me know that they're thinking of me. A lot of them are inside jokes that I shouldn't share on a podcast.
Lisa Bodnar:
Sure. Yeah.
Louisa Smith:
But one that I found really sweet was one person who wrote that their introduction to epi was in fall of 2015 with you as my GSI, what they call it TA at Berkeley. "Now I'm a first year in the PhD program and I have you to thank. Thank you for teaching me about two by two tables with such enthusiasm and kindness." So, I thought that was so sweet.
Lisa Bodnar:
Absolutely is.
Louisa Smith:
I inspired somebody. Yeah.
Lisa Bodnar:
Yeah. What a lasting mark you had. That's super cool.
Louisa Smith:
Yeah. My old advisor wrote in it about you've got the causal diagrams chapter marked up. So, it was just a really ... I don't know, a really sweet way of sharing some inside jokes and some experiences we had together, as well as just created a memorable little book for me to have. It also meant that I got to keep one of my copies at my office and one at home. So, I always could reference Modern Epi when I needed it.
Lisa Bodnar:
It's critical.
Louisa Smith:
Yeah.
Lisa Bodnar:
It's critical. Tim Lash would be very happy about that.
Louisa Smith:
I'm sure. I had this conversation with one of my advisors after ... or in the middle of treatment. I had told everybody at school, this was clearly not a secret. I was completely bald and was in and out. But I had a conversation with him where I was like, "How open should I be about this when it comes to professionally?" Because it's definitely a risk for anybody with any kind of disease or disability to be open about that because it is held against people. And I didn't want people to think that I would be a liability or think that I was going to keel over at any moment. And so, he obviously left it up to me totally, but suggested that people in our field and public health in general are ... He didn't think that it would be a problem for me to let people know that this had happened, which I was glad of.
Louisa Smith:
It would have been hard for me to keep this to myself. And I'm also ... I think sharing it hopefully can help other people feel more comfortable with aspects of their health or with sharing difficult things that have happened to them during their PhD. Like when I am teaching, I try to make it clear to students that if they have something that's going on, that's preventing them from turning in an assignment or something like that, that that's very understandable because I also came to points when I was just like, I actually cannot do this homework. And I have never felt like that before in my life and it's just a totally different feeling.
Lisa Bodnar:
Yeah.
Louisa Smith:
Yeah. I mean, I also just ... I don't know, it's something that was really hard and challenging and I'm proud of the fact that I made it to the other side and still, hopefully, fingers crossed, will complete my PhD soon while going through all of this.
Lisa Bodnar:
Yeah. When would that be maybe?
Louisa Smith:
Sometime in the spring. January ... January or May.
Lisa Bodnar:
That's amazing. Yeah. How is your work going?
Louisa Smith:
It's going well, there have been a lot of setbacks.
Lisa Bodnar:
Sure. Always.
Louisa Smith:
Partly due to cancer, partly just due to data-
Lisa Bodnar:
Research.
Louisa Smith:
... availability and things like that. But I think I'm hopefully in a good place to graduate soon.
Lisa Bodnar:
That's awesome. That's awesome. Congrats.
Louisa Smith:
Yeah. Thanks.
Lisa Bodnar:
You're almost there.
Louisa Smith:
Yeah.
Lisa Bodnar:
So, speaking of that, I was thinking about how, when you're training for a career, you're always thinking about the future and I'm sure that people in your cohort were also talking about their graduation, their defense, where they were going to go next, their five-year plans. How was that impacting you?
Louisa Smith:
At first, it was definitely really hard to even hear anybody talking about making plans. I mean, the first thing that happened was that I had to cancel all of my plans basically for the year of treatment, that I thought would help my career. And all these things are suddenly things that I can't do. It's really hard to travel when you're getting chemo every week. And so, that was really hard, also just the idea that I'd ... Didn't know whether, at first, whether I'd get to have a career. So, that was definitely difficult. So, it was hard to hear people talk about some things, but it also made it a lot easier for me to plan for my future in some ways, because I decided that I was done doing anything that I didn't enjoy or get some kind of personal satisfaction out, just for the sole purpose of it being good for me or helping me in the future.
Louisa Smith:
So, I think I was working on, at the time of project, in SAS and I hate SAS, and I was just like, there's so many more interesting things that I want to work on, that's over.
Lisa Bodnar:
Bye-bye.
Louisa Smith:
And I've tried to keep that mentality for better or for worse. I don't care. I'm going to do what I like. There's plenty of stuff for me to do. And so, who knows what will happen in the future and if I'm not the best candidate because I haven't done such and such thing, then who cares?
Lisa Bodnar:
Tell me about how you decided where to go to school for your PhD.
Louisa Smith:
I took a week off of school when I was trying to decide where to go in the spring of my second year of my masters and traveled around visiting places and talking with professors and came to this point where I was like, none of these places would be notably better than any of the other ones for me. So, let's just leave it to chance.
Lisa Bodnar:
I hope that you didn't say, "Alexa, flip a coin."
Louisa Smith:
Haha no. So, this was March and it was while March Madness was going on. So, one of the schools was UNC and UNC was playing in the final four. What if I just do my own final four? And I had narrowed it down to four schools. So, it was perfect. I assigned each of them a team. UNC was obviously UNC, but the other schools were based on some combination of geography or letters in the name. So, Villanova was Harvard because they both had Vs. And I decided that I would just let basketball teams decide where I would go to school. I remember I was grading with my co-TAs.
Louisa Smith:
We had a computer going with the final basketball game, which was between Villanova and UNC. So, Harvard and UNC for me, I was like, "We have to pause grading. We have to watch this, this is really momentous."
Lisa Bodnar:
"This is my future."
Louisa Smith:
"This is my future." I've never watched final four ever before in my life. I have no interest in basketball. It was the most incredible ending to a sports game I've ever seen.
Lisa Bodnar:
I remember this ending. It was bananas.
Louisa Smith:
It was. It was absolutely wild. So, I truly had no idea where I was going to school up until the last second when Villanova won on a buzzer beater. And I turned to my friends, I was like, "Okay, I guess I'm going to Harvard." And that's what I did.
Lisa Bodnar:
Yeah.
Louisa Smith:
So, one other weird situation I found myself in was on an outhouse racing team.
Lisa Bodnar:
Wait, say that again.
Louisa Smith:
So, I was on an award winning ... I'm not sure it was an award winning ... We won the one and only competition per year of outhouse racing. There are teams of four who race around with an outhouse.
Lisa Bodnar:
Wait, is it full?
Louisa Smith:
The outhouse is not full. You actually have to build your own outhouse. This was when Hunger Games was popular, our team name was Plunger Games and I was not Katniss, I was Katpiss. It's in the winter in South Dakota. You run around this track of ice and snow dragging this outhouse cart while one person sits on the toilet seat. It's really competitive. We would put nails or screws in our shoes to help us run on the ice.
Lisa Bodnar:
You didn't buy crampons? That wasn't a thing?
Louisa Smith:
No. This was a low budget.
Lisa Bodnar:
Okay. Was there drinking involved in this game?
Louisa Smith:
Oh no.
Lisa Bodnar:
Oh, okay.
Louisa Smith:
Afterwards, absolutely. And all of our friends throughout, but we, the racers, the four of us, absolutely not because we had to be in tip-top racing condition.
Lisa Bodnar:
What activity instantly calms you? Don't say data analysis, because I think that's what you were going to say.
Louisa Smith:
Possibly. No, I think my first instinct was to say teaching, even though it's not really ... it doesn't make me feel calm. It makes me feel much more present in the moment and not thinking about anything beyond that. I feel like when I'm teaching, I just become a totally different person and am fully engaged. And I actually really enjoy that when I'm feeling stressed, because that's one of the few things that I can do that makes me leave anything else behind.
Lisa Bodnar:
So, you live with your parents, right?
Louisa Smith:
Yeah. So, I just moved in, in September. I gave up my apartment in Boston and moved in with my parents.
Lisa Bodnar:
So, what's the best and worst part of living with your parents?
Louisa Smith:
The best part is that my mom cooks. I also cook and help out in the kitchen. The worst thing about living with my parents.
Lisa Bodnar:
Are they going to listen to this podcast?
Louisa Smith:
Yes.
Lisa Bodnar:
They will? For real?
Louisa Smith:
Oh yeah. Oh yeah.
I told my mom that I was going to be on this podcast today and she said, "Oh, what's the topic?" And I said, "Me." And she said, "Oh, so do they want to interview me?"
Lisa Bodnar:
Is your mom there?
Louisa Smith:
Yeah, she's downstairs.
Lisa Bodnar:
Go get her. Go get her, bring her up.
Louisa Smith:
Okay. I'll go get her. Okay. Yeah. Here she is. You're not actually on video.
Megan:
First of all-
Lisa Bodnar:
Hi.
Megan:
Hi. First of all, I'm hearing lots of laughter and I have no wine.
Louisa Smith:
You're not actually on video.
Lisa Bodnar:
Just stick your head in. Yeah, there's no-
Louisa Smith:
This is Lisa.
Megan:
Hi, Lisa.
Lisa Bodnar:
Hi.
Megan:
I'm Megan.
Lisa Bodnar:
Hi, Megan. Louisa really loves living with you. Can I ask you a question that I asked Louisa?
Megan:
Sure.
Lisa Bodnar:
I asked her what is the best and the worst thing about living with her parents? Can I ask you what the best and worst thing is about living with Louisa?
Megan:
And I don't get to hear her answer, right?
Lisa Bodnar:
You can-
Louisa Smith:
After you listen to the podcast.
Megan:
I mean, Louisa is really fun to talk about things with, and to laugh with and to cook with. I mean, there are so many reasons that I love having her here.
Lisa Bodnar:
That's great.
Megan:
The worst thing, she often forgets to bring her dishes to the sink.
Lisa Bodnar:
Louisa, come on. You're not 16.
Louisa shared with me her blog.
Megan:
Oh.
Lisa Bodnar:
It was so moving and informative and helpful to read.
Louisa Smith:
My mom is crying.
Lisa Bodnar:
Oh.
Megan:
Go ahead. I'm sorry.
Lisa Bodnar:
I didn't mean to make you cry. If this is too much, we can stop.
Megan:
No, no, it's fine. It's fine.
Lisa Bodnar:
Okay. I read your entry and I thought it was wonderful that you wrote something to give some additional perspective. And I also just want to say that to go through all of this, you're such a strong woman.
Megan:
Thank you. I have a strong daughter.
Lisa Bodnar:
You do. Oh my gosh. The two of you. Well, I just wanted to meet you.
Megan:
Well, thank you. It was nice meeting you.
Louisa Smith:
Bye. Thank you.
Megan:
Thanks, Louisa.
Louisa Smith:
You're welcome. That's great.
Lisa Bodnar:
Well, I really appreciate your time, Louisa. This is so much fun to get to know you.
Louisa Smith:
Yeah. Thanks a lot for inviting me.
Lisa Bodnar:
Thank you for sharing your story. I'm so happy you're doing well.
Louisa Smith:
Thanks. Well, I did realize that I didn't say the worst thing about living with my parents.
Lisa Bodnar:
Oh, what's the worst?
Louisa Smith:
Well, I just thought of this when my mom came in, is that my mom ... She's like one of the children who's interrupting their parents while they're trying to work. I have had to share my calendar with my mom, so she doesn't come and knock on the door and say, "Hey, what's up?" While I'm in the middle of a Zoom meeting.