Thứ Ba, 28 tháng 11, 2017

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SECRETARY TILLERSON: Well, good morning, and thank you, Jane, for that very kind introduction,

and also thanks to the Wilson Center for this opportunity to address you today.

The Wilson Center has made many important contributions to public policy over the years,

and therefore it's a very fitting venue for our discussion today on Europe, considering

that 100 years ago this year the United States entered World War I under the leadership of

President Wilson.

While we tend to associate Wilson with spearheading America's first major involvement in European

affairs, I think it's worth remembering that our commitment to Europe was earlier

championed by a predecessor of his, Theodore Roosevelt.

When Roosevelt died in 1919, just as Wilson was striving for peace in Europe, European

leaders joined the American people in an outpouring of grief and praise.

British Prime Minister David Lloyd George remembered him as an "inspiring figure far

beyond the country's shores."

Another British politician said he had been "the greatest of all Americans in a moment

of dire stress."

And a French senator said he had been "the apostle of the cause of right on the other

side of the Atlantic."

President Roosevelt was beloved in Europe because of his vigorous commitment to the

continent in the years before and during World War I.

While President Wilson steadfastly adhered to a neutrality policy, Roosevelt felt a responsibility

to come to Europe's defense.

It was reported he even once asked President Wilson for permission to personally lead an

Army division into Europe, and he had even written to a British army officer, saying,

"If we had done what we ought to have done after the sinking of the Lusitania, I and

my four boys would now be in the Army getting ready to serve with you in Flanders."

What motivated Theodore Roosevelt's rejection of neutrality and an ardent commitment to

the defense of Europe?

We can see the answer in something Roosevelt told the U.S. Congress in 1904, and I quote,

"A great free people owes it to itself and to all mankind not to sink into helplessness

before the powers of evil."

Roosevelt knew that the defense of freedom demanded action from free nations, confident

in their strength and protective of their sovereignty.

Roosevelt also knew that the United States and Europe, then as we are now, are bound

by shared principles.

Our nations live according to a self-evident truth on which Western civilization is built:

Liberty, equality, and human dignity.

These foundational principles are protected by the construct of our institutions dedicated

to the rule of law, separation of powers, and representative government.

Our principles are also protected from external threats by our collective determination, action,

and sacrifice in the face of security challenges.

World War I was the first great test in the 20th century of whether the United States

would pay the high cost of liberty.

Theodore Roosevelt never participated in that war, but he did pay that high cost: His son

Quentin, a fighter pilot, was killed in the skies over France.

In past decades, our way of life – and by extension, our core Western principles – have

been tested by the totalitarian threat of Nazism, by Soviet power and its communist

ideology, by ethnic and sectarian conflicts, and by internal political pressures.

Together, the U.S. and Europe have passed these tests, but we know that the United States

and Europe are again tested today and we will be tested again.

Under President Trump, the United States remains committed to our enduring relationship with

Europe.

Our security commitments to European allies are ironclad.

If we are to sustain the shared security commitments that ensure stability in the region, the Trump

administration views it as necessary for our allies to be strong, sovereign, prosperous,

and committed to the defense of shared Western ideals.

Over the past 10 months, we have embarked on a new strategic policy that bolsters European

and American security: namely, a recommitment to Europe in the wake of the failed "Russia

reset;" a new effort to adapt security institutions to combating emerging threats like terrorism,

cyberattacks, and nuclear proliferation; and an expectation that European nations accept

they are more secure when they contribute more toward their own defense.

These new policy directions will better position the United States and Europe to confront the

challenges that threaten our prosperity, the actors that seek to sow chaos and instill

doubt in our laws and institutions, and the enemies that threaten our security and oppose

our way of life.

This is a message I will repeat in my meetings with NATO and OSCE leaders, and in bilateral

meetings in a trip to Europe next week.

The preservation of our liberty begins with guaranteeing that our people can live in safety.

To that end, the United States places the highest importance on security relationships

with European allies, including NATO.

Alliances are meaningless if their members are unwilling or unable to honor their commitments.

Earlier this year, President Trump reaffirmed the United States commitment to Article 5

of the NATO treaty because it is the best mechanism we have to deter aggression.

And as the text of Article 5 reads, "The Parties agree that an armed attack against

one or more of them in Europe or North America shall be considered an attack against them

all."

Any attack by any actor on a NATO member-state will trigger Article 5, and the United States

will be the first to honor the commitment we have made.

We will never forget how NATO members came quickly to stand with us after the September

11th attack, and we will do the same for them if they are attacked.

While the West continues to seek a productive new relationship with post-Soviet Russia,

thus far it has proved elusive, as both attempts by the prior administration to reset the Russia

and U.S.-Europe relationships have been followed by Russia invading its neighbor Georgia in

2008 and Ukraine in 2014.

Russia continues aggressive behavior toward other regional neighbors by interfering in

election processes and promoting non-democratic ideals.

We, together with our friends in Europe, recognize the active threat of a recently resurgent

Russia.

That is why the United States has strengthened its deterrence and defense commitments in

Europe through the European Deterrence Initiative, or EDI.

Earlier this year, the administration requested $4.8 billion in its budget towards the EDI.

This increase of $1.4 billion over the previous year will enhance the U.S. military's deterrence

and defense capabilities and improve the readiness of our forces in Europe.

The EDI facilitates training and exercises with our European allies and partners to better

integrate our militaries and provide security for Europe.

And it will bolster the capacities of our Army, Navy, Air Force, and Marine Corps to

deploy assets and support NATO joint exercises.

In view of Russia's Zapad military exercises conducted near the borders of Baltic States

in September, our ability to respond to an attack in concert with our allies is more

important than ever.

The EDI also includes $150 million to help Ukraine build its capacity for defending its

territorial integrity.

The United States recognizes that the war in Ukraine – in which people are still dying

every day – must come to an end.

We have repeatedly urged Russia to begin the path to peace by honoring its commitments

under the Minsk agreements.

Any resolution of the war that does not entail a fully independent, sovereign, and territorially

whole Ukraine is unacceptable.

Russia chose to violate the sovereignty of the largest country in Europe.

The United States and Europe have stood shoulder-to-shoulder since 2014 in confronting this Russian aggression

with a coordinated sanctions policy.

Our transatlantic unity is meant to convey to the Russian Government that we will not

stand for this flagrant violation of international norms.

We hope Russia will take steps to restore Ukraine's full sovereignty and territorial

integrity and fully implement its Minsk commitments, allowing us to begin then the process of restoring

normal relations.

But let me be clear, Minsk-related sanctions will remain in place until Russia reverses

the actions that triggered them.

We are committed to the success of an independent and whole Ukraine.

However, Ukraine's future depends also on winning its internal struggle to implement

a broad range of economic, justice, security, and social sector reforms.

We encourage Ukraine to continue building capable, trustworthy institutions that will

reduce and eventually eliminate corruption, strengthen their judicial system, and deliver

economic prosperity to their citizens.

The Ukraine crisis also made clear how energy supplies can be wielded as a political weapon.

Enhancing European energy security by ensuring access to affordable, reliable, diverse, and

secure supplies of energy is fundamental to national security objectives.

The United States is liberalizing rules governing the export of liquefied natural gas and U.S.-produced

crude, and we're eager to work with European allies to ensure the development of needed

infrastructure like import terminals and interconnecting pipelines to promote the diversity of supply

to Europe.

In July, President Trump announced at the Three Seas Summit that the United States will

provide technical support for Croatia's Krk Island project.

The United States will continue to support European infrastructure projects, such as

LNG-receiving facilities in Poland and the Interconnector Greece Bulgaria pipeline, to

ensure that no country from outside Europe's Energy Union can use its resources or its

position in the global energy market to extort other nations.

We continue to view the development of pipelines like the Nord Stream 2 and the multiline TurkStream

as unwise, as they only increase market dominance from a single supplier to Europe.

The United States recognizes the fragility of the Balkans and will continue to work with

partners in the EU to bring stability, prosperity, and democracy to the region.

The people of the Balkan countries, to them we say: Abandon your old animosities so that

peace may become permanent.

You have a chance to direct a new course of history.

Bloodlines should no longer be battle lines.

The United States and the world long to see a new generation of Serbs, Croatians, Albanians,

Bosnians, Kosovars, and others who will forgive the past, even if they can never forget it.

A testament to America's shared values with Europe is our cooperation on issues beyond

the borders of Europe, which affect us all.

The United States and our European allies have partnered to hold Bashar al-Assad accountable

through sanctions for his crimes against his own people.

Since the beginning of the Syrian crisis, the EU and its member states have pledged

over 9.5 billion Euros in humanitarian, stabilization, resilience assistance, and those efforts are

continuing as the Global Coalition to Defeat ISIS stabilizes liberated areas.

As the last pockets of ISIS are defeated in Syria and international focus turns to resolving

the Syrian civil conflict, our European partners must continue to be strong advocates for the

UN-led Geneva process under UN Security Council Resolution 2254.

That alone can be the basis for rebuilding the country and implementing a political solution

that leaves no role for the Assad regime or his family in Syria's government.

Our European partners have also been strong supporters of our diplomatic and economic

pressure campaign against North Korea.

In addition to enthusiastically supporting UN Security Council resolutions, countries

have taken unilateral steps to maximize pressure on the regime in Pyongyang.

Portugal froze all diplomatic relations with the DPRK in July.

Spain and Italy have expelled North Korean ambassadors.

Latvia has fined banks who have violated the sanctions.

Our European allies know North Korea is a threat to all responsible nations and requires

a coordinated response.

We commend our allies for increasing pressure on the regime in Pyongyang in order to achieve

the complete, permanent, and verifiable denuclearization of the Korean Peninsula.

The partnership that the United States and European nations have forged are critical

– are a critical basis for confronting the threats of today and tomorrow, both in Europe

and outside of Europe.

The United States and Europe face many challenges and threats that – unlike in the past – are

simultaneously dispersed among many geographic frontlines and across multiple domains, whether

non-state terrorist actors, threats of a more conventional nature, cyber threats, or nuclear

threats.

Because we know we are stronger in confronting these challenges when we are working together,

we will pursue even greater cooperation from and with the nations of Europe, our best partners.

History has shown that when we are united, we succeed in the face of shared challenges.

As I remarked earlier, one of these challenges is Russia.

Europe and the United States seek a normalized relationship with Russia.

However, Russia has shown it seeks to define a new post-Soviet global balance of power,

one in which Russia, by virtue of its nuclear arsenal, seeks to impose its will on others

by force or by partnering with regimes who show a disregard for their own citizens, as

is the case with Bashar al-Assad's continuous use of chemical weapons against his own people.

The dissolution of the Soviet Union liberalized Russian society and created new trade opportunities

that benefit Russians, Europeans, and Americans.

But Russia has often employed malicious tactics against the U.S. and Europe to drive us apart,

weaken our confidence, and undermine the political and economic successes that we have achieved

together since the end of the Cold War.

Playing politics with energy supplies, launching cyber attacks and disinformation campaigns

to undermine free elections, and serially harassing and intimidating diplomats are not

the behaviors of a responsible nation.

Attacking a neighboring country and threatening others does nothing to improve the lives of

Russians or enhance Russia's standing in the world.

We want Russia to be a constructive neighbor of Europe and of the larger transatlantic

community.

But that is Russia's choice to make.

Russia can continue to isolate and impoverish itself by sowing disorder abroad and impeding

liberty at home, or it can become a force that will advance the freedom of Russians

and the stability of Eurasia.

Following the President's recent decision regarding our policy toward Iran, there is

actually much more that binds the United States and Europe together than drives us apart.

The JCPOA is no longer the only point of U.S. policy toward Iran; we are committed to addressing

the totality of the Iranian threat.

We ask our European partners to join us in standing up to all of Iran's malign behavior.

The Iranian regime is antithetical to Western principles in its totalitarian suppression

of individual, political, and religious freedom.

Neither the United States nor Europe wants another type of North Korea nuclear threat

on its hands, nor are any of our nations at ease with Iran's attempts at hegemony in

the Middle East through support for terrorist organizations, militias on the ground in Iraq

and Syria, and an active ballistic missile development program.

At Europe's intersection in the region, we know Turkey cannot ignore Iran because

of geographic proximity and cultural ties.

But we ask Turkey, as a NATO ally, to prioritize the common defense of its treaty allies.

Iran – and Russia – cannot offer Turkish people the economic and political benefits

that membership in the Western community of nations can provide.

We recognize the important contributions of our NATO allies that have been made in Afghanistan,

and we ask them to maintain their commitment to the mission.

The end state of the United States' new South Asia strategy is to destroy terrorist

safe havens and deny their re-establishment while the Afghan Government continues to strengthen

its own capacity to maintain security and create the conditions for reconciliation with

the Taliban and an inclusive government that accounts for the ethnic diversity of all Afghans.

We know this will take time.

But if we fail to exercise vigilance and undertake action against the terrorist threat, wherever

it is found, we risk re-creating the safe havens from which the 9/11 plot was hatched

and carried out.

We urge proportionate contributions of troops, funds, and other forms of assistance as we

seek to eradicate a terrorist threat that will not be confined to the place where it

was born.

NATO's Resolute Support mission is essential to our shared goal of ensuring that Afghanistan

develops the capability to contribute to regional stability and prevail over terrorist threats,

including al-Qaida and ISIS.

Even though ISIS is on the brink of complete extinction in Iraq and Syria, the threat of

ISIS and associated terror networks will persist in our own country and in others.

ISIS is looking for new footholds wherever they can find them, including the Sahel region

of West Africa.

We must take action so that areas like the Sahel or the Maghreb do not become the next

breeding ground for ISIS, al-Qaida, or other terrorist groups.

When these groups are able to occupy territory without disruption, their strategists, their

bomb makers, and online propagandists have an easier time encouraging, plotting, and

executing attacks elsewhere in the world.

This was for many months the case in Raqqa.

In support of our African and European partners, particularly France, the United States recently

committed up to $60 million to assist the G5 Sahel Joint Force to combat terrorism and

the potential rise of ISIS in the African Sahel region.

The emergence of ISIS in the Sahel is just one indication that threats to the safety

and well-being of our people will continue to have new and unexpected origins.

The evolving and unpredictable nature of the threats we face is already clear to the residents

of Paris, Brussels, Orlando, Nice, Berlin, Istanbul, London, Manchester, Barcelona, New

York, and many other places where our people have suffered at the hands of Islamist terrorists,

many of whom were radicalized in front of a computer screen inside their own homes inside

their own countries.

And the threats we face are clear to countries like Turkey, Greece, Italy, and Germany, who

have confronted the destabilizing impact of waves of irregular migration from North Africa

and the Middle East.

In the darkest hour of World War II, Winston Churchill declared that the British people

would fight on the fields, in the beaches, and in the streets to protect their country.

Today, our fight is increasingly located on the internet, at passport checkpoints, and

in the hearts and minds of young people in Europe and around the globe.

European security institutions, including NATO, must be properly adapted to address

internal and external threats such as radical Islamic terrorism to address cyberattacks

and to address unchecked migration.

Though we know these are the threats of the future, too many headlines have already declared

these are the threats of today.

New threats to the United States and Europe are long-term, unpredictable in timing, and

localized in many different places.

Properly anticipating and combating these threats require a greater European commitment

to security, because local responders are the most effective deterrent.

While the United States will continue to maintain our guarantees against a catastrophic failure

of security in the region, and will continue to expend resources to maintain our protective

umbrella, the nations of Europe must accept greater responsibility for their own security

challenges.

Our alliances must be made stronger in the current strategic environment; a lack of diligence

and duty will only invite greater risk.

President Trump said in Warsaw, and I quote, "We have to remember that our defense is

not just a commitment of money, it's a commitment of will."

Our expenditures are in some ways a reflection of how much we seek to protect peace and freedom.

We once again urge European partners who have not done so already to meet the 2 percent

of GDP target for defense spending.

This year, Albania, Croatia, France, Hungary, and Romania have newly committed to attaining

the 2 percent benchmark.

These nations know they must invest in security to preserve liberty.

Every NATO member has previously agreed to the Wales Pledge on Defense Investment.

It's time for each of us to honor that agreement.

We also urge greater security integration, provided that the relationships are efficient

and serve shared interest.

These commitments are necessary because our freedom and security is at stake.

The United States and all nations of Europe – especially those who once lived under

the weight of communist dictatorships – value our freedoms as nations who can act on our

own authority.

If we do not exercise responsibility, we will not have sovereignty; and if we do not have

sovereignty, we will not have freedom.

Maintaining sovereignty also entails cultivating the virtues that make it possible.

Free nations must exercise vigilant protection of civil societies and the groups, families,

and individuals that compose them.

Rule of law and representative governments are empty shells when detached from a vibrant

civil society and a deep respect for certain self-evident truths.

We can win every great geopolitical struggle, but if we are not perennially vigilant of

our own behavior, our own people may lose in the long run.

The preservation of Western ideals depends on how willing we are to protect the core

truths upon which our political and economic freedoms are based.

We know the people and leaders of Europe are having many conversations about their future.

America will not attempt to impose answers to those questions.

We recognize that Europe is composed of free nations who, in the great tradition of Western

democracy, must be able to choose their own paths forward.

As in the past, the United States is committed to working with Europe's institutional arms,

and while we also recognize that our allies are independent and democratic nations with

their own history, perspective, and right to determine their future.

This position has a particular relevance for what is transpiring in the UK over the Brexit.

The United States will maintain our longstanding special relationship with the United Kingdom,

and at the same time maintain a strong relationship with the EU, regardless of the outcome of

Brexit.

We will not attempt to influence the negotiations, but we urge the EU and UK to move this process

forward swiftly and without unnecessary acrimony.

We offer an impartial hand of friendship to both parties.

The next chapter of European history must be written in Europe's own words.

As I mentioned at the beginning, 2017 marks the 100th anniversary of America's entry

into World War I.

But this November also marks the centennial of another event in world history: the beginning

of the Russian Revolution.

Though the Soviet Union collapsed 26 years ago, a few symbols and phrases associated

with decades of Soviet rule endure in the English language: the Gulag, the five-year

plan, the Iron Curtain, the Berlin Wall.

These few words, almost universally understood, capture the bitter and brutal history of communist

rule in Europe and Russia.

And they remind us of what can happen if we fail to defend the core principles of liberty

and sovereignty in the Western tradition.

In our time, forces like authoritarian nation-states, radical Islamist terrorists, and hackers with

a lust for chaos are attempting to erode our principles of freedom, equality, human dignity,

the rule of law, and representative government.

We cannot fail to take on the sovereign responsibility of protecting those freedoms.

As Theodore Roosevelt also said, "Every nation, whether in America or anywhere else,

which desires to maintain its freedom, its independence, must ultimately realize that

the right of such independence cannot be separated from the responsibility of making good use

of it."

Aware of this responsibility, the U.S. will remain firmly committed to peace, stability

and prosperity, and liberty for Europe.

As we reflect on how our ties with Europe have endured over the past 100 years, the

United States stands by our European allies and partners, so that our free societies will

be standing strong together another 100 years from now.

Thank you.

(Applause.)

MS HARMAN: Thank you, Mr. Secretary, for a speech that I think is worthy of many of the

leaders you cited – Woodrow Wilson, who served us as president a hundred years ago;

Theodore Roosevelt; Franklin Roosevelt; Winston Churchill.

You linked all parts of the world, and that is why we honor people like you with our public

and business awards over the years.

So let me focus just a bit more on Europe since that was your topic and you're going

to Europe next week.

Bob Dickie and I were recently at NATO visiting with our extremely able ambassador, Kay Bailey

Hutchison, and she convened a lunch of eight foreign ambassadors to NATO.

And what came through is – to me, is a view they have that this is a zero-sum game.

As the United States focuses on problems around the world like – urgent problems, and you

cited many of them – like North Korea and Iran, it will pay less attention to Europe.

I thought that your speech made the point that this is not a zero-sum game, that if

a strong Europe stands with us, we are stronger together to face the tough problems around

the world that are also developing blowback to Europe.

And am I right?

Is that – was that the elevator pitch?

SECRETARY TILLERSON: Well, that – yeah, that is the message that I'll be taking

next week, that just as the last 100 years I think have proven, we view the current times

we're in similarly, that the United States cannot alone confront all of these threats.

They are so widespread, and they are also so interconnected.

You can pick any one of the threats that I went through and you will find points of connection

between every one of them, in some form or fashion, whether it's a Russian involvement,

a China involvement, an Iranian involvement, Islamist terrorism involvement.

But we are confronted with a particularly complex time in our world of dealing with

threats to our civil society.

And we're only going to prevail against those threats with continuing to use our allies,

the strength of our allies.

And one of the things the United States is blessed in our foreign policy and in our national

security posture is we have many, many allies, many allies, all over the world, and those

alliances were forged in shared blood and shared sacrifice, unlike many of our adversaries

who can count their allies on less than all the fingers on one hand, because they didn't

forge those alliances through those shared sacrifices, nor are they forged through shared

ideals.

So I think what we're recognizing and promoting is the strength of these historic alliances,

which I think over some period of time, perhaps since the end of the Cold War, we lost our

way a bit in some of these relationships, maybe a view in particular in Europe that

with the end of the Cold War, the imminent threat that everyone faced for that 70-year

period was now diminishing, and what we now realize is it didn't.

It didn't diminish.

It's still defining itself; it's still searching for its role in the name of Russia.

But these threats that are emanating out of the Middle East, which now have brought themselves

right to the shores and to the borders of our European allies, whether it be through

the mass migration but also with the mass migration comes the transport of those who

would kill others and sacrifice themselves in doing it, that these are threats that we

can only confront with a very strong network of the alliances.

And so it is really – in some respects, it's a recommitment, but it's also a redefinition

of what this alliance means.

And I think the message President Trump carried early on when he went to Europe – and received

a lot of criticism for it – was to demand of our allies that you care as much about

your freedom and you care as much about the security of your people as we care about you.

And when you looked at the commitments that the U.S. – the sacrifice that the U.S. makes

in terms of not just the taxpayers' dollars but our own men and women in uniform, the

commitment we made seemed to be a little out of balance.

And I think the President was just sending the message that we're committed to this

alliance.

You have to get committed – you need to get as committed to it as we are.

And I think what I've heard in my – and I've had a lot of dialogue with European

counterparts – that message has resonated.

And we're seeing it in the commitments to NATO, commitments to defense spending, a recommitment

of personnel.

And this is really what was needed at this time, where we are under these enormous threats,

and we have to strengthen the alliances; we have to strengthen NATO's capability to

deal with what are now new and changing threats.

And that was really the purpose of the President's message early in his presidency, which we've

now followed through on in crafting these stronger relationships.

We have more work to do, but I think our message to Europe is nothing has changed in terms

of our commitment to you.

Nothing from that time we made that decision 100 years ago to enter World War I in your

defense – nothing has changed fundamentally.

The same values that bind us are still there.

MS HARMAN: Thank you.

SECRETARY TILLERSON: Let's keep that strong.

MS HARMAN: Mindful of your time, I just want to get in a few questions about other topics,

including questions from the audience.

But I would note that an interesting point you made in your talk was about Turkey, that

Turkey now has a choice: It can become more connected to Europe, which is a huge advantage,

and to us, or not.

And I heard that loud and clear.

I want to turn to the question of State Department funding and organization, something that many

people are interested in.

Every organization needs renewal.

The Wilson Center needs renewal.

And surely, everyone here, including long-serving Foreign Service officers, think the State

Department needs renewal.

However, questions have arisen about the steep cuts in your budget proposed by the Office

of Management and Budget – that doesn't mean that's what Congress will enact – and

what some claim is a hollowing out of your department.

Most recently today, two valued friends of the Wilson Center, Nick Burns and Ryan Crocker,

both of them enormously experienced Foreign Service officers and ambassadors, wrote a

piece in The New York Times with a lot of information about who's leaving and what

its implications are.

My understanding is there is another side to this story.

And so I would like to ask you to tell your side of this story and give us your vision

for what the State Department should become.

SECRETARY TILLERSON: Well, let me start quickly with the budget, because it's – I think

it's the easier – actually easier question to address.

The budget that the State Department was given in 2016 was a record-high budget – almost

$55 billion.

This was above what traditionally has been a budget that runs kind of the mid-30 billion

level.

And this was ramping up over the last few years, in many respects for some good reasons.

But as we look at that spending level, quite frankly, it's just not sustainable.

It is very difficult to execute a $55 billion budget and execute it well.

That's a lot of spending and deployment of resources, and I take our stewardship of

those dollars very seriously, and I take the congressional oversight obligations on us

very seriously and am not going to brush them aside light handedly.

So part of this was just a reality check: Can we really keep this up?

And the truth of the matter is, it'd be very difficult to keep it up and do it well.

And secondly though, part of this bringing the budget numbers back down is reflective

of an expectation that we're going to have success in some of these conflict areas of

getting these conflicts resolved and moving to a different place in terms of the kind

of support that we have to give them.

So it's a combination of things – that sustainability, a recognition that those numbers

are really the outliers.

The numbers we're moving to are not the outliers; they're more historic in terms

of the levels of spending.

As to the State Department redesign – and I use the word "redesign" because it would

have been really easy to come in on day one and do a reorg.

A "reorg," when I use that word, is moving the boxes around on the org chart.

When I showed up in the State Department, I was stunned when I got the organization

chart out and I had 82 direct reports to the Office of the Secretary, to me – 82.

Now, almost 70 of those are special envoys, special ambassadors, positions that have been

created.

So we immediately undertook an examination of just what's a reasonable way to run the

place, and that isn't it.

Having run a large global organization – and I have been through three major reorganizations

in my history and actually enjoy doing it – it's always focused on how do we help

the people be more effective, how do we get the obstacles out of their way.

So we undertook a different approach, and since I don't know the department and didn't

know its culture, we had a massive listening exercise.

We had 35,000 people respond and we had over 300 face-to-face interviews, and we continue

an active dialogue with people today about what is it – if I could do one thing for

you that would make you more effective and make you – make your work more satisfying,

what would that be.

And we got hundreds of ideas.

We've actually selected about 170 of those ideas that we are now perfecting.

The reason we call it a redesign is most of these have to do with work processes internally

and work processes with inter-agencies that we should be able to improve the way people

get their work done.

Some of it is tools and enablement, so things like – we have a really antiquated IT system.

I was shocked when I went down to spend an afternoon with the A Bureau, and I said, "What's

the one thing I could do?"

And they said, "Get us into the cloud."

And I looked at them.

I said, "What do you mean?

We're not in the cloud?"

And they said, "No, no.

We're still on all these servers."

Well, that's a big cyber risk, first.

But it really made it very cumbersome for people, and when I started using my own computer

I started realizing just how cumbersome it was.

So a lot of the projects that have been identified out of the redesign are process redesigns

and some enablement for people, and it's all directed at allowing the people of the

State Department to get their work done more effectively, more efficiently, and have a

much more satisfying career.

We have a lot of processes in the HR function that have not been updated in decades, and

they need to be updated.

How we put people out on assignment – we invest enormous amounts of money in people

that we deploy to missions overseas, and I was stunned to find out in a lot of the missions

these are one-year assignments.

So we invested all this money; we send them out to the mission.

They're there for one year, and about the time they're starting to figure it out and

have an impact, we take them out and we move them somewhere else.

Well, a lot of people have said to me, "I would really like to stay another year and

start contributing."

So it's a lot of things like that that came out of the listening exercise.

So the – so we have five large teams.

They're all employee-led.

I've brought in some consultants to help us facilitate, but the redesign is all led

by the employees in the State Department.

The issue of the hollowing out – I think all of you appreciate that every time you

have a change of government you have a lot of senior Foreign Service officers and others

who decide they want to move on and do other things.

We've had a – our numbers of retirements are almost exactly what they were in 2016

at this point.

We have the exact same number of Foreign Service officers today – we're off by 10 – that

we had at this time in 2016.

There is a hiring freeze that I've kept in place, because as we redesign the organization

we're probably going to have people that need to be redeployed to other assignments.

I don't want to have a layoff; I don't want to have to fire a bunch of people.

So I said, "Let's manage some of our staffing targets with just normal attrition."

Having said that, I have signed over 2,300 hiring exceptions, because I've told every

post if you have a critical position and you really need that filled, just send it in.

And I think I have out of 2,300 requests I think I've denied eight positions that I

decided we really didn't need.

So we're keeping the organization fully staffed.

We've had over – we're still running our Foreign Service officer school; we've

hired over 300 this year.

So there is no hollowing out.

These numbers that people are throwing around are just false; they're wrong.

There was a story about a 60 percent reduction in career diplomats.

The post career diplomat was created by the Congress in 1955 to recognize an elite few.

The number of career diplomats in the State Department have ranged from as low as one

at any given time to as many as seven.

When I took over the State Department we had six.

Four of those people have retired.

These are your most senior – they were – they reached 65, they retired, they moved on.

We have a review process – we're very selective in replacing those, but we actually

have a review process underway and we're evaluating a handful of people who might be

worthy of that designation.

But we still have two.

But we went from six to two; it was a 60 percent reduction.

It sounded like the sky was falling.

The other comment I would make is while the confirmation process has been excruciatingly

slow for many of our nominees, I have been so proud of the acting assistant secretaries

and people who've stepped into acting under secretary roles.

And when the – I read these articles that there's this hollowing out, I take offense

to that on their behalf because the people that are serving in those roles are doing

extraordinary work, and they know they're not going to get the job permanently.

They already know we have a nominee, but they come in every day, they work hard, they travel

with me around the world, and that's – it's that group of people that have helped me put

in place and helped the President put in place the North Korean strategy with the international

sanctions; a Syrian approach to the peace process that we think we're about to get

on the right track; an approach to negotiating with the Russians on Ukraine; an approach

to the Defeat ISIS campaign; the Iran policy, the South Asia policy in Afghanistan, our

new posture towards Pakistan; the open – free and open Indo – all of that's been done

with the people that are working there today, and I'm very proud.

I'm very proud of what they've done.

They're working hard and I'm offended on their behalf.

I'm offended on their behalf when people say somehow we don't have a State Department

that functions.

But I can tell you it's functioning very well from my perspective.

Have we got more we want to do?

Yes, we got more we want to do.

And my only objective in the organization redesign is to help these people who are – who

have chosen this as a career – because I'll come and go, and there will be other politicals

that will come and go – what can I do to help them?

Because they've decided they want to spend their life doing this and they should be allowed

to do it as effectively and efficiently and without a lot of grief and obstacles.

And if I can remove some of that for them, that's what I want to do.

MS HARMAN: Let me tell you, that message will resonate around the world.

A lot of people wanted to hear that.

Your time is very short.

I just would like to group, briefly, three questions from the audience into one.

Molly Cole who works for Representative Gerry Connolly, and I'm sure was one of our vaunted

stars in our foreign policy programs, asks, "Do you think support for democracy and

human rights abroad is an important part of the State Department's mission?"

That's one.

Matt Rojansky who heads our Kennan Institute – George Kennan literally was a scholar

here at one point – asks, "Where do you think progress with Russia is possible?"

And finally, Mike Sfraga, whom you met, who heads our Polar Initiative, asks, "In light

of the increased interest and activity in the Arctic, is the Arctic and Alaska of strategic

importance to the United States and to its European Arctic allies?"

SECRETARY TILLERSON: Well, as to human rights and human dignity, of course they are priorities.

What I have said about those elements of our foreign policy is those are values, and those

are values that are enduring and they never change.

Now, when you're constructing foreign policy and strategies and approaches, you have to

prioritize, and you can't de-prioritize human rights.

It's with you, it's part of every policy decision you make.

The question is how do you want to affect it?

And if you make – if you say, well, it's a priority, priorities can change.

Well, this can never change.

This is enduring and it's a part of every foreign policy construct that we develop.

What I would say is that – but if you're dealing with a place like Syria or Iraq was

in under ISIS occupation, the most important thing was saving people's lives.

How can we keep people from getting killed?

Because the ultimate human right is the right to live.

The right to live first.

If I can live, then I can begin to take care of my family, then I can begin to fight for

my human rights, then I can begin to fight for my human – but if I'm being killed

every day, I'm being bombed, I'm being gassed – our priority was save lives.

So we want to save lives first, and if we do that, we stabilize areas and then we can

start creating the conditions to ensure people's human rights and dignity are respected.

With respect to Russia, there are areas of mutual cooperation.

We're working hard in Syria to defeat ISIS and we are on the cusp of having ISIS once

and for all defeated in Syria.

We got work yet to do.

We are working together with Russia on how to prevent the civil war from re-erupting,

and so we've had a lot of conversations over what does Russia see as the end state

of Syria, what do we see as the end state, and there's a lot of commonality there.

Tactically, how we get to those to peace talks, we're working very closely with one another

on.

We have our ups and downs.

If you saw – I think it was a very important joint statement was issued by President Trump

and President Putin from Da Nang, Vietnam on the margins of the APEC meeting.

That was an important alignment of how we see the Syria peace process going forward,

and it was an important statement to have Russia confirm that they see it the same way

we do.

We'll use that and we'll build on it.

I think there are other areas of counterterrorism.

Russia has great fear of migration out of the Central Asian regions and terrorism inside

of Russia.

We think there's areas of greater cooperation on counterterrorism with Russia.

There may be opportunities for cooperation in Afghanistan.

We've not yet come to what that might be, but we're talking about it.

In Ukraine, what I've said to the Russians is we're never going to get this relationship

back to normal until we solve Ukraine.

It just sits there as an enduring obstacle, and we've got to address it.

So, as you know, I appointed a special representative, former ambassador to NATO Kurt Volker, to

focus on nothing but working with his Russian counterpart which Putin appointed to see if

we can find a way forward – not marginalizing the Normandy process, but working with it

to see if we can break the logjam.

We've had some very substantive discussions.

We're pursuing the possibility of a peacekeeping force in Ukraine to stop the ongoing – every

day people are killed, civilians are killed.

We want to stop that first and save the lives first, and then let's start working toward

the process.

So there are many areas of cooperation with Russia, and they have many others they'd

like to work with us on.

We just don't think it's time to do that.

Now, with respect to the Arctic, the Arctic is going – is important today.

It's going to be increasingly important in the future, particularly as those waterways

have opened up.

What I can tell you is the United States is behind.

We're behind all the other Arctic nations.

They are – they have dealt with this.

They've gotten way ahead of us.

The Russians made it a strategic priority.

Even the Chinese are building icebreaking tankers.

Now, why are they building icebreakers?

They're not an Arctic nation.

Because they see the value of these passages.

So we're late to the game.

I think we have one functioning icebreaker today.

The Coast Guard's very proud of it – (laughter) – as crummy as it is.

MS HARMAN: Yeah.

Yeah.

SECRETARY TILLERSON: And I know in the budget – there is money in the budget for us to

-- MS HARMAN: For one more.

SECRETARY TILLERSON: -- to make – to build another icebreaker.

But the whole Arctic region, because of what's happened with the opening of the Arctic passageways

from an economic and trade standpoint, but certainly from a national security standpoint,

is vitally important to our interest.

And so our engagement through not just the Arctic Council but through other mechanisms

is important to working with the Arctic countries on international norms, what are the rules

of the game going to be, because these are areas that have not been addressed in the

past, so very important.

MS HARMAN: So time is up.

I was going to ask you what you want your legacy to be, but listening to you, I don't

know that that question can be answered yet.

You're all over the world, you're focused deeply on the tough questions.

You're headed to Europe next week.

You have to come back and answer all the other questions we couldn't ask today.

(Laughter.)

Was that a yes?

SECRETARY TILLERSON: Yes, I'll be back.

(Laughter.)

MS HARMAN: Thank you, Mr. Secretary

For more infomation >> Secretary Tillerson Delivers Remarks on the U.S.-European Relationship - Duration: 51:28.

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Meghan Markle's And Prince Harry: The Story of Their Relationship I CNFtv - Duration: 4:02.

Prince Harry Britain's most eligible bachelor is no longer quite so eligible following the announcement of his engagement

to California born actress and United Nations advocate Megan Markel the newly engaged

Pair who revealed their engagement on Northpoint?

2/7 dated for at least 15 months before Prince Harry popped the question

Despite having them relationship under heavy scrutiny by the international press

The couple has made valiant attempt at keeping their romance as private as possible

Appearing in public just a handful of times together since confirming their union

Here's what you need to know about the royal relationship on everyone's lips how did Prince Harry and Megan Markel meet?

Prince Harry

33 and Los Angeles born Markel

36 met for the first time in London in July 2016 when they were introduced by a mutual friend

Mark were confirmed in an interview with Vanity Fair in September how long have Prince Harry and Megan marquel dated a

Close friend of Harry's confirmed to people in late October 2016 that the pair had been dating seriously for around two months

Meaning as of November 2017 the pair have been together for roughly 15

months when half prince harry and megan Markel appeared together in public

Prince Harry and Marco were photographed in public together for the first time in December 2016

Shopping for a Christmas tree at the pines and needles store in London a few days later

They were spotted while on a date to see the hit play the Curious Incident of the dog in the night-time

in London's West End the week before Harry had made a

1700 mile detour from his tour of the Caribbean to visit mark on her Toronto home

That day after picking her up from London after the ceremony in March

Mark will joined Prince Harry at a wedding in Jamaica for one of his close friends

What have they said about each other?

Mark will commented on her relationship for the first time in September

In her interview with Vanity Fair in which he referred to Harry as her boyfriend

numerous times

We're couple she told the magazine

We're in love

I'm sure there will be a time when we will have to come forward and present ourselves and have stories to tell

But I hope what people will understand is that this is our time

She added this is for us. It's part of what makes it so special that it's just ours, but we're happy

Personally I love a great love story

Prince Harry has not commented about the relationship quite as candidly as Markel however

He did tell competitors that the Invictus games in September that his girlfriend was loving the event

What will Prince Harry and Marcos wedding be like the event will take place in spring 2018?

But details about the nuptials remain under wraps Prince Harry and Mark

What could opt for a large royal wedding like Prince William and Duchess Kate's?

2011 nuptials or choose a low-key ceremony's somewhere outside of London such as st.

George's Chapel at Windsor Castle where Harry's father Prince Charles had a service of blessing with his second wife Camilla parker-bowles

in

2005 as for the honeymoon antique was Prime Minister

Invited Harry to spend his honeymoon on the Caribbean islands of Antigua and Barbuda during a visit in November

2016 making the Royal turn bright red

according to sources on the ground

Sadly the islands were badly hit by this year's hurricane season so the royal couple might have to look elsewhere

You

For more infomation >> Meghan Markle's And Prince Harry: The Story of Their Relationship I CNFtv - Duration: 4:02.

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Money And Relationships - How To Handle Money - Duration: 11:27.

Marriage and money and relationship, most people say that's a recipe for

disaster and bankruptcy and divorce but I'm excited to share with you how to

prevent that from happening. I've been married 35 years, worked with

lots and lots of couples around the conversation of money and marriage in

love and how to make it work. So you'll learn how to deal with money in a

relationship.

So excited to talk about this topic. How to deal with money in a

relationship. So I'll just tell you right up front why I'm so excited to talk

about this because this was such a major issue in my marriage. Now you have to

know, I've been married 35 years and part of the reason I've been married 35 years

is financially, we got divorced about 18 years ago and so most people are like,

what? But seriously, we have had money conflict for so many years. It was to the

point that it was like, we either separated our finances and stayed

married or we got divorced because we had been fighting about it for so long,

we just didn't see any way to have a peaceful resolution and so

there's a lot of reasons for that, I'll just give you a little bit of

background because it couldn't illustrate some of the differences that

happens in a couple's relationship. So I grew up on a farm, very conservative, very

self-supporting, expecting to work when I was young but part of living on a farm

is feast or famine, right? You plant every year but hail storms come,

predators come, there's so many unknowns in the elements that you always plant in

faith but you don't always harvest what you plant because there's all these

other things that happen and so I was taught a really great work ethic but

also there was just this fare and anxiety because anything could happen,

it's like always waiting for the shoe to drop so there's this underlying fear and

anxiety. Now my husband's family was vastly different, his dad worked for

an employer, they moved every two years and they just kind of tend to like,

"We have it, enjoy it and when it's gone, it's gone and we're not gonna worry about it,

we'll wait for the next paychecks." So two very different family systems, two very

different individuals. I tend to like to plan and save and be prepared,

he tends to be spontaneous and spur in the moment and let's me have it, let's use it

and so two major major major conflicting conversations and so when we got

married, I was like, okay so, you have see now he worked and I didn't, so here's

your allowance and you can only imagine how that went over. Anyway, so it was

the beginning of our many years of financial struggle so some things that

we learned through that whole process and it's not just my own experience as

I've worked with families and couples, this is a big deal. They always say the

biggest cause of divorce is money and it is, it is such a volatile subject because

what we do with our money is such a part of who we are, it's what we value, what we

exchange for is what we value and so when you try to start managing what

people value, it can be very intrusive, it's a very different feeling and so

it's not just the money, it's learning how to value your partner,

it's learning how to understand them, it's learning how to make money flow and

manage in a way that everyone can be satisfied. So the first thing is just

throw away whatever rules you think that there are based on the family that you

came from because you get to decide as a couple what works best for you and

that was a big problem for us because I felt like, and let me tell you, I could

get all kinds of proof, I work in the industry that tell you this how does

and you have to save and whatever and so I could stand on my soapbox,

I'm right, this is how it has to be done and I could do that all day long

and if it didn't feel right for him and I didn't honor him, then it wasn't right

for us as a couple. So the first thing is, just look

at your family of origin, look at how they managed money, look at the pros and

cons, the probability that there are good in both is there and so like when my

husband and I finally got to a place or we can have this conversation as we were

learning a lot more about ourselves and our experiences with money and our

experiences in our family, one of the things that we recognized was that one

of the gifts that he brought to our relationship was that spontaneity, that

"let's go have fun and let's just do these amazing things" because my whole thing

was saved for a rainy day and that doesn't mean a lot for fun and

whatever, it's like, "No, we can't use our money because we have to have it for an

emergency and so one of the sweet spots that we found was that, "Oh goodness,

you know, we can have fun and we can enjoy our money." And the gifts that I

bring is we can enjoy and have our money but we also will have a future and so

between those two conversations, we have this place where we could come together.

Now we live in a world where we have divorces and alimony and people are not

just bringing situations and experiences from their childhood,

they're bringing stuff from previous marriages and that also is very volatile

and so give yourself permission to create something different, give yourself

permission to have separate finances if you have to because I run into a lot of

couples who do that because they do, they have separate family obligations and so

what works best for them is to just clearly define who is going to take care of

what. When we got a financial divorce, we just sat down and I said, "This is what I

need to take care of." So I know that I have certainty, I feel at peace that I

have what I need and then you can do whatever you need to do there and

even within that, there was communication, there would be

times where I'd be like, "Hey, you know, I'd like to do this and I don't really have

the budget for that and would you help me out?" And so my husband would be freely

would be giving and sharing but what that allowed us to do is for him to be

able to have the freedom to do the things he felt were important and it

allowed me to create that structure and that safety that I needed and as a woman,

we want stability and security and men tend to want more

of an adventure. So for us and our personalities and our family situation,

that worked really really good. So be aware of the conversations in your home

and then the conversation of the conversations and experiences of your

own personal life because each of those mold us

into where we are today. Look at the gifts and the benefits, weaknesses and

strengths of all of those and find this unique place where you can really really

come together and then most of all, give yourselves permission to do whatever you

need to do to make it work in a way that both people are honored and that does

take the time to know your partner and this isn't just marriage or couples,

it's kids, it's business partners. What do they

value? What is really their core beliefs and values? And allow money to

support that so that they feel valued, they feel honored, they feel heard and so

creating those really clearly defined roles helps a lot. Now if there is a

place where it is best if you can agree on big decisions, right? So there's these

places where you can define roles and separate, that there's office of those

places where really for the good of the unit and everyone together that we come

together and so that's another one of those conversations and maybe it's

just an agreement, before I spend about X amount of money, we'll have a

conversation about that so that we're on the same page and that does allow us to

have that cohesiveness and we're making decisions that will affect both parties

but can be done jointly but still allow within that a partnership individuals to

have their own say so it's so powerful and it doesn't matter roles, it doesn't

man, it doesn't matter if it's a woman, I mean we do we have so many unspoken

rules about how marriage and finance is supposed to work and and if you're

somebody who doesn't have a part of the financial conversation,

I encourage you to step up and ask your partner to be a part of that because one

of the biggest downfalls in a relationship when you have one person

who controls and knows everything and it's not that they're controlling but a

lot of times, one partner says, "Yeah, I don't care. I don't want to know, you just

take care of it." We do live in a world where death happens and divorce

happens and so it is important that you're vested and interested in what

what is happening with your money or you can find yourself alone and have

no idea and so you do whether you do everything jointly or separately,

it's really important that both partners are very educated about what you have,

where's your savings, where's your investments, where's your insurance

because when life happens and is disrupted for whatever reason, if you're

not involved and aware, it can really cause a lot of heartache

and pain so just encourage you, take a look at that, find a place to honor

every partner, everyone gets a voice, everyone gets to

be honored, everyone has this say and we're all different and that's what's

beautiful about our marriages and our relationships, is we bring certain gifts

and attributes and so when we came cohesively, allocate, and work our money

to honor all of those things then we will have peace and harmony and

ultimately, we will actually be way more profitable and have a lot more

prosperity.

Thanks for watching the video. So are you ready to have a really

empowering conversation with your spouse? Comment below, we'd love to hear what you

thought about the video and subscribe for great future content.

For more infomation >> Money And Relationships - How To Handle Money - Duration: 11:27.

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Bella Hadid Might Be Looking At Open Relationship With The Weeknd After His Katy Perry Date - Duration: 3:26.

Bella Hadid Might Be Looking At Open Relationship With The Weeknd After His Katy Perry Date

Is Bella Hadid contemplating an open relationship with The Weeknd? By the looks of things, Hadid and her on-and-off boyfriend, The Weeknd, are going for an open relationship.

Since Selena Gomez ended her romance with The Weeknd, he has been spotted on numerous occasions outside of the model's apartment.

Many of their fans are hoping they have rekindled their love, while others are begging her to stay away because he will break her heart again.

A source said she is not sure she wants to be with him and added: "Bella was touched that Abel took the time out to send her flowers and to let her know that he was thinking of her, she thinks it was super sweet of him.

He's saying and doing all the right things right now, but Bella is still really cautious of him.

She wants to make sure that his intentions are good, and that he's not just trying to get with her as some rebound romance.

Bella has never stopped loving Abel, but he hurt her before, and she doesn't want to ever feel like that again.

She can't help questioning his timing, now he's single again he's suddenly declaring his love for her, but the whole time he was with Selena she didn't hear a thing from him.".

However, the Canadian star seems to be serious and is hoping for a long-term romance.

He sent her flowers and a sweet note after she walked the Victoria's Secret Fashion Show's catwalk.

A pal claimed: "Bella loved every minute of the show, and she looked absolutely stunning.

The event went off without a hitch, and it was a raging success.

Bella was on a high the whole night.

Abel sent her a gorgeous, huge bouquet of flowers along with a super sweet note telling her how amazing she is and how proud of her he is.".

Despite being hooked on Hadid, The Weeknd was spotted on a romantic dinner with Katy Perry.

Another tipster stated: "Bella has no problem with The Weeknd meeting with Katy for dinner.

Bella and Weeknd have been broken up for a long time, and while they have spent some time together recently, they are not exactly getting back together anytime soon.".

Open relationships are the new thing in the entertainment world.

For more infomation >> Bella Hadid Might Be Looking At Open Relationship With The Weeknd After His Katy Perry Date - Duration: 3:26.

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Prince Harry's relationship with Meghan Markle - Duration: 2:43.

Prince Harry's relationship with Meghan Markle

July 2016, The pair meet in London through friends and begin a relationship.

30 October 2016, News breaks that the prince and Markle are dating.

8 November 2016, Kensington Palace confirms in an unprecedented statement that they are dating. The prince attacks the media over its "abuse and harassment" of his girlfriend.

11 November 2017, Markle is spotted in London amid unconfirmed reports she is enjoying her first stay at Kensington Palace since the relationship was made public.

10 January 2017, Markle reportedly meets the Duchess of Cambridge and Princess Charlotte for the first time in London.

5 September 2017, The engagement looks set when Markle graces the cover of US magazine Vanity Fair and speaks openly about Harry for the first time, revealing: "We're two people who are really happy and in love."

24 September 2017, Markle makes her first appearance at an official engagement attended by the prince when she attends the Invictus Games opening ceremony in Toronto, Canada – although the pair sit about 18 seats apart.

19 October 2017, It emerges that the prince has taken Markle to meet his grandmother, the Queen, whose permission they need to marry. They met over afternoon tea at Buckingham Palace.

22 October 2017, The prince's aides are reported to have been told to start planning for a royal wedding, with senior members of the royal family asked to look at their diaries to shortlist a series of suitable weekends in 2018.

21 November 2017, Markle is spotted in London, prompting speculation she is preparing for an engagement announcement.

27 November 2017, Clarence House announces the engagement, and the Queen and Duke of Edinburgh say they are "delighted for the couple and wish them every happiness".

For more infomation >> Prince Harry's relationship with Meghan Markle - Duration: 2:43.

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WWE News: Batista on his relationship with Brock Lesnar and The Rock - Duration: 3:48.

WWE News: Batista on his relationship with Brock Lesnar and The Rock

On a recent edition of The Ross Report, Batista spoke to Jim Ross on a myriad of topics including the close but competitive relationship he shared with Brock Lesnar.

Additionally, Batista also asserted that he's still in contact with The Rock, and has a ton of respect for The Brahma Bull, especially given the fact that he was trained in pro-wrestling by The Great One's uncle. In case you didn't know….

Batista was one of the WWE's top Superstars throughout the Ruthless Aggression era, but fan reaction to the Animal turned highly negative in recent years, owing to the WWE Universe diverting their support to newer stars such as Daniel Bryan (now retired), Seth Rollins, Dean Ambrose, Kevin Owens and others.

Nevertheless, given Batista's clout in the professional wrestling business, and him having appeared in multiple major Hollywood productions, the former WWE Champion is still a big name in the world of sports and entertainment. The heart of the matter.

Expounding upon the relationship he and Brock Lesnar shared during their OVW (Ohio Valley Wrestling) days, Batista emphasized that the Beast would often encourage guys to train harder, and each and every one of them shared a close but competitive relationship.

Furthermore, Batista explained that he recently called The Rock and asked the latter whether he'd be alright with co-starring in a Fast and Furious franchise film, to which Rocky expressed his delight, and gave highly positive reactions during the conversation with Batista.

Besides, Batista revealed that The Rock is a very cool and gracious guy; adding that perhaps a big reason behind their cordial relationship is the fact that Rocky's uncle Afa Anoa'I trained the Animal.

Batista also revealed that he'd love to work in a movie with The Rock, and he does indeed stay in touch with the latter.

Batista and The Rock presently pursue their respective careers in Holywood; with the latter making sporadic appearances for WWE, while the Animal has expressed his desire to return to WWE for a program with Triple H.

As for Brock Lesnar, the Beast is the reigning, undisputed WWE Universal Champion, and is on the lookout for his next challenger who he'll face at the Royal Rumble.

Batista may very well be one of the most grateful and classy people in sports-entertainment today. Honestly speaking, should Batista make his WWE comeback today, he'll most definitely get a better reception than he did during Daniel Bryan's 'Yes! Movement' time period.

For more infomation >> WWE News: Batista on his relationship with Brock Lesnar and The Rock - Duration: 3:48.

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Trust: The Keystone of the Patient-Physician Relationship—Dr. Carlos Pellegrini 10-4-17 - Duration: 58:05.

[MUSIC PLAYING]

DOUGLAS WOOD: I'm Doug Wood, the Chair

of the Department of Surgery.

Welcome to the Surgical Grand Rounds,

and we've got a special morning this morning.

And I know that there are many more people trying to get here

because I just got a text that the line to get into S1

is 15 minutes long, and that there are still

people waiting to get into S1.

So it's a very special morning for us

because we have our own Dr. Pelligrini that's

giving Grand Rounds.

And I'm going to take advantage of him being our special guest

to give a little bit more of an introduction

than we would normally do particularly because we have

so many guests here, people beyond the Department

of Surgery from many other departments.

Dr. Pelligrini grew up in Argentina

with parents who were doctors, and if you

look at this first slide, you can

see that although he had a very happy childhood,

I guess some days, he didn't look as happy

as represented by the rest of his childhood.

But he grew up near Rosario, Argentina.

And one little known fact that most people don't know

but was an important area of connection

between Dr. Pelligrini and myself

was when he was a senior in high school he

was a foreign exchange student and actually

went to high school and graduated from high school

in Kalamazoo, Michigan.

He graduated from Portage High School in Kalamazoo, Michigan.

You can see him as a student in high school,

and he was a good student.

But I also want to emphasize he was somewhat of a nerd

as you can see from the well-established pocket

protector so popular in the 1960s.

So Carlos graduated from high school

in Portage High School, Kalamazoo, Michigan, returned

to Argentina, went to medical school,

and then completed a general surgery residency

in Rosario, Argentina.

He then had an opportunity to do a research fellowship

at the University of Chicago, and he was so well-received

there that they actually offered him another general surgery

residency.

So Carlos had the benefit of a second general surgery

residency in the United States after completing one

in Argentina.

And it was there at the University of Chicago

where he was mentored both by Tom DeMeester and David

Skinner, who were important influences in his life

and important aspects of him becoming

a prominent esophageal surgeon.

Carlos was then recruited to UCSF as an assistant professor

and actually has many connections

here at the University of Washington

from his time at UCSF.

As an assistant professor at UCSF,

he rose rapidly through the ranks,

both in terms of academic promotion and leadership

to the point that he was recruited

to be the chair of the Department of Surgery

here at the University of Washington in 1993.

So Carlos was the Chair of the Department of Surgery

for 23 years, by far the longest Department

of Surgery Chair ever at the University

of Washington, even exceeding the first Chair of Surgery,

Henry Harkins himself, who was chair for 17 years

I put up here-- and I think this speaks volume of the person

that Dr. Pelligrini is.

These are the things that he is most proud of.

And I want to talk a little bit about what Carlos

has done within the Department of Surgery

and within UW Medicine and why he is giving

this lecture this morning.

In the Department of Surgery under Carlos's leadership,

the of the faculty and the number of clinical programs

has more than doubled.

We now have 177 faculty in the Department of Surgery--

and only a fraction of this when Dr. Pelligrini came here--

and a breadth of clinical programs that are outstanding.

We have division chiefs and faculty that are leaders

locally and nationally.

At the same time, Carlos has developed 19 Endowed Chairs

and Professorships during his tenure as Chair, and many of us

are the recipients and beneficiaries

and support the research programs

in the Department of Surgery.

Carlos has been focused on the development of research,

an example being the development of the Surgical Outcomes

Research Center with Dave Flum, an example of his leadership

on the side of research.

He has also been focused on education.

We now have four residency programs and 11 fellowship

programs in the Department of Surgery.

And every single one of them is at the top of their peer

group in the United States.

That has to do with the leadership of our program

directors and the leadership of Dr. Pelligrini.

Of course, Carlos has made numerous scientific

contributions.

His curriculum vitae is a wealth of accomplishments

and publications.

But I think what people most respect and know him

for is his leadership.

The fact is he has been a leader of most

of the important surgical associations

in the United States--

the American Surgical Association,

the Society for Surgery of the Alimentary Tract,

the Society of Surgical Chairs, and probably

the pinnacle of leadership in American surgery,

the President of the American College of Surgeons.

He has honorary fellowships from all over the world.

In fact, it's kind of embarrassing

how many honorary fellowships and professorships he's had.

And he's a recipient of the French Medal

of Honor from the French government

for his contributions to surgery.

Two years ago, Carlos was named as the first Chief Medical

Officer at UW Medicine.

So we are now privileged to have his leadership at the highest

level in UW Medicine after his long and successful tenure

as Chair of the Department of Surgery.

While all of these accomplishments are terrific,

I think what most of us respect and appreciate Carlos for

is his mentorship--

and most of the seven the recipients of that mentorship

and support--

and his leadership and integrity.

He has an incredibly deep well of close friends.

In fact, I don't think there's anyone that he doesn't know.

Whenever I talk with him about somebody that I've just met,

Carlos says, oh yes.

I know them.

They're a very close friend.

I mean, it's almost ubiquitous.

Carlos knows everyone I have ever met,

and he is close to them.

He's shared a meal with them, they've stayed at his house,

and it's so extreme.

His generosity and the breadth of his connections

is remarkable.

And as you'd expect, it even extends to the Pope.

So this is no joke.

Pope Francis and Carlos are both from Argentina.

And one time I'm challenging him about

whether he knows the Pope.

And of course, he does.

And I don't remember the reason, whether they played

on the same soccer team or whether they

went to school together, but Carlos knows Pope Francis.

Most of us have been the beneficiaries

of the great stories that Carlos tells.

He is an amazing storyteller, and we've

been the beneficiaries of stories

of intrigue, excitement, embarrassment, accomplishment.

And some of them are even true.

Carlos, I think, is one of the best examples

that we can hold up as a person of honor, integrity,

and an incredible, deep, moral compass

and emotional intelligence.

And it's why we love you and what

we respect as your colleagues and as your friends.

And those of us here today are glad that we

are your close friends because those of us in this room are.

Dr. Pelligrini has had a long interest in ethics

and in the ethics of surgery.

And last year, he was honored to be

asked to give the John J. Conley lecture on ethics

and philosophy at the American College of Surgeons.

And so we are very lucky to have Dr. Pelligrini give us

this lecture again this morning that he gave to the American

College of Surgeons last year--

Trust: The Keystone of the Physician-Patient Relationship.

Dr. Pelligrini.

[APPLAUSE]

CARLOS PELLEGRINI: Well, Doug you out did yourself as usual.

I am honored that you'd introduce me today.

I was thinking Dave was going to introduce me,

and I would have loved to have Dave introduce me.

And I had thought about what to say about Dave, but not

about you.

[LAUGHTER]

I can say one thing about you, and that is, as the new Chair

of Surgery--

obviously, I'm delighted that you

have taken the Department of Surgery reigns--

you have an influence in the school.

I have never seen so many people come to Surgicial Grand Rounds.

And I realized on Monday night when

I was at [INAUDIBLE] department, and he

was making just announcements.

He announced on Wednesday, October 4, 6:30 in the morning,

everybody has to be in T625.

And I just thought, T625, that's where I'm speaking.

And I see Richard sitting there as well as so many of you.

So thank you and good morning.

Thank you all for being here.

I'm certainly very appreciative that you came,

and I'm confident that what I have to say

applies to most human beings.

So if you're a surgeon, this touches you

probably a little bit closer.

But if you are not a surgeon--

you know, we in surgery talk about surgeons

and the rest of the population, which we call non-surgeons.

So if you're not a surgeon, I hope that you

will find this of use as well.

I have no conflict of interest to disclose,

but I do want to disclose to you--

and I think Doug alluded to it--

that what I am about to tell you is not

the usual talk about techniques or outcomes in surgery.

But it is about ethics, it is about philosophy,

and it's about relationships with fellow human beings.

And I say so because if you think of surgery--

and if you think of Surgery Grand Rounds--

you sort of think, I think, this way, right?

You view in your mind a picture of an individual

with a few others helping, working, with his hands,

in this case, trying to solve a problem,

trying to change the anatomy, trying

to resect, remove, change what's going on there and take

care of an ailment.

And because of that, most people,

when you think of surgery, the reality

is that the focus is on the technical ability

and the dexterity that the individual has.

And most of the training that we tend to receive

has to do with technique and dexterity.

A lot less has been emphasizing ethics and philosophy

in general.

And today, my task is to convince you--

as I talk a little bit about some thoughts on ethics

and philosophy as I see them--

to convince you that focusing on the generation of trust

through adequate communications is an essential elements

of a surgeon's life.

I have come to believe that it goes

far beyond the relationship that we establish with the patient.

Because it is the relationship that we establish

with everybody around us that makes

surgery and the surgical results what they are.

To that end, let me tell you a little bit

about my own journey.

Doug told you my life journey.

I'll tell you my own journey into this particular field,

I joined surgery because I had that picture in mind

just as well.

And I was at the time fascinated and interested in the GI tract.

And I thought that surgery was a vehicle for me to make changes

to the GI tract with my own hands that will hopefully

improve the quality of life of other human beings,

and that occasionally I would cure somebody

from a dreadful disease, as it is

a case with esophageal cancer.

Most often I would prolong life or palliate somebody.

Very often we would be changing the function of the GI tract

and improving the quality of life of somebody else.

I did not embrace the study of philosophy or ethics

or read anything about it in the early stages of my development.

But as life went by, I came to realize that the power

to heal that I had, if any, the ability

to have good outcomes with patients

was directly related to the type of relationship

I established with the patient.

That the more I delved into the patient's life,

the more I established that relationship

between the surgeon and the patient

that was based on something that I couldn't describe then,

but I then realized later on it would be trust.

As soon as we established that bond,

the chances of having a better outcome,

as seen by the eyes of the patient,

increased significantly.

And [INAUDIBLE] and I started reading and studying

a little bit about what are the mechanisms that get two

human beings closer together.

I realized that that allowed me to understand myself

a lot more, to know what things ticked me off,

to know how to control myself when

I was facing one of those events,

and slowly to understand myself.

And as a consequence of this not because I programmed it,

but it came to the realization that we

work in a health system.

We work every day with other surgeons,

with physicians of other kinds, and that if I establish

the same relationship-- which is a relationship based on respect

and mutual understanding of caring for another human

being--

with the members of the team--

and when I'm talking about members of the team,

I'm talking about members of the operating team,

but I'm also talking about the nurses on the ward,

I'm talking about the residents that are on your team,

I'm talking about the Department of Surgery

faculty, the administration--

if you had that essential elements

that I will describe for you in a moment that

are the basis for the generational trust,

then life was better.

And to me the greatest discovery of this--

and maybe one day I can come and talk about that--

is the tremendous effect that this has in preventing work--

in preventing burnout.

Because I realized that as you become happier with what you

do, as you're welcome with a smile by people that are

working with you that day, as you find the friends that I was

talking about-- people that you establish a relationship that

maybe is just this story, a little something that happened

between two human beings that is a little bit different than

just the professional aspect--

that that to me personally is the biggest deterrent

to feeling burned out.

I wake up in the morning sometimes early, sometimes

very early.

And believe it or not, at my age of 71,

I say, how many hours before I go to the office?

It is that kind of thing that makes you not

feel overwhelmed or overburnt.

So the title of this talk was supposed

to be Trust: The Keystone of the Patient-Physician Relationship.

And I will keep it to that, but I just

wanted to give you that brief introduction in terms

of the importance, I think, that the generation

of those relationships are.

To the effect of this talk, I want

you to think for a moment of trust as a little red stone

there.

And imagine that little red stone for just a second.

And let me go back to the human relationships

that I talked to you about before.

And I think or imagine a human relationship as an arch

as depicted on this picture.

And I think of the physician on the one side,

and on the other side of the arch, I think are the patients,

I think of the physician herself or himself, I

think of the system that the individual relates to.

And so that's a human relationship,

and that little red stone that I told you there is the trust.

Now that stone, if you think for a moment,

you remove that stone, the whole thing crumbles.

The arch disintegrates.

It is that stone, the so-called keystone,

the concept that was actually developed by the Etruscans

2,500 years ago, that keeps that integrity

of that particular arch.

And that concept was not only developed by them a long time

ago but then taken up by the Romans who started perfecting

that keystone and started perfecting it to the extent

that they started using it on gates,

they started using an aqueduct, they

started using it on bridges as something that would have--

as the most important element of the arch itself--

would have the ability to keep that in its full integrity.

So I view trust then to a relationship

like the keystone is to an arch.

I think that it is essential to keep the integrity of the arch,

and it is with that concept that I

would like to describe trust in a little bit

more detail in just a minute.

But before I do that, if we have agreed

that this is a pictorial representation

of a human relationship with somebody else

or with the person himself, and if we have agreed

on the importance of trust as represented by the keystone,

I have learned that communication

is what sits in the middle of that arch between the person

and himself, or the person and the patient,

or the person or somebody else.

It is through communications that we

establish that relationship.

But I'm not talking about a verbal communication here.

I'm not-- I'm talking communication in the broadest

extent.

Communication is a smile.

Communication is looking at somebody eye to eye

like I'm looking at Roger right now.

Communication is recognizing somebody.

Communication is getting upset.

Communication is making a face.

Communication is not paying attention

when someone is telling you something

because you grab your telephone, and you

start answering a message.

So in every one of those behaviors that you model,

you're communicating something.

And you're communicating something

that sometimes you don't think you're communicating.

But you are communicating something

no matter what you do.

And that has become something that I

think if we look at it from a practical perspective, not

an academic perspective, is an important aspect

to preserve that.

So let me then start.

I'll give you a few thoughts about trust itself

as it relates to medicine and then

three or four slides on what I think communication is

and how communication directly relates to trust.

So for trust itself, a definition that I like

is this one from the dictionary that says essentially it's

the assured reliance on the character, the ability,

the strength, or the truth of someone or something,

where I believe the key word is reliance.

And reliance from one person onto another person character

onto another person's strength.

And it's not only about the persons.

The animal kingdom shows us trust all the time.

Think of a flock of birds and think of the leader

of a flock of birds.

It's only trust on the strength and reliance

on the strength of the leader of that flock

that makes all the other birds fly in the same direction.

And that reliance is very important

because that reliance brings about vulnerability.

And so Edmund Pellegrini--

Pellegrino actually, a very famous philosopher

that wrote a lot about trust, talks

about the fact that to trust and to entrust

is to become vulnerable--

it's a vulnerability, because you

are relying on somebody's character--

and dependent on the goodwill and the motivation of those

who we trust.

And Bernard Barber, the sociologist

that writes a lot about trust, defines trust

with three sort of conditions--

persistent moral order-- remember that reliance

on somebody else is based on the moral order--

perform technical role properly when

relating to any profession--

so it's a commitment that you have--

and altruism, or will do so with a concern for others.

So there is these three conditions

that lead us to think that in medicine you can translate

those conditions from a practical perspective

in the possession of knowledge necessary to do something

to another person, the autonomy given to you

by the person necessary for you to practice and exercise

your skill and your set of values

hopefully with the understanding of the values

of the other person in the treatment,

and the fiduciary obligation to individuals or to society.

It is always the moral character.

It is always the permission.

And it is always the vulnerability and the altruism

that go together.

It's the beliefs on the benevolence

and morals of the physician.

In medicine, I view trust as having

five or six different twists that are not

seen in most other professions.

The first one is the affective nature,

the dependence that a person who is sick has on the physician.

So it is and like most other professions where perhaps

a relationship with a lawyer-- and I'm not trying to be

disrespectful to a lawyer--

but a relationship to an accountant or relationship

to a technical person, that relationship

is subject to less affection than it is to a physician.

You see embraces, and you see hugs,

and you see the kinds of things that most patients associate

with trusting their provider.

In medicine, it's important that we keep skills and values

very clearly up front because we can make the promise.

We have a contract, if you wish, with society.

We are relied upon--

as the original sentence that I showed you said--

to provide skillful work and that means continuous

learning throughout our lives.

There's a lot of papers that have

shown that trust is directly associated

with adherence to treatment.

And this gives a base to my original premise

when I started telling you that I thought that my power

to heal somebody was directly related to the trust generated

on that person.

And we know now from a lot of studies

that patients who trust their doctor,

as you would logically think, tend to adhere to treatment.

And so you can see they discuss a direct therapeutic effect

on the patient.

Interestingly enough, patient satisfaction

is directly related to trust.

So if you look at papers that relate the issue of trust

to patient satisfaction, you see that, again,

patients that have trust in physicians,

particularly when they have [INAUDIBLE] what

I will describe in a moment, a mutual trust.

That is they, the patients, perceived

the physician trusting in them.

And satisfaction indices are much greater.

It is not surprising to me that [AUDIO OUT]

pay a lot more attention to the issue of trust

and how to gain the trust of another human being

and how to deliver on the promise just for a business

perspective to get better patient scores.

And of course, in medicine, we go back to that vulnerability

that Edmund Pellegrino had described

when you rely on somebody else.

Vulnerability is something that happens

in every state of dependence, as the theory goes, right?

Any state of dependence [? is ?] spiritual,

the state of dependence, a learning state of dependence.

And you now can tie learning environment and the power

that the teacher has over the student, or the resident

or whoever it is, because that person is relying

on the teacher and that person is showing their vulnerability.

When the dependence originates from injury,

originates from disease, originates from something

that the person who gets it has very little control on,

and not only has very little control,

but has very little means of becoming non-dependent.

Unless and until that person seeks the care of somebody

else who has the power of healing, who

has the ability to heal, who has the skills to heal, et cetera.

So that poses, I think, an important philosophical duty

on us.

Is that fiduciary duty that, coming back

to the altruistic portion of trust, that we have to respect?

We have to be advocates, and we have to make sure

that we are not in any way exploiting the vulnerability

of a patient, because a patient is much more

likely to take my advice.

If I say I think you need an operation, I

am sure some of you have been patients, when the doctor says,

you need an operation, the patient

is much more likely to say yes because of an inherent trust

on the physician.

It is then our obligation to make certain

that we have disclosed the rationale,

that we have disclosed the risks,

that we have looked at the values

from the perspective of the patient to the extent that can.

That we recognize we are not inside that patient.

We will never know what the real values are, right,

for that individual.

But it is incumbent upon us to make sure

that we remember the tremendous vulnerability

that the state of dependence caused by an injury cast

on a patient.

That is particularly relevant at a time of incentives.

Some of you have heard me talk about incentives before.

We work in a system where every service that we provide

is remunerated in some form or fashion

and you receive, I receive, and every one of us

does, a certain amount of payment for the services

that we provide.

We are in a system that, by the nature of fee for service,

the system is potentially facilitating

the exploitation of the vulnerability of a patient.

Now, I do not want to get too deep.

This is not a political talk about how the system should be,

but perhaps I give you my own thought on my stance.

The system of fee for service is one

that has to be used very carefully by us,

the entrusted parties, if we want

to deliver the fiduciary duty that I was talking about

before, because the system is asking us to do more.

And for those of you who think that I

am talking against a value based system,

value based does not solve this problem at all,

because on the value based system

we have the opposite, right?

On the value based system, we are asked to do less.

The system is asking us to do less.

On the fee for services system it is asking us to do more.

And in either case, we can err in delivering the entrustment

that the patient had to us.

I believe that it is very important for us

to learn a little bit about how to generate that trust.

To learn a little bit about the philosophical aspects

of how do you deliver the moral contract that we

have as physicians.

Whether we are in the fee for service system

or on the value based system, how

do we guard the rights of those patients,

and how do we protect the vulnerability

that I was talking about?

Because of these underlying currents that systems have

developed, there is a whole chapter in ethics that is

the ethics of distrust and the ethics of distrust in one word

is to say we cannot trust that.

How do we get around that?

We get around that with a contract.

What we do is we convert, we transfer the trust

from the person to person relationship

to a formal obligation in the form of a contract.

And that could be a living will, a power of attorney, an advance

directive.

That would be the consent that we sign every day for surgery.

As you think about it, when the signatures come into place

and when you do a lot of promises

that this is going to happen, or I

will give you permission to draw my blood, to hit my head,

to putting my picture up on the web.

Whatever it is that patients give permission to,

those are contractual relationships

that, to a certain extent, are the result of someone

having lost their trust on the person to person issue.

If you go to practice in underdeveloped areas

of the world, you will see that, for some reason,

trust has been preserved in those areas

to a much greater extent, and contractual obligations are not

as commonly set.

Those contractual obligations sometimes

have problems because people tend

to write down what they think they would like

to do in a certain position at a certain time,

when that has never been faced by the individual.

Sometimes that eventually conflicts

with the values of the persons.

I told you a little bit about the mistrust that

has occurred in our culture as we become more pervasive.

The rise in suspicion that patients

harbor towards physicians.

Occasionally, the degradation of social trust

in our political systems, and the general erosion

of trust between employees and employers.

That leads to something that society has created to replace,

I think in a very imperfect fashion, trust.

And you have to be careful what you write in an advance

directive, you know?

Interpretation of wishes, as this cartoon says.

As one is telling the wife, just so that you know,

I never want to live in a vegetative state

dependent on some machine.

If that ever happens, just unplug, OK?

How that is interpreted by the other person

is sometimes important to remember.

Two more aspects of trust before I

turn it to communications briefly,

and that is the physician's trust in the patient.

It is also extraordinarily important.

We know that when the patients believe

that there is mutual trust, the potential consequences

for both parties, studies have shown that,

and these are mostly soft studies

based on philosophical analysis, that physicians derive

a substantial amount of pleasure when

they feel trusted by patients.

And not difficult to understand, patients

derive a substantial amount of pleasure

in their relationship when they feel the physician trusts them.

To the extent that you can with your patients, entrust them.

Just like in other states of dependence, like learning,

we tend to empower our residents.

Show them that we are confident that what

they can do by allowing them to do something that

goes a little bit further and perhaps beyond what they think

they are capable of.

And as that little stretching, carefully done over time,

whether it is in a procedure or in a conversation

with a patient or a decision making or something,

that empowers another human being, that

shows the other person you have trust on the person.

That is an important element that patients

come in with trust in the institution,

they establish trust to patients,

they trust a physician, trust a patient.

That eventually leads to more enhanced treatment,

more satisfaction, and better outcomes all together.

The last element of trust in this medicine part

is the social aspect of trust.

Social trust is a little bit of a different animal,

but it is essentially based on people's experiences in life.

So every one of us, just think of you at any time,

you walk into an environment.

In this case, let's make it that the environment

is the hospital, or the clinic, or the place where you

are going to see a physician.

You walk into that area with a certain amount of trust

in the system, in the institution, right?

That is what I was talking about vulnerability.

How important it is that when somebody is sick,

somebody does not have any other place to go than the hospital.

Every one of us has a different degree

of trust on the system itself.

Think communities of color.

How they would feel when you think

of the Tuskegee experiment, or many other genetic experiments

that have been done on Native Americans and others.

How those communities feel with regards

to the trust of the system and the people that

populate the system that is us.

Physicians, health care providers of all sorts.

The interesting aspect of social trust

is that it is much easier to manipulate,

much easier to change, much more dynamic than the person

to person trust.

To me, that was a very important discovery

as I was reading because we physicians and health care

providers in general can really improve the social trust

by things that we do in a visit, or we

can decrease the social trust.

As shown, for example, that the patient that

comes in sort of like, what is this going

to be like, I am going to see a doctor, the doctor

makes a lot of money, doctor has abused my community.

You know, those kinds of things.

And finds a person that greets them with a smile.

Finds a person that maybe is a little bit late

and apologizes for being late.

Takes responsibility for being late.

How that starts working on the social trust of that patient

that is looking at that individual.

Think for a minute of the opposite.

Think that you walk in and you say,

I did not know you were here, I work in this place

and they gave you an appointment at the wrong time.

They had me overbooked.

it is always the same.

In this hospital, they overbook me all the time.

So what is your problem?

And think of the two differences on how the person there

would perceive the trust in the institution or the improvement

or the disapproval of trust.

Trust in general, as I told you before, is to the relationships

like the keystone is to the arch.

It is essential for the integrity.

Without it, you cannot have a good relationship with

a patient.

And you can translate this to the other health care

workers that work around you.

With it, I think you not only improve the patients,

but you also improve yourself.

So, communication.

How does communication come into play in my mind with regards

to the trust?

Communication is the act or process

of using words, sounds, signs, or behaviors, OK?

To express or exchange information,

or to express ideas, thoughts, feelings.

Communication is a very broad perspective, first of all.

Remember when I talked to you about the smile,

when I talked to you about the things

that we do to pay attention to somebody else who was talking

to us et cetera, is the behavior that

becomes part of communication.

Wikipedia defines communication as the act

of conveying intended meanings from one entity

to another through the use of mutually understood signs.

I do not think it is always intended meaning.

Sometimes you communicate a lot that is unintended.

You did not mean to offend somebody

when you said something, when you

make a smirk on the face, when you did something different.

You did not mean it.

So, it is not always intentions.

I am not giving you all of that just because I

want to make it more complicated,

but because I wanted to bring you to this graph

that, to me, it was very revealing the first time I

saw it.

Communication starts with intent,

and I would say to you many times, starts without intent,

so I differ a little bit of this sort of mechanism

that I am putting in here for you.

Let's assume that there is an intent in your brain

to communicate somebody do something.

Your brain very rapidly composes a message.

Is the message going to be a smile?

Is the message going to be being upset?

Is it a word?

Is it a scream?

Very rapidly then the brain encodes that message

and then the brain transmits that message usually

through movements, through expressions, through behaviors.

This is all, more or less, part of your control.

Then the other party receives the message, right?

Remember what we talked about social trust and so forth.

They decode that message but then

they have to interpret the message.

You can see that, in any aspect of communication from here,

the way you compose and encode it, the way you transmit it,

the way the other person receives the [? codes ?]

[? and ?] interpreted, it is possible that at the end

of the day, you actually relay the intended message or that

you did not.

And that the message perceived by others was not what

you actually intended to do.

First of all, it is obvious that communication

is much more than words, right?

Let me show you this slide, and then I

will tell you what I was about to tell you a minute ago.

This is somebody that studied what people hear or interpret

from actions from other individuals.

Look at how little verbal, how much

more tone, and how much nonverbal communication exists.

This is not scientific.

This is philosophy and ethics and interpretations

of observations of human life.

They are not statistically significant.

But it just gives you an idea that what we say

is tiny, little.

it is what we do.

It is the way we walk the walk of life that that really means.

My personal tips.

Knowing that from the intent to the interpretation,

there will be a lot of potential changes.

Whether I am talking to a patient to a colleague

or to somebody else, it is first of all,

I love this sentence, do not attribute

ill intent to anything that you hear.

My first posture when I do not understand the message,

when a message as I have decoded it in my mind

and as I have interpreted the message,

is not in parallel with my values

or with the values of the other person,

is to not attribute ill intent.

It is very easy to get upset otherwise.

It is very easy to just attribute ill intent.

I believe most human beings are this

and most human beings have values similar to mine

and therefore I give them the benefit of the doubt.

If I cannot reconcile it after some thought,

and sometimes I cannot, and you will find that in your life

many times as well, then if I cannot reconcile what I heard

with my values, [? our ?] feelings, viewpoints,

et cetera, then I seek a chance to re-discuss it.

I give it another thought, another chance,

and I tell the other person.

When you are talking with me, try

not to get the god damn phone and start answering messages.

It displeases me.

You are not paying attention to me.

You are doing something else.

You are diverting your attention.

I know that you do not mean it, right?

I try to go on that route.

Give the person a second chance.

In order to get here, I would not

say that every single time, that I do not like

something I go for a second go.

Sometimes I say I do not think I am

going to go anywhere with a second discussion,

so I just quit.

But in general, I think it is a good idea

to say there are these three steps that

are possible if you want to preserve a working

relationship.

The third one is the most difficult one by far and away.

For me anyway.

If it still does not work, maybe it is time to let go.

It is the most difficult one because if you

decide that you are going to let go, then you have to let go.

You have to do that.

You have to let go, meaning you are never

going to think about it again or talk to that person about it

again.

Just let it go, OK?

It is not worth it.

If this one did not provide the explanation,

then you can let go.

Sometimes you are not going to be able to let go

and you are going to hold a grudge,

and that relationship will, by necessity,

crumble because that communication led

to a falling of that keystone.

The trust that you have in that person is gone,

and that is OK too.

Not everybody is perfect, and sometimes human relationships

go that way.

A very important aspect of communications

is the patient centered communication.

Epstein, who has written the most about that,

defines it as, one that elicits understands and validates

the perspective of the patient.

This is very difficult to do as you know.

Understands the patient's psychological and social

context.

The more you read about this, the more

you realize how difficult it is for any one of us

walking into a clinic today and meeting another human being who

is facing a tremendous problem.

Really, really put ourselves in the shoes of that patient.

We should try it.

But it is extremely difficult.

If you do those two, you reach a certain understanding,

and then eventually you empower the patient

with that relationship.

The environment has a lot to do with the communication.

I like this picture, which is actually a picture of ours here

and it is on our own website, because I

see the right [INAUDIBLE] of this person really tight.

She does not have a neurological disease

she is just trying to use it to raise her head.

As an elderly person, it is very hard

to extend the neck muscles to look at the physician who

are standing up and talking.

To the extent that you can, try to make it look

like you are not in a hurry.

Try to sit down.

Try to put yourself at the same level of a patient.

Try to remember that, in all this communications,

there is a lot that can happen.

Studies have shown that we communicate

in a very different way.

We all, men and women, communicate in a different way

to women than to men.

I will let you read all those things for yourself.

We communicate differently to elderly patients.

Significantly different.

When we perceive somebody to be a lot less knowledgeable,

we treat those patients in a different way.

I am sure that if you look in your mind,

you will remember events in which you

gave no credit to somebody and you started describing

something in childish ways.

Wanting to realize that this person is an engineer that

worked all his life in Boeing and is now in 78 years of age.

But he invented the triple seven or something of that nature,

and you feel like an idiot and you should.

A particular aspect of the communication,

of course, that hurts us every single day,

is when we have to communicate with people that

speak a different language.

Many think that having interpretive services

is the key to that.

Well, remember, interpreters can only

tell you words that they know how to translate into English.

Remember that those words originate from somebody whose

social trust is different.

Whose experiences in life have been different,

whose culture, whose ethnic background,

whose beliefs on others are completely different.

There is a lot more than the words

that the interpreters can do that

have to do with the culture of the person

or where the person comes from.

I have tried to describe primarily for you today

aspects that I believe are important in the

patient-physician relationship.

I believe that, when that is enhanced

through the practical understanding of what

trust and communications are, that you

improve physician well-being.

I am absolutely convinced that for many of us,

it is a great deterrent to burn out.

I have told you almost nothing about the surgeon and the team

because a lot of this is related to this.

If this worked well, if you know yourself

and you can talk to your soul, and the only way that you

can talk your soul is when you walk the walk that we are

talking about, then this one almost automatically

works just as well.

All of that is to try to show you that trust is important.

That trust takes a tremendous amount of time to construct.

As this picture tries to show you, it is complicated,

it is fragile and it can be destroyed in one minute.

It takes forever to get it really

cemented as a bond between two human beings

and it can be completely destroyed in just one second.

Be aware of both circumstances.

You cannot accelerate the process by which somebody will

trust you.

You can certainly accelerate the process

by which somebody will not destroy it.

With that in mind, I submit to you,

take every opportunity that you have in your professional life,

in your personal life, to show other people that you really

care.

That way, as you [? transcend ?] the life of yours,

and through the winding parts of life,

keep remembering that as people [? he ?] said in other words,

no one will care how much you know until you show them how

much you care.

Thank you very much.

[APPLAUSE]

DOUGLAS WOOD: Stay up here.

[APPLAUSE]

Well, I think you can all see why there was value

in coming here this morning, including

canceling neurosurgery, Grand Rounds, and being here.

Thank you, Rich.

We have time for a couple of questions.

What questions do you have for Carlos?

Rich.

We will use the microphone.

RICH: Carlos, that was a wonderful talk as usual.

Have you ever gotten a patient that you say I will not operate

on because I cannot establish trust with?

In other words, someone who comes to you,

says I want a 100% confidence that you

will take the esophageal tumor out

or I will go somewhere else.

CARLOS PELLEGRINI: Yes, Rich.

The answer is yes.

Very rarely, because I have tried

to get around and show around, but I have had both situations.

Unfortunately, I remember one in particular,

walked away, feeling that I had disillusioned him.

He was a 60 some year old patient whose values, he said,

had nothing to do with mine and I was unwilling to help him.

So the patient walked away from me.

I have rarely, but I have occasionally found,

that I could not deal with a patient because I cannot trust

them.

I just tell them, look, I have been trying desperately

to help you.

That is why I chose to go into medicine.

I am unable to do that.

I am not putting a judgement on this--

I am just not the right person will help you.

So I can connect you with somebody else but I cannot

help.

And I think we have to be truthful with that.

DOUGLAS WOOD: You talked early on about trust

and about being educated about how

to gain trust, that there is obviously

courses and processes.

I was thinking about it and how much value we could

have in that, but also thinking about, in a sense,

a way that there are conflicts and incentives.

Trust can also be used adversely.

It can be manipulative.

Salesmen gain trust and use it to manipulate emotions

and to make us want something that maybe we do not need.

How do we navigate that and get educated

about how to gain trust better and use it sincerely?

CARLOS PELLEGRINI: I understand exactly what you are saying,

but I think that that relates back to the concept

that we were talking about.

I look at the physician in a way,

and it may sound paternalistic, but I look

at the physician as a guardian.

As a guardian of that trust that you want

to generate from the patient.

In order not to manipulate it, I think that the best we can do

is to remember what are the incentives that

drive us to do X or to not do X. And to then back off and say,

I have a commitment to altruism.

That was one of the three conditions of trust

that Barbara described, the sociologist that I showed you

earlier.

How do I best protect the interest

of this vulnerable person today?

What is my role in doing that?

I think if you know as much as you can,

what drives you to do that--

I want to sell this car to you, but I

have a moral obligation that that salesman does not have.

The person who is trying to sell you a car, for example,

does not have a social contract that obligates that person.

The trust that society has put on us physicians

is totally different.

Patients are not going to be checking you out,

usually, as much as they would check the salesman.

Knowing what drives us, knowing that the patient is vulnerable,

knowing our obligation to altruism.

I say, all I can do is try to navigate the best I can

with balance between what incentives I have,

what obligations to society I would have,

and what obligations I have to the patient.

There isn't a perfect solution.

DOUGLAS WOOD: Right.

Well Carlos, you kept a straight face

while this came down during the questions and that was a--

CARLOS PELLEGRINI: I kind of imagined.

DOUGLAS WOOD: That was impressive.

I am glad that you did that.

[? Barclay, ?] [? Acelle, ?] and Katie,

can you come back up here?

You guys disappeared.

You were up here.

In honor of Dr. Pellegrini's 23 years

as chair of the Department of Surgery,

we commissioned a painting, a portrait of Dr. Pellegrini

to be hung up in the hallway of the Department of Surgery.

We thought this was a great place to unveil it.

You have just given us the perfect Grand Rounds

on trust and on all the reasons that you

have had the leadership positions that you have had

and the reasons that we respect you and admire you.

So, three of our chief residents who

managed to navigate that down here,

because I could not find a place to hide it

upfront, and managed to navigate it successfully, good job.

I thought you guys would be the great people to unveil it.

CARLOS PELLEGRINI: I cannot see it from here.

[APPLAUSE]

Great job.

Great job.

[APPLAUSE]

Great job.

[APPLAUSE]

Thank you.

Thank you.

DOUGLAS WOOD: Thank you.

CARLOS PELLEGRINI: Thank you.

DOUGLAS WOOD: Thank you, Carlos.

Thank you all for coming to Grand Rounds.

Perfect.

Really appreciate it.

CARLOS PELLEGRINI: Very nice.

I love it.

[MUSIC PLAYING]

For more infomation >> Trust: The Keystone of the Patient-Physician Relationship—Dr. Carlos Pellegrini 10-4-17 - Duration: 58:05.

-------------------------------------------

Prince Harry & Meghan Markle Tell All On Relationship Struggles & Proposal Details - Duration: 4:51.

Prince Harry and Meghan Markle couldn't keep their eyes off each other when they sat

down in their first interview only hours after confirming their engagement.

Prince Harry, 33, explained to BBC's Mishal Husain that he proposed while they were cooking

dinner at their cottage during a "cozy night." 

"It was just an amazing surprise," Markle, 36, said.

"It was so sweet and natural and very romantic.

He got on one knee…

I could barely let you finish proposing.

I said, 'Can I say yes now?'"

Prince Harry added, "Then were were hugs and I had the ring in my hand and I was like

'Can I, can I give you the ring?'

She goes, 'Oh yes the ring.'

It was a really nice moment, it was just the two of us and I think managed to catch her

by surprise as well."

PHOTOS: Watch Out, Meghan!

Prince Harry Cozies Up To Rihanna At Barbados Concert The couple got engaged after a year

and a half of dating.

A mutual friend set them up on a "blind date."

Markle explained that she met Queen Elizabeth "a couple of times."

"It's incredible," she said.

"To be able to meet her through his lens, not just with his honor and respect for her

as the monarch, but the love that he has for her as his grandmother, all of those layers

have been so important for me so that when I met her I had such a deep understanding

and of course incredible respect for being able to have that time with her.

She's an incredible woman."

Markle added that Prince William and Kate Middleton have been a "fantastic support."

PHOTOS: Prince Harry Pushes Forward With Engagement Plans To Meghan Markle As for the ring, Prince

Harry explained he picked a yellow gold band because it is her "favorite."

The main stone is from Botswana, where they vacationed, and the diamonds on the side are

from his late mother Princess Diana's jewelry collection.

"I think everything about Harry's thoughtfulness is — and the inclusion of that and obviously

not being able to meet his mom it's so important to me to — to know that she's a part of

this with us."

The couple then discussed the challenges of their relationship, such as struggling with

long distance.

"It was a choice," the Suits star said.

"Very early on when we realized we were going to commit to each other we knew we had

to invest the time and the energy and whatever it took to make that happen.

With the filming schedule it was not the easiest."

PHOTOS: So Naughty!

Prince Harry's Cross-Dressing Scandal EXPOSED Her future husband added, "I tried to warn

you as much as possible, both of us were totally surprised by the reaction… you could have

as many conversations as you want and try to prepare as much as possible, but we were

unprepared for [the scrutiny.]"

Markle then discussed race, as she was criticized for her ethnicity.

"Of course it's disheartening," she said.

"It's a shame that is the climate in this world to focus so much on that.

At the end of the day, I'm proud of who I am and where I came from.

We have never put any focus on that we just focused on who we are as a couple.

When you take all those extra layers away and all of that noise, I think it makes it

really easy to enjoy being together and tune the rest of that out."

PHOTOS: Prince Harry Betrays Markle By Telling Another Woman He Loves Her She added, "We

were hit so hard in the beginning with a lot of mistruths that I made the choice to not

read anything positive or negative.

We focused all of our energy on our relationship."

Although Markle will be leaving her acting career, she will work more closely on her

humanitarian efforts with her future husband.

"What's been really exciting is the transition of this out of my career and into the role

of the causes that have been important to me," she said.

"I can focus more energy on the causes I care about.

I don't see it as giving anything up.

I see it as a change.

It's a new chapter.

I've been working on my show for seven years.

I'm very fortunate to be able to have that longevity on a series.

Once we hit that 100 episode market I have ticked this box and I feel really proud of

the work I have done there and now I can work on a team with you."

Prince Harry then explained that the couple hopes to start a family in the "near future."

The couple will tie in the knot in Spring 2018.

For more infomation >> Prince Harry & Meghan Markle Tell All On Relationship Struggles & Proposal Details - Duration: 4:51.

-------------------------------------------

GETTING STARTED IN RELATIONSHIPS | Masculinity's Guide to Accountability & Commitment w Steve Mayeda - Duration: 16:17.

so how do we make a relationship work what kind of a crazy question is this

this is our Daily Awesome podcast and Men this is a podcast about men's

development men's excellence where we talk about all sorts of crazy stuff like

this so anything with dating sex perspective mentality you know how to

get yourself right that's what this podcast is about and if you like it

click the Free Stuff Link down below check out what we got we have almost 800

videos that all deal with this and not only that we have just tons of free

programs so it's super great like fitness stuff there's dating stuff

there's pdfs there's video series there's groups there's the Asda men's

development group and there's immense development excellence group that's AMD

plus we got you covered and this is all recorded live on a call

it is the 8th of November 2017 and we are on a men's development excellence

call in fact I'll stand corrected we're on at TSL online call and the men's

development excellence calls a little bit later so if you want to get involved

in those you got to sign up for TSL Online or md excellence and if you're a guy

that wasn't better yourself I'd recommend it so let's get into the meat

of all this now that we're done with that and let's dive into it because this

is a huge question and it's coming from so many different perspectives what's

very important is that we have a dialogue about this so the guy that

asked this question is he's fairly young he's 24 or 25 I forget the exact age but

got a lot going in his life has great dating skills is able to meet women and

be sexual and so on and so in that context it's a certain type of question

but let's say you're 30 and you're asking that question let's say you're 40

let's say your dating skills aren't great and you're 28 so there's all sorts

of different variables that come in it and one of the things I ask people to

start with is a definition now rule number one is your definitions about

what you want in your life are bullshit they're most likely not going to happen

but the reason why we need to look at them is for a couple of reasons number

one self responsibility all right so we're looking at ourselves to guide us

we're accepting our problems our wants our desires and our directions to move

into very very big I mean this is this is

paramount in at all however we see this so much in the dating world so if

anybody's on an online dating app you see well I don't want to you know just

be used I don't want to have this and that I got out of a relationship here's

what I wanted a relationship here's the type of guy I'm looking for here's the

type of girl I'm looking for there's this endless checklist of different

things that we think we want and the fact of the matter is is what we end up

dating that the relationships that we end up having are never that and I could

say this for myself because my amazing wife you know I wanted I know what I

want I knew exactly what I wanted I knew all of that stuff but guess what it

never amounted into the picture of exactly what she is it was very

different than what she is now that doesn't mean I'm unhappy that doesn't

mean anything it just means that when we don't have a relationship it's very hard

to have a definition so we create a definition so that we can one have

personal responsibility of our desires our wants and so on and when we

encounter problems we solve them ourselves but also it's a starting place

for us to know the direction to go in so very very important is to go like hey

what do you want so my man you know who's very good with women and he's

about 24 years old you know he's looking at like man I don't know what I want but

I know I have this urge and this feeling towards it so here's the other

interesting and amazing thing about it so when it comes down to dating

relationships sex all these different things as soon as we start to have our

emotions involved in somebody as soon as we have our sex involved with somebody

as soon as that desire builds guess what happens we stop having a choice we stop

having this this idea of controlling things we just want to experience so our

hearts open up is an open field our minds open up is an open field

our sex opens up as an open field and it just says go go go it's easy to fall in

love it's easy to to feel good about something and if you're not having those

experiences for instance if you're dating a lot and you haven't really

hooked a girl or fallen into a relationship or have these

have them have these experiences that a lot of these people talk about well

there's two things that you're having trouble with and that's not exactly what

this podcast is about but I'll include a playlist where you could learn about

those things and that would be a modem so your connection isn't strong with

your emotions and sharing in exchange having that empathy or your seduction

your seduction is not connecting okay and if you have those two things in over

in order you're going to naturally connect with people all right into a

point where you hit that open field you know love and sex become this natural

phenomenon so let's talk about this natural phenomenon and then we'll get to

the overall answer of you know what do we do when we really want a relationship

to happen you know how do we make a relationship work so the thing is is

that when we have these feelings and we need to we need to talk about this as

men this is huge guys you need to realize this is going to happen when

your heart opens up when your sex opens up with a woman you feel the feelings of

monogamy monogamy is a phenomenon right so monogamy is a social definition for

how we have relationships and there's all these arguments of is this good or

is this bad and so on and I've been in monogamous relationship for a while now

but the thing is is yeah it's also unnatural and whatever but here's what's

natural about it let's take away all the social definitions and all the kudos

should of what does if you were sexually active of somebody if you're having an

emotional exchange with somebody there's going to be a point where she wants full

commitment from you she feels that it's not even making a commitment there's no

definition yet there's just this overwhelming feeling that a woman is

gonna have when that happens that's like oh my god I need this man this man needs

to be here that wears my security of this I want this I just I'd get so

jealous if somebody else was around this is feeling that saying that and there's

this feeling that comes across with a man that could have some of those

characteristics involved in it but also this feeling of a man saying man I want

to do everything for this woman like I am good I like I would have her for the

rest of my life I I want this this is beautiful I'm gonna do everything for

let's go on a trip let's do blah blah blah blah blah all this stuff that you

know what we hear in a lot of the man culture which is like you know where

we see all these men looking searching for definitions of themselves not

because we don't have that but this is one of those things where from the hurt

man culture they go that's weakness that's how you get hurt and so on it's a

natural feeling all right it's a natural feeling and you got to acknowledge that

first if you deny it it's gonna be imprisoned and fight fight fight to get

out so you're gonna have a feeling of what we'll call socially monogamy but

remember it's a feeling first the woman has her feelings of like I want this guy

can't be with anybody else and then there's this dude with his feelings

going like I want this girl she can't be with any anybody else they have

different characteristics and flavors of one another then through life and

cultures and so on and you know different types and styles of

relationships you know we then call that monogamy so you're gonna feel that and

it's gonna be awesome so when you feel that and you want to to continue on with

it you then make a commitment now here's what's gonna make your relationship work

is your alignment to that commitment here's the thing guys you're gonna feel

that commitment you're gonna have the desire to make it you're gonna overcome

it you're gonna commit to shit which you

don't know about because one you may not be familiar with the phenomenon of love

and your experience with that but more importantly you don't really know her

you know her on the 4-month her the 2-month her the few good weeks of good

sex her those types of things and she knows you in that way so you guys don't

fully know each other yet but you make a commitment now you can be wrong about

that commitment you just have to learn to communicate out of it but in that

commitment and I don't mean this in some old-fashioned way that commitment is an

attempt to fulfill that feeling that you wanted remember that feeling that that

turns into that definition of monogamy if I want to give myself to her I want

to do everything for her well guess what you know you stop having sex fuel your

relationship you stop having the novelty of new experiences fuel your

relationship you stop having or you start having arguments you start having

things which piss you off about her you know she doesn't you know do certain

things that maybe another girl should or would

whatever and you start losing that momentum right and it starts getting a

little bit boring and guess what you're probably getting a

little bit boring to her or unknowing to her but where does that commitment stand

when you made that commitment in that choice just as a personal thing again

don't think of this as like this old-fashioned like get in line with your

commitments in it and it can translate to that but I want you to think of it in

this way that commitment is going hey I had a value and I had a feeling that I

felt that was real and it made me decide this and remember that checklist of that

personal definition of what we wanted what was the main reason the main reason

was personal responsibility so ownership of self knowing that you made a

definition of what you wanted to go for and as I said for me man I fucking know

what I want but what did I get something totally different that I was absolutely

happy with all right but in all of that my commitment the same thing it's just

as blind is that want but my commitment may want to continue is that part of

myself that wanted to dedicate my life to her or so on and these types of

things right which now is you know conflicted with these annoying things

these other problems these things in a relationship that we have that that you

know fuck us up and so on and and whatever you know is that still there

and that's a hard thing to determine that's why you need a men's group man

that's why you need to bounce stuff off other guys who know you and can can hold

you to account ability not accountability like did you get your

goal done but the accountability of actually going like hey man I know what

you're capable of I know your potential and are you living up to it so in that

man like can we find the commitment to that you know can we find the the

accountability of ourselves and the man that shows like hey I want to dedicate

the cell myself to this because I believe in me and I believe in love and

I believe I wanted to do this but perhaps it's that I wanted to see if I

could do this in my life perhaps I wanted to see if I was capable of this

type of relationship perhaps I was capable of deciding whether or not you

know man this girl could live up to whatever and that is far more important

than your annoyance if let's put it this way if you ever so many people break up

with women for stupid reasons for or women break up with men either way

oh man I didn't like him oh we had this fight oh we had this dramatic thing oh

he's an asshole oh the sex was bad oh the blah blah blah and we go through

this checklist which probably wasn't true and we're not being real with

ourselves anytime I hear somebody complaining to me about a breakup and

they're like they want to blame the other person in any sort of way you're

lying to yourself you're taking your responsibility out of it that's not the

real reason why you broke up that's not the total picture that's the one thing

that you could flag that makes you look good or whatever it is but the thing is

is that I hate this we need to break up with somebody because we make a choice

that this wasn't the right person all right and so that's why we need to

cultivate this to make a relationship work you need to get in touch with the

commitment that you had when you felt the feeling of monogamy when you felt

the feeling of you wanted to dedicate your life to somebody because I'll tell

you this man five six years down the road where I'm at I don't have that

feeling anymore I don't have that feeling don't like oh my gosh

Maria is is this woman that I just want to do everything for but the commitment

that I made in it has elements of that so take out the novelty trick take out

the crazy like sex six times a day which would like to do them fuck the fucking

crazy man I'm pretty sexual person but this was beyond beyond man that's that's

that's one thing that really solidified the beginnings of that relationship but

take all of that out of it take all of the highlights take all of the things of

going that oh my god this is so amazing and what do we have it's so much more

it's actually so much more but if I just cave to the annoyance the little fights

the times when we do have misinterpretations or bad sex or things

that don't communicate with each other or the times where we crossed each other

in whatever ways if we if we did not align with our commitment

of who we you are in the person that we believed we could be in the road that we

wanted to walk down on if we didn't align with that and then keep that in

check yeah we deject in the fact of the matter is is what I want from all people

whether you're learning to talk to people where you're going into a

business interview you're learning to talk to women for the first time or

you're actually you know having relationships

I want you making a choice I don't want you making a reaction all right because

the reaction doesn't accept responsibility of self and it causes

conflict and disconnect where it doesn't need to be we're so afraid of being

judged that we don't show our real selves and you know then we just react

towards one another so we need to fuel our relationships by choice and we can

decide this isn't working out for us so just know guys we're gonna have this

feelings overwhelming feeling to commit to somebody we're gonna want that that's

gonna run out you know that's gonna change it's not a question of this

monogamy or polyamory or swinging or whatever the fuck it is or you know

going you know signing off women forever or whatever is the the answer it's more

that there's different phases in your life that you're gonna feel you need to

learn to articulate them that being said you know if we feel that it's not the

right thing we also need to learn to break up properly cuz that's tough too

you know that's a lot of pain sometimes you don't want to feel that sometimes we

need to react and masks our masks ourselves and be a total asshole to make

that happen we don't want to have relationships and breakups like that we

want ones where we're fluid in ourselves and it's a very confusing thing why you

need a men's group in any case this is what we're talking about tonight on a

daily awesome podcast and what we're gonna be talking about more and more and

more and more and we're gonna go on it's early on it's only 8:50 this call is

probably gonna go to a 1 a.m. and man it's an amazing experience guys from all

around the world hop on it if you want to be a part of that subscribe to the

channel when you subscribe it's a lot better if you click that little gray

bell that comes up because that keeps you notified when other videos like this

come up but in addition to that and the free stuff link man you get access to

tons and tons of videos stuff on Fitness stuff on dating free video courses very

very cool and you can find out our courses like men's development

excellence if you want to step it up if you want to make

your life better men's development excellence is the way

to go it will change your life being a part of a men's group or there's

accountability you can access them 24 hours a day and you can get on calls

talk as well as just a mountain of content just more than more than you

could more than you can imagine any case that's all there for you and guys I also

put up some suggestive videos for you to watch check those out when you're

subscribing to the channel those will help you get an understanding of

relationships dating sex and the different confusion in that and the ways

we can communicate to be better people all right we'll talk to you guys later

tonight ciao

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