Live from Washington D.C., it's CUBE Conversations with John Furrier. Hello everyone, welcome to a special CUBE Conversation here at Amazon Web Services headquarters in public sector in Washington D.C., actually in Arlington, Virginia. It's a CUBE coverage on the ground in Washington D.C. Our next guest is Shannon Kellogg, who's the director of AWS Public Policy in Americas here joining us. Thanks for spending the time with us. It's a pleasure to be here. So obviously public policy is a big part of public sector hence the success you guys have had. Amazon's had great success. When you go back four years ago, the shot heard all around the cloud was the CIA deal. And since then there's been this gestation period of innovation, you guys have been penetrating, doing a lot of hard work. I know how hard it is and kind of knowing the D.C. culture. How hard was it and how hard is it for you guys now? Is it getting easier? Policies, got a lot of education, involved a lot of moving parts. Yeah, well, I joined over five years ago. And when I joined, there was very little understanding that Amazon was even in the cloud computing business. And so we really had to start from scratch. And so it was just basic education and awareness work. And I wouldn't call that easy, but it certainly wasn't a different time where people were curious about Amazon, AWS, and cloud, what is cloud computing? The cloud computing directive of the federal government, cloud first policy had just come out a year prior. And so there was a lot of curiosity. So people were willing to talk, people were curious, but they didn't really understand what cloud computing was. And again, they didn't even realize that AWS was in that business. And back at that time, and I think you have a tech history with EMC before in RSA, you know the tech game. You've seen many waves of innovation. And it's almost a time where you saw some interesting shadow IT developing. Shadow IT term referred to kind of in the shadows, experiment, put your credit card down, get some Amazon, get some cloud and test, kick the tires if you will, kind of without anyone seeing it called shadow IT. That became a big part of the growth. How much shadow IT has been involved to kind of force the Amazon to the table? Did that help? Was that a help driver for you guys? Was it going on? Well, it's interesting because when you look back four or five years ago, there were a lot of first movers in departments and agencies, folks in little units that I had actually even never heard of in some of the big agencies, customers that I would speak to that were experimenting with AWS and commercial cloud. And in those days, they were able to take out their credit card and experiment a little bit with it and discover what was possible. And we saw a lot of uptake and interest as a result of some of that experimentation. But really, things started to change in a big way when AWS won the contract to build the community cloud for the intelligence community. And following that win, and as that project was implemented and in the six months to a year after that award, we saw a lot more interest by agencies to not just experiment, but to go bigger. I couldn't get Amazon to confirm, I've tried many times on theCUBE, Jassy, and to Recept to get them to confirm that that was certainly a shadow IT effort that someone within the CIA came out of the woodwork and said, hold on IBM, we have an alternative. Yeah, well I can't comment on that either but I can tell you that it was a very open competitive process that we won and it was a very big deal for the community and a very big deal for us. And that's when we really started to see a number of other agencies and organizations really not just experiment with cloud but how can we leverage this to get the same benefits that the Intel community has? And IBM didn't help either, they got cocky, they figured they're going to sue you guys and end up amplifying it with a judge actually said on the ruling, Hamilton is a better service. I mean you couldn't get a better testimony but let's talk about that move. It was a resounding legal opinion and I would encourage your viewers who haven't read it to read it. It's well documented, SiliconANGLE, search SiliconANGLE, AWS, IBM, CIA deal, you'll find it. But I think what's notable about that is it's kind of cocky because the old way of doing things was schmooze when the ivory tower have that relationship, rely on that, lean on that relationship and the IT just, they were just like going through security at the airport, you know, just whatever, right? Just check the boxes. You got to win the C level. That now has changed where not only is the buying and evaluation process bottoms up, there's a lot of consensus involved there's now new stakeholders. You bet. Talk about that new dynamic because this is a modern trend, it's not just, you know, send it to the department for a check box, it's truly agile. Talk about this new modern procurement process that people are going through. You bet, and it's still evolving. But over the last few years, we've seen a lot of interest by federal organizations to shift from what is traditionally a capital expense model to an operational expense model. And you'll probably laugh at me that I actually even remember this, but in the 2015 budget with the previous administration, President Obama's budget request in 2015, there was actually on page 41 of that budget a line or actually a paragraph that talked about how the federal government would need to continue to move to commercial cloud services. And in the language, in the budget, it actually talked about the consumption model, the operational expense model versus, you know, the traditional CapEx model. What is commercial cloud? Because, you know, I mean, again, back to the old days, kind of back in my days when I was growing up in the industry, you had a federal division that managed all the government stuff, sometimes separate products, right? I mean, absolutely different unique features in the government. Now with the cloud, are you hearing that this is the same cloud that Amazon runs? Is it a different product? I know there's different, you know, private cloud. Certainly our cloud is one option. Explain with commercial cloud. Yeah, our cloud is one option in this area of commercial cloud services and we think it's a great option. But if you look at the different types of solutions, NIST actually talked about this when they put out the definition on what cloud computing should be described several years ago. I think the final definition came out in 2011. And at the time they called public cloud, which, you know, we in federal agencies now really refer to as commercial cloud as one of the deployment models. But it also is really emphasizing commercial solutions and commerciality versus having an agency go out and try to build its own cloud or to issue a special contract that is controlled by that agency that does a traditional private cloud type of build like for example, California did with CalCloud several years ago. We're seeing more and more agencies move away from that model and into procuring. Why is that? Well, because, yeah. Just like HP and everyone else backed out of cloud? Same reason? It's costly and one thing looking at CalCloud and if you haven't sort of looked at what they did with their policy. In 2014 they issued a policy California did which basically created a preference for CalCloud and by August of 2017 they moved away from that preference, reversing the policy and then doing sort of a about face and saying not only is there not a preference for a CalCloud that's privately built cloud anymore in California, but there's going to be a preference for commercial cloud services and leveraging commercial solutions and technologies. Was that, again, the same reasons why a lot of commercial vendors like HP, even VMware and others who kind of backed out of the cloud, it's expensive, it's complicated, right? Is that the main driver or is it more of talent? I mean, why did CalCloud move from that to the model? Yeah, I mean, I obviously can't speak for what other generalities have done, but I think based on our observations at the federal level, at the state level and even internationally, we're seeing more and more governments in their cloud policies focus on how to leverage commercial cloud services versus build their own or go out and spend a billion dollars and trying to build their own through a contract or a traditional contract. I talked to Theresa Carlson. And by the way, just for the record, in California it was IBM who actually ended up building CalCloud. Nice dig on IBM there, good one. So I just talked to Theresa Carlson and she and I were talking about the notion of commercializing the ecosystem of bringing tech in with government, kind of the mashup or integration culturally and among other things, technology. I had an interview with an executive, New Relic, one of your Amazon's top customers. I think they were saying they were getting FedRAM certified, but there's a variety of certifications that you guys offer essentially people in the ecosystem non-governmental, but they can come in and provide solutions. Can you talk about that dynamic because we're seeing that become a trend now where folks in the Amazon or in general tech ecosystems says, hey, you know what, I can go in through Amazon and do some business with the public sector. Sure. What do you guys offer? Is there a playbook? Is there a roadmap? Is there checkboxes? What's the playbook? Well, first of all, if you don't, your viewers don't know what FedRAM is. It's a federal government security evaluation process for cloud computing providers and service providers who want to sell to the US federal government. And the framework itself was created on international security standards as well as existing and evolving in some cases, in this security standards. And so it's a common security framework that any company of any size can align to. And AWS, because we believe so strongly in security and because we had a lot of first mover customers in the federal government marketplace, we really invested in that process early. And as a result of that, we meet the FedRAM requirements at the different security levels that exist. And we were one of the first providers to actually do that. And then partners started working with us and leveraging that and not just resellers or systems integrators.  It's like the stamp of approval. You can't get into the party without it, right? Yeah, you have to have FedRAM certification in order to provide certain types of services to the US government. A lot of agencies now require some type of FedRAM certification to do business with them. It's very common. Any other certifications that they need? Well, that's the most common one at the federal level, but there are some department-specific requirements too. So for example, when you look at the Defense Department, they've added additional requirements on top of FedRAM and providers like us have to go through those additional processes. And then again, if you're partnering with an AWS and we've gone through that process and we made the investments and you have some software that's based on AWS, that's gonna be favorable for you in order to sell to that market segment. Take a step back and zoom out and talk about the big landscape in DC. Obviously, DC is the center of the action for policy in this obviously public sector all around the world as well in the United States. What's the trend that you're seeing? I mean, obviously Amazon is kind of like its own black swan if you think about it. They're lowering prices and increasing functionality on a daily basis as the business model of Amazon. They win on scale. Customers are happy with that and the government seems to be happy. Yet the competitive landscape couldn't have been at an all-time high, certainly Oracle, IBM, Microsoft, the others are competing for the same dollars potentially. So you have the old guard, as Andy Jassy would say, and you guys, you know, self-described new guard. What's the landscape look like? How are you guys competing? What observation can you share and the role of policy makers in the middle of it? Are they stuck between all this? Well, it's been quite a ride over the last seven or eight years. Again, going back to the one the first cloud policy was issued by the federal government CIO at the time, Vivek Kundra. Very early days they talked about each agency trying to move three applications to the cloud. And so we're in a much different time now and there are a lot of agencies who are going all in on cloud services. That's actually been really fast-forwarded and emphasized even more over the last couple years, starting with the previous administration and the emphasis that they had. I talked about the 2015 budget, but we also saw a number of other policy initiatives in the previous administration during President Obama's eight years. And then you had the new administration come in and really emphasized this early too. And one of the cornerstone things that's happened by the new administration over the last year has been the development and then the release of the President's report on IT modernization. And they set up a new Office of American Innovation and a new tech console to advise on the development of that report. And they went out, the administration did, and got a lot of input from the industry. And then they came out with a final report of recommendations in December and they're already moving to actually implement a number of those recommendations in pilot, a number of recommendations in agencies. And they're really emphasizing shared services and commercial cloud services as a key part of that effort. And then in tandem with that, and this is probably gonna shock you, but in tandem with that, Congress actually worked with the administration to also make a number of changes to law, including in December of 2017, a really important piece of legislation called the Modernizing Government Technology Act. And that was added to the Defense Authorization Bill for 2018, you know in this town that's often how legislation moves at the end of the year is through the Defense Authorization Bill. And so that legislation was passed and it really is focused on helping agencies in their IT modernization efforts move again from legacy IT systems to the cloud. And they're not doing that just because it lowers costs and it's a good thing to do. They're actually doing that as part of a way to improve the federal government's cybersecurity posture. And that's the last thing I'll talk about that's happened in the last year is I mentioned what the administration did about its IT modernization report. I mentioned also what Congress did with the Modernizing Government Technology Act, while there was also a new cybersecurity executive order that was issued during the year by the president that married those two things. And basically it made very clear that there's very little possibility to actually improve the security of federal systems without moving forward with the IT modernization efforts and moving the cloud. And the cyber warfare we're living in and truly is a cyber war. This is not just hand-waving IT modernization. It's beyond that because it's critical. Critical infrastructure now being compromised. This is our security, right? It's the state of the security of our people. You bet, and quite frankly, we're seeing this trend internationally too. You see more and more governments making this link between IT modernization and improving the country's cybersecurity posture. We've seen that in the UK. We've seen that in Australia. It takes a cyber war to fix IT. I mean, is that what we're coming to? Okay, final point is obviously IT modernization is key. I love that that's driving it. We need to go faster. Question for you, Cloud First, certainly a big initial orientation from the government to go Cloud First. Question for you is, do you see the expectations yet in the agencies and throughout public sector for cloud speed? Meaning, I don't mean like speed and feeds, like moving to an agile outcome, fashion delivery, under budget, on time, lower prices. Is that expectation now set? Or is it still getting there? No, we believe it is being set. And if you look at developments over the last six months, I mean, you now have the Department of Defense that has come out with changes to policy to move faster to the cloud. And if you look at the Secretary, I'm sorry, the Deputy Secretary of Defense's memorandum in September of last year, he talked a lot about leveraging cloud computing as part of a way to make improvements in the implementation of technology such as artificial intelligence and machine learning. And in that memo they talked about that's a national security imperative to do that. And so they're seeing technology, not as the end result, but as a way to enable a lot of these developments and changes. And we've already seen many of those steps forward in the intelligence community. So it's very encouraging to us that we're also seeing now the Department of Defense move in this direction. So they're running towards the cloud. They're running towards AI. They're trying to. They're going as fast as they can because they need to. They're trying to. Final word on security, what do you hope to have happen in our government in America to really crack the code on cyber security and surveillance, all these holes, especially with IoT, the surface area, it couldn't be bigger. So before I answer that question, one thing I did want to say, because we were talking about the Department of Defense and you had added a question in earlier about what some of the legacy providers may or may not be doing. Well, these two things are married. What we're seeing at the Department of Defense is that they really do want to move faster to the cloud. But you probably noticed in the press that there are many different legacy providers out there. And as our boss would say, Andy Jassy, a lot of the old guard community who want to try to slow that transition down. And so that is really something that's going on right now. There's a lot of effort out there to pursue this status quo, to continue to keep the lights on. And if you look at what amount of the federal budget that is being spent on keeping the lights on an IT, it's over 80% is what the number is commonly referred to. And so a lot of companies are making traditional companies, old guard companies, as Andy Jassy would say, are making a lot of money following that same path. And you know what? The taxpayer can't afford that anymore. The mission owners can't afford that anymore. And so it's really time to move forward into the 21st century and leverage commercial cloud technologies, some of these advanced capabilities like artificial intelligence and machine learning. And then to answer your final question. Hold on, just on the DOD thing. I did see that news. It's completely fud, fear, uncertainty, and doubt as they say in the industry from the old guards to slow down the process. That's classic move, right? Hey, slow down, we're going to lose this thing. We don't put the brakes on it. It's a classic move that some companies have been practicing for a few decades. Decades, decades. We all know it's called selling 101 when you want to secure the ivory tower, okay? So, but this is the tactic and I want to get your opinion. This is a policy question. It's not in the best interest of the users and the society and the citizens to have a policy injection for political warfare on deal selling. So that's essentially what I see happening. Yeah, we agree. And we get your comments on this because it comes up to a very political topic, technically, multi-cloud, right? So the move is, whoa, you can't go to one cloud. We're putting all our eggs in one basket. So we have to speck it to be multi-cloud. That's the policy injection. What's the impact of that in your opinion? It doesn't matter, does the government say, hey, we should do multi-cloud or? Or first. You actually want to have one cloud. That's what the agency wants. Well, actually, you know, that's not true. What I'll say and take a step back here is that what we want is what the customer wants. And, you know, a lot of companies are forgetting the customer in this debate about multi-cloud versus single cloud. So you're jump ball. Just your philosophy is jump ball. We welcome open competition. So multi-cloud, single-cloud. We want to serve the customer. What happened with the intelligence community is they had an open competition for a single-cloud approach. One thing that's happening right now, you know, as part of this broader discussion is some of the old guard companies are spreading a lot of misinformation about the different types of contracts. And so there's been a lot of misinformation about DoD trying to pursue a sole-source contract for this Jedi program, you know, that they're trying to do to implement cloud. And what DoD has said in the stories that I've read on the record is that they want to have an open competition. And whether or not they choose a single award, which is different than a sole-source that's not competed, if they choose a single award that's competed like the intelligence community did, or they choose a multi-award, it's going to be their preference. And let me tell you something in the policy space. What we've heard consistently from members of Congress and other policymakers is they don't want to be in the business of telling the Department of Defense or any other federal agency specifically what they should do or shouldn't do in a technology procurement. What they want is an open competition. And I'll tell you on the record, we embrace an open competition and that will serve the customer as well. But don't tell the customer if you're an old guard company what they should or shouldn't do and don't ignore the customer. Well, I would have run from just on a personal standpoint, industry participant, I would say that that's going backwards. If you have the companies doing old guard tactics, injecting policy and FUD to slow a deal down just to save it, that's really bad form. Yeah. And that's going backwards. It's bad policy, but it's also bad for the taxpayer and it's bad for the mission owner. So let there be open competition, let the customers like DOD make the decisions that they're going to make, which is going to be best for their mission. Well, Shannon, as Teresa, a basketball fan would say, jump ball, make it fair and let the chips follow what they make. Let's do it. All right, open competition. That is Amazon's position here in DC policy, no problem. We can play that game, but it's all about the customers. Shannon, thanks for your insight and observation. Shannon Kellogg, who's in charge of policy in Americas for AWS. This is CUBE Conversations. I'm John Furrier. Thanks for watching.


Hi, I'm Jim Dodie and welcome to dialogue. We have one of our favorite guests, Yaron Brooke, who is the president and executive director of the Einran Institute, former professor of Santa Clara University, regular column in Forbes.com. I know, Christina, you have a thing for Yaron Brooke. Well, I'm hoping he's going to solve the world's problems today because, boy, we've got plenty out there to solve. Yeah, and somebody with a background in Einran, you'll have a randy in perspective that you could give some of the major issues facing us. Desperately needed these days. Desperately needed. And I guess it must be fun to think about how how Einran would react to some of the world's problems. But before we get into that, Einran is hot right now, isn't she? I mean, she's the best seller again. I mean, she wrote Atlas Shrug back in the 50s, came out, I believe, in 1957. Kind of negative reviews, but it's become one of the classics in literature. It was, it got negative reviews both by the left and the right, which was interesting. The New York Times trashed it and so did the National Review. So it was, the hostility was from everywhere. Yet it still became a best seller. Her second, the Fountain Head, was her first best seller. And over the years, particularly, I'd say since she died in 1982, sales have just kept growing and they kept increasing. And the, you know, in 2007, which was the 50th anniversary of the book, sales got up close to 200,000 copies a year of Atlas Shrugged. And we thought, wow, this is fantastic. And it's a huge book to read. Huge book, we're talking about 1200 pages. I still haven't gotten through it. People are buying it. Yes. Is this like, are these Tea Party people buying this book? Well, so 2008 it peaked, right? More sales than when it was a best seller back then. 2009 was better than 2008. Wow. And, and the 2000, and then so 2008 was better than 07. In 2009, it exploded. And it sold in 2009 over half a million copies. Oh my God. A million copies. So we got weekly sales figures. So we could track this. And it tracks what happens in politics almost to the tee. It's amazing. So top passes. Yes. Sales go through the roof. The bailout of the auto companies, sales go through the roof. Obama gets elected, sales go up. And that whole late 2008, early 2009, sales just sustained an incredibly high level. And I think what's going on is people are realizing that what's going on in the real world out there so parallels this book written 53 years ago that they remembered it. And they said, oh, I need to read that book again that I read in college because this, and they recommending it to their friends. And it's just, it became a cultural icon during that period. And sales have tapered off a little bit since then. But there's still it all time. But it sounds like what you're saying is that whenever there are things that happen like the bailout, anything where government is becoming bigger or there's an interpretation of President Obama, a stronger or more dominant role for government in our society, then Ein Rand, who has an opposite view, there's interest in what what you've said about all this. I think that's right. And I think what happens in Atlas Shrugged is, is, you know, the economic decline in America blamed on capitalism blamed on businessmen as a consequence, more government controls, more government regulations, greater decline blamed on businessmen. That kind of dynamic is in a book written in 1957, and it played out right in front of us. Now, you're going to solve the mystery for a lot of people out there who have wondered, what does this bumper sticker mean? Who is John Galt, which relates to Atlas Shrugged.  Well, I don't want to say because I want you to go read the book. Okay. And it's a mystery, right? The book is partially a mystery. And part of the mystery is who is John Galt. But who is John Galt is the opening line of Atlas Shrugged. It is the first sentence in the novel. And it is, it repeats itself throughout the novel. And of course, the mystery is revealed in the third part of the book. And in a sense, John Galt is, is, is the producer. John Galt is the thinker. John Galt is, is whatever it is within us that, that, that is focused on reason, that is focused on independence, that is focused on, you know, making the most out of your own life and making your life the best that it can be. And through being rational through being productive, that, that really is John Galt. So how does the Institute take this groundswell and guide it down the avenue that would be better, I presume, than the end of the book, which I haven't gotten to yet? Well, yes. And in the book, society collapses. And, and, and I ran said when she wrote Atlas Shrugged and said over the years, that she wrote Atlas Shrugged so that it would never happen to prevent it from happening. So we are, we're, we're not only happy because it's an, you know, I ran selling, but we're really happy because a lot of people are reading it. Hopefully they'll get the message. Now, beyond that, what we're trying to do is, is get the word out there on a, on a massive scale and explain what, what Atlas means and what the rest of the philosophy means. And we do that through programs targeted at high school students. We try to get her books taught in high school so we can take the 500,000 that bought the book in, in the bookstores and leverage that into hundreds of thousands of kids reading the books, which we do every year. We ship over 300,000 books to high school teachers every year to, and they teach Anthem and the Fountainhead and Atlas Shrugged. We have high school programs, we have university programs, and then we have a lot of, a lot of media and public speaking, a lot of commentary on what's going on in the world today, you know, particularly around this financial crisis and around the economic crisis, why state isn't bad? What are the solutions? How can we get away from what seems like an inevitable decline in the culture and the economy of the United States? They're solutions. This is not inevitable. And we're trying to get the message out there. And I think the Tea Party movement has been quite receptive to this message. If you went to Tea Party gatherings, you would have seen big signs about Atlas Shrugged and who is John Gultz and, you know, about Ayn Rand. They've picked up that there is a parallel between the book and what's going on. They are looking for answers. I generally view the Tea Party movement as a very positive movement, as a movement of people basically saying, enough is enough. We've had it. It's an expression of kind of the American sense of life. You know, we don't want government in our lives and we want, you know, we've tolerated it so far, but this is it. Enough's enough. And then the question is, do they have the intellectual ammunition? Do they have the intellectual knowledge and the capacity to present a positive agenda for resurrecting this country? And that's where I think Ayn Rand and I think where we can play a role in helping them articulate a positive position. It's great to say no. No is important to say, but then you have to have an alternative. And I fear that Tea Parties don't yet, but one of the things that we try to do at the Institute is present that alternative and hope that groups like the Tea Party pick it up and reverse course for the direction this country is heading in. Can you take us back a little bit and maybe tell our viewers what the difference is between individualism and collectivism and why we want to slant more towards individualism? No, we don't just want to slant more. We want to be all the way over. Collectivism is the idea that we as individuals should live for the sake of the group. And you can define a group in different ways. You can define the group as a race. You can define a group as an ethnic group. You can define the group as a country. Country first was McCain's slogan. That is collectivism. Placing some entity out there, some group above yourself. So your interests are not important. What's interest is the group. And every fascist regime, every totalitarian regime in history has used collectivism in one form or another to get people to sacrifice for the cause. We believe that that is wrong. And I think the founding fathers, the central revolution of this country was a rejection of the idea that your life belongs to somebody else. The very fundamental basis for the revolution is the idea that we are sovereigns of our own life. That you own your life. You have an inalienable right to your life, your liberty. And in the most astounding statement in human history, I think politically, you have an inalienable right to pursue your own happiness. That's individualism. Individualism is the idea that you own your life, that you are responsible for your life. You should be the beneficiary of the good stuff that you do. And you should suffer the consequences of the bad stuff. Makes sense to me. And Ayn Rand was born and lived through the Russian Revolution. Her parents lost their business as a result of the Russian Revolution and emigrated to the United States to escape that. So she lived through this, collectivism. I mean, almost a classic period of collectivism. Absolutely. You know, kind of some of the one of the worst forms of collectivism. There are many forms of collectivism. Communism certainly is one of the worst forms of it. A bad idea, you know, badly executed, but that's all you can do when you have evil ideas. You know, she lived through it. Not only was the business taken, all property was taken. So the house was taken.  I would recommend reading a book called We The Living, which is her first novel, and it's the most autobiographical novel. It's about her life. It's not about her life, but it's about a fictional character's life in the Soviet Union at about the age I ran lived through that. So it's very autobiographical, at least in terms of the sentiment. She managed to escape that. She, her family didn't. Only she managed to get out. She got out in the 20s and late 20s to the United States. And we were talking before the show. Well, yeah, but our viewing audience, we know we have a wonderful Dodge College of Film and Media Arts and an icon here in the Dodge College and a Chapman is Cecil B. DeMille, whose granddaughter, C.C. Presley, is on our board of trustees, donated wonderful memorabilia. We had a show on all of that. And there's a connection between Cecil B. DeMille and Ayn Rand. Tell us about that. Ayn Rand is a young woman, fresh off the boat from Russia. She goes first to spend some time with family in Chicago. One of the family members owns a movie theater. And Ayn Rand studied film in Russia and was fascinated by silent movies, American silent movies, and her dream was to work in Hollywood. So she comes down to Los Angeles and the first day in Los Angeles she goes to Cecil B. DeMille's studios and hands her a letter of introduction from her cousin in Chicago.  And Ayn Rand is this, you know, small woman with a very strong, heavy Russian accent and she's fresh off this boat and she walks out of the office and in the driveway is this big convertible and in the convertible is Cecil B. DeMille. And she stops and she stares. And he comes driving by and he stops the car and he looks at her and he says, why are you staring at me? And she says, you know, I'm from Russia, I admire your movies, I love your movies and I want to get into the movie industry. And Cecil B. DeMille says, get in the car. And she gets in and he drives her to the back lot where they are filming, you know, Cecil B. DeMille's silent movie, The King of Kings. And he gives a three-day pass. He says, if you want to get into the movie business you need to see how movies are made. And he gave her a pass and she, you know, she came and she becomes an extra on the movie. And we have photographs at the Institute where, of crowd scenes where we've marked where Ayn Rand appears. She actually met her future husband on the set of The King of Kings. He was also one of the Roman gods. And she managed to get jobs in Hollywood. She started out doing things like working in the wardrobe department. But her goal was to write scripts. And she landed up ultimately reviewing scripts for the different studios and ultimately became a script writer. And she wrote a number of scripts for movies before she became a best-selling author. So, you know, Ayn Rand's story is truly the American success story. It is, you know, the young immigrant coming here with nothing. And literally she came with nothing. And becoming a huge success and really becoming a cultural icon. I mean, it's not just that she made a lot of money in America. She did, you know, through the sale of her books. But she became, in a sense, more American than, you know, any other author you can think of. Atlas Shrugged is and fountain head of the American novels.  Unprecedented in publishing history. There is no other author whose books are not being picked up, let's say, by university system or by school system. But just on the power of the novels themselves and the power of the ideas, sales are far higher after they're dead than when they were their life. Just unprecedented. Let's talk about some current policies and issues, the issues of our time, and ask how would Ayn Rand look at them and maybe you can be her voice. And if you have a different point of view than Ayn Rand, give it to us. Let's start with what I think may be very important in the rising importance of Ayn Rand and the growth of a Tea Party movement. And this idea that we just experienced the Great Recession. Supposedly we're out of it, but it was the market system, it was capitalism, it was this individualism, this idea that greed is good, that led us into this Great Recession and now it's the government that's getting us out of it, President Obama's policies and so on, and there's a reaction against that. What would Ayn Rand say about the Great Recession and is that true? Is it true that that individualism caused it? So first let me say I can't channel her, so I hope what I say reflects, I believe what I say reflects exactly what she would say, but I'm sure she would be much more brilliant in her answer than I am.  This whole notion that in 2007 we had capitalism in America, we had free markets, we had rampant individualism, and that failed is just bizarre. Think of the markets that failed. Housing, mortgages, banking. Three of the most regulated businesses in America, I would argue banking is the most regulated business in America. Starting with Fannie and Freddie, instituted by the government. Well, Fannie and Freddie, but you know, because you have some knowledge of how banks work, but the banks are heavily, heavily regulated. You can't start a bank without having your business plan approved, your board approved, your CEO approved, your investors approved, regulators in your office and they can come in any time and they irregularly, they tell you when to sell the business, when to fire the CEO, everything. This is, if we have one sector of the economy that is fascist, fascist in a sense of government control without ownership, it is the banking sector. So here are the sectors of the economy that failed are clearly the most regulated control sectors in the economy. Fannie and Fannie, for example, each had a regulator dedicated only to regulate them, and yet each one of them had a whole regulatory agency just to regulate them, and yet they failed on a much bigger scale than any private bank did. So the more regulated, the bigger the failure. It's no accident that this crisis happened in banking and not in technology, which is not very regulated, or not in other industries that are not regulated. So this is, so first it's bizarre to think of this as a crisis of free markets, because we don't have free markets and we certainly don't have free markets in these industries. We have government controls and regulations over so much of what we do today in the business world. But if you start digging in, if you start peeling this off, you suddenly realize that, well, this is a government-caused crisis from beginning to end, whether it's the low interest rates that the Fed, Fed is a government entity, had interest rates at below the rate of inflation, anybody who's taking a finance class, that is a negative real rate of return, basically that paying you to borrow money, guess what people did? They borrowed money because they were being paid to do it, and they borrowed lots of it, they borrowed it on our homes and our cars and our credit cards and everything. This is, we took on too much debt, that's what this financial crisis is really about. That's a government entity, that's government-caused. Well, the government told us to give them, told the bankers to lend. Well, then Allen Greenspan actually went on television and said, in a new era of low interest rates, get variable rate mortgages. They're better than fixed rate mortgages. That was about the worst advice anybody's given to anybody in decades. But he was, it's Allen Greenspan. Well, Allen Greenspan speaks because he's chairman of the Fed, all powerful. But that's what happens to politics, you know, when we give governments so much power and so much control. Then we talked about Fenni and Fenni, government entities who encouraged these ridiculous mortgages and bought them and sold them and we packaged them, but created this market all subsidized by us, the taxpayer, and we're paying hundreds of billions of dollars to cover their losses. So this idea that the government caused the recession is absolute bunk. That the government caused it is true, that the market caused it is absolutely bunk. In fact, it's the government that got us into all of this. And then the idea that the government is going to get us out on that basis is absolutely preposterous. It's preposterous and the fact is that what we've learned is the opposite lesson and therefore everything the government is doing. I'd say since March of 2008, almost every action that's Federal Reserve and this Treasury Department is engaged in and Congress have engaged in, has been detrimental to the economy and to getting us out of this crisis. Even the stimulus package? Well, I mean there's an example in my view and you're an economist so maybe maybe I should commute to you. Well, no, we're aligned, I think. Stimulus package. So here's an example of a policy that's been tried many, many, many times. It was tried during the Great Depression and failed. It's been tried in the U.S. before and failed. It's been tried in Japan for the last 20, 20 years since 1990 on a massive scale and has been a massive failure. This is a classical example of the fact that economic facts, reality, does not drive policy. Ideology drives policy. Stimulus package is a way to grow government and have a veneer of an excuse to do it. That's all it is. It's to grow government power. They use economics as a veneer they use Keynes as a veneer. Keynesian economics has been proved to be wrong over and over and over again. It doesn't matter to anybody. But just think logically about a stimulus package. All the stimulus packages is taking money away from some people whether it's bondholders or taxpayers who are in the private sector who would use that money productively because nobody likes to just sit on piles of cash. They would actually invest to create jobs.  On the favorite projects of politicians. Anybody who believes that that could be more productive than leaving it in the private sector is delusional. The private sector is best to allocate that capital and indeed politicians waste it. It's destructive. The stimulus package in my view actually destroyed jobs. It's not an issue of how many jobs were saved according to Obama. It's literally destroyed jobs. Every job in the public sector destroys multiple jobs in the private sector. The only jobs that are meaningful are jobs that are productive. The jobs where stuff is being created, where services are being provided. And those jobs are private jobs. They're not public jobs. So in your view, would we be a lot better off without the Federal Reserve? Yes. In my view, we would be. Milton Friedman would agree with Anne that one. Milton Friedman I think at the end, you know, I think he alternated between two views. He believed that he probably believed that the Federal Reserve would just had it and therefore, you know, we needed to give it a rule and he had this rule for the Federal Reserve. You could say as long as you give it rules and take away its autonomous power. I'd say even if you had rules, it would be a bad idea because it's not a market institution and it doesn't respond to supply and demand. I believe that banks should be unregulated. They should be completely private. They should succeed or fail based on their own merits. They should not be deposited insurance. We as depositors should actually care whether a bank was run well or not. And I think that the Federal Reserve should not exist and banks should basically be issuing currency. And while that sounds bizarre and freaky, that's how the U.S. was from the Civil War until 1914. And during that period, the U.C. economy grew at the fastest rate in human history. We became the industrial powerhouse that we are. Many people don't realize that when we had a private banking system. I'd like to change from the economy to international politics and affairs. I'd be interested in what you would think on this particular issue. You know, Ein Rand was an atheist. And I wonder, what would she say about this planned Islamic community center and mosque near ground zero? Well, you know, I think that this mosque is a tricky issue. And I don't know exactly what you would say because I think it has some subtleties. But I think the most important point about this mosque is that the fact that is at the issue, the fact that we're even talking about it, is a reflection of the fact that we have no foreign policy. We have no clue what we're doing in the world. We have no strategy. We were attacked in 9-11 and we've been floundering since. And I think this is not a Republican-Democrat thing because I think I'm more critical of Obama than of Bush. But I don't think we've seen any change from Obama. I just think we've seen him continue Bush policies in worse, in a worse way. If we had actually recognized after 9-11 that we were at war, if we'd identified who we are at war with, if we had gone out there and crushed the enemy, which I think exists out there, brought our troops home, this would all be over now and who would care about a mosque one way or the other. You know, and they would indeed be so timid in my view that they would even consider building, the fact that they would consider building a mosque by a pretty radical sheik, Imam, a religious leader. At 9-11 this suggests to me that they think they're winning. And so think about this. Here's this Imam who I think is fairly radical, but yet the State Department sends him overseas to speak for America. I mean, how can we object to a mosque run by a guy who the State Department thinks is one of the good guys? Then you've got, he says, you know, he's ambiguous about Hamas, where the Hamas is a terrorist organization. But we have, George Bush is the guy who gave Hamas the Gaza Strip, right? He was the guy who assisted in elections among the Palestinians, which Hamas won. He recognized them, you know, their victory and in a sense, acknowledged them. So why can't we condemn this guy? Now, so there's so much hypocrisy. There's so, you know, non-existent real foreign policy based on principles, based on American self-defense, based on protecting this country and doing what's necessary to protect the lives and property of Americans.  Now, I do think that it's ridiculous that a mosque be built near the site. I do think that it's outrageous. I think that- It's three properties. It's their property that don't we believe in individualism and freedom of religion? We do, but at a time of war- Or not at war. But that's the problem. I believe we are at war. Whether the government has declared it or not, I believe we are at war. And I think, I think we should be outraged at the fact that the enemy, and I do believe that he represents the enemy, even though the State Department doesn't agree with me, that the enemy build a shrine to itself on the site of their attack against us, I think is a sign of defeatism and weakness and really surrender by the American people and the American government. War has changed its look. Yeah, and one thing I'm particularly worried about for the economy, but it's a global peace, and that is the possibility of Israel, perhaps in partnership with the U.S., bombing nuclear facilities in Iran. I think that's the greatest risk to the world economy, but world peace as well. What do you think of that? I think the risk is the reverse. I think the greatest threat to the world economy and to world peace is Iran building a bomb. If Iran has a bomb, that is a game changer. It's a geopolitical game changer. It changes the dynamics of the Middle East. It changes the dynamics of oil. It changes. It puts at risk the very existence of the state of Israel. I think Israel is really a threat. I don't think you can use the mutually assured destruction model of the old Soviet Union with a suicidal regime like the Iranian regime. These people, religious fanatics who believe that going to heaven dying for the cause of Islam is virtuous. I think we were lucky that the commies were atheists and believed that this was the only life they had. So if they launched, they would die and that was not a good thing. These guys, if they die for the cause, that's a good thing. So I really hope and I think the only thing the only thing that can sustain long-term peace or peace relative peace and can sustain economic growth long-term is if somebody takes out the Iranian nuclear reactor and actually takes out the whole regime, I think. Iran, unfortunately, we're out of time. We need a continuation. We can go on. Yes. We're going to have to you're one of our favorite guests. Yes, definitely. Christina has a thing for you, right? Well, it's just, Iran is a I think there's some very famous groups. I'm going to blush, yeah. Absolutely. I kind of have a thing for you too. So we want you to come back. We're good fans. Maybe when we come back we'll reassess the situation and see if it's surprised you or if it's consistent with the strong road that we're moving down.


Technology plays a huge role and it also is critical based on the various touch points that consumers are consuming media based on their receptivity habits and to that extent technology does play a critical role and that's where every company and every marketer has to step up to the need of the moment. Media has evolved phenomenally. There are people with infinite resources who can engage consumers at every touch above the line, TV, media, digital, but there are people who are with scarce resources. To them the one with the scarce digital plays a huge role and that's where the media consumption habits also have changed so dramatically and that's where it brings an opportunity as well as a challenge in terms of which media to engage, which consumers and at what point in time. And to that extent I would genuinely believe that every consumer has far many more choices and you have to be very very choiceful in terms of which way to engage him or her. Absolutely, I mean if you don't have the right candidates throwing money down the gutter so I would definitely not do any communication where the content is not engaging the consumer. First of all, do you know your consumer? Who is your consumer? Second is what is his or her barrier and what is that you are trying to overcome and why should he listen to you? Do you have a story that engages him or her and why should he believe you? So I think it's in that order knowing the consumer and taking him to the entire path to purchase till engagement and try your content. Absolutely, I mean that's the best part of not only effectiveness but also efficiency in the cost part of it. The more engaging content is the media cost can dramatically reduce by a huge huge portion.


Cold workers pneumoconiosis or black lung disease is caused by long term exposure to cold dust which is common in coal miners and others who work with coal. Most who might have black lung disease in our area end up traveling long distances to see a doctor since the current law states that only board certified pulmonary specialists can perform exams. I spoke with Governor Andy Beshear, Kentucky House of Representatives member Angie Hatton and CEO of Pipeville Medical Center Donovan Blackburn about House Bill 239 which would allow qualified physicians to perform exams for potential black lung cases. I believe by doing the right thing by addressing this problem and so many others we lead with our values in a way that shows this commonwealth but also this world what amazing people we have right here in eastern Kentucky. So no doctors in the eastern Kentucky coal fields or western Kentucky coal fields currently are qualified to be bee readers and bee reader doctors have their testimony given presumptive weight in black lung hearings and the presumptive weight doctors are the ones who are ruled to be correct. So we need doctors from the coal fields that are easily accessible to miners without traveling all day long and we need the doctors who are doing a great job already to be able to serve their clients in the coal fields. My husband worked 27 years underground before he went to work for the state and I've seen it first hand. I know the sound of a man's lungs turning black. It's nothing that you ever want to have to see or hear.   There is no cure. There's lung transplants which a lot of them aren't qualified for and I'm tired of seeing people that I love wait so long for hearing that they pass away before they ever get their benefits. Well, listen, our coal miners helped build not only this community in our state but this country. They powered this nation for so many years. In Kentucky they provided us the low cost energy that helped us bring in so many of our employers that are now our largest anchor employers all across the state and everybody should be treated fairly when they work hard. And for our coal miners all too often that hasn't happened. Whether it was our black jewel or other miners that weren't paid for work that they did or whether it is those suffering from black lung that have to drive to Louisville or Lexington just to see a specific doctor, that's wrong. It's time we stand up for our people and unfortunately our coal miners have been almost under attack. It's time we changed that. Well, you know one of the things that PMC did last year or about a year and a half ago was really invest more into our black lung clinic. So having the ability of doing the initial assessment and keeping people in the area, you know again these are our miners. These are the people that build our country. There are uncles or our fathers or our brothers or sisters or daughters and our mothers that went back into the abyss to really help not only again build this region but build this country. The very least that we can do with them is to accommodate them in a way that makes healthcare accessible to make the assessment accessible. So I applaud Angie and Representative Hatten on her initiative and the governor's support and all the legislators on both sides of the aisle because this isn't an R or D issue. This is an issue for Kentuckians that we need to look at and to address. So we're certainly proud to do our part as a hospital offering those services. But likewise we need to make sure that we're doing all we can to protect and to take care of our coal miners. It's a financial burden. It's a time burden and there's no reason for it. We have perfectly good world-class physicians in the coal fields.


We are going to discuss about some of the complications that mother may kind of experience, but you know to be frank in like over last 14, 15 years you know once we started learning the correct latching technique, once we started understanding lot of this counselling points I have not seen so many complications so I must confess that, but in case if you find a mother who has say nipple sore or if she has flat nipple or if she has any of those other conditions or even breast conditions so you know if she has say mastitis, if she has a kind of some lump in the breast, if she has any abscess you know we have created to tell them these tools are meant for healthcare workers okay. So we have not gone in detail exactly what to do like you know what medication to give or you know what kind of IND to do, we have not gone into that because this tools are clearly not meant for medical therapies okay or surgical therapies okay, but we have given the overall overview of you know what advice to give. So for example you know I do see in India that lot of this mothers they are given syringes or you know when they are say pregnant or after delivery if a nursing staff or doctor finds that the patient has flat nipple or inverted nipple or a trica nipple they use syringes and believe me I have not used any of those syringes ever many patient have a flat nipple what we do we only focus on the way to hold the breast in a cross cradle hold or any hold we make sure that the fingers of the mothers are parallel to baby's lips so if that is done then you know you do not need to use any syringe the whole areola becomes like a big nipple okay that is what is important you know you just have to contour the breast so the baby can be you know latch on really well so please if anybody is using syringes or nipple shield also you know absolutely no nipple shields on babies or mothers actually mothers areola are no need for any nipple shields okay so thank you so much do watch it and let me know what you think okay thank you welcome to this spoken tutorial on nipple conditions in lactating mothers in this tutorial we will learn about sore or cracked nipples and flat or inverted nipples the first nipple condition is sore or cracked nipples it is a condition where mother develops cracked and bleeding nipples this causes the nipples to become itchy and dry now let's discuss the various causes of sore or cracked nipples which are nipple feeding fungal or bacterial infection habit of cleaning the nipples after every feed and baby with tongue tie let us begin with the nipple feeding nipple feeding is the first and foremost cause of sore or cracked nipples during nipple feeding nipple gets rubbed on to the heart palate of the baby's mouth baby pinches this nipple between the heart palate and the tongue this pinching makes the breastfeeding painful and results into sore or cracked nipple nipple feeding is the result of improper latching therefore correct latching plays an important role to avoid sore or cracked nipples due to nipple feeding note that we have discussed the correct latching technique in another tutorial of the same series remember sore or cracked nipples does hurt during correct latching if the mother continues with the correct latching technique then slowly and gradually it stops hurting next is fungal or bacterial infection if the mother has fungal or bacterial infection she should consult the doctor next some mothers have habit of cleaning the nipples before every feed this causes dryness of nipples thus this routine should be avoided remember mother can clean the nipples once during bath however once a crack nipple has developed mother should clean it after every feed after cleaning mother should apply her hind milk on the wound as hind will contain substances that aids in healing and fighting infection thus preventing the organisms from baby's mouth to lick into the crack of the nipple next is the baby with tongue tie tongue tie is a condition in which the tip of the baby's tongue is attached to the inner bottom part of the mouth it is a very rare condition nipple feeding is commonly observed in baby with tongue tie in case the baby has tongue tie then mere correct latching is not enough and surgery is required thus in such cases mother should always consult the doctor now let's discuss the treatment for sore or cracked nipples if a mother has sore or cracked nipples then the health workers should examine the mother's breast and the nipple tell the mother to express some breast milk with her hand before breastfeeding it will soften the breast and baby will easily attach apart from these expressing will reduce the risk of infections nipple fissure and mastitis then guide the mother to attach her baby correctly to her breast remember breastfeeding frequency is one of the factors which determines the breast milk supply therefore mother should not stop breastfeeding during breastfeeding she should begin to breastfeed on the side that hurts less if breastfeeding is still painful then she can express the breast milk using her hand and feed it to the baby with a spoon or a cup also apply few drops of hind milk onto the affected area after each feed as discussed earlier remember not to use the following on sore or cracked nipples and even on healthy nipples soaps oils lotions bombs and perfumes they may contain irritants it will worsen the condition if a mother has sore or cracked nipples in severe conditions mother should consult the doctor or the health worker for preventing sore or cracked nipples start breastfeeding immediately after birth always make sure that baby is lashed on deeply while breastfeeding the nipple condition that we will discuss next is flat or inverted nipples flat nipples are not protruded from the level of the areola whereas inverted nipples are usually pointed in the inward direction it is very important for the mother to understand the fact that flat or inverted nipple is not a hindrance to breastfeeding since during correct clatching baby latches on to the areola and not on the nipple note that in case of flat or inverted nipples mother requires help in first week of delivery during this period health workers should guide the mother about correct clatching this will build her confidence remember in case a mother has flat or inverted nipples then the best holes for effective attachment are cross cradle hold football hold and semi reclining position as explained in an earlier tutorial in any hold it is of utmost importance that mother should hold the breast in the correct manner where baby's lips and mother's fingers will be in the same direction note that incorrect clatching will result into sore nipples remember do not use feeding bottles or nipple shields it will make difficult for a baby to breastfeed from breasts having flat or inverted nipples mother should provide plenty of skin to skin contact to the baby it helps stimulate oxytocin reflects in the mother and breast milk easily comes out always remember correct clatching is the key to deal with most of this nipple conditions this brings us to the end of this tutorial welcome to the spoken tutorial on the complications of using nipple shields in this tutorial we will learn about nipple shields disadvantages of using nipple shields suggestions for adequate breastfeeding let us begin a nipple shield is used to help with breastfeeding it is a nipple shaped cover made of plastic silicone latex or other materials while breastfeeding it is positioned over the nipple and ariola it is a temporary solution to help the baby latch on to the mother's nipple nipple nipple shields are usually recommended to mothers who have flat nipples they are also recommended to mothers who have inverted nipples they are also used when the baby doesn't latch on or suck the breast properly mothers with cracked nipples also use them to avoid pain however use of nipple shields during breastfeeding has many disadvantages they create a barrier between the infant and the mother's breast they make breastfeeding feel unnatural they reduce the stimulation of the ariola this may interfere with prolactin and oxytocin release in the mother prolactin and oxytocin are hormones needed for lactation prolactin helps in breast milk production oxytocin helps in releasing milk out of the mother's breast therefore nipple shields reduce breast milk supply during breastfeeding this increases the overall time taken for breastfeeding the mother and the baby feel tired after feed on long-time use the infant becomes dependent on nipple shields infants may refuse to breastfeed without a nipple shield this dependency combined with reduced breast milk supply is not good over time it decreases breast milk production therefore it causes early weaning early weaning is found among many mothers who use nipple shields nipple shields prevent the nipple from reaching deep inside the baby's mouth this does not let the baby deeply attach to the mother's breast this might also interfere with the baby learning to suckle correctly the baby's suckling pattern is changed when a nipple shield is used nipple shields increase the baby's sucking speed they also increase the baby's time spent resting during breastfeeding the baby might swallow too much air because of the nipple shield nipple shields often fall off the breast thereby interrupting breastfeeding nipple shields give a feeling of inconvenience to the mother and the baby it is difficult for the mother to clean them later after use hence they increase the chances of passing the infection to the baby a nipple shield with an improper hole gives poor flow of milk this can tire the infant and cause poor growth sometimes nipple shields of improper size or fit are used they can cause choking in infants they can also cause or worsen cracked nipples in the mother nipple injury from squeezing of the nipple and areola is possible nipple shields should not be recommended if the baby is not sucking properly the current research does not yet show safe practices for using nipple shields some experts recommend nipple shields when the baby refuses to breastfeed causes for refusal may include flat or inverted nipples they also include premature birth another cause is the baby not sucking the mother's breast properly other causes are neuromuscular issues or imprinting imprinting is a behavior that happens in the early hours of life ideally the baby naturally attaches to the mother's breast after birth however without early breastfeeding the baby attaches to something else it could be a thumb bottle plastic nipple etc this causes the baby to refuse to breastfeed sometimes a mother may be stressed she may be considering bottle feeding in such cases nipple shields may provide temporary relief to her they may also prevent bottle feeding she must be helped by a lactation expert properly some mothers may wish to use nipple shields for longer periods however they must go for regular follow-ups to check if the shield is helpful here the risk of the baby not feeding directly from the breast is high self-made nipple shields should not be used nipple shields should not be altered for use sometimes a mother may ask about using a nipple shield it is important to first ask her about her breastfeeding technique and problems inquire about her breastfeeding history inquire about her attempts to correct the baby's breast-sucking technique then offer suggestions to correct the mother's breastfeeding technique nipple shields should only be initiated by a healthcare provider they should be an expert in breastfeeding skills they should thoroughly assess the benefits and risk of using a nipple shield they should also plan with the mother for regular follow-ups while using it babies can get used to breastfeeding with a nipple shield later they may refuse to breastfeed directly from the breast without a shield they may also not be able to attach deeply to the mother's breast later therefore follow-up is especially important in the first 48 hours mother should be helped to wean from the use of a nipple shield some healthcare providers cannot help the mother appropriately they should refer her to a lactation expert mothers should always be taught the proper techniques of breastfeeding she should know that babies must attach to the lower areola not to the nipple so it is not mandatory to have a protruded nipple for the baby to attach most often the nipple can protrude naturally with the help of deep latching this happens over a few days due to good sucking by the deeply latched infant the use of nipple shields can make this natural process difficult initiating breastfeeding within one hour of birth is important to do so skin to skin contact must be performed immediately after birth skin to skin contact after birth is explained in another tutorial mother should also learn the correct techniques of breastfeeding cross cradle hold is one of them this hold will help in adequate breastfeeding even if the mother has flat nipples in this hold the mother's fingers on the breast are parallel to the baby's lips this helps the baby latch deeply to the breast cross cradle hold is explained in another tutorial of the same series patients in learning breastfeeding skills must be encouraged repeated attempts must be made to breastfeed without a nipple shield remember exclusive breastfeeding for the first six months of life is crucial breastfeeding must be effective for the baby's growth correct breastfeeding techniques will ensure that the baby gets enough milk milk any artificial product can never replace natural breastfeeding an expert must always guide a mother to learn proper breastfeeding skills this brings us to the end of this tutorial thank you for joining welcome to this spoken tutorial on breast conditions in lactating mothers in this tutorial we will learn about breast engorgement and mastitis let us begin with breast engorgement engorgement occurs most commonly between three to five days after delivery it occurs in both breasts simultaneously mother should not confuse breast engorgement with breast fullness thus now we will discuss the difference between breast engorgement and full breasts in engorgement breast become firm swollen and painfully full of milk it gives shiny appearance and shows dilated veins on the surface mother may suffer from fever that lasts for more than 24 hours and latching becomes hard for the baby whereas full breasts are normal full breasts appear big but they do not give shiny appearance full breasts are not painful and fever is absent during breast fullness now let's discuss the causes of breast engorgement in lactating mothers breast engorgement can occur in the following conditions if mother has not fed the baby soon after delivery mother is not feeding the baby frequently baby has poorly lashed on mother's breast during breastfeeding and mother has stopped breastfeeding suddenly now let's discuss how engorgement can be treated first ask the mother to wash her hands with the clean water then bring the baby closer to the mother so she can see smell and touch the baby if baby is too fuzzy mother can smell the baby's towel after that mother should drink a glass of water then keep wet warm cloth on the breast for five to ten minutes or mother can also take a warm shower it will help the breast milk to come out after that health worker should tell the mother to relax as excess of stress will affect the let down reflex and milk will not come out now either health worker or any family member should massage on the mother's neck and upper back it will help the breast milk to come out since nerves apply towards upper back and breast is same then mother should start gently massaging her breast in circular motion massaging will make her relax and will improve the let down reflex all these things will help in releasing of oxytocin it is known as oxytocin reflex or let down reflex oxytocin is a hormone which helps the breast milk to come out then mother should manually express some amount of milk to soften the areola it will help the baby to latch on the breast correctly during expressing the breast milk mother should apply pressure around the areola after expressing mother should guide the areola in the baby's mouth as it would be difficult for a baby to self attach try to breastfeed on both sides between the feeds mother should keep wet cold cloth on breast for 5 to 10 minutes or mother can keep cold cabbage leaves on breast she can store this cabbage leaves either in refrigerator or in earthen pot it helps in reducing the tenderness and edema in the breast then mother should breastfeed frequently now let's learn how can we prevent breast engorgement first try to understand the hunger signals of a baby such as squirming, increasing rooting reflex in rooting reflex baby turns her head towards anything which touches her cheek or mouth sucking on fingers in late stage the baby starts crying breastfeed the baby whenever she shows early hunger signals and not wait for the baby to cry make sure that the baby is latched on properly and feeding well remember empty one breast completely before you switch to the other side next let's learn another breast condition called mastitis it is a condition where part of a breast becomes red, swollen and hard mother feels severe pain, fever and ill many mothers go through mastitis in first six weeks but it can occur at any time during lactation it is sometimes confused with breast engorgement however engorgement affects whole breast and often both breasts whereas mastitis affects part of the breast and usually only one breast mastitis may develop in an engorged breast or follow condition of block ducts now we will discuss how block ducts develops into mastitis if untreated block duct is a condition where milk is not removed from the part of a breast usually this duct is the part of breast blocked by thickened milk it leads to lump formation this lump is tender and often present with redness of the skin over the lump block duct and breast engorgement causes milk stasis when milk stays in part of a breast in block ducts and breast engorgement it is called stasis if this stasis is not removed it could lead to inflammation of breast tissue it is called non-infective mastitis whereas sometimes breast becomes infected with the bacteria and this is called infective mastitis in following conditions bacteria will easily enter through fissure if fissure is present on the breast mastitis remains untreated and delayed treatment note that breast abscess is a progression of untreated mastitis now let's discuss the causes of mastitis the first and foremost cause of mastitis is infrequent feedings if lactating mother is a working woman then frequent breast feeding becomes challenging other reason for infrequent feedings could be illness in mother or a baby second is nipple feeding in nipple feeding baby will not empty the breast completely third is oversupply of milk fourth is rapid weaning where baby eat other foods apart from breast milk fifth is tight clothes if mother use tight clothes especially in night if mother wears a tight bra it brings pressure on the breast and can block the milk ducts sixth is maternal stress if mother is going through any stressful conditions it will affect the let down reflex seventh is nipple fissure it provides a way for bacteria to enter the breast tissue and may lead to mastitis let's look at the treatment for mastitis first try to identify the cause and then start the treatment mother should use warm compresses before breastfeeding or should take a warm shower she should start breastfeeding from affected breast first if it is increasing the pain or affecting the let down reflex then start with the unaffected breast remember frequent breastfeeding is necessary if the open wound is not on the nipple or on the areola then mother can breastfeed on the affected side remember whenever a mother is feeding to a baby from mastitis breast she should monitor the baby for signs of infection as there will be a risk of infection to a baby since breast milk from affected side will have many harmful bacteria massaging the breast may improve the milk supply it should be a gentle massaging from affected area towards the nipple and mother should take enough rest if symptoms are severe then she should refer to the doctor breast abscess will require surgical drainage of abscess and antibiotics apart from these mother should make a special effort to relax her body and breathe deeply and evenly listen to the soothing music and think about your baby to help in starting the let down reflex remember for preventing mastitis correct clatching is necessary it will avoid blocked dug and baby will get enough milk keys to prevent all these breast conditions are proper attachment and positioning of a baby and frequent breastfeeding this brings us to the end of this tutorial thanks for joining


a fiery horse for the speed of light, a cloud of dust and a hearty high old silver, the lone ranger. When the Western United States were first open to settlers, the promise of easy wealth brought both honest men and criminals to the new territory. Both found that wealth could only be purchased by hard work and the criminals returned to their old habits. The mass crowd of the planes fought them tirelessly. However, as fried his great horse, Silver, he rode through the length and breadth of seven states in the cause of justice. And in time, he brought law and order to the lawless frontier. Return with us now to those thrilling days when the West was young and adventure lay at the end of every trail. The lone ranger rides again. Vic Adler, the sheriff at Carter City, his face grim and his fists clench, nervously paced the floor of his living room. His eyes never left the door leading to his wife's room. Finally, it opened. And John Mackenzie, Carter City's elderly doctor, came out, closing the door softly behind him. Doc. Easy, man, easy.  But I got to know, Doc. I got to. Is she gonna get better? She can be cured, Vic. Thank heavens for that. But, but what? Well, Vic, you might just as well know the worst of it now and have it over with it. The worst of it? Doc, what do you mean? She needs special treatment if... There, there ain't no way out of it? It's absolutely necessary. Then she'll have it. When can you start, Doc? Not so fast, Vic. But I want you to... I can't do it. I haven't the training or the equipment. It'll take a doctor in one of the big cities. It will. And that Vic will cost money, I'm afraid. Look, Doc, I got close to 300 saved up. Would that be enough? I'm sorry. You mean it wouldn't? Vic, the kind of doctor your wife needs comes high. It would cost you $1,000 at least. $1,000? And that's not counting the cost of sending your wife away and keeping her there while she's being cared for. Would she have to be gone for long? Oh, three, four months, perhaps. And all that, it cost close to another $1,000. I'm sorry, Vic. If there are anything I could do... Sure, Doc, I know. You could borrow the money. On the sheriffs, wages. Hmm. Have you told Mary? She insisted, Vic. Uh-huh. That's the way she is. They don't make him any braver in her. She wanted me to keep it from you. She said there was nothing that could be done and that telling you would only make you unhappy. But I thought you ought to know. Thanks. Well, I'd have to be leaving now. Anyhow, Doc, you've done what you could. And well, I'd sort of like you to know I appreciate it. You don't have to tell me, Vic. If you need me, just call. Oh, uh, and another thing. Yeah? There'll be no charge for the calls I've made, Vic. That's, uh, well, we'll say that's a gift from one friend to another. Goodbye. Doc, you're one of the finest fellas I've ever known. But heaven helping, you will be paid. So long. Oh. I guess as bad as things seem, a fella could be worse off if he didn't have a friend like the doc and a wife like Mary. Knock, knock, knock. Is that you, Vic? Can I come in, honey? Of course. He, he told you. Honey, how did you know? Vic, you never have to speak a word. I'd still know what you was thinking. Well, I, I reckon I never was much of a hand for hiding things from you. Well, then stop your worrying. Everything's going to be all right. Sakes alive. Doc McKenzie's most likely mistaken, anyhow. Honey, listen to me. Yes? I know you're saying them things just to make me feel good. It's your style. And maybe that's why I've always loved you so much, Vic. But there's one thing I'm swearing to. If it's going to take $2,000 to make you well, then I'm going to get it for you. I don't know how. But there'll be a way, and by heaven's I'll find it. It was several days later that the lone ranger called a greeting to his faithful Indian companion. Tonto just returned to their small, well-concealed camp after a trip to town. You're back early, Tonto. Oh, Scott. Oh, you got the supplies we needed? Huh? Me got them. Well, why did you come back so soon? Me see, Pellar. Me think, crook. What's that? Me not sure. So me won't tell you. You mean he's someone we've seen before? That's what Tonto think. What did he look like? Him big, Pellar. Him got beard. Him wear a gun by left hand. Big man with a beard and left handed. How was he dressed? Him wear a black coat. Like a gambler's? Not right. I thought that sounds like Wolf Corby. I'll have to go into town after all. You wear in disguise? Yes, I'll put on the disguise. And if the man you saw is still there, I'll know at once whether he's Wolf Corby or not. But even as the lone ranger spoke, Wolf Corby and one of his lieutenants, a man known as Squint, were reigning in their horses before the sheriff's office. Hold it, man. Sure, this is safe, Wolf. And I've been in town for an hour a week without being recognized. Don't you worry about anybody in these parts knowing who we are. It'd go bad for us if we was caught. Yeah. After I get through talking with the sheriff, that'll be took care of. Come on. You let me do the talking. I say we ought to handle his kind and you don't. Suits me. Come in. Howdy, sheriff. Howdy. Ain't you the stranger I've seen around town for the last few days? That's me. This here is Squint, a part of mine. Pleased to meet you. Howdy.  The tall one's Mike and the short one's Sam. I'll do. I'll do, stranger. Howdy, fella. Sheriff, would you mind if me and Squint was to speak to you alone? Alone? It's something mighty important. You can tell your deputies about it later if you ever mind it.  Yes, you say, Sheriff. We'll take a walk down the cafe. See you later. Well, then, what's on your mind? Sheriff, like you've noticed, I've been around for a few days. And being a good listener and sort of going from here to there doing all the listening I could, I've heard a few things. Yeah? For instance? We're like your wife being sick. What's that to you? Now, hold on, Sheriff. You can't blame me for knowing what everybody in town knows, can you? I can not. And another thing I heard was how the banker turned you down when he asked for a loan. Not only the banker turned you down, but everybody else in town with any cash. Seems to me you've been making my affairs your business. Maybe I have. In that case, take my advice. You're getting mad because we want to do you a favor? Sheriff, I said a favor, and that's what I meant. Just how much would you like to get your hands on a thousand in cash with another thousand later on? A thousand in cash? Right. You mean you're offering me that? You, a stranger? That's what I'm here for. You're local.  What chance would I have of paying you back? That won't be necessary. But I don't get you. You can pay me back all right. And you won't need cash to do it neither. No. Look here, let's put our cars on the table. Suppose I was to hand you a thousand dollars. Then suppose that later on somebody in your county got robbed and was mistaken enough to claim me or my men done. Oh, that's your game. Then, Sheriff, all you'd have to do is point out how foolish they was to think as crooks. I've been an honest sheriff for 20 years, and you skunks come in here offering me a bribe. That's just it, Sheriff, a bribe. A thousand dollar bribe. You're under arrest. You got witnesses to anything I've said? I don't need them. The folks around here take my word for things. The banker and the rest of them are rewarding you for your 20 years of being an honest sheriff by refusing to let you have the cash you need. The cash you need to save your wife's life. Just think that over. Get out. Changing your mind about arrest, understand? I'll have to get out before I change my mind again. Sure, we'll go. Remember what I said. A thousand now and a thousand after we've pulled a few raids. $2,000. Just what you're needing to send your wife away. You. Just think it over, Sheriff. Just think it over. Come on, Smith. Let's get moving on. That night, striking with the ferocity of a pack of wolves, Corbyn's men descended upon Mort Powell's ranch house. Inside, fellas, you shoot down the first dog, right-raising the hand of stoppers. Come on. Lift your hands, Proto. Let's just hold up.  Search the place, fellas. Mort's got cash here, and we're taking it. Now get moving. Come on. The following morning, when the sheriff unlocked the door of his office and walked inside, he first noticed a broken window, and then a bundle wrapped in paper that lay on the floor just below. Now, what in Sunday? The whistle blamed anxious to deliver a package if they had to bust the window to do it. Then let's just have a look at it. Wrapped up good. Can't figure out what a lovely folding money and $1,000 of it. I'll bet I know who threw this in here. My fellow that had come to see me yesterday wore the low-down lock. Sheriff, Sheriff, are you there? Anybody was to see this cash. Why is it, Sheriff? Can't you hear me? Just a second, Mort. Just hold on a minute. The drawer. I'll do for now. I'll find a better place. I can't wait all day. I'm coming. Now, what in blazes do you want? You come along with me. Come on. Maybe here'll be gone before we get back there. Who'll be gone? Where'll be gone? To the cafe. But I don't. Do you recollect my center of one of my men into town last night to tell you about them outlaws raiding my place, don't you? I sure do. Well, I'd just seen one of them robbing pole catch. I did. And he's in the cafe right now, unless he's got away while I was trying to get you. You mean you recognized him? You bet I did. And you're jailing him. Is he a fellow from town? Nope, a stranger. You better be awful sure you're accusing the right fellow. I couldn't be no more sure of my own name. But you're no more. Here we are. Come on. He will stand in the bar having a drink the last time I seen him. What's it look like? He's tall with a beard. Oh, that fellow sitting at the table there, huh? Well, I'll do it. That ain't him. There's the one I mean by the bar. Oh, him? That's him. Now go on and arrest him. I'll give you all the evidence you need. But now, Mort, I've. I just hear somebody say something about arresting me. You're arresting even crook and you can't fly out of it. Go ahead, Sheriff. Do your duty. Well, I. What do you stand there for? Arrest him. Sure, Mort, sure. Stranger, don't try to get away. I'm the law here and you're going to jail. The curtain falls on the first act of our thrilling Lone Ranger drama. Before the next exciting scenes, please permit us to pause for just a few moments. Now to continue the story. Although the $1,000 offered to him by Wolf Corby as a bribe was lying in the drawer of his desk, the sheriff was forced to arrest the outlaw when he was identified by Mort Powell. He just stand there grinning at you, Sheriff. Show him you mean business. Didn't you hear me when I said you was under arrest? Now just wait a minute. I ain't no crook. There's some mistake. If I could maybe have a word in private with the sheriff here, I reckon it could be fixed up already. What have you got to say to the sheriff alone? Why, I just thought I'd explain to him why it is I can't be the crook you think I am. Unless, of course, he'd rather have some explaining to do. Huh? What did he mean by that, Sheriff? Just wait a second, Mort. And I'll see what he's got to say for himself. Well, I'll be hogtied. You're going to listen to the skunk? Mort, you let me handle things my own way. Vic, I've known you for 10 years.  I know my job. Step over here, stranger.  Now don't get excited, Mort. Look here, you loader. You ain't arrested me, Sheriff. What's to stop me? You've got the $1,000 that I sent you. Sure. But you'll arrest me, and I'll tell about you having that cash. I could explain it some way. It ain't likely. And there's something else maybe you didn't notice, huh? Every last one of them bills are marked. Jail me, and I won't only tell folks you've got that money, but I'll describe them bills so there can't be no mistake where they came from. I'll get rid of them. Yeah? You'll still have to arrest me first before you get the chance to do it. And then it'll be too late. I'll see to that. You. If you ever arrest me, all I'll have to do is tell why you didn't arrest me this time. And this is going to look suspicious enough so those folks will believe my story. I don't know what to do. Then do like I say. Yeah? Tell Mort you seen me in town last night. About the time his ranch was raided, that'll give me an alibi. And don't worry about me being recognized another time. I just let Mort see me last night so as to force your hand. The lowest rottenest thing I ever seen. You got me where I have to do like you say. Thought you'd see sense. Now, if I was you, I'd pretend Mort must have mistook me for that fella sitting over there. He's tall. He's got a beard, too. Come on. Mort, you was wrong. Sheriff, did I hear you right? This couldn't be the fella you met, Mort. What in places has he been saying to you? Well, he was just reminding me where it was I seen him last night. After he described it to me, I recollected him. And it was the time you said you was robbed. So of course it was. Sheriff, you've gone crazy. I'll swear you were the man that. Mort, that stranger over there looks suspicious to me. Hey, there you. Step over here. You were talking to me, Sheriff? Yes, you. That ain't the man. You was likely so excited last night, Mort. You didn't know what he was. I want you to answer some questions. That's what. Yes? What's your business in town? Where was you at last night? What's the handle you go by? I don't know. There are a lot of questions. What if I don't answer them?  No, I won't. It's a draw. Slap by the shelf and out fire. Don't follow me. After him, you'll go after him, if you mind, Sheriff. But I'm staying right here.  I don't know what's got into you. But it's something funny. And maybe I'll find out what. I didn't see the man you described, Otto, until this morning. And it was Wolf Corby, all right? You tell, Sheriff. No, there's something strange there. What that? I know the sheriff's reputation. Everywhere in the state, he said to be one of the most honest sheriffs Texas ever had. That's right. But today, he not only refused to arrest Wolf on the word of a truthful witness, but he tried to arrest me instead. Why him do that? I'm not sure, Kimosabe, but I've got an idea. Huh? When I was in town, I learned a number of things. One of them is that the sheriff has been trying to raise money to care for his wife, who was seriously ill. That looked bad. But this morning, after the sheriff had tried to arrest me, I pretended to leave town. I circled back and waited for the sheriff to return to his office. And I saw him take paper money from his desk. Where him get money? That's what I don't know. But it could have been a bribe from Wolf. Him not take bribe?  Any man might weaken under those conditions. But if the sheriff did take a bribe for that reason, I have a plan. What that? First, we'll go back to town, Kimosabe. Then we'll pick up Wolf's trail. I noticed the direction he rode from town this morning. Then what we do? And then we'll pay a call on Wolf and his gang in their camp. Let's go town. Get them up, Scarlet. Come on, Silver. Their work in town finished. The masked man showed Tonto the direction in which Wolf had traveled. And the keen eyes of the fateful Indian followed the outlaw's trail to the gang's hidden camp. We see the masked man and Tonto as they set astride their horses, hidden from the outlaws by a grove of trees. My mask will probably convince them I'm an outlaw. So I don't expect them to make trouble. But you stay here. If anything goes wrong, you'll be able to help. Tonto will do that. I'll have to pretend to know more than I do. My guess was wrong. If they didn't bribe this year, they'll probably suspect me. But if I was right, then our plan should work. Tonto will not think you do wrong. Keep out of sight, Tonto. I've worn my way. Me? Take care. Come on, Silver. They'll have to do our best, old fellow. Too much depends on us to fail now. And they've seen us. Hey, what's up? A mask! Where did you come from? Oh, Silver. Hey, look here, you. We don't like strangers come busting into our camp. Go! So you can just turn around again and start traveling. Very well, Wolf. You know my name? I know your name. And I know that you're going to lose the money you paid the sheriff for. Just a minute. Hold on. Seems to me he knows an awful lot, boss. Hang on to him and make him talk. That's what I came here for. Stranger, just who are you? That doesn't matter. He's some kind of a crook, boss. Take off that mask he's wearing, and maybe we'll know him. Don't try it. We want a gunfight or information. What I want to know is how you found out about the cash I gave the sheriff. Did he tell you? He didn't. Then who did? I found out for myself. Just as I found out, you've been tricked. Tricked?  But when you paid him, there was something you didn't know. What's that? You probably wouldn't believe me if I told you. All right, Thunder, you'll talk or we'll make you. I'll do this, Wolf. I won't tell you myself. I said you wouldn't take my word for it alone. But I'll send you to a man whose word you'll believe. Yeah? You know John Mackenzie, the doctor in Carter City? I know him. What about it? I'll talk to Mackenzie and ask him just one question. What question is that? Ask him how long he expects the sheriff to live. Huh? Kay, do you mean it? You'll find out what I mean when he tells you. That's thousand. If something's going to happen to him, if he won't be able to give us protection after taking our cash. And why were you, Wolf? I'd see Mackenzie as soon as I could. I'll do that same. Hey, what are you telling me this for? It might be that I want to join your gang. Yeah? So that's it, huh? You can draw your own conclusions. Strangers, we're going to look into what you said. Good. All of you. Get to your horses. We're riding. And stranger. Yes? If you've told us the truth, you can join us anytime. What's more, we'll make it worth your while. You coming with us? Steady there. No. But I'll give you my word. You'll see me later. That suits me fine. Everybody ready? And come on. Get over there. Get over there. Just a moment.  That gun. Doc, take a good look at that shooting eye and then start talking. Talking? There's something I want to know, Targon. Bear, you can tell me. Yes? Well, one thing is there's something wrong with the sheriff. But you're asking me to tell a professional secret. Tell or get grilled. Well, I've seen men in better health. Don't try to fool me. Talk out and talk straight. Is there anything wrong with them that you'll maybe die from? I- Quick. I shouldn't say. I'm giving you one more chance. If you don't take it, well, then maybe you won't never talk again. Now, let's have it. It's possible that he might die within a week. Within a week? It's very possible. That's all I wanted to know. But wait.  Was the man back around the truth, boss? Yep. He was. He's got the cash. What are we going to do? Take it back and make him wish he'd never met up with Wolf Corby. Right now, we're heading for the sheriff's house. Get up there. Get up there. What is it? Stand where you are, sheriff. You again.  One squint, Blackie. Keep the sheriff covered. Right. You'll wake my wife. That's just too bad. Not too bad.  You know where we've just been? Huh? To see the duck, that's what. And he told us the truth about you.  Taking the cash I gave you, and all the time knowing you wasn't going to live long enough to do so any good. Are you a local? I figured we wouldn't find it out, huh? I don't know what you're talking about. Right, sir.   Will you? I ain't got time to argue with you. Where's the cash? You want it back? I want it, and I'm getting it. I'll get it for you. I won't. Just stay where you are. You tell us and we'll get it. I ain't taking chances on no more of your tricks. That desk. It's there? Which drawer? The bottom one. In the cash box. Look forward, squint. I'll find it. But, but there's more. And what belongs to you there? You ain't going to take the cash as mine, are you? I ain't particular. Here's the cash box, boss. Bring it here. It weighs pretty heavy, woof. There's more than just folding money in it. You got the key, sheriff? And I'll open it. Give it down, squint. It'll find my keys. And I hear they are. This is the one. There. Now I'll take it. Use the thousand, all righty. Gold and silver, too, eh? Well, that's just fine. I reckon I'll just take the whole thing along. My life's savin'. Nice of you, sheriff, to save it for me. Now, for you, woof. My plan. There's the game. The master and the sheriff's deputy. Come on. And you run.  You can't arrest us. We can't? Well, you're already arrested. Sheriff, look here. This thousand, you've talked about the thousand, woof. The sheriff took it. It was a bribe. He took it. What kind of a yarn is that? You pulled cash out of your pocket and tried to claim it as a sheriff's. Now I suppose you'll say what's in that cash box ain't the sheriff's. The maskeller. It was him that done this. Say, and he wanted to join us. I said I might want to. It was a trick. The sow bones, right? They didn't lie, either. He said it was possible the sheriff wouldn't live. The same thing could be said of any one of us. You hear that, woof? The maskeller knew what the doc said. I better make him and he put doc up to it. That's enough out of you, fellas. You're heading for jail a whole lot of you. And, sheriff, yeah? When the maskeller came and got us, he told about woof being wanted in Montana. There's blame near $3,000 in reward money on the heads of him and his gang. There is. Then where's the maske gone to? Get a hold of him. Tell them the reward's his. That ain't the way he wanted it, sheriff. Huh? It was his rightly so I could do with it what he pleased. And he said it was to go to you so your wife could get the kind of doctrine she needs. He said that. Sam, the NFL, I know of that do a thing like that. Except one. And that's the Lone Ranger. For you have just heard is a copyrighted feature of the Lone Ranger Incorporated.