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Compassion - the Authentic Tea podcast with Susy

Susy is trained as a TimeToThink coach and supervisor and currently shares her expertise as Associate Dean and Coaching Lead for Health Education Yorkshire and Humber.

In addition to her amazing roles in medical education and leadership, Susy is also the founder of Hestia Blankets, her textile studio creating beautiful Harris Tweed blankets.

In her leadership roles, Susy supports doctors and healthcare professionals to be their best selves and do their best work.

In Episode 27 I am joined by Susy. We chat about how the quality of what we do is related to the quality of our thinking. Susy shares her thoughts on the value of coaching to provide protected time to think and how compassionate leadership can allow individuals to thrive.

Rachel: (00:00):

Today I am excited to be chatting with Susy. In her leadership role, Susy supports doctors and healthcare professionals to be their best selves and to do their best work. Susy has trained as a Time to Think coach and supervisor and is currently sharing her expertise as associate dean and coaching lead for health education in Yorkshire and Humber. In addition to these amazing roles in medical education and leadership, Susy is also the founder of Hestia Blankets which is her textile studio creating beautiful Harris Tweed blankets. Welcome, Susy.

Susy: (00:33):

Thank you. Thank you for such a lovely intro, Rachel.

Rachel: (00:36):

I'm so excited to be chatting with you today. I have to confess that we came across each other years and years ago, and you're definitely a part of my own path and journey to where I am today. I am so pleased that you've continued that on particularly in supporting other people in their medical education and their leadership development. Maybe we could start with medical education and what you think about the value of coaching and how you think that organizations particularly within the NHS in the UK but other healthcare organizations as well can use coaching to support doctors to be their best selves.

Susy: (01:17):

First of all, thank you for those kind words. It's been a pleasure and a privilege to walk alongside you for some of your decision-making. With regard to coaching and medical education, well, I would ask you two questions I think like a true coach. The first is, when was the last time that you were able to think to the end of your thoughts? I'll just leave that with you to know. And then the second one is, how do you personally answer a question that doesn't have a Googleable answer?

Susy: (01:54):

When we consider those well, let's think about the first one. Mostly we don't think to the end of our thoughts, so we're not enabled to do so. In other words, we're interrupted and then our thinking stops or is at best stifled. Coaching is protected at Time to Think. That's independently of other people, that's thinking for yourself. I think we can see that medical training is excellent at teaching how to follow guidelines, appraise evidence, look at what's been done before, follow the recommendations. All of which are an essential part of good patient care and safe practice.

Susy: (02:33):

But the things that people struggle with once they get further into their professional responsibilities are not how to implement best practice guidelines. They're about working out how to manage challenging relationships and how to work out who they are in their particular role, what they stand for, and therefore what they stand up for.

Susy: (02:53):

These are also all essential components of good patient care. We know that if we have poorly functioning teams, we know now that patients do worse. So that's huge. That's hugely important for a patient well-being and also staff well-being. And yet this examination of how we behave relationally to each other in the workplace is often neglected or you might get a two-day course just before you reach your CCT.

Susy: (03:20):

So I believe that coaching can provide us the space for people to explore some of this stuff and to work out how they're going to tackle it in advance of having to. That's individual coaching in a one-to-one context. I think action learning sets also provide this sort of space for this level of self-inquiry, and then the group element of support and the sharing of wisdom gets built in. So both of those disciplines do the same thing in supporting medical education.

Rachel: (03:51):

Thank you. The action learning sets that you've just explained is something that I was fortunate to be part of when I was going through my public health training. So maybe you can just tell us a little bit more about what an action learning set looks like and how they can support individuals to problem-solve.

Susy: (04:07):

Yes, I'm a big fan of action learning for the same reason as I am as coaching. In working in healthcare, we sign up for huge responsibility and also the possibility that we might harm someone. Obviously we hope we don't, but that possibility exists nonetheless. People are often anxious about that and for good reason, and that's entirely appropriate. We wouldn't want people to take that anxiety lightly, but where do you put it? Where do you put that uncertainty, that risk?

Susy: (04:40):

It's not sustainable to examine it and fret about it every day, but it's also not okay to deny it or laugh about it or ignore it even though those might all be entirely appropriate coping strategies at times. What is necessary is having spaces in your professional life where you can explore this sort of stuff safely. So some people luck out and get it with their partner or their friendship group. But generally often like in coaching there's another agenda there.

Susy: (05:08):

Usually, one of those people will want you to be okay. They'll want to see your distress and soothe it or mend it or solve it. But what we actually need is people who can listen to us acknowledge to ourselves our deepest concerns and to take them seriously. So if you think you might make a mistake, how are you going to address that? What would safe practice look like? What do you need to do differently? Were your actions appropriate? Rather than someone rushing all over you saying, "Oh, I'm sure you're fine. You're great. You're always great. I'm sure you'll be fine." That doesn't really cut the mustard.

Susy: (05:46):

The things that made action learning sets work are trust and the creation of a safe space where it can be okay to say, "I'm not sure I did that right. I need to explore it." So in practice, what that looks like is this small group of between five and eight people. It's usually a closed group with either a facilitator or some training so they understand the setup of the group and the boundaries, and then it's allocated time. It's about making a professional engagement that goes into the diary, and people would meet every couple of months for a year or something like that

Rachel: (06:19):

From my own experience of that action and inset, it definitely gave me that feeling that I could be open and honest and share. But there was a level of respect for everybody, so everybody was also sharing their deepest thoughts. And we were all doing that in a confidential space where we were able to--Yeah, and I suppose creating those relationships and that environment is so important. Looking back on our interaction and the space that you gave me when you were able to give me coaching sessions, and I know that part of your training has been through the Time to Think approach as a Time to Think coach.

Rachel: (06:57):

I remember you sharing with me the book from Nancy Kline at that point in time, and it was the first time that I had started to ever think like that and to see the value of listening and having that space. Could you explain a little bit more about that approach, the Time to Think approach and maybe a little bit more about how you use that to support some of the doctors and healthcare professionals when you're coaching?

Susy: (07:24):

Well, if we think back to that first question I asked, when was the last time you were able to think to the end of your thoughts? It's a bit of an odd question, isn't it? But it's very challenging. That question itself encourages you to think about the quality and importance of your own thinking in solving your own issues. And in coaching, we say the mind with the problem is also the mind with the solution.

Susy: (07:46):

And that's what Nancy Kline is talking to in her work on the thinking environment, so I would recommend her books to anyone listening who hasn't come across them. She's written several; Time to Think, More Time to Think, and recently The Promise which is all about the principle of non interruption. Basically, her work examines how we do our best thinking. She says the quality of everything we do depends on the quality of the thinking we do first. That is both barn door obvious and genius.

Susy: (08:17):

It feels like it shouldn't need pointing out, and yet it does. So what we're talking about here is creating a space where good, independent thinking arises. And in our context, that's so we can improve patient experience and patient outcomes. When I talk about independent thinking, I'm talking about people understanding that their thoughts have value and also understanding that other people's thoughts are valued too. In other words, that's about listening to understand rather than listening to reply.

Susy: (08:43):

How many of us have been in meetings where we've been talked over? Or perhaps we're the ones talking over, and we're interrupting others. Or in meetings where someone has said what they think very forcefully, and there's been no invitation to hear other's thoughts or explore diversity of thinking. Too often, the meeting environment becomes about ego and power over rather than power to or power with.

Susy: (09:13):

If we have a workplace challenge or we want to deliver better patient care or reform a patient pathway or experience in some way, let's be honest, most of the easy solutions are in place by now. We are very often looking at wicked problems in a VUCA environment. I don't know if your listeners have come across VUCA. It stands for volatility, uncertainty, complexity, and ambiguity. We sometimes talk about it in the context of leadership skills.

Susy: (09:42):

We need a way of addressing these issues which brings new thinking and doesn't fall into the traps of cynicism, skepticism, defeatism, or focus on ego or power and power games. The thinking environment creates it as an elegant and effective way of enabling new thinking to emerge. It pays attention to 10 components that she describes. You can read about them in Time to Think or on her website.

Susy: (10:11):

She would say if any of them are present, the quality of thinking increases. But if all of them are present, you can get much, further, much faster in terms of solving problems. And so far, I'm mainly talking about this in the context of meetings. But it does also apply to coaching and interaction learning. If you come to coaching with a challenge, you've probably been wrestling with it for some time. If there was an easy solution, you would have reached it. So it's much more. Coaching tends to be much more about creating a space where that new thinking can emerge. It's much more about the being than the doing, and the being comes about because of the presence of the 10 components.

Susy: (10:38):

If we return to the idea that people tend to struggle with stuff that isn't about implementing nice guidelines, the things people struggle with, their difficulties, with relationships, challenge to their sense of identity, challenge to their values which then means something at work or in a relationship becomes troubling or problematic, we need the safe spaces for people to think through that stuff and find their own solutions. And in doing so, we then support their sense of reward and engagement in the workplace. And we know that there's impact positively on patient care or patient outcomes and experience. So that's the fantastic win-win.

Rachel: (11:34):

How do you think you've been able to find those safe spaces for yourself through your own career progression?

Susy: (11:42):

What I choose to do is put time in the diary for thinking partnerships. So ever since I trained as a Time to Think coach, I have been in a thinking partnership with another Time to Think coach. This is going back a few years now. We meet every sort of six weeks, four weeks. And that is just immensely productive thinking time. I don't think you have to do it for very long to realize that you get out far more than you put in. People often say about coaching, "I'm not sure I can devote the time. I don't think I can give that much time to coach you on action learning set."

Susy: (12:25):

I would say consider the thought that you might not have time not to because when you think about what it's like to wrestle with something in your mind, it goes round and round, doesn't it? For an awfully long time before anything settles. And that's if you're lacking something, you do reach a conclusion. But productive thinking in a time-limited safe space like a thinking environment or thinking partnership can get you very rapidly to a solution. That's what I have found to be just personal experience. I found it to be deeply rewarding and effective. So that's what I tend to do.

Rachel: (13:08):

And how has your career sort of found its own little path to where you are now? When did you start to become interested in coaching and development, and where did your clinical path to public health path lead on to those skills and developing that passion and that interest?

Susy: (13:28):

Well, when I became training program director for public health which I gave up about a year ago but I did it for about a decade. And I also became involved in annual assessment panels for other specialties through working in the deanery. It became clear to me that we were shortchanging people on the support that they needed because the years that people are in training in whatever specialty they choose are also the years when they may be navigating important personal relationships, trying to have a baby, buy a house, care for a sick parent, or they have other new caring responsibilities as well as sit major postgraduate exams and chart their course through their chosen specialty and sometimes reconsider their career choices.

Susy: (14:13):

Sometimes people could do with a bit of space to explore that stuff. And it's not often a huge investment of time or resources that's required, but it was definitely a gap. What was clear was we're not talking about people needing time off sick. Obviously that does occur, and there are clear pathways for that. But I think I just became interested in how we keep people at work, if that's what's right for them. How do we support them, and how do we create environments where people can flourish? How do we help people reach their potential? How do we see them as whole human beings with all of their entails and enable them to do their work?

Susy: (14:51):

What I noticed was that sometimes people just needed space to think for themselves. If you're wondering if you've made the right career choice, it's difficult to go to the person who's responsible for your training in your rota and who signs off your competency to progress in your training and say, "I'm not sure this is for me." Just like it's difficult to go to a partner or a parent or a friend. As we've said, those people have an agenda for you. It might be to support you, but it will always have elements of their own stuff in it. So there's a need for independent, nonjudgmental as far as it can be space to consider key issues and how they impact on your ability to be your best self at work.

Susy: (15:15):

If you look at other professional fields where people hold a considerable burden of responsibility for decision making like finance or law or management consulting, then coaching is well established as an added value professional resource. Medicine's come relatively late to the party to embed this as a norm. There are plenty of freelance coaches out there. But a decade ago when I set up the coaching scheme in the deanery, we went saying to people, "This is normal. You could benefit from it. Your patients and colleagues could benefit from you having it, and we need to put it in place."

Susy: (16:05):

It was a fight in a sense to get it embedded as a scheme. But it's there now, thankfully. So it's a place where people can begin to explore. I think my public health training helped me to see it as a system issue. So we'll let this coaching sit with regard to other disciplines like mentoring action, learning, peer coaching, near-peer support, human factors, training, counseling therapy, and professional support units. There's a whole plethora of other things. And also to embed this within our Yorkshire and Humber offer to trainees, make it a sort of system solution.

Susy: (16:42):

I connect it very much with Michael West's work on compassionate leadership and how we look after each other in the workplace. That's how I sort of make sense of it as an investment and as a strategic resource that's necessary and people and patients could benefit from.

Rachel: (17:01):

You touched on there about the compassionate leadership style and the approach. So could you add a little bit on that and your reflections on learning more about that and how you've been able to incorporate that into your own leadership style and how you are able to now share that with other people?

Susy: (17:21):

Well, at the beginning of my clinical career I worked in a rural hospital in KwaZulu-Natal in South Africa. And two things were notable there, I think. One was that the environment was supportive amongst the team of small team of doctors. You didn't do anything new until you were comfortable and confident, and others were there to teach and support you. And having come from early jobs and teaching hospitals in this country, so-called teaching hospitals, I found the opposite was true there.

Susy: (17:50):

They were called teaching hospitals, very little teaching occurred. So this very enabling environment in South Africa created a joy in learning and gaining greater skills and doing more for patients and one which was resolutely not teaching by humiliation with a side order of exhaustion and then someone reminding you how easy you have it and how hard it was in their day.

Susy: (18:12):

These are all things that I'd experienced before getting to South Africa and I was glad to be without. And now when I look back, I think that supportive, enabling learning environment is foundational to compassionate leadership. That's a core piece of it. The second notable thing for me was at the time KwaZulu-Natal was becoming the epicenter for HIV. So we're talking 1984 or '85 or '86.

Susy: (18:39):

People in that community were really poor, and many relied on them as their family were moving away to the mines for migrant labor. And they were allowed one trip home for a year, and migrant men often had new sexual relationships in the city. They were denied access to health care. They brought STIs including HIV home with them to their rural communities, and very quickly HIV spread throughout the whole community.

Susy: (19:02):

We lost our lab technician. We lost his wife who was a nurse. We lost senior nurse leaders as well as newly qualified nurses. We lost social workers, teachers. And the question became, how do we care for the carers? Because if we didn't have a system that worked for everyone, we would lose the fabric of our communities, the pivotal roles upon whom so many relied for their well-being.

Susy: (19:23):

That division we like to have in our minds between us as healthcare professionals and our patients, that vanished. We were all potential patients, and we needed ways of looking after ourselves that then everyone had access to good and safe care. So compassionate leadership to me means recognizing our humanity in the workplace and that healthcare staff are just people trying their best. Compassionate leadership is giving your staff the tools, really, for them to do their best.

Susy: (19:53):

In the context of COVID, we've seen how uncomfortable healthcare workers are who've been given a hero status. Actually, compassionate leadership has given people safe conditions to do their work well. Partly, that will be appropriate pay and recognition. In the context of NHS, is often basic things that still need reinforcing, the ability to have a tea break or a meal or somewhere to connect with other staff or have adequate rest. But it's also diverse opportunities that work for the diversity of people we have both in our work force and our patient population. So, to me, compassionate leadership is all of those things.

Rachel: (20:31):

Oh, that's so fascinating to be able to reflect on your experience from when you were in South Africa and also to see the parallels like you're seeing now when we're in the middle of the pandemic as we're talking to each other. But to see that compassion and that ability to look after each other and to check in on each other and to be compassionate in a setting that is very highly stressed is very full of anxiety and pushing people to their limits can change the outcomes of people individually but also the outcomes that they're delivering to other people. So there's such a knock-on effect, isn't there? By creating those environments where people are able to be supported and to be cared for.

Rachel: (21:16):

Do you think that as you've gone on in your career that you've found different points where you felt more comfortable and you felt like you're being your authentic self? The big idea of my podcast is that we're just able to turn up like we are and be all sides of ourselves and all sides of our personalities, me, the true me. Can you also look back now and see that you were at points in your career doing different roles that didn't feel quite like they were for you or you were being your authentic self?

Susy: (21:51):

Yes. An interesting question, isn't it? I think we hear a lot about the word authenticity. Obviously it's a key part of your message, Rachel. I think that in terms of my career, well, I would describe it as non-linear. I haven't known what on Earth I'm doing most of the time. I've just sort of followed the next thing that's come along, and that's been good and bad. I think you're often surrounded by people that seem to have some sort of resolute knowing about what they're professionally about, and I certainly haven't felt that. It's been a slow evolution for me.

Susy: (22:28):

I definitely feel that age helps. I know more about myself now just because I've been sort of around the block. Yeah, so it's easier for me to make decisions. It's easier for me to understand what will work for me. I think a lot of that stuff was opaque to me in my early career. I didn't know what it meant to examine your values or my values, for instance. We talk a lot about values in coaching. And when I talk about values, what I'm meaning is that sort of inner GPS. What's the thing that pulls you forward that makes you know that you've done the right thing or made the right choice?

Susy: (23:06):

I think I see a lot of people in medicine through coaching who have been directed to medicine. They're doing it because it's someone else's idea, not their own idea. It was my idea to do medicine. I'm glad I did it. I absolutely loved it clinically when I was a clinician. But I think one of the things that I reflect on is the fact that I feel like I had an accelerated clinical career.

Susy: (23:36):

If you work in a rural hospital in an era of deprivation, you end up doing a bit of everything. And it feels a bit like a hundred miles an hour which is very, very rewarding. It's also very challenging, and it can be very traumatic the sort of stuff you come across. So whilst that worked for me then, I'm not sure it was sustainable. And I don't think it fitted in with a sort of roadmap, to use current terminology, that anyone else was showing me.

Susy: (24:10):

I'm not sure if I saw my decisions in terms of authenticity or not at that point. I saw them in terms of what was exciting and inspiring. They get more complex ones decisions the more people that you factor in. And of course, once I had a family and I had other commitments, I had to make decisions in a different way. But, yes, I would say broadly I have felt more me as I've grown older.

Susy: (24:38):

I used to describe myself as a square peg in a round hole in medicine because I didn't necessarily feel that I had found the right niche for me. I do think I've found the right niche for me. And it's coaching, it's personal development, leadership work, it's workshops, it's supervision, it's helping people to unpack what makes them tick so that they can go on and do a better job. That's an interesting place to have ended up. I don't think I would have spotted that ahead when I think back to careers conversations in school.

Rachel: (25:15):

We're glad that you've ended up in that role, Susy. Believe me. And I know that you will have helped so many people to be able to, like you say, identify their own solutions and find their own path. So, very grateful. From me to you. I'm very grateful that you are doing that. And in amongst all this amazing work that you're doing, you've also being able to create your own business, both your coaching business and also having a business making blankets.

Rachel: (25:43):

Can you reflect on how having a business has been something that's different for you, both of those businesses, working for yourself? Was there a period of transitioning into that and maybe a reflection on some of the joys of doing that as well as maybe some of the challenges?

Susy: (26:00):

There's quite a lot in that question, isn't there? So, joys and challenges. I definitely have discovered that I'm not a business woman. So I don't like marketing, for instance. I don't like invoicing, and I don't like asking people for money. So I've had to think about ways around those sorts of things. What I do love and the reason that the blankets came about was I love crafting and sewing and creating.

Susy: (26:30):

I think that it took me a long time to realize that was a sort of part of me. I think that probably lots of people was okay at science at school. And for some reason in our country the certain educational hierarchy plays in there. So if you can't do science, why wouldn't you? That generally sits higher than creative disciplines.

Susy: (26:53):

I was encouraged towards science, and it took me a long time in my life before I realized it's okay. You can do creative stuff as well. You can bring it in as a hobby or it can be more. And it was accidental how it turned out. I was on holiday in the Hebrides. We liked to go up there quite a lot and came upon this amazing fabric. I knew about Harris Tweed, but I don't think I understood how beautiful it was until I got my hands on some.

Susy: (27:26):

It's got to be hand-woven on a loom by a crofter in their croft on an island, and it's the only fabric in the world that's protected by an act of parliament. So it's got this incredible pedigree to it, and it's gorgeous. To me, having grown up in Edinburgh, Harris Tweed was tartan and it was scratchy. That was what I knew about it.

Susy: (27:51):

This was like a reawakening. Vivienne Westwood would be proud of me, wouldn't she? But this was about recognizing it as a different thing. So I came across it, and there was clear colors and quite stunning colors. So I bought some, and I brought it home. I made a blanket. Then basically got lots of compliments, and people wanted them. So that's when I started making.

Susy: (28:16):

So it wasn't that I wanted to be a businesswoman, it was more that I wanted to create some. And I enjoyed creating it. And so I created a few for other people and then got involved in a design show. That was also a lovely trip into another creative world which I hadn't experienced before. So it was just a nice thing to sit alongside my world in the NHS and coaching.

Rachel: (28:40):

I think that purports the joy. That definitely sounds joyful, and it's lovely to hear that story of how it all developed really. What's interesting is when I've spoken to some of the other guests on the podcast, they also have these elements of creativity, creating things, whether that's art or design or using your hands in a different way but also your brain in a different way.

Rachel: (29:03):

Do you think that there's an element of revisiting that? Was that something that you would have done as a child? Would you have been knitting or sewing as a child? Is it something that's come back into your life or is it a totally new craft and skill?

Susy: (29:18):

Yeah, I did do it as a child. I did a bit as a child, and then we had to do sewing at school. We had a very scary sewing teacher actually, so we were all terrified of doing the wrong thing. But actually what that taught me, I now realize, is you can have a go. So you don't have to be great at something, you can just have a go and see where you go with that.

Susy: (29:45):

I enjoy that freedom that it's given me, that confidence to try something out. So I do quite a lot of sewing now. Not because I want to make fancy things, but I feel relatively confident I'm going to be able to pull something off like look at a pattern and make something. And I like that. It's great. So, yes, I think that is connecting a thread to continue the most for with my earlier life. Yeah.

Rachel: (30:09):

When you now do your sewing and you're making blankets and having that time, is it also part of a mindful process for you? Does it take you to a different faith?

Susy: (30:20):

It does. It definitely does. I think I find all parts of creating mindful. So for me, with the blankets, it's the textures, it's the colors, it's the combinations, the casting, the sewing. It definitely feels like it's sort of enhancing well-being. So I think that that's one of the reasons that I keep coming back to it. It's relatively easy to sort of dip in and out of, it's a timeframe that suits me. But yeah, it can take me to a place which is different from the cognitive one.

Susy: (30:54):

I think one of the troubles if you do a job with responsibility in it and then lots of thinking is you can live in your head and not live in your body. I suspect this is part of your journey with yoga, learning to inhabit your whole self and include your body and not just think of your head as something that's carried around by your body.

Susy: (31:13):

I think for me, it's part of that. It's part of that whole existence thing. And I suppose connecting back to the sort of humanity we were mentioning before, what is it that makes me me? How am I different from you? Well, one of the things is what I choose to do when I've got bits of creative time.

Rachel: (31:33):

Thank you so much Susy for sharing all of your story and the wonderful things that you're able to offer this world. It's been lovely to be able to listen to you and to hear a little bit more about things. So where can people find out a little more about you if they want to connect to you or hear more about your coaching or your blankets?

Susy: (31:53):

I'm on LinkedIn although I do have a very limited relationship with social media, it has to be said. But I would say to people [apply to the option now?] for your postgraduate training because then you can come via leadership fellow with me on the Future Leaders Programme or be coached by me. Other work streams I'm involved in are the SuppoRTT one which is Supported Return to Training and GP trailblazers scheme which is where I'm working with deep end practices. I offer coaching supervision. So if you are a coach, then you could email me and get in touch.

Rachel: (32:30):

We'll put some of the links so that people can find where you are online. We'll put those with the podcast so that people can look you up and get in contact if they want to chat more, which I would thoroughly encourage everyone to do. So a closing question Susy is that my podcast is called Authentic Tea. So where and with who would you choose to have your most authentic cup of tea?

Susy: (32:52):

It's such a tricky one because not obviously I went through the list with Beyoncé or Michelle Obama on it. But anyway, there's too many people. But someone who came to mind who I would love to have a cup of tea with, with Susan David who you might know from her TED talk and her book Emotional Agility and her podcast.

Susy: (33:14):

It's partly because her work is fascinating and so valuable. And it's also because she's from South Africa, as you may know. I'd love to discuss the place of both of them, both of our lives. And she talks a lot about the Zulu word "sawubona" which you might recognize from your time in South Africa which means I see you.

Susy: (33:30):

I think that's what I try and do in my work to see people as they are and as they wish to be seen. And so it would be a wonderful opportunity to connect with Susan and see her and talk more about what she's brought to the world.

Rachel: (33:51):

Thank you, Susy. That's a beautiful way to finish our conversation today. And thank you for being a guest. It's wonderful to connect with you, and so I'm very grateful.

Susy: (34:00):

Thank you so much. I've really enjoyed it.

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