Scott Tinley was one of the most prolific triathletes of all time, competing in and winning hundreds of triathlons all over the globe. Scott has been suffering through hip problems for a number of years and recently decided to have his hip resurfaced on Thursday, December 13th in Wisconsin with Dr. Rogerson The Hip Chronicles Part 1
I am preparing to have my body cut; to have tools and lights and fingernails and foreign things cross my somatic borders. Soon enough, I will be invaded. I know what these people will be doing. I’ve invited them, willed them and will compensate them to move a long thin blade across the lithe desert of my ass. We have agreed that they will leave metal parts in when they are through cutting muscles and tendons and bone that I worked for decades to improve.
Yes, many forms have I signed and contracts made; some are with the hospital and the surgeon, some are between me and a higher up. I must trust both. Factory parts have worn out and need some modern spit and polish. But this is no forty minute, outpatient, and arthroscopic procedure. I am imagining that they will articulate my right leg (It’s the right one, not the left—let’s not get confused here) in some contorted angle like we used to do with our sister’s Barbie dolls. They have to get at the head of the femur, which is like getting at the air conditioning unit on a ‘94 Buick Park Avenue—some idiot figured that it would never wear out so they just stuck it way down behind the valve covers and windshield wiper fluid tanks.
But the head of my femur, also buried near the core of something central, is the largest ball and socket joint in the human body. Mine looks more like a pumice stone than the shiny, well-lubed and smooth piston of my past. And the soft ligamental-coating of the acetabulum that soaks up the pogo has left the building with Elvis. So, where too now, St. Peter? Live with the grinding, painful reek of bone-on-bone or have the mechanic go in and replace the air-conditioning unit even if it means having to cut through the intake manifold? Ah, the sins of our youth. Am I being too hard on myself by denying the tenacity that gave me so much through athletics? Do I want to pay the experience forward? That tenacity is now the cause and the cure for the hurdle which now stares me in the face like Hemingway’s bull.
I cannot say that I am not afraid.
The Hip Chronicles Part 2
Hospitals scare me. They shouldn’t. But other than the birth of our two children and a few of the good days when I worked as a paramedic, nearly all of my experiences with hospitals have been related to something bad. Trauma, illness, death, the smell of Lysol and lime green jello…these are the things I conjure when considering hospitals. That’s my notion of the habitus effect and with great luck and some fancy talking, the only times I’ve spent a night in one was when I was born or as guest of a family member patient.
I suppose that’s not fair, really, for hospitals do wonderful things to heal the sick and repair the injured and provide backdrop for successful TV shows. In a few days I will be an overnight patient in a breezy white gingham gown that shows my white ass. I’m not even looking forward to the self-medication of a morphine drip, thinking only that since I’m in a city far away, I have no pals who’d sneak in an oaky ‘98 cabernet in a Scott USA water bottle. But I have power bars and books and my maple-backed Baby Taylor guitar, all of which will likely sit in the corner while I lie there like some worn out 50 year old ex-jock wondering why I was such a fool to think that 80 miles a week on the concrete Mission Beach Boardwalk was as good as it gets. There are old people in hospitals. And sick ones. All I need is a bit of steel wool to the femur and a fresh layer of human cartilage. Heck, I’ll take sheep cartilage if it works. Bahahahahaha!
Actually, what I will get is a BHR—a Birmingham Hip Replacement. If it sounds exotic, it’s not. It’s just a very cool cobalt chrome alloy cap that is placed atop the worn out head of the femur. There’s a hole to be drilled and a bit of fitting to be done but I won’t go there right now. The reciprocating female side looks like a post modern ash tray and the thing spins in there like a top. That part fits in the hip socket. A bit of Willhold Glue, I imagine and shazaam—new joint. New age-group record in Kona. You know, the shin bone’s connected to the…ankle bone, and so on. At least in theory.
Scott in Ironman competition
Hip Chronicles Part 3
We checked into this place called the Hip Hab. It’s a groovy apartment that is set in a retirement home, sort of like a half-way house for orthopedic patients who come from out of town and will be self-indentured as part of my surgeon’s non-negotiable 5 day rehab. When my wife, VT and I check in I felt a sudden wave of relief as I noticed the bike wheels grouped together in the corner of the foyer. When I looked to see if there were any cool titanium rigs I realized that they were all wheelchairs. In our room there was a nice present in a long thin box. A bottle of wine! Great, these old folks can still bring it. But no, it’s a long handled shoe horn.
Damn. But as days go on I will appreciate that more than a vin ordinaire.
I’m imagining the PT program will seem pretty geriatric and if some old coot name Ike wants to tell me about when he was a Golden Glove boxer in Philly back in ‘54 for the fourth time while we do legs lifts in the 92* therapy pool, well, I just might duct tape a pull buoy to my ass and roll over to the lap pool and swim 5,000 yards or until my sanity returns—whichever comes first.
I’m wondering how long it will take to get used to the idea that I won’t be 100% natural. Will I have to compete in a special class, assuming that I can run again? I’m already at war with the Homeland Security Gestapo at the airport. How will I react when they wave that metal divining rod next to my Boys in search of the elusive BHR? Funny thing, I don’t give a shit about the scar. Scars, I’ve done; big ones, little ones, some from knifes and broken bottles and some from the Old Man Sunshine. I’d rather have a 12″ scar if it meant they didn’t have to use a chainsaw to get through my quads. I’m hoping that I’ll forget about chrome parts pretty quick–at least before I lose my temper with the airport TSA folks and knock one over with my cane.
The first time I saw a BHR prosthesis it was at a coffee shop in Hillcrest. At first I thought it resembled more of a cute child’s toy or a hood ornament for a Dodge Dart than a sweet cutting edge medical prosthetic. But what struck me was the way the cap spun in the tray like a top—10 second on a bearing-less surface. I just couldn’t image blood on this shiny BHR. I wanted to hang it from my rear view mirror. But my lava-topped femur was just not letting me pivot around the point guard and hit the lane with any speed.
The man whom I’ve chosen to do the ship-in-a-bottle procedure is one Dr. Rogerson. Much can be said about the months and years I spent leading up to choosing him, not the least of which is that if he lived in LA or San Francisco there would be a waiting list of five years for the honor of having his fingers do the walking inside your body. He is what the French call…oh who cares, the man is a perfectionist. Before I got on a plane to come and see him I knew that he and his staff had the stuff to bring it—all the skills, all the facts and all the spirit.
In a few days I’ll have a Birmingham Hip. Groovy, Baby. It will be secured and snug down and awaiting the anxious weeks and months for the bone to welcome this new thing and grow in and around it while I sit on the beach and watch my friends surf and at least I don’t hurt anymore. Damn, let’s just get it done.
I have faith in my doc, knowledge of the procedure and for the first time in some months I will read a bit of the Bible tonight before tomorrow’s surgery.
Damn. Or, uh…darn. Let’s get it done.
Scott getting ready to walk with his crutches after hip resurfacing surgery
Hip Chronicles Pt. 4
It’s two hours since I’ve come out of the surgery. I’ve been to war. I cannot tipe wwell and will keep this short. This passage from moby Dick plays over and over in mymind. I won’t let it go. I willnot go down like Ahab but right now I am as close as I will evr git to his black darkness of bone pain. If you want to understand Ahab’s quest do not read melvilles book—have someone take the larget bone in your bodi and chlean it up with a hand tool. I kid you not shipmates, it is through suffering that we grow—new clean bone under perfect materials that will not wareout. Godbye…
“For long months of days and weeks Ahab and anguish lay stretched together in one hammock rounding in mid-winter that dreary, howling Patagonia cape; then it was that his torn body and gashed soul bled into one another,”
Scott walking with crutches after hip resurfacing surgery
Hip Chronicles Pt 5
Early on Friday, 12/14
I remember having a roommate named Gene. He told me that he worked at the Oscar Meyer plant here in Madison, Wisconsin for 32 years and then retired. Now he cuts lawns. It is snowing outside and the high will be 23*. There are tents out on Lake Manona. They are covering up the ice fisherman who sip whiskey, listen to talk radio and wait for the lake to thicken enough so that they can park their 4x4s next to their tents and their holes in the ice. Fishing in Madison, Wisconsin is an extreme sport.
Gene’s church group comes and visits him. They speak of Midwestern things and I am trying hard to get some sleep. Just before I ask them if they can be quiet the preacher-type asks God to bless Gene’s roommate in the bed next to him. I have not seen Gene or his friends yet, only known them through the darkness and the curtain. But this is not OZ and these people are more real than imagination. And I will not forget them.
I remember a nurse with the name of Cherry. Before I leave the hospital I will write a poem for her and leave it tacked to the wall. I do not think I am being sentimental in my state of debilitation. I am finally open to the grand goodness around me. Cherry is a healer. She works the noon to midnight shift most days on the orthopedic floor of Meriter Hospital. She snowshoes and takes no bullshit from mouthy patients or incompetent hospital staff. If you are driving through Wisconsin some time, I would recommend that you stop and see her. She will make you laugh. You will walk away feeling better about life. That shouldn’t that hard for you right then.
Hard comes later, when you stop believing that good people still exist, even when we don’t give them a chance to break through the mask.
The doctor comes in to see me. He tells me that it went very well and that the BHR fit great and that I had plenty of bone spurs for him to shave and a few cysts to pack. I wonder if he knows that I have spent two years searching for the very best surgeon on the planet to do this procedure. I almost went to India. I almost went to England. There are a few great surgeons who have been doing it longer than Dr. Rogerson. I ended up in Madison, Wisconsin because my gut told me it was the right place. I love it when my gut is right.
I am beginning to urinate and that makes me happy. When you get cut deep you resort to deep childhood pleasures. I like my long thin cup with the cap that I can pee into without getting out of bed. I was feeling cavalier about midnight and decided that I would get out of bed and pee in the toilet. I nearly passed out. Cherry picked me up with one hand like a firefighter holding a buddy from falling off a fiery ledge. I asked her if she will keep this between us—you know that I couldn’t walk to the bathroom after surgery. She said the secret is safe. She put me back in bed and I peed in my little cup.
Dr. Rogerson’s surgical assistant and PA, Renee, checks on me. She asks me about my nausea. “My gut?” I tell her, “It did just fine.” With faith and morphine, I get a bit of rest.
Scott learning to do stairs after hip resurfacing surgery
HC Part 6
Friday, 12/14 Midday
Gene is going home. He had a THR (total hip replacement) five days ago and I am jealous that he can get around the room slowly with crutches. My moves are glacier. He sits near my bed, opens a chocolate bar and offers me half. We speak of levels–pain, mobility, family, spirit, chocolate—reduced to the common denominators in life, speaking across a narrow dark space, it seems odd to me that I am having this kind of conversation with a person I just met and will never see again. He’s a strong guy, almost mountain-manish. If we were in a war together he’d have my back.
His chocolate is good.
In the afternoon the room is quiet, Cherry moves my bed next to the window, brings in pain pills, fresh pillows and a menu. It’s still snowing outside and for the moment, the halls are quiet. I think about health care. If you live in America and have good coverage, consider yourself very, very lucky. Doctors are straight jacketed with billing conflagrations; HMOs take away choice; there is a dearth of nursing staff; costs are exorbitant…everyone has a plan on how to fix it but the mirage on the horizon only seems to get further away. I am lucky. I am getting arguably the best care anywhere, taking a page from Emerson and foregrounding facts shot through with spirit. Like Lance, I got involved, did the work, made the calls, read the research. And it’s made a difference. Hip resurfacing with the BHR has only been FDA-approved in America for a few years. I know people who’ve gone out-of-country to have it done. For me, Madison, WI. and Dr. Rogerson and the Meriter Hospital are the best of old and new worlds.
Our demographic balloon is screaming upward. More and more boomers will need medical care that will allow them to stay active. They will ask for hip resurfacing instead of total hip replacements. This will be a bottom up model of health care driven by demographics, technology and lifestyle. The best will be found out as will the followers and the hacks.
It’s snowing outside and nice just to lie here and think. When did you do that last—just lie on a floor and let your mind wander? Ideas might start out in the world, get filtered through reading and research but they are catalyzed in the rare quietude of the snowy winters of our lives; those soft moments when we allow ourselves to be taken down and taught by some teacher who waifs across the room, the sound of her steps imperceptible. The white noise of modernity stands as aural barrier to what potential lies inside. There is a time for rock and a time for Bach but what is missing is what exists in the rents and seems of our nervous days—reflection.
Scott’s incision by Dr. Rogerson after his hip resurfacing surgery
HC Part 7, Friday, 12/15
I’m home at the Hip Hab now. I signed one form at Meriter Hospital and after investing thousands of dollars, incalculable skill and something called kindness, Meriter had a sweet young gal in nursing school, Ashley, help my wife pour me into a taxi. I felt like fine china being returned from loan to a keg party. I’d like to come back here one day, socially.
And the Hip Hab? I had it all wrong. A retirement facility replete with physical therapists, training rooms, warm water exercise and lap pools, massage therapists and long hallways lined with octogenarian cheerleaders is the perfect place to rehab. Dr. Rogerson has modeled his post-op therapy on the European model: find a place to land your patients after they come back from the hospital, teach them how to walk again, how to breathe, how to live without a computer. And teach their family and friends how to be involved with the entire process. Imagine if we took all of our returning vets and did the same thing? It’s not the same but it has paradigmatic similarities—coming back from major surgery is like coming back from war. Like it or not nothing is ever as it was. But with intricate attention and care, life can be lived as well as before the trauma and sometimes better for what you’ve experienced.
* * *
Last night was Cora’s birthday. She sat in a corner near the front door of the facility’s dining room by herself and spooned her soup and boiled trout and red jello. After dinner the hostess brought her a piece of chocolate cake with a single candle. I asked her name but she’d forgotten her hearing aid. She told me good luck with the leg.
The pathos surrounding the plight of the elderly in America is too horrible to feel. These people are the lucky ones—they have good care and others to grow old with and see out their lives with. For every one of the Coras there are a hundred Melbas and Irvs and Franklins and Madges that are disposed of in cheap hotels and cheaper back bedrooms of in-laws. They sit in lonely hovels counting their pennies to save up for an ice cream scoop or a movie at the cinema. This administration has cut more funding for social programs since Regan gutted the last opportunity to die with any dignity during his second term. If you want to see your future while you consider your past, get on a plane right now and we’ll have dinner tonight at the Season’s Café in the basement of the Hip Hab with Cora and Thomas and Dorothy, if she’s feeling up to it (It’s just the sniffles.)
Tomorrow, I’ll show you around. They have a hand bell performance at 2:00 P.M. and for lunch they are serving French onion soup with a whole wheat grilled cheese sandwich for about $3.50.
Outside the snow has stopped. Tomorrow VT and I are planning a walk to Capitol Square to visit the library and sip lattes with the students from UW. We’ll look for a present for Cora.
Today is a good day. Every day will be a good day.
HC Saturday, Part 8, 12/16
First rehab appointment with Desiree this morning. I walked nearly 50 yards, much of it with one cane. Then we did a series of standing exercises. She was gentle. I nearly fainted. She’s worked with every one of Dr. Rogerson’s patients but a few and has seen it all. Facts shot through with spirit. Desiree told me that it was the toxins from anesthesia being released by the exercise or maybe one of the meds. I am not surprised by anything now. Two days ago, I was unable to will my legs to move. With great concentration I can walk with a normal gait putting all my weight on my operative leg. The human body is truly an amazing structure. And the technology available to fix it is nearly as awe-inspiring. Within six months and some hard work, it is forecast that my range of motion on my operative leg will improve 150% and I’ll be running (who care how far or how fast?)…all because a skilled surgeon was able to use a uniquely advanced prosthesis and place it exactly where the skull and crossbones of my degenerative hip used to be. It is plausible that I will be able to walk two miles without pain by the end of the week. I have not done this in five years. If I were still in Madison, I would walk to the hospital to see Cherry. If it was four or six months from now, I’d run the 10K to Dr. Rogerson’s office and say what up, Doc?
There are many ways for writers to describe personal and life experiences, perhaps none better than satire. If Dr. Rogerson had his practice in LA or San Francisco he could be a rock star doc working on former NBA players and Fortune 500 execs. I don’t see that happening. If hanging out in a retirement home where one spouse takes care of the other immutably, is what our need-it-yesterday society requires for old married couples to come to know each other again, well, so be it. And if a modern chrome alloy part is what a wood-water-and-sand guy needs to keep him from climbing that bell tower with an M-16 thought, well, I’m happy to have them.
Tomorrow I’m going back into the therapy pool. You see, I met someone and she used to be nurse. I was floating on my back, baptized in my new liberty and I backstroked right into her. One thing led to another and well, I never actually met anyone who was enlisted in the German Army during Operation Overlord. Helga is 94 but doesn’t look a day over 86. The elderly carry around in them so many facts. It is up to the spirited-young to pry them loose.
Hip Chronicles part 9, Tuesday, 12/18/07
Roger Daltrey sneered the Pete Townshend lyrics. Now, with both in their early 60s, you have to wonder if they’re sad things hadn’t worked out as they’d hoped. Few people look forward to getting “old” but most are pragmatic enough to not to wish for death instead. I don’t see old people here at the Hip Hab—I see living beings that didn’t die before they got old, I see a collective of life experience in the middle four figures, I see interested and interesting old folks…I see myself, if I am lucky enough to cast my lot that far into the setting sun.
We did exercises in the therapy pool again today, and walked to an Irish pub for Guinness, and took a nap and had a message and read the NY Times in the library by the fire. Life is tough here while I recover from surgery. This is what the body wants. This is what it needs. Otherwise you’ll end up like Ahab, with a fragmented soul, abjected from the form in which it existed before the trauma. I brought a stack of theory texts, final essays to grade, even an Ipod but they have not risen about the antecedence of something that comes next; after the soul has re-entered the body that it jumped out of in shear fright when it saw that brilliant light from the operating room ceiling. There will be time enough, if there is time.
But it’s still a roller coaster at best. By early evening I realize that I’ve already gone back to my habit of over-training. That last lap down the corridor with one crutch took its toll. With luck I keep the Guinness down, take a pain pill, curl up into a fetal ball…and wait. Why is it so hard? Because the facts don’t always agree with the spirit and the soul stands on the sideline in confusion. The fact is, I had major surgery and lost a lot of blood five days ago. The spirit, for the moment, is culpable. It wants to forget that nasty little episode, sneak into the lap pool after the lifeguard goes home, read a few of those essays until midnight a sip a good cab. The spirit is projecting itself into a period that the soul is not absolutely convinced of. You see, the soul is the smartest of the three. But like the shy girl with braces who knows all the answers in high school chemistry, you have to give it time to flower on its own terms. I lie there, fully alive, awake and aware that I am paralyzed to do anything but let the images and the past and the present and the pain and the world that beats away toward some pounding horizon sit around some table of my heart and talk things out—to convince the soul that she can return, will always and already be welcome.
It’ll be okay. Tomorrow I will listen to her answers, tell her she’s pretty and smart and that it’s okay if she’s not a cheerleader. I’ll share my chocolate.
We’re going home tomorrow. I could stay another day but there are family and electric bills and Christmas and my dog and people that want things…at home there is a different kind of life, something squared and at times, cubed.
The Hip Chronicles, Part 10, Wednesday 12/19/07
Today is my sister’s birthday. I don’t know exactly how old she is. I don’t know here number to call her but I remembered the day. Or perhaps it remembered me—the fact taking the lead. It’s a start. We traveled today. Went home on a big ol jet airpliner. After the Transportation Safety Agency bent be over the Homeland fence, saving America from Muslims one metal body part at a time, I boarded and felt my four days of intense rehab fall away as each hour passed. My wife, Sherpa Virginia, schlepped heavy bags like a teamster and we landed to Smilin’ Jimmy Black at the curb with a cold holiday ale in the center console and Jackson Browne in the dash. San Diego never felt so Ithacanian, the tired ship of my body so Odysseusian.
I went home and with what energy I had left, poured myself into bed. What a long, strange trip it’d been. I keep thinking that there is something I needed to say, something important that’s been missed and will resurface like The Hand in the movie, Deliverance. But it’s not forthcoming. I suppose it’s like everything else—it just goes on, it just is.
I fell asleep at three in the afternoon. At midnight I awoke and tried to get comfortable. Will I live as long as Cora? Learn a skill as well as Dr. Rogerson? Come to know compassion like Cherry?
I feel bad for Ahab. And I suppose if I was moving in the right direction, I’d feel bad for airport security folks as well.
I hope I get old before I die. I hope you do as well.
Scott Tinley Surfacing after hip resurfacing
Scott Surfing 3 Months Post Op Photo by “Big Al’s Pics”
I was back in the water paddling around at approx. 3 weeks post op. At four weeks I was stand up paddle surfing and the following week regular surfing, though tentatively. By week 6 I was hitting it pretty hard; likely a few weeks sooner than I should have. As my strength and range of motion improved the skills came back to levels beyond where I was pre-op. The attached photo was taken 3 months post op. I expect to return to levels I’ve not seen in some years since the lack of flexibility had been hindering my surfing. My recommendations would be that patients not get back in the water before six weeks unless the conditions are flat. I was quite careful and perhaps a bit lucky. It was a calculated risk at best.
August 20, 2009
18 Month Update
So, (and it’s a two letter word covering 18 months), my new BHR hip is bitchin. That’s the best way I can put it. Forget that I am running 15-20 miles/week and could do thrice that if I could win the Super Lotto and give up my day job. Forget that the pain I feel is in other places from other activities and other poor choices. (Why do I think that I can play eight tough games of 2-person beach volleyball just because I have blonde hair?). Forget that when I try to show someone my scar they don’t believe me because you can’t see it. And forget that I’ve mostly forgotten about my BHR hip resurfacing from Dr. Rogerson that snowy December of ’07.
Metal parts? What metal parts? Anyone want to hit some tennis balls?
The thing about working with the body in repair is that unlike the mind or the spirit, clichés work. “When it’s all said and done, at the end of the day and your ship has come in, you get out of it what you put into it.” When studying and writing about 16th century philosophers it would not work to work well to say that Descartes wanted his cake and to eat it as well. But when discussing rehabilitation from surgery I can claim that a well oiled and smartly driven machine rewards the driver. And every reader would get it.
So, here I am one and one half years after Rogerson placed some bitchin new cobalt chromium parts inside me and if I was any better I’d be twins. My ducks are in row, baby and I shoot out of the blocks in the morning like a bullet and make a beeline for the stairs. I never feel my age even when it’s as cold as ice outside.
My surgery wasn’t “better late than never,” and I swear on my grandmother’s grave this stuff works.
Here are a few thought on rehab:
Think about relearning many basic motor movement skills (i.e. walking, standing up from a seated position) since you may have compensated for years of degeneration and need to rebalance your musculo-skeletal alignment. You want to incorporate these basic techniques of proper movement along w/ gentle non-weight bearing activities as you can tolerate them.
As soon as you feel ready (and even if you don’t but are being well-advised to), start moving that hip in the advised motions. Remember there are limitations on certain hip/leg angles for a few weeks post op. Your surgeon and therapist should have advised you of this. But, the point is, you want to regenerate and reformat the soft tissue surrounding the operative joint. This begins by moving it—if only sliding your leg up and down on the bottom of your foot. Sitting on your ass for two weeks is the worst thing that you can do for a new hip. Old bodies and old cars need oil and fluids run through their innards to keep them from rotting away.
Consider message and/or an ART-styled (active release therapy) session. Beginning 3 days post op and continuing for 5 months, I had good hands-on body therapy to increase circulation to the area, break up scar tissue and gradually to increase ROM. I think this was key to my successful rehab.
As soon as your suture site is healed, get in the pool and start moving. Even it you start with a pull-buoy the simple act and idea of being physical and training again is a great benefit. Like Steinbeck said, “good things love water, bad things always been dry.”
Get as much information about activity levels in rehab from as many good sources as you can and then come up with your own program. There is a wide disparity in the kinds of approaches. My surgeon, John Rogerson, takes a moderate and mindful stance on rehab that considers a variety of factors surrounding the patient and the success of the surgery. Other surgeons are both more and less aggressive in what they suggest a patient do. Be your own best consultant.
Be cautious when considering weight-bearing activities. I waited 4 months before I ran a step and then worked my way up from 100 years to 5 miles over a one year period. But, now I can run as long and as fast as I want; my BHR hip is not a limiting factor. I do chose not to run more than 15-20 miles a week and often only do half of that in considering that while the wear is likely minimal we just don’t have enough empirical data to claim that excessive weight-bearing use will not increase a metal-on-metal hip wear of the prosthesis.
Think like an athlete in training—you have a job to do and that’s get your physical life back. Make yourself a plan with regular goals and objective and find the best “coaching” that you can out there. The resurfacing family is very supportive. It’s quite amazing really; people coming out of nowhere to offer advice and support.
Eat well. Drink lots of fluids. Get good rest.
Think in terms of years and decades not weeks and months. Be patient with your body and your new hip but also require of it to serve its master. It’s only new body parts.
Share what you learn with others.