Daniel Guzman. M.D., Pediatric Emergency Medicine Physician and Medical Director of the Aim for Safety Program

0:00Welcome to Untold, the stories of Cook Children's. For more than two decades, Dr. Daniel Guzman has cared for children in the emergency department at Cook Children's. But for him, protecting children doesn't begin or end in the hospital. After a heartbreaking moment in the ER changed his perspective, Dr. Guzman began working directly in the community, helping families understand injury prevention, fire arm safety and how small decisions can save lives. This is Dr. Guzman's story. So my name is Daniel Guzman. I'm an ER physician here at Cook. I've been here for 22 years now. I'll go on on 23. And I have multiple roles at the hospital. I started off as an ER doctor still working at ER, obviously, which is my first love, my passion. And I've grown into gosh numerous roles at the hospital over the years, just being able

1:04to provide whatever service I can and whatever insight that I'm able to provide given my role. And so part of that is I'm medical director for the community, the Center for Community Health. I've been doing that for about three years now. But I also serve as the Assistant Medical Director for Transport in the ER, as well as Assistant Medical Director for Trauma in the ER. So those are the roles I serve as, but what I do kind of goes beyond the walls of Cook Children's. And I spend a lot of time in the community doing what I can to kind of make a difference and help individuals, families, and definitely the kids that we serve in the area. So I grew up in Donna, Texas, which is on the border in South Texas in Mexico. Small town about 7,000 people when I was growing up, but I actually grew up outside the city. So in the countryside, and gosh, growing up in the countryside, that in that time, my closest neighbor was a mile, two miles away.

2:06And so literally when we talk about, I think older folks talk about, and my day, we would leave it in the morning and you'd be gone all day, literally, and then you'd get back home at dark. And that's pretty much what my life was like. I spent a lot of time just outdoors just having fun, doing things with my cousins who were the closest neighbors we had, and just, you know, enjoying life at that point. Never really had a care in the world, never thought about somebody abducting you, it was just, you know, you just were out there having fun and things seemed so simple. And we were in our own bubble, really. When you think about the valley and where I grew up, so far away from everything else, you know, the closest city, the large city with San Antonio, which is almost a three and a half hour drive. And so everyone around me looked like me and talked like me, and so it was really comfortable at that time. But I never really imagined myself being a doctor until I actually went to the doctor for the first time that I can remember. And that was an ophthalmologist.

3:06And that was my kind of first introduction into, this is kind of a cool thing. And part of it was, oh, I got prizes from the doctor, but I also had to wear glasses, which is kind of the downside of, you know, a hard thing growing up, kids can be cruel. And so that was a challenging kind of, and always has been challenging for me is, you know, self-confidence kind of a factor in my life. But that was my first introduction to medicine and what it was. And kind of sparked my interest in, God, this is a cool job. Now, no one ever told me, this is something I could ever do. And it was one of those things is, you know, you go through school in first grade, second grade, and people are asking you, hey, what do you want to do when you grow up? I want to be lawyers and, you know, nurses or policemen. And I said, I learned to be a doctor. And that kind of just stuck with me. I don't know why there's no influences in my life other than that one, you know, those once a year checkups that I had, because all the other doctors that I saw were all negative. Like, you're getting a shot. You're, you know, something bad is happening. You're, you're, you're crying. You're like, oh, my gosh.

4:09And so that was the first positive experience for me. And then no one in my family, immediate or, you know, kind of extended or in medicine. So there was no guidance to what that meant. I had no clue what being a doctor really meant and how that would shape and, and, and kind of the challenges in the barriers in front of me as I grew up to figure that out. It was, you know, you got to just, you literally figured out on my own as, as you went along. And so that's kind of what I strive for. It was like, oh, but it was always my answer. I'm going to be a doctor. I'm going to be a doctor. Before, before you know it, this is like, I just kind of believed in that's what I was going to do. And I'm like, I had no other plans. Like, I didn't have, I didn't have an escape plan. Like, I'm going to go be a teacher or I'm like, this is what I, I think I, in my mind, I have to do and I want to do. And so that kind of just started me on that, you know, that, the launching pad of, you know, this is the direction I'm going, somehow, some way I'm going to get there. I don't know how, but we're going to get there. So, you know, throughout my, you know, high school career, just kind of kept working and doing what I do.

5:09And part of it is just kind of that innate, my family instilled in my parents and still made just hard work, right? Just, you know, do everything you can every single day, be the best you can at what you do. Went to school in Boston and spent my four years there and really wanted to get back to Texas. You know, the weather in Boston is cold. In South Texas, the coldest ever gets is in the forties, maybe, you know, maybe in the thirties, Boston was a totally different experience. So I came back to Texas and Dallas and did my residency in my fellowship over at Dallas Children's. And then I found that I needed something different in my life and Fort Worth kind of, it was calling me a little bit. And so I came, you know, to the cooks and interviewed and found that the culture here was amazing, the people were amazing. And the opportunities for my growth was, you know, an opportunity I couldn't pass up. And so kind of jump ship from Dallas to Fort Worth and started, you know, my career here.

6:11But it's been one of the best experiences of my life. I mean, you know, you have these moments in your life where it changes you. And I think my ability and the people that I was working with in the ER were amazing. I mean, supportive, you know, from, you know, the docs that I worked with initially to the nursing staff to even, you know, those who were, you know, cleaning rooms. You know, you just, you find a place where everything just fits and I loved it. And so 23 years later, I'm still here and a lot of that is the people that I've, you know, have been able to meet and the growth I've had with them really has resonated with kind of outside of the hospital, what it means for me to be here, right? I think that growth there has allowed me to do what I do in the community because we care. You kind of just, you bond with people and you're like, oh, gosh, there's so much more that we can do. And there's, you know, definitely times in your life when, when that, that just changes.

7:14And then for me, you know, what I do in the community has really instilled in me. And for my family that I, you know, there's more that we can do to make our community safe to really uplift the kids of the community. And so I spend a lot of time doing that, but it benefits my family as well because they grow up in an area that's, that's safe for them and has opportunities for them as well. But you know, when you look back and I look back at 23 years, I'm like, I didn't, I never thought I would be in one place for 23 years, no one ever thinks that. And you realize, gosh, I've got a long way. I've come a long way to a point where I'm extremely happy and fulfilled with what I do. And I'm making a difference, I think, in someone's life, you know, you know, when I go out and do the work that we do and even in my own family, like just being that positive role model for them gives them the opportunity to say, I can do whatever I want. I never, I never had that in my life where, you know, someone was, other than my mom, my mom was probably the rock in my life and when she passed away in 2006, that was really

8:18rough just to be able to know where is that next step and how do I get there. I'm one of six, so that also, you know, you have brothers and sisters, but you know, it's not the same as having your mom there. And that's kind of how I look at, you know, what I do and with what worth kind of, gosh, this is kind of being able to equate it to, I feel like I'm helping them, helping my kids, but I'm also being there as a role model for those kids in the community to be able to help them know that, hey, there's more you can do. Just because you live in this situation doesn't mean you can't get out of that situation. It's got to be in here, you got to want to do it. And that's part of what I hope I can pass on to my kids to say, hey, anything's, there's no goal that you can't reach. It's just a matter of knowing that you can do it here and here, and then move forward and just, every single day, just get after it and go 100% and try, try and try, and good things will happen for you. Aim for safety is one of those things that I'm extremely proud about.

9:21And unfortunately, it started because of a patient that I took care of in 2017. And we all, I think we all have those moments in our life that impact us so much that you feel like I got to do something different. We have to do something different, whether as a person or as a community or as a medical center, a hospital system, we need to do more. And I love the fact that it gives us that opportunity to be able to grow and not only takes care of children, but they fight for children, right, you know, they give us that opportunity to be able to do that and get on to it and have a platform in order to achieve that. Unfortunately, that patient in 2017, I took care of him in the ER. He did not survive the injury from a gunshot wound. And they had found a gun in the house and one individual, one, you know, patient was shot by his brother. And so when I was taking care of him in the ER, you have all these motions that come over

10:24you. You're doing everything you can to save a life and you hope that, you know, you're able to do that. And in some cases, you can't do that. It just doesn't. It doesn't. God has a plan for that child. And I think I have a plan for everyone else around and that's, and my four year, my 11 year old now was four years old at the time. And so all I could see was kind of his face there. And I don't know why that was. It was just an odd movement of eye-owned firearms at home. You know, I've grown up in Texas, you know, and I needed, it was just a connection for me that said I needed to do more. And so that launched me on a campaign to what can I do? How can I reach more individuals? How can I, you know, obviously talk to children, talk to parents to make a difference in their lives or at least give them the opportunity to see what could happen? We always in the ER talk about, you know, folks come in unfortunately and they're like, I thought, I never thought this was going to happen to me. And you never see yourself in that position where you're going to be in the ER with your

11:26child for whatever reason, whether it's a car accident, a drowning, or, you know, a fatal gunshot when you just don't ever expect that, right? And so I wanted to give parents an opportunity to kind of have a do over to be able to see and hear what could potentially happen. And guns are a hot topic. It's a, you know, it's a polarizing subject that, you know, once you start talking about that, people kind of get on one side or the other. And my goal was really to, I don't want to get on any side. I just want to get on the side of saving kids' lives and knowing that they're at risk. And how do you decrease your risk if you have a firearm in the home and do that in a way that makes sense? And so I started knocking on doors. I mean, and I wasn't sure what was going to be the response, you know, one of the first people I talked to was Winnie. And Winnie was like, whoa, what are you doing? Why are we talking about this? And I was like, we need to be talking about this. We are the experts in our community.

12:28We're the ones who are seeing these injuries, you know, weekly. We are the ones that should be out there talking about this and engaging the community and educating the community about, gosh, this is a real problem. This is before it has become kind of the problem or it's always a problem, but before it's gotten it's kind of the eyes on it, if you will, of the press and now what's going on back and forth. And when you think about all the political back and forth, but it was an opportunity for me to say, all right, we can do this in a way that makes sense. And that can provide that education to families. And so we started knocking on doors, talking to different people and was able to gain support in kind of that initial idea. And part of that was, I wanted to give people a really kind of insight into what would your kids do if they found a firearm, right? And it kind of turned into a research project where I wasn't intending for it to do.

13:32But I wanted to bring in families and just kind of put them in a situation where there was a firearm in a room that was non-functional and there's no way it could ever go off and just let parents see what their kids would do if they found that gun. And so that idea kind of started and worked with different folks at the hospital, Stan Davis, and also in folks in education and was able to get enough support. A lot of it was, you know, blood sweat and tears from my side. It was just, you know, I'm going to continue to do what I do because, you know, this is kind of the, my M.O. I'm just going to continue to work hard and knock on doors and this is an important enough topic that we need to be involved in. And I think administration saw the importance of what, you know, what that means in our community, right? We're still seeing kids that are being injured and, you know, firearms on an animal and killer of our children in this country. So we, you know, have been able to kind of move that agenda forward in a way that makes

14:34sense that that provides education not only to the kids, but also most importantly, parents who own the firearms, right? It's if you're a gun owner, you get to responsibility to make sure you put that gun away so that others can have access to that firearm who shouldn't have access to it. And so they, it's really kind of turned into that kind of campaign of talking to the parents and educating kids about the right things to do, but knowing that they're still evolving, they're still developing that they're going to make decisions that we are not always happy with as parents, right? You know, though, and they may do the right thing 99 times out of 100, but it just takes that one time, that one time, and that bullet leaves that chamber. It doesn't care where it's going to go. It's going to go where it's been pointed at, and it could be horribly tragic to some family and a child. And so, you know, what we've built now is an entire education around that. And it's really important that I, you know, I do my part to educate our system and our docs and our, you know, advanced practice providers on kind of how to

15:35have those conversations and just have those conversations with parents and be able to give them some insight. But I think, well, amazing things that we do at Cook is we provide gun locks, but we provide gun safes to committee, you know, anybody in the community who needs one. And I think that's the difference maker. You know, we can talk about, gosh, you need to do this, you need to do this. But when you give someone the tools to be able to really go that next step, then that makes a huge difference. And I think, you know, you can never measure what we do. It's hard to measure injury prevention and how many lies you're saying, saving by just having a campaign, whether it's around drowning or around safe sleep or firearms. But I know we're making a difference. You know, the team that I have at the Center for Community Health doing an amazing job of being able to go out in the community and have conversations around these injury prevention topics that we're so passionate about that. I think truly make a difference for my job too, right? Working in the ER, see these things happen. Or, you know, my colleagues and I just, you know, at some point,

16:37it's hard to deal with those outcomes, those negative outcomes day in and day out, right? It wears on you. You can become cynical at times. But when I think the biggest value that we have is being able to go out and talk to families about it and make that difference, right? I think being able to go to the community and show that we care. We're not just here to provide you, you know, the health care, but we're here to, because we genuinely care when I help you, you know, in whatever way we can to have a better life and to feel like you can, you know, move out of that situation and then I'll see something bigger. And I think kids have to be able to see that. That's why I feel like it's so important that I'm out there when we're out there on, you know, whatever weekends or evenings and we're doing town halls with Fort Worth ISD that the kids see us there and see me there. You know, I think all physicians, it's really important that we're all out there being role models for a lot of the kids and not only in our own home or own schools, but around the

17:39city. I can really have a huge impact even though people may not see that. I think I've realized that over time that people see me in an event. They're like, why are you here? I'm like, you know, you should be doing something else or I'm like, I'm here because I care and because I think it's important for me to be here and talking to you guys about what, you know, what you need or how can I help you? Understanding their needs makes a huge difference in how we're going to treat them, I think, ultimately and how we shape, you know, the healthcare around them. I think that makes a world the difference. When I look at kind of just firearm intervention, you know, education that we do now, that's extremely important, but there's a bigger part of that education that really affects everyone in the community right in Tarant County at Fort Worth and that's just violence in general. And so I'm part of a steering committee and it's part of something called one-second collaborative, which is an effort between United Way Tarant County, Fort Worth Police, the city of Fort Worth,

18:40and the county as well, to decrease violence over on our city. And the goal is to support community-based organizations in the city and provide them funding so they can go out and do their work in the community to help those individuals who are suffering from poverty or, you know, they don't have food to eat, they don't have housing and help provide them some of those resources in that help, but also to help them with mental health services as well. And so as part of this collaborative, I didn't realize how important what I do and what other health systems in the area do can be extremely important to tie it all together. And so, you know, we do a great job here at Cook and other adult hospitals taking care of those individuals that come to our hospitals. You know, we do a great job of taking, you know, getting them back to to 100%, and then we kind of discharge them. And then, you know, there's those touches afterwards that are really important

19:42when you think about trauma and what that means to that individual and their mental health, but not also not only that, but their family. So they have kids, they have a husband or a wife at home who are going to be touched by that traumatic event. And there's so much more that we can potentially provide these individuals and these families is, and that's where this entire new project that I'm working on with Hospital Violence Intervention Programming can really elevate what we do and how we treat our trauma victims in our city. And I'm excited about that because I'm getting three health systems together, JPS Health, THR Health and Cook Children's Health System to come together and find a way to work with each other to improve and provide wraparound services for these individuals when they have these, you know, these traumatic events in their lives. So they come, someone comes to our ER and they've been assaulted or they've been a victim of a gunshot wound

20:42that we can have a trusted messenger at the bedside who can help them understand that we're here to help them and provide some of that trust so that they we can kind of help them through the process of getting over this traumatic event. And then perhaps even finding a different path in their life that can be lead them out of, you know, whatever situation they're in. And I think that's huge. I'm excited about kind of what we're at and what we're trying to do and getting things together and no longer working in silos. I think that we've been doing a lot of that where everyone's doing their own thing, but we're not working together to really, you know, elevate and really solve the problem of what we see in our community. And so that really excites me that that I'm able to at least be a part of that. And there's so much more to come. This is, I mean, we're in the gosh, we're in the toddler phase of this entire project. And so I over the course of the next year, hopefully we can find an FTE that can help lead that kind of trusted messenger

21:45programming in our hospital here at Cook. And so that we can start to provide those services. You know, we have that project with JPS over at LVT that, you know, with our new building that's going to go up in those health services. We're going to provide that. I'm hoping that we can use that as a place where individuals who may have been shot and presented a JPS who come back for, you know, their follow-ups. We, as Cook, can then intervene and help their entire family as well. Provide care to the children who have been part of this traumatic event, right? We all talk about adverse childhood experiences that affect our children and how they grow and what ultimately, you know, their destiny might be that we can help intervene and maybe make a difference in their lives and help them go in a different direction. But if nothing else, provide them some of the resources any from day to day, whether it's food, housing, mental health, any of those small things that already are, you know, we're struggling to find. But hopefully it can bring that together

22:51to provide them those services and, you know, give them a different path. I think that's the most important thing that we can do. When I look at the work that I do in the community, when I talk to kids and families, when you kind of see the light bulb in their eyes, you can, you can always, as much as I talk to people in the ER, but also out in the community, you kind of figure out when something kind of hits home and you see that, see them say, oh, that makes sense. Those are the moments that I cherish. And I always talk to families and folks about, if I just talk to one person and I can get them to change, that's really what I, that's why I'm here. It's like, it's one person at a time. I can't expect, and don't expect to change an entire community. But if you do it one person at a time, generationally, that makes the difference. Like, the project that I'm, you know, we're working on is not going to be something that changes everything and for worth in a month. It's going to take five years, 10 years, but that difference, you'll, we'll see it at some point. And I think that's what keeps me going.

23:56When I, when I see that, those individuals who, you know, when we're talking, they're, you could always find people who are negative and who are like, oh, that's just not, I can't do that. It's not reality. I think understanding why people do what they do in their homes really makes a difference. That really helps me to understand how do I talk to that next person? How do I get you to, to understand the risks that you may have at home with the, with a firearm if you leave it out? And that to me really launches me into the, to the point where I can do this again the next day. Because there's so many challenges and frustrations when you think about what, what I'm trying to do and what we're trying to do is, as, as an injury prevention program that is, you know, challenging. Getting people to change, getting the system to change is one of the kind of the biggest things. It's like, you can't, there's so many things that are, I think, against us. When it comes to that, that it's, you just have to believe that what you do every single day is making a difference in

25:00individual lives. And that's what keeps me going is I know that if I talk to someone that I'm planting a seed that may help them say, man, there's just something I can do differently at home. Whether, and it doesn't matter what it is, I'm not just talking about guns, but I'm talking about, you know, water safety and putting on a seatbelt, but also just mental health. Like, you know, rather than, you know, we all do things in our lives that we regret, right? And I talk to kids like, you know, there's things that you're going to do that you're going to regret. But if you can take a moment before you make that decision and say, is this the right path for me? Should I do this? Because I know that it's going to have repercussions. Or should I do this instead? If I can get you to stop and think about that. And if you decide to go down that path, at least you thought about it before you just acted. And I think so many of our kids do that. It's just a response, right? And I'm hoping that we can help kids understand conflict resolution and how to deal with that, but also how to make a good decision and not just act, but think about those actions and what, you

26:02know, what those consequences are going to be. And I think that makes a difference, I think, overall. It's really fulfilling when I see someone's behavior change, right? To be able to see that in an individual's face or have a conversation that goes from, this is what I'm comfortable with. I'm not going to change to at the end of that conversation. I see what you're talking about. I understand what you see. And I think that's really so important for me to be able to allow individuals kind of a view into the ER through my eyes. Me and my colleagues have seen so much, right, in the ER, to be able to provide that insight to a family is really important. And I think that happens every time I'm out there, I think. I feel like there's one person you touch. There's individuals who see that. There are a couple of children that I really remember. When I was over on the east side of Fort Worth at one of the schools, and kids are amazing,

27:06they start to tell you about everything in their lives that parents were probably like, please don't share that. But that's what I love about kids. And we talked about guns in the home and how they have, you know, they're so cool. They've picked them up and they kind of pointed them at the wall. But to be able to talk to them and say how dangerous that is for them and their safety, but also for someone else in the house that that gun goes off. And to see the light bulb, and just to see their eyes kind of look and say, that makes sense. And I won't do that again. And for me, to know that what they're saying is believable, like, you know, so kids will say whatever you want them to say sometimes in a situation, especially if they feel like they've been caught. But these kids are able to provide that information freely and not ghosts. And they're just talking about what their home environments like. And this is what they have. And this is what they think is cool. To be able to know that in their minds, I think I've made a difference in

28:07how dangerous that scenario is for them. Even though they may see it all the time, they see it on whether they're playing games and what they watch on TV. And then what they see on social media, that that becomes a real something that they think is cool to help them understand that that's that's all cool. That can really really be tragic for you or someone else in the house that that that's something that you shouldn't do. And that we, you know, can provide your family with something that can make you more safe. And that's a gun safe. And so I think those are the opportunities that I relish to, you know, just I really just love to be able to talk with people and just kind of have these conversations. So people will tell you a lot of different things. And they'll justify what they do. And I get it. It's all about safety. And you want to keep your family safe. But the risk you can put your family in can be greater than the actual threat that that's outside. But I don't, it depends on where you live in the city of Fort Worth. That risk can be different. And understanding that when when I'm talking to parents is really important. You know, when you hear

29:10someone say, I hear gunshots every night. I can't even imagine what that is. I don't hear that in, you know, where I live. And for them to have to hear that every day and for their children to live through that every single night would be nightmarish for me. I'm like, you know, you would want to do more to keep your family safe. But you have to do it in a way that makes sense that you don't put your family in more danger by having something in the house that could harm them as well. So I really encourage all our cook physicians to really get out there. You know, you just have to stay, you know, get up and say, I'm going to go out to the committee this weekend and go to an event and just talk to people. I challenge everyone to do that. I think that's really important. It can really shape the city. It can really shape your practice. I think you can really have a different relationship with the people that you serve. You have to understand what their concerns are, right? That you can't always get in a five minute, ten minute visit in the office. And so when you get out there, you really understand, gosh, what effects these folks? And how can we, as a system,

30:13do something to help them? And I think that's really important. So I challenge all of them to get out there, you know, once, if nothing else, once a month or, you know, once a quarter to see what your community needs and how can you help and serve? I know we're all busy. I get it. I, you know, I work full time in the ER and I do a lot of other things. But I think that can really change the landscape of what we do in Fort Worth and how we can be different than other parts of the country in many ways. They get a lot a lot of our physicians out there and seeing. And I think that, again, I talk about this relationship of trust. That makes a difference. I think it really makes a difference in how people receive the message. Physicians are no longer trusted as like we used to be before 2020 in COVID. There's definitely, there's more challenges. There's, there, you know, technology has gotten better, which allows people access to information. And that's great. But it's the perspective of that information can really shape what that means,

31:14right? And that's what we as physicians do is we help to shape the understanding of what that diagnosis means, what testing that needs to be done. And that can be all built with trust with a family or the community. If they understand why we're doing something and not just, you know, the AI generated, hey, this is what you should be doing. You know, this, I think that can help, you know, us treat our families and our patients much better. You know, we're all busy, right? In our lives, whether it's work and, and at home, I have three kids who are now kind of in that teenage years and each one of them is doing something different. So it's a challenge, you know, with my wife and I to be able to kind of get them to the different activities they do. And to balance that with what I do at the hospital, it can be, it can be tough, right? It's, it's, it's definitely a situation where I have to know my limits, but it's not impossible. I'm able to, to, to provide that service and work a full-time FTE in the ER and still do the,

32:18the vast majority of, of, of outside and community events that I do in addition to starting, you know, like you said, new initiatives to help the community. And it's, it can be challenging, it can be it. Some days, you know, you can be tired, but it definitely keeps me, keeps me young. It kind of keeps me going, keeps my mind, you know, moving all the time to be able to challenge myself. And I challenge everyone else out there to kind of get out there and, and, and do something and get outside the norm, right? Do other, of where they're comfortable and say, yeah, maybe I do have one, one day a month to provide and, and come and help me. I'm like, I'll take all the help I can get to come out and, and, and help me and at a community event will be somewhere on Saturday on Magnolia talking to families about gun safety. But also to just be able to get out in the community, we do other things, ask a doc where they can come out and, and just, you know, for 30-minute answer questions, you know, of something that we already know about, right? It's not anything challenging. There's nothing that, that, that, that I think from a medical standpoint that we can't answer. But I think it's just, it comes from within. You've

33:22got to make time for it. You got to prioritize certain things. And I understand we all have different priorities in our life. I tend to prioritize all of that equally. I'm like, I think my ability to get out there and provide mentorship to kids and, and, and families and provide that, that, that level of, of service goes beyond the walls of the hospital. I think what I do, and, and what the knowledge I have, I need to be able to give to someone else, not just in the ER setting room where I'm treating a specific illness. But outside in the community, talking to folks, but also balancing that with my own family. I don't want to give, you know, I don't want to say that, that, that's not important because it's 100% important. But I spend, you know, three days a week at baseball practice in the afternoon, and most of my Saturdays, you know, at baseball tournaments. If not, I'm with my middle child doing, you know, cheer and,

34:25and go into different events with her. And, and so I think it's really important that we have work-life balance, you know, it, but also we need to be able to provide something more to the community. And I think it's our, it's, it's, it's part of, it's not really part of our job description, but I think, you know, we all know that it's something that is important that, that as physicians that we should be able to do. So my motivation for what I do is seeing the difference that I can make as an individual in the community. Imagine what we could do as a collective in the community, as a group of physicians, advanced practice providers, nursing, social work. Imagine all of us out in the community providing just a part of what I do at a scale that's just amazing. I think we could obviously make a huge difference in what we see in our own hospital and elevate the families in our community. There are so many challenges for

35:27so many of our families out there that we may be out of touch with. And so when you have that ability go and see these individuals where they live, how they live, and what their needs are, I think it only drives a person to say we can do better as a city, we can do better as a health system. I can do better as an individual just to help them. And I think that's the motivation that drives me is that I know I can make a difference. It can be a small difference, one person at a time, or it can be a grander scale of 20, 30, or whole community. But I know I can make a difference, and why not provide whatever I can to those individuals and help them feel valued. I think that really makes a difference. I think it helps my children understand why they're here. We're not just here to fill our own cup and it's all about me, it's about someone else. And I hope they see that in what I do and all the work that I do with other individuals that sometimes they understand

36:33that I'm not there for a reason, that I'm helping someone else in the city who needs that help. And that they're taken care of, that they're provided for, but there's so many other individuals who are not. They don't have the advantages they have at this point in their lives, that I didn't have as a kid, that I want to give back to my community to be able to make that difference, to help another child who may not be my own child have a chance at life. That makes a difference. And honestly, I believe this is what I'm supposed to be doing on it. I mean, every single day I go out there and I wonder, why am I here? This is why I'm here. I'm here to make a difference in someone's life. I wouldn't change a thing that I'm doing. This makes sense to me. It's what God has led me to do and I will continue to do it and I hope everyone else can follow in my footsteps and come and help me. For Dr. Daniel Guzman, caring for children doesn't stop when a patient leaves the emergency room. Through his work in the community, educating families, preventing injury and building

37:36trust, he's helping make North Texas a safer place for children to grow up because sometimes the most powerful medicine is prevention. Thanks for listening and we'll see you next time on Untold, the Stories of Cook Children's.