Dr. Misha Pangasa: There is an enormous amount of moral distress that comes with that. It is heartbreaking. It is really discouraging, and I’ll admit, the really scary part is after a while, you get really used to it. It’s like this thing that just becomes normal– we know what the right thing to do for this patient is, but we know that we can’t do that. I think, for example, living in Arizona, this is one of the things that was so striking to me, is that people have been saying that for so many years that it’s not even weird anymore. I remember one of the first days that I got there, people were talking about a patient whose water broke when they were 17 weeks, and there was no chance of this patient actually making it to the point that they could deliver a healthy baby to take home, and the management plan was to just keep watching her until she developed a fever or started to look like she was sick. And I had just come from a hospital in Utah where if you knew that was the outcome, we would take care of them. And so, to be in Arizona now and to just watch everybody else in the room say, “Yeah, okay, that’s what we’re doing.” This is no discredit to my colleagues, because they also know what the right thing to do for that patient is, but it’s been years of the standard. Again, that’s pre-Dobbs. We have numerous other restrictions at the state level, not to mention the Hyde Amendment, which prohibits basically acting in any place that has federal dollars attached to it. And so, the moral distress is there, but it’s almost sometimes only when you sit to reflect on it. When you have to do the the same things over and over again, you know, I think it’s the normalization of this terribleness that is even harder. It’s almost like you become a little hardened to moral suffering. It’s part of the job when you sign up to live in a state like this.