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Guest: Sami Khella, MD With personalized approaches, alternatives to steroids, and novel therapies like efgartigimod, the treatment landscape for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is continuing to evolve. Join Dr. Sami Khella as he shares expert insights on our available options. Dr. Khella is the Director of Clinical Electrophysiology and a Professor of Clinical Neurology at the University of Pennsylvania, and he spoke about this topic at the 2025 American Academy of Neurology Annual Meeting.
Guest: Sami Khella, MD With personalized approaches, alternatives to steroids, and novel therapies like efgartigimod, the treatment landscape for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is continuing to evolve. Join Dr. Sami Khella as he shares expert insights on our available options. Dr. Khella is the Director of Clinical Electrophysiology and a Professor of Clinical Neurology at the University of Pennsylvania, and he spoke about this topic at the 2025 American Academy of Neurology Annual Meeting.
Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Eric Klein, MD With an urgent need to screen for cancer, clinical trials have shown that the multi-cancer early detection (MCED) test Galleri® can screen for more than 50 distinct cancer types in adults 50 and over and predict its origin. Questions have remained regarding the risk of cancer for those patients with a CSD MCED result, followed by a diagnostic evaluation that did not result in a cancer diagnosis and a second MCED test. Recent research was conducted to help address this gap, and now, Dr. Eric Klein joins Dr. Charles Turck to share the real-world outcomes following a Galleri MCED retest. Dr. Klein is a distinguished scientist at Grail and one of the elite investigators on the clinical studies that led to the development of the Galleri MCED test.
Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Eric Klein, MD With an urgent need to screen for cancer, clinical trials have shown that the multi-cancer early detection (MCED) test Galleri® can screen for more than 50 distinct cancer types in adults 50 and over and predict its origin. Questions have remained regarding the risk of cancer for those patients with a CSD MCED result, followed by a diagnostic evaluation that did not result in a cancer diagnosis and a second MCED test. Recent research was conducted to help address this gap, and now, Dr. Eric Klein joins Dr. Charles Turck to share the real-world outcomes following a Galleri MCED retest. Dr. Klein is a distinguished scientist at Grail and one of the elite investigators on the clinical studies that led to the development of the Galleri MCED test.
Host: Peter Buch, MD, FACG, AGAF, FACP Guest: David P. Hudesman, MD With so many therapeutic options for Crohn's disease and ulcerative colitis, it can be challenging to determine which one best matches your patient's needs and preferences. Onset of action, risk of infections, disease location, and therapeutic goals are all key factors in the decision-making process. To learn more about these considerations, Dr. Peter Buch sits down with Dr. David Hudesman and explores the current therapeutic landscape for inflammatory bowel disease.
Unknown: Arnold Advincula, MD With over 20 years of experience performing the transabdominal cerclage, Dr. Arnold Advincula, Chief of Gynecologic Specialty Surgery at NewYork-Presbyterian and Columbia, has a deep expertise in helping women with cervical insufficiency achieve successful pregnancies. Through the expanded use of robotics, Dr. Advincula and his team are completing the procedure minimally invasively and with more accuracy and precision. Watch to learn how this advanced technique is transforming gynecologic surgery by reducing recovery time and helping women reach their reproductive goals. © 2024 NewYork-Presbyterian
In this episode we discussed the differences between physiological closed loop spinal cord stimulation and traditional stimulation. Our guests, Dr. Jason Pope and Dr. Johnathan Goree talked about the data behind Saluda's closed loop stimulation and how it differs with Medtronic's therapy. They also discussed knowing and controlling the dose of stimulation and what they think the future is for this therapy. Full Disclosure: Dr. Pope and Dr. Goree are consultants of Saluda Medical. Host, Patrick Buchanan, MD: Dr. Buchanan is double board certified in Physical Medicine and Rehabilitation and Pain Medicine. His goal is to help his patients get their life back by managing their pain and focus on things they love and enjoy. https://www.californiapaindoctors.com/patrick-buchanan-m-d/ https://www.instagram.com/patdbmd/?hl=en Host, Timothy Deer, MD: Dr. Deer is the president and CEO of the Spine and Nerve Centers of the Virginias. Dr. Deer has led a revolution in interventional spine and nerve care by teaching thousands of physicians an algorithmic approach to care including methods that are less invasive at a lower risk for complications. https://centerforpainrelief.com/about/tim-deer-md/ https://twitter.com/doctdeer?lang=en https://www.instagram.com/timdeer30a/?hl=en Guest, Jason Pope, MD: With over a decade of experience, and regarded as one of the most influential key opinion leaders in the field of pain medicine and neuromodulation, Dr. Jason Pope in Santa Rosa is triple boarded in Pain Medicine, has published over 80 peer reviewed journals, spoken at numerous national and international conferences, and has consulted with many start-ups and established companies. https://evolverestorativecenter.care/ Guest, Jonathan Goree, MD: Board certified in anesthesiology and pain medicine, Dr. Johnathan Goree is a proud alumnus of Catholic High School in Little Rock, Arkansas. In 2014, Dr. Goree returned home to Little Rock, Arkansas to join the faculty at UAMS where he serves as the Director of Interventional Pain Management Services and an Assistant Professor in the Department of Anesthesiology. He primarily focuses on the treatment of chronic pain conditions using minimally invasive procedures, spinal cord stimulation, and vertebral augmentation. https://medicine.uams.edu/pain/meet-our-team/johnathan-h-goree-m-d/ About ASPN: ASPN was created to bring the top minds in the fields of pain and neuroscience together. ASPN has a mission to improve education, highlight scientific curiosity, establish best practice, and elevate each other in a quest to improve the field of pain and neuroscience. All initiatives of ASPN are dedicated to improving patient outcomes, education, research, and innovation. ASPN's website and social links: https://aspnpain.com https://www.youtube.com/channel/UCixMNhEtOiRm1aQmDWtzxmg https://www.instagram.com/aspn_painneuro/ https://www.facebook.com/PainNeuro https://www.linkedin.com/in/aspn/ https://twitter.com/aspn_painneuro Our sponsors: Mainstay Medical: The Only FDA Approved Restorative Therapy for Chronic Mechanical Low Back Pain caused by Multifidus Dysfunction. Restore Control, Restore Function, Restore Stability, ReActiv8 Life. https://mainstaymedical.com/ Saluda Medical: Saluda is the first to directly measure the spinal cord's physiologic response to stimulation. A 10+ year journey since the first ECAP measurement to transform the science and practice of SCS using Evoked Compound Action Potentials (ECAPs) to pioneer smart neuromodulation therapy. The Evoke® System listens and responds to each patient's neural signature. https://www.saludamedical.com/ Nalu Medical: Nalu Offers a Long-Term Solution For Pain. More than just new technology; it's a whole new world of opportunities. https://nalumed.com/ Medtronic: Medtronic leads global healthcare technology, boldly attacking the most challenging problems. Our Mission — to alleviate pain, restore health, and extend life — unites a global team of 90,000+ people, and our technologies transform the lives of two people every second, every hour, every day. https://www.medtronic.com/us-en/patients/treatments-therapies/pain.html Spinal Simplicity: Spinal Simplicity is a Healthcare Technology company dedicated to creating simple, innovative procedure solutions for our physician partners to help improve their patient's pain and quality of life. We believe strongly in AO orthopedic principles of Early & Safe Mobilization, Bone Decortication, Joint Stability and Anatomy Restoration. Our brands include Minuteman, Liberty-SI, Patriot-SI and Hero-SI. https://spinalsimplicity.com/
Breaking Science Changes the Beauty Landscape Guest: Bestselling Author Fred Pescatore, MD With any change of season, it's always important to know how to protect your skin from overexposure. Whether spending time in the sun, pool, or even in air-conditioning, science-based knowledge will help you create the best routines to prevent discoloration, increase hydration, and make smarter choices to prevent premature aging. This hour is jam-packed with easy-to-follow solutions to have fun in the sun. Ask for it by name: Pycnogenol.com Check out: DrPescatore.com
Jeffrey Gladd, MD With twenty-one years of experience in the medical field, Dr. Jeff Gladd, MD is the owner of GladdMD Integrative Medicine and since 2019 has been the Chief Medical Officer at Fullscript. Dr. Jeffrey Gladd graduated from Indiana University School of Medicine in 2001. He then went on to train in family medicine at Ball Memorial Hospital in Muncie, Indiana. After completing his residency, Gladd started a family practice that encompassed full spectrum care, including obstetrics, colonoscopy and endoscopy in Columbia City, Indiana In 2006. After the birth of his second child, Gladd transformed his professional and personal focus toward health through nutrition. By educating himself and applying the principles of eating whole foods, he lost 50 pounds, and reveled in improved energy and mental clarity. As a physician, increasing doses and adding medications was no longer acceptable. Gladd delved into his patients' lives — how they ate, how they managed stress, and discovered real health care. Gladd completed the University of Arizona Integrative Medicine fellowship program under the direction of Dr. Andrew Weil, MD at the end of 2009. While in the fellowship, Gladd served as the medical director of the Parkview Center for Integrative Medicine in Fort Wayne, Indiana, and in 2010 opened GladdMD Integrative Medicine where he blends health-promoting care with high access technology. With the success of GladdMD, Dr. Gladd has become a sought-after speaker on physician entrepreneurship, social media, and technology in healthcare. Tieraona Low Dog, MD From a young age, Dr. Tieraona Low Dog has been deeply drawn to the natural world and the field of natural medicine. Her academic journey encompasses a diverse range of disciplines including massage therapy, martial arts, midwifery, and herbal medicine, before going to earn her medical degree from the University of New Mexico School of Medicine. As a pioneer in the field, Dr. Low Dog not only served as a founding member of the American Board of Physician Specialties' American Board of Integrative Medicine; but she was also among the first cohort of physicians to be board certified in this newly emerging field. Her leadership extends to her tenure as Director of the first Inter-professional Fellowship in Integrative Health and Medicine, Fellowship Director for the University of Arizona's Center for Integrative Medicine that was founded by Andrew Weil, MD, and Co-Founder and guiding teacher for the New York Zen Center's Fellowship in Contemplative Medicine. She currently oversees the Fellowship of Integrative and Functional Medicine at the University of California-Irvine's Susan Samueli Integrative Health Institute. Dr. Low Dog's dedication to public service is exemplified by her appointments to significant positions, including her service on the White House Commission for Complementary and Alternative Medicine Policy by President Bill Clinton and her advisory role at the NIH National Center for Complementary and Alternative Medicine, being appointed by HHS Secretary Thompson under President George W. Bush. Her leadership has been instrumental in her long-standing role (25 years) as Chair for various dietary supplements and botanicals expert panels at the United States Pharmacopeia. Recognized as a foremost authority in integrative medicine, women's health, dietary supplements, and herbal medicine, her scholarly work encompasses over 54 peer-reviewed scientific articles, 25 chapters in medical textbooks, and numerous authoritative books on health and medicine. Dr. Low Dog's global influence is highlighted by her participation in over 600 medical and scientific conferences worldwide.
Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are covering two popular documentaries that have recently been getting a lot of attention, "Escaping Twin Flames" on Netflix and "Love Has Won: The Cult of Mother God" on Max. We discuss how cults prey on vulnerable people, some red flags to look out for and discuss similarities between these two cults as well as others. We hope you enjoy! Psychology Today Article Instagram Youtube TikTok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Furey, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is analyze scripts, a podcast where two shrinks analyze the depiction of mental health in movies and tv shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM five, and enjoy. Welcome back to another episode of analyze scripts. We are doing something a little bit different today. Usually we focus on fictional tv shows and movies, but we have decided to take a stand against cults. And we have decided that we will make an exception and talk about cults when they're in the media, because they are honestly just so atrocious. So we're going to try to walk a really fine line here and still be ethical. We're not trying to analyze anyone specifically in terms of the people that are talked about and the two documentaries we're going to be talking about today. But we want to use this material to talk more broadly about cults in general, again, because it is really pervasive, it's really dangerous, it's heartbreaking, and we see it a lot in the media, but there's still so much confusion about it. So, again, if you want to hear more, you can also revisit one of our older episodes about yellow jackets season two with Dr. Jesse Gold. We talk a lot about Lottie's cult. And so, basically today what we're going to do is I watched a documentary about a cult. Portia watched a different documentary about the cult. A different cult. And we didn't watch each other's documentaries. And we're going to tell each other about the different cults. Right? Did I explain that? Yeah. Okay, so do you want me to get started, or do you want to get started? Portia Pendleton, LCSW: Portia, why don't you intro yours and get started? Dr. Katrina Furey, MD: Yeah, not my cult, but the cult. Too short. Okay, so I'm going to be referring to a recent Netflix documentary called escaping Twin Flames. I think that's what it's called. It was only about three episodes. They're about an hour long each. Interestingly, I watched them on an airplane when we were flying down to Disney World. So it was like an interesting juxtaposition, like going to the happiest place on earth and then watching all of this sadness and heartbreak and intensity sitting next to my children. It's interesting. This documentary follows an organization which obviously they don't call themselves a cult, but they have some experts kind of weighing in who do call it a cult, or also a high control group is like another phrase used to describe cults these days. And basically it's run by these two people, Jeff and Shalia, who I was just looking up their Wikipedia before we got started, Portia. And they both have had different names throughout their lives, according to Wikipedia, which I just think is interesting. And they run something called the Twin Flames University. I had never heard of twin flames until Megan Fox and machine gun Kelly. Right. Like, weren't they all about twin flames? Had you heard of this before? A little. Portia Pendleton, LCSW: Like, it's like an extra. Like, that was my understanding of what. Or, like, not an extra, a soulmate to the right. Dr. Katrina Furey, MD: Right. Yeah. So I again looked it up on Wikipedia, because doctors use Wikipedia, too. Portia Pendleton, LCSW: Did you donate? Dr. Katrina Furey, MD: No, it's Christmas time. I'm a little stressed. But basically, according to Wikipedia, it says, the term twin flames was coined by the english novelist Marie Corelli in her novel of romance of two worlds. And since then, it has sort of evolved into a lot of new age spiritualism. Kind of focuses on twin flames. It's kind of like, it's my understanding it's like your soulmate, but even greater than that. So it's almost like meeting your counterpart and that you have to find each other in order to both achieve your full potential. That's kind of what it is. And then I guess these two folks started this twin flames university where you could take classes about bettering yourself and finding your twin flame. And again, like we talked about in our yellow jackets documentary, always be very careful when someone calls themselves a guru. Someday we'll have merch that has that slogan on it. Right. But just always be careful. And I was looking, and their class that they sold was over $4,000. That's a lot of money. A lot. But again, I see this. I don't know if you see it in people you're treating or evaluating, but I see a lot of people coming to me who are paying a lot of money out of pocket. They don't take insurance. They're also not advertising themselves as clinicians. They might advertise themselves as, quote unquote, life coaches or a coach of some kind, but you can charge whatever you want for whatever you're selling. And it's just interesting to me how some people get hooked and some people charge so much money. Anyway, what the premise of the documentary, Portia, is, is know. So these two people start this twin flames university, and they kind of use themselves as, like, we found our twin flame and this is how we did it. And look at how successful we are and how happy we are and stuff. And then people start joining, and it kind of becomes. I feel like they always become these MLM type things, right? Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: Where it's like you buy in and then you become the teacher. Did you watch that documentary about the Nexium cult? Portia Pendleton, LCSW: Not that one, but Portia, I think I did the Lululemon. Not Lululemon, the Lula Rowe similar. Dr. Katrina Furey, MD: So the nextium was really good. Also, like, heartbreaking and awful, but it's a really good expose about typical cult psychology. But again, it's like we are up here on a pedestal. Typically, cult leaders are like, malignant narcissists who want to be idealized, and they want people to obey them no matter what. And they have this sociopathic flair to them. Again, I'm not analyzing anyone specifically or individually. I'm just talking about, in general, what we see. They have this sociopathic flare where, again, they kind of get off or get a rush from controlling people. So those tend to be the people at the top of a cult, and then below are people who are vulnerable to this type of influence. And I think that's where the psychology is really fascinating. Like, how do people get hooked and kind of. It's not always like someone waiting on the end of the road, like, hey, come sign up for my cult. No one would do it. Right? So it tends to be people who are vulnerable in some way. Whether there's been a history of trauma, I would say really common. If there's developmental or intellectual disability, if there is some type of mental illness that can be exploited. Like, I remember in my training, a colleague of mine was treating a patient with psychosis who was getting sucked into these cults. And for someone like that who's already struggling to tell reality from not reality, you can see why you're vulnerable to this. And other times, I think you can just think of it as an unclear sense of self, like someone who maybe is feeling a little lost or who's looking to feel connection or community or love. I think those types of people might be more apt to, I don't know, just, I guess, feel, like, enticed by someone saying, I have all the answers. Look how great my life is. Like, you can have this, too. If you pay me $100 million and do everything I say and change everything about yourself, isn't that great? I think people who have a really strong sense of self, who have more of a secure attachment style, probably will sniff out the bs and turn away and not be as easily manipulated as other people who maybe are struggling with that. I don't know. What do you think? Portia Pendleton, LCSW: I think that's pretty true. I mean, I think a generalization would be that people who tend to kind of fall into cults or even like mlms, it's like you're looking for something and then this organization is promising to deliver, and then there's this added layer of like, you're a family. And obviously that feels really strong in a cult as we know it. And then also we do see that show up in Lularoe and your team and your girl boss thing. So it can be obviously different levels of it, but totally. Dr. Katrina Furey, MD: I found a really interesting article that we're going to link to in our show notes because we know how to do that now on psychology today, that really explains cults, written by Stephen Hassan, a PhD I thought was like a really good, easy to digest description. And they also say you can see these dynamics not just in cults, but you can see it in mlms, you can see it in religious organizations, you can see it in schools, you can see it in families, you can see it in the workplace. Again, it's not like this phenomenon is unique to cults. I think it's just from the outside. Like when you're watching a documentary like this, you're just like, what? How on earth did these people stick around? And it's because it's so insidious and slow, right? Like we're seeing it in a three hour documentary. This has been going on for years. I think these people started this organization like 2007. It doesn't happen overnight, right? So usually the leader is really charming and charismatic and captivating in some way, but then there's a lot of nefarious things going on underneath. So we'll link to that because it's really interesting. And I think it's important just to note that these dynamics exist other places. And that's one reason we want to talk about it again, to sort of help educate and push out some information. So I guess with this one, with the twin Flames university. So again, the whole goal is like, sign up for this class. You'll become self actualized. I feel like that's another thing. All these cults sort of advertise like, you'll be your best self, and then that's confusing. Because I feel like Weight Watchers advertise this, too, and other types of self help advertise that. So how do you draw the line? But then you pay for this. And then as this documentary goes on, Portia, you meet different characters in it, and you meet, like, there was one. I was trying to just look up their names again really quick. Portia Pendleton, LCSW: So is this online mostly, like, the university? Like, I could sign up and take the class. Dr. Katrina Furey, MD: You could go right now. I went to the website, actually, to see if it's still there. And it is. So it is online. And then they started having in person meetups, which I think once you do that, then those connections are even stronger. Right? Like, now you're seeing each other in person, and it's like, this is our community. This is our. He did, the leader, Jeff did have a goal of eventually having an actual community. Like, we're all going to move to this place. I don't know if that ever happened or not, but so we meet a lot of different people involved. And one person involved that really struck me was this young girl named Marley. I think she was in her late teens when she got involved. And again, I feel like that's, like, the perfect person who's susceptible. Like a 17 year old with an Internet connection. Portia Pendleton, LCSW: You're really figuring out who you are. Dr. Katrina Furey, MD: Right, exactly. You don't have a fully formed identity yet because you're so young and you're just trying to figure it out. And we don't know anything about her background, so I'm not going to speculate, but basically, she was super young going to these classes. I don't know how she's paying for it. I'm not sure. And then what really struck me is basically, like, jeff and Shalia, the leaders would tell their participants, like, we know who your twin flame is. So, like, once you're self actualized enough, we'll let you know. Or we're going to help make the map. Yes, exactly. Like this ultimate puppeteer, right? This ultimate. And, like, they showed this scene where they were at the in person meetup, and they're all meeting for the first time, and they're talking to Marley and saying, like, well, is there anyone special in your life? Right? You know, they're showing this stuff, and somehow they have footage of it in real, like, they have the old footage. So someone was, like, filming all this, but then they're also showing Marley, like, present day, reflecting on the experience, and they're asking her, is there anyone special in your life right now? And she's kind of shy because she's like a kid and like, well, not really. And then Jeff's pushing her, like, are you sure? Are you sure? Sort of like, suggesting, like, he knows. And then she says, like, well, this guy has been texting me. And he's like, oh, that's it. That's it. This random guy who's texting her, and then that's her twin flame. Over time, she starts having a relationship with this guy. She moves in with him when she's really young. I can't remember the age difference, but there was a pretty significant gap. Not like 20 years, but maybe somewhere between five to ten years. And he had a criminal past. He was doing a lot of drugs. That's all we know. We don't know if there's any other trauma going on in the home as they're living together. I wouldn't be surprised if there was. And it just broke my heart that this young girl gets sucked in to thinking this is the person she's supposed to love, right? And you're just so brainwashed by it. So that was really captivating and sad. And then the other things that we see in the twin flames universe is we see a woman named Keeley, who's a key character in the documentary because she got in early and became, like, one of the teachers. So she was someone who was know. Jeff and Shalia are here. She's like the next level and trying to train other people. And how do you do the classes and stuff? And by the way, all these people are working for free. No one's getting paid. Eventually, Jeff and Shalia somehow incorporate to be a religion so that they don't have to pay taxes. And it's just like, again, all of this stuff is messy and very classic for so. But what's interesting about Keely in this documentary is that she comes in, she finds her twin flame very early on and is sort of put on this pedestal of the ultimate example of, like, look, it's not just us, Jeff and Shalia, who found our true love. These people also did using our methods, and now they can teach you. So they're like the ultimate teachers. And over time, she starts to kind of doubt what's going on. She eventually leaves, and you really see her grapple with the shame and guilt of what she did while she was part of the cult. And there's a scene at the end where she meets another former cult member who she used to be, like, the teacher of and would really push to do unhealthy things. And they just have this moment, this conversation where she's so genuinely apologetic, and it's really heartbreaking. You really see how that whole thing about how someone who's been abused becomes an abuser, and it's really heartbreaking to witness. So she's a really compelling character. And then the cherry on top of this awful Sunday, Portia, is that. Portia Pendleton, LCSW: Just nervous. Dr. Katrina Furey, MD: I know. You should be like, hold on tight. So as if all of this wasn't bad enough, as they know, Jeff and shalia start morphing their teachings to include that everyone is either a divine masculine or a divine feminine. Okay? So they're saying you're either a divine masculine or a divine feminine. You don't have both characteristics of both. And you have to find, like, if you're a divine, if you are a divine feminine, you have to define your divine masculine and vice versa. Like, two divine feminines, two divine masculines can't be together. Okay? So then they start telling people whether they are a divine masculine or feminine, whether or not that matches with that individual's own sense of their gender, okay? And it's also not based on the person's outwardly appearing gender. So they're not telling all the outwardly appearing girls you're defined feminine, and all the outwardly appearing males, you are divine masculine. The reason why is because they had way more women as students than men. So I think they started running out of men to pair with people. Honestly, it seems like. So they started telling certain women, like, you are a divine masculine, and this divine feminine is your twin flame. You need to be in a relationship with them. And some of these people now who are being interviewed are like, I'm not attracted this person. I don't feel like I'm trans or anything like that. In Portia, it goes so far that some of the people got top surgery. I know. And so abuse 100% across the board. This is why I feel like we can make the exception and talk about cult like this, because it is so atrocious. It's like a human rights violation, I feel like. And what I really liked about this documentary, actually, is that. And I was, like, talking about this just socially with some of my friends who aren't in the mental health field. And they agreed that they really appreciated how in this documentary, they had someone who is, I forget exactly what their title was, but they work at, like, a university and gender studies and do a lot of advocacy for transgender rights and things like that. And they very clearly said, this actually is anti trans. Like, twin flames university is advertising itself as pro. Like, we support this. We'll support you when no one else in your family does. We'll support you getting your surgery and things like that. But they're like, this is actually completely anti trans because you are telling someone what they are and how their body should look, and you don't care if that matches their own inner experience. Right? And that is like, bad. So bad. And so this documentary does follow a couple of people in particular who ended up getting surgeries. And one of the most heartbreaking scenes is when they follow a group of mothers who have been disconnected from their children, who have joined this cult. And one of them is watching her daughter talk about getting top surgery because she was told she's a divine, masculine, and it's just so heartbreaking to see. And then the other two pieces of the documentary that just blew my mind were at the beginning, they advertised having, and there was a psychologist involved, okay? Like someone with real training. They advertised having some sort of treatment for PTSD, of all things. And I just think that is disgusting. It is egregious. It should be reportable to whatever medical or psychology board this person is licensed by because they're advertising like, we have this treatment. And really they're just like indoctrinating people. And so that was really disgusting to me. And the last thing I wanted to tell you about was we saw one of these moms as she's talking to the camera about basically her child cut her off. And she keeps trying to reach out. She's not hearing back, but she keeps trying. And I feel like that's a message I want to get out is like, if you have someone you love in one of these cults or high control groups, just keep reaching out, even if you're getting nothing back, because you just have to keep that thread of attachment going so that when the person is hopefully ready at some point to leave, they know you're still there. So this mom kept reaching out, kept reaching out even though she wasn't getting anything back. And then as she's talking to the camera, her child text messages her. And you see her very genuine reaction, just like. And all the text said was like, mom, it's me. I need help getting out of this relationship. And she's just like, I just got chills trying to tell you about it because it's so moving and it's so sad. And you see just such a genuine reaction of her saying, like, oh, my God, she got back to me. I want to say something, but I don't want to push her away. I want to keep this going, but I don't want it to be too much like what do I way? And then you see her telling the other moms that she heard from her child and how they're supporting each other. Oh my God. It's really intense. And I would say this documentary is very hard to watch because you really see how so many people have been exploited and traumatized and how they're trying to pick up the pieces and how there's still so many people in it. But I think it really speaks to cults and kind of what it's like. And I feel like twin flames to me always sounded like ludicrous. It just sounds like something that's so ludicrous. But I think that's also an important point is that to some people it's not ludicrous. Yeah. And it just depends on what you're searching for. Right. Whether it's like love or a family or money for MLM schemes. Portia Pendleton, LCSW: Right. So that key part, I think in your cult and that what you not. Dr. Katrina Furey, MD: Dr. Fairy's cult, I do not have one. Portia Pendleton, LCSW: I am not a guru. Right. So in love has won, which I watched, which is on HBO or Max, three parts, 3 hours. It sounds like there's a lot of people who are in general prior to joining are kind of like anti establishment. Some the government isn't working for us anymore, which a lot of people feel that way. Dr. Katrina Furey, MD: Exactly. Portia Pendleton, LCSW: So there's these know, I think sometimes really normal thoughts or feelings somebody could have. Dr. Katrina Furey, MD: And then it's like the kind of. Portia Pendleton, LCSW: Takes that and it's like, oh, yeah. So like we also believe this. And then they kind of continue to pull you in. I think we saw that a little bit with QAnon stuff. It's like some of what I'm sure they had out there is pretty believable. So that kind of draws the person to do more research and then all of a sudden you're in a cold. Dr. Katrina Furey, MD: Right. And again, it's like, I feel like it's certain types of people who are going to keep getting sucked in. And the leaders have an uncanny ability to sniff that out and they know who they can manipulate and exploit, right. Portia Pendleton, LCSW: No, totally. So speaking of that. So Amy Carlson or mother God. Dr. Katrina Furey, MD: Oh, mother God. Portia Pendleton, LCSW: Or mother Earth or divine mother was a young, I'd say attractive woman who had three husbands and some children who she ended up leaving all for her own kind of spiritual journey. So her mother and sister describe her as being really charismatic. She worked at McDonald's and was kind of immediately, like in a leadership role, she was constantly being promoted. Her team loved her. She had this way with people. During that time, she was with a partner, and she had several children, et cetera. So then she starts to kind of join these online chat groups, which I feel like is a pretty common start to the depths of the Internet. So she started with spiritual singles, and she ended up meeting this man who was much, much older than her, or at least he appears much older than her on lightworkers.org. So they were, like, messaging back and forth. It's basically just people who are, I would imagine, interested in spirituality, and you can chat with each other about the divine and mutually interesting things. So she meets Amorith White Eagle, and she ends up meeting him. Dr. Katrina Furey, MD: What's that name again? Portia Pendleton, LCSW: So it's amorous white eagle. Dr. Katrina Furey, MD: Is this person, like, indigenous? Portia Pendleton, LCSW: I don't know. Okay, so this all kind of then takes place in the Pacific Northwest, it appears Colorado, Oregon, kind of back and forth. So she meets him. They end up getting married. I'm not sure if it's a legal marriage or they just have a ceremony, and they start putting their message out online. So they're interviewing him. He appears, I don't know, like, 70, and she's, like, 30. But funnily, that is. She, though, seems like she's running the show still. So he's very peace and love, and he's kind of going along with whatever she's saying. So she wants to put more on social media. He's like, okay. And then she ends up leaving him eventually, I think, like, after a year, to kind of start an organization with people that she also met online who are then more close in age to her. Dr. Katrina Furey, MD: Did she use his money or something? Portia Pendleton, LCSW: No, it seemed kind of like they lived in nature. He didn't really have much. He seems like this is an opinion, like, sweet. Like, just like a hippie. Like, living on the land. Dr. Katrina Furey, MD: New ag. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: Okay. Portia Pendleton, LCSW: And so she then he, like, compost. Yeah, totally compost. She takes that and runs with. She gets. She meets this guy who she, um. So this is a big kind of part of her. So she heals him of cancer. Dr. Katrina Furey, MD: They always are healing people of cancer. Jeff and Shalia said they could do that, too, by the way. And they also call themselves the divine father and the divine mother. And they went through ivf to have a daughter who's the defined daughter, and I worry for her. But sidebar. Anyone who's calling themselves divine father or mother, run away. Run away. Yeah. Portia Pendleton, LCSW: And that always seems to be a theme of healing people. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: So he comes to live with her, works with her, and then there's this other person who comes in who then becomes, like, the second father God, who he appears to not be in the cult anymore as he's being interviewed for the show. So he kind of has, like, a different stance than everyone else who is interviewed who appear to still really believe some of her messages. So this is not even the crux of the story. So she gathers these group of people who they talk about have pretty significant trauma histories, and then these beliefs come out where. So they believe that they are being led by, like, Robert Williams, St. Germain. Most of these people who are deceased, there's only one living person who is Donald Trump. So they have this board with all of their pictures, and she's constantly getting messages from Robin Williams and has been. So she's God who's billions of years old. She has been Marilyn Monroe, she has been Cleopatra. She's been all of these kind of famous women throughout history who've done different things. So I was like, you're Marilyn Monroe and you're like Joan of. Oh, okay. They're just different. Dr. Katrina Furey, MD: Like reincarnation or something. Portia Pendleton, LCSW: Only for her, it's not. Dr. Katrina Furey, MD: Ultimate exception. Portia Pendleton, LCSW: Yeah, so Robin Williams is telling know, I'm kind of skipping some things, but basically that she needs to be at a really low weight to be picked up by the starships. So she starts restricting her food intake, which is just interesting because that's what I do in my private practice. I was like, oh, here we go. And to be, like, 103 pounds, she has to be under 103 in order to be picked up. So other people in the group as well start restricting nutrition. The lighter you are, the higher frequencies you can tolerate. So they also believe that marijuana and alcohol are, like, tools of healing if used appropriately, which they do say, which I was like, okay. But apparently her use of alcohol combined with her food restriction seems to lead to her downfall. So she gets really sick, like, pancreatitis. I think her liver is failing, probably. And so she's very small. They go to Hawaii to try to heal her. She gets Kauai. They get literally driven out of Kauai by the people who live there because she is now saying that she is, and I'm not remembering it at the time, but she's like, there this goddess that they believe in, and she's saying that she's that person or that spiritual leader, and they're like, no, you're not. That's really disrespectful. So they leave Kauai go back to Colorado, and she's dying. And meanwhile, this whole time they're trying to save her, and she's ingesting high levels of colonial. Dr. Katrina Furey, MD: Oh, just try to heal her. Portia Pendleton, LCSW: Quote unquote. Dr. Katrina Furey, MD: Yeah, okay. Portia Pendleton, LCSW: And so she ends up passing away. And meanwhile, her family, before this, has put her on Dr. Phil to try to point out that she's a cult. Dr. Phil is involved. It doesn't work. She presents as just, I'm really spiritual and not giving culty vibes at all. Doesn't do anything. Meanwhile, they interview her daughter, who's just sad watching it. She feels abandoned by her mom. So Amy dies, and they are convinced, per her, that she is going to be picked up by the starships. So they have her body at home, or it happens in a hotel, and they are, like, holding up these freak. Dr. Katrina Furey, MD: These. Portia Pendleton, LCSW: They use them in the ghost stories where you hold up this instrument and, oh, the thing goes crazy. The frequency. So they're, like, holding it up to her dead body. Meanwhile, all of this, they have filmed. They've filmed and written down everything that she's ever done. She sleeps five times. She did this because she's God. Dr. Katrina Furey, MD: And so they have a dead body. Portia Pendleton, LCSW: With them for a week, like a week or two. They end up leaving the hotel because people are really confused and concerned. They go back to the house in Colorado. The police end up coming. She's modified. Dr. Katrina Furey, MD: Yeah, that's what. Oh, my God. Portia Pendleton, LCSW: And it was never taken. And they still kind of were saying that they believe to this day that we are so curious what her autopsy showed. She has three hearts. I'm sure all the medical people were blown away and everyone still believe it. To kind of branch off and do something with spirituality. Again, it was a pretty small cult. There was, like twelve to 20 active members who were living there. Then again, they made over $350,000 that one of the members then stole after she died and took because all of it was in his name. Because there's always a theme of money, greed, power in a cult, in my experience. So I think we saw all of the key themes of a person with a really unique ability to have charisma and charm. It just seems like there's always common themes with cults which we see over and over again. And I think really what I was keeping in mind while watching this documentary is there can be such a fine line between spirituality and just having different beliefs that maybe are not mainstream, and that's okay. But there becomes this little line that gets crossed where there's like abuse and someone taking advantage over someone else. And it's like that, to me, is really the difference between anything you want to believe in or do or how you want to live. But when you're harming others or being harmed, it's like that's when it's not. Dr. Katrina Furey, MD: Okay. Right. And I think I had a friend recently ask me, how do you tell the difference between someone who's psychotic and someone who is running a cult but not psychotic? So the woman you were just describing to me, Portia, the mother God person, sounds like she may have had elements of both, which is possible, although I would imagine, although I don't know for sure, more rare. But again, I would say people who are cult leaders tend to meet criteria for what we call malignant narcissism. So, again, as we talk about with narcissistic personality disorder, they really elevate themselves into this God role. They believe God is talking to them, but then they also take advantage of other people, whereas I think someone who is just struggling with a psychotic disorder, who may have religious delusions, again, they might also believe that God is talking to them, but then they're not using that to their advantage and exploiting people to make money or for sex or some other kind of secondary gain. So I think that's something important to note. Portia Pendleton, LCSW: Yeah, no, I would agree. It's so hard. And I think we should, like you said, create some merch. We need, like, a clear checklist to ask yourself to disseminate to everyone. Like, is this a cult or not? Where are the red flags? Dr. Katrina Furey, MD: Seriously? Seriously. Again, I would say be very wary of anyone calling themselves a guru or using words like that who doesn't have the applicable training or credentials. That even goes, I think, for getting medical advice online, like on Instagram and TikTok, be really cautious and look into what is this person's credentials? Are they really qualified to be telling me these things? Be mindful of how much are they charging? What are you getting from it when they're charging you? And what does your gut tell you? If your gut red flags are going off, you got to listen. Portia Pendleton, LCSW: Yeah, that's a good one. I like the part about the cost, because things should feel balanced. If you're getting a worksheet or if I'm paying an insurance via insurance for therapy and I'm paying, I don't know, it can be anywhere from 90 to 150, depending on an insurance rate, for an hour. And that person is credentialed. Right. If you take insurance, you have to be a certain quality of practitioner. And so if you're seeing someone who's like a guru or a coach and you're paying privately and they do not have the credentials, and I'm paying maybe $800 for an hour sessions, it's like. Dr. Katrina Furey, MD: That just feels off. Portia Pendleton, LCSW: And I'm not talking about private pay or for someone who does have credentials, but if you can get therapy from a certified, licensed practitioner that generally, sometimes insurance covers, sometimes it doesn't, for around $100, depending where you are and someone, a coach is asking for hundreds and sometimes thousands of dollars, that just feels off. Dr. Katrina Furey, MD: Right. And that is a theme we've seen, at least in these two documentaries we're talking about today, is the cost of the classes or whatever it is you're buying seems exorbitant. I mean, like at twin Flames University, I read they were charging $4,000. That's crazy. That's really a lot of money. So you really just have to be mindful of what are you getting out of it. And as soon as you start to get a whiff of someone trying to change who you are or someone trying to convince you that they know you better than you know yourself, huge red flag. Run away. If you're feeling devalued around them and they're always putting themselves on a pedestal. Run away. If everyone's fawning over them and the people who bring up a criticism or have a question get ostracized. Run away. Run away. Portia Pendleton, LCSW: Yeah, that's a good point. That's on the sweatshirt. Dr. Katrina Furey, MD: Run away. Yeah. Portia Pendleton, LCSW: So you can find both of these documentaries. One of them, the one Katrina watched, twin flames, is on Netflix. And then the one that I watched, love has won, is on Max, both short kind of docuseries, which I loved that it wasn't 8 hours. Both sad and just the after effects are sad. And cults obviously can be so dangerous and abusive. There's many practitioners out there who specialize with treatment of people who have been in a. If you're. If you have more interest in it, like Katrina is going to link that psychology today article and then know, I think our biggest theme is please reach out. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: So in the one I watched, there was a mother who continuously was kind of getting police involvement and calling her daughter and contacting her, and they ended up reuniting at the end. And just as painful as it is, please don't give up. Dr. Katrina Furey, MD: Don't give up. Don't give up. Yeah, that's a big theme I want to get across, too. And we'll keep covering cults I think moving forward, again, we want to be mindful and be really clear. We're not analyzing any one person in particular. We're just using this media to talk about this phenomenon in more detail because it is so dangerous and so many people are getting hurt by these things. And I would imagine like coming out of COVID with so much more happening, think, you know, it's reaching more people these days, like cults, and all you need know, you can be in a cult of one. It doesn't have to be huge. So that's another thing to keep in mind is these dynamics can play out in smaller communities, smaller relationships, even within families. So we're hoping to try to shed some light on these toxic dynamics so you can protect yourself totally. Portia Pendleton, LCSW: Well, thank you for joining us today, and we look forward to catching up with you next time as we cover another movie or tv show. Dr. Katrina Furey, MD: Yeah, and find us on TikTok and Instagram and YouTube at Analyze Scripts podcast. Please rate, review, and subscribe and let us know what you think. And let us know what you'd like to hear us cover. Next. Bye bye. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts, all rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited unless you want to share. Dr. Katrina Furey, MD: It with your friends and rate, review, and subscribe. That's fine. Dr. Katrina Furey, MD: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.
Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Amy Sehnert, MD With the FDA's approval of CAMZYOS® (mavacamten), the first and only cardiac myosin inhibitor for symptomatic New York Heart Association (NYHA) class II-III adult patients, healthcare professionals and patients now have another treatment option that targets HCM at the source. Learn more about the clinical trial data that supported the FDA approval, and how healthcare professionals can prescribe CAMZYOS from Dr. Amy Sehnert, Vice President and Head of Cardiomyopathy and Heart Failure Clinical Development at Bristol Myers Squibb.
Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Amy Sehnert, MD With the FDA's approval of CAMZYOS® (mavacamten), the first and only cardiac myosin inhibitor for symptomatic New York Heart Association (NYHA) class II-III adult patients, healthcare professionals and patients now have another treatment option that targets HCM at the source. Learn more about the clinical trial data that supported the FDA approval, and how healthcare professionals can prescribe CAMZYOS from Dr. Amy Sehnert, Vice President and Head of Cardiomyopathy and Heart Failure Clinical Development at Bristol Myers Squibb.
Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Naga Chalasani, MD With the increasing incidence and prevalence of cirrhosis in patients, healthcare professionals have to routinely consider giving anticoagulants to these patients. Understanding how we can safely administer these types of medications to cirrhosis patients is important. To learn more, tune in with Dr. Peter Buch as he speaks with Dr. Naga Chalasani, Co-Author of the article, titled “The Safety of Anticoagulants and Antiplatelet Agents in Patients with Cirrhosis,” which was published in Alimentary Pharmacology and Therapeutics in November 2022, and the David W. Crabb Professor of Gastroenterology and Hepatology at Indiana University School of Medicine in Indianapolis.
Host: Jay Fishman, MD With a global shortage of human organs, xenotransplantation offers a potential new way to save lives. But what are the immunologic barriers? Tune in as Dr. Jay Fishman, Director of Transplant Infectious Diseases and Compromised Host Program at Massachusetts General Hospital, recaps his session from the 2023 IDWeek.
Host: Jay Fishman, MD With a global shortage of human organs, xenotransplantation offers a potential new way to save lives. But what are the immunologic barriers? Tune in as Dr. Jay Fishman, Director of Transplant Infectious Diseases and Compromised Host Program at Massachusetts General Hospital, recaps his session from the 2023 IDWeek.
Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are analyzing the 2007 film "Awake." This movie stars Hayden Christensen, Jessica Alba and Terrence Howard. There is a nefarious plot to kill Clay who finds out during surgery. According to our guest, Dr. Gonzalez from the Yale Anesthesia Department, Clay experiences intraoperative awareness AKA "awareness" during surgery. The movie is filled with plot holes and some pretty inaccurate medical information. We learn so much from Dr. Gonzalez about anesthesia and patient pain. PTSD, medical factiods and financial stressors are topics in this episode. We hope you enjoy! Dr. Gonzalez Podcast Episode on Interoperative Awareness Website TikTok Instagram Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. And I'm Portia Pendleton, a licensed clinical social worker. And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Our hope is that you learn some legit info about mental health while feeling. Portia Pendleton, LCSW: Like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. And if someday we pay off our. Portia Pendleton, LCSW: Student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. So sit back, relax, grab some popcorn and your DSM Five, and enjoy. Welcome back for another very exciting episode of Analyze Scripts. As part of our Halloween month today, we are covering the 2007 thriller mystery movie called Awake with our wonderful guest, Dr. Antonio Gonzalez. And I cannot think of anything scarier than being awake during a surgery, so this is perfect for our Halloween month. But just as a quick bio, dr. Gonzalez is an associate professor of anesthesiology and the director of the Obstetrics anesthesia Fellowship at Yale New Haven Hospital. He completed his residency program at Rutgers in New Jersey and decided to pursue a fellowship in obstetric anesthesia at Columbia University in New York. And I will actually be joining one of his podcasts in the near future to talk about eternal mental health and anesthesia, which I'm really excited about. But thank you so much, Dr. Gonzalez, for joining us. Dr. Antonio Gonzalez, MD: Thank you so much for the invitation. I'm really happy to be here with you today. Dr. Katrina Furey, MD: So, Portia, where do we even get started with this movie? Have you seen it before? Portia Pendleton, LCSW: I have not seen the movie ever. I think that something like this would probably have been a little scary to watch. Yeah, I think a lot of people who are not in medicine and maybe people who are in medicine, I think it's a common fear to wake up during surgery. I think a lot of people going in get really calmed down once talking to the anesthesiologist or telling them that this is their process or this is. Dr. Katrina Furey, MD: How it's going to be. Portia Pendleton, LCSW: And all of the machines and monitors that they now have, you were saying a little bit before we got started today. So I think this is just like a pretty common fear that people have going into surgery. Dr. Katrina Furey, MD: What do you think, Dr. Gonzalez? Dr. Antonio Gonzalez, MD: Yes, I think that definitely introvertive awareness. It's definitely a fear of our patients. And unfortunately, this movie actually may have hyped that fear. But fortunately, the reality is that introvertive awareness is relatively rare, particularly these days. We have way better medications, way better monitors that help us to prevent intraperative awareness. The incidence has been documented to be somewhere around 0.1% to 0.2% in the United States. Dr. Katrina Furey, MD: So what is that, like, one to two out of 1000 cases? Something like that? Dr. Antonio Gonzalez, MD: That is correct, yeah. Because there are so many surgeries in the united States, that's about 20,000 to 40,000 cases a year, which still a lot. Right. The consequences of interoperative awareness can go from just having fear of future surgeries, even withholding surgeries for some of their relatives, particularly their kids, because they are so scared of what happened to them, they may actually be very fearful of letting their relatives go through surgery. Yeah. So that is one of the consequences. But, again, it's relatively rare these days. Dr. Katrina Furey, MD: Okay. Dr. Gonzalez. Portia Pendleton, LCSW: Is there anything in common. Dr. Katrina Furey, MD: That the people who this happens to. Portia Pendleton, LCSW: With each other, or is it just kind of like yeah. Dr. Katrina Furey, MD: Is there, like, a way to predict it that it could? Dr. Antonio Gonzalez, MD: So we don't have particularly great ways of predicting who will have operative awareness. We do know that there is a certain patient population or certain surgeries. So there are surgeries like trauma, cardiac surgery, and Obstetric. Anesthesia. Obstetric cases seem to be and when I mean Obstetric cases, Caesarean deliveries, particularly. These are cases that are very well known to have an increased risk of intraperative awareness. The reason behind it is because trauma patient and cardiac patients have a very delicate hemodynamics, meaning their blood pressure, it's low, tends to be on the lower side. They have a high risk of coronary vascular disease. So having their blood pressure too high or too low, it's at extreme risk. So in order to maintain that balance between the anesthesia that it's provided and the hemodynamics, those patients tend to be at a higher risk. And that implies for both trauma patients and cardiac patients. Now, the Obstetric patient population is at increased risk because of the risk that the anesthesiologist may perceive from the drugs transferring to the baby. So all the medications we give to mom will go to baby, and that increase in medications has been thought to be pretty dangerous to the baby. So anesthesiologists at some point, we're very scared of giving extra medications to mom nowadays. Again, I think that because our monitoring and the drugs that we have available and the awareness that introvertive awareness in this particular patient population, it's higher, we have improved the techniques that we have for providing general anesthesia. Now, that being said, we do a lot of our anesthesia under regional, and having pain during a surgery, even with epidural or a spinal, can be equally as scary, if not even more scary than having introvertive awareness while asleep. Dr. Katrina Furey, MD: I was wondering that. So, before we get into this a little further, I just want to give a quick recap of the plot of this movie. So, in the movie Awake, we see Hayden Christensen playing the main character, Clay Bearsford Jr. Who is, like a fancy pants financial person, super uber rich. He does something with stocks, probably, that I don't understand. And you see this interesting relationship with his mom early on, who's played her name's Lilith, and she's played by Lena Olin. And then we see Jessica Alba. This is one of her big roles, playing Sam Lockwood, who's his fiance. They get married very quickly because he is waiting for a cardiac transplant due to history of cardiomyopathy, which is something that happens. That seemed pretty accurate. And then we see Terrence Howard playing his friend and surgeon, Dr. Jack Harper. And spoiler alert, turns out all of the medical professionals on the team, including his fiance, were in on this plot to murder him during the transplant in order to inherit all his money and pay off some malpractice debt. Luckily, I think it was the anesthesiologist. The original one backed out. So this other guy was there, and somehow he figured out the plot, and he alerted authorities. And eventually, I think Dr. Harper injected the heart with adriamycin. I believe the Clay did, I guess, technically die on the table. When they delivered that news to his family, the mother committed suicide. I can't remember what she overdosed on. I'm assuming maybe Digoxin, which was in his bag. And then they wheeled the mom in and gave him her heart. And so he survived, and all the people got arrested. The end. That's basically the plot. Really quick. So getting back to what you were saying, Dr. Gonzalez, about the intraoperative awareness. So when you were saying that with these certain cases, trauma, cardiac, and OB with regional anesthesia, I'm thinking like an epidural, like for a C section or something like that. Like, if they give the epidural and it fails either in a C section or a regular delivery, vaginal delivery, would that be considered interoperative awareness? Dr. Antonio Gonzalez, MD: Well, if the patient is experiencing pain, yes, that can be as traumatic as experiencing intraperative awareness, because the patient mentally is completely there, but the patient is completely feeling the experience of the pain. And the definition of pain, actually, it's not only physical, but there is an emotional component to pain. Right. So what you describe as pain, you can only be the person that knows what pain is for you. So what we've learned through the years is that we are not the best judge of what pain is. The patient is the best judge of what pain is because pain is what the patient tells you pain is. Portia Pendleton, LCSW: I'm so glad you said that. Dr. Katrina Furey, MD: I think that's really important and to keep in mind the emotional side of it. Portia Pendleton, LCSW: I like that also, just as I don't know a similarity right. In mental health, like pain mental pain, emotional pain is, like, what the patient is describing versus my definition in the DSM. But I really like that. Or just validating their experience. Well, this is what they experienced. Maybe someone else's was different. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: I really like that. Dr. Antonio Gonzalez, MD: Yeah. I think that it's a great opportunity, because, as you mentioned, sometimes if, as physicians, we try to give an explanation to pain, right. We may actually minimize the patients. And at the end of the day, what ends up happening is that the patients feels that their feelings, they're being gaslighted. So the patient is telling you, this is what I feel, and you say, well, it's not that big of a deal. Right. But it is to the patient, it is. So pain is, again, what the patient tells you pain is. Dr. Katrina Furey, MD: No, I think that's great. And in my line of work, in private practice, I do end up seeing well, I see primarily women around pregnancy and postpartum. So I've heard many cases where the epidural failed, or it only took on half the side, or someone had a history of back surgery, so they met with the anesthesiologist ahead of time to talk about pain management options. And it is a super important aspect of prenatal care, especially delivery, and I'm sure that extends to other surgeries as well. So, Dr. Gonzalez, what are your thoughts about the way anesthesia was depicted in this movie? What they get right, what they get wrong? Dr. Antonio Gonzalez, MD: Well, there are so many things that they well, the one thing that they got right was to select the patient that was having a cardiac surgery. As we mentioned, patients with cardiac surgery have an increased risk of having introvertive awareness. So they got that one part right. Then the other thing is that it seems like they have a substitute anesthesiologist that's coming from another institution. It doesn't quite happen that way. You need to have privileges at that place. It's a little credentialed. Yeah. Unless he's a traveler. Sometimes we have anesthesiologists that are considered what is the term? Locums. That's correct, yes. So locums might have been a locums that they call in to substitute, but it's actually quite hard to find locums for very specific cardiac surgery. So I think that the other thing that I think was very wrongfully depicted was how easy he may look. The induction. The induction was basically he took this three CC syringe or four CC syringe. He gave it to the patient. He said, count back to ten. Cardiac inductions are very complicated. It requires a balance of many medications. Again, because there is this hemodynamic balance that you want to maintain. You don't want the patient's blood pressure to go too high. Do you want the patient's blood pressure to go too low? So that also it seems like it was completely off. And there is a point where the surgeons are discussing, like, well, we won't need you for a little bit, so go get a drink. We never leave the operating room. Dr. Katrina Furey, MD: Right. Dr. Antonio Gonzalez, MD: I know there is always somebody from anesthesia in the room that be like the anesthesiologist or anesthetist, but we just don't leave the patient in the or. Just because the surgeon tells us that they're not going to need us for a bit. So that was totally wrong. Dr. Katrina Furey, MD: Right. In my experience in medical school, rotating through that's exactly right. Even these long cases like cardiothoracic surgery, the anesthesiologist, maybe a resident, maybe the nurse, anesthetist. These words are hard to say. Someone's always there watching the monitor. They might be doing something else at the same time. I remember one time there was a resident practicing his golf swing, and I was like, this seems pretty unprofessional. But they're always watching the monitors. And I would imagine like this, especially watching the blood pressure, the heart rate, things like that. And they're always checking. They kept checking, at least in the cases I would be in, they would do things to check. The patient was still under enough. Not too far under. Not coming out of it either. Dr. Antonio Gonzalez, MD: Yes. And as you mentioned, sometimes the anesthesiologist, a lot of what we do, we may not be actually looking at the monitors, but because we're actually trained for so it's a three year program. By the sound of the machines, you actually know what is wrong. Like the pulse oximeter has a very typical sound. When the saturation drops, the alarms on the monitors are set off to go at X levels. Right. So you can set up your alarms. So even if we're like, let's say, fixing our medication drips or we're working on something that it's not necessarily looking at the monitor, just hearing the monitor, we are aware of what actually the vital signs are, and of course, the alarms are ever present. So we're always very aware of these alarms and everything that surrounds. We use pretty much all our senses when caring for patients. Dr. Katrina Furey, MD: That makes a lot of sense. Portia Pendleton, LCSW: It's interesting. I think there was an episode on Grey's Anatomy years ago about the anesthesiologist at the hospital was like, has a substance use disorder. And he was, like, falling asleep next to the patient. And of course, it's a drama, so the young resident had to do something and didn't want to get in trouble by the attending or something. But I feel like I've seen not a lot of medical dramas. I mean, that's not like my jam. But the couple that I have there seems to always be the anesthesiologist is like sometimes a villain. I don't know. Dr. Katrina Furey, MD: Is that a stereotype? Yeah. Is that a stereotype? Portia Pendleton, LCSW: Or like, maybe just in TV, the. Dr. Katrina Furey, MD: Psychopath is often the villain too, so we can empathize. Portia Pendleton, LCSW: Yeah, it seems like it's a lot of risk with that job. Dr. Antonio Gonzalez, MD: I think that psychiatrists, dentists, and anesthesiologist seems to be the highest the physicians with the highest incidence of substance use. Dr. Katrina Furey, MD: Disorder, I believe that's right, yeah. Dr. Antonio Gonzalez, MD: And suicide as well, I think. Yeah. Maybe media has picked up on that. Maybe. Dr. Katrina Furey, MD: Interesting. I think in my training, I was taught that in those specialties, you have the easiest access to controlled substances in terms of the risk of substance use disorders. So that's one reason the rates are higher. And then suicide. I didn't know anesthesiologists also had a high rate of suicide. Dr. Antonio Gonzalez, MD: Yeah. I haven't reviewed the statistics on this, but I think that it used to be that way. I think actually, dentists might be number one. For some strange reason, anesthesiologists are high up in there. Dr. Katrina Furey, MD: One big issue I had with this movie was the plot, because I feel like they went to great lengths to pay off a prior malpractice lawsuit. And I feel like they'd all have malpractice insurance, right? Even if I know there's certain specialties. Like, I think OB, for example, has a really high rate of malpractice insurance. Wouldn't they have malpractice to cover any claims? Dr. Antonio Gonzalez, MD: Yes, they would. Dr. Katrina Furey, MD: Think. And Portia, I think you were reading some criticisms of the movie. I think the general public also caught on to that, like, wow, this is like a really intricate plot to go through to pay off prior lawsuits. Portia Pendleton, LCSW: I don't know. Murdering someone, you have to be so backed into the corner hopeless, like no other options. And it's like, I mean, A, yeah, like, you're right about the malpractice. You should have an insurance through the hospital. You're not even in private practice paying for your own, and that maybe you cut corners with that. It just seems OD that they taking going to these lengths of murdering a patient that Dr. Jack Harper was, like, friend. And it's like, at what point did the friendship turn into this? Was it fake? The whole, like, I think that's know, I watched the movie, you know, taking. Dr. Katrina Furey, MD: Notes because we're professionals. Portia Pendleton, LCSW: We're professionals at watching TV here, and I was just lost with a lot of the line, so I'm glad to hear it know, I guess just me, but pretty gaping holes in some of it. Dr. Katrina Furey, MD: Yeah. And what did you think about that relationship of the friendship between Dr. Harper and Know? Because at least in psychiatry, we are big and not just psychiatry, but mental health in general, we are big boundary people. We really talk about boundaries and how to maintain them, especially in professional settings. I think in some other fields of medicine, I'm thinking more like primary care pediatrics in the old school days when you'd have the family doctor who took care of everyone in the town, I think the boundaries would have been a little different. But I always thought, especially when it came to things like surgery, it was really important not to operate or doing a seizure on people you're close to. Is that still the case? Dr. Antonio Gonzalez, MD: Well, I think it's probably the right thing to do because your feelings for your significant other or friend may actually interfere with your judgment. But again, I think it's more of a judgment call than a set rule. I do think that there are certain surgeries and certain procedures that we probably shouldn't be doing for our family members or for close friends, because, again, our judgment may be cloud by our feelings for that person. You may not necessarily take the best decision when you're put in that place. Dr. Katrina Furey, MD: Yeah, I think suturing up a superficial wound like your child cuts their knee. Oh, I can suture that up real quick. Feels very different to me than doing cardiac anesthesia or surgery on your buddy that you go fishing with. Yeah, right. Yeah, I would agree. Portia Pendleton, LCSW: I could see I was thinking just, like, what would I be comfortable with a friend doing? But maybe I don't know. I mean, I'm thinking of specialties, like, ortho I could see a friend doing but not OB. It's, like, all private, and then definitely not psychiatry, but I don't know. Cardiac surgery? I don't think cardiac no, it's like your heart opening my chest. I don't want you I think it's. Dr. Katrina Furey, MD: Important you feel like you trust the surgeon and the anesthesiology team, but to have it be like your buddy, that's risky. And what an ultimate betrayal. Portia Pendleton, LCSW: I mean, he trusted this person. He chose to have this procedure done by, I guess, at least rating wise, like a doctor with a lower success rate than right. The mom brought in this specialist who was operating on presidents and had all. Dr. Katrina Furey, MD: This prestige play picked Dr. Harper. Portia Pendleton, LCSW: And then right. To have this nefarious plot going on was just I was really shocked. I was also really shocked that Sam was in on it, his fiance, because at first, I think the movie kind of sets you up to not, like the mom. Right. Like, Lilith seems, you know, like, she doesn't have his best interests at heart. Dr. Katrina Furey, MD: It's controlling. Maybe they're enshring and not letting him. Portia Pendleton, LCSW: Live or be independent. Right. But then know, I was like, wow, really weaseled her way in. So I don't but she was a nurse, I think, so she had some info about his medications, which the mom, Lilith, was first, really surprised and pleased. Like, wow, like, you really have been taking care of him. I see all the medications in your bag. But then that's also ultimately how she found out that Sam was in on it. Right. Dr. Katrina Furey, MD: She saw, like, I think Sam left her purse behind, and the medications fell out. And when she went to go put everything back in the purse, she saw some mail where the name didn't match up, and then somehow she put it. Portia Pendleton, LCSW: Together, but that wasn't clear. Dr. Katrina Furey, MD: But again, also like, okay, so the names don't match up. That wouldn't automatically make me think, like. Portia Pendleton, LCSW: Oh, no, you're in on it to. Dr. Katrina Furey, MD: Murder my son while he's in this heart transplant. The plot was a little far fetched, but I did think it was entertaining, and I did know with Clay on the table, often the anesthesiologist is, like, the first person you meet when you're coming in for surgery that day and. Portia Pendleton, LCSW: The first person you see when you wake up. Dr. Katrina Furey, MD: So I think that's very important, as well, to your whole experience of surgery. And can you tell us a little bit, Dr. Gonzalez, about in your role, what that entails and how you sort of take care of the patient in broad strokes. And if this movie we've already talked about how the induction was totally off, but what the movie sort of got right and wrong. Dr. Antonio Gonzalez, MD: Yeah. So I think that the role of the anesthesiologist is very important. And I think that as anesthesiologist, we realize that, as you mentioned, unfortunately, the way our system is, we usually meet our patients just the day of surgery, right? So what that entails is that we actually need to create rapport with our patients very quickly. We know that the patients are coming in for a very stressful moment in their life. Sometimes it's very big surgery, sometimes it's very minor surgeries, right? But independently of what type of surgery the patients are coming for, we need to create that rapport and we need to bring the confidence to the patient. And as anesthesiologist, I think that we try to do that the moment we're talking to the patient. The first time we talk to the patients, it's all about creating rapport and creating a team experience in which you let me know what are your goals and we can try to meet those goals and expectations. What are your fears? Some patients tell you that their major fear is pain. Some patients tell you their major fear is throwing up because all the nausea, they've experienced so much nausea after. So then you can reassure the patient, okay, so this is our plan. This is going to be our plan to address the pain. This is going to be our plan to address the nausea. And again, we do this for all types of surgery. And I think that's very important as anesthesiologist to try to create that rapport and always be, when talking to the patient, basically addressing what are your major fears and how this is our plan to address those. Portia Pendleton, LCSW: That's such an important question. I think such an important part of the team. I think other people are just kind of part of the team, which makes sense. Like, okay, this is a surgery. They ask you a million questions like why are you here? What's your name? What's your birthday? Over and over again. So they're doing the right thing. But then for someone to ask, right, what are you scared of? Dr. Katrina Furey, MD: Right? Portia Pendleton, LCSW: What are you scared of today? How can we help you? Do you have any questions? Is really helpful. And I think just lets see the patient feel like they're a part of the team, like they're being validated, listened to, important, which of course they are. But I think in the system when you have maybe two to five, maybe surgeries that day, it's just like it becomes for everybody that's working, there just procedure. So I think those questions just stand out as really helpful and nice, good patient care. Dr. Katrina Furey, MD: And the anesthesiologist is the person who you really meet at the beginning, who asks you all these questions, checks on your allergies, looks in your mouth to see like, okay, how big are those tonsils? How are we going to sort of intubate? You most comfortably asks you what you're worried about, and then they walk with you in most of the time, and they're with you, getting you on the table, getting you positioned, making sure you're comfortable, saying, okay, it's going to be cold in here, let's put a blanket on. They do a lot of that caretaking right away. I think when people are really scared, even if it's a minor surgery, I don't know who's not scared when they're going into a surgery. And of course, the surgeon comes in and they're really focused on the surgery, and of course, they want to make the experience good, too. But you're usually, like with the anesthesiologist, I think, the longest as you're consciously awake and then coming out of the surgery, that's who's also waking you up and making sure you're okay. That's who's checking on you in post op and things like that. So it is interesting that such an important member of the team and you're right, you really meet them that day and then you don't see them again, right? Like at the follow up for the surgery and stuff, you never get to see them. Is that a part of the job? Do you mind that, or do you wish that you could check on these people again? Dr. Antonio Gonzalez, MD: Well, it's actually very interesting that you ask because one of the things that actually inspired me to become an obstetric anesthesiologist, particularly, was I sometimes felt that I was in these very long surgeries, and when I went to see the patients post op, they would not remember me. And there wasn't really a problem with the patient not remembering me. It wasn't really an ego thing. It was more like, I don't feel like he thinks I'm part of this team taking care of him. I didn't feel like I was part of the team again. But on the other hand, I just happened to see a patient in a hallway and he's like, oh, you did my epidural for labor. And I'm like, oh, I did. And that was like, oh, these patients do remember me. Do appreciate what we're doing. And although, again, it's not an ego thing, but it's just that feeling of being part of something more, like, you know, that you help somebody and they actually remember that you were part of that, alleviating the pain, and it just feels good. It makes you feel like you're really part of a team that addresses the patient's pain and all this. And that's what really brought me into obstetric anesthesia. Going back to what we were talking about, the patients, the pre op part. Again, because of my obstetric anesthesia background, most of the literature that I've reviewed is on that field. And there is a very interesting article that has changed the way I practice that basically addressed what we were just discussing, which was basically, you ask the patients would you rather have better analgesia or more side effects, depending on the dose? And the interesting thing it's a very interesting study, but the outcome of the study was that patients actually knew exactly what they wanted. The patients that were overly concerned about pain ended up consuming more pain medication. And the patients that were overly concerned with the side effects did not consume as many medications. So the patients always know. And that's why always asking your patients, what are your weigh the risk and benefits, or what are your main outcomes? What do you want to experience here? More pain, slightly less pain, slightly more side effects of the medications, or you're okay with pain knowing that your side effects are going to be less? Dr. Katrina Furey, MD: The patients know that's actually really interesting and really important to keep sort of their autonomy and their preferences. So, Dr. Gonzalez, I know you're not like a transplant surgeon, but I thought it was pretty unlikely that the mother would just be, like, wheeled in, especially after having overdosed on something and her heart would be given right to her son. Dr. Antonio Gonzalez, MD: Yeah, absolutely. Dr. Katrina Furey, MD: What do you think about that? Dr. Antonio Gonzalez, MD: Yeah, absolutely. I think you're absolutely right. And at some point, I was hoping to bring that up. First of all, as you mentioned, there is a battery of tests that the donor needs to go through before they can be a donor. Portia Pendleton, LCSW: That's number one blood type, right? Dr. Katrina Furey, MD: It's not just like, oh, it's a blood type match. There's like, so many more things they have to check. Dr. Antonio Gonzalez, MD: There's so many more tests. And it seems from the movie that the mom have actually taken the purse from Sam, right? So presumably she took medications that could have actually make her heart stop. Right, which means that the period of ischemia of the heart may not have make her a good donor for her heart. She might have been able to donate her cornea and other things that actually don't have a very specific ischemia time. But there are organs that have a very limited ischemia time, meaning that the time that the organ is without perfusion or without oxygenation, without blood flow. And that is very important. The heart is one of the organs that needs perfusion for very crucial timing. It's a very small window of ischemia for the heart yes. Dr. Katrina Furey, MD: That she'd take, again, cardiac medication that likely stopped her heart. It does seem like she called her surgeon of choice ahead of time and was like, get here now. We only have so much time. But still, it's just completely unlikely that that would have happened. It was kind of a beautiful, I guess, part of the story that they could both, in this other realm, connect with each other and she could talk to him and they got to say this goodbye. That was pretty beautiful. But in terms of accuracy, there's no way that would have happened. And so getting. Back to the title of the movie Awake, and the whole premise that he's awake in surgery and aware of everything that's going on. I think a fascinating question that comes to my mind is like, how do we define awake? Is it consciousness? Is it memory? Is it feeling? And then how do you assess it during and after something like a major surgery? Dr. Antonio Gonzalez, MD: Yeah, that's a very interesting question. And I was thinking myself the same thing throughout the movie. And at the end, I'm still not even clear that either he was awake. We probably will never know the answer, according to the movie. But interoperative awareness, it's basically the incidence of a failure to suppress arousal, experience and episodic memory. So for you to have recall, in order for you to have introoperative awareness, there has to be recall. There are some incidents of patients actually hearing things, but they may not have necessarily distress about it because hearing and depth of sedation, the depth of sedation goes anywhere from hearing to actually not even being able to have recall. So you're going to see the worst cases of interoperative awareness when there is recall, and the patient can actually tell you how stressed they were about the experience. So they've come up with some classification. It's called the Michigan Awareness Classification, and it goes from zero, class zero, which is basically no awareness, to class one, which is auditory perceptions, class two, which is tactile perception. So they feel the surgical manipulation, they feel the endotracheal tube. And then there is class three, which is they actually feel pain. Class four, they actually have paralysis. And this is what seems to actually be happening here. He's experiencing paralysis because he said, just move something, right? He's trying to move something. He can't move anything. So he probably is there at a class four. Later on, we know that he's definitely at class five, where he's probably experiencing pain and paralysis. And then you can actually assign a D if the patient tells you that it was very stressful. They have the fear, they had fear, they had anxiety, a sense of suffocation or doom. So basically all these classifications, you can actually add a D to them. And the higher they are, and especially if they have a D next to them, the more likely these patients will have sequela. As in your profession, you can probably talk about what happens to these patients that have interpreted awareness. Right? And you were talking about moms that have pain during surgery. So that could lead to post traumatic stress disorder. But I'm not the expert there. Dr. Katrina Furey, MD: I would imagine it would. Right. I would imagine when we think about post traumatic stress disorder, I like to think of that as a disorder of Stuckness. And I always tell my patients, like, it's normal after you've lived through something traumatic, to have the symptoms of PTSD, the hyperarousal, the hyper, vigilance, intrusive thoughts, altered avoidance, altered mood, altered line of thinking and things like that initially, because who wouldn't? We sort of call that an acute stress response. But then once it persists, usually after, like, a month or continues beyond that, then we start to think of it as something called PTSD or post traumatic stress disorder. And there's some really great treatments out there for that, including things like cognitive processing therapy or CPT, EMDR, different types of psychotherapies and medications, and patients can really get a lot better. I love treating PTSD for that reason. But I would imagine the first criterion to meet diagnostic criteria for PTSD is to have a life threatening situation happen to you or to be vicariously exposed to it, which I think is really important as a new addition to the DSM criteria. I think this will qualify. Portia Pendleton, LCSW: Yeah, I'm just even imagining a patient coming in and describing this. I would expect a person to develop PTSD from it, and then it's like. Dr. Katrina Furey, MD: Is that a disorder, or is that, like, a normal human response to being consciously awake but paralyzed during cardiac surgery? Right. Portia Pendleton, LCSW: That's where you're like, well, like, trouble sleeping following. I would imagine maybe some nightmares. Might be afraid to fall asleep 100%. Or obviously, like you were saying before, Dr. Gonzalez, afraid of returning for future medical care or surgeries or telling loved ones to not do it, or their experience. So it feels really serious. And obviously, many traumas can be, but also unique. I haven't worked with someone that this has occurred to, obviously, because it is rare, but I'm just imagining, like, poor Clay when he wakes up, and if he does recall at one of those levels that you described, then what? And also write the murder plot. I mean, that was like taking the cake, let alone feeling pain. Dr. Katrina Furey, MD: I know. Like, such intense pain, right. And being so paralyzed and helpless. I almost can't imagine anything worse. Portia Pendleton, LCSW: He's standing up. We talked a little bit about the dissociation. That being an interesting way to show it. So sometimes when somebody's experiencing a trauma, they might dissociate and kind of see. Dr. Katrina Furey, MD: Themselves from up above. And they did show that when he sort of zoomed out, then it took a turn where he's then solving the. Portia Pendleton, LCSW: Plot, like, walking around, figuring it out. Dr. Katrina Furey, MD: Like, I don't think yeah, that's not quite dissociation, but up until that point. Portia Pendleton, LCSW: It was a great depiction of. Dr. Antonio Gonzalez, MD: It. Portia Pendleton, LCSW: Just it was wild. Dr. Katrina Furey, MD: It was wild. What a wild movie. Dr. Gonzalez, as we wrap up, is there anything else you'd like to add or anything we haven't touched on that you think is important? Dr. Antonio Gonzalez, MD: What it's really important here is for the patients to really voice out their experience. Right. One of the things that we see as physicians, we're not necessarily, particularly not psychiatrists or psychologists, we are not necessarily very well versed in how to deal with the consequences of what happens interoperatively. And it's important for the patients to say, hey, this is what I felt. But equally as important is for physicians to actually avoid minimizing what the patient felt and actually acknowledge that something happened and say, hey, I'm really sorry that you went through this. Let's try to figure out what resources we have to help you to get better, to get through these. It's actually something that I've always wondered is when is the best time to reach out for the patients? When, for example, in our case, we do C sections, right? And the patients are telling us that they're feeling pain, so they actually quickly voice out their experience so we can quickly do something about it. And even then, it's hard to figure out if you should approach the patient, shouldn't approach the patient, because not every patient won't consider a short time of discomfort or pain as traumatic. So it's a thin line in which basically we rely on the patient telling us, this is what I felt, this is how I feel now, so that we can actually look for help again, because as anesthesiologist or, surgeons may not be the best person to deal with it, but we can look for the resources. Dr. Katrina Furey, MD: And I do think, actually, at least in my clinical experience, given what I do, it has been I can tell you without a shadow of a doubt, it has been so validating and healing for my patients who have experienced trauma within previous childbirth deliveries or IVF procedures or other things like that, who felt minimized by the team at the time when they go in for the next thing and their anesthesiologist is the one who asks them just the questions you're mentioning. Now, I'm wondering if it was you. Portia Pendleton, LCSW: Or if you've just trained, like, some. Dr. Katrina Furey, MD: Really good team members. But when they ask them about these things and they share their prior traumatic experience, which is very hard for them, right, like, to even share, period, but then, especially if they've felt minimized or invalidated in the past, when they share it this time, and it's met with compassion and validation, it goes so far in their healing. And so I think you're spot on, and I hope this can serve and your continuing education can serve to just keep reinforcing that to the anesthesiology team that that is really important and such a crucial time to give that validation to patients who might really need it. And I think that would go for any patient, but especially any patient with a history of PTSD prior to that. And that's a hard thing to ask about. Portia Pendleton, LCSW: Yeah, I could definitely see it in pregnancy traumas. I think it's a pretty common experience with just, like, whether or not it's their perspective of something happening. Everything moves fast sometimes, as both of you know, I'm sure if it's supposed to be a regular delivery and all of a sudden it's not like that can be scary. And sometimes you have to prioritize saving a patient so things aren't explained slowly. It's the after of, like, okay, I know. That was really scary. Dr. Katrina Furey, MD: Kind of debriefing. Portia Pendleton, LCSW: Yeah, the debrief I would imagine being really helpful. Dr. Katrina Furey, MD: And we always I think in mental health, we always assume our patients have a trauma history rather than assume they don't. And I don't think that's because there's like I mean, maybe there is a higher incidence given the patients we're seeing. But I think then if you can just sort of approach it in more of like a trauma informed framework and just assume, like, okay, let's just assume this person has had some experience in their life where they felt helpless or stuck or not heard. How do we approach them here so that they don't feel that you don't even have to ask, do you have a trauma history? You could just assume. And then I think that just goes a really far away. So I'm so glad, Dr. Gonzalez, to hear that you're just doing know that makes this psychiatrist very happy. Dr. Antonio Gonzalez, MD: Yeah, well, I think that a lot of it has to do with the fact that some time ago, we actually read this very nice article that came out that was titled Failure of Communication, and it was actually written by a patient who experienced interoperative pain. I actually had the pleasure to have a podcast with Susanna Stanford, who is a patient who experienced introvertive pain, and she shared with us through that paper that was a couple of years ago, her experience. And from the time I read that paper, I started realizing how important that communication part is and not minimizing their pain and actually trying to address the situation in the moment and offering alternatives. Right. The most important thing, as you mentioned, is the patient needs to feel that first of all, they're being heard and that their concerns will be addressed. The worst we can do is tell them that it's not that big of a deal. Baby is okay. That's usually what we hear. Oh, the baby's okay. So it's going to be fine. The means doesn't justify the end. Dr. Katrina Furey, MD: Well, that's wonderful. Thank you so much, Dr. Gonzalez, for joining us today. I think we will try to link to that paper in our show Notes. If anyone is interested in reading that. Portia Pendleton, LCSW: Further and maybe also your podcast, if you want to tell us, give us. Dr. Katrina Furey, MD: A little shout out yeah. Portia Pendleton, LCSW: Where they can find your podcast. Dr. Antonio Gonzalez, MD: Yes, the podcast is Yale Anesthesiology, and I will share the link as well. Dr. Katrina Furey, MD: Thank you. And we want to thank all of our listeners for joining us today. You can find us at Analyze Scripts podcast on Instagram and TikTok. We recently updated our Instagram handle, so now it's Analyze Scripts podcast across the board, and we hope that you will join us next week as we cover the Nightmare Before Christmas on our Halloween month. Portia Pendleton, LCSW: Yes. Dr. Katrina Furey, MD: So we'll see you next Monday. Portia Pendleton, LCSW: Thank you so much for joining us. Dr. Katrina Furey, MD: Bye. Dr. Antonio Gonzalez, MD: All right. Thank you so much for having me. This was great. Thank you. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts, all rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with your friends and rate review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time. Dr. Katrina Furey, MD: Our don't.
Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we review "The Morning Show" season 2. This season is pretty heavy with themes of substance abuse, toxic relationships and Mitch Kessler's [SPOILER ALERT] death by suicide. We spend time discussing cancel culture and the complexities of the human experience. We also explore Cory's charcter, is he hypomanic? Or is it more of an ADHD presentation we are seeing? Who does Bradley choose? Is everyone in love with their mother? Listen now to your favorite TV loving shrinks for our full break down. We hope you enjoy! Instagram TikTok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fury, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM Five and enjoy. We get started. We just wanted to include a trigger warning for this episode. This episode could include discussion about some themes and topics that might be upsetting, including, but not limited to things like substance abuse, suicide, self harm, disordered, eating, and harassment and assault. So if any of those topics are too upsetting, we totally get it. Please feel free to skip this episode and join us next week. Otherwise, we hope you enjoyed. Portia Pendleton, LCSW: Thanks for joining us today to cover the Morning Show season Two. If you have not listened to our take on season one, feel free to scroll back a couple episodes in our feed. Season two did come out in September of 2021, which was kind of in, like right. The throes still of COVID I mean, not like the Lockdown, which this show oh, my God. With that visual of New York City, which was eerie, to say the least. But did you watch this in real time? Dr. Katrina Furey, MD: No, I think I watched it last year, maybe, but rewatching it again. I had, like, a visceral reaction to all of the COVID stuff. What about you? Portia Pendleton, LCSW: It was weird. I really like and we talked about this about season one, how they show, right? Like, real time things. And it's so funny thinking back to hearing about, you know, it was like, in more of the Asian countries in Asia. It was kind of, like, sprinkling through. And I remember having some friends traveling internationally and being like, yeah, it was weird. Like, a lot of people are wearing masks, not domestically. And then all of a sudden, it was here, right? And it was like this very March white. I don't know, like, the grocery stores were full, and then they were empty. Schools were open and they were closed. It wasn't a smooth transition. Oh, this is coming. It was just like, okay, we're making this decision. Dr. Katrina Furey, MD: Oh, my gosh. I remember I'm so ashamed to admit this, but I was supposed to go on a bachelorette party to New Orleans, like, right in mid March, and it was for my very good friend, Dr. Kristen Heisel, an infectious disease physician at Mass General Hospital, so you can imagine what her March 2020 turned into. But as the news of COVID was, like, trickling in, I remember sitting in the psychiatrist talking to a colleague being like, this is just going to be like ebola where we all freaked out. And then it was fine. And I was like, trying to tell myself this because I really wanted to go on this Bachelorete trip and I feel so selfish saying that. Should we cut that? Like, does that make me look at. Portia Pendleton, LCSW: I can share a similar thing. Dr. Katrina Furey, MD: But then my friend kristen called me after they had this super secret meeting at MGH and was like, we're not like, you need to go to the grocery store immediately. This is like a really big deal. Harvard is preparing. They've talked to like, this is going to be a really serious thing. And I was like, oh, my god. And then two days later, yeah, everything shut down. Portia Pendleton, LCSW: It's funny because I was in DC. In February, like mid February, and there was still nothing. I don't know which speech I know that's not the right word for it was happening, but everyone in congress and the senate were there and it was really busy and it was fine. The airports were all good. But then I ended up having to come back from puerto Rico early. So I've told this story, obviously to my friends, but for my new friends out there listening. So we had been here and meeting family down in puerto Rico who had missed it by three days of what was kind of happening. And we were like, should we go? Should we not? And we're on the airplane, it's about to take off. They shut the door and everyone's like, phone alerts start to go off if you have news alerts. And it was that all international travel was stopped and we weren't going internationally. But I was immediately like, I need to get off this plane. Obviously I couldn't. So we went to Puerto Rico. We told our family that was down there and they just did not get it's. The like, this isn't a big deal. Why is everyone up there freaking out? Brian were like, my partner and I were like, how can you not understand? The grocery stores are empty. So we ended up flying home early and thank goodness we did because the island closed down. There was a ship in the port there from Italy that had some italian travelers that were sick and so it was just chaos. And then I remember coming back to work on Monday and we closed, right? So we had this meeting of how we were going to handle it. Everyone took their laptops and we went home. And then I never went back to that job. Dr. Katrina Furey, MD: Yeah, it was scary. I don't know, I feel like triggered watching this show and all the COVID stuff. It's like hard for me to watch. I notice kind of like not looking at the empty street. It's just like really hard for me to watch. I thought they did a magnificent job, though, covering it and how they had Daniel, the lone wolf, sort of like raising the alarm and seeing how Mia, who's now in Chip's old role, is kind know, not covering, know, choosing other stories to cover instead. And then they send him to China, right? Portia Pendleton, LCSW: And he is just like in the throes of it being like, this is serious. They keep giving him a short segment, they cut his segment, he's like but. Dr. Katrina Furey, MD: It'S so symbolic of how we were all thinking about it until it was really serious, right? And then we sort of see the COVID sprinkled in, I thought, even starting with New Year's Eve and how joyous it all was, like, woohoo. Portia Pendleton, LCSW: 2020. Dr. Katrina Furey, MD: And now as we watch it, you're just like, if we all knew what was coming. And then they still sort of sprinkle in COVID throughout the whole season as it builds. And I enjoyed how they kept reminding us of the date. Like, oh, Alex comes back February 20. And I was like, oh my God, that's like three weeks before it's going to start. And then her last day was like March, I don't know, like 14th or something, right? Like, it just kept building and building and building till we see Alex with COVID and we see Bradley, like, rushing into the Er to find her brother in the chaos of the emergency room with COVID cases. And it was just like, we see them all go home and trying to figure out contact tracing and Corey with. Portia Pendleton, LCSW: The and being silly with like, I don't know what that know? Dr. Katrina Furey, MD: Well, we didn't know what it meant. And Corey's like, can you stand can you step back? 6ft, right? Oh my God. Portia Pendleton, LCSW: It was such like an awkward time because I think everyone it was new social norms that we all had to just adopt and everyone had their own length of time for getting on board with specific social norms or not. And I think it was just like, there's a lot of awkward interactions with people. Dr. Katrina Furey, MD: I think what I found personally interesting as a physician and as a psychiatrist, as the time when it all hit, I was still doing some moonlighting at a local hospital and fortunately that was like extra work. And so as soon as I started to feel unsafe, I stopped. And I had a lot of guilt over that, but certainly I had a couple of shifts. I never will forget how scared I felt because I didn't have enough PPE. And I remember nurses coming in and smuggling in masks to each other and saying, don't tell the supervisor. And we were trying to figure out, as a psychiatrist, what do you do when there's a code and you don't know if the patient's COVID positive? Like a behavioral code, agitation, delirium, things like that, that you get called for in the middle of the night, like, how close do you get? How close do you not get? We didn't know yet how is it transmitted? How does it affect if you have history of asthma, how does it affect you? How does it affect kids? All of that stuff. I just will never forget being so scared. And I remember leaving one of those shifts and realizing, like, I can't do this right? Like, I'm terrified. And one of the nurses being like, Dr. Fury, are you okay? And I was like, no, I'm really not. And then I think as a physician, realizing this is really serious, during that time when everyone was trying to figure out, like, do we really need to stay home? Do we really need to stock up? And when people were like, oh, it's just 60 days lockdown. And I was like, this is going to be years, and it's just hard to watch. Portia Pendleton, LCSW: It was an interesting theme, like, you said that even I know one of the producers who went up to Mia with one of like it was a COVID story about a number going up, but there was also, like, three other things happening that day. And she was like, Nope. No, we're not running that story. And it's just right. Like, they didn't and then all of a sudden, it was the most important thing, right? Like, in mid March, everyone that's all anyone could talk about. And I remember, funnily enough, with the morning show being like, right, a news network. I'm just not, like, a news watcher. And I watched the news, right, for like, 72 hours when things had locked down. And then I was like, this isn't. Dr. Katrina Furey, MD: So great for my mental mental health. Portia Pendleton, LCSW: Yeah, but it was wild. Dr. Katrina Furey, MD: It was wild. Portia Pendleton, LCSW: Dr what was it? Fauci. And then that woman with the scar, Deborah. Dr. Katrina Furey, MD: And just watching them try to keep their composure. I'll never forget that. Meme going around with Dr. Fauci, like, touching his forehead in frustration and being like, you know, it's bad when the man telling you don't touch anything is like touching its head in frustration, right? And they showed clips of Dr. Fauci in this. So the season does culminate with COVID and I'm really interested to see now that we know season three is about to come out, like, how does that evolve? But there was a whole lot more in season two, and I have no idea how we're going to cover it. Portia Pendleton, LCSW: All in this know? So so we have some new characters. We have Stella, who's the new president of the news division. Dr. Katrina Furey, MD: I think she took Cory's job. Portia Pendleton, LCSW: Yep. Dr. Katrina Furey, MD: And then Corey took Fred's job, right, because they fired Fred. Portia Pendleton, LCSW: Yeah, that was a little I mean, it became clear, but right at the end of season one, it seemed like Corey was going to be let go, and then they ended up letting Fred go. And then Corey stepped into that role, which is what he wanted, right. And I think he kind of set some things up so that happened. Dr. Katrina Furey, MD: And I think also we come to find out he's kind of in cahoots with right? Like, it kind of sounded like I was a little confused by this, but it kind of seemed like Bradley thought she walked in and said, I'm not coming back if you don't rehire Corey. And then they did. But then we sort of found out later on that Fred was like, corey should be my successor and give me all this money. And then he's maybe pulling some strings in the background. So he's like gone but not really gone. That kind of confused me. Portia Pendleton, LCSW: Yeah. Corey is an interesting guy. Dr. Katrina Furey, MD: Do you think he's hypomanic? Portia Pendleton, LCSW: He is something. He is so animated and constantly hyper and activated. I just want to know his routine off when he's not at work. We saw some of his exercise routine. Dr. Katrina Furey, MD: When I saw that I was like, I think he's hypomanic constantly on the go. But explain that a little bit. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: So when we think about hypomania, what we mean by that clinically is when you think about depression, we think about people who have clinical symptoms of depression for two weeks or more. That's where your mood is lower than your average baseline. We all have mood fluctuations over the course of our life, but when you're feeling depressed, your mood is way too low. Now, the flip side of that is something we call mania. This is what we see when you have something called bipolar disorder where not only do you have the depressive episodes, but then you also have the manic episodes where your mood is way too high, right? Like, you don't need sleep. You're talking a mile a minute. You have all these big grandiose ideas. You're really impulsive. Portia Pendleton, LCSW: And people can tell. Dr. Katrina Furey, MD: People can tell when you are fully manic. That's a psychiatric emergency. You need to go to the emergency room. A lot of times people end up getting hurt either because they're doing something really risky like skateboarding down a highway or something or because they're using substances or sex, gambling, spending money, things like that. There's something in between what we call euthymia, which is like a typical normal baseline mood. You still have fluctuations because you're human, but it's all within a controlled range of feelings. It never dips too low or too high. Mania is like the highest you ever get. Hypomania is kind of like halfway in between. And some people with hypomania function really well in society. Like maybe corey, right. Like, maybe he only needs 4 hours of sleep. Cool. He can get a lot more work done. Maybe he has boundless energy, but he's not like, talking way too fast or having really big ideas that are people with mania might write their memoirs on postit notes and put them all over their room, for example. He's not really behaving like that outside the norm. But sometimes people with hypomania are really successful and productive because they just don't need as much sleep, and they have more energy than the average person. He also could be abusing stimulants or something. Portia Pendleton, LCSW: He could be and sometimes I think there's that little edge or overlapping, also, potentially, of ADHD, just like, really hyperactive. You know, what if you have ADHD? Some of the symptoms with mania are not presenting, though. But just that on the go. And we think about people who, in adulthood often find careers that do fit better if you have attention hyperactive or you're inattentive. It's hard when you're a child. I know I'm taking a little bit of a left turn here because school is pretty much the same. Right? We have expectations for everything. But when you get into adulthood, there's so many hands on careers. There's so many careers that you can be on the go that we see people typically be able to function a little bit better with that. So even I'm wondering for him, right. He's constantly being stimulated. He's constantly thinking of these things. So it's like that's a great point. He's got something, though. Dr. Katrina Furey, MD: Man, I'd love to evaluate him. He also has a history with his mom, which we won't get into all the details. Please watch the show. But which clearly influences his behavior and his love, it seems like, for Bradley. One thing I thought season two did a really interesting job of is, like, depicting how they're all falling in love with who I imagine their parents were. Right. I don't know. What did you think? Did you pick up on that at all? Portia Pendleton, LCSW: Yeah. Or, like, with Bradley. Right. It's like, for me, I felt like Laura was someone she never had. Right. Like, safe. She was really empathetic, really nurturing, really sweet, kind, really good advice, really validating, not dismissive. And then it's just, like, interesting now with, like, in the mix. It's like, who know in season three, I guess, where does and it's like it depends on, I think, where she is with herself and doing work or not. Because I would say and again, this is just like a guess if she hasn't done work on herself, I could see her picking Corey, and if she has, then it's like Laura. Dr. Katrina Furey, MD: So I think it's going to be Cory. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: What did you think about that scene with Laura and Bradley where Laura was encouraging Bradley to go to therapy? Portia Pendleton, LCSW: I thought it was excellent. Dr. Katrina Furey, MD: Right. I thought it was so gentle. Yeah. Portia Pendleton, LCSW: You're crazy. You need to go to therapy, or you need to get over this, so you should go to therapy. It was just, like, very like, it seems like you need to talk about this, or you need some support, you need someone to help you figure this out. Stuff with your brother. Dr. Katrina Furey, MD: Yes. After her brother Hal. And we'll get into this a little more later. That depiction of being the sibling of someone with an active addiction coming from a dysfunctional home life, we'll definitely get into all of that. But I thought the way Laura so, like, validated how hard all of that was for Bradley and said, I think you need some help figuring this out. Have you tried? Therapy was just such a nice way to bring it up. And then I thought it was so honest when Bradley was like, I think they're going to tell me I'm crazy, I'm scared. And I was like, girl, me too. I hear you. I think we all feel like that, right? Portia Pendleton, LCSW: And what a great Know line for her to say, right? Dr. Katrina Furey, MD: I thought that was such a beautiful depiction of sort of like a nice way to encourage someone you love to seek help and a really nice way to introduce a really tough concept of boundaries and when is it time to walk away? That's hard. Portia Pendleton, LCSW: That's hard. And I think in the spirit of therapy, everyone could use it on the Know. I think Mia certainly needs some support. I mean, what a complicated loss she is experiencing. Right. Dr. Katrina Furey, MD: It's like Mitch, you mean? Portia Pendleton, LCSW: Yeah. And even just of this distance, right, of just know, fall from grace as a loss, his loss of the show and then ultimately, right, like his death and then reporting on it and you can see her tearing up. But knowing that he also did all these horrible things and know had come out in this episode, these questions around, like, was he praying specifically on black mean? I just was like, Mia, I would love to I don't just I really like her character. I really empathize with her and I would love for her to get all the support she can. She seems like she's throwing herself into work, which is the job. I mean, I think it just is what it is. Dr. Katrina Furey, MD: At the end of season one, he looked so haggard and disheveled and exhausted. And I was like, you are like, going to collapse at the beginning of season two. He looks great. He's like well groomed. He's engaged. He's got this beautiful little house. Portia Pendleton, LCSW: He's driving a Subaru. Dr. Katrina Furey, MD: He's probably getting 8 hours of sleep a night. He's probably exercising. Maybe he's playing pickleball. Like, he looks so good. And it was fascinating to me how he so early on told Bradley, like, if I ever talk to Alex again, I got a lot to say to her. But then when she shows up and asks him to come back, he's like, okay, yeah. Why do you think he did that? Portia Pendleton, LCSW: I don't know if it was a selfish, not like, self seeking, self serving thing where it's like, I do want to be a bigger producer, right? Like, I'm this little smaller station and this is really my world. Or was it his connection with Alex? Does he think he owes her? Is there, like you had mentioned before, a trauma bond with like I don't know if it was for I mean, it could be all of those things at the same time. So what about you? Dr. Katrina Furey, MD: I think my theory is that I do think, like, near the end when they have that knockout fight in the car where they're really raging at each other and she mentions that she feels like he's in love with her and she doesn't love him like, that that got me thinking, like, is that true? Especially because then when he was making out with his fiance and was like, let's go do it in Alex's office, and that is kind of creepy. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: It got me thinking, like, was his mom, like Alex? Did he have a self centered, narcissistic mother who was constantly absent or critical? And is he seeking that validation unconsciously? Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: But is he seeking that approval, that acceptance, that validation in a super unhealthy way? That's what I think. So I'd love him to get some therapy too. And I think what we were talking. Portia Pendleton, LCSW: About with who Bradley will choose based on her own internal path, I think same with like, if he is a well self, he's going to choose his current right like life, right. Working at the smaller station with his this this quiet, healthier, seemingly life, but maybe not so big and showy, right? Like you could see him kind of being pulled back and back and back into this abusive relationship. Dr. Katrina Furey, MD: Right. And we see that with how in that final scene or the final episode when Alex is on air with COVID which was weird that he lied and said he tested positive too. So he's like, totally around her. He could have just put a mask on if he could find one. I guess back then they were hard to find, but we see his fiance call and he declines it. Portia Pendleton, LCSW: He also then puts something on the prompter that Alex wasn't expecting, which is like, so are you getting back at her or you just like it was confusing of where they're going to land. Dr. Katrina Furey, MD: 100% because in so many ways, their relationship continued evolving in a very raw, honest way. But then we continued to see the power dynamic stay the same when she FaceTimes him. Portia Pendleton, LCSW: Right. Initially from bed and after, they are still not okay. They had just had that big fight in the car. And then she's like, very sick. He's being kind, but he gets sucked. Dr. Katrina Furey, MD: Into her again and again. And she keeps using him as a narcissist will do again and again. And I felt like at the very beginning of season two with Alex, she's in her little chalet. It looks so cozy. She has a dog now. She's writing her memoir. And you see when she comes back to the station, that dinner party at Corey's house, I felt like she put on such a good mask of like, I've really done a lot of self reflection. I want to be different. And then as the season progresses, under more and more stress and scrutiny, I just feel like she's the same old narcissist she's always been. And we see it in such a big way that she goes to Italy to get this letter from Mitch as if he's not again, she doesn't care what he's dealing with. She doesn't care that know, at that point, we knew COVID was spreading. She doesn't care. We see how much she doesn't care about other people. She kicks them off the private jet so she can get back. She goes back to work despite knowing she was in it. She doesn't answer chip's phone calls for like weeks. She's just so utterly selfish and it's. Portia Pendleton, LCSW: Just such a big and telling Mitch's wife, right. I think she thought that she was being so kind, like, I'm going to tell her, look at me. Dr. Katrina Furey, MD: I'm such a person. Look at me. But it's like, no. And I loved when Mitch's wife really put her in her, right? Portia Pendleton, LCSW: Well, because her whole world was shattering then. Because it's like other people know, right? She had been so desperate to protect that secret that her and Mitch had know consensual sex. And now it's like, well, actually, other people do know, or other people. There were whispers. And then when Bradley got the excerpts from the book and she's interviewing Maggie, it was just so fascinating to watch Alex unravel, right? Because her whole world had changed. She's no longer in the driver's seat. Her world is falling around her. People are starting to not like her. Dr. Katrina Furey, MD: Because people are seeing the real her. And the whole world was about to see the real her. Like, we saw Daniel's reaction to the real her. And I was really proud of him again, in that early scene at the dinner party, that he didn't just let her off the hook and like, because that's what he's supposed to do. He really held her accountable. And you see how much he does not like that. Portia Pendleton, LCSW: Daniel may be doing some work therapeutically. He is starting to stand up for himself more. He's setting is he is doing what feels authentic to him. You know what? Dr. Katrina Furey, MD: He has the it factor. Portia Pendleton, LCSW: Okay. Dr. Katrina Furey, MD: I agree with his grandpa. Portia Pendleton, LCSW: Yeah. Okay. Dr. Katrina Furey, MD: I didn't love the cringy song and dance for Alex, and I'm sure that was humiliating for him, but he's got the if factor. And I would be ****** if I were him that I almost got the job at the other network and I agreed to stay. And then Alex just like, stabbed. He just uses people. We really saw that in that scene with Laura when they talked about going to see Bring into Noise, bring Into ****, we see how even with like and I thought this was actually really smart of the writers because it shows that Alex has always been this way, that she was new on the scene. Laura was like know, she was like the lead anchor. She was closeted at the time, but she had some close friends who knew. And it sounds like we're accepting, but it wasn't the kind of thing you just shouted from the rooftops back then. And then soon after, Alex coming into the social circle, all of a sudden it leaks and all of a sudden she gets fired. And then Alex disappears but rises up the ranks. And it was just really interesting to see Alex try to get on Laura's good side and sort of remember that whole scenario so differently from how it actually happened. Portia Pendleton, LCSW: Do you think that there was malicious intent or do you think Alex just had no, no. It was either malicious intent or zero self awareness at that time. Dr. Katrina Furey, MD: Honestly, I feel like for someone with narcissistic personality disorder, how do you split the difference? I really feel like Alex meets criteria for that and she's always just it might not be conscious, but unconsciously thinking for herself and putting her own needs first. And the whole world revolves around her and quite literally it does. Being in such a powerful position in the media, we see again, people kick people off the private jet so she can get home. Chip comes in and exposes himself to COVID so she can go on the like, quite literally, people do revolve around her. So it's hard to like, was it malicious or was it just selfish? But where's the line? Portia Pendleton, LCSW: I saw a really interesting TikTok with Alison Stoner. So she was a child star and so she just made this video. It's from September 1, if you want to watch it. And she kind of speaks on how in the film industry, especially starting out with in childhood, how narcissists are kind of grown, even if it's not like rightly. You're born with the trait. And so I think what we've talked about also with Succession 100% is just like how do you have developed drive, right? This internal drive that maybe separates you or you have what do you call it? Like predestined predetermined. Pre, whatever that word is. I'm not saying it predisposed to something that maybe comes out in some people, not others. I don't really see it in Daniel. Dr. Katrina Furey, MD: Right. But maybe is that why he's not so as successful? Portia Pendleton, LCSW: Because he's not so brutal? Dr. Katrina Furey, MD: That's the thing, is you have more empathy and you think about others. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: And so that kind of holds him back. Portia Pendleton, LCSW: Exactly. Dr. Katrina Furey, MD: Whereas Alex was thinking for herself and wanted what she wanted and was going to get it at and then she. Portia Pendleton, LCSW: Did and then she did and then she did over and over and over again doing it. And then there are her expectations. I mean, even her family we saw in season one way more, but the facade with her partner, they did that because of her career, because she asked them to. It was expected. Dr. Katrina Furey, MD: And when you're on her good side, when you're on the good side of the split, she is so charming and funny and. You feel special being in her orbit, right? Like, we see that time and time again with Chip. And I feel like that's how she keeps sucking people in to help further her own agenda, though. That's the thing. Even Bradley again, I think because Bradley hasn't done the work, she's getting sucked in in a way that they I don't even think consciously realize. But Bradley's getting sucked in, too. And in many ways, we see that Bradley's mom, although very know in terms of not being successful, not being wealthy, but is still very critical, dismissive and invalidating. Much like Alex's, when you're on her bad side, like when you try to confront or criticize or point out that she's done something wrong, quickly flips on you. But I think that's why Bradley keeps getting sucked, why all these people get sucked into her orbit and she just uses them to get what she wants. Portia Pendleton, LCSW: So what do you think? Do you think it was Bradley being sucked in? What do you think about the interview with Bradley? And, like, what was Bradley's angle? I mean, I liked it. I know a question I'm saying to me. I liked it in the fact that I don't like Maggie, really. And I don't know if that's because I'm in Alex's. I just thought as a woman, instead of being about Mitch, which I'm not saying that in the way that it dismisses, because Alex is not like, a good person, really, but the fact that she kind of lied the whole time about what the book was. And it's like, I remember when Bradley was scrolling through the pages, gets in the back, right? She see her name twice. And then Alex, it's this huge thing. She's on the COVID And I thought that was a really I liked how she challenged her on some of like, why isn't this about Mitch? This was supposed to be about all of the guys and whatever. And yes, Alex is a part of that, which she doesn't want to admit. But I did appreciate kind of the pushback on, too. Dr. Katrina Furey, MD: I did too. And I think I would imagine Alex has really hurt Maggie. She must like I feel like this was Maggie's way of calling her to the carpet. Is that a saying? Maybe we'll go with know, like, holding her accountable and being, like, exposing who she really is to the world. But I think what Bradley was saying was, like, was that your right? Portia Pendleton, LCSW: Why'd? Dr. Katrina Furey, MD: You do know, why did you do this? Especially when she came to you and begged you not to. And that is true. She did. It was interesting. Yeah, I think it was really interesting. I don't think Alex expected it at all. I don't think anyone did. And then I'm wondering, why did Bradley do it? Portia Pendleton, LCSW: Right? Dr. Katrina Furey, MD: And again, is it like. Portia Pendleton, LCSW: Corey keeps putting her in these interesting, like, of, well, you should do it because you're fair. And it's like what does that mean? Remember when he's like, can you do the interview? And she's like, well, why? I don't know. This might be difficult. And he's like, I just know that you'll be really fair. But it was a drawn out it was intentionally that we heard that moment. What does that mean? Dr. Katrina Furey, MD: And I feel like especially in season two, we see that I hate this about professional settings, when people are saying one thing but really meaning something different and you have to learn the lingo and the undertones and what's being implied. I feel like we saw that a lot with season two. So just that when he's saying fair, does he mean, don't hurt the network. Let's keep us in a good light? Is that what he really means or does he mean, you'll be fair? Portia Pendleton, LCSW: I think it's almost both. But I'm only saying it's both because I think the fact that he likes her complicates things for him. I don't think he's used to that. I don't think he knows what to do with Bradley initially. He likes her. He keeps giving her all of these things. He keeps promoting her, promoting her, promoting her. Is it because he truly right, has this almost fantasy of how amazing she is as a career woman? Or is it that love piece? Is it infatuation? Dr. Katrina Furey, MD: But then he's the one who outs her. So he also loves her, but he's hurting her. And that makes me want to know more about Corey's mom. We learned just a little bit how he was taking care of her and he's kind of taking care of Bradley in terms of giving her the job, giving her a place to stay, rising through the ranks, giving her even Laura, like sending Laura into her life. Can you please help her? Portia Pendleton, LCSW: But with her in a really weird way? Permission. I think he made it in his head, okay, for him to do that when he outed them. Because Bradley he made Bradley say, right, he set her up to be like. Dr. Katrina Furey, MD: You have to do whatever it takes to protect. Portia Pendleton, LCSW: And, like, I think I don't know, maybe Bradley would at the end of the day, if it was super black and white or she knew the outcome later on, that she'd be like, maybe she would have given permission for that. I don't know. But in his head, I think he got permission from her. And that absolves him of the guilt. Yeah, guilt. Maybe it comes out in season three, maybe. Dr. Katrina Furey, MD: Because I don't think he ever told her that it was him. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: I thought he was going to at the end, but then he said, I love you. And then I was like, can he not sit with the guilt of telling her this? So he says he loves her instead, right? He's fascinating. I really hope we see a lot more of his development. I really hope we see Bradley in therapy in season like, I really, really hope we do. Portia Pendleton, LCSW: I think that would be a great line of whatever, to see Alex and. Dr. Katrina Furey, MD: Bradley in therapy together, almost like couple therapy or family therapy. Portia Pendleton, LCSW: And maybe she did she would go to therapy twice. Right. Dr. Katrina Furey, MD: And she's good. That's right. Portia Pendleton, LCSW: She talks some of the external problems, like the network or the cancellation. Right. But it's not about her. It's not deeply rooted in her Psych for interest. Dr. Katrina Furey, MD: And then she'd be good. She'd be like, I'm good. Or it would be like we saw in succession with the family therapy, right. Where you can't actually go anywhere substantial or honest. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: So rewatching those episodes with Alex and Mitch and watching Mitch's death by suicide was really emotional for me. But what about for you? What did you think of all that? Portia Pendleton, LCSW: It's interesting. Bringing then in paola paula. Paula because I feel like I was just feeling many different feelings towards Mitch. At the one hand, I obviously don't like his character. I think he's like, a crappy person. Dr. Katrina Furey, MD: Really hard to see Steve Carell like this. Portia Pendleton, LCSW: Yes. Right. But 100% such a good job. Dr. Katrina Furey, MD: And he's also such a good choice because I think it automatically makes you, like, ambivalent. Portia Pendleton, LCSW: Yep. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: And he is right from the office like this. Like everyone loves my favorite boss. But then, obviously, this is also another character. But it's like, oh, it's a perfect character based on his other fictional characters. Dr. Katrina Furey, MD: 100%. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: Because he's just, like, beloved. He's funny, rodeo virgin. There hasn't been bad press about Steve Carell, as far as I know. So him being in the role, it just automatically, I think, plants that seed of ambivalence in our minds. Portia Pendleton, LCSW: Yes. So when he was in Italy and that woman kind of came up to him right. And was, like, saying those things to him, and then we know her friend is filming it. Yeah. Paula come in and kind of interject. I didn't know how to so Mitch was like, right. He's excommunicated. He's living in Italy. He's by himself again. I think at that moment, he doesn't still have self awareness. I think he has more than his mentor. I think there's lines that Mitch won't cross that mentor did, but he still, I think, is lacking self awareness or really kind of understanding. He's still trying to, I think, come back or liked again. But I was again torn with that woman kind of saying those things to me. He's like, he's here minding his business. He's a hat on. Like, he's not right. Dr. Katrina Furey, MD: Exactly. Portia Pendleton, LCSW: Clear the restaurant for me. Dr. Katrina Furey, MD: And I thought it also brought up this idea of cancel culture and that exploration in a really smart way, how, like, yeah, he's done something many things that are awful and egregious. But, yeah, he's alone. He's not doing anything egregious right then. And we're just going to provoke him in hopes of filming it, that it'll go viral for that person's. Personal gain. That was. Portia Pendleton, LCSW: I i the one thing that I liked Paola said to them was kind of just the pointing out of, like, you're doing this to post it. And I was, yeah, like, this isn't you kind of coming up and having a conversation and being like, I just feel like I need to say you whatever. Like a small thing, which, again, still is unprovoked, but whatever. I think just like, people do that, right? People do that. She would have gone viral and had her moment and that feels just a little icky. So anyway, moving through that, I think, just because I always am. So I don't think it's naive, but, like, go lucky, optimistic, never ending. But I feel like Mitch, in his way, on his path, which is not mine or other people's, was kind of exploring what he did. Dr. Katrina Furey, MD: He was I thought so, too, way more than exactly. Portia Pendleton, LCSW: Like, I think he, with time was changing, maybe with more support. I think that documentary that he did with Paolo was powerful or learning of that survivor in Italy that she was talking about or trying to film or make the documentary about. I think he was learning. And so I'm wondering if because he was it was like all of a sudden there was this guilt or like he couldn't handle the fact that he was this person who did these terrible things because he wasn't suicidal before. It was on his journey almost to changing that he took his life. Dr. Katrina Furey, MD: It was so sad. Like that scene where he swerves and then you see his hand let go. I was like, oh, it really gets him. And he shuts his eyes like he's at peace. Portia Pendleton, LCSW: Oh, so sad, portia I mean, he's a children. I don't know. I feel like he had the capacity for change and you have to want it, and he didn't want it before. I don't think he wanted to be. Dr. Katrina Furey, MD: Alone, away from everyone. COVID, like, thinking about your life, I do think I was seeing more and more capacity for reflection and introspection and ability to change, and I wasn't seeing that from Alex. To me, it was a fascinating juxtaposition of her coming out to Italy, won her letter from him, really railing on him, saying anything she could to get what she wanted. Portia Pendleton, LCSW: And then them being good and then them not being good. Dr. Katrina Furey, MD: It was like this whiplash and then them dancing and having these really tender, loving moments and then parting ways, it seemed like, on good terms. And then that happens. But then in between, I guess, then he is intimate with Paola, who he's. Portia Pendleton, LCSW: Very upset by the allegations about it being like, preying on black women. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: I don't know. It was sad. It was definitely sad and unexpected for me. I did not see that coming. Dr. Katrina Furey, MD: And one thing we've talked about in some previous episodes is that humans are complicated and flawed and complex and you can be a perpetrator and a victim. Like, we talk about this a lot with children who grow up in really abusive households and then, unfortunately, become abusive as adults, but I feel like we see that with Mitch here. And again, I'm not trying to be a Mitch Apologist or anything, but he did awful bad things, and now he's being treated so and, yes, he should be held accountable and be fired and maybe arrested or charged with things like all of that. And I think this show, we see what could happen to a human soul going through that and then being just, like, piled on, piled on, piled on top of it, as he does seem to be trying to figure it out or figure out how do you move forward? Right. Portia Pendleton, LCSW: I think it's also, like, the power of cancel culture, which is what I heard you kind of saying, but not saying those specific words just now. Because I think when some things are very clear, like taking absolutely social media or any kind of presence out, it's like, okay, you do something bad, maybe you do get convicted. Like, you actually are part of the criminal justice system, and you go to jail. It's like you are then treated poorly and in this terrible system. But it's clear then it's like the world, everyone hates you. They are death threats, making things about your kids. It's so interesting to hear people talk about cancel culture or being canceled because everybody says it's, like, the worst thing, because it's so unique. I don't know. It feels nuanced. I know it's not super new at this point, but it's just this weird thing. Dr. Katrina Furey, MD: And I think, too, with social media, I feel like that has to add to it. It's not just like you're being canceled at your place of work, in your immediate family, or even in America. He was canceled internationally, and again, in some ways, he deserves it. 100 million%. And then all the piling on at the same time. You just think about that is a human at the end of the day, too? And this is really tricky. I feel like this is really hard for everyone, humans, me to wrap my head around. The show just does such a good job portraying really difficult topics. And as we wrap up, I do want to make sure we talk about Bradley and Hal. What did you think of this? Portia Pendleton, LCSW: I thought it was was because I was so moved and I was so angry at him when he know, I'll make it really simple. He's describing how their mom has impacted him right. By being threatening, manipulative, all of these things. And he does it exactly to Bradley, like, within the same sentence. And it's just like I was speechless at how well they got it. Right. Dr. Katrina Furey, MD: I know. Portia Pendleton, LCSW: And then Bradley, the guilt tripping, the threatening, the putting it it's on you. My substance use is on you. Showing up and hurt me. Job horrible. Dr. Katrina Furey, MD: All of it. You can just see how much she is struggling with wanting to help and support him. Especially now that she has so much money, like more money than they ever had and she can't help him. But then being totally like, what are you doing? Like, why are you showing up here? Are you using? She looks through his bag and then he notices. But then it's like, of course she right. And it's just they perfectly demonstrated that dance. And that scene when she's dropping him off at rehab and trying to set those boundaries like Laura was encouraging her to, was heartbreaking. But I felt like if I was her therapist, I would say you have to set boundaries. Portia Pendleton, LCSW: I would have been very proud of her for how she was when she dropped him off. I can't do this for you. This is your decision. Go in or go out. I can't make you sober. And then sucked back in again later on. Dr. Katrina Furey, MD: But Manipulatively leaves all the money and disappears again. It's like just like Alex disappearing with her back and not answering anyone's calls. It is such a primitive way of getting someone's attention, right? By scaring them, being like, oh, you don't want anything to do with me? Well then look what's going to happen. And it totally worked. Portia Pendleton, LCSW: And it's so hard to not be impacted by that. People do it 1000 times over and over again. Sometimes they never stop and sometimes they do, but it just breaks you as a person and having to do that over and over and over again. Dr. Katrina Furey, MD: You really need help navigating that. And that's where support groups, even like Alanon, your own individual therapy can help with that. I don't think there was any way for Bradley to stick with her boundaries in that situation. I thought her reaction was really accurate and human and you just saw all the desperation and remorse and guilt and everything that she was feeling. And I feel like, unfortunately, people who love someone affected by substance use will totally relate to that. Portia Pendleton, LCSW: And the people who know in a relationship like Laura with Bradley, because I think that can oftentimes alienate the person like Bradley even more. Because as things are happening, as Hal is pushing Bradley and kind of like making her unwell, there's the people around Bradley like Laura, who then even more so will start to be know, you really can't do this anymore. You really need to set a boundary. And sometimes that know, break a relationship, right? And so then it's like, then you're more know, you're without more it's so it seems know, okay, it's just between Bradley and it just the spider web goes out so far with how substance abuse impacts families. Dr. Katrina Furey, MD: That's what we always say, right? It's a disease of the family. It affects everyone. Which I guess you could say about most mental health conditions. But we really see it with substance use. And it was just what a portrayal. And I mean, so expertly done and so heart wrenching. I was so glad she did finally find him, but I'm really worried they're both going to get COVID now. Or I was like, Bradley, what if you have COVID and you're running in exposing all these other people? And it's just like the chaos, right? Portia Pendleton, LCSW: And it's still so at the beginning. So they hadn't shut down, no visitors yet. It's within all the chaos of her own life. And then it's like you're seeing which we love, the parallels of all the chaos that now the world is being pushed into. Dr. Katrina Furey, MD: So where do you hope season three goes? Portia Pendleton, LCSW: I'm sure there'll be at least a couple episodes, right, with them working from home. And I'm curious how that is. But then I'm wondering where season three ends. I know I'm getting way ahead of myself, but because will Cobra be, quote unquote, over? Are they back into the office? Does anyone die? Are Corey and who does Bradley end up with? Is anyone fired? Is Alex ever able to gain anything? Does she keep doing her? Dr. Katrina Furey, MD: No, I don't have any hope for her. I'm sorry. Portia Pendleton, LCSW: I think it's interesting because the show, or maybe not the writers, but the producers or the directors in an interview had talked about how they really wanted to give Alex her redemption at the end of season two. And I feel like maybe a person without mental health background would think she did. Dr. Katrina Furey, MD: Were you watching, like, the stay tuned for the show? I did watch that for a couple of episodes, including the last one, and I think they touched on, like they were trying to say, like, Alex is human. And I'm like, yeah, and really far on the narcissistic spectrum, like, really lacking empathy and ability to appreciate how our actions affect others. So I just don't think that's going to magically develop. Portia Pendleton, LCSW: Yeah. And if it does, I don't know. I think the writers, like we've talked about a million times, are wonderful and have they must have mental health experts they have to, helping them develop these characters. Dr. Katrina Furey, MD: If you want some more, you can find us at Analyze Scripts podcast. Portia Pendleton, LCSW: Exactly. So please reach out to us anywhere. You can find us on Instagram or TikTok at Analyze Groups podcast or check out our website. You can also email us if you'd like to get in touch with us on a more of a professional level. But stay tuned for more of our episodes and check out the ones that we have back in the feed. There's a lot. Dr. Katrina Furey, MD: There's a lot. All right, thanks for listening and we'll see you again next Monday. Portia Pendleton, LCSW: Bye bye. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts, all rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Dr. Katrina Furey, MD: Unless you want to share it with your friends and rate review and subscribe, that's fine. Dr. Katrina Furey, MD: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.
Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are analyzing "The Bear" season 1. We meet the chefs and other restaurant staff this season and WOW, was anyone else's heart racing? We root for Carmy and the restaurant to be successful but see poor interpersonal skills, trauma, grief and trust issues impact everyone. Mikey's story line is tragic and unfortunately a common reality when mental health issues combine with substance abuse and financial troubles. Be sure to watch this show with some snacks, we hope you enjoy! Instagram TikTok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM Five and enjoy. We get started. We just wanted to include a trigger warning for this episode. This episode could include discussion about some themes and topics that might be upsetting, including, but not limited to things like substance abuse, suicide, self harm, disordered, eating, and harassment and assault. So if any of those topics are too upsetting, we totally get it. Please feel free to skip this episode and join us next week. Otherwise, we hope you enjoyed. Portia Pendleton, LCSW: Hi. So we are back again with another episode, and we are going to refer to each other today as, like, yes. Dr. Katrina Furey, MD: Drink, yes shrink, yes, chef, cousin, cousin. Portia Pendleton, LCSW: Whatever kind of comes to mind. We're not going to be swearing and putting each other down. Dr. Katrina Furey, MD: Hopefully not kind of abusive, which we. Portia Pendleton, LCSW: See a lot in the show. The Bear, which you're coming today. Season one, kind of blew up recently over the summer. I definitely had not heard about it last year. Dr. Katrina Furey, MD: I hadn't really either. Portia Pendleton, LCSW: It was all over, like, TikTok. A couple months ago, Jeremy Allen White. Dr. Katrina Furey, MD: Is all in the news because he got a divorce. And I don't know all the details about it, but it seems to be, like a hot. Portia Pendleton, LCSW: Yeah, yeah. People really like. So what how do you want to start talking about this? First, I would like to say that my blood pressure was so high, I'm making this up. Dr. Katrina Furey, MD: Okay. You weren't, like, checking it? Portia Pendleton, LCSW: No. Watching some of these episodes, this level of stress that I was feeling, and my heart was racing, I was like, I feel like I'm back in a restaurant, and I'm not. Okay. Dr. Katrina Furey, MD: Yeah, you worked in a restaurant too at some point, right? Yeah, I did too. Only for, like, six months. Like, in between college and med school, I took a year off to apply, and it was really stressful. I worked in a Mexican restaurant. It's closed now, unfortunately, one of the owners embezzled money and went to federal prison. Fortunately. But I was trying to get out of this other job, and so when I applied, I said I was available for all shifts. So I got all the lunch shifts and made, like, no money, and I would have to come in early and clean, like, literally move the heavy tables, clean the windows. It was, like, a lot of hard work. Portia Pendleton, LCSW: It's like, labor, labor, physical labor. Dr. Katrina Furey, MD: I lost a lot of weight because you're, like, running around all day. And I'll never forget my last day was Cinco de Mayo. I was like, I have to work Cinco de Mayo. Right? I'll never forget. The floor was, like, so sticky with tequila. It was a good restaurant. The food was really good. But at the pre shift meeting, one of my coworkers was like, hey, guys, I got Adderalls. Does anyone want one? And all these people took Adderall. And I was like, I'm good. I'll be okay. I don't know. It really shocked me. But then I guess in watching this show, and I don't know if in your training, you learned that there's a lot of mental health issues in the restaurant industry. Because I learned that. Portia Pendleton, LCSW: Yeah. I mean, I think it seems like and of course, we're generalizing here, but in my experience, and even hearing from clients who work in the restaurant industry, there is so much substance use. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: And with that often comes mental health issues. I'm just curious about who ends up in the restaurant industry. Right. I think you have to be really personable. You're really friendly, energetic. Energetic, I would say. And I think this is like, a little bit of just like anecdotal information. I feel like it's often kind of you have a little bit of ADHD. You're good, right? You can BOP brunch the 100% environment for you because it's so stimulating and. Dr. Katrina Furey, MD: It'S so quick, fast moving. I totally agree. And I think a lot of young people, I think, work in restaurants or bars or things like that when you're younger. But then I think you're right that there is a lot of substance use. I think there's, like, erratic hours does. Portia Pendleton, LCSW: Not help mental health, sleep. And then I think people often might, in that example that you provided, will take something to help stay up. Dr. Katrina Furey, MD: And then oftentimes, once the restaurant closes, shifts over, I think people go out for drinks. Or then there's, like, substance use with downers, kind of. I think, like we said, it is really hard work. Like, physically demanding. I think the pay can be good, right? Portia Pendleton, LCSW: Depends. Dr. Katrina Furey, MD: Depends. It fluctuates, and you don't really get benefits, so there's a lot of stress. It's certainly like, when we think about what are, like, risk factors, I guess, for mental health conditions, there's a lot of environmental risk factors just right there. And then you're also dealing with people who are hard to deal with. Right? Like, you have demanding customers, people complaining you're not doing it fast enough. There's a mistake. I can't imagine, right? Like, just all the complaints you have to deal with in a personable, happy way. Portia Pendleton, LCSW: And now I always think about everyone having sensitivities or allergies right to foods and how many requests we're making. I do make one request, but I'm just thinking about how complicated things are now. Everyone at a table could be like, okay. And I've been at a table before where it's like, every single person has a something, and I'm just like, oh, man, it's just so much more work. Dr. Katrina Furey, MD: Than just accommodating like, a regular taco salad. Portia Pendleton, LCSW: It's like, no cheese on this one, no meat on this one. We have to leave out the taco because it's corn based so much. It's a lot, and I think the pressure for certain people gets to them, and I think that's why we see. Dr. Katrina Furey, MD: Also just, like, a lot of abuse yes. Portia Pendleton, LCSW: With the hierarchy within the kitchen, and it can get really ugly. Dr. Katrina Furey, MD: Yeah. So when I started watching the Bear preparing for this, unfortunately, Hulu just, like, auto played the last episode of season two. I didn't get through the whole thing. We got through maybe the, like, ten or 15. No, I know. And then we're watching it, and I'm like, am I supposed to understand who these characters are and how they relate? And then all of a sudden, my husband noticed, and I was like it. Portia Pendleton, LCSW: Was like, s two, like, episode ten or something. Dr. Katrina Furey, MD: I was like, oh. So I felt like I had, like, a preview. Not in a great way, but then it's like, I don't think it's going to spoil all that much. So then we restarted it. But even in season one, we sort of see these flashbacks of Carme right. Played by Jeremy Allen White, the main character who worked in a really fancy like, they kept saying, the best restaurant in the world, and we saw Joel McHale. I was surprised to see in, like, a dramatic role. Do you know who Joel McHale is? Did you ever watch The Soup? No. Okay. Again, I'm older than you, but I. Portia Pendleton, LCSW: Know I didn't like. Dr. Katrina Furey, MD: It. Portia Pendleton, LCSW: I don't love him. No offense. That's okay to him. If you're listening, that's okay. Dr. Katrina Furey, MD: Does he have any weird outcomes? Portia Pendleton, LCSW: I just don't think he's funny. No. To me. And maybe he is now, but I remembering watching The Soup and being like, not your thing. Dr. Katrina Furey, MD: That's fine, but yeah, dark, like, abusive. And it was very hierarchical, like, almost like the military. It kind of reminded me of and you have to go up the chain and sort of that kind of thing. In prepping for this episode, I did some quick research, and it does seem like the restaurant industry hospitality has very high rates of depression, anxiety, substance abuse, and harassment, which I think makes sense, like, if you've ever worked in one. And then I think this show really accurately portrays that. Like, you were saying in watching it, your heart rate is high, your blood pressure is high, you feel stressed, and you're like, God, it is a lot. It's a lot. Portia Pendleton, LCSW: I mean, when they had finally implemented the to go, oh, my gosh, and they didn't notice that they had done, like, preorder selection, and it was just, like, coming out of the machine. I was just I felt like, I mean, a good acting, good storyline sucked me in. I don't know if it's because I can, like, I have some restaurant experience, but I was just like it's like a trauma response. So some people freeze, some people flee, and other people freak out and fight. Whoa. Dr. Katrina Furey, MD: Interesting to see everyone's individual response. And carmi just freaked. Like, it was almost I felt like his explosion of pent up emotion. Right. I feel like his sister Sugar had been saying, you're not expressing things. And he wasn't really he was really holding it in, and then it just all exploded. Like, he couldn't take it anymore. I was really proud of Sydney and Marcus for walking away and being like, we don't tolerate know I didn't see that coming, but I was really proud of them for doing that. Portia Pendleton, LCSW: And I think what I thought was interesting was when we see Carme working at that Michelin star restaurant, and he's being right, like, verbally berated saying all these horrible things to him. I thought it was so interesting because Sydney and, like, have a similar experience with working at higher end places. They know, yes, chef. Behind you, chef, all that stuff. So Sydney, in one of the later episodes when she is accidentally a stabs richie in the behind. But also, you see her absolutely berating him. Right. She's like, you're a loser, your kid, your partner. And I think for her, that almost felt like she was so horrified, almost, that that's how she had become in this place. Right. Because her and Carmen talked about how horrible that was, and then she did it, and it's like, place brought it out of her. Right. Dr. Katrina Furey, MD: It's like the abuse becomes the abuser, which we see. I'm thinking more along the lines of children who grew up in abusive environments and then sort of take on those behaviors in adulthood. It's reminding me of that. Yeah. And I feel like she couldn't it was really sad. And when she was sitting there at the lockers, and he was like, are you okay, chef? And she's just like, no. And it's like, no, you're not. You're right. And she has to walk away. And I think you're right. I think it was a combo of Carmen berating her, but then her doing that too. Portia Pendleton, LCSW: Right. And losing it, and right. They are these experts, and she's holding the knife right out. No intention right. Dr. Katrina Furey, MD: Of like yeah. Portia Pendleton, LCSW: First she's waving around, but then she's pointing it out, and he just, like, turns like, you don't ever walk with a knife pointing out. That stuff can happen. Dr. Katrina Furey, MD: Exactly. Right. Portia Pendleton, LCSW: And you can stab someone in the a fatty tissue place where it's, like, less right, right. Whoa. Dr. Katrina Furey, MD: I know. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: And so, again, it's just like, how did all that come to be? Was it, like, stress? Was it trauma? Probably a mix of everything. Also, like, Richie I don't like him. There have been very few characters so far in all the shows and movies we've watched, which is quite a bit by now, where I really don't like them. Like, the whole time I'm watching it, I'm trying to find something redeeming. And since I did see the first. Portia Pendleton, LCSW: Ten minutes of the final episode of. Dr. Katrina Furey, MD: Season two, and I see what role he assumes and he's behaving a little differently, spoiler alert. It's not much of a spoiler, but still, I kept trying to find something redeeming about him, and I had a really hard time. What about you? Portia Pendleton, LCSW: I think that I really did not like him until the last episode, and I wouldn't even say I like him. I feel like I just have empathy for him. I feel sorry for him. Dr. Katrina Furey, MD: Why? That's where I struggled. Portia Pendleton, LCSW: I feel like he is so broken. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: And I want to know nothing story. Maybe we learn it because they said in season two read an article that was like, season two gets right with the only thing that season one got wrong, which is like, there was no backstories for anyone. We didn't know anything about anyone. And so I'm wondering if we get his because I'd be so curious. Dr. Katrina Furey, MD: It just seems like he's. Portia Pendleton, LCSW: And why he was really hearing what Sydney was saying when she's calling him a loser. Dr. Katrina Furey, MD: I feel like he feels like he's. Portia Pendleton, LCSW: A loser, and he's a loser in every way. And then he talks about his daughter saying to his ex or her mom, right. Like, he's bad news, Richie or something. Dr. Katrina Furey, MD: I just feel like that's more. Portia Pendleton, LCSW: I feel bad. I don't like him. I don't want to be his friend by any means. I don't want him to be around him. But I just feel sorry for yeah. Yeah. Dr. Katrina Furey, MD: I kept wanting to feel sorry for him and trying to access that empathy, but I had a really hard time. And again, I hear what you're like. It seems like before Mikey died by suicide, richie was, like, the head guy, like, maybe the manager, or like, he was, like, running the show. And then I think to have Carme and Sydney come in, like, out of Sydney, a younger girl, a younger black girl, which, again, maybe that's not intentionally getting under Richie's skin, but maybe it is. We don't really know yet. But again, I could see how that would threaten his ego, because this is. Portia Pendleton, LCSW: All that he has. And then he kind of says that at the end, right when Carmen picks him up from the jail, which I thought was really interesting. And this is a little bit of a sidebar, but I think it's so risky, little PSA, to ever be in a fight with someone that's physical, because we all talk. Oh, someone says something to you. Everyone's drunk in a bar. A bar fight, right? Someone gets punched in the face. It doesn't seem crazy, but it's like the wrong hit you could fall. You hit your head, you can die. And it's like now it's literally manslaughter. And it's like things can escalate so quickly where it's like it's not just like right, a punch in the schnaws or getting pushed. Dr. Katrina Furey, MD: It's like hitting your head wrong on the curb. Portia Pendleton, LCSW: Yes. I'll never forget and I'm going to talk very loose circumstances here, but witnessing someone hit someone and they fell and they hit their head on the curb, that's scary. They got up. But I know another instance that I did not witness but happened at my college. Dr. Katrina Furey, MD: Even like if you're super intoxicated and you fall the wrong way right. You could die. Portia Pendleton, LCSW: Yeah, it's really know. And I don't know if it's just like I respected and this is such a stretch. I respected Richie for completely owning that he was the one that did he there was, you know, because it was messy. Right. Everyone's pushing, pushing. And there was no question he was going to take the and I think that's also when he comes out, he's like, no, this is all I have. I would do anything for you. It seems like they connect. I'm curious to see in season two how that plays out. I'm hoping that that's like a change then for Richie. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: But up until that episode, I was so irritated with him. He just kept messing everything over and over. Dr. Katrina Furey, MD: That's what I mean. And I do think that's like the perfect depiction. And I'm like I am really curious. And I hope we do learn more about his backstory because I wouldn't be surprised if he had, like if I'm making it up. Really critical parents, like one parent who's really critical, one who's absent, whether it's because of substance abuse or like a father left or something like that, that's setting him up to never feel good enough. So he's going to keep trying, keep trying. And then he just gets to the point where it's still never good enough and he starts getting in his own way. Portia Pendleton, LCSW: Right? Dr. Katrina Furey, MD: Like he just kept messing up. Yes. Like when they did the kid's birthday party and he doesn't bring the ketchup. Right. His Xanax. Portia Pendleton, LCSW: Oh my God. Dr. Katrina Furey, MD: And the drink and all the kids pass out and no one calls the ambulance. Portia Pendleton, LCSW: I was like, waiting for your take on that. I was just like, dying. Dr. Katrina Furey, MD: When they just show, all the kids. Portia Pendleton, LCSW: Pass and the guy right? They're like mobster uncle is like, well, this is preferable, to be honest. Because he's like annoyed, right? Kids suck. Kids are annoyed. Dr. Katrina Furey, MD: Kids are annoyed. At least they're quiet. Portia Pendleton, LCSW: But I was like, are they breathing? Dr. Katrina Furey, MD: Has anyone put their fingers under their nose to see? Portia Pendleton, LCSW: Is their breath? Dr. Katrina Furey, MD: Oh my God, I can't believe no one called the police or the is. Portia Pendleton, LCSW: Such a bare minimum, and you're going to be like, you're crazy. But I was kind of pleasantly surprised that Carmen told him. Right? I feel like, it could have been like, oh, because you could literally go to jail for that. Again, not intentionally, but you could go to jail. Dr. Katrina Furey, MD: Maybe you should. Right? Portia Pendleton, LCSW: So the fact that he told him. Dr. Katrina Furey, MD: I was like, okay, at least have. Portia Pendleton, LCSW: A moral compass in there. Dr. Katrina Furey, MD: Get somewhere in there, I guess. Yeah, but then no one does anything. Portia Pendleton, LCSW: But I was thinking would have been in there, right? Let's talk about that. Because it looks like it was one bottle. So were they like, bars? Dr. Katrina Furey, MD: That's how Xanax comes, right? I don't remember what the dose was. So Xanax is the trade name for Elprazolam, which is a very short acting benzodiazepine. Incredibly addictive, right? That's why most people don't prescribe it, hopefully, except in very specific circumstances, like flight phobia or something like that, where you only need a little relief for a little bit of time. Portia Pendleton, LCSW: You're not getting prescriptions every month for it. It's like you're getting ideally, right? Like, once a year should be enough. I think providers feel comfortable with that. Dr. Katrina Furey, MD: Depending on the situation. I think, unfortunately, it is really abusable. And the reason it's so abusable is because it is so short acting. So it hits your system really quickly, like, within 30 minutes or so, you feel so good, you feel a lot calmer, but then it's out of your system really quickly, too. So then you're like, oh, I need more, I need more. And thus starts the cycle of dependency and addiction. And again, I specifically use those words because there's a difference, right? You can become physically dependent on a medication like this. Like, your brain gets used to it. If you don't have it, you develop withdrawal symptoms. You need more. You can have that without perhaps being addicted. But again, they kind of go hand in hand, I guess. But with addiction, you also think of it as like, okay, then you start doing riskier things to obtain it, right? Like, you might start stealing, or you might start obtaining it illicitly, like, on the street, or you might be spending a whole lot of time trying to find it at the expense of work or spending time with your family. There's a lot of criteria that go into addiction, but you can also be physically dependent on I mean, that is like, one of the main criteria, too. Portia Pendleton, LCSW: And I believe right. You can die from the withdrawals from. Dr. Katrina Furey, MD: A benzo 100% class. Yes. Benzos act on the GABA receptors in the brain, very similar to alcohol. So it's also incredibly dangerous to mix benzos with alcohol. When you're intoxicated with both, what can be fatal is the respiratory depression. Basically, you start breathing so slowly that you could stop breathing. And that's what I was worried about with these kids, just, like, sleeping. I was like, is anyone making sure they're breathing and they're getting enough oxygen to their brains? Like, these little kids getting whatever the adult dose is. I mean, it looks like the whole bottle got in there somehow. Who knows how much is in there was so dangerous. And then if you are addicted or physically dependent on alcohol or benzos and you just try to quit cold turkey, that's also potentially fatal because you can develop seizures and cardiac instability. So, like, really high blood pressure, really high heart rates, you could have a stroke, you could die. So it's really dangerous. I was very uncomfortable with that whole. Portia Pendleton, LCSW: Like, you need a medical detox, right, versus, like opiates. It's a horrible detox, but you can stop. You won't be very sick, you won't die. But a couple of kids, and I say kids because they were under 18, who I worked with in a residential program, if they were abusing benzos, they would still be on them, right? So they would come in and they'd receive a lower and a lower dose versus some of the kids who were on opiates, they would be very sick or they would have been in a very fast detox like in the hospital. Dr. Katrina Furey, MD: Yeah, I did a lot of detoxing when I worked at the VA in residency, and I did a lot of time in the emergency room there. So that was like one of the main things we saw. And you're totally right that alcohol or benzodiazepine detox is medically necessary. Like you could die. And that was like one of the hardest conversations to have with patients when they would get to day two. And of course they're waiting for a bed because we don't have enough access to treatment in the whole country. We've already talked about this. But by day two, they're starting to feel cravings. They want to get out of there and we have to have the discussion like you're just starting the detox. We still don't know which way it's going to go. There's like risk factors and algorithms we can keep in mind to help predict it, but we just don't really know. You could get delirium tremons, which is potentially fatal. I mean, it's really scary and a lot of times they would leave against medical advice and probably start drinking again, which is very sad. But then in other ways you're like, well, I guess it mitigates the risk of death from an unsupervised detox, but it's really risky. But you're right. With opiate withdrawal, that's where the phrase cold turkey comes from. It feels like the worst flu of your life. It's incredibly painful to go through, but it's not medically dangerous. So in either way, like with benzo or alcohol withdrawal, we do taper using the benzos. And then you can also give other medications to help with other symptoms to help make people more comfortable. And then with opiate withdrawal, some places will start, like Suboxone once you're a couple of days out to make sure there's enough out of your system where it doesn't plunge you into a worse type of withdrawal. But then you also give other agents to help make people feel more comfortable. So that too, it's like ideal if you can do a medical detox, but not medically dangerous if you're just trying to quit, like, on your own. Portia Pendleton, LCSW: Yeah. Circling back now to restaurant employees right. Often not having insurance. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: And being or I think, too, what's interesting now is with a lot of credit card tips right. That is on the books versus cash tips. So it's like they pay taxes on right. So you could be, I think, right on the line with, like, you don't make a ton, but you also don't qualify for Medicaid or full Medicaid. So I just think there's a lot of people that are underinsured or not insured who specifically work in this field of know with with sometimes raging substance use issues and mental health issues. It's just like a perfect storm. Dr. Katrina Furey, MD: Yeah. And I mean, most detoxes would be at least five days. So when you're imagining, like, in restaurants, you often do, I think, live day to day in terms of your income. It's not predictable. You're not going to have short term leave or things like that. It's really hard to think, like, I'm going to take five days away and somehow pay for this treatment and make up for not and then come back. The same environment. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: It's really tough. Portia Pendleton, LCSW: Yeah. I was just thinking about Mikey in that and just like, it seemed like he was struggling for a while with opiate abuse, and some people knew, some people didn't. And that was kind of really eating at Carme for not knowing. Dr. Katrina Furey, MD: Yeah. So what did you think about Mikey's story and then this show's depiction of addiction and grief and people reacting to someone's suicide. Portia Pendleton, LCSW: I thought it was good. I thought it did a good job of showing multiple reactions and responses, which I think hits the nail on the head with everyone will respond differently. I think if we look at it in kind of a black and white way, like, some people shut down, other people have really big reactions immediately. So it's like right. Someone if you're picturing at a funeral, which is kind of morbid, there's people who are, like, wailing and visibly upset for weeks. Tanya from Lettuce. Yes. And then there's people who are just totally shut down right. Haven't cried at all. And that doesn't mean that they're not processing it or grieving, but I'd say because they might be doing it at home. But if you're not doing it at all, I think then sometimes there's a bigger reaction that comes out later, which we see with Carmen kind of starting to lose it or some of his other symptoms, which I was curious to get your take on with some of the nightmare being sleepwalking. Right. And in his apartment earlier on, it seems like he's having a horrible time sleeping, which isn't helping any of his symptoms. And then at the end, we see, right. Him kind of what appears to be maybe he's, like, dissociating when he tries to light a cigarette and then the whole stove catches on fire. Two different things, I feel, like, all around fire, too. Dr. Katrina Furey, MD: Yeah, I mean, I think you're totally right. Portia this show, I thought, again, another expert portrayal of grief, and I think the complicated grief that comes from losing someone to suicide, of all things. Like, just how many questions are know Carmen? No one saw a note until the very end, and it's still in my mind. It's like, Was that a suicide note? I think so. Portia Pendleton, LCSW: I think it was meant to be, but it wasn't, like, by the know, maybe not by Mikey, but it just. Dr. Katrina Furey, MD: Wasn'T it wasn't clear. And I think in the know, it sounds like Mikey and Carmee, they were brothers, right? They sort of bonded over cooking. And then Mikey goes on to open the Bear, but then won't let him. Portia Pendleton, LCSW: Eat the beef store. Dr. Katrina Furey, MD: Sorry, the beef, but then won't let Carmen work in it. And that created a really big rift in them. And I think we still don't really understand why he wouldn't let him in. I started wondering, was there some connection to organized crime? It seemed like Richie maybe had a connection. And those feuding groups on the corner that Sydney placated with the sandwiches and even, like, the Uncle Jimmy, I was like, Is he a like, is that why Carmen wasn't he was trying to keep him away? Or was there something like, is that how Mikey got introduced to Opiates? There were a lot of questions for me, but then that was, like, a real wedge in their relationship. And it sounds like in the very last episode with Carmen's Monologue at Al Anon, first of all, how moving was. But then we finally start learning some of this backstory, and it sounds like that almost, like, fueled Carmen's desire to show, like, just achieve know, really escalate to the best of the best, to be like, you're lost, dude, and then gosh, how complicated and confusing for carme to lose your brother in that way. And then learn that he left the restaurant, that he'd never let you work into you, and you have to leave your position at this best restaurant in the world to come here. Like, Whoa. Portia Pendleton, LCSW: And also was and maybe it didn't feel like a choice, but that was his choice, that a lot of people were like, what are you like, you didn't need to come back. I think Richie was upset that he was coming back and taking over. I think the staff initially were all. Dr. Katrina Furey, MD: Upset that he was, because it seemed like the like, Tina Ibrahim, like, all the staff, it seems like, had been there for that. They forever, right? And then all of a sudden, you have Carme coming in out of nowhere again, this white guy. A lot of the staff. Were people of color. And then he hires Sydney, this young girl, and they're like cleaning everything up, operationalizing things. And I could imagine and we see how the old crew reacted and we're like about it. Yeah, exactly. But then eventually they do warm up to it. And I did think at the beginning, Carme was really respectful in terms of saying, we call each other chef. We have high standards. This is what you need to do well. And at first, they weren't really believing it. Like the family dinners I thought were so I never had that at the. Portia Pendleton, LCSW: Restaurant I worked at. Right. I was like, Where did this come from? Dr. Katrina Furey, MD: This is really nice. We all have dinner before it's. Like, that's really nice. I think eventually it did help them sort of get on board. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: But it took a while, especially with Tina. Portia Pendleton, LCSW: And know, it seemed like Tina kind of bought know after a little bit with Carmee, but then it was really like an interesting dynamic watching her and Sydney, and then Tina pretending not to speak English, like, here and there. And Sydney's like, I know you can you just were doing it and calling. Dr. Katrina Furey, MD: Carme Jeff instead of Chef. Just all these slight jabs. I can't remember what it was that finally got her to come around, but eventually she did with Sydney. Portia Pendleton, LCSW: It was something with the potatoes, right? So, like, Tina didn't burned something or something and then Sydney already had it going, but didn't criticize. Tina was like, just get it over with, do it. And Sydney was like, no, it's fine. And then she complimented her later. And then I think Tina was like, okay, we're good. Dr. Katrina Furey, MD: Yeah. Sydney kind of like, helped her out instead of rubbing her nose in it. But getting back to, I think what you originally asked me about grief, I also thought it was interesting that I was like, is there a gender dynamic here? Because his sister seems to be more openly grieving or at least talking about the death. She's like, trying to get him to go to Al Anon, which to me suggests she's going to Al Anon and then Carmi is really closed. And I I think you could say that might be a more stereotypical man reaction. Portia Pendleton, LCSW: I'm sure it depends on generalizing, super. Dr. Katrina Furey, MD: Generalizing, like, depends on different families structures and dynamics and stuff like that. But I think what is that old phrase? What is it we talk about a lot with trauma? Like what you won't remember eventually comes out or something. What you try to avoid thinking about eventually comes out, whether you like it or not. Death of anyone can be very traumatic, but I think a suicide in particular is very traumatic for all the people involved. And it sounds like in Mikey's case, it's like, was it planned or was it impulsive? Right? Like, was he intoxicated and had a mean it's not really clear until we find the note, right? Portia Pendleton, LCSW: I don't know. Dr. Katrina Furey, MD: What did you think? Portia Pendleton, LCSW: I think it was unclear. I mean, I think I could go on the one hand with him stashing the money for so long. Was he planning on ending his life for that time, or was that just like a side project of him? Just like, stashing all this money away to avoid taxes? To avoid taxes or in the end to give to Carme? I don't know. Was his plan like, okay, Carme is going to be this amazing chef, and then we're ready for him, we're going to have all this money? Or was it like, I know I'm going to die? I don't know. Dr. Katrina Furey, MD: It's a weird spot to leave a suicide note, right? Usually I feel like if someone does leave a note, it's with the body, like it's nearby. Portia Pendleton, LCSW: Do you think it was maybe, though, supposed to be in a locker and fell out? Like, maybe, like, Carmen's locker from years ago? Because that was my question. Why was it behind lockers, the lockers on the floor? Had it fallen somewhere? Was it supposed to not be there? I don't know. Did he mean to bring it with? Dr. Katrina Furey, MD: That's what I mean. Portia Pendleton, LCSW: How could anyone find that? Someone could have easily thrown it away, could have easily gotten damaged by water or something. It just was so risky. And also right. If you're leaving someone, like, $300,000, you want that to get to them. So that was just strange. Dr. Katrina Furey, MD: It was strange. Portia Pendleton, LCSW: Why do you think Richie put it back? Dr. Katrina Furey, MD: I think at that time, when he first found it, he was still really mad at Carmen for coming in. In this season, we really see how the landscape of Chicago, the landscape of their neighborhood, the landscape of the restaurant itself is changing. Portia Pendleton, LCSW: Gentrified. Dr. Katrina Furey, MD: Yes, exactly. And I think Richie's like having an identity cris and not on board, and I think he was just at that time, really mad at Carmen, didn't want to help him along. Portia Pendleton, LCSW: I guess this is where my little thread of empathy comes out. It's like he could have thrown it out. Dr. Katrina Furey, MD: That's very true. Why did he put it back? Portia Pendleton, LCSW: Put it back. Dr. Katrina Furey, MD: That's actually a nice point, Portia. Portia Pendleton, LCSW: I don't and there's million different reasons why, but I'm thinking maybe it was because not right for Carmen. But he couldn't do that to not. He's he wasn't just being this huge. Ahole. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: There was just something in there. I don't think it was he was looking out for Carmen. He didn't think Carmen was ready. Dr. Katrina Furey, MD: I don't know. Portia Pendleton, LCSW: Maybe. But there was something. Dr. Katrina Furey, MD: You're so right. He could have thrown it. Oh, okay. Now I'm feeling something for him. Portia Pendleton, LCSW: You're right. Dr. Katrina Furey, MD: Like, he definitely could have, and he didn't. Portia Pendleton, LCSW: Just interesting. Dr. Katrina Furey, MD: Yeah. That's really making me think. Really making me think. Portia Pendleton, LCSW: So we know from past episodes how important sleep is, right. And how the lack of sleep can literally bring someone right to have some psychosis. Dr. Katrina Furey, MD: Yeah, and mania like sleep is the biggest trigger of a manic episode. Psychotic episodes, for sure. I've seen a lot of first breaks in college. Students who were flying internationally didn't sleep on the plane. That's what brought it out, finally, which. Portia Pendleton, LCSW: Is what you said, that I am good because I went to Europe and I was up for like 48 hours and I'm fine. I was like, that's a really good sign. You don't bipolar disorder in Portia winning in some ways here, but also in. Dr. Katrina Furey, MD: The restaurant industry, like other industries, too, like if you're working third shift or other things like that, it is so disruptive to your sleep. And I think the high energy, fast paced environment of restaurants makes it really hard, even when you get home to fall asleep. I think that is why so many have a drink after work or take another substance like Xanax to try to calm their brain down. Portia Pendleton, LCSW: It's also so bright in the kitchen. You know what I mean? It has to be, but the lights are so fluorescent. It's so bright and shiny in a cleaner restaurant. I was impressed at how much they were cleaning. Dr. Katrina Furey, MD: I was very happy. I think, again, that's, like, where Carme comes in and is like, this is unacceptable, even if we're like a sandwich, like, let's have high standards for ourself. And I thought, that's a nice way to live as long as the standards aren't impossibly high. But I think it does. And we saw that it did lead to feelings of self efficacy and pride in your work. But yeah, certainly you hope all the restaurants are that clean. I sort of doubt they all are. Portia Pendleton, LCSW: I think it's so funny, like, being kind of near New York and going and right. And seeing the know, just kind of how they showed in Chicago, because they don't do that in the like I'm sure there's, like, a public health infected, but they don't have that in the. Dr. Katrina Furey, MD: Window, which I just think is so, like and it was interesting, like, when they didn't get a good grade, and he's, like, blaming Richie, but then it turns out it was his fault. That's like another time where he was sort of like kind of I did, I think at least in the initial time where he was setting his apartment on fire, they both felt dissociative to me. And I think that's part of his trauma response. Portia Pendleton, LCSW: Right? Dr. Katrina Furey, MD: Just like trying to keep putting 1ft in front of the other, but you're not processing what you're feeling, and it will inevitably come out and sort of that's how it was coming out at the end with the fire in the kitchen. At first I thought, is he going to intentionally let the restaurant burn down and be like, okay, now it takes care of it. But then everyone sort of grabbed the fire extinguisher and took care of it. Portia Pendleton, LCSW: Yeah, that was an intense scene. So, like with Mikey's suicide, I think we kind of talked a little bit around the edges here. But suicide, I would consider is like a complicated loss, right? So there's some losses that are really uncomplicated. Like losing a grandparent in a natural way, right? It's like it's sad and can be really life shattering, but it's expected. It's like the natural way of life. And those losses are typically more easy to process, just like as a human. But then these complicated losses, like losing a child as a parent or losing a parent when you really suicide exactly. Or really unexpected deaths are complicated. And it doesn't mean that this is way harder or it's a much bigger loss, but it's just a different loss. And I think it can make it harder to process. And I would really say specifically with suicide, because there are so many times that people somebody does die by suicide, the people who are left right, are often like, what did we miss? How did I not see this? How could I have stopped it? And there's so many of those lingering questions that we don't ask ourselves when again, it's like a grandparent has an attribute loss. Dr. Katrina Furey, MD: And sometimes you ask yourself those questions right. In the grieving. Like, when we think about grief, that is a common, universal human experience right. Portia Pendleton, LCSW: There'S the what stage would that be like? Bargaining. Yeah. Dr. Katrina Furey, MD: So there's Elizabeth Kubler Roth has her five stages of grief theory shock, denial, bargaining, anger, acceptance. We don't think of people as moving through those stages linearly. Like, you can feel things at the same time. You can go back and forth. But those are like, the universal emotions all humans feel. When you're grieving in the field of mental health, then we sort of think about, okay, what's like a typical grief reaction versus, like, a complicated grief reaction? And again, it's not because we're trying to have grief Olympics where one person is worse than the other. It's just grieving. A suicide is very complicated, and I think it is traumatic. I think a lot of people develop trauma reactions or even post traumatic stress disorder when these things happen. And I think you hit the nail on the head portia that it leaves so many questions and people when you're faced with an unimaginable trauma, you try to make sense of it. And a lot of times that leads you to blaming yourself. And that's where really good therapy is important. And sometimes you can find that, like in Alanon, which is the sort of what would you call it? Portia Pendleton, LCSW: It's for people who have been impacted by people with substance use. So someone who is struggling themselves currently or in the past, who goes to know that's typically for them, and then maybe their brother, their sister, their parents would go to Al Anon, right? Dr. Katrina Furey, MD: Exactly. And it can be a really healing, helpful place. And finally carme started. I was I remember, like, midway through the season when things were really stressful. He's like, I have to go. I have to go to a meeting. And then Sydney was like, you just left us here. And they finally sort of connected over it, remember? And then she was like, Chef, that's too much. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: And he's like she's like, I'm just kidding. But yeah. I think to lose anyone by suicide has got to be devastating and traumatizing and so hard to cope with. So there are resources out there. I mean, in terms, of course, your own individual therapy, but Nami, the National Alliance on Mental Illness, certainly has a lot of resources available to people who have lost loved ones by suicide. I would imagine that feels lonely, right. Hard for someone to talk to their friends about, or their family about, if they haven't gone through it. Portia Pendleton, LCSW: I think there's a lot of perceived and it might not be real or not, but like, perceived judgment from others. I know that a lot of parents who have lost teens to suicide really feel like there's a lot of judgment on them for they should have known, they should have stopped it. So I think it's really hard to reach talk to people who haven't experienced it, and what a wonderful way for a very horrible thing to occur. But if you can find a group with other shared experience, it can be so helpful and such a safe space. Right? Dr. Katrina Furey, MD: And I think it's really scary to start attending a group. Whether it's group therapy or a support group, I think it can be really scary. And that's totally normal if you're feeling like that. I always try to encourage my patients, just go sit in the back and just see, test it out. You don't have to say anything, just see what it's like. And I always say not everything's going to stick. Especially things like AA. There's a lot of resistance to it from different people. And some people don't identify with the religious aspect. There are non religious AA groups out there these days. But I always try to tell people, like, go take what works and leave the rest. You don't have to accept everything to find some healing or benefit from some of the things. But there are, I think, nami, and I'm sure, other groups out there with support groups or people who've lost loved ones to suicide. I think that's a uniquely terrible way to lose someone you love. And especially when there's substance abuse, too. It's just even murkier, right? And you could see these characters really be like, how did we not see it? Should I have done more? And it's just I think a lot of the healing and therapy comes from just exploring that with people and trying to help people not blame themselves. But it's really it is really hard. Portia Pendleton, LCSW: It's heartbreaking and it's hard. And not to deter anyone from going to see a therapist, but it's hard as a therapist to sit in that. I think grief is hard because there's no really clear treatment plan based on time, right? It's like, okay, well, we should be processing this better now. Sometimes it's shorter and other times it's so long and grief is challenging. And I know even additionally to that, a lot of clients who are a support for someone who is going through grief, it's so hard just to sit and be there because we want to make people feel better, right? We want to get people okay and feeling happy and positive and sometimes it's just not we can't do that yet and we just have to wait. Dr. Katrina Furey, MD: And that's hard. Portia Pendleton, LCSW: It is hard as a provider and it's hard as obviously a person who's not a provider. Dr. Katrina Furey, MD: And sometimes when people do die in very tragic ways, it is hard to bear witness and sit with someone in that suffering. But it's so important. And again, I think that's where it's really important for therapists to also know their own limits or have their own support system, right? We're all supporting each other. But you're right, it is really hard to bear witness to grief, I think, as we wrap up. Isn't it interesting that thus far in our podcasting journey, there have been some common themes of shows that are big hits in society and a lot of them are about like, we talked about shrinking, we talked about succession season four with Logan's death. Now we have the like I think, again, that just speaks to how grief is such a universal experience and we all can connect to that. Yeah, that's a good know. Portia Pendleton, LCSW: I think a lot of people resonate with tough topics and whether it's we're seeing it done in a comedic way or really dramatic and intense way, it's like everyone knows someone who knows someone or themselves who struggled with substance use. Everyone knows someone is someone who struggled with grief. And it's just like, again, these universal experiences that I think it can be really helpful to have a media or write some content out there that helps you cope, whether you're crying through a show or laughing through a show 100%, right? Dr. Katrina Furey, MD: It's like a way of connecting and experiencing it or feeling less alone, right. I think we're all wanting to feel like someone out there understands what we're going through. And even if it's not, or most of the time it's not the exact same experience, but these shows really let you know, like, okay, the writers, the creators, the actors, they're all doing such a good job because they know in some intimate way and then whoever's watching it can also feel understood. Even like the whale, everything, everywhere, all at once. Like everything. These themes are coming up again and again and I think these expert portrayals of it are just so great to have. Portia Pendleton, LCSW: And that's why they're nominated, right? That's why also these are successful. Dr. Katrina Furey, MD: So it's really interesting. I'm excited to see where season two. Portia Pendleton, LCSW: Leads now that you have maybe a little window into some things. I'm excited to watch it too. I'm looking forward to it. I was laughing because I started episode one, season one, and I was like, trying to get my husband to come watch it. And he was like, oh my gosh. And he has restaurant experience too. And he was just like, I don't know if I can watch this. And I was like, it's really intense. I don't know. Anyway, but thanks for listening to our episode today on The Bear, season one. We will be covering season two at some point, so stay tuned. Dr. Katrina Furey, MD: I think next month. Portia Pendleton, LCSW: Yeah, so we're excited. Make sure you follow us on Instagram for some more content at Analyze Scripts and on TikTok at Analyze Scripts podcast, and we will see you next time. Dr. Katrina Furey, MD: Bye bye. This podcast and its contents are a copyright of analyzed scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with your friends and rate review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time. Portia Pendleton, LCSW: Sam our channel.
Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are discussing "She's the Man," a 2006 film starring Amanda Bynes and Channing Tatum. Did you know this movie is based on the Shakespeare's play "Twelfth Night?" This is arguably one of Amanda Bynes' best performances. She is hilarious, captivating and witty. We discuss gender identity and sexuality at great lengths in this episode. Dr. Furey provides us with some medical facts about sex organs and we talk about where a person can fall on the gender expression spectrum. You don't want to miss this one, we hope you enjoy! Instagram Tik Tok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM five, and enjoy. Portia Pendleton, LCSW: Welcome back to another episode of Analyze Scripts. We are so excited to be covering the movie she's the man, which came out in 2006 and starred Amanda Bynes and Channing Tatum. Dr. Katrina Furey, MD: Whoa. I'd never seen this movie before. It's almost 20 years old. Isn't that crazy to think about? Portia Pendleton, LCSW: I've seen it many times. Dr. Katrina Furey, MD: That's interesting. Yeah. Portia Pendleton, LCSW: Like, loved it. One of my favorite movies from, like, teenhood. Dr. Katrina Furey, MD: Nice. I think this is, again, where I feel really old, but that's okay. So, this movie was based on a play by Shakespeare the 12th night. Right. Portia Pendleton, LCSW: So I didn't know that until I did research for this podcast episode. Dr. Katrina Furey, MD: Because we're professional. Portia Pendleton, LCSW: Yeah. Because we want to plan things out. But apparently it's based on the Shakespeare's play, and it's about even by name. Viola and her twin brother Sebastian, they're shipwrecked. They believe that each other drowned. So Viola disguises herself as a young man in order to get a job as a servant for Duke, the Duke of what is it? Or Sino. And it's, like, funny because Duke is played by Tatum. So I had no idea that there were all these references to this. Dr. Katrina Furey, MD: Right, right. And I think it's just interesting. Right. Like, a girl dressing up as a boy, how that has been in culture and society forever. Right. Really interesting to talk about this movie now, just, again, in the political climate of today and everything going on in terms of gender identity. Portia Pendleton, LCSW: Yeah. So we see. Amanda Bynes did a lot of work at this time in some other movies that I absolutely loved. One of them, she goes to, I think, like, England or something to find her long last dad, and then she's absolutely a gem. So she was 20 when this was filmed. Channing Tatum was 26, which I think. Dr. Katrina Furey, MD: Is we always kind of laugh at. Portia Pendleton, LCSW: People who play high school role. Dr. Katrina Furey, MD: Right. They were totally in high school. Yeah. And he was 26. Yeah. It was funny to see Channing Tatum as, like, a youngster and just be like, he really bulked up for magic Mike. Yeah. Portia Pendleton, LCSW: This was even pre, like, the dance movies, not magic. Step up. Step. Dr. Katrina Furey, MD: Yep. And I did find it hard to watch. I'll be Amanda Bynes, like, in her quote unquote prime, given what we sort of have seen happen to her. And again, we're not here to offer any thoughts about someone's personal mental health issues, but I think, Portia, you were pointing out that she's 20 years old in this movie, and around age 24, things started to change for her, which we do see in terms of when women tend to develop significant mental health issues. Portia Pendleton, LCSW: Yeah. And something that I learned more recently as well is that Amanda Bynes actually really lobbied to have Channing Tatum in this role. And it was his first role where he was like a main character. Dr. Katrina Furey, MD: I think I did read that somewhere. I think you recently said that or was giving an interview about that, how we really appreciated that. Portia Pendleton, LCSW: Yeah, so that was sweet. And then we have some other cast members who I thought most notably Daphne, who plays Viola, and Sebastian's mom, played by Julie Hagerty, was also the mom and wife in what about Bob? Dr. Katrina Furey, MD: And she kind of played the same kind of like a loop, stitzy, disconnected character. I thought it was really funny. The whole thread of the debutante ball is that something that happens up here in the Northeast. So growing up in the south, this is like a thing. And it seemed know, I believe, like, debutante balls back in the day were for maybe even still presently. Like, I remember a couple years ago, reese Witherspoon's daughter was like, in a debutante ball, it's supposed to be like the way high society girls are introduced to society and maybe meet a suitor. Interestingly. Just yesterday I saw a New York Times article about debutante balls or like, debutante societies, but in an African American community, I believe in Detroit or somewhere in Michigan, and how those women really appreciate the balls because it helps them find mentors. So it's interesting because I always thought it was like to find a husband, but it sounds like at least in this community, it shifted a bit to find mentors, which I thought was really positive growing up in the south. I did go to something called Catillion. Portia Pendleton, LCSW: Okay. Dr. Katrina Furey, MD: Have you heard of what that is? Which they sort of depicted, like, when Amanda Bynes'character is coming in and they're all eating on china and stuff like that. I just remember I had to wear these white gloves and learn how to handshake and how to curtsy. And we had homework assignments in between the sessions where you'd have to shake certain people's hands and they'd have to sign off and you had to learn all these fancy dances like the foxtrot. Portia Pendleton, LCSW: I mean, that's exactly what I envisioned it being. Dr. Katrina Furey, MD: Yeah, I hated it. I remember I used to pretend to have stomach aches so I wouldn't have to go. And then the final dance, you're supposed to dance with all these boys and it was like in 6th grade or something. I just hated it. So sorry. Mom, if you're listening, I just really didn't love it. But that's sort of spot on depicted, I think, in see. Portia Pendleton, LCSW: So it's kind of just the plot is that Amanda, bynes Viola's character, learns that her high school women's soccer team is being cut, but due to low. Dr. Katrina Furey, MD: Participation numbers and she is really into soccer. Portia Pendleton, LCSW: Right. We see the opening scene. They're playing on the beach. She seems like she has a good relationship with her boyfriend and her friend. He seems supportive in the moment. So they are really upset and they kind of go up to the boys soccer team and they want to play, and the coach is kind of like, laughing. Like, that's absurd. You can't do that. Dr. Katrina Furey, MD: Can't play with the boys. Portia Pendleton, LCSW: Exactly. And so girls aren't fat. Initially, it seems like they're not even going to let them try out, which, per Title IX, if there is not an alternative sport, then they have to be allowed to try out. Dr. Katrina Furey, MD: Can you explain portia for our listeners what Title IX is? Portia Pendleton, LCSW: So Title IX basically is for education systems and kind of guarantees equal treatment. And what we're seeing now is a lot of Title Nine being brought up with gender identification in sports. So basically it guarantees an equal amount of so I'll just speak to it with sports. I know that it's bigger, but it guarantees an equal amount of sports per school. So, for example, if there's six boys sports teams, there has to be six girls sport teams. If there is a 7th sports team, it has to be coed. So, for example, a lot of I'm thinking about in my high school team, like, golf was coed, and then there was like, boys and girls tennis, football, field hockey. So that's the kind of counterpart. But there has to be an equal number. Dr. Katrina Furey, MD: Okay. And I think aren't there also, like, I think at colleges and stuff now, they have like, Title IX offices, title Nine coordinators. And I think that's also maybe where you go if you've experienced like a sexual assault or there's some concern about harassment or things like that. Portia Pendleton, LCSW: Right, yeah. So it prohibited sex based discrimination in any school or education program that receives any funding from the federal government. And it started in 1972. Dr. Katrina Furey, MD: Oh, I thought it was like, recent. Portia Pendleton, LCSW: So they've made amendments to it, I'm sure, over and over since then. But that's when it started. Dr. Katrina Furey, MD: So this initial school would have been in violation of Title Nine then. Okay, good to know. I thought maybe that came about after in the past 20 years, but I guess not. Portia Pendleton, LCSW: No. Dr. Katrina Furey, MD: Okay, good to know. But so they won't let her sort of try out or play. Her boyfriend is really icky and dismissive about her feelings, so she breaks up with him. Good. And then she has this idea that she's going to dress up like her brother and impersonate him at his school for two weeks so that she can make that male soccer team and kind of beat her boyfriend's team. Yeah, it's Cornwall and Illyria Illyria, which was a funny name, but I bet those stem back to the Shakespeare play, right? Portia Pendleton, LCSW: That makes sense, I think. Dr. Katrina Furey, MD: So that makes a lot more sense. Portia Pendleton, LCSW: Because they're kind of OD. Dr. Katrina Furey, MD: So basically, that's the premise of the movie. And we see Amanda Bynes portray stereotypical gender roles and mannerisms in a comedic way. And she's always been known for her comedic timing and the slapstick nature and the physical comedy. She's always been known for that. So you definitely see that here. But what were your thoughts, Portia, about the way she sort of portrayed masculinity versus femininity? Portia Pendleton, LCSW: So I think she also let's first remind ourselves that this film was probably made in 2004, right? Came out in 2006. So some of the things that they were even just saying when she's in the shower room with Duke and she's just like, calling Brosif broski G money, a lot of those things are also just like from then. And people did say, you know, it's not that outrageous, but I thought she first of all, which we already said, she is just phenomenal at that kind of humor. And so I think ironically now, looking back, though, she in this role is bringing a lot of gender issues and questions up onto the surface in a really big way. Again, that we did not see. Dr. Katrina Furey, MD: Yeah, and again, using humor, which we think of as a mature defense mechanism to explore really complex, difficult topics, much like we talked about with our Barbie episode, but in a different way. And I'm like, was that intentional or was that like, it just happened. Portia Pendleton, LCSW: And they take it even further with you see her because they could have easily just thrown a wig and write the sideburns on and just had her wearing like a tightly fitted sports bra. But you see them like, they take the espinage and they're like binding, which is a pretty common practice if someone's trans and they are trying to have like a flat chest. You see her kind of packing like a filled sock to look like a ***** to use in her pants. And again, that's something that is used. So I thought even that could have easily been left out and I don't think anyone would have noticed. Dr. Katrina Furey, MD: Right, I totally agree. And I thought before we continue, I did just want to give a couple of definitions for our listeners because I think as we start talking about gender dynamics, sexual dynamics, trans, cisgender, like, things like that, it can be really confusing. So, again, I want to just give a couple of standard definitions. So when we use the word sex, like in the medical field, the definition of sex is a biological category based on reproductive, anatomical and genetic characteristics, generally defined as male, female and intersex. So something I hear a lot in the popular press and media is like, you're born a boy or a girl that's it. And actually, that's just not true of the human species and a lot of other species if you look into different animals and things like that. So there are several medical conditions where a child isn't born at birth with what we consider male genitalia or female genitalia. Those things can include things like Kleinfelter syndrome, turner's syndrome, and androgen Insensitivity syndrome. And these are complicated things, and we won't get into all the details, but in those different know, the anatomical chromosomal or gonadal, sex varies in some way from what we would typically call male or female genitalia. So for people who are constantly shouting, like, you're either a boy or a girl, that's just not true. Like, there are humans again, it's rare, but there are humans born who, for example, like their internal organs don't match the external genitalia or vice versa. And so, again, usually at birth, parents are kind of advised, like, you can pick the gender. Now, it might change for some of these conditions. Other times, maybe the parents just maybe especially today, like, don't pick and sort of see what the child chooses. But that can change over the course of a child's life. And sometimes people with these conditions prefer to be called intersex. I think back in the day, we used to call people with these conditions hermaphrodites. And that, I think, can have a really negative connotation attached to it. But I think that is important to just point out that not everyone is just born a boy or a girl. So that is sex. That's medical based on these factors, gender is different from that, right? So when we say gender, that refers to socially constructed roles, behaviors, activities, and attributes that a given society associates with being a woman, man, girl, or boy, as well as relationships with each other as a social construct. Gender varies from society to society and can change over time. I think that's really important that we understand that that's what gender it is. I think we see Amanda bynes'character Viola sort of display that right? And so someone's gender identity is an individual sense of being a man, woman, boy, girl, genderqueer non binary, et cetera. And this doesn't have to be visible to other people. What you see from the outside is what we call gender expression. That's how someone chooses to convey their gender identity through their behavior, clothing, or other external characteristics. And not everyone feels safe to do that. And so I just thought it was important to sort of bring up those topics and give those legitimate definitions to help us as we conceptualize this movie and the effects it's had. Portia Pendleton, LCSW: So if we also think about gender kind of being on a spectrum, I think we have either end where you are highly feminine appearing or highly masculine appearing, and then we see kind of people forever, right? Like, kind of being in the middle. Like, that would be a tom boy. So a girl who feels more masculine, maybe plays more with masculine toys. They might be more like, I'm just envisioning a little girl who has braids and overalls and is like playing in the dirt with a monster truck, like. Dr. Katrina Furey, MD: Roberta from now and then. I don't know if you saw that movie. Oh, my. Again, I'm it's so good. Portia Pendleton, LCSW: Portia but I will also add that I think it's always been way more. Dr. Katrina Furey, MD: Acceptable to be a tomboy than a. Portia Pendleton, LCSW: Girl to be more masculine presenting than for a boy to be more feminine presenting. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: So, again, we just see there's this really long range of how you present yourself. And I think what's interesting that you just kind of spoke to, though, is it's different in culture to culture, right. So if I'm thinking of, like, we also covered the movie Barbie. If we think about that Barbie feminism, it's like I'm thinking of someone who might be all the way on one of the spectrum who's wearing, like, all pink, driving a pink car and is, like, in this pink role and likes everything that's feminine. Dr. Katrina Furey, MD: But that's what that culture calls feminine. Portia Pendleton, LCSW: Exactly. And another one might be entirely different of they're all the way at that end. Femininity right. Dr. Katrina Furey, MD: And again, their inner gender identity might not be the same as what they're expressing outside their gender expression. And I think that is where, as people grow up and you start to figure out who are you, really, things can change. And speaking to that in different cultures, again, how gender is such a social construct, I was really interested to learn recently about the concept of two spirit in the Indigenous culture. So Indigenous people I didn't know this before doing a little research before this episode, have kind of always had this concept of two spirit which they sort of define as a person who identifies as having both a masculine and a feminine spirit. And this term is used by some Indigenous people to describe their sexual, gender and or spiritual identity. I thought that was just really interesting. Like, other cultures sort of have lingo to talk about these difficult concepts. And I'm sure it varies from culture to culture, too. Right. Portia Pendleton, LCSW: And even, I think as simply as like in, I don't know, I guess American culture, it's like there's some women we could think of it just as this, who don't ever want to wear a dress or a skirt, and they just feel more comfortable always wearing pants or shorts or something like that. And that's such not a big deal. But again, I'd say that is someone who's on a different place of the gender spectrum than someone else who does feel more comfortable or wants to do that because they think of it in a feminine way. So I just think it doesn't have to be that huge. Right. Which I think that's the big kind of conflicts going on. It's like we all land somewhere on it. And I think everyone would be surprised that they're probably not on the end. Dr. Katrina Furey, MD: Right, exactly. Right. Yeah, exactly. And I think like you're saying, how you define masculinity or femininity is really determined by the culture you're growing up in and how you're reacting to that. Right? Yeah. And sometimes I like that example about the dresses or the pants. Just because you like to wear pants, that doesn't mean your gender identity is male. It could not always. Like a lot of women like wearing pants too. It's different. Again, exactly. I think the way you're expressing yourself is different from your gender identity for some people. So given that example, why don't we also define what transgender means? Because that is a term that we use a lot in our American society. It is hot in politics right now. Portia Pendleton, LCSW: Also a lot with title nine, specifically in sports. Dr. Katrina Furey, MD: Yeah. That has been everywhere these past few years. So the official definition of transgender is someone who identifies with the gender other than the one that was assigned to them at birth, period. Okay, guys, that's it. It has nothing to do with your genitalia. It has nothing to do with your anatomic, chromosomal, gonadal, sex organs. That is it. It means that the gender you identify with differs from the one you were assigned at birth. There is a lot of discussion, I think, about this term because in some ways it feels outdated or there's some criticisms about it because it sort of implies that there was a point at which someone was cisgendered, which means that your inner gender identity matches the gender you assumed at birth. The word trans in some ways, some people, some critics of that word will say like, implies that you were cisgendered than you became transgendered, I think, which can be really harmful. But it does give us a language to use. So often when someone identifies as a trans man, that would be someone who perhaps or who at birth was assigned a female gender or identified female gender and finds that they identify more with being a man, a trans woman would be the opposite. And a lot of people don't like those terms. And so they might use something more broad like gender non conforming or non binary. Portia Pendleton, LCSW: So in the know, we're seeing viola by definition cross dressing. Right. So it's like she is putting on male clothes. She hasn't said anything that she's feeling like she is thinking of having an identity as a man or anything like that. So by a definition, using just like language, that's what she's doing. But in it, it expands this whole question of like well, and again, we're pretending to know her inner thoughts as viola. It's like, is she does she have some thoughts of maybe wanting to identify more with a male persona or does she feel more comfortable that way? Where does this go in the, like I think it's just really interesting because she can still know attracted to Duke, right. That has nothing to do with how you express your gender, but is know kind of throughout the end of the film exploring this, and does it feel good for her and is that something that then she might choose to do? Dr. Katrina Furey, MD: Right? And I personally don't think so. I don't think Viola is trans. I think that she had a goal in mind. She wanted to play soccer, and that is why she's doing this. It didn't seem like she was having confusion or what we might call gender dysphoria, which is a lot of distress about the gender you feel like you have to express. I didn't get that from her. I got that she just wanted to play soccer, but the whole time felt female. I think you could see that, like when she would slip back into her girl voice or these girl mannerisms and things like that. But I do agree that this film does open that up and it does show someone in adolescence exploring their gender. Now, again, what we know about people who identify as trans or non binary is that this starts really early, just like someone else walking around who identifies as cisgender and they say, like, I've always known I was a girl. These people have always known that this is where they fall. And it's even normal in toddlerhood, right, for boys to wear dresses or girls to pretend to be boys. This is normal as you're trying to figure it out. But then, typically, people who identify as trans keep wanting to if you're born of boy gender, you might want to play with dolls, you might want to dress up. That starts really early and tomboys start. Portia Pendleton, LCSW: To not be enough. Right. This is why it's a spectrum experience. Exactly. So it's like you're kind of portraying a little bit more of a masculine expression and then that's not enough. Right. And you still are having kind of this gender dysphoria. You still feel distress, and then you kind of keep following along the spectrum until you land somewhere that feels good. Sometimes that is with surgery, and other times it's not. Dr. Katrina Furey, MD: Right? And I think it's really important that we also talk about that. These are real things, right? And this type of dysphoria that stems from a mismatch between your inner gender identity and the outer gender expression you've sort of been raised to abide by or is socially acceptable, is really significant. And it's been around forever. Like, this is just a thing. This is real. This has happened. And what we know is that trans youth and trans adults have significantly higher rates of mental health conditions, substance abuse conditions, and suicide compared to people who identify as cisgender. And I think that's really important that we talk about that because studies have shown that 40% 40%, that's almost half of transgender adults have attempted suicide in their lifetime, not just thought about it, but tried it, and that 30% of transgender youth have attempted suicide in the past year, that's huge. Those rates are so significantly higher for any other mental health condition that I can think of. And add to that if these transgender youth, for example, also, I mean, being transgender, you already are facing a lot of stress from being a minority, like in that way. But if you add other intersectional identities to this in terms of race, socioeconomic status, religion, family structure, poverty, like things like that, your rates just go up and up and up and up. And what we have found is that by providing gender affirming care, which again is a spectrum, right, it runs all the way from gender affirming psychotherapy to explore your feelings, to hormonal treatment and puberty, which again can be reversed. There's this big fear like, oh no, we're going to do something that is permanent and we can never fix it. The hormonal therapies basically stop puberty from happening. And so it gives a child who's experiencing this the chance to sit with it and really figure it out. And there are so many guidelines that you have to wait a certain amount of time. Someone has to live in their well, I think that's actually for surgery, but there's a lot of guidelines before you just do that, before you stop puberty. But then if this person sort of changes their mind down the road, which is incredibly rare, but does happen, it is easy to reverse and then sort of start puberty in the gender you were assigned at birth anyway, all the way to gender confirming surgeries, which, again, a lot of rules around qualifying for surgeries like that, at least in our state. You have to live in your gender identity for at least a year. You have to express that outwardly. And then you also have to have psychiatric evaluations and be cleared from a psychiatric standpoint by more than one physician. There's a lot of hoops you have to jump through. And what are your thoughts about that, Portia? Do you think that's helpful or do you think that is kind of further stigmatizing or a barrier? Portia Pendleton, LCSW: I think it really depends on the like I think it can be, I think I guess I'd say as a whole, I don't know. I think it can go either way. I think there's positive experiences where it's just like it is catching people, making a secure choice in something that they've always known. But surgery has risks and I think it's just to really prepare you for that. I guess we're kind of going, I'm going to bring up something totally different. But it's like if an 18 year old female would want to have their tubes tied, right? It's like if a 30 year old is coming to you and want to have their tubes tied, sure be done. But it's like, okay, we need to give you information. Do you know, because I'm actually unsure of permanent for the most part. Dr. Katrina Furey, MD: I think there's some that you can. Portia Pendleton, LCSW: Reverse, but yeah, some more permanent options. I think it's just important to educate, write the risks, if this is something that you really want to. So it's thoughtful and I think most of the time, again, it is like it's been years and decades of wanting or not feeling comfortable in the gender you were assigned at birth. So I guess, I don't know. I think in some cases it can be useful just to prepare yourself for a very significant surgery. Dr. Katrina Furey, MD: Just like any surgery, huge change. Portia Pendleton, LCSW: Right. But I also do think there's absolutely aspects of it that can be super harmful. Like really navigating it with insurance, which I think if you are paying privately, I think it's a much quicker process. Right, so I think that's true. That's always just like something to throw in there, right? Dr. Katrina Furey, MD: True, very true. And also, I think we know that people who identify as trans face so much stigma and violence. Like trans youth, trans adults are so much more likely to be victims of physical violence, assault, murder, things like that, than cisgender people. Portia Pendleton, LCSW: Especially when they are presenting a gender and they're not passing. Right. That's the highest risk time for them. So you're asking them to stay in the year. Right. Dr. Katrina Furey, MD: That's the part where I'm like, oh, on the one hand, I get it. It's like you want to make sure you're sure. On the other hand, it really increases I think I don't know this for sure. I don't have the data to back it up, but I worry that it increases their risk of harm coming to them. And there is something just so stigmatizing about the system being like, well, you. Portia Pendleton, LCSW: Have to really make sure that you're sure before we help you and offer. Dr. Katrina Furey, MD: You this care that's been shown to significantly decrease your risk of suicide. Again, I don't pretend to know all the answers or have a better system option in my mind, but I just think these are really complicated issues. And coming back to the movie, she's the man, we see her kind of dealing with that as she's trying to pass. Portia, can you define what passing means for our listeners? Portia Pendleton, LCSW: Sure. So if somebody's passing, that means they appear, I'd say, I don't know, to 99% of people the gender that they're intending to pass as. So if somebody is making a transition from male to female, they look like a female. Like, you would never question it. And I also would just ask people to know that there's a lot of people that you don't know who are 100% passing and you're feeling safe with them. So it's like the people who are not passing yet who are coming in. And I'm thinking this is the big issue to a bathroom where you're still kind of looking like a guy, but you're dressed as. A female. That's where people get really scared and it feels but again, that's where the danger comes for them. Dr. Katrina Furey, MD: Not 100% you. Portia Pendleton, LCSW: That's just what the data says. Dr. Katrina Furey, MD: And again, the data says that people who identify as trans are not sexual deviants or aggressors or pedophiles or things like that. That's just not true. That's like an really unfortunate stigma and bias that just keeps getting perpetuated and. Portia Pendleton, LCSW: All the way know. I think we've seen we see this date back centuries is like people performing, right? Like drag queens are going to shows where people are cross dressing like Shakespeare around forever. The idea that it is this harmful, right? Sexual deviant going to corrupt children is. Dr. Katrina Furey, MD: Like this new thing ridiculous, right? And again, we see this in other animals too. I can't think of anything off the top of my head, but I do remember in college, in my animal behavior class with Professor Wasserman, learning about different species where the women would pretend to be men to protect their young and vice versa. So we see this in other species. We've seen this in humanity dating back centuries, like forever. This is just a thing. Portia Pendleton, LCSW: Yes. So you brought up you before, right? Or was that in another so so getting back to she's the man worth noting that we see Malcolm, who's just kind of like this annoying guy, right, who's trying to figure out what's happening with Viola and Sebastian, like expose her. He is stalking Olivia. Like, he has pillows with her face. Dr. Katrina Furey, MD: Creepy. Portia Pendleton, LCSW: He's always trying to talk to her. And I was just just just also keeping in mind, like, yeah, that seems silly in the movie, but it's not. Right. Stalking is the opposite of funny. It's the most terrifying experience. Per again, all the data to go through. So it's just like Malcolm is you're. Gross. Yeah, we don't like you. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: But a little bit of stalking we see in this movie and then we see right. Dr. Katrina Furey, MD: Olivia too. Portia Pendleton, LCSW: So Olivia, initially we're introduced to her because Duke really likes her. And then she develops feelings for Sebastian. Sebastian played by Viola. Right. I thought that is so interesting for Olivia. Like, how does she feel knowing that she wanted to kiss and was really into a girl playing a guy, right. And then she ends up being with the real Sebastian. Dr. Katrina Furey, MD: I know. Portia Pendleton, LCSW: So I'm just curious about like that was just interesting. Dr. Katrina Furey, MD: And I think that brings up a great point, again, Portia, that there is a difference between your gender identity and your sexual identity. Right? So we've talked about gender identity. Your sexual identity is who you feel attracted to. And that is under the umbrella of things like heterosexual, homosexual, bisexual, asexual and again, I was like, is this movie a little homophobic? Like Amanda or Viola when she's playing Sebastian, wouldn't kiss the girls and stuff. Maybe she doesn't want to. Right. But I also thought it sort of did play off of that like you're saying. And it was interesting that it seemed like Olivia was attracted to the feminine aspects of Viola playing Sebastian's character, right. Portia Pendleton, LCSW: And not Duke, who presenting to outside people, is not that sensitive guy, but he is closed doors to other guys, right. Dr. Katrina Furey, MD: So, again, it explores these themes of gender, sexuality, and just how you kind of express yourself and move through the world in a really interesting way. But again, if you are a trans person, that doesn't mean you are homosexual or bisexual. And so that is something important to keep in mind that you can be a trans man and still be attracted. Portia Pendleton, LCSW: To whoever you are attracted to. Dr. Katrina Furey, MD: They're not like mutually exclusive, one doesn't lead to the other or anything like that. Portia Pendleton, LCSW: And we see Amanda Bynes really come to life when she is at the carnival and performing the rapid gender changes, code switching in how she's talking and how she's walking. And it's just a being a good actor. And also I think it's part of the humor that they pulled from the play. Yes, the play. I think it's like carnivally. It's silly. It's again, it's supposed to give that gender ambiguity which I think is just interesting. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: Shakespeare's from a long time ago. Dr. Katrina Furey, MD: And can you again define code switching for our listeners? Portia Pendleton, LCSW: So we also talk about code switching with people. Describe it as going to different groups of people. Right? So you might have a way that you speak at home and then when you're in a certain environment, like maybe work or like a classroom, you become kind of different. And you say words differently, you use different words, you carry yourself differently. I think I was more thinking of it or I've been aware of it more from black Americans kind of identifying their experience with being home and then being in a colleges are historically white places. So kind of having to adopt a white code when going to them to appear, right. Like the norm, which is like professional. You can be an educated black person in your home code, but in order to be perceived as educated in some of these other environments, you need to adopt the bigger code all the way. Dr. Katrina Furey, MD: From what you wear to the way you do your hair to do you have tattoos or not, like all of those things. Portia Pendleton, LCSW: So we see in the movie where I don't want to say it necessarily gets wrong. I just think it's like the times and it's not them continuing to educate the masses, but right when they identify their gender by showing their body parts at the end. So it's like we see Sebastian pull his pants down. Which also that's I feel like we don't get arrested. Dr. Katrina Furey, MD: It's indecent exposure. Portia Pendleton, LCSW: And everyone's like, oh. And then they're all kind of joking because seemingly he has a large *****. Right? Dr. Katrina Furey, MD: It seems like. Portia Pendleton, LCSW: And then we see Viola later on lift up her shirt to prove she's a girl. Dr. Katrina Furey, MD: So, again, even in the movie, they're mixing know, anatomical sex parts and your gender. I also thought the principal just like, calling out this issue in front of everyone. Weird stopping the game. There's title nine violations all over the place here, and that's just like, not the way you do it. Portia Pendleton, LCSW: He's also just like a weirdo. Dr. Katrina Furey, MD: Remember when he's like, over identifying and assuming that Viola as Sebastian's experience is the same as his? Yeah, kind of crazy. Portia Pendleton, LCSW: Did you recognize him? Dr. Katrina Furey, MD: No, I did. Portia Pendleton, LCSW: He's in a lot of things, actually, when I clicked on his name. But I think I recognized him from Men in Black. He's in the first movie, I believe. And I used to really like that movie and I watched it a lot. Dr. Katrina Furey, MD: But I was like, how do I know this guy? Probably from then. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: So, yeah, in general, I thought I wasn't expecting all of this. Like, when you said we should cover this movie, I was, huh. Okay, amanda bynes cool. It's a throwback. All right. But it really did bring up a lot of big themes about gender identity, sexual identity, girl versus boy. Why do we divide sports all the time? Just like all of these sort of gender archetypes really brought it out. And again, thinking that this movie is 20 years old, it's really interesting, again, that so many of these themes are still something we're trying to sort through in our culture today. Portia Pendleton, LCSW: And really, I think it was just kind of dismissed probably as like a teen movie. But I think The Band of Buys, she was excellent in it, I think, based on the Shakespeare, twelveTH Night was excellent. I think I'm almost comparing it. And we're laughing because we also recorded Barbie on this day. And I think it's very similar to Barbie in some ways, right? Where I think, yes, of course the movie could have been better. It's also almost 20 years old. But I think that she didn't get the credit that she was owed for playing this role and for the writing. And again, I just think it's a really clever idea for a movie and people like me loved it. Dr. Katrina Furey, MD: And you were saying there's been a lot of discussion about it, even in the present day, where they're really sort of analyzing the gender roles and the way she portrays it, the way she's code switching, people are still talking about it. And so I think that is what makes art beautiful, is that it can provoke these feelings. These thoughts give you a means to discuss these bigger issues, especially when you might not agree with the person you're talking about it with. But it's like a maybe safe, neutral place to talk about it. And we're still talking about this stuff. So it was interesting. Portia Pendleton, LCSW: Yeah. So of know, I think it's worth saying we wish Amanda finds well. She's iconic and I selfishly would love to see her back in theater, but I don't know if that's good for her or know, who am I to say? But I love her. She was through my childhood and stay tuned. Maybe we'll do another one of her things, but thank you for listening today to our podcast. If you would like to follow us, you can follow us on Instagram at Analyze Scripts or TikTok at Analyze Scripts podcast threads at Analyze scripts podcast, and you can check us out on our website to get more information or continue to search through some of our older episodes. They're great. Dr. Katrina Furey, MD: Yeah. All right, we'll see you next Monday. Portia Pendleton, LCSW: Bye bye. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Dr. Katrina Furey, MD: Unless you want to share it with your friends and rate review and subscribe, that's fine. Dr. Katrina Furey, MD: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.
Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are analyzing "White Lotus" Season 2. In this season we follow Tanya and Greg to beautiful Sicily where the water is a dreamy blue and the passion red hot. This season has received 23 Emmy nominations and we think they deserve them all! We continue to analyze Tanya for a personality disorder, discuss the power and currency of sex, and talk all things complicated relationships. If you are missing this season come along with us to admire the clothing, food and of course their mental health. We hope you enjoy! Instagram Tik Tok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fury, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM Five, and enjoy. Portia Pendleton, LCSW: Welcome back to another episode of Analyze Scripts. Today we are covering White Lotus, season two. I'm so excited. The scenery is beautiful. They're in Italy. Dr. Katrina Furey, MD: Oh, my gosh. Portia Pendleton, LCSW: I just want to be there. Dr. Katrina Furey, MD: You've been to Italy? Portia Pendleton, LCSW: I have that part or a different no. So I think this is in Sicily. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: So I visited Naples and then Positano and Capri. Dr. Katrina Furey, MD: Oh, wow. Oh. Was it like this? Portia Pendleton, LCSW: It was literally everything of the sort. Like, stunning, beautiful, incredible. The food I could write home about every day. Just the most beautiful, stunning place ever I've been. Dr. Katrina Furey, MD: I mean, that reads true in this series. It looks so beautiful. Portia Pendleton, LCSW: I definitely want to go there. I noticed, too, in season one of White Lotus, right, there's a lot of cuts of the water, the waves crashing, that the water scene often either comes out of or into another scene of a person. It kind of fades into the scene of underwater or something. So I think that's like an interesting. Dr. Katrina Furey, MD: And sometimes it would be like the waves are slowly, gently crashing. Other times, there's a big crash. And I feel like that was purposeful and sort of played into the scene or what's going on with the then, you know, spoiler alert. Tanya eventually dies in the water. Portia Pendleton, LCSW: The water takes her. Dr. Katrina Furey, MD: The water takes her. She almost made it. Like, I thought she was going to make it, and then she slips. Portia Pendleton, LCSW: I think that was they said the writer director was commenting on how it was so important for him that Tanya did not die at the hands of someone else, that she still was kind of able like, she still was in charge even though she slipped and died, but he didn't want her being killed. Know the quote unquote gaze? Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: Oh, my gosh. Dr. Katrina Furey, MD: So let's just jump right in, I think, with Tanya. Yes. So we talked a little bit about our feelings toward her last time we recapped season one. We talked a lot about how she displays some traits and characteristics of borderline personality disorder and how the character talks about how her mother actually also had borderline personality disorder. Did you feel, Portia, like that was consistent in season two or I think so, yeah. What did you notice? Portia Pendleton, LCSW: So I think, again, her interpersonal experiences with both Greg with know, fun to see my name in the light, for one. She just seems to really be only thinking about. Right. So, like can't hear Portia. They were having a conversation. We were talking about this before the podcast. And it's like she almost like tunes her. It's kind of is talking over her. Just goes back to her. Right, right. She can't even hear Portia. I think she's asking for a day off to Albie. Dr. Katrina Furey, MD: Yeah, there was that scene where Portia was like, I know I'm kind of on the clock, but could I take the day and hang out with Albie? And she sort of tries to make a case for it, and there's like a pause. And then Tanya just keeps talking about her own issues. Like doesn't even acknowledge that Portia said anything. Almost like Portia didn't say anything. And I think that actually so tracks with people with cluster b traits, whether it's borderline narcissistic histrionic that the way they relate to other people is almost like other people in their lives are objects that are only there. To serve a purpose in relation to really? They can't see these people as their own independent humans who have their own wants and needs, who are both good and bad. Right, exactly. And so Tanya couldn't even hear it, didn't even register in her consciousness that Portia was asking for some distance from her. And I think that probably played into her intense fear of abandonment. And she just didn't even acknowledge it. I thought that was such a smartly written scene. And I wonder if the writers were really going for that, if they knew, or if that just happened, if that's just the way I'm interpreting it. Portia Pendleton, LCSW: I feel like it's got to be intentional just because it's so perfect, you know? And Greg also says to her at one point, I think at the beginning when he sees that Portia is there, they get into a fight and he says, you discard people. You drop people on a dime, you fire people. And then she calls him a full of ****, man. And then she says, I hate so. Like, I think that even their dynamic you see over the couple of episodes that he's there in Italy with her for, she's really easily know. She's really emotive. Which again, if someone was on vacation with me, like my partner, and all of a sudden they were like, oh yeah, I'm going to leave you for two days, I might have a reaction to that as well. Dr. Katrina Furey, MD: It was unknown. So again, maybe that's why she brought Portia, because she had a feeling he was going to leave and she didn't want to be. Portia Pendleton, LCSW: So my question is the ultimate kind of problem or issue, I guess I would say with Bpd is right, the fear of abandonment. And so is Tanya picking up on Greg's right like other relationship, his obviously very nefarious plan to have her murdered know, I think this is hard talking with clients. It's like, are you picking up on something that's real or not? Dr. Katrina Furey, MD: Or are you projecting such a difficult question? Portia Pendleton, LCSW: Exactly. Dr. Katrina Furey, MD: That is such a hard question. I also think as a therapist, it's really hard when you only have your patient's perspective. I wonder if that's easier to pick up in couples or family work. But I think that's part of the therapy is learning where your own baggage ends and where the person you're interacting with begins. And that is almost like the definition of an interpersonal boundary which people with these personality disorders really struggle with. And we see that displayed so know throughout this series with Tanya. And I think you're totally like, at first when I was watching this, I thought Greg was upset Portia was there because he wanted to just be on vacation with her. Then I realized it's because he was planning to murder her and didn't want a witness. But yeah, why did she bring Portia? Like a why does she have an why? Um, but I wonder if she was picking up on, like, pulling like, we easily see that. We also easily saw that in season, like, from the yeah. And we talked about how, like, isn't a safe attachment figure for her, but that's probably what she's used to. So for her, that feels like it's, you know, and we just see how mean he is to her, like, with the macaroons. Right? Portia Pendleton, LCSW: Yeah, totally. Dr. Katrina Furey, MD: So mean. He's just always putting her down, always criticizing her. It's just mean. Portia Pendleton, LCSW: And in some points, I was like, it's interesting, Tanya's interpretation of that. Right. Dr. Katrina Furey, MD: She said to herself, like, oh, he. Portia Pendleton, LCSW: Cares so much about me. That's why he's saying that. And it's like, no, he just said something mean to you. But then, on the other hand, she has a quote unquote inappropriate reaction to something that isn't that bad. So it's just like her it's skewed where and again, I'm a third party. I'm also a therapist. It's also a show, but I'm watching. I'm like, Tanya, you should have had a bigger reaction to him, like food shaming you and a lesser reaction over here, right. Dr. Katrina Furey, MD: And a bigger reaction when you overhear him in the bathroom saying, like, I love you. I'll be there soon. And I know, right? Portia Pendleton, LCSW: That's what was just, like, interesting, confusing, and I think maybe difficult for someone who doesn't know or isn't thinking about her in terms of Bpd. Dr. Katrina Furey, MD: Yeah. But I also wonder if that is just, like, a really accurate portrayal of the inner world of someone with Bpd. She was saying at one point to Portia later on in the season, basically saying, like, Portia, you remind me a lot of me when I was younger, and you could see Portia, like, recoil inside, like, no, no, I don't want to be like you. But then she said to Portia, when you're empty inside and you have no direction, you'll end up in some crazy places, but you'll still be lost. I think she said that to her after Portia and Jack sort of, like, dined and ditched, and Portia was, like, sort of high off the thrill of that. And Tanya was like, Aaron, teeny balls are like a like, what are you doing with this guy? And I just thought that spoke to another core feature of borderline personality disorder, which is this pervasive inner sense of emptiness. And I think that's exactly what Tanya was speaking to. And I thought that was just, like, a really beautiful way to put words to a really difficult experience. And I just thought in general, we've really got a feel for the chaotic inner world of, like, in all of her big reactions, her small reactions, where you think they should have been bigger, and just kind of all of it. Like, her whole character, I thought, really just portrayed the inner emotional chaos people with Bpd often feel and how, again, that's in such discrepancy to also their inner emptiness. And that goes right back to that old sort of, like, splitting defense mechanism. Right. It's just fascinating and just really well written, really well portrayed. Portia Pendleton, LCSW: Yeah. I think Tanya I wish that she could go on to season three. I know I'm definitely disappointed that she's not going to be, but also, I think that was intentional. This was the end of her story, and we'll see if there's some talks that maybe Portia is in season three. Dr. Katrina Furey, MD: I would love that. Portia Pendleton, LCSW: That was a cliffhanger. Like, what does she do with this? You know, is in this weird position of being scared and not sure if it was Tanya. Right. She learns from Albie that a guest was found dead in the water, and then there was this ship with all these gunshot weddings, and that's kind of all she knows. Dr. Katrina Furey, MD: And I just think I hate I. Portia Pendleton, LCSW: Just how dare you? Dr. Katrina Furey, MD: How dare you? Greg and I just feel like he's going to get off, like, he's going to inherit all the money. He just used everyone he used. Right. Like, we come to find that Greg was like, the cowboy from the past that Quinton was in love with. And it sounds like I didn't quite understand why Quentin felt such loyalty to Greg, but he's, like, doing his dirty work, I think for financial reasons, too. Like, Greg's like, I'll give you some of the money. It sounds like Quentin really needed it. He's kind of spent all his money, but he used that love from Quentin to get rid of his wife so he could get the money. And he also knew that Quentin and his friends could suck Tanya in, and she would quickly idealize them, which she does with everyone, and she did. And they knew how to make her feel exactly how to manipulate. I was like, is he trying to give her make the last week of her life the best ever. Like, even when they play out her fantasy in Italy on the Vespa, which I thought was hilarious, I was like, on the one hand, you're like, is that kind of nice? But then you know you're going to kill her, or is it just like you're getting even more over on her? Portia Pendleton, LCSW: Well, and how do you do that as a person, right? Like, if we try to diagnose Greg, what does that even look like? I mean, you come into someone's life and have the gall to take their family money after being married to them for a year. It's just so gross. How do you think you can do that? Dr. Katrina Furey, MD: I think he's, like a know, and I think he just is so and again, like, is looking and relating to Tanya as just like a means to an end for like, she's an object to him, and now he's ready to discard her and kill her. And I was just so sad that it took her so long to figure it out. And even as she is shooting the gays, as she calls them, she asks, is Greg having an affair? And again, it just speaks to that is the core fear of abandonment. Like her life is in danger, and she still wants that answer. Right. Portia Pendleton, LCSW: Because that's more heartbreaking. Dr. Katrina Furey, MD: Right? It's just so heartbreaking because it's almost. Portia Pendleton, LCSW: Like the money isn't about her, but him cheating on her is about her. Dr. Katrina Furey, MD: Right. And her just being so rejected and unimportant, and yet he treats her as unimportant, and he rejects her all the time, and she's constantly coming back, wanting to feel good enough, and she's just not. Like, she'll never get that with him, but she doesn't have a secure sense of self enough to be able to walk away. Portia Pendleton, LCSW: No, totally. I think, too, there was some question of were we seeing more borderline traits with her or more histrionic traits, right, yeah. So histrionic just a little bit of background is in the same cluster as borderline. You experience discomfort when you're not the center of attention. You might engage in provocative or dramatic behavior. There's, like, mood swings, over the top, displays of emotion. So some of these sound, like, pretty in line with Bpd, seeking reassurance or validation. Extreme sensitivity to criticism. Impulsive behavior, easily influenced, but also, like, a lack of concern for others, which I think in some ways, Bpd, it's not a lack of concern of others due to being how do I say this? Because you want to. It's almost like you have deep concern for others. You are often just so stuck in your head about you because your emotions are so intense. A lot of people with Bpd have care. Loved ones do have great relationships, are often used or often vulnerable. So I think that was just, like, a little bit of a difference. Dr. Katrina Furey, MD: Where do you think Tanya falls? Portia Pendleton, LCSW: I think more in Bpd, especially just primarily because we know of her trauma history, and we know we think of her mom's diagnosis. There's less research with histrionic personality disorder, so maybe they also have strong connections to childhood attachment trauma, but the research is more so currently with Bpd. Dr. Katrina Furey, MD: And like you're saying, Portia, there's so much overlap. And that is why we sort of lump or think about personality development when we're trying to organize such a complicated, convoluted topic into more concrete ways of understanding it. We've sort of come up with these clusters, like these buckets of, like well, people with these types of personality traits tend to have one of these personality disorders, but often there's some overlap. So she very well could have traits of both. And sometimes some traits might be louder, others are softer. And it can go back and forth. Yeah. Portia Pendleton, LCSW: No, someone I saw online, the main difference between histrionic and Bpd is that Bpd with I'm sorry, that histrionic personality disorder are motivated more by receiving and their desire for attention, while people with Bpd are more motivated by fear of abandonment and rejection. But I would ask, like, okay, but why do people with HPD need this desire for attention and different from narcissism? Exactly. So I think there's some questions that I have with HPD. Dr. Katrina Furey, MD: Yeah, I feel like HPD we don't talk about as much. It doesn't get as much airtime, I guess, in the media or even clinically. Maybe we kind of leave it at like, oh, those are histrionic behaviors. Yeah, I would say. And then what. Portia Pendleton, LCSW: Do we come from? Dr. Katrina Furey, MD: Right. And how is that different from someone with narcissistic traits also needing to be the center of attention? Or else they feel like nothing. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: Is that what's similar? And people with histrionic personality disorder just really act out in a more behavioral, attention seeking way? Portia Pendleton, LCSW: It just feels unclear to me. Dr. Katrina Furey, MD: It does feel unclear, and it's murky. And again, I think it is unclear because personality development is so complicated, and sometimes this is just us trying to put words to such a complicated topic. Portia Pendleton, LCSW: No, I agree. And some of the parts of thinking back to attachment trauma, childhood trauma, maybe, is when Tanya is having sex with Greg, right. And she says that she is disassociating. Dr. Katrina Furey, MD: Disassociating. I just want to put this out there. The word is dissociate. Dissociate. I hear so many dissociating. It is a tricky word with all the S's and C's, but I don't think it's disassociate. But I hear a lot of people say it that way. I don't know why. Maybe this is just splitting hairs, and I'm just being a snob, but I thought that was hilarious. Right. And again, so well written and perfect. Right. Like, her and Greg are finally having sex. She had come in in her beautiful lingerie, beautiful. Trying to get his attention after he'd really shamed her for all the macaroons. He's so mean to her and so dismissive. Like he's just constantly rejecting her. But finally he's like, okay, let's do it. And then as they're having sex, she freaks out, right, and pushes him away. Pushes him off of her. And he gets offended and annoyed. And she's like, I'm sorry. I was just disassociating. Do you remember what she was imagining in that moment? Portia Pendleton, LCSW: Well, it kept, I thought, showing, like, one of those statues or those heads. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: And then she tells him she's like, this head was on you and then you were gone and you were right in my face. And he's just, like, looking at her like, she has three heads. And then he's I didn't I didn't get off. And she's like, okay. I was proud of her for know, getting him off. Dr. Katrina Furey, MD: Me too, Portia, because it was so interesting. Right. They're finally connected in a very physical, intimate, sexual way. And then she dissociates and pushes him away. And I wanted to be like that. Is your gut instinct telling you, Get away from him. He is dangerous, but she can't stay there too long. But she did stay there enough where she didn't just get right back to having sex. Which, again, I was proud of her for, but only further pushed him away. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: What a fascinating scene. I would love to interview Mike White and just pick his brain and figure out how did he get these complex interpersonal dynamics depicted just so perfectly. I'm just now realizing also, his name is in the title White Lotus. Portia Pendleton, LCSW: That's funny. Dr. Katrina Furey, MD: Interesting. Portia Pendleton, LCSW: So then we know around Tanya, Greg and Portia's kind of dynamic, we see. Dr. Katrina Furey, MD: Portia and Jack develop who's the alleged nephew of Quentin. And then we find them having sex. So we sort of come to find out he's not actually the nephew. He's also being used. That was sad to me. That was really sad. And to see that actor really portray the heartbreak when he was really drunk and talking to Portia near the end. Portia Pendleton, LCSW: How did you feel with all that? I thought it was really sad. My guesses are maybe that he was struggling either with contemplating suicide when Quentin came about him. Maybe some substance use, maybe being unhoused. Dr. Katrina Furey, MD: He probably had his own trauma history. Portia Pendleton, LCSW: Seems like he was in a really dark place. I mean, he says, then he cries. Which is so different from this character that Jack, the character, is portraying as this macho man who's very appealing to Portia after she has been having some fun with Albie, who we will cover. You know, Albie seems more like kind, soft spoken, very aware of using consent. And Portia is then all of a sudden very taken by Jack who kind of comes in and kisses her. And it's more like a little bit aggressive and hot and sexy to her. But we see this downside to it, which, again, is not typical. Typically, if someone's kind of like taking swept off your feet in that way, you don't end up in a murder plot. But know, I think just Jack's story was like it made me sad. Dr. Katrina Furey, MD: It made me sad too. I found him really obnoxious, and as soon as he came into the show, I was like, oh, no, Portia, you've been talking about how you want to make better decisions. Albie's right here. He seems really sweet, but you're noticing, like, he's not chaotic enough or bad enough. And then here comes this guy. And I was like, oh, no, she's totally going to go for him, and he's going to be such a bad choice. But I still feel like she's, like, young and learning these things and making these choices and mistakes, and it all. Portia Pendleton, LCSW: Feels very appropriate, to be honest. Dr. Katrina Furey, MD: Yeah, this feels like kind of like appropriate development. I did find her costumes really interesting. I felt like she was such a great character that just embodies the early 20s person of today. I actually thought her dialogue with Albie on the pool chairs just about how struggling through COVID and how it affected her mental health. And now she's feeling lost. She doesn't know what to do for a job. She has this awful boss. I was like, this is all so accurate, and she's really putting good words to it. But then she's opening up a lot to him and dumping a lot on him, and he's, like, just listening. That didn't feel like a really equal relationship right away. Portia Pendleton, LCSW: Well, maybe that was part of her discomfort, maybe after a while with Albie and then why Jack felt so good because he didn't know anything about her. Right? It was just purely physical. She hadn't shared anything emotional with him. It was just like, based off having sex and being hot and sexy and doing these wild things, and there was no nothing deeper emotional vulnerability. Dr. Katrina Furey, MD: And in that way, I kind of did find myself wondering, is Portia like, a younger version of Tanya? Is this sort of the development of something like Bpd or attachment? Like, she's opening up to Albie so quickly, but then pulls away so quickly? Is that more in line with a personality disorder brewing, or is this also just like, normal development and she's figuring it out and just like, what an interesting character. I felt like she some of her clothes I loved, and then some of them reminded me of limited two. And I think, again, that was probably intentional to just play up, like, how she's so childish and immature in some ways. But again, she's like a young person. Portia Pendleton, LCSW: And they did intentionally include her talking right about COVID being alone. And I think we've seen both littles adults and really specifically, at least for me, adolescents, and how COVID and the social isolation and not being around your peers has impacted them. I see a lot of more immature behaviors that shouldn't be, quote, unquote, happening. So I think even so, if we picture her more as maybe like she's a little stunted 18 instead of maybe 22. I'm thinking, right when you get out of college, she feels more appropriate. Dr. Katrina Furey, MD: And again, like we talked about last time, we've talked about before, you can get psychologically stunted when a trauma has occurred and COVID is a trauma. We have all lived through this collective trauma, but it affects us all in different ways. And we are seeing just skyrocketing rates of youth and adolescent mental health issues also in adults, but I think especially in that population, it's huge. And that social isolation was a really big deal and it was a really scary time for people and for the youth. So I totally agree. I was really glad that they touched on that. I also thought it was interesting that I guess the first season of White Lotus was filmed in 2020, and that was partly why they were restricted to the resort. Remember? I was always like, why doesn't anyone go explore Hawai? And I'm like, oh. And then season two was still in COVID y times, but things were loosening up so they could film elsewhere and leave the resort a little more. And I was like, oh, that makes a lot of yeah, but that scene when Portia's like, starting to put together that something really bad is going on and then I couldn't tell if she was supposed to be killed too, and then Jack spares her or if he was just supposed to keep her away. What did you think of that? Portia Pendleton, LCSW: I think it's left intentionally kind of like, unclear. There was some talk of why didn't he kill her? And it was just more people were talking about it's not because he loves her at all. They developed this connection. It's just because of his character. He's not a murderer. Yes, he's capable of other things, but we saw how it feels like all this world that he's in is so destructive for him. And he's kind of holding the line at like, and I'm not a killer. He seemed torn for that know, he was angry, which I think, you know, coming off to Portia, which again is so like, he seemed scary. Yeah, he might kill, but like, I don't know, maybe there's some inner conflict at that, like, what to do? And then he drops her off right kind of near the airport and just go to the I thought, you know, that to me was like, he's a victim of his circumstances, but still has like a moral compass. Dr. Katrina Furey, MD: Right? Yeah. And I thought, did he end up having sex with Quentin to spare know? Was that happening all along? I bet it was happening all along, but he really seemed so distraught. And I really didn't know until he drove away if Portia was going to be okay until we saw her in the airport again. And I don't know if he knew. I don't know if he was supposed to bring her back or not, or if he was going to then get hurt because he didn't follow through with the plan, or I just really felt for him by the end. I found him really obnoxious at first, and then learning about his whole backstory, he's just so vulnerable and was just taken advantage of. It's so sad. Portia Pendleton, LCSW: Yeah. I mean, I think Portia's character, people like, I wouldn't say maybe loved, but some people had really big reactions to her. Didn't like her at all. Thought she was, like, the main villain. Dr. Katrina Furey, MD: Of the that I find shocking. Yeah. The main villain. Right. Like, whoa. Portia Pendleton, LCSW: I think that's more and this know, my opinion. I would imagine that's probably coming from a little bit of an older commentator who's watching, because I think if you are a working with Gen Z or if you are in Gen Z, she feels really normal, feels so relatable. And I think she's actually not the villain. She's trying to find herself. She's, like, in Italy with her boss. She doesn't know what to do with. Like, it all makes sense. So she actually had come out with a quote, which I thought was interesting yeah. About commenting on people not liking her. And she said it. The one thing that I thought was actually kind of unfair and warped was the people who were saying that she was awful or that she was the real villain of the season. There's no way that you can look at that young woman and be like, she is the most awful one on this show. People who think that way should go to therapy. And I was like, or maybe just spend some time around the yeah, yeah. Dr. Katrina Furey, MD: I totally so, you know, expanding out from know, we talked a little bit about Albie and just the stark difference between Albie versus Jack and how they were so different and how you sort of saw both cute. Portia Pendleton, LCSW: Yeah, of course. Dr. Katrina Furey, MD: Both, like, physically know. But yeah, albie went to Stanford. He seems really modest. He humble, he's really sweet, sensitive, and it's like, you can tell she kind of wants to be attracted to that guy, but there's something missing for her, like that spark and that sexiness. And I think all people maybe can relate to that or I think a lot of people have felt that at different points in their life. Probably in their early 20s. Yeah. And then here comes Jack, and she's just, like, totally taken by him. What did you think of Albie's character? Portia Pendleton, LCSW: I thought that he was so interesting in how season or episode one portrayed him. And then the final episode, episode seven, did. So it's like we learn that he is kind of stuck in the middle of this family dynamic, where he's often the moderator. He often, it seems like, also has power in the family. He can kind of go to mom or dad and make changes or make. Dr. Katrina Furey, MD: Them move things over. Portia Pendleton, LCSW: Yeah, exactly. So he seems initially really sensitive, and I think he still is, but he's sensitive. He does not like what his dad, Dominic, is doing to his mom. It sounds like Dominic has chronic issues with cheating. Maybe some kind of sexual addiction. I don't know. Dr. Katrina Furey, MD: And the kids know at this point, it sounds like he has a sister who's not on the trip. The mom refused to come because of his dad's actions, but he came. And his grandfather oh, my God, what a character and what a stereotypical caricature of older man. Portia Pendleton, LCSW: And it seems like so Dominic has contacted Lucia prior to going, that was my interpretation. And then she meets up with them there know, Lucia is like a sex worker. And then we kind of go through all the stages of Lucia and Mia being with or a part of the evening for Albie, Dominic, and Burr, all in different ways. And then at the end right. So his arc from episode one to seven with Albie, it's like, we see Albie, Dominic, and Burr all kind of their heads turn as this attractive Italian woman is walking by in the airport. And I don't know. Would that have happened at episode one with Albie? I don't know for sure. For Burt and Dominic, burt is like this flirt ladies man. Dr. Katrina Furey, MD: The scene where they're arriving, and the young receptionist walks him to the room, and he's flirting with her, and then he farts. Portia Pendleton, LCSW: Ever. Dr. Katrina Furey, MD: Just the look on his face, like, pretending it didn't. Portia Pendleton, LCSW: And the employee is so professional, she's just, like, ignoring it. Dr. Katrina Furey, MD: But he's so trying to hold on to his suaveness and his ladies man vibe, but then he's, like, farting and falling, and he's older. It's too much. Portia Pendleton, LCSW: Yeah. So I thought what I really liked hearing about this family was when Dominic challenges Bert about Bert's relationship with his wife, who is deceased, Dominic's mother, where Dominic knew that Bert was cheating on his mother. It seemed like she knew. And he kind of talked about her as like, she's either a martyr or she's like, I forget what. It like really resentful, like a bitter woman. And Bert seems so taken aback. Dr. Katrina Furey, MD: That his son. Yeah. And that's new. Portia Pendleton, LCSW: All his experience or that he sees Bert's love of his life. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: So Bert has this image of his wife, his deceased wife, who's like, that's everything to him. And then we learn of these actions that kind of say differently. It's interesting him being challenged on that. Dr. Katrina Furey, MD: And it's almost like speaks to Bert's own defensive reactions to keep all of that out of his consciousness and just think, like, wow, we have a great life, and, you know, my girlfriend's on the side, and no one's the wiser. And then Dominic's, like, really in his face, like, we all knew, and this was really hard. And then Dominic, though, is repeating it. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: And then in that generation, it's like everyone in the family still knows, but in an even more open way, know the earlier generation. And then we at first think Albie's not going to repeat it, and then the question for me is, does he or was he sort of taken advantage of by Lucia, right? Like, was he really developing strong feelings for her or not? What do you think? Portia Pendleton, LCSW: I don't know. I think it could go either way, and I think the writers and they do that intentionally. They totally do that intentionally, because I think it could go 100% either way. I think also I'll be learning that Lucia is a sex worker. I think that then was where I see his path to go either way. He was either, okay, this is something that we do, and I care about. Dr. Katrina Furey, MD: You and accept that about you and sort of kind of love you, want to move forward with you, or then he's like, okay, I can use that to my advantage. Portia Pendleton, LCSW: Right? Is that what you're so I think, you know, albie still feels like the better choice than Jack, but I think that I don't know. I guess what happens in Italy stays, or does the question yeah. Dr. Katrina Furey, MD: And I think, like, asking his dad for all that money and phrasing it as how did he phrase it, it's. Portia Pendleton, LCSW: The least you could do, or think. Dr. Katrina Furey, MD: Of it as, like, retribution for all your prior actions. And they were both so manipulating each other that I found it really interesting, and that's when I thought albie really did care about Lucia, and they had that whole scene where her pimp is, like, following them, and she has to go with him, but then that's fake. Oh, was it? Yeah. Portia Pendleton, LCSW: So then at the end, when it's showing, her and Mia, like, last five minutes of the movie, and they're walking down the street, they stop, and they kiss and hug her pimp who's working at some other place I think it was a friend. Dr. Katrina Furey, MD: Maybe that's her boyfriend. Portia Pendleton, LCSW: I think it was a way to get more money. That's what I interpret it, because we saw him, and they were cheek to cheek, kissing, smiling. Dr. Katrina Furey, MD: Yeah. Oh, I didn't know that was the same person. Wow. Whoa. My mind is whoa, whoa because I kept wanting Lucia to, like she was fascinating. She was a fascinating character to me, too. If we want to move on to know the, like, the depiction of a sex worker, is that the politically correct way to sort of refer to her? Not it's not clear to me if that's legal or illegal in Italy, but you certainly saw all the shame coming from Valentina, the manager of the White Lotus. At first, you see Lucia talking to Mia about it in terms of sort of the way they both view money and sex. I just thought it was really fascinating. What was your take? Portia Pendleton, LCSW: Yeah, it seemed also like Lucia at times, though, was really ashamed of what she was doing. She didn't want Mia to be a part of it. And then there were times where she's like, I don't like this feels not okay. And other times where she felt like, really manipulated and also in charge, right? Like, she was manipulating these men to make a lot of money. I was like, wow, get your bag, girl. Dr. Katrina Furey, MD: That's a lot. But then I thought she just wanted to make enough money to get out and open her own store. But then by the end, I wasn't sure if that's really true or if she's just happy and fine doing this job right. Portia Pendleton, LCSW: I would have liked to know. And again, it seems up for interpretation. Like, as her and Mia, I thought that after I saw that that was not her pimp, I thought that she was going to show. Like, this is the store I bought with the money from Albie because they didn't I was this is this something that she does frequently. And it wasn't this one time opportunity with Albie to get this huge amount of money. So then I was like, I don't know. Again, I think it's ambiguous on purpose. Dr. Katrina Furey, MD: Exactly, and I think they do that on purpose, ending with them strolling down the street, looking in the windows, but not being like, okay, this is the store I bought, and now I can have this new life. And again, I think that speaks to just the strong feelings. The whole concept of sex work, I think, stirs up in everyone, and it's so different for everyone. And I think it perhaps is also different culturally. Like, I'd imagine there's some cultures where it's more accepted than it is in our American culture. And I thought Lucia's influence over Mia was also really interesting. Right. On the one hand, she's, like, bringing Mia along at the beginning, and Mia's, like, not really wanting to, and she's pushing her she's kind of pushing her to like, let's go have a threesome. Like, come on, come on. And then when Mia starts to participate with the original pianist, and then eventually with Valentina and sees like, oh, I can know sex as currency, know, use that power to my advantage to get what I want in the world. I feel like Lucia has mixed feelings about it, kind of. Portia Pendleton, LCSW: Yeah, no, I thought that was an interesting dynamic, the two of them, because as I thought initially, like, Lucia seems like she's getting out, mia's getting in. Yeah, but then I think they both were. Dr. Katrina Furey, MD: But it seems like kind of they want to be. I think it was sort of like thinking, like, oh, poor Lucia. She has this pimp. She can't get out no matter how much she wants to, but maybe not. Like, maybe she is fine with it. Portia Pendleton, LCSW: And is that the intent, right, to have this question in your mind when you finish of, like, this isn't a clear cut visual of sex work in a really vulnerable way. It's more like they're in charge of it, and they actually got some nice things. Mia, her music career. She gets to sing here, it seems like, too. At least they showed besides the pianist. And I think that was also just like Mia's discomfort, maybe because it was like the first time she was doing something like that. But all of the experiences seemed consensual. Dr. Katrina Furey, MD: Right? Yeah. Portia Pendleton, LCSW: And like, gross or where they're feeling or being portrayed as like a victim. They seem very much in charge. And I think that's even more clear when I think you learn that that's not her pimp. Dr. Katrina Furey, MD: Yes, I agree. I totally agree. And I'm sure all of that was intentional. And it does stir up important, I think, questions. And then also with Mia and Valentina. I loved the character of Valentina. I loved how quick witted and strong she was. I loved her initial commentary when everyone's getting off the boat and she's saying to Bert, like, well, you're so old, right, but you're like just some of the things she would say was so funny. But wow, it really turned it on its head. Right. Because you really saw how she was shaming Lucia and Mia at the beginning, throwing them out, like just being so derogatory toward them, treating them like they're subhuman, which, again, I think a lot of people in the sex work industry, that's probably how they're treated. Right. But then by the end, it's like Valentina's a willing participant. And Mia is it's like, in some ways was that kind of beautiful that Mia was finally helping, like, explore her sexuality, which had been so repressed and unsafe for her to explore? That actually seems like take the sex work out. That seems like a beautiful way for someone to explore their sexuality, finally righteous. I don't know. It stirs up a lot of mixed feelings for me. It does. Portia Pendleton, LCSW: And I think also interestingly, just her character being gay, I know historically and I don't know, like anecdotally that Italy. There's a lot of gay men in Italy. You have been allowed to have a homosexual relationship there since the 18 hundreds. Dr. Katrina Furey, MD: Wow. Portia Pendleton, LCSW: In parts. So they've been historically progressive in that way, especially with men. And there's like parts of Italy where there's like a lot of gay beaches. Dr. Katrina Furey, MD: I mean, look at the gay posse around which is sidebar. I feel like part of that posse was like Borat and Albert Einstein. Like, I couldn't stop thinking that when I was watching. Portia Pendleton, LCSW: That's so funny. Dr. Katrina Furey, MD: But then yeah, compare that to Valentina's experience as a gay woman, and she certainly seems like it was not safe at all to know give any ounce of it was so repressed. Portia Pendleton, LCSW: She also seems to really not like men. Dr. Katrina Furey, MD: Yes. Like in that coffee shop. Portia Pendleton, LCSW: Yeah, the coffee shop. And then she's really like it's so funny. Dr. Katrina Furey, MD: Rocco. Rocco. Portia Pendleton, LCSW: Yeah, she makes Rocco go and work down at the beach. And then she's so, I think, trying to almost use her not 100% fluent in english to challenge and shame Dominic when he's asking for lucia and Mia to be added to his room. And she's like, I don't understand. So they'll also be sleeping with your dad? Dr. Katrina Furey, MD: And he's like, no, you'll all be. Portia Pendleton, LCSW: In the same bed. Yes. That was funny. And I think, like, her doing that purposely. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: Oh, I think so. Dr. Katrina Furey, MD: I think she has, like, contempt for men, and that makes me wonder why. I'm sure there's a lot of background there we didn't get to learn about, but watching her evolution, I also thought was really fascinating. I kind of just wonder how she felt at the end of the like, did she feel, like that relationship with mia, if that was, like, did it end there, or did it continue? Did it feel okay to, like, how is she doing? Portia Pendleton, LCSW: I and I think that's another right. Like, because she ends up after her and mia had spent the night together, kind of unmia. Didn't ask her, but obviously she made it known that she wanted to sing there. But valentina dismisses the other guy, the other pianist, and he's very upset by it, and she's just like, no, we're moving forward with this. And then she kind of, like, smiles at mia and then goes about her day. So it's like, again, right. Dr. Katrina Furey, MD: Like, sex is passed. Portia Pendleton, LCSW: What happens next? Do they have another night together, or is Valentina now, like, this confident woman? Dr. Katrina Furey, MD: I think she's going to go meet someone else to have another night. I think she had said, like, if you're not busy, but how long does that continue? Right. I loved mia. She did have this sort of naive innocence, in a way. All she wants to do is sing, and then she's finally singing, and she's so happy, and I was so happy for her. I did think she was a lot better than the guy. Yeah. The scenes with her and the guy trying to have sex in the chapel, I did feel grossed out by oh. Portia Pendleton, LCSW: And she kept turning her head, and there's, like, right, jesus, there's mother mary. Dr. Katrina Furey, MD: And I was just like, oh, my god. And I thought it was humorous when she gave him the wrong pill, and that can happen, so you have to be really careful. As I put my doctor's hat on, be really careful what kind of pills you're taking. Don't take your friends pills. They can interact. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: ****** can interact with blood pressure medications and lead to really serious problems, which I think is maybe what happened with him. But just be careful. We do see in this season a lot of talk about prescriptions, like, there, and then we see harper and her ambient and kind of sharing it around. Ambien is also not something you should just be sharing around. Yeah. Portia Pendleton, LCSW: And she seems to think like it's so normal for everyone to take. And I'm like, Ambien is often, like, a last resort. Dr. Katrina Furey, MD: It should be, I think. Unfortunately, it can be quickly prescribed, but it's really powerful. Do not mix it with alcohol. Do not mix it with other drugs. Please don't. You could get really hurt or stop breathing. It's really serious. But yeah, maybe that's a nice segue to our last crop of characters, who I found perhaps the most fascinating of know we have Ethan and Harper, who seem to be married, no kids yet, maybe I think they're thinking about starting to have a family, but they haven't really yet. And it seems like Ethan has come into this. Portia Pendleton, LCSW: Right? Right. It seems like he's in tech. Maybe he just sold some that he created. Dr. Katrina Furey, MD: Yeah, harper's a lawyer, right? She's a lawyer, so she has her own career too. But they were, like, all of a sudden, like, uber wealthy. And they're on vacation with Cameron and Daphne, who are also uber wealthy, but it seems like he's in finance. I think they live in Connecticut, and she's, like, sort of a stay at home mom. And we come to find out that Cameron and Ethan were roomies at Yale. Right. And then it seems like their dynamic was always like, Cameron always had to be, like, the big guy on campus and was threatened by, like, quiet power. And so I think Ethan was saying whenever he expressed interest in a girl, cameron would swoop in. Which reminded me of Olivia. Yes. Right. From season one. It's just like, in, like, Olivia and yes, yes, kind of fast forward, and now let's switch up the gender roles. So what were your first impressions of these folks? And I can't wait to pick your brain about Daphne. Portia Pendleton, LCSW: Well, I think intentionally, right. Like, Harper is made to appear as, like, oh, I know she's fabulous as, like right. Like, I'd say, like, really liberal woke and not in an icky way. Dr. Katrina Furey, MD: Like Olivia from season one. Portia Pendleton, LCSW: Right. Like, in a really smart way. Dr. Katrina Furey, MD: Yeah, like, she's a lawyer and she's, like, fighting for the employees and all that stuff. Yep. Portia Pendleton, LCSW: It sounds like she's either fully or, like, half Puerto Rican, so she has that kind of experience and knowledge base. Dr. Katrina Furey, MD: But, like, white passing. Portia Pendleton, LCSW: Ethan seems like he's Asian to some degree. So again, not white, but also, I'd say, like, what do they call what's the phrase? Dr. Katrina Furey, MD: Model minority. Portia Pendleton, LCSW: Yeah. So so Ethan might also be considered right. Like, part of the model minority and also very stereotypical in tech. Made a lot of money, very smart. Right. So just interesting that dynamic then kind of pushed against Cameron and Daphne, who seem opposite in some ways. Right. Like, more clear gender roles with, like, Cameron makes the money, daphne stays at home with the kids, and then the conflict or how, like, tolerates that comes. Dr. Katrina Furey, MD: Out that I thought was I I sort of, from the jump, had this feeling like, okay, so Cameron and Ethan were friends. Our friends, I don't know. And they're like, on this vacation together, harper was spot on to say, like, he invited you because he wants your money, so just be ready for it. And like, yep, that's what happens, right? It totally blindsided me. I knew Cameron was cheating and stuff. I didn't think Daphne was also getting back at him, but in major ways, like, almost like she has the power. And again, it's like she is using Cameron's fear of abandonment to her advantage. What did you think of that? Yeah. Portia Pendleton, LCSW: And also I was just wondering, like, chicken or the egg, right? Like, who pushed who first? Dr. Katrina Furey, MD: And they get off on pushing each other. Right. It's like, real toxic, but, like, hot. Portia Pendleton, LCSW: And we're going to spend some time talking about them, but I think, again, where we're left to wonder, right, is it's not entirely confirmed, but, like, did Harper and Cameron have sex? And did Ethan and Daphne have sex? Dr. Katrina Furey, MD: Yes. And the final scene of them waiting at the airport where Cameron and Daphne feel kind of distant, but then Harper and Ethan are way more connected, and. Portia Pendleton, LCSW: They know sex back in the hotel room. Dr. Katrina Furey, MD: Finally, it's like, finally that spark is reignited. Right. It seems like they were married and maybe going through, like, a dry spell. And they were so openly talking about how well, Ethan watches **** all the time. He wants to have sex in the morning, I want to do it at night, all this stuff. And you could see how when Harper's trying to seduce him, he's, like, pushing her away, and then it's like the flames rekindle. Portia Pendleton, LCSW: Right. And so right. The question is why. Is it because they both had sex with others and now they're in this relationship similar to Cameron and Daphne, or did they not? And they are now feeling really close and connected to each other because of that? I don't know. Dr. Katrina Furey, MD: I know. I don't know either. And I could see it go both ways. Did they redefine the terms of their relationship and they're both on board with it, or did they resist and that made them realize how much they really care about each other, and that's what reignited the flame? It's so ambiguous. It is clear. I don't know either. I don't know either. Portia Pendleton, LCSW: So we see them have so Daphne and Daphne tricks Harper to go spend. Dr. Katrina Furey, MD: The night somewhere, some palazzo or some fancy thing. I was like, who wants to do that? It seemed kind of boring, right? Portia Pendleton, LCSW: They were, like, in this know, beautiful. Dr. Katrina Furey, MD: Space, but, like, by yeah, like, where do you get dinner? I don't know. I don't like she could find one strand. Portia Pendleton, LCSW: They took an edible yeah. To relax. Dr. Katrina Furey, MD: But I would feel like yeah. Like Harper felt like she was trapped. Portia Pendleton, LCSW: And she was and then Daphne's like, well, don't call Ethan. I want to call Cameron first. Right. Like, she needed to call Cameron first to let them know that they just got so swept up and are just going to stay here now. Dr. Katrina Furey, MD: But that wasn't true. She knew the whole time that she was going to stick it to him in this way. Is it because she knew he was bound to cheat on her, or he has before and she's spending his money. Portia Pendleton, LCSW: And this is her okaying. It because if they had never left, they never would have had the opportunity to do that. Dr. Katrina Furey, MD: Never crossed. Portia Pendleton, LCSW: She left intentionally, like, giving him this, which, again, he obviously didn't need to do it, but she gave him this space to have this day that could have just been jet skiing. Dr. Katrina Furey, MD: Oh, that never crossed my mind. I always thought she was mad at him and getting him back, but this is also like she's giving him an invitation. Yeah, but it's also like this is where their toxicity plays off each other because she knows it's going to hurt him. And she says that to Harper, like, oh, he has this fear of abandonment. I think she even calls it that. Portia Pendleton, LCSW: And fear of missing out, having this phone experience. Dr. Katrina Furey, MD: Right. And she was like, yeah, they're going to stick it to him and spend his money to rent this place, but then maybe she knows that's going to make him mad enough to be unfaithful to her, but then maybe somehow that justifies her. And the scenes between Harper and Daphne where Harper's trying to bring it to her attention, what did you think of Daphne's responses and the actress's responses? Portia Pendleton, LCSW: I would say first, not typical. Not what know, I guess the knee jerk. Dr. Katrina Furey, MD: Not what I was expecting at all. Portia Pendleton, LCSW: And she kind of initially gets pretty severe with Harper insisting that she is not the victim. Dr. Katrina Furey, MD: Yes. She gets very hard and defensive very quickly, like when they're still in that palazzo or something, and she's like, I think something happened with them. Right. And when Harper's like, do you think he cheats on you? And she's like, once or twice, like. Portia Pendleton, LCSW: A year, a month. Dr. Katrina Furey, MD: And I think at first you're left to think like, he does that, and she accepts it. And then it hit me out of left field when she's talking about her personal trainer. Right. Did you pick up on the kid that it's like his kid? Yes. Right. Yes. And that's like the ultimate sucker punch, I feel like, to Cameron. Right. Portia Pendleton, LCSW: Because she describes and this was very, in my opinion, intentional. She describes the trainer as like he looks this blonde haired, blue eyed guy. And then she shows them a picture of her two kids and the one that I zoomed in on, which again, it was probably edited, so I would do that was this blonde haired, blue eyed boy. And Cameron has brown eyes and Daphne has blue. That's possible. But I just thought it was like. Dr. Katrina Furey, MD: No, she's trying yeah, and she was allegedly trying to show Harper a picture of the trainer, and then Harper's like, oh, this is a picture of your kids. And she's like, oh, is it? And that's like, Daphne leaves so much she says so much by saying so. Portia Pendleton, LCSW: Yep. Dr. Katrina Furey, MD: And I feel like that is her power and just like, what a thing to hold on to. And does Cameron know, or like, I. Portia Pendleton, LCSW: Think no, I think he thinks that he is the one who's getting away or being hot shot, but I think it's like, Daphne is the one, ultimately, and she knows it, and that's how I think she can tolerate and that's. Dr. Katrina Furey, MD: How she gets, I think oof, icky. Yeah. Portia Pendleton, LCSW: And not expected. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: When we meet her, she's like, oh, hi. Dr. Katrina Furey, MD: She's always so fun. I think I voted last year. When I get drunk, I donate to know. I didn't see that coming. Like, what a fascinating character. I kind of want Daphne to be in season three. I want to see where Daphne goes. I never liked Cameron. He gives me the like right away. Portia Pendleton, LCSW: Well, in her comments, daphne's of not having a lot of female friends or having a hard time with that. I was like, well, is it because Cameron's, like, touching them? Is it because he's trying to have sex with all your friends? Or are they picking up on just, like, your toxic relationship and don't want anything to do with it? Dr. Katrina Furey, MD: Just icky. Yeah. And then it's like, look how she relates to right. Like, at first, she's really complimentary and seems kind of sweet, and one of those like, at first I was like, you're just one of know, people who can just see the good and block out the bad news and stuff like that, whereas Harper and Ethan are more based in reality. But then this whole other nefarious side to Daphne came out, and I'm just left wondering, is this who Daphne is? Or has she turned into this in relation to Cameron? Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: And this toxicity. I don't know. It's fascinating. Portia Pendleton, LCSW: It is. It's so fascinating. I mean, I thought the four of them were a really interesting storyline to follow. I think also, just, like, it seems to be that if there's something that you're trying to get away with, it's, like, the truth seems to always come out right. Of course, Harper finds the condom, and then she starts pulling all this other information out of Ethan, which I was like, ethan, come clean earlier. It's like you kept adding things in over time, over and over, and it's like, I understand that you still, by sharing what happened, are going to make Harper uncomfortable or upset, but she thinks that you had sex with someone. Dr. Katrina Furey, MD: And on the flip side, Harper didn't bring it up right away. Like, she found it. She kind of kept it. They went to dinner as if everything's okay. Portia Pendleton, LCSW: She kept asking him questions about last night, and he was really evasive. Dr. Katrina Furey, MD: I know. I was just like, you guys communicate directly, right? Like, come on. But I don't think they really know how to and then they really start to mistrust each other. Portia Pendleton, LCSW: And it seems like it's all because of cameron and right. Dr. Katrina Furey, MD: Like I blame for yeah, for sure. Portia Pendleton, LCSW: It's like he's the one who's stirring the pot. Dr. Katrina Furey, MD: And I think ethan touching her leg is right. Portia Pendleton, LCSW: Flashing back to college, where it seems like he actually really doesn't like cameron, and cameron took a lot from him, and that's why then he becomes really paranoid, which may be rightly. So about cameron and harper. And then he beats him up in the water, which I loved. And then they're all, like, dining together. Dr. Katrina Furey, MD: Oh, my know, I don't even know I know. And then it's like, I felt like harper was seeing ethan maybe like, is this why we're on the trip? Because you want to show him? Like, you finally win it's like, again, them on the jet skis was so perfect. They're just having, like, a man contest, like, who wins? And he want to rub it in his face. But then it's like you see cameron for who he is, and he's always been that way. Right? Oh. It's just really, you know, and we. Portia Pendleton, LCSW: Saw power dynamics as well in season one, but it's like the power of yeah. The power of relationships manipulating each other. It just was a really interesting season in that way. Dr. Katrina Furey, MD: It was really interesting. I mean, I totally see why it swept the emmy nominations right. Under succession. All of the characters in that forsome were nominated for emmys. So was just it was such a good show. Portia Pendleton, LCSW: And lucia and mia, which I loved, the fact that they were I think. Dr. Katrina Furey, MD: It was actually lucia and valentina. Portia Pendleton, LCSW: Valentina, yeah. Dr. Katrina Furey, MD: But just really remarkable. And I thought, again, right up there for me with succession and you and just getting it so right in terms of the dialogue. But even more than that, everything else besides the dialogue when they're acting and staging and their body language and what's not said and the silences and the facial expression, all of it is so good, so compelling and so accurate. Portia Pendleton, LCSW: And even the more quieter characters on this show, like jack, like know, maybe he's a little bit of a bigger character than but, like, I think they're also such good actors. We felt so many different emotions towards all of the characters, all at different times, and I feel like that to me, really speaks about someone's ability to be an actor. Yes. And we also have coming out next month, one flew over the cuckoo's nest, and we talked, too, about jack nicholson's performance in that where it's like his character is set up so that you automatically should not like him. And then there's this weird dynamic in the show where you're rooting for him. And again, I feel. Like, I see that with Jack, right? Like he's participating in this horrible scheme, but I feel really sorry for him and know, have empathy and I think, well, most people can feel empathy. Empathy. Dr. Katrina Furey, MD: Sociopath. It's confirmed. Portia Pendleton, LCSW: Yeah, confirmed today. But I just think all of their characters are so well written and so well acted. I know we just said that, but I'm repeating it because I'm just such a fan. Dr. Katrina Furey, MD: Yes. Mike White, please come on our show. Portia Pendleton, LCSW: I'd love to pick your brain. It must be an amazing place to be in your brain. Dr. Katrina Furey, MD: I know, right? Portia Pendleton, LCSW: So what is your prediction for season three? So we saw an emphasis on money. There's an emphasis on sex. Dr. Katrina Furey, MD: What could be greed? Portia Pendleton, LCSW: I mean, I'm thinking maybe of like the seven deadly seven deadly sins. Dr. Katrina Furey, MD: Like gluttony, like sex. I'm fascinated by like I would actually love it if Portia's the one who we sort of follow next. I think that'd be really interesting. I found Daphne really fascinating. I don't know Portia. I have no idea what to expect. I bet all the writer strike and the SAG strikes, which I fully support, but I think that will sort of delay. Portia Pendleton, LCSW: Yeah, that's such an interesting thing to think about. I was watching a rerun of a show that I like, I watch Big Bang Theory sometimes at night because I've. Dr. Katrina Furey, MD: Seen all the episodes fun, silly, soothing. Portia Pendleton, LCSW: And I was like, this is what we're going to have to do, like watch all these reruns because everything is going to be delayed, right? Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: I'm sure they can throw out some Hallmark movies because they're really good at producing and getting those ones out fast once this is over. But some of these shows we know yellow Jackets, White Lotus, you. Dr. Katrina Furey, MD: Know, like. Portia Pendleton, LCSW: You said, I'm supportive, but I just want the content. I know. Dr. Katrina Furey, MD: So if these corporations could just get it together, that'd be great. But in the meantime, if you're enjoying this content, please rate, review and subscribe. Our show is doing better than we expected, but if you're listening and you haven't subscribed yet, please do follow us on Instagram at Analyze Scripts. Follow us on TikTok at Analyze scripts, podcast. Follow us on Threads at Analyze scripts. Podcast. Let us know what you want to hear us analyze next and we'll see you next Monday. Portia Pendleton, LCSW: Yeah, thanks for listening. Dr. Katrina Furey, MD: Bye bye. This podcast and its contents are a copyright of Analyzed Scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited unless you want to share it with your friends and rate, review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. 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Guest: John J. Russell, MD With so many COVID-19 vaccines in development, new medical ethical questions have been brought to the forefront of the healthcare field. With that in mind, Dr. John Russell takes us through the history of ethics and vaccinations throughout the world. Published January 4, 2021
Guest: Lawrence Nathan Shulman, MD With the requirement of social distancing and growth of telehealth in full swing, reentry into clinical facilities may be a challenging process for healthcare professionals and patients alike. Dr. Lawrence Shulman, the Deputy Director of Clinical Services at the University of Pennsylvania, gives his answer to the question on everyone's mind: how will this change after the pandemic? Published October 9, 2020
Host: Matt Birnholz, MD Guest: Donald Meyer, MD Guest: Travis Mickelson, MD With physical and behavioral health practices often operating in silos, many healthcare providers are left wondering whether their patients' holistic needs are being adequately addressed. To help bridge this gap in care, Drs. Donald Meyer and Travis Mickelson helped lead the implementation of a more integrative approach to behavioral health services within their organizations and are now sharing the benefits and challenges that came along with it.
Host: Jennifer Caudle, DO Guest: Mark Friedberg, MD With the use of alternative payment models (APMs) on the rise, the American Medical Association and the RAND Corporation joined forces to investigate the impact of APMs on physicians across the country. So what exactly did the study uncover? Diving into the study's findings with Dr. Jennifer Caudle is Dr. Mark Friedberg, senior physician policy researcher at RAND and director of its Boston office.
Guest: Leslie Ramirez, MD Host: Larry Kaskel, MD With tens of millions of people in the United States living without health insurance, lower prices for medicine and tests can mean the difference between seeking care and going without it. Even for those with insurance, lower prices can significantly ease out-of-pocket costs. How can we help patients find these lower prices, and might we also use price comparisons in our own practice? One physician has taken these issues into her own hands, creating a website that offers comparative pricing for tests and medications in the Chicagoland area. Host Dr. Larry Kaskel learns more about this website, leslieslist.org, from its founder, Dr. Leslie Ramirez, who also works full-time as a general internist. How has her work on the website changed her prescribing habits, and could they change yours too? Dr. Ramirez also shares a few tips for you to help your patients with bargaining on prices, and other ways to drive down costs.
Guest: Sandra Aamodt, PhD Host: Leslie P. Lundt, MD With a myriad of overlapping hormones and neurotransmitters involved, weight regulation is a complex task. While our bodies aim to stow away energy reserves for emergent times, our patients simultaneously try desperately to shed unwanted pounds. As Sandra Aamodt, PhD, author and former editor-in-chief of Nature Neuroscience, tells host Dr. Leslie Lundt, thanks to leptin, and a host of other regulatory compounds, many patients face long odds making a permanent change in food intake.
Guest: Holly Atkinson, MD Host: Leslie P. Lundt, MD With our special skills, ethical obligations and credible voices, health professionals are in a unique position to be human rights advocates. What is being done and how can you get involved? Past president of the board of directors of Physicians for Human Rights, Dr. Holly Atkinson tells host Dr. Leslie Lundt about her experiences.
Guest: Paul Donatio Host: Larry Kaskel, MD With the looming threat of Medicare and Medicaid payment cuts to physicians, fees from other sources become even more important to a physician's practice. The healthcare industry has traditionally instilled few consequences for patients who pay late or fail to cover uncollectable insurance balances, but times are changing. How can you re-train your patients to pay you on time?
Guest: Jay Iams, MD Host: Michael Benson, MD With the growing epidemic of prematurity in the US, there is a pressing need to understand the biology of preterm labor. Why do some women deliver early? Do we even know? Our guest today is Dr. Jay Iams, who is a nationally recognized expert on preterm labor. He is the Frederick Zuspan Professor of Obstetrics and Gynecology and Vice Chair of the Department at Ohio State University College of Medicine and Public Health. With hundreds of publications in the medical literature he is a member of the steering committee for the Maternal Fetal Medicine Network of the National Institute of Child Health and Human Development.
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