Pauline (00:00)

I'm like really fired up today, Megan.

I'm really fired up about this topic

I'm still way fired up

fired up

fired up

I'm fired up. We have a lot to talk about.

Megan (00:12)

I I don't like

Pauline (00:18)

Sorry, I have now fired you

Megan (00:19)

Yeah.

Pauline (00:20)

up.

Hello everybody

and welcome back. I'm Pauline and I am here with my faithful co-host, Megan Nelson.

Megan (00:44)

Hi everyone.

Pauline (00:46)

Good morning, Megan.

Megan (00:48)

Good morning. We're recording early so I have my coffee here.

Pauline (00:52)

Yes. And I have not had enough coffee, but you will be surprised because I'm in rare form today. I think our followers are gonna see a different side of me that doesn't come out very often. But boy, when I get worked up, does it come out strong. So I'm really fired up about this topic today and I'm I'm looking forward to getting into this with you, Megan, and I'm really sorry because

You're gonna be on the other side of the camera for this.

Megan (01:21)

It's alright. We can we might have to do a series a series of rants.

Pauline (01:25)

Yes,

yes. I'm re I am ready to rant. So

we thought we would do a look back, talking about the Lindsay Clancy trial and what that experience was like for us as perinatal mental health providers, and also as women and moms, as healthcare providers. We don't know Lindsay, right? And I've been

Megan (01:47)

Yeah.

Pauline (01:47)

really cautious.

about myself or anybody from our practice really commenting on what her experience was because we only know what we see in the media. And I think that that's so important for everybody to to realize that yes, I know what I see on Instagram and TikTok and when I watch the court videos and I know what the attorneys tell us, but I haven't evaluated her.

I don't know. We haven't reviewed her medical records. Right.

Megan (02:13)

Right. We haven't seen her chart. Yeah. Mm-hmm.

Pauline (02:17)

So all of us

Society is getting a very prescribed amount of information about who she really is and what happened.

Megan (02:25)

And fragmented. It's yeah. Yeah.

And you know, even post trial, like even in the footage that is like her colleagues that are, you know, were being interviewed by Oprah, we don't know that that's the colleague that she was closest to or knew her the best like we don't know, you know, it's

Pauline (02:44)

Right, right.

Megan (02:45)

the person who agreed to go on camera.

Pauline (02:47)

Yeah, and and to be honest, even if we heard from Lindsay herself, we would hear what she wants us to hear, unless you are treating somebody, unless you are living somebody's life, you can't possibly know. And so we can all armchair.

Megan (03:05)

Even

if I'm gonna pause here 'cause even if you are treating someone, they're only gonna let you know what they want you to know. And that is

Pauline (03:12)

Absolutely.

Megan (03:13)

actually one of the dilemmas.

Pauline (03:16)

Yeah, And that caused a lot of anxiety for therapists everywhere, right?

Megan (03:19)

Mm. Yeah.

Pauline (03:21)

my God, is that gonna happen to me? Am I gonna be that that provider on trial that like I didn't ask this question, I didn't put a comma in my notes, I asked

Megan (03:30)

Uh-huh.

Pauline (03:30)

and they said no, but they weren't telling the truth. So what has happened in the media is that

this real tragedy that Lindsay's family experienced has caused a ripple effect.

Which maybe some good will come and it's it feels even painful to say that, but we are talking about maternal health. We're talking about the breakdowns in the healthcare system. I have goosebumps 'cause like don't even get me started.

Megan (03:59)

we're talking about the signs that people can look out for and there are I think there are more partners who have become aware that wait, maybe I need to be more supportive and maybe I need to really look and see what they're going through.

Pauline (04:19)

Yeah, yeah. And hopefully partners who were like, maybe I need to get myself into therapy too.

Megan (04:25)

Yeah.

Pauline (04:25)

Like being a parent is freaking hard. Being postpartum, being sleep deprived. I mean, I tell my clients all the time, we use sleep deprivation in war torture. And then

Megan (04:37)

Mm-hmm. Yeah.

Pauline (04:39)

we expect parents to not sleep and take care of a really needy dependent child.

Megan (04:47)

Yeah, yeah.

Pauline (04:47)

While they're not feeling well, while they

have had major abdominal surgery, while their lady parts have been shredded in half,

Megan (04:56)

On top of whatever else is going on in their life. Relationship conflict, financial strain, job stress, anything all of that doesn't go away because you have a baby too. Yeah.

Pauline (05:07)

Yeah.

One of the things

Megan (05:08)

yeah.

Pauline (05:08)

that we do know this woman and this family were begging for help, right? we will never really understand why, but they saw multiple people. These were not

Megan (05:21)

Yeah.

Pauline (05:23)

a poor family that couldn't access care, They had the resources.

They were willing, they had the insight, they knew something was wrong. They went to many, many, many, many different people. And still something happened that she wound up in a situation with a tragic outcome. and I don't know. Is it was it too much meds? Was it not enough meds? Was it I'm I don't want weigh in on that because I don't know. All I know is in the end.

Clearly something didn't work. so many people have been paying attention to maternal mental health, following the story. I know as a team we've talked about, like our parents are calling us, like, what do you think about this story? Right? Everybody everybody

Megan (06:05)

Mm-hmm. Friends are calling. Yeah. Totally.

Pauline (06:09)

is like following, and what I'm noticing, and even in myself, is we're all searching for some answer.

as to how this could possibly happen. like a mom can't kill her kids. That that like just doesn't happen.

Megan (06:25)

A loving mom can't kill her children.

Pauline (06:27)

Right, a loving white mom, right? Because sadly, for many different reasons, which is a whole other episode, like people are more likely to believe that that could happen for

Megan (06:39)

Mm.

Pauline (06:40)

other types of moms, right? But

Megan (06:43)

Yeah.

Pauline (06:44)

here we have a nurse, a wealthy, a beautiful, like that can't possibly happen. so how do how like our brains

Megan (06:52)

Mm.

Pauline (06:53)

Go about life trying to find an explanation for things. So, how do you explain something that seems unexplainable? Like a loving, nice mom would never kill her kids, So she must be evil.

Megan (07:04)

Yeah

Pauline (07:06)

She must be a monster.

Megan (07:08)

a monster, yeah.

It must be another reason.

Pauline (07:11)

I

mean, then we go

down the

Megan (07:12)

Yeah.

The rabbit holes

of like

Pauline (07:14)

all

the conspiracy theories, right? And

Megan (07:16)

yeah, yeah.

Pauline (07:17)

I am

equally guilty to be like, ooh, that sounds plausible. Like.

Huh, I wonder if because

Megan (07:25)

Yeah.

Pauline (07:25)

we just don't wanna believe that parents are stressed,

Megan (07:30)

yeah.

Pauline (07:30)

that it could happen, and that the brain could be so ill that some sort of tragedy like that could happen.

Megan (07:39)

And then I see the other side of it of mothers who have experienced postpartum overwhelm even.

Pauline (07:47)

Mm-hmm.

Megan (07:48)

And in myself as well. It's like that the response is: was I just five sleepless nights away from something like that happening to me? And that anxiety

Pauline (07:58)

For sure.

Megan (07:59)

and fear and grief that that has this has caused is so real that

when

Pauline (08:06)

my gosh.

Megan (08:07)

we hear people calling her a monster. It's like, are you calling all of us a monster? If that cause that could have happened to us. So it's almost like the reverse side of like demonizing to like, no, that could have been me, you know, and and this is where we it's so

Pauline (08:24)

Yeah. And it's scary. I mean,

Nicole Tropiano was who was on our podcast a few weeks ago has been really public on her social media about oh like I started to freak out. Is my anxiety psychosis? Am I gonna

wake up in the middle of the night and like do something tragic? Took herself to the emergency room for an evaluation.

Because she was like, I don't know if this is anxiety and intrusive thoughts or if this is psychosis and I don't want that to happen to me.

Megan (08:55)

Right, right. Yeah.

Pauline (08:58)

Right. It's causing you know, I think this story has touched so many people in so many different ways and it's really been a privilege to be able to use our podcast to

bring humanity and voice to some of the things that we're hearing about in the news.

So, you know, if we look back to the episodes that we've done in the past few weeks, which were strategically done because people are talking about maternal mental health. And if we're talking about it, we certainly want to be the ones talking about it.

Megan (09:33)

it's our obligation to bring in people who have a lived this experience and who are working to change the systemic structure to better support moms. So like that's our

obligation.

Pauline (09:44)

Yeah.

So we were so lucky to have

Aisha

Megan (09:48)

I shall

Pauline (09:48)

Alvi,

who wrote a book about her own experience with postpartum psychosis.

she really talked about what her symptoms were like.

Megan (10:02)

and how it can be missed. one of the most helpful things that she really was honest about.

Was this

experience of not wanting it to happen and also feeling like it had to happen. And that really that nuance I think is so powerful for me as a provider to have understanding around. and so I'm really re I'm really grateful that she was so willing to share her experience with

Pauline (10:34)

Yeah.

Megan (10:35)

us. Yeah.

Pauline (10:36)

Yeah. And one of the things that she is really passionate about is helping people to understand the difference between intrusive thoughts and psychosis. Also

not saying that it's rare, right?

Megan (10:48)

Yeah.

Pauline (10:48)

So many people have said like, yes, postpartum psychosis happens in only one to two per thousand births. But when we say it's rare, we give people permission to not pay attention to it.

Megan (11:01)

To say it's never gonna happen. Yeah.

Pauline (11:03)

we'll show the clip, but she talked about going back to her doctor afterwards and the doctor saying, I'm so sorry.

Megan (11:10)

Mm.

Pauline (11:10)

You were the first person that I have ever seen that had that. Right. And so when we say it's rare, we don't look for it, we don't know what it looks like.

Megan (11:22)

And it's

a spectrum. So when when we're only imagining the worst version of something, we're missing everything underneath.

Pauline (11:32)

Yes. And the worst version often starts with a subtle version. And yeah, the statistics are one to two in a thousand births.

Is that changing? Right? Are we just not recognizing it? Are we dismissing so many moms? Are we not getting people help? So we have a long way to go, but we have to we have to start talking about it. And providers have to get educated so that when it walks into their office, we're not convincing moms that that's not happening. You're fine, you're just a new mom. You're sleep deprived. It's okay. It's not okay. It's not okay.

Megan (12:09)

Mm-hmm. Because even

if it isn't, that anxiety also deserves to be treated.

Pauline (12:15)

Yes, No matter what it is, we

have to listen to moms when they say, I'm not okay, I'm

Megan (12:21)

I'm not okay. Yeah.

Pauline (12:22)

not myself, there's something wrong. We have to listen to them. so

Megan (12:29)

Okay,

let's roll a clip of Aaisha

Aaisha (12:32)

So firstly, I think that too many providers, too many organizations still want and insist on calling this condition rare. And what they do not understand is that when you call something rare, you are giving permission to society and healthcare providers.

to not know about it because you're basically saying you're never gonna see this. Why commit any brain space to this condition that you will never see? the first provider, she actually, that one that dismissed me the first time when I went, she apologized and she said to me, I'm so sorry, but you were the first case of postpartum psychosis that ever came into my office. And I was like, maybe not. Maybe you just never knew to recognize it. You know what I mean?

Pauline (13:16)

Right.

Yep.

Aaisha (13:18)

So that's

the first issue that when we call it rare, we give permission for people to not know about it, to not keep the hallmark symptoms of it top of mind. Okay. we do this and I've been told we do this calling it rare so that we don't frighten women. But you know what? You can't be frightened in developing postpartum psychosis. It's a medical condition. Like if I tell you, my God, did you know people could have strokes? You're not going to suddenly develop one just because you heard about it.

Pauline (13:45)

Right.

Megan (13:45)

Right.

Pauline (13:45)

then we got to talk to Lauren Devins, a nurse practitioner who was working as a perinatal prescriber in a perinatal mental health program, one of the biggest programs in New York.

she's the person doing the work.

Megan (14:04)

Yeah, she's

the person saying, I can help you. Yeah.

Pauline (14:08)

Right. And then she had

a baby and she was like, What the heck is happening to me?

Megan (14:14)

Yeah, none of us get a get out of jail free card.

Pauline (14:16)

No, it can really happen to anybody, even when you know about the symptoms, even when you are prepared, even when you do everything right. And she shared her experiences of, you know, being a working mom and having relationship issues and her family changing through divorce.

Megan (14:37)

And

infertility, going through infertility

does create stress. That can increase chances of experiencing a perinatal mood or anxiety disorder.

Pauline (14:46)

Yeah. Infertility is a risk factor for PMADs. So

roll the clip. We got Lauren Devons.

Lauren (14:53)

So we sat down with the nurse, we got the paperwork. I think because you're I was at this place of feeling so desperate to get pregnant at this point and have a successful

transfer and pregnancy that I really we signed stuff but it was like a blur and I really didn't focus or hyper focus on that because I think I was just very naive at the time thinking, well

I don't even know if I'm gonna have embryos and if we did if we did get divorced, like we're young, we're you know, you don't think about someone passing away, you don't think about divorce at that time when you're family planning. So we did sign that in the event of a divorce that they would be what we call discarded.

And I didn't I don't think looking back that I understood really what that meant or how emotionally that would feel.

especially once you go through this process, you go through the process and later on for me, they were potential

Pauline (16:00)

Yeah.

Lauren (16:01)

my potential children and Jack's siblings, potential siblings. So I think that's hard for someone to understand if you're not really going through this or understanding the process. So even for me being so naive not having done IVF yet, the round of IVF, but having lost,

I just said, yeah, yeah, you know, like just

not really considering it as much as I should have.

Megan (16:28)

Then we have Paige, which I really love this episode. And the reason I love it so much is A, she also had this lived experience. And then her story's a little different because then she went on to work in the field following her experience, but was a social worker before and used that. Yeah.

Pauline (16:48)

Yeah, and so many people do that. Like I'm just

gonna sidebar for a second because we train perinatal therapists. So many people who come to our classes, who come into this field, come because they had their own lived experience

yeah, absolutely.

Megan (17:04)

Well you and I both did. I mean we've talked about

it on here. Like that's this is a reason this is my like heart mission is because I know

Pauline (17:15)

we had another episode way back with Birdsong Doula.

And you and she said something like, you know, taking care of another mom is like taking care of yourself. You said it you remember that? 'Cause

Megan (17:26)

Mm. Yeah.

Pauline (17:29)

you said it so much more beautifully.

Megan (17:31)

Well, she asked me this question that hit me and she was like, What did that do for you? And I said it healed a part of me.

Pauline (17:38)

Yeah. And so so

many people get into this work because there's a part of them that was never taken care of or wasn't seen and we want to help other people to never experience and we help ourselves by helping others.

Megan (17:52)

Yeah.

And it's treatable. That's

Pauline (17:56)

Yeah.

Megan (17:57)

the big thing, it's like it's treatable.

Pauline (18:00)

Yes, yeah. So Paige is an icon in this in this land and really a role model and she's out there doing so much good work and advocacy for perinatal mood anxiety disorders.

Megan (18:14)

Yeah. I love her hope around systemic change. Like I love this really defiant hope that she has. that's really helpful for me to be like, okay, I don't really have to worry so much about what's not happening as long as like I keep my foot on the gas pedal.

Pauline (18:33)

Yeah. I might have to go back and watch that episode because I need some defiant hope today. Cause today I'm just

Megan (18:38)

Okay.

Pauline (18:39)

feeling defiant.

Megan (18:44)

That's fine.

Yeah.

Pauline (18:46)

but yeah, Paige is doing

amazing work moving these initiatives forward. and we're all so grateful for the for the work that she's doing.

Megan (18:55)

So roll that clip.

Paige Bellenbaum, LCSW (18:56)

This concept that I always share with new mothers.

That I think gives them a sense of relief because it's what they long for. I I say never is there ever a time in our life where we desire to be mothered more than when we are becoming a mother. And God, I just wanted to I wanted the proverbial mother to scoot me up on her lap and hold me and rock me back and forth and tell me it was gonna be okay. And I have spent years of therapy working through giving myself that. So personally, that is what I wanted

Professionally, I wish that as a social worker who

is moving through the School of Social Work and getting my degree, that there was a course on perinatal mental health so that if it happened to me, I would know. Hence, fast forward, I'm teaching a class at the Silberman School of Social Work at Hunter College. It's one of the first perinatal mental health courses. There's very few in the country. we're in the process of trying to publish a book to accompany the course, and we're

turning it now into a year-long trajectory. So that social workers and hopefully other disciplines, right, will be able to access this education so that when they go into the field, they know what to do. And as we know, so many people that are drawn to this field do so because of their own lived experience.

Pauline (20:16)

let's talk about Dr. Ruth.

she's a mom, right? So she talked about her experience as a mom and even, you know, struggling with how hard that was and being

Megan (20:26)

Mm-hmm.

Pauline (20:27)

a working mom and a physician in our current healthcare in a traditional

Megan (20:34)

Mm-hmm. And

Pauline (20:36)

healthcare model.

Megan (20:37)

yeah. And she even put up some public posts too around the same time of like her own lived experience having children and working in this environment and things that she had to go through and navigate.

Pauline (20:51)

And so this this is the part where I'm like really fired up today, Megan. and you know, it relates to Lindsay Clancy, but just how broken and fragmented our healthcare system is, and how hard it is to access good care.

Megan (21:11)

Mm-hmm.

Pauline (21:12)

Using your health insurance.

Megan (21:14)

Mm.

Pauline (21:15)

and I'm fired up today because I spent I think two hours on the phone yesterday trying to get an appointment for one of my kids. And I am like literally ready to lose my mind because it's it's just too hard. And I'm a healthcare worker with an education who does this for a living and

Megan (21:35)

Mm-hmm.

Pauline (21:36)

I can't get an appointment and I can't get a prescription to be covered by my insurance that says it's covered.

It's just it's absolutely mind blowing. we all work really hard. We feel like our insurance is a benefit that we get through our job, yes, yes, a benefit that we pay a lot of money for.

Megan (21:52)

That we also pay significantly for ever

Right. Like most people they do have to contribute. Like very few people their insurance is covered for them and they don't have to pay

Two hundred and fifty dollars a week, or whatever it is,

Pauline (22:09)

I mean it is absolutely maddening. And she talks about how maddening it was to be the provider on that side. And

Megan (22:17)

Mm-hmm.

Pauline (22:17)

she thought about leaving medicine altogether and just like giving up medicine and just finding another career because it all of us healthcare providers go into this work because we want to help people and then we're placed in systems that tie our hands.

Megan (22:32)

for shareholder.

Pauline (22:35)

For corporate greed. Dr. Dr. Solomon or Dr. Ruth Said like, you know, she would have this huge caseload of patients. She she didn't have enough time to spend with them. it was a machine, and I've worked in that machine. I know

Megan (22:47)

Yeah. Yeah.

Pauline (22:49)

that it exists. And I have like an allergy to it now that when I go back into

any kind of like corporate healthcare setting, I want to tear the place apart. I'm so

Megan (23:02)

Yeah.

Pauline (23:03)

angry from the minute I walk there.

Ruth Solomon, MD (23:05)

And to be honest, I wasn't even aware of this until I was doing my research into how can I pivot from where I'm at

because I was actually thinking about just leaving clinical medicine altogether. So I was like, what can I do with my doctor skills?

Because yeah.

Pauline (23:19)

Which is crazy when you go

back to the beginning of this conversation where you talked about how much training and education and competencies you have to have as a family medicine doctor and you were so

burnt out that you were like, Mm, maybe I'll just bake cookies leave medicine altogether.

Ruth Solomon, MD (23:36)

Yeah, yeah, that's kind of where I was at. And so in my research of direct primary care, I learned about health shares. So health shares are not health insurance, but what they are is basically

Everyone's saying that we're going to pool our money together. And this is like a list of things that will be covered by this health share. So sometimes people will do that because the monthly expense is a lot lower. And then you have like the hospitalization or the emergency care that will be covered with it Unfortunately, no system is perfect. So with health shares, you have to be very good about reading the fine print to make sure that you know exactly what's covered because they basically will list out like, this is what

we take care of.

Pauline (24:13)

So like, you know,

I I've been seeing the same primary care doctor for the past probably 30 something years. I adore him. And if it wasn't for him, I would not be at that place anymore. But like from the instant where I get to the desk and they're like, no, you can't talk to a human. You have to go sign in on an app.

Megan (24:32)

Mm-hmm.

Pauline (24:32)

And

PS, our Wi-Fi isn't really that good in this building. So the app is gonna struggle to load.

Megan (24:37)

You might want to go to your car, log on. Yeah.

Pauline (24:41)

I'm like, this is insane. I don't wanna do this. And you know, the the receptionist is like, are you an add-on? I was like, No, I'm Pauline. Like, I I'm not just w what are you talking about? Are you an add on? She's Well, you're not on the schedule. I was like, you

Your app just texted me that when I get here I need to check in. And she was like, well, you're early. That's why you're not on the list yet. And I was like, it says that my appointment's at 9.45. She's like, well, it's not. It's at 10. That's just a robot that texted you. And I'm like, like, where is the humanity? How about good morning? How are you? Who

Megan (25:20)

Yeah.

Pauline (25:20)

are you here to see today? I didn't have any of that.

And then I get to my doctor who I love. And he was like, not in that happened in my office. And I'm like, Yeah. Yesterday I called that same doctor to be like, Look, I really need I can't. I'm trying to make an appointment for my son with you. I've gone through like a million hoops because he's in this, you know, he aged out of his pediatrician.

now he's an adult.

So I'm trying to make an appointment and they're like, well, you already had a physical this year. You can't you can't have two physicals in a year. And I'm like, but he

Megan (25:52)

This is a while.

Pauline (25:54)

needs a doctor, he needs somebody looking out for him. well, you can't be a new patient, you can't be an established patient, you can't have a telehealth appointment, you're gonna have to come in. The next appointment's in November, but you already have an appointment with somebody else. Why are you gonna see this person? And I'm like,

Can you

please just go ask my doc? Like he knows I'm coming. I spoke to the doctor directly. Can you just go down the hall and ask him? And they were like, nope.

And I'm like, well, I ha I have his personal cell phone number. Do I need to call him on his personal cell phone number? They're Yeah, you can if you want. I'm like, This is maddening. And I text him and he, because I've been seeing him for thirty years and I have a relationship, texted me back. But that doesn't happen.

Megan (26:40)

No. And when you do

establish that kind of relationship right now, it feels like gold we just had to change all my son's specialists that we had a five year relationship with, and I am losing my mind because who's gonna advocate for him if he needs it?

Pauline (26:58)

I'm sorry, Megan. It's you. We are the ones responsible to advocate

Megan (27:01)

Yeah. Yeah.

Pauline (27:03)

because I I love this doctor, but he's gonna retire at some point. And

Megan (27:09)

Yeah.

Pauline (27:09)

also like I don't want to call him on his personal time. I

respect that we are humans with a life outside of our job. And so the only way that we can get good care is by intruding on somebody's personal life.

Like what is wrong with our system?

Megan (27:27)

Well and also like

why do insurance companies not trust a doctor's recommendations even afterwards? Like what's happening?

Pauline (27:36)

It it

it's it is insane. I call my husband, I'm like, that's it, I'm paying out of pocket. I'm like gonna go to concierge medicine, I'm gonna get an appointment for him. And my husband, who's not a healthcare provider, he's like, but I don't understand why. We have insurance.

For everybody listening who thinks that you're gonna get good health care because you have insurance, there are good providers out there. My doctor's one of them. I adore him. He is in a system. So insurance might get you access to good doctors, but it seems like it gets you really shitty access to accessing those good doctors.

Megan (28:14)

Yeah. Yes.

Pauline (28:16)

I'm still way fired up about it, but like it shouldn't take me hours to get an appointment. Not even to wait for appointment on the phone, trying to give get somebody to give me an appointment. I had to go the through the computer, say your name, say your date of birth, get transferred here, go to the call center.

And then when the call center finally scheduled the appointment, the front desk called me back and said, the call center just called us, but we need to cancel this appointment. I was like, what do you mean you need to cancel this appointment? It took me an hour to schedule that appointment. Well, they said that you're a new patient, but they put you in an established patient spot. And I was like, They said I couldn't be a new patient because you already had a physical. It was like insane. It's insane.

It is so frustrating. Not to mention the whole reason he needs this appointment is because he has multiple medical conditions that multiple different doctors have told him he needs treatment for, that the insurance company has said that treatment is covered. And still when he goes to fill the prescription, the insurance company denies it.

So who's advocating for your kid, Megan? Sorry, it's us. In between,

Megan (29:25)

Yeah, no. Yeah. Yeah.

Pauline (29:30)

running up our own lives.

Megan (29:32)

That's not

it, but it's not enough. Like, that's the problem. It's like I've advocated for my kid before, and that did get me a relationship with a doctor, but she's the one that had to fight the insurance company to cover a life-saving treatment, to be honest. Yeah.

Pauline (29:50)

Yeah. Why

do we have to fight for life-saving treatment?

Megan (29:57)

For children

Pauline (29:59)

For ch for anybody. I mean, yes, I love

Megan (29:59)

and young adults. Any for anyone. But

Pauline (30:02)

children and we and we want to raise a future.

Megan (30:04)

But also it's like

I I don't like

Pauline (30:13)

Sorry, I have now fired you up.

Megan (30:14)

Yeah. Well,

okay, so it's like what do we want for people's lives?

Pauline (30:20)

Do

we? Do we want and by we, I'm talking about institutions, systems, government, healthcare. Health care. Insurance is not about health care. It's about

risk management, I think. I don't know. I think it's a I I mean clearly it's about profit.

Megan (30:37)

It's about I think it is sh

it's shifted to profit. I think at some point it was about risk management. But in the last ten years it's exploded to profit. And we see

that because the recent news article that the United Healthcare, is it United Healthcare, is no longer going that they are putting a life coach.

With a high

school diploma requirement and 10 weeks training, 10 days training, who knows? Not training. Before someone can see a licensed therapist for mental health

concerns. And

Pauline (31:13)

Mm-hmm. Yeah.

Megan (31:15)

then they have to establish that they need to see a licensed, licensed education. You go to grad school, you go to medical school if you are that kind of provider, but licensed.

Pauline (31:29)

Right. So if you are somebody

Megan (31:30)

Provider.

Pauline (31:31)

struggling, you are supposed to go and speak to a high school graduate who's got some training to determine if you actually need quality mental health treatment.

Megan (31:44)

And when and when we say training,

we mean a few weeks of learning how what things to say to somebody, not how to assess someone.

Pauline (31:53)

Right. Trained

and who is training them, Megan? The insurance their employer, the insurance company.

Megan (31:58)

I don't know. A computer? Yeah, a computer.

Pauline (32:03)

Right? yesterday when we were having a problem with our phone service, and I had to talk to the offshore person who read through a manual and was like, Okay, thank you for calling. Thank you for bringing this to my attention. Is there anything I can help you

Megan (32:17)

Yeah.

Pauline (32:17)

with? That's what we're gonna get for mental health care.

We're gonna get people who are trained to route people's problems. And why is that? Because there's a shortage of mental health providers and there's an increased demand for mental health. So our society is getting more depressed and more anxious.

Megan (32:36)

and then they're gonna be there like AI will be prompting them.

Pauline (32:41)

Right.

Megan (32:41)

And we know

AI cannot assess people.

Pauline (32:45)

I mean, I'm I'm fired up and sad and frightened and angry and all of the things because

Megan (32:54)

Yeah.

Pauline (32:56)

this is what's happening, right? This is and and it results in in tragedies. My my kid who has multiple medical issues needs to be on a medication that everybody agrees he should be on, can't get it.

'Cause he's

just not sick enough.

And I'm fortunate enough to be able to get him help, pay for it out of pocket if I need to, but the only people who are going to be able to get the medical care they need is the people who can afford to pay out of pocket. The people who have that privilege.

Megan (33:32)

Privil yeah, that health is got health is a privilege

in this country.

It's wild.

Pauline (33:39)

Yeah. I mean even when we talk

about the Lindsay Clancy trial,

She has the privilege that there are people who have sympathy and empathy for her, but that doesn't happen

Megan (33:49)

Mm.

Pauline (33:52)

to a lot of women,

Megan (33:53)

Yeah. The color

of her skin the allowed her to get a level of pause before people created judgment.

Pauline (34:02)

she had a lot of privilege that came from how she appears. Right down to what

that we

were allowed in her trial to talk about her medical history, where

Megan (34:14)

Mm.

Pauline (34:14)

there are other women with very similar profiles

Megan (34:20)

Not even considered. Yeah.

Pauline (34:22)

Where it's not even considered, So Latarsha Sanders was on trial in that same courtroom with that same judge, and they did not allow her medical record to be brought in. She did not garner the sympathy and

Megan (34:35)

Mm-hmm.

Pauline (34:36)

empathy that has come out to support Lindsay Clancy. And her trial is now being reopened because

this brought attention to that.

But where are we as a society? Where are we as a system if only the people with privilege and power and money can access good health care? the rest of the society is depending on our insurance I'm more and more thinking about insurance as catastrophic care.

I think it's

Megan (35:07)

Mm.

Pauline (35:08)

gonna be really good if I have to be hospitalized or if I like

Megan (35:12)

Mm-hmm.

Pauline (35:13)

need a serious procedure, knocking on wood. But for everyday care, I don't see insurance as particularly useful. For preventative medicine, I don't see insurance as particularly useful. For mental health care, I mean mental health ha

We've been leaders in struggling with insurance companies. More

Megan (35:37)

Yeah.

Pauline (35:38)

I mean, I think medicine is now feeling what behavioral health has felt for years. Like

if you've

Megan (35:44)

Mm.

Pauline (35:45)

ever wondered why it's so hard to get a therapist who takes your insurance, it's because it's so undervalued by insurance companies because it's preventative or because it's not medically necessary. And

Megan (35:59)

Mm.

Pauline (36:00)

now we're seeing that with health.

care with like medical health care, right? GLP ones, for example. There's

Megan (36:05)

Mm, yeah.

Pauline (36:08)

so much research showing how beneficial they are, but you have to be sick enough for insurance to cover it.

Megan (36:17)

And even then

if there's another treatment that's cheaper but maybe less effective, there you gotta have to do that one first. It doesn't

matter what the side effects are, you have to do that one.

Pauline (36:28)

Yeah. So

Megan (36:29)

So

Pauline (36:30)

I'm fired up. We have a lot to talk about. I has been our privilege to be able to bring some of these conversations to your living room and dining room tables.

And unfortunately and fortunately there's more where that came from.

stick around 'cause

Megan (36:49)

Stick around,

we have some good guests coming up. And let us know what you want us to who you want us to have on. What's the thing that no mom told you you want to hear someone talk about?

Pauline (37:00)

Yeah, if you're fired up. Join us.

Megan (37:04)

Bye guys.

Pauline (37:04)

have a great day. Bye everybody.