Making Sense with Sam Harris - #203 — A Conversation with Caitlin Flanagan

Episode Date: May 13, 2020

Sam Harris speaks with Caitlin Flanagan about her cancer recurrence and the response to her recent article in The Atlantic discussing it. They discuss the dynamics of apologies and forgiveness, the #MeToo movement and the allegations against Biden, modern feminism, and other topics. If the Making Sense podcast logo in your player is BLACK, you can SUBSCRIBE to gain access to all full-length episodes at samharris.org/subscribe.

Thank you. episodes, you'll need to subscribe at SamHarris.org. There you'll find our private RSS feed to add to your favorite podcatcher, along with other subscriber-only content. And as always, I never want money to be the reason why someone can't listen to the podcast. So if you can't afford a subscription, there's an option at SamHarris.org to request a free account. And we grant 100% of those requests. No questions asked. I am here with Caitlin Flanagan. Caitlin, thanks for coming back on the podcast. Thanks for having me again. So, um, I'll give that dog a moment. My God, you sent someone over to kill my dog?

I'll sacrifice a lot for a podcast, but probably not your dog. Okay, good. Thank you. So Caitlin, so now people have read the article that was embargoed last the last podcast so we'll talk about it here as well but I can't feign surprise at the ordeal you've been going through but let's take the article part first because people obviously should just go read it it's this really just wonderfully luminous and wise and witty. I mean, this is sort of not a surprise with you ever, but it all came together on this topic, which is revealing both your current health concerns and the way in which they're compounded by the COVID pandemic. And it was just all interesting and beautiful and triggered an

outpouring of appreciation on Twitter, which again was totally unsurprising given who you are and how many people I know love you because having done now a few podcasts with you, it's just absolutely obvious the degree to which you inspire love in an audience. And this may not be something that was obvious to you, but it was very obvious to me because I've been on the receiving end of it. So I guess my first question is, was there anything about the reception on Twitter and anywhere else you saw it that surprised you? The bigger feeling was embarrassment, you know,

because it's really intimate to open up your health issue. I mean, some people are really comfortable with it. And for me, it's not something obviously that I talk about. So it was the first wave of it was I just felt embarrassed to have laid all this, laid this heavy trip on people or to feel that I was getting, I don't know, I don't know, I just felt embarrassed. But then after about 24 hours, as always happens when you come out of whatever closet you're in, when the minute you come out of it, you're like, oh, what an incredible relief, because I would be sort of tiptoeing around this many, many, many times in my work or in what was expected or hoped that I could do in terms of sort of

making appearances places. So it just, it's always easier to just sit out there, just to have told the full, any relevant truth. Once people know it, then you're not hiding it anymore. And it had really gotten to the point that I felt like I was hiding my illness, and that felt really bad. Well, let's summarize it for people who haven't read it. What is your diagnosis, and perhaps just track through the stages of its presentation? All right, I'll tell everybody. I bet they'll be super bored and just fast forward over this part of the podcast. But for anybody who's interested. And I should say, whatever we're going to say now is no substitute for reading your piece,

because I want that read. So please go. Thank you. Well, so I was a young mom in the sweet spot of, I mean, I was 40, so not a young mom, but I had really young kids. I had twins who were four years old. And I had like behind my generation, I guess, I was just one of these girls who really, I didn't ever really want a career. I mean, I thought about teaching school, which I did. And I thought about writing, which I do. But I really wanted to be a mom.

I really wanted to be, I wanted to be a housewife. I didn't know the dark side of it, but I just thought. I really wanted to be, I wanted to be a housewife. I didn't know the dark side of it, but I just thought having kids, which will be the best part of my life. And then when they're little will be the super best part because my parents really hated having adolescent daughters. And I got, I kind of remembered how horrible that was for them, but it was no picnic for us either. But so everything was fine. Never been sick. Never thought of myself as sick. Nobody that I knew in our family. We don't have a lot of family history, but nobody had had cancer, breast cancer. And I went for this like routine checkup mammogram. And then it was like, well,

can you just wait a few minutes? We need to get another film. Oh, sure. You know, I'm not really, my ears aren't like pricking up at this. And then, oh, he wants to have a sonogram. And two of my closest friends had had to have a sonogram after their mammograms and been totally fine. So I thought, I guess that's what happens when you're in your forties, you get the sonogram. And then right then and there, he said, yeah, you have cancer. And he said, and we're doing a biopsy now. And he never asked me if he could do a biopsy. Just the things that happen to you when you're really heavily medicalized, it's really hard to assert your will again or to even know. Because I remember lying there thinking, well, do I have a say in this? But I didn't say anything.

And then he said, like, this needle biopsy, a little bit painful. And then he kept saying, you have to prepare yourself. You have to prepare yourself. It was a Friday. So it would take, I don't know, till the next week early to get the results of the biopsy. I guess it was Monday. And he kept saying he didn't want me to drive. I got in dress. He wanted me to see him in his office, at which point he told me it was aggressive, very aggressive. And then he said, I don't want you to drive and I should call your husband. And I just had this animal need to get as far away from him as I could and to contain the information as much as I could. I just thought

something weird has happened in this building. I got to get out of here. I got to not have anybody know about it. And so I'm sure I shouldn't have driven. I'm sure I was in shock. And then my husband called. So the guy had called my husband. And I'm not blaming the guy at all. It's just sort of interesting that you start losing your, I don't know. It's very easy to lose your sense of who you really are in this. But I'm sure the guy was right to call my husband. But I got home safely. But wait, before we proceed, that does strike me as an anachronism. That does seem like a throwback to the 50s where doctors sort of messaged around the woman to the man.

And in some cases, didn't even tell the woman their actual diagnosis. This seems like a slightly Mad Men era doc you were seeing. Does it strike you that way in retrospect? Now, at the time, you're thinking of so many things. That's the last thing. I remember being like, oh, goddammit, because my husband called on the cell phone and saying he knew. I just heard from so-and-so. But I think the doctor whom I had really gotten to know, he'd helped me with another problem earlier. I think he was freaked out. And I just think there was a lot of very human emotions going back and forth between him and me. And I blame him 0% for either of those acts. It just was part of the introduction to me of what it's

like to have cancer, what it's like to have a really serious disease where like suddenly you think you've seen things. I've had a cesarean section. I've been up against it. You know, you haven't been up against it till you get that really serious disease and you're in a whole other world. And so I got, so I had to turn a stage three and I got slammed with the, just this kind of chemo. I don't think they give it anymore. They've written books about it. It's called the red devil. I can't remember what it's tax it here. Maybe it's a, just a horrible, horrible, horrible experience to go through that kind of chemo. But I had the chemotherapy. I had the surgery, the lumpectomy. I had the radiation by a very charming doctor who I later heard was kind of in the early stages of dementia.

But I totally dug him. So he got along great. He was always telling me how beautiful I was. And I was like, this is the best doctor I've ever seen. Like, I'm bald. I'm shriveled. I'm like. Is that the first sign of dementia?

A compliment? I think so. I think so. I'm shriveled. I'm like. Is that the first sign of dementia, a compliment? I think so. I think so. I should have run for the hills. But anyways, I had a good remission and I was just at that five-year point that's kind of hyped up as a significant point. And I had a huge devastating recurrence where it was in my liver and my chest wall and my lungs. And I thought, oh my God, I'm really going to die. I'm going to leave these kids, you know?

And how old are your kids at that point? They are just about 10. And so on the one hand, I was like, okay, I got them through to double digits area, you know, but a kid really needs and wants his mom, especially a boy. I think 13, 14, 15, up until then, they have a very deep need for a mom because they're so behind developmentally girls at that point. Obviously, girls and mothers, et cetera. But I've noticed that boys have a deep need for mom until kind of that age. I was like, oh, I wish I'd gotten them there. Give me a little more about your life at that point. Now, are you still married to your boy's father? Yes. Okay. So yeah, I don't actually know the backstory. You guys are still married.

Oh my gosh. Yes. He's the cancer husband of the year. I mean, he just, you really, that's one of the things about, everyone's had a crisis and everybody's had a tragedy and that's where you really find out what people are made of, you know? Yeah. Okay. Well, I'm very happy about that. Yes. As is everyone listening. Yes. Were you at this point working full-time as a writer or are you still, are you at Harvard Westlake School as a college counselor? No, no, no, no, I was, by then I had quit the school to become a mother. Took me a year and a half to get pregnant. I had the children.

And what was it? What was I doing? Well, I had just started writing. I was just writing these articles at The Atlantic. I just started as a writer and they'd given me this chance to write. Right. And they'd liked what I'd written. So I'd written more and more.

And then I had written one that caused this huge sensation. And I had been given this huge book deal. And I literally am getting the deal at the same week that I'm finding out. I'm so sick. This is back at the original diagnosis. So anyways, I got better. I published the book. There was a lot of press, a lot of negative press. But then a lot of people who really liked the book, but of course, I ignored of negative press, but then a lot of people who really liked the book, but of course, I ignored them entirely as fools and really trusted everybody who hated me. More dementia. Yes, exactly. So I had done that and I had a contract for the next book. And I felt a lot

of pressure about that. But yeah, I was out there in the culture. I was doing my thing that I do and getting more and more confident in it. like TV movies of the week. And it would always be like, gosh, my elbow hurts. You've got elbow cancer. And then like the whole rest of the TV movie is the person like losing their hair and dying. So I thought this is so bad. And then a nurse in the private practice, I was in a really, I knew so little about cancer when we started all this, that we just thought, you know, we asked people for names of practices. And it just, and it was a private practice, Cedars-Sinai, excellent practice, excellent doctor.

I love him to this day. But so I thought, oh, a private practice, that's got to be better than a public hospital or a teaching hospital obviously you know if you pay for some more for something or if your insurance that's really the the hero of this whole thing is I happen to have great insurance or my husband's job but it turns out that you don't always have access to everything that you could possibly have access to if you're kind of down the line in a private practice. They're kind of getting the first crack at medications that are being put out there, but they're not getting it the way the labs are. And when you're stage four, nobody's going to question what they offer you, you know. So a wonderful nurse took me

aside at that private practice and risked his job by closing the door and saying, I think you should get a second opinion. Because I'd really trusted him. And I asked him, what should I do? And he said, I think you should get a second opinion. And that was profound. Maybe we should define stage four for people who haven't been through this on any level. So you originally had breast cancer, but now it has metastasized to your lungs and liver and elsewhere. And so stage four is just the fact of having metastasized elsewhere in the body from the primary site. In most cancers, I think that's the way the staging works. It's certainly the way the staging works in breast cancer. Stage four in most cancers

and in breast cancer just means it jumped the fire break, that you had it contained within just one, within the breast or whatever the primary form of cancer was. And maybe it's even in the lymph node, which was in my case true when I first got it, so that you really get whomped with the chemo and all that to try to kill it from ever getting into the blood at all, although it's in a little bit, starting to get a little bit. But when it breaks the fire, you know, jumps the fire break, as I say, that's when that cancer has wildly gone through the system and is attacking and finding locations to build itself in different parts of the body. And that's really serious. And in my mind, I'd always thought, and it used to be kind of a pretty soon death sentence,

but someone else I know in Los Angeles, and if she's listening, she'll smile because she'll know who she is, who knows a lot about cancer. She just looked at me and said, you have to get closer to the science. You have a particular kind of breast cancer. It is marked by the overexpression of a certain kind of genetic material. All of that work is being done at UCLA. And I know you have to wait longer to be seen, and it's a hassle, but that's where you need to go. Because this guy, Dennis Slayman, you have her two new breast cancer, and he's the guy who's really hacked into that. So with this new drug, Herceptin, and then with a whole armamentarium that followed that. So I got an appointment with one of these brilliant young

oncologists in his lab, Sarah Hurwitz. And my last practice, it said, well, we're going to section your liver and take out the part of your liver with the cancer in it. I was like, that sounds really bad. She was like, not at all. She had so many treatments. She said, I think this one will be the best. We'll give you six treatments, six. It's chemotherapy plus the Herceptin plus some other things that were from their armamentarium. And after three treatments, we'll give you a scan and see how it's going. And, you know, you go for the scan after three treatments.

That's terrifying. But the really terrifying part is going to find the result, you know, getting the answer. And we had actually, we booked a night actually, because they're her offices in Santa Monica, and we're far east of there. And we just thought, okay, we're going to book a night in a nice hotel, because if it's bad news, we'll need time to pull ourselves together before we see the kids. And if it's bad news, we'll need time to pull ourselves together before we see the kids. And if it's good news, we'll have a nice night in a nice hotel. So she walks in and said, your tumors are gone. Like there's still traces in the blood. We have to finish this.

But they were gone and they stayed gone for 11 years of durable remission. 11 years. And you just think, I mean, if it had been five years earlier, the thought that a woman with metastatic breast cancer, with lesions big enough to be biopsied in the OR, would not have a single one of them after three treatments of chemotherapy, that was much easier than my first chemotherapy. And I was tiptoeing

into, there's a cohort, a very small cohort of women in Dennis Slaman's sort of research and work who doctors are starting to tiptoe around calling them cured, which, you know, stage four cancer, there's no cure, et cetera, et cetera. We're never going to use that word, but they have gone so long with no remission of any kind or no recurrence rather of any kind that they're starting to wonder if they're actually cured of breast cancer. And I thought I was going to be in that group. And then my tumor numbers started going up. And sure enough, eventually a scan came about a year and a half ago or almost two years ago, a year and a half ago, that I'm once again metastatic. So it's not good news to find out you have metastatic cancer, obviously. And it was in my spine that was really scary to me

because I could just sort of see, not being a person who did well in biology, but was interested in biology, I could sort of see a tumor in a soft tissue kind of disappearing. It was harder for me to think of a tumor in bone disappearing. But yeah, they do. The lesion goes and then the bone starts to heal, even in someone who's like, what am I, 58? And I've had all this treatment. So my biggest issues really are I have from all of this treatment over all these years, I have a lot of health issues that come from the treatment, not from the cancer. And it's mostly these issues that now I've been taught before they were just my conditions, I guess, but now they're my underlying conditions. It's really bad if your worst condition becomes an underlying condition. Then, you know, it's like someone just layered on another even worse condition.

So just telling the public, to the extent that I have a public, or any public of people who haven't read me at all, that I have stage four cancer in a shortish essay was going to take a lot of unpacking anyway to explain that this tall subcategory that I've been in and maybe still am in that's very good news relative to bad news, and then trying to layer the COVID on over it, it was like an exposure dream in a way, even though it's been a relief. Had you spoken about it or written about it at all? Because I had sort of missed it, but I got the sense that you hadn't been completely in

the closet with respect to having gone through the initial round of cancer. Well, in my first book, in the very epilogue, because I wrote it after I'd had this first bout of cancer, but was now back on my feet. I wrote about, oh, I had other one other thing to tell you, I had cancer, you know, and this is what it was like. It was just a few pages. And then a few years after that, the Oprah magazine asked me to write something about it, and I foolishly agreed. And something came out that was kind of, I don't know, I didn't do a good job with that. And then I thought, oh, never again will I write about cancer. And then I- What was the painful response to that?

Oh, it wasn't the response. It was my feeling that I hadn't done a good job in the essay, that I hadn't, I didn't like what I'd done. But the Oprah reading public is not a big overlap with the people who often read my, I don't know. It just was, the thing is that it's true that this is a very deathy situation. And so people who have no idea that you've been in a deathy situation, obviously respond thinking you're dying, which of course I am as we all are. but then that kind of makes you look anew at your situation like oh my god this is a really shocking terrible situation and then trying to resettle yourself especially in a pandemic where you can't go and see the people you can talk to them but I guess you know whenever whenever someone hears about it from the outside

of me and my family or people who really know us, the reaction of the people tell me, yeah, I've been through a lot in 17 years. But when you're living your life, that's not ever how it feels. It's just you live your life with whatever hand of cards you have. Yeah. Well, there's a lot in there that's interesting. First, I want to flag that a deathy situation is a phrase I'm going to use now. Okay. It's yours. Take it. It's yours. That's one of the windfall prophets of this episode of the podcast.

Okay, good. You know, it is interesting the way in which talking about something reifies it just based on the response you get to having spoken about it, and then you're dealing with the response. And often, that feels like it concretizes a problem in a way that's not entirely representative of the experience of going through the problem, right? I guess in microcosm, I've experienced this where I've, and this is highly non-analogous, but if you, I don't know, if you have a fight with your spouse, right, and then a friend catches you right on the heels of that, and they ask how you're doing, and you say you just had a, you know, a fight with your spouse, you know, then the next time

they talk to you, they're asking you how it's going, you know, in the marriage. Have you found a good lawyer yet, right? You're like, what are you talking about? Yeah, like, who's going to keep the kids? Right. But that has no relation to what you've actually gone through, right? And so I can imagine there can be a kind of amplification that happens when now you're dealing with this huge public response. The other thing that's unique about cancer, it seems, is just the word, the concept of this particular illness being

word, the concept of this particular illness being unlike any other. And this is still true, but I'm sure it was even more true 17 years ago. It's a scary word, and it is the quintessence of a deathly situation. How has the concept of having cancer influenced the experience of having it? In the beginning, it was, I remember thinking that first weekend, because I had the appointments Friday afternoon. And I remember the first weekend just thinking, I can't incorporate this information. I just felt like it was outside of me. And I had to somehow get it into me, you know, that it's just, you know, the cliche that this is something other people get. You know, we really, you know, Freud, we live by convincing ourselves we're invulnerable when we're very vulnerable. You know, somebody's got to get breast cancer. I couldn't take it in. I

just could not take it in. And it does seem different from getting a diagnosis of heart disease or emphysema. I mean, there are obviously bad things to get that kill people, but don't have this same charge. Do you think it's the result of the difference or the very common difference in treatment around cancer where chemotherapy and radiation are what you're now picturing and in many cases actually going to experience. And so this is the one disease you go to war with in a way that you don't with, say, heart disease. Yeah, I think that's a huge part of it, for sure. And I think that it is, again, so deathy. And that most of the, I always felt, and I used to say beforehand,

you know, just kind of looking at, you know, you always look at obituaries and you read them. And I remember thinking, yeah, the three things I notice over and over are smoking, car accidents, and cancer. I mean, it was not a scientific study, but I noticed that the things that I tended to be, like whenever I would be about to take off on an airplane, if I felt frightened at all, I'd say, you know, it's not smoke, you're not smoking, you're not this and you're not that, you know, numbers are on your side. And it's just, you know, the war on cancer. I remember Nixon had that. And it was just that all of these other diseases were sort of falling by the wayside. And my mother told me, my sister's older than I am, by the wayside. And my mother told me, my sister's older than I am, so she was a baby in the 1950s.

And my mother said, sitting with the baby in her lap in New York to go and get one of the first kids to get, be in the cohorts that got the polio vaccine. My mother said, she just thought, my baby's never going to have polio. It was such a joyous, amazing, she couldn't wrap her mind around it. Because if you had been born in the 20s, you knew a lot of kids who had gotten polio and a lot of parents whose lives had been just completely taken to a terrible place because their kid's getting polio. And so all these other diseases seem to be falling by the wayside and yet cancer has stayed with us for so long. And we know that it's the one that, and I've always been adamant that I'll not be in this situation, that you could be treated in such a way that made your life even worse for three

months and then you die right after that. So it's kind of like this thing that can potentially, the treatment can be so horrible and it might not work. So it's really kind of a heavy thing to think about. Although no bravery, I can't tell you how many times I've been told in the last 72 hours, thank you to anybody who said that to me, and many times in my private life, how brave I am. Zero bravery, zero, zero bravery. Someone comes to you and they say, hey, got a choice here. You have a life-threatening disease. It can kill you in a few months, or we could try out this treatment. I'm like, I'll take the treatment. Let's give it, let's roll the dice here.

Door number two, yeah. I'll take door number two. I mean, maybe it's a zonk, but maybe, you know, maybe I'll get there. So a lot of things I've learned about cancer are like, number one, how you feel, total myth. Like, you know, if you have a good attitude, you know, you're going to do better. It's a lot of studies on that. You can be a total bitch. You can be upset. You can cry every day. It's not going to, you know, you take the medicine, you take the chemotherapy. Sometimes it works for you. Sometimes it fails you and you have to try another one. You don't have to have a good attitude. You don't have to be right with God. You don't have

to be, you know, it's nice to be nice to all your caregivers and you will be because they are so great, but you don't have to be nice to anybody. It's just the chemicals go in, there's a response. You know, I think probably there's probably more compliance with treatment in people who have a good attitude. I mean, I've never had a good attitude ever in my life. And look at me, it's 17 years later. Wait a minute. Are you in the total bitch cohort of this study? Well, there have just been... I remember asking somebody who knew about this very early on, who studies this. And I said, I just feel like I have to be so good because I'm in such a precarious situation. She said, oh, no, Caitlin. I have seen the nicest people.

And you probably know many very good people who died of cancer. And I'm like, well, that's really true. And then she said, trying to cheer me up. And I've known some real bitches who made it. And I'm like, okay, somewhere between total bitch and really nice person, but maybe more to the former that it's irrelevant. It's just irrelevant what? Obviously, we know this. Children get cancer. Who's punishing them for that? What have they done? Nothing. It's just, it's beyond our knowledge. I mean, it's not beyond our knowledge. It's, I mean, it's not beyond our knowledge. It responds well. Some cancers respond well to certain kind of chemotherapies. So. Yeah. So yeah. So one of the aspects of your essay, which I know touched a lot of people is the way in which you discuss reaching these various landmarks by reference to

your sons, you know, their graduation from preschool and elementary school and reserving a hotel suite for their college graduation, which now is indefinitely postponed due to COVID, and just seeing the psychological suffering based on uncertainty, which again, we all, if we have our wits about us, should be experiencing in some measure without a cancer diagnosis. We're all in a deathy situation, as you point out. We're not, you know, no one knows how long they're going to live, and therefore we could be magnifying the preciousness of time in this way anyway. And I think a fair amount of wisdom is dependent on taking death seriously before you've had any kind of diagnosis.

But in your case, in the case of anyone who gets cancer, it sharpens up the story considerably. And I know that moved me, and I'm sure it moved a lot of people. How has just thinking in terms of being a mom and seeing various hypothetical dates out there on the calendar been the way in which this whole experience has been framed for you? Well, very helpful, because it was just, I've got a mission and it's not a mission about my life. It's a mission about my children's lives. And to the extent children can have their mother, they want their mother. So I just, I, well, I counted my life in two ways by,

it just so happened that they were in preschool when I was diagnosed. And there was, you know, nowadays there are all these constantly graduations, but there was this, you know, sweet little preschool graduation. And everybody was just so happy and bustling and taking their pictures. And I, you know, had no hair. I was in a headscarf. And I just remember thinking, this is going to be the only graduation you're going to get. And kindergarten rolls around. Well, they got a graduation. I'm still alive. And I made it a few more years. And I thought, I'm going to make it to elementary school graduation. And then I had my recurrence. And I thought, oh, I'm not going to get there. But I did well. I made it to elementary. The years pass. I'm like, I think I've got high school in the back. Yep. I got it to high school. And then I really thought this I had made it to to college. And then I had this recurrence halfway through there being in college. But I got treatment. I did well. I like sat on the phone to make the very first reservation allowable for the graduation of this year at

Kenyon, wonderful Kenyon College in Ohio at the Mount Vernon Grand. And then now because of COVID, you know, it's been canceled. So like in the movie version of this, I have to keep it getting canceled forever so that I can stay alive because the graduation will be the end point. That's your appointment in Samara. Exactly. My appointment in Gambier, exactly. But what you ask about death, two things, and how we hold life preciously. I remember 25 years ago, do you remember when there was an Alaska airline flight that crashed maybe off the coast of Santa Barbara? It was a big crash, full of people from LA. So it was very meaningful, touched a lot of people. And the weekend edition of the LA Times after that, they had a one-pager where they went and asked different religious leaders, what meaning do you make of this? What meaning are your followers or does your faith hold for this event?

this event. And, you know, some people said there's, you know, predetermination or there's mystery or life is, you know, God has plans that we don't see. But the last one was a Buddhist, and the Buddhist said, the cause of death is birth. And I was like, oh, yeah, like, that's really accurate. There's one thing we can say for sure, that once you're born, at some point you're getting out of here. You know, you're checking out. It's temporary. But the other thing about how we should be holding our lives in such a tender, close way all the time, I think that's kind of the lesson of the play Our Town by Thornton Wilder is that you can't. You know, it's kind of a corny play, but it's about a girl who kind of comes back to life and realizes how preciously she should be holding and everyone in the room

should be holding each moment. But you just can't do it even after you've gotten the word about it. You, if we lived life with the intensity of somebody who's looking at their kids after getting cancer diagnosis, we wouldn't be able to do anything. And to some extent, we're in such a precarious situation at all times that the only way to deal with how precarious it is is to almost pretend it's not precarious, you know? I think there's one strand of that kind of wisdom in extremis that we can seize and maintain at its highest level. And I'll grant you that we can't say goodbye to everyone like we're mounting the scaffold every time someone is just leaving to run an errand. So there's an intensity to our awareness of our connectedness to other people that we can't quite maintain. But I think we can resolve to

not suffer over trivial things the way we would. It would be obvious we shouldn't be suffering over those things under the shadow of a cancer diagnosis. Right, right. Although, like maybe someone is kind of a jerk to you and you have cancer, you don't have to necessarily think to yourself, I must see the humanity in this person. Because it's like, I think you get to still know, you still get to have, I mean, it's very refreshing. Let me tell you, when you're in a deathy situation, the minute some small trivial thing bothers you, you're like, oh, what a wonderful sensation. You know, to just be like annoyed by something. God, it's excellent. Okay. Well, speaking of that, I wasn't sure I was going to bring this up, but you did have one response on Twitter that was just amazing. I mean, amazing to a degree. Wasn't it great? Wasn't it the best thing ever for all Twitter kind? It was glorious, but it was so

perfectly crafted that it was one of those moments where you think, okay, this is a simulation we're living in and it's showing its seams because this is just too on the nose. So you receive a tweet, which has since been deleted, I think. Oh, has it? Yeah, which is, I guess, maybe shows some scruple. No, no, it shows anxiety. Yeah. It shows anxiety. If it had been a lauded tweet, it would be the pinned tweet. Yeah. It wasn't based on any scruple. I'm sure you're right about that, but I'm going to bend over backwards to be charitable to this person. Okay, good. All right. And you don't even have a deathy situation. I should be. Actually, I was charitable to this person, but carry good. All right. And you don't even have a deathy situation. Actually, I was charitable to this person, but carry on. You were, actually. You were perfect in your response. No, I was even more perfect in my response, but I'll tell you at the

end. Okay. It was private communication. Oh, good. So yeah, I want to hear everything. So anyway, this woman, Dr. Amita Kalechandran, who is a doctor and a, I was surprised and doubly horrified to learn, a New York Times writer, tweeted at you in response to your cancer article in The Atlantic, yes, but open your eyes to the other Karens in the room. You're going to have to explain what Karens are to people. Yes, but open your eyes to the other Karen's in the room, like Caitlin Pacific. That's your Twitter handle. Her piece was slightly less overt and was likely edited down for tone. I read Caitlin's cancer story and sincerely hope she uses these last years of her life to learn to be a little bit less racist and anti-feminist. Okay, so- Isn't that the best thing ever? I mean,

I'm not saying it in like a badass way. It's just, if we just needed any evidence that, I'm sure if she met me, she wouldn't have said that, but that Twitter is just this kind of, this place where you float all these trial balloons, you know, and and sometimes and they're kind of meaningless. You know, they're just absolutely meaningless. And even as I saw it, I thought I knew there'd be a ghoulish response by from somebody because you're always hearing about, you know, how in the murders in the elementary school in Connecticut, Sandy Hook. And there's this whole branch of thinking that they were not killed and it was a simulation. And parents can't even go to their children's graves. Even the phrase children's graves is so obscene.

So you know that it's a big country with a lot of people. But I didn't think it would be somebody who is a physician. It writes for the New York Times occasionally. And the other really horrible discovery was that she wrote her first thing on her own Twitter site was, here's my first article for The Atlantic, which two weeks ago she wrote for The Atlantic. And I was like, oh, is there any? And then also mindfulness.

Mindfulness is one of her main passions, which was fantastic for my brain. I felt like the only thing I was going to find, like, what else? It's like, and she slept with your husband. You know, it's like, what else has this woman done to me? So that it just became kind of droll, you know? There was nothing but drollery to be had. Well, so I'm less interested in singling her out for abuse than in flagging what was so interesting

about seeing this tweet from me. First of all, my... Obviously, I feel very protective of you and as did many people following you. And so the response from Twitter, you know, collectively, was just analogous to this will date me and you perhaps. But do you remember the film Silkwood with Meryl Streep? Of course.

You're telling me that that's not a current movie? Snap out of it, Sam. Half of our audience will have never heard of this on any level. But there's a scene where she's leaving the reactor and sets off the radiation alarm, right? And everything goes into just emergency mode. And she gets that horrific shower with the bristle brushes. And it's like everyone following you on Twitter just had that reaction. It was just, oh, my God, this is the most toxic, despicable hot take possible. my God, this is the most toxic, despicable hot take possible. And people were fairly modulated in how much they slammed her. But I mean, the one thing that could be said in her defense is she couldn't have been referring to your cancer article for having been edited down for tone.

She must have been referring to some other piece that she thought. Oh, oh, well, this is the thing. So I published a long piece about Meghan Markle about two months ago. And it was a very positive Meghan Markle. It was sort of saying explicitly, she's the best thing that ever happened to the royal family. It's a multicultural Britain, and that's an all-white up there and really talked about what she had been through and ultimately decided that the Queen of England is really an adm a perception that it was motivated by racial animus. And I was really interested. And I was what I sort of engage with people. I said, what is it that you find here that's racial animus? And they would say, you never said this. You never said this. You never said this. You said this. You said this. You said this. And I said, I did say all the

things you thought I should say. I never said any of the things you thought I shouldn't have said. And then I started replying to the Twitters with the tweets about it with lines directly from the article itself so that they would see that I think that they just saw the article and that it was about Meghan and they're very protective of Meghan, which I certainly understood because when I was young, I was very protective of Princess Diana, whatever. So that had been kind of what she was responding to for sure was this two-month-old Megan Markle piece. So a Karen and a Becky. I don't know what happened to Becky. I don't know if Karen killed Becky and now Karen is ascendant or if Becky and Karen are like cousins and like kind of like Midge and Barbie where there's some slight distinction.

But these are middle-aged white women who are maybe any age woman. Maybe Karen is the middle-aged one and Becky's the younger sister. I don't know. But they're clueless white women whose casual expectation of privilege, which they wouldn't even think of as privilege in the world, comes at tremendous cost to other people and in particular to African-American women. And I think they have the people who believe in a Becky-Karen continuum. I would say they're absolutely right about that. I have no argument, have seen it many times. And I wrote 15 years ago, a long cover story. It was really the first story in a big national magazine that really said at length, though, what we think of as a women's movement is feminism has been tremendous gains for wealthy white women. And not only has it been far fewer gains for women of color and poor women, but in fact, white women have leveraged, you know, rich white women have, successful professional white women have leveraged their gains on the exploitation

of darker skinned women. So I'm really, I agree with them about a lot of that, but she was dead wrong about this essay. And then you would sort of think- But not only wrong about the essay, she seemed to be suggesting that the transgressions were all the more conspicuous for their absence, right? It had been likely edited down for tone. So now we have to deal with the dog of racism that doesn't bark, right? It's incredible. And the thing that I think provokes such delight in people, certainly in me, is that this was a crystallization of the problem that we've, we've been commenting on for now years, but the way in which the antecedent good intentions

that get organized into wokeness become a kind of mental disorder, right? I mean, this is just such a bad take at this moment on you and your cancer story from a doctor. And again, the fact that she's a New York Times writer is, I mean, she's written, I don't know, six or seven pieces for them, and that's enough to call her a New York Times writer. It compounds the horror of this. I mean, honestly, if she were just a doctor, I'm not sure I'd be inclined to even name her in our discussion here. But she has a journalistic responsibility not to be this clueless. Beyond the Hippocratic Oath of a doctor, you know, you could imagine a doctor who just doesn't know how social media should work. But that's not the case here. Upon reading that, how much of your brain's real estate was given over to being offended or annoyed

and how much of it was just pure delight? I will be honest that in the moment, it was extremely painful. Yeah, it was. And I always remember this great routine Aziz Ansari had where he said, you know, he's scrolling through, you know, his tweets or whatever. And there was some young woman who said, I just love Aziz Ansari. And he said, she just assumed that, like, I would never find that tweet. And he's like, of course, I found the tweet. That's all I do. I'm a comedian. I sit home looking at Twitter and then I go to work at night. So it's sort of like a lot of times people tweet things out, assuming that the other person won't see them or maybe won't react to them as a human being in a sense. And it was such a shocking thing. It was so shocking.

Well, the fact that she's- The remaining years. And in the first place, it was a lie to the fact that she's the remaining years and yeah first place it was a lie to say i sincerely hope she spends her remaining years so the conflict the idea is like okay she has decided that i am anti-feminist and a racist and i'm going to spend my few remaining years which she's done she's you know giving me a prognosis now. And then when I am a perfect vehicle of cleanliness, I can die. Like there won't even be like that I can bring this out to the world. It's just that I must prepare for death by cleansing myself of sins that she says I have but cannot prove that I have. Right, which were all the more evident by their absence in your article,

because you had been so successfully edited. Right. Yeah, I mean, the fact that she's a doctor, there's something truly vile about a doctor playing the prognosis card in some way to dunk on you to make a social justice point. That is obviously an error. I mean, it's just the fact that this is what's so fucking vile about this. The fact that the social justice triumphalism could co-opt the Hippocratic oath, the role of a doctor in talking responsibly about- About cancer. A cancer diagnosis and all of the suffering and uncertainty and sheer chaos that is in that bag when you open it. That's what I think everyone found so despicable.

And I think rightly so. And so, I mean, she's deleted the tweet, you know, for reasons that are, I'm sure, self-serving. It would be nice for her to actually apologize to you. Let's pivot to that, because for me, it's interesting to consider how we repair our public conversation around moments like this, because, you know, it seems to me that there should be some apology adequate to this moment that you and anyone else could accept, right? It's like, for me, this is something I've referred to in previous conversations as the physics of apology. I think it's an interesting question to consider what constitutes and what should constitute an adequate apology.

So you do something wrong, you say something stupid, you reveal intentions that were despicable, and you think better of it, and you actually want to repair the situation. And so that really the only instrument available is an apology. It has to be clear what process you went through so that you're no longer the same person who committed least a relevantly similar place to her original, in this case, tweet that you and everyone else who found it despicable do. She has to be able to look back on what she did with more or less the same horror that everyone found appropriate in the moment the tweet was seen and to apologize from that place. And it has to be intelligible how a person had that epiphany. Otherwise, people will think they're just faking

it. They're just trying to get out of hot water, and it's not a sincere apology. So for an apology to be sincere, you have to be able to articulate or at least seemingly display a journey out from the place where you were the asshole who was so clueless as to say or do this wrong thing. And now you're the person who you're able to say, I can't believe I did that. That's just mortifying. I'm so sorry. I hope you accept my apology. It can only be credible if that journey is plausible. Well, I think a lot about apology. I've had to make a lot of apologies in my life because I screw up a lot. Maybe everybody screws up to some extent, but this is for me when I make an apology. And number one, I have to own every part of the thing that was hurtful about what I did

yeah you know so it's not about I and not about a lot of explanation for why I would do that thing it's just that thing must have hurt you in this way and this way and this way and that is grievously wrong and I am extremely sorry and I really want to know if there's anything I can do to, in any level, repair this, you know. And so that's, to me, is the gold standard for apology. Now, the gold standard for forgiveness, there is no gold standard. I forgive her a thousand percent. And the reason for that isn't that she sent me what I consider a very not good apology and sort

of the pantheon of apologies. The reason for that is I don't want to be changed to her in anger. You know, I have to, if I don't release her in a complete forgiveness so that I can look forward, you know, hey, she's 31, she's learning, she's trying to get her hustle on with this website. hey, she's 31, she's learning, she's trying to get her hustle on with this website. If I don't turn away from that and just say forgiven and mean it, even though I can laugh at how cruel it was and how much it hurt me, then I'll be chained to her forever and I can't even really remember her name right now. So I totally, really legitimately forgive her. Right. Oh, so I missed that part of me perhaps you telegraphed that in the last few minutes did she send you an apology that was so i look back on at

the i looked back on at the twitter that day and and somebody said that was really cruel and she said i've apologized privately and i that was my only second tweet. It's like, I didn't see any apology. And she said it was sent out at 5.28 PM as though I was maligning her about her apology and she had the receipt for it. But then I found it, she'd sent it to my work email. And it was a super long, it started with that in the sense, well, first place as an editor told me, and I was like, you're really right about that. She's like, why a private apology for a public wrong? Yeah, that's the first mistake. Yeah.

She said something really terrible about you in public, but you didn't apologize for it in public. You're sneaking it around this way. But I kind of scanned it. It was more upsetting to me in many ways. And then I thought, hold on. There's a really good game I rarely play and I can always, but it's always a good game to play,

which is like, what if I were an incredibly evolved good person, which I'm not. Yes, what would the Buddha do? Exactly. They would accept the apology and not be lying about it. They would accept that there was some apologetic intention. And then my brilliant son, Patrick, whose picture was in that,

the article you're talking about, his picture when he was a little boy the day before I got cancers in there, he said, and then you would tell her to stay safe in this pandemic. And I'm like, would tell her to stay safe in this pandemic? And I'm like, oh, Patrick, that's the killer right attitude. Can I have it? And then I had to think through that several different ways. And I was like, yeah, I hope she stays safe. You know, she's a young woman. She's a physician. She's she did something really hurtful. I don't see any evidence that she's I don't know. I just hope she does well. And I do forgive her completely. Now, forgiveness doesn't mean that you're open to be hurt by someone again. You know, you don't make yourself vulnerable. You're not kumbaya. We're not going out for high tea anytime soon ever. But it just means I'm not chained to her anymore.

I got a lot of other enemies to keep chained tightly to my body. You think out loud rather freely, and that's what makes you such a delightful interlocutor. And so no doubt you have provoked people to send tweets of this sort in the past. Never this bad. I've had some bad tweets sent to my way. I've had some horrible reviews. No one has ever said, I hope she spends her remaining years atoning for sins she doesn't have. No one's gone that far. Yeah, well, I think we all hope that the good doctor spends the remaining years of her life learning to be less sanctimonious. I think

that would be a good use of it. You know she's going to be writing. We will, like, in two days see her New York Times piece about how horrible we are to have had this discussion. So. Yeah, well, I'm trying to have it in a way that I will not feel the need to apologize for. Again, I'm not, I'm holding her. So even on the heels of a bad apology, I think there would actually be a way for her to adequately apologize. Can you apologize for a bad apology? Can you pull yourself up by the final bootstrap here and get back to zero? I mean, can you imagine that conversation? I would not have had that level of self-knowledge when I was her age. I'm 58. What if we could get her on the line right now and have a conversation. Do you think there's any way that conversation would go well? It would converge on a full reboot of basic human decency and we could all be friends? I would start it

with someone much higher up on the feeding chain of my enemies than this one. I don't see any need to have any. I really think that maybe you need to be a, you know, I really think that, you know, maybe you need to be a lot more deathy to really, really understand how apology and forgiveness works and to really understand that, you know, forgiveness releases you and you don't have to do, you know, you'll see these people who like forgive the killers of a loved one. Yeah. I'm never going to, you know, you can spare me from cancer for 500 years. I don't think that's going to be happening. But I can free myself from her. But part of it is, what I'm trying to say is,

just because you've forgiven someone doesn't mean it's a love-in. And it certainly doesn't mean, as I always tell people who are in any kind of abusive relationship, it doesn't mean you let the abuser back into your life if they haven't shown any possible sign of having changed. You know, you forgive them, but you keep your fence closed to them. Yeah, you're talking about there's two layers of forgiveness here or two forms. So you can forgive somebody who is actually unrepentant, who's still a, even in the extreme case, a danger to you, without losing your awareness of the danger they represent. You want nothing more to do with them, but you can forgive them in some deeper, whether the Christian model summarizes it or the Buddhist, what you can notice is to fail to forgive is to grasp some kind of hot coal of suffering, which you actually can release on your side. I mean, there's no reason to be carrying this person around in your mind with your hatred of them or your anger or resentment. So you can perform that miracle on your side, all the while leaving this person

out there in the real world completely unchanged. What's interesting for me is the warranted forgiveness based on that person's true apology. I would love to fully understand what makes it possible for someone who has really wronged another person to become aware of it and apologize, and for that apology to be so sincere and real such that genuine friendship between those two people is thereafter possible. That's the thing we need more of in our world. We also need the former. We need people just to be able to put down the burden of their reaction to assholes. Well, I often talk to young women about, because some of the best minds of our generation or of their generation, some of the best minds of the generation that's young now that are

female, the female half of it, they just feel for reasons to protect themselves, they can't go on any kind of a public platform such as Twitter because these hideous, hideous things that flow back to them are so poisonous. And boy, once it gets gendered, once you have really angry anonymous men saying things to young, very public women, it gets into a place far, far, far beyond what this was about. And so I'm always telling them, don't worry about that. Pay no attention. It's nothing. It's pixels. It's somebody else on the other side who's just, you know, you're as remote to them as like Richard Nixon, who's dead and gone. You're just like a public figure. They don't think if they're not having any kind of personal communication with

you, just ignore it. So I tried to live into the advice that I always give young women, which is just this had a little more bite, as I say, because she publishes where I publish. And because she like I said, I have children, I want toes where I publish. And because she like, I said, I have children, I want to live for their graduation. She told me to like, I should use my remaining years atoning for a sin that she's divined that I have, but that was edited out. So forget your children, just spend the free hours becoming less racist and less anti-feminist. Yes. That's the project. And if she thought that the Atlantic would public, I mean, the Atlantic began, it was founded by abolitionists that thought that they would be, oh, we have this racist writer. Let's just lightly edit her for tone is absurd.

There was another thing I noticed. I don't know if this is, I've thought about this before. I don't know if, I don't think we've spoken about it. This doctor's obviously very focused on the problem of privilege. And, you know, I looked at her Twitter feed after I saw this tweet, and there's just a lot of stuff about privilege and wokeness, more or less wall to wall. But I couldn't help but notice that she's a very attractive woman, right? And this is a form of privilege that few of us are talking about, but it is as real as privilege gets. There's just being a beautiful woman or a very handsome man is not nothing in this world. And I guess it sort of compounds the irony here, but it struck me as a final layer of a lack of

awareness. I mean, if you look like Padma Lakshmi and you're going on and on about privilege, there's a ridiculousness to the project. When you think of the advantages that just effortlessly flow to people who are very attractive in our culture, you have to at least take the wokeness game a little more lightly than you would otherwise. How do you think of that form of privilege in our society? Well, first place, if there's anything in the world she is not unaware of, it would be her beauty, I would say, just the way she displays herself, rightly so, beautiful young woman. There's a wonderful English expression that at age 50,

you get the face you deserved. Like that it is going through life as a beautiful or pretty or attractive young woman. Oh man, a lot of doors fly open and you're intensely aware that it's going to stop. But then you kind of charter over into confused older lady and they open the doors too. So maybe it's not as dire, but for sure, I would say more to the point is that she's Canadian and she's presenting herself as a sufferer of the ancient wrongs against people of color in this nation, which is just a very odd part of it. But I don't even want to... Let's not talk about her anymore.

I don't want to think about her. Maybe she's a Russian bot. Maybe we just have been successfully trolled. Well, only a Russian bot could troll the op-ed section of the New York Times. Yeah, it's just a matter of time. Yeah. Okay, well, not to put too fine a point on it, but the goal of this post-mortem Amita was not to be mean-spirited,

but to try to extract whatever lessons can be found in yet another amazing installment of social media in the midst of the deathy situation we call life. Right. Oh, that's a good title for a book. Kind of a cheesy book, but one I wish I could write and make a fortune on because it sounds like something I would buy. it sounds like something I would buy. Okay, so before we move on to even more superficial topics than Twitter, so what is your understanding of your prognosis now? And just one of the points of your article was the way in which this COVID pandemic has compounded the hassle, among other things, of just dealing with ongoing cancer treatment. Give us a picture of your current situation.

And these are some of the implications of the pandemic that people aren't really thinking about. I mean, we think about elective procedures not being done, but an elective procedure is a cancer scan, or even in some cases, a cancer surgery. Bring us up to the moment with your health. Well, part of having cancer at this stage is that you have to get a lot of PET-CT scans because you have to find out if the treatment you're on is working and if it has the cancer stable or if the cancer is growing during in the presence of this treatment meaning you have to get a different treatment you have to change your treatment

so and then because of very long story with these other cancer treatments I've had in the past they have given me certain other problems that have to be checked a lot that I gained because I was treated for cancer so I should have really had a PET CT scan probably a month ago. And I will have it this month on the 27th because they're really trying to push anything they can do. I don't know really in the beginning if it was because they felt that the hospitals out here in California would be overrun as they are, have been in New York City, or if they just wanted patients that have these underlying conditions to stay out of hospitals that are so full of every kind of thing floating around, could be COVID as well, as much as possible. I don't know. But at a certain point, you have to get your scans. So I'll go there.

And then I have to go a lot to get my infusions. So with that, it's just a lot of like they call you first and ask you the questions and then you're out in the about symptoms. Do you have any of the symptoms? No. And I would love to have a test for this thing because I wonder if in early January I might have kind of been exposed to it because I was a bit sick in early January. And so was my husband and he'd just come back from New York. But you know, there's the beautiful, perfect available tests are not as perfectly, beautifully available as we've been led to believe. But anyways, then they take your temperature.

And then finally, they let you in to the infusion space. And you're kind of like, ah, I've made it to this horrible place where I get treated for cancer. But everyone there is really nice. So there's a lot of just things you have to jump over. And I'm not parking down in the basement because I don't want to have more people in my car, but I want to go down there to give a tip to the guys I know. So it's all a little bit challenging, I'll admit. But a lot of people are in a lot worse, a lot worse situation. And are you still taking Herceptin or has it moved on to other drugs?

And are you still taking Herceptin or has it moved on to other drugs? It's still Herceptin? Well, now I take Herceptin because obviously it failed me because I'd been on Herceptin every three weeks for 11 years. So I started to, the cancer assert itself more strongly against it. But I still get it in combination with this other drug that's now in the armamentorium called Progetta. And then with an injection of huge horse-sized injections of something else every three weeks. The first one that, the thing is I'll be on treatment the rest of my life until or unless something better comes along or more definitively curative. So the first one that I tried was doing a good job, but I just couldn't imagine living

my life on it. I was just too sick from it. Right. I mean, I was nowhere near as sick as I was on actually being on chemo. And the new, it was a chemo, but it was this smart bomb kind of chemo where it goes through your body and it only explodes inside a cancer cell, which is wonderful, but it does still, so you don't lose your hair or anything, but it does still leave, left me really tired and kind of sick. So then I switched up to this new treatment. So there's a

lot, there's a lot in the armamentarium and it just goes to show when you throw a whole lot of money and a whole lot of science at one very particular problem, you start getting some answers to it. You know, it's science is real, I guess. Well, needless to say, vast numbers of people love you who haven't even met you because your spirit comes through so clearly in your voice, both on the page and in conversation. So I think not meeting me

is probably in the middle of it. Inducive to me. This could be the sweet spot. Yeah, just enough, Caitlin. It's my next bookive to that. This could be the sweet spot. Just enough, Caitlin. It's my next book, your next book. Okay, so pivoting to, in some ways, these are equally existential topics because we're talking about the fate of global civilization here when we're talking about politics at the moment.

But in our last podcast, you and I said that, I think we called out the New York Times, but in general, journalists would have to deal with the Tara Reid scandal. If you'd like to continue listening to this podcast, you'll need to subscribe at samharris.org. You'll get access to all full-length episodes of the Making Sense podcast and to other subscriber only content, including bonus episodes and AMAs and the conversations I've been having on the Waking Up app. The Making Sense podcast is ad-free

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