fayetteville for persons of color and he attended those as well. these were not unsophisticated people with the exception perhaps of shield green who was not educated. ..

some photocopies of the letters written from jail and perhaps they didn't get out. and so nat was one place -- also these ah-ha moments you have when you're doing this research, i discovered that another writer had said that the copeland family had gone to new columbus, indiana, actually they'd again to new columbus, ohio, and the giveaway was they talk about meeting a farmer named pettite, and i went to the census records and there was no pettite in new columbus but there was in a small town in ohio on the ohio river and i thinged listening to a preacher and the preacher was at the town in ohio. and they thought they'd correct the record.

also, many reference have been to john copeland jr. but his father was actually john c. cope around and he was john an behind -- anthony copeland. so i was fortunate enough to happen families provide information. and he did a look of reference in archives and newspaper archives and it was a great challenge and journey, and i went to overland and i went to ontario and i want to hannibal, utah, a population of 162, to interview the relative of dangerfield nuby and it's a journey that continues but one that was singh essential, and

i'm -- essential and i'm glad i was able to be part of it. >> thank you so much, gene, paula, don't be shy but buying their books, called "five for freedom" and "a civil life in uncivil times." thank you for being here. have great day. >> thank you for be here. the next is saturday may 20, 2019. meyer will be available for signing and as well as paula whiteache kerr.

>> neuroscientist bash la lipska is next. >> here's a look at some books being published this week: >> and legal historian, records the oral histories of 100 female attorneys who impacted the profession in "stories from trailblazing women lawyersle" also being published, pulitzer

prize-winning journalist charlie leduff offers his thoughts on today's economic and political landscape, nbc weather anchor al roker chronicles the deadliest flood in american history in" tide." and james polk can explores the growing militia movement in the american west in "chosen country." look for these titles in book stores this coming week and watch for many awe theirs no the near future in booktv on c-span. >> when i start to talk about my book, "invisible no more" one of the first quiz throw out to oddens is what is the first name that comes to mind when i say police brutality? >> times have changed. usually it's been sort of different across generations but

almost universally male. so it's been rodney king, diallo, oscar grant, brown, eric garner, freddie gray, the list goes on and this week if we ask the quicker what's the first name that came to mind this week in terms of police violence, we would think stephan clark and not sylvia williams what was killed by police also. i ask why that's the case, and i think my answer always focuses really on the power of the story and of the narrative, and the story that is so deeply entrenched that racial profiling and police violence and state violence happens exclusively to black men, that we perceive to be not transgender and not gay, even though they might be, and that violence against women is something that only happens to white women in private spaces, and some of us out here in the

cold. experiencing violence of both kinds every day without it being seen as part of any story. so, the goal with invisible no more was to really expand our understanding of police violence and racial profiling and mass incarceration and mass criminalization in the country by bringing into the narrative the stories of black women and girls that have driven the growing in the women's prison population by 700% over the past four decades. which means the rate of growth of the women's prison population increased at a rate 50% greater than the rate of incarceration for men. so, what are the stories of the women who wind up in those cages? and who are predominantly black women, black women incarceratessed in a rate twice as much as white women. that doubles even again when we look at the population of black women or women in jail.

that a has increased 14 times over the last four decades. so women might not be doing as much hard time in prison bus as much time cycling in and out of jail cells, three days, ten days, 30 days, 90 days, six year at rikers instead of going upstayed and there's less health care and less supporting no those places. with look at the 13th and read the new jim crow, the story is one that doesn't include the stories of those women. and so the goal of "invisible no more" was to tell more stories to fold more stories into the next, note just add them but see how they changed the gumbo. how does that actually change how we understand things. so, it would make visible black women's experience of driving while black beyond the notable example of sandra brand. a woman named ayala airy airy

mass. and the population with the most track stops in ferguson was black women of any other population. when we see the storieses that just came out of st. louis, the study that showed the only group of people in which the majority of people are killed when they're unarmed is black women. so, the police officers are more likely to perceive black women to falsely -- falsely per receive black women as a threat than any other group -- as a fatal threat. it helps us to better understand this narrative of what it means to be black in america. >> you can watch this and other programs online another booktv.org. >> here's a three-quarter authors recently feet featured own "after words."

journalist jerome coresy argued there's an effort to thwart the presidency of jump donald trump. kris choose shared this thought on a guaranteed income for the working class, and john kessler reporting on the inner workings of the trump administration. and former defense secretary donald rumsfeld will recount the presidency of gerald ford, join the former vice president which heny. television and radio host bill press will retrace his transition to progressive politics and this week, the science behind how the body ages. >> you have an -- i'm not a buddhist but i'll say buddhists

say -- you have to lose yourself. loose yourself -- lose yourself in your work, art, movements that consume you, and then death becomes kind of incidental. i consider my long involvement in women's movement, and movements for economic justice. when i'm gone, it's going to go on. other people will do things i've been doing or do them better. so that's good. it's not scary. wonderful. and i -- one of my tasks in old age is in fact to reproduce myself to help younger writers, write erred of color, people in poverty, become journalists, and get an airing and get a start, and those are like children to me, and my own children of

course are amazing. >> that's true. >> yeah. so i just think of the -- that's one of the jobs of being old, is passing the torch. taking what you know and have done or accomplished or want done, and passing it on to younger hand. >> "after words" airs on book tv every saturday at 10:00 p.m. eastern and sunday at 9:00 p.m. eastern and pacific time. all previous "after words" are available to watch on the web site, booktv.org. >> now live from the gaithersburg book philadelphia in maryland, barbara lipska, author 0 of the "neuroscientist who lost her mind."

>> good afternoon. thank you for coming. we always -- politicians like to tell you when something is free. this is free. afro event for the public. we proudly support the arts and humanities and pleased to bring you this fabulous event for free in part -- thanks in part to the generous support of sponsors and volunteers. when you see our volunteers and see our sponsors, please say thanks for supporting the book festival, and did i say it was free? before i introduce our author i have a few announcements, first for benefit of anyone here, please silence all your devices so it doesn't ring in the middle of a talk. second, we hope you're following

the festival on facebook and instagram or twitter and if you feel like tweet organize posting, use the #gbf just like that. third, your feedback is very important to us, and it very valuable so surveys are available at the tent and on the web site. by submitting a survey you will be eligible to enter into a drawing for a $100 series visa gift cart. and author will be signing books immediately after the presentation. you can buy it at the politics and prose who lost her mind. " this is a free event but helps the book festival you buy a book. the more books we sell at the event, the more thank you publishes want to send the authors their speak to us. purchasing becomes from politics and prose helps support one.

the greatest independent book stores stores and benefits our local economy and provides jobs. please buy the books here today. so, as the resident neurosin 'tis on the city -- scientist on the city council i get first crack to introduce offers whose subjects are brought -- about the brain so it's a special treat to introduce a neuroscientist, barbara lipska, her story about what happened when cancer invaded her brain and went wrong. the amazing part is that barbara lived tell us about it. barbara born, raised and edokay inside warsaw in communist poland. enteredder in masseters of signs keying in the university of warsaw and ph.d in medical sciences in 1988 from the medical academy of warsaw. she emigrated to the nuss 1989 with her husband who is here in

the audience, and her two children, to take up research position at the national institutes of mental health at bethesda and she was doing neuroscience research in mental illness and human brain development in 2013 she was pred of the -- an internationally recognized leader in humans, -- she has authored -- has time be marathon runner and a tri-athlete. i couldn't put this book down, reminded me of other classics about the brain, its function and dysfunction and being human. barbara lipskas able to explain

at several levels but here cancer in the brain and mental state as the cancer grew and was treated. you don't need to be a neuroscientist to understand this book. that's the beauty of it. but if you're a neuroscientist it's even more important. there's enough to be learn but the brain and cancer and treatment. you'll learn but the functional organization of the brain that allows one to perceive the world around you and also how you relate to it and how you behave within it. and she shares her insights with news in a compelling read that reveals quite a bit about the potential causes of mental illness and cancer and surviving. please join me in welcoming, neuroscientist and survivor, barbara lipska, to the gaithersburg book festival. >> thank you. thank you for having me here. thank you for coming. in this weather. i hope to warm you up here with

my story. so as mike said, i am a neuroscientist, and i've been studying mental illness all my professional life. first my native poland and then when i came to the united states at the national institute of mental health, and i'm still there. i was -- i became a director of the human brain bank, in 2013. we call it brains. postmortem brains of people who died and they had all kinds of mental illnesses in their lifetime. also collect brains of people who don't have mental illness bass we want to have a comparison group. this is to serve research on

mental health and hopefully one day we'll know what happened. in the brains of these people at the molecular level. this what he mainly study. >> i became -- i never thought i would experience mental tall illness miss. mike mentioned i am an endures athlete. i run marathons and i did many triathlons. i never thought also that these trainings for these kinds of sports was to prepare me not for the races necessarily, although i raced a lot, but will help in my survival. i really believe that they did. both mentally and physically,

they made me stronger. so, so how did this all start? starts in the 2015 in january. i was training for my first half ironman triathlon, a long race, and i was swimming almost every day, running, cycling. so, one day -- i now read a little passage from my book. one day, on a thursday morning, of 2015. is a pulled myself from the pool of one of my swim training sessions, i suddenly feel dizzy. i must have overtrained. or run out of calories, i tell myself. i'm looking forward to a productive and happy day at work. tomorrow morning, i'm leaving

for a conference on brain research in montana. , where i am meeting the -- my son and his girlfriend for work and skiing. and i'm excited about the trip, but as i drive to work, i have a strange feeling that something is off. my driving feels shaky, although i can't tell what is wrong. at my office i sit down and begin to eat a bowl of pure cut oatmeal i brought from home. i reach out to switch on my computer. my right -- my stomach clenches. my right hand disappears. i move my hand toward the left. there it is. it is back.

but when i slide it back to the lower right quadrant of the commuter keyboard -- computer keyboard it vanished hand. when i place place my hand in this lower right quadrants of my visual field it disappears completely as if it were cut off the wrist, nearly paralyzed with fear i try again and again to recapture my disappearing right hand, but once it answers the -- enters the part of my visual field it's gone. it's like a freaky magic trick. mesmerizinging, frighten and totally inexplicable except brain tumor. i immediately try push the thought from my mind. no, i think. this can be. this cannot be happening. i was sure that i beat stage

three breast can center 2009, and stage one melanoma three years ago. but breast cancer and melanoma often metastasize into the brain, the area at the back of the brain that controls the vision is the most likely explanation for this bizarre vision loss. and i know that any brain tumor indicating met toes to cease, they spread of cancer sells is horrifying news. >> i current entertain the thought i had a tumor, so i sat in the conference room issue spoke to my colleagues.

it took hours before the called my doctor, my family doctor, and made an appointment with him the same afternoon. he was immediately very worried, and -- but after examining me, what i saw, where i saw it, with one eye, with another eye, he was absolutely sure that it is in the brain, but i wasn't. i was upbeat. i didn't want it to be a tumor. and i was going the conference. i was about to ski, which is my beloved sport. how ick do this? and it was the conference i organized. so, there were people there, waiting for me. was about to give a welcome address. how i cannot go? tumor? tumor? at this time? it's very inconvenient. but i went to the doctor, and he said, you have to have a scan. i said i can't.

i'm leaving. i have flight, i have a ticket. he said you can't. you could die. my husband, who is sitting here, at the time already arrived in the office and also tried to convince me that i cannot go. maybe i can postpone by one day. okay, i said, one day. i'm giving you guys one day for clarifying this situation. so, next morning, we go to the hospital to get an mri scan and it shows three brain tumors. one is bleeding in the visual cortex. the bleeding strongly suggests that it is melanoma. so that is melanoma that i had on my neck spread to my brain. so what did we do? i couldn't go to montana, unfortunately. i cancelled the trip. went to boston instead to do surgery, radiation, and we knew

that all of us knew that i basically got a death sentence. there's not much to do if you have brain tumors, melanoma brain tumors or breast cancer brain tumor. same thing. either extremely hard to survive it or rather people do not survive it. melanoma in the brain at the time was predicted to give me four to seven months to live, and i was prepared for this. i actually was absolutely sure i will die. i was even more sure because in my life, it already happened. my first husband died of melanoma in his brain. so i had already this experience, and it was pretty terrifying. so we go to boston instead of montana, and we check out into the hospital and i have surgery, and then what?

we have to enroll in something very new and hopefully something that will have a potential, at least to save my life, it and was immunotherapy. when i was enrolled in immuno therapy, ann around me thought, that the chances are grim because i was in a clinical trial for tumors in the brain. immuno therapy was used if the -- at the time it was fda approved for the tumors in the body but not in the brain. they didn't know it would help me or i would die sooner without it. i there was nothing else to do so i said, okay, i'm going in. if i die i will at least die fighting. that was my thinking.

so we prepared for rough times and it was rollercoaster ride through this therapy. it is -- they say better than chemotherapy i had for breast cancer but has its own very difficult side effects, and this was what i was prepared for, both mentally and physically, but i didn't know that i would get into some situation that it don't know at all about, and i didn't predict it will happen. i will lose my mind, and during this therapy, i almost lost my life. so i got through all four infusions of the immunotherapy drug but i start behaving very strangely in the middle of it. as if i was very stressed. out. at the beginning i was angry all

the time. i was yelling at my family. i couldn't hold a conversation on the phone. i was yelling at my husband. i was even yelling at my grandsons who are like six and eight at the time, which is very uncharacteristic for me. everybody was stressed out. everybody thought that it is just stress. so we're living through it. but when it got to the point that i started being really difficult, i thought that everybody scheming and plotting against me. i thought that everybody around me change but i was the only one who remained the same. and i will read you another very -- how much time do i have? not yet. okay. okay. so, another very small passage from the time -- during

immunotherapy starting to behave very strengthly, but we didn't go -- very strangely but we didn't go to the doctor yet. i wake up and haded to the kitchen to begin making dinner. each time cooking has been harder for me about now is a stand here i can't remember that would. do not even the simplest steps. where are the pots? where are the spoons? i grumble. why cannot i find anything? everything is gone. my family has gone behind me back and rearranged my kitchen. i slam drawers. pull open cabinets in a frenzy. it's all wrong. everything has changed. why would they do this to me? i finally find what i need, but as i set to work, the simple recipe i've made hundreds of times, seems like a complex

mathematical equation. i tried to re-call the iningredients and locate them in the pantry, but it's so hard. i grow more agitated. swearing and banging cabinet doors. my hour off ever -- my husband offers to help. no, i shout. i make the dinner. i always make the dinner. i'm not going to stop now just because you have moved everything around. i managed to create some strange concoction that they politely eat, my family was there with me at that time. at a tense dinner table. where no one talks. for the rest of the evening, i barely speak, and when i do, it is only to criticize them. so, it was somewhere in the middle of this immunotherapy i

start behaving strangely. i'm get at the lab work and i didn't remember what proportions i need to use to cook pasta. i'm not talking recipes. to took pass pasta. i didn't know how much water to add to the pot. but i was very good at compensating, and perhaps in masking my inabilities. i did cook, and i didn't care who and how everybody feels. i didn't care what they think. i lost insight. into my behavior. i was completely unaware that i was different than before. i just felt that they were plotting, they were doing some weird things around me. i'm sorry for that.

so i lost insight. i lost inhibition, that is i didn't care how i looked. didn't care about running, skimpily dressed in our neighborhood with the air dye dripping down my check in my face and my shirt and my chest. i looked like a monster but i didn't realize it. i did some other really strange things. i lost emotion and empathy. my loving husband didn't recognize me. i saw tears in his eyes but i didn't know what they mean. i also lost memory. when i was running with the hair dye dripping down my neck, i didn't know where my home is. couldn't find it. i was not worried at all. i was like, okay, whatever.

whatever happened to me was as if it happened to some other person. and i became very suspicious that -- the final point was when my family decided to take me to the er, to the hospital to be checked, was when i was absolutely convinced that i was poisoned with a pizza that was stuffed with plastic. and when i talked to my daughter and tried to explain, i could talk very well -- i -- and i was very convincing but plastic in pizza? not possible. she said, mama, you have to go and see what happens in your brain. i didn't have any scans for two or three months. during the treatment. so when we finally got to the hospital, turned out that my

brain was extremely swollen, almost two-thirds, the frontal parietal, cortical swollen and informed and i had a more tumors in my brain. i was basically another death sentence, but was i worried? not at all. i was like, oh, i had tumors before. i'm sure therapy will help. it's working and will help me it and is just a phase in the treatment. we have to go through this and then everything will be okay. my doctor just shook his head over me. had dish remember this looking with his tears in his eyes and thinking, she lost it completely, and i did, but

believe it or not, i was actually right. so, what happened to me was incredible inflammation in my brain, it was caused by my super strong reaction to neurotherapy drug. they were fighting like crazy, the melanoma cells in my brain. that's why all of the swell interesting -- swell interesting my cortex, especially the front tall part, was completely difference functional. that is why i was -- dysfunctional. that's why was behaving in some aspects like mentally ill person, and i didn't realize it because i needed my frontal cortex, the part just hind the forehead to understand i was missing one, that mine was not functional. and i couldn't. it was like a catch-22 situation. i couldn't know it.

i was treated with steroids and then treated to directly kill the melanoma cells butfully doctor now agrees with me in my altered state. it was just such a strong response if we didn't go to the hospital and the swelling wasn't reduced, my brain would stop walking altogether. i couldn't dish would not be able to breathe. i wouldn't be able to function at all. so, over the next two, three, perhaps months, i was going back slowly to reality, and it was a very slow process. it was as if through my broken brain, the lights started getting in very slowly.

and i remember some of the facts, many i did not remember, but what i didn't remember mostly were the emotions associated with the fact. so i could remember that i was walking with my son but i didn't know what he was thinking, how i was feeling, did i love him, didn't i love him, same with my husband, as if emotional part of memories were not existent, were not encoded. maybe they were not encoded because they didn't exist. i lost emotional part of me. so, a month later, we come back to the same hospital for a scan. and to our incredible surprise, all the tumors disappear, or reduced so dramatically that

there's almost nothing left. my doctor comes back to the office where we sit. he say come here. i'll show you the scan, it's like a miracle. said i dope want to see it. it just could -- i don't want to see it. just could not bear to see my brain so hurt and so abnormal. my daughter went and came back with a big smile on her face, saying, oh, mama, so good, incredible, dramatic improvement. but it is not this simple. took a very long time for me to go back to kind of normal state, and then more problems started. describe them in the book. if you get a lot of immune nor therapy -- my response was so strong and a lot of radiation, which i got for every tumor i

had, -- i lost vision in my left eye, i lost some balance, not that well-oerned in space. i like to have my husband next to me at all times. especially in these situations like here. it is really difficult for me, like in a maze. i feel like a rat in a maze. but what i'm terrified mostly is not what happening now to me. i can deal with it. and this is what i told you about -- i started from a relatively high level, very high level of both physical abilities

and mental abilities. i'm not worried all the time. not at all. what i'm worried about, actually terrified i will -- that my lacking -- lack of awareness if something happens in my brain, will come back, and that i will be behaving in inappropriately, be hurting my family and people around me, and i wouldn't even know because that's the definition, if you lose your frontal cortex, you lose your awareness of the situation. and there's no -- it is not denial. it's completely different from denial. it's just not knowing which i don't know how to better explain, just no information. so, i am very happy that i'm

back, as good as i am. i still work. i draw tremendous satisfaction from every day i live. i'm really grateful to science that it did what it did to me. cancer research has made incredible advances in helping people who are like me in a situation of terminal illness. but we are very far away yet in the field of mental illness to see these kind of advances. this is what i study, and i feel a little bit jealous about how science went ahead in a different field, but it didn't. it didn't advance that much in our field. it is a lot more complicated, i have to say, brain is a

particularly difficult organ. it's complicated compared to cancer, which is also complicate but at least you can see the end point of your modification of your experimental treatment. you can see the tumor or cells appear, disappear, grow or diminish. in mental illness, everything is based on behavior, and behavior is our notoriously difficult to follow. we all different. right? we all different. we behave differently. if we behave a little bit more different than before or than other people, do we have mental illness? that's why it was so difficult, even for my family to notice what is happening with me. everything can be explained -- almost everything can be explained by stress, by circumstances, by all kinds of other things, but if someone

changes dramatically, in the end i did, that person needs help, and one message i'd like to send to all of you is that mental illness, although we didn't see that many research advances yet, i'm sure that we will because it is brain disease, it is disease like any other disease, like cancer, like heart disease, like kidney disease, just involves a very complicated organ, the brain. and we know it is physical. in my case it was obviously physical because i had tumors in the brain. in mentally ill people there are other changes, but these are

also physical changes at the molecular revel which we -- level which we try to understand and we don't yet. hopefully i will live to the days we do, at least somewhat. so my intention in writing this book was to demystify and to dee stigmatize mental illness and also any other illness that carries a taboo. cancer not that long ago and even now, carries a taboo, too. much less the mental illness. maybe because there are now treatments that help, and that many more advocates. i don't know what the reason. but i hope that the more people understand about it, the more tolerant they'll be towards people who suffer, and that is my message.

you have also to realize that mental illness affects a huge segment of the population, one in five people in the country and also globally, around the globe, are mentally ill, either with schizophrenia, bipolar, depression, or other billion illnesses. as we age, all of us -- i hope i will be lucky enough to age and experience again perhaps what i went through. loss of memory. loss of understanding of the world around me. because that is what happened if the brain stops working properly. i am also more driven to -- feel more urgency to work in my field of mental illness, and to

provide data that will help either the next generation or the scientists who will come, talented scientists who will come to the field to dissect this at the molecular level and would hopefully lead to better medication and better treatment. so, i think i will now take some questions. >> wait, if you have question, wait for in the microphone because we're broadcasting. [inaudible question] >> so many over the symptoms you describe, like at the beginning, look the journey that alzheimer's and dementia patients say, the change in the behavior, the anger, so many

features that you describe. i'm wondering, medically and scientifically, if that loss of frontal lobe you're now able to describe in your improvement state, thank god, is -- can that be aapplied to research in that particular disease? >> well, again, the same thing i said about any other mental illness, it is a physicalleness of the brain. it's very domestic ascribe it to a particular brain region because people -- also apples jeimer, they changes in the the hippo -- there was so much swelling in a huge part of my cortex it's illinois possible to

say this behavior is responsible for this -- sorry -- that this change, physical change, is responsible for the particular behavior. but it is absolutely true that my behaviors were very similar in many aspects to dementia, and alzheimer's, which is a -- dementia. not understanding what is happening, being angry. i think my anger and maybe people with dementia or old people in general with dementia are angry because they don't understand what is happening, because i didn't. i didn't understand what they're thinking, what they're feeling. maybe i didn't care. but i think i cared some. anger is also emotion. i lost all of the emotions in this except for anger.

so as if anger was this primitive kind of emotion that stays, and probably is localized to a different part of the brain that our higher cognitive functions, which are most lie localized to these knew -- neocourt cortical region is lost. we don't have medication for dementia and we don't for a majority of mental illnesses. we have drugs that have some but not the others. but they -- they aren't cures. they're not cures because be basically do not understand the mechanism. so we cannot design new drugs if we don't understand what the problem is. but many researchers are working

very hard to do just that. >> i am so happy you survived that. my curiosity is that you mentioned schizophrenia. now, from what i understand, schizophrenia is more associated with a chemical. balance. your problem seemed to be due to pressure ton the -- pressure on the brain. there is some pick reason you associate the symptoms with schizophrenia? do you feel there'sing? there somewhere that would help with schizophrenia? >> well, i started schizophrenia -- i study schizophrenia and we think it has to do with dysfunction of the frontal cortex. you can cause it physical change and how genes are structured and

how they function. we are studying this. of course, people with schizophrenia don't have tumors in their brain like i did. but the point i was making was that my frontal are co connection was not functioning probably similar toy the people with schizophrenia or bipolar or dimension should. just different kind of dysfunction, and but it affected similar brain regions. in my case, there was -- i am hesitant to use the word "cure" because i'm not cured, bit it's mitigated these tumors and swelling especially that was a problem. and people with schizophrenia, and other illnesses, we don't have it. we can help a little bit, and

then the flareup, you know, all kinds of problems that can appear. people don't want to takes the mission case nices have bad side effects and people don't know they need them, like i didn't. i didn't realize i was ill. knew i had tumor yo. they were a fact of life. i was not fake bid them. was not worried. i never cried. i never -- never terrified. and similarly with people with mental illness, many of them just don't know they're ill. wouldn't take the medication, which feels or tastes horribly, and it's a problem. >> i wanted to read your book about the brain and i read a love story. your children are phenommal.

you have great pride in their, hour husband and children. my question is about your work. when you received the brains at the brain bank, and and you have control brains without mental illness, how do you know it's not a brain with undiagnosed illness. >> we do a lot of work trying -- actually people from my lab are here. we are doing -- for each brain we receive, the family has to agree, and consent to the donation, and then we interview the families, and gather all the records from medical doctors, from hospitals, from all kinds of sources. actually, a lot of work to gather all this information, and exclude possible mental illness. we also test blood for all kinds

of substances so we know somewhere was abusing drugs or had antipsychotics onboard or other drugs onboard. we do a lot of work trying to figure out if the person had a particular illness or didn't. we also conduct our own neuropathological examination of the brain to so whether there are tumors or other problems they may explain that person's altered behavior if they're reported. >> i'll take a -- introducer's prerogative here and ask a question. i think the point here, you talked but the book as being partly a love story as well. mental illness doesn't just affect the person with the illness. it affects warren around them. sometime it affects an entire

community. i think that's an issue related to stigma. but your family seems to understand what was going on before you did, and all of that has kind of -- they dealt with it. a lot of what describe, they described to you every wards and you were able -- afterwards and you were able to make sense of it writing the book. can you talk but the family relationships. >> i have a particularly loving family. all highly educated in medical field so they know and still they were terrified. they didn't know what to do. they didn't want to accept that i'm losing my mind. it is difficult. it is extremely difficult, and they're terrified even now, but i that are loving and they have forgiven me. they were not even angry with me. although they suffered more than i did. and this is what i'm saying in

the book. i think they suffered more because they were aware of what -- of my -- off losing me basically. i wasn't. i didn't see my behaviors as changed. i didn't see myself as angry. i didn't notice anything. i just living. but it is so important to have such a loving family, or a support group, because without them, i wouldn't be alive. i wouldn't be here. very simple. >> hi, just a couple of questions. you mentioned you were immunotherapy clinical trial could you brieflytle us how difficult it was to find that trial, how your doctors and you determined which trial to go into, and how i difficult it was to get into. >> again, i describe the whole process in my book, and i think it is stromly -- extremely

important. your question is extremely important because we discovered, but we knew a lot about it even before. that is so important to have a team working with you, and do all the research possible on your illness. what are the most -- what are the current therapies available, and were. who are the best doctors, which are the best hospitals. we did this work together, and i was first treated in boston, in the cancer institute. we realized if i or two live there for a long time it would be very difficult so we found a very good hospital near where we live, georgetown, and my doctor is there.

but it was a long process before we realized. you ask what immunotherapy is also. so, these are anti- -- i got infusionsfusionsfusionsfusion a. they inhibit proteins that are inhibited and don't fight cancer. in case, melanoma so inhibition of inhibitors so my only system that led to this -- led to loss of part of the pituitary and other immune responsesment my system was haywire but it did

fight cancer and that was the point. >> you and your former husband both experienced brain melanoma. due you find that curious or inunusual. >> i don't think it's a link because everybody is -- at the doctors ski i asked think that it has to do with either sun and genes. so, we're brought up in poland. for anybody who was in poll poland, it's was a coincidence our again net -- genetic makeup that living would do it. >> you have a microphone, please.

this is going to have to be the last question. i'm very sorry. >> as the treatment you got which was the -- was the same as president carter got on his cancer? >> yes. he got one drug. got two drugs. he got different drug, but it's basically all the same, checkpoint inhibitor. >> i'm very glad you are alive. >> i am, too. thank you. [applause] >> thank barbara for her book and her story. she is a triple cancer survivor, and lived to tell us about a little bit more about the brain. the neuroscientist who lost her mind, great read ump you don't have to be a neuroscientist to understand her story. thank you for attending, please fill out the survey and

dr. lipska will be available so sign you books very soon. >> thank you, thank you. knotted [inaudible] conversation [inaudible conversations] >> you have been listening to neuroscientist, barbara lipska. talk about her book "the scientist who lost her mine mind. start starting shortly, a store about the opiode crisis.

>> here's a look at the current best-selling nonfiction books, according to a group of independent booksellers. former fbi director's james comey's reflexes. after that it's mark manson's advice on leading a happier life, followed by former secretary of state madeline albright's warning but all the rice of fascist tactics. next is educated. a recount of a childhood in the idaho mountains. and after physicist, neil degrass tyson's as, and and then michelle mcnamara and her

search for the golden state murder. and then investigative journalist ronin farrow in "war on peace." after that a cookbook from joanna gains, falls followed by thoughts on the fear of agency and how our bodies age. she will discuss the book on "after words" this weekend. and then then clinical psychologist, self-help book, rules for life. >> my favorite researcher -- my son says that's shows you what a dork i am because i have

favorite researchers dirk a guy named nicholas eppley and he was been researching intangible offered human nature for years. just recently, he did a very long study and found that when we read an opinion we disagree with in any form, it doesn't matter what i have it is printed in a newspaper, book, an e-mail, facebook, if we read is, we are much more likely to think we differ agree because that person is stupid and ignorant of the real issues. if we hear someone telling us the same opinion, whether it's recorded, in a podcast, doesn't mary. i we hear their obvious we're much more likely to thing they disagree with us because they have different experience and perspective. what that means is that the human voice is literally humanizing.

it is the voice itself, some quality of the human voice, that helps to us recognize each other as human beings. deserving of respect. and we do deserve respect. every person deserves respect. not every opinion but every person and also means this process that we're going through right now, of transferring all of our communication to digital world, is dehumanizing us. of course we hate each other. we don't see each other as human beings deserving of respect. and this is not a partisan issue if you think, absolutely, those liberal are always jerks, or the other way. doesn't matter what you're thinking. it's not partisan. every single person is equally prone to do this to the other side. every person is equally prone to

confirmation bias. you know what confirmation bias is? it's where you believe something, and then someone gives you evidence approving that belief is wrong, and it makes you believe it harder. we are the only species that suffers from confirmation bias. and that is because confirmation bias is not helpful. if you have a cat and that at that time truly believes there's no cat -- the -- a mouse -- you sew them evidence of catness he next room, lots of cats, and that makes the mouse believe harder there nor cats in the next room, mice would be wiped off the face of the planet. so you have to ask yourself, why

do we have confirmation bias? whoa do all of us have confirmation bias and how does its help us? because frankly, why would it survive? through all of millenia of evolution if it did not some n some way help. i'll tell you what i believe, even though we fully don't understand it yet. i think confirmation bias is a strength. i think what it does is approve to us constantly that we need each other. that we need to talk to each other. because we are our own checks and balances. i need you guys to tell me when i've said something nutballs. and i need to believe you. we need each other. all of us. there is no virtue in saying, i don't talk to people like that. it's not a virtue.

i don't care how vial you think their opinion is. that's not something to brag about. you can talk to everybody. i'll give you an example. anybody know who xirnona clayton is? one person. she was a good friend of the kings, dr. king and his wife, coretta. she -- when they decide to create the great neighbors initiative, great society initiative to strengthen neighborhoods in atlanta, she was pointed as the head of the program and had a whole bunch of different neighborhood captains, the mayor said to her, i have to warn you because she was an african-american -- still is an african-american woman -- that hasn't changed -- he said i have to warn you one of your neighborhood captains is a grand dragon in the kkk.

and she described that very first meeting where all the captains came in and one of them refused to touch her or shake her hand. she said, that's the one. so he could come from from time to time and sit in her offers and she would talk to him. about whatever. and she says, dr. king told her, don't try to change heards. leave that god. you don't have the fewer know if a heart is changed but youback human being and respectful. so he came sometimes two or three times a week and just sat down. at one point she asked him, why too you keep coming here? you don't even like me. he says i know but i like to talk to you. >> you can watch dismiss other program -- warm -- watch this and other programs. >> here's a look at upcoming

book fairs and festivals around the country: ed

[inaudible conversations] >> the gaithersburg festival continues. this is dr. edwards sederer. [inaudible conversations]

>> welcome to the gaithersburg book festival. i'm editor in cheech of the independent review of books. we proudly support the arts and humanities and pleased to bring you this fabulous event thanks to generous support of sponsors and volunteers. if you see them say thanks. a few aannouncements, silence your device if you're following us on social media, use the # #gbf. you can fill out a century x-ray you will be entered to win a $100 visa gift card. dr. sederer will be signing books. this is a free event but helps

the festival if you've the books from the speakers little make this festival possible and supports politic and prose, a wonderful, independent book store in the d.c. area. so if book the book, please. do okay. so, dr. loyd sederer is an adjunct professor, a contribute you rite for u.s. news and world report and chief medical officer for the office-mental health and a regular on -- in 2013 given an award for excellence in teaching residents about the american psychiatric association which in 2009 gave him -- recognized him as psychiatric administrator of the year. his new book "the addition solution" which is what we'll be discussing today. please join me in welcoming dr. sederer. [applause] >> thank you for coming. >> so i like to start with a broad question and to get more specific. the field of addiction and the

prevalence of addiction is a moving target and evergrowing and seems intractable sometimes. why this book and why now? what were you hoping to add to the national conversation. >> i'm a psychiatrist -- welcome, everybody. it's great to be here. i'm honored to be here. aim a psychiatrist and a public health doctor, and in both of those roles, i -- it's my job, if you will to look at how people's health, ill health and fatalities are ohe curing, in this case in my state, new york, and then throughout the nation. and i had covered a lot of about drugs over the year. opioids, cannabis, methamphetamine, sin the sick -- synthetic marijuana and i saw the problem worsening when in fact we have a lot of slices using ask that prompted -- he --

a lot of solutions we aren't using and i want to say we're can get out this epidemic. >> you mentioned in he book that another interviewer asked you what would be the one piece of advice or change you would make and you said to avoid the adverse childhood experiences that lead people sometimes down the path to addiction. can you define what ac es or and give some examples. >> this is a public health doctor speaking. ace, adverse childhood experience are to thers andenses that young children have, three, four, five six years old, who are abused, neglected, multiple foster homes, parents in prison, and to -- or homes with domestic violence, and these accumulate. so there's a score how many adverse childhood experiences

that child is exposed so and four or more almost always predict biz the time they're teenagers they'll have a variety of mental health problems, going to be obese, have diabetes, smoke, and to -- teenage pregnancy as well as addictions. so, one of the interventions that could make a difference with large numbers of children -- these are not infrequent ocurrents -- is to intervene, help families to better -- prevent the problems that are inescapable to them. >> to prevent those you would think it would require somebody detecting them. so, outside of the healthcare system, who should be on the lookout for the aces. teachers or any concerned-over adult?

who are the gate keepers. >> what a great question inch my day job with new york state i introduced a variety of screening tech nicks, example, for depression, substance abuse, and tarted the march toward trying to require speedattic practices, family practices, and schools, to screen for these adverse childhood experiences, because we're all socialized to screen. when you good to a doctor, you get a number, right? you get your weight, get your pulse, you get your blood pressure, you get your lipid levels, sugar levels, and all socialized to think, what is normal, what is not normal. so if you quantify a problem, it gets attention, and it is more likely that people will attend to it, and so that's the idea, which is in schools and in setting where, primary in care

settingsing to scene for this and then link the families to services in the community which ares a metedly very sparse but never build until the demand occurs. that's my view. . >> do you fine that pediatricians and schools are recep tonight this ideas in are they wellogy do this or just one more thing? >> they're actually quite different. pediatricians recognize the problems problems problems and have published white papers -- not supporting the screening because they feel it's not good services so it's -- they can be trouble for doctor to identify a problem and not have a way of solving it. schools on the other hand are mostly quite phobic but identify ing problems because they're resources are limited. >> something you wrote surprised

my when you talked about 12 ten programs and na and aa. they're so ubiquitous, seem to be the gold standard and yet their success rate is incredibly one, one in 10 to one in 20 is success rate. why is it the gold standard -- remain the gold standard. >> something i learned recently from a colleague is that attendance also aa meetings has not increased in 40 years. that's -- so maybe some of that is a reflection of our inaccessity but seem to be everywhere but few people respond to it. aa these, recovery programs are good thing but not sufficient, and that is my one thing really try to message to you people, and to -- through the book, collision that you need to combine interventions with a

complex problem. it's just as true with diabetes or heart disease, one intervention of medication alone is not enough. you have to combine recovery with medication, with therapy, with family support and get -- it's much more likely someone will get better. >> in the research or data on the kind of person who is recep tonight a 12-step program? a type of person who will installly benefit more from this type of program. >> not good research base it's anonymous. and it's hard to track people in these programs, but you can appreciate that those people who have spiritual core to them, who believe that spiritual -- being taken -- being recognizing that spiritual presence and the -- a higher power will make a difference, they're much more apt to respond to aa and na,

gambling anonymous and so forth. >> what i read is that spiritual doesn't really mean religious. >> yes, that's often confused. he see myself as a spiritual person who does not follow a religion. spiritual to me means that we think that there is a high are power, that there is a sense of connectedness, of continuity in life, and i think that's to me closer to what spiritual means. >> you had referenced the multifacetted approach to treatment and why that's so important. one thing you pointed out is being the standard of universality is the motivational interviewing, or mi. can you explain what that and is what it looks like. >> yes. so, imagine a mother who comes to her pete trix, bringing her child we -- pediatrics with her

child who has earaches and the pediatrics uncovers that the mother is a smoker and smoking is associated with ear infections and the doctor starts to berate the mother. don't you know that smoking is related, probably causing your child's earaches and she's trying to get out of the office. that's know motivational interviewing. motivational interviewing is understanding, you're a single mom, a lot of stress on you. i see that you smoke. how is that helpful to you? and what -- when do you spoke? why do you smoke? and so she is -- the doctor is siding with the person and

recognizing that tobacco use or opioid use, cannabis use, is serving a person. that's the premise. behavior serves a purpose. hey not be very good. the best that someone has and motivational interviewing is getting behind, appreciating that somebody is doing something that seems to destructive but it's useful to them and when you do that, that's how people begin to then feel more trustworthy and more able to say, well, wait a minute, it's not that it's so helpful to me and that's the tourneying point. dogs that give you a sense of motivational interviewing. >> it does but i read the book. i already know. guess like in the scenario with the pediatrician, almost like the doctor is planting the seed in the parent and they hopefully take ohm -- take home and act on. how do you quantify the success

of motivational interviewing and you may not see the result? >> a good. we it's hard to do research on program interventions where you're trying to train a group of pediatricians or primary care doctor's other doctors to use this approach. there's no funding foris, and it's hard to track actually where it made a difference as opposed to maybe something else. they got housing or something like that. so it's very hard, but experientially, manning -- many doctors and many people say this makes a differs and its goes back many, many years and first used with addictions and now used with a variety of behavioral problems like eating too much. smoking, sedentary lifestyle, as a way of helping somebody get on the other side of what is a problem behavior.

>> another thing you mentioned, another part over the multifaceted approach, there's promising research in using psychedelic jugs like lsd. what is it that makes them use ful in addiction. >> it's mere drug called psilocybin than lsd. it is like lsd. it's a softer form of lsd and comes from mushrooms. another term for it is called magic mushrooms. and we don't have -- we have some good treatments but we don't have as many effective treatments as we would like, nor do we have interventions where you do one thing or two things, the same thing twice, and its turns the course of somebody's life. the psilocybin causes a trip

that last six hours, and when done under the safe circumstances -- this has been studied in four august medical centers, imperial college of london, nyu, hopkins, and stanford. first with people who were terminally and i will were in a crisis. huge disstress but facing death and over 500 people were given psilocybin under the conditions and without one bad reaction. it's pure stuff. nicer a protected environment and they're guided,, and 80% of those individuals went from being in extreme distress to reconciling themselves with the circumstances, with their own death. and what is reported here is that people have this experience, and i don't know how many of you have had trips, whether it's lsd or psilocybin

or beladona which is the trip was bill wilson started aa went on. that is -- you get a sense of wonder or you restore -- a restored sense of one doctor, being one with the universe and you're not dying, you're continuing and that one trip, maximum of two, is lasting with that experience, with death. ...

so you can go to your local drug dealer to buy some. i'm not suggesting that. i'm saying that we-- a good idea for the medical and the general public to be open to the idea that addiction is a really tough problem and maybe for some people this will actually turn their minds into -- away from addiction towards a life, a different kind of life. so, mostly, it's still largely fear or stigmatized, but as more is learned about it, i wouldn't be surprised if more people began to say that this is maybe for me. >> have any of your own patients benefitted from that kind of therapy? >> no, i have not in my--

i don't have -- i have 700,000 patients every year, that's how many people are served by my agency in new york state and to my knowledge, and i've certainly not prescribed it for any of them, perhaps some have done it, i don't know. i only know what's been done under controlled research conditions. >> you talk in the book about how so often addiction and mental illness go hand in hand. but there are separate conditions, there are two separate problems and you add q advocate for good mental care and if you had two areas of the health care system hardest to find either access to or enough doctors or rehab beds, any of those things, how realistic is it that people who need that sort of concurrent mental health care or substantial abuse care are going to get it? >> what a great question, and

what i've learned from patients and families, is if they have to go two different places to get care for two different conditions. they probably don't go to any or they may only go to one. and that has led to more and more efforts to provide one-stop shopping, if you can be cured for for your diabetes, and cared for for your depression and you can be cared for for your cannabis addiction or narcotic pill addiction, all in the same place. and that's principally in primary care, which is where most people go. very few people go to a psychiatrist or mental health clinics and far fewer go to addiction centers. so, one stop shopping actually is what we're trying to develop in terms of services because that's what people will take, will accept. >> would that require sort of the wholesale retraining of

primary care doctors to-- because mental illness is its own thing and it's not simple and it's certainly not one size fits all and it's also a moving target. how do primary care physicians and nurses become equipped to spot it and treat it? >> well, it's easy to spot or easier to spot it than it is to treat it because we have the screening instruments, just like a cuff for your blood pressure or just like a lab value for your sugar. we have a questionnaire, very reliable questionnaires for mood problems, for substance problems and so, and when those are introduced, the standard operating procedure, you fill out this simple questionnaire. you fill it out, it's not -- you're not asked by a clinician, you feel it out and it goes to the doctor. it goes into medical-- and then that's, requires a change in practice, but that can be done. what most general practices

need are the presence of a mental health person or addiction counsellor because these are tough conditions and in rural areas, it's even harder-- urban areas can't bring in mental health specialists and rural areas are even harder. and we'll see that problem solved over the years ahead by what's called telehealth they'll punch in on screen and a protected type of skype or face-time for the patient and doctor to speak on expertise. >> you hear often about, especially in rural areas, and less populated areas, because there's such a lack of, you know, beds for treatment facilities and things like that, an addict will go to the emergency room, they have no reason to keep him or her because they're not in crisis at the moment and what they need is a bed in that facility

and they don't have one and that's happening constantly in this country. what changes could they do now to sort of fill the gap until they can get more facilities? what can they do at the local clinic or the local hospital? >> well, sometimes there's more available than people imagine, and some of the most inspirational communities that i have visited, communities where there have been high rates of overdose deaths, families lost a child, families lost a brother or a sister, they -- two things happen. the families came together, not only to support themselves, but to be a channel for people in trouble to get care and to link those people, literally by hand to services. that's one thing, and the second thing is police departments that start arresting and charging people with drugs and it is a -- and

the authority of a police department to determine whether to charge somebody. once they charge somebody, it's out of their hands, it goes to the d.a., but many police departments, fire departments now in a variety of states are saying, if you show up and you have a drug problem, and you want to surrender your drugs, we will not press charges, instead, we will call other families that are affected and they will help you get care, literally, at that time. not tomorrow, at that time. and those are-- those are grass roots activities that have yet to explode in this country, but i imagine we'll see more of that because those really work. and they are out of the ashes of tragedy that families create these programs and police join them in the process. >> sort of dove-tailing on that

with police not making arrests. you acknowledge in the books where countries where drugs are illegal or decriminalized where the incidents of the negative behavior with overdosing, contracting hiv, crime related-- or drug-related crime goes down and yet, you yourself say you're not an advocate for legalizing drugs across the board and even marijuana. can you explain why that is? >> yes, i'm an advocate for decriminalization, and not incarcerating people with disease, which is addiction is a disease. and also, incarcerating people with addiction means the hammer will fall dispoe portion natalie on poor people and people of color. and that's who is in for drug crimes. incarceration is not a solution, and it's not a solution for dealers who are users. if you're a user, you make a living or you cover your habit

in three ways, you steal, you prostitute yourself, or you deal drugs. so, decriminalization, including decriminalization and treatment for dealers who are users. legalization means that the more substances available in a community, the more it's going to be used. that's a public health principle. the more accessible something is, whether it's tobacco or alcohol or opioids, the more it will be used and with cannabis, we now have a number of states that have legalized recreational marijuana, and i've covered that story, visited those states, and when they're honest, they'll say, we still haven't figured out how to do this and we still haven't figured out how to get the quality and dosing safe.

we -- we're not making as much money as we thought we would make, and we're spending a lot more money because of enforcement because there's still a cartel and there's a lot of home grown stuff that's being sold. so, the states in five years now, in colorado, they haven't figured it out. so, we even saw a substance like cannabis where we need to know a lot more and we don't have much research on this because it's what's called a schedule one drug. so, we don't know what potency, what mixture of the plant is useful for what, and dangerous for others. we have so much limited information to just barrel ahead and say let's make this available to everybody, seems not a very thoughtful approach. >> how much time do you think

it would reasonably go by until you have a feel for how legalized marijuana, say, in colorado. its effects. ten years, 20 years? >> five, maybe five more years because there's such a focus on it and there's such a march by so many states to legalize it that, there's a lot of going on in terms of driving under the implants r influence, access by teenagers and the whole financial aspect and the whole quality control aspect. that's under the lights right now and i think we'll learn more in the next few years so that if we go ahead, we'll go ahead in a much more informed way. >> okay. i was struck in your book, generally by your kindness toward addicts and you're not judgmental and you even write that addiction pirates the brain, but it need not pirate our humanity towards those affected and yet there is-- >> who wrote that? that's pretty good. [laughter] >> yeah, pretty good, you're a good writer, you should buy his

book. no, you wrote it, you wrote it. so, do you think that over time, as people -- because of the opioid epidemic is so ubiquitous and so many families are affected, that more people are turning towards passion versus judgment? because right now when you say this is a crime, people think then punishment, but is that changing as people realize that while everybody knows somebody now who is addicted and this is a disease, it's not a crime? >> i think that's right. i think that because so many families, almost every family knows somebody who is-- has an addiction, whether it's alcohol or opioids and sees the tragedy of that has started to realize, we have a real big public health problem here. we have a disease that has gone unchecked and the answer is not

more law enforcement, the answer is more prevention and treatment. >> one sort of heartbreaking example in your book sort of as the poster child how life can spiral from addiction is billy holiday. can you tell people what her story is and how it illustrates every bad thing that can happen in an addict's life. >> i'm a big fan of billy holiday, i think she's arguably one of the greatest blues singers in this country's history and she grew up not far from here in baltimore. her mother was a prostitute. she grew up on the streets of baltimore, living that life as the child of a prostitute when she was a ten, she was raped. and they are screams brought the local police, who took her to be a prostitute, and arrested her and she spent a year in juvenile corrections. she wandered around for a while. she followed her mother to

harlem. her mother went to work in a brothel there and her mother wouldn't take her in and she was 14, and had no home, and she began as a prostitute herself. after a while, she got arrested as a prostitute. she went to predecessor institution to ryker's island and when she got out, she had only one goal, which was to get as far away from her interior experience of neglect, abuse, rape, incarceration, and she turned to high proof alcohol and to heroin and she used those for the rest of her life. she's an example of adverse childhood experiences in spades and she-- and she died when she was 44 in a hospital from cirrhosis. she's an example of someone whose early life and whose

trauma put her on a path to addiction that she could never escape and in some ways, i think it's a miracle that so many other people who have lives like hers, worse or not so bad, escape addiction. >> okay. i was also struck in the book, thinking back to sort of the crack epidemics in the '80s. and it seems like with crack it's a crime wave and with opioids, it's epidemic. is society changing and understand things better or why the disparate? >> i think that crack had more to do with neighborhoods of poverty and neighborhoods of color, just like heroin in the past, and then it used to be a problem of inner city poor and people of color. and so, crack didn't -- it was sensational because of the stories and particularly crack mothers and crack babies, but it never got that kind of

appreciation that this, too, is an addition, that, this, too, is a disease and it was mostly that these are people that are doing this to themselves and in some respects, it was a darwinion approach to crack addiction, i think. >> we have about ten minutes left and i wanted to ask if anyone in the audience had any questions for dr. sederer. i see-- we have a microphone for you. >> sir, i think we're going to give you a mic. >> yeah. >> so you mentioned adverse childhood experience as a root cause that we should alleviate to help address the opioid epidemic, but that's been going on since humanity's different, it's different from the narrative we've heard for the media and other researchers saying that lack of economic opportunity and like the eastern heartland, cheap access

coming from mexico and there's another one, but an overprescription of opioids from doctors, specifically, i mean, a lot of these opioids are going-- on the street are coming from a small subset of doctors. how do those issues compare fot childhood experience as it's doing right now? >> thank you for bringing up, in some ways, it's a considerable overlap. what you're describing is what gets called now the social determinenates of health and mental health. loss of job, loss of opportunity, chronic pain and you then -- those are vulnerable people and when suddenly your neighborhood or your city is infused with substances, opioids, this is the story in the midwest, this is the story in the south, in the northeast, that you have a whole-- a deeply vulnerable population. and you know, having social despair because of their circumstances, loss of jobs for themselves, loss of prospects

for their families, that when they try-- an opioid, which they're often given by doctors because they have chronic pain, they've injured themselves, they have arthritis, they discover that suddenly they're transported away in a way they've never known before, from not only their physical pain, but their psychic pain. so, you have and could convergence here of social malaise, social disease, if you will, with physical pain and with the availability of a substance that's very effective, at least at the beginning, in taking people away from their suffering. >> next question. >> yes, a number of commentators have said that-- or suggested that the large pharmaceutical companies have played a role in the opioid addiction. i was wondering if you'd like to share your thoughts on that.

>> that's certainly the case, and that's a story that goes back 20 years to the late '90s. ap one company in particular called purdue pharmaceuticals, the manufacturers of oxycontin. they had a drug that had been used for terminally ill pain, people with terminal illness and pain, and they suddenly began to market it for any kind of pain, and so they used fictitious reports in some journals to say nobody gets addicted to this stuff. so, and they had a huge work force of what are called drug detailers, that people go to doctor's offices and say, here is what your patients need, it's safe, they don't have to suffer any more. so, pharma has always played an important role in terms of promoting drugs and in this case, opioids, and there are

only two countries on earth that allow what's called direct to consumer advertising and that's what you see when you're listening-- watching tv or listening to the radio, direct to consumer advertising, the united states and new zealand. and what the reason it's so popular is because if we are exposed to a drug that offers a solution, whether it's for pain, whether it's for erectile dysfunction, whether it's for diabetes, directly exposed will be much more likely to go to a doctor and ask, can i get this? most doctors are decent people and they want to make their patient happy. they want to give their patient what the patient wants. so, these are slippery slopes, and pharma -- and this company settled a suit for bad

advertising, $600 million a couple of years ago, but that was a pittance compared to the billions they made over the years. >> i think we had a question in the back. >> actually have a point to make and wanted to get your response and then i had a question. as far as marijuana legalization, or decriminalization-- >> could you hold it closer to your mouth? thank you. >> sure, as far as marijuana decriminalization, i think you have a good point making sure it's safe, but i feel like people have been using it for a long time, maybe not legally and i think it would be fair to say it's at least as safe as alcohol, if not safer. people don't die from blood poisoning from it or overdoses.

and i think one of the issues with decriminalization as opposed to legalization is that people can still lose their jobs over using it. it stays in your system for so long so there are some challenges as far as that's concerned so i was wondering your thoughts on that and also wondering if you'd heard of ibagain and wondering what your thoughts are on that. >> the cannabis is not good for the developing brain. so, our brains are under construction into our 20's through a process by which we cover the nerve fibers. so, when a brain is under construction, it's very vulnerable to substances, particularly potent stuff, thc, the active ingredient in cannabis is 60 times more powerful today than it was when i was smoking pot in college. it's really strong stuff, and when a child, a youth's brain is exposed to it, that can

interfere with the normal development of the brain and also for youth who have some underlying mental illness, it runs in their family, it's apt to unleash that. so that's another reason to be careful about not just-- not decriminalization, but legalization because when it's more available, it will get in the hand of kids and none of these states have controlled access. they-- it costs them a lot of money to enforce, trying to prevent kids from buying this stuff, so, it's-- you know, it's a complicated problem. you know, and it's safe for a lot of of people and it works for a lot of people both in terms of anxiety or pain, what have you. ipagain is another psychedelic drug, but very limited use as far as i understand it in this

country. >> oh. i was just going to ask about some of the new pharmaceuticals that are coming along to help like break the addiction cycle and how you feel about them and does that really have a purpose or is somebody better off going cold turkey and treating another problem by another pharmaceutical? >> this is called medication treatment and in the '60s, methadone, an alternative to heroin. it's a way by which people don't use dirty needles, steal to pay for their habit ap since 2002, we've had another medication similar to methadone, but safer called suboxone. and for some people it's a way to detoxify and for some people it's a maintenance drug like methadone, but it's safer, it's very, very hard to overdose on

it, and which means it doesn't stop you breathing. and it's-- but it's hard to get off of. so, no solution is perfect, but for some people, this is life saving and i wanted to give an example because you mentioned emergency rooms before and i know you have contact with the hospital if that's the case. emergency rooms are where people are taken, often, after an overdose or during an overdose and they are given an antidote to the opioid called narcan. and what narcan does, it helps them start breathing again, but it puts them into immediate withdrawal and that is not deadly, but that is extremely uncomfortable. and then the person is discharged from the emergency room and the first thing they want to do is get a fix because they feel so horrible. now the -- some emergency rooms

are trying the practice of giving this medication, this is a film tab, a few days of it, to somebody who has taken an overdose and is in withdrawal because they know that that person is likely to be back in three days. so, it's a life saving measure, but also, emergency rooms have enough patients than those that they send out knowing that they're going to come back. so, this is another innovation and it's one that is-- it should be carefully considered because it is not easy to get off of it. but it is life saving. >> check? okay, yeah. >> i had a chance to interview a few homeless people recently and one of the issues they told me they had was getting medicine for their mental illness, the cost was so high.

if the medical marijuana was grown on a farm and would that be more cost effective? >> in my year i've had a lot of contact, you as well, in new york city we're seeing people who are homeless, poor with mental illness, smoking synthetic marijuana, k-2, spice, and it is really cheap compared to just even illegal joint and, but it's -- it drives these people even crazier than they are, many of them are now coming to emergency rooms and some of the latest concoctions are very sedating, so some people have gone into coma with it. but it-- i see this, also, as their effort to medicaid themselves, to try to feel some relief from the pain and hopelessness that

they experience. is that what you experienced? >> a question back here, i think. can you shed some light on microdosing people? >> on-- >> microdosing? >> microdosing. yeah, so micro-dosing is small doses of lsd. 10 micrograms taken every few days rather than 100 or 150 taken for a trip. and it doesn't cause a hallucinatory state, but it has become pretty popular and it's an alternative to attarall and ritalin where performance is everything. and there's a word out that

this enables you to be more creative, it energizes you, it allows you to think out of the box and it probably does. but it is not easy to get. and you don't know what you're going to get when you buy it. micro-dosing. and a woman, a writer and actually an attorney, former federal attorney waltman wrote a book about micro-dosing a year or two ago called "a very good day" and that was her experience after depression and have a remedy and taking microdosing. somebody in the back? >> yeah, right here. >> yes, hi. i've had a couple of friends that i grew up with have passed away as a result of this disease and i've done a fair

amount of research on this and it seems that when soldiers came back from vietnam, many of them came back hooked on heroin and offered morphine at morphine clinics and that became too expensive and moved to methadone and became too expensive and moved to suboxone. do you think that suboxone is the better alternative to the other two medications or think it's as harmful? >> i think that's a really good question. it depends on the person. that story, the vietnam story is a really important story. apocalyptic story because the department of defense became concerned potential-- how many soldiers in combat in vietnam were using heroin, which was cheap, high-potenc