The Unspeakeasy With Meghan Daum

My guest is Dr. Sunita Puri, a palliative-care physician and author of That Good Night: Life and Medicine in the Eleventh Hour. We talk about what it really means to care for patients when cure is no longer the goal, why our medical system resists honest conversations about death, and how clarity and compassion can coexist at the end of life. Topics we cover: • What palliative care really provides (beyond hospice) • Why "more treatment" ≠ "more life" • Prognosis, probabilities, and telling the truth kindly • How families can ask the right questions • Documentation that matters (and what to avoid) • The moral distress of clinicians • Cultural/faith factors that shape decisions • Dignity, autonomy, and realistic hope Guest Bio: Dr. Sunita Puri is an Associate Professor of Medicine at the University of California, Irvine School of Medicine, where she is the Director of the Inpatient Palliative Care Service. She has written for The New Yorker, The New York Times, and The Atlantic, among other publications. She is the author of That Good Night: Life and Medicine in the Eleventh Hour, a critically acclaimed literary memoir examining her journey to the practice of palliative medicine, and her quest to help patients and families redefine what it means to live and die well in the face of serious illness.

In this episode we discuss:

• How Helen defines "the great feminization" and why she thinks it explains contemporary "wokeness"

• What changes when institutions tip female—journalism, academia, law, nonprofits

• HR-ification, hostile-environment law, and why managers vs. judges should handle culture

• Agreeableness as a social virtue—and a professional liability in truth-seeking fields

• Innovation, risk tolerance, and the gendered vibes around tech, nuclear power, and exploration

• Whether "women in STEM" initiatives help, hurt, or just rebrand office politics

About the guest: Helen Andrews is a senior editor at The American Conservative and author of Boomers: The Men and Women Who Promised Freedom and Delivered Disaster. Her new Compact essay is "The Great Feminization."

This week I interview journalist and author Olga Khazan about her new book on personality change, Me, But Better. We talk about the Big Five traits—openness, conscientiousness, extraversion/introversion, agreeableness, and neuroticism—and how they play out in ordinary life rather than in personality quizzes. Olga explains what research actually shows about how much you can change, how anxiety and depression tie into neuroticism, and why introversion can quietly turn into isolation. We also discuss everyone's favorite personality expert, Carl Jung, the politics of "openness," what's happened to our social lives since the pandemic, and how the culture of "self-care" has blurred into hiding from the world. Other threads include: • The science behind gradual, behavioral change instead of "life hacks" • How "fake it till you make it" can work without faking yourself entirely • Gender differences in agreeableness and the social cost of being direct • Why liberals often score higher on neuroticism—and what that might really mean • The relationship between personality, motherhood, and the urge to optimize everything Guest Bio: Olga Khazan is a staff writer for The Atlantic and the author, previously, of Weird. She is a two-time recipient of journalism fellowships from the International Reporting Project and the winner of the 2017 National Headliner Award for Magazine Online Writing.

Novelist and screenwriter Bruce Wagner returns to discuss his exceptionally timely new novel Amputation—a strange, exuberant, and ultra meta work set against a topic I've talked about a lot this year, the January LA wildfires. Bruce, an L.A. native and prominent literary figure in the city, explains how the book came together in less than two months, why he resists "political novels" even when writing inside a political moment, and how language (not legacy) keeps him making art. We also talk about real-life figures who appear as characters (Stephen Colbert, Mayor Karen Bass, Debra Winger, and a Timothée Chalamet student double, among others), the surrealism of driving through miles of leveled neighborhoods, and the deranged comic-tragic chorus of the Nextdoor app. Bruce also reflects on being an L.A. "outsider who outsided his way inside," why the book is opera, not noir, and what it means to keep walking the "narrow, burning road to the palace." Guest Bio: Bruce Wagner is the author of fifteen novels, including the "cell phone" trilogy, The Marvel Universe, The Met Gala and Tales of Saints and Seekers, Roar: American Master, and now Amputation. A longtime Hollywood insider/outsider, he has written for film and television and is currently published by Arcade.

Katie Herzog, co-host of the Blocked and Reported podcast (BarPod), is best known as an anthropologist of, as she puts it, "internet bullshit." But she's swerved far out of her lane for her latest project. In her brand new book, Drink Your Way Sober, Katie combines personal history with deep reporting to chronicle a lifetime of drinking and explain how a little-known drug called naltrexone, combined with an approach called The Sinclair Method, finally allowed her to quit for good.

Photojournalist Jeremy Lee Quinn has spent years documenting protests, rallies, and moments of public unrest that often look very different on the ground than they do on the evening news. In this conversation, he talks with Meghan about what really happens when a "mostly peaceful protest" turns chaotic, how viral clips can erase context, and why the incentives of freelance journalism can skew coverage. They also discuss what it takes to build trust with sources across ideological divides, the ethics of filming in volatile environments, and how ordinary viewers can tell when the narrative doesn't match reality.

After years of institutional groupthink and policy whiplash, what have we actually learned—and what are we still not allowed to ask? Lisa Selin Davis returns to discuss the evidence (and non-evidence) around youth gender medicine, talk about the ongoing taboo and confusion around AGP (autogynephilia), and consider how to hold two truths at once: some people report thriving post-transition while others were clearly harmed.

In this episode, we discuss / talk about:

• How "don't question it" became a default and why that stalled real inquiry

• What the evidence actually says (and doesn't) about pediatric interventions

• Thriving vs. harm: talking about real outcomes without slogans

• Gender clinics closing under political pressure—who might be quietly relieved, and why

• AGP: why it's still taboo and how that affects research and discourse

• The NFL cheerleader controversy and what it revealed about intellectual consistency

• "Stopping" vs. "ending": Lisa's framework for irreversible choices and life after medicalization

About the guest Lisa Selin Davis is the author of two novels and two nonfiction books, with a forthcoming book on the culture of trans kids and gender identity. She writes the Substack BROADview.

Dr. Andrew Hartz is a practicing clinical psychologist and the founder of the Open Therapy Institute, an organization dedicated to overcoming sociopolitical bias in the mental health field. He was last here in 2023 and returns now to talk about what's changed—and what hasn't—in the mental-health landscape since then. We discuss the rise of "everyday dissociation," how screens and Zoom relationships dull presence and feeling, and why talk therapy can miss the mark when the problem is disconnection from the body. Andrew also explains how anxiety became a form of social currency (from dating to testing accommodations), the overuse of diagnostic labels online, and why Acceptance and Commitment Therapy (ACT) offers a saner path than endless self-rumination. Guest Bio: Andrew Hartz is the Founder, President, and Executive Director of the Open Therapy Institute. He's also a practicing clinical psychologist and was formerly a professor in the clinical psychology doctoral program at Long Island University, where he also completed his Ph.D. He's been featured in the New York Times, on The Dr. Drew Podcast, on Dr. Phil Primetime, and in The Free Press and has written about political issues and mental health for outlets such as the Wall Street Journal, City Journal, Discourse, Heterodox Academy, the New York Post, and Quillette.

This week, I welcome back Rob Henderson, the social psychologist, author, and commentator who coined the concept of luxury beliefs: ideas that confer status on the upper class while inflicting real costs on lower-income communities. Rob was last here in early 2024 discussing his memoir, Troubled: A Memoir of Foster Care, Family, and Social Class, which chronicles his journey through California's foster system to the Air Force, and onward to Yale and Cambridge. In this conversation, we explore what he's been thinking about since the book's release—particularly the so-called "mating crisis," why many young people delay or avoid partnerships and family, and what that means for the future. We also dissect the emergence of Zohran Mamdani, the New York City mayoral hopeful who, according to Rob (and I would concur), embodies luxury beliefs in action. Finally, Rob answers questions from Substack readers.

Rob will be a speaker at our Unspeakeasy Small Gathering for Big Ideas weekend, October 11-12 in New York City. Programming and ticketing info here.

GUEST BIO

Rob Henderson is the author of Troubled: A Memoir of Foster Care, Family, and Social Class. He grew up in foster homes in Los Angeles and in the rural town of Red Bluff, California. After enlisting in the U.S. Air Force at the age of seventeen, he subsequently attended Yale on the GI Bill and was then awarded the Gates Cambridge Scholarship to study at the University of Cambridge, where he obtained a PhD in psychology in 2022. He is currently a Senior Fellow at the Manhattan Institute, and his Substack newsletter is sent each week to more than 70 thousand subscribers.

HOUSEKEEPING

📖 Order my new book, The Catastrophe Hour: Selected Essays, on Amazon or directly from the publisher here.

📘 The Catastrophe Hour book club for yearly paying subscribers starts June 11 and will run for 14 consecutive Wednesdays, 3-4 pm ET. We will meet on Zoom.

Stuff to read and listen to:

New York Times, Jan 31, 2025: The L.A. Fires Taught Me To Accept Help

Recent(ish) solo episodes:

• January 9: The First 24 Hours
• January 16: The Immaterial World
• January 27: Housing Wars
• February 5: Remembrance Of Things Past
• February 13: What Is A "Catastrophe?"
• March 2: A Mental Infection
• March 31: Dignity Is Out Of Style

📺 Visit The Unspeakable on YouTube.

✈️ The Unspeakeasy's 2025 retreat season is underway. It includes a COED retreat with more attendees and multiple speakers. October 11-12 in New York City. Programming and ticketing info here.