Trinity’s Leslie Orne on the future of the pharma services sector

Trinity’s Leslie Orne gives her view on the future of pharma commercialization, including whether real-world data (RWD) is the new market access, and Trinity’s approach to scaling through M&A, partnerships and investment, in this interview with Marc Iskowitz. Lecia Bushak recaps a congressional hearing on the use of psychedelics as mental health care for veterans and Jack O’Brien dives into the $216 million ruling in the Take Care of Maya case. Music by Sixème Son.

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Hey, it’s Marc

Since arriving on the scene a few years ago, private equity firms have catalyzed a new cohort of pharma commercialization platforms.

Bolstered by this infusion, the marketing firms have looked to fill out service offerings. 

Their acquisition sprees and remonetization deals have enabled them to scale up and acquire market share.  

Until now, their most sought-after subsegment has probably been the market access agency. But with most of the payer-oriented shops accounted for — either having been scooped up by a PE-backed entity or one of the traditional strategics — speculation has begun to build concerning their next big acquisition target.

Enter real world data. RWD has application along the whole continuum, from molecule to market, and – much like market access – has the potential to help marketers establish differentiation and competitive advantage. 

But it won’t come cheap. All the RWD firms have double-digit valuations. 

This week on the podcast…will the new strategics make moves to acquire an RWD property?

Leslie Orne, CEO of Trinity Life Sciences, joins us to provide her take on the future of the pharma commercialization sector, including whether RWD is the new market access, and whether Trinity’s approach to scaling through M&A, partnerships and investment could catch on elsewhere.

And Lecia’s here with a health policy update…

Hey Marc, this week, Congress held its first hearing on the use of psychedelics as mental health care for veterans. I’ll discuss some of the main takeaways of the hearing – and what this means for future psychedelic treatments.

And Jack, what’s trending in healthcare this week? 

This week, we’re talking about the $261 million ruling in the Take Care of Maya-Johns Hopkins All Children’s Hospital case; Lecia takes us through TikTok’s shadow work trend and its effect on mental health, then we finish with a viral video documenting the case of a 38-year-old woman who went to the hospital to receive an ostomy, only to wake up to the news that she had stage 3 colon cancer. 

This is markuskowitz editor large for mmm and I’m speaking with Leslie orn CEO of Trinity Life Sciences Leslie. Welcome to the mmm podcast.

Thanks so much. Mark happy to be here

great. So you took on your current role CEO there this past July. So you’re all of what four months in and just wanted to see how’s it going?

Yeah. No. Thanks. Absolutely. I did I’m a long time are here at the company over 20 years, but just took on the CEO role as of July so meant day about a hundred and ten or so and just starting to figure out a lot of the priorities that we’ve got to do and excited to tackle them.

Excellent, you know, one of the things that you know you as you said you’ve been with the company for a while you over saw the companies acquisition strategy, it’s made several of those including blueprint research group CB partners and DQ analytics kind of building out a nice analytics infrastructure there and you also led the Strategic Partnerships with being

Company as well as Havas health and you and I wanted to see if you would mind talking a little bit more about the rationale behind this evolution of Trinity from a narrowly positioned smart Boutique firm to something with broader appeal.

Yeah. Thanks for that question mark I love to tell the story so it everything we do it Trinity is really driven by our belief our purpose that every decision impacts a life.

That is that is really the the umbrella for everything that we do across all of our strategic moves, whether it’s m&a or internal product development or you know, overall strategy. I mean our vision is to have an impact on the life sciences industry and the patients that this industry serves. So when we’re thinking about bringing other companies into the Trinity Fray when we’re thinking about our strategy that really drives us and so everything we do is very Mission driven. We’re not growing for growth sake very much the strategy is a belief that we can have an impact on this industry and that the best way we can do that is to scale. So you’re right when I started a trinity. We were a strategy consultancy. I was employee number 13 and we’re really good at what we did. We brought data to the table. We brought a strategic mindset and we helped our clients across a range of things like m&a and new product planning and that was a really

Wrong foundation for the company. We really got to know the industry. We got to be smart. We got to see what it meant to impact high level decision making that ultimately impacts people’s lives and that’s really the foundation and the culture that we’re built on but you’re right. We’ve been on a bit of a rocket ship from a growth perspective. We’ve actually had two investors. We had Parthenon Capital part. We have Parthenon Capital Partners. We have kohlberg and Company now, which have been great Partners to us starting in 2018 and then kohlberg in 2021.

And it’s given us a bit of a shot in the arm in terms of what we’re able to do to really expand our impact and grow the platform. So we’ve really we’ve kept true to our brand you’ll notice we’ve kept the Trinity brand through all that we’ve done and that’s really important to us. We believe that Trinity for us really represents this this fundamental Trio of capabilities, which is strategy and insights and analytics. Those are really our three pillars and we’re still growing them and everything that we buy or build is really looking to enhance our either a strategic platform our insights platform or analytics platform. So that’s what we’re doing and we’re still on a mission to help revolutionize the commercial model. That’s what gets us up in the morning. So you’re right. We’ve actually done five Acquisitions over the investment period started with a data management company called Bell Canyon. We acquire benchmarking business called tigas helps companies think about size structure and res.

Forcing and then the three that you mentioned value and access company called CB Partners market research company called blueprint research group and most recently DQ analytics sort of self-named DQ actually means data-driven decisions and that very much jives with our mission and our vision of what we’re trying to do. So we fully integrated all five of those companies that’s very much our strategy. We’re leaning into building or buying things that really help us properties that really help us move towards being the best commercial Solutions provider across our range of capabilities. And that’s what we’re doing. You did also mention. We do have two very important Partnerships our partnership with Bane and Company help us to really Elevate our brand and really get access to the c-suite that some of our clients and help them with some of their biggest decisions. That’s a great partnership where we work together on on sort of the trans.

Emotional process and then we carry it through in the trenches and our second big partnership is with Havas health and you so an ad agency at Trinity. We’re maybe not the most creative people. So having an agency is one of our sister companies has really been an interesting and really expansive opportunity for us to grow really bringing what we have to offer again strategy insights and Analytics.

To marketing campaigns worldwide so it’s been a wild ride but I think at the end of the day, you might see more growth from us coming. But really we’re not gonna grow for growth sake we’re growing for the purpose of believing that we can have an impact on the industry and really help guide the industry as we revolutionize the commercial model. That’s really our calling and really what drives everything we’re doing.

Creates that that was a really nice sum up, you know from the recapitalization of Trinity from Pantheon Capital to kohlberg and all the Acquisitions and the Public Partnerships. And what’s the the rationale, you know, you say that it was you know, it was an acquiring for acquiring sake obviously it was acquiring with a purpose and you know the very strong purpose in mind, you know to to serve the industry and to and to ultimately benefit patients. Was it to kind of become this new strategic, you know, alongside the traditional strategics the big holding companies was that part partially your aim

Yeah, I love that term Mark. I might have to borrow it the new strategic for sure everything that we do in terms of our work has a very strategic lens. That’s our heritage. That’s where we’ve come from and what made us great as a small company. So we we really make sure we’re bringing strategy to the Forefront. I kind of think of strategy work is sort of like the visible part of an iceberg, right? There’s the visible part but there’s a lot beneath the surface of what we can do now as an integrated.

Strategic firm we can really we are one p&l company. So you’re right. We’re not like a holding company in that. You know, we’re a house of brands or you know, multiple competing priorities across p&l’s. We are one p&l. We bring the right tool to the table no matter what our clients need and I think that’s really helping us to to do what’s right for our clients. So whether we’re reaching for part of the companies that we’ve integrated and bringing them to the table or any of our own homegrown functions, you know, we’re very very integrated. So when a client actually sees us show up we could show up with a strategic advisor Market researcher somebody with a deep value and access background and an analytics background all in one team so we can really connect the dots for our clients and not have to rely on them to do so, but I do love that term new strategic. I think we believe

Leave very much an integrating and showing up as a client-centric team and that is certainly what will continue to do. So thanks for calling that. Hopefully you won’t mind if I if I borrow it

not at all, please go ahead that that’s my gift to you.

you know the

And I like you the way you put it, you know a house of Brands versus a branded house one p&l integrated. I was going to ask you that’s the new

Frontier if you will

That we’ve seen with a lot of these other.

a form of commercialization platforms that have scaled that have pursued market share through PE backing

as they’ve gone to say the next phase of their remonetization their recapitalization.

Is to make sure that now that they’ve amassed all these parts that they’re bigger than the sum of their parts and that comes through integration. How do you put the pieces together? How do you think about that making sure that the off that what you bring to the table is bigger than some of its parts.

Yeah, great question.

Quite simply integration is not easy right getting the m&a done.

Is most certainly less than half the battle and and then the real work starts of actually truly integrating. We integrate front and back and processes. So, you know, obviously we integrate from a company perspective on all things. We have Integrated Systems, we have access to each other’s knowledge Capital we have access to each other’s you know, really what makes everybody special which is is all of that knowledge that’s been accumulated over the years, but more importantly I think is really the front end integration. We have to start with the people people are number one across all of our businesses whether it’s data analytics technology or anything else. It’s it’s still about the people. So the very first thing we have to do is build trust with people and make sure that people realize that Trinity

Can be a really great home for people of from all different backgrounds and doing all sorts of different jobs globally. So, you know, for instance we’ve got three offices in India. Now, we’ve got two offices in Europe. We’ve got individuals throughout Latin America and Southeast Asia, we want to be a destination for leaders. And so as we acquire properties, we must create trust in order to really build that people base that knowledge base that we’re trying to do and then the next move is to move to the clients and make sure that the clients are having a unified Trinity first experience. It’s not that easy and I think we’ve seen a lot of our competitors not do it. So well such that, you know, it’s still Legacy brand this Legacy brand that we go to our clients as Trinity and whether you’re working with advisory your insights or Analytics.

You’re gonna get the same quality people driven by the same values and we’re going to bring the right tool to the table in a very integrated way. So that that is hard work and I think that sets Trinity apart from some of the other PE back strategics that have grown through m&a and have either

in some cases sort of lost the value of those Brands over, you know, the integration process as people the human capital walked out the door or another cases, you know, we’re unable to integrate at all and just left these, you know different companies with their full brand name and not bringing the value of the integration to clients.

So we’ve got to integrate people. We’ve got to integrate for our clients. And of course the company sort of comes along with that but that will be a continued Philosophy for us. We will always work hard to integrate and keep the talent that we’re so lucky to bring into the Trinity Family and you know, I think it’s not easy. It’s not easy but it’s something that we think is really important and what’s differentiating for us as a platform versus potential other companies out there. Appreciate you asking the question, but you know it all starts with the people


Let’s switch gears for a second and look toward the future conventional wisdom would point to Pharmacy EOS Outsourcing more including that commercialization piece. You know, the the pipeline is so so big so strong that what do they need to build commercial infrastructure for when they can just Outsource it right and as such platforms like yours are seeking to close whatever gaps they may still have in their offerings. And you said that I believe that Trinity is still on the hunt for Acquisitions or open to new Partnerships. Can you share maybe what some of those boardroom conversations around m&a or new combinations might look like and what some are your priorities might be going forward?

Yeah sure as I mentioned earlier.

We are on a journey to help revolutionize the commercial model. So we will continue to buy or build Best in Class offerings that help our client companies to do that. We’d like to have a best in breed offering across every commercial function. So for US commercialization starts very early. This is not something that begins at launch. We want to help during the clinical development process. We want to help optimize.

The development of the right drugs for the right patients and the right way then of course we come to to Mark and Readiness and launch Readiness and we want to make sure that we’re finding those patients out in the wide wide world and enabling these drugs to get to them and then of course, we’ve got life cycle management of making sure that we can get you know, we can really do it the right way of managing drugs and getting that value to patients. So we will continue to buy or build

Things that help us move towards that vision of revolutionizing the commercial model. As I said, we talk a lot in the boardroom that we’re not going to grow just because something is for sale or because growth is good for growth Zone sake I think that’s a very short term.

Driver and not something that’s sustainable and we intend to be a company that lasts.

So we’ll continue to be very Mission driven in what we’re doing. I do think one thing we’re leaning heavily into Analytics.

Technology, we believe that that’s one way that the commercial model will revolutionize over the years and we’ve got to connect the dots of the data with actual improvements and care and improvements in patient outcomes. That’s something that we’d like to play a really critical role in that’s really the driver for our DQ acquisition which brought with it a technology platform. Not just

A single point use case but actually a platform that enables us to develop apps that actually democratize data across decision makers at our clients and those apps really help improve patient outcomes because you can see what’s happening in the data. You can see are your drugs being distributed equitably are those patients having the right outcomes are there gaps in care. So we’ll continue to lean into data and analytics as we build and grow and you know, that’s that’s sort of across the commercial Spectrum even with our partnership with Havas which I mentioned earlier something that we’re really leaning into is how we can use our data and analytics capabilities to really push the boundaries on how marketing is done how you build a brand how you ensure a Best in Class patient experience. So where Havas is making all the creative and the beautiful images and and stories that they’re that they’re creating. We’re helping figure out.

A channel that information what channel are you actually delivering it through to What patients at what time so, you know, we’re loving that aspect of data and analytics as well. So I think you’ll see more along those lines from us.

Terrific and since you mentioned the analytics piece of your strategy insights and analytics Mantra and that will be a priority going forward. I wanted to touch on real world data as well. Some have said that worries Market access shops were sort of the preeminent take over Target of the last few years. Now that most of the pay oriented firms have been scooped up either by a PE backed strategic or one of the traditional holding company firms that a new

A new you know desirable commercialization piece is emerging in the real world data firm and that real world data really informs.

All the phases of the life sciences life cycle and so it’s really helpful. And I know you have the partnership with Komodo Health as well. Could we touch on that for a minute and get your take on real-world data where you see that heading?

Yeah, we have we have been into the data world since the very beginning and you know, even the day I started at Trinity our founder put a slide up John Corcoran put a slide up in front of me that said data plus strategy equals Trinity and you know the PowerPoint animated and it was quite Innovative at the time. But in any case yes data is part of our heritage, you know, we we use data for strategy. We help our clients manage their data and obviously, I think we’re kind of on the cusp of a of a data Revolution. There’s data coming real world data coming from so many corners of the Earth right now from a collection perspective. It’s it’s a huge task right and that our clients are swamped by

Data, there’s data coming from every Retail Pharmacy. There’s data coming from insurers. And in the form of claims data. There’s unstructured data coming from electronic health records. There’s data coming from you know, Apple watches and all of the wearables. So we as Trinity decided that our best strength is used in staying data agnostic. We are not sellers or providers of data. We’re integrators of data. We have Partnerships and the public domain with Komodo, which is really the most comprehensive integrative data set that we’ve yet encountered. We’re all partnered with Symphony Health with their more traditional data coming from pharmacies and from traditional claims, and we also buy several pieces of data from other providers across the industry. So we kind of see ourselves as

Integrators of that data users of that data and we believe that it’s our job to figure out how to manage that data such that you can actually use it for analysis and then to help direct that data out to the particular use cases where data is needed. So for instance, the marketing team needs to understand how to use data to direct their campaign. The sales team needs to use that data to direct their field Force the market access team needs to use that data to prove value and prove value and value-based Care Arrangements things like that. So our perspective on rwd is that we will continue to collect and harvest it our real spot and ecosystem is to help unlock that data for our clients. We’ve thought about whether we should own data.

and I think in a lot of ways data is becoming commoditized and you know, if we found the right truly unique and differentiating data asset would we be willing to own an rwd property maybe but at this point I think our best position is really to stay agnostic to the data source and use the right data for the right question that our clients bring to us, but we do think that that this is the way the market will move and this is how commercialization will

Will modernize itself and we want to be on the front end of driving that Revolution with data

sure. Thank you for addressing that and speaking of new business combinations. Another one that some people Envision envisage is promotional or aor type agencies taking a closer look at how they can be leaders on that Tech and AI front especially as generative AI continues to evolve in this industry that or one of the large platforms making a transformational move to purchase a large data business, but they don’t come cheaply do they

No, no, the data data is very expensive whether you’re buying it as a client or you know, as a company like ours, but but you’re right. I think the aor’s in particular are realizing that the shotgun approach of, you know direct to Consumer advertising on Super Bowl spots and things like that are really does not cost effective and in you know, we’re gonna see a lot of clients tightening up from a margin perspective as things like the IRA come to the front and you know other you know other aspects of budget management, so we have to be smarter with the money that our clients are investing in promotion. So when I think about our partnership with avas, that’s our big value proposition is how can we be smarter with your investment in marketing? How can we be smarter with your investment in media such that we can get the right message to the right person in the right way that’s got to be data driven. That’s where

You know the fact that we house a lot of data and make that accessible.

To have us to havas’s clients to our own clients. That’s a big part of of our strategy is again democratizing that data across the Spectrum. It’s not it’s not cheap, but it’s worthwhile. And ultimately we do believe that this will actually help make the industry more efficient with how they do promotion broadly speaking

sure one of the question about Trinity and it’s Future Path one of the other high probability avenues for new business combinations. I’ve heard

involves High science

Consulting and access businesses like Trinity’s potentially aligning with high science medcoms firms

Which we’ve seen a lot of and especially amongst these PE back strategics any comment there.

Yeah, I love the idea of you know connecting in some way to medcom’s businesses and fact, you know, that’s that’s part of why you know, we are partner with Havas, but but you’re right I think medical medical Affairs and medcoms of all types are really kind of having their

Their Stars rising in terms of the impact that true medical Communications and true Med Affairs can have on the commercialization process. So I think we have a lot of friends in the medcoms industry and we we have a lot of both formal and informal Partnerships. So we get to know each other a bit and see whether our core capabilities across our advisory services our insights and analytics businesses can help.

Empower the medcoms industry. So yeah, absolutely. We are open-minded on on how we will move forward. But I do believe that what we have to offer would improve outcomes from a medcom’s perspective and make it even more effective. So I do believe there’s some Synergy there, you know as I mentioned and as you’ve seen, you know, it doesn’t have to be a trinity owned asset we found the right one.

Again, we’re open-minded but I think we really believe in the ecosystem effect of Partnerships as well. And so we’ll continue to lean into those and see how we can use what we’ve built here at Trinity to improve medcoms across the board. So it’s a great Avenue of growth. I believe again the Stars Rising for the medical Affairs function at Pharma companies, and we certainly want to be a part of that. We have a fledgling Med Affairs business and it’s something we’re growing organically as well. So certainly a great thought we’ve heard that rumor ourselves and again something that that, you know, we’re interested in growing organically and and exploring opportunities in organically.

Sure. Okay, so it’s organic or inorganic buyer build you’re staying flexible. It sounds like one last question in terms of the services the pharmace services sector as a whole do you think others?

Will follow your Mappy model m&a Partnerships investment versus straight out acquiring. Do you think that you’ve kind of set the the template if you will for that kind of a strategy?

I think we are a Pioneer with that strategy and you know, I think in many ways you’re seeing the commercialization services companies starting to coalesce. I mean, I think the model that we were looking at as we

built our strategy was the cro space which had Consolidated long before the Commercial Services businesses into some bigger companies with broader offerings. And I think the absolutely we’re seeing a lot of companies.

Kind of mimic the strategy to some extent. I think where we feel really fortunate is and a number of places the fact that our company was founded on tenets of strategy Plus data really makes it a very authentic growth story for us and we’re not adding on pieces of business that that don’t fit with the with the story, you know, and I think we’re lucky that we’ve got out in front of that. We were able to get some really nice other companies join up in our in our umbrella and we got our pick of the litter and we think we’ll continue to get our pick of the litter in terms of actually bringing other companies on board. But I mean you see humanity and and Ever song and these sort of um, I guess like brand Creations they came from from I don’t know creative agency somewhere, but Trinity has stayed the same as when we were founded in 1996 from a values perspective and from a strategy.

Effective so that makes us really strong and you know, I think we see some folks mimicking the strategy to some extent but you know, I think that we’re really delivering on authentic growth for ourselves and that really makes us different in a head of the curve,

right? Yeah, all those other firms that you names started off as something else right and then they through Acquisitions they

Morphed into their currents shape. So it’s interesting and interesting distinction there.


Les. They want to give you the last word. What do you think is next for?

The industry, you know, maybe it’s formalizing Partnerships versus buying. Do you have a prediction for maybe not who’s the next high-powered and creative marketing firm to partner with a p firm but perhaps, you know some prediction along those lines.

see continued consolidation across the Pharma commercial space

and you know, I think

you know, we want to be we want to be the winner in that consolidation. I think we believe that we’ve got the energy we’ve got the passion. We’ve got the people to do that and and that’s what we’re here to do. We’re here to help our clients to revolutionize the commercial model help our clients get their great great Innovations out to patients all around the globe. And yes, we will see other companies rise up and also carry part of that burden, but we as Trinity believe we can be a big part of that story. So we’re gonna push on we’re not done yet.

Great, sounds good. Well, this has been a fascinating chat with you. Thank you so much Leslie.


Health policy update with Lecia Bushak.

This week, the House Committee on Veterans’ Affairs held what appears to be its first official hearing on the use of psychedelic therapies for veterans’ mental health care – dubbed “Emerging Therapies: Breakthroughs in the Battle Against Suicide.”

The hearing included statements from Dr. Carolyn Clancy, the assistant under secretary for health in the office of discovery, education and affiliate networks at the Department of Veterans Affairs, or VA. It also featured testimonies from other VA officials, psychiatrists, researchers, veteran advocates and veteran clinical trial participants.

During Clancy’s opening statement, she noted that the VA is committed to studying psychedelics for the treatment of PTSD and other mental health issues like depression and substance use disorders among veterans.

CLANCY: The VA is committed to safely exploring all avenues that promote the health of the Nation’s Veterans… Our focus isn’t just on finding the best innovative treatments for our veterans, but on doing so safely. This is especially true for studies that test compounds like MDMA and psilocybin as part of an intensive psychotherapy program to treat veterans with PTSD, depression and other mental health issues.

The VA itself is conducting some of these studies on psychedelic-assisted therapy, but Clancy noted the agency was looking to outside research on the drugs as well. One recent study published in Nature Medicine found that MDMA-assisted therapy was effective in alleviating PTSD symptoms.

Veterans face a heightened risk of mental health issues as well as suicide, with the average number of daily suicides among veterans rising from 81 per day in 2001 to 121 per day in 2020, according to the VA.

Veterans’ health advocate Brett Waters, founder and executive director of Reason for Hope and the Veteran Mental Health Leadership Coalition, said during the hearing that he’s seen psychedelic therapy be beneficial for veterans.

He noted that veterans often QUOTE “credit psychedelic therapy not only with saving their lives, but also with helping instill a renewed sense of purpose, meaning and connection to themselves. With dozens of veterans dying by suicide each day, it is morally unacceptable that so many have been forced to leave the country they served to access these lifesaving therapies.”

The hearing is another sign that psychedelic therapies are one inch closer to gaining mainstream approval in the U.S. This summer, the Food and Drug Administration (FDA) laid out first-ever guidelines for psychedelic drug trials. I’m Lecia Bushak, Senior Reporter at MM+M.

And this is the part of the broadcast when we welcome Jack O’Brien to tell us what’s trending on healthcare social media. Hey, Jack.

Hey Marc, Just a few highlights that missed the cut: last week, Tallulah Willis appeared on The Drew Barrymore Show and shared why it felt important for her family to be open about frontotemporal dementia, her dad, Bruce Willis, has.

Also, listeners may recall that a few months ago, we talked about the #HotSauceChallenge, a  fundraising effort for research into PGAP3, an ultra-rare disorder. 

Well, there is welcome news as a recent study found the AAV9 gene therapy was found to be effective in treating mice suffering from PGAP3, so there is promise on that front.

A jury in Florida awarded more than $261 million in compensatory and punitive damages to the Kowalski family in their well-documented lawsuit against Johns Hopkins All Children’s Hospital.

The case was featured in the widely-acclaimed Netflix documentary Take Care of Maya that was released earlier this year.

The upshot is that this was an alleged child abuse case wrapped up in a complicated healthcare diagnosis.

The titular Maya dealt with increasingly severe and seemingly unexplained pain starting at the age of 10. After going through a number of doctors and hospitals, she was diagnosed with complex regional pain syndrome (CRPS) and treated with ketamine. At one point, she was placed in a medically-induced ketamine coma to treat her pain, which worked until she relapsed in October of 2016.

Her dad admitted her to the emergency room at Johns Hopkins All Children’s Hospital who questioned her diagnosis and treatment plan before alleging child abuse against her mother Beata.

A judge ordered Maya to be sheltered at the facility under state custody while the investigation commenced, prohibited physical contact with Beata and put restrictions in place on their phone calls.

Ultimately, Beata died by suicide in January 2017 and Maya was released without having a chance to see her mother again.

The jury found in favor of the Kowalski family in relation to charges of False imprisonment, battery, medical negligence, fraudulent billing, survivor claim for intentional infliction of emotional distress, wrongful death claim for intentional infliction of emotional distress causing death and Maya Kowalski’s claim for infliction of emotional distress.

I don’t know Lesha or Mark if you have seen this, it was extremely unnerving to watch as somebody that doesn’t even have kids but the idea of watching this as a parent or as somebody that’s ever gone to the hospital and then being stuck there for I believe the number was around 96 days for Maya at the age of 10. I mean just the number again and the family had spoken about this. The number will never be able to rectify the fact that Beyond a died during this process and was so emotionally burdened by what the state and what the hospital.

Did but just a truly moving documentary if you get the chance to watch it,

I didn’t watch the documentary, but I did read up about the case. There was a long article in the cut and I was reading that it definitely gets into some details with it. It’s interesting that the alarm Bells initially went off while Maya was in the ER at Johns Hopkins regarding ketamine because her mother said that ketamine was only treatment that could help so it’s interesting that that was like the first concern that you know, the staff had because the reality is that ketamine has actually been approved by the FDA since 1970 for medical use it’s not typically a first line treatment for pain but it is used for pain treatment when other treatments don’t work. So that was One initial thing that seemed off to me, you know, when I was reading this the other thing is chronic pain.

People who suffer from chronic pain are often misdiagnosed or you know, you hear stories about people with chronic pain going from Doctor to doctor finding that. No treatment works. No doctor can figure out what’s wrong with them. I personally have dealt with some chronic pain as well. And I’ve been to rheumatologists and physical therapists and I’ve had MRIs and x-rays done a known can figure out what’s wrong, you know, as a patient being sent from Doctor to doctor that can be extremely exhausting and stressful doctors can be dismissive to chronic pain patients the this idea that you know, chronic pain patient is making this up and it’s all in your head. That’s a common thing that even I have heard so, you know, it’s it was definitely alarming and

Yeah, definitely alarming to hear this happening to a child and her family but a really interesting story with a lot of complex layers about the Healthcare System, you know ranging from child abuse allegations to mental health to chronic pain to ketamine to you know, this idea of the Munchausen Syndrome so many interesting elements to this but yeah, definitely a sad story

and before I throw it over to you Mark, I wanted to just kind of pick up on a couple of threads that Lesha talked about there at the Munchausen by proxy was an incredibly interesting aspect of the documentary because and they talk about it too. They say beyonda who I believe was from Poland. She was somewhere from Eastern Europe. They say she was very direct and sometimes that could rub people even that loved her the wrong way. You can only imagine you’re admitting your daughter to a hospital and they suddenly become so abrasive that they then level child abuse allegations against you.

Actually take your child away from your care, but it’s interesting that they talk they do a deep dive in the story about how there’s been an increase as child abuse cases have been reported more since the 1970s. There’s been a significant increase in medical child abuse cases, especially really into Munchausen by proxy that hasn’t always beared out. It has been the same way as like if you’re parent hits you or if they’re sexual abuse or things like that. There hasn’t always been that same thing because there have been you know cases in terms of people using Academy or using different drugs and basically the Healthcare System says, no, no, that’s not how we do it and if you even

Feigned even if you have this idea of disagreeing with them, then they have that power to be able to take your child away or be able to interrupt your life. They interview a number of other parents that dealt with similar things and obviously that gets into an area that’s not totally our realm in terms of child abuse and the legal system down there certainly in Florida, but it was a really disturbing aspect of it Mark. I want to bring you into the conversation as the parent in this group too. I I implore you to watch it at some point but I also warn you that’s gonna be something that is very upsetting on a number of levels. Yeah. Thanks Chuck. I haven’t had a chance to watch it either and you know in terms of the pulling the threat on the ketamine aspect and using that, you know, as a painkiller there was a point and I was reading some of the coverage by the local Fox affiliate where they said one of the one of Maya’s doctors was cross-examined about whether he was aware of the risk of using ketamine and there was a 50% chance of death according to the medical literature.

And it was like well, you know, you’re flipping a coin there, you know. Yes, there’s a risk with every medical tree, but that seemed to be a pretty high risk. So it seems like the hospital was was you know, there were Computing claims on both sides not not to be reductive here one even pretend to be but you know, the hospital insisted it was following the state’s mandatory reporting law and Reporting suspected child abuse and when those suspicions were confirmed by District Court, they they complied my his attorney of course accused to facility of failing to protect your child from child abuse taking advantage of her vulnerability while there during those three months and quote unquote victimizing her during those three months. The bottom line is that the jury found the hospital liable on all seven claims and just to kind of bring It a business angle to this the Johns Hopkins All Children’s Hospital, which is part of the Baltimore based Johns Hopkins Health System just reported a loss at one point nine million dollars for the third quarter. And so there are serious doubts as to whether it can even pay that to 260 million dollar award and just this week Maya file the criminal complaint against

Hospital for an alleged sexual assault to add insult to injury the poor girl that happened while there while she was in their care. So the hospital’s legal troubles related to this case continue. Absolutely and I think girl is the inter just a put a cap on this too. I think girl is the right word to use there because this all happened when she was 10 and even when they interviewed her lot of the interviews it took place last year. They have some of her depositions from 2021. She’s 15 or 16 years old. She’s 17 now like the the things that she has gone through that our documented that have been found by a jury the loss for mother and the allegation of sexual abuse, which was alluded to in the documentary too it you again you can’t even put a price tag on it. And this is a pretty hefty Price Tag, Too you talk about it Mark with being you know over a quarter of a billion dollars. It’s it

It outrageous this outrageous on somebody friends. Absolutely. It’s and it’s shocking because we all you know associate, you know, the Johns Hopkins Health System with being one of the best in the country in terms of an academic and Medical Center so shocking that’s what happened at such a prestigious institution.

“Shadow work” is rooted in ideas developed by Swiss psychiatrist Carl Jung, repackaged into a viral book written by a self-help author and proliferated across TikTok by thousands of creators spanning from real therapists to spiritual gurus.

Supported by the hashtag #shadowwork, the trend has garnered more than 2.3 billion views on the platform. It involves people digging deep into their subconscious patterns to reach “inner child wounds” and trauma spots in order to get to the root of anxieties, fears, self-sabotage and other mental health issues.

While seemingly well-intentioned, shadow work brings with it an array of controversy. Some users claim that shadow work has transformed their mental health for the better, while others have called it a scam and “demonic” in nature.

What gave the trend mainstream popularity was a book that went viral earlier this year. 

Written by 24-year-old self-help author Keila Shaheen, The Shadow Work Journal is a mental health guide that allows readers to fill in answers to shadow work prompts as a form of self-help or self-therapy.

After getting posted to the TikTok Shop, the book skyrocketed in popularity. Just this fall, the book outsold every other book on Amazon. Nearly half of its Amazon sales were driven by TikTok.

Numerous videos show TikTok users buying the The Shadow Work Journal and trying it out for themselves, as a sort of cheap alternative — or complement — to traditional therapy.

However, when digging further into Shaheen’s background, one finds that she’s far less of a therapist or psychologist than she is a marketing and brand strategist with a focus on self-help. According to her LinkedIn profile, Shaheen’s background is mainly in content and creative strategy, including a stint at TikTok itself as a creative and brand strategist.

Shaheen often posts videos on TikTok under the @zenfulnote account, in which she personally dictates to her followers how to engage in shadow work.

Now, some mental health experts have stated in response to the trend that it CAN be helpful if done correctly and under the guidance of a trained therapist – but that the trend is missing a lot of what Carl Jung originally intended with his concept of ‘the shadow.’ Yet another example of people turning to influencers on TikTok who package themselves as mental health experts, which leaves real life therapists competing with those voices. Thoughts?

I want to hop in there first if that’s fine. I know that when we have less a run through these social media stories and usually there’s the don’t try this at home, you know, if you’re not a professional and that applies to when we were talking about shaving your teeth down or you know, all these sorts of other really troubling and I would almost say like physical aspects but the same applies to mental health too and I’m here as a proponent. I’m in therapy. I you know, we all have stuff that we have to work through we all of our own demons and traumas and all that sort of stuff but when it comes from what essentially feels like a Perpetual cycle of somebody that had worked at tiktok that knows how to Brand themselves that is in Creative content all that sort of stuff but is passing themselves off as some sort of Self Health author or a therapist want to be or something really troubling from that and I know that we have a shortage of psychiatric and psychologist help in this country and that’s a whole separate issue, but does

Mean that you have to go and buy this book, which you talked about has been, you know, huge on Amazon and it’s fed by that tiktok cycle. I don’t know it gave me all sorts of yuck. When I was reading it. It made me really unhappy to kind of see where the state of everything is. I don’t know. Yeah, when when I want to pull on that sort of self-help thread a little bit Jack and and to luscious comment when you describe that some people view it as demonic, you know, the hair stood up on my on my neck, but you know that increases unfortunately the you know fascination with things like this, but you know getting back to self-helbert reminds me a little bit of the comment I made in an earlier show also regards to one of your tiktok health translation about how therapy speak has kind of pervaded Our Lives, you know, when non-licensed people say things like that’s toxic or you know, you’re stepping on my boundaries or we need some self-care the fact that that talk has seeped into social media can be a good thing in terms of people being able to talk about and give voice to

And to the extent that it gives them agency to get help without fear stigma. That’s a good thing where it’s dangerous is that many of us when we adopt the role of professional therapists tend to get it wrong. Everything becomes a red flag, you know, I don’t take out the garbage him a narcissist and one line in your story last year where you describe the numerous Shadow work videos showing tiktok users trying the book out for themselves quote unquote as a sort of cheap alternative or complement to traditional therapy said it all a little bit of knowledge is indeed dangerous thing delving into younging and their theory is incredibly complex. And as you wrote, this is one area of mental health work. That’s probably beyond the scope of the typical tiktok self-help Guru. Yeah. It’s just one of those things where we’re not Carl Young. We’re not Freud. We’re not all these other people and we can cosplay all we want as it but at the end of the day just go see a therapist or go to better help or any of these online service. Like they’re just has to be something else out there other than you know buying into what is seemingly the latest Fad in terms of

Now this could be mental health but it probably is just like you said Mark just mimicking the language that we heard and that was a big thing not to completely derail a conversation like the Jonah Hill thing earlier this year where he was having the issues with this ex-girlfriend and it was kind of the weaponizing of therapy language like in a way we’ve all become a little too comfortable with it and it’s all helpful to destigmatize and some people do need to say you are stepping on my boundary. So that’s toxic Behavior or that’s narcissism. It’s not Mark not taking out the trash in narcissism, but it’s some other sort of narcissism. But the idea that you know, we’re all suddenly, you know deputized to be therapists. I don’t know. That’s just not

Absolutely. The weaponization is the other down Farm legit.

For our last story, we’re talking about a viral TikTok that documented the case of Devlynn Cyr, a 38-year-old woman who went to the hospital to receive an ostomy, only to wake up to the news that she had stage 3 colon cancer. 

While Cyr was under anesthesia, doctors had to give her a hysterectomy because, as she said, “everything was like concrete.” Her husband was told by the doctors that she had a tumor lodged in her uterus that was causing chronic pain, constipation and inflammation. 

Cyr posted her video to TikTok to share her story and see if others who had gone through a similar experience had anything to say about living with cancer and infertility. 

She has remained active on the app as she begins a six-month chemotherapy process since her cancer has a 50% chance of recurring.

The TikTok has already gained more than 1.5 million views 

A new patient influencer is born. Yes,

right. Yeah, I mean people of course is a magazine normally known for dishing scoops on our favorite celebs and what the Royals are up to but you know, you got to love that. These true Health sagas have become a part of their coverage and I agree Lesha a new health influencer has been born here. How can you not be moved by what this woman has gone through on her journey the no win choice that her husband was forced to make for her and then her experience of waking up to discover that he had authorized the doctors to perform a hysterectomy, which saves her life, but of course left her unable to have children personally. I was moved to read about this man was there for his wife how he broke the news to her and a stood by her. I find it to be a wonderful story of caregiving as much as it is showcasing the patient experience. Yeah. I don’t think this will be the last we hear about this case and it’ll be interesting too because I was kind of prison through the comments and just the fact that other people have been through something similar obviously disturbing. I think it’s something that people always talk about where it’s like, oh what happens when I’m under

Anesthesia, but you know things can happen and you know, people have to make quick moves on the medical side and certainly on the the caregiving side, too.

Yeah, I would say this is a good.

Follow-up to the shadow work topic because it’s you know a sign of how ticked up can be beneficial and you know, when it comes to health because patients can share their stories like this and reach other patients who have gone through similar things and create a sense of community. So, you know, I think that’s definitely one of the positives to be taken from this

and I’ll just add on to that to I should because I think that it’s so important to highlight the the community aspect of not only tiktok, but just, you know patient populations in general last night. I was at the Dexcom dinner in SoHo they were honoring for World diabetes day and I heard from a number of different patients there some of them influencers some of them just you know regular Joe’s like us and they were talking about the fact that hearing other people talk about living with type 1 diabetes or type 2 diabetes and having similar complications and highs and lows means something to them and I can only imagine for this woman, you know having gone through something that is so traumatic and sudden to have other people saying like hey, it happened to me. It wasn’t good.

But here’s how I got through can really be uplifting in a way. Yeah, totally and you know, I also again I identified with was his name Greg, you know and kind of facing that impossible decision, but but doing it and then being there on, you know, when she woke up and then having you know, his wife ask him. Did you even ask them to save any my eggs? Yeah, and of course that never occurred to him, you know, I wouldn’t have occurred to me either but like it’s like, you know, typically, you know, as guys we try to do the best thing, you know, when we’re faced with decisions in our life always points out something so blatantly obvious that I feel like like idiots, you know afterwards but I think that’s life why exactly so important, you know, that was terrific discussion.

Thanks for joining us on this week’s episode of the MM+M Podcast. Be sure to listen to next week’s episode when we’ll be joined by Dr. Gregory Scott Brown to discuss prioritizing your mental health during the upcoming holiday season.

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