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Bad Luck Or Bad Genes? Dealing With BRCA And 'A Cancer In The Family'

Oncologist Theodora Ross discusses the hereditary nature of cancer and her own predisposition to breast and ovarian cancer, which led her to have a double mastectomy and to have her ovaries removed.

21:15

Other segments from the episode on March 14, 2016

Fresh Air with Terry Gross, March 14, 2016: Interview with Dr.Theodora Ross; Review of the music album "Good Grief;" Interview with Gillian Jacobs and Paul Rust.

Transcript

TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross. If you have a history of cancer in your family, you may be wondering if you should get a genetic test to see if you have any genetic mutations that might predispose you to cancer. My guest has had a lot of experience with that issue, professionally and personally. Dr. Theodora Ross directs the Cancer Genetics Program at the University of Texas Southwestern Medical Center. She is an oncologist who specializes in treating breast cancer, and she directs a research lab focusing on how cancer genes turn normal cells into cancer cells.

In spite of her knowledge and in spite of the history of cancer in her family including her uncle, father, mother, brother and sister, she didn't get tested until she was diagnosed with a melanoma. The melanoma was successfully treated but it scared her into wanting to know if she had the so-called breast cancer gene. After getting tested, she found out she had that gene. We'll hear what she did in response a little later. Dr. Ross has written a book that's part memoir, part medical science, called, "A Cancer In The Family."

Dr. Theodora Ross, welcome to FRESH AIR. So I have never gotten a kind of genetic testing that you've gotten, so I do not know if I'm genetically predisposed to cancer. I'm not sure I want to know. For me it, a little bit of self-deception is probably - (laughter), is maybe a healthy thing. You're an advocate of testing. You direct a cancer genetics program yet you put off getting tested yourself for years in spite of a history of cancer in your family. So why did you put it off for so long?

THEODORA ROSS: I was around the edges of trying to understand my own family's history of cancer. We were in a study by a research institution. I talked to a genetic counselor and asked them if they knew anything. And, it's interesting, they said it was not clearly hereditary in our family, but I changed the words around and told my fiance at the time that it was clearly not hereditary, and we went ahead and got married. But within the first year of getting married, I came down with melanoma, and at that point, I think, was when that denial went away.

And I decided to talk to another friend who was a genetics expert at The Ohio State University, and they evaluated me. I got tested. And I can just say it really changed how I saw things. So I went from this state of constant uncertainty and not knowing to knowing, and it was exhilarating. It was...

GROSS: Exhilarating? Scary is a word that comes to mind for me. (Laughter).

ROSS: It was exhilarating because all of a sudden, we discovered we had a particular mutation, a BRCA1 mutation, going throughout our family that certainly was a contributor to my sister's death and...

GROSS: Your sister died of breast cancer.

ROSS: Breast cancer, yes. In her 30s.

GROSS: So you mentioned you were diagnosed with melanoma before getting genetically tested. That was treated surgically and that...

ROSS: Exactly, it was tiny melanoma. (Laughter).

GROSS: OK so you were done with that, but then you got tested, found out that you tested positive for the so-called breast cancer gene, which also left you predisposed to ovarian cancer. So after getting this information and thinking it through, you decided to have a double mastectomy and to have both of your ovaries removed. How did you reach that decision?

ROSS: Well, once I figured out I had the mutation, it was pretty clear because I think I'd been thinking about it for years. You know, being a doctor, being an oncologist, seeing the data, I'd been thinking about it. So I was already prepared, plus I'd seen my sister go through this and other people in the family go through these things. And so for me, it was an instant decision - I don't want to get that, I don't want to go through that, and the data is really good for that preventing cancer. So it was a pretty quick decision for me. Many patients, it's not. It takes them some time.

GROSS: So you had the surgery done. How long ago was that?

ROSS: That was in 2004. So 12 years ago.

GROSS: So how effective was getting the double mastectomy and the - getting your ovaries removed? How effective was that in diminishing your fear of getting cancer?

ROSS: A hundred percent. (Laughter). I mean, I - of course, I could have a relapse or I could get a new melanoma, if that's caused by this BRCA mutation. I could have cancer, yes. But the reality is, is I probably have a lower risk of breast cancer and ovarian cancer than the general population.

GROSS: So you tried to understand the source of your genetic predisposition to cancer. Your father and your mother had cancer. One of your uncles had cancer. Your sister died of cancer. Your brother had cancer. So - but you were assuming that since Ashkenazi Jews are especially prone to have this genetic predisposition, and since your father is Jewish and your mother not, you assumed that this gene came from your father's side of the family. But in doing your genetic research, you learned something very interesting about your mother's family. What did you learn?

ROSS: Well, yes, it was really quite shocking. So, you know, Mother's always right, as they say. So when we discovered that I had the mutation, we went to visit her. We had Sunday dinner with her and we were talking to her about it and telling her that this came from her late husband's side of the family, certainly, since he was a Jew.

And she said, no, that's not the case. And we said, no, it is the case. And she also didn't get the idea that my brothers each had a 50 percent chance of having this mutation. They hadn't been tested at that time, it was so early in this discovery. And as we were talking, it became clear that as part of this research study we were in, she had received a letter when my father was dying.

He was in hospice and so she kind of filed it away - but, a letter from them saying, we have new information for you. And when I got all the records from them and I'm reading through it, I find that they'd never tested my father. They'd tested my mom, and she was the one -the Polish Catholic - that carried his supposed Ashkenazi Jewish mutation.

GROSS: So what responsibility did you feel to the rest of your family when you found out that you had this gene? 'Cause if it runs in the family, do you have a responsibility to tell, like, you know, nieces and nephews and uncles and aunts and cousins? And, say they don't want to know?

ROSS: Yes, once you find out you've found a mutation, there is a responsibility to inform as many relatives as you can because you can save their life. When I first got the mutation information, I called my uncle - my dad's brother - because remember, he's Jewish and so we thought that's where the mutation was. And he's a psychiatrist and understands medicine.

And he, right away, even though he's Jewish and ultimately we would've found out it hadn't come from his family, he still tested to make sure because he's got four daughters and a son. And he turned it out to be negative, which was really great for them. My mother's side of the family, it's more difficult. We don't know people like my father's side of the family, and one of the hopefully exciting parts of this book will be that they'll read it and they'll find out they have a mutation and save their life.

GROSS: So you are a strong advocate of genetic testing, but not everybody needs to get tested? Like, who should get tested?

ROSS: I think it should start out with looking at your family. And a family history is so important, so hard to get. It's a noble cause to try to get an accurate family history. You'd be surprised how inaccurate our family histories are, including my own. I don't know if my aunt had ovarian cancer, or was it endometrial cancer? Everybody goes back and forth on that, and the records don't exist. But getting that family history is the first step before testing.

And if you find your family history has a strong, you know, component of cancer in it or of some other disease - heart disease or a neurologic disease - seeing a genetic specialist and flushing that out, they help you. They go through each step, they tell you what the issues are and whether or not you're really looking at this right. So it's an objective view. And then they can help you determine whether or not there's a specific gene or set of genes to figure out whether there is a genetic predisposition to your disease, cancer or otherwise.

GROSS: Why do you need to know this before getting tested? I mean, why can't you just give a sample and say, tell me what mutations I have?

ROSS: It's tough because we have 20,000 genes in our genome. We have lots of interspersed sequences. We have a very complex genome. So just sequencing your genome won't help you very much. If you're Ashkenazi Jewish then it is a reasonable thing to consider getting tested for the mutations with that heritage. So there are three BRCA mutations - BRCA1, two of them, and BRCA2, one of them - that are at a high enough frequency in the Ashkenazi Jewish population that screening for those is a reasonable thing. I think it's 1 in 40.

And so those are reasonable getting without any family history - you're Ashkenazi Jewish, I'd test for those three. But in general, just testing people is kind of a random process and so the family history will tell you. And in addition to that, if your family history is, you know, very - there are lots of cancers - like, for example, Angelina Jolie had a BRCA1 mutation, and she had a very strong family history. With that, her risk is higher than somebody who has the same mutation but doesn't have a family history but has a large number of females in it. It's not just the mutation that contributes to the risk, it's also the amount of cancer in the family and how early those cancers occurred.

GROSS: If you're just joining us, my guest is Dr. Theodora Ross. Her new book is called, "A Cancer In The Family: Take Control Of Your Genetic Inheritance." She leads the Cancer Genetics Program at the University of Texas Southwestern Medical Center, and she leads a lab that investigates how cells transform from normal cells to cancer cells. Let's take a short break then we'll talk some more. This is FRESH AIR.

(SOUNDBITE OF MUSIC)

GROSS: This is FRESH AIR. And if you're just joining us, my guest is Dr. Theodora Ross. She's the author of a new book "A Cancer In The Family: Take Control Of Your Genetic Inheritance." And she leads the cancer genetics program at the University of Texas Southwestern Medical Center in Dallas. She also leads a lab that investigates how cells transform from normal cells to cancer cells.

And she tests positive for the gene that predisposes people to breast cancer and ovarian cancer. She had a double mastectomy and had her ovaries removed in around 2004 when she found this out. So do you give people any advice about how to make the decision if they do test positive for the breast cancer gene, how to decide whether to have a mastectomy or not?

ROSS: Yes. I mean, you really - it's so individual. And luckily, we have genetic counselors who can help, you know, with the daily process of going through that. It takes more than, you know, just oh, I have the information and therefore I'm going to have the surgeries or I'm going to be followed and try to catch an early cancer. You know, it takes some time.

And if a person doesn't have cancer when they find out they have the mutation, there's no rush. So that's the first thing, you know, take your time. But in the end, the reality is that if you have these surgeries, you prevent cancer. This is one of those cancers - situations - it's like smoking. If you stop smoking or you don't smoke, the chances are you won't get lung cancer. If you have prophylactic surgeries, the chances are you won't get breast cancer or you won't get ovarian cancer - pretty good chances. I mean, there's a very slight chance that you will, but you've reduced it by 95 to 99 percent.

GROSS: Say you get tested and you're positive for the gene, but you don't want to get a mastectomy. Is this going to be on your health records? Will employers ever know about this and decide not to hire you because you're predisposed to cancer? Will your health insurance rates go up? What are some of the outcomes as information ripples out into the world, if it does?

ROSS: Well, there is the Genetic Information Nondiscrimination Act that was passed in 2008, which does in some cases prevent such discrimination. So, for example, if you're - work for an employer that has more than 15 employees, they can't discriminate if they find out that you have a mutation, a genetic defect that may affect your health. In this case, If you have the surgeries, however - and life insurances are starting to catch on to this - is if you do this, it's sort of like not smoking. All of a sudden, you're a good bet for them. And they're starting to catch that.

So life insurance is also something that you probably want to get before you find out if you have a mutation. But I've talked to people who are insurance agents for life insurance companies, and they're starting to advocate for it and for action, which is remarkable. But in terms of the Nondiscrimination Act, it was a big deal for genetics so that you can get tested. And in terms of insurance companies - health insurance - you cannot be discriminated against.

It does get into your record now. It used to be we had these shadow records where we didn't put them into the real record. And that was a real problem because then we lost all these people who had mutations and we weren't able to have an accurate medical history on these patients. So now it's in the record, it's good. And in terms of discrimination, I feel it's becoming a historical fact.

GROSS: One of the things you write about in your book is how there's a lot of secrecy surrounding cancer. You write about the difference between secrecy and privacy. Privacy came up for you when you found out that you were positive for the cancer gene, the breast cancer gene. And your husband - who works in a lab that shares a building with a lab that you had - he sent out to what I think is a really interesting email to his fellow workers in that lab. And I just want to read an excerpt of it.

It starts with you may have noticed I've been unusually busy and stressed lately, and I thought it important to share with you some personal information. And he goes on to tell them that you were diagnosed with melanoma in the fall, you had surgery. It was caught early. But as a result of that and cancer in your family, you got the genetic test, which came back positive.

So he writes (reading) the medical issues are complex and distressing. As as a result, Theo and I are quite preoccupied as we work to resolve them. I'm sure that you can understand that this is personal and know that you will respect our privacy by keeping this information confidential. I realize that you may be concerned, but please don't ask for updates or additional information from me or Theo as we're trying to figure this stuff out ourselves. I thought that was really an interesting - I understood the explanations and him asking for, you know, his colleagues to respect your privacy. And I was kind of surprised when he said don't ask for updates or additional information. Can you talk more about that request and why it was important to you both?

ROSS: You know, we really wanted to do the right thing. We wanted to get the right surgeons. We wanted to tell all the family members. We wanted everybody who needed the information to have the information. It was complicated, you know, just trying to figure out where to do things, how to get them done, how to keep our jobs going, how to keep our family happy. And to have distractions of other people, that was a big issue is just to keep it simple and keep go forward and get it done.

GROSS: Now, if I understand correctly, all cancers are caused by genetic mutations but only some of those mutations are genetically passed on...

ROSS: Right.

GROSS: ...Within families.

ROSS: That's right.

GROSS: So what percentage of cancers are genetically passed on?

ROSS: People say 10 percent of cancers have an inherited component that we know of. There was a recent study - it was called the Nortrac (ph) study in Norway and other countries in that area. They looked at identical twins versus fraternal twins and looked at their cancer incidents.

So if you looked at an identical twin and it had cancer and then its other twin had cancer, how frequent was that compared to the fraternal, where they're not identical genetically? And from that, they did a lot of mathematical gimcrackery, something like that, discovered that 33 percent of the common cancers have a genetic component, meaning an inherited component that contributes to their cancer.

GROSS: That's pretty high. And what happens to the genes when it's not an inherited issue? Like, if the genes are still causing cancer, what do we know about how they're transformed during the course of a person's life?

ROSS: Well, the genes that are important in causing cancer - in that, we call it the sporadic situation. It's like you have a blueprint. Your blueprint is what you inherit. And then on the blueprint, there's a renovation, and it's a malignant renovation. And the malignant renovation is these other genes - oncogenes are formed, translocations are formed where a gene becomes too active. And it can cause the cell to proliferate and proliferate and proliferate. And more mutations occur as it proliferates liberates.

Every time a cell divides, it has to copy its DNA. And every time it copies its DNA, there's a mistake here or there. And sometimes that mistake's not fixed. And so we get more and more mutations. And when you get mutations and genes that prevent the cell from dying, so it just keeps surviving, causes it to invade organs, causes it to survive in an organ it shouldn't survive in, that's when you get cancer. And those are sporadic mutations added on to your blueprint.

GROSS: If you're having a preemptive double mastectomy to preventer yourself from getting breast cancer, you're exposing yourself to a lot of risk. That's a pretty major surgery. Convince me that it's really worth the risk when you don't know what the odds are for sure that you would get breast cancer, but you do know for sure if you have the double mastectomy or exposing yourself to the risk of infection to, like, if you want reconstructive surgery, you're exposing yourself to the risk of several surgeries. It's going to take a toll on your body. You know for certain that that's going to happen.

ROSS: Yes, you do. But a mastectomy - you know, bilateral mastectomy and reconstruction puts you at some risk for, like you said, infections and side effects and issues. But if you have a 50 to 80 percent chance of getting a breast cancer that's going to kill you, weighing at the pros and cons there, I think the mastectomy is the way to go because then you prevent that. You go from, you know, a 50 to 80-percent chance down to maybe a 5 percent chance if some cells are left over. And you have a nice long life. You know, if you do the math, it's not so bad.

I have to say, you know, mastectomies are not a big surgery. The oophorectomy is a little bit more complicated because you're taking out the ovaries and you have all of a sudden instant menopause. And there are issues with that - you know, bone density issues, you know, health issues as well as quality-of-life issues, hot flashes, those kind of things. But still, it's a lot better than the alternative, the alternative of dying in your 40s or 50s.

GROSS: That's an alternative you witnessed with your sister.

ROSS: Yeah. Yes, with my sister and many patients who've had these mutations.

GROSS: Well, Dr. Ross, thank you so much for talking with us.

ROSS: Thank you.

GROSS: Dr. Theodora Ross directs the cancer genetics program at the University of Texas Southwestern Medical Center. She's the author of the new book "A Cancer In The Family."
TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross.

In a relatively short time, the band Lucius has attracted a wide, diverse following that includes the Nobel Prize-winning economist Paul Krugman, who's blogged about the group. Lucius is a five-piece Brooklyn-based band whose signature sound is the voices of its two female lead singers. Our rock critic Ken Tucker has a review of the new Lucius album "Good Grief."

(SOUNDBITE OF SONG, "BETTER LOOK BACK")

LUCIUS: (Singing) We'll say it perfectly, and it slips right through the cracks. They'll mince our words down to a nugget for the masses. And they'll push it down the conveyor belt once more, more. Something for everyone, something that's so different from before, before.

KEN TUCKER, BYLINE: The first thing you probably notice about Lucius is its lead vocals. Singers Jess Wolfe and Holly Laessig sing in unison as frequently as in harmony, creating an urgency and emphasis on whatever idea, emotion or thought the band is trying to get across. Sometimes, that goal is simply to convey what it's like to feel like a kid again, as they do on a quick, peppery ode to adolescence called "Born Again Teen."

(SOUNDBITE OF SONG, "BORN AGAIN TEEN")

LUCIUS: (Singing) It's a feeling, like a born-again teen. Got a heartbeat like we're only 16. Would you take my hand, baby? You know you know I like to dance. Maybe we'll be good. We can be good, you and I. You can follow me, or if you want to take a leap, you know it's obvious we're naturally aligned. It's a feeling like...

TUCKER: Wolfe and Laessig met as students at the Berklee College of Music and formed Lucius, moving to Brooklyn. The music is a magpie mix of styles and pop music periods - '60s girl group, '70s disco, '80s electropop - with the occasional florid ballad that would not sound out of place emerging from the throat of a contestant on "American Idol" or "The Voice." In other words, Lucius's music could have been excessive and derivative. But on the strength of tightly-stitched melodies, an occasionally striking image and those surging voices, it is more often lovely, well-crafted stuff.

(SOUNDBITE OF SONG, "MY HEART GOT CAUGHT ON YOUR SLEEVE")

LUCIUS: (Singing) Don't know how to start this. No, I don't know what to say. They seemed to fall out of the sky. Lost and found is all the same. Trying to think of my heart as an ocean where there's room enough for things to come up to the top. I'm counting on it sinking down again. Oh, oh, my heart got caught on your sleeve. I need it. Please give it back to me. My heart got caught on your sleeve. Please give it back to me. Please give it back to me.

TUCKER: One could point out that there's a certain sameness to Lucius's subject material, which tends towards the post-breakup, why-did-we-treat-each-other-so-badly mood. But I frankly don't much care about the meanings of the words when there's so much being communicated in the music and the tone of the vocals.

Listen to this song, "What We Have To Change." It's built around a chorus that would not be out of place in a gospel context or forming the architecture of a soul music single. It features Wolfe and Laessig singing as one as they climb a mountain - a mountain of melody, a mountain of romantic challenges - carrying the implication that there ain't no mountain high enough to keep them from getting to you.

(SOUNDBITE OF SONG, "WHAT WE HAVE TO CHANGE")

LUCIUS: (Singing) Don't want to talk to you today. Don't want to play the games you want to play. I love you, baby, but I just don't know what we have - what we have to do to change. Leaving you has crossed my mind. I'm afraid another heart is hard to find. I love you, baby, but I don't know why - why our love - why it's fallen so behind. Find me a mountain or any grand canyons. Just find us an igloo, and I'll freeze with you. I'll climb any tower, take any grand notion. Just find an ocean to swim into. Anyway, if we don't find a way, I'll have to get over you.

TUCKER: Lucius has attracted quite a range of fans. New York Times columnist Paul Krugman has put aside his thoughts on the economy to write about his fan crush on Lucius more than once. And Lucius appeared onstage alongside Pink Floyd's Roger Waters at the 2015 Newport Folk Festival. The album "Good Grief" was co-produced by Bob Ezrin, who's produced famous albums for Pink Floyd, Kiss and Alice Cooper. The songs frequently have a big sound. But they remain scaled to the proportions of the vocals. The result isn't a series of pretty showcases, but rather opportunities for them to blast past the instrumentation.

(SOUNDBITE OF SONG, "ALMOST MAKES ME WISH FOR RAIN")

LUCIUS: Here we are. Thought you'd have to rescue me. But thankfully, didn't get the best of me. It's not worth the fuss. It's not worth my time. I could lose it, but I'd be out of (unintelligible). So here we are on the side of the road, but the sun is out lightening my load. Just a flat tire and a helping hand - I could lose it, but it's just not so bad. Looking for...

TUCKER: I have emphasized the two vocalists in Lucius. They are very much the focal point of the group. The two women are credited with writing all the songs on this album, and they also tend to dress alike on stage. But Lucius is a band - a tight band and a very crafty group. The album title, "Good Grief," has a certain literalness. Even when lamenting love lost, gone or destroyed, mourning over it can be healthy if done the Lucius way. Romantic grief can be powerful, renewing - good grief.

GROSS: Ken Tucker is critic-at-large for Yahoo TV. He reviewed "Good Grief," the new album from the band Lucius.
TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross. Our guests, Gillian Jacobs and Paul Rust, star in the new Netflix comedy series "Love" as two people who are trying to figure out if they want to start a relationship with each other. The series was co-created by Judd Apatow, Paul Rust and Rust's wife, Lesley Arfin, who also wrote for HBO's "Girls." Gillian Jacobs is perhaps best known for her role as Britta on the TV series "Community." She was also a guest star on "Girls." Paul Rust has written for "Arrested Development" and "Comedy Bang Bang." He's acted in several films, including "Inglourious Basterds" and "I Love You, Beth Cooper."

Gillian Jacobs and Paul Rust spoke with FRESH AIR producer Ann Marie Baldonado. Let's start with a scene from "Love." Paul Rust plays Gus, a somewhat geeky aspiring TV writer. Gillian Jacobs plays Mickey, a producer for a self-help satellite radio show. She lives a somewhat wilder life than Gus does. Both of them have just gotten out of bad relationships. After a chance meeting, Mickey and Gus spend the day driving around Los Angeles getting to know each other. They stop at Gus's ex-girlfriend's house and pick up boxes of his stuff. Mickey is driving while Gus looks through his box of DVDs and Blu-rays. He soon starts throwing them out the window in disgust.

(SOUNDBITE OF TV SHOW, "LOVE")

PAUL RUST: (As Gus) So I just keep believing in this lie that a relationship evolves and gets better and - why do I believe that? Where do these lies come from? And it's like, oh, I know - songs and books and, you know, movies. All these movies I've watched, they're not real. They're lies. They're lies like me and Natalie were lies, you know? It's like - what am I doing with these? "Pleasantville?" It's like, [expletive] you, "Pleasantville."

GILLIAN JACOBS: (As Mickey) Woah, yeah.

RUST: (As Gus) Oh, I shouldn't have...

JACOBS: (As Mickey) No, I like it. Do it again.

RUST: (As Gus) "Pretty Woman?" "Pretty Woman" is such a lie. Like, a prostitute wouldn't fall in love with you. She would just, like, steal your [expletive] and sell it for coke.

JACOBS: (As Mickey) Yeah, do it. Go get him, tiger.

RUST: (As Gus) Oh, my God, this feels - "Sweet Home Alabama." Lies. "What Women Want?" Lies. "When Harry Met Sally." Lies. "Homeland," season three?

JACOBS: (As Mickey) Very confusing.

RUST: (As Gus) Yeah, like she could ever just sneak into Iran. That's like - all these Blu-rays have been weighing me down. Get it out of my life.

ANN MARIE BALDONADO, BYLINE: Gillian Jacobs and Paul Rust, welcome to FRESH AIR.

JACOBS: Thank you.

RUST: Thank you for having us.

BALDONADO: Now, in that scene, both characters are blaming what they've seen in pop culture for their bad luck in relationships. What kind of pop culture did you both watch when you were growing up that you feel influenced, at least early on, what you thought about adult relationships and love?

JACOBS: I watched a lot of Katharine Hepburn, Cary Grant movies so maybe I was anticipating more witty banter than I've actually experienced in real life.

RUST: For me, early on I guess I watched just a lot of bad TV. You know, I would love to be able to say Cary Grant, but it was probably more like Tony Danza.

(LAUGHTER)

BALDONADO: Now, you really slow this story down - the two characters meeting and becoming involved in each other's lives. Judd Apatow, who's one of the executive producers on the show, has said it took five episodes to do what usually happened in the first five minutes of a pilot because you all found the details of that really fascinating. What is it that you wanted to make time for? What do you get by spreading it out over those 10 episodes?

RUST: Yeah, I think us knowing also that we sort of had these two seasons and 22 episodes ahead of us meant we had the luxury to slow it down. And, you know, I think maybe what was gained by that was sort of our feeling that usually when two people start a relationship, it's rarely easy, and a lot of times either somebody's still hung up about an ex or there's stuff going on at work that just makes it more difficult to be open and available to starting a relationship with somebody.

And it was just really exciting to see how patient we could be and to see how, oh, you could do an entire episode just about the agony of sending out a text at 9 a.m. and not hearing back from it until 8 p.m. (Laughter). So a lot of those sort of, like, missed connections and fumbling towards five seconds of happiness I think was appealing to us.

BALDONADO: Gus and Mickey go out on 10 of their first official date, and Gus takes Mickey to - I'm sorry, what is it? The Magic...

JACOBS: Castle.

RUST: The Magic Castle.

JACOBS: (Laughter).

BALDONADO: So it comes out that Gus is very interested in magic and Mickey is not. And that gets at something that I think is interesting about this show. Often people in college or in their 20s, they kind of use sensibility or the things that you're interested in - whether it's movies or music - as a way to sort of find partners. And I think one thing that happens with Mickey and Gus is they're kind of in different social spheres and they kind of think different things are interesting. So in this example, Gus is into magic and Mickey isn't.

JACOBS: Yeah, I think that in high school and college and in your early 20s, you really look to those signposts of taste as things that make a good match. And I've - certainly, for my own life -come to value much different things in people as I've gotten older and what makes them a good partner or a good friend.

RUST: Yeah, and I remember a couple of years ago talking with a friend, and he was saying, you know, he didn't know if this woman he was seeing was right for him because they didn't like the same things. And I remember saying, like, what are you, in the 7th grade?

(LAUGHTER)

RUST: Like, it does seem like a weird reason to - I mean, certainly, shared sensibilities are nice, but, you know, somebody doesn't have to like "Three Amigos," (laughter), in order for me to like them. I mean, helps but...

BALDONADO: Now, Gus - Paul's character - works as an onset teacher for an hour-long drama about witches. It's called "Witchita." But he's an aspiring writer, too, and we actually get to see the inside of a writers' room, which to me is something very fascinating, the TV writers' room.

Now, you, Paul, have worked on TV shows like "Comedy Bang Bang," "Human Giant," even the Netflix season of "Arrested Development." Your wife, Lesley Arfin, wrote for "Girls," "Brooklyn Nine-Nine," and, I'm not sure if any of you wrote for shows like "Witchita," or, one-hour shows, but why did you want to feature that kind of writers' room as opposed to maybe a more comedy one?

RUST: I think because - yeah, none of us have worked in a drama writers' room. It sort of fascinated us to put it there. And maybe also there's something funny about seeing people care so deeply about an hour-long supernatural drama. That was funny to us. I mean, I always was curious what a writers' room is like for a drama because when you're in a writers' room for a comedy, you can make a joke and everybody laughs. And if everybody laughs, you know, oh, it's effective.

And I always wondered, like, what are writers' room for dramas like? Somebody's like, and then the son comes in and tells his dad he loves him. And then everybody in the room, their eyes fill up with tears. They're like, yeah, yeah, that's good. And then what if - what if the dad tells the son he loves him too? Then you just have a room of crying people (laughter), and then you know it's working. So yeah, and I think also we were already doing enough navel-gazing, you know, to have to make it a comedy writers' room, either. We can try to move it just two notches away and make it a supernatural drama.

GROSS: We're listening to the interview FRESH AIR producer Ann Marie Baldonado recorded with Paul Rust and Gillian Jacobs, who star in the new Netflix comedy series "Love." There's more after a break. This is FRESH AIR.

(SOUNDBITE OF MUSIC)

GROSS: This is FRESH AIR. Let's get back to the interview FRESH AIR producer Anne Marie Baldonado recorded with Gillian Jacobs and Paul Rust, the stars of the new Netflix comedy series "Love."

BALDONADO: Now, Gillian, you started acting when you were a kid. Can you describe how you first got interested in it?

JACOBS: The school called my mother and told her that I didn't have any friends, and I was talking to myself on the playground during recess and suggested that she get me into an extra-curricular activity. And she said that I was a very overly dramatic child, and she thought I would enjoy acting. So she signed me up for my first acting class. And I just instantly fell in love with it. And from there on out tried to take as many classes and be in as many plays as I could in Pittsburgh, where I grew up.

BALDONADO: You wrote this wonderful piece for Lenny, which is the newsletter that's edited by Lena Dunham about growing up and getting into acting and then going to college for acting at Juilliard. You received there at Juilliard a classical training. And I was wondering if you could talk a little about that. What is classical training for acting? You use words like movement work and neutral mask work. Can you talk a little bit about that?

JACOBS: Sure, yes. At Juilliard, there's a heavy emphasis on classical theater. So we would do one Shakespeare play a year, a lot of classical theater. And also, there was a heavy, heavy emphasis on voice and speech work, things like movement classes, neutral mask work, yes, also character mask work, I have to add, took, like, a classical clowning program. (Laughter). It's a very...

BALDONADO: What is neutral mask work?

JACOBS: Everyone is given this mask that has the same blank expression on it. You do various movement exercises trying to communicate different things, but you don't have the benefit of having any kind of facial expressions. So it's really about, like, learning how to communicate through your whole body. There's a lot of that.

And then, you know, once you've graduated from neutral mask work, you're given a character mask which has an exaggerated expression or exaggerated facial features. And then you're supposed to let that inform a character and sort of build off of that. You know, you do things like go to the zoo and observe animals and then go into your acting class and act out scenes as those animals. I spent a lot of time pretending to drink imaginary beverages, all sorts of things.

BALDONADO: In that Lenny piece, you talk about how you had a hard time at Juilliard. And at one point, you tried to do a comedy piece. And you felt like it was the first time you got a good reaction from students, but you got completely discouraged by a teacher. What was the comedy piece and what was the reaction to it?

JACOBS: I think it was from a play by Christopher Durang. This was the first time that I got a really enthusiastic response from my classmates. They were really laughing. And, like, it was the first time they really seemed to respond to something that I had done, which was exciting for me. And then the teacher said well, you can clearly do that so never bring in a piece like that again. And it made me feel like being funny was unimportant or less important and that it wasn't valuable. And it wasn't really until, you know, years later out of college that I started to learn that that was important and it was a skill that I possessed and that it was something worth exploring.

BALDONADO: So many people know you from your role as Britta from "Community." I just wanted to play a short scene to remind us all of the series. This is from the third season. It's just a quick scene from the room where the study group meets. The group has just found out that Shirley is getting remarried to her ex-husband, and the rest of the group is skeptical.

(SOUNDBITE OF TV SHOW, "COMMUNITY")

DANNY PUDI: (As Abed Nadir) It's cool that Shirley are getting married again. There's a whole generation of viewers that didn't get to see the original.

DONALD GLOVER: (As Troy Barnes) Let's hope it's more of a Bale than a Kilmer situation.

CHEVY CHASE: (As Pierce Hawthorne) Second weddings are OK, I guess. If I had to rank them, I'd go fourth, seventh, second, fifth, first, third, sixth. No wait, first then fifth.

PUDI: (As Abed Nadir) Got it - fourth, seventh, second, first, fifth, third, sixth.

JACOBS: (As Britta Perry) When's our culture going to outgrow this wedding thing?

ALISON BRIE: (As Annie Edison) You're anti-wedding now?

JOEL MCHALE: (As Jeff Winger) No, she's just pro-anti.

JACOBS: (As Britta Perry) No to everything you both said. Weddings are like little girls tea parties except the women are the stuffed animals, the men are making them talk and they're not drinking tea, they're drinking antiquated gender roles.

MCHALE: (As Jeff Winger) Somebody tell Britta what an analogy is.

JACOBS: (As Britta Perry) I know what it is. It's, like, a thought with another thought's hat on.

BALDONADO: That's a scene from the third season of "Community." You've said that "Community" was like graduate school for you, that you had to unlearn some of your dramatic training. What are some examples of that?

JACOBS: There were very technical aspects about comedy that I really felt like I had to learn, like, you know, the timing of how you deliver a line makes or breaks if it's funny or not. I had a sense of that, but I didn't always feel like I had a mastery of it when I started. So I would sometimes get very nervous when I write a script and I felt like they'd given me something that I wasn't quite sure if I could pull it off, things like that. And then I sort of realized that I really enjoyed physical comedy, so making bolder choices in that way.

But, I learned so much from sitting around that table. You know, Donald Glover is one of the most naturally funny people I've ever met in my life. You know, Jim Rash, Ken Jeong, Joel - you know, I could go down everyone and list you things I've learned from them. But I really felt like the first couple of seasons, I was just sort of - I would read it in the script and then I'd watch how they delivered a line and what they did to make it funny and sort of try to apply that to myself.

BALDONADO: You're already moving forward with the second season of "Love." Did you always have an idea of where you wanted it to go over the two seasons? Did you already kind of have it mapped out?

RUST: I mean, I think we had it mapped out in very broad strokes. I think the thing we realized once we started writing the first season is just getting a lot of joy about seeing how patient we could be. And so anytime that we would start sort of accelerating the storytelling or the progress of Mickey and Gus's relationship, we would ask ourselves sort of can we go slower? You know, as Judd has said, the part of the romantic comedy that people most like is the falling for each other and the getting together. So we're just trying I think in a way that people do in real life and their own relationships try to relish and cherish the initial moments of connection.

And then yeah, as far as - when we brought Gillian in, you know, we did write the part for her in mind. And it was so exciting when Judd called up and said hey, I think Gillian's going to be available. And it was a dream come true getting to have Gillian 'cause I am such a fan of hers and the work she's done. But it was funny, when she came into the - it wasn't the first time we met, but it was definitely the first time you came to the writers' room to hang out with us.

JACOBS: Oh, God.

RUST: We had a very Gus and Mickey moment where she walked in the writers' room holding a coffee. And then I went in to hug her and I knocked the coffee out of her hand and it spilled everywhere on the floor.

(LAUGHTER)

RUST: And then we both turned out to the writers and like this is the show. This is it.

(LAUGHTER)

BALDONADO: Gillian Jacobs and Paul Rust, thank you so much.

JACOBS: Thank You.

RUST: Thank You.

GROSS: Gillian Jacobs and Paul Rust star in the series "Love." All 10 episodes of the first season can be found on Netflix. They're currently shooting season two. Paul Rust co-wrote the new Pee-wee Herman film that will premiere on Netflix this Friday. Gillian Jacobs stars in Mike Birbiglia's new movie don't think twice, which premiered at South by Southwest last night.

Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.

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