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Other segments from the episode on March 26, 2009

Fresh Air with Terry Gross, March 26, 2009: Interview with Michael Grodin; Interview with Colin Hanks.

Transcript

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PTSD Treatment Designed Specifically For Monks

TERRY GROSS, host:

This is FRESH AIR. I’m Terry Gross. Tibetan monks who have post-traumatic
stress disorder from being tortured, Holocaust survivors who have dementia and
believe their nursing home is a concentration camp, these are some of the
problems that my guest, Dr. Michael Grodin, deals with. He’s co-director of the
Boston Center for Refugee Health and Human Rights, where he works with people
who have survived imprisonment and torture.

He’s also a professor of psychiatry, bioethics and human rights at Boston
University’s School of Public Health and the director of the Program for the
Study of Medicine and the Holocaust at the Elie Wiesel Center for Judaic
Studies.

Dr. Grodin’s work is part of a growing field of cross-cultural medicine, which
tries to offer health care that’s more culturally sensitive to immigrants.

Dr. Michael Grodin, welcome to FRESH AIR. I want to start with something that
I’ve read about your work that I just found fascinating, which is you’ve been
treating Tibetan monks who were tortured for opposing Chinese rule. And these
monks practice meditation, but for these monks who survived imprisonment and
torture, meditation was leading to flashbacks. How did you find that out?

Dr. MICHAEL GRODIN (School of Public Health, Boston University): Well,
obviously meditation is the essence of being a monk.

It’s part of their life and part of who they are. And so one of the things I
talked to them about was when they came to see me was how has their life been
and how has their meditation practice been, and as part of that discussion,
they were somewhat embarrassed, but they started to tell me that they were
having difficulty with their meditation.

Now, usually meditation is comforting, obviously, to someone, but in this case,
it was something quite disturbing because as they would start to meditate, in
certain states they would have flashbacks and images coming into their mind,
and this would be quite distressing to them, causing them to have to stop their
meditation practice.

GROSS: Do you have any idea why that was happening?

Dr. GRODIN: Well, that’s a terrific question. I wish I did know. I spent many
years working with Holocaust survivors, and the Holocaust survivors as they age
are starting to have dementia and starting to have strokes, and they get
disinhibited and start to think they’re back in the concentration camps.

And my hypothesis is, is that something in the meditation practice is equally
disinhibiting the monks. So the repression of the memories and the horrible
things that happened to them starts to come to the surface, and then they start
to have flashbacks.

GROSS: So how widespread was this meditation problem among the Tibetan monks
that you were treating?

Dr. GRODIN: Well, I’ve treated seven monks, and this seemed to be a problem to
some degree with all of them.

GROSS: So what kind of advice were you able to give them? It must have been so
upsetting to them because their spiritual lives are based on meditation.

Dr. GRODIN: Absolutely. But I think it’s not just the meditation practice that
was a problem. They were obviously in a new land. They were away from their
monasteries. They were away from their families, and they had a lot of
problems.

I think they missed their mothers. Many of these monks were put into the
monastery at a very young age. Some of them I think were homesick. They had
heartache, and they felt a longing for Tibet, for their homeland. And so, there
was a lot of guilt because they were here in this country, and their family or
other monks were back in Tibet.

They had problems concentrating and often would ruminate on these issues, and I
tried to tell him to try not to do that which was bothering them, but I tried
to teach them a different type of meditation, a more body kind of meditation,
more breathing kind of meditation, and I would actually teach them a qigong,
which is simple exercises, coming in contact with their body.

One of the other things that happened to many of them was, is that when they
were imprisoned, they were beaten every day and electrocuted, and so they
started to separate from their bodies and just live in their minds, if you
will.

And I was trying to reconnect them to the calmness and relaxation of their body
through the qigong exercises, through tai chi, through chanting, which we did
in my office, and through singing bowls, which I have many in my office, which
are very calming and relaxing and cause them to resonate with the sound, which
causes them to calm down their hyper-vigilance.

GROSS: Dr. Grodin, I know you brought one of those singing bowls, one of those
meditations bowls, with you. Before you strike it for us or play it for us, so
to speak, tell us how it’s used in meditative practice.

Dr. GRODIN: It’s a way of separating the kind of space of every day to the
sacred space of the monks in the Tibetan tradition, and the bowl is played
usually three times, three gongs, before the start of a meditation practice,
and then the monks meditate, and then someone rings it at the end, which gives
a sign that the meditation practice is over.

So I use it in many ways to resonate, calm the monks, but I use it at the
beginning and end of a meditation practice.

GROSS: Let us hear how it sounds.

Dr. GRODIN: Okay.

(Soundbite of singing bowl)

GROSS: It has beautiful overtones.

Dr. GRODIN: I often hold it above their heads and around their body and bathe
them in the sound, if you will.

GROSS: Mm hmm.

Dr. GRODIN: Which is really very relaxing - It’s kind of like a waterfall, a
shower of sound coming over their body.

GROSS: Now is this from Tibetan practice, or is this from another culture, and
you brought it in for the Tibetan monks who were tortured?

Dr. GRODIN: Well, I think it’s used by many people who have practiced
meditation, but these bowls come from Nepal and Tibet. So they’re quite
familiar to the Tibetan monks.

GROSS: Mm hmm. So tell us more about what you’ve done to help the monks be able
to meditate without suffering flashbacks.

Dr. GRODIN: Well, we also often chant together in my office. Om Mani Padme Hum,
which is a meditation chant, mantra, which is about compassion.

One of the things that’s most remarkable about these men is this ability to
still maintain compassion. They’ve gone through this incredible ordeal, and yet

they meditate on compassion. They meditate on compassion for their captors.
They meditate on compassion for their perpetrators, and it’s really a
remarkable thing.

So we often chant Om Mani Padme Hum.

(Chanting) Om Mani Padme Hum. Om Mani Padme Hum. Om Mani Padme Hum. Om Mani
Padme Hum. Om Mani Padme Hum.

And that’s meditative. Again, these are all ways to get back to re-experiencing
the calm relaxation that they’ve had and trying to rekindle that type of
calmness and special state that they’ve learned so much from their time in the
monastery.

GROSS: So has this been effective?

Dr. GRODIN: It has. Again, what exactly it is that’s been effective - I think
there are many things. One is, is that they come to my office, and my office is
full of Tibetan flags and Tibetan pictures of monks, and I know a number of
monks from all over the world.

And so I think they have trust, and they have a sense of security and safety in
my office. And then of course the fact that I know a fair amount about Tibetan
Buddhism and have been involved with the Tibetan community for over 15 years.
They have trust in being able to come and talk to me and talk to me about their
worries and their fears and their difficulties.

Many of them are doing kind of manual labor here in this country. One of my
Tibetan monks works in a restaurant at night, cleaning the floors, and he asked
me, you know, do I do a good job? Do I do a good enough job?

Here’s a very famous, venerable reincarnated monk who’s world-renowned, and he
wants to know if he’s doing a good enough job cleaning the floors in the
restaurant.

Another one of my monks was a baker and another one a gardener. And so they’re
involved in all kinds of activities, simple activities, which is quite
different than what they did, obviously, in their tradition in Tibet.

GROSS: Do you think the people who work at the restaurant, where the monk who
you mentioned cleans the floors, know who he is and what he’s been through?

(Soundbite of laughter)

Dr. GRODIN: I’m sure they have no idea. I’m sure they have no idea. But he’s
this very, very kind, warm, caring person who is committed to being a certain
type of person, a certain venerable Tibetan, and I think that he is an example
of the incredible sincerity and honesty and forthrightness of these Tibetan
monks.

GROSS: Is post-traumatic stress disorder a concept in Tibetan medicine, or have
you had to find ways of translating this Western diagnosis into Eastern
medicine?

Dr. GRODIN: Well, that required some learning, also. I’ve used Tibetan doctors.
There’s a Tibetan doctor here in Boston. But the Dalai Lama’s physician was
here visiting - I’ve met the Dalai Lama on a couple of occasions. And the
Tibetan doctor would diagnose these problems that the monks are having as
rLung, R-L-U-N-G, which is a type of wind, Tsa-rLung, which is life-wind
problems.

And it’s a variation on what I would call post-traumatic stress disorder, but
it really relates to a sense of being kind of vigilant, re-experiencing things
but also something that we don’t see in Western times, this kind of
homesickness, this heartache.

They describe heartache, but they’re not talking about their heart being in
pain. They’re talking about kind of a longing, and over the years, I’ve been
able to kind of see this, and I can see when a monk comes in that he has a
diagnoses of Tsa-rLung.

The Tibetan amchi - amchi is the Tibetan word for doctor - prescribed certain
pills that they take. And actually when I first began working with the amchi, I
was concerned that the antidepressants that I was prescribing might interact
with the Tibetan medicines. And only in Boston, you know, we have such this
great institution - there’s somebody at McLean, which is this famous
psychiatric hospital, who only studies the interaction of herbs and
antidepressants and said that there probably wasn’t going to be a problem.

GROSS: How effective do you think antidepressants have been for the Tibetan
monks who were imprisoned?

Dr. GRODIN: You know, that’s a good question. I’m not sure, you know, because I
use all different methods to treat these men, and so it’s hard to know what
exactly is helping them.

And I must say that I’m not sure that all the monks take the medicine that I
prescribe to them. So sometimes I write a prescription and ask them if they
need a refill, and they no, they have enough, but it’s been beyond the time
when their prescriptions ran out.

So I’m not sure if they always take the medicine. But insofar as they get
better, whether it be from my medicine, from the amchi’s medicine, from the
meditation practice, the breathing practice, the qigong, the singing bowls, the
chanting is less concern to me as long as they get better and they feel better.

GROSS: I’m wondering how your experience with the Tibetan monks has affected
your recommendations about whether, say, American soldiers who are suffering
from post-traumatic stress disorder should use meditation as a way of helping
them through it or if you fear that meditation would open their minds more to
reliving the traumatic moments.

Dr. GRODIN: Well you know, I think that it’s a good idea. The question is what
kind of meditation to teach. And I think these monks have been meditating their
whole lives, and so obviously, they’re very, very - at a high level of
meditation, and they do different kinds of meditation practice.

But kind of calming relaxation - meditation can be divided up into three types
of meditation. One is called concentration, which is when you concentrate on a
mantra, a sound, an image, a visual object.

And then there’s mindfulness, which is once your mind starts to go away from
that concentration, you gently recognize it and say that your mind has gone
away and bring it back.

And then a third type is contemplative meditation, which I think is somewhat
what the Tibetan monks are doing. But the simple kind of concentration
meditation, which a lot of people do these days - breathing, relaxation, yoga -
is a pretty simple technique to calm one’s body and to calm one’s mind and to
ground one.

One of the things that happens with these vets that come back is that they’re
hyper-vigilant. They’ve kind of always on guard. They’re ready to snap when
they hear a sound, a siren, and so one of the – any way you can calm them and
relax them I think is very, very helpful.

So I often make audiotapes of relaxation exercises and breathing exercises and
give it to them to take with them. One, they hear my voice, which is a contact
with me and is calming and relaxing, but also it gives them a way to meditate
and follow a methodology which I think is helpful.

Another thing I do sometimes is hypnosis. Well, they wouldn’t call it hypnosis,
but a certain type of almost trance where I have the monks and/or my other
patients sit and breathe and imagine sitting on the side of a river, and
whenever a thought comes into their mind, taking the thought and putting it on
a lotus blossom and imagining the lotus blossom floating down the river.

And so they can continue to stay in their breath, and when a new thought comes
up, they gently put it on a lotus blossom and let it go away so that they come
back to the present.

One of the things that people have a hard time doing is staying in the present.
They are constantly either in the past with flashbacks and with re-
experiencing, or they’re fearful of the future. They’re hyper-vigilant. They
don’t want to go out. They don’t want to interact with people for fear of being
triggered. And so they have a hard time being in the present, and that’s one of
the things that meditative practice can be very helpful with.

GROSS: My guest is Dr. Michael Grodin, co-director of the Boston Center for
Refugee Health and Human Rights. We’ll talk more after a break. This is FRESH
AIR.

(Soundbite of music)

GROSS: My guest is Dr. Michael Grodin, co-director of the Boston Center for
Refugee Health and Human Rights. He works with torture victims from around the
world, including Tibetan monks, sub-Saharan Africans and Holocaust survivors.

Now in working with Holocaust survivors, you’ve been learning that some
Holocaust survivors, when they get dementia - and many Holocaust survivors now
are quite elderly and have dementia - that the dementia can make them think
that they are back in the concentration camps again.

And that’s so tragic to think that Holocaust survivors at the end of their
lives would actually believe that they’re back in the camps, that they’d be
spending their final days believing that they were in the camps.

Dr. GRODIN: It’s incredibly distressing and disturbing. I’ve done several
consults to nursing homes, you know, where the Holocaust survivor smells urine
in the bathroom or lines up to get food and flashes back to Auschwitz and
thinks they’re back in the camps.

And this is obviously not only disturbing to the family and the staff - it
depends on how demented the patient is as to how much they really appreciate
what’s going on – but incredibly frightening. And you can see it in their eyes.

You know, the patients that I see have what we call complex post-traumatic
stress disorder, which is more than just, you know, the hyper-vigilance, being
on guard and the re-experience, the nightmares and the avoidance.

It’s really a much deeper problem because these are people who have been
traumatized but are entrapped, and they can’t leave. So you know, when you have
a hurricane, or you have a horrible disaster, that’s a single-event trauma, but
when you’re imprisoned and tortured or in a concentration camp, you’re
traumatized, but you’re unable to escape.

And so you have to try to somehow develop a mechanism to survive, and when they
come out, it was described that many of them have kind of lost their sense of
self. They’ve lost their soul.

I’ve often called it soul death, and you can see it in their eyes, and this is
a much, much more complex problem and much more difficult to deal with, to kind
of reconstruct their sense of self, their sense of who they are and what the
meaning of life is.

GROSS: Can you talk a little bit about what approach you’ve taken to try to
reconstruct that sense of self?

Dr. GRODIN: Well, it takes – first of all, it takes a long time, and the most
important thing one needs to remember is that the patient has to be in control.

The one thing that was taken away from them when they were in camps or when
they were in prison is their control of their lives and their ability to make
their own decisions. And so the one thing you don’t want to do is force
anything on them.

And so it takes time, and you have to listen, and you have to be prepared to
listen. You know, there was a conspiracy, a silence, where people came out of
the camps and out of the torture chambers, that we’ve seen patients where the
patient doesn’t want to talk for fear of hurting you.

The person doesn’t want to hear because they’re scared of what they’re going to
hear, and this is incredibly distressing because it’s almost as if it’s taboo,
that it’s unacceptable to talk about, and people don’t want to hear it.

So what you have to learn to do is to sit, to sit with these patients and to
listen and to be connected with and be open to hearing anything. So one of the
things that I tell my patients is that, sadly, over the last 30 years, I’ve
heard all kinds of stories, and so I know what’s happened to them.

And so I can reassure them that what they tell me is not going to hurt me and
that I will be with them, and I won’t abandon them, but they’re in control.
They have to decide what they want to talk about, what they don’t want to talk
about.

The last thing you want to do is tell someone how they’re supposed to feel or
how they’re supposed to think or what they’re supposed to do.

GROSS: Let me just stop you here. I think it’s interesting you have to reassure
them that they’re not going to hurt you by telling you the horrors that they
experienced.

Dr. GRODIN: Yeah.

GROSS: Why do you need to do that? Why do they need to know that?

Dr. GRODIN: Because they’re very frightened about telling their story because
it’s like letting it out, and once it lets out, the evil will consume everybody
around them. And some of the things that have happened to them - the beatings,
the rapes - about 70 percent of the women patients that we see, including the
Tibetan nuns which I’ve seen, have been raped. About 25 percent of the men have
been raped.

This is a very, very distressing trauma, and there’s embarrassment, and there’s
disbelief. There’s concern that people won’t believe what happened to them, and
it’s a horrible, horrible experience that they’ve gone through.

And they’re frightened to talk about it because they don’t think anybody will
believe it or everybody will understand or be able to listen and tolerate their
trauma.

GROSS: Let’s get back to the idea that some elderly Holocaust survivors with
dementia believe that they’re back in the concentration camps. So how do you
convince somebody who has dementia and thinks they’re back in the concentration
camp that they’re not, that yes, they’re in an institution, but they’re safe?

Dr. GRODIN: Well, that’s a real challenge. You know, one of the things you need
to do is to ground them. But insofar as you can bring people from their
contemporary life, their family, people that they know, people they recognize,
and bring the things that they are familiar with, that will be very much
helpful in terms of grounding them as to - they’re here, you’re here. You’re
now – let’s feel the floor. Let’s step on the floor. Let’s bang on the chair.
Let’s experience what’s going on here and that it’s today, that we’re no longer
back there.

But it’s very, very hard, and it’s an international problem. I spent – last
summer - I spent about six, seven weeks in Yad Vashem in Israel, and I met with
not only Holocaust survivors but people who care for Holocaust survivors.

Obviously, the largest number of Holocaust survivors are in Israel, and this is
a known phenomenon.

GROSS: You know, one of the things I just find so disturbing about this is that
you would like to think that when you’ve been through an unimaginably horrible
experience, that when it ends, you get to appreciate life again. You can put it
behind you.

But the fact that no matter what, it keeps coming back to haunt you and that
even in your dying days, you might think that you are back there again, it’s
just – the thought that it doesn’t stop, it doesn’t go away, it doesn’t end, is
so disheartening and upsetting and frightening.

Dr. GRODIN: Well, I think you’re right. One of the things that I try to do
while they still have capacity is try to get them so that they can remember
without reliving. I think there’s an important distinction.

GROSS: Absolutely, yeah.

Dr. GRODIN: They can’t – you know, they can’t get rid of the memory. Often they
come to my office and say, I want to get rid of the memory. I’m trying to get
rid of the memory. But the problem is when you try to put out the memory, which
you can’t do, you become numb because you don’t have any memories then, and you
can’t just isolate some memories and not other memories.

So what we try to do is have the past be in the past and the present be the
present. So they have memories of what happened, but it doesn’t have the

reliving experience, the effect that they are there. And that can be done
through time and through talk and through vigilance.

GROSS: Dr. Michael Grodin will be back in the second half of the show. He co-
directs the Boston Center for Refugee Health and Human Rights and is a
professor of health law, bioethics and human rights at Boston University’s
School of Public Health. I’m Terry Gross, and this is FRESH AIR.

(Soundbite of music)

GROSS: This is FRESH AIR. I’m Terry Gross back with Dr. Michael Grodin. He is a
psychiatrist who has spent 25 years working with torture victims from around
the world, helping those who have survived imprisonment and torture also live
with their traumatic memories. He co-directs the Boston Center for Refugee
Health and Human Rights and is a professor of health law, bioethics and human
rights at Boston University’s School of Public Health. His work is part of a
growing field of cross-cultural medicine, which tries to offer health care that
is culturally sensitive and in tune with immigrants and refugee patients.

Torture is probably as old as mankind, but have you found that in the years
you’ve been doing this work that the techniques that have been used to torture
people most commonly have changed or that there are techniques that seem to be
specific to different regions?

Dr. GRODIN: That’s a great question. Sadly, the perpetrators, which I have also
done some writing and work on perpetrators - I interviewed some of the Nazi
doctors and I wrote a book on the Nazi doctors in the Nuremberg trials - but
the perpetrators actually read the literature that we write and try to develop
new techniques.

They try to develop techniques that cause harm but don’t leave scars, because
after the fact we’re going to document - and that’s one of the important things
that we do, is document the torture, use it to present to not only their asylum
case, because most of our patients are seeking asylum because they can’t go
back to their country where they were tortured - so we develop evidence which
is used in the court, but also hopefully evidence at some point to prosecute
the perpetrators.

But the perpetrators get more and more sophisticated in using various
techniques of electrocution, banging on the bottom of the feet. And we know
that certain types of torture occur in certain areas. We know that there’s
certain types of suspension that’s done in Latin America. In Africa it’s very
common to hit the bottom of the feet. And in various areas of Tibet they use
electrocution devices. So you can get the history and we see the type of
torture that was used.

The other thing that’s very, very disturbing is, is that in many places
physicians have been involved or are involved in the torture. If not in the
actual carrying out the torture, they’re there after the fact to say that, you
know, you can’t continue because you might kill the person or it’s okay to
continue, or after the fact they examine the patient and see the scars and the
wounds and don’t document it or even change the death certificates.

And so medicine is often complicit around the world, which is incredibly
horrible, you know, and it causes people not to be able to trust. Who can they
trust when they come to this country? So it’s really a horrible thing.

GROSS: What are some of the torture techniques that you’ve always described as
torture that you subsequently learned the United States had used in secret CIA
prisons?

Dr. GRODIN: Well, actually, I’ve been a consultant to lawyers representing the
detainees in Guantanamo and I actually read the medical records of some of
those detainees. And I never thought it would be the day that I would say that
the same kind of tortures are used by the U.S. in black sites as well as in
Guantanamo itself. It’s just unconscionable. You know, waterboarding, which is
a technique that’s used in many countries and Arabic countries - to think that
the U.S. would carry out these kinds of things is unconscionable.

And I’ve read the medical records - you know, the force-feeding of the
detainees is a violation of international medical ethics. And of course the
depriving of food or banging loud sounds or preventing people from sleeping is
used around the world, but I never thought I’d see that it would be done by the
U.S. under U.S. auspices.

GROSS: Now, I know you’ve been studying cross-cultural medicine so that you can
understand the medical practices of the people from different cultures who you
deal with. But does it work to use one country’s medical practice on somebody
from another culture? Like if you take what you’ve learned from patients around
the world and kind of mix it up and…

Dr. GRODIN: Well, I think that, you know, the idea of grounding people and
causing them to - calm and relaxation is true universally, but how one goes
about doing that I think has to be culturally bound.

GROSS: So you’ve dealt with a lot of people from Sub-Saharan Africa. What are
some of the medical practices that you’ve learned from their cultures that
you’ve applied?

Dr. GRODIN: Well, one of the things that’s quite interesting is, is that many
people from Sub-Saharan Africa hear voices. They hear the voices of their
ancestors. And so, you know, in our chronomonology(ph) we might say that they
are psychotic. And I think that there are some people that hear the voices of
their ancestors and some people that literally hear voices, and so it’s a
little hard to tell sometimes. And so we have to try to understand within their
culture. The other thing is, is that in many African cultures people who hear
voices are special.

So in this country we would say that they have schizophrenia or they would have
psychosis, whereas in their country they’re chosen by the gods to hear these
voices. And so, you know, the value judgment as to what’s good about the voices
or what’s bad about the voices is fairly culturally contextual. So that
requires a lot of experience, and the patients teach - teach you. You don’t
want to stereotype, you don’t want to assume.

One of the dangers in doing cross-cultural medicine is to assume that everybody
follows the culture that – that they come from, or you learn a little bit and
then you assume that everybody has that. So each person should be treated
individually, and each person needs to be understood in their own sense of
their sense of self.

GROSS: Can you tell us about one of the people you work with, one of the
torture survivors from Sub-Saharan Africa who heard voices and how - how you
learned about those voices and how you address that therapeutically?

Dr. GRODIN: Well, one of my patient’s hears voices quite a bit. And sometime
she hears voices of her ancestors talking to her about, you know, her life, and
I think that’s normal. But when she hears voices, they tell her that she is a
bad person, or when she hears voices that say that she’s going to be harmed or
that maybe she should harm someone else, then that moves into a dangerous area
where whatever we want to call it, it’s not going to be helpful for her. And so
we’ve used antipsychotic medications, which have been helpful.

But you know, sometimes they work and sometimes they don’t, and I’m convinced
that sometimes when they work, it’s somebody who has real psychosis and when
they don’t, it’s this cultural-bound notion of hearing voices.

GROSS: So say they don’t work. Then what?

Dr. GRODIN: Well, at least one patient that I had we had hospitalized. And that
was a horrible thing, you know, what we call counter-transference, which is the
therapist’s feeling about the patient coming from their background. I just felt
horrible in having to commit this person. But they were unsafe and they were
not going to be able to function. They were flashing back and they were
dissociating, meaning that they were not there, and we had to hospitalize her.
But I felt like I was a torturer, putting her in a prison essentially. But I
think that was the right thing because she was not safe.

But afterwards she agreed that she was not in a good way and kind of gave me
permission to say that it was okay what I did.

GROSS: I know you’ve heard stories from so many people from around the world
who you’ve treated for post-traumatic stress, people who have been victims of
torture. And you’ve heard it before. You were there to help them. You have to
reassure them that they are not going to hurt you by telling you their story.
At the same time, do you feel affected by those stories in a way that can be
very troubling? Do you have nightmares from those stories? Do you feel like
they are having an effect on you that – that is unsettling?

Dr. GRODIN: They can’t help but have an effect on you. And this is the constant
challenge, which is not shutting down and defending so much that you don’t
hear, but not taking it in so much that you become traumatized by what you hear
also. So this is a constant balancing of how far to go and what kind of
boundaries to set up. But we know that what people have, what’s call them
vicarious traumatization, which is that people who do this kind of work and
listen to these stories become traumatized themselves and they start to take on
the same symptoms that their patients have, and they start to have flashbacks
and they start to have nightmares.

And I’m very cognizant of that with our staff, which we monitor, and we have a

social worker come from outside the institution to talk to us and to be with
us. Nobody sees patients for more than, you know, 15, 20 hours a week – these
kind of patients. And even that’s probably too much. But it can be incredibly
rewarding work, because people can get better and do get better. And when
someone comes back who’s gone through this ordeal, gotten asylum, we’ve found
their family and reunited them and they’ve gotten a job and the kids are going
to school and they pull their life back together, it’s a remarkable thing.

GROSS: Well, Doctor Michael Grodin, thank you so much for talking with us.

Dr. GRODIN: My pleasure. (Foreign language spoken) - that’s what they say in
Tibetan, which is peace be with you.

GROSS: Dr. Michael Grodin is the co-director of the Boston Center for Refugee
Health and Human Rights. Coming up, actor Colin Hanks, co-star of the new film,
“The Great Buck Howard.” This is FRESH AIR.
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Colin Hanks: The Magician's Apprentice

TERRY GROSS, host:

My guest, Colin Hanks, stars in the new film, “The Great Buck Howard.” Hanks’
father, Tom Hanks, makes a couple of brief appearances playing Colin’s father.
Colin Hanks is on Broadway starring with Jane Fonda in the play “33
Variations,” and in season two of “Mad Men” he played the young priest. Here is
a scene from “The Great Buck Howard.” Colin Hanks plays Troy, a young man who
has given up law school in the hopes of becoming a writer. To make ends meet,
he takes a job as the assistant to a washed-up mentalist who can no longer get
bookings in Vegas and instead does a show in small town theaters.

In this scene, Troy is at a restaurant getting interviewed for the job by Buck
Howard and Howard’s agent. The agent is played by the sleight-of-hand artist
Ricky Jay. The Great Buck Howard is played by John Malkovich.

(Soundbite of movie, “The Great Buck Howard”)

Mr. JOHN MALKOVICH (Actor): (As Buck Howard) Young man, I am delighted that you
are interested in this job. I’m very busy. I did…

Mr. COLIN HANKS (Actor): (As Troy Gabel) One thought kept racing through my
mind as Buck talked. I had no idea who this guy was. And I guess that must have
shown.

Mr. MALKOVICH: (As Buck Howard) You do know who I’m, don’t you?

Mr. RICKY JAY (Actor): (As Gil Bellamy) You have seen “The Tonight Show.”

Mr. MALKOVICH: (As Buck Howard) You have to say with Johnny Carson. Not the
nitwit with who’s on there now.

Mr. JAY: (As Gil Bellamy) Buck did “The Tonight Show” with Johnny 61 times.

Mr. MALKOVICH: (As Buck Howard) I think you are a magician, right?

Mr. JAY: (As Gil Bellamy) Buck’s a mentalist. Magician is kind of a dirty word
around here.

Mr. MALKOVICH: (As Buck Howard) I was a magician when I was three years old,

but I evolved out of that. Not that I have anything against magicians, as long
as they’re dead.

(Soundbite of laughter)

Mr. JAY: (As Gil Bellamy) Look, Buck’s been on the all big shows - Jim Nabors,
John Davidson, Sally Jessy Raphael, Dinah – he was the co-host on Dinah many
times. He has performed over the world. Las Vegas.

Mr. MALKOVICH: (As Buck Howard) But not lately.

Mr. JAY: (As Gil Bellamy) Your job would be to take care of all of Buck’s
travel and then to go on the road with him to ensure that the engagements were
handled smoothly.

Mr. HANKS: (As Troy Gabel) It is a very demanding but ultimately rewarding job.
For instance, in a few months’ time we’d be very hard at work on a benefit that
I started for sick children with my friend George Takei, who is perhaps best
known for his portrayal of Sulu on the “Star Trek.” He is a dear friend.

Mr. HANKS: (As Troy Gabel) This certainly wasn’t the kind of job my father
would have envisioned for me. But there was something kind of exciting about
Buck. He told these long stories about a world full with his famous friends -
Johnny Carson, Ed McMahon.

Mr. MALKOVICH: (As Buck Howard): The Captain and Tennille.

GROSS: Colin Hanks, welcome to FRESH AIR. Congratulations on the movie.

Mr. HANKS: Thank you.

GROSS: The character of Buck Howard is so washed up, as we heard that, you
know, his claims to fame are - include having been a co-host on Dinah and being
pals with the Captain and Tennille.

Mr. HANKS: (As Troy Gabel) Yeah.

GROSS: Did you even know all these references when you heard them?

Mr. HANKS: Yeah. I mean, I know the references for sure. I have vague
recollections of those kinds of programs, and in the script it was just “The
Tonight Show,” but John really would improv quite a bit and really make Buck
even farther than what he initially was and would come up with references like
Dinah and Jim Nabors and stuff like that. And Ricky Jay of course picked up on
that right away and it went running.

GROSS: So what was your role in getting this movie made?

Mr. HANKS: Well, really it was just sort of - Sean and I met. We spent a great
deal of time trying to get financing for the movie, which was kind of a
difficult thing to do because we didn’t have a Buck Howard at that time. And of
course if you don’t have a Buck Howard, then you don’t have your money, but you
can’t get money without having a Buck Howard. So there’s a little conundrum
there. And someone had suggested Playtone, which is my father’s production
company along with Gary Goetzman. And that wasn’t necessarily my idea, and it
wasn’t necessarily something I was super-keen on, but obviously I know
everybody there and I admire their tastes very much.

So I sort of said to Sean, I said, well, look, here’s what we should do. We
should send the script to them and just ask what they think, really, just, if
they have any ideas, that’d be great, or if they know of anyone who would be
interested in making the movie, that would be really great, but I don’t want to
go to them saying, hey, do you want to make this movie, because I just – I
think that’s, you know, not necessarily the easiest thing to do. It puts them
in a weird position and I don’t want to do that.

GROSS: Uh-huh.

Mr. HANKS: So we sent it to them just to say, hey, take a look at this, tell us
what you think. And they ended up really loving it, so much so that my dad
ended up reading it; he fell in love with it and said, We are going to make
this and I’m going to play your dad. And I sort of went, Ah, okay, that wasn’t
my intention, I didn’t really – I had never planned on that. But at the same
time I couldn’t say no.

GROSS: No.

Mr. HANKS: If someone of his caliber wants to be in your movie, you’d be an
idiot to turn them down. And you know, obviously I’ve had about 31 years to
prepare for the role, so that came pretty easy.

GROSS: Let’s hear a scene from early in the film in which you and your father,
Tom Hanks, appear together, and in this scene you’ve dropped out of law school
and taken this job as the road assistant to he Great Buck Howard, the
mentalist. But you haven’t told you father you dropped out of law school and he
certainly hasn’t been told about this job. So one day, right after one of Buck
Howard’s shows, you’re back stage and who should show up, but your father. And
Buck Howard, on meeting him, congratulates him on having such a fine son, but
your father isn’t feeling proud. He’s feeling really angry and betrayed. The
scene starts with John Malkovich as the Great Buck Howard talking to your
father.

(Soundbite of movie, “The Great Buck Howard”)

Mr. MALKOVICH: (As Buck Howard) You know, Mr. Gable, I can imagine how you
feel. My father didn’t want me to go into show business. He wanted me to be an
accountant. Obviously that wasn’t my calling.

Mr. TOM HANKS (Actor): (As Mr. Gable) Yeah. Well, I’m not going to touch that.
But if carrying your bags is Troy’s calling, then I just wasted a lot of money
on his education.

Mr. C. HANKS: (As Troy Gable) Dad…

Mr. MALKOVICH: (As Buck Howard) Troy, may I? You know, sir, I have a theory
about that, I call it my onwards and upwards theory. Perhaps you noticed in the
musical portion of…

Mr. T. HANKS: (As Mr. Gable) Listen, I’d like to talk to my son alone.

Mr. MALKOVICH: (As Buck Howard) Very well. I was merely trying to add a little
perspective, as the Latins say.

Mr. T. HANKS: (As Mr. Gable) I think you’ve done that.

Mr. MALKOVICH: (As Buck Howard) Well, good evening. Troy, you can bring that
and toss my salad when you get back to the hotel.

Mr. T. HANKS: (As Mr. Gable) That’s a hell of a guy.

Mr. C. HANKS: (As Troy Gable) Dad, I’m sorry.

Mr. T. HANKS: (As Mr. Gable) I haven’t heard from you in over a month. I had to
call you friends like I was some kind of freakin’ cop.

Mr. C. HANKS: (As Troy Gable) I know.

Mr. T. HANKS: (As Mr. Gable) I would have killed to go to law school, Troy. I
would have killed.

Mr. C. HANKS: (As Troy Gable) I hated it. I wasn’t happy.

Mr. T. HANKS: (As Mr. Gable) You think I danced out the front door every
morning in my adult life, happy about where I was going to be spending my day?
I don’t know what you’re doing here and I don’t think you do either. But come
on, you’re smarter than this. You are. You are smarter than this.

GROSS: That was Tom Hanks, Colin Hanks and John Malkovich in a scene from Colin
Hanks’ new movie, which is called “The Great Buck Howard.” You know, I’m
wondering, like when you’re acting opposite your father, did it feel like – oh
yeah, this is how he is like my father; I could imagine him being just like
that with me if he was angry? Or is he so in character that it was completely
different…

Mr. C. HANKS: Oh no, he is so different…

GROSS: …than the Tom Hanks father person? Was it?

Mr. C. HANKS: So different, yeah. I mean this is - this is unlike any
conversation we’ve had. I mean, he has always been really supportive of
everything that I’ve done. So obviously just the words themselves are very
different. But no, he’s most definitely acting.

(Soundbite of laughter)

Mr. C. HANKS: It’s not – it’s not like him at all, in fact. It’s interesting.
This is, you know, pretty much what Sean McGinly did, you know. As he says, the
first 15 minutes of the movie is really exactly what Sean McGinly did. He quit
law school, he didn’t tell his family, and he moved to Los Angeles because he
had this notion of being a writer, and the only job he can get was working for
a mentalist.

GROSS: Did he work for the Amazing Kreskin? Because he’s thanked in the
credits.

Mr. C. HANKS: He did, yes.

GROSS: Oh.

Mr. C. HANKS: But we embellish quite a bit. You know, we wouldn’t say that –
you know, the handshake is most definitely - we definitely lift it from
Kreskin, that’s for sure.

GROSS: Oh man, that’s the kind of handshake where they - every time he shakes
somebody’s hand, he nearly pulls their arm out of the socket.

Mr. C. HANKS: Yeah. And…

GROSS: It’s so vigorous and long.

Mr. C. HANKS: And that’s exactly what it was like. I met the man for the first
time the other night at the screening here in New York and he nearly took my
arm off.

GROSS: My guest is actor Colin Hanks. He stars in the movie “The Great Buck
Howard.” We’ll talk more after a break. This is FRESH AIR.

(Soundbite of music)

GROSS: My guest is Colin Hanks. He stars in the new film “The Great Buck
Howard,” and he co-starred in season two of AMC’s “Mad Men.” Now, I want to
talk to you about your role on “Mad Men,” the AMC series about advertising
executives in the early 1960s. And you played not an advertising executive but
a young priest who takes a special interest in a young woman in his parish
named Peggy. Peggy works at the advertising agency and she has gone from a
secretarial position to copywriting position. I’m leading up to a clip here.

(Soundbite of laughter)

Mr. C. HANKS: Okay.

GROSS: And she’s the only woman to have risen like that. But she has a secret.
She had a baby out of wedlock and gave it up for adoption. She has been helping
you, the priest, with some church business and has agreed to use office
machinery to make copies of a flier for a church event. And you’ve come to the
advertising office to pick up those copies. So let’s hear that scene. Peggy is
played by Elisabeth Moss, and my guest, Colin Hanks, plays the priest.

(Soundbite of TV show, “Mad Men”)

Mr. C. HANKS (Actor): (As Father Gill) Peggy, do you have something you need to
talk about?

Ms. ELISABETH MOSS (Actor): (As Peggy Olson) Excuse me?

Mr. C. HANKS: (As Father Gill) Well, I’ve noticed that you don’t take communion
and I don’t think it’s too much of a leap to ask if there’s something you need
to talk about.

Ms. MOSS: (As Peggy Olson) No.

Mr. C. HANKS: (As Father Gill) God already knows whatever it is, Peggy.

Ms. MOSS: (As Peggy Olson) Well, then I don’t need to talk.

Mr. C. HANKS: (As Father Gill) Well, I’m here, right now.

Ms. MOSS: (As Peggy Olson) Father, don’t take this the wrong way, but I don’t
think you’d understand.

Mr. C. HANKS: (As Father Gill) God is bigger than what we were raised on.

Ms. MOSS: (As Peggy Olson) Father, you don’t have to live life like the rest of
us. Maybe you’re lucky.

Mr. C. HANKS: (As Father Gill) I’ve lived life. I wasn’t born a priest.

Ms. MOSS: (As Peggy Olson) Of course not.

Mr. C. HANKS: (As Father Gill) You know, when you distance yourself from the
church, you are distancing yourself from everything. That’s why it’s called
communion. It’s not just being with God, it’s being with people.

Ms. MOSS: (As Peggy Olson) I know that.

Mr. C. HANKS: (As Father Gill) Then why are you pushing everyone away?

Ms. MOSS: (As Peggy Olson) I’m not.

Mr. C. HANKS: (As Father Gill) There is no sin too great to bring to God. You
can reconcile yourself with Him and have a whole new start. You’re a smart,
beautiful young girl. You have so much to offer. Do you feel you don’t deserve
his love?

GROSS: That’s Colin Hanks and Elisabeth Moss in a scene from the AMC series
“Mad Men.” Colin Hanks, I think it’s so interesting to see you playing a
priest, a young priest who knows that he has to service the spiritual and other
needs of a community, many of whose members are much older than he is. And he
is also, I think, struggling with certain emotions slightly beyond priestly
emotions that he is feeling for – for Peggy, as we kind of heard in the scene
that we just played. Did you find yourself going to church just to kind of…

Mr. C. HANKS: No.

GROSS: …get in spirit of the role?

Mr. C. HANKS: No, not so much.

GROSS: I don’t even know what religion you were born into, if any.

Mr. C. HANKS: I’m not a very religious person, no. But you know, more than
anything else, what was interesting was - is that, you know, obviously it’s
Roman Catholic but pre-Vatican II. So that was really the thing that was most
interesting to me, was that we were dealing with a church that was about to go

through, for lack of a better phrase, evolution and change. And they were about
to make very drastic changes within the church and how the church reaches out
to the community. And so with Father Gill, here is a young man who is a priest
and is going - trying to find this new way to bring young people into the fold,
and he sees something in Peggy that he, you know, he felt that God brought him
there for Peggy.

And what’s interesting is that, you know, we never really discussed whether
there were any other ulterior motives for Father Gill, but interestingly enough
that sort of people brought that to the relationship. You know, really he is
just sort of fighting for her soul and any other feelings that he has is
secondary. But a lot of people were really wanting that to happen, which I
found very interesting.

GROSS: Well, let me just interject here.

Mr. C. HANKS: Yeah.

GROSS: As somebody who thinks there’s something else going on here, it’s not
necessarily that I want that kind of relationship to happen…

Mr. C. HANKS: No, no, I - no, yeah.

GROSS: But I just do feel like he is feeling stirrings from Peggy, that he -
that he’s very uncomfortable with and he doesn’t know what to do about it. And
he’s may be not even fully aware of it because he doesn’t want to be aware of
it, but that they’re there. So…

Mr. C. HANKS: It’s possible.

GROSS: And maybe - maybe you don’t know, because you have to be so inside…

(Soundbite of laughter)

Mr. C. HANKS: Well, they…

GROSS: …of him. But that’s the way it’s coming across.

Mr. C. HANKS: Yeah. Well, hey, that’s okay. I like people being able to look at
it and come up with something on their own.

GROSS: Absolutely, yeah, I’ll bet you do.

Mr. C. HANKS: That’s exciting.

GROSS: Yeah, yeah. My guest is Colin Hanks and he’s starring in the new movie
“The Great Buck Howard,” and he is also Father Gill on AMC’s series “Mad Men,”
and he’s currently on Broadway in the new show “33 Variations.” Now, I know
your parents divorced when you were how old?

Mr. C. HANKS: Well, so young that you go by grades, not by age.

(Soundbite of laughter)

GROSS: Right.

Mr. C. HANKS: You know what I mean? So third grade.

GROSS: Were you on your father’s sets a lot, and was it – if so, was it fun to
be there?

Mr. C. HANKS: Yeah. Oh yeah. I mean, I’ve got a lot of memories going on a lot
of different movie sets. And there wasn’t like a crazy allure to it. From me, I
just saw it as what a great way to spent time with my dad, you know, so I can
go with him to work. How many kids can do that? Not many. You know, it’s always
bring your kid to work day, or it can be. And so even though I was spending
time with him while he was at work, there was a lot of downtime. And so there’s
is a lot of laughing and playing gin rummy and stuff like that, and there was
always interesting people.

And since some of those movies have since become, you know, such huge iconic
movies, it’s kind of hard to properly describe. But at the time it was just,
you know, another sort of day at the office, for lack of a better phrase.

GROSS: Colin Hanks, thanks so much for talking with us, and good luck with your
new movie and your Broadway show. Thank you.

Mr. C. HANKS: Thank you.

GROSS: Colin Hanks stars in the new film “The Great Buck Howard,” and he’s on
Broadway starring with Jane Fonda in “33 Variations.” You can download podcasts
of our show in our Web site, freshair.npr.org.
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