Dr. Bandy Lee: A Duty to Warn

Dr. Bandy Lee:

I had been concerned about the rise of somebody like Donald Trump because I was observing a weakening of the nation's collective mental health, mainly through the socioeconomic policies that vastly accelerated inequality.

Ken Harbaugh:

I'm Ken Harbaugh, and this is Burn the Boats, a podcast about big decisions.

My guest today is Dr. Bandy Lee, a forensic psychiatrist and an expert on violence. In 2017, she edited The Dangerous Case of Donald Trump, in which she and 37 other mental health professionals deemed Trump's mental state to be a clear and present danger to the country.

Since then, she has published a full psychological profile of the former president called Profile of a Nation.

Dr. Lee, welcome to the show.

Dr. Bandy Lee:

Thank you. Thank you very much for having me.

Ken Harbaugh:

As a psychiatrist, you have spent time face-to-face with (and I think these are your words) some of the most violent individuals our society has produced.

When did you first realize that Donald Trump was not just a showman with political ambitions, but someone who could provoke thousands of his followers to commit acts of violence and who had no reservations about making America as a whole a more violent country?

Dr. Bandy Lee:

Yes, it may be astonishing for most people because I myself considered Donald Trump simply a shady businessman and an odious personality while I was growing up in New York City.

But during his campaign, of course, there were a couple decades of experience with violent offenders who are my patient population that I came to recognize much more.

And it simply took a few seconds of watching him on television. I think he was at one of his rallies saying something like he will pay all the legal fees if you knock the hell out of somebody.

And the way he interacted with his followers was the key to my recognizing his personality disposition which was very much familiar to me from working with street gangs, prison blocks, and as I said, people with violent personalities.

Ken Harbaugh:

And this isn't just a rhetorical critique of the former president. You're not just talking about his speeches. This is a clinical issue. You're talking about his mental state not his performative persona.

There is something you argue going on in his brain that makes him a violent individual and able to provoke others to act violently. And your insight comes from your experience with very violent people.

Dr. Bandy Lee:

Yes. And I would say the two are not so distinguishable in that someone whose behavior is aggressive and violent will tend to have aggressive thoughts as well as consistent patterns that I came to recognize.

And of course, it had nothing to do with being opposed to him as a candidate or political considerations. It's an entirely different paradigm of thinking in psychiatry and medicine where I was concerned about the safety of others, and especially the public and the nation as a whole.

Even though I had not been politically involved as much before encountering his dangers, I could deduce from his psychology and the nation's state what kind of dangers could spread.

Ken Harbaugh:

Can you talk about the duty to warn. I've got a law degree. I'm really drawn to this idea in tort law, and obviously there's an analog in the medical profession because I think we need to understand that, to understand the path you chose and the price you paid.

What is the duty to warn, and how did you feel about it when you saw this threat to the nation?

Dr. Bandy Lee:

Yes, in general, it's a duty that derives from our responsibility to society. Psychiatrists don't just have a responsibility to patients. They also have a responsibility to society as outlined clearly in the preamble of the American Psychiatric Association's ethical guidelines, even though they negated it at the onset of the Trump presidency.

And there was a case in California called the Tarasoff’s Doctrine that brought about the phrase duty to warn. But the general principle was that confidentiality, which is sacrosanct in medicine and psychiatry still has a rule that supersedes it and that is the duty to warn against danger.

So, you can break confidentiality in the case of a patient if the patient expresses an urge to harm others or to become a danger to the public. Now, that's in a patient situation.

In a public situation, the duty to warn is even more encompassing because there is no confidentiality to break. Whatever we're making our assessment from is public knowledge.

And what we're sharing actually is our decades of specialized knowledge, general knowledge, as well as clinical experience. Which we have a duty to share with the public, not just as professionals, but as citizens who are obligated to share our gifts with society.

Ken Harbaugh:

You sounded the alarm as a clinician about Donald Trump long before just about anybody else in the medical profession, and you paid a terrible price for it. I want to get to that in a second.

But can you talk about your decision to warn the American public about the danger that Donald Trump's, and I'm probably going to use the wrong word, please correct me, but his psychopathy, his violent tendencies, his mental proclivity to provoke violence.

You saw that and decided to warn the American people. How did you make that decision to be that public about it? And then we'll talk about the aftermath.

Dr. Bandy Lee:

I did not consider it so extraordinary at the time. What was extraordinary what was the situation. And it was ordinary standard obligation to speak up when there are dangers to the public. We would do that in an airport, in a subway station, out in the streets.

If we saw somebody who was a danger to the public, we actually cannot just walk away. We have an obligation to intervene and even take that person on as a patient. That is, we don't have a choice not to. That's one of our medical obligations.

And so, when we saw this unprecedented situation and people were not responding in a commensurate way to the situation, I spoke with a bunch of my colleagues and we actually all agreed, there was a medical consensus that this was a very dangerous situation.

By the way, dangerousness is not about the individual, it's actually about the situation. I personally have examined close to a thousand individuals just like Donald Trump, but they're not all the greatest danger to humankind because they are not in the position and situation as Donald Trump had been in the office of the presidency and afterwards.

So, speaking up was matter of fact to me. I thought to myself, well, if I've devoted my entire career to studying predicting and preventing violence, then why would I turn away in the face of the greatest dangers that we saw? And so, my colleagues agreed.

That's why I organized the conference at Yale School of Medicine in the beginning of the Trump presidency, where I invited the most highly renowned luminaries of the field. And we decided collectively that it was important for us to speak up.

And that gave rise to our first book, The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President, which was an unprecedented in New York Times bestseller of its kind.

Ken Harbaugh:

You said you had diagnosed more than a thousand people or spent time with and understood the psychopathy of more than a thousand individuals with behaviors and symptoms similar to Donald Trump's.

I would submit that you probably have more data on the former president from the thousands of hours of his public pronouncements, his speeches, his depositions now, than you probably had on just about any one of those other patients you may have spent a couple hours with.

This is important for the conversation we're going to have about the Goldwater Rule, but is that a fair judgment?

Dr. Bandy Lee:

Yes, absolutely. And I'm not the only one who would say so. At a conference at Harvard Medical School among my colleagues, we all agreed that we have more information on Donald Trump than any patient we've ever treated.

And so, we've just never had this kind of information objectively, publicly, as well as unfettered access to his stream of consciousness through constant social media. And as I said, it's not a mystery what he exhibits, which I recognized within a matter of seconds, not even minutes.

Ken Harbaugh:

And what does he exhibit? I want to be accurate. I want to be fair. I'm throwing out words that I think have a clinical meaning, but is it psychopathy? Is it narcissistic personality? If you had to summarize it for the rest of our conversation, what is the diagnosis?

Dr. Bandy Lee:

Yes. First of all, I'll say that mental illness does not give rise to dangerousness necessarily. In fact, those who are mentally ill are more often victims of violence rather than perpetrators. So, violence has very little to do with mental illness.

But there are a couple diagnoses that you've mentioned that are violence prone, which include psychopathy, which is one of my specialties, and narcissistic personality disorder, borderline personality disorder.

And there are a number of diagnoses that could predispose to violence either against others or against oneself.

But dangerousness is a separate assessment from a diagnosis. Diagnosis is for individual treatment, which you do in a private office. You wouldn't divulge a person's diagnosis unless you get permission from them because they're your private patient.

Dangerousness on the other hand, is an assessment that is made for the public. It's not for the individual. And there's really no reason to do a personal interview because dangerous individuals actually often lie and mislead and are very manipulative. And they often even mislead the most seasoned clinician.

So, you don't make a judgment based on a personal interview. You make it based on their objective behavior, how they interact with others, collateral interviews of their coworkers, their family members and friends, their criminal history. These are the kinds of things you assess dangerousness on.

And as I said, it's an evaluation that is done for the public or anyone who is requesting the assessment rather than for the individual. And you don't require consent.

Ken Harbaugh:

So, you and many others assessed Donald Trump long before most people came to the same conclusion, or most sane people came to the same conclusion.

You assessed him as a danger to society, which he has proven to be. He is provoked riots. He is instigated individual acts of violence.

There was a swift and fierce backlash from — well, you'll have to tell me exactly who, but it was the psychiatric governing body that invoked a ‘60s era rule to say you had violated the ethics of your profession and you lost your job at Yale. Can you tell us how that unfolded?

Dr. Bandy Lee:

Yes. Well, one thing that alarmed me in this entire era was the behavior of the American Psychiatric Association, which is not a governing body for the profession. It's one trade association actually, among many. The name should not be misleading. They don't have authority over those who are not members.

And I was not a member at that time. In fact, I resigned even though I was a fellow and received awards through them. In 2007, I resigned from the organization because they were getting a third of their funding from the pharmaceutical industry, and it seemed to affect their policies.

Now, in the Trump era, they did something very odd. They took what was called the Goldwater Rule. It's not actually a rule, it's a guideline. And you can tell from the name that it was politically driven.

It was inserted into the ethical guidelines, not from clinical experience or scientific data, and not even a lawsuit against a clinician, but a lawsuit against a tabloid magazine at that time called Fact, which basically sensationalized some psychiatrist who spoke ill of Barry Goldwater during his presidential campaign, which led to his landslide loss.

But what the American Psychiatric Association did at that time, they took this very obscure guideline, which nobody considered really important.

And it was superfluous because of course, you don't diagnose someone you haven't examined and you don't speak about their diagnosis unless you get their permission to do so. That's for private patients, for everybody, it holds for anybody.

But they specifically singled out public figures and said public figures should not be diagnosed without a personal exam. And their diagnosis should not be publicized without consent. That didn't need to be said. It applies to everybody.

But they're giving public figures privilege. This kind of singular privilege has led them to be able to stay in the Trump era.

As soon as he was inaugurated, it did not take two months for them to announce that the so-called Goldwater Rule meant that psychiatrists could not make any comment, not just diagnosis, but any comment in any situation, regardless of the danger he posed to society and even in a national emergency.

This to me, just had glaring red alarms attached to it because this was, first of all, not what the guideline was supposed to be.

The guideline actually, those who are specialists in it would say it's an affirmative obligation because it points to … the only way it got in was because it was a guideline on our societal role.

So, what it actually says is that psychiatrists have an obligation to participate in activities that improve the community and better public health. When we're asked about a public figure, educate the public generally, but just don't diagnose.

And we wouldn't diagnose anyway because they're not our patient. And a diagnosis is, again, irrelevant to the public's interest. What is relevant is dangerousness and unfitness, and neither of these require a personal interview. You try to get one, but it's not the foremost requirement.

Ken Harbaugh:

And that has been the focus of your assessment of the former president, his dangerousness, not his individual mental state, is that right?

Dr. Bandy Lee:

Not his diagnosis. And not anything of interest in treating him as a patient. He is not a patient, and he is of interest to us only because of the danger he poses to public health and public mental health.

Now, the champion of the Goldwater rule during the Trump era was Jeffrey Lieberman, who was a heavily pharmaceutical industry funded psychiatrist.

And he was recently removed from his position as chair of Columbia's psychiatry department because of his inappropriate disparaging of races and women, I feel that he's practiced for decades.

But the pharmaceutical industry has been promulgating the notion that psychiatry is all about just individual treatment that you do secretly in a private office and for the purpose of treating with medications. And whatever you cannot treat with medications does not even exist.

Now, this is antithetical to every tenant in psychiatry, which is biopsychosocial, and increasingly ecological, but there are many psychiatrists who are taking on this position, and he was one of them.

Ken Harbaugh:

I'm intrigued by the phrase biopsychosocial, especially the social aspect because you have written and spoken a lot about the societal impact of mental health.

We just had Dr. Steven Hassan on and I think you have worked with him in the past, and he beats this drum very, very loudly about the importance of understanding the societal aspects of mental health.

Can you talk about declining mental health as a contagion, as something that a society can suffer from and not just an individual?

Dr. Bandy Lee:

Yes. Again, it's a fallacy to think of mental health issues as affecting only individuals. In fact we know very well about emotional contagion and even mental symptoms are not confined to individuals. They can be even more infectious than certain physical diseases because you don't require physical exposure for the symptoms to spread.

And so, I warned against Donald Trump's psychological dangers spreading into social, cultural, geopolitical, and civic dangers for a very long time.

There was conference I held at the National Press Club in 2019, bringing together top experts from all different fields for that reason. And I thought that would be the beginning of mental health being a part of the conversation.

But in essence, we never recovered from the American Psychiatric Associations intervention and slander really, calling us armchair psychiatrists, doing what we were for self-aggrandizing reasons, and using psychiatry as a political tool.

You can already tell it's not a very professional use of language and breaks their newly revised own Goldwater Rule, because we were public figures by that time.

But that has more to do with authoritarianism than psychiatric proper application of psychiatric principles.

So, I had been concerned about Donald Trump as a public health threat from the very beginning. That's what I said in the very introduction of The Dangerous Case of Donald Trump.

And what we're seeing today is the spread of what I'm now calling Trump contagion, which is the spread of symptoms. And all psychiatric symptoms are psychosocial, biopsychosocial to be more exact. They're not confined to the individual.

And this is what we had cautioned against and feared because one of the problems of the spread of mental symptoms is that unlike any other symptom, it comes with the loss of insight which is awareness that one is ill or unwillingness to recognize it.

So, the sicker one is, the farther one will run from hospitals and doctors and anything that would get them better.

And again, the APA, instead of educating the public on the need to inform ourselves of psychiatric principles and to prevent further regression into a state of poor health, they took advantage and exploited the symptoms in order to gain political and financial advantage.

Ken Harbaugh:

Can you elaborate on the contagious nature of this phenomenon? Because I think it'll be obvious to some people but not everybody, that you're talking about social media as a vector.

You're talking about the internet itself as having the power to transmit this in a way that an airborne disease would require proximity or another kind of disease would require contact. The type of mental health issues you're talking about can cross oceans in milliseconds.

Dr. Bandy Lee:

Yes, that's right. Well, any contagious disease requires at least three conditions to be able to spread. And one is a primary agent, meaning the infectious agent. Secondly, an environment that facilitates transmission. And thirdly, weakened hosts.

And we can apply those principles in the exact same way to mental symptoms. And I've actually seen this quite a bit as a prison psychiatrist and a public sector psychiatrist working in jails and prisons and state hospital settings where individuals can go for extended periods of time being untreated and their symptoms become very severe.

What happens is that rather than healthy individuals making them well in the ordinary setting without the intervention of experts and treatment settings, that it's really the symptomatic person who spreads their symptoms.

Because there's such a high emotional drive behind their delusions, their paranoid ideas, their fear, their violence proneness, that it becomes infectious far more than any kind of rational persuasion.

So that if they are isolated with family members, for example, or enclosed in a community … and it has been described as a phenomenon nationwide by persons such as Carl Jung or Erich Fromm who have described how this can happen to an entire nation.

But it's the same phenomenon that I've observed in smaller settings with street gangs, with family members.

And what happens … and this is a well described phenomenon. At the severe stages, it's called shared psychosis. You can diagnose it in an individual as shared psychotic disorder.

But it occurs more generally as a phenomenon of shared psychosis in that the secondary individuals previously healthy or predisposed individuals come to look almost identical to the person with a primary illness.

Such that as a clinician, when you go into this setting, it's almost impossible to tell apart who's primary from who's secondary until you do a history and figure out who originated these symptoms, who transmitted these symptoms in the beginning.

The treatment is removal of the offending agent. In other words, the person with the primary symptoms. You hospitalize them, you separate them into different cell blocks, and the symptoms in the transmitted individuals dramatically decline. Now, there are some variants to this, but that's the general picture.

And what I found, and what I feared was that Donald Trump, with the exposure that he had from an influential position, would similarly transmit symptoms through the emotional bonds that he formed.

And through the insulation from other ideas, evidence, facts, rational discussions that he would create by disparaging other news sources. He called real news, fake news. He said, even at one point, “Don't believe your eyes and ears, but just listen to what I say.”

Ken Harbaugh:

When it comes to a physical disease that is transmitted, I understand the concept of the weakened host, someone with a compromised immune system or something like that.

When it comes to a biopsychosocial transmission, can you talk about what weakens a host?

You alluded to isolation or insulation. Surely there are aspects of American society that make us, if not uniquely susceptible then unusually susceptible to this kind of transmission, this kind of manipulation. Why are so many individuals and collectively, groups in our society weakened hosts?

Dr. Bandy Lee:

Yes, I would go back a little to describe that because I had been concerned about the rise of somebody like Donald Trump because I was observing a weakening of the nation's collective mental health, mainly through the socioeconomic policies that vastly accelerated inequality.

And inequality is not just deprivation of material goods. It has a very strong influence on the nation's psychology.

And you can imagine that this kind of oppression and injustice that results from inequality actually impairs the nation's ability to reach its full potential psychologically and mental health wise.

So, that was the background. And when I saw Fox News first air, I believe it was in the late ‘90s, I was still in training at that time, but I thought to myself that, “Well, if this were to continue, then there would be serious ramifications for the nation's mental health.”

And lo and behold around I believe the early 2000s, it was a number one news program, so-called news program, because it's not really news, it's spreading misinformation as well as conditioning people not to be able to critically take in facts and logical conclusions.

So, that was a setting in which Donald Trump rose. And astonishingly, the violent individuals that I saw mostly in jails and prisons, and seemed to be confined in the correctional setting for the most part, earlier in my career, over the course of my 25 year practice, I have noticed that more and more such individuals were taking leadership positions such as chief executive officers, judicial roles, and now, politicians. And that was a setting in which Donald Trump came to the presidency.

And also, as part of the environment was the change in the media landscape in that non-news was held to be the same as news.

And just as an mentally impaired individual, next to a healthy individual would be no contest. In other words, if given this kind of public exposure such as through being a presidential candidate, then the symptoms will spread much more rapidly than any kind of rational persuasion.

So, the media landscape changing, including social media, which you can tell by the expressions, things going viral, make them more conducive to spreading mental symptoms.

Ken Harbaugh:

In assessing the danger that someone like Donald Trump poses to society, a historically significant figure like the former president, does it help to have a sense of history? Did you have a frame of reference beyond just your clinical experience?

Do you have a background, even a shallow non-academic background in the rhetoric and behavior of someone like Mussolini or Franco? Do you make those kinds of comparisons in making a threat assessment?

Dr. Bandy Lee:

Yes, absolutely. I'm not a historian. A historian brings a historical perspective to all kinds of settings and could be a minor focus or larger societal focus.

Psychiatrists would do the same, I would argue. We bring a mental health lens, a psychological lens, either to the individual setting or the population setting.

And as social psychiatrists, I trained in medical anthropology and I worked with the World Health Organization on public health approaches to violence prevention. So, I'm used to working with populations.

And thinking in terms of prevention, working with larger scales, and had consulted and advised on policymaking with a number of governments, both domestically and abroad. So, I was used to thinking in these terms, which are very easy to carry into historical contexts.

When I think of something like Benito Mussolini, or Adolf Hitler, Joseph Stalin, Nazi Dan, I don't bring the historical perspective or the political perspective, but I bring a psychological perspective.

And they make total sense to me because that's exactly what will happen. What has happened is exactly what will occur if any of the individuals that I've treated, the dangerous personality disorders that I have treated, were put in such positions of power.

So again, dangerousness is about the situation, and Donald Trump may have just remained an odious businessman that nobody liked and would succeed and do lots of damage in his petty business, but not be a threat to the survival of humankind as he is now, if he were not given the power.

Ken Harbaugh:

You've described, I guess implicitly, Donald Trump as a threat to America's soul. Your last book was titled Trump's Mind, America's Soul, and your assessment of the danger he poses implicates the broader nation.

Can you explain extending that assessment to America itself and how our soul is affected by the former president?

Dr. Bandy Lee:

Yes, I have mentioned that because the trajectory we are in is very perilous. I think many people recognize that when I said that Donald Trump was dangerous at the onset of the presidency, people may have thought that I was being hyperbolic or exaggerating.

But many years later, I think we can see why that kind of framing was necessary.

Since the spread of the Trump contagion, I've also described the course we are on as a death spiral, because from my perspective, fascism is not a political ideology. It is mental pathology and politics.

And the course of mental pathology is destruction and death regardless of what the afflicted persons, groups, nation will claim.

And we have seen this historically through other leaders when none of these leaders were mentally healthy. In fact, if one is healthy, one's decisions will be life affirming regardless of one's ideology. So, it's really not about ideology or political positions.

I mentioned the soul so that we would truly take this seriously. And ultimately, it is a matter of our own ethical and spiritual grounding, if you will. Our ability to keep our center and confront the onslaught of this pathology and to stand up for truths and health and what is right that will save the nation.

Because pathology comes with an innate death drive, and in order to resist it, it is a kind of war. Mahatma Gandhi spoke of non-violence training as the training of a warrior, and I would see the task before us as being very similar.

Psychiatry can bring us solely so far. As a mental health professional, it's been extremely difficult for me to watch on the sidelines once I was removed from public discourse by the APA.

At one point, we were the number one topic of national conversation three months after our first book was released, and we had an extremely hearty reception by the public.

Our New York Times bestseller was nothing that McMillan, one of the five big publishers, was even prepared for. It took them five weeks to replenish the stocks so that they could keep up with the demand. And that was organic.

All the network news and cable news, all the major programs invited me and I myself was astonished that there was no barrier and no stigma attached to speaking about mental health. They simply called me on as any other expert on an area of expertise.

It was really after the APA intervened recruiting the New York Times to denounce us as being unethical, when in fact we were trying to fulfill our societal ethical duty, that we were excluded from discourse.

And exactly what we predicted, that without proper intervention, without proper knowledge, the nation has suffered calamity and destruction in ways of the exact severity and exact timeline that we predicted.

Ken Harbaugh:

I don't imagine you derive much satisfaction from the vindication of seeing your predictions play out. It's vindication, but it can't feel good to see your predictions about Trump's violent tendencies actually made real.

Dr. Bandy Lee:

Well, vindication was what I've been hearing even from Congress members since January 6th attack on the US Capitol. And there was a major subtitled The Vindication of Bandy Lee by Mother Jones, as you may know.

But my concern is three years later, where are we? Where are the mental health voices? Why are those who are speaking about mental health issues only non-experts?

And if we as a nation cannot derive the proper knowledge and intervene properly for a given crisis, (it's not always the case that we're dealing with a mental health crisis, but in this case, it is) then why will we not hear from the appropriate experts and why are we still sidelined?

So, for me, the vindication is not very relieving. It's rather more tragic.

Ken Harbaugh:

One of the MOs of the former president, and probably most psychopathic personalities when they are accused of crimes or misdeeds, is to immediately turn a turn around and their accusers.

Alan Dershowitz has been in the news a lot lately alongside the former president for reasons that many people probably know about, not the subject of this interview, but we may do another one when more facts come out.

But you tweeted this out about both of them on this phenomenon. “If you understand offender psychology, they actually make it easy for you. They falsely accuse with the exact severity they need to be correctly accused. Consider this whenever Donald Trump or Alan Dershowitz makes an accusation.”

Dr. Bandy Lee:

Yes, that is called projective identification. And it's a commonly observed phenomenon. Actually, I like to use Dr. Jennifer Freyd's acronym, DARVO, which means deny, attack, and reverse offender and victim, and that's the way that they respond.

Those who deal with violent offenders know that this is coming. In other words, first you can recognize where they are guilty by how they accuse others.

As we know, Alan Dershowitz suppressed my speech by complaining to Yale and causing my termination after 17 years of teaching there. And also, my student years were spent there.

So, after about 30 years of devotion to Yale, I was removed without due process, and that was purely Alan Dershowitz's doing because it was within 48 hours of his complaining that I heard from my superiors who knew me and supported me, and actually just a couple years prior affirmed my right to academic freedom.

Now, Alan Dershowitz is going around campuses and law firms stating that students who think a certain way and law firms that hire lawyers that think a certain way should be called out and sanctioned, and students and lawyers be removed.

And essentially something that no other legal professional would agree with. I think actually another lawyer described it as the new McCarthyism.

And so, we see that violent personalities will accuse others of their own guilt and their own crimes in order to deny what they've committed and to essentially alleviate their own psyches by attributing their own unacceptable thoughts and deeds onto others.

And the more severely impaired they are, the more they will do so. So, it's a good measure that clinicians use.

Ken Harbaugh:

Dr. Lee, thank you so much for joining us.

Dr. Bandy Lee:

Thank you so much for having me.

Ken Harbaugh:

Thanks for listening to Burn the Boats. If you have any feedback, please email the team at [email protected]. We're always looking to improve the show.

For updates and more, follow us on Twitter @Team_Harbaugh. And if you enjoyed this episode, don't forget to rate and review.

Burn the Boats is a production of Evergreen Podcasts. Our producer is Declan Rohrs and Sean Rule-Hoffman is our audio engineer. Special thanks to Evergreen executive producers, Joan Andrews, Michael DeAloia, and David Moss.

I'm Ken Harbaugh, and this is Burn the Boats, a podcast about big decisions.