Why is it so difficult to find meaningful help for the severely mentally ill, including those exhibiting patterns of violence? And why has this question become politicized?

This week, Ben Appel joins me to talk about his new book, Cis White Gay: The Making of a Gender Heretic, a memoir about leaving one kind of cult only to stumble into another. Raised in a rigid Christian community, Ben found refuge in the gay rights movement and, later, the Ivy League—until "allyship" started to look less like solidarity and more like a loyalty oath.

My guest is Dr. Sunita Puri, a palliative-care physician and author of That Good Night: Life and Medicine in the Eleventh Hour. We talk about what it really means to care for patients when cure is no longer the goal, why our medical system resists honest conversations about death, and how clarity and compassion can coexist at the end of life.

Topics we cover:
• What palliative care really provides (beyond hospice)
• Why "more treatment" ≠ "more life"
• Prognosis, probabilities, and telling the truth kindly
• How families can ask the right questions
• Documentation that matters (and what to avoid)
• The moral distress of clinicians
• Cultural/faith factors that shape decisions
• Dignity, autonomy, and realistic hope

Guest Bio:
Dr. Sunita Puri is an Associate Professor of Medicine at the University of California, Irvine School of Medicine, where she is the Director of the Inpatient Palliative Care Service. She has written for The New Yorker, The New York Times, and The Atlantic, among other publications. She is the author of That Good Night: Life and Medicine in the Eleventh Hour, a critically acclaimed literary memoir examining her journey to the practice of palliative medicine, and her quest to help patients and families redefine what it means to live and die well in the face of serious illness.