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December 8, 2022 56 mins

On this episode, Kay-B is joined by Superfan & TV connoisseur Ashley Ray (@TheAshleyRay) to chat about GREY'S ANATOMY season 3 episode 3 "Sometimes a Fantasy." We discuss all things Cristina & Burke, Alex's dynamic character growth, and Meredith being courted by 2 men! Later, Kay-B chats with Dr. Karyn (@Karyn_Oh), an expert in human genetics and experimental nutrition about a case on Congenital insensitivity to pain with anhidrosis, and so much more! For more information about Color of Genes, go here: www.ColorofGenes.com .

On-Call with Kay-B is an iHeart production with lead editing by Randie Chapman of Wordie Productions (@wordieproductions on IG). Please follow Executive Producer & Host, Kay-B, on Instagram & Twitter @TheLadyKayB.

For more information about the case highlighted in this episode, read it here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564101/ 

See omnystudio.com/listener for privacy information.

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Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:14):
Welcome everyone to a brand new episode of On Call
with k B. I am your host, KP and I
am looking forward to this segment today because we are
going to dive into some iconic classic Gray's Anatomy with
season three, episode three called Sometimes a Fantasy. I am
joined with super fan comedian TV I say podcast host

(00:38):
uh and honestly iconic TV connoisseur because I follow you
on Twitter, so I'm super excited about this. Ashley Ray,
Welcome to the show. Hi, I'm so glad to be here.
Gray's Anatomy is probably I could probably have a degree
in Gray's Anatomy. Listen if they are offering courses, you know,
I think that like we could do some some guest

(01:00):
lecture series, like Hey, guys, come to us every week.
We can give you all of the t on this
iconic Shonda Rhymes show. It's actually kind of hard to
believe that this was our first show because it was
so great, so good, and just I went back and
rewatched this episode for this and just again, I immediately

(01:21):
got hooked. Like two hours later, I was still watching,
like it still grabs you no matter how many times
you've seen the show. Yes, yes, and I don't mean
that as a slide. I mean I'm just so impressed that,
like her first show was able to catapult in the
way that it did and currently still is into season nineteen.
I'm like, girl, give me that formula because it is

(01:43):
really you are you are the one, Like this is amazing.
I want to know every single behind the behind the
scenes detail of how she put this show together, truly. Yeah.
So in this episode of Gray's Anatomy, you know, um,
the main patient is Megan portrayed by young Abigail Breslin.
I mean she's been killing it since she was a
child apparently. So she is a pediatric patient who is

(02:07):
in foster care and believe she is a superhero because
she doesn't feel pain. And so let me start off
by saying, actually, one of my favorite things about this
episode is, you know, this is the journey for Alex
where Addison is really pushing him. She sees something in
him and believes that he could be fantastic in peas
and he is truly like fighting it, running from it,

(02:29):
not doing it. So this is actually one of my
favorite character evolutions. Yes, it's uh, that's when it starts
right here, and it's so sad because as like the
most dramatic childhood out of pretty much anyone on this show.
I don't know, like him and Meredith kind of rival
each other in that, but I feel like his was
worse and so was definitely worse. Like I think like
he talks about his dad beating him then being homeless

(02:51):
at some point. Yeah, yeah, I feel like it isn't
really until we get the introduction of Joe, who is
the only person who understands what it's like to grow
up in the same is Alex like truly, because Joe
was also homeless at one point. It's almost like he's
running away from himself than all the pain that he
went through. Yeah, yeah, and that's why he puts up
all these walls and impedes. You can't put up walls.

(03:12):
It's hard, can't. You can't. And so Alex, um, you know,
he's he grows up essentially impedes. And Megan is really
the first patient that kind of challenges him in so
many ways because also she talks back to him, which
is funny because I feel like she's just a version
of Alex, Like she's probably talking Alex would talk to
adults as a child, exactly. She's like, I can't beat her.

(03:34):
I can handle this. Punch me right now. But every
time she asked someone to punch her in the stomach,
it is the funniest thing it is. And every time
I'm also like, but girl, please stop asking these adults
to abuse you, why to hurt you? Like, this is
not good at all. Um. So you know, Dr Bailey
is like, Alex test her threshold for pain and ice water,

(03:54):
so you know, he does it. Get another adorable scene
where he's like, oh we can both, I'll do it
with you and you're like, oh, Alex, cute. And then
he's like, oh my god, girl, take your arm out.
You're it's gonna fall off. What is gonna happen? And
he like runs away screaming, which is hilarious because people
are literally walking him through the window laughing. Um. But
it's so interesting because you know, her foster parents are

(04:17):
really adamant that they're not abusing her. She's really adamant, like, hey,
I'm good, they're not um. And come to find out,
she has a genetic disorder called congenital and sensitivity to
paint with andy hedrosis, and so she has SIFA. That's
really the underlying cause we'll get into that with the experts.
But apart from you know, Megan and Alex's journey into peds,

(04:38):
we have Izzy who is still just shrouded in trauma
honestly from Danny's death. She can't walk into the doors
of Seattle Grace anymore right now. I mean she's still
barely able to wake up in the morning and to
like function as a human being. So the idea of
going back to work is literally, you know, kind of
stifling her and and really kind of she's struggling. So

(05:01):
and yeah, I did, I do love her, like beautiful
little short monologue she gets where she's like, you know,
every girl dreams of that wedding dress, and I have
to stop dreaming of that before I can go back.
But it's like, girl, maybe do it in your bedroom,
you know, don't just stand outside the hospital all day
for hours, literally hours? Girl? Are you cold? Are you hungry?
Do you need to the bathroom? Yeah? Are you good?
Like yeah, I just had so many questions. Uh. And

(05:23):
then of course elsewhere, which we're going to dive more into,
Meredith is finally just dating. She's dating Fen, she's dating Derek,
She's finally just dating, Like, shout out to you, girl,
because I feel like you skipped so many steps with
men um. And then we have Burke who is recovering
and Christina kind of is being a little bit of
a pain in his ass right now. Yeah, just a
little bit. She's being whiny. She's being a little whiny.

(05:46):
She's really thinking about herself and less about him in
his healing process um, which is interesting and interesting turn
for her. Uh. And then of course we have George,
who is incapable of communicating like an adult, and yeah,
who is a child the whole episode, the entire episodes.
So uh, you know, let me just say, obviously you
are a Grace connoisseur. You uh, you know, could teach

(06:08):
the master class on it. So when did you first
fall in love with it? Was it the pilot? Did
it take you a little bit, you know, kind of
why why are you here with Grace? It was love
at first sight? It was the pilot immediately, And I
remember watching the day at debut. It was like after
it was like when the show was on Sundays. It
was after I think the Super Bowl, some football game.

(06:29):
I don't know. I didn't care about that part I
was just like, huh, what is this show with doctors?
And it just got me immediately. It was like the music.
I loved that intro with the peace app song. It
was like so just cool to me as a high schooler,
and then it was sexy and funny, and the cast
had immediate chemistry to me, Like I just remember being like, oh,

(06:52):
these people know each other, like they really know how
to like do the funny one liners and just bounce
off each other, and it was exciting to watch them
all flirt and it pulled me in immediately. I saw
myself and Meredith Grey, um my best friend, like we
would argue over which one of us was Christina and
then eventually I was like, no, I'm Meredith, you're Christina,
like and I think that's true because I still watched

(07:13):
the show into the ninth season, just like Meredith, like
I would not give up on it, and all my
friends like gave up they stopped watching like when Christina
left or you know, when McDreamy dies, and I am
still here. I watched every single Thursday, like I don't
get behind on episodes even though like no, like everyone
from the original is gone now except for Bailey and

(07:35):
Webber and I still watch Oh my gosh, listen. I
will say the very first time I saw the pilot,
I loved it. I you bring up a good point
when it comes out to the cast chemistry. When it
comes down to that, I really need to find out
who did the casting, because honestly, they are so good,
Like it is like the best blend of of on

(07:58):
screen personalities, and so even the way the characters are
written and then the way that they are acted, I
think it just works so seamlessly and honestly, like the
first three seasons of Grays are some of the most iconic,
um you know, episodes of television that I have ever seen.
Now naturally, during COVID definitely struggle and also because every

(08:19):
single TV show pivoted to having a COVID storyline and
I was and they did not do great with their
COVID storyline. I mean, Meredith was in it, and it
was just like what are we doing? Like what are
we watching? Why are we just watching her on a beach?
Like what is all of this? It's so hard because

(08:42):
I mean I do think in order for the show
obviously to continue, like it needs to continue to reinvent
itself in new ways, and bringing in a fresh class
really is the only way to do it. I mean
because also o gs are tired, like the o g
s are like Leah. Honestly, at this point, I wouldn't
mind if like they flash forward somehow we see Meredith

(09:03):
and she's somehow invented I don't know, like a time
travel something s machine, and then instead of like bringing
in a new class, they just go back in time
and we see it from her mom going to the
whole school, and it's like it's still Grays And I
would rather go backwards and see her like having her
affair with Richard and all of that, than watch this

(09:24):
like newcast. I'm just saying Gray's Anatomy the prequel get
into it. Yeah, I'm like, actually that that doesn't sound bad,
like going back to like Ellis and just kind of
pouring Ellis's life, um and a young Richard and what
that toward affair did you know between her and past
the misogyny and racism they faced at the hospital, like

(09:44):
their intern class. I think it could be very like
Gray's Anatomy madman esque, and I probably like it more
than what we're getting with this new class. I'm not
mad at it. Okay, So in this episode, you know,
I want to start with Callie and O'Malley, and mostly
because not George went behind Callie's back to convince her

(10:07):
patient that's to have surgery instead of just talking directly
to her, Like I know that George has a lot
of issues. I mean, we see with George's family in particularly,
has a lot of issues with sticking up for himself.
He's just not very assertive. He doesn't really express himself
that well. We even see it in season two with
Meredith where he basically is just like following her look
a puppy instead of honestly just telling her how he feels. Um.

(10:29):
And so it's interesting because in this dynamic, Calli is
vastly more assertive in like every single way. But also
she has to be because she's an orthopedic surgeon in
a mostly like male dominated field. She has to learn
how very quickly, just even at work, how to assert herself.
So their balance is interesting when it comes to their relationship.
But in this particular episode, I'm like, now, George, you

(10:52):
are just dead wrong because she did ask you multiple
times and you're sure, yeah, sure, And now you're being
passive aggressive, and now you're interfering with my patients, So like, yeah,
it is a problem. It's like clear he doesn't trust her,
doesn't like her. It's this is when I started being like,
please just break up. Like what am I supposed to

(11:14):
root for in this relationship? So I was going to say,
you know, like, what did you think about their relationship
overall as a couple and not just in this episode,
because I actually never thought they should up dated. I
think that this was a huge mistake in terms of
writing same. That's how I feel about it, is that
they kind of just needed to give O'Malley something. They

(11:34):
didn't really know what to do with O'Malley and the
Meredith thing because she already had this other like love
triangle with two guys, which also, by the way, one
of my favorite openings ever is just that in this episode,
Meredith is like, wish I was having a three someone
with two dudes. It's absolutely great. But I think they
didn't know what to do with O'Malley, so they were like, oh,
just like mush him with this character, and it never

(11:56):
made sense to me, Like I was always just like,
why would Callie like this boring? Dude, like Kelly was
so much better. I didn't like that it made I
didn't like that it made Meredith and everyone be mean
to Kelly. Like everyone was so mean to Kelly, and
I didn't like that this relationship put that character in
that position. But you know what that's true. I mean, like,

(12:17):
first off, I didn't like how George was, Oh, Meredith,
you gotta kick her out. First off, George, this is
your girlfriend, and it's very girl for me to be like, hey, girl,
you gotta go. Why why don't you just have a
conversation with her and say, hey, I'm not really ready
to move in together. I thought this was going to
be temporary. It's expanding into a bit more. We need
to discuss, you know, where you'll be going and what

(12:40):
the timeline will be for that. Yeah, instead of throwing
it on Meredith, which the fact that you even think
it is appropriate to be like merriedith girl right, totally wrong.
So um, let's get back to Meredith in this dream
where she wanted to have this threesome, which, um, girl,

(13:01):
good for you. Listen. I love that Meredith is dating.
It's really refreshing to see. It was lovely to revisit
this episode, um, you know, just to remind myself that
I should be dating more and to go ahead, barrenth like,
live in spirit and in truth. Now. One thing I
will say is that we see that it becomes more
of like a pissing contest between Derek and Finn and
less about romancing her, which is you know why she

(13:23):
has that grand monologue. But um, she's right, it's hard
being an intern. Um you literally like the bottom of
the barrel. And at the end of the day, She's like,
if I'm choosing to get dressed and spend my time
with either of you, y'all better step it up. So
I'm like, listen, are you team McDreamy or you know,
are you looking for mcbett. I am teammid Dreamy all day,

(13:46):
every day, since day one till the end, even now,
like McDreamy one true love. That's why after he died,
they never let her day anyone hotter than Derek because
no one will ever compare with their like the moment,
the chemistry between those two from the pilot, it's just electric.
There's no one the way he looks at her. The

(14:09):
mc vet thing was such a distract, like such a
silly distraction. I think they were mostly like to play
it up in the magazines, like oh no, which one
was she picked? Because it was so clear, like make
Dreamy and Meredith were endgame perfect and they couldn't like
rush to get there, but like it was always make dreamy,
always make dreamy. And yeah, I mean listen the monologue

(14:32):
she does at the end. Rewatching this episode. It moved
me so much that as soon as it was over,
I changed all of my bios on every dating app
to meredith monologue at the end. All of them are
just like I want moonlight, I want candy, I want heat. Listen.
I'm not mad at it again. I told you, I
was very inspired, Like, yeah, maybe I will get back

(14:53):
on the apps because honestly, girl, good for you. Just
dating is fun. It is fun. It should be fun.
She was having fun until she was not having fun
and then had to give that big speech. But I
just find it so, you know, I am on the
side of I do believe that eventually Meredith and Derek
are in game. But I do think in the very beginning,

(15:15):
beyond the chemistry and beyond the looks that he gives,
Derek is actually a terrible partner to her like quite
literally awful, And a lot of that has to do
with the fact that he had not dealt with all
of his issues from Addison's. With Addison, Oh absolutely, he
has all these trust issues, a lot of baggage around
women outshining him. Uh women, you know, following their own dreams,

(15:38):
being a different you know, far away. When Meredith was like,
oh well, or when he was like, oh, I'm gonna
have to go and do this thing in d C
or whatever. Uh yeah, I mean yeah, you know, that's
why we get the famous Christina line, you know, like
he might be dreaming, but he's not the son you are,
whatever it is. You know. That I think is a
big lesson in the show that they have to kind

(15:59):
of deal with his insecurities. But I think that would
have been the case with any guy Meredith ended up with.
I mean, I think it needs to be the case
with any human being, Like we should all be doing
work to better ourselves. But it's glaring with Derek because
you know, I feel like a lot of fans do
romanticize their relationship from top to bottom, and for me

(16:19):
it was different. In the very beginning, I was like, oh,
he talks to her real crazy, Like I was like,
are you guys listening to the way that he communicates
with her, because it's not Yeah, like it is not good.
It's not and it's it's not healthy to like put
a girl in a position where she's like pick me,
choose me, love me like you're down bad if if

(16:40):
your guy has you doing that like you're that's not good.
But but also they had so much kind of stry
and it was odd. So it's like, it's truly you
just have to pick your level of chaos in this
show when it comes to relationships quite frankly, because there
are a lot of issues you know, with Danny and

(17:03):
Izzy a lot, but I adored them, But I adored
them in such a problematic relationship, but I wanted it
to work. It's probably worse than Meredith and Derek. I mean,
Derek eventually gets there, but you know, Danny dies, and
it's also like, oh, everything goes downhill. But I will
say the way he loves Izzy is very pure, and
the way he teaches her how to love life a

(17:26):
bit more like enjoy life, to truly live and to
truly love. He teaches her so many things throughout the
course of their wildly inappropriate relationship with in which you
would have been fired you know, well before he I
think and quote unquote quit, but really, girl, you was
gonna be fired that same day. So I don't know
if you quit, y, yeah you girl, you would have
been definitely. But here we are so like, okay, sure

(17:49):
you're not a surgeon anymore, when we were gonna let
you be so right right, like girl, pack it up,
it's okay, um. But we can see that, like he
has such a lasting impact on her, and we see
it in this episode, like we see how hard it
is for her to even be able to like function
in life without it. And so something I do like

(18:11):
is here you can kind of see the glimpse because
Alex said, you know, they had already had their kind
of like sexual will they won't they scenario happening, like
you know, Frank benefits occasionally, and when she fell in
love with Dinny, like it changed, Alex. You could visibly
see how it changed, because I don't think he was
expecting to really like her, Like I think he thought

(18:32):
he would be okay with them just being completely physical,
and then the way he shows up for her when
Dinny Dies is also like so incredible to watch because
he's watching the woman he likes to go through an
unimaginable heartbreak, but he's still trying to be there for her.
And so even in this episode, she's standing outside for

(18:53):
hours and he's like okay, like like come on girl,
Like he still checks in on her. And Alex such
a sweetie is even when he's like running away from
being one why yeah, he can't help it. He just cares.
Oh my gosh. It's that's so good to see. So
what is your favorite kind of relationship driven? Seeing this
episode specifically? I mean, I like I feel like I

(19:18):
have to go with that opening of just Meredith like
dreaming of this threesome because I always think it's so
interesting that she's like I want to be dated in
romance and all this, but it does seem like she
wants to kind of just slut around at this point
in her life. It's like, I don't know why she's
trying to rush into anything with Derek or anyone at
any point of like you know, just mereth have fun,

(19:38):
focus on your job, And so she has this dream
but then she's like, oh yeah, like you know, just
date me and let's see which one of you is
a gentleman who can make me feel like a lady.
It's like, girl, this morning you were dream about getting
double penetrated. Don't play around, girl, It's like girl, But
also truly, I need you to focus on your job

(19:59):
because things are falling always at work. Yeah, you're not
doing a great job, Girly, why are you here? Are
you here to work? Are you here to find a boot?
Because honestly, I'm not mad at either. I just need
for you to decide which when you're here for. Yeah, Like,
I don't even think Meredith was on a case this episode.
She just like got pulled into the brain thing when
Derek was like, oh, this is a way I can,

(20:21):
you know, manipulate her into being with me. But I
don't even think she was like a sign of patient. No,
she was literally just walking around. Girl, what like what
what are you busy with? And also, girl, this is
your training, so like you do to find something to
do fully and totally please um. And maybe she would
if the attend thinks has something to do, but apparently

(20:43):
they don't because look at Addison. So you know, here
comes Mark, which shout out to mixed team. You know,
he's always working up for his girl, always showing up
for a good time, not a long time. And Addison
is like, can you go home? And He's like, no,
not unless, if only if you come with me Addison,
I mean mixed Teamy is the hottest I Like, I

(21:06):
did always think Ms Steamy's hotier, the hotter than Mike Dreamy,
like obviously, but I actually always liked Addison and him together.
I always liked Mark and Addison together. Actually, you know what,
I think that they were better suited for each other, Like, yeah,
i'd that Derek. I don't know, I think that like
in certain instances. And I don't want to say this
in a wrong way, because I do believe that Addison

(21:27):
is a strong woman. But I think that Meredith challenged
him in ways that he had not been challenged before. Yeah,
and there are certain things that she could tell him
that only she could say it, do you know what
I mean? Like, Yeah, I think Addison and Derek at
that point had so much just baggage between each other
and hatred between each other that it was just kind
of clear it was never gonna work. Like they didn't

(21:48):
have that same chemistry anymore. It just was gone. So Mark,
much like Alex, is very misunderstood in the sense that like, yeah,
they like having sex, but at the end of the day,
they're also very kind people. Like when you really think
about it, you're like, dang, they're actually kind people and
they make mistakes, of course, I mean, we're all humans
who make mistakes, but they're kind people. And Mark really

(22:12):
loved Addison, Like it was not ideal naturally because she
is your best wife, best friend's wife, great, you know,
not stellar, But I do think that they found something
in each other that was unique for the both of them,
and so I think for that time in their lives,
he truly truly loved her. Um, but let's get into
your faiths, because you mentioned that Burke and Christina are

(22:33):
your favorite couple, which is wild to me because they
are definitely not mine. So let's get into it. Because
I adore Christina like I she is actually my favorite character.
I love Christina. Christina is my favorite character, and Burke
is just someone who like accepted her as she was.
I love that about them. I think my the moment

(22:54):
that got me for them was when he finally goes
over to her place and it's like a mess. And
she's just like this is who I am. Take it
or leave it. And I was like that's me. Wow,
Like yes, just I need someone who's like I take it,
that's who you are. So, you know, I loved that
aspect about them. But then you see like a shift
in Christina's character this season where she suddenly starts becoming

(23:17):
very about like her image and her image with Burke,
and it's like, we're Burke and Christina the amazing surgeons
and she has to be seen that way. And so
here when Burke is like not a surgeon, he can't
do it anymore and he wants to quit and all
this stuff, you know, that really shakes her and makes
her kind of act like an asshole here. I mean,
it's mostly like her identity is wrapped up and then

(23:38):
being the surgical power couple, and when he is injured,
she doesn't allow him the time or the space to
just be able to heal and feel whatever emotions he
has about it. She like is centering herself like, oh,
I'm sorry of getting caretager, and it's like, girl, if
you don't sit down, because honestly, this idea of seeing

(23:59):
him as superhuman when he really is just a man.
And honestly he just he just alright, girl, Like, girl, yeah,
he's okay. Like you know, I was like, just give
him some space right now. Maybe y'all could just take
a break for a few weeks while he does you know,
physical therapy. You don't need to be this intense about it, right.
And also I find that like to you know, he's

(24:21):
giving her the facts kind of like, oh, this is
how long it could potentially take for me to get
back to you know, where I am, And she's seeing
it as defeat. But I'm also kind of like she's
not allowing him, like to just have whatever feelings he
has on his own. She's projecting everything onto him. And
I'm like, girl, where is the grace? Like, just yeah,

(24:43):
give him space, give him grace, focus on you, Christina.
Oh And yet she's not. And yet she's taking this
into her her case. And yet she's talking to this
lady who is an actual caregiver for her husband for
years because he, you know, is having these seizures and
Jess newborn baby. Christina is like complaining about being complaining
about her get it. She's just like and you don't

(25:04):
even understand how hard it actually is. Where the caretaker
and she's complaining so much that this guy is like,
I'm about to drop a baby, and she doesn't understand.
I'm like, girl, she has a newborn and a husband
that she's a she is a two time caregiver, and yeah,
like Christina, clearly she's a little more nurturing than you
in the first place. If I were that woman, I

(25:24):
would have been like, now, ma'am, I need you to
just whatever issues you have, and I need you to
pass because we need to figure out what's wrong with
my husband instead of making this happen. Yeah, like, honey,
I see you're having your own issues, but this is
that don't don't put this on me. Okay, so is
this in this episode? Since they are your faiths, I mean,
who could you empathize more with? I mean, I I

(25:46):
was on Burke's team here, you know. I I understood
when Burke was like, you know, I don't know that
I wanna be back, and when he like is standing
there with Izzy and they have a moment, you know,
and everybody being like you're missed. I like Burke's intensity
as a surgeon in everything, but I did like that
they gave him this moment to be like, well who
is he without that? You know? So yeah, I was like, Christina,

(26:08):
come on, stop stop making it about you. Stop stopped
complaining to everybody, or be open to Burke about it,
or just give him the space he needs. And I
think that's why Burke doesn't feel comfortable telling Christina you
know what he intends to do. You know what. It's
interesting because in this episode, Burke really doesn't have friends
in this hospital, like truly. Yeah, so Christina has kind
of like it just so happens that their intern class

(26:32):
jelled really well because it's very easy to see how,
you know, people could be very isolated, but it's really
like it's glaring in this episode. I think because he
has to rely so much on Christina that he doesn't
really have anyone else, so she really is kind of
the only person that he has. And when O'Malley was

(26:52):
like oh you miss, I was like, is he though?
Because who? Right? It's really like by who, like whom
is him? Because I think he just kind of competes
with everybody, you know, So it's kinda I think his
his actions here are totally understandable. Yeah, I would have
to agree, and girl, Christina, you down bad. I need

(27:12):
you to sit down truly. So back to Izzy, what
do you think will take her? What it will take
to bring her back fully? Because I actually I have
to watch season three in a really long time, so
I don't really remember the details of how she I
don't really remember. I know in the previous episodes, like
Bailey is like, it's my fault, I wasn't there to

(27:34):
teach you, and she helps her with the whole cake thing,
and that's what makes a z be like, oh, I
can even go to the hospital. So it's not another
pep talk from Bailey because she already had that. So
I'm gonna guess at this point it's gonna be some
magical words from Dr Webber, Like it's it's gonna take
something like a Webber talk to get her to be
like you're right, I am ready, or something equivalent to that,

(27:59):
or the way they usually like to do it. I
can't remember if this happens, like they always do that
thing where when someone leaves the hospital, they'll be like
out somewhere or they like go to visit the hospital
and then someone has a medical emergency and they're like
forced to act and then they're like, oh, I guess
I can't walk away from medicine. So I can't remember

(28:21):
if that happens after this, but one of those two things, yes, absolutely,
Or maybe it's Alex, you know, giving an unexpected pep
talk because he can't be very kind and good with
pep talks when he wants to be. And maybe it's
like a gentle nudging from Alex and I could see,
like Alex his new thing with Pede's making her be

(28:41):
kind of be like, oh, wow, you found this new
thing in New passion. You know, maybe I can redirect
to maybe I feel like it is. These honestly most
defining character moments on this show are around Dinny because
even when she has to answer and she's having like
sex with the ghost, it's still about Danny. So you know,
I feel like in every capacity real those were kind
of some of her biggest defining moments. And then that thing, Yeah,

(29:03):
and then they just tornadoed her O'Malley and then they
tornado her character and it was kind of like, okay, okay,
but back to Alex. So you know, Alex has this
case and truthfully, he doesn't believe Megan at first, but
you know, we get there and and we finally figure
out what's going on between him, Dr Bailey and Addison,

(29:25):
they figure out what's going on with Megan. So I
just have to say when it comes to this case
of her, you know, having this high tolerance of pain
and then also internal bleeding, which like, girl, of course
you have internal bleeding, asking everyone who meets you. Yes,
She's like, hi, my name is is Addie? Punch me?
Like that's how she greets people. She's like, listen, she

(29:47):
was like, you know, I'm Megan. I had a hard life.
You can punch me. It's like, girl, what like called out?
Like she was like, you beat up a lot, And
come to find out, girl, you are not getting beat
up a lot. You are instigating this. Children. Children are
wildly hilarious what they want to be. And it's like, girl,

(30:07):
these are You're not making smart choices, Like what are
you doing? And then I do like that she thinks
she has you know, she's a superhero. I do like
that they like centered in a really kid childish way
of thinking where it's like, of course she's she thinks like,
oh I'm special, I have these superpowers. I do like
that they set it up that way. Well, I do

(30:27):
also love that O'Malley buys into it, right, Like I
love that he like knows the whole superhero origin story
and he's like, oh, well she's missing you know you,
she's not gonna want you to do surgery on her
because then what's not going to do to her powers?
So like, of course she's going to disappear like O'Mally
is basically like he has the same childlike wonder, which
I love, Like, I actually love that they connected that

(30:50):
as it makes sense. What I love more Alex repeating
it to her later, like Alex being like, oh I
hate you O'Malley, this is so annoying, and then later
being like, well Green Lantern is still a hero even
that his ring right, And it's like I was like, Alex,
you were listening. You're not an asshole, Like not, you listened,
And then it back to her and it was like yeah,

(31:13):
and you knew it's what she needed to hear, like
Alex preparing for fatherhood to children that he doesn't see
for decades. Yeah, So God, I hate that whole story.
Did we know this was asked someone who you know
is is not a medical professional but did you think

(31:33):
it was a realistic case for the show. Yeah, I
guess I'm sure this exists. I feel like I've seen
it on oprah Maori or one of those like Mari
or one of those you know, daytime shows. So I
feel like this is probably a real thing. And I
could see Alex being so concerned about child abuse that

(31:54):
that's what eventually like gets them to run all these
tests instead of just you know, giving her stitches and
send her on her way. Oh yeah, it feels realistic. Yes,
So it definitely does exist. It normally it's found in
in newborns, like they normally can diagnose it in newborns,
but because she's in foster care, it was probably overlooked. Yeah,

(32:16):
and so I'm like, okay, got it. So I mean
so it feels really and the Yeah, in the Gray's world, sure, right, right,
because they did not dive that deep into it, and
they didn't go terribly in depth, but they gave us
a little hint of it. Got to see a few
cases of her pain or her tale her pain being high.

(32:38):
I mean when she took out those staples with her teeth. Yeah,
I was like I believe her, like that would have
been enough for me. We don't need to get ice out,
Like yeah, she just pulled staples out of her arm
with her teeth like okay, I'm like okay. And she
just sat there and was like okay, what next And
it's like okay, well then yeah, I guess. I guess girl,
Yes you win. So I have to ask who's your

(32:59):
favorite character this episode? I'm gonna go with with her,
with Megan the little guy. I really I love that,
you know, like when they when they're all arguing and
then she just like runs away, and then Alex is
the one who's like, where's the little girl? And I'm like,
isn't that the first to like wheel her into the
room instead of just leaving her in the hallway, And

(33:20):
it's the way they were not watching her, and I
was like, yeah, she's still a little kid, Like she's
still a little kiddy. Guys like you should really be
paying attention, you know. So I would say she was
my favorite. And then I always love when they connect
like the overall message of the story with like one
of the patients, and here obviously it was like pain

(33:41):
is there for a reason, you know, it helps you grow,
and all of them are experiencing some kind of pain,
and so I like that. You know this, like Sassy
Little Girl is the one mirroring like the biggest kind
of theme of this The episode Grades is known for
their parallels and the reasons why I keep watching, And
I do have to say that my favorite care through
this episode definitely has to go to Alex. He's the

(34:02):
only one that has any sentences episode. I mean, at
the end of the George's being wildly irrational, so is Christina. Actually, yeah,
Meredith is trying to have fun but it's kind of working,
but it's not really. But also she's not doing any work. Yeah,
it's like, but Alex is doing work. He's being loving,
He's giving Izzy this pep talk about pain. He is,

(34:25):
you know, working it out with Megan trying to figure
out her issues, but also being kind to this little child.
I don't know. Alex just takes the m v P
of this episode award for me. Yeah, he also like
still has some fun. Like the episode when when Meredith
is on her little coffee day and Alex is like,
let's take bets, what's gonna happen, It's like he's doing
it all this up. He is. He is a renaissance

(34:47):
man of sorts. But thank you again. I really appreciate it.
Thank you. This was so much fun. I am thrilled
to be diving into seas in three, Episode three of
Grace Anatomy called Sometimes a Fantasy, which is a wildly
interesting title. UM with nutritional geneticist extraordinary and founder of

(35:11):
Color of Genes, Dr Karen on Jeniho. Hello, Hi, Hey,
kb Oh, my goodness. So I'm thrilled to have you listen.
Dr Karen's research background focuses on investigating the genetic architecture
of type two diabetes melitis and adults of African ancestry

(35:31):
in order to develop interventions to combat the disease at
the molecular level through genetic testing. And so, um, we're
gonna let her talk about this later on the episode,
where her company Color of Genes connects communities of color
historically known to be underserved in human genetic research, testing
and counseling with culturally conscious genetic services and evidence faith

(35:55):
health resources or improved health outcomes. So basically, we're closing
the gap on these health care disparities. That's yes. Um,
I am so excited because my first question for you
Dr Karen, tell the listeners just a little bit about
your life and how you got into genetics. You know,
so tell me why why genetics? Well? Thank you so much,

(36:18):
okaybe this is really a pleasure to be here with you,
and I'm really excited to get into episode three. UM
and So, I am a nutritional geneticist by training called
a PhD from Howard University and Nutritional Sciences and Human genetics. UM. So,
my background and research focuses on investigating excellent sequencing and
UM what's called genome wine association scans also known excuse

(36:41):
me as gass of single nucleo type POLYMORPHOSISMS or genetic variants.
The goal is really to study the genetic architecture of
type two diabetes alitis hereditary disease risks. And so, really
my interest in human genetics began before I even pursue
my PhD. I would say about a year before I
applied for Howard, around the time that my grandmother Caroline

(37:03):
passed away from type two diabetes complications. It was really
then that I was interested in discovering, you know, what
is this disease? Because I wanted to understand more about it.
And that's what eventually led me to pursue a pH
d UM where I could really investigate, you know, the
genetic underpinnings of the disease. In two thousand twenty one
is when I found a color of genes and the

(37:24):
goal really was to help underserved communities, especially communities of color,
who continually faced health inequities and human genetics research, diagnostic
testing and genetic counseling. And this all of course sometimes
happens due to pervasive factors such as race based medical practices,
which I'm happy to dive into a little bit later. Listen,
I am so sorry, you know, to hear about your grandmother,

(37:47):
but it is so interesting how, um, just this portion
of her life really transformed yours, you know, from from
the inside out and helped give your life purpose and meaning. Um.
So that is something you know, very positive to take
out of that for sure. So, UM, I'd like to

(38:07):
ask every guest because I have had people on here
who have never seen an episode of Grace, which um
is also wildly fascinating to me. So I like to ask,
what is your relationship, your personal relationship with Gray's anatomy?
You know, Um, have you seen this episode before? And
this is your second rewatch? You know, were you like
a huge fan, kind of watching with friends or family,

(38:29):
you know, what did that relationship look like? Absolutely? I
love Gray's anatomy. I started tuning in this is like
senior year in high school. Um, this was back in
the early two thousands, and so yeah, I did have
to rewatch this episode, but I do remember it vividly,
especially because of the young girl who's portrayed with this
genetic disorder and how she was essentially bullied in school

(38:50):
and had to sort of put on this grave face
even though she was, you know, undergoing a very serious
health condition. Um. And so I really really liked this episode.
I say, Grace and Enemy is I think one of
the most entertaining shows on television because it really is
what you're doing. It like ties entertainment and two important
issues through live experiences. And so in this case, talking

(39:13):
about SIPA and bringing attention to the importance of bird
diseases and hereditary disease risk um as well as the
importance of genetic testing really captivated me. And so definitely
episode three would be one of my favorites. Oh, I
love it. Okay, So let's get into the episode because
you know, there are a lot of highs, there are
a lot of lows. I mean, truthfully, Megan stories is

(39:33):
quite sad because she's been bounced around from you know,
home to home in the foster care system. She actually
really adores these parents that she has now. She said,
they're the best family that she's had. UM. But here
she is, you know, kind of coming in with this
unknown genetic condition, UM, a lot of internal bleeding. She's
going to have to have surgery, you know, things capping
kind of aggressively and very quickly. And of course her

(39:55):
foster parents are concerned not only about her health and
her well being, but be because of what it looks like.
Right Like Alex when he first meets her, thinks that
she's being abused by the parents. UM. I think a
lot of that is just his like traumatic past in
history kind of coming to the surface as well. UM.
So what are some of the best parts of this
episode for you? Give me the highlights? You know, who

(40:17):
had the best character moments, What was the most upsetting
or unsettling, and what did you find that you needed
more or less of when it comes you know, to
Megan's case specifically, even I really like how the episode
showed the lived experiences of patients. Oftentimes we don't get
to see that, especially in the case with young Megan. UM.
I think even just highlighting the disease that she was

(40:38):
carrying how rare it is. I also love the dynamics
of the medical staff, like you pointed out with Meredith
and sort of her being challenged with her relationships at work,
trying to find that work life balance, um. But more importantly,
Megan really captivated me. You know, this young, tough character, UM.
You know, I was putting on this brave face battling

(40:59):
yet a very very serious genetic disorder. UM. And I
you know, oftentimes, UM, we don't really know what those
experiences are in the healthcare setting from a patient, especially
when you're talking about a child in her case. So
I really do appreciate how the episode raised awareness about
her genetic disorder and not just being a genetic disorder,
but it being a rare disease. In fact, just a

(41:21):
couple of years I believe after or no before the
episode aired, was when the Human Genome Project was completed,
and that was really sort of the first step to
understand really truly genetic disorders and hereditary disease risk UM
and the episode. I think maybe if I could uh,
you know, extend the episode, maybe another hour, it would

(41:41):
have been really nice to see, you know, what happened
to young Megan after her surgery. At one point she
was she was scared, you know, she was trying to
put on this brave face, but eventually she planned to
the doctor that due to cost, she didn't want to
undertake any surgery. I think it was really her fear
UM and SPA. As we all know, unfortunately, in most

(42:03):
cases UM, those who have been diagnosed with this genetic disorder,
they don't survive beyond the age of so I would
love to see, like exactly how Megan evolves from being
a child into adulthood. Did she uh did she survive um?
You know, how was her how were her parents able
to handle sort of seeing her evolve with this very

(42:23):
serious disease. UM. Also, I think when you think about
rare disease, especially the research, I think that, especially in
this case with SIPA, more research is needed because right
now with SIPA and other rare diseases, we have very
limited information as far as like how does this disorder
impact other sub populations like minoritized populations. Um, not a

(42:46):
lot of research is out there. UM. And if not,
if we don't really address maybe some of the research
in rare disease U CIPA and beyond, this could lead
to miss opportunities, for example, in Megan being really um
being able to understand the genetic variation that she carries
raven and as I mentioned, in other populations where potentially

(43:07):
other populations are not studied as much. So Yeah, I
would have loved I think Aronessy exactly. You know what
happens to Megan. Does she survive? Um? You know, she
does she reach adulthood, you know, with her genetic diagnosis. Yeah,
it's interesting. You know, there's never enough time on Gray's
which makes sense. I mean, you know, they cut down
the show. They want to make sure that at the

(43:28):
heart of it, it's a relationship drama. UM. And so
the medical cases oftentimes are either wrapped up very quickly
um or it doesn't really feel finished, which makes sense.
I mean, you know, again, we just don't have that
type of time. But I agree it would be interesting
to have had a look back, maybe in seasons later, um,
you know, to maybe have Megan come back and see

(43:48):
what that looks like. And especially because I mean, you
know they're at season nineteen now, so um they have
her come back to see what was going on. So um,
when did you first come across or hear about congenital
insensitivity to pain and kind of elsewhere? Which I'm actually
more interested in, is it's what's the most intriguing genetic
disorder you've learned about or taken an interest in over

(44:12):
the years. Absolutely, so I've heard a SIPA before. I
think this episode really sort of brought it to light
and truly understanding the nature of the genetic disorder. And
I think when I started my doctoral studies back in seventeen,
learning more about hereditary disease risk did help open my
understanding of a little bit more about these types of

(44:32):
genetic disorders. Beyond SIPA, there are other inherited genetic disorders
that we can be diagnosed with. And um, in some
cases you don't feel the pain right um, in the
case with SIPA, or in some cases you may not
have a sense of smell. There is another congenital disease,

(44:52):
I believe, congenital aznamia, and that is a condition in
which beginning at birth, you lose your sense of smell.
Of course, that could be hazardous, right if you're living
in an environment where you are exposed to toxins that
could potentially create health burdens, some leading to morbidity, co

(45:13):
morbidity or mortality. Uh. And so this episode kind of
really helped give thinking even greater understanding about genetic disorders,
especially in a child, because oftentimes a lot of our research,
as we know, is focused on a certain population, usually
those under eighteen and those over sixty five are considered
underrepresented when we talk about age disparities, and so that's

(45:37):
something that I thought was really intriguing. I think overall,
as far as what I find to be one of
the most intriguing genetic disorders that I've learned about or
even have taken interest in over the last few years,
I would say is genetic variants that are linked to
type two diabetes. Militis right, Melidas. Type two diabetes is
um Unfortunately, UM more prevalent among communities of color. For example,

(45:59):
um At Americans are nearly twice as likely to be
diagnosed with type two diabetes, and we know that that
leads to morbidity comorbidity and unfortunately, in some cases mortality.
And so one of the most significant genes that have
been linked to type two diabetes is called transcription factors
seven like two or TCF seven L two UM. That gene,

(46:23):
although there's been tons of research done on it, has
been understudied in populations of color UM, namely persons of
African ancestry. Uh. And of course, when we don't understand
the genetic underpinnings or genetic architecture of a disease, then
we truly are missing out on advances and science. We
have limited understanding on pathogenesis or pathophysiology, and unfortunately we're

(46:45):
not creating a diverse pool of genetic variation that scientists
can use for scientific discovery. And so that gene I've
taken a great interest in learning more about UM. This gene,
by the way, is involved with regulating the expression of
genes that are involved in lipid and glu close metabolism,
you know. But unfortunately, due to under representation of minority populations,

(47:08):
namely persons of African ancestry and glass which we mentioned earlier,
this gene is understudied UM and primarily is understood in
persons of European ancestry. In fact, my doctoral research involved
investigating this gene were I found novel variants among communities
of color, those subpopulations in the US, Nigeria, South Africa, Ghana, Kenya,

(47:36):
and Uganda where the where these novel variants were found
to be common among these racial and ethnic minoritized populations
to provide really richly diverse human genetic understanding to hopefully
further population health studies. UM and so yeah, I would
definitely say, uh that gene a t c F seven

(47:59):
eld too has been uh and still is one of
the most intriguing aspects of my research career and really
still trying to understand and learn more about how prevalent
this this gene and its variants are among understanding populations. Yeah,
and I love that it's coming back, you know, kind
of full circle to that familial aspect for you and

(48:20):
doing all the research and that it's still at the
top of mind how you can learn more about this
in order to improve um, the communities that are just
you know, um suffering with type T diabetes the most.
So UM, I love that. So let's get into CIPA. So,
according to the National Center for Advancing Translational Sciences. There

(48:43):
are less than a thousand cases of SIPA in the US,
so it's interesting that they chose to really highlight this
condition and feature it on the show. So I found
an article from Tehran University, the Department of Pediatrics, and
it in off just looking at four cases of sipa. UM. SIPA,
I should note, is often characterized by its self mutilating behaviors,

(49:07):
which in her instance, you know, she's pulling out the
staples out of her arm with her teeth. Um, she's
allowing people to kind of punch her repeatedly. In fact,
that is she is truly a child because the whole
episode she's just saying, punch me, just try it. Punch me.
It's like, okay, stop asking people, um, Megan. But it
also is you know, um, something that happens are recurrent infections,

(49:30):
fever and more. And so the subjects featured in this
case are between ages seven and thirteen. So I'm curious
to hear just a little bit more about um kind
of what you found in terms of, you know, this
genetic disorder, how many people it impacts, and if you
thought that this was a realistic kind of depiction of

(49:54):
disorder of this disorder based on your research. Yes, for sure,
you know SIPA is a very aerious inherited genetic disorder.
Because of its rarity, it's really not understood or well
understood or in some cases, those who may be carriers
of genes are associated with the genetic disorder are truly
unaware that they are in danger UM in Megan's case

(50:18):
until they've been diagnosed genetically. And so it is an
inherited genetic disorder, which means that it's it's passed down
from from both parents who actually don't show symptoms, and
that's why genetic testing is imperative UM and and truly
it happens in terms of diagnosis when one or more
genes aren't working working properly and most of the time.

(50:39):
In order to actually learn how to treat UH this
genetic disorder, it comes from educational education and nature right.
Patients for example, have to learn how to avoid getting
injured UM as a Megan's case, she was self mutilating
herself UM and so some of the other educational treatment
options would be you know, at various moments for payations

(51:00):
to assess themselves after an injury you know, checking to
see if they have any injuries and then seeking treatment
immediately should they occur. Um. So, because SIPA is an
extremely dangerous genetic disorder I mentioned earlier, most patients, according
to the scientific literature, do not, unfortunately, live past the
age of five. And that's another reason why I think

(51:21):
more funding in the space is needed to really build
a robust evidence space to truly understand to understand this
disease and even better treatment options. Yeah, you're right, because honestly,
there could be a number of things happening. I mean,
most disease bases have like very very similar um factors
that engage them. So you know, when you're saying we're

(51:42):
you're having recurrent infections, that could be a whole host
of other things, do you know what I mean? Like
it's not necessarily directed at SIBA. Would you have you know,
a host of infections or you have a fever? I
mean literally, a fever is almost the baseline for so
many different disorders and diseases, so that wouldn't necessarily on
the baseline. And depending on the age group, self mutilation

(52:04):
might not be either. Um you know, that could be
a whole host of things. So you're right. I think,
you know, like genetic testing, particularly in infancy, particularly with SIPA.
And of course we know she didn't get it because
she was adopted. UM, it made it seem like she
entered the excuse me, not adopted, she entered the foster
care system at birth. We don't know much about her

(52:26):
birth parents and and so you know, it's interesting because
they did not perform a genetic test, you know, prior
to her coming in with these um specific set of
symptoms and then doing some additional scans. So before we
get out of here, you know, real quick, I just
want you to dive into you know, your heart and soul,
your passion, color of genes UM. Tell the listeners, you know,

(52:49):
kind of where they can read more about color of
genes and how they can support absolutely. First, I wanted
to say an amazing time with you, Kaby. This was really,
really awesome, and I commend you on all the work
they you're doing as well to highlight these very important
issues in a very fun way. So thank you so
much for having me as a guest. And with regard
to color of genes um really truly UM, something I'm

(53:10):
incredibly passionate about because Our goal is to put the
health needs of individuals as well as their families first,
and we do that through providing the highest quality of
health education, access to evidence based health resources, including culturally
conscious genetic services and products, and genetic professionals in three domains,

(53:30):
and those include human genetics, health promotion, and disease prevention. So,
like Alex, I'm incredibly passionate about helping patients, especially underrepresented patients. UH.
And if you want it to learn more, especially UM
your wonderful listeners out there, feel free to visit www
dot Color of Genes dot com and I'd be happy

(53:52):
to engage and or provide access to some of those
resources that we have. But again, thank you so much
for having me. This has been a really, really awesome dialogue.
Oh my goodness, I'm so excited for everyone to just
be able to read up on all of the work
that you are currently doing and will continue to do
on Color of Genes. UM, just your passion, your heart
for you know, serving the undersherved communities and providing a

(54:16):
way for all of us to lead and live healthier
lives and and and live longer and use genetics to
our advantage in order to do so and to to
help in that way. It's just so beautiful to see.
So thank you for all of the work that you
do and continue to do, And thank you so much
for taking time out of your schedule to be on

(54:37):
this show to dive into SIBA in this way and
to be able to shine a light on this, but
not only this type two diabetes, melitis and you know,
more genetic disorders, like I think we do need to
start having more open dialogues about it. And honestly, that's
why I created this show, just a safe space and
a fund space to be able to dive into you know,

(54:58):
some very interesting cases is that are happening UM to us.
And and I love talking to problem solvers UM and
people who are doing the work on the ground, and
you are one of them. So just thank you so much.
It's been a pleasure. I appreciate this opportunity and I
look forward to seeing what I know will be a
really really successful path that you are forging ahead. And

(55:20):
so thank you, thank you, thank you. Well, that's it
for this episode of On Call with Kape. Join us
each and every Thursday for brand new episodes where I
chat with an expert and a super fan about the
science behind the scenes. Until then, listen to on Call

(55:42):
with KP on the I Heart Radio app, Apple Podcasts,
or wherever you get your podcasts.
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Kay - B

Kay - B

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Stuff You Should Know

Stuff You Should Know

If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.

The Breakfast Club

The Breakfast Club

The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy And Charlamagne Tha God!

Music, radio and podcasts, all free. Listen online or download the iHeart App.

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