August 15, 2022

News and Update

Studying to Stay After Loss – Chasing Life with Dr. Sanjay Gupta

To start with it felt like whole fog.

Dr. Sanjay Gupta


You by no means actually know what grief will really feel like till it hits you. And even then, it’s completely different for each one in all us. Sundari Malcolm’s mother handed away in 2007, and within the months that adopted, her life fell aside.

You already know, proper after she died, I laid on the sofa and watched the Meals Community and drank plenty of wine and didn’t do a complete lot of a lot. I used to be actually type of frozen in my grief at that time. I keep in mind I’d get up and I don’t even know how you can clarify this, however it’s like for a break up second, you don’t keep in mind it’s occurred. And there’s this like break up second of like, Oh, it’s one other day. After which it’s like a truck hits you.

Dr. Sanjay Gupta


For seven years, Sundari had been taking good care of her mother, who had breast most cancers, and despite the fact that she knew her mom was dying, nothing braced her for what got here after.

I wasn’t ready for the grief. I wasn’t ready about what number of completely different locations grief would contact. Like one thing like a telephone, one thing like a music or a odor, a vacation, seeing different household. Like I didn’t know the way a lot it was going to shift. I don’t know that there’s a option to put together for that.

Dr. Sanjay Gupta


After the preliminary fog and numbness, she felt plenty of anger after which disappointment. Finally, issues obtained so insufferable, Sundari determined to flee.

For me, it turned a holy shit. I obtained to get out of right here. This isn’t working for me. Like I felt actually stifled in my grief.

Dr. Sanjay Gupta


She jumped on a airplane and simply spent the subsequent few months touring.

I had seen Eat Pray Love. I used to be a nineties child. So Julia Roberts is my like. I used to be, like an enormous fan.

Eat Pray Love Trailer


You need to go away for a yr? I used to have this urge for food for my life, and it’s simply gone. I need to go someplace the place I can marvel at one thing.

I really like that it was this concept that I might hit the street and have these actually deep, significant experiences in solitude. There was such a freedom and being on the street like nobody knew my story. Proper? Like I might meet folks they didn’t know. My mom had simply died. So it wasn’t the very first thing they have been asking me. It was simply, The place are you from? I might say no matter I wished. I didn’t should convey it up, you recognize, and that felt good. And there’s a distinction between attaching to the trauma of a narrative and permitting a narrative to maneuver you ahead. And I feel the attachment to it was launched once I was capable of get out of my setting.

Dr. Sanjay Gupta


She went to India, Italy after which Guatemala. And alongside the way in which, Sundari regained her pleasure for the world round her. The journey impressed her to channel her ache into a brand new profession. She’s now a grief doula, a educated, non-medical skilled whose job is to supply emotional and social help by means of bereavement. She’s additionally director of Bipoc Wellbeing for the Dinner Get together. That’s a nonprofit that helps younger individuals who have suffered important loss.

I work with folks holistically, that means we discuss issues like, What are you consuming? What are you consuming? What are you watching? Who’re you surrounding your self with? However we additionally discuss how are you feeling on this second? We speak concerning the completely different triggers. We discuss how you can construct your calendar yr so that you simply perceive what it’s going to be like round Christmas and Thanksgiving. We discuss conversations and how you can have them with your loved ones, how you can handle issues with your mates, how you can transfer ahead in life. And I feel that turns into my essential focus is how can we make you’re feeling good regardless of? How can we inject pleasure? How can we handle your daily? In order that’s grief doula work.

Dr. Sanjay Gupta


It has now been 15 years since her mother died. There are nonetheless moments when grief hits or seemingly out of nowhere, however she has realized to take it because it comes.

You look again at issues like that, it was like, I can say the identify now, I can… And so I feel for everybody, I all the time liken it to the ocean prefer it’s waves and it’s simply out and in. And similar to each wave is completely different than the one earlier than. Like, your grief wave goes to maintain altering and it’s important to preserve assembly it and studying it and determining how you can trip it.

Dr. Sanjay Gupta


Dying is common. Everyone knows that. However in the previous couple of years, greater than 6 million folks world wide have died from COVID. To not point out those that die throughout wars of gun violence and of pure causes. It looks like all of us are grieving indirectly. However what does that imply? And the place can we go from right here? Nicely, on this episode, we’re going to embrace grief in all its ugliness and messiness, however we’re additionally going to study the instruments to assist ourselves and others going by means of grief. We’re going to try a brand new medical analysis. It’s referred to as extended grief dysfunction. And for individuals who stick round, we’re gonna have a bit shock for you on the finish. I’m Dr. Sanjay Gupta, CNN’s chief medical correspondent. Seize your tissues. Take a deep breath. It’s time to begin chasing life.

Wendy Lichtenthal


My story just isn’t an authentic one by any means. So I had an early loss. My dad died once I was about 13, happening 14. And so for me, the the ache of the grief, the struggling by means of it, and this drive to type of determine what am I going to do with my life coincided. And so it was about how can I assist folks with this? This stinks.

Dr. Sanjay Gupta


That’s Wendy Lichtenthal. She’s a psychologist and he or she’s director of the Bereavement Clinic at Memorial Sloan Kettering Most cancers Heart in New York Metropolis. Like Sundari Malcolm, she has devoted her life to serving to others handle their grief.

Wendy Lichtenthal


All the things is motion. I say to folks. It’s all ahead motion. It’s all a part of your course of and a part of your course of for all these causes that you simply couldn’t go to that place of grief three months in the past and now it’s actually developing. That is sensible. I perceive why it’s developing extra now. Let’s attend to it now.

Dr. Sanjay Gupta


Since we’re born or since we are able to kind of perceive life as people, we do know that we are going to die someday and that the folks round us will die. I imply, that may be a a certainty, not less than it’s for now. And I feel it kind of raises this query, Wendy, from an evolutionary perspective, why can we grieve? What’s the function of grief?

Wendy Lichtenthal


So I feel the body that we we have a look at this with is what the aim of relationships and attachments are and the evolutionary advantage of the way in which we connect proper that it promotes survival for folks to guard their younger and for the younger to yearn for union with the protection of their mother or father. Proper. In order that attachment preserves life. You already know, considering of an toddler, a toddler with their main caregiver and considering of that second of separation, I consider when the grownup walks out of the room and you’ll think about, conjure up in your thoughts this baby wailing. You possibly can see all of the feelings that plenty of us really feel after we’re grieving. Rage, like, don’t you permit me. And utter terror. Please, please, please don’t depart me. And that’s that separation misery response. The kid is craving for reunion. And so after we are grieving and as we become older and are observing our personal grief and saying, what the heck am I experiencing right here? That’s as a result of it it’s this stomach stage response to separation. We’re wired to protest it.

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Dr. Sanjay Gupta


If we simply speak concerning the right here and now for for a second, as a result of that’s very visible, what you described, you recognize, with a toddler after which kind of making an attempt to think about that that lack of attachment, whilst somebody will get older, is it harmful to our our bodies and our brains? I imply, that that stage of loss, can we expertise one thing that’s damaging in any option to our our bodies and brains?

Wendy Lichtenthal


It’s a controversial query you’re asking as a result of, you recognize, you and I each know there’s plenty of analysis about stress responses and what they do, the toll they tackle on the physique. However I don’t suppose that’s a useful body. Proper, as a result of then we begin worrying about being upset and begin fascinated about I’m nonetheless grieving. Is there one thing fallacious? Am I hurting myself? And and I don’t need to promote these concepts. So a special option to maybe take into consideration what is occurring is to grasp that stress response and it’s pure to really feel dysregulated physiologically that’s widespread and comprehensible and that we are able to take into consideration methods to handle these completely different experiences. I need to use the phrase signs right here, however you recognize, I need to additionally watch out to not pathologize what’s the expertise, the phenomenon of grieving.

Dr. Sanjay Gupta


You already know, I feel many people who find themselves listening, I’m positive you could have learn the Kubler-Ross kind of 5 levels of grief. And, you recognize, it’s attention-grabbing. I all the time I learn the e book and there have been instances once I felt like, wow, that actually appears to slot in this explicit situation. And there’s different instances when folks didn’t appear to undergo the levels or they didn’t undergo the levels so as or they didn’t undergo the levels in any respect. What what’s the present analysis say about this? Is there’s there a method of kind of fascinated about these levels of grief and the development of it?

Wendy Lichtenthal


It’s, once more, a harmful line to go down as a result of it could find yourself feeling prefer it’s prescriptive to say that on common, we see, you recognize, folks have these completely different phases that they undergo. The way in which that we give it some thought is that individuals can undergo intervals of time the place some emotional state is extra dominant than others. However that may come and go. These states can overlap and that there isn’t any common order or method that individuals grieve. And so we wish a street map. We need to know that there’s, you recognize, an order to this. Can somebody inform me the way in which that is going to look? Providing that, although, when it doesn’t like that, then leaves folks within the shoulds. I must be going by means of this stage proper now. I must be on this house. And the place I feel we see among the greatest struggles for folks is once they’re should-ing themselves round their grief, once they’re self assessing and saying, I must be feeling higher by now, I ought to be capable of do that. I shouldn’t be laughing proper now. I shouldn’t be having fun with myself. This feels fallacious. So when we’ve these well-liked concepts, just like the 5 levels of grief, we additionally need to debunk the parable that there’s this set path and that everyone grieves in some prescribed order. It’s simply not the case.

Dr. Sanjay Gupta


The thought of somebody dying in a method that appears mindless, you recognize, a tragedy that simply appears mindless versus as I suppose, you recognize, a extra anticipated after an sickness, for instance, loss of life. How a lot of a distinction does that make within the within the longer run?

Wendy Lichtenthal


You already know, it’s about the way it is sensible to the person. So I once more, I work in in a most cancers heart. I work with individuals who typically lose folks after most cancers. However how they expertise that sickness and what their ideas have been, their expectations, how they thought this was going to go, performs a distinction. So it may not be sudden to the medical staff, however it is perhaps utterly surprising to the surviving griever. So I feel that’s simply an vital factor to bear in mind. That stated, the circumstances do play a task, how ready somebody feels for the loss, whether or not, you recognize, there have been traumatic parts of of the loss expertise and somebody is having a traumatic stress response. Proper. They’re traumatized. They’re re-experiencing what occurred, whether or not as a result of they witnessed it or imagining it. So circumstances completely play a task. However these circumstances, we’ve to grasp it’s based mostly on the notion of the griever.

Dr. Sanjay Gupta


You already know, I’ve to let you know a fast, fast story. You already know, once I was in faculty, a really shut buddy of mine, this girl, she was killed in a automobile accident. It was very it was very unhappy, very tragic. A number of years later, she had this she had this love of birds. So her you recognize, we had all gotten collectively and primarily created this fowl sanctuary in her reminiscence. And all of us went there to to mainly open up this sanctuary. And her mother and father have been there and her sisters. And it struck me on the time, Wendy, and that is, I don’t know, just a few years after she had she had died that her her mother actually had by no means gotten over this, so to talk. I’m not even positive if that’s the best option to body it, however however she simply she was so so it was so painful for her. It was so uncooked for her. And it simply made me marvel, now that I’m a mother or father myself, does grief finish? Does it ever finish? Will we count on folks to, quote unquote, recover from a loss like that?

Wendy Lichtenthal


Completely not. Proper. In order that’s so vital to to to get that message out that there isn’t any expectation that grief ends as a result of then it’s concerning the relationship. It’s concerning the love, the attachment, the connection, and that we don’t count on that to ever finish that particular person matter. Their influence in your life mattered. And sure, after all, the influence of that loss is endlessly. A distinct method to consider it’s to consider how you will discover your method and study to coexist along with your grief. How do I coexist with my grief? How do I create a life that feels value it sufficient and has sufficient of the elements that matter to me and that enables me to remain linked to this particular person? How do I proceed to maintain that relationship as mattering in my world? Coexist with the ache because it comes within the ways in which it comes and discover different parts of the world that make make it value sticking round for. I imply, you recognize, that is about chasing life, proper? That is about determining how do you join with life once more. When an individual in your world who was life defining, who made life value dwelling isn’t bodily right here anymore. And that’s that’s the psychological job we’re up towards.

Dr. Sanjay Gupta


Once we expertise loss, our lives modified endlessly. So how can we determine how you can reside on this new actuality? And what occurs when you’ll be able to’t discover a method out of your grief? Docs now have a reputation for that. It’s referred to as Extended Grief Dysfunction.

It was similar to a eureka second. There was a light-weight on and it’s like, wow, this can be a circumstances. I’m not loopy. And there are folks like me and other people undergo this.

Dr. Sanjay Gupta


And now again to chasing life. Grief doesn’t finish. We’re all the time going to overlook our particular person. However, with time for most individuals, issues do get simpler. However the passage of time might not all the time be sufficient. Generally grief will be so overwhelming it stops some folks from functioning. They get caught on this perpetual loop, experiencing the identical depth of craving and loss as they did once they first realized of the loss of life. It’s the worst type of Groundhog Day.

Wendy Lichtenthal


And consists of profound disabling ranges of craving, intense craving, and it consists of preoccupation, however intense and disabling ranges of preoccupation. After which the opposite signs that could possibly be thought-about embrace continued numbness, continued avoidance of reminders, loneliness, id challenges, not feeling like you recognize who you might be. Not not the identical as I really feel a bit loss. I don’t actually really feel like myself. However somebody is saying I don’t know who I’m anymore.

Dr. Sanjay Gupta


That’s Wendy Lichtenthal once more. A part of her analysis includes serving to individuals who have debilitating grief that persists over lengthy intervals of time.

Wendy Lichtenthal


We’re speaking concerning the individuals who say, I don’t know why I’m right here. Life doesn’t appear value it with out this particular person bodily right here.

Dr. Sanjay Gupta


Within the midst of the pandemic, alot of individuals might not know this, however however extended grief dysfunction was formally added as a as a brand new analysis to what’s referred to as the the DSM, the Diagnostic and Statistical Handbook. That is kind of an inventory of psychological problems for psychological well being professionals. Now, for lots of people, this was new, however not for you. I imply, that is your space of research {and professional} work. Was this the best factor to to to confer with this now as a dysfunction? Given all that we’ve talked about. And if that’s the case, why? Why now? Why now make it official?

Wendy Lichtenthal


So I feel there are just a few layers of points on this. Proper. One is concerning the wording. Proper. So dysfunction is a really loaded time period and it’s loaded due to stigma of psychological well being. It’s loaded as a result of it has implications for well being disparities. It’s loaded in so many ways in which we need to be actually, actually cautious about. After which the extended a part of that identify can also be a bit difficult as a result of it has an implication of time. And we simply obtained completed speaking about the truth that grief doesn’t finish. And within the DSM, it’s 12 months. That may be the period the place we might look to see if a analysis is perhaps warranted. That somebody saying are you saying if I’m grieving after 12 months, I’ve a dysfunction? Proper. In order that’s problematic. However that’s not the intention of the analysis. The thought with the analysis and what we’ve understood with ages of analysis and the timing of it’s simply because it will definitely simply occurred. It’s been many years of type of working towards discovering a spot for the subset of people who proceed to be debilitated by their grief. And I feel quite than considering of it as extended grief, you recognize, possibly we might consider it as protracted debilitation after dropping somebody.

Dr. Sanjay Gupta


You’ve stated that there’s a subset of individuals. How widespread or I imply, how massive do we expect that subset is?

Wendy Lichtenthal


So estimates utilizing these definitions are 7 to 10% of the inhabitants at giant total. The chance components embrace how we connect generally people whose historical past of attachments have been much less safe. These people could also be at higher danger people who had a extremely dependent relationship on the particular person they misplaced. It would indicate emotional dependance. It is perhaps sensible dependance. Individuals who have a historical past of different psychological well being challenges could also be at higher danger. We all know that people who find themselves remoted might put somebody at higher danger as nicely.

Dr. Sanjay Gupta


So what does it really feel prefer to have this kind of grief overtake your life?

The extended grief is you’re on the prepare, you arrive on the platform, you’re able to go, and then you definitely’re derailed. So that you’re simply caught. And also you simply want somebody to get you again on the tracks and enable you go in your method once more. Since you simply all and also you simply can not see any which method of getting by means of it.

Dr. Sanjay Gupta


That’s Fiona Jones, a girl who was recognized with extended grief dysfunction. It began in 2008. Fiona was on a trip when her father unexpectedly died in his sleep.

He was 71. He was match and wholesome, as you recognize. There was no. So it was very, very surprising. The entire world simply stopped. And I simply keep in mind we have been going again to the resort. And I can simply keep in mind wanting round, seeing everybody speaking, laughing. I used to be considering, why is the world simply carrying on? You already know, my dad’s gone.

Dr. Sanjay Gupta


11 years handed. And that stage of grief that Fiona felt when she first heard about her father’s loss of life didn’t subside.

I all the time cried on daily basis. There wasn’t a day that I didn’t cry and I cry for a very long time. And I obtained to a stage the place we’d sit on the dinner desk and I simply actually didn’t need to eat, however everybody was watching me and which is horrible as a result of clearly they’re my youngsters they usually’re nonetheless younger. And I used to kind of say, Oh, I’ve simply had lunch or I’ve eaten later and I used to make excuses as a result of I simply didn’t need to eat. My physique and my thoughts have been simply utterly loopy. And that was my existence. I, I couldn’t wait to go to mattress. I’d be in mattress throughout the day. I simply couldn’t wait to fall asleep. And once I’m sleeping, I’m not being upset. I’m not considering. That was my heaven. I used to go to mattress within the early days simply considering if I die, I actually, I actually don’t care. However then I feel I don’t need to die as a result of clearly I’ve obtained my kids, I should be right here for my kids. So it was a extremely powerful factor. Whereas earlier than my dad had died, I was fearful of dying, however then I simply thought, No, it’d simply be consolation. I’ll simply have peace.

Dr. Sanjay Gupta


Via the years, Fiona noticed two completely different therapists, however nothing appeared to assist. Then someday in 2019, she stumbled throughout a web site for the Heart for Extended Grief at Columbia College.

And it was similar to a eureka second. There was a light-weight on and it’s like, Wow, this can be a circumstances. I’m not loopy. And there are folks like me and other people undergo this.

Dr. Sanjay Gupta


With assist from the middle. Fiona discovered a therapist educated particularly to assist folks with extended grief. They met as soon as per week for 16 weeks.

She’d give me duties to do throughout the week and he or she’d do recordings. I imply she used to file me rather a lot. And I used to have to talk within the current tense concerning the second I heard about how my dad had died. After which for that week, I used to should take heed to it as soon as a day. You already know, initially it used to kill me as a result of all I might hear was myself crying the entire time. And it used to make me cry. And I used to dread listening to it. However in time, listening to it turned a bit simpler.

And so then my diary turned extra reasonable. My numbers can be possibly 4 or 5. After which I’d discover that, you recognize, we take my canine for a stroll and for that break up second or the half an hour we have been strolling, truly, my second was possibly two or three. And in order that made me notice that once I stated I’d been depressing for 11 years, I had had moments of good instances, like when my youngsters had their graduations, after we went on vacation. That possibly I hadn’t seen it because it truly was. I simply assumed it was depressing, depressing, depressing. And clearly it wasn’t. I did have moments of fine instances and glad instances.

Dr. Sanjay Gupta


Steadily, Fiona’s life began to really feel regular once more. She’s now thought-about recovered from extended grief dysfunction.

It took some time. It didn’t occur in a single day. And likewise, I kind of didn’t actually know who I used to be, actually. I’d misplaced myself. And I nonetheless say I’m nonetheless on that journey. As the times go on, I’ve extra higher days than unhealthy days and my unhealthy days are very, only a few now.

Dr. Sanjay Gupta


Fiona has a message for individuals who is perhaps experiencing one thing related.

You already know, we’ve such brief lives, we don’t should be so depressing for thus lengthy. And if we are able to keep away from it or we are able to get assist, then completely 100% go for it.

Dr. Sanjay Gupta


Grief is difficult. It’s painful and it’s messy for all of us. And there’s nothing we are able to do to alter that. However there are some instruments that may be useful as we study to maneuver ahead. So I requested Wendy Lichtenthal if she had any tricks to share. Tip primary. For many who are grieving. Don’t be onerous on your self. Give your self permission to really feel all the sentiments. It’s okay.

Wendy Lichtenthal


Simply saying like that is my course of. That is a part of how I’m dealing with it. Giving your self that that grace and allowance is vital.

Dr. Sanjay Gupta


Tip quantity two. Be open about the way you’re feeling.

Wendy Lichtenthal


Discovering shops, discovering methods to discuss your loss or to be with it’s important for many individuals, whether or not it’s by means of an individual or by means of journaling or by means of simply your personal dialog, to simply be along with your grief. Giving your self that permission to grieve is basically, actually key.

Dr. Sanjay Gupta


Tip quantity three. For many who need to help a griever, there are alternative ways you are able to do so. And if you happen to’re undecided how, ask them.

Wendy Lichtenthal


Would you like me that will help you resolve some issues proper now? Or would it not be higher for me to simply type of sit right here and hear and give you help and present you I hear you proper now? Generally we do want somebody to resolve an issue, and generally we simply have to say it and have somebody say, I’m so sorry. That stinks.

Dr. Sanjay Gupta


Tip quantity 4. Don’t attempt to keep away from the subject as a result of it feels uncomfortable.

Wendy Lichtenthal


Give house to speak about the one who has died. Ask them about them. Speak about them. Or if you recognize them, your personal recollections of them, or the way in which that you simply consider them. Sharing that and bringing their presence once more. Presence is the antidote to a way of absence, proper? So we need to convey of their presence.

Dr. Sanjay Gupta


And tip quantity 5. Generally it’s sufficient simply to be there as somebody is grieving.

Wendy Lichtenthal


Don’t reduce what it’s to be there, be current and to be in an area the place you’re somebody who’s tolerating their ache, the place they’ll freely categorical it as a result of they know you’re not going wherever. You’re not going to be like, Oh, this particular person’s annoying, so I’m going to not name them once more. You’re somebody who’s unconditionally there. So after we will be that that unconditional presence and make it okay for somebody to simply be unhappy and simply maintain an area for that.

Dr. Sanjay Gupta


Look, I do know this episode has been fairly heavy, so I do need to depart you with a bit one thing uplifting. Generally it helps to take a second and simply breathe. Keep in mind the grief doula, Sundari Malcom, from earlier within the episode? Nicely, I requested her to steer you thru a brief meditation, the identical method she would with their shoppers.

So let’s start. Your eyes will be closed if that’s what’s snug for you. Or you’ll be able to merely discover a house in your room to stare upon. And soften your gaze. Let’s simply begin first with the physique. So discover your toes. And if you happen to’re holding stress in your toes and loosen up. See if you happen to can loosen up your ankles. Think about that from the size of your ankle to your hip. It begins to melt in your chair with the intention to really feel your butt muscle tissue loosen up. Can you’re feeling your arms turn into a bit bit softer? Discover if you happen to’re holding stress within the arms and extra particularly in your shoulders and determine to simply let go for the second. Are you able to loosen up the tongue within the mouth? And convey your consciousness to that place between the eyebrows and see if there’s stress there. After which let’s simply take three breaths in by means of the nostril and out by means of the mouth. Releasing no matter we walked in right here with, deciding that on this second, on this breath, that is the one factor it’s important to do. And after the third exhale, returning the breath to the nostril. And I would like you to position one hand over your stomach and one hand over your coronary heart. See if you happen to can really feel your coronary heart beat underneath one hand. After which see if you happen to can really feel the breath transfer underneath the opposite. A whole lot of instances after we’re within the midst of grief, a lot of our breath occurs solely in our chest. So are you able to convey it a bit bit decrease in order that the stomach strikes on the inhale and the exhale. Absorb simply three extra breaths this fashion. After which bringing each arms over the stomach after the third exhale. As a result of generally after we observe respiration, after we’re in ache, after we observe respiration, after we are grieving, it may be actually onerous to maintain the thoughts centered. In order you breathe in, say to your self, mentally, simply breathe. As you breathe out, simply breathe. That is your solely duty on this second. There’s nothing else to do. Simply breathe. Absorb three extra breaths this fashion. After the third exhale, let your arms relaxation in your lap. Remembering which you can all the time come again to those phrases when it turns into too noisy within the thoughts, you’ll be able to all the time come again to this breath when the inhale is just too excessive within the chest and also you’re feeling a bit untethered. You are able to do this. Namaste.

Dr. Sanjay Gupta


Thanks, Sundari. And we’ll be again subsequent Tuesday. Thanks for listening.

Dr. Sanjay Gupta


Chasing Life is a manufacturing of CNN audio. Megan Marcus is our govt producer. Our podcast is produced by Emily Liu, Andrea Kane, Xavier Lopez, Isoke Samuel, Grace Walker and Allison Park. Tommy Bazarian is our engineer. And a particular due to Ben Tinker, Amanda Seeley, Carolyn Sung and Nadia Kounang of CNN Well being, in addition to Rafeena Ahmad, Lindsey Abrams and Courtney Coupe from CNN Audio.