0:05

When Rob Dart was growing up, he

0:08

was good at just about everything. He

0:10

was voted the Renaissance man in high school.

0:12

He was the captain of the football team.

0:15

He got straight A's except for French. This

0:18

is Rob's sister, Jennifer Dart. Can

0:23

you describe Rob before?

0:27

Yeah, I call him the real Rob.

0:29

He was the nicest person. He

0:32

was always putting his friends

0:34

and his family first. One

0:37

of his high school friends told me that

0:39

Rob was the designated driver for the parties.

0:42

So he was just never wanting to put

0:44

anything in his system that

0:47

would jeopardize his brain because he knew how

0:49

smart he was. Rob

0:52

went on to Duke University and then to

0:54

law school. He moved to California and started

0:56

a family. And he and Jennifer

0:58

stayed in touch. Hey Jennifer,

1:00

it's Rob. Just calling to say hi. Hope you're

1:02

doing well. Hope it's not too late to call.

1:05

You can call me back later if you want

1:07

to or tomorrow. I love you. Bye

1:09

bye. We definitely

1:12

have been close until he

1:14

got sick. Of course,

1:16

I go back and listen to his

1:18

voicemails and look at old pictures and

1:20

have wonderful memories with him. Hopefully I'll

1:23

be able to have that relationship again. You

1:30

talk about the real Rob. What

1:33

do you call this Rob? So

1:35

I just call this the sick Rob. That's

1:37

not the Rob I know. The sick

1:40

Rob. That's what my mom always reminds

1:42

me that this isn't Rob. He's sick, which

1:45

is true. Today

1:47

Rob Dart suffers from psychosis. And

1:50

at 44, Rob's homeless and living on

1:53

the streets of Los Angeles. And

1:55

everything his family has done to get him

1:57

help has failed. I

2:01

think my brothers is an extreme example, but

2:03

a great example of how the system does

2:05

not work. Welcome

2:11

to The Journal, our show about

2:13

money, business and power. I'm Kate

2:15

Limebaugh. It's Friday, May 10th. Coming

2:21

up on the show. Finding

2:23

Rob. This

2:37

episode is brought to you by AARP. They

2:40

have re-skilling courses and career tools to help your

2:42

income live as long as you do. The

2:44

younger you are, the more you need AARP.

2:47

Learn more at aarp.org/skills.

2:53

The younger you are, the more you need AARP. Learn

2:55

more at aarp.org/skills. Rob

2:58

Dart first started hearing voices about 10

3:00

years ago. You

3:02

just never think that your

3:04

brother has Schizoaffective disorder. This

3:07

was in his 30s. Everything

3:10

I had read said that

3:12

schizophrenia, schizoaffective disorder starts more

3:14

in your teens. So,

3:16

and he was so brilliant, you

3:19

would never think that

3:21

something like this would happen. What

3:26

exactly is a psychotic disorder?

3:30

In some ways when we talk about

3:32

psychotic disorders, it's this umbrella term for

3:34

what can be actually a very diverse

3:37

array of symptoms. That's

3:39

our colleague Julie Wernau, who covers mental

3:41

health. There are

3:43

delusions. Sometimes there's hallucinations, which

3:46

can make people think, you know, that they

3:49

are convening directly with God or that they're

3:51

running for President of the United States. Or

3:54

it could also make them think that, you know, there's people

3:57

recording everything that they do. How

4:00

is it treated? Well, the first

4:02

line of defense is antipsychotic medication, which

4:04

is something that Rob was on. They

4:07

are very difficult medications to be on. Weight

4:10

gain is so common and so

4:12

difficult that people often end up

4:14

with other things like diabetes. Some

4:16

people have tremors. After

4:23

his diagnosis, Rob went on these medications

4:25

and went on with his life in

4:27

LA. He had a job, an apartment

4:29

in Pasadena. He shared custody of his

4:32

son with his ex-wife. Things

4:34

for Rob were pretty stable until about

4:36

2020. It

4:39

really changed in the pandemic. I

4:42

was investigating sort of why we were

4:44

seeing more people on the streets who

4:47

seemed to be having delusions. And

4:50

it turns out there are more

4:52

people who have had psychotic episodes

4:54

since the pandemic. A

4:56

lot of gaps in care happened, but

4:59

it was particularly bad for people with

5:01

psychotic disorders. Around

5:03

the country, insurance claims related to

5:06

psychotic episodes rose 30% since 2019.

5:10

And at the same time, many

5:12

patients stopped connecting with their doctors.

5:15

That can be a problem for

5:17

people on antipsychotic drugs because regular

5:19

check-ins are considered a standard part

5:21

of care. This is

5:23

part of what happened to Rob. He

5:27

really had just lots of time

5:29

alone and no one

5:31

to really check in on him. He didn't have

5:34

a partner. His therapist went

5:36

online. Another

5:38

one seems to have maybe quit

5:40

the practice. In

5:42

2022, Rob stopped taking

5:45

his medications. And

5:47

you know, no one was around to see

5:49

it. He was working from home.

5:53

And little by little, the

5:56

people in his life started to notice

5:58

that things didn't seem right. quite

6:00

right. When

6:04

I called him, I could tell that

6:06

he wasn't taking his medicine because he

6:08

was speaking fast.

6:11

He was in a manic state and

6:14

eventually he stopped talking to me

6:16

and my mom at all.

6:18

He blocked me from Facebook. He

6:21

wouldn't return my text or my calls.

6:24

I had gone from Rob calling me almost

6:26

every day, leaving me these sweet voicemails.

6:29

To him not calling me at all. When

6:32

was it clear that things were like really

6:35

bad for Rob? My

6:38

mom started hearing from

6:40

people who lived at his apartment

6:42

complex. That he

6:44

was walking around in his

6:47

underwear sometimes talking to himself.

6:49

People could hear him talking through the walls or

6:52

walking down the street talking to himself. Rob's

6:56

psychotic disorder had returned. He

6:59

started to experience delusions and

7:01

he posted about them on Facebook. He

7:04

thought that he heard satanic voices and that

7:06

people were trying to hypnotize him.

7:10

Eventually, Rob lost the

7:12

ability to hold his life together. He

7:15

believed he needed to pull his money out of

7:17

the American banking system. He stopped

7:19

paying rent, stopped going to work, stopped

7:22

taking care of his hygiene. Okay,

7:26

I feel like we went fast

7:28

from like not taking medication to total

7:30

collapse. Was it fast?

7:33

It was pretty fast. I

7:38

think within three

7:41

months he had lost his job. Within six months he

7:43

had lost his home. Within

7:46

a year he lost custody of his child.

7:53

And then he was homeless.

8:00

Did he ever seek out treatment? No,

8:03

he didn't think he was sick. His

8:06

sister, Jennifer, did think he was

8:08

sick and she wanted him to

8:10

get treatment and go back on his medication.

8:13

But Rob wasn't talking to her. Which

8:17

is very scary when you're across

8:19

the country and he won't respond

8:21

to any of our calls or

8:23

texts because at that point

8:25

we hadn't heard from him in months. And

8:28

eventually you decided to go see him. Right.

8:34

Someone had said they had seen

8:36

him sitting in front of the Starbucks with bags

8:38

and that image just broke my heart

8:40

thinking about my brother sitting in front

8:43

of the Starbucks with plastic bags.

8:46

Jennifer went to L.A. because she thought

8:49

maybe Rob would talk to her if

8:51

he saw her in person. Maybe

8:53

she could convince him to get some

8:55

help. My brother was

8:58

sitting there at Starbucks staring into

9:00

space with one cup of water.

9:03

He had nothing with him and I barely

9:05

recognized him. His hair was, you

9:08

know, very long hair, long beard.

9:10

He was totally tan. I didn't even know

9:12

we could get that tan. My family has

9:15

pretty fair skin. So I didn't even know that

9:17

was possible, but he was so tan and

9:20

skinny. His pants, he

9:22

was dirty, clothes were his teeth were

9:24

yellow, but his eyes were the

9:26

same. He has these beautiful blue eyes. So

9:29

I was thinking that Rob was still in there. Yeah.

9:32

And I called his name and at first

9:34

I thought he looked up and smiled at me

9:36

and I said, Rob, do you know who I

9:38

am? Because he just looked so

9:40

lost. And he said, yes, I know who you

9:42

are and I don't want you to be here. Please

9:45

leave. Rob

9:51

wouldn't let his sister help him to get

9:54

medical treatment. And in most states,

9:56

if an adult doesn't want to be admitted

9:58

to a hospital, they can refuse. That

10:01

makes it hard for people like Jennifer

10:03

to get mental health care for friends

10:05

or relatives without their consent. And

10:08

in Rob's case, he was sent to a

10:10

hospital several times, but was released

10:13

because he didn't want to stay. So

10:16

almost a year after his

10:18

first hospitalization in the

10:21

pandemic, he ends

10:23

up in a hospital bed where

10:25

his friend had sort of tricked him into going to

10:27

the hospitals and they

10:30

commit him.

10:33

They've got everything in place, you know, to

10:35

make sure this time he stays. And

10:38

Rob actually argues before

10:41

a judge from his hospital bed

10:44

for his own sanity and

10:46

convinces the judge that he should be released

10:48

and they let him go. She

10:53

wanted to find Rob to ask him

10:55

about his side of the story. She

10:58

emailed him and tried to reach him on Facebook,

11:00

but she didn't hear back. So

11:03

earlier this year, she flew to LA. So

11:06

I got in, dropped

11:09

my bag at my hotel, and

11:11

now I am on the

11:13

street looking for Rob. So

11:16

I'm at this Starbucks. This

11:20

store manager there said

11:24

he definitely knows Rob, but

11:26

he hasn't seen him in weeks. Julie

11:29

checked places where people had seen Rob,

11:31

another Starbucks, and

11:35

said they haven't seen him there in almost a year. She

11:38

tried just walking around neighborhoods where she thought

11:40

he might be. So

11:43

I'm going to walk on

11:45

this road here because there's

11:47

a lot of homeless people

11:49

on it and I'm hoping one of them is Rob. But

11:53

ultimately, Julie didn't find

11:55

him. I just keep feeling like

11:57

I see him, you know, and then I

11:59

turn. and then somebody else.

12:02

And then somebody else. And then somebody else.

12:06

Julie resigned herself to not hearing

12:08

Rob's side of the story. But

12:11

then she got a

12:13

message on Facebook. All of

12:15

a sudden, he pops up

12:18

and he says, Hi, Julie,

12:20

I'd really like to hear about the

12:22

story that you're writing. Rob

12:27

and Julie decided to meet up. That's

12:30

next. And then she goes to

12:39

the other side of

12:46

the story.

12:50

Julie went back to L.A. to meet

12:53

Rob in a neighborhood called Silver Lake.

12:56

I went up there, you know, about

12:59

a month ago on a Monday, and

13:01

we spent most

13:03

of the day together. Hi. Hi.

13:06

Hi. Hi. Hi.

13:10

Hi. Hi. Hi.

13:13

Hi. Hi. Hi.

13:15

Hi. Hi. Hi.

13:19

Hi. Hi. Hi.

13:22

Hi. Hi. Hi.

13:25

Hi. Hi. Hi.

13:28

Both. He seemed to both.

13:30

Most recently, I was a plaintiff's attorney working

13:32

in class actions, consumer class actions mostly, also

13:34

some employment. They talked about Rob's life before,

13:37

and also about his life now. The

13:40

problem with Silver Lake is it like it gets cold

13:42

at night, so if you're

13:44

homeless, you

13:47

know, it's harder to sleep. Hmm,

13:50

it's colder here than over at

13:52

Manhattan Beach? You know, it probably

13:54

is, even during the day,

13:56

but most, I notice it more at night. Do

14:00

you ever get scared? Sometimes.

14:05

And I try to have like walls around me somewhere

14:07

like in a corner or something. Because

14:10

you're just out on the beach, you know, like someone could

14:12

just like come up to you

14:14

from any angle. You know, it would be kind of hard. I

14:17

think about this sometimes. And

14:20

you know, we'd talk about normal

14:23

things and then he would very easily just

14:25

kind of like slip into something that

14:27

was a delusion because to him

14:29

it's all one thing, right? It's

14:32

his reality. And so, you know,

14:34

we're sitting at the diner and he just kind of

14:37

leans in and says, you know, I don't usually

14:40

tell people this because it sounds a little

14:42

crazy, but you know, people are using these

14:44

keywords to hypnotize me and

14:47

I never know when it's going to happen. And it's

14:49

erasing my memory. And so sometimes I forget things. You

14:52

know, it's like, so

14:54

once you like head box someone, you could probably

14:56

like put in like a hypnotic

14:58

code to like make them like, you know,

15:01

just not remember. It's

15:04

like, here's what I give you. And now like now

15:07

you remember this stuff. And

15:09

then we would just kind of go from

15:12

there. I

15:14

asked him why, you know, what happened

15:16

with your like being a lawyer and say, I,

15:21

you know, like it was big, you

15:23

know, it was like something about people

15:27

feeling his intellectual property and like making

15:29

him do entertainment instead of law. You

15:32

know, at a certain point, it

15:34

seemed like a lot of what I was

15:37

doing was somewhat law and somewhat entertainment. If

15:40

that makes sense, like not entertainment law, just like

15:42

pure entertainment. It's like I'm doing law

15:44

and I'm doing entertainment. And

15:47

that's just the way things are right now for some reason.

15:50

And it's something I've asked since

15:52

asked some psychiatrists about because I said, why does

15:54

this happen? Like when when he would start to

15:56

talk about something and I was trying to understand,

16:00

In his reality, often it would just kind of

16:02

unravel into these like a lot of words that

16:04

seem like they should make sense, but they just

16:06

never would add up. And

16:08

I couldn't quite figure it out. And

16:12

apparently that's quite common. After

16:14

you met with Rob, what did

16:16

you tell Jennifer? I

16:19

called Jennifer and her

16:21

mom together from my hotel room that night.

16:24

And I said, I understand why you love

16:27

this guy. We had a great

16:29

day. And Jennifer asked,

16:32

did he say anything about us? And

16:34

I said, he did. He said he doesn't want to talk to

16:36

you. If

16:40

he were to get treatment and go

16:42

back on his meds, could

16:45

he get back to the

16:47

real Rob? What

16:49

his friends and family call the real Rob? I

16:54

think it's unclear. I think from

16:57

what people tell me, what psychiatrists say,

16:59

what people in this field say, is that

17:02

the outcomes for someone who's been in

17:05

this state for this long get

17:08

worse and worse the longer it goes on, but

17:10

that people do recover. And what

17:12

recovery looks like might

17:15

not be what the

17:17

people in his life want it to look like. Maybe

17:20

that he gets to a place

17:22

where he can distance himself from these ideas

17:26

and delusions enough to kind of

17:28

focus more on things like his

17:30

own basic hygiene and getting a

17:32

job. But he might not ever

17:34

let go of them. If

17:37

a person doesn't believe that

17:39

they're sick and doesn't

17:41

want any help, it

17:44

is almost impossible

17:47

to bring them back. I

17:50

watched his family go through months and months

17:53

of all the things that you think

17:55

you're supposed to do for someone in

17:57

this situation. worked

18:01

and he's still after. What's

18:06

going to happen to Rob now? Well,

18:09

Rob, um, is

18:12

going to be homeless. He

18:15

said it sucks. Um,

18:19

literally is what he said. Um,

18:22

it's, uh, he doesn't

18:25

really seem to

18:27

have much thinking about

18:29

the future. It's, it's very like in the

18:31

here and now, like, how am I going

18:33

to eat today? Where am I

18:35

going to sleep today? Is it safe? I

18:39

think one of the

18:41

more overwhelming things about the day was

18:43

just how clear he was

18:46

about how lonely it is to be someone who

18:48

is homeless and who people kind of

18:52

avoid. You

18:55

know, sometimes when it's cold, you know, if I have food or something

18:57

or not, like

19:00

I'll, I'll end up just walking until I

19:02

kind of get tired and then I kind

19:05

of just lay down. Sometimes if I'm

19:07

in a residential area, I

19:09

just walk until I'm getting tired and

19:11

then I just lay down. So it's

19:13

kind of just like next to a sidewalk. Before

19:23

we go today, we wanted to tell you about a new series coming out on Monday. It's

19:36

called trillion dollar shot and

19:38

it's about a new class of blockbuster

19:41

drugs. The series is

19:43

hosted by our colleagues, Jessica Mendoza

19:45

and Bradley Olson, and they're

19:47

here now to talk to us about it. Hey

19:50

guys. Hi, howdy. It's

19:52

nice to be in studio with you. So

19:55

great to be in studio with you. So

19:57

excited to have you guys on. So excited

19:59

for your. series and

20:01

this series is about

20:03

a new class of drugs. So

20:06

tell us about them. Yeah.

20:08

So you've heard of Ozepic, maybe

20:11

also Mount Jaro. These drugs were

20:13

initially made for diabetes, but they're also

20:16

really effective for weight loss. There's

20:18

been a big zeitgeist moment around

20:20

them. Everyone's talking about them. They

20:22

came up with the Oscars. Elon

20:24

Musk was using it. Recently, Oprah

20:26

came out with a special. So

20:28

they're absolute blockbusters. I

20:30

think this is one of the biggest business stories of the

20:32

past few years. In fact, the reason that

20:34

we're calling it trillion dollar thought is

20:37

that because these drugs have become so

20:39

successful, even with all the questions still

20:41

surrounding them, the two companies

20:43

behind them are actually racing to

20:45

become the first trillion dollar pharmaceutical

20:48

company in history. But

20:50

at the same time, people have a

20:52

lot of questions about them as well,

20:54

even as they've hit

20:56

the mainstream. How safe are they? How

20:59

is this affecting our cultural conversations

21:01

about obesity, about weight? How

21:04

can people afford them? And so we wanted to get

21:06

into all of that with the series. And

21:09

Brad, you're here

21:11

because you have some first-hand experience

21:14

with these drugs. That's right. That's right. I

21:16

took one of the drugs and

21:19

lost 40 pounds. I

21:21

took it over about five months.

21:23

And it just led to this

21:25

just big explosion of emotion and

21:28

kind of unexpected feelings

21:30

and things I learned. Like what? Well,

21:33

like, kind of makes

21:35

you reflect on identity and

21:37

willpower and how we

21:39

treat people who struggle with their weight or

21:42

how we've always treated them, right? Like, this

21:44

is a you problem. You're

21:46

big because you made bad choices. And

21:49

I think if there's a magic pill that

21:51

fixes it and you're not big anymore, then

21:54

it makes you think, maybe

21:56

it wasn't me. Maybe I'm not just some big

21:58

failure, you know? Among

22:00

the big drug discoveries, where

22:02

is this going to rank? Some analysts

22:05

have said one of the drugs could be,

22:07

you know, one of the highest-grossing pharmaceuticals of all

22:10

time. Now, adjusted for inflation, I think it would

22:12

be in the neighborhood of statins and a few

22:14

other ones, but massive, massive.

22:18

The first episode will be in your feed

22:20

on Monday morning. Here's a

22:22

sneak peek. All

22:24

of a sudden, just the weight starts

22:26

falling off, you know, eight pounds the first

22:28

month. I felt like it was a miracle.

22:30

Three pounds the second month. Life changing, for

22:32

sure. Ten pounds the third month. That's

22:36

how powerful this medication is. Then it

22:38

just was like, how is this happening? I

22:40

could tell it was working, and I

22:42

could tell that it was changing my

22:45

relationship with food, and I

22:47

liked that. This

22:49

type of success has meant huge windfalls

22:51

for drug makers. We said, oh, Jesus,

22:53

this can become a big, big drug.

22:55

It's been a boon. There's no denying

22:58

that. You know, the demand is higher

23:00

than what we can deliver to people

23:02

today. And that demand

23:04

for these drugs is reverberating across

23:06

society. And I thought, well,

23:08

I'll stay on this for life because it's

23:12

so helpful. And then I realized

23:14

what it was going to cost me. They're just bank

23:16

breakers. OK, if I

23:18

can't get the drug, what can I

23:21

take instead? What's close? There

23:23

are so many people even

23:25

selling bathtub ozempic. There's a lot of

23:27

excitement. There's a lot of skepticism. And

23:30

I can imagine a future where life

23:32

expectancies are actually increasing because of this

23:34

concentration. Whether

23:37

you think these drugs are a miracle or

23:39

you're skeptical of what they promise, they're

23:42

changing how we approach one of the

23:44

most intractable issues in our society, obesity.

23:48

And it's just the beginning. That's

23:54

a preview of Trillion Dollar Shot, our

23:56

new series. Check it out Monday.

24:04

That's all for today, Friday, May

24:06

10th. The journal is a co-production

24:08

of Spotify and The Wall Street Journal. The

24:11

show is made by Annie Baxter,

24:13

Katherine Brewer, Maria Byrne, Victoria

24:15

Dominguez, Pia Godkari, Rachel

24:17

Humphries, Ryan Knudsen, Matt

24:19

Kwong, Jessica Mendoza, Annie

24:22

Minoff, Laura Morris, Enrique

24:24

Perez de la Rosa,

24:26

Sarah Platt, Alan Rodriguez

24:28

Espinosa, Heather Rogers, Pierce

24:30

Singey, Lai Ying Tang,

24:32

Jeeva Kaverma, Lisa Wang, Katherine

24:35

Whelan, Tatiana Zamise, and me,

24:37

Kate Leimbaugh. Our engineers

24:39

are Griffin Tanner, Nathan Singapak,

24:42

and Peter Leonard. Our theme music

24:44

is by So Wylie. Additional

24:46

music this week from Nathan Singapak

24:48

and Blue Dot Sessions. Fact-checking

24:50

by Kate Gallagher, Najwa

24:52

Jamal, and Mary Mann. Thanks

24:59

for listening. See you Monday.