ISPP 2015

Career Opportunities in Pharmacy

Challenge accepted! The actor who played Joker,
Joaquin Phoenix, said, “I didn’t want a psychiatrist to be able to identify the type of person
he was.” Leaving now for the theater to watch the opening showing. I’ll be right back. I’m Dr. Karthik Ramanan. I’m a licensed naturopathic
physician specializing in integrative mental health and lifestyle medicine. On this channel
you’ll find the Dr. K Show where I help ambitious individuals end self-criticism with tools
and strategies and fire motivational speeches to create optimal everyday mental health.
If you need to silence that negative self talk and get out of your own way, I encourage
you to subscribe button right now. OK, Joker. Look, I don’t usually review movies,
so I’m going to try to keep this as spoiler free as possible. I won’t explicitly say what
happens in the plot. Let’s go. I just got back from watching the film. Now,
as a physician, we don’t diagnose people without actually sitting down and having a visit with
them, going over labs, etc. Given that, I can’t make a true diagnosis based on a movie.
That said, Joaquin, you win. Arthur and Joker are very hard to nail down. I had this notebook
with me and I was scribbling delusions, inappropriate laughter, lack of remorse, etc. But really,
as he goes through this transformation from Arthur to Joker, there are so many layers
to his experience of this world that it’s very hard to nail down specific diagnoses.
So, good job Joaquin. You were extraordinary. You win. So, is Arthur, Joker just… crazy? I thought
Joaquin did a fabulous job exploring the transformation of Arthur to Joker. Originally in DC comics,
the Joker was more of a punny type of character. Then we had the Jack Nicholson Joker that
was more sinister and violent. I felt Joaquin’s exploration of the character led more to that
style of Joker, with the original colors and all. Whereas, Heath Ledger’s version was more
later stage, truly an intensely psychotic version. The story line in this movie wasn’t anything
groundbreaking or new. But what was groundbreaking to me was the way Arthur’s transformation
was shown, not told, through the soundtrack, his dancing, and the various types of laughs
that the actor developed for different situations and phases of the movie. Arthur/Joker was
really a character in flux, from moment to moment, and it was really incredible to watch.
And through that soundtrack, dancing, and laughter you’re able to see other characters
like Bruce Wayne’s father through a different lens. What also struck me was the way Joaquin
acted out Arthur’s suppression of emotions. It was uncomfortable, tightly wound, and painful.
I hope he wins awards for his performance, because it was truly extraordinary in every
way. We see how Arthur is just an ordinary guy
with some behavioral traits that were largely a function of the environment he was raised
in. His backstory is rooted in a reality that we can relate to. And through it all, Arthur
genuinely believed it was his role in the world to bring joy and laughter to those around
him. He wasn’t born violent. He just wants love and adulation, from his parents, from
others. He just wants a hug. But what does he get? He’s bullied, beaten, and ignored.
He says, “Nobody ever saw me. Nobody ever listened to me. I didn’t know if I even existed.”
He intensely lacked two critical factors that we all need: connection and purpose. As the world around him started crumbling
from an already weak foundation from a painful childhood upbringing, he descends into violence.
And as he becomes Joker, he starts to notice he’s being heard. He starts to matter. He
makes eye contact with others wearing the clown mask as you probably saw in the trailer,
that connection. He develops connection and purpose through violence, which brings out
the less suppressed, more free flowing version of himself. I don’t believe Joker is the person
Arthur strived to be, but Joker is the person who filled those two voids of connection and
purpose. If you’re enjoying this so far, smash that
Like button. By the way, this is spoiler free, but if you want me to go in depth with spoilers,
leave me a comment below saying “I want the spoiler version!” I think the film did a remarkable job showing
some of the shortfalls of mental health in society. Obviously, this is a fictional character
in a fictional city at a time in the past. But there are times when Arthur feels he’s
not heard, despite his efforts to get treatment. He’s unable to get medication he needs. His
clinicians don’t seem to empathize with him. That all sounds like the unfortunate reality
that a lot of people experience. The film also showed the lack of empathy in
society that we see in the world around us. Human beings are a social species. We need
our tribes and we need purpose within our tribes. Lack of empathy leads to lack of connection.
Lack of connection makes it very difficult to have purpose. And without purpose, some
people resort to horrific acts to feel like they matter. To get noticed. To have a sad
sense of purpose. What if a neighbor genuinely asked Arthur how he was doing? What if someone
genuinely tried mentoring him in comedy? Would his trajectory of life been changed? What can we learn from Arthur? Well for one,
I don’t believe anyone is born inherently violent. They become that way when they commit
their first act of violence later in life. I think it’s easy to blame others having beliefs
that we don’t agree with, but if there’s anything that being a physician has taught me, it’s
that there’s always a reason if you’re willing to listen to someone’s story. Arthur shows
how suppressing emotions and not adequately processing past trauma can lead to terrible
outcomes. I think we can learn that we do need to empathize with others, listen to them,
acknowledge them. Does that mean we can exonerate Joker for committing acts of violence because
of his tragic upbringing? No, absolutely not. We can be empathetic and hold others accountable
for their actions. Some people take their painful pasts and take it out on others, perpetuating
the problem, like Joker does. Others take their painful pasts, reprocess it, and use
their experiences in the service of others. What if Joker had been in an environment where
he could turn his pain into good? Oh right, I forgot to say whether I recommend
this movie or not. It’s awesome. Go see it. Joaquin Phoenix was extraordinary. If there’s anything we can learn from Arthur,
it’s to reach out and connect with our friends, neighbors, families, strangers. We ARE in
a society that lacks empathy. And we can be empathetic and hold each other accountable
for our actions. Not taking action when we see something troublesome counts as an action
too. We are too quick to avoid meaningful conversations but rather talk about the weather
or complain about our favorite sports team. We struggle to even ask our neighbor in the
elevator “How are you?”, when that might have changed their entire day. We avoid difficult
conversations with family members, day after day, until those suppressed emotions boil
over irreparably and ruin relationships. We don’t stop to think about the cumulative effect
of these acts of lack of empathy, these acts of disconnection. Remember what Arthur didn’t get, that turned
him into Joker? Connection and Purpose. Everyone needs to feel connection with their fellow
human beings. Everyone needs to feel purpose. It’s not just something people get from a
therapy session or a doctor’s visit. We all can give it in our everyday lives. My challenge
to you is to be even more empathetic. I challenge you to reach out to someone and tell them
what they mean to you. Let them know they matter. The smallest act can make someone’s
day, and the collection of those genuine acts of connection can transform a culture. You
have the power within you, to be that change. I believe in your greatness.


  1. Yes, I want the spoiler version too! Going to see the movie tomorrow. Can't wait! So awesome that you made a video like this doc!

  2. Great review Dr. K! We need to be aware that our actions and lack of action have unintentional impacts on others. Intentional acts of humanity/kindness can have far greater impact then you might ever know. Your one moment of caring has the potential to save a life.

  3. Outstanding job Doc. You did better than the trailer did in convincing me to see this movie. Now I'm interested. Nice.

  4. So the take away I got is to say "how are you" to more people in elevators and we may avoid a world full of Jokers. j/k Great video. Thanks for sharing. 👊

  5. I have always loved the Joker. I actually hand sewed a purple trenchcoat the night before the Heath Ledger film so I could dress up in costume to the premier.

  6. Great video Dr. Karthik Ramanan! I am very happy to hear that you tough same way about the movie. 🙂 Joaquin was brilliant indeed. He should finally get Oscar!!

  7. I'm glad you liked it. I felt nothing. It was so slow. For me, Heath Ledger was and will always be the best Joker.

    It's good that you can bring real world application and analysis.

    Would I recommend this movie? 4 thumbs down. Not really, maybe 5 😜

  8. How do you think the movie affects people who feel excluded and are dealing with violent thoughts? Would it give them more violent ideas or would it comfort them in a way?

    This is the first video of yours that I watched, I found it to be very interesting.

  9. This is such an interesting video. Great job!! We totally agree with what you said about the cumulative effects of lack of empathy and connection.

  10. AWESOME and much needed insight! Also. WE WANT THE SPOILER VERSION.

    Such an excellent and well video too! A great example for us IC-ers. 🙌🏽

  11. Murray is America personified. While society in the US is just as hypocritical and self serving as the show host, Arthur once believed in it; believed in a world worth saving. The joke is that we want to medicate ourselves to fit in to the hypocrisy. We want to conform and rebel … A-Murray-ca is the personification of consumption of the weak and kind.

  12. Would definitely like a more in depth review/exploration of this character. I think so many people (mostly media) missed the point of the movie. While I was watching I never felt pure excitement and joy, I was uncomfortable most of the time and was actually rooting for Arthur to not lose it. The movie in my opinion doesn't act as an encouragement, but rather a warning.

  13. UPDATE: You asked, and here it is! Dr. K's scene-by-scene breakdown (spoiler) review:

  14. Dr, let me tell you a little bit about my mental health, Im telling u the truth Okay!! This is not a joke orrr liar. I've been did a check up witha psycho doctor in Malaysia. I do im just like "Joker", my mind i mean i always thought about " why people doesn't hear my scream?", " whyy people doesn't look at me when i was in pain bcus i really need a help?" . I can say mostly everyday in my whole life i always had a negative thoughts, it cames out since i was 9years old. I'd realized i stuck in these mental illness bcus my beloved already gone andd i cried a lot until i cam cry and laugh at the same time.

    I tell you this is not a Joke!! This is the real one issss!. I always cried fr myself blame myself why i was born like this andd why people aren't like me whyyyy i'm weird between them. Im tryin to kill myself but i couldn't bcus i try to find another way to survive but i can't. Nobody can't help me ..

    Dr. K, pleaseeeee .. Pleaseeeee reply my comment, if there's have a solution to vanish all this pain. Can you tell me how??

  15. Dr Karthik Ramanan Thank You so much for your review.
    Check out this lead NeuroCriminalogist who has studied violent killers and serials killers for 40 years has to say

    "The child who is not embraced by the village will burn it down to feel its warmth." African proverb

    This Film will go down as a Classic piece of Cinema, when viewed with compassion.”Joker” It’s Not a Left or Right or White Film but a Human film, It addresses the plight of Fatherlessness, Class Warfare / Wealth Inequality, Child Abuse, Gaslighting an abused Kid-possibly sexually abused, Repressed Trauma, Mental Health, the importance of Mental Health Services, Nationalised Health, Over Medication – Big pharma, News Media fanning the flames of violence, Gun Violence, Loneliness , Isolation, Depression and how if we keep hurting each other and ignoring each other – Regardless of if You're an MCU fan / DC fan /Man / Woman / White / Ethic Minority/ LGBT etc If Anyone lived Arthur's Life – This would be the end result – All done with loving attention and the seriousness it deserves WITHOUT Ramming down an obvious political agenda from Either side of the Spectrum. But a compassionate look at a human being's downward spiral.

    Amazing Work of Art. This Truly elevates Cinema And Comic Book films. We Should ALL be proud this is what will keep Comic Book films from going the way of the Westerns. Marvel are Fantastic at creating Episodic Very Fun Popcorn Movies, But DC have always tried to Push the Boundaries Artistically – The Richard Donner- Superman/ Tim Burton -Batman, Christopher Nolan Dark Knight Trilogy, BVS ( love it or hate it it was not the template Jokey Joke Comic Book Film ) Wonder Woman, Aquaman Batman The Animated Series, Justice League Animated & Justice League Unlimited, Most of the DCAU & Joker. Please Understand this is NOT a Diss to the MCU. Disney PG Films are fun and entertaining but rarely spark so much thought and conversation. Deadpool was Marvel's R Rated Film which was good silly fun . Joker is how DC makes R rated film that is truly Adult and not just a PG film with CG Blood and swearing.

  16. You describe Ledger’s Joker as an “intense, psychotic version” of the Joker character. I’m curious if you can speak to the use of the word “psychotic” here. Psychotic is often misused by laypeople interchangeably with psychopathic. Though Heath Ledger’s Joker certainly acts out violently and behaves erratically, I don’t necessarily see his version as having had a break with reality or being very disordered in his thinking. It seems much more performative than genuinely evidence of psychotic thinking, and therefore more in line with a psychopathic character, whereas Arthur has delusions of grandeur regarding his future as a star comedian, even has some delusional romantic fantasy regarding women he sees or interacts with. Can you speak to this at all? Also do you feel the film implies a strong correlation between Arthur’s eventual violent actions and his mental illness, and if so, does that concern you in terms of further stigmatizing the mentally ill?

  17. your review on the mental health aspect was good ..,i went to watch a movie today with a friend of mine

    and it turned out to be something ..

    this is a strong movie and needs too be seen with the intelligence that understands the context and disposition of the flowing story, i also suffer from Cyclothymia( an extreme rapid form of BiPolar) , (long comment sorry)

    i really got connected with it and it made me feel very depressed far lower than i am usually , dont get me wrong the film was absolutely amazing and the attention too details and how it displays having a condition that not many people understand or want too understand is amazing .. and yet at the same time made me feel so so hard for the person in the movie too the point it affected me in a very negative way and i left the cinema shaking and crying .. i had too go into the bathroom and force myself too recover (as my friend dont have an understanding of cyclothymia so i hide it as best i can as he came with me ) the film deserves to be watched as it is very very good but can be hard on people who can relate and boy does it relate .. im feeling better now took many many hours .. but did concern me it was the lowest i have felt in more than 10 years FAR lower than im used too and accept .. i will be going too see the consultant about it and im hoping it was just a glitch as im not used too that and i dont think i could cope with it .. please dont let this put you off seeing it tho .. as it is really does portray a real world view of hidden conditions and the side effects … a masterpeice film that for once shows how hidden or unliked mental conditions affect people in reality for sure

  18. I noticed that in the audience there were alot of people who would laugh at his laugh. But for me dealing with a mental illness that i have no diagnosis for. I do not quite know what it is other than trauma based. I shed tears whenever there were moments others were blindly ignorant to. I felt the pain behind the laugh. Because i too in times of turmoil and pain laugh.

  19. Unless things affect people directly people really don't care. People know what to say and how to say it in public to make themselves look and feel noble but again they really don't care at all

  20. I hope you can review the movie “unsane” 2018 it’s about a mentally ill woman whether or not if she was really crazy I’m still trying to figure it out if you ever see it I would like to know your thoughts thanks here’s the trailer

  21. 'Probably, Siply, a 'Hidden Psychopath's …. Unknown, even to Himself … Until a Series of Personal Incidences Brought it Out, in him … Not having Subsequent Remorse, Illustrates this !"

  22. "It's Unrealistic, however, for Him Not to be on.a HEALTH PLAN …. Cutbacks in Gothom's Economy Should Not have deprived him of Required Meds ….Even, in 1980's, MeidiCare for Handicapped Persons was Available !"

  23. Here's a challenge for you; using only the footage that's available and the stories of all the behind-the-scenes weirdness, how about an analysis of JARED LETO'S Joker? >;)

  24. "someone mentored him" "what if he had taken his painful past and turn it to service of others" you're basically talking about bruce wayne and batman there, the joker is the other side of the decision coin.

  25. Just a reminder to anyone watching this: In some countries, it is a criminal offense for naturopaths to label themselves as medical professionals.

  26. I have had friends with mental issues and unfortunately the world just mocks them and bullies them since they are so hard to understand, but this movie really helps

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