Psychiatrist and Neurologist Todd Feinberg

DATE January 30, 2001 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Todd Feinberg discusses his research into how the brain
creates a sense of identity
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

Scientists have made many breakthroughs in understanding which parts of the
brain control certain behaviors. But one of the great remaining mysteries is
how the brain creates a sense of self, an identity. Dr. Todd Feinberg is a
neurologist who's investing this by studying patients with brain injuries or
disorders that have disrupted their sense of self. For instance, a person who
no longer recognizes that his arm is part of his own body, or a person who
thinks his own spouse is a stranger. Dr. Feinberg describes his work in his
new book, "Altered Egos: How the Brain Creates the Self." He teaches at the
Albert Einstein College of Medicine and is the chief of the Betty and Morton
Yarmon Division of Neurobehavior and Alzheimer's Disease at the Beth Israel
Medical Center in New York.

I asked him what he means when he says he's looking for where the sense of
self is located in the brain.

Dr. TODD FEINBERG (Neurologist): Where is your subjective sense of who you
are, what you are and how you feel about yourself. So I'm trying to find the
neurological underpinnings of the inner I, the self, the subjective self, the
ego; the part of yourself that you feel is the most intimate aspect of your
inner self.

GROSS: In order to research what part of the brain might control the sense of
self, you're studying people with brain injuries and brain disorders.

Dr. FEINBERG: Correct.

GROSS: How can studying the brain injuries and disorders help you figure this
out?

Dr. FEINBERG: By studying patients who have brain damage, we find that many
areas of the brain make a contribution to the self. So I set out--this is now
15 years ago--through behavioral neurology and neuropsychiatry, to determine
what areas of the brain contributed to the self. And we do that by doing an
analysis of a particular area of the brain is damaged, this leads to a certain
disorder of the self. Another area of the brain is damaged, this leads to a
different disorder of the self. Trying to put all these areas together in the
brain can help us understand how diverse areas contribute to the unified self
that we experience as our inner I.

GROSS: And your book is filled with really fascinating case studies of people
with brain disorders that really do affect their sense of self. For example,
tell us the story of the woman who didn't recognize that her arm was her own
arm.

Dr. FEINBERG: This disorder is called asomatagnosia, and it is actually very
common. It occurs when a patient has damage to the right hemisphere of the
brain, the non-dominant hemisphere. Our language is in our left hemisphere,
and vast majority of right-handers and even the majority of left-handers, have
language in the left hemisphere. A stroke on the left side can give you what
we call a phasia, which is a disorder of language, the inability to
communicate or understand what is said to you. On the other hand, a patient
with a right hemisphere lesion has a different syndrome that we call
hemispacial neglect(ph), and this is where the patient ignores, or fails to
pay attention to, the left side of space and the left side of their body
sometimes.

Asomatagnosia is when the patient with the right hemisphere lesion disavows or
denies ownership of the limb. So what we do in a right-hemisphere stroke
patient, we'll take the arm, lift it up, show it to them and ask the patient,
`Well, what is this?' And patients who have asomatagnosia, as many of the
cases in my book do, will misidentify that arm. They may call it a deodorant,
a rusty chicken wing. They may refer to it as the doctor's arm. Some people
may give it a name like `Gammie' or `Toby' or `my little monkey.' And they
will treat it often as an entity separate from themselves. Some patients even
try to feed the arm, or they'll pick it up and pat it and sing songs to it, or
treat it as if it were a child.

Women typically misidentify their left arm, when they have this condition, as
belonging to a husband. Men, interestingly enough, I have found, often will
misidentify it as their mother-in-law's arm.

GROSS: I won't ask what your interpretation of that is.

Dr. FEINBERG: I--it--this is a true fact, though. I've seen this over and
over again. So it's--it's interesting.

GROSS: So do you ever try to convince the patient that the arm is actually
their own? And if so, what's their reaction to that?

Dr. FEINBERG: One of the interesting things about asomatagnosia, and indeed
really all of the disorders that I consider in my book, are that they're
refractory to correction. Patients resist the truth in these circumstances,
which is why there's somewhat different from other simple neurobehavioral
syndromes, such as paralysis of the right arm, for example. These patients
will, oftentimes, deny the truth of the situation, in spite of being told over
and over again, for instance that, `That is your left arm. Look, it's
connected to your shoulder. It's got your ring on it. It looks identical to
the other arm,' and yet these patients will still resist the truth. And one
of the perplexing problems in behavioral neurology is why are patients so
resistant to the truth? It's almost as if they're denying the truth about the
left arm.

And this pertains not just to asomatagnosia. This pertains to another
disorder that we're interested in called anosognosia, which is unawareness of
the paralysis. Most of these patients have paralysis of the left arm. They
have a right-hemisphere stroke, they can't move their left arm, and not only
do they misidentify it, but they may claim that the arm is as strong as the
normal arm, that there's been no change in its function, and that it can move
quite normally. And those two conditions, anosognosia and asomatagnosia,
often go together.

GROSS: Let's look at another brain disorder that creates a pathology in the
sense of self. And this is one that--that's called delusional
misidentification syndrome, where--where a person thinks that--that their
family or their friends have been replaced by--by imposters. What's an
example of that?

Dr. FEINBERG: There's a common delusional misidentification syndrome known
as Capgras syndrome, and this is one that, actually, I'm sure many of your
listeners have either heard of or may have even had a--a--a loved one
experience, because it is actually rather common and it occurs in, for
instance, Alzheimer's disease and other dementias. And this is where an
individual of the patient's, particularly a spouse or child, is claimed to be
an imposter.

So for instance the common scenario is--and this is a patient who, by the way,
has psychiatrically not had problems previously, but develops a brain disease.
And you can see this in psychiatric conditions, but in neurological cases
these are patients who have no delusional thinking prior to the development of
the brain disease. And they'll walk in and they'll say, `This is not my wife.
This is an imposter. I don't know where my wife is, but this is not her.
This is not the original. This is not the one that I know. This is not the
one that I'm related to. This is not the original. The original's somewhere
else, and this is a double.' And that's called a Capgras syndrome. And we
see this quite commonly in the neuropsychiatric clinic. It is a denial of the
identity of a person, particularity someone close to you. So it--it's a
daughter, a spouse, a brother, someone that the patient has a lot of
interaction with. And when this presents, it's often in the early stages of
brain disease, so that the patient, in other respects, is actually quite
normal. They just have this one particular delusional misidentification
syndrome.

GROSS: Now you're studying these disorders of the self to help you understand
what part of the brain, or what parts of the brain, help create the sense of
self.

Dr. FEINBERG: Yeah.

GROSS: What clue does this disorder give you?

Dr. FEINBERG: Well, one interesting aspect of the Capgras syndrome--and
there's the related syndrome, the Fegoli's Syndrome, which is where the
patient will claim that a stranger is actually somebody that they know. The
opposite scenario is that the right hemisphere plays an important role in that
particular--these particular syndromes. Patients with right hemisphere
damage, be it stroke or atrophy of one hemisphere, or a brain injury from a
car accident, oftentimes have damage to the right hemisphere, again
implicating the importance of the right hemisphere, the non-dominant
hemisphere, in establishing relatedness and the sense of self and who you are.
So that points us in a direction of localization; that there appears to be a
dominance for that hemisphere, for the right hemisphere, in self-awareness and
the subjective self of who we are and how we're related to people in the
world. So that's another clue that that's an important part of the brain that
contributes to the self.

GROSS: If you're just joining us, my guest is Dr. Todd Feinberg. And he's
the head of the Division of Neurobehavior and Alzheimer's Disease at the Beth
Israel Medical Center in New York. He's written a new book called "Altered
Egos: How the Brain Creates the Self." Let's take a short break here and
then we'll talk some more. This is FRESH AIR.

(Soundbite of music)

GROSS: My guest is neurologist Dr. Todd Feinberg, and he's the head of
Neurobehavior and Alzheimer's Disease at the Beth Israel Medical Center in New
York. His new book is called "Altered Egos: How the Brain Creates the Self."

Let's talk about another disorder of the self, the Alien Hand Syndrome. Tell
us about that.

Dr. FEINBERG: The Alien Hand Syndrome is really one of the most interesting
disorders that we come across. What happens is that the patient has damage to
a structure called the corpus callosum, which is this massive fiber bundle
that connects the left and right hemisphere and coordinates the actions of the
two hemispheres. If that structure is damaged, cut either surgically or by
tumor or by stroke, one hand may not know what the other hand is doing. And
there are circumstances where, in particular if it's only the corpus callosum
that is damaged, the left hand escapes the patient's conscious willful
intentions. And that left hand may grab cups and throw them across the room,
and the patient has no sense of purpose about doing any of these things. The
hand actually may attack the patients. One of my patients repeatedly woke up
at night with the hand around his throat. And that's not uncommon.
Self-strangling of the left hand occurs. Another patient's hand would grope
along his leg, rip of his pajamas with the left hand. The right hand had to
grab it, wrestle it to the floor. And this kind of intermanual conflict can
occur especially early on when the corpus callosum is divided.

Why this is interesting is because what it tells us about unity, about brain
unity--what it tells us is that indeed there is no consciousness or mind that
does not require cerebral integration. If you destroy the corpus callosum
there are times at which the brain can act as if it possessed two minds, two
independent entities. So anatomical integrity is critical to mental unity.
On the other hand, there's another interesting aspect to this problem, which
is that Alien Hand is rare. Most patients who have damage to the corpus
callosum alone don't get it. And if they do get it, it resolves rather
rapidly.

GROSS: It's amazing how so many of these disorders that you're describing
have echoes in horror movies.

Dr. FEINBERG: Yeah. Well, this--actually, the left Alien Hand, or the Alien
Hand, is sometimes called the Dr. Strangelove effect, from the movie where
Peter Sellers has an arm that repeatedly--the character that Peter Sellers
plays repeatedly tries to make a Nazi salute and the other arm has to wrestle
it down. And indeed, many of these disorders--I wouldn't say restricted to
horror movies. I think that the literary and cinematic themes frequently draw
from these neurobehavioral syndromes. And when you become aware of them, it's
extraordinary how commonly you'll see doubles represented or Capgras syndrome
represented.

I mean, the "Invasion of the Body Snatchers" is classic delusional
misidentification syndrome, and all their variants. I point out that the
"Wizard of Oz" is probably the most well-known Fegoli's Syndrome ever
reported, where the Tin Man, the Lion and the Scarecrow are actually--they
have other identities, the farmhands from Kansas, inserted into their beings.
This is a Fegoli's Syndrome par excellence. So if one becomes aware of these
things you'd be amazed at how widely they ramify in cultural themes and in
personal dreams.

GROSS: Well, it sounds as if there are various parts of the brain that work
together in creating a sense of self.

Dr. FEINBERG: That's exactly it.

GROSS: It's not like you're going to find one part that handles it.

Dr. FEINBERG: Well, that's my opinion. I mean, I just had a very lively
debate with somebody at a meeting in Florida about that, but my opinion, I
have great difficulty excluding virtually any area as making a contribution to
the self. I find more areas that make a contribution to the self than those
that don't. And I would include the frontal lobes, the left hemisphere, the
right hemisphere--all these areas of the brain, or at least many of these
areas of the brain make a contribution to the self. And the real puzzle then
becomes--you see, we like to find--we like to take a finger or a probe, and
point and say, `Eureka! There it is. I've got it. There is the self. All I
need to do is take this area and image it and I'll image the neurological
basis of this person's self,' but it's not that easy. There are so many areas
that contribute to the self. The real perplexing puzzle, the mystery, is how
do these areas all combine, how are they all put together, to create the
seamless inner `I' that we all experience as `I'?

GROSS: Say you actually succeeded in figuring out a model for how the brain
creates a sense of self. Where will that leave us? What would be able to do
or understand that we can't do or understand now?

Dr. FEINBERG: Well, to be perfectly honest, most of this work is done for the
love of the work. It's done simply to get a better understanding of who we
are.

GROSS: What it means to be human.

Dr. FEINBERG: What means to be human. And, I mean, I recall, I'd say
probably the age of seven or eight, and becoming aware that I had thoughts
that didn't seem to be anywhere. And I started to think, `Well, where is my
mind?' I mean, I know I have this brain inside my head, but--and I can point
to my brain, but where's my mind? How does this material object, how does
this brain, produce the mind? And ultimately, in my training and practice as
a neurologist and psychiatrist, which is really quite aside from the more
neurophilosophical implications of the work that I do, I became fascinated by
these patients who had these disorders of the self. So it's really simply an
intellectual pursuit, a greater understanding of what it means to be a human
being, what means to have a mind, what it means to have a self.

GROSS: Can...

Dr. FEINBERG: Now I do believe that actually, if I'm correct as to what's
going on here, I believe it does have important implications for the
neuroscience and understanding how the brain is combined and organized.

GROSS: You know, I'm thinking, when someone takes their loved one to you, to
you the doctor, and their loved one has one of these brain disorders in which
their sense of self is broken in some fundamental way, the people in the
family must be just horrified and upset...

Dr. FEINBERG: Yeah.

GROSS: ...about this really disturbing phenomenon, whereas for you it's in
part just absolutely fascinating because it's leading to all these larger
observations about the brain and the sense of self. And I'm not sure what my
question is, but I guess you must be operating on a really different level
than the really worried family is. And is that ever of any consolation to
them that...

Dr. FEINBERG: What we try to do is help the family understand what's going
on. I'll explain the phenomenon, relieve them of their guilt, help them to
cope with the circumstances from an emotional standpoint, which is a big part
of the therapy. And at the same time, we're trying to cure, with medication,
counseling, the patient's problem in the first place. For most of these
conditions we have an approach to treatment, be it medication, psychotherapy,
family counseling. You'd be amazed at how much we're able to improve the
patient's life, the family's ability to deal with that patient, avoid a lot of
conflict within the family by explaining to them what's happening here; why
this is going on; that this is not the patient's fault; this is not your
fault; this is what the brain does; this is how the brain adapts. In the
meantime, we're trying to cure them. And, indeed, many cases of these
conditions can be treated.

GROSS: What's one of the most amazing breakthroughs in the treatment of brain
disorders that have developed during the time that you've been practicing
medicine?

Dr. FEINBERG: Well, for me, probably the most important development has been
the memory medications that we have. When I started back in--when I started
my practice back in '86, '87, we had no medications at all. Now we have
several that are available to treat memory disorders and we've--so we've seen
that kind of advance. It's not a cure, but it helps the disorder. And also,
our greater understanding of Alzheimer's disease and its neurobiology--we're
hopeful in that the next couple of years we're going to really have some big
breakthroughs, so we're waiting for those. And I would say that our
understanding of that condition has just exploded over the last 10 years. And
I think our understanding of the brain in general has seen enormous advances
from when it was when I was back in medical school, for instance.

GROSS: Well, Dr. Feinberg, thank you so much for sharing some of your work
with us.

Dr. FEINBERG: OK.

GROSS: Dr. Todd Feinberg is the author of the new book "Altered Egos: How
the Brain Creates the Sense of Self." He's chief of the Division of
Neurobehavior and Alzheimer's Disease at the Beth Israel Medical Center in New
York. I'm Terry Gross, and this FRESH AIR.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Tom Fontana talks about his career as executive producer
and writer for "Oz"
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

(Soundbite from "Oz: The Soundtrack")

Mr. AUGUSTUS HILL: Oz. That's the name on the street for the Oswald Maximum
Security Penitentiary. Oz is retro. Oz is retribution. You want to punish
a man? Separate him from his family, separate him from himself, cage him up
with his own kind.

(Soundbite of music)

GROSS: That's an excerpt from the new CD "Oz: The Soundtrack." "Oz" is the
HBO series that follows the lives of inmates in the experimental unit of a
maximum security prison. Prisons are violent places, but hopefully, few are
quite as violent as life in Oz, where rape, murder and creative acts of sadism
are routine aspects of daily life. The series has become famous for its
violence, nudity, bizarre and surprising plot twists and terrific acting. My
guest, Tom Fontana, is the co-creator of "Oz" and writes many of the episodes.
He also co-created the series "Homicide: Life on the Street." "Oz" started
its fourth season this month. Fontana first joined us when the series
premiered in 1997. We invited him back to discuss how the series has evolved.

In our first interview about "Oz" when the series was first beginning, you
explained that you'd done research in prisons not so much to get stories,
where people told you the best and the funniest anecdotes about being in
prison--what you said you wanted was to just get a sense of the texture and a
feeling of the place.

Mr. TOM FONTANA (Executive Producer; Writer): Yeah.

GROSS: ...to try to get to--if there was a common feeling about what it was
like to be locked up in a prison. Do you still feel the series is about what
it's really like to be locked up in prison, or do you think this series is
headed off in another direction?

Mr. FONTANA: Well, I would say still that it represents, it approximates
what it's like to be living a lifetime in prison. I think that from an
individual story point--every once in a while I've gotten a little giddy in my
storytelling.

GROSS: Thank you for saying that, yes.

Mr. FONTANA: But I also think because if we just did the actual rhythm of a
life in prison, it would get very repetitious by this point. And, you know,
as I said, I think we're still approximating what it's like, and still a lot
of the stories that I'm doing are actual things that have happened in prison.
I haven't invented too much stuff. It's just every once in a while, I get a
little Jacobean(ph) in the twist and the turn of the story.

GROSS: So some of the stories are based on reality, but they don't all happen
to the same person in the same place on the same day as they do in "Oz."

Mr. FONTANA: Exactly. Exactly. Exactly. You know, the thing about
episodic television, in general--if you looked at "N.Y.P.D. Blue" or
"Homicide" or "Sopranos" or any television drama series--over the course of
seven seasons, so many things happen to a character that it does start to seem
like the Book of Job. That's why, you know, a movie, it's just clean. It's,
OK, here's two hours of whatever's going to happen to this character. So the
accumulative effect of what a character like Tobias Beecher has gone through,
let's say, can feel to somebody, like, `Oh, my God, you know, it's
impossible.' And I suppose in real life, it is impossible. But, as you said,
the actual specific events are still very real.

GROSS: "Oz" has like, you know, the handsomest prisoners in the world.
There's some, like, mighty attractive guys in this prison.

Mr. FONTANA: Well, you know, what's funny about when you go to a real
prison, you're stunned by how healthy--I mean, they're all buff because they
work out in the gym. They don't have anything else to do.

GROSS: So these...

Mr. FONTANA: They all look great. They look much better than I look.

GROSS: But, I mean--when I say attractive, I mean their faces--their bodies,
their faces. I mean, these are real, like, hunks in prison. Is that
intentional on your part? Do you think that's part of the appeal of the show,
to have a few of the guys be really attractive for the men and the women who
are watching? And I should add some of these guys end up appearing naked in
the series as well.

Mr. FONTANA: Well, I would say that I've never cast anybody consciously
because they were attractive or unattractive. I do think that the show has a
mix of faces and a mix of looks about it. There are some, you know,
good-looking guys in it that I cast because I thought they were the best
actors, but I'm sure that's why some people watch the show. I hope it's not
the only reason people watch the show.

GROSS: Can you compare the feedback you get from men and women about the sex
on the show and the men's bodies on the show? And I don't mean to treat
lightly what goes on at Oz, which includes a lot of very violent rape, but, I
mean, it's just so clear in the series that there's a lot of, like, sex appeal
that the series is supposed to have.

Mr. FONTANA: Yeah. I guess so. Maybe I'm overly naive about these things,
because it's not something that I think about--I mean, I don't put people in
the hole naked because I go, `Oh, well, this is a moment where somebody's
going to get excited watching television.' I don't do the violence or the
nudity because I can. I do it because that's the moment--I mean, you'll
notice there's some times when people get sent to the hole where you don't see
very much, because throwing somebody in the hole naked has now become almost a
cliche on the show. So for me, it's less interesting to do that. And if
somebody says, `Well, they're not doing that anymore'--I mean, it's not that
we're not doing it at all, but we're doing it less. But if somebody says,
`Well, I'm not watching the show anymore because there's no more naked male
bodies in the hole,' well, then they should go watch something else. I wish
them well.

GROSS: I'll tell you the scene that particularly surprised me, and this was,
I think, at the end of last season. One of the characters was urinating nude
into a bucket.

Mr. FONTANA: Yes.

GROSS: And it was the most explicit urination scene I've ever seen on TV.

Mr. FONTANA: Well, he was actually really urinating. I mean, the actor was
actually urinating. There was no tricks up our sleeves. Well, he was naked,
so there were no sleeves in any case. But that, again--the purpose of that
was not for us to go, `Nyah, nyah, nyah, we can show a guy really urinating in
a bucket.' It was to say, well, we've been in this hole how many times, and
if you're going to actually be still shocked by the fact that people are
shoved in this hole, maybe you ought to be reminded that they don't just go in
there and sit there; that they actually have to, you know, perform bodily
functions in there. And you get a sense of the smell and you get a sense of
the totality of what it is to be locked in that room for, let's say, a month,
you know. I mean, it's to make a point. It's not to say, you know, `Oh,
look, aren't we adorable that we did that?'

GROSS: It's probably just a little bit of both, don't you think, though,
that--I mean, don't you make waves in what might be an interesting way by
doing that and get attention for it?

Mr. FONTANA: Well, I hope so. I don't actually know how much attention we
got in the sense of--I think people might have talked about it the next day.
And you're right. I mean, I definitely want to make waves. It's not that
I'm, you know, saying I don't want to make waves. But what I'm saying is I
wouldn't do it if I didn't actually think that the moment was right for it.
It wasn't an arbitrary, like, whimsical, well, what haven't we done? Oh, we
haven't shown a guy pissing in a bucket. It was to say, `Well, what's the
next thing to keep the audience, you know, stunned by what the lifestyle is in
a prison?'

GROSS: Have there been any protests? Have there been any special interest
groups or lobby groups who have been on your case because of the sex and
nudity and violence?

Mr. FONTANA: No. No, not that I'm aware of. The only people that I've ever
gotten negative letters from were, like, the Aryan Brotherhood, who think...

GROSS: What were they angry about?

Mr. FONTANA: I think sometimes they think our portrayal of the Aryan
Brotherhood isn't as positive as it might be. But other than that, I've never
gotten any kind of negativity off of the violence or the sex, because, again,
I think that people understand they're going to watch HBO, there is a
different criteria. But also if they're going to watch "Oz," it's not about
us being sensationalistic. It's about us doing what I think we need to do to
represent the world that we're showing.

GROSS: My guest is Tom Fontana, co-creator of the HBO prison series "Oz."
We'll talk more after a break. This is FRESH AIR.

(Soundbite of music)

GROSS: My guest is Tom Fontana, co-creator of the HBO prison series "Oz." He
also writes many of the episodes.

Do you ever get letters from prisoners or former prisoners?

Mr. FONTANA: All the time. All the time.

GROSS: What's the range of response you get?

Mr. FONTANA: Well, I mean, the bulk of the letters are usually, you know,
`I'm innocent. Can you help me get out?' or, `I heard that you did a story
about this, and that's like my case. Is that based on anything that I could
use for my defense?' or `I'm getting out of prison and I would love to come in
and talk to you and see if I could get a job.' And I treat every letter, you
know, very seriously, and I've met with a number of men who have gotten out of
prison to see if I could help them. You know, it's a tricky situation because
you, obviously, want to do the best you can. I mean, a lot of our extras are
former inmates, so, you know, sometimes that's a way to help people out is by
giving them a job as an extra.

GROSS: Has that worked out smoothly, working with former inmates on the set?

Mr. FONTANA: Yeah. We haven't had one problem. We haven't had one problem.
It's a pretty happy set, all things considered.

GROSS: Now the prisoners in "Oz" watch this kids' TV show, and it's a TV show
in which there's a woman host, and the puppet that she uses is often near her
breast, and it's quite sexual to the prisoners who are watching. What gave
you the idea for that show and for those prisoners' sexual interpretation of
what's happening?

Mr. FONTANA: Well, they tend to watch the most--they watch like aerobics
shows and things like that because they're really interested in seeing women
and women's breasts. And I wanted to do the "Miss Sally's Schoolyard(ph)."
In one part, it's like an homage to Burr Tillstrom and "Kukla, Fran and
Ollie," but also because I just love the irony of the fact that these
criminals were watching this children's show and they would have these dopey
little morals like be friendlier to your neighbor or, you know, don't forget
to, you know, say thank you. And just the absurdity of the fact that these
guys would be watching Miss Sally's for totally the wrong reason, only to look
at the woman, you know.

GROSS: Right. There's a lot of new prisoners on "Oz" this season. And one
of the new prisoners is played by Luke Perry who played Dylan on "Beverly
Hills 90210."

Mr. FONTANA: Mm-hmm.

GROSS: Why don't you describe his part on "Oz."

Mr. FONTANA: Well, what he is is he's a televangelist but he's not a, you
know, `Swaggartie,' Falwell guy. He's not a kind of a button-down, Midwest
guy. He's a much more of a--I mean, Luke's got very long hair and he's got a
beard so he actually looks more like Jesus than he does like Falwell. And the
idea was that I didn't want to bring this guy in as a phony. I wanted him to
be whatever crime he committed, which is embezzling from his own church--I
didn't want him to be just this like blow-hard, you know, fundamentalist. I
wanted him to have real Christian values and to see how those Christian values
helped or hindered people in the prison.

And also, to put that character through and--what he goes through in the
episodes he's in is a number of the seven deadly sins he is subjected to or
tempted by, I should say. And I thought it would be interesting to take a guy
who does truly believe in his Christian values and put him--you know, Mark
Twain said, `Virtue isn't virtue until it's tempted.' And it's easy to be in
a life and say, `Well, this is what I do and this is what I believe,' and
that. And then to put him in an intense environment like Oz and put his
virtue to the test and see where he comes out at the end of it.

GROSS: Let's hear a scene that's an example of that and in this scene Luke
Perry is working out, lifting weights and a young, you know, very attractive
prisoner who's new comes up to him and offers to give him sex.

(Soundbite from "Oz")

Mr. TIMMY KIRK: Hm, healthy body. Health mind. In the Catholic Church, the
body is a temple of the Holy Spirit that we're supposed to keep pure. Do you
believe that, Preacher?

Mr. LUKE PERRY: The body is God's gift to us. We're obligated to take care

of it.

Mr. KIRK: Well, what about sex? Is that a gift from God, too?

Mr. PERRY: Of course.

Mr. KIRK: How would you like a (censored)?

Mr. PERRY: What makes you think I want a (censored)?

Mr. KIRK: Everybody wants a (censored).

Mr. PERRY: No, thank you. Step back, please. You made a lifetime out of
being adorable, sexy in a lost little boy kind of way. But you threw your
baby in the trash. That's a man's crime. It's time for you to be a man.

GROSS: You want to talk a little bit about writing that scene?

Mr. FONTANA: Well, you know, as I was just saying--starting with the two
characters in the scene, both of whom were established before the
scene--Luke's character is a guy who the rest of the prisoners are now going
to be kind of sniffing around him to see what they can get from him and what
they can do to entice him. And the other character, Timmy Kirk, who has been
this kind of little boy sneaking his way through and getting things that he's
wanted by, you know, flirting and things like that. The fun or writing "Oz"
is to create different characters and then put them in--put all these
different characters, you know, two by two or three by three, in a scene
together and see what kind of explosion happens. And so that was where that
scene came from. I thought, `Well, let's see what this guy's got. Let's see
what Luke Perry's character's got. You know, this is his first temptation.
Let's see what he's really made of.'

GROSS: What came first for you wanting to give Luke Perry a part in "Oz," or
writing this character of the televangelist and then looking for somebody to
play it and deciding on Luke Perry?

Mr. FONTANA: No. They actually happened simultaneously, as it does with a
lot of the actors on "Oz." If I know their work, I try to create a part for
them. I've known Luke a number of years and always wanted to work with him.
And I didn't want to write something that he'd already done. And I thought
it'd be kind of great to bring him in as this famous televangelist because,
you know, Luke is famous and I thought it justified the fact that most of the
actors on "Oz" are unknowns but Luke Perry isn't unknown and this
televangelist wasn't unknown. And to Luke's credit, he was extraordinary. He
jumped in both feet. He--you know, a lot of times the actors are just
background. They have no dialogue and I said to you, `You're going to be
sitting around for--a lot, you know, in the background. The camera may see
you, it may not see you.' And he said, `Tom, I am here. I'll do it.' And he
had such a great spirit and everybody--all the other actors just loved having
him around, so...

GROSS: Now I didn't see this episode, but I understand that Uta Hagen, the
great stage actress and the revered acting teacher...

Mr. FONTANA: Yeah.

GROSS: ...had a part on "Oz." How did you end up casting her?

Mr. FONTANA: Well, again, I've known Rita--Rita--I've known Uta a long time
and she and I had worked together before and I just called her up and said,
`I've got this part,' and she read the script, said, `I'm on my way over.'
And actually when she was done--because it was just the one scene there. She
had a scene with George Morfogen, playing his mother, and we shot it and she
got up and she said, `You know, I've done a lot of movies. I've done a lot of
things.' She said, `That's the fastest I've ever worked and I had the best
time,' because it was just--it was all about spontaneity and it wasn't about
the, you know, technology of making a film. So she had a blast and I
actually--you know, I adore working with her. She's just--I mean, the set was
like--I could have sold tickets to the set that day because there were so many
actors sitting around watching her work, you know.

GROSS: Was there anything you felt you had to protect her from?

Mr. FONTANA: No. No. Uta Hagen? No. She's tougher than anybody.

GROSS: OK.

Mr. FONTANA: I mean, you don't survive that many years in the theater
without having a--you know, the skin of a rhino. She's--yeah, you don't have
to worry about Uta. She can take care of herself.

GROSS: Now here's one of the really improvable plot twists on "Oz" that I
have to ask you about.

Mr. FONTANA: Mm-hmm.

GROSS: A couple of episodes ago there was a group of Chinese immigrants that
had absolutely no place to stay and it was arranged through the government--I
think it was through the government, that they...

Mr. FONTANA: Yes.

GROSS: ...would stay on cots in Oz. And they're even allowed to mingle with
the prisoners and I guess, no big surprise, one of them is brutally murdered.
I mean, did it ever really happen that immigrants were...

Mr. FONTANA: Well...

GROSS: ...put up in a prison and allowed to mingle with the most hardened
prisoners?

Mr. FONTANA: ...what happened--well, yeah. No. I mean, yeah. I did--I
mean, they were put in prison facilities. They were separated more than I did
on the show. But they were basically, you know, shoved anywhere they could be
shoved while the situation was resolved. No, I don't disagree that it
was--that I took a little license there and put them in Oz--I mean, put them
in Emerald City. But, you know, that's--for me, it was more about a story
about, you know, another kind of prisoner, another kind of disenfranchised
person in the world, you know. And how does that measure up to what goes on
in a prison? So I may have been gone too far out on the limb with that one,
but I'm glad I did the story and I thought that actor was terrific.

GROSS: My guest is Tom Fontana, co-creator of the HBO prison series "Oz."
We'll talk more after a break.

This is FRESH AIR.

(Soundbite of music)

GROSS: My guest is Tom Fontana, co-creator of the HBO prison series "Oz." He
also writes many of the episodes.

Strange question, I'm not sure if your parents are even alive so forgive me
for asking this.

Mr. FONTANA: My mother is.

GROSS: Does your mother ever watch "Oz?"

Mr. FONTANA: Yes. Yeah.

GROSS: What does she have to say about it?

Mr. FONTANA: Well, it's interesting. When the show first was coming on the
air, she, `Oh, Tommy, I hear you have another show coming on the air.' And I
said, `Yeah. But, Mom, I don't think you should watch this one.' And she
said, `Why not?' And I tried to, in very, you know, gentle ways explain what
the show was about and why I didn't think she'd watch it. And she said, `Oh,
I think I should watch that.' And we got into a kind of argument on the
phone, you know, almost as if she was my daughter and I was, like, going, `No,
under not circumstances can you watch that. And I'm going to get a V-chip and
put it on your TV set.' And blah, blah, blah. And she said, `You know, you
can't tell me what to watch and I can watch whatever I want to.' And it was
playful, but it was--you know, I was really concerned. And I finally said to
her, `OK. You can watch the show under two conditions. One is, is that, we
can never speak of it again and, two, that if any of your friends say, "I saw
your son's show," say, "Oh, no, that's the other Tom Fontana who writes that
show."'

So the first episode premiered and she didn't--we talk every Sunday and that
Sunday she didn't say anything and I thought, `Oh, phew.' And then the second
week, same thing. She didn't say anything. Third week she said to me, `I've
got to ask you a question.' And I go, `What?' And she says, `It's about
"Oz."' I go, `Ma, we agreed we'd never talk about it.' And she said, `No, no
I have just got on question.' And I go, `All right. What's the question?'
And she said, `Is anybody going to die next week?' She said, `Because they're
all such nice boys, I don't want to see any of them die.' And she and her
girlfriends, they watch the show and then they call each other the next day
and they talk about it. And it's one of those things that you say to
yourself, `Oh, my God. My 80-year-old mother watches "Oz."'

GROSS: And thinks that they're all such nice guys.

Mr. FONTANA: Nice boys. Nice boys, yeah. She gets very--you know, because
she understands them like a good mother, you know.

GROSS: I think it's because they're your creations. Now I understand
that--at the beginning of "Oz" we used to see somebody getting an Oz tattoo
and we see the tattoo being inscribed and...

Mr. FONTANA: Yes. Yes.

GROSS: ...then being a little bloodied by the inscription.

Mr. FONTANA: Yes.

GROSS: And I understand you have an Oz tattoo?

Mr. FONTANA: That is me in the opening sequence of the show. That is my
shoulder. I didn't let them shoot my face because I was screaming. No.
Actually, I have several tattoos and when we were doing the opening--actually,
Sheila Nevins, from HBO, suggested that I do the tattoo. And I thought it was
such a good idea and I set the whole thing up and we got a real prison--a
tattoo artist to come. The guy was out of prison, came to do it. And so we
were all--and everybody kept saying, `Who's going to get the tattoo?' And I
was going, `Oh, somebody'll get it. Somebody'll get it.' And we got to the
moment of truth and nobody wanted to get it and I said, `Well, I'll get it.'

And we sat there and we were shooting it and the director of the sequence kept
going, `All right. Let's do one more take.' And, `Oh, OK. Let's do one more
take.' `All right, we'll do one more take.' And, you know, I'm sitting
there and the thing--and the whole crew's waiting for me to, like, cry or
scream or something but I didn't because, as I said, I have other tattoos so I
knew the sensation. And the tattoo artist finally said--when the director
said, `Let's do another take.' He said, `You know, if I cut into this guy
anymore, he's going to bleed to death.' So that's when we stopped shooting
that sequence. But that is my actual arm. And it was funny because a lot of
people said to me, `Well, what are you going to do?' This is the first season
and we didn't know how the show would be received. They said, `What are you
going to do if the show gets canceled?' And I said, `Well, I'll either meet a
girl named Roz and put an R in front of it or change the--put a little dot
after it and make it ounces. I'll figure out something.' But, fortunately, I
haven't had to and now I've had all of my shows tattooed on my body, so...

GROSS: Right.

Mr. FONTANA: ...I'm a walking resume.

GROSS: Have people said to you, `What are you going to feel like when you're
80 and you have this Oz tattoo on your arm?'

Mr. FONTANA: Man, if I live to be 80, I won't even have to answer that, you
know.

GROSS: So do you like the way your tattoo came out in the shot that we see
every week at the opening?

Mr. FONTANA: Yes. Yes. I'm very proud of my tattoo.

GROSS: And your mother, what does she think of the tattoo?

Mr. FONTANA: Well, I don't think she's thrilled by any of the tattoos, but I
think...

GROSS: You don't really have the other tattoos on your body, do you, of the
other names of your shows?

Mr. FONTANA: No, no, no. Not the other...

GROSS: Right. Oh...

Mr. FONTANA: I have other tattoos, but they're not the other names of the
shows. No, I was just kidding.

GROSS: Oh, yeah. Well, what are the other tattoos?

Mr. FONTANA: Well, we'll save that for next time.

GROSS: Well, this, apparently, is none of our business. OK. We'll use our
vivid imagination.

Mr. FONTANA: Yes. Exactly. Exactly. That's the whole point of "Oz,"
right? Get people to use their imagination.

GROSS: So you are now working on next season's episodes?

Mr. FONTANA: We're writing the ones that we're going to shoot in April.
That would be the next season, yes.

GROSS: Any clues about what's happening?

Mr. FONTANA: Everyone loves each other. There's no more sex. There's no
more violence. It's a perfect universe.

GROSS: Nothing but reconciliation.

Mr. FONTANA: Right. Well, it's the Bush years now. I have to, you know, go
into another mode.

GROSS: Well, Tom Fontana, thank you so much for talking with us.

Mr. FONTANA: Well, it's always a pleasure. Thanks for asking me back.

GROSS: Tom Fontana is the co-creator of the HBO prison series "Oz."

(Credits)

GROSS: I'm Terry Gross.
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