The Stigma of Chronic Illness in Hollywood: "No One Wants to Work With Someone Who Isn't Healthy"

Dimitrios Kambouris/Getty Images
From left: Susan Sarandon, Padma Lakshmi, Lena Dunham and Allison Williams at a 2016 fundraiser for the Endometriosis Foundation.

Padma Lakshmi and Lena Dunham open up about fears of letting down networks and crews, risking insurance and future work as experts reveal how stress management and a support system can help: "Honor your pain, then make appropriate choices."

It was minutes before she was to go on live TV that Emmy-nominated host Padma Lakshmi had a medical crisis. "I really needed to take my prescription medicine, and my network executive said, 'No, you shouldn't take that because we're going live.' I know that the executive was trying to do the best for me and the show, but it was misguided."

For years, Lakshmi has suffered from severe endometriosis, struggling not only with pain, but also with how to handle it while working. "Because of what I would experience every month — five days of being in severe pain and sometimes bedridden — I had to say no to things. I could look at a calendar and I knew not to take jobs at that time. I lost income because of my health."

In an industry where everyone is expected to work long hours, admitting to a chronic health condition can hurt one's career by raising questions of reliability. When asked about female actors, writers, producers and directors with chronic ailments, a female executive producer with more than 20 years of experience says, "I don't know anyone who fits the bill, but then again, people tend not to talk about those things for fear of losing work." Another female showrunner adds, "No one in Hollywood wants to work with someone who isn't 'totally healthy.' "

Beyond perceptions, there can also be anxiety around workflow and financial repercussions. Like Lakshmi, actor-writer-director (and THR guest editor) Lena Dunham suffers from endometriosis, having endured 12 surgeries in the past four years and 30 hospitalizations in the past 12. "When I was working on Girls, I didn't feel like there was even an option to call in sick," says Dunham, "because I was number one on the call sheet, the executive producer and, for a lot of episodes, the director, so I would have been calling in sick in all three of those roles." She adds, "You have the network — people who are putting a lot of financial faith in you — and your crew, who can lose hours and pay, to think about. That puts a huge amount of stress on you."

While Dunham credits the various unions with providing extensive health care coverage once a worker is eligible, she says there's a concern that missing too many days makes one uninsurable. Such fear can lead to drastic measures to keep working. "I get asked a lot, 'I'm run-down, do you do B-12 shots?' " says Margarita Velona, an 18-year set medic who's not legally allowed to administer them. But if you have a condition that needs monitoring, "if you're diabetic or take blood pressure medication, let me know. I can help with blood sugar testing," says Velona, who is bound by HIPAA confidentiality laws.

Velona adds that if the industry wants to keep workers healthy, the 12-, 14- and 16-plus-hour production days that have become standard need to change. Says Dunham, "If I'm being honest, this business — where you can't stop going, you can't get sick — has created a lot of unhealthy habits that I'm still working really hard to turn around." Ken Best, a Los Angeles-area chiropractor who is frequently called to sets to treat cast and crew, says that cumulative stress from long hours is the biggest culprit he sees: "It's vital to remember that while the body is adaptive, it will eventually break down." He recommends short activity breaks, like stretching, walking and/or doing a few yoga poses. "There's a lot of time pressure to keep production going, but in just five to 10 minutes you can break the patterns of stress," he says. Even a downward dog held for a minute or two can help. Best also recommends minimizing sugar and caffeine, which can "just blow up your adrenal glands. Putting that in your body all the time is constantly compromising your immune system."

If you are already dealing with a chronic health condition, a strong personal support system is key, says veteran broadcaster Joan Lunden, who was diagnosed and treated for an aggressive form of breast cancer. "One of the biggest issues of dealing with chronic illness is just feeling like you're the only one going through it," she says. "Don't shy away from sharing with your group. You need them." Dunham agrees: "I have a few friends who suffer from Lyme disease and a few who have fibromyalgia who are all in the industry. We're in deep touch, and having these people to talk to is invaluable in helping me feel like I can handle my illness."

What doesn't help, says Dunham, are comments like, "I heard you were out with bad cramps," "Man, you get sick a lot" or "Are you sure you weren't just partying?" from male co-workers. "Jokes are jokes," she says, "but to be mocked for not being able to make it to work for something that's completely out of my control is unacceptable to me."

While her illness may have limited her somewhat, Dunham would like every generation of women in Hollywood to know that suffering from a chronic condition doesn't close the door to opportunities in the industry. "You have to be honest about what you can and can't do. Having something like endometriosis, asthma or fibromyalgia doesn't mean you can't be an actor, writer, director or whatever you want to be. But you must honor your pain, listen to it and make appropriate choices for yourself regardless of any pressure put upon you."

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HELP TO COPE WITH CHRONIC ILLNESS

General

Caring Voice Coalition

Caring Voice Coalition aims to improve the lives of people with chronic illnesses with outreach programs ranging from health insurance counseling to disability assistance.
► caringvoice.org
► 888-267-1440

The Saban Center for Health and Wellness

Part of the Motion Picture & Television Fund’s health resources, the Saban Center for Health and Wellness is exclusive to those who work in the industry. Featuring the Jodie Foster Aquatic Pavilion for water therapy and exercise, it also offers educational seminars. On the MPTF board: Casey Wasserman, George Clooney, Jim Gianopulos and Jeffrey Katzenberg.
► mptf.com/saban
► 818-876-1777

211 LA County

In partnership with AltaMed and the L.A. County Department of Public Health, 211 LA County provides info and referrals for all health and human services. Phone lines are staffed 24/7 with trained advisers.
► 211la.org
► 800-339-6993

Medical

UCLA Health Centers

Five locations are offered exclusively to the industry in partnership with MPTF. Their network of 500 physicians teams with on-site experts for X-rays, lab draws, family and internal medicine and social work.

Bob Hope Health Center
335 N. La Brea Ave. Los Angeles
► 323-634-3850

Santa Clarita Health Center
25751 McBean Parkway #210 Valencia, CA
► 661-284-3100

Toluca Lake Health Center
4323 Riverside Drive Burbank, CA
► 818-556-2700

Westside Health Center
1950 Sawtelle Blvd. #130 Los Angeles
► 310-996-9355

Jack H. Skirball Center
23388 Mulholland Drive Woodland Hills, CA
► 818-876-1050

Endometriosis Resources

Endometriosis Foundation of America

Co-founded by TV host Padma Lakshmi and gynecologist Tamer Seckin in 2009, the nonprofit advocates for increased awareness of endometriosis; helps find care and treatment options for patients; funds research; and conducts the worldwide school- and community-based education program ENPOWR Project. The annual Blossom Ball has honored Lena Dunham, Susan Sarandon and Halsey for supporting the cause.
► endofound.org

Endometriosis Association

The self-help organization of women collaborates with doctors and scientists to share information about endometriosis to ultimately find a cure. The association works on prevention, education, support and research.
► endometriosisassn.org
► 414-355-2200

Counseling

The Samuel Goldwyn Jr. Center for Behavioral Health

The center caters to adults over age 55 with mental health needs, including those with anxiety and depression. The 12 private rooms at the Wasserman Campus in Woodland Hills are available to those working in Hollywood via MPTF. 
► mptf.com/healthcare/ behavioralhealth
► 818-876-4140

National Alliance on Mental Illness

NAMI advocates for those affected and helps navigate work issues, from requesting leaves of absence to requesting work accommodations. Ambassadors include actors Utkarsh Ambudkar, Mayim Bialik, Carly Chaikin, Clark Gregg and Corinne Foxx.
► nami.org
► 800-950-NAMI

Financial

Filing for disability

California is one of few states with a short-term disability program, which pays employees a portion of wages while they are temporarily unable to work because of a disability. If you meet state requirements and file the necessary paperwork, you will receive benefit payments, generally every two weeks.
► ssa.gov/disability
► 800-772-1213

Partnership for Prescription Assistance (PPA)

PPA helps match patients with assistance programs that may lower medication costs. The organization also locates nearby clinics.
► pparx.org
► 1-888-4PPA-NOW

GoodRx

Available via website or an app, it searches for and compares prescription medications to find the lowest price available.
► goodrx.com
► 855-268-2822

This story first appeared in the 2018 Women in Entertainment Power 100 issue of The Hollywood Reporter magazine. To receive the magazine, click here to subscribe.