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Leading advocate for airline safety measures to protect food-allergic passengers Lianne Mandelbaum discusses her article “When TV shows use food allergy as murder.” Lianne examines the dangerous trend in popular media where severe reactions like anaphylaxis are used as plot devices for violence without consequence. She critiques a recent miniseries that portrays food allergy murder as justified and fears this provides a blueprint for real-world bullying and harassment. The conversation highlights heartbreaking stories of loss and the reality that swapping an epinephrine auto-injector or exposing someone to allergens is not a prank but a crime. Lianne urges the public and content creators to understand that misrepresentation validates dangerous behavior and puts vulnerable children at risk. Learn why accurate storytelling is essential for protecting the safety and dignity of those with life-threatening conditions.

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Transcript

Kevin Pho: And welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back Lianne Mandelbaum. She is a patient advocate and food allergy safety advocate. Today’s KevinMD article is “When TV shows use food allergy as murder.” Lianne, welcome back to the show.

Lianne Mandelbaum: Thank you for having me once again.

Kevin Pho: All right, so tell us about this latest article and there was a recent show that caught your attention, right?

Lianne Mandelbaum: Yeah, it actually caught the attention of a friend of mine who messaged me that she and her daughter had watched this Peacock miniseries and at the very end, the character that is murdered is exploited to be murdered by using their food allergy. And they were not portrayed as the villain. They were actually portrayed as the hero. There were no consequences. It was truly shocking because I have written many times before about unfortunate jokes and other medical conditions being respected while food allergy is the Rodney Dangerfield of disease.

But I had never seen something quite as blatant as this. And it truly disturbs me, not because I want to censor art or criticize the entertainment industry in general, but because we fight every day to have food allergy recognized as a legitimate medical condition. It is dismissed. It is laughed at. There are battles that go on in schools and on airplanes and in restaurants and in all walks of life where people are not taken seriously. Their concerns are dismissed.

There is bullying that goes on. There is a whole host of issues. And now you add to the mix a literal blueprint for murder and how to get away with it. To give you a little more detail, the person has a soy allergy. They are kissed by their spouse on purpose, who has exposed themselves to soy, and then the epinephrine is switched for a way-expired pen, and the backup is hidden, and the person dies and it is celebrated.

We live in a culture that is steeped in peer pressure and pranks, especially for teens and young adults. And I just think that, again, not trying to censor, but I do feel like it is our duty as advocates, as medical professionals, and as concerned human beings to speak up and at least counter this with: “OK, you are portraying this, but let’s try to bring the discussion about why this is so harmful.” I can go into why it is so harmful with some real-life examples.

Kevin Pho: Sure. So I think that in this particular miniseries you mentioned, I haven’t seen it myself. You mentioned it was actually the villain who passed away and this villain’s death was celebrated.

Lianne Mandelbaum: Yes. Yes. So that is part of the problem. I think it is All She Ever Wanted. I have blocked it out of my mind. I would have to go back and look at my article. I swear. I refreshed myself before this. I think the title is, and I have still blocked it because it is much…

Kevin Pho: It is All Her Fault. All Her Fault is the name of the show.

Lianne Mandelbaum: OK. All Her Fault. Thank you.

Kevin Pho: Serious. So how does that trivialize food allergies just to be used as a plot device and specifically a way to commit murder? As an advocate yourself, turning something so serious into a plot device and a method to murder, what does that do to the condition?

Lianne Mandelbaum: Well, first of all, you sort of laugh at it, right? So it is like not because whereas maybe you would watch another show and you wouldn’t laugh at murder, this is clearly something you would almost laugh at and cheer for. So that is a problem right there.

And I thought back to a couple of concrete examples. Much of the way my advocacy is shaped is I think about the dad that I met, and I have written about this and I wrote in this article that his son was exposed to his allergen unintentionally, and he felt his son’s heart stop while they were waiting for the ambulance. People don’t understand that this is not entertainment. This is something that can become fatal in minutes. When you make it entertainment and you make light of it and you create a blueprint, the unfortunate end result can be embarrassment and so someone doesn’t speak up.

I will give you a really concrete example of something that just was in the news where there was an anaphylaxis event aboard a Virgin Australia plane about two weeks ago. The person accepted the airline meal and had a reaction and spoke up immediately. And not only did he have his own EpiPen, but he actually went into a biphasic reaction, which is when the reaction comes back. And they didn’t have any epinephrine it seems like, and someone had to lend them an autoinjector.

Now, if this person was embarrassed to speak up for his safety or hadn’t told the crew about his allergy, he wouldn’t be here because this is a swiftly moving reaction. I worry that portrayals like this and framing food allergy as either funny or a way to commit murder actually can lead to real-life consequences.

And I think about the football player who had peanuts put in his locker. I pointed to this example. They did it on purpose. He was a very good football player. He was a valued member of the team. Yet still his teammates thought it was hilarious to fill his locker with peanuts and he had head-to-toe hives. The school didn’t treat it seriously. They basically said it was like “boys being boys” or an innocent prank. You know that innocent prank could have very well killed him. They barely punished these teammates to the point that he needed to switch schools, and he is now thriving. But how sad is it that he needed to switch schools and the adults that were supposed to protect him also downgraded the seriousness of this?

So I think this just all whittles away and downgrades the seriousness of the disease. And before I was preparing for this interview and I wanted to share this study with the people listening, it was done by a colleague of mine, Linda Herbert, out of Children’s National, and it is on bullying. So if you listen to this, I wanted to write it down so if I don’t look exactly at the camera. So one in three kids or teens are bullied. Over half are overt physical acts. That means with the food. 30 percent had the food waved in their face. 10 percent had the allergen thrown at them. 5 percent had the allergen put in their food, and 10 percent were forced to eat their allergen. And 66 percent reported having remarks or criticisms or verbal abuse and intimidation. And this was in pediatric psychology.

And so you think about that as a whole. And you then think about these portrayals in the media and you see a real intersection of where media portrayals and silence by those who treat patients and those who are related and the community around them can actually lead to these incidences flourishing. And it worries me because bullying is something that is taken seriously again in so many other venues, but somehow food allergy just doesn’t get the attention.

Kevin Pho: So why is it that food allergies specifically are used in such a throwaway manner? And we have been on the show multiple times talking about food allergies being used as jokes on Saturday Night Live and comedians, and now in murder. You don’t see this with most other diseases, right? You see this with inflammatory bowel disease or cancer or heart attacks, but food allergies, people literally die from this as we have talked about many times before. Why specifically food allergies? Why is it being used like this in the entertainment industry?

Lianne Mandelbaum: I have wondered that. I think: “Is it the word allergy? Does it connote runny nose?” Is it that in the media on X and on other platforms, parents of children with food allergies are framed as “Karens” or helicopter moms? If you have seen your child, like I have, have the light go out in their eye, you know differently. I literally remember my son has these deep brown eyes and they sparkle, and I can just close my eyes and think of the time where that sparkle just vanished until that epinephrine was administered, and then it came right back up. It is almost like you were lighting a match and all of a sudden the flame is back.

They don’t understand that. And maybe some people do understand which is worse, but I think the majority of people don’t understand it is quick, it is swift, it is potentially fatal. I don’t think it helps that we don’t get outcry from all the associations that treat and advocate for people with food allergies. I really don’t think that helps. I don’t think it helps that most people misunderstand the condition and there is just such a lack of education. Yet millions of people in the United States alone have food allergies. Adult onset is growing.

I think another misconception, and I did slide this into the piece, is that yes, we have found out that feeding people often and early, meaning babies, not people, the allergenic foods, has led to what we believe is a decrease in food allergies. That does not help the people who already live with the allergies and it doesn’t help the people who have been eating these foods their whole life. And we have this growing global onset of adult-onset allergies, so it doesn’t help those people. I think that even when I deal with airlines, there is this misconception that we have discovered what can help not develop food allergy so we don’t have to worry about them anymore. There are so many misconceptions and misunderstandings.

I think people think if we ignore it, that would be better because I am giving air time to this kind of storyline. But I completely disagree. I think we have to have a third rail for our community where we say: “This is just not acceptable.” Because it doesn’t silence the abuse. All it does is normalize the abuse with food allergy. Maybe that works in other places. I don’t know, but it doesn’t work here. I have been shouting about it for so long. It never leads to a conversation besides the one we are having because I am writing about it. But it never leads to anything meaningful taking place that could actually curtail the lives and the situations that are so untenable for those living with food allergy.

I remember one of the testimonials I collected was an adult woman allergic to shrimp, and she went to go to the bathroom. She had informed the flight crew. And she, before she went to the bathroom, they said: “Oh, you better be careful. There were shrimp all over the bathroom.” And then she was thinking that they were laughing. These were adult flight attendants laughing at a woman who was scared and informed people because she was frightened and because shrimp was being served on her flight. Even though she wasn’t sitting in the class that was being served at, it was being served. And then she is thinking to herself: “Did they like touch the shrimp and go rub my chair’s handles or my table because they think it is hilarious?” I mean, these are the consequences of not speaking up and not educating real people, not just children.

In fact, I feel worse for the adults because they are the ones who are more likely to be silent. I will give you one other very sad example of Chandler Swink. He was a college student. He went to a party. They had baked chocolate chip cookies, and I believe that the baking sheet was also used for peanut butter chocolate cookies, like there was a trace there. He started having a reaction and he didn’t tell anyone. He gave himself the autoinjector and he drove himself to the hospital and he died in the parking lot of the hospital. He never made it in because he didn’t tell anyone. It was embarrassment. Not speaking up because you don’t want to be seen as different because people do laugh at food allergies because people think that the EpiPen or the nasal spray is a magic wand. And most of the time, thankfully it is. I have seen it work like magic. We described it, but sometimes it is not. And sometimes you need advanced life support.

Kevin Pho: So you have been a food allergy safety advocate for many years now. Of course. And you have been on the show many times. Have we moved the needle specifically with the entertainment industry? I know that certainly in the airline industry we have talked about the difference that you have made, but how about specifically with the entertainment industry? We keep hearing about no jokes and murder plots and just kind of like you said, normalizing it. So I think that have we made some inroads in the last few years regarding specifically in the entertainment industry?

Lianne Mandelbaum: No. No, I really don’t think so. I don’t think there are any guardrails. I think that if this show had any other disease filled in the blank for the script that maybe it wouldn’t have made it out of the drawing board. And there is still this sense that they can get away with it. And so they do. Whether it is late-night jokes, whether it is making fun of the helicopter mother on a plane, whether it is going on social media and saying things. I imagine if you went on social media and you said: “I am going to load a gun,” or “I am going to take a packet of cyanide powder and I am just going to walk up and down with it open.” You would be arrested if you posted it on social media. You would be restrained on a plane if you did that and it was clearly labeled cyanide. But yet you can make fun of someone being afraid to be next to something that perhaps has had them intubated unconscious.

There was a story years ago I covered where it was Panera. They settled out of court, but there were fellow employees putting actual allergen peanut butter in something or on the person’s desk. It just seems to be acceptable. An acceptable thing like: “Oh, laugh it off. Grow a pair. You need to be able to laugh at yourself.” Well, if that is all it was, I can laugh at myself. I make fun of myself all the time for whatever my idiosyncrasies are. But making fun of something that can kill someone and has killed someone is different. I just think you wouldn’t do it like you said before in other diseases, and I don’t know what the red line will be for the entertainment industry, but they are causing harm. So until that red line is drawn, I will be writing about it and hopefully promoting discussion about it and hopefully getting people who treat patients and who intersect with patients in everyday life to see and perhaps take a different lens to the situation. It is not just about growing a pair of something or teaching people to live in the real world, because you don’t want someone to actually follow through on some of this and harm someone.

Kevin Pho: We are talking to Lianne Mandelbaum, food allergy safety advocate. Today’s KevinMD article is “When TV shows use food allergy as murder.” Lianne, as always, let’s end with take-home messages that you want to leave with the KevinMD audience.

Lianne Mandelbaum: I want people to recognize food allergies as life-threatening. I want people to go and search out the studies that show children and adults being bullied with their allergen and understand how their patients, their friends, and their loved ones could actually be facing these untenable situations. I want people to be able to talk to their children and adults that have these conditions and ask broad questions so you can actually find out if they are being bullied. People don’t want to admit they are being bullied. It is not an easy thing to talk about. And they may need to talk about it with their medical professional.

They also need to be referred to Linda Herbert who did the study at Children’s National, and she is really big on the mental health side of food allergy. So I think you may need to refer a friend or a patient to someone who can help them deal with this and have tools and be able to have the voice to stick up for themselves.

And again, I think giving people a sense of confidence to talk about their allergies as a real life-threatening condition is important. So that if an untenable situation happens, like that young man on the Virgin Australia flight a few weeks ago, they do speak up. They do ask for borrowed medication. They do treat right away because we know that when you don’t treat right away, that is when you have the biggest possibility of a fatal outcome. So supporting people that have the condition and speaking up when people make fun of it and saying why it is not a great idea is key. Also, I would say putting it on the same stage as other diseases, even though it is intermittent, it still has a fatal nature, and respecting that and respecting people who have to deal with this is crucial.

Kevin Pho: Lianne, thank you so much for sharing your perspective and insight. Thanks again for coming back on the show.

Lianne Mandelbaum: Thank you for having me again. Pleasure.