How Tuca & Bertie Depicts the Grim Reality of Women’s Healthcare

Season 3 of Adult Swim's Tuca & Bertie depicts the frustrating aspects of women's healthcare with humor and empathy.

Tuca (Tiffany Haddish) talks with her Bee Doctor about her chronic pain
Photo: Adult Swim

This article contains spoilers for season 3 of Tuca & Bertie

Even in its shift from Netflix to Adult Swim and HBO Max, animated comedy Tuca & Bertie isn’t afraid to tackle heavy topics. Season 2 sees Bertie (Ali Wong) start therapy to deal with her anxiety and childhood trauma, with her growth continuing on into season 3. Tuca’s (Tiffany Haddish) sobriety is a big part of the series and we get to see how that decision both enriches her life and makes some things more challenging. Given that creator Lisa Hanawalt also served as the production designer for BoJack Horseman, it’s really no surprise that Tuca & Bertie is able to adeptly balance serious issues with humor.

The series isn’t funny because its characters are dealing with trauma, but rather because their situations are both absurd and completely relatable. Even though Tuca and Bertie are anthropomorphized birds that live in a fictional town filled with other plants and animals, a lot of their experiences mirror those of people in the real world. Through Tuca and Bertie, the series calls attention to real issues that people deal with, and at the same time gives catharsis to those of us who have gone through something similar. The second episode of the show’s third season “The Pain Garden” is one of the best examples of this.

In “The Pain Garden,” Tuca finally goes to see a doctor about the recurring and intense period pain that she’s had for most of her life. She’s essentially bedridden during her period, and only has one week a month where she isn’t in some kind of pain or discomfort. Unfortunately, even though she now has health insurance through her job, it only covers a health facility run by bees who are more interested in finding a new queen for their hive than actually solving Tuca’s problem.

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She is passed from bee doctor to bee doctor, without getting any answers as to why she is in so much pain every month. After a montage that literally involves a group of doctors poking and prodding her, Tuca finally declares that enough is enough. She says that “my body is a galaxy, not just one planet”, and asks why the specialists can’t just work together to determine what’s wrong with her since her condition is affecting her whole body, not just a single part or system.

The bees’ song and dance reply is both funny and depressingly familiar. Essentially, because the doctors aren’t able to find the cause of her pain, they just shrug their shoulders and tell her it’s probably anxiety, and maybe she should just lose some weight. Tuca then insists on going to a real hospital that’s not run by bees, but even there the tests they run come back normal or inconclusive. Ultimately, Tuca ends the day defeated and still in pain, resigned to just keep pushing through this flare until it subsides and she finds a few days or weeks of relief.

What Tuca goes through in this episode has come to be known as “medical gaslighting.” “Medical gaslighting” occurs when a patient – usually a woman, non-binary person, or person of color – is dismissed or misdiagnosed by their doctor or another medical professional. It’s not that the patient believes that they know more than the doctor, but rather that the patient feels as though their concerns aren’t being addressed or taken seriously. When Tuca is passed from doctor to doctor at the bee facility, each one brushes off her concerns in a different way.

The first doctor that Tuca sees tries to have her rate her pain levels, not with anything quantifiable, but instead with a group of cartoon faces that have various expressions (and hats for some reason). Tuca quickly becomes confused and accidentally chooses one on the lower end of the pain scale. She is then almost instantly referred to an o-bee-gyn (the bee’s version of an obstetric gynecologist, naturally) who refuses to acknowledge any of Tuca’s symptoms that don’t have to do with her reproductive system. Even when she is finally transferred to a regular hospital, no one tries to help her figure out what her next steps could be since her tests and scans don’t reveal anything conclusive. 

Just as the bees are quick to dismiss Tuca’s symptoms as psychosomatic or weight-related, so too are real-world physicians. Patients sometimes have to go through months or even years of what Tuca experiences before finding a doctor that can either help determine the cause of their symptoms or at the very least not be condescending when admitting that they don’t know what’s wrong. Research shows that diagnostic errors occur in one out of seven clinician visits primarily due to human-error or a lack of knowledge around certain conditions.

While I’ve thankfully never had bees for doctors, they are an astute representation of how the American healthcare system operates. In larger healthcare systems, doctors tend to be booked with back-to-back patients leaving them always busy and moving about, kind of like bees. Sometimes it feels as though they are trying to get through an appointment as quickly as possible, not necessarily because they don’t care, but because they are overworked and don’t have the time they should to provide more personal care to their patients. Like the hive hospital, the American healthcare system has its own absurd barriers to receiving care that leave patients suffering for way longer than they should.

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In an interview with the New York Times, writer Raimey Gallant details her struggles with having a male doctor describe her as “young, healthy and just lazy” in her twenties when in reality she has Graves’ Disease, an autoimmune disorder affecting thyroid production, and endometriosis, a chronic condition where tissue similar to the lining of the uterus grows in other parts of the body. As shocking as it may be, it took Gallant twenty years to receive her endometriosis diagnosis. This is double the average 7-10 years that most people have to wait before they’re diagnosed with endometriosis.

According to Lone Hummelshoj, the chief executive of the World Endometriosis Society and the World Endometriosis Research Foundation in an interview with Forbes “The normalization of painful symptoms is a huge issue. And there’s still a very low recognition of endometriosis at the general practitioner level…If these symptoms are dismissed as primary dysmenorrhea, which it may be for some people, then a doctor won’t investigate further and this contributes to the delay in diagnosis and timely management of symptomatic endometriosis.” While Tuca’s quest to find the cause of her chronic and debilitating period pain is both disheartening and laughably absurd at times, it’s not far off from the truth of what women with chronic pain, especially chronic pelvic pain have to go through to get help.

Not only does “The Pain Garden” shine a light on the reality of “medical gaslighting” through Tuca’s experience, but it also gives context to a lot of her behavior in earlier seasons and in season 3 as it progresses. In the seventh episode of season 1 “Yeast Week,” Tuca is hesitant to go see a doctor for a sharp pain and lump in her side. She would rather try some questionable homemade “remedies” like drinking dish soap and garlic than let Bertie take her to see a doctor. At first glance, Tuca’s fear of going to the doctor seems like just another manifestation of her chaotic “I make my own rules” personality, but after seeing what she goes through in “The Pain Garden,” her fear and hesitation make sense.

Because she’s been dealing with this unexplained pain for so long, it’s likely that she’s had similar experiences with doctors throughout her life. When Tuca finally goes to the hospital in season 1 for the lump in her side, she finds that the ultrasound machine has been programmed to comfort patients because they tried to teach doctors empathy and it “didn’t take,” which is obvious in how condescending her doctor is when prepping her for X-rays. Even though Tuca does find answers and treatment for her pain in this episode – she has an egg stuck in her ovary that has to be surgically removed – that doesn’t mean that she suddenly trusts the healthcare system again.

Between this experience and what she goes through in “The Pain Garden”, it’s hard to fault Tuca for seeking methods of pain relief outside of traditional medicine. In the seventh episode of season 3 “A Very Speckle Episode,” we see Tuca briefly become obsessed with crystals, plant signs (their version of astrology), and juice cleanses because she’s desperate to find something that will help her feel better and in control of how her body feels.

In a moment of vulnerability, Tuca says “I just want to know what path to take” while doubled over in pain with tears in her eyes. This doubt and uncertainty that Tuca feels is unfortunately something that myself and so many others with chronic illness are familiar with. It’s hard to know how to move forward with your life when you feel stuck in a cycle of pain that you don’t know how to stop.

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Even though I first showed symptoms of Endometriosis in high school, it took me seven years to receive a diagnosis. Like Tuca, I saw a variety of doctors and specialists who made me feel like the amount of pain I was in was normal or that it was all in my head. I know their intent wasn’t malicious, but a person can only hear things like “have you tried taking ibuprofen and tylenol,” “your scans are normal,” and “I can’t help you here, go see this doctor” so many times while in the worst pain of your life before you start to wonder if you actually are going crazy.

Just like Tuca, I’ve felt defeated when tests have come back “normal”, confused as to why my gynecologist doesn’t seem to care that my periods hurt so much that I’m nauseous and can barely eat, and embarrassed when the ER doctor acts like asking for an ultrasound is “too much” even though my pain has been at an 8/10 for over a week. But even though Tuca & Bertie is a comedy, the show isn’t making a mockery of my pain, or what I and others go through, instead it allows me to process my trauma in a new way.

“The Pain Garden” not only excels at depicting the grim realities of women’s healthcare through Tuca’s experience, it also does a great job of showing the kind of support we need from loved ones. The title of this episode comes from how Tuca’s pain is depicted. When she first feels this flare coming on, she lays in her bed as dirt covers her and vines grow around her. She feels trapped by this pain, and is scared to let people see her like this.

Through flashbacks at the beginning of the episode, we see Tuca’s pain dismissed first by her Aunt and then by a teacher at school. They both treat Tuca like she is exaggerating her pain for attention, which later plays into how she reacts to Bertie and her boyfriend Figgy (Matthew Rhys) being around her during this flare. At first, she lies to Figgy about why she can’t hang out with him over the weekend. She does the same thing to Bertie when she comes over to help take care of her. Tuca feels like she has to act tough and just push through the pain because adults in her personal life and medical professionals have made her feel like it’s not a big deal.

Even with Bertie constantly reassuring her that her pain is valid and that she’s not a burden or “too much” for wanting answers, it takes a while for Tuca to build up the courage to tell Figgy. When she finally does share this with him at the end of the episode, his reaction is compassionate and understanding. Even though Tuca doesn’t find the answers she craves at the hospital, it’s important that she still has people in her life that understand and validate the pain she is going through rather than dismiss her because she doesn’t have an official diagnosis.

When Tuca passes out at a wedding at the end of season 3, her friends don’t hesitate to rush to her side and find her the help she needs to feel better. Her ex-girlfriend Kara (Sasheer Zamata) refers her to Dr. Mole (Tom Scharpling), who takes Tuca’s pain seriously and reassures her that he has seen many cases like hers before. He offers to perform surgery to relieve her pain, however, even with all of his experience he is unprepared for what he finds when he enters Tuca’s body (he’s tiny and literally goes inside of her body). Bertie has to shrink herself and follow him inside of Tuca in order to help her best friend.

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Bertie and Dr. Mole discover that one of her ovaries is tethered by unknown clumps of tissue, and they have to work with a manifestation of Tuca’s consciousness to free it. While freeing Tuca’s ovary will likely help with her pain and prevent her ovary from bursting, it could also affect her ability to have children. This leads to an important conversation between Tuca and Bertie, and further emphasizes the importance of having the right kind of support when going through life-changing medical events – whether that’s from friends and family or the medical professionals from whom you’re seeking help.

Season 3 of Tuca & Bertie helps people like me feel seen and understood for what we’ve gone through. Even though some aspects of Tuca’s experience in “The Pain Garden” and the season finale “The Mole” are exaggerated for comedic effect, they are not far off from the truth at all. It’s hard to describe the amount of emotional and physical pain I’ve dealt with the last few years trying to find answers to my own chronic pain, and yet this season manages to do so effectively while maintaining the series’ lighter tone.

Tuca’s experience not only validates the struggles that I and others like me have gone through, but it also shows people that aren’t deeply entrenched in chronic illness chat rooms and online communities how hard it actually is to receive answers, and that seeking treatment for chronic illnesses is often not as simple as one might think. Above all, this season of Tuca & Bertie shows us how important it is to approach the people you care about with compassion and understanding – you never know who might feel buried in their own pain garden.