This article contains spoilers for the Season 3 finale of “The White Lotus.”
After the season finale of “The White Lotus,” viewers may never look at a piña colada the same way again.
The long-teased murder-suicide fantasies of Timothy Ratliff (played by Jason Isaacs) come into sharp focus during the episode, as his family faces an uncertain future. He decides to poison them with the seeds of the pong-pong tree’s fruit rather than face their disappointment over losing their fortune.
A hotel worker at the luxury Thai resort has already warned Ratliff of the tree’s toxicity. By the season finale, the same worker inadvertently gives him instructions on how to extract poison from the seeds of what locals call the “suicide tree.”
But what’s the real story behind the pong-pong?
What is pong-pong fruit?
Pong-pong trees, or Cerbera odollam, are indigenous to South and Southeast Asia, tropical Pacific islands and parts of Australia, according to the National Tropical Botanical Garden, a research garden in Hawaii.
The fruit is two to four inches in length and turns from green to red as it ripens. Ty Matejowsky, the chairman of the anthropology department at the University of Central Florida who specializes in cultural anthropology and food studies, said the fruit’s cardiotoxin is concentrated in the seeds’ kernels, “almost like a peach pit.”
The tree is similar to the oleander plant in the United States, Dr. Matejowsky said. Like the oleander, the pong-pong tree has “a really pleasing aesthetic quality but is very dangerous in terms of consumption.” The same toxin can be found in lily of the valley and foxglove plants.
How poisonous is it?
Pong-pong fruit contains the toxin cerberin, a type of cardiac glycoside that attacks a pump in the heart that controls sodium and potassium levels in the body. A low dose of a cardiac glycoside can help increase the contraction of a heart, but too much can be fatal, said Dr. Mary Wermuth, a medical toxicologist at Indiana University who has treated pong-pong poisoning patients.
What amounts to a fatal dose of pong-pong kernels depends on a person’s underlying conditions, Dr. Wermuth said, but some research suggests it can take as little as one seed. Vomiting and nausea can be the first symptoms as the heart rate drops.
What is the history of its use?
Because of its toxic qualities, pong-pong has been used for suicide attempts in the regions where it grows. It has also been used in “trials by ordeal” for generations, Dr. Matejowsky said. Until the early 20th century in Madagascar, for example, pong-pong fruit was used as a way to determine the guilt or innocence of individuals who had been accused of witchcraft. If they were guilty, they would die from ingesting the pong-pong fruit, and if innocent, they would be saved by supernatural intervention.
“It’s a way of putting the onus on the supernatural to make these life or death judgments, while also insulating the people who are meting out the punishment of the crimes from feeling guilty,” he said.
Could Lochlan Ratliff really have survived?
In a study coauthored with other toxicologists around the country, Dr. Wermuth and her colleagues found that the earliest symptoms of pong-pong poisoning could appear was three hours after ingestion. In Sunday’s finale, Lochlan Ratliff (played by Sam Nivola) becomes sick within minutes of accidentally ingesting pulverized pong-pong fruit seeds.
It is also hard to say if a small sip of pong-pong-laced piña coladas — which the other members of the Ratliff family consume — could cause any issues, Dr. Wermuth said. But in the case of Lochlan, his survival may be a case of television drama and the suspension of medical disbelief.
“Could he have survived? Sure,” she said. “But it depends how much he got. It could be that he just had nausea and vomiting, and his heart didn’t stop beating.”
Had he not miraculously recovered, the youngest Ratliff would have received an antidote called digoxin immune fab, which is stocked at most hospital emergency departments.
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