Deprived of food, our bodies do the best they can to keep us alive and functioning as long as possible. As the days pass, the rhythms of our lives change: our metabolism, our heartbeats, our hormones, even our thoughts shift to adjust to this period of scarcity. This response is evolutionarily engrained, following a variable but fairly prescribed path. In this episode, we trace that path, exploring what happens when our bodies are not given the energy stores they need, how patterns of metabolism alter, leading our bodies to consume themselves, and the profound consequences this has on every part of our physiology and psychology. We also tell the story of how we came to learn about these outcomes, chiefly through a WWII-era study called the Minnesota Starvation Experiment. This is the first of two episodes centered around malnutrition, starvation, and famine. Next week, we’ll explore the broad topic of famine, of which starvation is merely one component.

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The United States is in the midst of a monumental mental health crisis, with one in four people predicted to experience mental illness at some point in their lives. Adequate mental health care remains out of reach of so many due to a myriad of factors: unaffordability, stigma, shame, and racism, to name a few, leaving enormous gaps in mental health equity. The roots of these inequities can be traced back decades, to the earliest psychiatric hospitals founded on harmful racist notions of mental illness. In Madness: Race and Insanity in a Jim Crow Asylum, author and award-winning journalist Antonia Hylton explores the story of Crownsville Hospital, a segregated asylum in Anne Arundel County, Maryland, built in 1911 by its first patients: twelve Black men. Over the course of the 20th century, the shifting perspectives of race and mental illness played out in the overcrowded and understaffed Crownsville Hospital, with powerful implications for understanding our current failing to deliver adequate care to all in need. Madness is a powerful and necessary book that sheds much-needed light on the intersections between race, racism, and mental illness.

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Every year, millions of babies around the world are screened for dozens of treatable conditions within the first day or two of life. What it takes is a few drops of blood on some filter paper, and what it gives is profound: potentially life-saving information. The advent of newborn screening is one of the greatest public achievements of the 20th century; since their earliest implementation, screening programs have diagnosed hundreds of thousands of babies early enough for medical intervention. And the life-saving potential they hold continues to grow with the development of genomic sequencing technology, which will increase the number of screenable conditions by an order of magnitude. In this episode, we explore the serendipitous origins of newborn screening, what the process looks like from a parent’s perspective, and how cutting-edge technology could revolutionize these programs. To help us navigate the exciting future of newborn screening, Dr. Joshua Milner, Professor of Pediatrics and Director of Allergy Immunology and Rheumatology at Columbia University Medical Center joins us to discuss an ambitious research program at NewYork-Presbyterian hospitals titled the GUARDIAN study, or Genomic Uniform-screening Against Rare Disease in All Newborns. Tune in for a truly thrilling episode!

For more on the GUARDIAN study, the groundbreaking research program using genomic sequencing technology to screen newborns at NewYork-Presbyterian hospitals for hundreds of conditions, check out the Advances in Care podcast episode titled “Newborn Gene Sequencing: Expanding Early Detection of Treatable Diseases.”

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None of us are ever truly alone. Our bodies are home to untold numbers of microbes, chilling on our skin, in our guts, throughout our respiratory tract, inside our bellybuttons, under our fingernails, and beyond. For the most part, we live in harmony with these critters, never giving them a second thought. But occasionally, they may grow a bit too friendly, taking advantage of our hospitality to grow and spread with abandon. Candida yeasts are especially fond of this tactic, leading to millions of infections around the globe each year, many of which can cause significant illness or even death. In this episode, we explore the characteristics of these yeasts that make them so prone to overgrowth, how severe infections can develop, and why one of medicine’s greatest achievements may have helped usher in this new fungal era.

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When your car breaks down or your fridge goes on the fritz, you can order a replacement part and get things back up and running in no time. The same cannot always be said for another intricate machine: the human body. For centuries, scientists have grappled with making or transplanting suitable replacements for nearly every body part, from hearts to hair and from legs to lungs. We’ve come quite a long way in that quest, so that at times, it feels as though we’re living in a sci-fi novel, where skin cells are printed and we can grow a customized heart. Yet we still have further to go, thanks to our magnificent immune system, who proves to be quite a worthy opponent. Here to tell you all about the weird and wonderful world of regenerative medicine is the one and only Mary Roach, who joins us this week to chat about her latest book Replaceable You: Adventures in Human Anatomy. As with any Mary Roach production, this is the perfect combination of informative, fascinating, and fun. Tune in today!

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Last week, we took you through all the ways that cold can harm us and the harrowing history of humans perishing at its icy hands. Ending the story there would be skipping over the parts where cold gets to play the hero, rather than the villain. In the second installment of this frosty miniseries, we explore the situations in which we might use cold to protect us and how it actually works. We also delve into the surprisingly long (and unsurprisingly grim) history of therapeutic hypothermia, a journey that wouldn’t be complete without a debate over sea cloaks, a reconsideration of the plot of Titanic, and a brief jaunt into cryonics.

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For all our wondrous adaptations as a species - our big brains, our capacity for language, our opposable thumbs - we humans are not well-equipped to deal with the cold. Take us out of our insulated dwellings, take away our winter clothes, and things can get dicey fast. From frostbite to hypothermia, the cold can settle into our bones, leading us down a path where injury or death are possible outcomes. In this episode, we explore that path: how our meager cold-survival adaptations are vastly outshone by other animal species, the long and grim history of hypothermia in war, and what exactly is happening inside your body when your temperature drops. Tune in to this unexpectedly strange grab-bag of an episode.

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The development of antibiotics was one of the greatest turning points in the history of medicine. Bacterial infections that were once death sentences were cured within a matter of days after administration of these lifesaving compounds. But the honeymoon didn’t last long, as resistant bacterial strains emerged and spread. Now, antimicrobial resistance poses one of the greatest threats to global health; frankly, we can’t invent new antibiotics faster than resistance develops. Fortunately, there may be a solution, one that has existed even before antibiotics came on the scene: phage therapy, the use of bacteriophages to treat bacterial infections. In The Living Medicine: How a Lifesaving Cure Was Nearly Lost—and Why It Will Rescue Us When Antibiotics Fail, author Lina Zeldovich takes readers through the incredible and long-forgotten story of phage therapy and the doctors who developed it. Tune in to learn how phage therapy, after almost being relegated to a footnote in the history of medicine, is reemerging as a possible solution to the deadly problem of antimicrobial resistance.

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Some things just go together: peanut butter and jelly, bacon and eggs, milk and cereal, London and smog. Or at least, that’s the way things used to be until the Great Smog of 1952. (Don’t worry, the first three pairings are safe). If you’ve watched The Crown, you may remember an early episode in which a thick, noxious smog surrounded the entire city of London for days on end. People coughing, hacking, collapsing. Traffic ground to a standstill. Authorities in denial. What was actually going on in December 1952 to lead to such conditions? What was in the smog to make it so toxic? And how did this severe pollution event lead to massive changes in air quality regulations around the world? Tune in to find out all this and more (including what The Crown got wrong).

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For most of us, there probably hasn’t been a good reason for you to think about your gallbladder. Ever. Much of the time, it sits there, silently storing, concentrating, and, when needed, churning out bile every day. But occasionally, this unassuming organ will announce itself through waves of unceasing, excruciating pain brought on by a blockage of some sort. Why it does this to us, what we do about it, and how we can live a gallbladder-free life are just some of the things we cover in this episode. We’re also taking this opportunity to deep dive into the substance most closely associated with the gallbladder: bile. Bile plays an outsized role in the history of medicine, mostly through its role as one of the four humors in the humoral theory of disease. Are you of a choleric temperament or is your vibe more sanguine? Maybe melancholic or phlegmatic suits you better. Don’t know what the heck we’re talking about? Tune in to find out.

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