This Podcast Will Kill You

At the turn of the 20th century, a severe burn was often a death sentence. Today, that is no longer the case. Over the past eighty years, burn care has undergone a profound transformation thanks to crucial advances across diverse areas of medicine, such as skin grafting, antiseptic technique, and fluid balance. In this episode, we trace how those pieces of the puzzle were integrated to bring new hope to those with severe burn injuries. But this revolution in burn care is far from over. As we discover, thrilling research in this area is blurring the lines between science and science fiction. Bioengineered skin? 3D-printed skin scaffolding? Nanoparticles? Tune in for all the exciting details!

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Burns have been a part of the human experience since our hominin relatives began controlling fire 1.5 million years ago. Until very recently, we’ve been limited in our ability to manage burn wounds with any success, having instead to rely on our body’s innate healing responses. In this episode, we delve into those repair responses, explore what makes burns different from other types of injuries, and examine how we categorize burns based on severity. On the history side of things, we take a tour through humanity’s quest to alleviate the pain and suffering caused by the near-universal experience of getting burned. Ever wondered what Hippocrates would have recommended for a burn? Or what distinguishes a second- from third-degree burn? Tune in to find out.

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An accurate diagnosis can give us so much. It can give us a path forward. It can give us answers to long-standing questions. And it can give us much-needed hope. Yet many people around the world wait years to receive an accurate diagnosis, which can take a profound physical and emotional toll. What underlies these missed or incorrect diagnoses, and what can we do about it? In this week’s TPWKY book club episode, health journalist Alexandra Sifferlin joins me to discuss The Elusive Body: Doctors, Patients, and the Diagnosis Crisis. Her compassionate and sweeping exploration of this topic takes readers across the US as she connects with patients, doctors, and researchers that are deeply impacted by the diagnosis crisis. While plumbing the depths of this pervasive issue, Sifferlin also encounters many people who have dedicated their careers to addressing the diagnosis crisis and bringing people the answers they need and deserve. Tune in for a fascinating conversation on a subject that has affected so many of us.

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It comes on sneakily. You become aware of your stomach. You break out in a cold sweat. Your mouth fills with saliva. And before you know it, you’re leaning over the side of the boat (or out of the car, or into the airplane sick bag), barfing up your breakfast. Motion sickness. We’ve all been there, or at least most of us have. Why? What is it about our physiology that breaks down as soon as we travel via water, vehicle, or air? That’s exactly what we’re going to explore in this episode. From how long humans (and other species) have been coping with these debilitating symptoms to what’s actually going on in your brain to trigger the breakdown, from what’s in the most nauseating historical “cures” for motion sickness to why the drugs we have today have some positive effect, we’re covering it all.

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Once thought to be a rare, always fatal disease, histoplasmosis is now recognized as one of the most prevalent fungal infections in North America. It infects hundreds of thousands of people every year, and its distribution is growing. In this episode, we dissect this abundant fungus, examining how it makes us sick, who tends to get sick, and what we can do about it. We also take you through the history of this fungus, a story that features a surprise discovery, more evidence that everything is tuberculosis, and a spotlight on an extinct bird. Curious to know how all the pieces fit together? Tune in for the full picture.

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In a time when smallpox, tuberculosis, measles, and typhus ran rampant through the streets of London, there was another disease that instilled even more fear than these other killers: syphilis. So feared and so stigmatized was syphilis that it was sometimes called “the secret disease.” A diagnosis would not only sentence you to a drawn-out and painful illness possibly resulting in death, it also labeled you as an outcast and not fit for polite company. Skyrocketing infection rates drove a corresponding rise in syphilis “cures” and an increasingly desperate public. In this TPWKY book club episode, Dr. Olivia Weisser, associate professor of history at the University of Massachusetts, Boston joins me to discuss her recent book The Dreaded Pox: Sex and Disease in Early Modern London. She transports readers to the hidden shops and stalls that promised a remedy to this feared disease, to the courthouses where a syphilis infection was an important piece of evidence, and to the country houses that held recipe books for those who could not purchase a cure. Tune in for a fascinating glimpse into a time and place where morality, sex, and disease were so strongly entangled.

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If you’ve come across the latest dietary guidelines, a few things may have caught your attention: a big ol’ steak front and center in the new “inverted pyramid”, beef tallow and butter recommended as “healthy” fats, a declaration that the war on protein is ending. “Since when have we been at war with protein?” you may reasonably ask. In part 2 of our episodes on dietary guidelines, we get to the bottom of the latest iteration of these guidelines and investigate which changes are good (there are a few), which are bad (definitely a few there), and which are somewhere in between. Then we explore what science has actually shown about what constitutes a “healthy” diet. Tune in for a lively discussion that features lots of complaining about protein-enriched products, exasperated sighs, and a few shocking revelations about “the American diet.”

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Over the decades, dietary guidelines have taken a diverse array of shapes, from pamphlets to wheels, from plates to pyramids. In many cases, the shapes have changed more than the recommendations they contain. This week and next, we explore those recommendations - who’s making them, how they have changed over time, and how closely they align with what we should be eating. First, we delve into the long history of dietary guidelines and how their intentions have evolved as the food landscape drastically changed over the 20th century. Then we interrogate the conflicts of interests at the heart of their formation, questioning how much these recommendations are backed by science vs industry interests. Ultimately, we come back to the question of “if few people actually use these guidelines, why should we care about them at all?” Turns out, we have lots of feelings on the matter.

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Why do we believe what we believe? Is what we believe the truth? How can we convince others of our beliefs? If you’ve ever found yourself pondering these questions, you know that the answers are rarely clear-cut. We need to form beliefs in order to navigate the world, but how skilled are we at evaluating evidence for those beliefs or weighing new data that contradicts them? In this week’s TPWKY book club episode, Adam Kucharski, Professor at the London School of Hygiene and Tropical Medicine joins me to discuss latest book, Proof: The Art and Science of Certainty. With this book, Dr. Kucharski presents a compelling and thoughtful examination of the concept of proof, delving into topics ranging from the justice system (what’s a reasonable doubt?) to infectious disease, clinical design to the founding of this country. And he leaves us with a powerful lesson: what convinced you of something might not convince someone else. Tune in for a fascinating conversation!

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Tear gas is an expected, normalized part of protests today. But its use in international war is banned. How can that be? That’s just one of the questions we investigate in this episode. First, we take you through the long history of tear gas and its emergence alongside deadlier chemical weapons before discussing how its use became routine, fueled by industry interests. Then we delve into what’s in tear gas that causes the painful physical reaction and consider whether claims of non-toxicity are backed up by research (spoilers: not really). This is an info-packed episode that will leave you with many questions answered, but not all of those answers will be satisfying.

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