This Podcast Will Kill You

In an anatomy and physiology class, you may learn how the different heart valves work to circulate your blood, how the structure of your kidney helps to maintain electrolyte levels, and how the expansion and contraction of your lungs sets off a carefully orchestrated cascade of gas exchange and transport. The human body is an endlessly fascinating machine. But when you spend so much time learning about the body, you can lose sight of the fact that it isn’t a machine. It is the story of your life. In this book club installment, I am joined by surgeon and award-winning writer Gabriel Weston to discuss her latest book Alive: Our Bodies and the Richness and Brevity of Existence. In this compelling blend of memoir, science, and meditation, Weston examines different body parts chapter by chapter - what they have meant to her or her loved ones, their significance in history, and how their meanings are shaped by our scientific understanding. Weston inspires readers to take a moment to reflect on what it’s like to live in your body, feel your heart beat, your lungs expand. Doing so can help us connect with ourselves and others. Tune in for a delightful conversation!

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If you were asked to describe necrotizing fasciitis in three words, you might choose: rapid, deadly, and rare. The third of those adjectives may provide some comfort, but the first two are the clear inspiration for this infection’s more lurid nickname: flesh-eating bacteria. In this episode, we get up close and personal with necrotizing fasciitis and its causative agents. We start off by examining step by step how these infections wreak so much havoc and why doctors still struggle with its treatment. Then we take a tour through its grisly history, featuring maritime misadventures and wicked war wounds. We wrap up the story with a look at the global trends in these infections as well as some promising new research. This episode may not be for the faint of heart, but it is for the endlessly curious.

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It’s the stuff nightmares are made of. A fly lands on an open wound and lays hundreds of eggs, from which hatch countless ravenous maggots. There they writhe, devouring flesh, insatiable and relentless. Every minute they dig deeper and deeper until flesh gives way to bone. Even the species name of these maggots inspires a shiver of fear: Cochliomyia hominivorax - “man eater”. This nightmare of a fly is the horrifying reality for many mammals in South America and some Caribbean islands, particularly cattle. And it seems to be making a comeback in the places it was previously eradicated - Central and North America. What exactly this fly does, why it’s such a problem, and how we came to defeat it (temporarily) all feature in this week’s episode. Sterile flies? Archival footage? Gnarly descriptions? This episode has it all.

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Science doesn’t always get it right the first time (or the second, or the third, or even the ninety-ninth!). And while we may chuckle at the outlandish things people believed or the goofy experiments they tried, we forget two things: 1) those failures helped us get where we are today and 2) a hundred years from now, people will probably be laughing at the “cutting edge” medical knowledge of today! In this week’s book club episode, Erin and I chat with two of our all-time favorite science communicators, Dr. Lindsey Fithzarris and Adrian Teal to discuss their newest book Dead Ends!: Flukes, Flops & Failures That Sparked Medical Marvels. This hilarious and insightful book, geared towards middle-school readers (but enjoyable for all ages!), frolicks through some of the strangest stories in the history of medicine, accompanied by delightfully grotesque illustrations. There’s learning, there’s laughter, but most importantly, there’s a lesson: failure is okay. Not just okay but a necessary part of science. Tune in for all this and more!

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As we learned last week, starvation extends far beyond hunger and what a lack of food does to the human body. Similarly, famine is much more than a food shortage and starvation on a population-level scale. This week, we’re picking up where we left off last episode to explore the definitions, drivers, and many dimensions of famine. We trace famines throughout human history, asking how they have changed either in their incidence, severity, or cause. No two famines are exactly alike, but taking a bird’s eye view of patterns in famine over time gives us insight, especially into the famines of the past 100 years. We conclude the episode with a discussion of the ongoing famine in Gaza and other food insecurity crises in other regions of the world. Tune in for a broad overview of this heavy but incredibly important topic.

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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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