This Podcast Will Kill You

It’s got all the ingredients for a classic TPWKY episode: Deadly zoonotic bacterium (Burkholderia mallei). Tier 1 Select Agent role in war (greatest risk from a bioterrorism perspective). Historically caused devastating outbreaks resulting in mass casualty (of equids). And yet few people know what glanders is (unless you’ve recently watched The Americans tv show). This week, we’re aiming to lift glanders out of obscurity and bring it the attention it so deserves. What exactly is Burkholderia mallei and how does it cause the painful and lingering symptoms it’s known for? When did glanders first strike, and how did it play a role in the US Civil War? Why does it currently rank high up on the list of possible agents of bioterrorism? Tune in to find out all this and more!

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Since his first appearance in A Study in Scarlet in 1887, Sherlock Holmes has captured hearts and imaginations around the world. Featured in countless tv shows, movies, books, plays, comic books, songs, and other media, Holmes has been firmly cemented as one of the most recognizable characters globally. But less well known is the man whose observational prowess inspired Arthur Conan Doyle to create his famous detective in the first place: Scottish surgeon Dr. Joseph Bell. In Sleuth-Hound: The Case of the Real Sherlock Holmes, New York Times bestselling author and historian of medicine Dr. Lindsey Fitzharris brings long overdue recognition to the man behind the icon. Through her captivating storytelling, Fitzharris transports readers to 19th century Edinburgh, a revolutionary time for medicine and forensic science, and reveals how Dr. Joe Bell was at the center of it all. As pathologist at the Royal Infirmary, he impressed medical students by using his preternatural skills of observation to make a diagnosis, and as a frequent consultant of the Edinburgh police force, he applied those same skills to solve crimes. Tune in for a behind-the-Holmes peek into the man and world that gave rise to this famous detective.

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Looking to get swole (do people still say that)? Want to rewind the clock and smooth those bothersome wrinkles? Trying to lose weight rapidly and without a prescription? If you’ve spent any time on social media lately, chances are you’ve been inundated with ads, influencers, and podcast bros extolling the seemingly unlimited powers of peptides. With GLP-1s turning ‘peptide’ into a household word, the online “wellness” market has been flooded with the newest iteration of snake oil salesmen. According to them, these bespoke peptide combinations can reverse baldness, build muscle, and restore youth, all for the low, low price of… you get the idea. But what the heck even are peptides? How are they regulated? Is there any evidence to support these bold claims? What isn’t your peptide dealer telling you? Tune in to find out.

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Come one, come all to learn of the miraculous news we’re buzzing to share with you at this limited time, low price offer. If you’ve been troubled by aches and pains, sores and sneezes, look no further than this very special episode - good for whatever ails you. Brimming with historical detail and outlandish claims, we’re marching through the wild west of patent medicines in the 19th century. We begin with the widespread rejection of professional medicine in the 1820s (sound familiar??) and continue through the century as quack doctors and snake oil salesmen proliferate and hawk their fraudulent goods across the landscape. Fueled by a lack of regulation and the eternal desire for a cure-all, these fraudsters grew ever wealthier and more daring in the claims they made. When consumer protections finally kicked in at the turn of the 20th century, it left people wondering: did the snake oil salesman truly die or did he just take on a new disguise? Tune in to learn that the more things change, the more they stay the same.

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A diagnosis of dementia of any kind is devastating. For those with the hereditary form of frontotemporal dementia (FTD), it could mean an entire family is destined for the same fate. In this week’s TPWKY book club episode, award-winning author Robert Kolker paints an intimate portrait of one such family in The Vanishing Family: Love, Fate, and the Quest to End Dementia. Through Kolker’s compassionate and incisive writing, readers learn about FTD alongside this family and gain a unique insight into the painful and complex decisions the siblings face. Kolker also presents a scoping view of the history and possible future of dementia research, one that may allow fate to be rewritten. Tune in for all this and more.

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Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, has long mystified the medical community and brought tremendous sorrow to those impacted by the condition. But to tell the story of ALS as one solely of tragedy would do a disservice to those who have long fought to develop an effective treatment or raise awareness. Because it is through their tireless efforts that those with ALS will eventually be able to rewrite their own ending. In today’s episode, we attempt to convey the full picture of ALS: from what we know about its causes to the earliest medical descriptions, from the baseball player whose impassioned speech captured the public’s hearts to the promising research on the horizon. Tune in for all this and more.

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Shortly after birth, many newborns are given vitamin K to help their blood clot properly and reduce the chances of hemorrhage. Increasingly, especially here in the US, parents are refusing this life-saving intervention, leaving these babies more likely to develop deficiency bleeding which can lead to life-long brain damage and death. In this episode, we explore the many dimensions of vitamin K: how it acts in our bodies as an essential compound, when we discovered the clotting properties of this vitamin and applied that knowledge to prevent catastrophic bleeding in newborns, and why some people are turning away from this life-saving injection. You’ve seen the headlines, now tune in for the full story.

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Imagine yourself as a 17th century English peasant or merchant or noble. Let’s say you’re dealing with some intense stomach pain or a cut on your leg that won’t heal. Where do you turn to for help? Today’s book club episode reveals that the answer depends on your medical needs, your wealth, your social standing, and your gender. But one thing’s for certain: you had some options up your sleeve. In The Surgeon, The Midwife, The Quack: How to Stay Alive in Renaissance England, Dr. Alanna Skuse, Associate Professor at the University of Reading, takes readers through the layered world of Renaissance medicine and the many different healers (both licensed and self-professed) that occupied it. As Dr. Skuse demonstrates, people have always sought experts to help them return to or remain in good health, and this has in turn fueled the growth of new medical professions as people carved out their healing niche. How did this era set the stage for the birth of modern medicine? Tune in to find out.

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This week, we’re picking up where we left off last episode in our exploration of ECT by examining how this therapy is administered, which conditions it’s used for, and what we know about why it works. To start off, we take you through the procedure step-by-step, including prep and what someone might experience in the days or weeks that follow. We then examine the situations for which ECT might be recommended as well as the barriers preventing its wider use, which include issues with both access and stigma. How on earth does an electric shock improve symptoms of depression or catatonia? That burning question is one we do our best to answer. To help us present an accurate and comprehensive perspective of this important but underutilized therapy, we bring on an expert. Dr. Leonardo Lopez, Associate Professor of Psychiatry at Weill Cornell Medicine and Vice Chair of Inpatient Services in the Department of Psychiatry, works alongside NewYork-Presbyterian to expand access to ECT across multiple hospitals (check out the Advances in Care podcast episode featuring his work, The Positive Impact of Electroconvulsive Therapy for Severe Psychiatric Illness). Dr. Lopez shares with us a remarkable story of a young girl whose rare condition (anti-NMDA receptor encephalitis) was treated in part with ECT (watch the video of her journey). He also shines a light on the current limitations facing ECT as well as his hopes for the future. Tune in for a truly fascinating episode!

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For many, a mention of electroconvulsive therapy (ECT) conjures images of torture or mind control from popular media like One Flew Over the Cuckoo’s Nest or Requiem for a Dream. Comparatively few know that ECT is not only still used today but is an incredibly safe and effective treatment for an array of psychiatric conditions. In this and next week’s episode, we explore this stigmatized and misunderstood therapy from its questionable origins to its current uses. We start by diving into the history of ECT and placing its discovery in the broader context of psychiatric medicine and leading notions of the causes of mental illness. We learn that ECT’s troubling reputation is not entirely unearned but is a relic of the past, as substantial advancements in safety and administration have established this as a truly powerful therapy that has stood the test of time. Tune in for a big picture view of one of our oldest and most effective psychiatric treatments.

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Already this summer, heatwaves are causing thousands of deaths across the world, catastrophic flooding threatens millions, wildfires rage across enormous swathes of the globe, many regions face extreme drought conditions, and a very strong El Niño is predicted for later this year, leading to further climate chaos. It’s a lot to take in. The devastating consequences of climate change can be measured any number of ways, and in this week’s book club episode, we delve into some of the more insidious and less explored impacts: those on our cognition, our mental health, our brains, and our behavior. In The Weight of Nature: How a Changing Climate Changes our Brains, author Clayton Page Aldern, neuroscientist and journalist who leads the data journalism program at Grist, presents a compelling and sweeping examination of the many unseen ways that climate change is changing us. Why do we have a shorter fuse when it’s hot outside? How are our memories and language impacted by our changing climate? What pathogens pose a greater threat to our brains as the climate warms? And most importantly, how can we begin to process these effects on our inner selves? Tune in to find out.

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Few spiders hold the dubious honor of name recognition among the general public. Most that do, like black widows, Australian funnel-web, the Goliath birdeater, are renowned not for their cute colors or weaving skills but for being fearsome, dangerous predators. The brown recluse is no exception. A bite from one of these arachnids can send someone to the hospital with a painful necrotizing wound and weeks of recovery. But do these spiders actually deserve all the hatred they get? In this week’s episode, we argue no. Breaking down not just the bite of thebrown recluse but also its behaviors, its distribution, and its lore, we present a more complete picture of this vilified arachnid. Tune in for the low down on this shy spider.

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If you have a medical question, where do you turn? How often is google or social media your first stop? As you sift through the AI overview and countless reels professing to have the answers, it becomes harder and harder to separate fact from fiction. Do these supplements actually do what they promise? Should I be wary of this commonly prescribed medication? Even if you’re not directly seeking this information, it finds you anyway, preying on health anxieties and promising an easy fix. In this week’s TPWKY book club episode, Dr. Deborah Cohen, medically-trained, award-winning journalist, broadcaster, and editor, joins me to discuss the implications of this flood of health misinformation, which she explores in her recent book Bad Influence: How the Internet Hijacked Our Health. From podcast bros touting peptide injections to TikTok influencers swearing by supplements, Cohen demonstrates that the internet is a wild west in desperate need of consumer protections. But it has also been a double-edged sword, providing community and connection alongside these bad actors. How can we continue to leverage the good of the internet to democratize health information while putting guardrails on nefarious wellness influencers hawking lies for profit? Tune in to find out.

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Last week, we set the stage by breaking down the science behind cholesterol: how it moves through our body, why it causes disease, and when we discovered the link between LDL and atherosclerosis. This week, armed with that knowledge, we’re asking the big question: what do we do about high cholesterol? Statins emerged as a highly effective intervention but one that is not without its share of controversy and misinformation. We delve into the story and science of statins and other cholesterol-lowering drugs, from their brilliant discovery to early promising trials, from barriers preventing their use to the heaps of misinformation abounding on the internet. How do statins actually work? What does penicillin have to do with their discovery? What’s the deal with side effects? Tune in for all this and more.

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So your latest blood test results have come in, and you see a couple of numbers for cholesterol. What do those numbers mean, and why do we care about them? In this first part of our cholesterol miniseries, we break down the science behind this compound and trace how we made the link between certain types of cholesterol and heart disease. First, we follow the path that cholesterol takes in our bodies and what LDL and HDL mean in the context of heart disease. Then we delve into the history of this compound, which involves an over 2 billion year journey back in time, fascinating experiments that revealed the stubborn nature of medicine, and a terrible - but hopefully memorable - baseball analogy. Tune in for the low down on cholesterol.

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You’ve seen the headlines: a food-borne parasite is infecting people across the US, leaving them chained to the toilet sometimes for weeks on end, as they are ravaged by wave after wave of gastrointestinal upset. What the heck is cyclosporiasis and where did it come from? How scared should we be of our raspberries or lettuce or cilantro? To dish out the answers as fast we could, we put together this fact-filled episode about the biology of Cyclospora cayetanensis, how this parasite makes you sick, when we first learned about it (more recently than you might think), and what we know about this current outbreak (or outbreaks). We also probe how recent changes to foodborne pathogen surveillance on a national scale are contributing to the challenges in understanding the scope and origin of outbreaks such as this. You don’t want to miss this one!

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Social media ads for egg freezing. A craigslist-like site for breast milk. Fertility fairs featuring IVF clinics alongside shamanic nutritionists. Surrogacy contracts offering a discount for multiple embryos. The rapidly-growing global fertility industry promises hope, fulfillment, and control, as long as you can afford it. Participating in this industry can be empowering. All parts of reproduction are commodified these days, so why not use your free will to take advantage of that, whether through selling breast milk or freezing your eggs? But the global fertility industry is also blatantly exploitative, preying on those who are desperate and vulnerable in order to maximize profits. In Cash Cow: How the Maternal Body Became a Global Commodity - and the Hidden Costs for Women, author and journalist Alev Scott explores that blurred line between empowerment and exploitation in this globally varied industry. Her reporting takes her through the underbelly of the breast milk market, the complicated world of fertility tourism, and the legal and emotional turmoil of surrogacy. As she describes, the morality, legality, and expenses of different procedures are a moving target across the globe, reflecting the struggle to attach moral judgment when science and circumstances change so rapidly. Tune in for a truly fascinating conversation.

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In keeping with last week’s theme of “bodily excretions that are kinda gross that you don’t really think about but are actually really important”, we’re devoting this episode to earwax, aka cerumen. In one hour, we somehow manage to weave together stories of earwax impaction, misadventures in ear candling, glimpses of earwax in art history, and a whale of a tale as revealed by cetacean cerumen. The biology and history of earwax proves to be surprisingly rich and revealing and will have you second-guessing yourself as you reach for that cotton swab. Armed with this week’s episode on earwax and last week’s on boogers, you’ll be ready to take on even the most daunting office icebreaker.

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Hard and crusty. Green and gloopy. Clear and watery. Boogers come in a veritable rainbow of colors and a full spectrum of textures from liquid to solid. They’re really quite impressive if you think about it. Which, of course, few of us do, besides adding tissues to our shopping list or cursing the dagger-like boogers that emerge during a trip to a particularly dry locale. But boogers deserve a lot more credit, and this episode is our attempt at righting that wrong. What are boogers, and what purpose do they serve? How long have handkerchiefs been around, and when did mucus evolve? How many of us are nose-pickers, and how do other species deal with their boogers? More stuffed with snot facts than a nose during flu season, this episode has all the best tidbits to share at your next dinner party.

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Stories of unethical medical experimentation often center around the individuals who spearheaded such atrocities or highlight how patient protection laws were changed in response to the studies. But rarely do they focus on the people who fought to bring these harms to light: the whistleblower. What does it take to blow the whistle, and what does it cost? Are we all capable of blowing the whistle or is there a “whistleblower type”? What happens when there’s no one left to hear the whistle being blown? These are just some of the questions we explore in this week’s TPWKY book club episode, where I’m joined by Dr. Carl Elliott, [Professor of Philosophy at the University of Minnesota] to discuss his latest book The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No. In this profound and personal work, Dr. Elliott reflects on the drivers and consequences of blowing the whistle, interviewing whistleblowers in past scandals as well as drawing from his own experience. We may all think we’d do the right thing, but how many of us are prepared for the cost? Tune in for an enlightening conversation about medical ethics and human nature.

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