How to Cure What Ails You

Summary

Radiolab Episode Summary: "How to Cure What Ails You"

Release Date: May 16, 2025
Hosts: Lulu Miller and Latif Nasser
Description: Radiolab delves into the complexities of diagnosing mental health conditions, exploring the intersection of technology, science, and human individuality. Through engaging discussions and historical anecdotes, the episode examines the promises and pitfalls of using brain imaging for psychiatric diagnoses.

---

1. The Quest for Biological Diagnosis of Mental Health

The episode opens with Lulu Miller reflecting on the timeless question of how to accurately diagnose mental health conditions like depression. She introduces the concept of using functional Magnetic Resonance Imaging (fMRI) to peer into the brain, aiming to objectively identify disorders that have traditionally relied on subjective assessments.

Jad Abumrad and Robert Krulwich engage in a dialogue highlighting the challenges of diagnosing depression:

[01:19] "Diagnosis, the easy kind. We're not going to talk about it. Easy would be you come into my office. I'm a doctor, you have a broken arm... But let's suppose you came into my office and you were sad."
– Jad Abumrad

Eric Kandel, a Nobel Prize-winning professor at Columbia University, supports the feasibility of photographic diagnosis:

[02:27] "This is happening. There is no question."
– Eric Kandel

Cynthia Fuhr, a psychiatrist at King's College London, discusses a pioneering study where machine learning algorithms correctly diagnosed depression with 86% accuracy using fMRI scans:

[06:55] "More than 85% of the time, 86% of the time, the algorithm correctly diagnosed whether that person was depressed or healthy."
– Cynthia Fuhr

This breakthrough promises a future where mental health diagnoses could be as straightforward as taking a brain scan, potentially revolutionizing psychiatry:

[07:38] "Psychiatry is going to be absolutely revolutionized by this."
– Eric Kandel

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2. Debate on Biological Determinism vs. Holistic Approaches

Despite the promising technology, skepticism arises, particularly from Robert Krulwich, who is hesitant to fully embrace machine-based diagnoses. He questions the reductionist approach of equating complex human emotions and experiences solely to brain activity:

[08:17] "You mean to tell me that they're going to put people in machines and just go, boop?"
– Robert Krulwich

The discussion delves into the ethical implications of treating patients as mere data points:

[09:28] "But don't kind of get in my head and tell me what's right and what's wrong."
– Robert Krulwich

Lulu Miller provides a balanced perspective, acknowledging the advancements in brain imaging while emphasizing the importance of treating patients as whole individuals:

[24:XX] "We're certainly not living in the world that Eric Kandel predicted we might be... it's still forcing doctors to treat us as full individuals, as not just brains to reckon with our full personhood."
– Lulu Miller
(Timestamp approximated as the transcript provided ends at 27:02)

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3. Historical Case Study: SIDS and Medical Misdiagnosis

The episode shifts to a historical narrative narrated by Robert Sapolsky, illustrating the dangers of premature scientific conclusions. He recounts the early 20th-century misdiagnosis of Sudden Infant Death Syndrome (SIDS) due to misinterpretation of thymus gland sizes.

Initially, doctors observed enlarged thymus glands in SIDS cases and hypothesized that these glands could suffocate infants by pressing on the trachea during sleep:

[16:00] "So people decided, let's go dissect SIDS's kids... If you're one of these babies with an enlarged thymus and you're asleep and somehow you roll over... that gland might press down on your trachea and suffocate you during the night."
– Robert Krulwich quoting Robert Sapolsky

This led to the controversial treatment of irradiating infants' throats to shrink the thymus glands:

[16:53] "They even came up with a name for it and it was called status thymicolymphaticus... and to do that, the best solution, obviously, is to irradiate their throats."
– Robert Sapolsky

The misguided intervention resulted in severe consequences, causing thyroid cancer deaths in thousands:

[17:25] "Decades later, you've killed 20 to 30,000 people with thyroid cancer."
– Robert Sapolsky

This cautionary tale underscores the importance of accurate scientific understanding and the ethical responsibilities of the medical community.

---

4. Conclusion and Reflection

Lulu Miller returns to update listeners on the advancements in brain imaging over the past 17 years. While machine learning has improved in predicting differences in brains affected by disorders like bipolar, schizophrenia, and depression, these technologies have not yet become reliable enough for everyday clinical use. As a result, the medical field continues to balance technological progress with the nuanced treatment of individuals:

[24:00] "We're definitely not living in the world that Eric Kandel predicted we might be... but we're not quite living in Jad's world either. We're sort of in this in-between still."
– Lulu Miller

She highlights the ongoing need for doctors to treat patients holistically, respecting their full personhood while leveraging scientific advancements:

[24:XX] "It's still forcing doctors to treat us as full individuals, as not just brains to reckon with our full personhood."
– Lulu Miller

The episode concludes on a hopeful note, recognizing the steady progress of science while valuing the complexity of human experience.

---

Notable Quotes:

• Eric Kandel:

  [02:25] "This is happening. There is no question."

• Cynthia Fuhr:

  [06:55] "More than 85% of the time, 86% of the time, the algorithm correctly diagnosed whether that person was depressed or healthy."

• Robert Krulwich:

  [08:17] "You mean to tell me that they're going to put people in machines and just go, boop?"

• Robert Sapolsky:

  [17:25] "Decades later, you've killed 20 to 30,000 people with thyroid cancer."

• Lulu Miller:

  [24:00] "We're definitely not living in the world that Eric Kandel predicted we might be... but we're not quite living in Jad's world either. We're sort of in this in-between still."

---

This episode of Radiolab meticulously explores the intersection of technology and mental health diagnosis, while providing a sobering historical perspective on the pitfalls of premature scientific conclusions. It invites listeners to consider the ethical dimensions of medical advancements and the enduring importance of treating individuals with empathy and respect.

Transcript

[Lulu Miller]

This is Radiolab. I'm Lulu Miller. It's May, which means we are right in the middle of Mental Health Awareness Month. And because of that, I found myself thinking about an episode we did many years ago about what was at the time a brand new way of peeking inside the brain to try to see various mental health conditions like depression and many other things. It's a fascinating piece, and while it was recorded 17 years ago, and you'll find some of the language reflects that time, the question at the heart of the story is really timeless, really provocative, really fascinating. So we are going to air it today, and at the end, I will be back with a short update on where some of the technology has come in the subsequent years. So here we go. Buckle up with the episode called how to Cure what Ails you.

[Jad Abumrad]

Yeah. Wait, you're listening.

[Robert Krulwich]

Okay.

[Jad Abumrad]

All right. Okay. All right.

[Lulu Miller]

You're listening to Radiolab.

[Robert Krulwich]

Radiolab from wnyc. Rewind. Hello, I'm Jad Abumrad.

[Jad Abumrad]

And I'm Robert Krulwit.

[Robert Krulwich]

This is Radiolab. This hour we're talking about diagnosis.

[Jad Abumrad]

Diagnosis, the easy kind. We're not going to talk about it. Easy would be you come into my office. I'm a doctor, you have a broken arm. I take a picture, I say, hey, you've got a broken arm. The picture says so.

[Robert Krulwich]

Yeah, because you can see the break right there.

[Jad Abumrad]

But let's suppose you came into my office and you were sad. You tell me that your sex drive is down. I'm the doctor, so just between you and me. Well, right away, my learning tells me that you may be a candidate for depression. But how do I know that you're depressed?

[Robert Krulwich]

What do you mean, how do we know? We talk about it.

[Jad Abumrad]

You just said, well, you can't measure sadness or depression. You can't go to a test tube and count anything.

[Robert Krulwich]

Right.

[Jad Abumrad]

It's not hard science.

[Robert Krulwich]

Yeah, because until now.

[Jad Abumrad]

What if I put you in one of those FMRI machines that we've talked about so often? I snap a picture of your brain in action and I look at it, and from your picture I say, you are depressed.

[Robert Krulwich]

You're gonna tell me I'm depressed just from looking at a picture of my brain?

[Jad Abumrad]

Yes.

[Robert Krulwich]

What? No way.

[Eric Kandel]

Look, it's now here.

[Jad Abumrad]

Photographic diagnosis of mental illness.

[Eric Kandel]

This is happening. There is no question.

[Jad Abumrad]

And that, by the way, is Eric Kandel, a professor at Columbia University, who just happens to have won the Nobel Prize for medicine.

[Eric Kandel]

Let me give you a little historical background.

[Jad Abumrad]

Did you get a Nobel? I don't think you did.

[Robert Krulwich]

I still don't believe you. What? Just because he's got a Nobel Prize, I'm gonna suddenly turn?

[Jad Abumrad]

No, no, no, you're not. So let's do this step by step. Okay? Step one. Imagine you're slipping into an FMRI machine. Okay. Now, I want you to just look at my face. Why is that so difficult?

[Robert Krulwich]

Yeah, I just want to know where this is going anyway. Okay, I'm looking at your face.

[Jad Abumrad]

So now that you're looking at my.

[Eric Kandel]

Face, different regions of the brain, they become active.

[Jad Abumrad]

There are cells in your brain that are saying, I know him.

[Eric Kandel]

The cells are more active. They need energy. Just like when you run, you have to breathe fast.

[Jad Abumrad]

And to get the energy, your heart pumps more blood. The body sends a rush of fresh blood to that particular group of cells. And because the blood has iron in it, the magnet in the brain scanner can see the iron and therefore see the blood flow. And take pictures of it. Many, many pictures in real time.

[Eric Kandel]

I'll show you a very nice example of this.

[Jad Abumrad]

Eric's now heading off across his ample office with an extraordinary view of the Hudson Valley. And he brought over a picture of a human brain with different colors in different areas. And he told me, when.

[Eric Kandel]

At a face, when you image the face, this area lights up.

[Jad Abumrad]

You're pointing to an area of the brain. An area of the brain on your forehead, kind of. That's right.

[Eric Kandel]

That's right. If you look at a house, some other area lights up, but this area does not light up. You look at another face, this area lights up again.

[Robert Krulwich]

Every time you see a face, same area.

[Jad Abumrad]

Yep.

[Robert Krulwich]

But you haven't told me anything about emotions yet.

[Jad Abumrad]

That's true. So let's move on to step two. Because we use faces to tell what someone else is thinking or someone else is feeling. Looking at faces also triggers an area.

[Eric Kandel]

Deep in the brain that is concerned with emotion called the amygdala. Now, very recently, a number of people have looked at the amygdala looking at faces, and it's extremely interesting.

[Robert Krulwich]

Step three. Okay.

[Jad Abumrad]

I'm gonna take you now to London.

[Cynthia Fuhr]

Hello.

[Jad Abumrad]

Hi.

[Cynthia Fuhr]

Yeah, hi.

[Jad Abumrad]

Yeah, that's good.

[Robert Krulwich]

Hey. Who's this?

[Jad Abumrad]

Oh, right. Sorry. Who are you?

[Cynthia Fuhr]

I'm Cynthia Fuhr. I'm a psychiatrist at the Institute of Psychiatry, King's College, London.

[Jad Abumrad]

And are you, like, in your 30s or your 40s or your 50s?

[Cynthia Fuhr]

This is part of the interview.

[Robert Krulwich]

Rude.

[Jad Abumrad]

No, I wanted to establish that she came into psychiatry.

[Cynthia Fuhr]

I'm trying to think. When did I graduate medical school?

[Jad Abumrad]

At a very critical time.

[Cynthia Fuhr]

I finished my training in 97. My training in psychiatry in 97.

[Jad Abumrad]

That's 1997, when the FMRI machines were first becoming available. And so Cynthia was able to do a rather amazing study.

[Robert Krulwich]

What?

[Jad Abumrad]

In this study, she got together a group of people who were clinically depressed.

[Cynthia Fuhr]

Depressed people.

[Jad Abumrad]

And then another group of people who were normal, healthy people. And she put them in the brain scan machine and showed them facial expressions.

[Cynthia Fuhr]

Faces ranging from more neutral expressions to more sad expressions.

[Jad Abumrad]

So they saw a sad face and then a neutral face and then a sad face.

[Cynthia Fuhr]

That's right.

[Jad Abumrad]

And what the person in the machine was supposed to.

[Cynthia Fuhr]

To look at these faces and decide whether it was a man or a woman's face.

[Robert Krulwich]

Huh? What does that have to do with anything?

[Jad Abumrad]

Because while they were doing that, while.

[Cynthia Fuhr]

They'Re making this decision, the emotion of the face is being processed automatically.

[Jad Abumrad]

The amygdala sees the emotion on the faces at that moment. And the machine, it's like, tick, tick, tick, tick, tick.

[Cynthia Fuhr]

And there were hundreds of pictures, tenth.

[Jad Abumrad]

Of a second to tenth of a second. A tenth of a second, that's right. Did you see a difference between the people who were depressed and the people who were normal?

[Cynthia Fuhr]

Yes.

[Jad Abumrad]

Was it a significant difference or a just barely difference as a group?

[Cynthia Fuhr]

It was a significant difference.

[Jad Abumrad]

And now she takes the big step. Step four, from the pattern she sees in bunches of people, she feeds all those patterns into a computer.

[Cynthia Fuhr]

It's called machine learning. She told the program, this is a pattern of brain activity in depressed people. This is a pattern of brain activity in healthy people.

[Jad Abumrad]

And then she shows the computer a brain scan of a new person.

[Robert Krulwich]

So this is someone the computer's never met before.

[Cynthia Fuhr]

Exactly.

[Jad Abumrad]

And she did this a bunch of times, Right?

[Cynthia Fuhr]

A whole bunch of people.

[Jad Abumrad]

And each time the computer tries to guess, is this new person depressed or not. Ooh. And what happened?

[Cynthia Fuhr]

More than 85% of the time, 86% of the time, the algorithm correctly diagnosed whether that person was depressed or healthy.

[Jad Abumrad]

With just a brain scan, a computer, and a patient. No doctor needed. Cynthia's computer got the diagnosis right. 86% of the time. A computer.

[Cynthia Fuhr]

When we saw the results, it was like, wow, this is amazing.

[Robert Krulwich]

Wait a second. Has she repeated this?

[Jad Abumrad]

Well, this is actually the very first time that this has been done with depression. And so it's just a pilot study. And like you say, someone else will have to do it again and again and again. But according to Cynthia, the potential is fantastic.

[Eric Kandel]

Psychiatry is going to be absolutely revolutionized by this.

[Cynthia Fuhr]

I think this method can Be applied.

[Jad Abumrad]

To any psychiatric disorder, any autism, schizophrenia, obsessive compulsive disorder.

[Robert Krulwich]

No way. Come on.

[Eric Kandel]

Why not? Every one of these illnesses ultimately must have an anatomical basis. Every one of these illnesses.

[Jad Abumrad]

So this means that it will soon or one day be possible for a patient to come in and you take a picture of him in real time of her, and you will have a diagnostic tool, that's what you're saying?

[Eric Kandel]

Absolutely.

[Jad Abumrad]

Absolutely.

[Robert Krulwich]

You mean to tell me that they're going to put people in machines and just go, boop?

[Jad Abumrad]

No, no.

[Robert Krulwich]

Schizophrenic.

[Jad Abumrad]

This is not a casual thing. You go to the doctor, you tell the doctor that you're feeling a certain way. The doctor will talk to you. And then he would come to you and say, well, my learning. And the test tells me that you're ill. So that's all that's happening here, is now the mental doctor will say, there's.

[Robert Krulwich]

Nothing in this that feels invasive to you. Well, obviously, it's tunneling into the deep depths of your personhood.

[Jad Abumrad]

No, this is. If you believe that mental illness is a mental illness, it is a structural condition which can be fixed. So it's not the deep inner you, it's the broken you.

[Robert Krulwich]

So it's like the broken arms that you started off with. So you would put the two side by side.

[Jad Abumrad]

I think I would. And then, of course, you get to the next.

[Robert Krulwich]

No, come on, Robert. I mean, human beings are way too messy for that. You're too messy for it to be that easy. No. No way.

[Jad Abumrad]

So you think this is out of science's reach? Really? It's just too.

[Robert Krulwich]

There's a part of me that does think it is out of science's reach.

[Jad Abumrad]

I think it's because you think that they're looking deep inside you. That's what you don't like.

[Robert Krulwich]

I do. Don't get me wrong. I find brain scans fascinating when it comes to questions like where is the soul? What is consciousness? That kind of stuff. But don't kind of get in my head and tell me what's right and what's wrong.

[Jad Abumrad]

What if you feel sad and sick? Don't you want to get better?

[Robert Krulwich]

Yes, but I enjoy the comfortable ambiguity that would come from a situation. Like sitting in a therapist's office and saying, well, how am I feeling? I'm feeling this way or that way. And in the messiness of trying to describe how you're feeling, there's a vast landscape of things that can happen. Choices you can make, therapies you can make.

[Jad Abumrad]

Let me just do it this way. Let's say you are sick and you know that you're sick, machine or no. Okay. If you are feeling badly, wouldn't it be nice if a machine could help you find the right kind of help?

[Robert Krulwich]

What do you mean?

[Jad Abumrad]

Well, Eric took me through a little.

[Eric Kandel]

Thought experiment, a mind experiment. You've developed a psychotherapy and I've developed a psychotherapy. We each claim it's the best in the world. Now, we have an objective way of seeing the machine allows you to, independently of any evaluation, see the outcome of treatment.

[Robert Krulwich]

So you can audit the doctor.

[Jad Abumrad]

Audit the doctor and give you evidence that it's working or no.

[Robert Krulwich]

Okay, I think I'm a little bit on board. I can give you 10% buy in now. Okay, so how far off is this stuff? Is it going to come soon?

[Jad Abumrad]

This is very early in the game, obviously, but I did ask him, like, how far into the future are we talking about here? Soon or long after you're dead?

[Eric Kandel]

I'm going to be around a long time.

[Jad Abumrad]

But the question stands. Will you make it to see that people will actually have.

[Eric Kandel]

You know, one can't in medicine, in all honesty, give a timeline for many of these things. Imaging methodology right now is quite sophisticated, but it's still primitive compared where it needs to be. You're picking this up in status necessity. You've become excited as the thing is beginning to emerge. We see it for the first time on the horizon.

[Jad Abumrad]

You're saying we got to this story too early.

[Eric Kandel]

That's what you're saying, just right. It's not going to be interesting. 20 years from now it'll be obvious.

[Robert Krulwich]

Or in 20 years it'll be obvious that we were wrong. Okay, That's a real possibility because what we don't know is vast. And I want to tell you a story now about just how wrong people can be.

[Lulu Miller]

That's coming up right after this break.

[Robert Krulwich]

Radiolab is supported by Capital One. Banking with Capital One helps you keep.

[Jad Abumrad]

More money in your wallet with no.

[Robert Krulwich]

Fees or minimums on checking accounts and no overdraft fees. Just ask the Capital One bank guy. It's pretty much all he talks about in a good way. He'd also tell you that Radiolab is his favorite podcast too. Oh, really? Thanks, Capital One bank guy. What's in your wallet? Terms apply. See capitalone.com bank capital1na member FDIC.

[Lulu Miller]

Radiolab is supported by BetterHelp. This month is a mental health awareness month, a time to shine light on all the hard stuff we can privately face in our own minds. But turns out a significant amount of people surveyed say they feel too ashamed to go to therapy, which is such a bummer, because waiting inside a therapy session is simply a person who wants to help with hard stuff, like shame or fear of conflict or stress or sadness or struggles with motivation, whatever it may be. Therapy is all about bringing in an outsider to help you get in better harmony with the people around you. And even with that tricky being called you yourself, I know I have personally benefited from therapy. And at BetterHelp, there are over 30,000 licensed therapists with all kinds of different specialties. So you can find someone who fits what you need. We're all better with help. Visit betterhelp.com Radiolab to get 10% off your first month. That's betterhelphelp.com/radiolab.

[Robert Krulwich]

The Internet is a dumpster fire, and.

[Jad Abumrad]

We are dumpster diving.

[Robert Krulwich]

Ice cream's so good, it's almost like watching a slap fight between a bunch of nerds.

[Eric Kandel]

I have to give you credit for being dogged with this boy.

[Robert Krulwich]

How often do you think about the Roman Empire?

[Jad Abumrad]

Sorry, what?

[Robert Krulwich]

I was just thinking about something.

[Jad Abumrad]

Unsolved Mysteries, Untold Histories, every Friday on our podcast, Endless Thread.

[Lulu Miller]

So go wherever you get your podcasts.

[Jad Abumrad]

And follow Endless Thread.

[Lulu Miller]

Radiolab, Lulu. Just before the break, Jad and Robert were debating how much science really can know about who you are from peering into one of your organs.

[Robert Krulwich]

And I want to tell you a story now about just how wrong people can be. Begins with a mystery.

[Robert Sapolsky]

Sudden Infant Death Syndrome. Perfectly healthy child goes to sleep and dies during the night.

[Robert Krulwich]

It's about the worst thing that can happen to a parent. And each year, it does happen about 7,000 times. Still, no one knows why. Oh, and by the way, that was Robert Sapolsky.

[Robert Sapolsky]

He's a professor of neuroscience at Stanford University.

[Robert Krulwich]

And Sapolsky tells this story of the mother the moment Sids was diagnosed for the first time, or at least classified. And a terrible mistake that was made.

[Robert Sapolsky]

Around 1900 or so. People were beginning to recognize this as a disease entity, and nobody knew what was up. So people decided, let's go dissect Sid's kids.

[Robert Krulwich]

Meaning when a baby would die, they would perform an autopsy.

[Robert Sapolsky]

Exactly.

[Robert Krulwich]

You know, check the baby's insides, see.

[Robert Sapolsky]

If there's anything different in them from normal kids.

[Robert Krulwich]

That seems logical.

[Robert Sapolsky]

Absolutely.

[Robert Krulwich]

They measure the size of the baby's lungs. Yep, that looked normal. Then they measured the size of the heart. Yep, nothing strange there. Stomach, kidney, liver. Yep, those are all fine. Then they would look in the throat.

[Robert Sapolsky]

They look in there and they say, oh my God, these SIDS kids, they have enormous thymus glands.

[Robert Krulwich]

The thymus?

[Jad Abumrad]

The thymus.

[Robert Krulwich]

What is the thymus?

[Jad Abumrad]

Yeah, what is a thymus?

[Robert Krulwich]

Well, it is a little tiny pink gland that is right here behind your collarbone at the base of your throat. And its job is to help you fight disease.

[Robert Sapolsky]

It makes one type of cell critical.

[Robert Krulwich]

To your immune system, especially in times of stress.

[Jad Abumrad]

Hmm.

[Robert Krulwich]

In any case, normally this little organ is about the size of a tiny tube of toothpaste, like the tribal kind. But in these sitschits it was huge, humongous, enormous. Twice the size.

[Robert Sapolsky]

Exactly.

[Robert Krulwich]

And since the thymus is dangerously close to the windpipe, doctors came up with.

[Robert Sapolsky]

A hypothesis, a perfectly reasonable hypothesis, which.

[Robert Krulwich]

Was that maybe if you're one of these babies with an enlarged thymus and you're asleep and somehow you roll over. Wrong.

[Jad Abumrad]

Uh huh.

[Robert Krulwich]

Well, that gland might press down on.

[Robert Sapolsky]

Your trachea and suffocate you during the night.

[Jad Abumrad]

Oh.

[Robert Krulwich]

So, ding, ding, ding, Medical mystery solved.

[Jad Abumrad]

Really?

[Robert Krulwich]

No.

[Robert Sapolsky]

They even came up with a name for it and it was called status thymicolymphaticus. It was in all the pediatric textbooks by the 1920s. And you would look in there and there'd be pictures. There would be pictures of the dissected thymuses, normal size, and here on the right, enlarged, abnormally large status thymicolymphaticus.

[Robert Krulwich]

And in no time at all, doctors came up with a treatment, a perfectly logical therapy, which is that if we're going to help these babies, we've got to shrink their thymus glands. And to do that, the best solution, obviously is to.

[Robert Sapolsky]

Irradiate their throats. Irradiate their throats? To shrink their thymus glands.

[Robert Krulwich]

Zap the child's throat with trillions of radioactive particles.

[Jad Abumrad]

Really? Literally?

[Robert Sapolsky]

You betcha.

[Robert Krulwich]

And this was considered like something every good loving parent should do?

[Robert Sapolsky]

Absolutely. If you worry about your child being at risk for sids, go and get their throats irradiated to shrink the thymus glands.

[Robert Krulwich]

And did it work?

[Robert Sapolsky]

Yes, it shrank the thymus glands.

[Robert Krulwich]

But he says it did have another effect.

[Robert Sapolsky]

Decades later, you've killed 20 to 30,000 people with thyroid cancer.

[Jad Abumrad]

20, 30,000 deaths, that's a real number.

[Robert Sapolsky]

Yeah, that's a fairly big one.

[Robert Krulwich]

So here's my question.

[Jad Abumrad]

Uh huh.

[Robert Krulwich]

How could these doctors have gotten it so, so, so, so, so wrong? Do you know what I mean?

[Jad Abumrad]

Yeah, I do. Well, don't you know what you mean? You just answered your own question a minute ago.

[Robert Krulwich]

No, no, I didn't. I'M about to answer it right now.

[Jad Abumrad]

They're playing with radiation. You just said that. But what they. But they didn't know that radiation would hurt you. They had. No, it was a brand new technology.

[Robert Krulwich]

But that's not what I was gonna.

[Robert Sapolsky]

This was, you know, a couple of decades into radiation having been been discovered.

[Jad Abumrad]

Isotopes are performing near miracles of diagnosis and discovery.

[Robert Sapolsky]

People were just tossing around radiation all over the place.

[Jad Abumrad]

Iodine 131, radioactive sodium, radar, gamma rays, neutrons.

[Robert Sapolsky]

And this was a period with Madame Curie, like dipping her arm into vats of uranium.

[Jad Abumrad]

Radioactivity is harmless.

[Robert Sapolsky]

And dying soon afterward from cancer. People would go into shoe stores and they would have their feet X rayed.

[Robert Krulwich]

Yes.

[Jad Abumrad]

X ray is a wonderful invention. I had that.

[Robert Sapolsky]

You had that?

[Jad Abumrad]

I did, yeah. You take off your shoes and then you could look at your bones.

[Robert Sapolsky]

That's exactly what they would do.

[Robert Krulwich]

Why would you do that?

[Jad Abumrad]

That was the thing you could do at the shoe store. It was very cool.

[Robert Sapolsky]

Yeah. It's showing how cutting edge of a shoe store they are.

[Jad Abumrad]

So that's your explanation?

[Robert Krulwich]

No, that may look like the explanation. I mean, sure, radiation played a role, but if you would have let me say what I was going to say, I would have told you the real explanation.

[Jad Abumrad]

Yes.

[Robert Krulwich]

Preceded the radiation by like a couple hundred years.

[Jad Abumrad]

Whoa. I don't have no idea what you're talking about.

[Robert Krulwich]

I'm going to tell you. Back in the 1700s, okay.

[Jad Abumrad]

That far back.

[Robert Krulwich]

That far back before radiation, before your grandpa.

[Jad Abumrad]

Well, before. Before the Civil War or the Eiffel Tower or Napoleon.

[Robert Krulwich]

I'm talking when the red coats were still wearing red.

[Jad Abumrad]

Yeah, yeah.

[Robert Sapolsky]

This was shortly after the Revolutionary War.

[Robert Krulwich]

Right about this time, says Cebulsky, the first med schools started to pop up in America and a supply and demand issue came into effect. Because with these med schools came med students, medical students, who needed to learn about anatomy. And of course, in order to do that, they needed bodies, you know, to dissect.

[Robert Sapolsky]

This produced this whole occupation. You could be a resurrectionist.

[Jad Abumrad]

A resurrectionist?

[Robert Sapolsky]

Yep. And they would go out and dig up bodies that night and sell them to the anatomists at the medical school.

[Robert Krulwich]

I'll need two more by Thursday. Dig, dig. Now, here's the key point. Since demand was so high, the resurrectionists had to go where the bodies were easiest to get, which meant, you know, avoiding the fancy graveyards.

[Robert Sapolsky]

If you were wealthy, you could have yourself buried in what was called a patent coffin, which was a triple layer coffin, which was meant to be resurrectionist proof.

[Robert Krulwich]

But if you were not wealthy, no fancy coffin for you, you'd probably just be buried in a sack in some pauper's field just a few inches under the soil. Very accessible for these resurrectionists.

[Robert Sapolsky]

Not surprisingly, that's where they went. Dig, dig.

[Jad Abumrad]

Are we still on the same topic? Are you explaining why children die?

[Robert Krulwich]

Yes.

[Cynthia Fuhr]

Yes.

[Robert Krulwich]

Bear with me. All right, What I'm trying to make is that the grave robbers targeted the poor, so much so that sometimes when they. You know, people would catch these resurrectionists in the act and see, like, oh, my God, that's my dad you're digging up. There'd be riots. Get them.

[Jad Abumrad]

Get them.

[Robert Krulwich]

Stop stealing our bodies.

[Robert Sapolsky]

Troops were called out. Rioters were shot.

[Robert Krulwich]

Are we talking, like, hundreds of people, torch bearing?

[Robert Sapolsky]

Yeah, it was townies versus the people who were trying to dissect their dead relatives.

[Jad Abumrad]

Okay, okay, okay. This is a lot of history, and I'm very fascinated in quotes. What does this have to do with kids dying of thief?

[Robert Krulwich]

All right, let me bring it home.

[Jad Abumrad]

Not that it hasn't been interesting, but bring it home.

[Robert Krulwich]

Okay. As a result of all of this hubbub over grave robbing, country after country throughout Europe decided, well, let's standardize how science gets its cadavers. Forget all this grave robbing.

[Robert Sapolsky]

So they passed laws which formalized anyone who died in a poor house, their body would be turned over to the anatomists.

[Robert Krulwich]

This was like the cadaver version of direct deposit. Okay, so grave robbing was gone, but now all the bodies used by medicine, not just some, but nearly all, now, came from the poor.

[Robert Sapolsky]

Estimates were by the end of that century, 99% of the bodies used for. For anatomy lessons had been derived from poorhouses.

[Robert Krulwich]

And that seemed okay until 1936, a.

[Robert Sapolsky]

Guy named Hans Selye showed that being.

[Robert Krulwich]

Poor actually warps your body. And now, Robert. Now we come back to the case of the mysteriously enlarged thymus. Because if you're poor.

[Jad Abumrad]

Mm.

[Robert Krulwich]

You're worried about your job, you're worried about feeding your family, you're worried about the bills. In other words, you are stressed out.

[Robert Sapolsky]

And during chronic stress, your immune system goes down the tubes.

[Robert Krulwich]

And since the thymus is part of the immune system, if you are chronically.

[Robert Sapolsky]

Stressed, the thymus gland shrinks.

[Robert Krulwich]

For 150 years, doctors had been dissecting cadavers, pointing at organs which they thought were normal but which were, in fact, shrunken from a life of poverty and stress and saying, that's normal. So that when these SIDS babies show up with these gigantic thymuses. Oh, my God. In fact, that was the first time they'd ever seen a normal one.

[Robert Sapolsky]

People had no idea what was normal and what was abnormal. And they got it backwards.

[Robert Krulwich]

Killing about 30,000 people in the process. Now, the scary thing, says Sapolsky, is that these doctors were not dumb.

[Robert Sapolsky]

No, these were the best, most careful researchers at the time. And these were the only logical conclusions that could have been made. And nonetheless, it produced an utter disaster. There's, you know, not the slightest reason to think we're not doing the same thing right now.

[Lulu Miller]

So it has been 17 years since this broadcast first ran. And I wondered, you know, circling back to the mental health stuff, the brain imaging stuff that we started the episode with, where are we now? Over the last nearly 20 years, as there have been more and more MRI studies and brains scanned over and over, our machine learning is letting us predict with way more accuracy differences in brains with bipolar, schizophrenia and depression. But we do not have MRI based tests for these things in clinical practice. There just isn't any biomarker that we found that's reliable enough for everyday clinical use. So we're definitely not living in the world that Eric Kandel predicted we might be. You know, where you can just scan your brain and tell you what's wrong with you and how you need to solve it. But we're not quite living in Jad's world either. We're sort of in this in between still. But it's one I have to say I kind of like where on one hand the science is getting better at telling us what's going on with our brains, and yet it's not good enough that doctors can quite use it. It's still forcing doctors to treat us as full individuals, as not just brains to reckon with our full personhood. And so we walk forward at the in between to the slow but steady beat of science.

[Robert Krulwich]

Hi, I'm Seb and I'm from London and here are the staff credits. Radiolab was created by Jad Abumrad and is edited by Soren Wheeler. Lulu Miller and Latif Nasser are our co hosts. Dylan Keefe is our director of sound design. Our staff includes Simon Adler, Jeremy Bloom, Becca Bressler, W. Harry Fortuna, David Gable, Maria Paz Gutierrez, Sindhu Nianasambandan, Matt Kielty, Annie McEwan, Alex Neeson, Sara Khari, Sarah Sambach, Anissa Vitse, Ariane Wack, Pat Walters and Molly Webster. Our fact checkers are Diane Kelly, Emily Krieger and Natalie Middleton. Hi, my name is Diana and I'm calling from Madrid. Spain. Leadership support for Radiolab's science programming is.

[Jad Abumrad]

Provided by the Gordon and Betty Moore.

[Robert Krulwich]

Foundation Science Sandbox, a Simons foundation initiative.

[Lulu Miller]

And the John Templeton Foundation.

[Jad Abumrad]

Foundational support for Radiolab was provided by.

[Lulu Miller]

The Alfred P. Sloan Foundation.

[Robert Krulwich]

Since WNYC's first broadcast in 1924, we've been dedicated to creating the kind of content we know the world needs. In addition to this award winning reporting, your sponsorship also supports inspiring storytelling and extraordinary music that is free and accessible to all. To get in touch and find out more, visit sponsorship.wnyc.org.