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That Can't Be True with Chelsea Clinton
Seeing the World Differently: Autism, Animals, and the Mind of Temple Grandin
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I am Michelle. And I am Craig. Craig here is my big brother. We are so excited for you to listen to our brand new podcast. It's called IMO with Michelle Obama and Craig Robinson. Together, Craig and I are gonna take your questions about the challenges you're grappling with in life.
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B
So get in touch, send us your
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questions and join us on IMO with Michelle Obama and Craig Robinson. Subscribe wherever you get your podcasts. Welcome to that Can't Be True, a show that sorts fact from fiction, especially on issues impacting our health. I'm Chelsea Clinton and today I'm speaking with someone whose work has changed the way our world understands both animals and humans, particularly as it relates to autism. Dr. Dimple Grandin is a professor of animal science, a best selling author, and one of the most influential advocates for autism awareness. She was diagnosed with autism as a child in 1950 at a time when very little was understood about autism. She went on as a young adult and then really over the last 50 plus years to revolutionize livestock handling systems and to really transform animal treatment to be more humane and more dignified human here in the United States and around the globe. Her ability to think in pictures has given scientists and farmers alike new insight into how animals experience the world. And she's inspired millions of people to understand that neurodiversity is a strength, not a weakness. We're going to talk about her life's work, why language and nuance matter so much when discussing autism. What we know and don't know, how, hopefully we all can be part of creating more supportive, strength based environments in homes, in schools and in workplaces where all kinds of different minds can thrive. Dr. Grannon, it's just an honor. Thank you for being here.
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B
Hi, how are you?
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A
I'm well, except it's very windy here in New York City.
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B
Well, we've had, we've had winds so bad that they closed the university for a day. We had 100 mile, 9 mile gusts, lost the roof on one of our equine arenas.
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A
Oh no.
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B
I've lived in Colorado here at Colorado State for 36 years. We've never had winds like this. They closed the freeway because semis were flipping over.
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A
That's really scary. Well, you know, Dr. Granite, I'm so thankful for your time. I have been such an admirer of yours for so many years. I hope we can perhaps go back even further when you really started your work in animal science in the feed yards in Arizona in the 1970s. I wonder if that's where you Always thought kind of you would be. Did you always know that you wanted to work kind of with and really on behalf of animals?
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B
Well, I can certainly go into that. I'm an Easterner originally and I got interested in the livestock industry because I got exposed to it as a teenager when I had the opportunity to visit my aunt's ranch in Arizona. So what that brings up is really important. Students have to get exposed to things to get interested. I tell students going into different programs, help professors with their research, do career relevant jobs, try on careers. I think it's very important. You might try something on go, I love it. Or you might try something on you go. I hated that. But at least you know you need to know. Yeah, that's something that you need to know. And as a very young child, I always wanted to be a scientist. My grandfather was the co inventor of the autopilot for airplanes.
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A
Oh, wow.
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B
And when I was a little kid, I used to just ask him endless science questions. Why is the sky blue? Why is grass green? Why do tides go in and out? And he would patiently explain that to me. So being a scientist is what I want to do. I majored in psychology. I got extremely interested in optical illusions. And I think some of that helped me in my work with cattle. Because you can have situations where you might have a shadow on the ground, might look like a hole in the ground. Cattle have poor depth perception. They have wide angle vision. The very first stuff I did way back in the 70s is I'd get down in the chutes and see what the cattle were seeing. And people thought I was kind of crazy to do that. Now I didn't know at the time that I'm a visual thinker. Everything I think about is a picture. Then when I got out building things, working with the industry and designing and supervising installation of equipment I design in major meat companies, I discovered all these people in the shop that were inventing all sorts of mechanical things. They cannot do higher math just like me. They're totally terrible at algebra, but they're super smart and mechanical. And then you have your pattern thinkers, your mathematical thinkers. Then you have your word thinkers. So in engineering, you see, you really need both. You need your mathematical people. Let's design a roof so the wind does not blow it off. That's where you need mathematics. And the visual thinkers are really good with the mechanical things.
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A
I know. Dr. Grannon, you very much have spoken and written about your view that eating meat can be ethical, provided, you know, the animals have a decent life and an honorable Death.
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B
That's right.
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A
I wonder if you've always felt that way. Is it really just through your work of kind of helping reimagine how animals live and die that you came to that view? And for people who might be concerned about the ethics of eating meat, like, what would you say to them?
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B
Well, you have to give the animal a life worth living. We've got to prevent suffering. So there's a guy named. There's a scientist named David Melore. He's came out with a paper on you. Have we got to prevent suffering. But does the animal have a good time now? I think beef cattle living out on pasture have a good time. When I first started out in Arizona, I handled cattle in all the feed yards. This is 50 years ago. Handling was terrible. But the living conditions in the feed yards actually was good. They had shade, they were nice and dry. The cattle looked nice and shiny and clean when they came in there. Good health and the handling I saw is something that we could fix. Handling today is way better. That has totally, totally improved. That I'm really pleased about. And the slaughter plants, I really worked hard on fixing them. And one of the biggest things is management. The manager of that plant has to care about doing things right, Maintain equipment, supervise employees. That will fix a lot of problems.
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A
And so for people who want to use their purchasing power as a reflection of their values, who would feel similarly to you that and to me that it's important that animals, you have a decent life.
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B
Well, the big plants, when they work right, can be just fine. We have a lot of low income folks. And one of the problems with the super high end welfare is it costs way too much. What's that person that works at a gas station gonna buy? I watched a lady just the other day, she bought 20 chicken legs and it was on the sell by date. They were gonna throw them out. She bought them for $5. I watched it ring up on the cash register. What's she gonna buy?
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A
Absolutely.
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B
So what I think what we really need to be doing is, okay, we have all our niche growers and we have to have a decent large scale commercial. And I think most beef is raised in a decent large scale commercial. In some of the pigs and chickens. Some of the most restrictive farm forms of housing we need to get rid of. Now, that doesn't mean we put every pig outside, but we need to get rid of very restrictive housing. Like sow gestation stalls where Sal basically lives in a box for most of her life. I call it living in an airline seat. And you're never allowed to walk in the aisle. Very small chicken cages where they can't stand upright and walk the normal little head bob. Chickens do, you know. Now there's some systems like McDonald's for example, I am a consultant for McDonald's, where they can walk around, they're on decks, they can move between the decks, they've got perches, they've got private nest box, which is something chickens want. It's still intensive, but it's like a decent apartment building rather than just jammed into something so tight we need to be getting the most restrictive stuff we need to get rid of. But that doesn't mean we put every bird in small things outside. Because I'm thinking about the lady that bought those 20 chicken legs. I've always said we need to have a decent large scale commercial and the large plants can work really well. I mean, being able to walk around, I think that's a very, very basic need.
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A
I agree. Whether you're a human or an animal feels like it should be a fundamental right.
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B
Yeah, that's right. But when it comes to one area where the industry has really improved and the pigs have improved in that too, is handling, handling of animals.
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A
I wonder, Dr. Grant, if we could switch topics to talk about neurodevelopment and autism. And you talked about how you were nonverbal until you were four. I know you were kind of formally diagnosed with autism in 1950 when you were 3. Your mother and your teachers, your science teacher you earlier referenced, your grandfather, who thankfully was very open to all of your curiosity. What do you think worked so well for you that we hopefully can continue to learn from? And what do you think we're not doing? Well, to ensure that every child is kind of recognized for who they are and met where they are in the way that you were.
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B
Well, one thing is I travel around, I'm finding too many three year olds who are not talking onto your wait lists. This is absolutely bad. You gotta start working with these kids very, very young. And I was into a very good program very early on. The other thing I'm seeing a problem, especially on the fully verbal segment, is not getting launched into the world of work. And then I talk to grandfathers and these grandfathers find out they're autistic later in life. Well, they all had paper routes as K. Now I know we don't have paper routes anymore, but we can do paper route substitutes. Walking the neighbor's dog, helping out a senior in your apartment building where they need to be working on a schedule for Somebody who is outside the family. And then the instant illegal getting real jobs. And I want to avoid what I call chaos jobs. Chaotic takeout windows. And another little thing that can really help, let's say they got to clean an ice cream machine. Make a pilot's checklist of the steps. You know, the boss just goes yak, yak, yak, yak, yak. I won't remember the steps. Let me just write them down like a pilot's checklist. And I think one of the worst things the schools ever did was taking out the hands on classes. And we need to be put in shop and home EC and sewing and all this stuff back into elementary schools.
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A
I mean when I was in seventh grade at what was then called Horseman Junior High School, I took shop. I had to learn how to use tools. I also had to learn how to disassemble and reassemble multiple different types of car engines. And Dr. Grannon, like I just thought, well, that's what we do in seventh grade. Like we take these classes. There was nothing exceptional about it. I mean the only exceptional thing was you could take home EC or shop. And I chose to take shop. And I think I was one of six girls out of the, I don't know, 150 or 200 girls in my seventh grade class that had chosen Shop Over Home Ec. But also the confidence that I gained through learning those, to use your words like hands on skills, was, was profound. Was profound, particularly as a girl.
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B
Well, and I think that taking this stuff out has been really bad.
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A
Well, you know, Dr. Grandin, again, before we go to. That can't be true. I'm just so struck by what you said a couple of minutes ago that you meet families where children are on two year wait lists.
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B
Yeah, I'm running into that.
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A
I travel all over the U.S. it's indefensible.
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B
Yeah, and it's, it's. Some parts of the country have really good early intervention, other parts don't. I think we'll leave the names of the states out.
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A
Well, I hope that for anyone listening you'll find out what those wait lists are in your area and what you can do to advocate for shortening them.
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B
What I've suggested because we've got to do something is maybe we start library play where we get some vulgar. We can't call it therapy for legal reasons, but we gotta start working on these kids and we'll call it library play and get some students coming and working with these kids. Because the first thing you gotta do with these little kids that aren't talking is engage them in little turn taking games and then start teaching them words, how to wait and take turns at games and basic skills eating with a spoon, for example.
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A
I love that we've talked a bit about some of the early intervention that every child who needs it deserves. I wonder, though, if we can now kind of go to that can't be true, which there's a lot of conversation around what, if any medication interventions there should be as treatments for kids or adults. Autism. And here's a recent news clip from cnn.
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B
All right. Okay.
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Take a look at this graph. That blue line shows how dramatically prescriptions of a drug called Leucovorin skyrocketed in late September, up 71% after this press conference at the White House.
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B
We have also identified an exciting therapy that may benefit large numbers of children who suffer from autism. Hundreds of thousands of kids, in my opinion, will benefit.
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But now a senior FDA official says they don't have sufficient evidence to support the drug's use in autism more broadly. The drug was approved, but much smaller subset of patients with an extremely rare genetic disorder called cerebral folate deficiency. Parents of kids with autism are telling us they're disappointed and some still want to use the drug. So I wonder, Dr. Grandin, if you have any reactions to that clip and what advice you would have for parents who might be trying to absorb all this information and think about how it is or isn't relevant for their kids.
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B
You know, I've heard about this drug before. There may be a subgroup where it has some beneficial effects. One of the big problems we have in autism is it's so variable. Okay. If you have a strep throat, there's a very specific test. You have tuberculosis, a very, very specific test. It can be diagnosed precisely. But autism is a behavioral profile. You're going from Einstein, who had no speech till age three, to somebody who cannot dress themselves. So there's all kinds of subgroups in there. I call it mixing apples, oranges, pears, grapes, and maybe some treatment comes out and it might have some benefits for the apples. And this thing going on with this drug right now is similar to what went on with B6 and magnesium years and years ago. And it seemed to help some kids. There may be a subgroup that could be helped by this. Now, if you take all the apples, orange, pears and grapes and you put them all together and test them, you'll say it doesn't work. But there's possibly a subgroup where it may have some benefit. I'm not cure. I Know, some people that are trying it right now, one mistake they made is they're trying that drug along with mixing it with some other drugs. And I go, wait a minute. You try one thing at a time, really carefully.
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A
And I know there's a lot of debate now that the rise in autism rates is largely attributed to these widening categories as well as to other factors. And I know there's also intense conversations among some scientists and researchers and others around kind of the difference between kind of being diagnosed with autism and having autistic traits. What do you think of these kind of ongoing conversations, and do you think they're useful?
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B
I mean, I can think of kids that, when I went to school with that would be diagnosed with autism today. I can think of shop people I've worked with. Oh, you see the patent portfolio, they were definitely autistic. Now let's talk about how the diagnosis has changed. When the diagnosis first came out, you had to have speech delay to be labeled autistic. Originally, where I would fit that. Then Asperger's came out in the 90s, which is basically socially awkward. No speech delay. Then that was merged together. So now you're taking the mild ones that might be a president of a tech company, and they're put in the same group with a very, very severe person who cannot speak that may have epilepsy on top of the autism. And you put the same label on that. See, this is the problem we have now.
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A
Well, and I know one of the reasons that Asperger's syndrome stopped being an official, distinct diagnosis is because of the revelation of Dr. Asperger's ties to the Nazis.
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B
Yes, I'm fully aware of that. But you can just change it to autism with no speech delay, because that's basically what Asperger's is.
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A
Is there other recent research that you think should be part of this conversation, or are there new studies that you think you should be pursued that haven't yet?
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B
Yes.
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Oh. So please, what would those be?
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B
My number one research priority would be sensory over sensitivities. This can be very debilitating. Loud noises that hurt the ears, clothes that feel scratchy and itchy. These sensory problems are real. Like the whole sensory system is overly sensitive. Now, there are some ways to help desensitize that. One method is I might hold a hot, warm cup of coffee and smell peppermint, you know, where you're stimulating across the senses. We need to be working on methods to desensitize these problems. They can be extremely debilitating. Be my number One research area and sometimes you can desensitize it. If a child's afraid of a vacuum cleaner because the noise let the kid turn on the vacuum cleaner. But if you let the kid wear headphones all the time, it's going to get worse, it's going to get more sensitive. What you want to do is have the headphones with you control and then if a fire alarm goes off, you can put the headphones on. My number one thing would be working on ways to desensitize these sensory issues be my number one area of research because the sensory issues can make it very difficult for people to live in the regular world. Not able to tolerate a noisy restaurant. I basically still I have some mild ones where I can't hear in a noisy restaurant. I still can't. But there are people where the sensory issues are so bad and these are real that it's just totally debilitating and makes it very difficult for them to do real things. And you can have some very severe sensory issues in a person that you know may be a brilliant computer programmer and we need to be working on treatments for those. And I think it's going to be mostly desensitization protocols.
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A
My fifth marathon is right around the corner and so most of my free time these days when I'm not working or with my kids is spent on running or thinking about running or thinking about what else I should be doing for my training in addition to running. And I really don't want to have to worry about what I'm going to wear while running or cross training. And I really have loved the Feathertech short sleeve top from Fabletics, especially as the weather gets nicer here in New York City. The VIP membership also gives you access to Fabletics scrubs for the healthcare workers in your life. Their scrubs are made with durable water repellent fabric and your first scrub set is $15 when you check out. As a new VIP member, Fabletics already has incredible deals and I'm really excited for an exclusive offer just for our listeners. You get 80% off everything when you sign up as a VIP with Fabletics. You can go to fabletics.com can't be true. Take a quick style quiz and be sure to select can't be True when prompted to unlock your 80 off. That's Fabletics.com can't betrue. I wonder. Just one more question about autism and neurodevelopment. There is a lot of debate and research happening on the origins of autism and why we've had, you know, more Children diagnosed as being on the autism spectrum disorder. And we've already discussed, you know, the broadening of the category, the earlier identification, thankfully, like the later diagnosis of people, which as you said, often is incredibly reassuring to patients. There are though, studies currently being undertaken as to whether or not there are any environmental factors, ecological factors, and I wonder your gut reaction to those questions given you've spent so many decades now working out in the world.
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B
Let's look at some of the old research. Genetics is a very big factor. And years and years ago they did twin studies, fraternal twins versus identical twins, they call concordance, which means whether or not they both have it. The identical twins were much more likely to both have autism than the non identical twins. It's got a very heavy genetic basis, Very, very heavy. Now I think you also could get some other things where environmental contaminant would interact with susceptible genetics, but genetics is probably 90% of it.
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A
And so Dr. Granad, you've already spoken about how you think schools at every level, like you know, elementary, middle school and high school need to have more hands on learning and skills building and that parents need to expose our children in, in whatever ways are possible for our families, given the enormous diversity of this country to kind of hands on activities at home. You teach at Colorado State, I, I wonder at the university level, like what do you think is going well from your experience at CSU and.
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B
Well, and I'm going to just talk about things in general. All right, let's say somebody wants to be a veterinarian, an MD doctor or a veterinary technician. We're screening out some of our best clinicians with all algebra and calculus. We're screening out the people who have good clinical skills. There are heart doctors right now that don't think you need to use a stethoscope. See, that's clinical skills because clinical skills are sensory. And okay, we have a thing at what's called our spur campus down in Denver where you can watch some spay cats and dogs. And there's a window you can go look through and you can, there's a camera that looks down into it. Oh, I've watched them spay a lot of animals there. And I'm watching them with the camera that looks right down into it. And I'm going, what does algebra have to do with spaying this dog? Now there's a little tiny bit of algebra you have to have for dosing medication that can be learned, that can be memorized. Now I think the reason why the mathematical people are pushing higher mass so much. I think they think you need it for thinking. But a visual thinker doesn't think that way. A visual thinker just sees a solution to a problem. It's also associative. I'll give you an example. I like to read Aviation Week for fun. And I was reading about a new airplane engine with a new alloy in the engine. What an alloy is, is a mixture of different types of metal and you get just the right mixture. It makes it really strong. But then since I'm gluten free and I like de gluten free things that don't taste like cardboard.
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A
Me too. Me too.
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B
I saw the label for red mill flour. Now if you just use potato starch, for example, starch source, the stuff's cardboard. But if you use the right ratio of starches, you see how they're both an alloy. One's an alloy of metals, the other is an alloy of starch sources in just the right mixture, then the brownies are just delicious. So that's how an airplane engine can be related to gluten free flour. That's actually decent.
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I love that.
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B
It's an associative method of thinking. Okay, let's say you were a veterinarian. You would go, oh, I saw a cat that had this five years ago. I'll do one test to confirm where the non visual way. You just, just do a smorgasbord of a jillion different tests on a fishing expedition until you find it.
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A
I wonder, Dr. Grandin, if you could also share how you think about strength based approaches to learning differences. Because I know that you've really spent a lot of time trying to help all of us understand how to support kids and adults in education and more broadly through a strength based approach. What do you mean by that?
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B
I like a strength based approach. So you let the kid have access to a whole lot of stuff and your math kid's going to gravitate towards the math. And we're not doing that good a job developing math kids, they're not getting moved ahead in math when they should be moved ahead in math. And then I'm the visual thinker and in my book on visual thinking, I present the research. You want research? This research shows that the object visualizer, like me, the non mathematician, thinks very differently than the pattern thinker. Who is the mathematician? Well, we need both kinds of minds. My kind of mind's going to work on the mechanical stuff in the factory and the mathematician's going to work on things like the refrigeration System for a food processing plant. Just to think of specific things.
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A
Dr. Grenna, I do love math.
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B
Okay.
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I've always loved math. And also as I was saying, thinking, reflecting, really kind of what you were saying. I realized I'm not great at spatial awareness. And I think even the mathematical thinkers, just to use your kind of heuristic, could really benefit from working with and learning with people who see the world through kind of shapes and objects and perceive the world that way but process the world that way. Like we could learn a lot too.
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B
Yeah, well you see, I'm worried we're screening out our very best veterinary and medical clinicians with all this emphasis on all this higher math, you know, and I'd be, I would be one of them. Now let's show you. In my book Visual Thinking, I discuss where we need visual thinkers to discuss risk. I use the Fukushima nuclear power plant disaster. I was just flabbergasted when I found out why that happened. I can't design a nuclear reactor, but maybe you need me for safety systems. It's not a very good idea when you live next to the sea, which is super important. Electric emergency cooling pump in a non waterproof basement. If they had had waterproof doors, the accident would not have happened. Simple old fashioned waterproof doors. And the problem is the mathematician didn't see, see, I can see the water going in there. They had a 10 meter sea wall. I looked up the historical data. Yes, it was going to get breached. That was about 20 minutes on Google. I found that waterproof doors. It would not have happened. I'm going, how could you do that? But you see, the mathematical mind doesn't see it. You see, you need to have both.
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A
It reminds me of when Dr. Richard Feynman testified on the Challenger disaster. I rem dropped the O ring on
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B
the table and when it got cold it got stiff.
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A
And when it got cold it got stiff.
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B
I remember that too. And it didn't seal when it got stiff.
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A
And had that design challenge been avoided, our astronauts would still be alive today, hopefully.
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B
Well, if they not launched it during cold weather, it would not have happened.
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A
Or if they had not launched it during cold weather.
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B
Yeah, the other thing they could have done.
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A
Doctor Grandin. Thank you. As our final segment we do something called fact or fiction where I'll throw out some common beliefs or I might think misapprehensions, but maybe you'll tell me differently or just even kind of recent claims that we've been hearing and then you'll say if they're fact or fiction.
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B
Okay.
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A
And then also feel free to add nuance if it's more. If it's more nuanced.
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B
Okay.
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A
Animals get vaccinated, too.
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B
All the time.
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A
All the time. I worked on a cattle ranch when I was, gosh, probably 19 years old. One of the things I did was I gave a lot of vaccinations to a lot of cows.
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B
I've done the same thing.
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I learned so much. Just kind of through. Through that process and the sense of real responsibility.
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B
No, I've given a lot of vaccinations, and I. This fall, I did my flu shot, and I did my Covid shot.
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A
Me, too.
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B
And I do space them out. I don't do two at once. But I. One year, I did not do my flu shot, and I paid for that. I got a very bad case of flu. I wasn't gonna make that mistake again.
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A
Probably not surprisingly, Dr. Grannon, we get all of the recommended vaccines in our house.
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B
I've gotten my shingles vaccines. I've, you know, I've got all my vaccines.
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A
Speaking about cattle, you have hugged cows to calm them down. Fact or fiction?
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B
Well, I got the idea for my squeezing machine where pressure helped me calm down. I got the idea from a cattle squeeze chute, which is a device they put the cattle in to hold them still, because you can't just walk up to them out in the pasture and put a shot into them. But occupational therapists have found that deep pressure is calming for some kids. I want to emphasize autism is so variable. Some kids will react really well to deep pressure for calming, and others, it doesn't work. Now, there's other simpler things you can do, like beanbag chairs and weighted vests, and they are helpful for some kids and not for others. See, this is where the autism's so variable. It isn't like a strep throat.
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A
This is a bit off the kind of fact or fiction, Dr. Granda, but do you have a pet? Do you have pets?
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B
I do not. Because I'm traveling 85% of the time. That's what I've been doing right now. I spend a lot of time talking to students about basic cattle handling, talking to parents and teachers about autism. I just try to give them good, practical information they can just go back and use.
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A
I feel like I have to ask you this because we've talked about it on this podcast before. Raw milk, safe to drink. Fact or fiction?
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B
I'm very concerned about getting diseases like brucellosis is the reason why we pasteurize milk.
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A
Bovine tuberculosis is A terrible disease you
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don't want to get. If you want to do raw milk, you better have very good biosecurity. And you maybe need to have a game fence to keep the deer out because they carry brucellosis. You've been a very, very good biosecurity because the reason why pasteurization was originally done is you don't want to get diseases like brucellosis and tuberculosis.
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Yes.
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They're very, very bad diseases.
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I agree.
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So you better make sure that you bring some new. Okay. Whether it's raw goat milk or cattle milk or whatever, you bring new animals in, you quarantine them, you have them tested, so you don't bring disease in. You have to have very good biosecurity to safely drink raw milk.
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A
I think pasteurization is pretty awesome, I have to say.
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B
Well, there's, you know, who wants to get brucellosis.
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A
I agree. Final question, which I think is a fun one. You have a doll that was made after you. Fact or fiction?
- [33:12]
B
Yeah, that is fact. Yes. And it was shown online. They should be coming available, you know, soon, like June or July. And they even put gray hair on it. It's very cute. And there's a little stuffed cow that goes with it.
- [33:24]
A
Well, Dr. Grannon, we'll definitely have to get one for our house. Do you have one already or do you have to wait till June, too?
- [33:29]
B
All of that probably have to wait till June. I've seen it, though. It's very, very, very cute.
- [33:34]
A
Well, I'm excited to see it. Dr. Grenna, this has just been fascinating. Thank you so much. I hope that you more than survive the winds and that all of your facilities kind of stay intact and together. And I'd already learned so much from you. Speak with you today and learned even more today. So just really thank you for all that you've taught so many of us, and thank you for your time in this conversation.
- [33:56]
B
It was great to be here, and thanks for having me.
- [34:00]
A
The sixth edition of Dr. Grandin's book, the Way I See it, comes out April 7th, and you can, and I hope will pre order it now. I'd also strongly recommend watching the documentary about Dr. Grandin that came out last year. It's called Temple an Open Door. Thanks for listening. Talk to you next week. That Can't Be True is a production of Limonada Media and the Clinton Foundation. The show is produced by Katherine Barnes, mix and sound design by Johnny Vince Evans. Kristin Lepore is senior director of new content, and Jackie Danziger is VP of narrative and Production. Maggie Kralshore is our Managing Director of Partnership. Executive producers are Jessica Cordova Kramer, Stephanie Whittles, Wax, and me, Chelsea Clinton. Special thanks to Erica Goodmanson, Sara Horowitz, Francesca Ernst Kahn, Caroline Lewis, Sage Spalter, Barry Lurie, Westerberg, Emily Young, and the entire team at the Clinton Foundation. You can help others find our show by leaving us a rating and writing a review. And if you can think of someone who might benefit from today's episode, please go ahead and share it with them. There's more of that can't be true with Lemonada. Premium subscribers get exclusive access to bonus content when you subscribe on Apple Podcasts. You can also listen ad free on Amazon Music with your prime membership.