Sick of “morning” sickness

Summary

Episode Summary: "Sick of 'Morning' Sickness"

Unexplainable delves deep into the perplexing phenomenon of morning sickness, particularly focusing on its most severe form, hyperemesis gravidarum (HG). Hosted by Julia Longoria and featuring insights from geneticist Marlena Fejdo, this episode explores the historical context, personal struggles, and groundbreaking research that sheds light on why morning sickness occurs and how it might be effectively treated.

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1. Introduction to Morning Sickness

Julia Longoria opens the episode with a personal touch, sharing her own battle with persistent nausea during pregnancy. She questions the misnomer "morning sickness," highlighting how the discomfort extends beyond the early hours.

Julia Longoria (01:59): "I don't know why they call it morning sickness when it's all day long."

2. Personal Stories of Severe Nausea

Marlena Fejdo recounts her harrowing experience with HG during her pregnancy in the late 1990s. Despite being a geneticist herself, Marlena found the medical community unprepared and dismissive of her severe symptoms.

Marlena Fejdo (07:04): "It was torture. I didn't keep any food down for over a month."

Her ordeal included multiple hospital visits, intravenous treatments, and even a feeding tube, underscoring the debilitating nature of HG.

3. Historical Context and Medical Missteps

The episode traces the understanding of pregnancy nausea back to ancient civilizations, noting that while the Greeks documented it around 2000 BC, significant medical advancements were stymied by tragedies like the Thalidomide disaster in the 1950s and 60s. The aftermath led to a chilling effect on research into effective treatments for HG.

Julia Longoria (16:35): "The drug thalidomide was given in the 50s and 60s for nausea and vomiting hyperemesis in pregnant and unfortunately that drug led to babies being born with severe limb deformities for decades after that."

4. Marlena Fejdo's Research Journey

Motivated by her personal suffering and the lack of scientific literature, Marlena embarked on a quest to uncover the genetic underpinnings of HG. Starting with a comprehensive survey, she gathered over 800 responses, revealing a significant familial link.

Marlena Fejdo (20:34): "We found that there was a 17 fold increased risk of having it if your sister had it. Women that had it once had it again in 80% of their pregnancies, which also suggests a genetic component."

5. Discovering the Role of GDF15 Hormone

Despite initial funding rejections, Marlena's perseverance paid off when she collaborated with 23andMe to include HG-related questions in their surveys. This collaboration led to the identification of the GDF15 gene, a hormone linked to vomiting.

Marlena Fejdo (22:12): "We found the first connection with the vomiting hormone GDF15."

Further collaboration with Regeneron enabled the sequencing of these genetic samples, solidifying the connection between GDF15 and HG.

6. Current Findings and Implications

The breakthrough research revealed that individuals with HG have lower baseline levels of GDF15 before pregnancy. Upon conception, the hormone levels surge dramatically, overwhelming the body's system and triggering severe nausea and vomiting.

Marlena Fejdo (25:07): "People with hyperemesis have lower levels before pregnancy."

This discovery not only demystifies the biological mechanism behind HG but also opens avenues for targeted treatments. Marlena discusses innovative approaches, such as desensitizing the body to GDF15 to prevent the extreme reactions seen in HG patients.

7. Challenges and Future Directions

Despite her groundbreaking findings, Marlena continues to face institutional hurdles, including repeated funding denials from the NIH. Undeterred, she pursues alternative research methods and supports women experimenting with new treatments based on her discoveries.

Marlena Fejdo (27:58): "I am doing a study of women that are trying it on their own, because many people are trying it on their own anyway with their doctors and are contacting me saying they're trying it."

8. Conclusion: Understanding and Moving Forward

The episode concludes by emphasizing the importance of Marlena's research in transforming the understanding of morning sickness from a mere inconvenience to a scientifically explicable condition. Her work not only provides relief to those suffering from HG but also challenges the medical community to recognize and address the profound impact of severe pregnancy nausea.

Julia Longoria (26:13): "She says other factors might also contribute to it, but she's convinced this is the main cause."

Marlena Fejdo's dedication underscores a broader message: persistent curiosity and resilience can lead to significant scientific breakthroughs, even in areas previously deemed "unexplainable."

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Notable Quotes:

• Julia Longoria (01:59): "I don't know why they call it morning sickness when it's all day long."
• Marlena Fejdo (07:04): "It was torture. I didn't keep any food down for over a month."
• Marlena Fejdo (20:34): "We found that there was a 17 fold increased risk of having it if your sister had it."
• Marlena Fejdo (22:12): "We found the first connection with the vomiting hormone GDF15."
• Julia Longoria (26:13): "She says other factors might also contribute to it, but she's convinced this is the main cause."

This episode of Unexplainable not only sheds light on the scientific intricacies of morning sickness but also humanizes the struggle faced by countless individuals, advocating for greater empathy and understanding within the medical field.

Transcript

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[Julia Longoria]

I'm Julia Longoria. This is unexplainable, and this one's going to get a little personal. That is the sound of me about to hurl. I really don't like making things about me, but that's not the reason I'm about to barf right now. If you've watched tv, sitcoms or rom coms in the last few decades, there's only one real reason a woman like me would be unexpectedly puking for a studio audience. She's been barfing for an hour.

[Marlena Fejdo]

The flu. I don't know.

[Julia Longoria]

I hope you're not pregnant. That sounds like morning sickness, Miranda. I don't know why they call it morning sickness when it's all day long.

[Miranda]

Yep, it's morning sickness, and I can assure you it's not just in the morning.

[Julia Longoria]

I haven't been able to track down whoever coined that term, but I hope they have the afterlife's equivalent of diarrhea. Misery Loves Company in early pregnancy, I was vomiting every day or every other day, mostly in the evenings. At week 15, I gave my pregnancy tracker apps the middle finger as they congratulated me on the end of my nausea. For lots of people, it stops in the second trimester, but not for me. I just puked everything I'd eaten that day. Some people have helpfully told me to eat more protein, just as others told me to eat less protein. Friends have gleefully announced that it must be a girl, while other family members maintained, well, that means it's a boy. My doctors have been just as unhelpful. Some pills prescribed to me seem to be helping some days, but other days I still retch multiple times. The question I'm left with shouted dramatically at the heavens why today on Unexplainable. You're gonna have to bear with me as I, Julia Longoria, turn my pain into art or at least into journalism. And I'll ask why? Why do pregnant people, who are presumably eating for two, why do so many of us barf so so much?

[Miranda]

Pregnancy nausea has been in the human record since about the year 2000 BC.

[Julia Longoria]

But the story of how we finally got some kind of scientific answer to why starts with a woman in the 90s.

[Miranda]

If you could think back to the Marlena, before you, you know, before you ever got pregnant, when you were maybe trying not to get pregnant, what is your earliest memory of the term morning sickness?

[Marlena Fejdo]

Just what I saw in television shows and movies. People saying, ha ha ha, she's pregnant. Like it's an aha moment.

[Julia Longoria]

Marlena Fejdo is a geneticist, and like so many of us, she didn't think much about pregnancy nausea until she found out she herself was pregnant.

[Marlena Fejdo]

When I woke up, I ran to the bathroom and I sort of laughed after thinking, this is morning sickness. Ha ha. But within a week, realized that it was not very funny. I had nonstop nausea and vomiting, so I couldn't get out of bed until around noon without vomiting. When I called the nurse, she said, this is normal in the first trimester.

[Julia Longoria]

From the sounds of it, Marlena's nausea was significantly worse than what I've been experiencing.

[Marlena Fejdo]

I ended up going to the emergency room twice for intravenous fluids. In that pregnancy, I was able to keep something down every day. It did go away in the second trimester, and the rest of my pregnancy was really not so bad.

[Julia Longoria]

By the time Marlena had seen a doctor, she was in her second trimester and she was already feeling better. She never brought it up, and her doctor didn't ask about her nausea. Marlena gave birth to a healthy baby boy, and she never thought about pregnancy nausea again until two and a half years later.

[Marlena Fejdo]

I walked by a gelato store and I didn't feel like going in. I thought I must be pregnant, because normally that smell would be delicious and I would have to go in, but I just did not feel like going in. And I was like, this is not normal. I must be pregnant. And I took a pregnancy Test, and sure enough, I was pregnant. It got bad really fast. Pretty soon, I could not eat, drink, or move without violently vomiting. It was like that feeling that you have a few seconds before you vomit that I had all the time where I'm just constantly about to vomit. And I had to spend every waking second trying not to vomit because once I started, I couldn't stop. And it would last hours and just be very violent because there was nothing in there to vomit. So my body would reach further and further down my. My intestines to try to find something to vomit up. So it was very violent, and I had to do everything I could to try to stop that cycle from happening because it was very hard to stop.

[Julia Longoria]

Wow.

[Marlena Fejdo]

It was torture. I didn't keep any food down for over a month.

[Julia Longoria]

This time, Marlena told her doctor about it.

[Marlena Fejdo]

The ob. He gave me the diagnosis. He said I had hyperemesis, hyperemesis gravidarum.

[Miranda]

What was going through your mind when you heard the word hyperemesis? Did you know what that was?

[Marlena Fejdo]

I don't think I knew what it was at the time. Must have been the first time that I'd heard it.

[Julia Longoria]

Hyperemesis gravidarum, or hg, is an extreme form of pregnancy nausea that affects about 2% of pregnancies worldwide. What I personally have gone through in my pregnancy is nothing compared to this condition. And when Marlena got sick in 1999, just like now, there weren't any proven treatments for it.

[Marlena Fejdo]

My doctor, he offered that I could have home health care, tried seven different medications at once. I actually had Zofran pump in my leg because I couldn't swallow medication without vomiting. And I lost the fat in my thigh so quickly that they had to move that pump to IV eventually, my doctor gave me a feeding tube. A feeding tube, it goes through your vein. It's pretty dangerous because it gets inserted above your heart. And if it gets infected, you can have serious consequences. So they try not to do it if they can, which is why I think my doctor waited so long. But I really was starving to death.

[Julia Longoria]

This was extremely scary. A small percentage of people die from hg.

[Marlena Fejdo]

I was in bed lying flat at home. I couldn't even sit up. I couldn't go to the bathroom. I couldn't brush my teeth. I also had something called hypersalivation, so just buckets and buckets of saliva coming out of my mouth. So I had, like. And it was really acidic, so I had kind of burn marks all over my face. And my doctor prescribed that suction machine that they have at the dentist. I had to have pretty much 24 hour care. I mean, my husband took care of it at night. He had to wake up in the night to change my tubing and everything. We hired someone who took care of my son because I couldn't even see my two and a half year old. My husband would just bring him in at night to say goodnight to me.

[Julia Longoria]

At one point in this fog, Marlena has a faint memory of getting a call from her doctor.

[Marlena Fejdo]

I suppose I did at one point talk to my doctor on the phone because I know that he did tell me that people who have this are trying to get attention.

[Miranda]

Wait, I'm sorry, what? He said this on the phone to you?

[Marlena Fejdo]

Yeah, yeah. He said I was exaggerating my symptoms to get attention.

[Miranda]

He said this directly to you? Like, are you like, factually, like in your hospital bed at home, talking to the doctor with a feeding tube in your. Like, where?

[Marlena Fejdo]

Yes, because I was only in one place the whole time. I couldn't even turn to my side. So I was lying flat on my back in my bed talking to my doctor. And he, you know, said that to me and starts telling me about, you know, he's actually even done the study. He's trying to be like, scientific with me, you know, like, I've done a study on this. I never saw that study.

[Julia Longoria]

Did you look for it later?

[Marlena Fejdo]

I did. I never found it. Not at that time. But he said he had done a study that showed that women with hyperemesis were infantile and just wanted attention from their mothers. And it's really the reverse, where a lot of women with hyperemesis will end up moving in with their mothers, because the mothers are the ones that will take care of them and take care of their children when they're going through this. But it's not because they want attention from their mothers. It's because they don't have a choice.

[Julia Longoria]

Right.

[Marlena Fejdo]

You can't cook when you're extremely nauseous. So you need someone who's willing to do that for you. But, like, what are you talking about exactly? Yeah, but it's actually pretty common for doctors to say that to their patients, unfortunately, even to this day. And I didn't have any energy to argue with him. I mean, I couldn't even barely stand up for more than a second.

[Miranda]

How did you feel in that moment?

[Marlena Fejdo]

I was definitely angry because obviously it's imprinted in my brain and I remember it so well. But I was also really too sick to really. I mean, I was really Struggling every second.

[Miranda]

Yeah.

[Julia Longoria]

So, yeah, during this pregnancy, she never saw the inside of her doctor's office again. After her very first visit, when she got diagnosed, she had gotten an ultrasound at that first visit.

[Marlena Fejdo]

That was the last picture of my baby that I ever got because I lost it in the second trimester.

[Miranda]

When you lost the pregnancy, like, how soon was it before you kind of stopped feeling nauseous?

[Marlena Fejdo]

It was immediate. It was crazy. Literally, that day I could eat again. And it was so strange because I was like, it's so easy to eat, and yet it had been so hard to, like, even just be near food.

[Miranda]

That must be, like, so heartbreaking. And so it was very weird because.

[Marlena Fejdo]

It was like, I felt so good to be able to eat again physically, but I felt so bad having just suffered so much for no reason. It took me about a month to recover. But when I did recover, I started looking into what was known about it.

[Julia Longoria]

Marlena is a geneticist. Up until this point, she'd been so sick and weak that she hadn't taken a scientific curiosity about why she was getting sick and what she could do about it. Now, out of the haze of hyperemesis, she put her scientist hat back on.

[Marlena Fejdo]

And then I just searched PubMed for medical articles related to nausea and pregnancy and hyperemesis, but there was very little out there at the time. I just was like, okay, I have to work on this because there's nothing out there and I need the answers. So.

[Miranda]

So you were like, I'm going to go find the answers.

[Marlena Fejdo]

Yeah, exactly.

[Julia Longoria]

Answers after the break.

[Marlena Fejdo]

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[Julia Longoria]

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[Marlena Fejdo]

Relax responsibly.

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[Julia Longoria]

I'm gonna hurl. To be clear, I have not been diagnosed with hyperemesis gravidarum. My symptoms come nowhere near to what Marlena went through. But it has become bad enough that I've found myself researching the long history of pregnancy puking to try to understand why we seem to know so little. Apparently the Greeks wrote about pregnancy nausea on Papyrus circa 2000 BC Roman doctors at one point recommended a hot wine bath to combat the illness. Don't knock it till you try it, I guess. Fast forward though to the 1950s and 60s and something happened that had a bit of a chilling effect on pregnancy.

[Marlena Fejdo]

Nausea research the Thalidomide Disaster so the drug thalidomide was given in the 50s and 60s for nausea and vomiting hyperemesis in pregnant and unfortunately that drug led to babies being born with severe limb.

[Julia Longoria]

Deformities for decades after that. As far as I can tell, we didn't do much else to figure out why pregnancy nausea happens. But it's pretty clear even from what little was out there when Marlena did her search that pregnancy nausea is not in your head, contrary to what her doctor claimed.

[Marlena Fejdo]

People said to me while I was sick that it must be psychological because only humans have it, but that is just not true. So there's evidence from veterinary journals that dogs, cats and monkeys all have early period of appetite loss, just like humans. The most extreme example is the octopus. They actually lay their eggs and then starve to death and die.

[Julia Longoria]

For humans, I read pregnancy nausea in general is associated with positive pregnancy outcomes, leading some scientists to believe that it's evolution. We puke to protect our babies. Like if we eat less then we won't need to go out and hunt and gather and risk getting eaten by predators, I guess.

[Marlena Fejdo]

Clearly we don't need that anymore as humans. Maybe animals still need it, but for us it's just click Uber eats. Our food is very safe and easy to get without risking our lives. So it's a mechanism that I think we should try to evolve away from.

[Miranda]

Leave in the past.

[Julia Longoria]

Yeah, I could not agree more. But Marlena's doctors seemed to still be stuck in maybe it's all in your head. She was determined to dump that hypothesis. But if you want to get rid of a bad theory you gotta come up with a better one, and that's not easy at this point. Marlena was very early in her career a postdoc at UCLA who was not focused on pregnancy nausea. She didn't have any funding to go into this. She just had a hole in her heart from her last pregnancy and a burning curiosity.

[Miranda]

And what did you do next?

[Marlena Fejdo]

I wrote a survey with all the questions I could think of related to hyperemesis.

[Julia Longoria]

She wrote a survey intended for people who'd been diagnosed with hyperemesis gravidarum, asking a lot of questions.

[Marlena Fejdo]

It was very long, it was like 30 pages.

[Julia Longoria]

But the main things she was curious.

[Marlena Fejdo]

About, what is the recurrence risk?

[Julia Longoria]

If you have this once, what's your chance? You'll have it again.

[Marlena Fejdo]

I asked about medications and which ones were effective and what the side effects were.

[Julia Longoria]

And most importantly for her potential research.

[Marlena Fejdo]

Did it run in families? I wanted to do a genetic study, and so I needed evidence to show that it was genetic.

[Julia Longoria]

If she got anecdotal evidence that hyperemesis gravidarum ran in families, then she could go out and get some funding to try and prove it.

[Marlena Fejdo]

My little brother was a statistician and he put the survey up on his website and we started getting, getting faxes back at that time.

[Julia Longoria]

This was around the year 2003, before things like SurveyMonkey and Google Forms were common. So Marlena and her little brother had gotten creative.

[Marlena Fejdo]

I had a lot of trouble publishing my survey results because people didn't believe the Internet. And who are these people that are like filling out these things? And how do you know they really have what they have? But like, why would someone sit down and fill out a 30 page survey if they didn't have it?

[Julia Longoria]

And over the course of two years, they got over 800 responses back.

[Miranda]

And what did you find?

[Marlena Fejdo]

So we found that there was a 17 fold increased risk of having it if your sister had it. Women that had it once had it again in 80% of their pregnancies, which also suggests a genetic component.

[Julia Longoria]

Next, Marlena set out to find biological proof that this was genetic. That meant collecting surveys wasn't enough. She had to collect DNA samples.

[Marlena Fejdo]

And so people were sending in saliva samples from all over the country.

[Julia Longoria]

This was still a sort of pet project of hers. So she got permission to store these samples in the fridge at work in one of UCLA's labs. And when she got enough samples, she. She applied for official funding to try and sequence them.

[Marlena Fejdo]

I applied for funding from the nih. I applied twice and was Rejected twice, unfortunately. So I had all these saliva samples sitting there.

[Julia Longoria]

And once again, 10 years into this pet project, Marlena got creative.

[Marlena Fejdo]

My brother gave me a 23andMe kit for my birthday in 2010.

[Julia Longoria]

23Andme, the direct to consumer genetic testing business. It had been named the invention of the year a few years earlier. And it had started a bit of a craze. Over 15 million people have sent the company their saliva. Marlena approached 23andMe with a small request.

[Marlena Fejdo]

I asked them to include hyperemesis in their surveys. And they were very receptive to it.

[Julia Longoria]

They asked their customers a simple question. Do you have hyperemesis gravidarum? A few years passed, and Marlena got some data back.

[Marlena Fejdo]

We found the first connection with the vomiting hormone GDF15.

[Julia Longoria]

Having at this point raised $0 to fund her research, Marlena had identified a gene that looked like it might play a role in HG, a gene, GDF15, that made the vomiting hormone, a hormone.

[Marlena Fejdo]

That everybody has, whether you're male or female, and we're whether you're pregnant or not.

[Julia Longoria]

For men and women, it's associated with stress.

[Marlena Fejdo]

This hormone is why you often lose appetite when you're under some kind of physical or mental distress.

[Julia Longoria]

It's why some people stop eating during finals week, for instance.

[Marlena Fejdo]

When it gets high enough, we think that it's a signal that's telling your body either to expel a poisonous food and not eat that again, or in our hunting and gathering days, telling you, hey, stay in your cave until you feel better.

[Julia Longoria]

23Andme customers who said, yes, I have hg seemed to share a similar variant of the vomiting hormone gene.

[Marlena Fejdo]

It was really an aha moment.

[Julia Longoria]

It turned out we already knew that placenta makes a lot of this vomiting.

[Marlena Fejdo]

Hormone, so it already had a connection with pregnancy.

[Julia Longoria]

She didn't yet know how exactly the vomiting hormone played a role, but it was something. So she published her findings.

[Marlena Fejdo]

After my paper came out, I was contacted by a scientist from the company Regeneron. He said he was very interested in my paper and could they do anything for me. And so I said, well, actually, I have all these DNAs in my freezer that haven't been sequenced. And I had actually applied to the NIH again and they denied me funding.

[Julia Longoria]

She'd been denied funding a third time.

[Marlena Fejdo]

Even though they funded a study very similar size on erectile dysfunction genetics. So I was not happy about that.

[Julia Longoria]

But the biotech company Regeneron would help her. They sequenced those saliva samples that she'd been storing in the university fridge for years.

[Marlena Fejdo]

And yet again, same gene showing up.

[Julia Longoria]

The vomiting hormone gene surfaced very strong evidence that the vomiting hormone and its corresponding gene were the stars of the morning sickness show. But how? What exactly was going on with the hormone? Why was it causing certain people to get really, really sick? To get to the bottom of this, Marlena did another study. Again, not funded by the nih, but this one involved researchers from around the world.

[Marlena Fejdo]

Our next paper was international collaboration of many researchers where we figured out what was going on.

[Julia Longoria]

And after years of Marlena just diying it, the team finally found an answer.

[Marlena Fejdo]

People with hyperemesis have lower levels before pregnancy.

[Julia Longoria]

For people who got really sick during pregn, like people with hg, they were making very little vomiting hormone before they got pregnant. So when they got pregnant, the levels shot up. And that change was an utter shock to the system.

[Miranda]

So, like, they had a low. It had to do with, like the sort of change in the level of the hormone.

[Marlena Fejdo]

Exactly.

[Miranda]

Rather than how. How much. Exactly how convinced are you that you have found the cause of hyperemesis? And I guess, like, is it also the cause of morning sickness? Quote, unquote, more generally?

[Marlena Fejdo]

Yeah. So it is the cause of all nausea and vomiting in pregnancy, as well as other forms of nausea. I'm convinced of that.

[Julia Longoria]

She says other factors might also contribute to it, but she's convinced this is the main cause. I was honestly kind of shocked to hear her say this. She figured this out almost single handedly eventually. Yeah, she had a team of researchers, but it's thanks to her curiosity about her own health that we know the cause of morning sickness, that she knows it and I know it. And now you know it. So why does the medical establishment act like we don't know the cause of morning sickness? When I asked my doctor about the cause of nausea, he said there could be lots of contributing factors, which I guess is true. But we have a pretty good idea for the main cause. And Marlena says she has some pretty good ideas for how we could treat the root cause of pregnancy nausea, thanks to an experiment that a colleague of hers at Cambridge did. He gave mice a high dose of vomiting hormone and they predictably puked. But when he gave them just a little bit of the hormone before giving them a high dose, the mice seemed to be desensitized. They didn't puke. Marlena applied for NIH funding last year to try and test this treatment on actual patients to try and desensitize patients with A history of H.G. shocker. The NIH denied her proposal. And another shocker. That's not stopping Marlena from trying to find an answer herself to her remaining unanswered questions.

[Marlena Fejdo]

I am doing a study of women that are trying it on their own, because many people are trying it on their own anyway with their doctors and are contacting me saying they're trying it.

[Miranda]

Based on your research. Basically, they've decided to just give it a go.

[Marlena Fejdo]

Yes.

[Miranda]

Is insurance covering it for them, or they're just kind of going for.

[Marlena Fejdo]

Some people, I think it is. Some people, it isn't. But, you know, people want to complete their families, and they want to be able to carry their pregnancies healthfully and safely. I mean, I can totally understand why these women are doing it.

[Miranda]

Yeah. And I am curious, just hearing your story and hearing about your research of if. If your experience with your second pregnancy affected your decision to try to get pregnant again.

[Marlena Fejdo]

Oh, yeah, definitely. In my second pregnancy, my body killed my baby, so I feel like I'm not gonna take that risk again and risk my body killing another potentially healthy pregnancy. So I ended up doing surrogacy, gestational surrogacy, and I was very lucky to have twin daughters as well, so I was able to complete my family, which, you know, really allowed me to feel happy and be able to work on this and give back.

[Miranda]

Yeah.

[Marlena Fejdo]

So I'm very grateful.

[Miranda]

And, I mean, you know, the experience that I guess I'm going through right now, just like, even any pregnancy, and I'm sure it's on a heightened scale with. With folks who have hg, but, like, talk about unexplainable, right? Like, pregnancy is, like, so mysterious, even to the person, especially to the person who's pregnant. Like, you have so little communication or feedback or information about the fetus or the baby. And to me, I guess, like, I've been reflecting on how, like, this sickness almost feels like one form of feedback, and it. And it's easy to feel like, oh, I'm. Am I doing something wrong? Is there, like, meaning in this? I don't know. What do you say to people who are looking for meaning in the vomit?

[Marlena Fejdo]

Yeah, no, I definitely think we don't need that anymore. I think that it's just a mechanism that our evolution has not evolved out of fast enough.

[Miranda]

It's like your appendix or something.

[Marlena Fejdo]

Yeah, I don't think we need it anymore. That heightened sense of smell and that extreme nausea and vomiting. You know, maybe animals still need it, but we do not.

[Miranda]

This episode was produced by me, Julia Longoria. We had editing from Jorge Just mixing and sound design from Christian Ayala, music from Noam Hessenfeld and fact checking from Esther Gimme.

[Julia Longoria]

Meredith Hottenot runs the show and Bird Pinkerton backed away slowly from the platypuses.

[Miranda]

As more and more kept coming out.

[Julia Longoria]

Of the tall grass. How could you? She yelled.

[Miranda]

One platypus stood up and said quietly.

[Julia Longoria]

We had no choice.

[Miranda]

Thanks as always to Brian Resnik for co creating our show. If you have thoughts about the show, send us an email. We're@ unexplainableox.com you can also leave us a review or a rating wherever you listen.

[Julia Longoria]

It really helps us find new listeners.

[Miranda]

You can also support this show and all of Vox's journalism by joining our membership program. You can go to vox.commembers to get AD, free podcasts and a whole bunch of other good stuff.

[Julia Longoria]

Plus you'll be helping keep this place.

[Miranda]

Running and make sure journalists like me get paid. Unexplainable is part of the Vox Media Podcast network and we will be back next week.

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