The Mystery of the Sleepy Sickness

Back in the early 1900s, a new pandemic happened out of nowhere with odd symptoms, that was never solved or cured. It just went away. Which means it's right up our alley. See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  This is an iHeart Podcast. Guaranteed Human.

• 0:04Josh Clark?

  Buy smart, drive for less and trade for more. That's Toyota Ford ability and it starts with a great deal on an off-road ready Tacoma or half ton Tundra, two of Toyota's longest lasting trucks, combining power for work, tech for adventures and style in between. And they're built on a reputation for quality and reliability, which is why Toyota trucks are known for holding their value, which could mean big savings when it's time for your next Toyota. So get a great deal today and a great value tomorrow. Shop toyota.com for more. Toyota, let's go places.

• 0:35Speaker 02

  Hey, I'm Niall Rogers. This fall, I'll be driving across the country, meeting some of today's coolest and most fascinating artists. We'll explore the stories before the moments that changed everything. Because every musician remembers the moment where it all began. Experience Before the Moment, a Lincoln original series on the iHeart Radio app, YouTube, or wherever you get your podcasts.

• 1:08Speaker 03

  Welcome to Stuff You Should Know, a production of iHeart Radio.

• 1:18Josh Clark?

  Hey, and welcome to the podcast. I'm Josh and there's Chuck and Jerry's here too. And this is a good old fashioned Stuff You Should Know Medical Mystery episode.

• 1:28Speaker 04

  That's right. Look at Jerry over there. She's just sitting there, she's frozen. And what you can do is, I don't know if you know this, Josh, if you walk over to Jerry and take her hand off the keyboard and raise it above her head, she'll just keep it there until you move it back down.

• 1:43Josh Clark?

  Well, Chuck, it sounds a lot to me like Jerry might have chronic encephalitic lethargica.

• 1:51Speaker 04

  I think you might be right.

• 1:53Josh Clark?

  I might be right. I might be partially right. I think I would have been more right if I had called it encephalitis lethargica. But that's probably what she has, if those are her symptoms.

• 2:04Speaker 04

  That's right. File this under medical mysteries and also file it under a Julia Jam. But we're basically going to call it EL or encephalitis lethargica here and there. It was also known as the sleepy sickness. Sometimes the sleeping sickness, although there's a new sleeping sickness that is not to be confused with the previous one.

• 2:26Josh Clark?

  No, it's spread by the tsetse fly and it's epidemic. I don't think it's endemic yet in Africa. And it has got a couple of similar symptoms, but they're in no way related from what I understand.

• 2:38Speaker 04

  That's right. We're talking about an outbreak that happened in the early 20th century in Europe. Starting in about 1916, wherein all of a sudden people would, kind of out of nowhere, they would lose mobility. Some people would fall into like a coma-like state or a sleep-like state. Many, many people would die within days and it reached epidemic proportions in at least four continents by 1919, killed hundreds of thousands of people. And it's a medical mystery because we still don't know exactly why it happened or why it just kind of suddenly went away.

• 3:15Josh Clark?

  Yeah. Where it came from, what caused it? Nothing. We don't know almost anything about it. They just kind of know the symptoms enough that when you see the very, very, very rare case come along these days, you can say, I think this actually is encephalitis lethargica. And there was something you said about people being struck into like a coma or sleep-like state. The people who were struck with encephalitis lethargica, they weren't like laying there like Sleeping Beauty on their backs with like their hands crossed over their chest. Like, it was like you were saying, like they might have their hand in the air and their mouth open and like a silent scream and their eyes were open. They just weren't moving at all and they were just sitting like that.

• 3:56Josh Clark?

  That's the kind of like horrible symptom that you could suffer from for decades. Like, once that started, it might just keep going on for the rest of your life, even though this happened to you in childhood.

• 4:08Speaker 04

  Yeah, exactly. So, and there's a bit of a reveal that we're going to hang on to here. But we're going to start off with not a reveal, because that's not how you do things. In the three act structure.

• 4:18Josh Clark?

  Not in the, not in the podcast biz.

• 4:21Speaker 04

  No, no, no. Uh, we're gonna start out in 1916 with a Dr. Constantine von, is it Economo or Economo?

• 4:31Josh Clark?

  I like the first one.

• 4:32Speaker 04

  That's like saying, is it economy or econami?

• 4:37Josh Clark?

  This sounds to me like a, um, a Cosmo Kramer alias.

• 4:42Speaker 04

  Why don't you just tell me the name of the movie you want to see?

• 4:47Josh Clark?

  I'll never not laugh at that. No, it's a good one.

• 4:50Speaker 04

  Oh, boy. Uh, so he was a doctor, um, at the University of Vienna's psychiatric neurological clinic. And he started seeing some, some strange cases come through his office in 1916 where the symptoms were, um, you know, they had diagnoses on the charts, things like meningitis or MS or delirium, but the symptoms weren't matching these things or anything else that he could think of.

• 5:13Josh Clark?

  Yeah.

• 5:14Speaker 04

  And the first thing he did was ruled out, uh, neurological toxins, uh, infections and neurological disorders. And then was like, all right, I'm, I'm open here. Let, let's like, no one knows what this is and we need to figure it out. So let's sort of put our minds to this thing.

• 5:29Josh Clark?

  Yeah, he dove in. Um, he started describing it. He wasn't actually the first one to describe it. I think he was actually beaten by a couple of days, even though some people say it was the opposite way around, by a French physician named Dr. Renee Crochet. Um, the difference was Dr. Crochet's take was that this was maybe a behavioral disorder. And, um, Dr. Economo, Von Economo said, no, this is like clearly some sort of infection or something like that. It's an epidemic. It's transmissible. So that's why this is sometimes called Von Economo, um, encephalitis. It was essentially named after him because he was the guy who said, this is what's going on. This is what I think's going on. Check out these nutso symptoms.

• 6:11Speaker 04

  Right. Uh, not so nutso at first because when people would come in at first, they had, uh, basically looked like the flu. Um, you know, fever, um, coughing, you know, kind of what you would think of. Everyone said the flu, right?

• 6:24Josh Clark?

  Yeah.

• 6:26Speaker 04

  Yeah, there you go. That's much better.

• 6:27Josh Clark?

  I watched Zoolander recently.

• 6:29Speaker 04

  You know, a picture is worth a thousand words. A Josh impression of the flu is worth at least 20 of my words.

• 6:35Josh Clark?

  All right. Thanks.

• 6:37Speaker 04

  Was that part of Zoolander?

• 6:39Josh Clark?

  Yeah, he had the black lung. When he went back home to mine coal with his dad.

• 6:46Speaker 04

  Oh, I love that dumb movie.

• 6:47Josh Clark?

  It's a really great dumb movie. I was like, this is pretty great still.

• 6:53Speaker 04

  All right. So flu-like symptoms at first, then just a huge array of neurological symptoms that were really inconsistent among the patients, the severity of which was pretty inconsistent. Sometimes it varied widely from one to another. But one of the most common threads of these neurological symptoms was something called hypersomnolence, which is just really, really sleepy, like feeling really sleepy. And then eventually it could lead to that coma-like state where you're just sort of locked in.

• 7:22Josh Clark?

  So here's the thing, I so the sleep, the type of sleep, though, that is like common among people struck with encephalitis lethargica is not what you would consider sleep. They're not getting rest. You can wake them very easily. They are probably semi-aware of what was going on around them the whole time they were sleeping. But they they couldn't not fall asleep. Another thing that sometimes gets chalked up under this hypersomnolence is freezing mid-action. Like maybe they're taking a bite of broccoli. That's a bad example because they probably are like, I can't make myself eat this broccoli. It's so disgusting. But let's say they're eating like a delicious animal cracker and they stopped mid-bite.

• 8:07Josh Clark?

  They're they might not move again. Or they might like hear a song or something like that. And all of a sudden they start eating the the the animal cracker again. Yeah, it's not. The point is, it's called a sleeping sickness. It's not sleep as you would understand it.

• 8:24Speaker 04

  Yeah, yeah, that's good to clear that up.

• 8:25Josh Clark?

  Thanks.

• 8:27Speaker 04

  Because sleeping sickness sounds pretty good to me right about now.

• 8:30Josh Clark?

  It kind of does.

• 8:32Speaker 04

  Half of these cases is a pretty wide age range. About half of them were in people aged 10 to 30. Like I said, a lot of the patients died. Sometimes they died within like a week or two after onset of symptoms. There was one case of a girl who was walking home from a concert, suddenly experienced a paralysis, fell asleep within about a half hour and died less than two weeks later.

• 8:56Josh Clark?

  There was also some weird stuff, as we'll see, that had to do with psychiatric symptoms, where sometimes people would be fine after, you know, suffering from this for a couple of weeks, but they will, their personality would have changed. There was one report of, I guess a study found four reports of people who developed kleptomania after having suffered this and then ostensibly were cured from it. So like, it could really mess with your head, essentially, in just about any way your head can be messed with.

• 9:29Speaker 04

  Did Winona Ryder claim that? What was her, remember when she was stealing stuff?

• 9:33Josh Clark?

  Oh, yeah, I remember. It was a

• 9:35Speaker 04

  So weird.

• 9:36Josh Clark?

  It was a big deal.

• 9:37Speaker 04

  She came back pretty strong, which I'm glad. I like Winona Ryder. She does a great job in Stranger Things.

• 9:43Josh Clark?

  Oh, she's awesome in everything she's ever been in. Heathers, dude, is one of the all-time great movies. She was great in Mermaids. And then, yeah, all the way through to Beetlejuice. I'm not gonna say Beetlejuice Beetlejuice, but definitely Beetlejuice. And then Stranger Things, sure.

• 9:57Speaker 04

  Yeah, and a great crush of much of Gen X.

• 10:02Josh Clark?

  For sure.

• 10:03Speaker 04

  Both dudes and chicks.

• 10:05Josh Clark?

  You got that straight. We're talking Gen X.

• 10:07Speaker 04

  Dudes and chicks.

• 10:09Josh Clark?

  Gen X says that.

• 10:10Speaker 04

  Yeah, they do. All right, so Von Economo was studying all these people. He was studying corpses of these people.

• 10:19Speaker 04

  He finally breaks it down into its subgroups, the first of which is acute EL. That is the initial sickness that you're gonna get. We talked about the flu-y kinda stuff that you get and all these neurological symptoms that are gonna follow. Then he broke those down into three forms, from most common to least common, starting with the most common, somnolent ophthalmoplegic. How would you say that? Ophthalmologic?

• 10:49Josh Clark?

  Ophthalmoplegic. That's what I'm going with.

• 10:52Speaker 04

  All right. That's the most deadly form. More than half the patients die when they have this form. This is a really overwhelming sleepiness, but like you said, you're aware, you're easy to wake up. The optimal part is ocular paralysis, so you have, you're not moving your eyes. So if people come and they wave their hand in front of your face, your eyes aren't moving or anything like that. And also those neuropsychiatric symptoms that you were talking about, like delirium sometimes, confusion, catatonia, stupor, stuff like that.

• 11:22Josh Clark?

  There was also the worst report that I saw in, like, I didn't see anything like this, but I checked and it does seem to have been a case report of a girl from the 30s who basically had a psychotic break because of it. And she pulled out all of her own teeth and gouged out both of her eyes. A little girl did because of this. And again, it's just some weird outlier symptom. But as you see, we get further and further into this. It's just the brain getting eaten up somehow, some way in some fairly predictable region. So it's creating this whole cascade or galaxy of different symptoms that are just the worst things that can happen to your brain happening.

• 12:03Speaker 04

  Yeah. The next subgroup, the next least common, or I guess the next most common, depending on which way you're looking at it, is hyperkinetic. That is, mania basically is the big part of this one. You have a manic phase, involuntary vocalizations and kind of herky-jerky movements. And then a hypomanic phase where there's a lot of fatigue, a lot of weakness. You can hallucinate. You can have nerve pain in your limbs and in your face. And this is one of the odder symptoms is your sleep pattern will flip from day to night, or I guess night to day if you were a factory worker or something.

• 12:41Josh Clark?

  Uh huh. And there's another thing with that sleeping sickness part, you know? Like your sleep is messed up. I also saw Chuck that in at least one of these, people might also be super sleepy, but not be able to fall asleep, no matter how hard they try, which sounds worse to me than most of the other stuff.

• 13:00Speaker 04

  For sure.

• 13:00Josh Clark?

  There's a third one that he said is the least common, but it's also a way that it can present. It's called hemiostatic akinetic, which is you can't move, achinesis. And this is kind of what the classic idea of what encephalitis lethargica looks like, where you're just, you're just sitting there with like, yeah, your right arms in the air. Your left arm's a little further down, your mouth's open, you're, you're basically a statue, essentially is how it's described. You're frozen in place and you're not going to move until somebody maybe puts some slight pressure on your arm and then maybe you'll move it down. But it's not like they're just going to put pressure on your arm for a second and then

• 13:45Josh Clark?

  you move your arm down. Like they have to move your arm down. And this is what's called waxy flexibility. You can pose somebody in this state any way that, that you want them to. So you have to be very kind when you're dealing with patients like this.

• 14:02Speaker 04

  Yeah. I could not help but think that waxy flexibility sounds like an album title.

• 14:07Josh Clark?

  For sure.

• 14:09Speaker 04

  Like Guided by Voices or somebody?

• 14:11Josh Clark?

  Um, Lips Inc.

• 14:13Speaker 04

  Is that a real band?

• 14:15Josh Clark?

  Yeah, they're funky town people.

• 14:17Speaker 04

  Oh, oh, okay. Yeah. Oh, waxy flexibility? Sure. Nailed it. Guided by Voices, what was I thinking?

• 14:25Josh Clark?

  This is the, the biggest part to me that's, I guess, part of all of this because of the sleeping part. The people suffering this, including the people who are, are wax figures, frozen in place for years or decades potentially, are there mentally. They're not like locked in as in locked in syndrome where they know every single thing that's going on around them at all times.

• 14:50Speaker 04

  Right.

• 14:51Josh Clark?

  But they're essentially in the same boat where they're aware of stuff, they're aware of thing, time passing, there were people coming and going and interacting with them. They cannot respond, they can't speak, they can't change their position of their eyes, they can't focus their attention, they can't do anything that would suggest to anyone that they are there in any way, shape or form. And it wasn't until a, a genuine medical miracle took place that we understood, oh my God, these people have been there in their heads the whole time. They're not just like comatose, like just completely out of consciousness, they're conscious.

• 15:30Speaker 04

  Yeah. Yeah, for sure. Uh, and you know, earlier I said like they're locked in. I didn't mean the literal locked in syndrome. I just meant sort of, you know, look like they're locked in.

• 15:40Josh Clark?

  Right, right. Yeah. I didn't take it like that.

• 15:43Speaker 04

  Yeah, but I think people might have so, yeah.

• 15:45Josh Clark?

  Well, come on, guys.

• 15:48Speaker 04

  We don't know how many cases there were. It was a legitimate pandemic, though. It's one of those things that was hard to diagnose. They think it was underdiagnosed and reported. Estimates run from 500,000 to more than a million. But they think that maybe half of the cases weren't even reported. So who knows how many it could have been? And about a third of them died, a third survived and were kind of okay. And then a third survived and then got it again later on. And that is acute EL. So maybe we should take a break and talk about chronic EL after this?

• 16:22Josh Clark?

  Let's.

• 16:23Speaker 04

  All right, we'll be right back.

• 16:39Josh Clark?

  Buy smart, drive for less and trade for more. That's Toyota affordability. And it all starts with a great deal on the truck from your local Toyota dealer.

• 16:49Speaker 04

  That's right. Make a smart buy on the off-road Ready Tacoma or half-ton Tundra, two of Toyota's most capable and longest lasting trucks, built with the strength for the tough jobs, the tech to power your next big adventure, and the rugged style for everything in between.

• 17:02Josh Clark?

  Or discover Toyota's off-road lineup, including the iconic 4Runner and Land Cruiser, designed to go beyond the everyday. And with Toyota's proven reputation for quality and reliability, plus hybrid power on many models, you can get more for every mile and drive for less along the way.

• 17:18Speaker 04

  That's right. And long after you leave the lot, your Toyota keeps delivering with great resale value. So you could trade in for more when you're ready for your next Toyota. From a great deal today to a great value tomorrow, a Toyota is right for you. Shop toyota.com for deals and details or stop by your local Toyota dealer today. Toyota, let's go places.

• 17:40Speaker 03

  Hi, it's Kathleen Griffith, co-host of the Unshakeables podcast. Listen in as Ron and Kelly Moore share their story.

• 17:49Speaker 05

  I'm Ron Moore.

• 17:50Speaker 06

  And I'm Kelly Moore. And starting our own business in our 50s was a little scary, but exciting.

• 17:59Speaker 05

  The biggest advantage was our community. The whole thing about business is relationships.

• 18:04Speaker 06

  We'll say team a lot, not just our internal team. It's the team of our vendors, the team of our clients.

• 18:11Speaker 05

  We help the Veterans Resource Center and we give scholarships. I'm doing this for my heart, for my children, for you, for your children's family. I don't want anything back. And I tell a lot of people, don't give back to me, pay it forward.

• 18:25Speaker 06

  If you work to give, you just see the world differently.

• 18:29Speaker 05

  I'm going to help as many people as we can. I can't take it with me.

• 18:32Speaker 03

  To hear more from Ron and Kelly, listen to the Unshakeables wherever you get your podcasts.

• 18:53Josh Clark?

  Okay, Chuck, so a lot of the stuff I was talking about, about people being frozen in place as if they were statues. They had waxy flexibility, mutism, catatonia. They weren't able to respond or move or anything.

• 19:07Josh Clark?

  When I said for like years or decades, more accurately, I would have been referring to the chronic form of encephalitis lethargica. Because it was essentially, it seems to me, kind of like amniostatic, a kinetic, but for years and years. The scariest part about all this was that you had gone through the standard case of encephalitis lethargica, one of those three that we just talked about, and got better. You may have died, you may have gotten better, but maybe you had like behavior changes, like you turned into a kleptomaniac or something like that.

• 19:45Josh Clark?

  Or you got better and thought everything was fine, but then you suddenly suffered from being just a ton of bricks being dropped on you. And all of a sudden, you can't move for the rest of your life, even though it's been 10 years since you had that case of encephalitis lethargica.

• 20:02Speaker 04

  Yeah, for sure. The chronic is much the same as the earlier, but with a few added symptoms, one of which is very, very strange. You can have mood swings, pretty, pretty normal, feelings of euphoria, and maybe even an increased libido, which is not the weirdest thing. Psychosis in about 30% of patients, again, not the, the most abnormal thing in the world, but excessive silliness and the use of puns was an actual symptom that they saw over and over again in acute cases.

• 20:33Josh Clark?

  Yeah. Isn't that bizarre?

• 20:35Speaker 04

  Or not acute in chronic cases.

• 20:37Josh Clark?

  Right. Yep.

• 20:38Speaker 04

  Yeah.

• 20:39Josh Clark?

  But again, the defining trait, the one that people would point to and be like, oh, that person has chronic encephalitis lethargica, is that statue thing that I was talking about. And that's more clinically called, rather than that statue thing, doctors tend to call it post encephalatic Parkinsonism. And Parkinsonism is one of those difficult things to grasp until you just stop trying to think too hard about it. It's essentially a bunch of movement and neurological symptoms and dysfunctions. And Parkinson's includes Parkinsonism, but not all Parkinsonism is Parkinson's disease.

• 21:17Speaker 04

  That's right.

• 21:18Josh Clark?

  Okay. It took me way longer than I care to admit to finally just nail that down and stop running in circles trying to figure it out.

• 21:26Speaker 04

  Yeah. I mean, I think they even, one of the reasons they call it post encephalitic Parkinsoni- Parkinsonism? Parkinsonism? Geez, that's a tough one.

• 21:36Josh Clark?

  I know.

• 21:37Speaker 04

  Or P E P is to distinguish it from Parkinson's, which isn't exactly the same thing.

• 21:41Josh Clark?

  Yeah. And one of the big things that distinguish it, because a lot of, that shares a lot of symptoms, but one of the things that distinguishes post encephalatic Parkinsonism and Parkinson's disease is that Parkinson's disease progresses gradually in a predictable pattern. Post encephalatic Parkinsonism, like I said, it can come out of the blue. You could be, again, sitting there eating an animal cracker, and all of a sudden, you never finish eating that animal cracker for the rest of your life. It just can suddenly come out of nowhere. And you're just living your normal life, and then all of a sudden you're in an institution, and you're bound never to move again unless you happen to be in the right place at the right time in the late 1960s.

• 22:22Speaker 04

  That's right. And this is the big reveal. If you were hearing these symptoms and you think, hey, that sounds awfully familiar. I think I saw a movie about that. Then you're correct. This is the movie from the book Awakenings, based on neurologist Oliver Sacks' book of the same name, about his work with EL patients in the 1960s. I think there were 80 chronic EL patients he worked with at Beth Abraham Hospital in the Bronx, New York in 1966. When this came around and Oliver Sacks was in there, EL had gone away, basically. It was a medical footnote and not a lot of people in the 1960s even knew much about it because it was one of those things that like, they never figured out what it was, or how it started,

• 23:04Speaker 04

  or how to cure it or anything. It kind of just went away. So every, all the doctors were like, all right, thank God, I guess we don't have to worry about that anymore.

• 23:11Josh Clark?

  Right, exactly.

• 23:12Speaker 04

  And they just moved on to their other work. There was a 1985 NPR interview where he was talking about, this is a quote, "motionless figures who were transfixed in strange postures, sometimes rather dramatic postures, sometimes not, with an absolute absence of motion, without any hint of motion. So everything looked frozen." And that was, you know, Robert De Niro's character in the movie Awakenings.

• 23:36Josh Clark?

  Yeah. And all the others that he eventually grabbed together.

• 23:39Speaker 04

  Yeah.

• 23:40Josh Clark?

  And assembled. When's the last time you saw Awakenings?

• 23:42Speaker 04

  Uh, it's been a while. I think I remember thinking it was a pretty good movie back then, though.

• 23:48Josh Clark?

  It's a great movie.

• 23:49Speaker 04

  Yeah.

• 23:50Josh Clark?

  I watched it last night.

• 23:51Speaker 04

  Who directed that? Do you know?

• 23:52Josh Clark?

  Laverne.

• 23:53Speaker 04

  Oh, was that Penny Marshall?

• 23:55Josh Clark?

  Yeah. She did a great job. It was great. I mean, like, I don't remember if De Niro got an Oscar or not, but if he didn't, that's one of the all-time great snubs.

• 24:03Speaker 04

  Yeah.

• 24:04Josh Clark?

  He did amazing. I forgot how wonderful Robin Williams is to just, man, what a great guy that dude was.

• 24:10Speaker 04

  Great dude.

• 24:12Josh Clark?

  Great movie, too.

• 24:13Speaker 04

  Watching a thing with him this morning and very, very sad stuff.

• 24:16Josh Clark?

  What were you watching?

• 24:17Speaker 04

  Uh, it was an Instagram post of him with his mother and his mother making him laugh. And I think the whole point of the post was like, you rarely got to hear Robin Williams like genuine laugh. And I heard it and I was like, yeah, I don't know if I really ever heard that. And his mom made him laugh that hard. It was really sweet.

• 24:34Josh Clark?

  Can you do an impression?

• 24:35Speaker 04

  It was kind of a ha, ha, ha thing.

• 24:37Josh Clark?

  Oh.

• 24:38Speaker 04

  I mean, not like that, but it was exuberant, but it was like, ha, ha, ha, ha, not like my goofy childish laugh.

• 24:45Josh Clark?

  I got you. Yeah, so good movie and it was a hundred percent based on this, so much so that it's funny, they, they went to the trouble of changing the names of the changed names that Oliver Sacks had in the book.

• 25:00Speaker 04

  Wow.

• 25:01Josh Clark?

  So, yes, Awakenings actually is pretty faithful in, in a lot of ways. I mean, there's a lot of like movie stuff literary license in there, but

• 25:09Speaker 04

  Yeah, sure.

• 25:09Josh Clark?

  For the most part, it's pretty faithful to Oliver Sacks' book. And again, it's nonfiction, like Sacks is a neurologist, or he was a great neurologist and a great writer, too. So he didn't take a lot of literary license as far as I understand. So the movie being close to the book means the movie was fairly close to real life. And one of the tests that Oliver Sacks conducted was he would demonstrate that these people were, had demonstrated what's called paradoxical kinesia, where somebody who seemingly can't move and hasn't moved for days, months, however long it was since the last time somebody moved them,

• 25:47Josh Clark?

  could suddenly move in a way that they just should not be able to. And the way that he demonstrates it in the movie, and I believe in the book he did this too, was he would toss them a ball and all of a sudden, somebody who's just sitting there with their hands in the air and their face frozen in this mask, this expressionless mask, just suddenly moves their hand without even moving their eyes and catches the ball. And that was, I think, again, at least in the movie, I haven't read the book, how he identified people in this, what they call the chronic hospital that he worked at in the Bronx, by, by finding somebody who kind of fit these, these symptoms and then tossing a ball at them.

• 26:27Josh Clark?

  And there's a very cute, funny part where he does it to one person and she gets hit in the face and is like, ow, why'd you do that? And she clearly didn't have encephalitis lethargica. It's pretty cute.

• 26:39Speaker 04

  It sounded a couple of minutes ago, like you said Oliver Sacks.

• 26:42Josh Clark?

  I know, and I didn't correct myself. You're an all time great conversation analyst, though, for noticing that.

• 26:49Speaker 04

  Well, I just, I mean, that's a different movie altogether.

• 26:51Josh Clark?

  Oliver Sacks.

• 26:52Speaker 04

  Yeah, also called Awakening, so.

• 26:54Josh Clark?

  God, was that a couple of minutes ago? Have I been talking that much?

• 26:58Speaker 04

  Oh, I have no sense of time. It might have been 10 seconds.

• 27:00Josh Clark?

  That was amazing, Chuck. You've been killing it with the jokes lately.

• 27:04Speaker 04

  Oh, thanks. One of the things you mentioned there is like they could catch a ball or something. Another thing that would happen, like he said that if there was an emergency, like another patient falls on the floor, all of a sudden, somebody who like previously has not moved for days or weeks or months, might just leap up out of their wheelchair and assist them, and then sit back down and go back to their statue pose. And that phenomenon that you're talking about is, that's the big key difference between PEP and Parkinson's disease, is called kinesia paradoxical, where you're switching, you know, between mobility and immobility, and that is not something that happens generally in Parkinson's.

• 27:44Josh Clark?

  No, but I saw that it does some, so, yeah, but I think for the most part, it's more associated with chronic encephalitis lethargica, right?

• 27:52Speaker 04

  Yeah.

• 27:53Josh Clark?

  So, this original thing, where this disease, this mysterious disease, encephalitis lethargica, suddenly appeared out of nowhere in 1915, 16, ravaged the world for 10 years, and then just vanished, and like you said, led a whole generation of neurologists off the hook for having to explain what it was.

• 28:15Josh Clark?

  Like, they, they really tried, like, people like Vonnegut, Kahneman, really tried to figure this out. I think 9,000 papers were written during this epidemic.

• 28:23Speaker 04

  Yeah.

• 28:24Josh Clark?

  And there were some things that they kind of were able to pin down, but the big, big questions were just left unanswered. We just don't know. Like, one of the big ones is, how do you even catch this terrible disease?

• 28:40Speaker 04

  Yeah, like, is it contagious or not? They still didn't have a definitive answer at the end of their, their study on that. Evidence on transmission was really, really mixed. There were a couple of anecdotal cases that kind of illustrate that. One of them, there was among seven members of a family in a small apartment, only one family member got sick. Another case, there was a girl living at something called the Derby and Derbyshire Rescue and Training Home, showed signs of EL and then very soon within two weeks, 12 of the 21 residents got sick. So, you know, both cases, like, one looks clearly contagious, the other one doesn't look like it's at all contagious. So, they didn't know. Maybe they thought some people might be immune, maybe there were different strains that

• 29:24Speaker 04

  were contagious, or had different levels of contagiousness. Or maybe it's just something that they never figured out.

• 29:30Josh Clark?

  Yeah, and I was wondering too, if the 12 of the 21 residents getting sick at that one home was maybe just a case of mass hysteria or something like that?

• 29:38Speaker 04

  Interesting, yeah.

• 29:39Josh Clark?

  No, I think half of the people who got sick died within 10 days of falling ill. So, they were not, that was not mass hysteria. So, that is just a genuine mystery, right? Like, it just doesn't make any kind of sense whatsoever. So, they started trying to rule out things they thought it wasn't.

• 29:56Speaker 04

  Right.

• 29:57Josh Clark?

  One was environmental causes, so that would make it toxic encephalitis. And I don't even know if we said at the outset, did, did you, I think that encephalitis is swelling of the brain and spinal cord?

• 30:07Speaker 04

  Oh, no.

• 30:08Josh Clark?

  Okay.

• 30:09Speaker 04

  I didn't say that.

• 30:10Josh Clark?

  So, I'm sure everybody got like a pretty good idea that encephalitis is something bad that you don't want to have.

• 30:16Speaker 04

  Right.

• 30:17Josh Clark?

  But what it is, is a condition where your brain and/or your spinal cord swells, and it can start taking on water, and from doing that, all sorts of terrible things can happen. The thing is, is encephalitis is not just specific to encephalitis lethargica. A lot of different things can make your brain and central nervous system swell. A disturbing amount of things can make that happen, actually, if you stop and think about it. And one of those things is environmental toxins. So, that's toxic encephalitis. And that got ruled out very quickly because there just was no pattern whatsoever where everybody was exposed to, you know...

• 30:55Josh Clark?

  Like a tesseract made of kryptonite or something like that for our nerd fans.

• 31:03Speaker 04

  Yeah, that's good.

• 31:04Josh Clark?

  I tried to touch you guys, Bone just screwed it up royally, so I'm sorry. I think I may have just conflated DC and Marvel.

• 31:12Speaker 04

  Oh, yeah, yeah. Tesseract is Marvel.

• 31:14Josh Clark?

  I'm dead, dude.

• 31:15Speaker 04

  No, I love it. I love it, man.

• 31:18Josh Clark?

  I'm gonna get killed.

• 31:19Speaker 04

  You should meld those. Superman meets Thanos.

• 31:23Josh Clark?

  Sure.

• 31:24Speaker 04

  I want to see those dudes fight.

• 31:26Josh Clark?

  Oh, that'd be great. I'm sure that would be a really interesting fight to watch.

• 31:30Speaker 04

  Somebody's gonna write in and say, actually, guys, it happened in 1987 when, you know, some dude put out a comic.

• 31:38Josh Clark?

  I suspect that those people aren't gonna speak to us any longer.

• 31:41Speaker 04

  I think you're right. So like you said, they ruled that out, the toxic exposure. Then they moved on to an infectious kind of possibility. Infectious encephalitis, in fact. And that can be, you know, infectious encephalitis is a thing. So it's not like we think it's that, that was already a thing. It can be secondary to bacterial or fungal or viral or parasitic infection. It's usually a virus. It's the most common type of encephalitis. It could be like from the herpes virus or maybe measles or West Nile even, influenza. And considering how this went on during the Spanish flu initially, which happened in 1918,

• 32:26Speaker 04

  and there were flu-like symptoms, they thought that, you know, this probably, early on at least, was an influenza-led infectious encephalitis.

• 32:37Josh Clark?

  Yeah, and that was, I think, Von Economo's leading theory, which makes a lot of sense because they tracked with one another, like you said, at least the start. So was this just some horrible strain of Spanish flu that managed to continue on for years after Spanish flu? And I think that was incontrovertibly proven incorrect.

• 32:58Josh Clark?

  Because, actually, when I did the end of the world, I talked about this guy who went up and dug up the corpse of an Inuit woman who had died from Spanish flu to get enough of the genome of it to bring the Spanish flu back to life to study it. It's one of the most breathtakingly arrogant moments in all of science for somebody to do that. But the reason we know that encephalitis lethargica wasn't caused by the Spanish flu is because we had the Spanish flu genome and we couldn't find any Spanish flu RNA in like, collections of tissue samples of brains of people who definitely died from encephalitis lethargica. Spanish flu wasn't there, ergo, it wasn't Spanish flu.

• 33:40Speaker 04

  And because Josh is always too humble to say so, after an end of the world reference, everyone, if you don't know, Josh had a great solo album, a eight-part or 10-part?

• 33:51Josh Clark?

  It was a 10-part, subtitled Waxy Flexibility.

• 33:55Speaker 04

  The End of the World with Josh Clark, where, and he, one episode at a time, examined 10, I can't think of the word.

• 34:05Josh Clark?

  Existential risks.

• 34:08Speaker 04

  Risks that could face humanity, some of which are currently underway.

• 34:12Josh Clark?

  Thanks a lot, Chuck. I appreciate that. That was really nice of you.

• 34:15Speaker 04

  Yeah, it's very great. You gotta be a smarty pants. But even if you're not a smarty pants, you should still give it a shot, I think. Because I gave it a shot and I'm not a smarty pants.

• 34:22Josh Clark?

  Hey, you are a smarty pants, but yeah, smarty pants or no, I think everybody can be equally scared by this.

• 34:28Speaker 04

  Yeah, you did live shows too. So if you have a time machine on your hands, go back and see one of those while you're at it.

• 34:34Josh Clark?

  And come talk to us if you have an actual working time machine as well. That'd be pretty neat.

• 34:38Speaker 04

  Streptococcal infection was another possibility at one point. There was some data that showed infection with streptococcal bacteria was in front of some of these cases of EL. And in 1931, our old pal, Dr. Yvonne Ikonomo, did an experiment and streptococcus vaccination actually led to EL, an EL-like condition in dogs.

• 35:04Josh Clark?

  Yeah, it's just sad, but.

• 35:07Speaker 04

  Yeah.

• 35:07Josh Clark?

  The thing is, the thing that makes it even more sad is it wasn't definitive. They weren't like, oh, it's a strep infection.

• 35:12Speaker 04

  Right.

• 35:13Josh Clark?

  It was like, I guess it could have been. Um, there was another group called the Matheson Commission that studied, um, encephalitis lethargica. Because a guy ostensibly by the last name of Matheson, I couldn't find who it was.

• 35:27Speaker 04

  Yeah.

• 35:28Josh Clark?

  He was a wealthy businessman from America who had been struck down by encephalitis lethargica. I believe he had gotten better, but not fully. And so he used some money to try to get to the bottom of this and funded this commission for 13 years. They put out four different reports and basically at the end said, maybe herpes? We don't know. And he said, your funding's cut off. I've gotten into Sherlock Holmes societies. That's who I'm funding now.

• 35:57Speaker 04

  At the end of all that dough for that many years, you come back with maybe herpes? Are you kidding me?

• 36:01Josh Clark?

  At the very least, give me herpes too. That reminds me, when I was a kid, I'll never forget, one of the first headlines that ever sunk in with me, because I was a Who's the Boss fan a little bit at the time. It was, it had to be the Enquirer or something, but it was Tony Danza gave me herpes. And I looked like just yesterday to see if Tony Danza actually had ever given anyone herpes and it does not seem to be the case. I don't believe Tony Danza has herpes. So that, that headline was totally made up. And I hope Tony Danza got some money from that for suing the Enquirer.

• 36:37Speaker 04

  Yeah. Oh, we should issue that correction too. You got that Tony Danza, uh, band name wrong.

• 36:43Josh Clark?

  Oh, I did.

• 36:43Speaker 04

  In the metal episodes.

• 36:44Josh Clark?

  What, do you know what the correct one was?

• 36:47Speaker 04

  Well, what do you, what did you call it?

• 36:48Josh Clark?

  I think I called it the Tony Danza Tap Dance Experience. Is that not it?

• 36:52Speaker 04

  I think if that's what you said, I think it was Tap Dance Extravaganza.

• 36:56Josh Clark?

  Oh, okay.

• 36:57Speaker 04

  Or it's the other way around. Whichever one you said was wrong.

• 37:00Josh Clark?

  Oh, it's fine. I can live with that.

• 37:02Speaker 04

  Yeah, yeah. We had a few metal people write in about that. So can't, you know, can't not correct the Tony Danza Tap Dance Extravaganza.

• 37:08Josh Clark?

  I'll bet they were nice though, like to a person, pretty much. All the, the metal fans that wrote in.

• 37:13Speaker 04

  Yeah, yeah.

• 37:14Josh Clark?

  Said, even the ones correcting us were like, that was great.

• 37:17Speaker 04

  Yeah, that's the metal way.

• 37:18Josh Clark?

  It is.

• 37:19Speaker 04

  Uh, all right. Shall we take our other break?

• 37:21Josh Clark?

  Uh, um.

• 37:27Josh Clark?

  Yeah, sure.

• 37:29Speaker 04

  All right, we'll be right back.

• 37:30Josh Clark?

  Wait.

• 37:46Josh Clark?

  Buy smart, drive for less, and trade for more. That's Toyota affordability, and it all starts with a great deal on the truck from your local Toyota dealer.

• 37:56Speaker 04

  That's right. Make a smart buy on the off-road Ready Tacoma or Half-Ton Tundra, two of Toyota's most capable and longest-lasting trucks, built with the strength for the tough jobs, the tech to power your next big adventure, and the rugged style for everything in between.

• 38:08Josh Clark?

  Or discover Toyota's off-road lineup, including the iconic Forerunner and Land Cruiser, designed to go beyond the everyday. And with Toyota's proven reputation for quality and reliability, plus hybrid power on many models, you can get more for every mile and drive for less along the way.

• 38:24Speaker 04

  That's right. And long after you leave the lot, your Toyota keeps delivering with great resale value. So you can trade in for more when you're ready for your next Toyota. From a great deal today to a great value tomorrow, a Toyota is right for you. Shop toyota.com for deals and details, or stop by your local Toyota dealer today. Toyota, let's go places.

• 38:47Speaker 03

  Hi, it's Kathleen Griffith, co-host of the Unshakeables podcast. Listen in as Ron and Kelly Moore share their story.

• 38:56Speaker 05

  I'm Ron Moore.

• 38:57Speaker 06

  And I'm Kelly Moore. And starting our own business in our 50s was a little scary, but exciting.

• 39:05Speaker 05

  The biggest advantage was our community. The whole thing about business is relationships.

• 39:10Speaker 06

  We'll say team a lot, not just our internal team, it's the team of our vendors, the team of our clients.

• 39:17Speaker 05

  We help the Veterans Resource Center, and we give scholarships. I'm doing this for my heart, for my children, for you, for your children's family. I don't want anything back. And I tell a lot of people, don't give back to me, pay it forward.

• 39:32Speaker 06

  If you work to give, you just see the world differently.

• 39:35Speaker 05

  I'm gonna help as many people as we can. I can't take it with me.

• 39:39Speaker 03

  To hear more from Ron and Kelly, listen to the Unshakeables wherever you get your podcasts.

• 39:59Speaker 04

  All right, so we mentioned some people studying, you know, different causes back in the day. They never could find anything out, like we said, and for about 30 years, they just kind of left it there. And it was in the late 1960s when neurology researchers that were working on Parkinson's really hit on it when they developed L-dopa, or levodopa, which is a substitute for dopamine, which is the missing neurotransmitter, in Parkinson's disease. And it was released in 1967, and it brought a kinetic Parkinson's disease patients back to life. And if you've seen the movie Awakenings, that's basically a big storyline. That's where it picks up, is when Oliver Sacks scores some L-dopa.

• 40:42Josh Clark?

  He did, off a guy selling it on the corner below Beth Abraham Hospital.

• 40:48Speaker 04

  Exactly.

• 40:48Josh Clark?

  Yeah, so he finally, he starts with Leonard Lowe, who's Robert De Niro, not the patient's real name, obviously, but there's just this amazing transformation where all of a sudden, these people, again, who are these frozen statue-like people in heaven for decades of their lives, suddenly like are like aware and talking and like focusing their attention on you. And one guy's playing the piano, and they're like going out on field trips now. It's like, they were just completely brought out of it.

• 41:17Speaker 04

  It's amazing.

• 41:18Josh Clark?

  And that supposedly was very much the case with people with actual Parkinson's disease. Like, they responded beautifully to L-dopa. But one of the reasons, one of the indicators that post encephalatic Parkinsonism and Parkinson's disease are different, is that the people in Awakenings, the people with encephalitis lethargica, they responded well for a little while, and then they started to show other symptoms.

• 41:46Speaker 04

  Yeah.

• 41:48Josh Clark?

  For some of them, it basically meant you can't take L-dopa anymore. And incredibly sadly, like one of the most sad things I can think of. They were left to just go back to

• 42:00Speaker 04

  Yeah.

• 42:00Josh Clark?

  frozen statue state again. And don't forget, there is a great level of consciousness within them when they're in the state. So they came out of that state in which they were conscious, came to full consciousness and full interactivity, and maybe even left the hospital on a field trip and then had to go back to their frozen statue state. Again, conscious of this whole experience.

• 42:22Speaker 04

  Yeah, very heartbreaking to see in that movie.

• 42:26Speaker 04

  There was one case of a woman who, is this the Rose of which you spoke of to me privately?

• 42:32Josh Clark?

  Yeah, that was Rose. And then Lucy was her name in the movie for some reason.

• 42:38Speaker 04

  Okay, well, this woman, just one of the cases of Oliver Sacks. She, she came out of it and she basically described like being aware of everything that was happening for decades and understanding what was happening, but just not feeling a connection to it. Like there was this weird disconnect. She, she knew about Pearl Harbor. She described knowing about the assassination of Kennedy, John F. that is. And she said that it just didn't seem real. She said, nothing has seemed real since 1926, when I got the encephalitis and came to a stop. I know I'm 64 now and that this is 1969 and that I'm an elderly woman in a bizarre situation in a chronic hospital. But I feel like I'm 21 and I feel like it's 1926.

• 43:22Josh Clark?

  Yeah.

• 43:23Speaker 04

  Man, can you imagine?

• 43:24Josh Clark?

  Yeah, and very sadly, she was one of the ones who did not like have, her symptoms with L-dopa were too extreme to continue on taking L-dopa.

• 43:34Speaker 04

  Yeah, and some people, you know, came out and were just overjoyed and elated with this kind of thing, obviously. And some people came out and obviously you could also see had a very hard time with lost decades. It could not have been an easy thing to accept either way. The movie, there is good news. There's a bit of a silver lining because the movie does not cover the fact. That after this, a lot of the patients finally regulated with the L-dopa and were able to leave, at least lead compared to sort of their previous life, a somewhat healthy life, like they weren't in that statuesque locked in state. They might not have fully recovered, but they led an okay life.

• 44:17Josh Clark?

  Right. Yeah. And they do mention that at the end in like one of those, I guess, epilogues, yeah, postscripts, where they talk about how they continued on experimenting and some people it kind of worked out with a little bit. So, but they don't, they don't show it in the movie. The movie's all sad at the end. It's so sad. And yeah, oh my God, just go watch Awakenings again. I even watched it. I accidentally watched Patch Adams first and I wanted to watch Awakening so bad, I still watched it after Patch Adams, after Zoolander, and then I finally watched Awakenings. I was up till like four in the morning today, last night.

• 44:54Speaker 04

  I never, I never saw Patch Adams.

• 44:56Josh Clark?

  Oh, it's not gonna-

• 44:57Speaker 04

  That was sex too, though, right?

• 44:59Josh Clark?

  No, it was just Robyn Williams too. It was, it was Awakenings, I'll tell you that.

• 45:06Speaker 04

  Yeah, I need to check that out. It's funny, I met a guy named Leonard Lowe one time years ago, and the only thing I could think in my head was, my name is Leonard Lowe. Like, I just remember De Niro saying that.

• 45:17Josh Clark?

  You didn't say that to him?

• 45:19Speaker 04

  No, because I figured, you know, like our listener, Robert Paulson, he's probably tired of those jokes.

• 45:23Josh Clark?

  I never stop saying that to Robert Paulson. I can't help myself.

• 45:28Speaker 04

  So what about these days? What do we think about EL, medically speaking?

• 45:32Josh Clark?

  Well, so one of the things that we did learn that we still don't fully understand, but was something that they recognized with L-dopa, and the study of the patients before they were administered L-dopa, is that while you're in a, like this frozen state, like I said earlier, somebody like throws a ball at you, or like you said, somebody sees an emergency, they can suddenly move like normal, and then they go back to that frozen state afterward. They found that it's not just like an emergency, like a ball coming at you, or your friend laying on the floor because they fell down, but things like music, human touch, even like obnoxious sounds, like a siren or something, can basically prompt

• 46:13Josh Clark?

  the person to start moving again, and like come back out of that frozen catatonia or mutism. And that was one of the things that they found. People could do on L-dopa too, like even with the extreme like tremors or inability to to control the movement of your mouth or eyes. Those could be tamed by the same things by stimulating your brain in some other way. And there is the story of a guy who was a cobbler by trade before he had gotten sick.

• 46:44Speaker 04

  Oh, yeah.

• 46:45Josh Clark?

  And the the after L-dopa came along, he asked for like a cobbler's bench and the hospital staff got him one. And when he was working at his cobbler's bench, he was able to like hold like nails in his teeth and like nail the heel of the shoe with these little tiny nails and just work and control the symptoms. Because there's something in the brain that was overriding the symptoms. We have no idea why. We just know that that was part of this whole thing. There's some some way that the the these problematic symptoms can be overridden by some other region of the brain. Taking importance or precedence over that, which is just bizarre. Like from start to finish, this is one of the most bizarre diseases in history.

• 47:27Speaker 04

  Yeah, yeah, for sure. Did you also watch Tremors by accident?

• 47:31Josh Clark?

  No, that would have been very pleasant. That's one of my favorite movies.

• 47:35Speaker 04

  All of a sudden, the sun's coming up and you still haven't seen Awakenings?

• 47:38Josh Clark?

  Right.

• 47:40Speaker 04

  So getting back to the modern perspectives and what we think medically these days. In the last 75 years, like I said it completely in a way. They kind of don't know. In the last 75 years, there's only been about 80 case reports. Where it looks like it might be EL. They call it like an EL-like presentation. You know, the the hyper somnolence, maybe ocular paralysis, maybe some of those neuropsychiatric symptoms. But they're really not sure because the you know, the cases are pretty varied and the symptoms are pretty varied. And again, they you know, all they have is sort of these case studies from before. They never landed on anything. So it's hard to tell if this is still going on at all or not. There's no like effective treatment.

• 48:24Speaker 04

  You know, they still use L-dopa, I think, right? Isn't that still on the scene? Yeah, so for the tremors and rigidity and stuff like that, sometimes ECT for if you have like pretty extreme psychiatric symptoms. But for Von Conemo's work, he got, he never won, but he was nominated three times for a Nobel Prize, pretty good.

• 48:45Josh Clark?

  Yeah, for sure. And remember, he also originally suspected that it was some sort of infection.

• 48:51Speaker 04

  Yeah.

• 48:51Josh Clark?

  He thought Spanish flu wasn't Spanish flu. But they do think that it's probable now that it is the result of an autoimmune disorder triggered by an infection.

• 49:02Speaker 04

  Yeah.

• 49:02Josh Clark?

  So what that would amount to is that you are infected by, maybe it is strep, maybe it is herpes, maybe it is influenza, we don't know. But something that resembles proteins found in different regions of your brain, trains your body to attack those proteins in your brain. So you, it triggers an autoimmune disorder. And those proteins are only found on specific regions of the brain that when you step back and look at what those regions do, they control the symptoms that you see in people with encephalitis lethargica.

• 49:37Speaker 04

  Right.

• 49:38Josh Clark?

  I just sounded like Tim Curry in Rocky Horror Picture Show.

• 49:41Speaker 04

  Get up on the, get on the slab.

• 49:44Josh Clark?

  Oh, that was good. I forgot how good your impression is of Dr. Frankenfurter.

• 49:50Speaker 04

  Oh, well, you know, I met the man. He held my cat.

• 49:53Josh Clark?

  That's right. He said your cat was naughty, right?

• 49:55Speaker 04

  I said he had dramatic ears.

• 49:57Josh Clark?

  Oh, okay.

• 49:58Speaker 04

  Yeah.

• 49:59Josh Clark?

  But also naughty.

• 50:00Speaker 04

  Yeah. Naughty. Get on the slab, Laurent. I got nothing else.

• 50:07Josh Clark?

  Oh, okay. Let's see, I guess I got nothing else either. That's it. We don't, we don't know the answer to all of this, and I don't know when we ever will. But it's just, it's so fascinating that you have to stop and remind yourself, like, this actually happened to people. And that then you realize how terrifying the whole thing really is.

• 50:26Speaker 04

  Yeah.

• 50:27Josh Clark?

  Well, Chuck said, yeah, twice within seven seconds, which automatically means, oh, well, now he derailed it. You have to say, yeah, one more time, hurry.

• 50:37Speaker 04

  Yeah.

• 50:38Josh Clark?

  Okay, now we're back on to listener mail.

• 50:42Speaker 04

  Uh, this is, uh, you're gonna like this one, Josh, I think. Hey, guys, this is about the eight tracks. Uh, I always learned something from you, sometimes unexpectedly, you guys. And the eight-track short stuff, you talked about cart being short for cartridge and sparked a memory. I'm from Buffalo, you see, and I used to listen to a radio announcer called Iron Mike Benson. He famously had what he called, and, uh, Jamie says, uh, sorry to you specifically, Josh, about this.

• 51:10Josh Clark?

  Okay.

• 51:11Speaker 04

  Where Mike, Iron Mike Benson would say, uh, that he had the heinous anus fart cart. And he would use it to play various fart sounds and strategically place them over top of, over the top of whatever songs happen to be getting played on the air at the moment. I always imagined the word cart at the time was referring to like a basket on wheels that contained a bunch of separate tapes.

• 51:30Josh Clark?

  Yeah.

• 51:31Speaker 04

  Of fart sounds. Now it all makes sense. It was a tape recording, but because it was a looped tape with multiple tracks on it, he could cue whatever selection he wanted much quicker than you could with a linear cassette tape. So it was the analog way to do that sort of thing before a digital soundboard was used and invented. Uh, thank you for all the useless, interest-grabbing, uh, information. Uh, and useless is in quotes, by the way.

• 51:55Josh Clark?

  Okay.

• 51:56Speaker 04

  Um, that is only useless until you can relate it to something else. Podcasts have come and gone, but your show is the one I haven't gotten tired of. And my sister Ashley agrees. Keep it up, boys. That is Jamie Lynn Bear.

• 52:08Josh Clark?

  Awesome. Thank you, Jamie Lynn, and thank you to your sister, Ashley, who ostensibly listens as well, and the whole Bear clan. How about that?

• 52:15Speaker 04

  Yeah. The, the clan at the Cave Bear.

• 52:18Josh Clark?

  I thought that as well.

• 52:20Speaker 04

  Yeah.

• 52:21Josh Clark?

  Uh, if you want to be like the clan of the Cave Bear and write in to let us know how much you like our show and/or, uh, we triggered some memory in you that helped you put things together and/or whatever else you want to say, we love that kind of thing. You can send it to us via email at [email protected].

• 52:42Speaker 07

  Stuff You Should Know is a production of iHeartRadio. For more podcasts, iHeartRadio, visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.

• 52:58Josh Clark?

  Buy smart, drive for less and trade for more. That's Toyota affordability. And it starts with a great deal on an off-road-ready Tacoma or half-ton Tundra, two of Toyota's longest-lasting trucks, combining power for work, tech for adventures, and style in between. And they're built on a reputation for quality and reliability, which is why Toyota trucks are known for holding their value, which could mean big savings when it's time for your next Toyota. So get a great deal today and a great value tomorrow. Shop toyota.com for more. Toyota, let's go places.

• 53:29Speaker 02

  Breathe in and reset with Lincoln Rejuvenate, an available multi-sensory feature in the 2027 Lincoln Navigator SUV. Experience the luxurious massage, visuals, and sense to help you relax in the driver's seat. It's your time for a reset. Visit lincoln.com to learn more. Lincoln Rejuvenate does not operate unless the vehicle is in park. When the vehicle is off or if any doors open, do not use the feature in a closed garage or in other enclosed areas. See owner's manual for important operating instructions. Lincoln and Navigator trademarks of Ford or its affiliates. All rights reserved.

• 53:59Speaker 00

  This is an iHeart Podcast. Guaranteed human.