Pod Insights Noble Blood Maria Theresa's Medical Legacy (with Matt Kaplan) About this episode Dana is joined by the science writer for The Economist, Matt Kaplan, to discuss 18th century medical progress, the legacy of Maria Theresa, and the tragedy of Ignaz Semmelweis. Order Matt's new book, I TOLD YOU SO! https://us.macmillan.com/books/9781250372284/itoldyouso/, now.
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1:35 Dana Schwartz? Welcome to Noble Blood, a production of iHeart Radio and Grim and Mild from Aaron Mankey. Listener discretion advised. Welcome to this very special episode of Noble Blood. I am so thrilled to be joined by Matt Kaplan, the science correspondent at The Economist. He's written about everything from paleontology and parasites to virology. He's a paleoclimatologist by training, I've just heard. I've written for The National Geographic, New Scientist, Nature, New York Times. But more relevant to this audience, his new book, I Told You So: Scientists Who Were Ridiculed, Exiled, and Imprisoned for Being Right, is out February 24.
2:21 Speaker 04 It has been such a roller coaster working on the book too. I mean, I set out to look at scientists who had been screwed by the system. Scientists who had had great ideas and then their ideas didn't make it even though they were right. And what I stumbled upon as I uncovered the history of science and looked at the underbelly, a lot of these relationships, it was unbelievable to me how often monarchs in particular in Europe got involved in all of this stuff. I mean, and top, top, like the cream of the crop was Empress Maria Theresa of Austria. I mean, she's just such an incredible personality.
2:59 Dana Schwartz? Well, that's really who I'm very excited to talk to you about because the very first chapter in your book, you start this story with Maria Theresa, who, as listeners of the show might know, was the 18th century leader of the, the only sole female monarch of the Habsburg monarchy in Austria, an incredibly interesting and powerful woman, the mother of Marie Antoinette, who's sort of a marquee figure.
3:27 Speaker 04 Yeah, she was also the mother of 16 children, 16 kids. I mean, like, I understand biologically how that works, but wow, really?
3:38 Dana Schwartz? Yeah, I managed one and I'm, I consider that a real pet on the back. Doing 16 feels, and also running an empire.
3:47 Speaker 04 Yeah, and I mean, the thing is, and she wasn't, I mean, okay, aside from being a baby machine, which clearly she was because, I mean, she was really popping them out. But there was also the fact that she, I mean, she, it wasn't just Austria she was ruling, right? She had territory all the way deep into Italy. She controlled Milan. She had sort of an arrangement where she had partial control of Florence, but she was also up in Croatia and into Transylvania and big chunks of Romania. I mean, she had so much control and her sister was the governor of Netherlands. And really, Maria Theresa is such an interesting character because she wasn't just
4:30 Speaker 04 The ruler because of all her kids, she had an incredible soft spot for the overwhelmingly impoverished women of her empire. There were swarms and swarms of women in her empire who got pregnant because I mean, there was no birth control back then. And women had no rights. And so there was rampant rape and incest and all kinds of other horrible stuff. As well as relationships where they just had sex and didn't know what was gonna happen next. Or I guess they do and did know what was gonna happen next and just let it go. But women were having babies all the time and could not feed them.
5:11 Speaker 04 And so their only option was to go to a bridge in the dark of night and throw the baby over the bridge into the river when no one was looking. And
5:23 Dana Schwartz? Horrible.
5:24 Speaker 04 Yeah, I mean, and I mean, I'm I'm taken aback by that. And I mean, I worked in the emergency services in university as an emergency medic and that kind of stuff chills my blood. And it turns out it chills noble blood too, because Maria Theresa really cared. She really wanted that to come to an end. And one of her first moves as Empress was the installation of drop boxes. Now, drop boxes, you're familiar with them at libraries, right? You have them in the United States still, I hope. We had them when I was growing up in California. We have them in the UK. I'm sure you still have them. You know, you, oh, man, you forgot to drop off the book, you're gonna drop it off in the box and the library will deal with it when they have opening hours.
6:06 Speaker 04 They installed these at all the hospitals in Austria so that women who were gonna throw their baby in the river could put their baby in the box, turn the box around, and hope that the state could give their child better care than they could. Yeah, I mean, the state did not have a lot, so this was really not a great option, but they were, you know, she was trying.
6:29 Dana Schwartz? She also had a vision, as you mentioned in your book, for a hospital that would be able to take care of impoverished people and these underprivileged women, these women who are forced into situations where they have to give birth, but don't have the resources to actually do so safely. This this hospital, Maria Theresa would die in seventeen eighty, but her vision would actually be fulfilled.
6:52 Speaker 04 Yeah, it was a huge deal, too. So Maria Theresa met up with Gerard van Sweeten. Gerard van Sweeten was the physician who looked after her sister, who was the governor of Netherlands. She had a stillborn child. Stillborn children often initiated bacterial infections in the mother. And Gerard van Sweeten was unable to save Maria Theresa's sister, the governor of Netherlands. But Maria Theresa was so taken aback by his professionalism that she brought him into her empire and started up a friendship with him. Now, Van Sweeten, I mean, you have to, we have to backtrack here for a second because Van Sweeten is a really interesting character in his own right. So going way back in time for a moment, we have Hippocrates during the age of the Greeks,
7:37 Speaker 04 who believed in the humors. Now Hippocrates, he did say, you know, as a physician, you should help or at least do no harm. But he also believed that you had blood, bile, phlegm, and all of this stuff in perfect balance, and that when you became ill, it was because one of the humors was out of balance. So if you had too much fever, the solution was, well, you've got too much blood in you. Drain them of blood. If you have too much phlegm in you, you know, not such a bad thing. Put them in a hot room, have them cough up the phlegm. There's actual benefits to that, right? You get a chest infection, go in the steam room or the sauna. So, I mean, like, he wasn't totally wrong, but his ideas weren't real great either for medicine.
8:19 Dana Schwartz? If he existed in the first place, I think, as you've made clear in your book, Hippocrates is, he might have existed, but we're kind of going on Plato's word on that.
8:28 Speaker 04 Yeah, we don't really know a whole lot about Hippocrates, but what we do know for sure is that a British physician named Thomas Sidonum, who was really active, like 1650s, he rediscovered Hippocrates' ideas, whether Hippocrates existed or not, and he adopted them. And there was this huge renaissance in medicine, which was not really a renaissance because people started bleeding patients again, which wasn't good. And Sidonum taught his ideas widely. And one of the people who really picked them up was Gerard van Sweeten. And Gerard van Sweeten ended up really convincing Maria Theresa that her hospital needed to have these ideas in her hospital. And one of the
9:08 Speaker 04 Possibly most disastrous things he did was he ended up hiring a guy named Anton de Heian. And I mean, de Heian was a real piece of work. De Heian believed in the devil and believed that vampires caused certain diseases. And any doctor who said, I think they're ill for some reason, other than God being angry at them, then Heian would not have it. No, no, they're ill because God has made them ill. End of story.
9:35 Dana Schwartz? Of course.
9:36 Speaker 04 Yeah, yeah, right. So in the midst of all of this, you've got this hospital being built. And this hospital would eventually house a man named Ignaz Semmelweis. Ignaz Semmelweis was an obstetrician who was really deeply bothered by a disease that killed one in 10 women who gave birth in the hospital. It was called perperil fever. And if you got it, you died. That was the end of story. It was only second to tuberculosis and killing people off. The reason no one really cared about it was because it only killed women off. And who cared about women back in that day? I mean, really, can you believe this? And so, but Ignaz Semmelweis saw all these women dying. There was nothing he could do.
10:21 Speaker 04 And he started running experiments to kind of explore, like, why do they get this? How does this happen? But he was operating in a hospital that had been established by de Heian, who believed that you only got ill if God made it so.
10:36 Dana Schwartz? Well, one point that you make in your book that I find very interesting is someone like de Heian believes, well, your illness has to do with, you know, the weather and the temperature and the position of the stars and the position of the moon. And sort of, if you're thinking scientifically, it wouldn't really make sense that one woman in a ward, when the weather's a certain way, gets sick. And the other, right next to her, with the weather the exact same way, and the moon in the same position, wouldn't get sick.
11:02 Speaker 04 Well, yeah, I mean, that's the thing. I mean, with that said, when paraparox fever happened, it tended to happen in waves. So the women in the ward, many women in the ward would all die at the same time for paraparox fever. So that's where they got this idea that it was the sun, the moon, and the stars. But here's the catch, and this is what really got Semmelweis thinking. And it didn't work in the hospital, because the hospital was founded by people like Dehaan and von Sweden. But Semmelweis said, wait a minute, there's this ward that is mostly managed by doctors, and there's this ward mostly managed by women, not women, by nurses, who were women. And fascinating, the ward that gets all of the
11:47 Speaker 04 paraparox fever cases, or most of them, is the ward with the doctors. The people tended to, by the nurses, don't get it. So, like, the weather's the same, around the building's the same, what the hell's going on? One of the things I write about in the books is, he noticed that the priest who was working at the hospital would come and ring his bell and smoke the incense in the room where the doctors were present far more often, because there were more people dying. And he thought, it's the priest, the priest is causing this. So he banned the priest from, and of course, that had no effect. But hey, you know, good on him for checking that out. And in the meantime, everyone's rolling their eyes, like, what
12:30 Speaker 04 is this guy doing? Why is he trying this stuff? But ultimately, he really had huge breakthroughs and demonstrated that it was doctors going to the morgue in the morning and examining their patients from the previous day. They were washing their hands with soap and water, but because corpse material was getting under their fingernails, and because soap and water is just not up to the task of getting rid of, like, corpse bacteria, which is rancid, they were then going, and when women were giving labor, going into labor, they would palpate to feel if they could feel the baby's head, to find out if the umbilical cord was around the neck, or whether or not the baby was going to be a breach. These were important things to know, and they were introducing corpse material into
13:12 Speaker 04 the babies, into the women. And the women were getting this infection and dying. I mean, it was a giant discovery and Semmelweis created this antiseptic solution that neutralized it. Unfortunately, the hospital was just not ready to accept what he discovered and his peers ended up throwing him into an insane asylum for all of his hard work.
13:36 Dana Schwartz? Because imagine, I mean, for these doctors, I'm sure it seems like a personal insult saying like your hands aren't clean enough to be treating these women.
13:47 Speaker 04 Yeah, I mean, in fact, actually, his ideas got out to some sections of Germany, the city of Kiel. There was a doctor surnamed Michalis, I can't remember his first name, but Michalis initially accepted Semmelweis's ideas and said, we've had tremendous success with this chlorine wash. And then it dawned on Michalis, oh, the thousands of women who have died in this hospital are because of me. And so he threw himself onto the railroad tracks and committed suicide outside of the city because he couldn't take the belief, the understanding, he understood what he had done in his life. And obviously, that's not
14:28 Speaker 04 good. But actually, the vitriol that Semmelweis received, you look at what these people were writing to them and what they were saying to him. Sure, part of it was they believed that God drove disease and it was the sun, the moon and stars. But I think deep in their heart of hearts, many of these doctors who engaged in character assassination, it was really all about the knowing deep inside that they actually were responsible and couldn't cope with that.
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17:24 Speaker 05 Hey, it's Niall Rogers, host of Before the Moment, a Lincoln original series. I'm driving across the country, meeting some of today's most fascinating artists. We're exploring the stories before the moment that changed everything. This week, I'm joined by my friend, John Legend. How does music actually enter your mind?
17:47 Speaker 06 I'm not sure why or how the music comes to me, but I think people who love music and write music, our brains are just filled with music.
17:56 Speaker 05 Right.
17:57 Speaker 06 Like, we have listened to so much music, we've been a part of so much music. I think of the story that I want to tell, the mood that I want to create with the music, start playing chords, see where they lead me.
18:08 Speaker 05 Sometimes, I'm just not even thinking about music, right? And I hear this little thing, and I go, oh, that could be this.
18:18 Speaker 06 You know, you just have to be ready for when the inspiration hits.
18:21 Speaker 05 And it comes.
18:22 Speaker 06 Yeah.
18:22 Speaker 05 Experience Before the Moment, a Lincoln original series on the iHeart Radio app, YouTube, or wherever you get your podcasts.
18:32 Dana Schwartz? Out of curiosity, what was in the antiseptic hand wash that Semmelweis came up with?
18:38 Speaker 04 Yeah, that's a great question. So, at the time, people were having, you know, cities were getting bigger and bigger, the sewers were getting stinkier and stinkier, and the folks of Europe worked out, hey, if we take this chloride of lime, which is basically chlorine, which you throw in swimming pools, and we throw it in vast quantities into the sewer, it makes the sewer a lot less stinky. And Semmelweis, when he was running his experiments to try to assess, like, what the heck is responsible for paraparilla fever, he noticed that even after washing with soap and water, he could still smell morgue odor on his hands. And he thought, he had no understanding of microbes.
19:22 Speaker 04 Bacteria would not be identified for another 40 years by Louis Pasteur, who's another really interesting character who rubbed elbows with royalty and engaged in all kinds of interesting behavior. But he worked out, it's gotta be the scent, the smell is the reason for the infection. So I want to eradicate the odor. So he got one of his friends who worked at the local sewage facility to give him a whole bunch of chlorine, and he created a mild chlorine solution and went... You know what? I dip my hands in this and the smell goes away. I wonder if this will work. And it was incredible. The effect of using the chlorine solution within three
20:03 Speaker 04 months, the he had an 18% death rate from paraplegic fever in the doctor's ward before running the experiment. At the end of three months, it dropped to zero. I mean, wow.
20:17 Dana Schwartz? Unbelievable. Yeah.
20:18 Speaker 04 Yeah. I mean, it was it was a coup. And the fact that the other doctors went, sir, how dare you tell us our hands are dirty. We are gentlemen. And in many cases, they were noblemen. He was, I mean, and this is this is where the noble blood side of this really comes into it, because Semmelweis was Hungarian. Hungary was a vassal state of Austria. So he was, even though he was a very successful obstetrician, he was a second-class citizen in Vienna. And these these nobles who had become doctors in the Vienna Hospital, they had all this cloud over him, just because of their blood. And
20:59 Speaker 04 there was, of course, on top of all of this, Hungary rose up against Austria. After Empress Maria died, her son, what's his name?
21:10 Dana Schwartz? Joseph.
21:11 Speaker 04 Yeah, Joseph the Second.
21:12 Dana Schwartz? Joseph the Second.
21:13 Speaker 04 He was not the sharpest tool in the box. He his favorite activities involved rolling around in the wastepaper bin and trying to swat flies with his hands.
21:24 Dana Schwartz? Yeah.
21:25 Speaker 04 Yeah, inbreeding. It didn't do him a lot of good. And I mean, he I mean, he had very serious mental deficits, and he should not have been ruler of the Habsburg Empire. I mean, really?
21:38 Dana Schwartz? You're sort of coming down to the thesis of this podcast, really, is when you just decide who's in charge of these wildly powerful empires based on who's born first. It doesn't always work out.
21:50 Speaker 04 No, no, definitely not. And so when the people of Hungary rose up and said, we don't like being vassals to the, to the Habsburg Empire, we would like to determine our own destiny. He went, okay. And of course, all of the nobles who were of Austrian blood ruling Hungary went, um, hang on, can we have a say in this somewhere along the way? And Semmelweis actually made a huge mistake because Hungary rose up against Austria. Um, and there was a fierce war between them. And in the midst of this, I mean, he's, he's working as a Hungarian in the Vienna Hospital. He started donning the uniform of the Hungarian soldiers while working in the operating theater.
22:35 Speaker 04 I mean, like, come on, dude.
22:36 Dana Schwartz? He's turning people against him. Yeah.
22:39 Speaker 04 Oh, it was, I understood that he cared, but he was reporting to a guy named Johann Klein, who was not a good doctor. He wasn't a bad doctor, but he wasn't a very good one. And he was, he was a shining example of what privilege and power will get you if, if you're raised in, you know, upper class Vienna society. And he, to his credit, when Semmelweis brought out the chlorine wash, he did try it. I mean, he did give it a shot. He did not like Semmelweis. They did not get along well. And ultimately, the uniform thing and supporting the Hungarian rebels really
23:20 Speaker 04 created a clash. And this is, I think, a huge part of why Semmelweis lost the battle with the aristocracy and the doctors in the Vienna Hospital. It was a mess.
23:30 Dana Schwartz? It's not always the, the message. It sometimes is the messenger.
23:34 Speaker 04 Oh, yeah. I mean, and I compare him in the book to Joseph Lister and Louis Pasteur, because Joseph Lister also got Just trashed by the aristocracy in London as he was coming up with his theories, demonstrating that when you're conducting surgery, you need to use antiseptic on your knives, right? Like, I mean, before Joseph Lister came along, you, if you were a surgeon, the more encrusted your blade was with gore and guts, the better surgeon you worked. It showed how many bodies you had cut open.
24:07 Dana Schwartz? Oh, gosh, yeah.
24:09 Speaker 04 Yeah. And I mean, it was, it was bad. And people wouldn't die during the surgery. They died of post-operative infection all the time. And Lister was the one who said, you know, I think we've got a problem here. And similar to Semmelweis, they were throwing carbolic, carbonic acid in, in the sewers in Britain. And he got some of that stuff and started using the acid on patients to treat them after cutting them open. And he received tons of pushback and aggressive attacks. He didn't get thrown in an insane asylum like Semmelweis, but he was forced into academic retreat for decades. And during that time, he just quietly taught what he knew.
24:50 Speaker 04 And eventually his students got everywhere. They were known as Listerians. And they spread the word and demonstrated through deed that Joseph Lister was right. And thank goodness for that, because it was an alternative approach that Semmelweis never managed. And fortunately, it ultimately did lead to understanding of how to engage in surgery and treat people properly. Ironically, ironically, I don't know, but it's just astounding. The day that Lister had his big breakthrough by treating a patient on the surgery table and not having them die of a post-operative infection, that would have been certain. It was a kid who had got run over by a wagon in Scotland. The bones were sticking out of the wound. It was really bad. He would have died. It was the same day that Ignaz Semmelweis died in the insane asylum in Hungary.
25:35 Dana Schwartz? Oh, my God. So.
25:39 Dana Schwartz? Ignacio Semmelweis, who had this really amazing breakthrough, which is that doctors should be washing their hands with the strong stuff before treating women giving birth, had this tragic end of dying in insane asylum, which I think just sums up some of the interesting stories and sort of fascinating ideas that you present in your book, which are a number of these stories, which is sometimes people, science purports to be this, this field that is completely rational, right, where it's like evidence-based and, and if people show up with the right information, the right idea will win out. But that is absolutely not always the case, as you make very clear.
26:18 Speaker 04 Oh, yeah. I mean, I just look at Galileo. I mean, Galileo had his ideas about the earth not, you know, about the sun not rotating around the earth and had all these observations of comets to demonstrate as such. But the people in power, I mean, the Pope said, well, you know, if you speak that, you're, that's heresy and we'll send you before the Inquisition. Galileo had to engage in such careful PR. I mean, he used pseudonyms to hide his identity and to protect himself from being eviscerated by the Inquisition. And it was all political. I mean, going back to Tuscany and the city of Florence, which, you know, would be ruled
27:01 Speaker 04 many years later by Maria Teresa through her, her relationships with the, the Grand Duke there. I mean, when, when Galileo was being challenged by the Inquisition, it was his relationship with Archduke Ferdinando, the, the leader of Florence and Tuscany. It was his relationship with that man that protected Galileo from ultimately being killed off or imprisoned in cells. And Ferdinando, we, it wasn't revealed at the time, but hundreds of years later, letters emerged revealing that Ferdinando had directed his ambassador to Rome to intervene on Galileo's behalf, which reveals that all of this mythology
27:44 Speaker 04 of Gallo being tortured at the hands of the Inquisition was actually a lie. It's incredible what Galileo had to go to, to be able to endure the political society of the age.
27:55 Dana Schwartz? Absolutely. Although sometimes things do ebb and flow and come around. I know that now, without getting too political, there are challenges to things that I had considered done science, but I do want to celebrate Maria Theresa for openly celebrating and realizing that smallpox inoculation really does help people. And she publicly inoculated her own children in 1768.
28:23 Speaker 04 Yeah, yeah. She herself was inoculated. I mean, and she was right up there with like Louis XVI and Catherine II of Russia and Frederick II of Russia. I mean, but you want to talk about, I suppose it's not so much noble blood as it is just American politics, but George Washington, so during the American War of Independence, George Washington was losing more men to smallpox than he was to the swords of the British. And I have to say this under hushed tones, living in Hertfordshire, the UK. You know, I guess I'm surrounded by British people around here, but he wrote to the Continental Congress, saying, would
29:04 Speaker 04 you please remove your stupid rule that says I can't inoculate the troops? Because Congress had said, you are not allowed to inoculate people because people can die from being inoculated.
29:15 Dana Schwartz? And you don't want, to be, to be fair, you don't want, if you give everyone an inoculation at the same time, you don't want everyone knocked out by the side effects or the dangers of that immediately.
29:26 Speaker 04 Of course not. But when you look at the numbers, you get, if you get a smallpox the normal way, you have a 30% chance of death. I mean, when you pair that against COVID-19, where we had things pretty badly, I mean, it's like nothing in comparison. Smallpox was so bad. But if you got inoculated, your chance of dying was 2%. And then you were immune for life. So George Washington argued with Congress and said, look, you gotta let me inoculate people. And when they kept saying no, he eventually disobeyed orders and inoculated his troops anyway. And I mean, it really turned the tide of battle. I mean, it's, it is incredible because that chapter of American history is so often forgotten. But it was
30:08 Speaker 04 really inoculation against smallpox that led the Americans to ultimately defeat the British and take their own country.
30:16 Dana Schwartz? I mean, that just goes to show when George Washington was able to sort of change course by what had been the the previously held idea of how to what what to do with your army and in 1777 was able to inoculate his entire army to turn the tide of war. There's really nothing more American than that.
30:33 Speaker 04 Yeah, I know. I know. And also, he was such it took such character and courage to stand up to the Continental Congress and say, you know what? You're wrong. I mean, that's that. I mean, it was a new country. I mean, it wasn't even a country yet. It was a new rebel state that was trying to do the right thing. And to be able to stand up to all these people who put their faith in him and say, nope, then we're going to inoculate anyway. And and he was right to do it. I mean, they they they were losing so many soldiers to the disease. I mean, and it's what's really galling is General Howe
31:13 Speaker 04 in Boston. He was actually engaging in germ warfare because Washington wanted to take back Boston after the British took it. But he couldn't because there was horrendous smallpox outbreak in the city. So and he knew that his rebel fighters could not enter without catching the disease and dying in droves. So Howe, knowing this, intentionally infected American citizens and then sent them out of the city to go and have a chat with George Washington and his soldiers in the hope that they would trigger a spread of the disease. I mean, literally germ warfare. And Washington figured this out. And that was a big part of him ultimately saying, I'm going to have to disobey Congress and do the right thing
31:58 Speaker 04 here. And, you know, and inoculation was absolutely the way to go.
32:02 Dana Schwartz? Well, Matt, thank you so much for talking about this topic, for writing this book, which, if you're a fan and a listener of the show, it is just chock full of fascinating historical stories. I loved it. The book is I Told You So: Scientists Who Were Ridiculed, Exiled, and Imprisoned for Being Right, out February 24. Matt, where can the good people find you if they want to follow you, follow your writing? And is there anything else we can plug?
32:32 Speaker 04 You guys can totally find me on the Macmillan page, St. Martin's Press. You can also find me, you know, I mean, I'm all over the place, but I do hope they have a good read.
32:43 Dana Schwartz? Absolutely. Thank you so much for taking the time to speak with us today.
32:47 Speaker 04 Absolute, my pleasure, Dana.
32:57 Dana Schwartz? Noble Blood is a production of iHeartRadio and Grim and Mild from Aaron Manke. Noble Blood is hosted by me, Dana Schwartz, with additional writing and research by Hannah Johnston, Hannah Zwick, Courtney Sender, Amy Height, and Julia Milani. The show is edited and produced by Jesse Funk with supervising producer, Reema Ilkayali, and executive producers Aaron Manke, Trevor Young, and Matt Frederick. For more podcasts from iHeartRadio, visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.
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34:47 Speaker 05 Breathe in and reset with Lincoln Rejuvenate, an available multisensory 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 are trademarks of Ford or its affiliates. All rights reserved.
35:17 Dana Schwartz? This is an iHeart Podcast. Guaranteed human.
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