Pod Insights Radiolab How to Cure What Ails You About this episode Now that we have the ability to see inside the brain without opening anyone's skull, we'll be able to map and define brain activity and peg it to behavior and feelings. Right? Well, maybe not, or maybe not just yet. It seems the workings of our brains are rather too complex and diverse across individuals to really say for certain what a brain scan says about a person. But Nobel prize winner Eric Kandel and researcher Cynthia Fu tell us about groundbreaking work in the field of depression that just may help us toward better diagnosis and treatment.
Anything that helps us treat a disease better is welcome. Doctors have been led astray before by misunderstanding a disease and what makes it better. Neurologist Robert Sapolsky tells us about the turn of the last century, when doctors discovered that babies who died inexplicably in their sleep had thymus glands that seemed far too large. Blasting them with radiation shrank them effectively, and so was administered to perfectly healthy children to prevent this sudden infant death syndrome...
Leadership support for Radiolab’s science programming is provided by the Simons Foundation and the John Templeton Foundation. Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation.
Transcript 4,678 words · 14 speakers
0:00 Speaker 00 WNYC supporters include Livrite, publishers of John U. Bacon's New York Times bestseller, The Gales of November, a chronicle of the S.S. Edmund Fitzgerald's 1975 shipwreck. Never has it been told better than by Mr. Bacon in this colorful book, writes John J. Miller of The Wall Street Journal, while author Hampton Sides proclaims that it's destined to be a classic. The Gales of November, now in paperback.
0:24 Speaker 01 This is Radiolab. I'm Lulu Miller. It's May, which means we are right in the middle of Mental Health Awareness Month. And because of that, I found myself thinking about an episode we did many years ago about what was, at the time, a brand-new way of peeking inside the brain to try to see various mental health conditions, like depression and many other things. It's a fascinating piece, and while it was recorded 17 years ago, and you'll find some of the language reflects that time, the question at the heart of the story is really timeless, really provocative, really fascinating.
1:05 Speaker 01 So we are going to air it today, and at the end, I will be back with a short update on where some of the technology has come in the subsequent years. So here we go. Buckle up with the episode called "How to Cure What Ails You."
1:19 Speaker 02 Wait, you're listening. Okay. All right. Okay. All right. You're listening to Radiolab. Radio. From... WNYC.
1:32 Speaker 00 Rewind.
1:33 Speaker 03 Hello, I'm Jad Abumrad. And I'm Robert Krulwich. This is Radiolab. This hour, we're talking about diagnosis. Diagnosis, the easy kind. We're not going to talk about it. No. Easy would be, you come into my office, and I'm a doctor, you have a broken arm. I take a picture, I say, "Hey, you've got a broken arm. The picture says so." Yeah, because you can see the break right there. But let's suppose you came into my office and you were sad. You tell me that your sex drive is down. Hey. I'm the doctor, so it's just between you and me. All right. Well, right away, my learning tells me that you may be a candidate for depression. But how do I know that you're depressed? What do you mean, "how do we know"? We talk about it. You just said.
2:16 Speaker 03 Well, you can't measure sadness or depression. You can't go to a test tube and count anything. Right. It's not hard science. Yeah, because... Until now.
2:30 Speaker 03 What if I put you in, you know, one of those FMRI machines that we've talked about so often?
2:34 Speaker 04 Yes.
2:34 Speaker 03 I snap a picture of your brain in action and I look at it. And from your picture, I say, "You are depressed."
2:42 Speaker 04 You're gonna tell me I'm depressed just from looking at a picture of my brain?
2:45 Speaker 03 Yes.
2:46 Speaker 04 What? No way.
2:47 Speaker 05 Look, it's now here.
2:50 Speaker 03 Photographic diagnosis of mental illness.
2:52 Speaker 05 This is happening. There is no question.
2:54 Speaker 03 And that, by the way, is Eric Kandel, a professor at Columbia University, who just happens to have won the Nobel Prize for Medicine.
3:02 Speaker 05 Let me give you a little historical background.
3:04 Speaker 03 Did you get a Nobel? I don't think you did.
3:07 Speaker 04 I still don't believe you. What, just because he's got a Nobel Prize, I'm gonna suddenly turn around like...
3:11 Speaker 03 No, no, no, you're not. So let's do this step by step, okay? Step one.
3:16 Speaker 03 Imagine you're slipping into an FMRI machine, okay?
3:20 Speaker 03 Now, I want you to just look at my face.
3:22 Speaker 04 Why?
3:22 Speaker 03 Is that so difficult?
3:23 Speaker 04 Yeah, I just wonder where this is going. Anyway, okay, I'm looking at your face.
3:26 Speaker 03 So now that you're looking at my face...
3:28 Speaker 05 Different regions of the brain, they become active.
3:32 Speaker 03 There are cells in your brain that are saying, "I know him."
3:37 Speaker 05 The cells are more active. They need energy, just like when you run, you have to breathe fast.
3:40 Speaker 03 And to get the energy?
3:41 Speaker 05 Your heart pumps more blood.
3:44 Speaker 03 The body sends a rush of fresh blood to that particular group of cells.
3:50 Speaker 03 And because the blood has iron in it, the magnet in the brain scanner can see the iron and therefore see the blood flow and take pictures of it, many, many pictures, in real time.
4:03 Speaker 05 I'll show you a very nice example of this.
4:06 Speaker 03 Eric's now heading off across his ample office with an extraordinary view of the Hudson Valley. And he brought over a picture of a human brain with different colors in different areas. And he told me, when you look at a face...
4:16 Speaker 05 When you image the face, this area lights up.
4:19 Speaker 03 You're pointing to an area of the brain?
4:21 Speaker 05 The area of the brain.
4:22 Speaker 03 Above your... on your forehead, kind of.
4:24 Speaker 05 That's right, that's right. If you look at a house, some other area lights up, but this area does not light up. You look at another face, this area lights up again.
4:33 Speaker 04 Every time you see a face, same area?
4:34 Speaker 03 Yep. Hmm, but you haven't told me anything about emotions yet. That's true. So let's move on to step two. Because we use faces to tell what someone else is thinking or someone else is feeling. Looking at faces also triggers.
4:48 Speaker 05 An area deep in the brain that is concerned with emotion.
4:51 Speaker 03 Called the amygdala. Now, very recently.
4:55 Speaker 05 A number of people have looked at the amygdala looking at faces, and it's extremely interesting.
5:00 Speaker 03 Step three.
5:04 Speaker 03 I'm going to take you now to London.
5:05 Speaker 06 Hello.
5:06 Speaker 03 Hi.
5:06 Speaker 06 Yeah, hi.
5:07 Speaker 03 Yeah, that's good. Hey, who's this? Oh, I'm sorry. Who are you?
5:11 Speaker 06 I'm Cynthia Foo. I'm a psychiatrist at the Institute of Psychiatry, King's College, London.
5:15 Speaker 03 And are you like in your 30s or your 40s or your 50s?
5:18 Speaker 06 Is this part of the interview?
5:21 Speaker 03 Rude. No, I wanted to establish that she came into psychiatry.
5:25 Speaker 06 I'm trying to think, when did I graduate medical school?
5:27 Speaker 03 At a very critical time.
5:29 Speaker 06 I finished my training in 97, my training in psychiatry in 97.
5:33 Speaker 03 That's 1997, when the FMRI machines were first becoming available, and so Cynthia was able to do a rather amazing study. What?
5:42 Speaker 06 In this study.
5:43 Speaker 03 She got together a group of people who were clinically depressed.
5:46 Speaker 06 Depressed people.
5:47 Speaker 03 And then another group of people who were normal.
5:49 Speaker 06 Healthy people.
5:50 Speaker 03 And she put them in the brain scan machine and showed them.
5:53 Speaker 06 Facial expressions.
5:54 Speaker 03 Faces.
5:55 Speaker 06 Ranging from more neutral expressions to more sad expressions.
5:59 Speaker 03 So they saw a sad face, and then a neutral face, and then a sad face.
6:03 Speaker 06 That's right.
6:03 Speaker 03 And what the person in the machine was supposed to do is.
6:06 Speaker 06 To look at these faces and decide whether it was a man or a woman's face.
6:10 Speaker 03 Ah, what does that have to do with anything? Because, because while they were doing that.
6:14 Speaker 06 While they're making this decision, the emotion of the face is being processed automatically.
6:19 Speaker 03 The amygdala sees the emotion on the faces at that moment. And the machine.
6:25 Speaker 06 It's like tick, tick, tick, tick, tick, and there were hundreds of pictures.
6:28 Speaker 03 Tenth of a second to tenth of a second to tenth of a second.
6:31 Speaker 06 That's right.
6:31 Speaker 03 Did you see a difference between the people who were depressed and the people who were normal?
6:37 Speaker 06 Yes.
6:38 Speaker 03 Was it a significant difference or a just barely difference?
6:42 Speaker 06 As a group, it was a significant difference.
6:44 Speaker 03 And now she takes the big step.
6:47 Speaker 06 Step four.
6:48 Speaker 03 From the pattern she sees in bunches of people, she feeds all those patterns into a computer.
6:53 Speaker 06 It's called machine learning. She told the program, this is a pattern of brain activity in depressed people. This is a pattern of brain activity in healthy people. And then.
7:02 Speaker 03 She shows the computer a brain scan of a new person. So this is someone the computer's never met before?
7:07 Speaker 06 Exactly.
7:08 Speaker 03 And she did this a bunch of times.
7:10 Speaker 06 Right, a whole bunch of people.
7:12 Speaker 03 And each time, the computer tries to guess, is this new person?
7:16 Speaker 06 Depressed or not.
7:17 Speaker 03 Oh, and what happened?
7:20 Speaker 06 More than 85% of the time, 86% of the time, the algorithm correctly diagnosed whether that person was depressed or healthy.
7:31 Speaker 03 With just a brain scan, a computer, and a patient, no doctor needed. Cynthia's computer got the diagnosis right 86% of the time. A computer.
7:42 Speaker 06 When we saw the results, it was like, wow, this is amazing.
7:46 Speaker 03 Wait a second, has she repeated this? Well, this is actually the very first time that this has been done with depression. And so it's just a pilot study. And like you say, someone else will have to do it again and then again and again. But according to Cynthia.
7:59 Speaker 06 The potential is fantastic.
8:00 Speaker 05 Psychiatry is going to be absolutely revolutionized by this.
8:03 Speaker 06 I think this method can be applied to any psychiatric disorder.
8:07 Speaker 03 Any? Autism, schizophrenia. Obsessive compulsive disorder. No way, come on.
8:12 Speaker 05 Why not? Every one of these illnesses ultimately must have an anatomical basis. Every one of these illnesses.
8:20 Speaker 03 So this means that it will soon or one day be possible for a patient to come in and you take a picture of him in real time or of her, and you will have a diagnostic tool. That's what you're saying?
8:33 Speaker 05 Absolutely.
8:34 Speaker 03 Absolutely. You mean to tell me that they're going to put people in machines and just go boop? No, no, wait, wait, wait. Do things clear. This is not a casual thing. You go to the doctor. You tell the doctor that you're feeling a certain way. The doctor will talk to you. And then he would come to you and say, well, my learning and the test tells me that you're ill. So that's all that's happening here is now the mental doctor will say, I have a test.
8:58 Speaker 04 There's nothing in this that feels invasive to you?
9:02 Speaker 03 Well, obviously.
9:03 Speaker 04 It's tunneling into the deep depths of your personhood.
9:06 Speaker 03 No, they're not. No, this is, if you believe that mental illness is a mental illness, it is a structural condition which can be fixed. So it's not the deep inner you, it's the broken you.
9:18 Speaker 04 So it's like the broken arm thing you started off with. So you would put the two side by side?
9:23 Speaker 03 I think I would. And then, of course, you get to the next.
9:25 Speaker 04 No, come on, Robert. I mean, human beings are way too messy for that. You're too messy for it to be that easy. No, no way.
9:31 Speaker 03 So you think this is out of science's reach, really? It's just too?
9:34 Speaker 04 There's a part of me that does think it is out of science's.
9:37 Speaker 03 I think it's because you think, you think that they're looking deep inside you. That's what you don't like.
9:43 Speaker 04 I do. I mean, don't get me wrong. I find brain scans fascinating when it comes to questions like, where is the soul? What is consciousness? That kind of stuff. But don't kind of get in my head and tell me what's right and what's wrong.
9:53 Speaker 03 What if you're feeling sad and sick? Don't you want to get better?
9:55 Speaker 04 Yes, but I enjoy the comfortable ambiguity that would come from a situation like sitting in a therapist's office and saying, well, how am I feeling? I'm feeling this way or that way. And in the messiness of trying to describe how you're feeling, there's a vast landscape of things that can happen, choices you can make, therapies you can pursue.
10:14 Speaker 03 Let me just do it this way. Let's say you are sick and you know that you're sick, machine or no, okay? If you are feeling badly, wouldn't it be nice if a machine could help you find the right kind of help?
10:24 Speaker 04 What do you mean?
10:25 Speaker 03 Well, Eric took me through a little thought experiment.
10:28 Speaker 04 A mind experiment.
10:30 Speaker 05 You've developed the psychotherapy and I've developed the psychotherapy. We each claim it's the best in the world. Now we have an objective way of seeing. The machine allows you to independently of any evaluation, see the outcome of treatment.
10:45 Speaker 04 So you can audit the doctor? Audit the doctor and give you evidence that it's working or no. Okay. I think I'm a little bit on board. I can give you 10% buy-in now. Okay. So how far off is this stuff? Is it gonna come soon? This is very early in the game, obviously. But I did ask him, like, how far into the future are we talking about here?
11:06 Speaker 03 Soon or after, long after you're dead?
11:10 Speaker 05 I'm gonna be around a long time.
11:15 Speaker 03 But the question stands. Will you make it to see that people will actually have?
11:19 Speaker 05 You know, one can't, in medicine, in all honesty, give a timeline for many of these things. Imaging methodology right now is quite sophisticated, but it's still primitive compared where it needs to be. You're picking this up in status nascendi. You've become excited as the thing is beginning to emerge. We see it for the first time on the horizon.
11:41 Speaker 03 You're saying we got to this story too early? That's what you're saying?
11:43 Speaker 05 Just right. It's not gonna be interesting 20 years from now. It'll be obvious.
11:48 Speaker 04 Or in 20 years, it'll be obvious that we were wrong. Okay? That's a real possibility, because what we don't know is A lot. vast. And I want to tell you a story now about just how wrong people can be.
12:02 Speaker 01 That's coming up, right after this break.
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14:38 Speaker 01 Radiolab Lulu, just before the break, Jad and Robert were debating how much science really can know about who you are from peering into one of your organs.
14:48 Speaker 04 And I want to tell you a story now about just how wrong people can be. It begins with a mystery.
14:54 Speaker 09 Sudden infant death syndrome.
14:57 Speaker 09 Perfectly healthy child goes to sleep and dies during the night.
15:03 Speaker 04 It's about the worst thing that can happen to a parent. And each year, it does happen about 7,000 times. Still, no one knows why. Oh, and by the way, that was Robert Sapolsky. He's a
15:12 Speaker 09 Professor of neuroscience at Stanford University.
15:15 Speaker 04 And Sapolsky tells this story of the moment SIDS was diagnosed for the first time, or at least classified, and a terrible mistake that was made.
15:25 Speaker 09 Around 1900 or so, people were beginning to recognize this as a disease entity. And nobody knew what was up, so people decided, let's go dissect SIDS kids.
15:35 Speaker 04 Meaning, when a baby would die, they would perform an autopsy.
15:38 Speaker 09 Exactly.
15:39 Speaker 04 You know, check the baby's insides.
15:40 Speaker 09 See if there's anything different in them from normal kids.
15:43 Speaker 04 That seems logical.
15:44 Speaker 09 Absolutely.
15:47 Speaker 04 They'd measure the size of the baby's lungs.
15:49 Speaker 09 Yep.
15:50 Speaker 04 "That looked normal." Then they'd measure the size of the heart.
15:52 Speaker 09 Yep.
15:52 Speaker 04 "Nothing strange there." Stomach, kidney, liver.
15:55 Speaker 09 Yep.
15:55 Speaker 04 Those are all fine. Then, they would look in the throat.
16:00 Speaker 09 They look in there, and they say, "Oh, my God, these SIDS kids, they have enormous thymus glands."
16:07 Speaker 04 The thymus.
16:08 Speaker 09 The thymus.
16:09 Speaker 04 What is the thymus?
16:10 Speaker 09 Yeah, what is a thymus?
16:11 Speaker 04 Well, it is a little, tiny, pink gland that is right here, behind your collarbone, at the base of your throat. And its job is to help you fight disease.
16:22 Speaker 09 Makes one type of cell critical to your immune system.
16:25 Speaker 04 Especially in times of stress. In any case, normally, this little organ is about the size of a tiny tube of toothpaste, like the travel kind. But in these SIDS kids, it was
16:38 Speaker 09 Huge, humongous, enormous.
16:41 Speaker 04 Twice the size.
16:42 Speaker 09 Exactly.
16:43 Speaker 04 And since the thymus is dangerously close to the windpipe, doctors came up with a hypothesis.
16:48 Speaker 09 A perfectly reasonable hypothesis.
16:50 Speaker 04 Which was that maybe, if you're one of these babies with enlarged thymus, and you're asleep, and somehow you roll over wrong, well, that gland might
16:58 Speaker 09 Press down on your trachea and suffocate you during the night.
17:01 Speaker 04 Oh. So, ding ding ding, medical mystery solved.
17:06 Speaker 09 Really?
17:08 Speaker 04 No.
17:08 Speaker 09 They even came up with a name for it. It was called status thymicolymphaticus.
17:16 Speaker 09 It was in all the pediatric textbooks by the 1920s. And you would look in there and there'd be pictures. There would be pictures of the dissected thymuses. Normal size, and here on the right.
17:28 Speaker 04 Enlarged.
17:29 Speaker 09 Abnormally large status thymicolymphaticus.
17:33 Speaker 04 And in no time at all, doctors came up with a treatment.
17:35 Speaker 09 A perfectly logical therapy.
17:38 Speaker 04 Which is that if we're gonna help these babies, we've gotta shrink their thymus glands. And to do that, the best solution, obviously, is to...
17:47 Speaker 09 Irradiate their throats. Irradiate their throats to shrink their thymus glands.
17:54 Speaker 04 Zap the child's throat with trillions of radioactive particles.
17:59 Speaker 03 Really? Literally?
18:00 Speaker 09 You betcha.
18:01 Speaker 04 And this was considered like, something every good, loving parent should do?
18:05 Speaker 09 Absolutely. If you worry about your child being at risk for SIDS, go and get their throats irradiated to shrink the thymus glands.
18:13 Speaker 04 And did it work?
18:14 Speaker 09 Yes, it shrank the thymus glands.
18:16 Speaker 04 But, he says, it did have another effect.
18:18 Speaker 09 Decades later, you've killed 20,000 to 30,000 people with thyroid cancer.
18:25 Speaker 03 20,000, 30,000 deaths, that's a, that's a real number.
18:29 Speaker 09 Yeah, that's a, that's a fairly big one.
18:32 Speaker 04 So here's my question.
18:34 Speaker 03 Uh huh.
18:34 Speaker 04 How could these doctors have gotten it so, so, so, so, so wrong? Do you know what I mean?
18:40 Speaker 03 Yeah, I do. Well, don't you know what you mean? You just answered your own question a minute ago.
18:44 Speaker 04 No, no, I didn't. I'm about to answer it right now.
18:46 Speaker 03 They're, they're playing with radiation, you just said that. But what they, but they didn't know that radiation would hurt you. They had no, it was a brand new, uh, technology.
18:55 Speaker 04 Yeah, but that's not what I was gonna...
18:59 Speaker 09 This was, you know, a couple of decades into radiation having been discovered.
19:03 Speaker 10 Isotopes are performing near miracles of diagnosis and discovery.
19:08 Speaker 09 People were just tossing around radiation all over the place.
19:11 Speaker 10 Iodine 131. Radioactive sodium. Radar. Gamma rays.
19:15 Speaker 09 Neutron. And this was a period with Madame Curie dipping her arm into vats of uranium.
19:20 Speaker 10 Radioactivity is harmless.
19:22 Speaker 09 And dying soon afterward from cancer. People would go into shoe stores and they would have their feet x-rayed.
19:29 Speaker 10 Yes, x-ray is a wonderful invention.
19:32 Speaker 03 I had that.
19:33 Speaker 09 You had that.
19:33 Speaker 03 I did.
19:34 Speaker 09 Yes.
19:34 Speaker 03 You'd take off your shoes and then you could look at your bones.
19:37 Speaker 09 That's exactly what they would do.
19:38 Speaker 04 Why would you do that?
19:39 Speaker 03 That's what, that was the thing you could do at the shoe store. It was very cool.
19:43 Speaker 09 Yeah, it's showing how cutting-edge of a shoe store they are.
19:48 Speaker 03 So that's your explanation?
19:49 Speaker 04 No, that may look like the explanation. I mean, sure, radiation played a role, but if you'd have let me say what I was gonna say, I would've told you the real explanation
19:58 Speaker 03 Yes.
19:59 Speaker 04 preceded the radiation by like a couple hundred years.
20:01 Speaker 03 Whoa, I have no idea what you're talking about.
20:04 Speaker 04 I'm gonna tell you. Back in the 1700s, okay?
20:07 Speaker 03 Oh, that's far back.
20:08 Speaker 04 That far back, before radiation, before your grandpa.
20:11 Speaker 03 Well, before, uh, before the Civil War, or the Eiffel Tower, or Napoleon.
20:15 Speaker 04 I'm talking when the redcoats.
20:18 Speaker 03 Were still wearing red.
20:19 Speaker 04 Yeah.
20:19 Speaker 09 Yeah, this was shortly after the Revolutionary War.
20:23 Speaker 04 Right about this time, says Sebolski, the first med schools started to pop up in America and a supply and demand issue came into effect. Because with these med schools came med students.
20:33 Speaker 09 Medical students.
20:34 Speaker 04 Who needed to learn about anatomy. And of course, in order to do that.
20:37 Speaker 09 They needed bodies.
20:39 Speaker 04 You know, to dissect.
20:40 Speaker 09 This produced this whole occupation. You could be a resurrectionist. A resurrectionist? Yep. And they would go out and dig up bodies that night.
20:55 Speaker 09 And sell them to the anatomists, to the medical schools.
21:00 Speaker 09 I'll need two more by Thursday.
21:03 Speaker 04 Dig, dig. Now, here's the key point. Since demand was so high, the resurrectionists had to go where the bodies were easiest to get. Which meant, you know, avoiding the fancy graveyards.
21:16 Speaker 09 If you were wealthy, you could have yourself buried in what was called a patent coffin.
21:23 Speaker 09 Which was a triple-layer coffin, which was meant to be resurrectionist-proof.
21:28 Speaker 04 But if you were not wealthy, no fancy coffin for you. You'd probably just be buried in a sack in some popper's field, just a few inches under the soil. Very accessible for these resurrectionists.
21:41 Speaker 09 Not surprisingly,
21:44 Speaker 09 that's where they went.
21:46 Speaker 03 Are we still on the same topic? Are you explaining why children died?
21:49 Speaker 04 Yes, yes, yes. Bear with me. What I'm trying to make is that the grave robbers targeted the poor, so much so,
21:57 Speaker 04 that sometimes when they, you know, people would catch these resurrectionists in the act and see like, "Oh, my God, that's my dad you're digging up." There'd be riots.
22:05 Speaker 11 Get them! Get them! Stop stealing our bodies!
22:09 Speaker 09 Troops were called out, rioters were shot.
22:13 Speaker 04 Are we talking like hundreds of people torch-bearing?
22:16 Speaker 09 Yeah, it was townies versus the people who were trying to dissect their dead relatives.
22:22 Speaker 03 Okay, okay, okay. This is a lot of history, and I'm very fascinated, in quotes. What does this have to do with kids dying of...
22:28 Speaker 04 All right, let me bring it home.
22:30 Speaker 03 Not that it hasn't been interesting, but bring it home.
22:32 Speaker 04 Okay. As a result of all of this hubbub over grave robbing, country after country throughout Europe decided, "Well, let's standardize how science gets its cadavers. Forget all this grave robbing." So they passed laws.
22:44 Speaker 09 Which formalized anyone who died in a poorhouse, their body would be turned over to the anatomists.
22:50 Speaker 04 This was like the cadaver version of direct deposit. Okay, so grave robbing was gone, but now all the bodies used by medicine, and not just some, but nearly all, now came from the poor.
23:01 Speaker 09 Estimates were by the end of that century, 99% of the bodies used for anatomy lessons had been derived from poorhouses.
23:09 Speaker 04 And that seemed okay. Until
23:11 Speaker 09 1936, a guy named Hans Seljai showed
23:15 Speaker 04 That being poor actually warps your body. And now, Robert, now we come back to the case of the mysteriously enlarged thymus. Because if you're poor, you're worried about your job. You're worried about feeding your family. You're worried about the bills. In other words, you are stressed out.
23:33 Speaker 09 And during chronic stress, your immune system goes down the tubes.
23:38 Speaker 04 And since the thymus is part of the immune system.
23:41 Speaker 09 If you are chronically stressed, the thymus gland shrinks.
23:47 Speaker 04 For 150 years, doctors had been dissecting cadavers, pointing at organs which they thought were normal, but which were in fact shrunken from a life of poverty and stress, and saying, "That's normal." So that when these SIDS babies show up with these gigantic thymuses, oh my god. In fact, that was the first time they'd ever seen a normal one.
24:08 Speaker 09 People had no idea what was normal and what was abnormal, and they got it backwards.
24:16 Speaker 04 Killing about 30,000 people in the process. Now, the scary thing, says Sapolsky, is that these doctors were not dumb.
24:24 Speaker 09 No, these were the best, most careful researchers at the time, and these were the only logical conclusions that could have been made. And nonetheless, it produced an utter disaster.
24:36 Speaker 09 There's not the slightest reason to think we're not doing the same thing right now.
24:50 Speaker 01 So it has been 17 years since this broadcast first ran. And I wondered, circling back to the mental health stuff, the brain imaging stuff that we started the episode with, where are we now?
25:10 Speaker 01 Over the last nearly 20 years, as there have been more and more MRI studies and brains scanned over and over, our machine learning is letting us predict with way more accuracy differences in brains with bipolar, schizophrenia, and depression. But we do not have MRI-based tests for these things in clinical practice. There just isn't any biomarker that we found that's reliable enough for everyday clinical use. So we're definitely not living in the world that Eric Kandel predicted we might be, you know, where you can just scan your brain and tell you what's wrong with you and how you need to solve it. But we're not quite living in Jad's world either. We're sort of in this
25:51 Speaker 01 in-between still, but it's one, I have to say, I kind of like, where on one hand, the science is getting better at telling us what's going on with our brains, and yet it's not good enough that doctors can quite use it. It's still forcing doctors to treat us as full individuals, as not just brains, to reckon with our full personhood. And so we walk forward at the in-between to the slow but steady beat of science.
26:37 Speaker 12 Hi. I'm Seb, and I'm from London. And here are the staff credits. Radiolab was created by Jad Abumrad and is edited by Sorim Wheeler. Lulu Miller and Latif Nasser are our co-hosts. Dylan Keefe is our director of sound design. Our staff includes Simon Adler, Jeremy Bloom, Becca Bressler, W. Harry Fortuna, David Gabel, Maria Paz Gutierrez, Sindhu Nenasamvandan, Matt Kielty, Annie McEwen, Alex Neeson, Sarah Kari, Sarah Sambach, Anissa Vitsa, Ariane Wack, Pat Walters, and Molly Webster. Our fact-checkers are Diane Kelly, Emily Krieger, and Natalie Middleton.
27:31 Speaker 13 Hi, my name's Diana and I'm calling from Madrid, Spain. Leadership support for Radiolab's science programming is provided by the Gordon and Betty Moore Foundation, Science Sandbox, a Simons Foundation initiative, and the John Templeton Foundation. Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation.
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