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In February 2012, Paul Volkman was sentenced to four consecutive terms of life imprisonment for his role in illegally prescribing and dispensing pain medications that resulted in the deaths of several individuals in his care. This was a remarkable case, both in terms of the lengthy sentence as well as the perpetrator. Paul Volkman was a highly-educated physician researcher, who earned both his MD and PhD and had decades of experience practicing medicine. How did he end up in a cash-only pain clinic in southern Ohio? In this TPWKY book club episode, journalist Philip Eil joins me to trace Volkman’s journey as outlined in Eil’s book Prescription for Pain: How a Once-Promising Doctor Became the “Pill Mill Killer”. Eil places Volkman’s actions in the broader context of the opioid epidemic and reflects on the lasting impact Volkman’s case has had on painkiller regulation and the communities most impacted by his crimes. Tune in for a fascinating conversation about what happens when a doctor decides he is above the law.
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For decades, it seemed like the appendix would go the way of 8-track players, pagers, and the phonograph. Outdated, obsolete, not worth keeping around. Surgeons performed appendectomies like it was spring cleaning - when in doubt, cut it out. But then the tides began to turn as medicine started to question the long-held belief that the appendix is a defunct organ (on a good day) or a ticking time bomb (on a very bad one). In this episode, we trace the story of the appendix from its earliest descriptions to the latest advancements in treatment of appendicitis. If you’ve ever wondered whether the appendix actually serves any function and what that function might be, then this is the episode for you!
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Among the many conditions that creep under your skin and make scratching irresistible, scabies alone holds the honor of being called simply “The Itch” for centuries. In this episode, we examine how the burrowing scabies mites cause this extremely uncomfortable sensation, what we can do to halt their progress, and how contagious they really are (less than you probably think). Today, the word scabies instantly conjures up images of the mite responsible for The Itch, but for centuries, medicine failed to make that connection, even when the proof was right in front of them and when traditional wisdom had long since known mite=scabies. Tune in to learn how the great scabies debate was finally resolved with a public demonstration, what role conscientious objectors played in scabies research during WWII, and where we are with scabies around the globe today.
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A mere 150 years ago, uttering the words “scarlet fever” was enough to strike fear into the hearts of many, especially parents of young children. For a brief period of time, this disease, caused by an infection with the bacterium Streptococcus pyogenes, reigned as a leading cause of childhood death in many parts of the world. It left its mark on gravestones, in public health decrees, in literature like the Velveteen Rabbit, but then something changed. The disease became milder, no longer the deadly threat it once was. But it didn’t go away entirely or lose its bite completely. In this episode, we examine the biology of scarlet fever and trace how it can make you sick before exploring its strange and tragic history. How did such a deadly disease change almost overnight, before any effective treatment was developed? And what can that tell us about its potential to change back? Tune in to find out.
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We really don’t give fungi the credit they deserve. Over the years of this podcast, we’ve covered only a handful of fungal pathogens, and pathogenic fungi themselves represent a teeny tiny proportion of the incredible diversity of fungal life on this planet. But with this book club episode, we’re attempting to correct this oversight, at least a little bit. Toxicologist and science writer Dr. Emily Monosson joins us to discuss her book Blight: Fungi and the Coming Pandemic. We chat about how fungal epidemics have shaped entire ecosystems, altered economies, and invaded hospitals. Despite the devastating impact pathogenic fungi have made, we still underappreciate their potential to cause harm in the future, as our climate changes, as our land use changes, and as globalization continues. In Blight, Monosson delivers an important reminder that we should use what we have learned about these historical outbreaks to limit the harm fungi may cause in the future. Tune in today to gain a new appreciation for this incredible group of organisms.
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That same little bottle of retinol serum sitting on your bathroom counter - how does it work? Does it actually work? Those are the questions we’re taking on in part two of our retinoids two-parter. The answers, as you might expect, are complicated. Because as it turns out, “retinoid” is a catch-all term for a bunch of different types of compounds, all of which work in slightly different ways. And on top of that, the testing required to demonstrate efficacy isn’t exactly held to the highest of standards. But we do the best with what we have to get to the bottom of this retinoid puzzle. Tune in to learn everything you ever wanted to know about retinoids.
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That little bottle of retinol serum sitting on your bathroom counter - what do you know about its history? This week, we’re digging deep into the man behind the medicine, renowned dermatologist Dr. Albert Kligman, and the unethical research he conducted at Holmesburg Prison in the mid-20th century. Kligman’s research program at Holmesburg spanned decades, involved dozens of experiments (including tretinoin) and thousands of individuals, received ample funding from public universities and many pharmaceutical companies, and was generally praised until it all came crashing down in the early 1970s. But, as we’ll discover, the unethical behavior persisted even after the program’s closure as Kligman fought to get tretinoin to market. The murky history of retinoids might be a bit too long to include on the label, but this episode forces us to consider the human cost of a household product and the importance of acknowledging that history.
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When the Massachusetts Institute of Technology admitted in 1999 that they had discriminated against women on its faculty, it sent shockwaves throughout institutions of higher learning across the country. In this TPWKY book club episode, Pulitzer Prize-winning journalist Kate Zernike joins us to discuss her book The Exceptions: Nancy Hopkins, MIT, and the Fight for Women in Science, which details the sequence of events that led sixteen scientists to demand the equality that had been denied to them for so long. Zernike, who was one of the reporters to break the story in 1999, centers this story on molecular biologist Dr. Nancy Hopkins, who, armed with a tape measure, brought this history of marginalization to light. Simultaneously personal and panoramic, The Exceptions carefully illustrates the sexism entrenched in higher education and academia and sends an important message: this problem is far from solved. Tune in for a fascinating discussion about an infuriating topic.
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Stiff person syndrome, like many rare diseases, does not get nearly the same amount of screen time or name recognition that other, more common diseases do. For many people, Celine Dion’s announcement of her diagnosis with the condition in 2022 marked the first time they had heard of it. This limited awareness surrounding stiff person syndrome marks just one of the many challenges keeping this disease and other rare disorders in the dark. In this episode, we attempt to shed some light on stiff person syndrome, exploring the complex biology, frustrating history, and hopeful future of this disease. Because while the field of stiff person syndrome research faces many hurdles, there are also so many individuals - researchers, patients, advocates - and organizations that fight to bring this and other rare disorders into the light. Tune in today!
Links:
National Organization for Rare Diseases
Genetic and Rare Diseases Information Center
Johns Hopkins Stiff Person Syndrome Center
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Five years ago, we asked you all to ask us anything, and you delivered. We answered dozens of listener questions, like how we first met, our favorite quarantinis, where we were in our career journeys, and so many more. But in the years since that first “ask us anything”, a lot has changed for both of us! So we’re coming back to you with the answers to more of your probing questions, like “what disease names would make good person names?”, “where are you in the world these days?”, “if you could have only one sandwich for the rest of your life, what would it be?” and a million more, ranging from serious to silly and everywhere in between. Tune in for a non-stop, self-indulgent Ask the Erins!
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How is it that we can’t remember where we put our keys or the name of the person we just met, but we can recall in excruciating detail the embarrassing interaction we had at the grocery store ten years ago? Sometimes it seems like our memory works against us more than it does for us. But, as it turns out, this aspect of our memory is more a feature than a bug, and the key to understanding the difference may lie in our evolutionary history. Dr. Charan Ranganath, Professor of Psychology and Neuroscience and Director of the Dynamic Memory Lab at the University of California at Davis, joins us today to discuss his book Why We Remember: Unlocking Memory's Power to Hold on to What Matters. Dr. Ranganath deftly guides readers through not only the “how” of memory formation but also the “why”, helping us to understand why we remember certain things and forget others. Tune in for a fascinating discussion ranging from the importance of context (like smell) in memory to the different types of memory, from decision-making to memory competitions, and so much more!
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One day, you’re enjoying a beautiful hike through the tall grass. A few months later, you find yourself in anaphylaxis from a post-hike hamburger. The culprit: a tick bite. In this much-requested episode, we take on alpha-gal syndrome, the red meat allergy triggered by the bite of a tick. Sometimes science is stranger than fiction. How exactly does an encounter with a tiny arachnid cause your throat to swell up and your skin break out into hives hours after eating red meat? Is it all red meat? Is it all ticks? How on earth did anyone even make this connection in the first place? Those are just a few of the questions we answer in this action-packed episode that has us venturing into surprising topics, like primate evolution, ancient epidemics, and cancer treatments. Tune in for all this and more.
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For life on this planet, iron is not optional. It is essential. When our iron levels are low, we can get sick, and when they get really really low, we can even die. But you know what they say, too much of a good thing can be a bad thing. In the case of iron, the genetic condition hemochromatosis is often to blame for iron overload, but why is too much iron a bad thing? In this episode, we explore that question and many others, starting with why iron is a biological non-negotiable and how a lack of iron regulation in hemochromatosis can lead to severe tissue damage. Then we’re going Deep Time™ to suss out the origins of our dependence on iron, a journey that eventually leads us to the Neolithic Revolution and the 20th century realization that a certain ancient medical practice is not as obsolete as previously thought. Tune in to catch us ironing out the details of this incredibly common genetic disorder.
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Phosphorus is an element that wears many faces. Its overuse as a fertilizer has polluted freshwater ecosystems, transforming rivers and lakes from thriving communities to lethal zones devoid of life. Its role as an explosive has brought fiery death and suffering to many during times of war. And its dwindling global supply poses an existential threat to humanity. Because phosphorus is not just a destructive force - it is essential for all of life on this planet. In The Devil’s Element: Phosphorus and a World Out of Balance, author Dan Egan explores the multi-faceted nature of phosphorus and the surprising ways this element has shaped our world. Egan, Journalist in Residence at the Center for Water Policy in the University of Wisconsin-Milwaukee's School of Freshwater Sciences, transports readers from the guano-covered islands off the coast of Peru to the fertile fields of the American Midwest, from the 17th century laboratories reeking of boiled urine to our tenuous future as the demand for this element outpaces its supply. Tune in to learn about this powerful yet underappreciated element.
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The stethoscope. It’s iconic. You’re playing Pictionary and you pull the “doctor” card? Easy - sketch a stethoscope. Need a last-minute Halloween costume? Easy - throw a stethoscope around your shoulders. Google image search “doctor” and you can count the number of stethoscope-less doctors on one hand. How did this instrument become so emblematic of the field of medicine? What can it tell us about our heart and lungs? And is its future under threat? That’s where this episode comes in. We explore the invention, evolution, and application of this tool, from the tragic life story of its inventor to the surprising amount of controversy over whether the stethoscope still holds a place in medicine today. Tune in for all this and so much more, including a doctor’s-ear perspective of the heart and lungs, complete with all the heart and lung sounds you could want!
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“Is it gonna be poop or is it gonna be barf?” It’s the question we all fear during a bout of food poisoning when time is of the essence and a decision has to be made before it’s made for us. Often, the germ forcing this question upon us is none other than the dreaded norovirus. First called “winter vomiting disease” for reasons obvious to anyone who has been unfortunate enough to become infected, norovirus now conjures up images of puking passengers aboard cruise ships or oysters on the half shell secretly harboring a vomiting virus. In this episode, we delve into the world of norovirus, examining what qualities make it spread so rapidly and sicken us so quickly. Our tour of norovirus history takes us down some surprising roads, where we meet Vomiting Larry and chat about vulture vomit. We round out the episode by looking at norovirus by the numbers, dispelling the notion that norovirus can only be found aboard cruise ships. Spoilers: it’s everywhere.
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In the pre-antibiotic era, tuberculosis was one of the biggest killers humanity ever faced. The specter of the ‘great white plague’ hung over towns and cities across the world, cities like New York whose population boom in the early 20th century paved the way for this deadly disease to spread throughout crowded tenements. As tuberculosis rates in NYC reached a breaking point, city officials sought to solve the problem by establishing a sanatorium on Staten Island. But they quickly ran into an issue - who would be willing to work there, exposing themselves to this untreatable deadly disease? In The Black Angels: The Untold Story of the Nurses Who Helped Cure Tuberculosis, author Maria Smilios tells the story of the courageous nurses who worked at Sea View Hospital on Staten Island, facing the constant threat of disease and perpetual racism from patients, colleagues, and neighbors. Smilios brings these women’s stories to life, describing how they persevered in these difficult conditions to ultimately help bring about the cure for tuberculosis, for which they have only recently been recognized. Tune in for a fascinating discussion about a monumental time in tuberculosis history!
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In last week’s episode/love song to poison control centers, we journeyed through the history of these centers, from idea to institution. This week, we pick up where we left off by taking stock of the incredible impact that poison control centers have had on public health and individual lives. We also get a thrilling behind-the-scenes look at the operational side of things - who is on the other end of the line when you call poison control? How do they know so much and where do they get their information? Dr. Suzanne Doyon, Medical Director at the Connecticut Poison Control Center and Assistant Professor of Emergency Medicine at the University of Connecticut joins us to answer these questions and so many more. If last week’s episode didn’t turn you into a poison center superfan, this one certainly will. Tune in today!
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If you’ve ever called poison control, you probably already have a deep appreciation for the voice on the other end of the line who provides solid answers, emanates calm, and empowers you to take whatever steps necessary to be safe and healthy. If you haven’t, this episode will turn you into a superfan anyway. How did this incredibly valuable yet often overlooked service come to be, and why did it arise when it did? In the first of what ends up being a two-part ode to poison control centers, we explore the origins of poison control centers in the US, from the early days when literally one guy answered calls from all over the country to the lifesaving nationwide coordinated organization it is today? Tune in to find out!
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Roads are essential to our modern lives, so much so that they largely exist in the background of our minds. When we do think of roads, we’re either complaining about traffic or celebrating them for enabling our restless need to explore. Can you imagine if all of the world’s 40 million miles of roads were suddenly erased? Chaos for humanity. But a boon perhaps to natural ecosystems. In Crossings: How Road Ecology is Shaping the Future of Our Planet, author Ben Goldfarb takes readers on a fascinating tour of the relatively recent science of road ecology. Even beyond their impact on roadkill, roads are powerful disruptors of natural ecosystems, bringing noise, pollution, and humans to natural areas and fragmenting landscapes. And as Goldfarb demonstrates, we are only just starting to reckon with the widespread effects of roads and integrate this knowledge into road design. After this fascinating conversation, you’ll never think of roads in the same way again!
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