Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Guinea Worms

Episode Date: July 9, 2015

This week on Sawbones, Justin and Dr. Sydnee are wrapping a parasitic worm around a stick with Jimmy Carter. Music: "Medicines" by The Taxpayers

Saabones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books! One, two, one, two, three, four! We came across a pharmacy with a toy and that's lost it out. We pushed on through the broken glass and had ourselves a look around.

Some medicines, some medicines, the escalant macaque for the mouth. Hello, everybody and welcome to Saul Bones, a metal two of misguided medicine. I am your co-host Justin McElroy. I'm Sydney McElroy Sydney, guess what I just realized what I've been at the same thing you just realized we didn't have a bit for this Well, what I thought was that we could just try it out Test it. I don't know where and get this dry run will just be like a test it, I don't know where, and get this dry run will just be like a test bed for this intro. We'll be testing it on this intro. Okay. You see how I'm going with this. This intro will be the guinea pig, and then we'll, you see? Okay. You see? That's great. The top line. Right. I read the top line. So. No problem.

How am I gonna? So the people, the listeners are the guinea pigs for this intro because we're just testing it out. We haven't tested it on ourselves yet. We're testing it out on them. Do you understand? Right, so they are the, they are the proverbial guinea pigs.

They are the guinea pigs. Because we used to do experiments on guinea pigs, I guess. Guinea, the word guinea, yes. Uh-huh. Yes, and what do you know other things that have the word guinea in them? Um, no, I don't. Guinea worms. Whoa, seamless transition.

That was awful. That was one of our best. So although to be fair, I don't think we could have come up with a better intro for getting worm because there is no way that you accidentally stumble into this topic if you don't already know what it is. Why is that? Well, because it's a weird thing and you don't know anything about it, right? Not a darn thing. Okay. Does anybody suggest this? Yes. Lots of people have suggested this. Jessica, Primrose, Dawn, Karen, and Jonathan, thank you all so much. This is a weird topic. Not, you know, we usually, most of our topics that I think we cover are like kind of bigger, broader things. Like we've talked about diabetes, and a plague, and urine.

This is a more specific topic. And like I said, there's no way you probably don't know anything about this and I've never heard of it, and it's kind of weird though, so I think it'll be fun to talk about. Well, good, Sidney, let's not waste any more chin music on this, let's just get going. Chin music.

Yeah, no more chin music, let's just keep going. All right, so a guinea worm is a parasite. It's in the phylum of an nematota, so it's a nematode. Got it. So it's a little worm, okay? Tiny worm. It's a tiny, tiny worm, and it lives in the gut of a water flea called cyclops. Okay, so.

It can swim around in water, but then it, that's where it has to grow, is in the gut of this water-free called cyclops. Reveared X-man cyclops. Yes. A leader of a rebel band of mutants built on a, a, a, a, a, help band on taking over humanity. Yes. I am not an X-man fan.

I'm brotherhood all the way. I am not an ex-man fan. I'm brotherhood all the way. I'm interested in this ex-man. I don't, I have no idea what you're talking about. I'm overdying. I don't. I'm overdying. That's what I say. Does that have something to do with Wolverine?

Cause he's the cool one. Don't do this. Don't pretend. Wolverine's the one everybody. You know, cause we've got the big, huge, Jackman with the hair and the cool. We'll put up buffers on your identity. I'm kidding.

No. You love Wolverine. Well, doesn't everybody love with before? I don't actually like Wolverine that much. Before he got all like Wolverine. Yeah. Okay. So I prefer Jean Grey. Okay, good.

I prefer Cyclops, which is the, because he is a water free with worms and is good. Hold on, there's spin on that curve. I can see why he's so kind, tanker, it's now. What happens is that the water fleas live in the water. Got that? You okay? And humans accidentally ingest them

because they're so small you don't know they're there. Great. So you drink the water, you ingest the water fleas. The- Do you think that's ever happened to me? No, it absolutely has not. Okay. Do you think that's ever happened to me? No. It absolutely has not. Okay.

Because you're gonna find out what happens later and then you're gonna be freaked out. Okay, good. Great. Okay, good, good. So the water flees are swallowed by the humans. Now, at this point, you should know that the water flees are probably, they're pretty much like, they're not dead, but they're kind of like zombie little creatures now. They're filled with these with these little worm larva and eggs and like the worms like when they get inside the cyclops like eat their ovaries and

testes and all this kind of I was I read this really graphic description of what they do to the waterfully which is even worse than what they do to us So they kind of destroy the cyclops inside. The cyclops is finally digested by us, right? So it gets to our stomach acid. We break down the waterfully. So the waterfully casing is gone, releasing the guts, releasing the worm into our guts. Did you got that? Yeah, I'm having trouble not getting it. So this is uniquely unpleasant. So the worms are not digested. The worms can the parasite is there of course they can and so they kind of like swim around in there and they mate And then and after a guinea worms mate the males die Okay

And something something Borshbel something something take my something, they won't work, please. Okay. Great one. That was a good, good bit. So the male dies. The females do not, they grow because they're now, you know, just dating eggs. And they get bigger and bigger and bigger about a meter,

it's about like three feet, right? Okay. So they get pretty big. And so they're in our gut. They're really big. They're full of eggs now. And they need to release those eggs to be free to the world. So what they what the worm does is it starts burrowing through our tissues until it gets to an extremity. It's looking for a way out and it works its way down. It just, that's how it knows to travel is down.

So it goes down our legs through the tissue in our legs to our feet. Mm-hmm. And by the way, this is about, at this point, this is about 10 to 14 months after you first swallow the foot. Oh, great, cool. So you have no idea that this is happening. And you don't, you have no clue

this is happening all the time. Cool. Until at this point, a blister will pop out on your leg, probably like your ankle or your foot, low on your leg or your foot. And what happens is it's incredibly painful. So the natural thing to do, it makes you want to stick your foot or your leg in water.

That is what people tend to do. Okay. Which is perfect. That's exactly what they get any warm ones. Because you stick your foot in water and it then vomits some of its eggs out through the blister into the water to continue the cycle, you know, so that they can infect cyclops and then other humans can drink those cyclops and blah, blah, blah, blah. Right? I hate this. It results, of course, in this worm being in your leg,

and you get fevers, you get swelling where the, you know, worm is, and the eggs are being released, and it's extremely painful, and then obviously the worst case scenario is that there's a worm sticking out of your leg. Okay, just that's very impressive. A foot long worm or a three foot. Yes, that's very impressive. That's a foot long worm or a three foot, sorry, three foot long worm. So, that's why we're going to talk about getting worm. That sucked. Sorry.

That sucked. So that's why we know you don't have it. Yeah, you would have heard about it every day for the rest of my life. Constantly. There's also another reason you don't have it, and that's Jimmy Carter, but we'll get to that. Do you, does it make you sick? I mean, did that sound like something

that happens to someone who's well? No, that's fair. That's fair. No, I mean, you get fevers, but otherwise it's just that your leg hurts really freaking bad. This is also called by the way, Dracunculiasis, which I think is a good name because it sounds scary, right?

Yeah, it does. Dracunculiasis. Dracunculiasis. It sounds really awful. It's also known as the Pharaoh's worm, and it is an ancient disease. It has been a known entity for a very long time. It's referenced in the Ebers Papyrus, which we've talked about before, ancient Egyptian text, and they actually already kind of knew how to take care of this, how to fix this problem.

What did you do? So what they describe in the Ebers Papyrus is that as the worm starts to emerge from your leg, you start winding it around a stick slowly to remove it. And they describe that process in the Eberspapyrus. At the risk of prolonging this mental image, like how long are we talking, like, slowly emerging or weeks? That is cool. Hope you didn't have any first dates because that's gonna be hard to explain.

No more going out in shorts for a long time. Yep. Wow, this sucks. Yes, it does. It is likely referenced in the Old Testament, Wow, this sucks. Yes, it does. It is likely referenced in the Old Testament, this specific guinea worm, this decunculisus, is probably references to the Old Testament. In numbers, there's a point where they talk about fiery serpents descending upon the

Israelites, specifically when they are along the Red Sea. And guinea worm at the time would have been endemic in that area and they they think that that is is what they're what they're talking about. That is just holy holy unpleasant top to bottom. They have found calcified guinea worms in mummies so we know it's been around for a really long time. When you're out there looking for mummies to eat. During your mummy hunting sessions. Yeah, sometimes you find calcified getting worms

It was probably there and then it was brought to mess with Potemia From captured prisoners who had getting worms in them and it's like I said, it's really efficient at Continuing its species because it makes you want to stick your leg in water and Then it vomits its eggs into the water. And then, like I said, then other humans are gonna end up drinking that. Like my skin, or larvae, I should say, not its egg is larvae.

I feel like it's gonna fall off. Like I feel like my skin's gonna come from my body. It's really horrible, right? I'm not even upset by stuff like this. And this is like the most profoundly upsetting solbons I think ever, maybe worse than cataracts. I'm not sure. The jury's out. Please let us know at solbons I think ever maybe worse than cat racks. I'm not sure. The jury's out. Please let us know at solbons on

Twitter. This is this is why everybody wants us to talk about it. And this is why also things like we haven't talked a lot about parasites on the show. Yeah, I mean, you'd rectify that. No, well, I have the parasite game. I have because I love parasites. I mean, I don't love parasites They're awful, but you know, I mean mean they're they're crazy to talk about the problem You love them you can say it well, I kind of do for a lot of them They there isn't like this huge history for getting where there is but they're crazy to talk about Because they shouldn't be in you. So a lot of these worms end up in you and it's not a good situation. You weren't you're not I don't know they just do a lot of damage. Anyway, Greek and Roman and Persian physicians

all wrote of the guinea worm. Galen wrote about it, Avacena wrote about it. Galen named it, which is weird because he never saw it. He never, he notes that he never saw a patient with it, but he read about it and heard about it, heard about it from a friend. That's classic Galen. He's trying to go on on to other people's successes. And the name is a Latin reference to Little Dragons, which is befitting.

Right. He thought, though, and this was a common misconception. A lot of people thought that it was like a a nerve sticking like a protruding nerve. What do they think nerves did? I had no idea what nerves did. I mean I guess if you touched it it would probably I can't. I can't even. Yeah they had no idea what it was and so they and the weather didn't know what nerves were and so they thought well maybe it's a nerve. I don't know. I've seen I've cut people open and seen nerves in there so maybe it is maybe has something to do with like with that

The Greeks did write about the Association with water When it comes out like they knew that if they saw that blister they knew that you could stick your foot and water and it would make the worm emerge I'm cuz it will and they also Reference the idea of winding the worm around a stick in order to remove it slowly, you know, to kind of wrap it up very, very slowly, like I said, over the course of weeks. And as many people have mentioned, when they have suggested this topic, that is probably, that is thought to be, we don't know for sure, that is thought

to be where the medical symbol, the snake wrapped around the stick. Sure, the caduceus? No. No. The rod of a sclapius. Rod of a sclapius? Yes.

I actually knew that and I felt, I was just trying to play my character of dumb Justin, but I'm honestly too broken inside even, to even front. So you knew, so you knew that it was probably the guinea worm is where that came from? No, I didn't know that. I don't know anything about that,

but I know it's the rot of slave pupils. Yes, so that, so there's some thought that it's actually, it's actually a worm wrapped around a stick and that it's a, because that would have been a sign of healing, you know, because that's how you healed this affliction. Um, and that that is where this comes from, which I think is a good, by the way, segue into, because you said caduceus. Yeah. And our show symbol is caduceus. Yep. Right. Staff of Hermes, right? Yes. Yeah. exactly. Mercury, Hermes, yeah. Which has nothing to do with medicine initially. Got it.

Right. Yes. As many people like to point out, the rod of a sclapius, which is one snake wrapped around a stick, is what was the medical symbol. Right. And is used by I think, like, the World Health Organization uses it. But the caduce is two snakes.

The caduce is two snakes, and it was not initially a medical symbol. But this is what I'm going to say now and this would be the end of it, okay? Okay, I'm ready. But symbols. Welcome to Sid's soapbox. Symbols have meaning that we pin on them over time and they can change. And now when someone sees a caducis, what do they think?

Medicine. They think medicine. So if we use a caduceus in our saw bones logo, people know that it's about medicine and also it has two snakes and there are two of us and one is wearing a dunce cap and that is funny. It is funny, I chuckle every time. And so it works way better for our show. Also, also, I have a caduceus tattoo and I thought about getting the rod of Sclapius and then I thought, nobody's gonna know what that is. Everybody associates the conducive with medicine. So what if it wasn't initially? It is now.

Because that's how symbols work. Because now people look at it and go, oh, are you a doctor? Are you in medicine? If I had the rod of Sclapius, they'd go, is that a snake? Sorry. Sorry. There's a reason. There. I'm sorry, and I know there are nerds like me out there who know the difference, but

most people just see a caduce and think medicine. Well, if you, well, some of you have been sufficiently put on blast, or maybe none of you maybe sitting with a shot in the wind, I have no idea. At least one person wants probably one time said that. Absolutely. And now we will come to you hat and hand asking for money. Let's go to the building department. The medicines, the medicines that ask you

lift my car before the mouth. So what Sydney did people think that the skinny worms wore? So like I said, there were people think that these getting worms were? So like I said, there were some theories that these getting worms were nerves emerging from the skin. Some people thought that it was some kind of dead tissue and you just needed to kind of like yank it out. And then that would fix everything because it's dead. And it did, right? Like it can just get through that no problem. What if you just yank it out?

Yeah. So, and that is a point I wanted to make because a lot of people probably wonder that question, why are you slowly wrapping a worm around a stick? Just get the worm out of my leg. Right, it's awful. So that's really bad. You don't want to accidentally break the worm.

You don't want to pull it in half. Yeah, I've listened. I drank to kill enough to know not to break the worm. The reason is that if you were to just like tear the worm, one, the rest of the worm would kind of, I mean, it would be stuck inside you. Great. Excellent. You can't.

The only way you could get the part that's way up inside your leg out is if it's attached to the part that's already hanging out of your leg without surgery. And of course, if we're talking about ancient times, surgery meant death. How's the rest of your life? You got a dead half a worm in your leg. Yes, and the worm will, if you rip it in half and it dies, it's going to create an intense inflammatory response number one. So it's going to be really painful and swollen and inflamed.

Number two, it's almost certainly going to get a horrible infection afterwards. You're going to have bacteria in there. You're going to lose the leg. And if we're talking about ancient Roman Greece or wherever, you're going to die. So like, OK, so oh, this episode sucks. So you're going to tell me that I'm going to see a weird little worm emerging from my leg.

My favorite, one of my top two favorite legs. I'm going to see a little worm emerging from my leg. My favorite, one of my top two favorite legs. I'm gonna see a little worm emerging from it. And my first thought is going to be, oh holy Moses, I have to keep this thing alive. No matter what. Yep. I have to keep this thing alive. You and the worm are in this together.

We are a team you and I. Until it's completely out at which point you can kill it. Man, that really stinks. Ugh. Now, I hate to get you warm. Leneas figured out that it was actually a worm, but this wasn't until the end of the 19th century. So it took us, or no, no, no.

He figured that out earlier. He figured out that it was a worm, but it wasn't until the end of the 19th century that we understood the whole thing with the water flea and the life cycle and the fact that it lived in water and and how we got it. And so it wasn't until then that we could actually do anything effective to try to stop from getting the getting worm. Which by the way I haven't mentioned this it it's called the guinea worm because European travelers called it that because they would

Good into the water off the coast of Guinea in Africa and that's often when they would get it And so the name was a reference to like tiny dragons or something. That's just dracunculiasis. Oh, sorry Okay, yeah, that's the proper name for it, but most people know it by guinea worm got it So like I said by the end of the 19th century, a Russian scientist, Fedchenko had described its life cycle and we kind of understood, okay, so drinking water is the problem if it has a fleas in it, blah, blah, blah. And we actually start to see it being eradicated bit by bit, just with this understanding from different places.

So once Fedchenko described that, we see it disappear pretty quickly from the Soviet Union, from the Americas, from the Middle East, from North Africa, but it persists as an issue in India and Pakistan and Sub-Saharan Africa up until the 1980s. And this is why I said you can think Jimmy Carter. Oh yeah. You not having any worm. I would track it to my fear of going into bodies of water, but go on. So. The natural water for me.

Hey come, don't jump in the creek with me. No, I don't think I will. I don't know if you're heard of the single getting worm, but I'm never getting into a creek again. You used to love crick-in. That's it. Is that what that's called? Yeah, you go out, crawl I'm never getting into a creek again. You used to love crickin'. That's it. Is that what that's called? Yeah, you go out cradad and you get some cricks.

Got the crick, get some cradads, rather? I don't think that's the thing. Oh, sure, yeah, I was Virginia. You can't go out sangin'. With now what's sangin'? You never heard of sangin'? I have not. So, you collect ginseng,

wild ginseng grows in most Virginia. This is a true thing. Wild ginseng grows in most Virginia. This is a true thing. Wild ginseng grows in most Virginia and it's worth a lot of money. So if you can collect some, you can sell it for people who like naturey things, use it for herbal things. Just wait a few weeks, I'm sure there will be two competing reality shows on TLC and animal planet about it. About sangers. S it. About singers.

Sangers. Sangers. One would be called singers, and the other one couldn't call it singers, so they'll be like West Virginia Wild Boys. Or something like that. If there is a show called West Virginia Wild Boys, I am all over that. I still want to watch that.

Pour me a beer. I'm just going to start strapping. I'm going to start searching on the direct TV now. For fear that I'll miss it. Should it ever be created? So, so Jimmy Carter, he decided that, you know, and this is pretty cool because you have to think like this was not a disease that was affecting, first of all anybody in this country.

And secondly, anybody in most places, it was limited at this point to just a few places, but it was still a huge problem. When he started tackling this issue, about 3.5 million people a year were getting this. Bleh. Okay, so that's a lot of people to have a worm slowly removed from their leg. Yes.

So he decided to form a coalition to eradicate it. He worked with UNICEF and the World Health Organization and then of course the Carter Center. And what's amazing is that the way that they did this was mainly through prevention, was through having people filter their drinking water. That's it. Just filter your drink.

Because a simple mesh filter can filter out the water fleas. Oh, okay. So through just having people filter their drinking water and educating people. By 2010, it persists in only four African countries. And it is still dropping in terms of the rate. Last year in 2014, there were only 126 cases of getting warm. That's an astounding.

Down from 3.5 million back in, I think it was 86, I believe, is when this started. And just a word on this, the Carter Foundation, by the way, they target this and for other neglect, what they call neglected tropical diseases. So basically what we mean is it's not affecting us. So we're not going to, basically we're not going to think about it, which is terrible. And they look for problems that no one else wants to take on, which I think is crazy cool. I agree.

There's sort of like us, if you think about it, with a lot of people aren't talking about these topics, and we have the courage to take them on and help bring them out, you know, kicking and screaming into the light of knowledge and awareness. And that's us doing our part really to help heal the world. I thought we were just trying to make people laugh. Yeah, but failing that, we are also saving the world. Okay.

Well, good, yay. Yay, yes. So we've kind of talked about the truth. That was intentionally self-aggrandizing and you didn't really pick up on that. So I think you, I'm worried that your straight legs respond to me, so I kind of a toolbox. I thought, I thought I was supposed to,

that was my thing. I have a straight leg that, that's what I do. That's my character. Yeah, but like, you cannot be afraid to pull me down to earth when this chubby, ecarus flies to close to the sun. You got your strengths, Smirrel. I know what you think of your podcasting abilities. So I never underestimate your ego when it comes to that.

Yes, that's good, puncture, that's good. Now you don't mean that, of course. But like, that's good for the show. That's good material, that's good pattern. So we've talked a little bit about the treatment of getting worms just to just to make it clear by the way, this is still the treatment. I don't know if I made that perfectly crystal clear. Yeah. You slowly wrap it around a stick as it emerges from your leg. That's crazy. That is still what we do. That's crazy. There's no bill or something.

No, no, There is no vaccine. There is no good medicine you can take for it. You just slowly apply traction, wrapping it around, you know, a sticker, a piece of gauze or something over the course of, again, weeks. Most people are out of work for an average of three months while they are being treated for this. And that is the biggest impact, not just, I mean, because people, if they're treated appropriately, they don't die from this

for the most part, but they they are out of work. They can't do anything. They just sit in a room because they hurt all the time and they can't do anything to disturb the worm or they will die. So or at least get really, really sick. So the social impact of the disease is horrible, you know, the socioeconomic impact for years was awful. The, like I said, the worm is a meter long, so it takes a while and you can treat them with pain medicine and then put some like topical antibiotic weightment on the site just to make sure it doesn't get like superfishing. But I have to say this is all nightmarish.

Obviously that there's no like, I mean, obviously, this is terrible. But I will say the one thing you can say in favor of the beginning one. You have something to say in favor? I have something to say in favor. You and I, in our existence, will never know a day as happy as the day. When this person hears a stick rattled to the floor

Confident in the knowledge that the worm has worked its way out of their body. There will net We I will never Have a day that is as cool as that day because that day is probably the happiest anybody could ever be. I mean, we look, I gave birth to our child. Nobody on earth could know the extreme thrill of having a worm come out of you for good. That's probably true. That's probably fair. Exactly. Now, I will say one other kind of neat thing about the gettingworm, it makes morphine,

which may help, they've done- You make morphine out of the gettingworm? No, like it, it makes morph, like it releases it. It's a creaks, I don't know, like in its body, it makes it. Which may help explain why it hangs out in your body for so long and like travel through your leg and stuff and you don't notice. That's just an interesting thing. People have learned studying the guinea worm.

See, it's not all bad. Another kind of cool fact is that a big problem with the guinea worm, with controlling the spread of it, was that there are a lot of nomads who would get it from traveling around and drinking water from different sources. So it was hard to target these people because You wanted them to drink through like you know a filter But then they they don't I mean everything they carry like everything they own they carry with them And so like they don't want to carry a filter

So I have these like cool pipe filters that you can you can look up. They've got mesh in them And you can just kind of suck water through them out of a water source And it will filter the water as you drink it. And so that's one big thing that the Carter Center has done is give tons of people these filters so they can just like strap them on, it's like this teeny little pipe filter and drink through it. They also print like pictures on shirts and dresses that people in communities can wear. So they just send them into villages like new clothes and the pictures

have like a woman using a filter with no guinea worm and then another woman who isn't using a filter and she's got a guinea worm sticking out of her leg. And so it's like the easiest way no matter what the language barrier is, if people can't read it doesn't matter just like. I would totally wear that shirt. There's pictures online they're pretty cool. I love that. What's kind of crazy is, you know, if we got rid of the last case of guinea worm, it would be gone, I mean, like forever, like we would eradicate the guinea worm completely.

Cause it's an animal, right? Well, because it's a parasite, it has to have a human. So it can't just live in the water fleas and the, in the water forever, it has to have a human host. So if we like completely eliminate it from going into humans, it'll just die and that'll be it. It'll be just, well, I hope it's not,

it'll be like the... It'll be like the... It'll be like the... It'll be like the... It'll be like the... It'll be like the... It'll be like the... It'll be like the...

It'll be like the... It'll be like the... It'll be like the... It'll be like the... It'll be like the... It'll be like the... It'll be like the... It'll be like the...

It'll be like the... It'll be like the... It'll be like the... It'll it, there it's good to remember there are people who are like struggling with this every day. So I'm glad it's, oh, so many fewer now though. So that's good. And hopefully in the next couple of years, we will see the end of getting worm forever. Take that getting worm. Which would be awesome.

Thanks to you so much for listening. Thanks to Max from Fun network for having us on. They got a ton of great programs for you to enjoy. This week I'm going to recommend the flop house, which is a show about bad movies. And it is, I know that there are a lot of shows about bad movies, but this one's been going on for like a decade or something.

There are tons of episodes and they're all really, really funny. So you should listen to the flop house. So maximum the Maxime Fund Network, and there's a lot of other great shows there for you to enjoy. Thanks to the Taxpayers for letting us use their song Medicines is the Intro and Attual Bar Program. And thanks so much to you for listening. Until next Wednesday, I'm Justin McAroy.

I'm Sydney McAroy. And as always, don't drill a hole in your head. Alright! Yeah! Maximumfund.org. Comedy and culture. Artists don't. Listen or support it. Maximumfund.org Comedy and Culture, Artistone

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