Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Mary Roach

Episode Date: June 1, 2016

Holy crap you guys, we talked to Mary Roach! Yes, THAT Mary Roach, the author of Gulp, Bonk, Spook and her newest, Grunt: The Curious Science of Humans at War, due out in early June. We spoke with Roach about a history of wrong thinking on diarrhea, why the military kept weather-related secrets from her and the Medicare code for maggots. Music: "Medicines" by The Taxpayers

Saubones 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, not a sense, the escalant macaque for the mouth. Hello everybody and welcome to Sobhones, a metal tour of Miss Guy of Medicine.

I'm Eric Coho's Justin McAroy. And I'm Sydney McAroy. Sydney, I am so excited. I am too. We're so excited. Yeah. We're not teasing. This isn't one of our classic bits.

This is true blue excitement. True blue excitement. We have for you such a treat this episode. It is our very first guest episode We have said on sobans for this is truth This is complete truth Justin and I've talked about if we were gonna have a guest who would we want? I was gonna say a ghost not a ghost a guest if we were gonna have a guest, who would we wanna guess to be? And we have had the same name that we keep coming up with, if we were gonna have a guest, as who do we want,

and we got her. It's Mary Roach. And she's on the show. She's got a new book called Grunt, the Curious Science of Humans of War. It's out the first week of June. You can pre-order it now, but this episode we are going to be talking to her about that

and a lot more and it's going to be a lot of fun. She has a lot of great books out there that if you have never heard of Mary Rich before, you should look her up and buy her books. I have been a fan for a long time. She's basically the most popular science author in the world. Fun science. Fun science.

But she makes it interesting. I'm not just because I'm a doctor, Justin can vouch for this. No, they're great. Yeah, for anybody, any interest. So, so we talked about your roach. And we're gonna listen to it right now. Well everybody, this is really exciting for us. We are joined by our first ever solbona guest. She is the author of Stiff,

the Curious Lash ofcandabra spook, bonk, packing for Mars, gulp, and her newest grunt, the curious science of humans at war, will be released in June of 2016. I believe, please welcome to show. I don't, you can't, because you can't applaud.

You're listening to podcast. That's right. I wish everybody. Yay! I'm clapping my face to do this. There's thunderous applause happening. Yeah, I can feel it. Clap wherever you're at in the subway or in a taxi.

So, Mary Roach, I don't know, Ms. Roach, Mary, I don't know what would be the most appropriate. I'll just go with Ms. Mary Roach. That sounds good. uh... i don't i don't know miss roach marie i don't know what would be the most appropriate i was going to miss marie roach that sounds late layered i am i'm a layered somebody sent me the deed it was that some reader in scotland is the thing we do you think it one foot square piece of land yeah technically

all get lady maybe but i like layered layered layered is good. Um layered. Yeah. So, uh, in our show, we throughout medical history, a lot of times you find scientific advances bumping up against preexisting knowledge or even superstition. You touch on this in your new book, Grunt, which is about the science behind humans at war. You touch on this like in the, you have a chapter pretty much just about diarrhea, which we're both way into. You talk about how soldiers, one of the soldiers talks about how he believes he shouldn't sort of block himself up with emotive. Even though the science seems to indicate that, you know, it may be better to let those things run their course without, you know, or with emotive to actually, you know, lean

on that in some cases. Is this a recurring thing you see in the military where where these men and women have sort of like Wrist their lives and have have relied on sort of pre-existing knowledge and and and what they have have known before sort of a Hasidence to adopt like new advances. Oh, I don't think it's unique to the military. I think you hear Everywhere we if you come if you can't have a direct people you've got a lot your body do your body do its work it's flushing toxins it's actually reading itself that is so widespread not just

yet not not just in the folks that i talk to in the military and i you know i i believed it to i was like the world seems to make intuitive sense and then come to find out these bacteria and these pathogens, it's not something your body is doing to them, it's something they're doing to your body, they're interfering with your ability to absorb moisture in the colon. Which I thought was like, wow, knowledge, science, cool. So I don't know, the military,

people in the military are unique in their sticking to these beliefs. These things that make intuitive sense are hard to shake. People just, they keep hearing it over and over and over again, like, oh, talks and your body's flushing talks and it's like, no, it's not actually the thought. How did you find that some of these researchers who are doing this work, you know, sort of encouraged adoption of these new ideas. You're talking another section about soldiers being hesitant about taking in new technology,

things that require a lot of electronics sophistication because they're just worried about reliability. How does the military handle that idea of adoption of this technology? Yeah, it's, there's always, the military is this massive machine. And there can be something at development, like you're talking about, I think, about the hearing loss and extreme noise chapter.

There's this kind of cool thing called teacaps, which is technical communication and protection, and as in protecting the ears. So it's this very cool system where you put on this headset and it amplifies quiet sounds and it blocks loud ones. So it's protecting your ears and at the same time you can still communicate because soldiers are like, you know what, I'm not putting on heavy duty hearing protection and foam ear plugs in my ears and then I can't hear what somebody is going to like look like look out somebody shooting at you

Yeah, so it's this conundrum of how do you how do you save their hearing and also not put them in danger and So then a lot of comes this technology first of all it's expensive and then it's also within the very cumbersome kind of like Machine of is it in the radio budget or the hearing protection budget? It breaks down into all this tedious bureaucracy and so the ability to get something pushed through is tough. And then also, there's a reluctance, like you said, the people who are out, the boots on the ground, people who are doing the job and carrying this heavy pack, the unit leaders are like, it's going to break down. I've got to carry the battery.

They've got to haul this thing out. It stopped working. They're very wary of new technology. Yeah, it worked great in the demo when you brought it into the Pentagon, however, but they're going to work in the field, you know, in harsh conditions. And how often does the battery battery gonna have to be changed? And so there's understandably a certain amount of reluctance to adopt under technology.

So. In medical history, we see military advances sort of trickling down into how we treat civilians. Since the 1960s, I think, said you were telling me the military has put a role in something like. Like eight different vaccines. And there are a lot of things. We talk a lot about this and things like wilderness medicine

and global health, things that we use out in the field like to stop bleeding or certainly like turtikets or an easy example of that or wound care. These are all things that we in civilian medicine have been adopted and has been perfected by the military. In your book, you talk about Navy Captain, Robert A. Phillips adding glucose to rehydration fluids. That helped absorption.

That was a huge breakthrough. That's something I'm very familiar with in like global health. Is that something that you saw like a theme of as you were doing this? Yeah, it comes over and over. I mean, anything that is helpful in keeping alive someone is hemorrhaging a large amount of blood. And that, you know, that happens in car crashes. It happens all the time in civilian life.

And there's all kinds of things that the military has had to come up with. Because this scenario happens so much, hemorrhaging, bleeding out, as they say, dying of blood losses, the number one combat fatality. So they've gotten to be really good at evaluating turnigits and coming up, you know, I mean, a lot of times, the military is working hand in hand with a private developer. You know, they're saying, this is what we need. You know, can you help us? So it's sort of a joint process.

It's not that the military necessarily invents everything, but they fund the research. And they, you know, they push it and they encourage it. And then it comes out. And then of course, it makes its way into civilian trauma care, or hospitals, or whatever it is. So it's burn care also. Yeah, a tremendous amount of emergency medical care. Not necessarily invented, but funded, encouraged,

put into use, tested. A lot of testing goes on to make sure, you know, this is something that's going to work and it's worth spending the money on. So yeah, a lot of a lot of good inventions. We see it in video games too. A lot of people know it's very starts and triggers down there actually from from their work. I host a podcast with a doctor. She's sitting across the table for me. And I would say about once an episode, I have to ask her to back up and define a term,

or something that she has used that I don't understand because I'm a layman. And that's definitely a big part of my job, I think, is a physician is trying to take complex medical concepts that I've taken big part of my job, I think, as a physician is trying to take complex medical concepts that I've taken a lot of time to understand and make them accessible for my patients who typically aren't also medical professionals.

As you study these topics and you immerse yourself in them and you become an expert on them as well, is it hard for you to then continue to make that so accessible because I think your books are very accessible for people, you know without any without having any Expertise necessarily. How do you do that? I think I do it by Never going all that deep. I mean you have a medical degree. You have spent years studying this stuff and you keep up to date and medical degree, you have spent years studying this stuff and you keep up to date. And, you know, I don't have it, so I'm still really operating at a very beginner's level. So it's not difficult to make that jump. But what does happen, although there are times when I, you know, even after just two years

of mucking around in a topic and absorbing what I can, I start to use words that, the words become to seem commonplace that two years ago I'd never heard that word. And so I rely on my editor to go, Mary, I don't know what you're talking about here. She's a poet and a novelist. She's intelligent, but she has no background in science and doesn't really read books about science. So she's a great editor for me. She'll go, Mary, what does this mean?

I don't get this. So it's very helpful for me to have that set of eyeballs on my work. Because every now and then I do kind of find myself using a word or a term and just thinking everybody knows that, right? I understand that completely. Justin keeps me in check a lot. Yeah. After a lot of episodes, I have to say, wait, is that not really hurt? Is not really hurt is not the not knowing it. It's her incredulity that I am not from the certainly your kid certainly your your kidding in. When you boil, this is a book about, as we said, about the military and about fighting

war and how to help people do that more safely and more efficiently. But when you boil it down to really base, and even, I would say this is even a sort of a crash generalization. But a lot of the advances that you talk about in the book are at their center, how do we keep people safer so they can still continue to kill other people. so immersed in keeping this person alive. I don't think it crosses their mind. I mean, the sort of larger institutional reason for keeping a soldier alive. I don't think they see their job. They see themselves as saving someone's life and keeping this person alive for themselves

for their family. I don't get the sense that they view themselves as contributing ultimately to the military goal of keeping as many soldiers in the fight as possible. I just don't, they're very caring, dedicated people, and a lot of them, I have to to say when you work day by day with alongside the aftermath of combat you you're not a fan of war there are a number of people i spoke to hate war i mean they because they see they they see this very vivid

graphic tangible result of bullets and bombs and uh... i i i i i did that there there not fans of of military it's kind of like you know used to work at the same for this go zoological society at the zoo and there was a group of activists who are her like set the animals free

and i was at the zoo and i'm like you know i'm not a fan of the work at work at the zoological side i don't like animals being penned up. I don't like that. But the solution is not to set them free. They're here and for better or worse, let's make their lives better and more pleasant and healthier. So people at zoos can both dislike zoos and care deeply about the animals in them and want to make their lives better. It's a similar, I mean, I'm not comparing soldiers with zoo animals, it's not my intent, but it's a similar kind of thing where you don't have to like the reasons that you're having

to do the work, you don't just still care about it deeply. So I didn't get a sense that they had that in their mind when they were doing their work and they're very committed and they're medical people. They want to keep people alive and make them healthy. And they care a lot about what they do. So, yeah, I didn't feel like that was a theme that came up in my research. It's something I was aware of just because, you know, you cut ever down and then you come across, you know, references to keeping folders in the game or that being part of the, you

know, it's a military funny. It's a huge, it's not a big monolith. It's a organization. It's tons of organizations that all add up to this thing that i don't care for but that there but there are chunks of people who who are involved in it who impressed the hell out of me and i really just saw them purely as devoted

care providers i want to hear so much more about your book but uh... we have to take a quick break and we will be right back after we visit the building department. Let's go You touched on this you mentioned in the book talking to people who have done I mean like really Made astounding sacrifices. I mean, sacrifices that would be unfathomable. Like, I feel pretty good about myself holding the door of them for somebody.

Like, I feel like a real big, big shot. But you talk, you make a sort of half jokingly you mentioned the book about writing a, I think you call it a gasping fan letter to a captain white who is terribly injured. But the first thought he had and his main concern was about the fate of his men and you know women in his area with, how did you as a journalist or were you able to sort of like keep perspective on the broader picture in the topic you're talking about while you were talking to such like the people who had done these astounding things?

Well it was an eye opener for me in that I've never spent time. I don't have family members or friends who've served in the military. So it was my first real exposure to that reality outside of movies and books and, you know, dramatizations and that sort of thing, which is it's even though that can be affecting and moving, it's just not the same as standing and talking to someone who's missing one leg and part of another leg and needs his urethra rebuilt and tells you in all honesty and for no reason for him to lie that because I said tell me this story and the for him he's hit the first thing that he throws on a tourniquet and he's trying to get up and see who's hit who's hit because he's the unit leader he's the commander and

he doesn't know who's been hurt and that's the kind of thing you kind of, I'm familiar with it as like a parent running into a burning building after a child. That kind of bond, parent's love for a child and that kind of sacrifice, but your buddies and you meanwhile are maimed and still do, I mean I just had to wrap my mind around that. It was a different experience for me. It was very, you know, kind of profound compared to, you know, I'm usually, you

know, I'm Mary Roach. I'm off with the cadavers and the maggots. And so this is something, this is a little heavy. It was heavy for, you know, for me. And it was kind of amazing. You briefly touched on this, but I'm curious what sort of baggage about the, just the idea of war, did you sort of bring this book initially? And I'm curious how that evolved over the course of writing the book. Well, I live in the Bay Area.

I'm kind of your typical Bay Area liberal. And I had a sense of the military, like I said, saying before it, this is sort of monolithic entity. And anytime you spend a couple of years, whether it's NASA or the military or the funeral industry, you begin to see that it's impossible to kind of to sum it up with, there's no one, there's no military, there's the Navy, there's the Army, there's the Marines, there's the Pentagon, there's the bureaucrats, there's the researchers and the scientists and the medics and all of these, they're all different entities and you can have different feelings about different ones and so it was a process of sort of

coming to see all the shades of gray and rather than this black and white sort of good and evil. So it was that kind of an evolution. Did you have that kind of, you mentioned that, you know, Mary Roach is usually with the cadavers in the maggots. Did you have that kind of, you mentioned that Mary Roach is usually with the cadavers in the maggots. Did you have that thought as you were writing this that this might be a little more like politically charged than or, or you know, people might have be a little more opinionated about these topics and something that you've written before? Yes, yeah, I do have that awareness. I mean, I'm writing about the science and explaining things and that's my comfort zone. But anytime you write about the military and war, I think you need to expect people are

going to want to make it political or want you, you know, want you to kind of bear down on things in a political way. So yes, yeah. Um, you, you, one of my favorite things about your books is you, you, you humor to really great effect and you, and especially in that sense of making things relatable that we talked about earlier and you certainly do that here. But I, I was curious if you at any point were a little bit hesitant about that considering that this is a topic that like people cared so deeply about or so deeply connected to and have such strong feelings about.

If you're worried at all about coming off as like, you know, flip because of the sort of gravity of the central central issue. Yes. Yeah, no, I do worry about that. I mean, I tried to keep the humor to... There's a couple of historical chapters, which are kind of hilarious because it's old, first of all, it's the OSS, the precursor to the CIA and some of the correspondence that went on in developing a shark repellent is one chapter and also sort of a stink bomb.

So it kind of lent itself to, I mean, it wasn't combat and no one was killed. And that's a bit... There's a reaction about red underwear. And it's... And the red underwear, yeah. So, I kind of compartmentalized the humor. I also tried to poke fun at myself as a total outsider and

clueless pogue, as they say in the military. I don't know what's going on around me. There's so much to learn to the culture of military is so foreign to me. It was like me stumbling around in Japan for the first time. Saying the wrong thing, doing the wrong thing. So I tried to use humor and also the footnotes, sometimes things that are kind of quirky or funny that strike me as too hilarious to leave out, but they're not ever in the main story of people being injured in the line of duty. So that was my hope, was that I kept the humor in places where it was appropriate.

But I'm, again, Mary Roach, and I don't necessarily have the best sense of what's dignified, respectful, appropriate, politically correct. These are not my strengths. So, you know, I'm hoping that, I mean, people I've sent it out, I sent the book out to most of the people in the book who, you know, I've been able to get addresses from and have gotten good feedback and that's incredibly reassuring and gratifying to me because those are the readers I care about most at this point is the people who are in it that they don't feel made fun of or exploited or disrespected. Yeah, and I will say I can vouch for the funny footnotes. I was reading the chapter about MAGET therapy and I'm just interested in in general and I remember the footnote about the CPT code for MAGET therapy, which I don't know if this is just I'm a doctor

It made me laugh out loud and then I had to text one of my friends and say hey, did you know the CPT code for I really I just love that there is a see it is a Medicare reimbursement code Exactly And the fact that they're approved at the FDA approved, maggots as a medical device. And I'm like, this is what I live for these little facts. So I'm glad that you enjoyed that. I'll ask Sidney what CPT stands for after the show.

You strike me somebody who has sort of like a boundless curiosity about pretty much everything. And the military is an organization that I think has their reputation for, being somewhat secretive from time to time. Did you find yourself like frustrated by any doors that were that were closed to you? You know that that wouldn't normally be in another topic? I was surprised at how few doors were closed to me. If something was classified, the door was closed. There was no argument or

debate. But things, anything that wasn't classified for the most part uh... people in the public military public affairs although they thought some of them were very weird requests and they didn't really know who to go to to get approval they were willing to try and they were helpful and i and these were people are like look you know i could send you a copy of my book that you know what you know what i my book. Because I want you to know what I'm doing.

I don't want people to feel like, oh, we thought this was a textbook you were working on. And by God, it's some weird, tasteless, stupid, trashy, pop science. So I would send them. I would try to send you know, especially it was a big request. Like I want to go out on a submarine, you know, out for a few days somehow, which is not an easy thing to have happened because some sections of it are classified. I mean, nobody knows where it is, and there's not a lot of space on a nuclear sub.

And so, you know, I knew that it was going to be a challenge, so I write up sent them copies of packing for Mars and it's like okay see what I did for astronauts I want to do that for soldiers can you help me and they got it and they were really helpful and I had anticipated the opposite for the reasons that you mentioned I had imagined the military to be very secretive and they are of course secretive if it's something that's going to compromise their service members, you know. Like, here's something called camouflage. That work is classified. Again, print on your fabric, that for whatever reason. That's something the information that they don't want shared.

Sometimes it was kind of a surprise to learn that something was classified. And other things were just, it made surprise to learn that something was classified. And other things were just, it made perfect sense that the answer was no. Like at one point I wanted to go out with the special operations, you know, the guys who do the high-risk missions, they have a weather arm. So there's a, because the weather, and you wouldn't really think about this, but the weather can make or break one of these missions. And so they have weather men, and I wanted to profile. Because I thought, God, you make it to special operations.

You're like the cream of the crop. You're like the guy, like the virile omnipotent special ops guy. And then people go like, oh, so specials, what do you do? And they're like, weather. I thought I really wanted to profile them. I called up special operations command public affairs and i explained all this and he's like

marie the classified missions he did you know and i think you've got to only talk about the weather i will talk about anything else yeah i think this is so not going to happen. They're literally doing the thing that they have to make the secret about. Like, they're making the secrets happen. Yeah. As shocked as Sydney is, when I don't know a topic, she is perhaps even more shocked when

I get yucked out by anything because she does not, nothing seems to phase her, except you have one thing. The only thing that I've ever found that bothers me is for some reason, like spit, especially if somebody wants to like, hawk a big loogie and bring it to you to show it to me, because that happens a lot. And I don't think I'm alone in that. I think most physicians get people bringing them loogie

and say, hey, look at this. Is this a normal one? So, I'm with you. That's the only thing that ever kind of I get a little bit of a gag reflex with, but everything else is pretty cool. Do you have anything? Do you have a thing? Does Mary Cameron ask you anything? Do you know what it is? Yeah, you know what it is? It's specifically, okay, I have a saliva chapter in gulp. And there's two kinds of saliva, as you know, stimulated and unstimulated.

And the unstimulated is that, like, ropey, mucusy, not clear and watery, really disgusting. And that grosses me out. I'm with you. There you go. Yeah, because the researcher and I, we collected, you can collect stimulated or on stimulated saliva, and we did that. I was like, ah, and she's going, look, look how the mucin strands. If I pull this away quickly, the mucin strands stretch away. It's remarkable. I'm like, yeah. It's like when your gumbo isn't, your okra isn't prepared right, and you

pick up your spoon from the bowl, and there's that strand like the soldier cord I can't even eat my gumbo oh no you've heard okra for me no yeah I don't order it anymore because it happens all the time oh my gosh well I'm glad I'm in good company there true marriage when will people be able to buy grunt for themselves? The release date is June 7th, but you can pre-order it right now. Alright, go do that, Mary Roach. Thank you so much for joining us.

Hey, thanks. Thanks for having me. It was really fun. Great. So, thank you so much to Mary Roach for joining us. And thank you to you, Sydney, because without you, there would be no solbones, without solbones. It would have gotten to talk to Mary Roach. Well, thank you, Justin, because you you, there would be no solbones, without solbones. It would have gotten to Dr. Mary Rich. Well, thank you, Justin,

because you have made a dream come true for me. Well, Mary Rich made a dream come true for you, but she said the emails. She did. But I'm certainly happy we can work it out. I'll give you a little, I would have been too nervous to email her myself, so I will give you that credit.

So thank you to Mary Richidge for talking with us. Go check out her book seriously. Stits and spook and gulp and bonk. They have great names too, right? It's fun to say. It's fun to say it's out of reach. I've read them. They're wonderful.

Read them. Oh, we, let's see. Oh, oh, oh, that's right. We're doing a live show in Boston with my brother, my brother and my on July 16th at the Wilbur Theater. If you want tickets, you can go to bit.ly forward slash mbmbm Boston is what it is. And you can go there and get tickets there or 25 bucks. I believe right around there, around 25.

We'll have more information as it gets closer. No, because they go on sale Wednesday at noon. If you're listening to this on Wednesday, that's today at noon. Well then we'll have. Yes, we won't have more information, but it's available for you on the website. I'm sure we'll be tweeting.

Forks.nbmbam Boston. So you can go get tickets to that and see us with, probably my brother, my brother, me, it's at the Wilbur Theater in Boston. It's going to be a lot of fun and we're really forward to it. We're going to be in New York and D.C. this weekend, but it takes a little bit of show that they're sold out. So don't you go buy them from scalpers now. Don't buy them from scalpers. We don't like that noise. Man, those scalping on our watch.

Thanks to the taxpayers for letting us use your song medicines as the intro and outro of our program. Thanks to the Maximum Fun Network for letting us host our show here. Be part of their family, podcast family, and I think that's gonna do for us. Until the next time, we have a show for you. My name is Justin McAroy. I'm Sydney McAroy.

As always, don't drill a hole in your head. Alright!