Sawbones: A Marital Tour of Misguided Medicine - Sawbones: The Papanicolaou Test

Episode Date: April 7, 2017

This week, Justin and Dr. Sydnee bring you the thrilling story of how a former department store clerk from Greece saved countless lives with the invention of a single test. Music: "Medicines" by The Taxpayers

Saw bones 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, talkies about books! One, two, one, two, three, four! We came across a pharmacy with a toy and that's lost it out. We were sawed through the broken glass and had ourselves a look around.

The medicines, the medicines, the escalant macaque for the mouth. Hello, everybody, and welcome to Saul bones, a marital tour of Miss guided medicine. I'm your co-host Justin McAroy. And I'm Sydney McAroy. Sydney. I, okay, sorry, let me start with the first one. So I go to see my guy in college. Is right in

this guy's. Hey, what, what are you doing? Uh, you, well, you interrupt me. I'll start with the beginning. So I go to see my guy in college. And this guy's, wait, wait, wait, what is this thing? What is this, this character? What is this whole? I curiously, what is this?

Well, you, you had said that you had said that this episode there wasn't a wasn't a lot of bad medicine that we could make fun of and be there. It was about perhaps nearest. So you told me you said I should come up with some pap spare jokes. So I wrote I got a stack here. It's away. Did I have books of perhaps? I don't want to know. No, I wrote, I wrote them. These are all my original Paps, mere jokes. But yeah.

I don't, I don't think I said make Paps mere jokes. I don't, I can't see, I can't see me saying that. Yeah, I don't think that's right. Yeah, like Paps mere. No, no, I don't, did I tell you to write bits about perhaps and perhaps I got to know, let me try this one. Um, so I'm, he's saying spread them and I'm like, no, well, oh, no, that's not mm, there's no, no, I can't see these going well, I don't see this

going well for you. Okay, well, maybe, maybe my prewritten material, maybe it should be more organic. Yeah, yeah, I mean, that's not the exact kind of humor. I think this show, like our whole show really, you know, the merits, like, that's not really our style. Yeah. Yeah. I mean, it's great. It's great. It's a great style. In your jokes, after we're done, after we're done with the whole show recording it and like done putting everything together like the music on it and then people listening to it. And it's all safe and sound. Then you can tell them to me.

Oh, okay. Kind of private like a private show. Okay. That's fine. Okay. Yeah. Deal. But for now, let's just we'll just stick to like the show.

Yeah. It's, I guess that's fine. Just go ahead and talk about pap smears in like a boring way. Well, thanks. Good. So everybody who's tuned into listen, Justin promises to be boring. No, I'm going to try to get a podcast. I can tell you're a professional.

I'm going to try to do some great live improvisational humor. I'm just not going to be able to do in my pre-written bits that I came up with. It's fine. Okay. Well, first of all, thank you, James and Esther for recommending the topic of PAP smears. If there is one thing, cytopathologist loves to talk about. It's PAP smears, so and I do do. Great. Let's go for it. Great company. I know. At the turn of the century, company. I know. At the turn of the century, the diagnosis of cervical cancer was was pretty devastating. It was pretty, it was seen as pretty hopeless. The, you know, in speeches given

by doctors at the time, researchers in this area, they were basically like we, we just don't have, we don't have a lot to, we don't know how to identify this disease. It tends to be pretty advanced by the time we diagnose it. And at that point, we admit that, of course, at this point in history, we don't have a lot of great treatments for it. So, you know, basically, we really need a lot of help in this area. Okay. You know, so, enter Dr George, Oppenicola. So he was born in 1883 in Kimmy, Greece.

And he was initially not... And what, Kimmy, Greece? Kimmy? It's unfortunate. Kimmy? Kimmy, Greece was also my gorgeous lady's wrestling name that I used. I was a champ couple of years running.

You were a champ. Yeah, I was the champ of glow. Really like a bad, really like one of the bad ones. I was a heel and then I had a face turn and I turned good. I don't know what that means, but okay. So initially he, Dr. George was initially interested in music and the humanities, influenced heavily by, I think his mom was into music.

And he really wanted to explore that, but his physician father convinced him to follow on his footsteps instead. And after completing university, he went on to medical school. Because his dad was a physician in his hometown, and he kind of wanted his son to come home and after after his training and inherit like the family business. Yeah, exactly.

So he finished in 1904. Initially, he also joined the military and he worked as an assistant surgeon. And then he also spent some time working in between, I guess, assignments back, back in his hometown, probably with his dad, with the local population of patients that had leprosy. So he did a lot with that population and helping to improve living conditions and annotation and that kind of stuff. But he got bored of this after a while of clinical medicine. He always kind of suspected that seeing patients wasn't

his calling. Okay. He didn't want to spend time kind of doing what I do, talking to people and seeing them in the office and diagnosing that kind of thing. He wanted an adventure. Yeah, he kind of did what adventure. He liked sailing. He liked being out on the sea. And he also liked, well, and I don't know if you consider this adventure. He also liked a bench work. It was what we would call it, meaning like a laboratory scientist that he had a bench and looking at things under my preserves. When you say bench work in your day to day life, is it, you can be honest with me here? Is it with a derogatory tone? Like office jockiness? Like a desk jocky?

Not at all. No, it's, it is not. You cannot think of them in a hierarchy. Dr. Bench Johnson, you're back in the bench. You can't handle the scuffle. They are there too. It is, there are areas in science where past diverge. And there are people who clearly like doing like laboratory research, bench work, that kind of scientific research. And then people like myself who clearly wanted to pursue science

in order to do clinical medicine interact with people and do that, that end of it. And it's just what you love. It just depends on what you love. Or what you hate, which is the other group, whichever one you didn't do that you hate. You don't hate the other group, but you might hate the work that the other group has to do and never want to do it yourself. You're happy that they're able to do it. Exactly. I'm very happy. So, he wanted to pursue a little bit more of a research path. So he actually went to Munich and studied zoology.

And he got a PhD there. And he actually, he also, after that, worked in Monaco for a time. He joined the Oshianographic Exploration Team that the Prince of Monaco for a time, he joined the Oceanographic exploration team that the Prince of Monaco led. Do you remember this team from our Anaphylaxis episode? Yes, they have a stamp, right? They did. The team that discovered Anaphylaxis that the Prince of Monaco took out on a science cruise.

That's a fun science cruise to the whole family. Yeah, that was back in like 1901. I think Dr. Papanicola went on one of the cruises, the science cruises in 1911, went along in like a physiology type role. So he also worked with Prince Monaco. And during all of these travels, he ran into, actually, I think on a boat

when he was traveling back and forth somewhere. He ran into a woman named Mary, who he had known when he was younger and their family had kind of been friendly and then he got to see her again and they started talking and they felt madly in love and he got married and she would become his wife. And also plays a very important role in this story. So the first Balkan war happens and Dr. Papua Nikola has to kind of go back to his military

role at this point, kind of abandoned all of his scientific pursuits and go back to actually being a doctor. And while he is in the military, while he is actively in the military, he starts interacting with people who are from and have been to the United States. And they start telling him about all of the job opportunities in scientific research and medicine and those kinds of careers that are available in the United States. And he's excited and intrigued and wants to pursue that. So in October of 1913,

this young couple head to New York City. So pretty much the most America place you could go. You're going to go to America. It's always strictly as odd that they, like if you're for a lot of people who come into America that like you come into New York City, it's sort of like the most trial by fire sort of like, you know what I mean? Like, oh, you want to see America and you're looking for a different culture? We'll check this out. Fire hose. Like, I know, it's almost like full of culture. It's almost like that you get this impression

like if you can make it there. Okay. You could make it I mean anywhere. I can't believe you've done this. So anyway they they head through Ellis Island they head to New York. Neither of them speak any English by the way. And they it it costs at this point in time about 250 bucks to enter the US. They have like a couple bucks over that. Wow. I mean, they have just enough to get in. And then they've got to try to make it work and pursue their dreams. So initially, both Mary and George get jobs at Gimbles Department Store.

Oh. jobs at Gimbles Department store. Oh, Mary is working as a seamstress and George works as a rug salesman for one day. She doesn't work out. It just doesn't, I'm not exactly sure. I did read one account, but I never saw this repeated that he, on his first day of work, he had to sell a rug to a woman who he had seen in like the first class cabin on the boat on his way over and it was embarrassing for him and he just couldn't do it. And so he just left.

So anyway, he didn't work out as a rug salesman. He had a couple other odd jobs. He played violin in a restaurant. He worked as a clerk at a newspaper, but he finally landed a job at New York University's Pathology Department and soon thereafter also at the anatomy department at the Cornell University Medical College. Now, when he got this job, which is exactly the area that he was wanting to work in, Mary actually quit her job at Gimbles and came along as a technician in his lab. Oh, did she have, oh, that's cool. And she along as a technician in his lab. Oh, did she? Oh, that's cool. And she would work alongside him in his lab for the rest of his career, helping him out and becoming a technician. Probably would have been one of the earliest female lab technicians,

research assistant, that kind of thing in the role that she plays, but she was never paid. She just helped. And so I don't know that she ever gets that title because she didn't technically have a job. She's a mature. Yeah, she was like a, she did it for fun. Her hobby. Her gigs. Her hobby. Her psychology. On the side, just for a laugh Every time I have the thing. So initially his research focused mainly on guinea pig reproductive cycles. I mean, of course, right? Nice. That's what everybody would want to go into. You know what I'm into?

You know my thing. The only problem was as he was doing his research and let me, let me preface this part of the story right now. He is researching Gennie Pigs. He is doing research on Gennie Pigs. And I'm about to talk about some aspects of scientific research involving animals that may be unpleasant for some listeners. I'd like to preface with that.

If that's the kind of thing you don't want to have to hear, you may want to get ahead. Sure. I don't know. 30 seconds. Two a minute. It depends on how deep we get. Like, you're really into Sure. I don't know. 30 seconds. Two a minute. It depends on how deep we got.

Like, you're really into it. I don't know. The problem is that he needs to harvest ovaries from the guinea pigs at a specific moment in their cycle in order to understand more about the guinea pig reproductive cycle. And that involves some guesswork because he didn't know exactly where the guinea pigs were in their menstrual cycles. So, and so that would result in sometimes he would guess wrong and he would sacrifice a guinea pig to remove the ovaries and he, and it was wrong.

And then that was, you know, that's that. So it occurred to him that just like menstruating members of other species, guinea pigs have cycles, and probably vaginal secretions that change with their cycle. Minstrating humans have vaginal secretions that change as their cycles change. We've talked about this before, the viscosity, the thinness or thickness

of the vaginal fluid and help you tell, you know, if somebody is ovulating or, you know, what stage they are when you're looking for like fertility and trying to get pregnant, that kind of. Their fortune is. Exactly. What kind of, what zodiac sign they would match. They're their kickboxing. Best with.

You really don't think you can't tell. It's like a snowflake. I read what's different. that they are kickboxing best with really nothing you can't tell like a snowflake I every once different vatinal fluid it's it's amazing so he thought if you can do this with humans you could probably figure this out with guinea pigs as well so he started he actually went out and bought a tiny little nasal speculum so like a little teeny device used to look up the no it was actually a pediatric one so look look used to look up tiny little nostrils, just to kind of hold the nostrils open and

look up there. You got a tiny little nasal speculum and started using it to examine guinea pigs and collect their vaginal secretions. I mean, I've had weirder days, but not today. So he starts collecting the vaginal secretions of guinea pigs and examining them on microscope slides. And as he notices differences in the fluid over time and the cellularity and different aspects of the vaginal secretion, he can actually perfectly predict the guinea pigs cycles. That's why he started this research. That's why he started preparing these what we call smears where he would take a sample fluid and smear it on a slide and then look at it. He started doing that so that he could try to predict exactly when a guinea pig was ovulating.

Right. Right. You follow? And still the world, the world held its breath. Certainly he's going to figure it out soon. We've just got to now. So from this, and he published papers on this and he was very successful, but from it, he began to wonder what else we could learn from vaginal secretions, particularly if we... Particularly in the human animal. What can we learn from vaginal secretions?

So he started collecting vaginal secretions from volunteers for his laboratory and examining them on slides just to look at the different points in the cycle, what does it look like in that kind of thing. In the midst of this, he happened to collect a sample from a patient who had known, who had diagnosed cervical cancer. And he noticed a very clear difference in the cells that he saw on the slide from the patient with cervical cancer, then he had seen on the slides from patients who didn't have cervical cancer.

This is the beginning of a huge breakthrough. I know you're wondering where I've been going with these guinea pig vaginal secretions. Well, I'm about to tell you. Oh, tell me. Well, first I'm going to take you to the billing department. Let's go. The medicines, the medicines that ask you let my God for the mouth. So said you were, you have me in suspense about what he did with the information that these cells from the vaginal fluids in the woman that have been diagnosed with cervical cancer were different. Right.

Now, before I tell you the, before I tell you what happens next in the story, I do think it's important to mention another doctor. Dr. Papanickola was not the only doctor to call attention to the fact that you can tell the difference between cancer and non-cancer cells with a technique like this, collecting some sort of secretion or fluid and looking at the cells and being able to tell the difference. He was not the first or the only physician to figure this out. There was a British physician, Walter Hale, who had already done it with lung cancer. Then there was a Romanian physician, Oral Babish, who had actually used a different method to diagnose cervical cancer. He was actually looking at the same thing. He just used a slightly different instrument and his preparation was different and it's crazy both him and Dr. Papanickla

published and presented their results. I mean within months of each other Wow, really, but we are talking about one physician who's practicing in the United States and one physician who is practicing in Romania. We have no evidence that the two knew about each other at all. So this was just one of those moments in scientific history when two smart people probably came up with a very similar solution at a very similar moment in time. It's a term for it. Multiple discovery happens pretty commonly. Actually, it's a very odd phenomenon because you subscribe to theory that ideas arise through like fluid networks.

So it's not just one person who's coming up with it independently. It's these ideas coming together and someone is the person that you know up with it independently. It's these ideas coming together and someone is the person that sort of identifies it. It's really fascinating. It's more common than you'd think. It makes sense. It makes sense because at this point in history, the standard for diagnosing cancer was some sort of tissue biopsy. So it was actually at the time, we didn't have a lot of non-invasive techniques to do that,

meaning we'd actually have to cut somebody open and take a sample of something to figure out if there was cancer or not and that procedure alone was dangerous. So the people were looking for a safer, you know, easier way, less invasive to diagnose cancer, sooner, you know, more quickly so that we could do something about it. So the two of them came up with very similar techniques. Dr. Papanickola is the one who we will, as we move forward, we will discover gets most of the credit for it and is most associated with the procedure. But to be fair, the test we're about to talk about in Romania is actually called the Babish Papanickola test in honor of this position who also who also figured out something very similar. So anyway, Dr. Papinicola collects more samples, standardizes his procedure, and publishes in 1928.

Here are my results. Here are some pictures of some cells with cancer. Here are some pictures of some cells that didn't have cancer. I did all this just with a simple vaginal, you know, smear. I got some fluid. I smeared it on a slide. It was all very easy and I was able to die or to, you know, this would be a way to diagnose cervical cancer. Isn't this great? The world of joist. No, nobody was particularly interested.

Uh-huh. Everybody said, well, that's, that's all well and good, but you still got to get a biopsy. You still got to go and get a biopsy. So it didn't really make a lot of waves. He went and presented his findings, actually, what was called the race betterment conference in Battle Creek, a bunch of eugenicists. Oh, yeah. Very common at the time. Yeah.

Yucky. I know. It's like, it's not, it's important to know that there was a, that this period, there was a, before this period, there was a, before we, we kind of saw, oh, that really broke bad over there. Like that really did not work out well over in Europe. There was, there's a lot that it was a common school of a racist one. But no, very racist one.

It's, it's always hard when I, I, I had told Justin this before I, we did this episode. Whenever I'm studying a physician or something that is said in this time period in the US, I always get really nervous, well, not just in the US in a lot of places, but because this is the moment when there was a eugenics movement in this country, and I'm always terrified that I'm going to find out

that this person I'm researching that they were involved or they were part of it and then It's awful. I mean we've talked about Dr. Kellogg and we mentioned that he was related to him He was part of the eugenics movement. Yeah, and I don't know I don't know that it was common to like soften the fact that no This is just this moment in case you didn't know there was eugenics movement in this country was popping off Yeah, yeah, and then that's, it's important to remember it and recognize it so that it we stop it from happening again. As you can tell, because you talked to me

about this before, as you can tell though, this is involved with eugenics as he got. He was exactly. At the time, I guess, was was a deep in the field and convinced him to come present there. Yes. Yes. Yes. As far as we can tell, this is the only interactions he'd had. I have no evidence that says Dr. Papinecola had anything to do personally with eugenics. I don't find anything that says that. So he presented it and they weren't even particularly interested in it either. He kind of said, look at this cool technique I've got. It's great. We should use it and they said, well, no, we're really into a lot,

a lot more awful stuff. Yeah. And this seems like a great thing for mankind, and that's not really, that's not really where we're at right now. We're gonna stick with Kellogg and his yogurt animas, and we're good. If you come up with anything about race purity, please,

just give me a call. You can call us back. But open door. I can imagine him backing out of the room, like slowly and then turning around and be like, oh, what was that? I'm like taking off. So none of this deterred him. This is one thing you got to know about this guy.

He was nonstop. He worked seven days a week. And according to most sources I read, never took a vacation in his entire career. There was one that said he actually did take one vacation. Either way, this guy worked seven days a week, his entire life. Wow. He was, and not because he had to. He said the work was too interesting to leave it. He couldn't stand the thought of not working on it. He had to keep working. He loved it.

Kidred spirit. He absolutely loved it. It's me. Yeah. That's you. Never taken a vacation. No. This is not believing it. I'm out of work. Or said, right.

Love my craft. So his wife, his wife stuck with him. Like I said, she worked in the lab with him. She's one. It seems like the only way to see him, right? That's true. Well, if you want to hang out with your boy, he said they off us again.

Not only that, there were times early in his research when he referred to a special case that he studied, a special case that he studied for 21 years and collected vaginal secretions from and learned a lot from. Very intimate. It's now pretty much thought that that's his wife, that he, so not only did she volunteer to help him out

with the actual lab techniques, but she was also one of his samples. Yeah. Either way, he continued to work and collect data. And he started collaborating with a Dr. Herbert Trout, who was worked in the gynecology department at New York hospital and was actually able to have contact with more patients. And through the two of them working together, they began to basically do a pap test on every patient with a cervix who came into the hospital.

So just collect tons and tons of samples. And then in 1943, they gave it another go. So together, they published diagnosis of uterine cancer by vaginal smear. And it just, I guess it was the right moment in history at this point, plus the data was a lot more robust. They had a lot more samples. Sure, right.

And they published this paper and everybody went nuts. Because here was this quick, easy, cheap, and pretty reliable test to diagnose their full cancer. Nice. And the medical community embraced it. He was a little nervous about that at first, actually, only because, not because he didn't want people to use it,

but he didn't want people to do it wrong. There was a little nervous about widespread use because he was afraid that people would start complaining and didn't work because they weren't doing it right. Right. He strikes me as the kind of guy who probably wouldn't have minded, like going around and

teaching everybody independently, like, listen, if you're going to do this. I've got the time. Just do it right, okay? I don't make a question. It's going to have my name on it. So Dr. Pap, as he came to be called after this, so the test, the Papanicalola test or Papanicola smear quickly became known as just the pap test or the pap smear. And and because of that, he became known as Dr. Pap. Actually kind of went backward. One of the, that didn't really happen to Anglo-Saxon names very often does it? No, I don't know.

Really, that it seems like people just go ahead and say the whole thing. Exactly. Yeah. Yeah. So Dr. Pap, as he came to be called by most of his colleagues and students and such went on to become a professor emeritus at Cornell University Medical College. He published four books over 100 articles. He got tons of awards in the US and Greece and Italy honorary degrees. He was on the 10,000 Dr. Monot before the for the euro. And he was on several Greek stamps and a US stamp. He is also known as the father of exfoliative cytology. That's exactly true. Buff the done. Which, you know, I mean, if there is a greater honor than that, I don't know what it is. He left for now for Miami to help them

develop their cancer institute in 1961. He had kept promising. He was going to retire, promising he was going to retire. And he just never could because he loved the work so much. And he finally said, you know what? At least we'll move to Miami. And I'll kind of work as a consultant advisor and develop this. And unfortunately, he passed away three months after arriving there at the age of 78. They still did name the Miami Cancer Institute,

the Papa Nicola Cancer Research Institute in his name. And this is part of why you think this, you think this guy would have a Nobel for this. He was considered and he was passed up initially. They were still considering him for the next year. But there was this debate about who came up with the test. Right. They first was it Papua Nicola or was it Bobbich and there were not

that this not that they had decided not to give it to him, but because there was some discussion and debate and they weren't sure. They were holding off and then he passed away. So then he couldn't get one. And then the other guy was like, well, I mean, I'm still here. I'm still here. Do you want to go ahead and prize me? Please, I'm still ready. I actually have no idea if he was still there. I don't know. I don't know. So the let's talk about the pap smear. It's reduced mortality from cervical cancer in the US by 70%

since the 1940s. Wow. Do you just briefly do you know what a pap smear is Justin? Well, you go to a person of the cervix and you put a, I'm just going to let's say what I Pepsi area is Justin. Well, you go to a person's service and you put a, I'm just gonna let's say what I think it is. Are you, would you rather meet? No, I'm not. You asked me.

Okay, ask me. Carry on. You get a cotton swab. Yeah. Carry on. Okay, not great. All right, so you get a cotton swab or scalp, scapula, get a scrub, you'll them,

and you put it in there. And then you smear it on a slide, and you put a cover slip on there, and you first you put on some dye to, yeah, some contrast dye to help it show up. And then you put the top on the slide, and you put it on your microscope, focus, please, and get the right magnification,

then check it out, check it out. Okay, so I mean, there's some get the right magnification. Then check it out. Check out the source. So, I mean, there's some clout, you're close. I mean, even some people I think who've had Papsomere's aren't always sure what exactly is happening. Well, I always try to talk through it as I'm lying people. Here's what's happening. But basically, what we do is we take either,

what looks like a little spatula, like a little one kind of spatula thing or like a little we call a little broom, little rubbery plastic soft broom kind of thing. And we use it, we have to use a speculum so that we can visualize, we can see the cervix, which is just the bottom part of the uterus. We use that to brush it in the center of the cervix where the opening is called the os and Collect some of those cells. That's all we're trying to do is just use that to collect some of those cells

We put it in a little now. We use like a liquid prep for the most part They used to just take that and smear it on a slide Now we actually like rub it around in a little bottle of liquid Wash it around in there get some of the cells in there. They take that, there's a whole preparation that they do with it now. It's a little more complicated than it used to be. One way or another, it ends up smeared

on a slide and examined again. So the reason that this test is so great, of course, again, is because we can identify free cancerous cells as well as cancer cells. So we can even tell when somebody might be likely to develop cervical cancer. That's on point. Yes, which is great.

Among patients that do die of cervical cancer each year, it's about half of them never got a pap smear, which is just, I only mentioned this, to prove that getting pap smears is very effective. Sure. And about 10% more were at least five years out of date on when they needed their pap smears. So again, not just getting them,

but getting them when you're supposed to is very important. We used to do paps yearly on everybody. This was a thing that changed pretty recently in medical history. Yeah, we used to do them at age 21 or three years after you start having sex and then yearly thereafter. Now we start them at 21 and we do them less frequently. It depends then on your age and your

risk factors and whether or not you've ever had abnormal ones. So I don't want to give you a hard cut off, but some patients could be only every three years. We do them less often because we found that we were doing them too much and we were doing too many procedures and maybe we didn't need to do them that often. Either way, it's important that if you have a cervix, you are seeing your physician asking them when you need a pap smear and getting them in the recommended time intervals because we know that it saves lives.

There are all kinds of interesting things when it comes to a cytopathology. Like, do you know pathologists can only read so many slides in a day, like legally, air prohibited from reading more? Why? It's a quality control measure. Okay, because they want to rushing for my stethere. Yeah, but there's actually like, I guess a lot of political stuff tied up in this because

now it's a semi-automated procedure, so it's not as hard to do, but there's still these limits. And I don't know. I was told in some of these emails that there's not as hard to do, but there's still these limits. And I don't know. I was told in some of these emails that there's a lot of political stuff. I don't know what it is though. It's not my world. I don't know.

Now, just on a side note, we also have the Gardasil vaccine. I wanted to mention that just to give it a quick plug. The Gardasil vaccine is a vaccine that can prevent some strains of human papilloma virus, which is the virus that causes most cervical cancer, not all but most. HPV. Exactly.

HPV. So, it was the first vaccine developed that can prevent cancer. It doesn't prevent all, but it can prevent cancer. It is a gray vaccine. I unequivocally throw my support behind it. It absolutely is something that I believe all people should get. We now give it to younger people. Around age 11, we start recommending it.

It's a series of three vaccines. And hopefully, we will see a time where while we still do pap tests, we find a lot less answer when we do them. Thank you to the Cardisol vaccine. That being said, a lot of us were too old to get it, which is why pap tests are still important. I am too old to have gotten it. Not only that, the vaccine is still not 100% effective

in that it can't cover every single strain of the virus, and there are people who aren't infected with the virus who can get cervical cancer. So it's still important to get your pap tests. There are other new tests for cervical cancer. So it's still important to get your pap tests. There are other new tests for cervical cancer, but the pap test is still winning out as one that's, you know, like I said, cheap and easy and quick and uncomfortable, but not not painful, uncomfortable, but not painful. And we're improving our methods every day. So they're pretty inexpensive and easy to get right now, right?

So, well, Justin, they should be. If you have insurance, usually your insurance should pay for you to get greening pap smears at the regularly recommended intervals, whatever that may be for your age group and risk factors and whatnot. So every one to three years. Obviously, there are places where you can get it for free. If you don't have insurance places like the health department here, actually, a lot of, I know a lot of patients who go to the health department because they provide free, cervical cancer screening and planned parenthood provides cervical cancer screening. and planned parenthood provides cervical cancer screening.

It's essential that those places continue to survive and provide the service to continue to save, I mean, 70% reduction in mortality by having widely available PAP test. So it's essential that these services are available. If your insurance does not cover this, or if you do not have insurance, and there are no free services available funded by charitable organizations or the government, to provide it, we're going to start seeing more people die from cervical cancer. That's the end of the story. It's too expensive for you to just go

pay for. The doctor's visit alone is going to be crazy expensive. I mean, if it's something you have to pay for at a pocket, then plus the procedure that the doctor's doing, plus the lab fee for having it prepared and read, it would be prohibitively expensive for most people to do out of their own pocket. So it's essential that these services are provided. They save lives, period. And not to stand on the set of for too long, but it's pretty cool. That dude was able to

emigrate here too, right? Right. You know, I think it's pretty cool. It's pretty cool, pretty darn cool. I think I'm glad to claim Dr. Papanickola as a fellow American. Folks, that's going to do it for us. Thank you so much for listening. We hope you have had fun. Thank you. Thank you. A million times. Thank you to everybody that donated to the maximum fun drive. It was a massive success. Didn't I do a really fun video on YouTube?

Remember? It was fun. Yeah. Remember? You're looking at me like I'm making it out. Oh, we did do a really fun video on YouTube. Okay. I was I was thinking it was live. It's like two hours long while it was live. Oh, we're pushing it to YouTube but I see what I didn't know that if you search for some owns live on YouTube, you can watch it and enjoy it

but we talked about pretty much everything out of the sun and Thank you the taxpayers for letting us use your song medicines is the entire natural program Head on over to maximumfund.org. Hey, here's a plug. We don't do very often if you want to buy Some of the sobans what you'll call it. Go to maxfundstore.com And you'll find sobans t-shirt and with our logo and you'll find one designed by Taylor's Pearl Sydney sister with a very cool skull and stuff on it but it's neat very cool very cool there's a ton of Mac cool Mac's fun gear on there for you to pick up

but anyway that's gonna do it for us folks thank you so much yeah thank you all so much I didn't say thank you right away because I was getting a secret doctor text but thank you Sydney has a secret doctor texting systems did you know this I did I do says doc halo It says, Doc Halo Secure Message. It's very cool. It does. And anyway, I was getting one. But thank you, thank you, thank you,

fun drive, the max fun drive. Thank you, everybody donated. You guys are great. We love you, thank you, thank you. It's going to do for us folks. Until next week, my name is Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head.

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