Science Friday - Cephalopod Wonders, Jumping Worms, Early Plastic Surgery. June 10, 2022, Part 2

Episode Date: June 10, 2022

Are Invasive Jumping Worms Taking Over? Most gardeners are thrilled when they find earthworms tunneling through their gardens. Normally, they’re a sign of rich soil, happy plants, and a bustling ecosystem. But one unwanted visitor is squirming its way into gardens and forests all across the country: the invasive jumping worm, known for its thrashing, restless behavior. Gardeners and scientists have become more and more concerned with these worms, which can cause damage in yards and forests. They’re known for taking dense, healthy soil and churning it into a coffee ground-like mixture, which can lead to erosion and make it more challenging for plants to anchor themselves. But it turns out that most earthworms we find in the U.S. are already invasive, and the jumping worm is just the newest one to join the party. How different is this invasive worm from the ones we’re more familiar with? To learn more, guest host John Dankosky speaks with Bernie Williams, a plant pest and disease specialist at the Wisconsin Department of Natural Resources based in Madison, Wisconsin. They talk about how to spot these worms, what kind of damage they inflict, and just how concerned we should be.   The Strange, Scrambled Genomes of Squid and Octopus Squids, octopuses, cuttlefishes, and other humble members of the cephalopod class of mollusks are many-armed (or tentacled) wizards. They change colors—despite being unable to see color themselves—to camouflage themselves. They squirt ink to escape danger. They have huge brains compared to their body sizes, which, in the case of octopuses, are distributed throughout their bodies. They can even edit their RNA to allow whole new kinds of chemistry in their bodies, potentially allowing them to adapt more quickly to changing environments. This year, SciFri continues the tradition of Cephalopod Week, celebrating the fancy tricks and ineffable strangeness of these animals. Cephalopod researchers Carrie Albertin and Z. Yan Wang talk to John Dankosky about the newest puzzles coming to light in cephalopod genomes, including genes never seen in any other animals. Plus, learn more about the dramatic, self-destructive process by which mother octopuses die after laying their eggs—powered, it seems, by steroids.   Plastic Surgery, Born In The Trenches The phrase “plastic surgery” may evoke different connotations for different people. For many, what’s conjured is a procedure done for cosmetic purposes, something likely not deemed medically necessary, and probably not covered by insurance. But the history of plastic surgery goes back to a time where facial reconstruction was often a matter of life and death. The practice got its start on the gritty, European battlefields of World War I, where surgeons and nurses had to learn fast to fix the often horrific facial injuries sustained in battle. For the men with these injuries, the innovative, often traumatic procedures were life-changing. No matter the reason, the decision to get plastic surgery is very personal, and reflects a desire to change something about one’s appearance. The World War I history of plastic surgery, and how it set the stage for today’s uses, is the subject of the new book The Facemaker, written by medical historian and author Lindsey Fitzharris. Lindsey joins guest host John Dankosky from Washington, D.C.   Transcripts for each segment will be available the week after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm John Dankoski. Ira Flaydos away. I'm going to brag a bit here. My gardens this year are better than they've ever been. The flowers are in bloom. The plants and trees are all doing well. And I've got to say I'm pretty happy about it. Now, one of the shore signs I've always looked for in a healthy garden is earthworms. They tell me that I've got soil that's bustling with life and nutrients. But this summer, I've got my eye out for one worm in particular. It's known for its thrashing, squirming, pestless behavior. It's the jumping worm. These critters are native to eastern Asia, but they've been quietly spreading throughout the U.S. for decades. Now they're in more than 30 states, munching their way through forests and gardens. Scientists and gardeners alike are concerned about

jumping worms, but just how worried do we need to be? Here to tell us more is Bernie Williams plant, pest, and disease specialist at the Wisconsin Department of Natural Resources, based in Madison, Wisconsin. Bernie, welcome to Science Friday. Well, thank you for having me. and thank you for letting me talk about some of my favorite animals today. Absolutely. No, we're happy to have you doing this. So let's get this out of the way, first of all. The word jumping kind of sounds a bit terrifying.

I mean, do these words actually jump? I mean, I wouldn't say that they actually jump. They thrash. They're very active. They throw their bodies about, I think, some of the best analogies that I've heard to describe them, people say that they dance about, which they do. It's such an amazing creature to see. but also just their active behavior is something to behold.

And that's why people become very alarmed because they see these thrashing worms. And they suddenly think, oh, no, what's that? I've picked up plenty of worms in the garden over the years. And sometimes the worms thrash around a little bit. And sometimes they're very, very gentle. Is that the difference between the jumping worm and maybe the better worm that I shouldn't be so worried about? Well, the thing about worms, when you're looking at them, you have to understand that most of the earthworms. worms that you're seeing, particularly if you're along the East Coast or you're in the upper Midwest,

most of them are generally going to be non-native worms. And we have a variety pack of European earthworms. And a couple of them will actually move very actively and people will mistake them for jumping worms. So when you're looking at a worm and I've looked at lots of worms, European earthworms, they tend to be, no, I wouldn't say spongy, but they're not as firm. Jumping worms, they're much more firm, active. Really, their skin is really tight. It's almost, they're turgid, they're firm. They're like a slightly over-stuffed bratwurst because they're so tight. It's also when you're looking at them visually, the clotelum, which is the reproductive area on earthworms, tends to be smooth, whereas the clotelum on European earthworms and a great deal of North American earthworms is raised. It's a very different worm. by all means. How exactly have these jumping worms spread so far and so fast? They've been in North America well over 100 years.

It's with invasive species that often, you know, they sort of hang out, they're dormant, they're here, but nobody notices them, and then all of a sudden they get this leading edge. So the same can be said for a lot of invasives that, you know, people deal with now. So garlic mustard was pretty benign for a long time. and then all of a sudden it was everywhere. And these worms are tending to follow that same pathway. So they've been here, but now people are really starting to notice them.

If I have this right, you were the first person to discover jumping worms in your state of Wisconsin? Well, I think there are documentation of them prior to our stumbling across them. We were doing a field trip for a conference on invasive species and Brad Heracus, the ecologist, at UW Arboretum. We worked on this field trip together and lo and behold are, you know, they had to sit through the day with boring people talking about plants and worms all day and then we took them out at the end of the day and lo and behold, we stumbled across all of the jumping worms out there. I like worms, so I was sort of excited and then we got other people excited. Were you worried about this when you found these worms?

Well, because I've been working with invasives for so long, I was sort of. sort of, I was awestruck. So you do a little of the ooh and awe like, ooh, a new invasive. But, you know, I mean, when you're, when you're looking at an invasive like that and it's a new discovery, it's the yin and the yang. It's something new that, oh, now we're going to have a problem with this. But then it's also, well, there's so many of them, how long they've been here actually. So should we really sound the alarms? And I do realize that people are very concerned about these worms, but I do think that we are lacking a great deal of information on them yet to put them in that category of, you know, oh, no, the roof's on fire.

What should we be concerned about? I mean, what damage do these worms cause? These worms, they're, they move really quickly. They're asexual reproductions, so they don't mate, whereas European earthworms and a lot of North American earthworms, they're hermaphrodites, but they mate. Jumping worms, you know, they're primed and ready to go and, you know, they're here for the season and they're gone. Unlike European earthworms, they could live for two years or they can live up to 10 years, whereas jumping worms are only here for a season. They're hatching continuously. They can out-compete a lot of the European earthworms.

Okay, so they're out-competing some of the other worms, the native worms and the European earthworms that we know here in the U.S. but the way that they churn through the soil actually causes problems with erosion, right? Well, but all worms can cause problems with erosion. I always like to remind people, keep in mind that the good worms are not native as well, and they can cause a lot of erosion as well. What jumping worms do to the soil is they turn it over really, really quickly so it becomes porous. So it almost becomes like coffee grounds, tapioca pudding, pearls. so it's really hard for plants, trees, shrubs to sort of anchor in there.

But, you know, they're also like speeding up that nutrient cycle within the soil as well. So you're that that soil texture changes dramatically with the presence of jumping worms. But it generally hangs out in first two inches. The first two inches of the soil, is that especially bad for forested areas? Forest is this dynamic place to begin with. And everything is happening low ground. and above ground. But within a forest, you have European earthworms, which can cause a lot of damage all on their own. And then if you, you know, you surmise that jumping worms are going to move

in there as well, you're going to see that cycle become faster. And it could potentially damage a lot of things, but you also have to take into account that this is the secondary invasion of an earthworm into a native forest. So when you get one invasive in, it sort of invites another one to come in and another one to come in. And they sort of just pile up on top of one another. I assume that they have predators. I mean, can we just count on the robins in my yard to pluck them out and eat them? Oh, and that's the really cool thing about these worms. Say, if you irritate them, you know, they'll thrash and they'll move about. Some may even, you know, throw their tail, so shed their tail. But they also have the ability to secrete a really distasteful liquid.

So almost like a secretion which says, oh, I don't taste good. Drop me. And so that's why you tend to see so many of them because a lot of animals are not predating upon them because they're distasteful. But if you look at how invasives evolve and move, they're going, you know, animals are going to adapt to it and they're going to start feeding on them as well. But that's a really amazing thing about these worms. And not to say that animals aren't eating them. I have lots of friends that have backyard chickens, and they swear that their chickens love them. So the rest of the birds just have to get on board with the chickens. Well, and this is a hard conversation to have with someone who loves worms at their core like you do. But I don't know, Bernie, what do we do if we find these jumping worms in our yard or in our

forest. The first thing is not to get so incredibly upset as people have because there's easy ways to get on top of them. You know, there are so many of them. You can remove them from the surface. So because they generally are right there on the surface of the soil. So they're easy to pluck out, put them in a Ziploc bag, you know, as you're out there weeding. You can put them in a bucket with some water and vinegar. You can bag them. If you have them in your compost or you suspect that you have them in your compost, well, you can tarp it because heat is really detrimental to them as well. So you just want to heat it up to hit at least 104 degrees. There's a lot of things that you can do.

I don't recommend pesticides. You know, you can certainly kill lots of worms with pesticides, but there's other options. But, you know, definitively, we don't have a cure-all for them. And I'm not quite sure we will. It sounds to me, though, Bernie, like what you're saying is that people are very concerned about this, but they maybe need not be so concerned. I mean, almost all of the worms that we're going to find in North America are probably already invasive, right? A good percentage of them, yes. I'm in Wisconsin. I'm originally from Pennsylvania. You're along the East Coast. The probability that you

have native North American earthworms in your area is 3%. There's so few North American earthworms in this particular area of North America. In Wisconsin, I've been doing worms for 20 years. I've never encountered a native North American earthworm. What I was talking off the top of our segment about the health of my garden, and I've always thought that the presence of earthworms is something that is good for my soil. Am I wrong about that, Bernie? Am I getting something substantially wrong about having worms in my soil?

No, no, not at all. No, I mean, earthworms are extremely beneficial animals. And when you look at the history of them, you know, they provide a lot of really good things. Nutrients, they turn over, they recycle everything. And, you know, they're providing really beneficial fungal relationships in that soil and the bacteria. It's really important. When people get upset about worms, you have to sort of point out to them, they, they, they, they, can be highly damaging to forests, but in urban areas, in agricultural settings, they're really amazing earth turners. You know, they are doing incredible things that you'll never quite see because they're underground. When they cause issues, it's really when you're looking at forests, natural areas, places that you want to preserve. You really have to look at it a big picture. That's the way I always approach invasives. It's not just one. It's the combination of a bunch of them, which really causes the issue. And earthworms, you know, they're just the cool kid on the block right now,

and everybody wants to talk about jumping worms. So it's great that they're getting their 15 minutes of fame. Well, I'm glad that you were able to be here to help us talk through some of the interesting things about these jumping worms, but also some of the problems as well. Bernie Williams is a plant pest and disease specialist at the Wisconsin Department of Natural Resources based in Madison, Wisconsin. Bernie, thanks so much. Oh, thank you.

After the break, from worms to cephalopods. Yes, massive brains, color-changing skin, and genes we've never seen in any other kind of animal. We'll dig into the many wonders of octopus, squid, and their kin. That's coming up next. Hey, Ira here with an update that Cephalopod Week is just around the corner, and it's going to be incredible. All squitting aside, I'd like to invite you to join the Cephaloparty by sponsoring some virtual Cephalopods. Here's what I mean.

Our talented team of digital producers has built a sea of support on our website, giving each of you the chance to sponsor a cephalopod for just $8. With each donation, you'll get to pick from one of eight beautifully illustrated sea creatures, which will post on our site, along with your first name and city. We're aiming to raise $8,000 here, folks, which will go to support all the great work we do at SciFri. So we do hope you'll conscriptor making a gift. Sorry for all the puns. We're cracking up over here. Just head to ScienceFriety.com slash see of support to join us and help us reach our $8,000 goal.

Again, that's ScienceFriday.com slash see of support. I'm Ira Flato, squitting you farewell. And thanks. This is Science Friday. I'm John Dankoski. Today is a very special day for us all at Science Friday. Why? Well, because Sepulapod Week starts today. Yes, if you love the big brains, complex behavior, scintillating colors, and ineffable strangeness of octopus, squids, and their cousins, then you're already a cephalopod convert. And you may already be attending one of our cephalopod movie night events next week. But even if you're on the fence about our tentacled friends, you can't deny that there's something kind of special about them.

In fact, new research into the genomes of several cephalopods is finding even more amazing things about them. For example, they carry genes that we've never seen in any other animal. They can actually edit how their genetic code is expressed. And some of the strangest genetic findings are connected to, you guessed it, their big donut-shaped brains. Here with me to Cephalobrate is Dr. Carey Albertine, a cephalopod researcher, and Hibbett's Early Career Fellow at the University of Chicago's Marine Biological Laboratory in Woods Hole, Massachusetts. Welcome, Carrie. Thank you so much, John.

It's a pleasure to be here. It's great to have you. And Dr. Yan Wong is an incoming assistant professor at the University of Washington in Seattle, and she studies cephalopod at death. Jan, welcome to the show. Thank you so much, John. Great to be here with you and Carrie. I just mentioned these big donut-shaped brains and tentacles,

but pretend that you, Carrie, were describing cephalopods to someone who'd never seen one or encountered them in all the media that's out there. I mean, what would you tell them about these animals? I mean, you know, the first thing, honestly, that they make me think of are the Yip Yep Yep Muppets from Sesame Street. They have this ring of flexible, sucker-lined arms that surround a beaked mouth. And then their esophagus passes from their beak on up through the middle of their brain that sits right in between these two massive camera-type eyes on up. to their muscular mantle that contains three hearts, two gills, and an ink sac. So they just look utterly bizarre. They look utterly bizarre to us. And I'm sure we'll get to some of that.

I'm sure to them, they're just perfect, right? But I don't know, Jan, how about you? I would say that they're very fancy water balloons. I think Carrie highlighted, you know, they have these massive eyes. And I think that's really something that we as humans gravitate to. and behind those eyes, there's that squishy mantle, as Carrie mentioned, with all of their inner organs. That to me kind of just looks like a water balloon. And then their arms are, well, the arms of an octopus are just constantly moving, sensing the world. And so, yeah, they're really, really special. So we're going to get into a little bit more about how special they are and why they're so special. Carrie, as I teased at the front, you've been doing

cephalopod genomic research for years, and new research is getting us a bit closer to understanding just how they do what they do. So I don't know, what's the story there? Yeah, Yan and I both actually worked on the first cephalopod genome for octopus by maculoides, or the California two-spot octopus, which came out a couple of years ago. Since then, we've been trying to dive in and really understand the genomes of not only octopus, but different kinds of squid to try and harness and understand some of the really unusual properties that we see in these animals. Because, of course, a genome is essentially the toolkit for building an animal and contains all of the instructions, all of the proteins that are important in their development and their biology. And so when we

sequenced the first octopus genome, we found out a lot of things about. these animals. We found out that they have really large genomes. So our genome contains about 3.2 billion letters. So if you think about all of the letters in, for example, war and peace, and then multiply it by like 2000, that's how many letters are in our genome. Squid genomes are half again as large. So they're 4.5 and 5.5 billion letters. And that's kind of a mind-blowing number. And so when we went in and tried to figure out what all of those letters code for, we saw a couple of really surprising things. The first thing that we saw is that they're really very rearranged relative to other animals. So we know that there are groups of genes that tend to be near each other and on the same chromosome in very distantly related animals.

So, for example, in a scallop and a nidarian, we see that in cephalopods, that order has been completely mixed up. So it's like they've been put into a blender and then just let the pieces fall where they do. And this is really exciting because where a gene is in the genome can affect how it's turned on and turned off. And this happened at a genome-wide scale. So essentially, cephalopods have all of this new gene orders to begin to play with and change how genes are turned on and turned off. We also see that they have lots of genes that are important for neuronal function.

And in particular, a family of genes that are thought to act as molecular barcodes that are important for helping neurons wire up correctly. And this is a family of genes that have only been studied in, in neural cells. mammals and other vertebrates. The octopus genome had 168 of these genes, and the squid genomes that we've just finished sequencing have nearly 300. But the first thing that we did to try and figure out what these kinds of genes were doing is to look at where these genes were expressed or turned on in these different squid and octopus. And we see that, for example, these genes that we think are important in making mammalian brains are also expressed in the brains of both squid and octopus. So this seems to be kind of a molecular smoking gun underlying these very different,

very large, very complex nervous systems. So Jan, as I said at the top, you look at octopus death, which is a fascinating thing to study. And this phenomenon where most octopus moms will actually die in the process of tending their eggs. Now, I had no idea they don't only just starve to death, but they actually kind of self-destruct. I mean, what can you tell us about this behavior, and what are you learning about this death process? Yeah, so this is a completely normal process in a mother octopus's life. So most octopuses are completely solitary. So they come together perhaps only once in their adult lives, which is to meet and reproduce. And after this point, the female will find a nice safe spot to lay her eggs. As she lays her eggs, that really marks

the beginning of the end for her. So from that point on, her primary behavior is to guard the eggs, protect them, blow water on them to keep them clean, and just watch over them essentially as they develop. Now, in the beginning of this maternal period, the female is still eating. And then, as you mentioned, she stops eating. And then as the eggs are approaching the time when they would hatch, the female undergoes a period that we call decline. And this is a process that is whole body death. And so she begins to lose color and muscle tone and oftentimes engages in self-cannibalistic behaviors. So, for example, she will eat the tips of her arms. Often she'll create lesions using her suckers on her

arms or on her mantle and behaves in really erratic ways until finally she dies. And so it is this whole process that is called, it was originally called the self-destruct system by Jerome Widenzki in 1977 because he found that when you remove a part of the nervous system called the optic glands, this entire sequence disappears. So if you remove the optic glands, this entire post-maternal sequence of behaviors stops. And the female is able to eat again, she can mate again, and she can live for four to six months longer. So, you know, unlike other death processes that we're kind of familiar with thinking about, it is a very, very active process. Why would it be evolutionarily smart for octopuses to have this feature, this self-destruct mechanism?

Well, there's a couple of different theories, and I think the most compelling reason is that the purpose of sexual reproduction is to create genetic diversity and for the next generation of baby octopuses to be able to grow up strong and healthy. And the one thing that you should know about octopuses is that they are very, very cannibalistic. As I mentioned, they are primarily solitary and, I can't guarantee that, you know, a mother would necessarily eat her own eggs, but a mother might eat another octopus's clutch of eggs. So if the previous generation, the mother did not die, it's very possible that the eggs really wouldn't stand a chance. And so this entire process,

if we looked at it on a larger scale, is a really foolproof way of ensuring that the next generation of young octopuses have a chance at survival. Do other cephalopods do the same kinds of things? Do they have the same sort of death processes? So that's a really exciting area of research. So other species of soft-bodied cephalopods, so that's cuttlefish and squid. In addition to octopuses, do you have an optic gland, but they don't seem to go through this exact sequence of behaviors as octopuses do. I know that when I look at an octopus or a squid, like one of my biggest questions is always, how did this happen? Like, as you were describing, um, it carry, you know, at the start, you know, how you would describe this creature to someone else.

It does seem remarkable that this thing lives, that this is on the earth with us. So, I don't know, do we know how they evolved to be the way they are? That's a fantastic question. And really, the driving question for me is trying to understand how this forms over both the course of evolution and development. We know that their close relatives are kind of equally bizarre. So snails and clams also put together their bodies in really very strange ways. And to me, the genome is the first tool we need to start exploring how they use all of their different genes to put together these incredibly bizarre bodies. And we're really at a place where we can start to try and understand this because a couple of years ago,

in collaboration with Karen Crawford and Josh Rosenthal, we've been able to create CRISPR-Cask guided genome manipulations. So we can start to study the role of these different genes in patterning these extraordinary animals. Again, are genes, though, the best way to understand why cephalopods are cephalopods? I mean, is there something about just watching their behavior that we can learn about them. I guess I'm wondering, what are the various ways you look at these creatures that you study and think about the ways in which we can take something away from them? We can learn something really fundamental about them. Yeah. Well, I think that genes, genomes, and genetic tools are really the exciting cutting edge of what's available in cephalopod research. So I think

that cephalopods have long captured human fascinations, not just from a scientific point of view, but from just a curiosity or a cultural point of view, you know, we see them accompanying human art and literature all throughout human civilization, right? I think behavior is one of the most immediate ways that we can connect with cephalopods, our large eyes, looking at their large eyes, right? That is really wonderful,

and I think a really strong foundation for behavioral neurobiology and neuroethology. But, you know, as modern science has kind of progressed, the technologies that are available in other model animals that help us ask new questions and find new answers to the questions that we ask, they've kind of eclipsed the study of cephalopods. And so I do think that genes, genomes, and genetic resources are really what is exciting about cephalopod research right now, because in addition to behavior, it allows us to study these amazing creatures in a totally new way.

I'm John Dankosky, and this is Science Friday from WNYC Studios. I'm talking to cephalopod researchers Kerry Albertine and Yan Wong about the mysteries of octopus, squid, and other tentacled creatures. This idea that these are such strange creatures is one of the reasons we're drawn to them. It's why we do cephalopod week. But do you think that they're strange based on what we know about other life forms we can study here on Earth? or now that you understand so much about their genes and about the way they're built, some people have said that they're like aliens. Are they like aliens or are they actually really geniusly put together?

They are fantastically, wonderfully bizarre animals. They very clearly are related to other mollusks and other animals just like us. So if we look in their genomes, animal genomes typically have on the order of 18 to 25,000 different genes, tens of thousands of these genes are shared between all these different animal groups with genomes that we've sequenced, including octopuses. And so this is sort of a little bit disappointing because you know, you want to discover the new thing that makes cephalopods just the way they are. But it's also a fantastic opportunity to be able to understand how these shared genes make such a weird animal, right? I've been digging into the developmental biology of these very highly conserved ancient genes.

And in so many ways we see over and over and over again that cephalopods are animals that are just using the same typical animal genes in their own particular way. Okay, lightning around last question, Jan, what's your favorite cephalopod? That's an unfair question, I feel. especially during sepulipod week. Wow. Dang. I think if I had to pick one exact favorite cephalopod, it would be the deep sea octopus mom who is found brooding her eggs, so taking care of her eggs for 53 months without feeding. She is my number one. That's a pretty good one. That's good. Carrie, how about you? Oh, I agree. This is just such an impossible question because there are so many

fantastic, fantastic adaptations that we see in these animals. I do have a very soft spot in my heart for metacepia fefferi, which is the flamboyant cuddlfish. They are, they can just put on these fantastic coloration displays. They are very appropriately named. And they also walk around on the floor with these projections out of the back of their mantle, and they look like little quadrupedal cephalopod. It's really impossible to not have them be completely endearing, but it's really hard to choose a favorite. Yeah, every sepulopod researcher we've ever talked to has the same reaction.

But thank you for trying for us. I appreciate it. That's all the time we have. Dr. Kerry Albertine is a Hibbitt's early career fellow at the University of Chicago's Marine Biological Lab in Woods Hole, Massachusetts. Dr. Yan Wong is assistant professor at the University of Washington in Seattle. Thank you both so much for taking off Cephalopod Week with us this time on Science Friday. Thank you so much, John.

Thank you. But we're not done with cephalopods. No, we're not. Follow us on Twitter, Facebook, and Instagram to fill your week with squid, cuddlefish, and nautilus joy. Share your questions for our cephalopod experts and vote for this year's smartest, sneakiest, and most sparkly cephalopods. or you can visit www.sfriety.com slash squid to subscribe to our Cephalopod of the day newsletter. You'll get a squishy new Ceph story from the Science Friday team every single day of Cephalopod week. Again, that's science friday.com slash squid.

We have to take a break now, but when we come back, we'll get a history lesson on plastic surgery. Stay with us. This is Science Friday. I'm John Dankowski. When I say plastic surgery, what do you think of? For many people, the phrase suggests a cosmetic procedure, something that's not deemed medically necessary and probably isn't covered by your insurance.

But the decision to get plastic surgery is very personal and reflects a desire to change something about your appearance, no matter of the reason. The history of plastic surgery actually goes back to a time when facial reconstruction was often a matter of life and death. The practice got to start on the gritty, battlefields of World War I, surgeons and nurses had to learn fast to fix the often horrific facial injuries sustained in battle. For the men with these injuries, the innovative, often traumatic

procedures were life-changing. The World War I history of plastic surgery is the subject of a fascinating book by my next guest. Lindsay Fitzherris is a medical historian and author of The Facemaker. She's joining us from Washington, D.C. Lindsay, welcome to Science Friday. Thanks so much for having me on the show. excited to tell you more about this story. And the heads up to our listeners that this conversation is about sometimes graphic surgery, and it might not be appropriate for all listeners. Your book starts by plopping us into the gritty trenches of World War I, and you say that there had never been so many facial injuries before this war. Why was that? Yeah, that's right. So during the First World War, there was an incredible number advances in artillery and weaponry.

So many, in fact, that a company of just 300 men in 1914 could deploy equivalent firepower as a 60,000 strong army during the Napoleonic Wars. You saw all kinds of brutal inventions at this time, like the flamethrower, tanks, chemical warfare. Men were maimed, they were burned. Some were even kicked in the face by horses. Before the war was over 280,000 men from France, Britain, and Germany alone would suffer some form of facial trauma. So this really opened up an opportunity for plastic surgery to enter a modern era. So this really was a war like no other war before it. Absolutely.

There was a bit of facial reconstruction going on during the Civil War, but there was a lot of differences between what was happening then and what ultimately happened in the First World War. First was that surgeons in the Civil War weren't very concerned about the aesthetics. They were really just concerned about restoring functions. So making sure that a person could swallow and eat and talk, but they didn't really care about what it looked like. The other difference was that there were only fewer than 40 plastic operations on record during the American Civil War. So when you compare that to the 280,000 men in France, Britain, and Germany during World War I needing facial reconstruction, you can really see the difference there.

And now early on in the book, you write, unlike amputees, men whose facial features were disfigured were not necessarily celebrated as heroes. Whereas a missing leg might elicit sympathy and respect, a damaged face often caused feelings of revulsion, and disgust. So facial injury was seen as, in some cases, a fate that was worse than death. Why was there such a stigma about facial injury? Yeah, absolutely. And I would argue that there's still that stigma today. I mean, you just have to turn on any Hollywood movie to see that the villain is often disfigured. You know, you have Darth Vader and Voldemort. I mean, the list goes on and on. So, you know, it's still well and alive today. But certainly in 1917, these men were facing incredible isolation because of their disfiguring wounds. And you even write, though, that prior to this, battle scars were actually

something that some men would take as a point of pride. You would want to keep a scar and show that you'd been in some sort of a fight or some sort of a battle that you had a past. Yeah, that's right. So in Germany, this was known as sort of a noble scar. And a lot of these men, they purposely would disfigure themselves with a scar because it was a class thing. You know, you were, you had gotten into a duel and you had survived the duel. And you had survived the duel. So in Germany, the attitudes towards disfigurement were slightly different than in other countries. But a lot of these facial biases go back hundreds and hundreds of years. You know, it's entrenched in society because of, for instance, diseases like syphilis that could be very disfiguring.

So when you have syphilis and it runs rampant, you can develop something called saddle nose where your nose caves into the face. And also certain kinds of crimes came with a punishment of purposeful disfigurement. So that's sort of ingrained in our. conscious as we enter into the First World War. So disfigurements associated with social diseases. It's associated with morality and ethics, criminality. And this is really why these men were facing such isolating lives in the face of their injuries. Isolated from the public because people would view people with facial injuries as disfigured, but also from loved ones too. Sometimes their families would not welcome them back. Yeah, absolutely. There is a man named Private Walter Ashworth, who I talk about

in the facemaker, and he was injured on the first day of the Battle of the Somme. And it was such a terrible injury. He actually fell forwards into a crater, and he laid there for three days, unable to scream for help because he had no jaw. And it seems crazy to us that someone could lay on a battlefield for three days and not be rescued. But you have to remember that when these stretcher bearers stepped onto the battlefield, they became targets themselves. So they were making life and death decisions very quickly. And because of the nature of a facial wound, anybody who's received a cut, we'll know it bleeds and it bleeds. It's very vascular. So because of the nature and the ghastliness of those wounds, a lot of times these men were just left on the battlefield. When Ashworth

was finally rescued, he was sent to Harrow Gilley's specialty unit at the Cambridge Military Hospital in Aldershot, and his fiancé learned of his wounds and actually broke off the engagement. It was a really sad story, and a lot of these men experienced that kind of story over and over again. In Ashworth's case, actually, though, it ends a bit happier because his fiancé's friend gets wind of this and she begins writing to him at the hospital. And soon they begin exchanging letters and soon they fall in love and soon they end up getting married. But not all of the men featured in the facemaker have that kind of happy ending. Maybe you can take us back to that time just so that we understand what medicine was like. I mean, what was surgery like back at the time of World War I?

Well, this is before antibiotics. So that's really important to remember. And that certainly was a challenge. Now, at this point, surgeons understood germ theory. They had adopted antiseptic techniques. So they could control infection a bit more than they could, say, in the Victorian period. The other challenge with these facial wounds was anesthetizing these men. Anesthesia hadn't really progressed since 1846 when ether had been discovered.

So you're talking about a rag over the face with chloroform or perhaps a mask with ether. In fact, there's a scene in the facemaker where Harold Gillies, is bent over a patient, and the patient is breathing ether right back into his face, and he's getting rather woozy, which is, by the way, not a good situation when you're reconstructing someone's face. So in parallel to advances in facial reconstruction and plastic surgery, you also see advances in anesthesia. And it was actually Harold Gilley's anesthetist at the time, a man named Ivan McGill, who comes up with intratial anesthesia. But the state of surgery, certainly, there were so many challenges. And also, you can imagine just getting the man off the battlefield and into the hands of

Harold Gillies, who was back in Britain, could also be challenging and certainly not guaranteed. So tell us more about Harold Gillies, who really is the hero of this book? Yeah, Harold Gillies was born in New Zealand. His family were originally from Britain. He was born in New Zealand. He went back to Britain. He studied at Cambridge University. He practiced as an E&T surgeon at the beginning before the war. So he was well placed, I would say. for the kinds of injuries he was ultimately seen in the First World War. In fact, when he went to France at the beginning of the war, he came across this character, and I call him a character because he really was a bigger-than-life character.

His name was August Charles Bladier. He was a French-American dentist. And he retrofitted his Rolls-Royce with a dental chair, and he literally drove it to the front under a hail of bullets. I mean, this guy was a legend. He worked for free the entire war. At the time, there were no dentist deployed with the army. which was unusual, actually, because in the 19th century, teeth were really important to the army.

They used to say that an army that can bite, can fight. And that was because you had to bite the cartridges off of the ammunition. So Vladia is working on facial wounds. And it's him who introduces Harold Gillies to this great need near the Western Front for this type of surgery and ultimately shows him the importance of good dentistry when rebuilding someone's face. So what sort of experience did he have as he started in this world of reconstructing faces? This is something that had been around in some way since the late 1700s, but it seemingly had not advanced very much. How ready was Dr. Gillies to take on this monumental task? I mean, you're absolutely right. So plastic surgery does predate the First World War, but it certainly wasn't being done on the scale that it was needed during the First World War. So he has no textbooks to guide him. He's really having to make this up as he goes. Some people will be familiar with the guinea pig club of the World War II. These were pilots who were terribly burned during the Second World War, and they were operated on by a surgeon named Archibald McIndoe.

That was actually Harold Gillies's cousin. And it was Gillies who introduced McIndoe to the strange new art of plastic surgery. A lot of people asked me as the facemaker about the guinea pig club, but actually this is sort of the prequel to that. And these guys were really the guinea pigs, because this is when a lot of these new methods were developed, tried, tested, and became indoctrinated in plastic surgery practice. The surgeries, I can imagine, were grueling for the men who were involved. Do we have any perspective from those who got these facial reconstructive surgeries and how they felt about

the whole thing? Yeah, I mean, this is the thing about World War I is everybody's writing letters. There's so much documentation. This book took me five years to research and write, and I could have spent another 15 years researching and writing it, to be honest. And part of my job as a medical historian and as a nonfiction writer is to get rid of material so that it's not overwhelming the reader. So I was really cherry picking the stories that had stood out to me. And some of that was because of the documentation around the men who I chose to include in the facemaker. So for instance, in the prologue, I opened the book with a man named Percy Claire. He gets hit in the face in 1917, which was incredible because of the detail he provided in his diary. He talks about

laying on the battlefield. He talks about the stretcher bearers passing. He talks about the stretcher bearers passing him by. He gets sent to the wrong hospital. There's a lot of different mishaps that happened throughout the book with Percy Claire. So I chose patients who did provide that kind of perspective. So we do have their letters and we have interviews with them later in life as well. But you have to also keep in mind, it's kind of like on Facebook, you know, how honest are we on social media about our lives? You know, there was definitely an aspect of these men putting a good foot forward to say that they didn't regret joining the army and that they, you know, were happy with their experiences to some extent. Some of them would make jokes as well. There was one man who joked to

his mother that she was going to have a fairly ugly duckling who was coming back to her. And you have to wonder, you know, how much of that was real, you know, or they were just putting on that kind of good face for the people around them. You say that impossible was not a word in Gilly's vocabulary, I can only imagine he was figuring out ways to do things that almost couldn't be done at the time. What were the methods he employed to actually reconstruct faces? Yeah, and when people pick up the face maker, you will see the photos of these men and you will be astounded at the kind of work that he could do over 100 years ago, again, before antibiotics. I included those photos not lightheartedly. I really thought about it. I went into consultation with a wonderful disability

the activist named Ariel Henley because they didn't want to objectify these men. But at the same time, I think it's important that people look at their faces. You know, these men were placed on brightly painted blue benches when they left the hospital so that the public knew not to look at them. And I didn't want to do that in 2022. So he came up with a lot of different techniques for reconstructing the face. So first of all, skin grafting did predate again, Gillies. And with a skin graft, it's completely removed from its blood supply. You might think of the skin grafts as the like the salami of plastic surgery. It tends to be quite thin cut. And then he also used something called flaps, which were like the stakes of plastic surgery. A flap remains attached to its blood supply,

and it tends to be a lot thicker tissue. So when you think about reconstructing somebody's nose, when the nose has completely been blowing off, you're going to have to use a flap because you're going to have to have a lot more tissue than just the skin per se. There are some old techniques that are still used that go back thousands of years where you take a flap from the forehead. So you cut the flap from the forehead and you move it down over the nose. And then you take the skin that's remaining on the forehead and stretch it over the wound. One of the problems with the flaps was that they would remain open on the underside. And this would leave them susceptible to infection. So Gillies actually invented a new method called the tubed pedicle. And so what he did was, again,

remember the flap is attached to the blood supply. He would take the flap and then he would roll it and so that the skin, the outer skin, would encase all of that tissue inside. So it looks like it's essentially a trunk of tissue. It remains attached to one side. He then attaches it to the new site. And once it molds to the new site, he can detach it from the old site. And so he could waltz these trunks of tissue all over the body. Like he could take a piece of tissue from your leg, for instance, and waltz it up to the abdomen. And then from that point on to the chest and from that point on to the face. It was incredible what he was ultimately able to achieve for these men. It's really remarkable. I want to tell our listeners, I'm John Dankosky, and this is Science Friday

from WNYC Studios. I'm talking with Lindsay Fitzharris, a medical historian and author of the book, The Facemaker. How much has facial reconstructive surgery changed over the last 100 years? It's an interesting question. You know, a lot of people ask me, well, plastic surgery has become something totally different since Gillies started operating in the First World War, which is true. However, you need to think of plastic surgery as one heading, and then underneath you have reconstructive surgery and cosmetic surgery, and they're both equally important to the practice of plastic surgery. There are surgeons who do both cosmetic and reconstructive work. There are surgeons that specialize in one or the other. After the First World War, Gillies moved into the cosmetic realm

because plastic surgery as a subspecialty of medicine didn't exist yet, and he had to survive. He had to expand his clientele, so to speak. So he started to do cosmetic procedures, and that excited him as well. He would say that reconstructive surgery was about returning something to normal, whereas cosmetic surgery was about surpassing the normal. And he really rose to those challenges. I also should say that Gillies continued to push the envelope in all directions. In 1949, he completed the first successful phalloplasty on a trans man named Michael Dillon. Gilles was really well placed to do the surgery at the time because he had been working on genital reconstruction of soldiers who had been injured during the Second World War. When Michael Dylan came to him,

Gillies agreed to do the surgery. And much later, Dylan is actually outed by the British press. It's a very sad story. And Dylan is driven from England because of the media circus. And Gillies really stands by him. And I said in the facemaker that there weren't many people in 1949 who might have seen Michael Dylan as a man, but Harold Gillies wasn't one of them. It was really important to him that people had control over their identities. Wow. It's such a remarkable story. And, you know, I guess it leads me to something I want to make sure we get to before we finish

our conversation is, as I said in the introduction, when people hear plastic surgery, cosmetic surgery today in 2022, they often think it's it's about narcissism. It's frivolous. It's not necessary. It's changing your appearance because of vanity. But the story that you tell in this book and the story that you just told really speak to how it can alter people's lives for the positive. There really is this through line of medical heroism here. Yeah, absolutely.

And Gillies would have agreed that, again, today, that people should be allowed to control their identities and that it wasn't about vanity. If something is small and is bothering the patient, he would say, who is he to judge whether, you know, that person should go through that process. But what Gilles was able to do for these soldiers certainly was give them back their identities. Like I said, he didn't just mend their broken faces, but also their broken spirits at this time. Because otherwise, these men would have led very isolated lives because of the facial biases in society of that day. Lindsay Fitzherris is a medical historian and author of The Facemaker. She's joining us from Washington, D.C. You can read an excerpt from her book on our website, ScienceFriiday.com.

slash facemaker. Lindsay, thanks so much for joining us. I really appreciate it. Thank you so much. If you missed any part of this program or you'd like to hear it again, subscribe to our podcasts, or you can ask the smart speaker to play Science Friday. I'm John Dankoski.