Something You Should Know - The Important Reason We Label Generations & The Strange Stories of Medical Breakthroughs

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Starting point is 00:00:27 Download June's Journey now on Android or iOS. Today on Something You Should Know, is spring fever a real thing and is there a cure? Then the fascinating differences in the generations from baby boomers, millennials, Gen Z, and the rest. Gen Z is the first generation where the desire to have children went down among teens. It was constant. Millennials said they wanted to have kids and then didn't.

Starting point is 00:00:53 Gen Z doesn't even say they want to have kids at 18. And Gen Z is very pessimistic. And people tend to have children when they're optimistic. Also, why a bar of soap may not be the best thing to use in the shower. And amazing medical breakthroughs that changed our lives. The work of real medical heroes. However, all of these medical heroes also were fallible and I think a lot of these stories show that they were petty, jealous, envious and certainly often obsessed with upstaging each other or getting credit.

Starting point is 00:01:25 All this today on Something You Should Know. This episode is brought to you by Melissa and Doug. Wooden puzzles and building toys for problem solving and arts and crafts for creative thinking. Melissa and Doug makes toys that help kids take on the world because the way they play today shapes who they become tomorrow. Melissa and Doug, the play is pretend. The skills are real. Look for Melissa and Doug wherever you shop for toys.

Starting point is 00:01:56 Something you should know. Fascinating intel. The world's top experts. And practical advice you can use in your life. Today, Something You Should Know with Mike Carruthers. Hi, welcome. Time for another episode of Something You Should Know. Most of us think, especially this time of year, most of us think of spring fever as really just a state of mind. But maybe there's more to it than that.

Starting point is 00:02:24 That's according to one professor at the University of North Carolina who says there are some very real symptoms to spring fever. They can include daydreaming, falling in love, and an overwhelming urge to be outside. That's because nice weather signals the brain to secrete endorphins, triggering a strong feeling of well-being. There's no known cure for spring fever, even if you wanted one. Some people are more at risk of getting it than others. But if you think you have spring fever, you might want to just get outside. Those spring fever symptoms are probably trying to tell you something.

Starting point is 00:03:03 Mostly that you need a change of scenery, you need some fresh air, and maybe some vitamin D. And that is something you should know. I guess it's been since the baby boomers that we have labeled generations. We now have millennials, Gen Zers, Gen Xers. We categorize people into these groups, but should we? I mean, can you really put people in a category based solely on when they were born? What does it even tell you? What should we know about these generational groups? How are they different from each other?

Starting point is 00:03:39 And why is it important to discuss this? Well, you're about to hear why from Gene Twenge. Gene is a professor of psychology at San Diego State University and author of more than a hundred scientific publications and several books based on her research on the generations. Her latest book is called Generations, The Real Differences Between Gen Z, Millennials, Gen X, Boomers, and Silence, and what they mean for America's future. Hi, Jean. Thanks for coming on Something You Should Know. Thank you very much.

Starting point is 00:04:11 So this idea of naming generations, baby boomers, millennials, all that, when did it start, why, and why did it start? Why this idea of categorizing people by when they were born? Generational labels are just really useful shorthand. Just like we talk about teenagers, or we talk about 20-somethings, with age groups, it's convenient to be able to talk about people born around the same time and the experiences that they've had and how being born around that time has shaped their lives. So help me understand, because I've always been a little skeptical of this idea of labeling

Starting point is 00:04:51 generations and assigning characteristics to them because, basically just because they were born. I mean, people are people, they're individuals. Some people are this way, some people are that way. So I guess I haven't seen a lot of value in it. And obviously you do, because you study this. So get me on your side, get me on the bus here. Sure. Well, I mean, pretty much everyone agrees that cultures change, that living right now is very different from what life was like 100 years ago, or 50 years ago, or even 20 years ago. That's going to mean that when you were born, has an influence on your behaviors, on your values, on your personality, on your life course.

Starting point is 00:05:40 Pretty much everyone agrees on that too. So we all agree that there are differences among people based on when they were born. So really I think the only place people are disagreeing is should we group people and what the cutoff should be. So should we group people? There is a natural human tendency to group people. We do it all the time. We group people based on lots of characteristics. We think about people from different regions of the country. We group people by age. We group people by gender.

Starting point is 00:06:15 Look at, okay, those are trees. Well, one of them is a lot shorter than the other, and one of them is a pine tree and the other one is a maple tree, but we call them all trees. This is just kind of how human brains work. So I think it is actually a natural thing as well as being extremely useful for research and trying to understand generational differences. Okay, so we have these generational groups and why are the cutoffs where they are? Seems kind of arbitrary And maybe we should run through what the generations are. Yes. The birth year cutoffs are somewhat arbitrary, but there's a little rhyme and reason to them. So the baby boomers born from 1946 to 1964, that's a demographic grouping.

Starting point is 00:07:02 That's based on the birth rate going up and then back down the cutoffs for gen x are a little bit more disputed but you know we know where the end of the baby boom was so then the beginning of gen x is 1965 and i define the end of gen x as being 1979 and then uh millennials beginning in 1980 definitely some play play in those cutoffs, kind of arbitrary where you put that. I think you can make a really good case, though, for that transition between millennials and Gen Z being around 1995, given some really, really sudden changes in mental health in particular and optimism versus pessimism among teens that occurs right around 2012 in the transition from millennials to Gen Z in that age group. Why? What happened then?

Starting point is 00:08:01 Well, the end of 2012 was the first time that the majority of Americans owned a smartphone. It was also around the time social media use moved from optional to virtually mandatory among teens. And that created mental health problems? Yes, because teens started spending a lot less time with their friends in person and a lot more time communicating online, which is not as good for mental health. Okay. And so when is the end of Gen Z and the beginning of the next one? So we're still trying to see where the end point for Gen Z will be. So I think it'll be 2012. And then the next generation, some people call alphas, I call them polars, are born 2013 and afterward. And I think that cutoff will stick because if you

Starting point is 00:08:55 were born in 2013, you probably will not remember a time before COVID-19. Okay. So we have these different generational groups, and somewhere along the line, somebody puts labels on them. The problem with millennials is they're this way, or Gen Zers are that way. Who says so, and where do they come up with that? There have been a lot of articles and a lot of books written about generations that have really been guesses, if not completely made up about the generational characteristics. So that bugs me as someone who really likes working with lots of data, like survey data, where, you know, let's go straight to the source. Let's ask people about how they spend their time and how they're feeling and what's important to them. We're in the age of big data now. We don't need to guess anymore. So that's what I did in this book. Generations is to take data from 24 data sets, 39 million people, and try to figure out what the generational differences actually are. And after compiling and sifting through all that data, I mean, what did you come away with?

Starting point is 00:10:13 A lot of different changes. You know, technology has really, really impacted how we live, our values, our life cycle. So I'll take life cycle as an example. We live longer now. Education takes longer to finish. And that's had a big impact on generational differences. So for example, it's very common for grandparents to say, God, my millennial grandchildren, they're all in their late 20s and they're not married and they don't have kids yet. And some of them haven't even figured out what they want to do for a living. I was married and had three kids by then. It's because the life cycle has slowed down at every point from infancy to old age. Kids are less independent. Teenagers take longer to do adult things like get

Starting point is 00:11:06 a driver's license or drink alcohol. Young adults take longer to settle down. And also a middle age and older age, you know, it's 50 is the new 40. 70 year olds look younger and enjoy better health than their parents and grandparents did at that age. So that's the slow life strategy. That's one of the big influences that has driven these big generation gaps. And what's interesting to me about this is, as you say, kids seem to be taking longer to grow up. They're failing to launch. They're not going to work. They're not getting their driver's licenses. They're still living at home. And every time you hear discussions about this, there's usually a moral judgment attached. And it's usually negative that this inability for kids to get up and get on with

Starting point is 00:11:58 their life is a bad thing. Is it a bad thing? I think the moral judgment piece and the immediate movement to is this bad or is this good misses the big picture. That this is a big cultural change that happens for a good reason, that we live longer. That said, there's trade-offs. There's trade-offs to growing up too fast or faster. There's trade-offs to growing up slower. So the advantage is parents, public health experts are thrilled that not as many teens are having sex or drinking alcohol. But where there are downsides is that they still have to enter a competitive workplace. Many will still go off to college. And they're doing those things without as much experience with independence and making

Starting point is 00:12:44 decisions on their own. So that's tough. That can be a struggle. So that's the downside. And I imagine this has gone on since there have been grownups and children, that grownups look at children and it's kind of the, you know, oh, these kids today kind of thing. And they say, yeah, but, and this time it's really different because now kids are missing

Starting point is 00:13:09 out on so much because they've got their face buried in screens on their phone, on their computer, on their video games, and they're missing out on the world. And at least that's what I hear. And I've often said myself. And, you know, again, it's trade-offs. There is absolutely some truth to that. You know, a lot of kids are missing out on those formative experiences of hanging out with your friends face-to-face, maybe even getting in a little trouble, having that driver's license, building up those experiences, those social skills.

Starting point is 00:13:52 On the other hand, they are physically safer. They are less likely to get in car accidents or fistfights. Medical care is better. Every time, every generation has upsides and downsides. We're talking about generations and the differences between them with Jean Twenge. She is a professor of psychology at San Diego State University and author of a book called Generations. Metrolinks and Crosslinks are reminding everyone to be careful as Eglinton Crosstown LRT train testing is in progress. Please be alert as trains can pass at any time on the tracks.

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Starting point is 00:15:46 We can absolutely manage it better. And there's some very straightforward solutions. Things like don't have your phone in your bedroom overnight so you can preserve sleep. Let's raise the age, the minimum age for social media to 16 and enforce it. We'd solve a lot of problems if we did those two things. And what problems do you think that would solve? A lot of the mental health issues that are out there, for one thing, especially for Gen Z teens, there's a lot of data showing that that link between social media use, excess of social media use in particular, and depression is by far the strongest for children and young teens. So we can put off social media use, get it out of middle schools.

Starting point is 00:16:30 Middle school's hard enough without social media. Put off that experience until they're older and better able to handle it. That might help a lot. Well, I couldn't agree more. I have a middle school age son and no parents of other middle school children. And it's a constant lament about social media, electronics, all of that, that it's a real, real problem. And I imagine I'm not alone. You're not. I have three kids myself. They're 16, 13, and 11. And the bane of my existence is the school laptop, which has YouTube on it and you can't put parental controls on it.

Starting point is 00:17:06 So that's my constant struggle. But my 16-year-old doesn't have social media even now. She only got her first smartphone a month ago, and she can't download apps on it, so she can't even download social media. My 13-year-old has a Gab phone where there's not even a capability of being able to download social media apps. You can text and call and that's it. So there's no workarounds. Wow. That's pretty strict. I actually don't think it is. I mean, they still have those phones. They still are texting their friends plenty. They're just not on social media. Well, back to our discussion about separating and labeling generations. One of the things you often hear is people will talk about a generation and then apply a characteristic to them. Millennials are this way. Gen Xers are that way. And therefore, we need to change the workplace because they're not used to this. Is that what this is all about? Is labeling them

Starting point is 00:18:07 to accommodate them in the workplace or in life or whatever? Is that what this is all about? That's certainly been one application of a lot of the research, but it can absolutely be taken too far of like assuming that all millennials are one way or all Gen Z people are one way, people differ in many ways, not just generational differences. But I think companies that assume that they can use the same strategies with young employees that they did 10 years ago or 15 years ago are going to find out quick that that's not true. Well, there seems to be this tension, maybe it's always been there, that the older generation, as they hire and bring into the world the younger generation, want that younger generation to be like them.

Starting point is 00:18:52 And then there's this resistance, as you were just pointing out, that their life experience doesn't get them there, that they can't just be little baby boomers, that their life experience is different. And to expect them to be that way is a recipe for trouble. It really is for me about understanding and empathy of trying to put yourself in someone else's shoes, which is tough to do, but extremely helpful, you know, when trying to understand somebody else's point of view. And I think that it's absolutely true for generations. You can't expect that 22-year-old employee to be just like you or even just like other people in your generation because they had a very different experience. So talk about some of the differences, the kind of broad stroke differences that you see, if you can, between these generations? There's three big drivers of generational change, technology, individualism, and the slow life strategy. And so that answers that question of how are baby boomers different? Well, they grew up faster. They grew up in a time that was less individualistic, although they embraced that later. And they had an analog childhood, adolescence, and mostly adulthood compared to, say, Gen Z, growing up more slowly, much more individualistic, born after all those things changed and have continued to change things, and then grew up in the age of the smartphone.

Starting point is 00:20:32 Well, it's interesting you hear traits assigned to Gen Xers or millennials as if they're stuck with that forever. But I would imagine that generations change, that how a generation is in their 20s is not how a generation is in their 60s. So can you predict how a generation will change or is it really the result of whatever happens? You know, it really does just depend on what happens, you know, because there are unpredictable things that happen. Gen X in the early 90s, depressed, high suicide rate, not doing very well economically. Gen X in middle age, doing well economically actually less a little less likely to be depressed and have a lower suicide rate than boomers in middle age so things

Starting point is 00:21:12 change and we shouldn't get stuck uh with a a view of a generation that's outdated you know the really big example is the perception of millennials as broke and doing very poorly economically, got stuck when they were young adults during the Great Recession. Millennials now have higher incomes than Gen Xers and boomers did at the same age. Is it pretty common for every generation as you look at as they go through life that they start off things start off difficult and get better or things start off better and get worse or i mean is is there a trend that happens as any generation matures yes and that things do change but yeah it's not it's not always consistent because for for gen x things started off bad and got better.

Starting point is 00:22:10 For millennials, they started off somewhat pretty well, a lot of optimism. Then the Great Recession hit. And economically, they got better. Mentally, in terms of mental health, they've actually gotten worse. So there's complex patterns. And so this research that you do about these generations, then what do you do with that research? What does that help to fuel? Well, I think, especially when you're looking at some of the research from really young populations, you know, we have there's a really good big survey of eighth graders. So we're talking about 13 year olds and 14 year olds. It gives you a little bit of a glimpse into the future. You can see what's coming. And what do you see that's coming?

Starting point is 00:22:48 The birth rate is probably never going to come back up. Gen Z is the first generation where the desire to have children went down among teens. It was constant since the 1970s until it went down for them. Millennials said they wanted to have kids and then didn't. Gen Z doesn't even say they want to have kids at 18. So that's one example. And Gen Z is very pessimistic. And people tend to have children when they're optimistic. So that's part of the issue. Gen Z is also less likely to say they want to get married or even have a steady partner. So I think we're going to see, you know, big shifts in family life, you know, over the next 10 to 15 years. Well, as I said before, I never thought much of this idea of grouping people by generation,

Starting point is 00:23:36 and then painting them with a broad brush of, you know, what they're like and what their traits are. But clearly, it's more than that. It's a lot more than that, and it's what you research, and it's actually quite interesting. I've been talking to Jean Twenge. She is a professor of psychology at San Diego State University and author of the book Generations, The Real Difference Between Gen Z, Millennials, Gen X, Boomers, and Silence, and What They Mean for America's Future.

Starting point is 00:24:03 And if you'd like to check that book out, there is a link to it at Amazon in the show notes. Appreciate it, Jean. Thanks for coming on. Thanks so much. It's been a really fun conversation. This winter, take a trip to Tampa on Porter Airlines. Enjoy the warm Tampa Bay temperatures and warm Porter hospitality on your way there. All porter fares include beer, wine, and snacks, and free fast-streaming Wi-Fi on planes with no middle seats. And your Tampa Bay vacation includes good times, relaxation, and great Gulf Coast weather. Visit flyporter.com and actually enjoy economy. This is an ad for BetterHelp.

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Starting point is 00:25:03 Connect with a credentialed therapist by phone, video, or online chat. Visit betterhelp.com to learn more. That's betterhelp.com. When you think of all the amazing things medicine can do to treat people and prevent disease, it's rather stunning how far we've come in the last hundred plus years. I mean, it used to be that childbirth was a lot riskier for both mother and

Starting point is 00:25:31 baby. Now, not so much. Lifespan has gone way up since the beginning of the 20th century, due in large part to medical advancements. But how those advances and breakthroughs happen is quite interesting, sometimes messy, even unethical. And the stories make for a fascinating discussion, which we are about to have with Andrew Lamb. Andrew is a medical doctor, assistant professor at the University of Massachusetts Medical School. He's a retinal surgeon, and he's author of the book, The Masters of Medicine, Our Greatest Triumphs in the Race to Cure Humanity's Deadliest Diseases. Hey, Andrew, welcome to Something You Should Know.

Starting point is 00:26:14 Hi, Mike. Thanks for the opportunity. So when I think about medical advances, new treatments, breakthroughs in medicine that help people live better and live longer, I think of it, I guess I think of it as this kind of very planned out, well thought out, we've got our top people on this process, but it's not like that at all, is it? Well, certainly I don't think anybody was able to have a master plan to, for example, take the average life expectancy at the turn of the 20th century from 47 years to 100 years later, where we're now almost double that, you know. So medical history and progress really moves in fits and starts. It's not linear. You know, what I've found is that people will make discoveries or have epiphanies or make serendipitous

Starting point is 00:27:07 mistakes even that literally opened up an entirely new avenue of research. So you'll have discoveries like the discovery of antibiotics, which was a wonderful story of serendipity, but also grit and perseverance that lasted a long time. And that, of course, dramatically changed the landscape for life expectancy. So from your perspective as a doctor and someone who's researched this, if you had to pick a couple of like really big landmark discoveries in medicine, where would we start? What would they be? Yeah, I mean, I think if you look back at the 19th century, a couple of major

Starting point is 00:27:45 innovations were the advent of antisepsis, which we credit Joseph Lister for figuring out that, hey, infections come from these invisible organisms that we can't see. And if we're going to do surgery to people, we've got to make sure that things are clean. And so there was a time not that long ago where cleanliness wasn't all that important, at least in terms of invisible things. You probably would clean blood off your knife, but antiseptic-y, that was a fairly new concept in the 19th century. It might surprise you that they didn't even bother to clean their scalpels sometimes. They certainly didn't clean their surgical aprons. If you were going to wash your hands, it made a lot more sense to do that after the surgery, not before, right? You know, Pasteur, Robert Koch were innovators who

Starting point is 00:28:33 discovered microbes in the 19th century. And before that, people had theories about how diseases occurred. Some people thought it was from the asthma or just bad air. And people really did not know there were microbes that spread disease through bacteria. Florence Nightingale was one who was a strong advocate of the anti-contagionist theory. She thought that things just needed to be super clean. Let's make sure all the hospitals are very clean, all the linens are clean. And in a way, that did help, but it did not get to the root of the problem. When things like this are discovered, is it typically kind of accidental or is it very deliberate or, you know, I have a theory and now I'm going to try to prove it or what? Yeah, I mean, it's all of the above. So there

Starting point is 00:29:21 are examples of certainly doctors who are simply hard workers and persevered, like a doctor named John Gibbon, who invented the heart-lung machine, which allowed us to take blood out of the body so the heart could be stilled and operated on. But certainly some of the best and most entertaining stories are the ones where there was serendipity. For example, Alexander Fleming was a British microbiologist. He is credited with helping to discover penicillin, the first major antibiotic. And he did this totally serendipitously at the beginning because he happened to be growing a bacteria on a petri dish. And a mold had happened to just fall on that petri dish. And around the mold, the bacteria were killed. And on the other side of the petri dish the bacteria were alive

Starting point is 00:30:05 so he later deduced something about that mold was killing bacteria and later this developed into penicillin which is a product of a mold and so what's another one of your favorite stories in this so one of my favorite stories is arguably one of the greatest medical advances in the 20th century. And I'm talking about cardiac catheterization and angioplasty, which has saved millions of lives since then. But at the start, of course, it was this idea of putting a tube into your heart through a vessel in the arm was a completely outlandish and crazy idea. So there was an intern in Germany named Werner Forsman in 1929, who got this idea of putting a catheter in the arm to reach the heart from an article he had read that

Starting point is 00:30:53 someone had done it in a horse. So he was a young guy and he asked his attending at the hospital, his supervising doctor, could I try this? And he was soundly rebuked, you know, it was seemed obvious that anyone who put a foreign object into the heart would almost all definitely cause arrhythmia and death so Forsman said that that's okay I get it that sounds very unethical I have a solution I'll do it to myself and his boss said that's crazy that's suicide you can't do that so Forsman realized he was not going to get official permission to do this but he secretly hatched a plot so the problem he had was to do this, he needed to get some supplies like a renal catheter and

Starting point is 00:31:30 surgical supplies that were locked in the cabinet. The person who had the keys to the cabinet was a nurse. So he decided to kind of beguile this nurse who was eventually somewhat infatuated with him. But by tricking her, he ended up getting the catheter. And you can picture him, you know, he anesthetizes his arm, inserts the catheter, and then he walks down to the basement of his hospital where there's an x-ray suite. And there, a friend sees what he's doing. And he tries to stop him by grabbing the catheter to pull it out because he thinks his friend is literally going to kill himself by trying this. And Forsman has to kind of push him away and kick him in the shins to keep him away and he shoots an x-ray and the catheter is gone from the elbow to the head of the humerus at the shoulder.

Starting point is 00:32:11 So he advances it like a foot and a half more and the next x-ray shows it's in the right atrium of the heart and he's not dead, which is like a miracle to these people. And so this led to advances that benefit us today like angiography of coronary arteries and balloon angioplasty and stents so what this is is that when you or a loved one is having a heart attack the reason is because there's a there's a clot in a coronary artery that's blocking the blood flow to your heart muscle and that's going to kill you unless you go to an emergency room quickly enough and an interventional cardiologist uses a catheter just like this to go into one of the coronary arteries and open up that narrowing or opening up that clotted area so that blood flow will be restored.

Starting point is 00:32:55 That's pretty cool. This guy later became a Nazi, and he served on the Eastern Front during World War II. And, you know, at the end of the war, it was clear they were not going to be winning. So he really wanted to surrender to the Americans and not the Russians. So he actually left his post and swam across a river under fire from his own guys, and he surrendered. And after the war, he worked as a lumberjack because ex-Nazis were not allowed to have positions of authority, like be a doctor. Now, many years later, he was able to kind of be this community doctor in this small town. And in 1956, he found out

Starting point is 00:33:33 that he was going to be awarded the Nobel Prize for what he had done as an intern way back then. And he said, I felt like a village priest who'd been told he'd been made a cardinal. And this story is just one of those examples where these medical heroes that we have, they weren't perfect. None of us are all good or all bad. So all of these medical heroes also were fallible. And I think a lot of these stories show that they were petty, jealous, envious, and certainly often obsessed with upstaging each other or getting credit. So certainly for most of human history, the whole concept of childbirth has been pretty risky.

Starting point is 00:34:12 Mothers died, children died in numbers that we can't even imagine, I think, today. And so why were they dying? And then who fixed it? Yeah, that's a great question. You know, childbirth was definitely the prime cause of maternal and fetal death for millennia. The reason they were dying was usually infection. There was a condition called purpural fever or childbed fever in which infection was introduced through the birth canal. And the person who discovered why, he actually discovered that doctors were primarily causing this

Starting point is 00:34:54 because they weren't washing their hands when they were doing vaginal exams. The doctor was named Ignaz Semmelweis, who in the 1840s worked in Vienna. And there was a situation where at their hospital, there were two maternity wards, one run by doctors and medical students, and another run by midwives. And the death rate in the midwife clinic was dramatically lower than the one in the doctor, than in the doctor's clinic. what some always finally realized was that

Starting point is 00:35:26 doctors were doing autopsies in the hospital and not washing their hands and going to the maternity ward and doing exams and this was basically directly introducing bacteria into mother's uteruses now of course the midwives weren't doing autopsies, and they were also doing far fewer pelvic exams because they weren't teaching students. So it's kind of a tragic story because Semmelweis realized this and started getting people to wash their hands, which dramatically lowered the death rate. But then when he tried to spread the news about this and get other doctors around Europe to change their practices, he was essentially ignored or people ridiculed him. They thought he was crazy because of course,

Starting point is 00:36:13 it wasn't possible that they were unhygienic. It wasn't possible that minute or microscopic organisms would be causing illnesses. I mean, Semmelweis became so upset about this, he would write open letters to doctors across Europe. And he would even say, like, accuse other doctors of being murderers or saying things like, I denounce you before God as a murderer, because they weren't washing their hands. And the sad thing is, he was basically drummed out of his job in Vienna. He was later

Starting point is 00:36:43 put in an insane asylum where he died, ironically, of an infection. And now today, obviously, people know that he was right. He was kind of a prophet before his time. And he's known as the savior of mothers. But his story is so tragic. So you talk about trauma, and that's one of those things that I mean it's not a specific singular disease but it's that ability to treat like yeah I guess like massive wounds and and injuries that that before were you were a goner and and that seems like a like how did that develop how did somebody say hey we need to be better at this well that's a's a really good question. I think the field of trauma care owes a lot to the history of military medicine, to be honest. There was a

Starting point is 00:37:30 surgeon in Napoleon's army named Dominique Jean Leray, who realized that soldiers who were wounded and left on the battlefield until the battle was over for often 24 or 48 hours had a much less chance of surviving than people who had been treated more quickly so he instituted something called flying ambulances in which there were kind of aid wagons with every front line unit and these aid wagons would go in to the battle and speed the wounded out and he instituted principles that we use today in our emergency room medicine for example he said people who are wounded the worst and closest to dying those are the ones we're going to treat first we're going to triage these patients so that we take whoever is it

Starting point is 00:38:19 doesn't matter how long you've been waiting it means we're going to treat who is the most gruesomely injured or most severely injured also we're gonna treat the enemy we're not just gonna treat our guys we're gonna treat the enemy as well so the he deserves credit for the institution of these ethics that we all use today was there anything else in in the treatment of trauma besides triaging which is really more of a timing thing, but anything more medical than that, that was a big advancement in treating trauma? So I think the realization that antisepsis was important in treating trauma was a major

Starting point is 00:38:56 breakthrough. And this was credit, this advance is credited to Joseph Lister. You know, he had read Louis Pasteur's papers that microbes cause disease. And the most famous case that was a breakthrough in retrospect occurred in the 1800s when he found an antiseptic solution called carbolic acid that he would use to cleanse a wound before amputating or doing anything. So there was a young boy who was, he was run over by a, by a metal rimmed wheel of a wagon. And he had a compound fracture of his leg, which means the bone was sticking out of the skin. And in almost all cases at this time, you would want to amputate because it was a very difficult to treat this without becoming infected and you didn't want to risk the life of the

Starting point is 00:39:51 patient through sepsis and getting a severe infection so you just amputate but he believes so strongly that he might be able to save the leg if he just prevented infection that he did something that most people would probably have considered not correct medicine medical practice he did something that most people would probably have considered not correct medicine medical practice he did not amputate he kept it clean with carbolic acid for multiple days and he set the bones and it healed and then he started doing it with all of his patients and he realized that his results were so much better than before. The number of infections were so much better than before he had started disinfecting patients. I would imagine that in a lot of the cases where

Starting point is 00:40:34 you're trying to figure something out like that, a lot of people along the way in the journey to discover, die, or get seriously hurt. They're basically paying the price of trying to figure this out. Yeah. Yeah, I definitely think in the same way that history is written by the winners, and we kind of only remember or are taught the events that made the difference or changed history. I am confident when I say hundreds of thousands, if not millions of patients died from bad medical practices or things that were tried that didn't work. But that's sadly not what we remember, I guess. Well, and I guess to some extent that will always be the case, right? I mean, we're always trying to learn new things. And if we knew then what we know now, a lot of people wouldn't have died, but you'll be able to say that in 100 years from now. to think of this one example. Edward Jenner is credited with developing vaccination. He did something completely unethical in the late 1700s. He had heard that milkmaids who kind of got this

Starting point is 00:41:55 innocuous infection with cowpox from milking cows often never would get smallpox, which is of course a deadly disease. So he tested a theory that if he could give a child cowpox, that they might not be susceptible to smallpox. He took a milkmaid and scraped some pustule cells from her wound and injected them into a young boy, who I'm sure could not really give informed consent and didn't really know what was happening to him the boy of course got a little sick but recovered after the cowpox infection then jenner injects him with lethal smallpox basically he's risking this kid's life just to validate a hunch and lucky for for him, it worked. But the point is, what if it hadn't?

Starting point is 00:42:47 He would have been a murderer. But it's just one of those examples where history sometimes hinges on lucky breaks, or in this case, he was right. But you're right many times when people are wrong. I think most people have heard the statistic that heart disease is the number one killer of people in the United States. And yet, you know, it does seem that there have been some big advances in cardiac care. So why is it still the number one killer? And where are we going with this? Well, there's no question it's still the number one killer, despite the major advances we've made. You know, the greatest advances have been things like statin drugs to lower cholesterol, of course, angioplasty to be able to open up coronary arteries. And cardiac surgery has come so far. You know, the idea of operating on a beating heart inside the chest was impossible 100 years ago. But now people are having heart transplants. So there's no question we've made great strides.

Starting point is 00:43:52 But heart disease is still the number one killer because of things like the way we live. Our lifestyle, our diet, it's very problematic. Also, we're living longer than we used to. So, you know, people who died in their 50s before from other problems, now we're living long enough to get problems like heart disease and cancer and things like that. Talk about the doctor, and some people may know this story, who started the Jimmy Fund and was a pioneer in leukemia. Pretty interesting and somewhat famous, but pretty interesting story. There was a doctor in Boston named Sidney Farber who in the late 1940s

Starting point is 00:44:30 was trying to treat a tragic disease, childhood leukemia. You know, these kids with leukemia would have overwhelming production of white blood cells in their bone marrow, which would overtake the normal production of cells like white blood cells in their bone marrow which would overtake the normal production of cells like red blood cells and platelets and these kids would die very quickly after diagnosis and he thought that he might be able to give them a medicine called folate like basically folic acid because he had read about a nutritional anemia that was improved by that so he had these leukemic kids like they're only two three four years old and he gave them

Starting point is 00:45:12 folate and this was a huge mistake because unfortunately this put the cell production into overdrive and actually hastened the deaths of many kids. So this was a horrible thing. He was ridiculed by his colleagues. But from this mistake, he realized he could consider trying an anti-folate medicine. Maybe if he inhibited folate and folic acid, which we now know is an important part of cell division, maybe he could actually do the opposite of what he had done, which is help patients, and he did.

Starting point is 00:45:47 He developed a medicine called aminopterin, which in the late 40s was the very first cancer chemotherapeutic drug to put leukemia into remission. And he started a fund, which is now known as the Jimmy Fund, which is one of the most successful medical charities in history. And today, childhood leukemia is treatable in over 90% of cases. Well, these are great stories, and I think they give people a sense of really how random

Starting point is 00:46:15 and how hit and miss some of the most important medical breakthroughs have happened. I've been talking with Andrew Lamb. He is a medical doctor, a retinal surgeon, and he is author of the book, The Masters of Medicine, Our Greatest Triumphs in the Race to Cure Humanity's Deadliest Diseases. And there's a link to that book in the show notes. Thanks, Andrew. Thanks for being here. Thanks, Mike. Really appreciated this opportunity to talk to you. If you use a bar of soap in your shower or by the sink, you may want to think about switching. It seems that most commercial brands of bar soap are made of substances that tend to stick to surfaces like walls, doors, floors, and the inside of the drain of your shower. That residue builds up over time, especially in the drain where you can't see it. If you switch to a liquid soap or use a glycerin-based bar in the shower,

Starting point is 00:47:14 you'll eliminate the problem and also some of the scrubbing in between showers. And that is something you should know. Remember to follow this podcast, become a subscriber, a follower, so that when new episodes come out, they get sent straight to you. You don't have to come look for them. And please tell your friends to give a listen. I'm Micah Ruthers. Thanks for listening today to Something You Should Know.

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Something You Should Know - The Important Reason We Label Generations & The Strange Stories of Medical Breakthroughs

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