Speaker 1: Pushkin. I love that you're wearing a T shirt that
Speaker 1: says Canada, just so that we have no ambiguity whatsoever.
Speaker 1: Where Where are you right now? Are you in Las Vegas?
Speaker 1: I'm in Vegas right now? Yeah, I just got back
Speaker 1: here two days ago. Nice, very nice. Did I tell
Speaker 1: you you know that? I was in Las Vegas and
Speaker 1: I had an afternoon and I sat in this coffee
Speaker 1: shop and there were three people next to me having
Speaker 1: the most interesting conversation and one of the guys started
Speaker 1: talking and I realized he was talking about you. Really. Yeah,
Speaker 1: he was a lawyer of some kind who like was
Speaker 1: a writer, lawyer or something. I don't know what. I
Speaker 1: couldn't figure it out. And I was eavesdropping on a
Speaker 1: conversation for like forever, and it was like the most
Speaker 1: interesting conversation. I love that story. No, you did not
Speaker 1: tell me, and I have no idea who you're talking about.
Speaker 1: Allow me to introduce a new voice to this podcast,
Speaker 1: Maria Kanakova. In basketball, they call people like Maria Swiss
Speaker 1: army knives, people who do everything. Maria got a PhD
Speaker 1: with the famous Walter Michelle, the guy who invented the
Speaker 1: marshmallow test. She's written a bunch of brilliant New York
Speaker 1: Times bestsellers. She decided at one point that she was
Speaker 1: interested in poker, taught herself poker, became a poker champion,
Speaker 1: made some enormous sum of money. She's the kind of
Speaker 1: person that random strangers talk about in coffee shops, which
Speaker 1: is to say, my kind of person. I'm Malcolm Gladwell.
Speaker 1: You're listening to Revisionist History, my podcast about things overlooked
Speaker 1: and missunders to it, and I had the pleasure in
Speaker 1: this episode to bring you the fabulous Maria Kanakova, who
Speaker 1: has agreed to become the first ever Revisionist History amostman
Speaker 1: or amast person. She is joining the show to be
Speaker 1: the advocate for you, dear listener, to call me on
Speaker 1: my nonsense, to be a voice of reason, to participate
Speaker 1: in the kind of whimsical, meandering flights of intellectual fancy
Speaker 1: that is our trademark here at Pushkin Headquarters. So Maria,
Speaker 1: welcome to Vision's History. I could think of no one
Speaker 1: better equipped to speak truth to the power that is
Speaker 1: Revision's History. Thanks so much for having me on the show, Malcolm.
Speaker 1: I'm very excited about this, you know, maybe you'll change
Speaker 1: my mind, maybe I'll change yours, But I think that
Speaker 1: the conversation is going to be very entertaining no matter what.
Speaker 1: Wonderful let's let's have at it. I am putty in
Speaker 1: your hands. Is that correct? Nice putty that's responsive and
Speaker 1: that and that talks back. Okay, you're driving this train,
Speaker 1: all right? Perfect. So one of the fascinating episodes of
Speaker 1: this season of Revisionist History was about the lack of
Speaker 1: iodine in people's diets and how this was discovered and
Speaker 1: how it was actually then addressed, and I had I
Speaker 1: actually did not know the story at all. It's such
Speaker 1: a fascinating question. You know, how do we think about
Speaker 1: these things in the present day. Would we be able
Speaker 1: to do something like this today, you know, especially like
Speaker 1: after COVID, after all of these things like add iodine
Speaker 1: for their salt or their water and see what happens.
Speaker 1: What do you think the response to something like that
Speaker 1: would be. Well, you know, it's interesting that there is
Speaker 1: a line, there's a common line of either complaint or
Speaker 1: congratulation among sciences where they say that experiment could never
Speaker 1: be done today, the Stanford's prison experiment could never be
Speaker 1: done today, than the Tuskegee siftless experiment could never be done.
Speaker 1: You know, there's a whole long list of things. They
Speaker 1: look at that and they say, and that's because we
Speaker 1: are much more mindful of people's autonomy, much better about
Speaker 1: obtaining consent. You totally today could not go to Akron
Speaker 1: and dose up a bunch of schoolgirls with a ton
Speaker 1: of eydine. However, what I my reaction to that argument
Speaker 1: is always the saying, which is, yeah, but we simultaneously
Speaker 1: conduct consentless experiments on human beings in the present day
Speaker 1: that are probably way more consequential, and we don't think
Speaker 1: twice about it. You know, think about the way we
Speaker 1: have disrupted the lives of I don't know children over
Speaker 1: the last twenty five years, with all of these new technologies.
Speaker 1: How is that not a massive experiment done without the
Speaker 1: consent of those who were experimented on. How is the
Speaker 1: Facebook algorithm, which you know shows you only the things
Speaker 1: that are likely to evoke a deeply emotional response in you? Um,
Speaker 1: has it not an experiment? I mean, there's a part
Speaker 1: of me that just wants to throw up my hands
Speaker 1: and say, you know, effort, well, there's not even let's
Speaker 1: not even let's not even bother making these distinctions. Once
Speaker 1: we've conceded that all these experiments can go on, let's
Speaker 1: just declare them experiments and let people pick and choose
Speaker 1: the one they want to be a part of. I
Speaker 1: think there's something to that, especially because you know, at
Speaker 1: least with the iodine, right, it was there was scientific
Speaker 1: evidence for the test, right, There was a reason why
Speaker 1: they did it. There was a huge body of evidence
Speaker 1: behind this, and the study was run as a study,
Speaker 1: and so there were scientific controls in place. You know,
Speaker 1: they actually could gather data, whereas with a lot of
Speaker 1: these other things, you know, it becomes a natural experiment,
Speaker 1: which is obviously MESSI has a lot of unintended consequences,
Speaker 1: and I mean there are a lot of different questions there.
Speaker 1: I'm actually curious about flipping it around where you have
Speaker 1: something like fluoride, right, which is another additive that's put
Speaker 1: in our water. And last year, I don't know if
Speaker 1: you were following this, but in a town in Vermont,
Speaker 1: it turned out that a town official for over a
Speaker 1: decade had been lowering fluoride levels below the accepted minimums
Speaker 1: because he thought that it was a government conspiracy. You know,
Speaker 1: fluoride in your water bad And he resigned and it
Speaker 1: was a big outrage, and everyone was outraged that their
Speaker 1: water wasn't being properly fluoridated, that they actually weren't getting
Speaker 1: the numbers that they needed for dental health, cavities, etc.
Speaker 1: I just did think that it was such an interesting
Speaker 1: counterpoint because normally it's, oh, don't add anything, right, I
Speaker 1: don't want anything at it that I don't know about.
Speaker 1: I want natural salt, I want natural water. I want
Speaker 1: I don't want you adding anything, you know, big pharma,
Speaker 1: big government, big big etc. And here the town was
Speaker 1: actually horrified, which which I think they should have been.
Speaker 1: You know, I'm biased, you know, I think there's good
Speaker 1: evidence that adding for it to water is a good thing,
Speaker 1: that adding I die to salt is a good thing,
Speaker 1: and that when things are good for our health and
Speaker 1: we're not going to get them in any other way,
Speaker 1: this is a great way of doing it. But a
Speaker 1: lot of people disagree. Well, I wonder, you know, if
Speaker 1: that are they responding to the Florida They're responding to
Speaker 1: what they see as the official abusing his position, right,
Speaker 1: you can you know, it's it's maybe it's a bit
Speaker 1: of both or you know, you could see people who
Speaker 1: might ordinarily be indifferent to floride just getting pissed off
Speaker 1: over this issue. This guy's like, you're not allowed to
Speaker 1: do that, sir. Hold on, hold on, it's time for
Speaker 1: a short break. When we come back, we'll talk more
Speaker 1: about how salt and revisionist history are changing lives, and
Speaker 1: also the infamous Minnesota starvation study. So let's read a
Speaker 1: letter about someone from someone who I actually I love
Speaker 1: this letter. I just saw it today and it is
Speaker 1: a very positive take on additions to food and someone
Speaker 1: who says that, you know, the Salt episode actually really
Speaker 1: changed their life. So this is from Mary P. And
Speaker 1: she writes that it was a crazy, awesome coincidence that
Speaker 1: I was listening to this episode around the same time
Speaker 1: my doctor felt a nodule on my thyroid. He told
Speaker 1: me to go get an ultrasound, and my thyroid and
Speaker 1: nodule both were large enough and suspicious enough that it
Speaker 1: was recommended automatically that I get a biopsy. So she
Speaker 1: went for her first biopsy and the results came back
Speaker 1: and conclusive, and I'm going to continue reading her letter.
Speaker 1: They sent another side for genetic testing. Meanwhile, I bought
Speaker 1: some iodised salt and started cooking with it. I had
Speaker 1: switched to kosher salt and other fancy salts over the
Speaker 1: past few years, and I'm an Avid at home cook.
Speaker 1: We also live in the Midwest. I used iodised salt
Speaker 1: in moderation, of course, and thought nothing more of it. Well,
Speaker 1: I went back for my biopsy and they took new
Speaker 1: ultrasound images of my thyroid. This was about two to
Speaker 1: three months after my original ultrasounds and biopsies. The ultrasound
Speaker 1: tech was asking me many questions and seemed confused, but
Speaker 1: kept to himself. The doctor came in and told me
Speaker 1: to sit up. My nodules and thyroids had all shrunk
Speaker 1: once sent to nodule was now around five millimeters. He
Speaker 1: had no reason to biopsy because there was nothing of concern.
Speaker 1: In fact, he would not biopsy it, no surgery, just
Speaker 1: a follow up scan in a year. Hallelujah. I told
Speaker 1: him my theory about the iodine and he said that
Speaker 1: very well could have been what shrunk everything. I asked
Speaker 1: if the cancer could be in there, just smaller. He
Speaker 1: scoffed at me and said no. What a great letter, right, Wow,
Speaker 1: for all of those who doubt the healing power of
Speaker 1: Revision's history. I present you this letter. Don't we don't
Speaker 1: just rile up our listeners. We save lives. This is
Speaker 1: a resounding endorsement of fate years of Revision's history, and
Speaker 1: those types of coincidences are great. Right, that you hear
Speaker 1: something and it actually has such an impact that would
Speaker 1: have been a life changing thing for her to have
Speaker 1: no thyroid function, half her thyroid function for the rest
Speaker 1: of her life. That's a huge thing. Yeah, you know,
Speaker 1: it's a reminder. This is one of these weird things,
Speaker 1: like one hundred years ago, what she's describing was commonplace.
Speaker 1: In fact, this is a little little fact in that
Speaker 1: episode that I can never get over my head is
Speaker 1: if you went to parts of the world that were
Speaker 1: eyed onto fish and some extraordinary high percentage of the
Speaker 1: population had these massive goiters on their neck, and like
Speaker 1: that was just part of the part of the experience
Speaker 1: of going to the Swiss Alps, or part of the
Speaker 1: experience of going to somewhere around the Great Lakes was
Speaker 1: you'd walk into a small town and you know, whatever
Speaker 1: quarter of the people had big, grape proof sized masses
Speaker 1: on their necks. It's just so strange. So it's it's
Speaker 1: crazy how how little we still know about nutrition. Right,
Speaker 1: Nutrition is complicated, and I think that's one of the
Speaker 1: reasons why people still have, you know, so many questions,
Speaker 1: so many issues, why we go back and forth with
Speaker 1: nutritional advice, because the body's a complex thing, right, It's
Speaker 1: a complex machine, and it's so it's it's very difficult
Speaker 1: oftentimes to know like this is the recommendation and it
Speaker 1: will always be the recommendation. And also, you know, it's hard.
Speaker 1: This is sort of what brings us to the Missus
Speaker 1: starvation experiment, which I'm sure we're going to talk about.
Speaker 1: But one of the big empathis is for that is
Speaker 1: that one of the reasons we know so little about
Speaker 1: nutrition is that it's impossible to test hypotheses about nutrition
Speaker 1: because how do you do it, right, Like, if you
Speaker 1: think about something as simple as does drinking alcohol harm
Speaker 1: or help your health? Right, that's a question that's being
Speaker 1: irrelevant for as long as human beings of drunk alcohol,
Speaker 1: So thousands and thousands and thousands of years we're still
Speaker 1: arguing about that. And the reason we're still arguing about
Speaker 1: it is it's virtually impossible to design a study which
Speaker 1: would satisfactorily answer that question. So there have been studies
Speaker 1: which say people who drink wine and moderation seem to
Speaker 1: live long, healthy lives. But you know the problem is
Speaker 1: that people who drink wine and moderation are people who
Speaker 1: otherwise live moderate, healthy lives. Right, They're like, you know,
Speaker 1: their villagers in the south of Italy who are getting
Speaker 1: enormous amount of exercise and living in bucolic surroundings. So
Speaker 1: you just don't know is it is. Are they Are
Speaker 1: they living long, happy lives in spite of their wine
Speaker 1: consumption or because of it? Right? Someone saying, you know,
Speaker 1: you see these so you can read. It's just incredible
Speaker 1: to me. I just reme by the other day, like
Speaker 1: there's a new line of thinking which says, you know,
Speaker 1: all alcohol is basically like really bad for you and
Speaker 1: should be avoided. I saw that. I have no idea
Speaker 1: what to make of that, Like, I didn't even know
Speaker 1: how do they reach that conclusion. It's just that that
Speaker 1: idea that we could be in twenty twenty three and
Speaker 1: still being capable of answering these questions with any degree
Speaker 1: of accuracy is fascinating to me. Yeah, it's totally crazy.
Speaker 1: It's so funny that you that you mentioned red wine,
Speaker 1: which is you know, or alcohol in general. The first
Speaker 1: one of the first studies I ever worked on as
Speaker 1: a journalist who who kind of is interested in these
Speaker 1: questions forever ago, was on resveratrol when it first came out,
Speaker 1: like the data that, oh my god, respiratral makes you
Speaker 1: live longer, and everyone was saying, great, red wine. It's
Speaker 1: amazing that a few years later we find out that
Speaker 1: the quantity of vers viatrol you need is just so
Speaker 1: much higher than you would ever get. And it goes
Speaker 1: back and forth, and I've seen that one question just
Speaker 1: go in circles for you know, almost twenty years now,
Speaker 1: and we just have no idea. Do you remember it?
Speaker 1: They were they giving rats large doses of Yes, Oh,
Speaker 1: that's the thing, exactly, That was exactly it. It was rodents,
Speaker 1: rodents and red wine. So the only the only thing
Speaker 1: we can say for certain is it within the rat population,
Speaker 1: those who enjoy a good bottle of wine every night
Speaker 1: are going to live a little longer. So I think
Speaker 1: that this is a good a good segue point. Um.
Speaker 1: You know, people who were not drinking any wine were
Speaker 1: taking part in the starvation study that was part of
Speaker 1: this season of revisionist history. So I mean, first of
Speaker 1: all that study, let's just kind of recap it very quickly.
Speaker 1: I mean we're talking actual starvation, like the number of
Speaker 1: calories that these men. So it was all men. It
Speaker 1: was all young, relatively healthy men who were, for one
Speaker 1: reason or another, not in the military, not serving abroad
Speaker 1: during World War two, and they were all brought to
Speaker 1: this place to try to control because as we've just
Speaker 1: talked about, it's really difficult to control food intake, to
Speaker 1: try to control it as much as possible, to try
Speaker 1: to do their part for the war effort to see
Speaker 1: how starvation affects the body. Is that a fair summaries, yes, exactly,
Speaker 1: because you are the impetus was. This was in the
Speaker 1: middle of the war, and the feeling was that by
Speaker 1: the end of the war one of the biggest problems
Speaker 1: the world was going to face was that millions of
Speaker 1: people around the world had suffered prolonged malnutrition throughout the conflict,
Speaker 1: and we didn't know how to help them. We honestly
Speaker 1: had no idea if someone has been malnourished for a
Speaker 1: year and a half, what is the best way to
Speaker 1: nurse them back to health, and literally we hit people.
Speaker 1: At the time didn't have the size his clue, right,
Speaker 1: So they were trying to answer that question with some
Speaker 1: you can at least get some information about that. So
Speaker 1: there was the stakes here were huge, I mean there
Speaker 1: were That's what gives the study it's kind of moral force.
Speaker 1: So that's an interesting question, right, does the study have
Speaker 1: the necessary moral force to do something like this, because
Speaker 1: when back in the day, right back when the study
Speaker 1: was done World War Two, we didn't have the sort
Speaker 1: of reviews on studies that we have today. So these
Speaker 1: days you need to go through an IRB, which is
Speaker 1: an institutional review board when you're doing any sort of
Speaker 1: human research, and you need to have every single subject
Speaker 1: give informed consent and and this is crucial. The benefits
Speaker 1: of this specific study have to outweigh and potential harm
Speaker 1: to the participants in the study. And so to me,
Speaker 1: you know, when I listened to kind of the details
Speaker 1: of the starvation experiment, I knew that it existed, but
Speaker 1: I actually didn't I'd never actually kind of gone deep
Speaker 1: into it. This was the most I'd learned about it
Speaker 1: was from you. And as I was listening, I was
Speaker 1: trying to think, you know, first of all benefits versus harm.
Speaker 1: You know, how do we think about that? And I
Speaker 1: think that's actually changed over the years. But the second
Speaker 1: part of it is how do you actually give informed
Speaker 1: consent of all the potential downsides to something like this
Speaker 1: when you're researching something where you don't actually know what
Speaker 1: the potential downsides are. Well, it's like spaceflight. You're sending
Speaker 1: an astronaut to the moon. Presumably you pull the astronaut
Speaker 1: aside beforehand and you say the benefit here is mankind
Speaker 1: will be able to say we went to the moon.
Speaker 1: But you know, in that situation, the first astronaut in space,
Speaker 1: we don't know what it's like to be out for
Speaker 1: a couple of weeks in zero gravity. So I don't
Speaker 1: know how do they do consent? I guess they said,
Speaker 1: you're taking a risk of unknown quantity, you might be
Speaker 1: damaged by what you're doing. Are you fine with that?
Speaker 1: And I think the answer they were fine with it
Speaker 1: is that many of those astronauts came out of the military,
Speaker 1: and so they were used to the idea that they
Speaker 1: were called to do something on behalf of their country,
Speaker 1: which carried with it a significant risk of illness and death.
Speaker 1: I think that's an interesting example, but it's not a
Speaker 1: complete analogy, because this was their profession, right, this was
Speaker 1: their career, this is what they had signed up for.
Speaker 1: They became astronauts with the knowledge that they would hopefully
Speaker 1: be able to go into space one day. Whereas these
Speaker 1: study participants were just ordinary men who were called upon
Speaker 1: by their patriotic feelings and said, you know, do you
Speaker 1: want to do your patriotic duty. That's a lot of pressure,
Speaker 1: and that's not your life. This is not something that's
Speaker 1: your career. You're being asked to do something that's just
Speaker 1: totally out of the ordinary. Wait are you are you
Speaker 1: a Minnesota's starvation experiment skeptic? Do you not think it
Speaker 1: should have been done? Now? I'm someone who wants to
Speaker 1: push back though, and to question how it was done
Speaker 1: and whether they could potentially have ever given and formed
Speaker 1: consent to something like this, especially given what we know
Speaker 1: now about the long, longitudinal, long term effects about starvation.
Speaker 1: Back then, the term epigenetic I don't think even existed.
Speaker 1: People did not know kind of what the interaction of
Speaker 1: genes and environment is. Today, we actually know that starvation
Speaker 1: has lifelong consequences. They actually change the methylation patterns of
Speaker 1: your of your genes, of your genome, and that there's
Speaker 1: actually a lot of damage that is going to be
Speaker 1: done for your entire life. And the funny thing is
Speaker 1: a lot of the data, the best data that we
Speaker 1: have on this didn't come from the starvation experiment, but
Speaker 1: actually happened from a natural experiment that came at the
Speaker 1: exact same time, more or less contemporaneous, which was basically
Speaker 1: the Dutch hunger winter. Was also during World War Two,
Speaker 1: there was a huge famine in the Netherlands because there
Speaker 1: was a blockade by the Nazis and thousands of people died.
Speaker 1: I think something like twenty thousand people ended up dying.
Speaker 1: But at the same time, there were a bunch of
Speaker 1: women who were pregnant and doctors were taking all of
Speaker 1: the measurements that you would normally take during pregnancy, but
Speaker 1: these women happened to be starving, and then they ended
Speaker 1: up following the women and the babies for their lives
Speaker 1: and actually got an amazing amount of data on what
Speaker 1: starvation does to the body. Oh well, we're still finding out.
Speaker 1: There are lots of things that end up happening later
Speaker 1: in life, you're more prone to gain weight because your
Speaker 1: body is prepared for starvation and has been prepared for
Speaker 1: from in utero. UM. It also ends up, you know,
Speaker 1: affecting you're the way that your kids are going to develop.
Speaker 1: So if you were I guess, a fetus during during
Speaker 1: this time, then by the time that you're you're an adult,
Speaker 1: when you have your own kids, you're actually going to
Speaker 1: pass a lot of these epigenetic changes further onto them. Um.
Speaker 1: They're also going to be effects on how you're going
Speaker 1: to just think and do in life. It turns out
Speaker 1: that there are labor market effects, hospitalization effects, so you know,
Speaker 1: it actually puts you down a notch. But this is
Speaker 1: once again we're talking about the people who were who
Speaker 1: were fetuses during this time, which is very different from
Speaker 1: the starvation study, but it ends up having a lot
Speaker 1: of downstream effects, and those studies are still being done.
Speaker 1: So there are you know, there's a new paper at
Speaker 1: least once every few years using this cohort which shows
Speaker 1: that you know, you didn't there are lots of things
Speaker 1: that you didn't know you were signing up for. If
Speaker 1: you thought that this was just going to be an
Speaker 1: easy you know, I starved myself completely and then I'm
Speaker 1: all better and this will never actually follow me throughout life.
Speaker 1: And it's interesting to me that I think some of
Speaker 1: our best data comes from a natural experiment, as opposed
Speaker 1: to something where a bunch of men said, okay, starve
Speaker 1: me and let's see what happens. So imagine that we
Speaker 1: were doing a version of the Dutch starvation thing involving
Speaker 1: pregnant women. But it was an experiment, right, all right,
Speaker 1: Magic watch definitely measure And what we learned from that
Speaker 1: is that actually starving people when they're pregnant has incredible
Speaker 1: as an unanticipated long term consequences, not just for the mother,
Speaker 1: but for the child, and even maybe for the child's children.
Speaker 1: Child shady absolutely so. In other words, and we had
Speaker 1: no idea of this before. So this is a kind
Speaker 1: of like, this is a this is a earth shattering,
Speaker 1: huge bit of understanding about human beings. Um, why wouldn't
Speaker 1: this be an argument? Why wouldn't the magnitude of what
Speaker 1: we learned from that such an experiment be an argument
Speaker 1: for doing the experiment? Not? Right, It's so important that
Speaker 1: hundreds thousands, millions more people could be helped from the
Speaker 1: knowledge gleaned from that experiment than those who were who
Speaker 1: were harmed by it. And if the people who signed
Speaker 1: up for that experiment had a at least a kind
Speaker 1: of reasonable suspicion that what was learned from the from
Speaker 1: them putting themselves at risk might help many, many, many,
Speaker 1: many many more people, then to my mind, that that
Speaker 1: settles it. It's fine. I mean, this is what I
Speaker 1: was trying to get to in the podcast, is that
Speaker 1: we're so indifferent to people who have altruistic motives. That
Speaker 1: doesn't where is the altruistic motive data point in the
Speaker 1: consent algorithm? Like you should be able to say, I
Speaker 1: know it's going to harm me, but I think it's
Speaker 1: going to help a lot more people, and I'm fine
Speaker 1: with that. Yeah. So, so, like I said, when you
Speaker 1: asked me, am I a skeptic of this? I said,
Speaker 1: I'm not necessarily someone who said this shouldn't have happened.
Speaker 1: I just think that, you know, there are lots of
Speaker 1: issues to consider. So yeah, there there is this. There's
Speaker 1: definitely an argument to be made that, you know, what
Speaker 1: we learned from Dutch famine shows that studies like this
Speaker 1: are incredibly important. But in this particular case, right. I
Speaker 1: think in the pregnancy case, you're also giving consent for
Speaker 1: your fetus. Right, So it's one of these things where
Speaker 1: that's even if you're an altruist, I think that that
Speaker 1: would be a very strange definition of altruism, because you're
Speaker 1: being altruistic for the world, but not for this one
Speaker 1: specific human who has no say in this whatsoever. But
Speaker 1: I would say this like so for much of human
Speaker 1: history consumed to the present day, a large percentage of
Speaker 1: the world's population suffers from prolonged malnutrition. Absolutely. One really
Speaker 1: important historical question is what can we do to convince
Speaker 1: the wealthier parts of the world that this is such
Speaker 1: an urgent problem that it needs to be addressed immediately, Right,
Speaker 1: wouldn't it make sense to try an extreme experiment of
Speaker 1: this sort to try and bring the world around? Yeah,
Speaker 1: I mean, I think that's a very valid point. And
Speaker 1: you actually had a letter from a listener, Robert A,
Speaker 1: who asked a question that kind of circles around what
Speaker 1: we've been talking about. He asks, who is responsible for
Speaker 1: a system which both restricts voluntary breakthrough research like that
Speaker 1: conducted by Ansel Keys and the Conscientious Objectors, and that
Speaker 1: which fails to take accountability when mistakes are made. So
Speaker 1: there's a that's I think an interesting question because you
Speaker 1: do have those two sides of it. So we do
Speaker 1: have a system that now does restrict that kind of
Speaker 1: breakthrough research quite often. I mean, when I was in
Speaker 1: grad school for psychology and I needed to do an
Speaker 1: experiment that had deception, I just I couldn't get it approved.
Speaker 1: I had to jump through so many hoops, and eventually,
Speaker 1: you know, with the support of all the senior faculty
Speaker 1: in the psychology department, it was just a silly thing.
Speaker 1: It wasn't even a major deception study, but we needed
Speaker 1: We couldn't tell them we were studying self control, right,
Speaker 1: because that would actually have defeated the purpose of the
Speaker 1: entire study. And how many studies are not done because
Speaker 1: of that. So that's kind of the one side of it.
Speaker 1: But on the other hand, there's a reason for all
Speaker 1: of these safeguards because you have things like the Stanford
Speaker 1: person experiment, right, you have things like Tuskegee. You have
Speaker 1: things that really cross the line without informed consent, with deception,
Speaker 1: with a lack of understanding of what was going to happen.
Speaker 1: I mean, one nutrition study that was done I don't
Speaker 1: know if you remember this one, but it was done
Speaker 1: in Washington on some young men who were working, you know,
Speaker 1: around DC at the time, and they were basically they
Speaker 1: agreed to be poisoned. They went to the Congressional cafeteria
Speaker 1: in their diet was very strictly controlled and they were
Speaker 1: just trying to figure out how different food additives work.
Speaker 1: And some of them got incredibly sick because it turns
Speaker 1: out that they were eating very toxic amounts of things
Speaker 1: they should not have been eating. Um. So that was
Speaker 1: that was a study gun a bit off the off
Speaker 1: the rails when it comes to nutrition. But so you
Speaker 1: have those two extremes and how do you how do
Speaker 1: you weigh that? How do you balance that? How do
Speaker 1: you not in retrospect where we can say, okay, you know,
Speaker 1: this is what we learned from this study and it
Speaker 1: was really good, but before it happens, how do we
Speaker 1: how do we think about that? How do we kind
Speaker 1: of how do we walk that line? Yeah, I will
Speaker 1: say that there is um, there is one area on
Speaker 1: this where I am I'm the you know, I've been
Speaker 1: talking so far about how I would I tend to
Speaker 1: be pretty lazy fair about giving researchers, the freedom to
Speaker 1: do things that are a little bit risky or um um.
Speaker 1: There's another area, though, where I'm on the exact opposite
Speaker 1: side of the fence, and what am I referring to, patience,
Speaker 1: grasshopper When we come back more from my conversation with
Speaker 1: Maria Konakova, we're back, and I was telling Maria that
Speaker 1: I'm pretty lais a fair about letting experiments go forward,
Speaker 1: except in the case of what might be the most
Speaker 1: awful natural experiment we're living through right now. I am
Speaker 1: incredulous at the idea that thousands of pages of text
Speaker 1: and hours of argumentation is spent on the ethics of
Speaker 1: one medical experiment or another. And at the same time
Speaker 1: we are, you know, completely indifferent or cavalier about the
Speaker 1: levels of violence that are present in media every day. Now,
Speaker 1: there had been moments every now and again, periodically, there
Speaker 1: are moments where various interest groups get upset about depictions
Speaker 1: of violence on television. Was a big deal, I think
Speaker 1: in the seventies, for example, and then it sort of
Speaker 1: went away, and then the people who were complained about
Speaker 1: this got painted as kind of buffoons or as naive
Speaker 1: sewer in the middle of nowhere, and you know, I
Speaker 1: don't want to give it away, but I had in
Speaker 1: the course of an episode of I'm doing in this
Speaker 1: upcoming season where I have these long conversations with trauma
Speaker 1: surgeons who deal with gunshot wounds, and what they have
Speaker 1: to say on this very specific matter is incredibly interesting
Speaker 1: and disturbing. They're not they're not like hiding their head
Speaker 1: in the stand about this. They're they're fully aware of it.
Speaker 1: The people who are who have a I believe a
Speaker 1: morally objectionable position are the people in Hollywood, many of
Speaker 1: who are self described liberals, who will go on and
Speaker 1: on and on about the you know, the terror need
Speaker 1: for gun control in America and how outrageous all the
Speaker 1: Second Amendment people is, and meanwhile they're making movies. We're
Speaker 1: like twenty people are slaughtered in the first fifteen minutes. Like,
Speaker 1: I'm sorry, this is just like completely incomprehensible behavior, right.
Speaker 1: This drives me nuts. Yeah, I know that there's a
Speaker 1: there's a lot to be said for that. It's it's
Speaker 1: like we've never outlived the instinct for public executions right
Speaker 1: where everyone would come to the town square. That instinct
Speaker 1: is still alive and well, yeah, it's an important tangent
Speaker 1: to go on and it is kind of related to
Speaker 1: everything we've been talking about about how do you study this?
Speaker 1: You know, what are the benefits, what are the harms?
Speaker 1: And there's you know, kind of coming full circle back
Speaker 1: to the starvation experiment. There is one thing that we
Speaker 1: haven't talked about, which was an important point that one
Speaker 1: of the listeners brought up. And this is an important
Speaker 1: point about a lot of the research not from that day,
Speaker 1: but that continues to be done to this day, which
Speaker 1: is how realizable are the results to the segments of
Speaker 1: the population that might actually benefit most from it. So Moura,
Speaker 1: this listener wrote, how can we treat eating disorder patients
Speaker 1: primarily young women using data collected exclusively on white men.
Speaker 1: How can we use this to study the impact of
Speaker 1: dieting and weight loss one dining is more prevalent and
Speaker 1: pressured upon among women. How can we use this to
Speaker 1: study obesity when non Hispanic Black adults and Hispanic adults
Speaker 1: have the highest prevalence of obesity in the United States.
Speaker 1: That's the end of her letter, But I would just
Speaker 1: go on and on. When we're talking about malnourishment and
Speaker 1: we realize that most of the malnourished population of the
Speaker 1: world is not white men. So that is kind of
Speaker 1: an interesting side note, and this is actually still a
Speaker 1: huge problem. That's not something that we left behind in
Speaker 1: the forties. To this day, most medical data comes from men,
Speaker 1: not women, and it's a very kind of that's an
Speaker 1: interesting way of looking at you what are the actual
Speaker 1: benefits from this to the people who need them, and
Speaker 1: how generalizable is it if you're trying to develop actionable
Speaker 1: policies and guidelines and approaches to affective populations. It absolutely
Speaker 1: does matter. And you know, we went through this with
Speaker 1: I think, with our understanding of heart attacks right where
Speaker 1: we started off testing a lot of these hypotheses in men,
Speaker 1: white men, and that's how we got our basically knowledge.
Speaker 1: But then we tried to use that information to kind
Speaker 1: of understand how to deal with women without realizing that
Speaker 1: the biology of a lot of these problems, physiology of
Speaker 1: a lot of these problems in women's very different. So
Speaker 1: I think it depends where you are into kind of
Speaker 1: stage that you're at. And the mistake we make, I think,
Speaker 1: is don't we don't honor this distinction between kind of
Speaker 1: basic understanding and actionable research. If you talk to some
Speaker 1: who works for a pharmaceutical company and is involved in
Speaker 1: drug trials, you know they will talk your ear off
Speaker 1: on this, and what they will say is, do you
Speaker 1: know how hard it is to put together a study population.
Speaker 1: It's insanely difficult to find someone. I actually thought of
Speaker 1: I was going to volunteer for a trial about lyme
Speaker 1: disease vaccine, and then I had that I the first
Speaker 1: thing to do is you have half an hour conversation
Speaker 1: with someone and they detail that I would have to
Speaker 1: go to drive to Albany an hour away, seven times
Speaker 1: and have to set aside half a day on each
Speaker 1: of those occasions. And I wasn't clear whether I'd be
Speaker 1: part of the treatment group or the pacebo group, right,
Speaker 1: So I listened to that. I was like, I'm like,
Speaker 1: I can't do that. I'm not taking you know, Somewhat selfishly,
Speaker 1: I decided I don't have that much time to devote
Speaker 1: to this, so I'll let someone else carry the burden.
Speaker 1: So it's like, it's really hard to do these studies.
Speaker 1: So when you if we say these studies have to
Speaker 1: be perfectly representative, you're just making it less likely that
Speaker 1: the study gets done in the first place at a
Speaker 1: certain point, right, So that's the trade off. It's an
Speaker 1: impossible tradeoff. Sure, No, I think I think there's a
Speaker 1: lot of truth to that. That said, I do think
Speaker 1: that even baseline knowledge studies these days should at least
Speaker 1: include women because you know, if you're omitting more than
Speaker 1: half the population and the basic biology is different, then
Speaker 1: but you couldn't have done the starvation experiment with women.
Speaker 1: That's so that's the other thing, right, what are we
Speaker 1: proposing in the starvation case? Do we want women there?
Speaker 1: And Hispanic and black where it's much more difficult to
Speaker 1: actually obtain consent because especially back then, but even to
Speaker 1: this day, you know, these are populations that have had
Speaker 1: a lot of negative research done without consent, and it's
Speaker 1: it's actually much more difficult, I would say, and the
Speaker 1: burden of proof is much higher to ask for consent
Speaker 1: from vulnerable populations. You can't do a starvation experiment on
Speaker 1: like that in Minnesota, on young women because if it
Speaker 1: has consequences for their fertility, yes, then you have so
Speaker 1: what are you going to see? So are we going
Speaker 1: to use are we going to use post menopausal women only?
Speaker 1: But that brings up a whole different set of issues
Speaker 1: because now you have a non an older population that's
Speaker 1: going to be less susceptible to whatever risks you're exposed
Speaker 1: in them too. It's tricky. This reminds me. We talk
Speaker 1: in the season about magic wands experiments we could do
Speaker 1: if we could wave a magic wand this one doesn't
Speaker 1: actually require a magic wand, although it would be very
Speaker 1: hard to do in the real world. But you mentioned
Speaker 1: that natural experiment in Holland, which gave us information that
Speaker 1: would have been almost impossible to get otherwise in a
Speaker 1: formal experiment. And it goes to the larger point that
Speaker 1: this is the great thing about natural experiments is that
Speaker 1: when you can find a good one, they almost invariably
Speaker 1: tell you stuff that you could never find another way.
Speaker 1: They're incredibly productive kind of experiment. So why can't we
Speaker 1: engineer natural experiments? So imagine this. Imagine if someone came
Speaker 1: to you and me and a million other people and said,
Speaker 1: we're at the stage now in our technology where we
Speaker 1: can put little sensors on you which can continuously monitor
Speaker 1: every one of your physiological signs and vital signs in
Speaker 1: real time. Would you agree to be basically monitored for
Speaker 1: the next whatever ten years, and you two million or
Speaker 1: ten million other people agree to be part of this,
Speaker 1: and we will we will simply wait and see what
Speaker 1: happens to you and use that massive data set to
Speaker 1: kind of improve our understanding of the kinds of things
Speaker 1: that lead to various sorts of diseases. I mean, if
Speaker 1: you had ten million people and they were giving you
Speaker 1: ten years of their life and every conceivable indicator and
Speaker 1: vital sign was being monitored on a moment to moment basis,
Speaker 1: you would be able to understand stuff that right now
Speaker 1: we have no clue about, right, and all it takes
Speaker 1: is for people just they don't even take in a risk,
Speaker 1: they're just being willing to be monitored and donate their data.
Speaker 1: That's essentially engineering a natural experiment. I don't understand why
Speaker 1: that hasn't been done privacy. No one who cares this
Speaker 1: is don't maybe we started on privacy. Privacy tries me
Speaker 1: just nuts. It's like, what an absurd thing in this
Speaker 1: day and age to be concerned about. Like, basically, as
Speaker 1: far as I can tell, every single fact about Malcolm
Speaker 1: Glovel is known by like some combination of Facebook, Apple,
Speaker 1: Google and someone else, and so I meant to ask, Malcolm,
Speaker 1: what is your mother's maiden name? I just have a
Speaker 1: few more questions before we were at I know, it's
Speaker 1: like a ludicrous and so it's fine for those guys
Speaker 1: to scour, you know, the Internet and put together massive
Speaker 1: dossiers of everything, every fact about me. But somehow, if
Speaker 1: I want to allow someone to peek into my it
Speaker 1: is a physiological you know, for the benefit of mankind.
Speaker 1: That's a problem. It strives me crazy. It is a problem,
Speaker 1: and I didn't know that I hit a nerve with
Speaker 1: that one word privacy. But here we are, so that
Speaker 1: I think is a nice place to wrap up our
Speaker 1: Starvation study, except for one final question. One listener was
Speaker 1: really fascinated by the cinnamon role recipe from the episode
Speaker 1: of the Starvation Study Tara A. She said, thank you
Speaker 1: for these episodes, Malcolm. So, Malcolm, thank you for these episodes.
Speaker 1: Any chance you know how we could track down that
Speaker 1: cinnamon role recipe. I was thinking it would be nice
Speaker 1: to make some and share in my community and for
Speaker 1: a refresher for our listeners who don't love cinnamon rolls
Speaker 1: as much as I do. So didn't immediately light up
Speaker 1: at this detail. So there was a character in the episode,
Speaker 1: Lester Glick, who was part of the study and one
Speaker 1: of the things things that mentally fortified him, although I
Speaker 1: think for me it would have probably had the opposite effect.
Speaker 1: As he carried around a picture of a cinnamon roll
Speaker 1: and he had it with him always and it was
Speaker 1: something that kept him going. And then and then later
Speaker 1: he would for the rest of his life, he would
Speaker 1: make them obsessively for family and friends, by the dozens.
Speaker 1: It was the defining one of the defining acts of
Speaker 1: the rest of his life. Now, I love cinnamon rolls,
Speaker 1: so I also wanted to track down that recipe. We
Speaker 1: will post it online and all those brave souls who
Speaker 1: want to recreate the famous cinnamon rolls can do that.
Speaker 1: That was fun. Thank you, Maria, That's really fun, of course.
Speaker 1: Thank you. Bye bye, Maria, Maria, Maria, thank you so
Speaker 1: much for agreeing to take on the role of revisionist
Speaker 1: histories inaugural obvious person. Just so all of you know,
Speaker 1: we hope to make Maria a regular on the show
Speaker 1: in the future. You may have thought she went easy
Speaker 1: on me this time. Let me just say I have
Speaker 1: no expectation that will ever happen again. Oh, if you're
Speaker 1: wondering why I said it takes bravery to make the
Speaker 1: cinnamon rolls, lest you say the recipe involves, among other things,
Speaker 1: mash potatoes, go to our website and see for yourself,
Speaker 1: and thank you to the Glick family for sharing that
Speaker 1: with us. Maria will be back soon, so send your questions,
Speaker 1: your challenges, your gripes, and your stories to all of
Speaker 1: us at revisionist history dot com. Revisionist History is produced
Speaker 1: by Leaving Gistu, Amy Gaines, Kiara Powell, and Jacob Smith.
Speaker 1: Our showrunner is Peter Clowney. Original scoring by Luis Gara,
Speaker 1: mastering by Sarah Bregare, and engineering by Nina Lawrence. Fact
Speaker 1: checking by Kishell Williams. Special thanks to Julia Barton. Subscribe
Speaker 1: to pushkin plus to hear all our episodes of Revisionist
Speaker 1: History add free, and as of this year, get our
Speaker 1: shows two weeks earlier than the rest of the world.
Speaker 1: I'm Malcolm Glabo.