WEBVTT - The Tipping Point Revisited: An Excerpt

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<v Speaker 1>Pushkin. Hello, Hello, Revisions History listeners. We are back with

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<v Speaker 1>a very very special announcement. I have a new book

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<v Speaker 1>coming out. It's called Revenge of the Tipping Point. It's

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<v Speaker 1>a sequel to The Tipping Point, my very first book

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<v Speaker 1>from twenty five years ago. It's like a little silver

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<v Speaker 1>anniversary present for you, my loyal listeners. The original Tipping

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<v Speaker 1>Point was about how the best way to understand ideas

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<v Speaker 1>and behaviors and social change was to use the model

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<v Speaker 1>of the epidemic. This time around, in Revenge of the

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<v Speaker 1>Tipping Point, I'm taking those ideas and going one big

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<v Speaker 1>step deeper. Now I'm interested in the dark side. I

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<v Speaker 1>go to Miami and try and figure out why Miami

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<v Speaker 1>is so strange. I go to a seemingly perfect little

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<v Speaker 1>town called Popular Growth, where a tragedy is unfolding. I

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<v Speaker 1>have a chapter on the Holocaust that I think will

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<v Speaker 1>completely surprise you. Yet another takedown of Harvard University. I know,

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<v Speaker 1>I know, I'm a broken record, but I'm inordinately proud

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<v Speaker 1>of this one. On and on a mixture of narrative

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<v Speaker 1>ingredients baked into a highly entertaining suffle. And today we're

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<v Speaker 1>sharing an exclusive preview of Chapter one of the audiobook

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<v Speaker 1>of Revenge of the Tipping Point. It's all about bank

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<v Speaker 1>robbers and doctors. And that's all I'm going to tell you,

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<v Speaker 1>because you'll have to listen to find out more. But

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<v Speaker 1>that's not all. Coming up in the next couple of

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<v Speaker 1>weeks on revisionist history, we have all kinds of goodies

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<v Speaker 1>related to my book. We've got a two part episode

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<v Speaker 1>on maybe my favorite criminal trial ever, something I call

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<v Speaker 1>the Georgetown Massacre. Then an episode where I go back

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<v Speaker 1>and audit the chapter I wrote on crime in the

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<v Speaker 1>original Tipping Point. Did I get it right? And finally

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<v Speaker 1>we're going to run the comment station I'm having with

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<v Speaker 1>the editor of The New Yorker, David Remnick, at the

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<v Speaker 1>ninety second Street y in New York. Stay tuned and

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<v Speaker 1>for now enjoy this preview of Revenge of the Tipping Point.

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<v Speaker 1>You can find Revenge of the Tipping Point wherever you

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<v Speaker 1>get your audiobooks. Part one three Puzzles, Chapter one Casper

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<v Speaker 1>and Sea Dog. It was just like wildfire. Everyone was

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<v Speaker 1>jumping into the gate. One In the early afternoon of

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<v Speaker 1>November twenty ninth, nineteen eighty three, the Los Angeles Field

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<v Speaker 1>office of the Federal Bureau of Investigation received a call

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<v Speaker 1>from a Bank of America branch in the Melrose District.

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<v Speaker 1>The call was taken by an FBI agent named Linda Webster.

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<v Speaker 1>She was the person in the office who fielded what

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<v Speaker 1>were known as two elevens shorts. A bank robbery's there

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<v Speaker 1>had just been a hold up. She was told the

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<v Speaker 1>suspect was a young white male wearing a New York

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<v Speaker 1>Yankees baseball cap, slender, polite Southern accent, well dressed. He

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<v Speaker 1>said please and thank you. Webster turned to her colleague,

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<v Speaker 1>William Rader, who ran the FBI's local bank robbery division.

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<v Speaker 1>Bill it's the Yankee. The Yankee Bandit had been active

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<v Speaker 1>in Los Angeles since July of that year. He had

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<v Speaker 1>hit one bank after another, slipping away each time with

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<v Speaker 1>thousands of dollars in a leather suitcase. Raider was growing frustrated.

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<v Speaker 1>Who was this man? All the bureau had to go

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<v Speaker 1>on was that telltale baseball cap, hence the nickname the

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<v Speaker 1>Yankee Bandit. Half an hour passed, Webster got another to eleven.

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<v Speaker 1>This one was from a City National Bank sixteen blocks

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<v Speaker 1>west in the Fairfax District. They had been taken for

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<v Speaker 1>two thousand, three hundred and forty nine dollars. The caller

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<v Speaker 1>gave Webster the details. She looked at Raider, Bill, it's

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<v Speaker 1>the Yankee again. Forty five minutes after that, the Yankee

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<v Speaker 1>hit a Security Pacific National Bank in Centry City, then

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<v Speaker 1>immediately walked one block down the street and held up

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<v Speaker 1>a First Interstate Bank for two thousand, five hundred and

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<v Speaker 1>five dollars. Bill, it's the Yankee twice, back to back.

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<v Speaker 1>Less than an hour passed, the phone rang again. The

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<v Speaker 1>Yankee had just hid an Imperial Bank on Wilshire Boulevard.

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<v Speaker 1>If you drive from Centry City to the Imperial Bank

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<v Speaker 1>on Wiltshire, you pass right by the FBI's office. He

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<v Speaker 1>probably waived at us. Raider told Webster they were now unnoticed.

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<v Speaker 1>History was being made. They waited, could the Yankee possibly

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<v Speaker 1>strike again? At five point thirty, the phone rang. An

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<v Speaker 1>unknown white male slender an accent Yankee cap had just

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<v Speaker 1>robbed the First Interstate Bank in Encino, fifteen minutes north

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<v Speaker 1>on the four or five Freeway, for two thousand, four

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<v Speaker 1>hundred and thirteen dollars. Bill, it's the Yankee. One man,

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<v Speaker 1>four hours, six banks. It was a New World's record,

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<v Speaker 1>Raider would later write in his memoirs Still Unbroken two,

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<v Speaker 1>no criminal has ever held as exalted a position in

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<v Speaker 1>American culture as the bank robber. In the years after

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<v Speaker 1>the Civil War, the country was riveted by the exploits

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<v Speaker 1>of bands such as the James Younger Gang, who terrorized

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<v Speaker 1>the wild West with bank hold ups and trained robbers.

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<v Speaker 1>In the Depression, bank robbers became celebrities. Bonnie and Clyde,

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<v Speaker 1>pretty Boy Floyd John Dillinger, Billy brought.

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<v Speaker 2>To Chicago recaptured after he had escaped from Lima, Ohio.

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<v Speaker 2>Despert public enemy now rises to fame as an underworld hero.

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<v Speaker 2>Where is Clyde Beryl and Bonnie Parker who died as

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<v Speaker 2>they lived by a gun.

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<v Speaker 1>But in the years after the Second World War, the

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<v Speaker 1>crime seemed to be fading. In nineteen sixty nine, a

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<v Speaker 1>total of thirteen hundred and eighteen banks were robbed across

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<v Speaker 1>the entire United States, a modest number given the size

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<v Speaker 1>of the country. There was speculation that bank robberies were

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<v Speaker 1>headed toward extinction. Few major crimes had higher arrest and

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<v Speaker 1>conviction rates. Banks felt they had learned how to protect themselves.

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<v Speaker 1>A definitive study at bank robbery was entitled nothing to lose,

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<v Speaker 1>meaning that the act seemed so irrational that its perpetrators

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<v Speaker 1>must have run out of other options. It seemed like

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<v Speaker 1>the twentieth century equivalent of cattle rustling, who does it anymore?

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<v Speaker 1>But then came an epidemic. In a single year, from

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<v Speaker 1>nineteen sixty nine to nineteen seventy the number of bank

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<v Speaker 1>robberies nearly doubled, then rose again in nineteen seventy one,

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<v Speaker 1>and once more in nineteen seventy two. In nineteen seventy four,

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<v Speaker 1>three thousand, five hundred and seventeen banks were robbed. Two

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<v Speaker 1>years later, the number was four thousand, five hundred and

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<v Speaker 1>sixty five. By the beginning of the nineteen eighties, they

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<v Speaker 1>were five times more bank robberies than there had been

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<v Speaker 1>at the end of the nineteen sixties. It was a

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<v Speaker 1>crime wave without precedent, and it was just getting started.

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<v Speaker 1>In nineteen ninety one, the FBI fielded a two to

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<v Speaker 1>eleven call from a bank somewhere in the United States

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<v Speaker 1>nine thousand, three hundred and eighty eight times, And the

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<v Speaker 1>center of this astonishing surge was the city of Los.

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<v Speaker 2>Angeles, the sprawling city that's home to Hollywood movie capital

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<v Speaker 2>of the world is also the bank robbery capital of

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<v Speaker 2>the world.

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<v Speaker 1>A quarter of all bank robberies in the US in

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<v Speaker 1>those years happened in Los Angeles. There were years when

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<v Speaker 1>the local FBI office handled as many as twenty six

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<v Speaker 1>hundred bank robberies. So many robbers robbing so many banks

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<v Speaker 1>that Raider and the Bureau were forced to give them

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<v Speaker 1>nicknames to keep them straight. The man who disguised himself

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<v Speaker 1>with surgical gauze became the Mummy Bandit. The man who

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<v Speaker 1>are a single glove became naturally the Michael Jackson Bandit.

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<v Speaker 1>A two man team who wore fake mustaches with the

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<v Speaker 1>Marx brothers. A short o beast robber was Miss Piggy.

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<v Speaker 1>A beautiful robber was the Miss America Bandit. A guy

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<v Speaker 1>who waved a knife was the Benni Hahonna Bandit. On

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<v Speaker 1>and on it went. They were robbers named after Johnny

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<v Speaker 1>Cash and Robert de Niro. One group robbed in threes,

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<v Speaker 1>one dressed as a biker, another as a cop, and

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<v Speaker 1>the third as a construction worker. Do you need to

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<v Speaker 1>ask what they were called? This was the nineteen eighties.

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<v Speaker 1>They were known as the Village People. It was just

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<v Speaker 1>like wildfire, remembers Peter Hoolihan, one of the unofficial historians

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<v Speaker 1>of the La Bank robbery Surge. Everybody was jumping into

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<v Speaker 1>the game. Ten years into the surge, incredibly, things got

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<v Speaker 1>much worse. The first generation of Ellie robbers were like

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<v Speaker 1>the Yankee Bandit. They walked up to a teller and

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<v Speaker 1>they had a gun, scooped up whatever cash was on hand,

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<v Speaker 1>and fled. People called them a bit dismissively note passers.

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<v Speaker 1>But then came a two man group called the West

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<v Speaker 1>Hills Bandits. The West Sails Gang went back to the

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<v Speaker 1>grand tradition of Jesse, James and Bonnie and Clyde. They

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<v Speaker 1>came in hot in wigs and masks, waving assault weapons.

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<v Speaker 1>They would force their way into the teller's cage and

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<v Speaker 1>clean out the entire bank, empty the vault if they could,

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<v Speaker 1>before executing a meticulously planned escape. The Bandits had a

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<v Speaker 1>bunker in the San Fernando Valley filled with military grade

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<v Speaker 1>weapons and twenty seven thousand rounds of ammunition to prepare

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<v Speaker 1>for what their leader believed was an imminent armageddon. Even

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<v Speaker 1>by the standards of nineteen nineties Los Angeles, the West

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<v Speaker 1>Hills Gang was a little crazy. On their fifth robbery,

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<v Speaker 1>the West Hills Gang broke into the vault of a

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<v Speaker 1>Wells Fargo bank in Tarzana and made off with four

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<v Speaker 1>hundred and thirty seven thousand dollars more than one million

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<v Speaker 1>in today's dollars. And then Wells Fargo made a crucial mistake.

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<v Speaker 1>The bank told the press exactly how much the West

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<v Speaker 1>Hills Gang had stolen. It was like putting a match

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<v Speaker 1>to kindling. Four hundred and thirty seven thousand, Are you

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<v Speaker 1>kidding me? One of the first to take notice was

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<v Speaker 1>an enterprising twenty three year old named Robert Sheldon Brown.

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<v Speaker 1>His street name was Casper. Casper did the math. I've robbed,

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<v Speaker 1>I've done burglaries, I've done a little bit of everything,

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<v Speaker 1>he would explain later. But the money couldn't compare to

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<v Speaker 1>the bank. You could go into a bank and in

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<v Speaker 1>two minutes get what on the streets would take you

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<v Speaker 1>six or seven weeks to get. John Wiley, one of

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<v Speaker 1>the prosecutors who eventually brought Casper to justice, remembers him

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<v Speaker 1>as a standout. He said, Casper was really ripped and

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<v Speaker 1>really smart.

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<v Speaker 3>Here he is he figured out the problem with robbing

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<v Speaker 3>banks is going into the bank, so he got somebody

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<v Speaker 3>else to do that. You would think, how could you

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<v Speaker 3>possibly get someone to rob a bank for you? And

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<v Speaker 3>that was his particular talent, was recruiting people to rob

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<v Speaker 3>banksworm and he recruited an unbelievable number of folks. He

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<v Speaker 3>was kind of a producer in Hollywood terms.

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<v Speaker 1>Casper had a partner in crime, Donzel Thompson, also known

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<v Speaker 1>as Sea Dog. They would pick a bank they thought

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<v Speaker 1>was ripe for a hit, then it'd find a getaway car,

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<v Speaker 1>known in gangs speak as the g ride. In the

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<v Speaker 1>early nineteen nineties, Los Angeles also experienced an astonishing surge

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<v Speaker 1>in carjackings, which were treated in the press as another

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<v Speaker 1>indication of the random mayhem sweeping the streets. But a

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<v Speaker 1>good chunk of it was actually just Casper and Sea Dog.

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<v Speaker 1>They had a guy they paid to acquire their g rides.

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<v Speaker 1>If you were doing as many bank robberies as Casper was,

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<v Speaker 1>you needed a lot of cars. Then he would pick

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<v Speaker 1>the crew Prosecutor Wiley.

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<v Speaker 3>Again, a lot of his robbers were just kids. I

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<v Speaker 3>think he probably paid some of them nothing. He just

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<v Speaker 3>coerced him into robbing. He was a big threatening guy,

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<v Speaker 3>and you know he was a member of the role

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<v Speaker 3>in the sixties was a very notorious crips gang.

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<v Speaker 1>Wiley recalled a particular recruit who was very young, no

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<v Speaker 1>more than thirteen or fourteen.

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<v Speaker 3>I remember he took the kid out of school and said,

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<v Speaker 3>you know, when can you rob this bank for me?

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<v Speaker 3>And the guy said during nutrition break. So during nutrition

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<v Speaker 3>break they picked him up and Brown and Thompson explained

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<v Speaker 3>how to do it. You go in scurbate to death,

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<v Speaker 3>get the money, get out.

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<v Speaker 1>Casper taught his recruits a technique he called go and

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<v Speaker 1>com akazi. His kids would come busting in, waving their

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<v Speaker 1>machine pistols and assault rifles, firing rounds at the ceiling

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<v Speaker 1>and screaming obscenities on the floor.

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<v Speaker 2>Mother.

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<v Speaker 1>They would stuff all the cash they could into pillowcases,

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<v Speaker 1>grab wallets, and rip rings off women's fingers if they

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<v Speaker 1>wanted a little extra treasure for the road. On at

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<v Speaker 1>least two jobs, Casper borrowed a school bus to ferry

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<v Speaker 1>his young charges to safety. Another time he borrowed a

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<v Speaker 1>postal service truck. Casper had imagination he would exercise managerial

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<v Speaker 1>oversight of his operations from a position of safety parked

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<v Speaker 1>in a car somewhere far down the block, then follow

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<v Speaker 1>his hand picked team as they raced through the streets.

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<v Speaker 3>These guys knew if they tried to get away with

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<v Speaker 3>them all the money that have these two roll in

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<v Speaker 3>sixties crips after him, and that would not improve their lives.

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<v Speaker 1>The g ride would be abandoned. The whole crew would

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<v Speaker 1>retreat to Casper's hideout, usually in a motel, where he

0:14:31.236 --> 0:14:34.116
<v Speaker 1>would pay them a pittance and let them go. They

0:14:34.156 --> 0:14:37.476
<v Speaker 1>were kids, Chances are they would get caught, but Casper

0:14:37.516 --> 0:14:41.116
<v Speaker 1>didn't care. Here's Wiley describing his general attitude.

0:14:41.876 --> 0:14:44.676
<v Speaker 3>I mean, okay, so that wasn't great. My guys got caught.

0:14:44.956 --> 0:14:46.836
<v Speaker 3>Now we have to get new guys. But we do

0:14:46.916 --> 0:14:47.676
<v Speaker 3>that all the time.

0:14:48.436 --> 0:14:53.196
<v Speaker 1>In just four years, Casper produced one hundred and seventy

0:14:53.236 --> 0:14:57.316
<v Speaker 1>five robberies, which remains a lifetime bank robbery world record,

0:14:57.676 --> 0:15:02.316
<v Speaker 1>crushing the Yankee Bandits previous mark of seventy two. Casper

0:15:02.316 --> 0:15:05.396
<v Speaker 1>and Sea Dog even came close to the Yankee Bandits

0:15:05.476 --> 0:15:08.796
<v Speaker 1>one day mark of six heists on a single day.

0:15:08.876 --> 0:15:11.396
<v Speaker 1>In a August of nineteen ninety one, they produced five

0:15:12.076 --> 0:15:15.716
<v Speaker 1>a first interstate bank on Losienega Boulevard, then banks in

0:15:15.796 --> 0:15:21.076
<v Speaker 1>Eagle Rock, Pasadena, Monterey Park, and Montebello. And remember the

0:15:21.156 --> 0:15:23.996
<v Speaker 1>Yankee bandit was a one man show. Casper was doing

0:15:24.036 --> 0:15:29.596
<v Speaker 1>something infinitely more difficult, organizing and supervising teams of robbers.

0:15:30.676 --> 0:15:33.556
<v Speaker 1>Once Casper showed the world how easy it was to

0:15:33.596 --> 0:15:36.956
<v Speaker 1>take over a bank, other gangs jumped in. The eight

0:15:37.036 --> 0:15:40.916
<v Speaker 1>tray gangster crips started putting together cruise. A duo called

0:15:40.916 --> 0:15:43.956
<v Speaker 1>the Nasty Boys did almost thirty takeovers in under a

0:15:44.036 --> 0:15:48.276
<v Speaker 1>year just the two of them. The Nasty Boys were nasty.

0:15:48.876 --> 0:15:51.556
<v Speaker 1>They liked to herd everyone into the bank vault, talk

0:15:51.676 --> 0:15:54.996
<v Speaker 1>loudly about executions, and fire their guns next to people's

0:15:55.036 --> 0:15:56.796
<v Speaker 1>ears just for the fun of it.

0:15:57.596 --> 0:16:00.076
<v Speaker 3>In retrospect, nineteen ninety two turned out to be the

0:16:00.116 --> 0:16:04.756
<v Speaker 3>peak year for bank robberies. Two thousand, six hundred and

0:16:04.796 --> 0:16:06.356
<v Speaker 3>forty one robberies in one.

0:16:06.236 --> 0:16:07.796
<v Speaker 1>Year Wiley again.

0:16:08.236 --> 0:16:12.036
<v Speaker 3>So that averages one bank robbery every forty five minutes

0:16:12.076 --> 0:16:17.676
<v Speaker 3>for each banking day, and the worst day was twenty

0:16:17.676 --> 0:16:22.916
<v Speaker 3>eight bank robberies in one day. This drove the FBI

0:16:23.076 --> 0:16:26.876
<v Speaker 3>completely crazy. I mean they were completely exhausted.

0:16:27.716 --> 0:16:32.396
<v Speaker 1>Robbing a bank takes minutes. Investigating a bank robbery takes hours.

0:16:32.956 --> 0:16:35.716
<v Speaker 1>As the robberies piled up, the FBI would fall further

0:16:36.116 --> 0:16:37.076
<v Speaker 1>and further behind.

0:16:38.036 --> 0:16:40.916
<v Speaker 3>So if you're having twenty seven robberies a day, if

0:16:40.956 --> 0:16:44.596
<v Speaker 3>one team is committing five robberies in one day, I mean,

0:16:44.676 --> 0:16:48.276
<v Speaker 3>just think physically, how you investigate that. These guys are

0:16:48.356 --> 0:16:51.596
<v Speaker 3>driving all over town as fast as they can robbing,

0:16:52.316 --> 0:16:54.956
<v Speaker 3>so just keeping up with them in La traffic is

0:16:54.996 --> 0:16:58.236
<v Speaker 3>a problem. You get to the bank and how many

0:16:58.236 --> 0:17:00.556
<v Speaker 3>people have witnessed the robbery, Well, how many people were

0:17:00.556 --> 0:17:04.396
<v Speaker 3>in the bank, You know, twenty people, So you need

0:17:04.436 --> 0:17:08.556
<v Speaker 3>to get witness statements from twenty witnesses. This is a

0:17:08.556 --> 0:17:09.756
<v Speaker 3>big project.

0:17:10.076 --> 0:17:13.636
<v Speaker 1>Then just as you start, what happens.

0:17:14.156 --> 0:17:16.676
<v Speaker 3>You're on the scene for five or ten minutes, and

0:17:16.676 --> 0:17:21.396
<v Speaker 3>there's another bank robbery emergency somewhere across town. The FBI

0:17:21.476 --> 0:17:22.876
<v Speaker 3>was being run ragged.

0:17:23.916 --> 0:17:26.956
<v Speaker 1>The city of Los Angeles was the bank robbery capital

0:17:27.156 --> 0:17:29.836
<v Speaker 1>of the world. Wiley held up a chart of bank

0:17:29.916 --> 0:17:33.436
<v Speaker 1>robberies in Los Angeles from the nineteen seventies through the

0:17:33.556 --> 0:17:34.476
<v Speaker 1>nineteen nineties.

0:17:34.996 --> 0:17:37.356
<v Speaker 3>There was no reason to think it would crust. If

0:17:37.396 --> 0:17:40.956
<v Speaker 3>you look at the trend line, it just seems like

0:17:41.036 --> 0:17:42.396
<v Speaker 3>it's heading for the moon.

0:17:43.276 --> 0:17:46.436
<v Speaker 1>The FBI put fifty agents on the case. Over the

0:17:46.476 --> 0:17:48.676
<v Speaker 1>course of many months, they gathered what they could from

0:17:48.716 --> 0:17:52.716
<v Speaker 1>Casper and Sea Dogs, terrified recruits, sorted through the layers

0:17:52.756 --> 0:17:55.396
<v Speaker 1>of deception the two used to hide their assets and

0:17:55.476 --> 0:17:59.276
<v Speaker 1>track them from one address to another across South Los Angeles.

0:18:00.076 --> 0:18:02.396
<v Speaker 1>It took forever to get a grand jury to indict

0:18:02.476 --> 0:18:05.956
<v Speaker 1>Casper and Sea Dog, because what had they done? Nothing,

0:18:06.636 --> 0:18:08.996
<v Speaker 1>They didn't rob any banks. They were just sitting in

0:18:08.996 --> 0:18:13.716
<v Speaker 1>a car down the street. All the FBI had was

0:18:13.716 --> 0:18:17.756
<v Speaker 1>a testimony of terrified teenagers who skipped school between lunch

0:18:17.956 --> 0:18:23.876
<v Speaker 1>and recess. Finally, prosecutors thought they had enough evidence. They

0:18:23.876 --> 0:18:26.916
<v Speaker 1>found Sea Dog at his grandmother's house in Carson and

0:18:27.036 --> 0:18:30.076
<v Speaker 1>arrested Casper as he stepped out of a cab with

0:18:30.156 --> 0:18:33.116
<v Speaker 1>the two of them behind bars. The bank robbery fever

0:18:33.436 --> 0:18:37.716
<v Speaker 1>that had seized Los Angeles finally broke. Within roughly a year,

0:18:38.076 --> 0:18:40.796
<v Speaker 1>the number of robberies in the city dropped thirty percent,

0:18:41.316 --> 0:18:46.276
<v Speaker 1>then drifted even lower. Bank robberies didn't head for the moon.

0:18:46.836 --> 0:18:54.676
<v Speaker 1>The contagion passed. When Casper and Sea Dog got out

0:18:54.716 --> 0:18:57.116
<v Speaker 1>of federal prison in the summer of twenty twenty three,

0:18:57.636 --> 0:19:00.796
<v Speaker 1>they shopped their story around Hollywood and took meetings with

0:19:00.916 --> 0:19:05.636
<v Speaker 1>film producers. Movie executives who heard their story were incredulous

0:19:06.236 --> 0:19:24.076
<v Speaker 1>that happened here. Yes it did. Three. I want to

0:19:24.116 --> 0:19:27.636
<v Speaker 1>begin Revenge of the Tipping Point with a series of puzzles,

0:19:28.276 --> 0:19:33.396
<v Speaker 1>three interconnected stories that seem at first glance to defy explanation.

0:19:34.316 --> 0:19:38.676
<v Speaker 1>The third involves a little town called pop Lagrove. The

0:19:38.796 --> 0:19:42.356
<v Speaker 1>second involves the story of a man named Philip s Forms.

0:19:43.036 --> 0:19:46.476
<v Speaker 1>And this first chapter involves the exploits of the Yankee

0:19:46.516 --> 0:19:52.476
<v Speaker 1>Bandit and Casper and Sea Dog. The Los Angeles bank

0:19:52.556 --> 0:19:56.636
<v Speaker 1>robbery crisis of the early nineteen nineties was an epidemic.

0:19:57.076 --> 0:20:00.236
<v Speaker 1>It fit all rules. This was not an outbreak generated

0:20:00.396 --> 0:20:04.876
<v Speaker 1>inside each robber like a toothache. It was contagious. A

0:20:04.916 --> 0:20:08.196
<v Speaker 1>low grade fever surfaced across the United States at the

0:20:08.316 --> 0:20:10.996
<v Speaker 1>end of the nineteen six sixties. In the nineteen eighties,

0:20:11.196 --> 0:20:15.316
<v Speaker 1>the Yankee Bandit caught that bug in Los Angeles. The

0:20:15.356 --> 0:20:18.716
<v Speaker 1>West Hills Bandits later picked up that virus, and in

0:20:18.756 --> 0:20:22.436
<v Speaker 1>their hands it mutated into something darker and more violent.

0:20:22.836 --> 0:20:25.556
<v Speaker 1>They passed a new Strainnan to Caspar and Sea Dog,

0:20:25.716 --> 0:20:29.996
<v Speaker 1>who reinvented the process outsourcing the labor and scaling up

0:20:30.076 --> 0:20:34.236
<v Speaker 1>dramatically like the late twentieth century capitalists they were. And

0:20:34.316 --> 0:20:37.876
<v Speaker 1>from there the infection went clear across the city to

0:20:37.956 --> 0:20:40.876
<v Speaker 1>the Eight Tray gangsters and the Nasty Boys, and on

0:20:40.956 --> 0:20:44.116
<v Speaker 1>and on, sweeping up hundreds of young men, until by

0:20:44.156 --> 0:20:47.356
<v Speaker 1>the time the bank takeover boom peaked in Los Angeles,

0:20:47.756 --> 0:20:50.916
<v Speaker 1>the small time note passing of the Yankee Bandit era

0:20:51.596 --> 0:20:58.556
<v Speaker 1>seemed like a dim memory. Socio epidemics are propelled by

0:20:58.596 --> 0:21:03.276
<v Speaker 1>the efforts of an exceptional few people who play outsized

0:21:03.396 --> 0:21:08.196
<v Speaker 1>social roles, and that was exactly how the LA outbreak unfolded.

0:21:08.676 --> 0:21:11.756
<v Speaker 1>This was never a mass participation event like one of

0:21:11.756 --> 0:21:14.916
<v Speaker 1>those big city marathons where tons of thousands of people

0:21:14.956 --> 0:21:18.196
<v Speaker 1>sign up. It was a reign of mayhem, driven by

0:21:18.196 --> 0:21:22.076
<v Speaker 1>a small number of people who robbed over and over

0:21:22.436 --> 0:21:26.716
<v Speaker 1>and over again. The Yankee Bandit robbed sixty four banks

0:21:26.796 --> 0:21:30.276
<v Speaker 1>in nine months before the FBI finally grabbed him. He

0:21:30.316 --> 0:21:33.556
<v Speaker 1>went to prison for ten years, got out, then robbed

0:21:33.556 --> 0:21:37.436
<v Speaker 1>eight more banks. The Nasty Boys did twenty seven banks.

0:21:37.716 --> 0:21:41.436
<v Speaker 1>Casper and Sea Dog masterminded one hundred and seventy five.

0:21:41.796 --> 0:21:44.956
<v Speaker 1>If you focused only on the Yankee Bandit, Casper and

0:21:44.996 --> 0:21:47.956
<v Speaker 1>the Nasty Boys. You would have a pretty complete picture

0:21:47.996 --> 0:21:50.756
<v Speaker 1>of what happened in Los Angeles in the nineteen eighties

0:21:50.836 --> 0:21:55.876
<v Speaker 1>and early nineteen nineties, A contagious phenomenon that rose and tipped,

0:21:56.236 --> 0:22:00.836
<v Speaker 1>fueled by the extraordinary actions of a few Casper, while

0:22:00.836 --> 0:22:04.036
<v Speaker 1>he said, is the super spreader if you want to

0:22:04.076 --> 0:22:08.436
<v Speaker 1>talk about epidemics, was the context in the nineteen eighties

0:22:08.476 --> 0:22:12.916
<v Speaker 1>and the early nineteen nineties ripe for a bank robbery explosion? Yes,

0:22:12.956 --> 0:22:16.036
<v Speaker 1>it was. Between the nineteen seventies and the end of

0:22:16.036 --> 0:22:19.076
<v Speaker 1>the nineteen nineties, the number of bank branches in the

0:22:19.156 --> 0:22:23.636
<v Speaker 1>United States tripled. Casper and Sea Dog were shooting fish

0:22:23.676 --> 0:22:27.036
<v Speaker 1>in a barrel. The fever that swept Los Angeles in

0:22:27.076 --> 0:22:31.116
<v Speaker 1>the late nineteen eighties and early nineteen nineties makes perfect sense,

0:22:31.956 --> 0:22:34.956
<v Speaker 1>except for one thing. There's a puzzle.

0:22:40.836 --> 0:22:41.116
<v Speaker 3>Four.

0:22:44.156 --> 0:22:48.756
<v Speaker 1>In the early morning of March ninth, nineteen fifty, Willie

0:22:48.756 --> 0:22:51.596
<v Speaker 1>Sutton rose and applied a heavy coat of makeup to

0:22:51.676 --> 0:22:55.596
<v Speaker 1>his face. The previous evening he had dyed his hair

0:22:55.796 --> 0:22:59.356
<v Speaker 1>several shades lighter, so that he was almost blonde, and

0:22:59.396 --> 0:23:02.476
<v Speaker 1>now he wanted to pair that with an olive complexion.

0:23:03.156 --> 0:23:06.836
<v Speaker 1>He applied mascara to his eyebrows. To give them some substance.

0:23:07.356 --> 0:23:10.716
<v Speaker 1>He stuffed bits of cork inside his nostrils to broaden

0:23:10.756 --> 0:23:14.036
<v Speaker 1>his nose. That he put on a gray suit, tailored

0:23:14.076 --> 0:23:18.636
<v Speaker 1>and padded in such a way as to alter his silhouette. Satisfied,

0:23:18.676 --> 0:23:21.596
<v Speaker 1>did he no longer look like Willy Sutton? Willie Sutton

0:23:21.676 --> 0:23:25.436
<v Speaker 1>left his house in Staten Island for Sunnyside, Queen's to

0:23:25.516 --> 0:23:29.036
<v Speaker 1>a Manufacture's Trust Company branch at forty fourth Street and

0:23:29.156 --> 0:23:33.436
<v Speaker 1>Queen's Boulevard in New York City. Sutton had spent the

0:23:33.636 --> 0:23:37.956
<v Speaker 1>previous three weeks standing across the street every morning, learning

0:23:37.996 --> 0:23:41.556
<v Speaker 1>the routines of the bank's employees. He liked what he saw.

0:23:42.116 --> 0:23:45.076
<v Speaker 1>There was an elevated subway stop across the street, a

0:23:45.116 --> 0:23:48.996
<v Speaker 1>bus stop, and a taxi stand. The street was busy

0:23:49.476 --> 0:23:53.156
<v Speaker 1>and Sutton like crowds. The bank's guard, a slow moving

0:23:53.236 --> 0:23:56.516
<v Speaker 1>man named Weston who lived nearby, arrived every morning at

0:23:56.516 --> 0:24:01.196
<v Speaker 1>eight thirty, engrossed in his newspaper. Between eight thirty and nine,

0:24:01.476 --> 0:24:04.476
<v Speaker 1>he would let in the bank's other employees, culminating in

0:24:04.516 --> 0:24:09.556
<v Speaker 1>the bank's manager, mister Hoffman, who arrived like clockwork at

0:24:09.636 --> 0:24:13.596
<v Speaker 1>nine o one. The Manufacturer's Trust opened to the public

0:24:13.716 --> 0:24:17.196
<v Speaker 1>at ten o'clock, much later than most bank branches. This

0:24:17.396 --> 0:24:21.276
<v Speaker 1>too made Sutton happy. He regarded the time between the

0:24:21.396 --> 0:24:24.276
<v Speaker 1>arrival of the first employee and the arrival of the

0:24:24.316 --> 0:24:28.276
<v Speaker 1>first customer as his time, and his time in this

0:24:28.396 --> 0:24:32.196
<v Speaker 1>case would be more than an hour. At eight twenty,

0:24:32.756 --> 0:24:35.476
<v Speaker 1>Sutton mingled with the crowd waiting at the bus stop.

0:24:35.996 --> 0:24:39.196
<v Speaker 1>A few minutes later, the Castilian Weston turned the corner,

0:24:39.396 --> 0:24:42.516
<v Speaker 1>lost in his newspaper. As Weston took out his keys

0:24:42.556 --> 0:24:46.316
<v Speaker 1>to open the door, Sutton slipped in behind him. Weston

0:24:46.396 --> 0:24:49.876
<v Speaker 1>turned in shock. Sutton looked him in the eye and

0:24:49.916 --> 0:24:53.796
<v Speaker 1>said quietly, come inside. I want to talk to you.

0:24:55.436 --> 0:24:58.796
<v Speaker 1>Sutton wasn't a fan of guns. Guns for him were props.

0:24:59.356 --> 0:25:02.996
<v Speaker 1>His real weapon was a quiet authority that compelled the

0:25:02.996 --> 0:25:06.476
<v Speaker 1>attention of others. He explained to the guard what would

0:25:06.516 --> 0:25:10.276
<v Speaker 1>happen next. First they would let him one of his accomplices.

0:25:10.956 --> 0:25:15.236
<v Speaker 1>Then the remaining employees would be admitted, exactly as they

0:25:15.236 --> 0:25:19.636
<v Speaker 1>were each morning. As each one entered, Sutton's accomplice would

0:25:19.676 --> 0:25:22.796
<v Speaker 1>emerge and lead them by the elbow to a row

0:25:22.796 --> 0:25:26.676
<v Speaker 1>of chairs he'd set up in preparation. Once you've taken

0:25:26.756 --> 0:25:29.836
<v Speaker 1>control of the bank, Sutton would write years later in

0:25:29.916 --> 0:25:33.956
<v Speaker 1>his memoirs. Sutton was sufficiently famous by that point that

0:25:34.036 --> 0:25:37.356
<v Speaker 1>he wrote not one, but two sets of memoirs. Like

0:25:37.396 --> 0:25:39.596
<v Speaker 1>a statesman who feels the need to respond to the

0:25:39.636 --> 0:25:43.116
<v Speaker 1>turns of history, it doesn't really matter who comes to

0:25:43.156 --> 0:25:47.076
<v Speaker 1>the door. A trio of painters once arrived unexpectedly while

0:25:47.116 --> 0:25:49.796
<v Speaker 1>I was taking a bank in Pennsylvania, and I simply

0:25:49.836 --> 0:25:52.756
<v Speaker 1>told them to spread out their drop cloths and go

0:25:52.836 --> 0:25:55.596
<v Speaker 1>to work. The pay you guys get, the bank can't

0:25:55.596 --> 0:25:58.636
<v Speaker 1>afford to have you hang around doing nothing. They're insured

0:25:58.676 --> 0:26:02.196
<v Speaker 1>against bank robbers, but nobody would insure them against you robbers.

0:26:03.036 --> 0:26:05.156
<v Speaker 1>All during the robbery, I was able to keep up

0:26:05.156 --> 0:26:07.516
<v Speaker 1>a line of chatter about how I could have retired

0:26:07.556 --> 0:26:10.516
<v Speaker 1>by now if we bankrobb had as stronger union as

0:26:10.556 --> 0:26:13.316
<v Speaker 1>they did. Everyone had a good time, and by the

0:26:13.316 --> 0:26:15.396
<v Speaker 1>time we walked out the door with the money, they

0:26:15.436 --> 0:26:21.876
<v Speaker 1>had one of the walls completely painted. Sutton was terrifyingly charming.

0:26:22.516 --> 0:26:26.356
<v Speaker 1>Did the employees of the Manufacturer's Trust Company realize that

0:26:26.476 --> 0:26:31.156
<v Speaker 1>the famous Willie Sutton was robbing them that morning? Undoubtedly

0:26:32.036 --> 0:26:35.356
<v Speaker 1>they filed into the conference room one by one. Don't

0:26:35.396 --> 0:26:38.636
<v Speaker 1>worry folks. He told them, it's only money, and it

0:26:38.716 --> 0:26:42.796
<v Speaker 1>isn't your money. At nine oh five, four minutes late,

0:26:43.156 --> 0:26:47.996
<v Speaker 1>mister Hoffman, the manager, arrived, Sutton sat him down. If

0:26:48.036 --> 0:26:50.436
<v Speaker 1>you give me any trouble, I want you to know

0:26:50.796 --> 0:26:53.836
<v Speaker 1>that some of these here employees of yours will be shot.

0:26:54.716 --> 0:26:58.676
<v Speaker 1>I don't want you to have any false illusions about that. Now.

0:26:59.076 --> 0:27:01.996
<v Speaker 1>Perhaps you don't care about your own safety, but the

0:27:02.036 --> 0:27:07.316
<v Speaker 1>health of these here employees of yours are your responsibility.

0:27:07.436 --> 0:27:11.036
<v Speaker 1>If anything happens to them, the blame will be yours,

0:27:11.916 --> 0:27:15.396
<v Speaker 1>not mine. It was a bluff, of course, but it

0:27:15.436 --> 0:27:18.356
<v Speaker 1>worked every time. He scooped up the money from the vault,

0:27:18.676 --> 0:27:21.476
<v Speaker 1>ambled out the door to a waiting getaway car, and

0:27:21.596 --> 0:27:26.116
<v Speaker 1>vanished into the New York City traffic. Willie Sutton was

0:27:26.196 --> 0:27:30.316
<v Speaker 1>the New York version of Casper, although that doesn't quite

0:27:30.396 --> 0:27:34.236
<v Speaker 1>do Willie Sutton justice. Nobody knew much about Casper at

0:27:34.276 --> 0:27:37.556
<v Speaker 1>the time he was orchestrating his bank robbery spree. Even

0:27:37.596 --> 0:27:40.916
<v Speaker 1>his trial barely made a dent in the news. Not

0:27:41.156 --> 0:27:42.196
<v Speaker 1>so Willie Sutton.

0:27:42.396 --> 0:27:46.036
<v Speaker 2>Willy Sutton, whose captur ends a five year manhunt still

0:27:46.036 --> 0:27:48.756
<v Speaker 2>carrying a big bank roll, the nation's most elusive bank

0:27:48.836 --> 0:27:53.276
<v Speaker 2>robber is arrested in Brooklyn, America's most wanted criminal, His

0:27:53.396 --> 0:27:54.356
<v Speaker 2>arrest brings promotion.

0:27:54.516 --> 0:27:57.716
<v Speaker 1>Sutton was a celebrity. He did it's starlit's. He was

0:27:57.756 --> 0:28:00.756
<v Speaker 1>a master of disguise. He made not one, but two

0:28:01.036 --> 0:28:04.356
<v Speaker 1>daring escapes from prison. He was once asked why do

0:28:04.356 --> 0:28:07.516
<v Speaker 1>you rob banks, and he replied, because that's where the

0:28:07.516 --> 0:28:10.756
<v Speaker 1>money is. Later he would deny having said that, but

0:28:10.796 --> 0:28:13.436
<v Speaker 1>it didn't matter. To this day. His quip is known

0:28:13.476 --> 0:28:17.396
<v Speaker 1>as Sutton's law, and it's used to instruct medical students

0:28:17.676 --> 0:28:22.916
<v Speaker 1>on the importance of considering the likeliest diagnosis. First, Hollywood

0:28:22.956 --> 0:28:25.316
<v Speaker 1>made a movie about his life. A writer turned his

0:28:25.356 --> 0:28:28.916
<v Speaker 1>story into a biographical novel. In Today's Dollars, He claimed

0:28:28.916 --> 0:28:32.476
<v Speaker 1>to have stolen more than twenty million over the course

0:28:32.516 --> 0:28:36.156
<v Speaker 1>of his career. Casper wasn't even in the same tax

0:28:36.236 --> 0:28:40.356
<v Speaker 1>bracket as Willy Sutton, assuming of course, that they paid taxes,

0:28:40.796 --> 0:28:44.076
<v Speaker 1>which neither of them did. The point is that if

0:28:44.116 --> 0:28:47.596
<v Speaker 1>anyone were to start a bank robbery epidemic, you'd think

0:28:47.636 --> 0:28:50.356
<v Speaker 1>it would be Willy Sutton. You would think that the

0:28:50.396 --> 0:28:53.556
<v Speaker 1>impressionable criminal classes of New York City would look at

0:28:53.596 --> 0:28:58.276
<v Speaker 1>slick Willie effortlessly slipping into bank branches without firing a shot,

0:28:58.396 --> 0:29:01.716
<v Speaker 1>and making off with the king's ransom and say to themselves,

0:29:02.236 --> 0:29:06.516
<v Speaker 1>I can do that. In epidemiology, there's a term called

0:29:06.836 --> 0:29:10.956
<v Speaker 1>the index case, which refer to the person who kicks

0:29:10.956 --> 0:29:13.516
<v Speaker 1>off an epidemic. We're going to talk about one of

0:29:13.516 --> 0:29:17.436
<v Speaker 1>the most fascinating index cases in recent history later in

0:29:17.476 --> 0:29:21.876
<v Speaker 1>this book. Willie Sutton should have been the index case, right.

0:29:22.516 --> 0:29:25.396
<v Speaker 1>He turned the grubby job of holding up a bank

0:29:25.916 --> 0:29:30.556
<v Speaker 1>into a work of art. But Willie Sutton did not

0:29:30.756 --> 0:29:33.836
<v Speaker 1>start a bank robbery epidemic in New York City, not

0:29:33.996 --> 0:29:37.516
<v Speaker 1>in the nineteen forties and fifties, in his heyday, nor

0:29:37.716 --> 0:29:41.476
<v Speaker 1>in the years afterward, as he wrote one memoir after another.

0:29:42.156 --> 0:29:44.996
<v Speaker 1>After talking his way out of prison in nineteen sixty nine,

0:29:45.276 --> 0:29:48.956
<v Speaker 1>claiming ill health, he would live another eleven years, Sutton

0:29:49.156 --> 0:29:53.756
<v Speaker 1>recreated himself as an expert on prison reform, giving lectures

0:29:53.836 --> 0:29:57.036
<v Speaker 1>across the country. He consulted with banks on how to

0:29:57.076 --> 0:30:00.596
<v Speaker 1>prevent bank robberies. He even did a TV commercial for

0:30:00.676 --> 0:30:03.636
<v Speaker 1>a credit card company pioneering a card with a photo

0:30:03.716 --> 0:30:03.996
<v Speaker 1>on it.

0:30:04.276 --> 0:30:06.396
<v Speaker 4>They call it the face God. You see it as

0:30:06.436 --> 0:30:09.836
<v Speaker 4>your face right on it. Now when I say, Lily Sutton,

0:30:10.716 --> 0:30:11.556
<v Speaker 4>if I believe me.

0:30:12.476 --> 0:30:15.036
<v Speaker 1>Did that make the world want to be Willie Sutton?

0:30:15.676 --> 0:30:19.316
<v Speaker 1>Apparently not. In the days of Casper, New York City

0:30:19.356 --> 0:30:23.596
<v Speaker 1>suffered only a fraction of the bank robberies that Los

0:30:23.636 --> 0:30:29.916
<v Speaker 1>Angeles did. An epidemic, by definition, is a contagious phenomenon

0:30:30.116 --> 0:30:34.396
<v Speaker 1>that does not respect borders. When COVID first emerged in

0:30:34.476 --> 0:30:38.356
<v Speaker 1>China in late twenty nineteen, epidemiologists worried that it would

0:30:38.356 --> 0:30:42.396
<v Speaker 1>spread everywhere, and they were absolutely right. Yet in the

0:30:42.476 --> 0:30:47.476
<v Speaker 1>bank case, the fever engulfed Los Angeles but skipped other

0:30:47.516 --> 0:30:54.316
<v Speaker 1>cities altogether. Why this is the first of the three puzzles,

0:30:56.476 --> 0:31:00.676
<v Speaker 1>and the answer involves a famous observation made by a

0:31:00.716 --> 0:31:13.396
<v Speaker 1>physician named John Weinberg five life. In nineteen sixty seven,

0:31:13.796 --> 0:31:16.956
<v Speaker 1>fresh out of his medical training, John Wenburg got a

0:31:17.036 --> 0:31:20.556
<v Speaker 1>job in Vermont as part of a federally funded operation

0:31:20.956 --> 0:31:24.836
<v Speaker 1>called the Regional Medical Program. These were the years of

0:31:24.876 --> 0:31:28.076
<v Speaker 1>the Great Society, when the US government was making a

0:31:28.156 --> 0:31:33.156
<v Speaker 1>concerted effort to expand the American's social safety net. Weinberg's

0:31:33.236 --> 0:31:36.196
<v Speaker 1>job was to map the quality of care across the

0:31:36.236 --> 0:31:39.636
<v Speaker 1>state to make sure everyone was getting access to the

0:31:39.676 --> 0:31:44.836
<v Speaker 1>same standard of medicine. He was young and idealistic. He

0:31:44.876 --> 0:31:47.556
<v Speaker 1>had studied under some of the best minds in medicine

0:31:47.756 --> 0:31:52.356
<v Speaker 1>at Johns Hopkins University. Weinberg arrived in Vermont, he said later,

0:31:52.676 --> 0:31:56.676
<v Speaker 1>still believing quote in the general paradigm that science was

0:31:56.716 --> 0:32:01.436
<v Speaker 1>advancing and that it was being translated rationally into effective

0:32:01.476 --> 0:32:06.396
<v Speaker 1>care end quote. Vermont had two hundred and fifty one towns.

0:32:07.076 --> 0:32:11.316
<v Speaker 1>Weinburg began by dividing up those communities according to where

0:32:11.396 --> 0:32:15.796
<v Speaker 1>their local residents got their medical care. That left him

0:32:15.836 --> 0:32:20.996
<v Speaker 1>with thirteen hospital districts across the state. He then calculated

0:32:21.036 --> 0:32:23.356
<v Speaker 1>the amount of money that was spent on medical care

0:32:23.636 --> 0:32:27.796
<v Speaker 1>in each of those districts. Wenberg assumed that what he

0:32:27.836 --> 0:32:30.516
<v Speaker 1>would see was that in some far away corner of

0:32:30.596 --> 0:32:33.996
<v Speaker 1>Vermont where there wasn't much money, spending would be low,

0:32:34.356 --> 0:32:38.236
<v Speaker 1>and by the same logic, in wealthier communities such as Burlington,

0:32:38.516 --> 0:32:41.076
<v Speaker 1>the biggest city in the state, home to the University

0:32:41.076 --> 0:32:44.396
<v Speaker 1>of Vermont and Champlain College, where the hospitals were the

0:32:44.436 --> 0:32:47.876
<v Speaker 1>newest and most sophisticated and the doctors more likely to

0:32:47.916 --> 0:32:51.836
<v Speaker 1>have trained at prestigious medical schools, spending would be a

0:32:51.876 --> 0:32:58.436
<v Speaker 1>bit higher. He was completely wrong. Yes, they were differences

0:32:58.436 --> 0:33:01.596
<v Speaker 1>in spending from one hospital district to the next. But

0:33:01.716 --> 0:33:06.236
<v Speaker 1>the differences weren't small. They were enormous, and they didn't

0:33:06.276 --> 0:33:10.196
<v Speaker 1>follow any apparent logic. They were as when put it

0:33:10.276 --> 0:33:15.516
<v Speaker 1>without rhyme or reason. Surgery for removing hemorrhoids, for example,

0:33:15.956 --> 0:33:20.116
<v Speaker 1>was five times more common in some districts than in others.

0:33:20.516 --> 0:33:24.636
<v Speaker 1>Your chances of getting an enlarged prostate surgically removed, or

0:33:24.676 --> 0:33:28.516
<v Speaker 1>your uterus removed in a hysterectomy, or your appendix removed

0:33:28.756 --> 0:33:32.236
<v Speaker 1>after an attack of appendicitis were three times higher in

0:33:32.276 --> 0:33:37.476
<v Speaker 1>some districts than in others. Here's Wenberg years later, describing

0:33:37.516 --> 0:33:40.076
<v Speaker 1>his early work in an interview with the Community Health

0:33:40.116 --> 0:33:42.836
<v Speaker 1>Centers podcast Conversations on Healthcare.

0:33:43.996 --> 0:33:46.716
<v Speaker 4>We first from at across this in Vermont, where we

0:33:47.356 --> 0:33:53.516
<v Speaker 4>looked at a whole bunch of different attributes of healthcare system.

0:33:53.556 --> 0:33:56.276
<v Speaker 4>The one that sticks out in most people's mind as

0:33:56.356 --> 0:34:01.156
<v Speaker 4>the incredible variation that we saw in time feleectomy rates,

0:34:01.356 --> 0:34:05.836
<v Speaker 4>where literally by going five miles up the road and

0:34:05.956 --> 0:34:10.476
<v Speaker 4>entering a new hospital service area, had jumped from about

0:34:10.476 --> 0:34:13.116
<v Speaker 4>a twenty percent risk of having a tonsil out by

0:34:13.156 --> 0:34:17.956
<v Speaker 4>age fifteen to well over sixty percent, So that gives

0:34:17.956 --> 0:34:22.596
<v Speaker 4>you an idea of what the basic variability was. And

0:34:22.676 --> 0:34:25.676
<v Speaker 4>this variation sembly could not be explained on the basis

0:34:25.716 --> 0:34:29.956
<v Speaker 4>of differences in the incidents of sword throats or tonsilitis

0:34:30.076 --> 0:34:32.156
<v Speaker 4>or anything like that, and it was traced pretty much

0:34:32.196 --> 0:34:35.556
<v Speaker 4>directly back to the medical opinion of the physicians and

0:34:35.596 --> 0:34:36.556
<v Speaker 4>the different communities.

0:34:37.476 --> 0:34:40.636
<v Speaker 1>Weinburg saw this firsthand. He was living at the time

0:34:40.796 --> 0:34:45.916
<v Speaker 1>midway between the small Vermont towns of Stowe and Waterbury.

0:34:45.996 --> 0:34:48.676
<v Speaker 1>His kids went to school in Waterbury, a town where

0:34:48.676 --> 0:34:51.956
<v Speaker 1>tons electomies were rare, But had Weinberg's family been living

0:34:51.996 --> 0:34:54.596
<v Speaker 1>one hundred yards north, his kids would have gone to

0:34:54.636 --> 0:34:59.556
<v Speaker 1>school in Stowe, where everyone got their tonsils out. It

0:34:59.676 --> 0:35:04.756
<v Speaker 1>made no sense. Stowe and Waterbury were both idyllic small towns,

0:35:04.996 --> 0:35:09.436
<v Speaker 1>full of weathered nineteenth century buildings. Nobody seriously I thought

0:35:09.596 --> 0:35:12.316
<v Speaker 1>that one was more worldly or was in the grip

0:35:12.356 --> 0:35:15.916
<v Speaker 1>of a different medical ideology than the other. It wasn't

0:35:15.956 --> 0:35:20.236
<v Speaker 1>that Stowe attracted one kind of person and Waterbury attracted another,

0:35:20.516 --> 0:35:23.836
<v Speaker 1>very different kind of person. The people were the same,

0:35:24.876 --> 0:35:28.436
<v Speaker 1>except that is that the children of Waterbury tended to

0:35:28.516 --> 0:35:31.876
<v Speaker 1>keep their tonsils and the children of Stowe did not.

0:35:34.076 --> 0:35:38.196
<v Speaker 1>Wenburg was now deeply confused had he stumbled upon some

0:35:38.316 --> 0:35:42.596
<v Speaker 1>strange quirk of the small towns of Vermont. He decided

0:35:42.636 --> 0:35:45.956
<v Speaker 1>to expand his analysis to other parts of New England.

0:35:47.916 --> 0:35:52.556
<v Speaker 1>He compared Middlebury, Vermont versus Randolph, New Hampshire. These two

0:35:52.596 --> 0:35:56.476
<v Speaker 1>cities are essentially twins. But when he looked further at

0:35:56.476 --> 0:35:59.916
<v Speaker 1>the data, he found that in Randolph the doctors conducted

0:35:59.956 --> 0:36:03.956
<v Speaker 1>themselves in a kind of over caffeinated frenzy, spending freely

0:36:04.196 --> 0:36:09.276
<v Speaker 1>hospitalizing and operating on everyone inside. But Middlebury Middlebury was

0:36:09.316 --> 0:36:13.596
<v Speaker 1>a different world. Weinberg called what he had discovered small

0:36:13.796 --> 0:36:17.516
<v Speaker 1>area variation, and he found evidence of it across the

0:36:17.756 --> 0:36:22.236
<v Speaker 1>entire United States. And what started as an idiosyncratic observation

0:36:22.676 --> 0:36:25.436
<v Speaker 1>about the small towns of Vermont has turned into an

0:36:25.436 --> 0:36:28.276
<v Speaker 1>iron law that, half a century after Weinberg made his

0:36:28.356 --> 0:36:32.956
<v Speaker 1>startling discovery, shows no signs of going away. How your

0:36:32.996 --> 0:36:36.716
<v Speaker 1>doctor treats you, in many cases, has less to do

0:36:36.876 --> 0:36:39.636
<v Speaker 1>with where your doctor was trained or how well he

0:36:39.756 --> 0:36:42.116
<v Speaker 1>or she did in medical school, or what kind of

0:36:42.156 --> 0:36:46.996
<v Speaker 1>personality your doctor has, than with where your doctor lives.

0:36:47.956 --> 0:36:52.276
<v Speaker 1>Why does place matter so much? The easiest explanation for

0:36:52.436 --> 0:36:55.756
<v Speaker 1>small area variation is that doctors are simply doing what

0:36:55.916 --> 0:36:59.956
<v Speaker 1>patients want. So, for example, let's pick a relatively simple

0:37:00.076 --> 0:37:03.876
<v Speaker 1>medical event, how many times a doctor visits a patient

0:37:04.196 --> 0:37:07.276
<v Speaker 1>in the last two years of their life. The national

0:37:07.356 --> 0:37:12.916
<v Speaker 1>average in twenty nineteen is around fifty four visits. In Minneapolis,

0:37:12.996 --> 0:37:17.596
<v Speaker 1>by contrast, the average is much lower, thirty six. But

0:37:17.676 --> 0:37:20.196
<v Speaker 1>you know what it is in Los Angeles, it's one

0:37:20.276 --> 0:37:24.756
<v Speaker 1>hundred and five. You get three times more doctor visits

0:37:24.756 --> 0:37:28.116
<v Speaker 1>in your dying days in LA than you do in Minneapolis.

0:37:28.556 --> 0:37:33.716
<v Speaker 1>That's a huge difference. Is it because dying Minnesotans behave

0:37:33.836 --> 0:37:37.356
<v Speaker 1>like stoic Scandinavians whereas the very old of Los Angeles

0:37:37.476 --> 0:37:40.676
<v Speaker 1>are needy in demanding The answer seems to be no.

0:37:41.796 --> 0:37:45.316
<v Speaker 1>Weenberg and other researchers have found that small area of

0:37:45.396 --> 0:37:49.516
<v Speaker 1>variation does not result from what patients want their doctors

0:37:49.556 --> 0:37:53.116
<v Speaker 1>to do. It stems from what doctors want to do

0:37:53.196 --> 0:37:58.516
<v Speaker 1>to their patients. So why do doctors behave so differently

0:37:58.676 --> 0:38:02.916
<v Speaker 1>from place to place? Is this just about money? Maybe

0:38:03.076 --> 0:38:05.956
<v Speaker 1>more people in Los Angeles have the kind of insurance

0:38:05.996 --> 0:38:10.396
<v Speaker 1>that rewards doctors for treating their patients aggressively. The technical

0:38:10.476 --> 0:38:13.716
<v Speaker 1>term for this is payer mix. A city with one

0:38:13.796 --> 0:38:16.836
<v Speaker 1>hundred percent of its citizens covered by fee for service

0:38:16.916 --> 0:38:19.756
<v Speaker 1>insurance where a doctor gets paid for everything they do

0:38:20.076 --> 0:38:22.236
<v Speaker 1>is going to have a very different pattern of care

0:38:22.516 --> 0:38:24.676
<v Speaker 1>than a city where one hundred percent of its citizens

0:38:24.996 --> 0:38:28.516
<v Speaker 1>are enrolled in managed care, where payments to doctors and

0:38:28.556 --> 0:38:32.596
<v Speaker 1>hospitals are fixed. But does Los Angeles have a radically

0:38:32.636 --> 0:38:37.516
<v Speaker 1>different payer mix than any other big city? No, it doesn't. Okay,

0:38:38.156 --> 0:38:41.476
<v Speaker 1>what if this is just random? After all, doctors are people,

0:38:41.836 --> 0:38:44.276
<v Speaker 1>and people are all over the map in what they believe.

0:38:44.596 --> 0:38:47.876
<v Speaker 1>Maybe Los Angeles is a place where, by chance, many

0:38:47.956 --> 0:38:51.676
<v Speaker 1>aggressive doctors happen to practice, while Minneapolis is a place where,

0:38:51.956 --> 0:38:53.876
<v Speaker 1>by chance, there are very few.

0:38:54.636 --> 0:38:54.676
<v Speaker 2>No.

0:38:55.756 --> 0:38:59.196
<v Speaker 1>Random would mean that aggressive doctors would be scattered across

0:38:59.236 --> 0:39:02.196
<v Speaker 1>the country in patterns that ebb and flow with each

0:39:02.236 --> 0:39:05.276
<v Speaker 1>passing year. Random would mean that every hospital would have

0:39:05.276 --> 0:39:08.956
<v Speaker 1>a different combination of physicians, representing a sampling of ideas

0:39:09.196 --> 0:39:11.956
<v Speaker 1>about how to practice medicine. They would be a doctor

0:39:12.036 --> 0:39:15.396
<v Speaker 1>Smith who always took out tonsils, and a doctor Jones

0:39:15.436 --> 0:39:17.996
<v Speaker 1>who never did, and then a doctor McDonald who was

0:39:18.036 --> 0:39:24.236
<v Speaker 1>somewhere in between. But that's not what Wemburg identified years ago.

0:39:24.716 --> 0:39:28.996
<v Speaker 1>What he found instead were medical clusters where the doctors

0:39:29.036 --> 0:39:32.756
<v Speaker 1>in one hospital district took on a common identity, as

0:39:32.756 --> 0:39:36.716
<v Speaker 1>if they had all been infected by the same contagious idea.

0:39:37.756 --> 0:39:41.476
<v Speaker 1>Jonathan Skinner, an economist at Dartmouth University who's one of

0:39:41.476 --> 0:39:44.796
<v Speaker 1>the heirs to Weinburg's work, said, it's a birds of

0:39:44.796 --> 0:39:46.956
<v Speaker 1>a feather flock together puzzle.

0:39:47.436 --> 0:39:51.476
<v Speaker 5>Like, okay, doctors have different opinions, like people develop opinions

0:39:51.756 --> 0:39:55.556
<v Speaker 5>about what works. But the question is, what is it

0:39:55.636 --> 0:39:59.076
<v Speaker 5>about an area that causes some people to practice in

0:39:59.116 --> 0:40:02.836
<v Speaker 5>one way on average and something that's kind of in

0:40:02.916 --> 0:40:03.596
<v Speaker 5>the water.

0:40:16.556 --> 0:40:23.276
<v Speaker 1>Six small area variation has subsequently become something of an

0:40:23.316 --> 0:40:28.396
<v Speaker 1>obsession for medical researchers. Books are written about it, scholars

0:40:28.556 --> 0:40:32.236
<v Speaker 1>spend their days studying it. But what's fascinating is how

0:40:32.276 --> 0:40:36.796
<v Speaker 1>the same inexplicable patterns of variation turn up outside the

0:40:36.836 --> 0:40:40.036
<v Speaker 1>world of medical care. Let me give you an example.

0:40:41.076 --> 0:40:44.476
<v Speaker 1>The state of California keeps the public database of what

0:40:44.596 --> 0:40:47.636
<v Speaker 1>percentage of seventh graders at any middle school in the

0:40:47.676 --> 0:40:52.916
<v Speaker 1>state are up to date with their recommended vaccines chicken pox, measles,

0:40:52.996 --> 0:40:56.316
<v Speaker 1>mom's rebella, polio, and so on. If you give the

0:40:56.356 --> 0:41:00.156
<v Speaker 1>list and it's a long list. A cursory glance, it

0:41:00.236 --> 0:41:04.636
<v Speaker 1>seems pretty straightforward. The overwhelming number of public school kids

0:41:04.636 --> 0:41:08.356
<v Speaker 1>in California have received all their shots. So what about

0:41:08.436 --> 0:41:12.756
<v Speaker 1>private school kids. Private schools tend to be smaller and corkier.

0:41:13.196 --> 0:41:16.476
<v Speaker 1>Could there be more variation there? Let's take a look.

0:41:17.116 --> 0:41:20.796
<v Speaker 1>Here are vaccination rates chosen at random from a selection

0:41:20.916 --> 0:41:24.956
<v Speaker 1>of private elementary schools in Contra Costa County east of

0:41:24.996 --> 0:41:29.716
<v Speaker 1>San Francisco. Saint John the Baptist one hundred percent, El

0:41:29.836 --> 0:41:35.196
<v Speaker 1>Sebrante Christian School one hundred percent, Contracosta Jewish Day School

0:41:35.636 --> 0:41:39.276
<v Speaker 1>one hundred percent. The list goes on. There are a

0:41:39.356 --> 0:41:42.916
<v Speaker 1>lot of private elementary schools in Contracosta County, and the

0:41:42.956 --> 0:41:45.876
<v Speaker 1>parents who live there seem pretty intent on protecting their

0:41:45.916 --> 0:41:51.316
<v Speaker 1>children from infectious diseases. Saint Perpetua one hundred percent, Saint

0:41:51.356 --> 0:41:55.716
<v Speaker 1>Catherine of Siena one hundred percent. But wait, there's one

0:41:55.756 --> 0:42:01.676
<v Speaker 1>school that's very different, East Bay Waldorf forty two percent.

0:42:02.836 --> 0:42:07.156
<v Speaker 1>Forty two percent. Is this a fluke, a chance deviation

0:42:07.356 --> 0:42:10.756
<v Speaker 1>from a consistent pattern. Let's take a look at private

0:42:10.796 --> 0:42:14.756
<v Speaker 1>schools in El Dorado County, just down the list alphabetically

0:42:15.116 --> 0:42:20.436
<v Speaker 1>from Contra Costa g HS Academy ninety four percent, Holy

0:42:20.516 --> 0:42:25.156
<v Speaker 1>Trinity School one hundred percent, and then wait for it,

0:42:26.276 --> 0:42:32.636
<v Speaker 1>Cedar Springs Waldorf thirty six percent. Estra Los Angeles. Most

0:42:32.636 --> 0:42:36.076
<v Speaker 1>middle schools, like their counterparts around the state are up

0:42:36.076 --> 0:42:38.996
<v Speaker 1>in the nineties or at one hundred percent, but once again,

0:42:39.236 --> 0:42:42.196
<v Speaker 1>there is an exception far on the west side of

0:42:42.196 --> 0:42:47.556
<v Speaker 1>the city, in the exclusive neighborhood of Pacific Palisades West

0:42:47.556 --> 0:42:54.276
<v Speaker 1>Side Waldorf twenty two percent. If you've never heard of

0:42:54.276 --> 0:42:58.076
<v Speaker 1>Waldorf schools, they're a movement started by the Austrian educator

0:42:58.196 --> 0:43:02.716
<v Speaker 1>Rudolf Steiner in the early twentieth century. Waldorf schools are

0:43:02.796 --> 0:43:07.516
<v Speaker 1>small and expensive and focus on holistic learning, seeking to

0:43:07.596 --> 0:43:12.356
<v Speaker 1>develop the creativity and imagination of their students. There are

0:43:12.396 --> 0:43:16.516
<v Speaker 1>several thousand Waldorff schools around the world, mostly kindergartens and

0:43:16.596 --> 0:43:21.156
<v Speaker 1>elementary schools, and about two dozen in California, and almost

0:43:21.236 --> 0:43:25.836
<v Speaker 1>without exception, the lowest vaccination rates in any California town

0:43:26.036 --> 0:43:29.756
<v Speaker 1>that has a Waldorf school are at the Waldorf school.

0:43:30.676 --> 0:43:33.716
<v Speaker 1>There are other schools with unvaccinateed rates as highest Waldorf,

0:43:33.916 --> 0:43:38.316
<v Speaker 1>but they're rare. Here is Sonoma County Saint Vincent de

0:43:38.396 --> 0:43:42.596
<v Speaker 1>Paul Elementary School one hundred percent, Rincon Valley Christian one

0:43:42.636 --> 0:43:46.756
<v Speaker 1>hundred percent, Sonoma Country Day School ninety four percent, Saint

0:43:46.756 --> 0:43:51.316
<v Speaker 1>Eugene Cathedral School ninety seven percent, Saint Rose one hundred percent,

0:43:51.996 --> 0:43:59.076
<v Speaker 1>Summerfield Waldorff School twenty four percent. California had two measles

0:43:59.116 --> 0:44:01.476
<v Speaker 1>outbreaks in the mid twenty tens.

0:44:02.116 --> 0:44:05.516
<v Speaker 4>Right now there are nine confirmed cases of the measles

0:44:05.556 --> 0:44:09.076
<v Speaker 4>which are tied to Disneyland or Disney's California.

0:44:09.116 --> 0:44:12.276
<v Speaker 3>As health officials try and contain the virus, parents are

0:44:12.276 --> 0:44:14.116
<v Speaker 3>being urged to vaccinate their children.

0:44:16.156 --> 0:44:20.476
<v Speaker 1>The outbreaks led many to say that California was suffering

0:44:20.516 --> 0:44:24.756
<v Speaker 1>from a problem with vaccine skepticism. But that's wrong. Look

0:44:24.756 --> 0:44:28.516
<v Speaker 1>again at those elementary schools with one hundred percent vaccination rates.

0:44:28.876 --> 0:44:33.076
<v Speaker 1>It's actually small pockets of people within the state, such

0:44:33.076 --> 0:44:34.876
<v Speaker 1>as the parents who sent their kids to a very

0:44:34.876 --> 0:44:38.356
<v Speaker 1>specific brand of elementary school, who have a vaccine problem.

0:44:38.996 --> 0:44:43.996
<v Speaker 1>John Wenberg would recognize the pattern in an instant vaccine

0:44:43.996 --> 0:44:49.596
<v Speaker 1>skepticism is small area of variation. This is the first

0:44:49.676 --> 0:44:54.396
<v Speaker 1>lesson of social epidemics. When we look at a contagious event,

0:44:54.796 --> 0:44:58.556
<v Speaker 1>we assume that there is something fundamentally wild and unruly

0:44:58.636 --> 0:45:01.996
<v Speaker 1>about the path it takes. But there is nothing wild

0:45:02.196 --> 0:45:06.276
<v Speaker 1>and unruly about the La Bank robbery epidemic, or the

0:45:06.316 --> 0:45:10.316
<v Speaker 1>patterns of medical practice in Waterbury versus Stowe, or the

0:45:10.476 --> 0:45:15.596
<v Speaker 1>ideas of Waldorf parents. Whatever contagious belief unites the people

0:45:15.716 --> 0:45:19.116
<v Speaker 1>in those instances has the discipline to stop at the

0:45:19.196 --> 0:45:22.636
<v Speaker 1>voters of their community. There must be a set of

0:45:22.716 --> 0:45:29.236
<v Speaker 1>rules buried somewhere below the surface, which brings us to

0:45:29.276 --> 0:45:37.356
<v Speaker 1>puzzle number two. Thanks for listening to that preview of

0:45:37.356 --> 0:45:39.916
<v Speaker 1>my new book, Revenge of the Tipping Point. You can

0:45:39.956 --> 0:45:44.676
<v Speaker 1>hear the rest on audible, Apple Books, Barnes and Noble, Spotify, Pushkin,

0:45:44.796 --> 0:45:49.076
<v Speaker 1>dot FM, or wherever you like to listen. Coming up

0:45:49.116 --> 0:45:52.636
<v Speaker 1>next on Revisionist History, two narrative episodes about my favorite

0:45:52.636 --> 0:45:55.516
<v Speaker 1>trial of all time, and a deep dive on broken windows,

0:45:55.916 --> 0:45:58.436
<v Speaker 1>a theory that I helped popularize in The Tipping Point?

0:45:59.156 --> 0:46:02.036
<v Speaker 1>Did I get it right? And what's changed twenty five

0:46:02.076 --> 0:46:02.596
<v Speaker 1>years later?

0:46:03.356 --> 0:46:04.676
<v Speaker 3>And I would go around and I would talk to

0:46:04.756 --> 0:46:06.676
<v Speaker 3>people in New York City, and the.

0:46:06.876 --> 0:46:10.196
<v Speaker 5>Liberal people, progressive people say oh, well, you know, we've

0:46:10.196 --> 0:46:11.516
<v Speaker 5>had this miracle in New York.

0:46:11.556 --> 0:46:13.836
<v Speaker 3>And some people would say, oh yeah, Malcolm Gladwell's idea.

0:46:13.876 --> 0:46:15.196
<v Speaker 3>Broken Windows.

0:46:17.676 --> 0:46:21.356
<v Speaker 1>Revision's history is produced by Nina Bird, Lawrence, Lucy Sullivan,

0:46:21.636 --> 0:46:25.196
<v Speaker 1>and Ben ad F. Haffrey. Our editor is Karen Chakerji,

0:46:25.556 --> 0:46:30.156
<v Speaker 1>and our executive producer is Jacob Smith. Special thanks to

0:46:30.236 --> 0:46:33.916
<v Speaker 1>Sarah Nix. The Revenge of the Tipping Point audiobook was

0:46:33.956 --> 0:46:37.876
<v Speaker 1>executive produced by Kerry Colan, directed by Alexandra Garreton with

0:46:37.916 --> 0:46:41.596
<v Speaker 1>help from Louis Mitchell, Engineered by Nina Bird Lawrence, guitar

0:46:41.716 --> 0:46:45.596
<v Speaker 1>by Ged Corbin. It was produced by Alexandra Garreton and

0:46:45.676 --> 0:46:49.196
<v Speaker 1>Louis Mitchell. Nicole op den Bosch is Pushkin's VP of

0:46:49.196 --> 0:46:53.516
<v Speaker 1>Operations and Publishing. Special thanks to Jasmine Faustino and of

0:46:53.556 --> 0:46:58.276
<v Speaker 1>course el Hefe Greta. Come, I'm Malcolm Popple