Speaker 1: Bushkin love that you're wearing a T shirt that says Canada,
Speaker 1: just so that we have no ambiguity whatsoever.
Speaker 2: Where are you right now? You in Las Vegas?
Speaker 1: I'm in Vegas right now. Yeah, I just got back
Speaker 1: here two days ago.
Speaker 2: Nice, very nice? Did I tell you? You know that?
Speaker 2: I was in Las Vegas and I had an afternoon
Speaker 2: and I sat in this coffee shop and there were
Speaker 2: three people next to me having the most interesting conversation.
Speaker 2: And one of the guys started talking and I realized
Speaker 2: he was talking about you.
Speaker 1: Really.
Speaker 2: Yeah, he was a lawyer of some kind who like,
Speaker 2: was a writer, lawyer or something. I don't know. I
Speaker 2: couldn't figure it out. And I was eavesdropping in a
Speaker 2: conversation for like, and it was like the most interesting conversation.
Speaker 1: I love that story. Now you did not tell me,
Speaker 1: and I have no idea who you're talking about.
Speaker 2: Allow me to introduce a new voice to this podcast,
Speaker 2: Maria Kanakhova. In basketball, they call people like Maria Swiss
Speaker 2: army knives, people who do everything. Maria got a PhD
Speaker 2: with the famous Walter Michelle, the guy who invented the
Speaker 2: marshmallow test. She's written a bunch of brilliant New York
Speaker 2: Times bestsellers. She decided at one point that she was
Speaker 2: interested in poker, taught herself poker, became a poker champion,
Speaker 2: made some enormous sum of money. She's the kind of
Speaker 2: person that random strangers talk about in coffee shops, which
Speaker 2: is to say, my kind of person. I'm Malcolm Gladwell.
Speaker 2: You're listening to Revisionist History, my podcast about things overlooked
Speaker 2: and misunderstand, and I have the pleasure in this episode
Speaker 2: to bring you the fabulous Maria Konikova, who has agreed
Speaker 2: to become the first ever Revisionist History amistman, or rather
Speaker 2: honest person. She is joining the show to be the
Speaker 2: advocate for you, dear listener, to call me on my nonsense,
Speaker 2: to be a voice of reason, to participate in the
Speaker 2: kind of whimsical, meandering flights of intellectual fancy that is
Speaker 2: our trademark here at Pushkin Headquarters. So Maria, welcome to
Speaker 2: Vision's History. I could think of no one better equipped
Speaker 2: to speak truth to the power that is Revision's History.
Speaker 1: 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 2: Wonderful let's have at it. I am putting in your hands.
Speaker 2: Is that correct?
Speaker 1: Nice putty that's responsive and that talks back?
Speaker 2: Okay, you're driving this train, all right?
Speaker 1: Perfect. So one of the fascinating episodes of this season
Speaker 1: of Revisionist History was about the lack of iodine in
Speaker 1: people's diets and how this was discovered and how it
Speaker 1: was actually then addressed and had I actually did not
Speaker 1: know the story at all. It's such a fascinating question.
Speaker 1: You know, how do we think about these things in
Speaker 1: the present day? Would we be able to do something
Speaker 1: like this today, you know, especially like after COVID, after
Speaker 1: all of these things like add iodine to their salt
Speaker 1: or their water and see what happens. What do you
Speaker 1: think the response to something like that would be.
Speaker 2: Well, you know, it's interesting that there is a line,
Speaker 2: there's a common line of either complaint or congratulation among
Speaker 2: sciences where they say that experiment could never be done today.
Speaker 2: The Stanford's Prison experiment could never be done today. Then
Speaker 2: the Tuskegee siftless experiment could never be done. You know,
Speaker 2: there's a whole long list of things. They look at that,
Speaker 2: and they say, and that's because we are much more
Speaker 2: mindful of people's autonomy, much better about obtaining consent. You
Speaker 2: totally today could not go to Akron and dose up
Speaker 2: a bunch of schoolgirls with a ton of eyeein. However,
Speaker 2: my reaction to that argument is always the same, which is, yeah,
Speaker 2: but we simultaneously conduct consentless experiments on human beings in
Speaker 2: the present day that are probably way more consequential, and
Speaker 2: we don't think twice about it. You know, think about
Speaker 2: the way we have disrupted the lives of I don't
Speaker 2: know children over the last twenty five years, with all
Speaker 2: of these new technologies. How's that not a massive experiment
Speaker 2: done without the consent of those who were experimented on.
Speaker 2: How is the Facebook algorithm, which you know shows you
Speaker 2: only the things that are likely to evoke a deeply
Speaker 2: emotional response in you. How's it not an experiment? I mean,
Speaker 2: there's a part of me that just wants to throw
Speaker 2: out my hands and say, you know, efort, well, it's
Speaker 2: not even let's not even let's not even bother making
Speaker 2: these distinctions. Once we've conceded that all these experiments can
Speaker 2: go on. Let's just declare them experiments and let people
Speaker 2: pick and choose the one they want to be a
Speaker 2: part of.
Speaker 1: I think there's something to that, especially because you know,
Speaker 1: at least with the iodine, right, it was there was
Speaker 1: scientific evidence for the test, right, There was a reason
Speaker 1: why they did it. There was a huge body of
Speaker 1: evidence 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, et cetera.
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 don't
Speaker 1: want you adding anything, you know, big pharma, big government,
Speaker 1: big big, et cetera. And here the town was actually horrified,
Speaker 1: which I think they should have been.
Speaker 3: You know, I'm biased, you know, I think there's good
Speaker 3: evidence that adding Florida to water is a good thing,
Speaker 3: that adding I had dined to salt is a good thing,
Speaker 3: and that when things are good.
Speaker 1: For our health and we're not going to get them
Speaker 1: in any other way, that this is a great way
Speaker 1: of doing it. But a lot of people disagree.
Speaker 2: Well, I wonder, you know, if that are they responding
Speaker 2: to the Florida They responding to what they see as
Speaker 2: as the official abusing his position, right, you can you
Speaker 2: know it's it's it's maybe it's a bit of both,
Speaker 2: or you know, you could see people who might ordinarily
Speaker 2: be indifferent to fluoride just getting pissed off over this issue.
Speaker 2: This guy's like, you're not allowed to do that, sir.
Speaker 2: Hold on, hold on, it's time for a short break.
Speaker 2: When we come back, we'll talk more about how salt
Speaker 2: and revision is history are changing lives, and also the
Speaker 2: infamous Minnesota starvation study.
Speaker 1: So let's read a letter about someone from someone who
Speaker 1: I actually I love this letter. I just saw it
Speaker 1: today and it is a very positive take on additions
Speaker 1: to food and someone who says that, you know, the
Speaker 1: Salt episode actually really changed their life. So this is
Speaker 1: from Mary P. And she writes that it was a crazy,
Speaker 1: awesome coincidence that I was listening to this episode around
Speaker 1: the same time my doctor felt a nodule on my thyroid.
Speaker 1: He told me to go get an ultrasound, and my
Speaker 1: thyroid and nodule both were large enough and suspicious enough
Speaker 1: that it was recommended automatically that I get a biopsy.
Speaker 1: So she went for her first biopsy and the results
Speaker 1: came back in conclusive. And I'm going to continue reading
Speaker 1: her letter. They sent another side for genetic texting. Meanwhile,
Speaker 1: I bought some iodized salt and started cooking with it.
Speaker 1: I had switched to kosher salt and other fancy salts
Speaker 1: over the past few years, and I'm an avid at
Speaker 1: home cook. We also live in the Midwest. I used
Speaker 1: iodized salt in moderation, of course, and thought nothing more
Speaker 1: of it. Well, I went back for my biopsy and
Speaker 1: they took new ultrasound images of my thyroid. This was
Speaker 1: about two to three months after my original ultrasounds. In biopsies,
Speaker 1: the ultrasound tech was asking me many questions and seemed confused,
Speaker 1: but kept to himself. The doctor came in and told
Speaker 1: me to sit up. My nodules and thyroids had all shrunk.
Speaker 1: My once once sentime to nodule was now around five millimeters.
Speaker 1: He had no reason to biopsy because there was nothing
Speaker 1: of concern. In fact, he would not biopsy it, no surgery,
Speaker 1: just a follow up scan in a year Hallalujah. I
Speaker 1: told him my theory about the iodine and he said
Speaker 1: that very well could have been what shrunk everything. I
Speaker 1: asked if the cancer could be in there, just smaller.
Speaker 1: He scoffed at me and said no.
Speaker 2: What a great letter, right, Wow, for all of those
Speaker 2: who doubt the healing power of Revision's history. I present
Speaker 2: you this letter. We don't we don't just we don't
Speaker 2: just rile up our listeners. We save lives. This is
Speaker 2: a resounding endorsement of years of Revision's history.
Speaker 1: And those types of coincidences are great. Right, that you
Speaker 1: hear something and it actually has such an impact that
Speaker 1: would have been a life changing thing for her to
Speaker 1: have no thyroid function, half her thyroid function for the
Speaker 1: rest of our life, that's a huge thing.
Speaker 2: Yeah, you know, it's a reminder. This is one of
Speaker 2: these weird things, like one hundred years ago, what she's
Speaker 2: describing was commonplace. In fact, this is a little little
Speaker 2: fact in that episode that I can never get over
Speaker 2: my head is if you went to parts of the
Speaker 2: world that were iodine to fish and some extraordinarily high
Speaker 2: percentage of the population had these massive goiters on their neck,
Speaker 2: and like that was just part of the part of
Speaker 2: the experience of going to the Swiss Alps, or part
Speaker 2: of the experience of going to somewhere around the Great
Speaker 2: Lakes was you'd walk into a small town and you
Speaker 2: know whatever, quote of the people had big grapefruit sized
Speaker 2: masses on their necks. It's just so strange.
Speaker 1: It's crazy 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 is a complex thing, right,
Speaker 1: It's a complex machine, and it's so it's very difficult
Speaker 1: oftentimes to know like this is the recommendation and it
Speaker 1: will always be the recommendation.
Speaker 2: And also, you know, it's hard. This is sort of
Speaker 2: what brings us to the miss starvation experiment, which I'm
Speaker 2: sure we're going to talk about. But one of the
Speaker 2: big impetuses for that is that one of the reasons
Speaker 2: we know so little about nutrition is that it's impossible
Speaker 2: to test hypotheses about nutrition, because how do you do
Speaker 2: it right, Like, if you think about something as simple
Speaker 2: as does drinking alcohol harm or help your health? Right,
Speaker 2: that's a question that's been irrelevant for as long as
Speaker 2: human beings have drunk alcohol, So thousands and thousands and
Speaker 2: thousands of years, we're still arguing about that. And the
Speaker 2: reason we're still arguing about it is it's virtually impossible
Speaker 2: to design a study which would satisfactorily answer that question.
Speaker 2: So there happens that which say people who drink wine
Speaker 2: and moderation seem to live long, healthy lives. But you know,
Speaker 2: the problem is that people who drink wine in moderation
Speaker 2: are people who otherwise live moderate, healthy lives. Right, They're like,
Speaker 2: you know, they're villagers in the south of Italy who
Speaker 2: are getting in enormous amount of exercise and living in
Speaker 2: bucolics surroundings. So you just don't know is it is.
Speaker 2: Are are they living long, happy lives in spite of
Speaker 2: their one consumption or because of it? Right simontanoing you
Speaker 2: know you see these so you can read. It's just
Speaker 2: incredibly I just read read the other day, like there's
Speaker 2: a new line of thinking which says, you know, all
Speaker 2: alcohol is basically like really bad for you and should
Speaker 2: be avoided.
Speaker 1: I saw that.
Speaker 2: I have no idea what to make of that, Like,
Speaker 2: I don't even know how do they manage that conclusion.
Speaker 2: It's just that that idea that we could be in
Speaker 2: twenty twenty three and still being capable of answering these
Speaker 2: questions with any degree of accuracy is fascinating to me.
Speaker 1: Yeah, it's totally crazy. It's so funny that you mentioned
Speaker 1: red wine, which is you know, or alcohol in general.
Speaker 1: The first one of the first studies I ever worked
Speaker 1: on as a journalist who who kind of is interested
Speaker 1: in these questions forever ago, was on resveratrol when it
Speaker 1: first came out, like the data that, oh my god,
Speaker 1: res vitrol makes you live longer, and everyone was saying, great,
Speaker 1: red wine, it's amazing. Then a few years later we
Speaker 1: find out that the quantity of versviatrol you need is
Speaker 1: just so much higher than you would ever get. And
Speaker 1: it goes back and forth, and I've seen that one
Speaker 1: question just go in circles for you know, almost twenty
Speaker 1: years now, and we we just have no idea.
Speaker 2: Do you remember was it were they Were they getting
Speaker 2: rats large doses of.
Speaker 1: Yes, Oh, that's the thing, exactly, That was exactly it.
Speaker 1: It was rodents, rodence, and red wine.
Speaker 2: So the only the only thing we can say for
Speaker 2: certain is that within the rat population, those who enjoy
Speaker 2: a good bottle of wine every night are going to
Speaker 2: live a little longer.
Speaker 1: So I think that this is a good a good
Speaker 1: segue point. You know, people who were not drinking any
Speaker 1: wine were taking part in the starvation study, that was
Speaker 1: part of this season of revisionist history. So I mean,
Speaker 1: first of all that study, let's just kind of recap
Speaker 1: it very quickly. I mean we're talking actual starvation, like
Speaker 1: the number of calories that these men. So it was
Speaker 1: all men. It was all young, relatively healthy men who were,
Speaker 1: for one reason or another, not in the military, not
Speaker 1: serving abroad during World War two, and they were all
Speaker 1: brought to this place to try to control because as
Speaker 1: we've just talked about, it's really difficult to control food intake,
Speaker 1: to try to control it as much as possible, to
Speaker 1: try to do their part for the war effort to
Speaker 1: see how starvation affects the body. Is that a fair summar.
Speaker 2: Race, Yes, exactly, because you don't already had The impetus
Speaker 2: was this was in the middle of the war, and
Speaker 2: the feeling was that by the end of the war
Speaker 2: one of the biggest problems the world was going to
Speaker 2: face was that millions of people around the world had
Speaker 2: suffered prolonged malnutrition throughout the conflict, and we didn't know
Speaker 2: how to help them. We honestly had no idea if
Speaker 2: someone has been malnourished for a year and a half,
Speaker 2: what is the best way to nurse them back to
Speaker 2: health and literally we hit people. At the time didn't
Speaker 2: have the size clue, right, So they were trying to
Speaker 2: answer that question with some at least get some information
Speaker 2: about that. So there was the stakes here were huge.
Speaker 2: I mean, that's what gives the study, it's kind of
Speaker 2: 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 this 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 i RB, which
Speaker 1: is an institutional review board when you're doing any sort
Speaker 1: of human research, and you need to have every single
Speaker 1: subject give informed consent. 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.
Speaker 2: Well, it's like spaceflight. You're sending an astronaut to the moon.
Speaker 2: Presumably you pull the astronaut aside beforehand and you say
Speaker 2: the benefit year is mankind will be able to say
Speaker 2: we went to the moon. But you know, in that situation,
Speaker 2: the first astronaut in space, we don't know what it's
Speaker 2: like to be out for a couple weeks in zero gravity.
Speaker 2: So I don't know how do they do consent. I
Speaker 2: guess they said, you're taking a risk of unknown quantity,
Speaker 2: you might be damaged by what you're doing. Are you
Speaker 2: fine with that? And I think the answer they were
Speaker 2: fine with it is that many of those astronauts came
Speaker 2: out of the military, and so they were used to
Speaker 2: the idea that they were called to do something on
Speaker 2: behalf of their country, which carried with it a significant
Speaker 2: 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.
Speaker 2: Wait, you are you? Are you a Minnesota's starvation experiment skeptic?
Speaker 2: Do you not think it should have been done? No?
Speaker 1: I'm someone who wants to push back though, and to
Speaker 1: question how it was done and whether they could potentially
Speaker 1: have ever given and formed consent to something like this,
Speaker 1: especially given what we know now about the long, longitudinal,
Speaker 1: long term effects about starvation. Back then, the term epigenetic
Speaker 1: I don't think even existed. People did not know kind
Speaker 1: of what the interaction of genes and environment is. Today,
Speaker 1: we actually know that starvation has lifelong consequences. They actually
Speaker 1: change the methylation patterns of your of your genes, of
Speaker 1: your genome, and that there's actually a lot of damage
Speaker 1: that is going to be done for your entire life.
Speaker 1: And the funny thing is a lot of the data,
Speaker 1: the best data that we have on this didn't come
Speaker 1: from the starvation experiment, but actually happened from a natural
Speaker 1: experiment that came at the exact same time, more or
Speaker 1: less contemporaneous, which was basically the Dutch hunger winter. It
Speaker 1: was also during World War Two there was a huge
Speaker 1: famine in the Netherlands because there was a blockade by
Speaker 1: the Nazis and thousands of people died. I think something
Speaker 1: like twenty thousand people ended up dying. But at the
Speaker 1: same time, there were a bunch of women who were
Speaker 1: pregnant and doctors were taking all of the measurements that
Speaker 1: you would normally take during pregnancy, but these women happened
Speaker 1: to be starving, and then they ended up following the
Speaker 1: women and the babies for their lives and actually got
Speaker 1: an amazing amount of data on what starvation does to
Speaker 1: the body.
Speaker 2: What does it do?
Speaker 1: Oh well, we're still finding out. There are lots of
Speaker 1: things that end up happening later in life. You're more
Speaker 1: prone to gain weight because your body is prepared for
Speaker 1: starvation and has been prepared for from in utero. It
Speaker 1: also ends up, you know, affecting your the way that
Speaker 1: your kids are going to develop. So if you were,
Speaker 1: I guess, a fetus during during this time, then by
Speaker 1: the time that you're you're an adult, when you have
Speaker 1: your own kids, you're actually going to pass a lot
Speaker 1: of these epigenetic changes further on to them. They are
Speaker 1: also going to be effects on how you're going to
Speaker 1: just think and do in life. It turns out that
Speaker 1: 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 starve 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.
Speaker 2: So imagine that we were doing a version of the
Speaker 2: Dutch starvation thing involving pregnant women. But it was an experiment, right.
Speaker 1: All right, magic wandftly measure.
Speaker 2: And what we learned from that is that actually starving
Speaker 2: people when they're pregnant has incredible as unanticipated long term
Speaker 2: consequences not just for the mother but for the child
Speaker 2: and even maybe for the child's children child.
Speaker 1: So absolutely so.
Speaker 2: In other words, and we had no idea of this before.
Speaker 2: So this is a kind of like, this is a
Speaker 2: this is a earth shattering, huge bit of understanding about
Speaker 2: human beings. Why wouldn't this be an argument. Why wouldn't
Speaker 2: the magnitude of what we learned from that such an
Speaker 2: experiment be an argument for doing the experiment?
Speaker 1: Not?
Speaker 2: Right, It's so important that hundreds thousands, millions more people
Speaker 2: could be helped from the knowledge gleaned from that experiment
Speaker 2: than those who were who were harmed by it, And
Speaker 2: if the people who signed up for that experien had
Speaker 2: a at least a kind of reasonable suspicion that what
Speaker 2: was learned from the from them putting themselves at risk
Speaker 2: might help many, many, many, many many more people, then
Speaker 2: to my mind, that settles it. It's fine. I mean,
Speaker 2: this is what I was trying to get to in
Speaker 2: the podcast, is that we're so indifferent to people who
Speaker 2: have altruistic motives. That isn't where is the altruistic motive
Speaker 2: data point in the consent algorithm? Like you should be
Speaker 2: able to say, I know it's going to harm me,
Speaker 2: but I think it's going to help a lot more people,
Speaker 2: and I'm fine with that.
Speaker 1: Yeah. So, like I said, when you asked me, am
Speaker 1: I a skeptic of this? I said, I'm not necessarily
Speaker 1: someone who said this shouldn't have happened. I just think that,
Speaker 1: you know, there are lots of issues to consider. So, yeah,
Speaker 1: there is this. There's definitely an argument to be made that,
Speaker 1: you know, what we learned from Dutch famine shows that
Speaker 1: studies like this are incredibly important. But in this particular case, right,
Speaker 1: I think in the pregnancy case, you're also giving consent
Speaker 1: for your fetus. Right, So it's one of these things
Speaker 1: where that's even if you're an altruist, I think that
Speaker 1: that would be a very strange definition of altruism, because
Speaker 1: you're being altruistic for the world, but not for this
Speaker 1: one specific human who has no say in this whatsoever.
Speaker 2: But I would say this like so, for much of
Speaker 2: human history, continue to the present day, a large percentage
Speaker 2: of the world's population suffers from prolonged malnutritionolutely, So one
Speaker 2: really important historical question is what can we do to
Speaker 2: convince the wealthier parts of the world that this is
Speaker 2: such an urgent problem that it needs to be addressed immediately. Right,
Speaker 2: wouldn't it make sense to try an extreme experiment of
Speaker 2: this sort to try and bring the world around?
Speaker 1: I mean, I think I think that's a very valid point.
Speaker 1: And 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 this silly thing.
Speaker 1: It wasn't even a major deception study, but we needed
Speaker 1: We couldn't tell them that 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 crossed 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. So that was that
Speaker 1: was a study gone a bit off the off the
Speaker 1: rails when it comes to nutrition. But so you have
Speaker 1: those two extremes and how do you how do you
Speaker 1: weigh that, how do you balance that? How do you
Speaker 1: 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?
Speaker 2: Yeah, I will say that there is there is one
Speaker 2: area on this where I am I'm the you know,
Speaker 2: I've been talking so far about how I would I
Speaker 2: tend to be pretty laissez faire about giving researchers the
Speaker 2: freedom to do things that are a little bit risky.
Speaker 2: Or there's another area though, where I'm on the exact
Speaker 2: opposite side of the fence, And what am I referring to, patience, grasshopper?
Speaker 2: When we come back more from my conversation with Maria Konakova,
Speaker 2: we're back, and I was telling Maria that I'm pretty
Speaker 2: laissez fair about letting experiments go forward, except in the
Speaker 2: case of what might be the most awful natural experiment
Speaker 2: we're living through right now. I am incredulous at the
Speaker 2: idea that thousands of pages of text and hours of
Speaker 2: argumentation is spent on the ethics of one medical experiment
Speaker 2: or another. And at the same time we are, you know,
Speaker 2: completely indifferent or cavalier about the levels of violence that
Speaker 2: are present in media every day. Now, there had been
Speaker 2: moments every now and again, periodically there are moments where
Speaker 2: various interest groups get upset about depictions of violence on television.
Speaker 2: Was a big deal I think in the seventies, for example,
Speaker 2: and then it sort of went away, and then the
Speaker 2: people who were complained about this got painted as kind
Speaker 2: of buffoons or as naive sewer in the middle of nowhere.
Speaker 2: And you know, I don't want to give it away,
Speaker 2: but I had in the course of an episode of
Speaker 2: I'm Doing in this upcoming season where I have these
Speaker 2: long conversations with trauma surgeons who deal with gunshot wounds,
Speaker 2: and what they have to say on this very specific
Speaker 2: matter is incredibly interesting and disturbing. They're They're not like
Speaker 2: hiding their head in the sand about this. They are
Speaker 2: fully aware of it. The people who are who have
Speaker 2: a I believe a morally objectionable position, or the people
Speaker 2: in Hollywood, many of whom are self described liberals, who
Speaker 2: will go on and on and on about the you know,
Speaker 2: the terror need for gun control in America and how
Speaker 2: outrageous all the Second Amendment people is. And meanwhile they're
Speaker 2: making movies well like twenty people are slaughtered in the
Speaker 2: first fifteen minutes. Like, I'm sorry, this is just like
Speaker 2: completely incomprehensible behavior, right. This drives me nuts.
Speaker 1: Yeah, I know that there's a lot to be said
Speaker 1: for that. It's like we've never outlived the instinct for
Speaker 1: public executions right where everyone would come to the town square.
Speaker 1: Instinct is still alive and well, it's an important tangent
Speaker 1: to go on, and it is related to everything we've
Speaker 1: been talking about about how do you study this? You know,
Speaker 1: what are the benefits, what are the harms? And there's
Speaker 1: you so kind of coming full circle back to the
Speaker 1: starvation experiment, there is one thing that we haven't talked about,
Speaker 1: which was an important point that one of the listeners
Speaker 1: brought up. And this is an important point about a
Speaker 1: lot of the research not from that day, but that
Speaker 1: continues to be done to this day, which is how
Speaker 1: realizable are the results to the segments of the population
Speaker 1: that might actually benefit most from it. So Maura, this
Speaker 1: listener wrote, how can we treat eating disorder patients primarily
Speaker 1: young women using data collected exclusively on white men. How
Speaker 1: can we use this to study the impact of dieting
Speaker 1: and weight loss when dining is more prevalent and pressured
Speaker 1: upon among women. How can we use this to study
Speaker 1: obesity when non Hispanic black adults and Hispanic adults have
Speaker 1: the highest prevalence of obesity in the United States. That's
Speaker 1: the end of her letter, But I would just go
Speaker 1: on and on. When we're talking about malnourishment and we
Speaker 1: realize that most of the malnourished population of the world
Speaker 1: is not white men, So that is kind of an
Speaker 1: interesting side note, and this is actually still a huge problem.
Speaker 1: That's not something that we left behind in the forties.
Speaker 1: To this day, most medical data comes from men, not women,
Speaker 1: and it's a very kind of that's an interesting way
Speaker 1: of looking at you what are the actual benefits from
Speaker 1: us to the people who need them, and how general
Speaker 1: of isable is.
Speaker 2: If you're trying to develop actionable policies and guidelines and
Speaker 2: approaches to affective populations, it absolutely does matter. And you know,
Speaker 2: we went through this with I think with our understanding
Speaker 2: of heart attacks right where we started off testing a
Speaker 2: lot of these hypotheses in men, white men, and that's
Speaker 2: how we got our baseline knowledge. But then we tried
Speaker 2: to use that information to kind of understand how to
Speaker 2: deal with women without realizing that the biology of a
Speaker 2: lot of these problems, physiology of a lot of these
Speaker 2: problems in women's very different. So I think it depends
Speaker 2: where you are in the kind of stage that you're at.
Speaker 2: And the mistake we make, I think is we don't
Speaker 2: honor this distinction between kind of basic understanding and actionable research.
Speaker 2: If you talk to somebody body who is works for
Speaker 2: a pharmaceutical company and is involved in drug trials. You know,
Speaker 2: they will talk your ear off on this, and what
Speaker 2: they will say is, do you know how hard it
Speaker 2: is to put together a study population. It's insanely difficult
Speaker 2: to find someone. I actually thought of I was going
Speaker 2: to volunteer for a trial about lime disease vaccine. And
Speaker 2: then I add that the first thing to do is
Speaker 2: you have half an hour conversation with someone. And they
Speaker 2: detail that I would have to go to drive to
Speaker 2: Albany an hour away, seven times and have to set
Speaker 2: aside half a day on each of those occasions. And
Speaker 2: I wasn't clear whether I'd be part of the treatment
Speaker 2: group or the pacibo group, right, So I listened to that.
Speaker 2: I was like, I can't do that. I'm not taking
Speaker 2: you know, somewhat selfishly, I decided I don't have that
Speaker 2: much time to devote to this, so I'll let someone
Speaker 2: else carry the burden. So it's like, it's really hard
Speaker 2: to do these studies. So when you if we say
Speaker 2: these studies have to be perfectly representative, you're just making
Speaker 2: it less likely that the study gets done in the
Speaker 2: first place at a certain point. Right, So that's the
Speaker 2: trade off. It's an impossible trade off.
Speaker 1: Sure, No, I think, I think there's a lot of
Speaker 1: truth to that. That said, I do think that even
Speaker 1: baseline knowledge studies these days should at least include women
Speaker 1: because you know, if you're omitting more than half the
Speaker 1: population and the basic biology is different, then but.
Speaker 2: You couldn't have done the starvation experiment with women.
Speaker 1: So that's the other thing, right, what are we proposing
Speaker 1: in the starvation case? Do we want women there? And
Speaker 1: Hispanic and black where it's much more difficult to actually
Speaker 1: obtain consent because especially back then, but even to this day,
Speaker 1: you know, these are populations that have had a lot
Speaker 1: of negative research done without consent, and it's actually much
Speaker 1: more difficult, I would say, and the burden of proof
Speaker 1: is much higher to ask for consent from vulnerable population.
Speaker 2: You can't do a starvation experiment like that in Minnesota
Speaker 2: on young women because if it has consequences for their
Speaker 2: fertility than you have So what are you going to see?
Speaker 2: Does so are we going to use are we going
Speaker 2: to use postmen apausal women only? But that brings up
Speaker 2: a whole different set of issues because now you have
Speaker 2: an older population that's going to be less susceptible to
Speaker 2: whatever risks you're exposing them to it's tricky. This reminds
Speaker 2: me we talk in the season about magic wands experiments
Speaker 2: we could do if we could wave a magic wand
Speaker 2: this one doesn't actually you require a magic wand, although
Speaker 2: it would be very hard to do in the real world.
Speaker 2: But you mentioned that natural experiment in Holland which gave
Speaker 2: us information that would have been almost impossible to get
Speaker 2: otherwise in a formal experiment. And it goes to the
Speaker 2: larger point that this is the great thing about natural
Speaker 2: experiments is that when you can find a good one,
Speaker 2: they almost invariably tell you stuff that you could never
Speaker 2: find out other way. They're incredibly productive kind of experiment.
Speaker 2: So why can't we engineer actual experiments? So imagine this.
Speaker 2: Imagine if someone came to you and me and a
Speaker 2: million other people and said, we're at the stage now
Speaker 2: in our in technology where we can put little sensors
Speaker 2: on you which can continuously monitor every one of your
Speaker 2: physiological signs and vital signs in real time. Would you
Speaker 2: agree to be basically monitored for the next whatever ten
Speaker 2: years and you and two million or ten million other
Speaker 2: people agree to be part of this, and we will
Speaker 2: we will simply wait and see what happens to you
Speaker 2: and use that massive data set to kind of improve
Speaker 2: our understanding of the kinds of things that lead to
Speaker 2: various sorts of diseases. I mean, if you had ten
Speaker 2: million people and they were giving you ten years of
Speaker 2: their life and every conceivable indicator and vital sign was
Speaker 2: being monitored on a moment to moment basis, you would
Speaker 2: be able to understand stuff that right now we have
Speaker 2: no clue about, right and all it takes is for
Speaker 2: people just they don't even take in a risk, They're
Speaker 2: just being willing to be monitored and donate their data.
Speaker 2: That's essentially engineering a natural experiment. I don't understand why
Speaker 2: that hasn't been done. Privacy, no one who cares this
Speaker 2: is don't even me started on privacy. Privacy drives me
Speaker 2: just nuts. It's like, what an absurd thing in this
Speaker 2: day and age to be concerned about. Like, basically, as
Speaker 2: far as I can tell, every single fact about Malcolm
Speaker 2: Glovel is known by like some combination of Facebook, Apple,
Speaker 2: Google and someone else.
Speaker 1: And so I meant to ask, Malcolm, what is your
Speaker 1: mother's maiden name? I just have a few more questions.
Speaker 1: Before we were at I.
Speaker 2: Know it's like a ludicrous and so it's fine for
Speaker 2: those guys to scour, you know, the Internet and put
Speaker 2: together massive dossiers of everything, every fact about me. But somehow,
Speaker 2: if I want to allow someone to peek into my
Speaker 2: is it physiological, you know, for the benefit of mankind?
Speaker 2: That's a problem. Just drives me crazy.
Speaker 1: It is a problem, And I didn't know that I
Speaker 1: hit a nerve with that one word privacy. But here
Speaker 1: we are, so that I think is a nice place
Speaker 1: to wrap up our starvation study, except for one final question.
Speaker 1: One listener was really fascinated by the cinnamon role of
Speaker 1: recipe from the episode of the Starvation Study Tara A.
Speaker 1: She said, thank you for these episodes, Malcolm. So, Malcolm,
Speaker 1: thank you for these episodes. Any chance you know how
Speaker 1: we could track down that cinnamon roll recipe. I was
Speaker 1: thinking would be nice to make some and share in
Speaker 1: my community and for a refresher for listeners who don't
Speaker 1: love cinnamon roles as much as I do. So did
Speaker 1: it immediately light up at this detail. So there was
Speaker 1: a character in the episode, Lester Glick, who was part
Speaker 1: of this study and one of the things that mentally
Speaker 1: fortified him. Although I think for me it would have
Speaker 1: probably had the opposite effect. As he carried around a
Speaker 1: picture of a cinnamon roll and he had it with
Speaker 1: him always, and it was something that kept him going.
Speaker 2: And then later he would for the rest of his
Speaker 2: life he would make them obsessively for family and friends,
Speaker 2: by the dozens. It was the defining one of the
Speaker 2: defining acts of the rest of his life.
Speaker 1: Now, I love cinnamon rolls, so I also wanted to
Speaker 1: track down that recipe.
Speaker 2: We will post it online in all those brave souls
Speaker 2: who want to recreate the famous cinnamon rolls can do that.
Speaker 2: That was fun. Thank you, Maria. That's really fun, of course.
Speaker 2: Thank you, Bye bye, Maria, Maria, Maria, thank you so
Speaker 2: much for agreeing to take on the role of revisionist
Speaker 2: histories inaugural homless person. Just so all of you know,
Speaker 2: we hope to make Maria a regular on the show
Speaker 2: in the future. You may have thought she went easy
Speaker 2: on me this time. Let me just say I have
Speaker 2: no expectation that will ever happen again. Oh, if you're
Speaker 2: wondering why I said it takes bravery to make the
Speaker 2: cinnamon rolls, let's just say the recipe involves among other
Speaker 2: things mash potatoes. Go to our website and see for yourself,
Speaker 2: and thank you to the Glick family for sharing that
Speaker 2: with us. Maria will be back soon, So send your questions,
Speaker 2: your challenges, your gripes, and your stories to all of
Speaker 2: us at revisionististory dot com. Revision's History is produced by
Speaker 2: Leaming Gestou, Amy gains Kiara Powell, and Jacob Smith. Our
Speaker 2: showrunner is Peter Clowney. Original scoring by Luis Gara, mastering
Speaker 2: by Sarah Braguaire and engineering by Nina Lawrence. Fact checking
Speaker 2: by Mishelle Williams. Special thanks to Julia Barton. Subscribe to
Speaker 2: pushkin plus to hear all our episodes of Revisionist History
Speaker 2: add free, and as of this year, get our shows
Speaker 2: two weeks earlier than the rest of the world. I'm
Speaker 2: Malcolm Pampa.