1 00:00:02,440 --> 00:00:03,360 Speaker 1: Happy Saturday. 2 00:00:03,880 --> 00:00:06,640 Speaker 2: We just had an episode on the history of iodized 3 00:00:06,840 --> 00:00:10,080 Speaker 2: salt and that has some connections to our previous episode 4 00:00:10,160 --> 00:00:15,080 Speaker 2: on the invention of radioiodine therapy. So that is today's 5 00:00:15,240 --> 00:00:16,200 Speaker 2: Saturday classic. 6 00:00:16,560 --> 00:00:19,760 Speaker 1: This one originally came out on June tenth, twenty nineteen, 7 00:00:20,040 --> 00:00:25,760 Speaker 1: So enjoy. Welcome to Stuff you Missed in History Class, 8 00:00:25,960 --> 00:00:35,920 Speaker 1: a production of iHeartRadio. Hello, and welcome to the podcast. 9 00:00:35,960 --> 00:00:38,000 Speaker 1: I'm Holly Frye and I'm Tracy B. 10 00:00:38,120 --> 00:00:38,559 Speaker 2: Wilson. 11 00:00:39,120 --> 00:00:42,159 Speaker 1: Okay, so true confession on this one. This episode is 12 00:00:42,200 --> 00:00:43,640 Speaker 1: inspired by one of my cats. 13 00:00:44,040 --> 00:00:50,280 Speaker 2: Yeah, but simultaneously fascinating and a lot older than I thought. Yes, 14 00:00:51,240 --> 00:00:54,280 Speaker 2: it's not about kitties or animals really at all, although 15 00:00:54,280 --> 00:00:58,680 Speaker 2: they are mentioned in terms of medical testing. Nothing particularly gruesome, 16 00:00:58,720 --> 00:01:02,160 Speaker 2: but just FYI if that's trouble for you. It is 17 00:01:02,200 --> 00:01:06,520 Speaker 2: in fact about science because my cat osile was hyper 18 00:01:06,560 --> 00:01:11,000 Speaker 2: thyroid and so we opted to have radioiodine therapy treatment 19 00:01:11,080 --> 00:01:14,600 Speaker 2: for him. And as my vent was describing this to 20 00:01:14,640 --> 00:01:16,040 Speaker 2: me and she's like, Oh, it's just like how they 21 00:01:16,040 --> 00:01:17,560 Speaker 2: do it in humans, blah blah blah blah, and I 22 00:01:17,600 --> 00:01:19,240 Speaker 2: was like, I have never thought about this one. 23 00:01:20,080 --> 00:01:21,200 Speaker 1: Where did this all begin? 24 00:01:22,840 --> 00:01:25,520 Speaker 2: So It just got me wondering about the origins of 25 00:01:25,560 --> 00:01:30,280 Speaker 2: this treatment because it is a very successful treatment and 26 00:01:30,360 --> 00:01:33,000 Speaker 2: it's one of those things that both humans and animals 27 00:01:33,000 --> 00:01:36,039 Speaker 2: seem to respond well to, which just was fascinating to 28 00:01:36,080 --> 00:01:37,640 Speaker 2: me because, as you know, I love a little bit 29 00:01:37,680 --> 00:01:40,600 Speaker 2: of science. So that is what we were talking about today, 30 00:01:41,120 --> 00:01:44,920 Speaker 2: the advent of radioiodine therapy. So first we're going to 31 00:01:45,000 --> 00:01:47,720 Speaker 2: talk just a little bit about your thyroid and how 32 00:01:47,720 --> 00:01:50,360 Speaker 2: it works. Your thyroid is a small organ that sits 33 00:01:50,400 --> 00:01:54,120 Speaker 2: below your larynx, and in the most basic terms, its 34 00:01:54,200 --> 00:01:56,160 Speaker 2: job is to convert the iodine and the food you 35 00:01:56,200 --> 00:02:00,720 Speaker 2: eat into hormones that regulate your metabolism. Thyroid cells are 36 00:02:00,720 --> 00:02:03,760 Speaker 2: the only ones in the human body that take in iodine, 37 00:02:03,960 --> 00:02:06,040 Speaker 2: but all of the other cells in the body are 38 00:02:06,080 --> 00:02:09,200 Speaker 2: affected by the work that the thyroid does. So the 39 00:02:09,280 --> 00:02:12,760 Speaker 2: hormone known as thyroxine abbreviated as T four and the 40 00:02:12,760 --> 00:02:17,400 Speaker 2: hormone triiodithyronine known also as T three are vital to 41 00:02:17,480 --> 00:02:21,520 Speaker 2: normal metabolic function. But the thyroid, which makes those again 42 00:02:21,560 --> 00:02:24,520 Speaker 2: out of iodine, isn't out there just functioning solo. It 43 00:02:24,600 --> 00:02:27,560 Speaker 2: is regulated by the pituitary gland, which is in turn 44 00:02:27,639 --> 00:02:32,320 Speaker 2: regulated by the hypothalamus. If your thyroid isn't producing enough hormone, 45 00:02:32,400 --> 00:02:38,079 Speaker 2: that's called hypothyroidism, and it doesn't present really obvious symptoms 46 00:02:38,200 --> 00:02:39,960 Speaker 2: at the beginning a lot of the time, but it 47 00:02:40,000 --> 00:02:44,079 Speaker 2: can lead to other problems, including obesity and heart disease. Normally, 48 00:02:44,160 --> 00:02:49,120 Speaker 2: hypothyroidism is treated with synthetic hormones to get the level 49 00:02:49,160 --> 00:02:51,079 Speaker 2: of thyroid function back up to normal. 50 00:02:51,240 --> 00:02:54,360 Speaker 1: And if your thyroid is producing too much hormone like 51 00:02:54,400 --> 00:02:58,760 Speaker 1: my cats, that is known as hyperthyroidism, And in this 52 00:02:58,880 --> 00:03:02,280 Speaker 1: case it's sort of overcla the body's metabolic function. So 53 00:03:02,520 --> 00:03:05,560 Speaker 1: in this case, unintentional weight loss and rapid heart rate 54 00:03:05,639 --> 00:03:09,280 Speaker 1: and even irregular heartbeat are all symptoms, which obviously can 55 00:03:09,360 --> 00:03:12,160 Speaker 1: lead to some pretty serious problems if they're left unchecked. 56 00:03:12,520 --> 00:03:15,200 Speaker 2: The advances in thyroid treatment that we're going to talk 57 00:03:15,240 --> 00:03:17,840 Speaker 2: about today took place less than one hundred years ago, 58 00:03:17,880 --> 00:03:21,200 Speaker 2: but thyroid disease has been part of recorded history going 59 00:03:21,240 --> 00:03:24,720 Speaker 2: all the way back to twenty seven hundred BCE, when 60 00:03:24,919 --> 00:03:28,919 Speaker 2: seaweed was prescribed in China to treat goiter. The goiter 61 00:03:29,040 --> 00:03:31,760 Speaker 2: is a swelling of the thyroid that's most commonly caused 62 00:03:31,760 --> 00:03:36,240 Speaker 2: by low iodine, but the thyroid itself wasn't even recognized 63 00:03:36,280 --> 00:03:40,160 Speaker 2: and illustrated until Leonardo da Vinci drew it in fifteen hundred. 64 00:03:40,800 --> 00:03:44,839 Speaker 2: The name thyroid didn't exist until sixteen fifty six, when 65 00:03:44,880 --> 00:03:48,480 Speaker 2: Thomas Wharton named it using a word for shield because 66 00:03:48,520 --> 00:03:52,640 Speaker 2: of the resemblance in shapes to ancient Grecian shields. In 67 00:03:52,720 --> 00:03:57,560 Speaker 2: eighteen twenty, Jean Francois Quonda made the connection between iodine 68 00:03:57,600 --> 00:04:00,920 Speaker 2: and goiter and began to use iodine as a treatment. 69 00:04:01,640 --> 00:04:04,800 Speaker 2: By eighteen thirty one, iodine used as a prophylaxis to 70 00:04:04,840 --> 00:04:08,960 Speaker 2: prevent thyroid disease was proposed by a Brazilian doctor, but 71 00:04:09,040 --> 00:04:13,560 Speaker 2: even so conclusive scientific literature establishing iodine as a necessity 72 00:04:13,600 --> 00:04:16,520 Speaker 2: to thyroid function was not published until nineteen oh seven 73 00:04:16,960 --> 00:04:19,960 Speaker 2: in a paper by doctor David Marine, and it was 74 00:04:20,000 --> 00:04:23,240 Speaker 2: Marine's work in thyroid research that eventually led to iodized 75 00:04:23,320 --> 00:04:26,600 Speaker 2: salt as a standard approach to preventing thyroid disease as 76 00:04:26,600 --> 00:04:31,280 Speaker 2: a public health initiative. I like how it was nineteen 77 00:04:31,320 --> 00:04:35,640 Speaker 2: oh seven when that happened, but using seaweed to treat goiter. 78 00:04:36,880 --> 00:04:40,360 Speaker 1: From thousands of years before they were onto it, they 79 00:04:40,480 --> 00:04:42,800 Speaker 1: just hadn't done all the math on what exactly in 80 00:04:42,839 --> 00:04:43,880 Speaker 1: the seaweed was fixing. 81 00:04:43,920 --> 00:04:46,760 Speaker 2: The pro seaweed has lots of iodine in it, That's 82 00:04:46,760 --> 00:04:49,960 Speaker 2: what was up with that. In the late eighteen nineties, 83 00:04:50,040 --> 00:04:53,560 Speaker 2: knowledge about the thyroid really started to accelerate, as Adolph 84 00:04:53,600 --> 00:04:57,760 Speaker 2: Magnus Levy made the connection between thyroid function and metabolic rate. 85 00:04:58,520 --> 00:05:01,000 Speaker 2: Radium was used to treat a pay patients goiter in 86 00:05:01,080 --> 00:05:04,680 Speaker 2: nineteen oh five by physician Robert Abbey, and the term 87 00:05:04,800 --> 00:05:08,760 Speaker 2: hyperthyroidism was coined in nineteen ten by Charles H. Mayo, 88 00:05:09,320 --> 00:05:11,919 Speaker 2: but descriptions of that condition actually date back to the 89 00:05:11,920 --> 00:05:15,760 Speaker 2: eighteen twenties, and for a long time the only real 90 00:05:15,760 --> 00:05:19,799 Speaker 2: treatment for hyperthyroidism was surgery, but it was so risky 91 00:05:19,880 --> 00:05:23,320 Speaker 2: that often doctors waited until the patient's illness was pretty 92 00:05:23,360 --> 00:05:26,040 Speaker 2: advanced to perform the surgery, and that meant that the 93 00:05:26,040 --> 00:05:28,640 Speaker 2: patient by that point was already in a week ined state, 94 00:05:28,960 --> 00:05:32,000 Speaker 2: which only reduced the likelihood of a successful outcome. There 95 00:05:32,040 --> 00:05:34,680 Speaker 2: was actually a pretty high mortality rate for that surgery. 96 00:05:34,920 --> 00:05:37,680 Speaker 2: In nineteen twenty three, Georges to have a seed developed 97 00:05:37,720 --> 00:05:42,359 Speaker 2: the idea of radioactive tracers to say metabolic pathways. A 98 00:05:42,440 --> 00:05:45,520 Speaker 2: tracer Permiriam Webster as a substance used to trace the 99 00:05:45,520 --> 00:05:48,760 Speaker 2: course of a chemical or biological process. He went on 100 00:05:48,839 --> 00:05:51,200 Speaker 2: to receive a Nobel Prize for his work, but not 101 00:05:51,279 --> 00:05:54,760 Speaker 2: for another two decades, and in the early nineteen hundreds, 102 00:05:54,839 --> 00:05:57,920 Speaker 2: research into thyroid function and disease was taking place in 103 00:05:58,000 --> 00:06:01,120 Speaker 2: a number of different hospitals and medical research centers, because 104 00:06:01,160 --> 00:06:04,039 Speaker 2: it really had, as we said, accelerated in terms of 105 00:06:04,040 --> 00:06:07,160 Speaker 2: what we knew about thyroid and thyroid disease in the 106 00:06:07,360 --> 00:06:10,040 Speaker 2: decades leading up to that, but it was not until 107 00:06:10,040 --> 00:06:13,159 Speaker 2: the nineteen thirties that a breakthrough idea occurred to a 108 00:06:13,160 --> 00:06:17,880 Speaker 2: physician to use radioactivity in the treatment of hyperthyroidism. And 109 00:06:17,960 --> 00:06:20,680 Speaker 2: to get into that, we have to talk about Sal Hurts. 110 00:06:21,480 --> 00:06:24,279 Speaker 2: Sal Hurtz was born on April twentieth, nineteen oh five, 111 00:06:24,320 --> 00:06:28,160 Speaker 2: in Cleveland, Ohio. His parents, Aaron and Bertha Hertz, were 112 00:06:28,200 --> 00:06:31,120 Speaker 2: Polish immigrants who raised Saul and his six brothers in 113 00:06:31,160 --> 00:06:34,920 Speaker 2: an Orthodox Jewish household. After a public school, Saul went 114 00:06:34,960 --> 00:06:37,520 Speaker 2: to the University of Michigan and then onto medical school 115 00:06:37,560 --> 00:06:40,360 Speaker 2: at Harvard. After he got his medical degree in nineteen 116 00:06:40,400 --> 00:06:43,600 Speaker 2: twenty nine, he did his internship and residency in Cleveland 117 00:06:43,640 --> 00:06:47,120 Speaker 2: before moving to Boston. Starting in nineteen thirty one, he 118 00:06:47,200 --> 00:06:51,000 Speaker 2: was at the thyroid clinic at Boston's Massachusetts General Hospital, 119 00:06:51,320 --> 00:06:52,120 Speaker 2: and five. 120 00:06:51,920 --> 00:06:54,720 Speaker 1: Years into his time at that position, in November of 121 00:06:54,800 --> 00:06:58,240 Speaker 1: nineteen thirty six, he attended a lunch at Harvard Medical 122 00:06:58,279 --> 00:07:02,160 Speaker 1: School in which Carl Compton was giving a lecture and Compton, 123 00:07:02,200 --> 00:07:04,200 Speaker 1: who was the president of MIT at the time, had 124 00:07:04,400 --> 00:07:08,279 Speaker 1: entitled his talk what Physics Can Do for Biology and Medicine, 125 00:07:08,520 --> 00:07:11,760 Speaker 1: and in it he discussed the concept of making radioactive 126 00:07:11,800 --> 00:07:13,640 Speaker 1: isotopes of common elements. 127 00:07:14,000 --> 00:07:17,080 Speaker 2: After the lecture was over, Hertz asked Compton a question, 128 00:07:17,480 --> 00:07:21,240 Speaker 2: could iodine be made radioactive? He was thinking about a 129 00:07:21,280 --> 00:07:24,400 Speaker 2: practical application of the science that Compton had discussed in 130 00:07:24,440 --> 00:07:29,120 Speaker 2: the talk, which was using radioactive iodine, which theoretically only 131 00:07:29,200 --> 00:07:33,440 Speaker 2: the thyroid could absorb, to address thyroid issues. Compton didn't 132 00:07:33,480 --> 00:07:35,800 Speaker 2: really know the answer to the question offhand, so he 133 00:07:35,880 --> 00:07:38,679 Speaker 2: noted the question, intending to follow up with Hertz later. 134 00:07:39,280 --> 00:07:42,160 Speaker 2: It took a month, and when Compton followed up on it, 135 00:07:42,200 --> 00:07:46,720 Speaker 2: he apologized, Yeah. That letter is dated December fifteenth, nineteen 136 00:07:46,760 --> 00:07:50,480 Speaker 2: thirty six, and it reads, dear doctor Hertz, to my chagrin, 137 00:07:50,880 --> 00:07:53,360 Speaker 2: I have just come across the memorandum which I made 138 00:07:53,360 --> 00:07:57,480 Speaker 2: on your question about the radioactivity of iodine. Iodine can 139 00:07:57,560 --> 00:08:01,200 Speaker 2: be made artificially radioactive. It has half period of decay 140 00:08:01,240 --> 00:08:04,360 Speaker 2: of twenty five minutes in amidst gamma rays and beta 141 00:08:04,440 --> 00:08:08,640 Speaker 2: rays electrons is put in parentheses with a maximum energy 142 00:08:08,680 --> 00:08:11,480 Speaker 2: of two point one million volts. It is probable that 143 00:08:11,520 --> 00:08:14,280 Speaker 2: there are several other periods of decay, but if so, 144 00:08:14,400 --> 00:08:17,560 Speaker 2: they correspond to types of radioactivity like the one indicated, 145 00:08:17,600 --> 00:08:20,800 Speaker 2: and they are not yet very definitely established. In his 146 00:08:20,880 --> 00:08:24,320 Speaker 2: response letter, dated eight days later on December twenty third, 147 00:08:24,480 --> 00:08:27,040 Speaker 2: Hertz thanked Professor Compton and wrote, quote, the fact that 148 00:08:27,040 --> 00:08:30,400 Speaker 2: iodine is selectively taken up by the thyroid gland when 149 00:08:30,440 --> 00:08:33,600 Speaker 2: injected into the body makes that possible to hope that iodine, 150 00:08:33,640 --> 00:08:37,160 Speaker 2: which is made radioactive, and which loses its radioactivity as 151 00:08:37,280 --> 00:08:39,920 Speaker 2: rapidly as you indicated, would be a useful method of 152 00:08:40,000 --> 00:08:44,240 Speaker 2: therapy in cases of overactivity of the thyroid gland. Then 153 00:08:44,280 --> 00:08:46,800 Speaker 2: promised Carl Compton that he would relay the results of 154 00:08:46,840 --> 00:08:49,200 Speaker 2: any of the tests that they conducted on animals using 155 00:08:49,320 --> 00:08:51,240 Speaker 2: radioactive iodine. 156 00:08:50,760 --> 00:08:53,680 Speaker 1: And Saul Hurts was ready to start exploring this idea 157 00:08:53,800 --> 00:08:55,559 Speaker 1: in the lab, and we're going to talk about that 158 00:08:55,679 --> 00:09:08,760 Speaker 1: after we first pause for a little sponsor break. Saul Hurts, 159 00:09:08,960 --> 00:09:12,440 Speaker 1: along with James Howard Means, who was his supervisor at 160 00:09:12,440 --> 00:09:15,480 Speaker 1: the hospital and was actually the man who established a 161 00:09:15,920 --> 00:09:20,360 Speaker 1: Massachusetts General Hospital's thyroid unit in nineteen thirteen, reached out 162 00:09:20,360 --> 00:09:22,920 Speaker 1: to the physics community to put their plan into action. 163 00:09:23,760 --> 00:09:26,960 Speaker 1: They joined forces with Robley Evans and Arthur Roberts of 164 00:09:27,000 --> 00:09:30,560 Speaker 1: the Massachusetts Institute of Technology to combine the work of 165 00:09:30,600 --> 00:09:35,480 Speaker 1: the physicists and physicians to treat hyperthyroidism. The team started 166 00:09:35,480 --> 00:09:38,520 Speaker 1: working with the isotope iodine one twenty eight or just 167 00:09:38,679 --> 00:09:41,360 Speaker 1: I one twenty eight in rabbits. In nineteen thirty eight. 168 00:09:41,760 --> 00:09:44,640 Speaker 1: They used a test group of four dozen animals. The 169 00:09:44,760 --> 00:09:47,560 Speaker 1: rabbits thyroids took up the I one twenty eight, which 170 00:09:47,640 --> 00:09:51,160 Speaker 1: was of great indicator that Hertz's idea would work. When 171 00:09:51,160 --> 00:09:53,679 Speaker 1: the rabbits were tested after the I one twenty eight 172 00:09:53,720 --> 00:09:56,920 Speaker 1: was administered, it was found that their thyroid glands had 173 00:09:57,000 --> 00:10:00,760 Speaker 1: quote nine times the concentration of radioactive eye iodine as 174 00:10:00,800 --> 00:10:03,920 Speaker 1: that found in the liver. Additionally, the rabbits among the 175 00:10:03,920 --> 00:10:07,280 Speaker 1: group with hyperplastic thyroid glands, which are glands that had 176 00:10:07,320 --> 00:10:11,160 Speaker 1: additional growth from cell proliferation, had an even greater retention 177 00:10:11,240 --> 00:10:14,280 Speaker 1: of radioactive iodine in the thyroid tissue than those who 178 00:10:14,320 --> 00:10:17,880 Speaker 1: had healthy thyroid glands. Yeah, so the rabbits with abnormalities 179 00:10:17,880 --> 00:10:21,280 Speaker 1: in their thyroids actually took up more of this radioactive 180 00:10:21,800 --> 00:10:25,360 Speaker 1: isotope than those that were healthy. And at this point 181 00:10:25,400 --> 00:10:27,360 Speaker 1: the I one twenty eight was being used as a 182 00:10:27,400 --> 00:10:30,520 Speaker 1: tracer to diagnose thyroid issues, it was not yet at 183 00:10:30,559 --> 00:10:32,480 Speaker 1: the phase where it was being used as a treatment. 184 00:10:33,240 --> 00:10:35,520 Speaker 1: In a write up of this initial success, Hurts and 185 00:10:35,600 --> 00:10:39,040 Speaker 1: his team stated, quote, it is therefore logical to suppose that, 186 00:10:39,080 --> 00:10:43,079 Speaker 1: when strongly active materials are available, the concentration power of 187 00:10:43,120 --> 00:10:47,880 Speaker 1: the hyperplastic and neoplastic thyroid for radioactive iodine may be 188 00:10:48,080 --> 00:10:52,520 Speaker 1: of clinical or therapeutic significance. This offered up hope as 189 00:10:52,520 --> 00:10:55,880 Speaker 1: well for an alternative to thyroid surgery, one that was 190 00:10:56,040 --> 00:10:59,800 Speaker 1: far less invasive and consequently less dangerous. This was, however, 191 00:11:00,160 --> 00:11:03,959 Speaker 1: very early on. There was also one fundamental problem that 192 00:11:04,040 --> 00:11:08,080 Speaker 1: twenty five minute half life. In very basic terms, the 193 00:11:08,120 --> 00:11:11,120 Speaker 1: isotope decayed so quickly that it had to be used 194 00:11:11,160 --> 00:11:14,040 Speaker 1: immediately after creation or it would just be useless before 195 00:11:14,040 --> 00:11:17,760 Speaker 1: it could actually treat the thyroid tissue. Hertz's Boston group 196 00:11:17,920 --> 00:11:20,640 Speaker 1: was sharing their information with another team on the West 197 00:11:20,679 --> 00:11:24,760 Speaker 1: coast at the University of California, Berkeley. The California team, 198 00:11:24,840 --> 00:11:28,440 Speaker 1: headed by Mayo Soli and Joseph Hamilton, conscripted the help 199 00:11:28,480 --> 00:11:32,280 Speaker 1: of two other scientists, Glenn Seborg and Jack Livingood, who 200 00:11:32,360 --> 00:11:36,040 Speaker 1: had access to a cyclotron. That's an early particle accelerator 201 00:11:36,080 --> 00:11:40,280 Speaker 1: apparatus that accelerates atomic and subatomic particles in a constant 202 00:11:40,320 --> 00:11:44,240 Speaker 1: magnetic field, and the cyclotron had only been patented for 203 00:11:44,280 --> 00:11:46,400 Speaker 1: four years before this, so it was still a very 204 00:11:46,440 --> 00:11:50,480 Speaker 1: new technology. Using the cyclotron, Seaborg and Jack Livingood were 205 00:11:50,520 --> 00:11:54,680 Speaker 1: able to create new iodine isotopes. First, I won thirty 206 00:11:55,000 --> 00:11:57,760 Speaker 1: for a half life of twelve hours, and eventually I 207 00:11:57,800 --> 00:12:00,600 Speaker 1: won thirty one. I won thirty one has an eight 208 00:12:00,720 --> 00:12:04,760 Speaker 1: day half life. These longer half lives made these isotopes 209 00:12:04,800 --> 00:12:08,280 Speaker 1: good candidates for Hertz's treatment. The longer half life meant 210 00:12:08,280 --> 00:12:11,160 Speaker 1: that doctors would have time to treat the problematic thyroid 211 00:12:11,160 --> 00:12:14,240 Speaker 1: tissue between the isotopes creation and the point where it 212 00:12:14,240 --> 00:12:17,360 Speaker 1: became useless, and as the California team was working with 213 00:12:17,400 --> 00:12:21,040 Speaker 1: the cyclotron to create those new isotopes. The Boston team 214 00:12:21,160 --> 00:12:24,240 Speaker 1: was working with humans to test whether they're thyroids like 215 00:12:24,280 --> 00:12:27,240 Speaker 1: those of the rabbits in the earlier tests, would uptake 216 00:12:27,320 --> 00:12:31,679 Speaker 1: the radioactive iodine and they had positive results. The data 217 00:12:31,720 --> 00:12:34,440 Speaker 1: collected from those early tests was also used to determine 218 00:12:34,440 --> 00:12:39,320 Speaker 1: procedure and dosage guidelines for human patients once they moved 219 00:12:39,320 --> 00:12:42,480 Speaker 1: into the treatment phase, and once those new isotopes were 220 00:12:42,600 --> 00:12:45,720 Speaker 1: established and could be replicated at the Boston LAMB after 221 00:12:45,800 --> 00:12:48,920 Speaker 1: it had acquired its own cyclotron, it was time for 222 00:12:48,960 --> 00:12:53,439 Speaker 1: a true clinical trial. In January nineteen forty one, Salhertz 223 00:12:53,520 --> 00:12:57,199 Speaker 1: treated his first human patient with hyperthyroid using a combination 224 00:12:57,360 --> 00:13:00,120 Speaker 1: of I one thirty and I one thirty one. This 225 00:13:00,200 --> 00:13:02,800 Speaker 1: is a patient identified in his notes as Elizabeth D. 226 00:13:03,720 --> 00:13:06,720 Speaker 1: Was the birth of nuclear medicine. It is often referred 227 00:13:06,760 --> 00:13:09,480 Speaker 1: to as the first and the gold standard in targeted 228 00:13:09,559 --> 00:13:13,600 Speaker 1: radio nucleid therapy. Hertz and his team treated additional patients 229 00:13:13,600 --> 00:13:16,000 Speaker 1: at the rate of one a month, tracking their progress 230 00:13:16,040 --> 00:13:18,839 Speaker 1: after receiving the radioiodine therapy, and most of them had 231 00:13:18,880 --> 00:13:22,719 Speaker 1: significant improvement in their conditions. The Cleveland Press ran a 232 00:13:22,760 --> 00:13:26,640 Speaker 1: story about Hertz's work under the headline former Clevelander developed 233 00:13:26,720 --> 00:13:30,720 Speaker 1: first atomic medical cure. After initial success with the treatment, 234 00:13:30,960 --> 00:13:33,800 Speaker 1: Heurtz began to take on more patients as candidates for 235 00:13:33,920 --> 00:13:37,880 Speaker 1: radioiodine treatment, and in nineteen forty two he expanded his 236 00:13:37,920 --> 00:13:41,439 Speaker 1: work with radioiodine therapy and began clinical trials of treatment 237 00:13:41,520 --> 00:13:44,840 Speaker 1: for patients with thyroid cancer. And this was actually something 238 00:13:44,880 --> 00:13:46,880 Speaker 1: that he had begun working on, at least in its 239 00:13:46,880 --> 00:13:50,240 Speaker 1: theoretical form, as early as nineteen thirty seven, when those 240 00:13:50,240 --> 00:13:55,079 Speaker 1: initial rabbit trials for hyperthyroidism were underway. This research had 241 00:13:55,120 --> 00:13:58,320 Speaker 1: gotten the attention of the medical community early on. In 242 00:13:58,400 --> 00:14:01,079 Speaker 1: nineteen forty two, the Mayo cli Clinic arranged for one 243 00:14:01,080 --> 00:14:04,559 Speaker 1: of their physicians, doctor f. Raymond Keating, Junior, to spend 244 00:14:04,559 --> 00:14:07,600 Speaker 1: six months in Boston working with the researchers at Massachusetts 245 00:14:07,600 --> 00:14:11,720 Speaker 1: General Hospital to learn about their work with radioactive iodine. Later, 246 00:14:11,960 --> 00:14:15,680 Speaker 1: the Mayo Clinics doctor Samuel Haynes wrote of this period quote, 247 00:14:15,679 --> 00:14:19,560 Speaker 1: when ray Keating finished his fellowship, we asked Howard Means 248 00:14:19,600 --> 00:14:21,960 Speaker 1: to let him go to the MGH for six months. 249 00:14:22,360 --> 00:14:25,480 Speaker 1: We were especially interested in having him see what means. 250 00:14:25,640 --> 00:14:29,800 Speaker 1: Saul Hurtz and Rulan Ralson were doing with radioiodine, a 251 00:14:29,840 --> 00:14:32,320 Speaker 1: program which as you know, was carried out with Robley 252 00:14:32,360 --> 00:14:35,800 Speaker 1: Evans and Wendell Peacock from mit Ray's day in Boston 253 00:14:35,880 --> 00:14:37,800 Speaker 1: was very successful, and when he came back he had 254 00:14:37,920 --> 00:14:40,240 Speaker 1: arranged with Evans to have small amounts of I one 255 00:14:40,320 --> 00:14:42,240 Speaker 1: thirty one sent to him to be used in some 256 00:14:42,280 --> 00:14:46,240 Speaker 1: studies in chicks. Haines also described the Mayo clinics first 257 00:14:46,320 --> 00:14:48,600 Speaker 1: use of I one thirty one in thyroid treatment in 258 00:14:48,640 --> 00:14:50,680 Speaker 1: the same writing, which was a letter that he was 259 00:14:50,680 --> 00:14:53,480 Speaker 1: writing to a colleague at Cornell, and he wrote of 260 00:14:53,520 --> 00:14:55,560 Speaker 1: the patient who was a woman who had been quite 261 00:14:55,600 --> 00:14:58,000 Speaker 1: ill and for whom surgery would have been a highly 262 00:14:58,080 --> 00:15:01,320 Speaker 1: dangerous prospect. He wrote, she had a good outcome with 263 00:15:01,360 --> 00:15:04,280 Speaker 1: the I one thirty one treatment. So this treatment developed 264 00:15:04,320 --> 00:15:08,600 Speaker 1: through Hurts' work was indeed one spreading to other clinics 265 00:15:08,640 --> 00:15:11,360 Speaker 1: and being used by other doctors, and was saving people 266 00:15:11,360 --> 00:15:15,000 Speaker 1: from very high risk surgeries. But Hurts had the unfortunate 267 00:15:15,040 --> 00:15:18,240 Speaker 1: timing of developing this breakthrough treatment at the same time 268 00:15:18,280 --> 00:15:21,280 Speaker 1: that World War II was brewing. Sal Hurts put aside 269 00:15:21,280 --> 00:15:24,600 Speaker 1: his medical research temporarily in nineteen forty three and joined 270 00:15:24,600 --> 00:15:27,840 Speaker 1: the Navy to fight against Hitler's Nazi regime. But before 271 00:15:27,880 --> 00:15:30,360 Speaker 1: he shipped out, Hurts, who did not want work in 272 00:15:30,400 --> 00:15:33,360 Speaker 1: this new field to be hampered by his absence, met 273 00:15:33,360 --> 00:15:37,280 Speaker 1: with a private practice doctor who worked part time at MGH, 274 00:15:37,480 --> 00:15:39,320 Speaker 1: and that was doctor Earl M. Chapman. 275 00:15:40,200 --> 00:15:43,160 Speaker 2: Chapman had continued to make time for medical research even 276 00:15:43,200 --> 00:15:46,520 Speaker 2: while running his own practice, and he was ineligible for 277 00:15:46,600 --> 00:15:49,880 Speaker 2: military service, so Hertz asked him if he would keep 278 00:15:49,920 --> 00:15:54,480 Speaker 2: working with Hurtz's roster of thyroid patients, and Chapman, probably flattered, 279 00:15:54,680 --> 00:15:57,920 Speaker 2: agreed and continued the work that Hurts had begun. But 280 00:15:57,960 --> 00:16:00,880 Speaker 2: when sal Hurts returned from the war, there were problems 281 00:16:00,960 --> 00:16:03,800 Speaker 2: between the two men. Chapman didn't want to give up 282 00:16:03,840 --> 00:16:06,080 Speaker 2: the project and give it back to its originator after 283 00:16:06,120 --> 00:16:08,720 Speaker 2: his two years of involvement, and of course Hertz wanted 284 00:16:08,760 --> 00:16:11,680 Speaker 2: his research project back, but he wasn't given his old 285 00:16:11,720 --> 00:16:15,000 Speaker 2: position at MGH. Instead, he took a position at the 286 00:16:15,000 --> 00:16:16,280 Speaker 2: Beth Israel Hospital. 287 00:16:16,560 --> 00:16:20,960 Speaker 1: Yeah, there are many stories that are told among their 288 00:16:21,000 --> 00:16:24,200 Speaker 1: colleagues about the fights that broke out over this issue. 289 00:16:24,680 --> 00:16:28,200 Speaker 1: And then those two former colleagues eventually found themselves just 290 00:16:28,280 --> 00:16:31,360 Speaker 1: each running their own trials, and then they both wrote 291 00:16:31,400 --> 00:16:35,080 Speaker 1: papers about them, and Chapman actually finished his paper first 292 00:16:35,360 --> 00:16:37,880 Speaker 1: and submitted it to the Journal of the American Medical 293 00:16:37,960 --> 00:16:40,160 Speaker 1: Association for review and publication. 294 00:16:40,720 --> 00:16:43,000 Speaker 2: This kicked off some drama, and we will get to 295 00:16:43,000 --> 00:16:45,240 Speaker 2: that paper and the rivalry between the two of them 296 00:16:45,280 --> 00:16:47,840 Speaker 2: and how that was stirred up after we take a 297 00:16:47,920 --> 00:16:58,760 Speaker 2: quick break and hear from one of our sponsors. So, 298 00:16:58,880 --> 00:17:01,480 Speaker 2: though Chapman had been eaten Hurts to the finish line 299 00:17:01,480 --> 00:17:04,480 Speaker 2: on writing the paper itself, he didn't get published. 300 00:17:04,480 --> 00:17:08,600 Speaker 1: First. The Journal of the American Medical Association returned his 301 00:17:08,680 --> 00:17:10,920 Speaker 1: paper and said it needed to be edited for length 302 00:17:11,000 --> 00:17:14,359 Speaker 1: before it could be published. And in the meantime, the editor, 303 00:17:14,560 --> 00:17:16,920 Speaker 1: who knew that Hurts had been the one to spearhead 304 00:17:16,960 --> 00:17:19,359 Speaker 1: the work in this field and yet had not even 305 00:17:19,400 --> 00:17:22,800 Speaker 1: been mentioned in Chapman's paper, reached out to Saul Hurtz 306 00:17:22,840 --> 00:17:24,840 Speaker 1: and encouraged him to do his own write up as 307 00:17:24,880 --> 00:17:28,560 Speaker 1: quickly as possible. So Hertz, along with Arthur Roberts, finished 308 00:17:28,560 --> 00:17:31,280 Speaker 1: his own paper recounting the methods and results of his 309 00:17:31,400 --> 00:17:34,800 Speaker 1: trials treating hyperthyroid patients with I one thirty one. 310 00:17:35,280 --> 00:17:38,080 Speaker 2: The end of all this jockeying was that the Journal 311 00:17:38,119 --> 00:17:41,399 Speaker 2: of the American Medical Association published both the Chapman and 312 00:17:41,480 --> 00:17:44,600 Speaker 2: Hertz papers, both on the same topic, both researched in 313 00:17:44,640 --> 00:17:48,520 Speaker 2: the same hospital, printed in the same issue on May eleventh, 314 00:17:48,600 --> 00:17:51,879 Speaker 2: nineteen forty six. Both scientists' findings were made available to 315 00:17:51,960 --> 00:17:55,280 Speaker 2: the Journal of the American Medical Association's readership, and if 316 00:17:55,280 --> 00:17:58,000 Speaker 2: nothing else, two papers on exactly the same topic with 317 00:17:58,040 --> 00:18:01,879 Speaker 2: only minor differences and treatment method achieved one thing. It 318 00:18:01,880 --> 00:18:05,520 Speaker 2: made nuclear medicine a really hot topic and established radioiodine 319 00:18:05,600 --> 00:18:08,920 Speaker 2: therapy as an effective way to treat thyroid disease. Yeah, 320 00:18:08,920 --> 00:18:11,119 Speaker 2: they had been writing other papers leading up to that, 321 00:18:11,200 --> 00:18:12,879 Speaker 2: but that was really the paper that was like, we 322 00:18:12,920 --> 00:18:15,359 Speaker 2: have figured out how to treat hyperthyroide. Here's how we 323 00:18:15,440 --> 00:18:18,280 Speaker 2: do it. Here are the methods. And they both essentially 324 00:18:18,280 --> 00:18:22,000 Speaker 2: did the same thing. Depending on whose account you read, 325 00:18:23,119 --> 00:18:26,439 Speaker 2: Chapman's approach was a little less careful in terms of 326 00:18:26,480 --> 00:18:31,160 Speaker 2: dosage and how he managed patient treatment, but they were 327 00:18:31,240 --> 00:18:34,919 Speaker 2: still very, very similar. And interestingly enough, that was not 328 00:18:35,080 --> 00:18:38,120 Speaker 2: the end of the squabbling over academic papers and who 329 00:18:38,160 --> 00:18:40,320 Speaker 2: got credit for the research that led to this game 330 00:18:40,400 --> 00:18:44,080 Speaker 2: changing treatment. In reference to an earlier paper on the 331 00:18:44,160 --> 00:18:47,960 Speaker 2: radioiodine work they were doing in MGH. Salhertz wrote the 332 00:18:47,960 --> 00:18:51,359 Speaker 2: following letter to a doctor Goldfbe on April twelfth, nineteen 333 00:18:51,440 --> 00:18:54,440 Speaker 2: thirty eight. He writes, quote with reference to the article 334 00:18:54,520 --> 00:18:58,320 Speaker 2: submitted for publication by doctors Shertz and Arthur Roberts, a 335 00:18:58,440 --> 00:19:01,560 Speaker 2: change is desired with the addition of Professor Robley D. 336 00:19:01,680 --> 00:19:05,240 Speaker 2: Evans as a third co author. He has shared considerably 337 00:19:05,280 --> 00:19:07,320 Speaker 2: in the time devoted to this problem, and we have 338 00:19:07,440 --> 00:19:11,160 Speaker 2: decided that full credit to the Massachusetts Institute of Technology 339 00:19:11,520 --> 00:19:15,119 Speaker 2: cannot be given without including him as co author. His 340 00:19:15,240 --> 00:19:18,520 Speaker 2: title is Assistant Professor of Physics at the Massachusetts Institute 341 00:19:18,520 --> 00:19:21,199 Speaker 2: of Technology, and we would appreciate the addition to the 342 00:19:21,200 --> 00:19:25,320 Speaker 2: authorship of him on the publication. But many years later, 343 00:19:25,440 --> 00:19:29,080 Speaker 2: in nineteen ninety one, doctor Arthur Roberts wrote a scathing 344 00:19:29,440 --> 00:19:33,240 Speaker 2: letter to doctor John Stanbury, who wrote a book titled 345 00:19:33,280 --> 00:19:36,320 Speaker 2: A Constant Ferment. This was a history of the MGH 346 00:19:36,440 --> 00:19:38,400 Speaker 2: Thyroid Clinic and the work that was done there from 347 00:19:38,480 --> 00:19:43,600 Speaker 2: nineteen thirteen to nineteen ninety. Apparently Stanbury interviewed Evans and 348 00:19:43,640 --> 00:19:47,119 Speaker 2: spoke very highly of him in the book. Roberts, who 349 00:19:47,200 --> 00:19:51,800 Speaker 2: had received pre publication manuscripts just tore into Evans in 350 00:19:51,880 --> 00:19:55,480 Speaker 2: this letter. Roberts had actually worked for Evans at MIT, 351 00:19:55,640 --> 00:19:58,440 Speaker 2: and according to his account, quote Evans made it a 352 00:19:58,520 --> 00:20:01,320 Speaker 2: condition of my employment. I wish I still had the 353 00:20:01,400 --> 00:20:04,640 Speaker 2: letter that his name was to appear on all publications. 354 00:20:05,200 --> 00:20:08,720 Speaker 2: Even at the time, this was unusual and occasioned much comment. 355 00:20:09,400 --> 00:20:12,320 Speaker 2: It led to the contretemps concerning the late edition of 356 00:20:12,359 --> 00:20:15,240 Speaker 2: his name to our first paper. It was on the 357 00:20:15,280 --> 00:20:18,440 Speaker 2: second paper, but after that Saul and I felt sufficiently 358 00:20:18,480 --> 00:20:22,440 Speaker 2: secure that we ignored him in our subsequent publications. Had 359 00:20:22,440 --> 00:20:24,840 Speaker 2: he actually participated in the work, there would have been 360 00:20:24,880 --> 00:20:29,440 Speaker 2: no problem including him. Roberts continued his takedown of Evans 361 00:20:29,480 --> 00:20:32,760 Speaker 2: over the course of several pages, calling him, among other things, 362 00:20:32,920 --> 00:20:38,879 Speaker 2: quote a thoroughly unprincipled racist manipulator. He also cautioned author Stanbury, quote, 363 00:20:38,920 --> 00:20:41,560 Speaker 2: I would believe nothing on this subject from Chapman, whose 364 00:20:41,560 --> 00:20:44,840 Speaker 2: self interest is obvious, and who bungled, whether deliberately or not, 365 00:20:45,000 --> 00:20:47,920 Speaker 2: the follow up on Hertz's original series when Hurtz joined 366 00:20:47,920 --> 00:20:51,520 Speaker 2: the Navy, apparently despite all of Roberts' passioned rhetoric, though 367 00:20:51,560 --> 00:20:54,640 Speaker 2: Stanbury did not make changes to his manuscript, this whole 368 00:20:54,680 --> 00:20:57,120 Speaker 2: mess of exchanges is a good reminder that even people 369 00:20:57,160 --> 00:21:00,359 Speaker 2: who do important and groundbreaking work are often my in 370 00:21:00,400 --> 00:21:04,000 Speaker 2: their own personal conflicts that are not necessarily apparent so 371 00:21:04,040 --> 00:21:07,800 Speaker 2: the outside, I, yeah, it's such a This sort of 372 00:21:07,800 --> 00:21:11,159 Speaker 2: thing does happen in academia with some frequency. If you 373 00:21:11,200 --> 00:21:14,120 Speaker 2: have any friends who are maybe professors or researchers, they 374 00:21:14,160 --> 00:21:18,199 Speaker 2: probably have similar stories. I should also note that in 375 00:21:18,240 --> 00:21:20,800 Speaker 2: the midst of that big shakeup, Evans went with Chapman 376 00:21:21,160 --> 00:21:23,920 Speaker 2: while Roberts went with Hertz, so they sort of separated 377 00:21:23,960 --> 00:21:26,399 Speaker 2: into two teams, and that's kind of why there is 378 00:21:26,520 --> 00:21:30,280 Speaker 2: so much friction between them. But as for Saul Hurts, 379 00:21:30,359 --> 00:21:34,040 Speaker 2: he continued his work in radioiodine therapy. In fall of 380 00:21:34,119 --> 00:21:37,840 Speaker 2: nineteen forty six, he set up the Radioactive Isotope Research Fund, 381 00:21:38,320 --> 00:21:40,280 Speaker 2: and a few years later that fund paid for the 382 00:21:40,359 --> 00:21:44,600 Speaker 2: establishment of the Radioactive Isotope Research Institute, with offices in 383 00:21:44,640 --> 00:21:47,440 Speaker 2: Boston and New York. Hertz believed that the study of 384 00:21:47,480 --> 00:21:51,120 Speaker 2: thyroid cancer and research into its possible treatments could lead 385 00:21:51,160 --> 00:21:54,239 Speaker 2: to breakthroughs in the treatment of all cancers, and he 386 00:21:54,320 --> 00:21:56,840 Speaker 2: was happy to discuss this work with the media anytime 387 00:21:56,920 --> 00:22:01,119 Speaker 2: they asked. Unfortunately, though that work was cut short. Salhurtz 388 00:22:01,160 --> 00:22:03,520 Speaker 2: died suddenly at the age of forty five, and he 389 00:22:03,600 --> 00:22:06,240 Speaker 2: had a heart attack on July twenty eighth, nineteen fifty. 390 00:22:06,800 --> 00:22:09,760 Speaker 2: His daughter, Barbara, who was just three when her father died, 391 00:22:09,840 --> 00:22:12,600 Speaker 2: has become the steward of his story and legacy and 392 00:22:12,640 --> 00:22:15,120 Speaker 2: has worked with professionals in the medical community to make 393 00:22:15,119 --> 00:22:18,720 Speaker 2: sure that his contributions to medical science are documented and remembered. 394 00:22:19,240 --> 00:22:22,200 Speaker 2: To that end, she's set up a digital archive online 395 00:22:22,320 --> 00:22:26,400 Speaker 2: and has made some of his correspondents and research available. Yeah, 396 00:22:26,440 --> 00:22:28,840 Speaker 2: I used a lot of that in any of these 397 00:22:28,880 --> 00:22:31,320 Speaker 2: letters that were quoting back and forth often came from 398 00:22:31,359 --> 00:22:35,959 Speaker 2: her archive. In twenty sixteen, the Society of Nuclear Medicine 399 00:22:35,960 --> 00:22:40,080 Speaker 2: and Molecular Imaging established the Doctor Salhurt's Lifetime Achievement Award 400 00:22:40,480 --> 00:22:44,159 Speaker 2: to recognize those who have quote made outstanding contributions to 401 00:22:44,280 --> 00:22:45,520 Speaker 2: radio nuclide therapy. 402 00:22:46,000 --> 00:22:49,600 Speaker 1: That's awesome. Yeah, So my personal thanks to doctor Salhurts 403 00:22:49,640 --> 00:22:52,440 Speaker 1: because now my cat has benefited directly from his work, 404 00:22:53,000 --> 00:22:55,359 Speaker 1: and that is because this process that he came up 405 00:22:55,359 --> 00:22:57,720 Speaker 1: with in the nineteen thirties, literally just after hearing a 406 00:22:57,760 --> 00:22:59,800 Speaker 1: lecture and going hi, I wonder if I could use 407 00:22:59,840 --> 00:23:03,840 Speaker 1: that still works. It is very common treatment with a 408 00:23:03,840 --> 00:23:07,679 Speaker 1: really high rate of success, so much so that with 409 00:23:07,720 --> 00:23:12,000 Speaker 1: only minor changes, it is really pretty much one of 410 00:23:12,040 --> 00:23:16,000 Speaker 1: the recommended treatments today in both people and animals. Yeah, 411 00:23:16,040 --> 00:23:17,080 Speaker 1: thank you, Saul Hurtz. 412 00:23:17,320 --> 00:23:19,600 Speaker 2: I know people who have had it, and only one cat, 413 00:23:19,640 --> 00:23:20,359 Speaker 2: which is yours. 414 00:23:20,680 --> 00:23:24,720 Speaker 1: Yeah. Yes, he went to what I called radio I 415 00:23:24,800 --> 00:23:27,679 Speaker 1: had i'd sleep away camp for a few days because 416 00:23:27,680 --> 00:23:29,959 Speaker 1: he was radioactive. Now he's home. We haven't had his 417 00:23:29,960 --> 00:23:32,000 Speaker 1: follow up blood work yet, but all signs point to 418 00:23:32,160 --> 00:23:36,919 Speaker 1: successful outcome. But it is just fascinating and cool. It's, 419 00:23:37,000 --> 00:23:38,919 Speaker 1: like I said, it's one of those things that it 420 00:23:39,000 --> 00:23:41,440 Speaker 1: is literally a ninety year old treatment that was come 421 00:23:41,520 --> 00:23:44,000 Speaker 1: up with just through like this moment of insight, and 422 00:23:44,080 --> 00:23:48,199 Speaker 1: yet it is still like really benefiting people's lives and 423 00:23:48,359 --> 00:23:50,639 Speaker 1: is still, as we said, the gold standard of treatment. 424 00:23:56,480 --> 00:23:59,320 Speaker 1: Thanks so much for joining us on this Saturday. Since 425 00:23:59,359 --> 00:24:01,440 Speaker 1: this episode is out of the archive, if you heard 426 00:24:01,440 --> 00:24:04,240 Speaker 1: an email address or a Facebook RL or something similar 427 00:24:04,280 --> 00:24:07,200 Speaker 1: over the course of the show, that could be obsolete. 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