Speaker 1: Pushkin Havana, Cuba, in the fall of twenty sixteen. The
Speaker 1: island's longtime ruler, Fidel Castro, an implacable foe of the
Speaker 1: United States, has just died. What upheavals, what power struggles
Speaker 1: his passing might set in train, are of considerable interest
Speaker 1: to America's intelligence agencies. In a pleasant neighborhood of the Capitol,
Speaker 1: one of the CIA's agents has returned home for the evening,
Speaker 1: fairly certain in the knowledge that Cuban operatives have him
Speaker 1: under surveillance, and then the American feels as if he's
Speaker 1: been hit by a beam of sound. Young and fit
Speaker 1: at the time of the incident, the agent eventually seeks
Speaker 1: medical attention at the clinic in side the US Embassy.
Speaker 1: He's been having headaches with acute pain in one ear,
Speaker 1: and his hearing in general isn't what it was. Two
Speaker 1: other officers soon say they too remember strange, sharp and
Speaker 1: disorienting sounds in their homes. Around the same time, a
Speaker 1: few more reports come in. The wife of one embassy
Speaker 1: official says she heard a strange sound and looking out
Speaker 1: the window, saw a van rush by. Was a Cuban
Speaker 1: operative at the wheel? You need to call a meeting,
Speaker 1: one diplomat tells the head of the American mission, the
Speaker 1: rumor mill is going mad, so he does. He tells
Speaker 1: the embassy staff that they may be being targeted by
Speaker 1: some kind of unknown sonic weapon, And after the meeting,
Speaker 1: cases of Havana syndrome explode. Staffers and their families report
Speaker 1: hearing the strange sounds at home, even in some cases
Speaker 1: a hotel room. They complain of dizziness, mental fog, ear pain,
Speaker 1: and headaches. By summer twenty seventeen, news was getting out.
Speaker 1: At first, the US State Department guardedly said they were
Speaker 1: looking into incidents which caused the variety of physical symptoms,
Speaker 1: but a journalist from the Associated Press got officials to
Speaker 1: speak off the record. He reported their belief that this
Speaker 1: was some kind of advanced device that operated outside the
Speaker 1: range of audible sound. Soon the official language became more assertive,
Speaker 1: not incidents, but attacks. Then President Donald Trump said he
Speaker 1: believed Cuba was responsible. In October, the Associated Press published
Speaker 1: another scoop, then obtained one of the recordings of the
Speaker 1: mysterious sounds that led to suspicion of a sonic weapon.
Speaker 1: The recordings themselves are not believed to be dangerous to
Speaker 1: those who listen, wrote the Associated Press. Sound experts and
Speaker 1: physicians say they know of no sound that can cause
Speaker 1: physical damage when played for short durations at normal levels
Speaker 1: through standard equipment like a cell phone or computer, so
Speaker 1: I should be safe in playing it to you. How
Speaker 1: to describe the sound, the Associated Press had to go
Speaker 1: It sounds sort of like a mass of crickets. What
Speaker 1: device produced the original sound remains unknown. One obvious possibility
Speaker 1: is that the device could have been a mass of crickets.
Speaker 1: That the sound of mere insects can't reduce the CIA's
Speaker 1: finest to physical rex, can it. I'm Tim Harford, and
Speaker 1: you're listening to cautionary tales. In an elementary school in
Speaker 1: Miami in nineteen seventy four, a couple one hundred children
Speaker 1: are rehearsing a musical. The fourth, fifth and sixth graders
Speaker 1: are singing in the school's caffetorium. That's a room that
Speaker 1: doubles as a cafeteria and an auditorium. At half past
Speaker 1: nine in the morning, one eleven year old girl begins
Speaker 1: to feel unwell. Let's call her Sandy. That's the name
Speaker 1: the New Yorker magazine gave her. When they wrote an
Speaker 1: article about what happened. Next, Sandy doesn't want to disrupt
Speaker 1: the rehearsal, so she tries to slip out of the
Speaker 1: caffetorium without anyone noticing. The teacher doesn't see her, but
Speaker 1: some of the other children do. Sandy goes to see
Speaker 1: the school nurse. The nurse isn't there, but the head
Speaker 1: secretary is passing by and she sees Sandy's slump, unconscious
Speaker 1: on the nurse's couch. The secretary takes out her smelling
Speaker 1: salts and wafts them under Sandy's nose that Sandy doesn't
Speaker 1: come round, The secretary calls the emergency services. They arrive
Speaker 1: just as the rehearsal ends. As the kids file out
Speaker 1: of the caffetorium, they see Sandy being carried off on
Speaker 1: a stretcher. And now another child says she's feeling ill,
Speaker 1: and another and another. Some say they're dizzy, some have headaches,
Speaker 1: some complain of abdominal pain, some are hyperventilating. Soon, seven
Speaker 1: more children have been rushed to hospital. Another twenty five
Speaker 1: are sick enough that the school calls their parents to
Speaker 1: come and collect them. What could be happening a neighborhood
Speaker 1: doctor arrives to offer his help and immediately notices a
Speaker 1: funny smell some kind of poison gas, perhaps leaking from
Speaker 1: a broken pipe. Police cars join the ambulances, so does
Speaker 1: the rescue squad from the fire department. The local media
Speaker 1: routinely look for stories by listening in to transmissions on
Speaker 1: the emergency services radio frequency, so word of the suspected
Speaker 1: poison gas leak soon gets around. Reporters from newspapers turn up,
Speaker 1: so do four film crews from the local TV news stations.
Speaker 1: Worried parents flock to the school. They're joined by curious
Speaker 1: neighbors and passers by. By the time Joel Nitskin arrives
Speaker 1: to investigate, the scene is chaotic. Dr Nitskin heads the
Speaker 1: county's Department of Public Health. He and his colleague have
Speaker 1: to park half a block away as the street is
Speaker 1: jammed with assorted emergency vehicles, their lights all flashing. Nitskin
Speaker 1: is six feet nine inches tall, so he's able to
Speaker 1: pick a path through the crowds of people. As he
Speaker 1: enters the school grounds, Nitskin sees hundreds of children sitting
Speaker 1: quietly in the shape of some trees, looking amused. Look
Speaker 1: perfectly healthy. That's reassuring, Nitskin thinks. Whatever's going on, hundreds
Speaker 1: of children are obviously unaffected. Nitskin and his colleague go
Speaker 1: into the school building. They notice the unusual smell, but
Speaker 1: they can't immediately place it. The school's head secretary greets them.
Speaker 1: There's been some kind of poisoned gas leak. She tells them, Oh,
Speaker 1: that's what she's heard. It all started with this girl, Sandy.
Speaker 1: She started to feel ill when rehearsing a musical in
Speaker 1: the caffetorium. Then more children got sick, dozens of them.
Speaker 1: Some have gone to hospital, some have gone home. We're
Speaker 1: treating about forty more now as best we can. Where
Speaker 1: are you treating these sick children, asks Nitskin. In the caffetorium,
Speaker 1: says the secretary. Nitskin exchanges a glance with his colleague.
Speaker 1: In the caffetorium, that's where Sandy got ill. Wouldn't that
Speaker 1: be where the poison gas must have been leaking, Oh,
Speaker 1: says the secretary. I don't know about that. Nitskin and
Speaker 1: his colleague head into the caffetorium, where, sure enough they
Speaker 1: find children stretched out on the floor and nurses and
Speaker 1: police and fire rescue workers buzzing anxiously around them. That
Speaker 1: strange smell is nowhere near as strong in here, Nitskin notices.
Speaker 1: He locates an office with the telephone and calls the
Speaker 1: hospital where Sandy and the other children were taken. They're
Speaker 1: doing fine, says the doctor. They all seem to be
Speaker 1: feeling better. The lab tests haven't all come back, but
Speaker 1: everything's coming up normal so far. Nitskin hangs up the
Speaker 1: phone and sees another colleague from the county's environmental health department.
Speaker 1: He's arrived separately, and he's been checking out the school building.
Speaker 1: About that funny smell when you come into the school,
Speaker 1: asks did you notice it? Any idea? What it is?
Speaker 2: Sure?
Speaker 1: Comes the reply, it's carpet adhesive. They laid a new
Speaker 1: carpet in the library a few days ago. Is it toxic? No, who,
Speaker 1: laughs the colleague, not at all. Have you found any
Speaker 1: hint of toxic gas? Nope. I'll investigate further, of course,
Speaker 1: but on a first check, everything seems normal, doctor Nitskin
Speaker 1: ponders as he walks back to the caffetorium. He trusts
Speaker 1: his colleague from Environmental Health. It doesn't seem to be
Speaker 1: poisoned gas. It can't be viral or bacterial. There wasn't
Speaker 1: time for Sandy to have infected everyone else anyway. The
Speaker 1: kids are complaining of all kinds of different symptoms that
Speaker 1: wouldn't make sense if it's an infectious disease. In Nitskin's mind,
Speaker 1: the pieces are starting to fall into place when he's
Speaker 1: accosted by a woman who works in the kitchen. You're
Speaker 1: a doctor, right, you're in charge here, yes, says Nitskin.
Speaker 1: I am. Then why don't you do something? Why don't
Speaker 1: you straighten out this mess? You know as well as
Speaker 1: I do that there's nothing the matter with these kids.
Speaker 1: Get them up on their feet, get them out of here.
Speaker 1: I have to start setting up for lunch. Nitskin stares
Speaker 1: at the woman, his mouth open. She's just bluntly put
Speaker 1: into words exactly where his own thoughts had been tentatively leading.
Speaker 1: Now he's pretty sure he knows what's wrong and how
Speaker 1: to fix it. Enough, says doctor Nitskin.
Speaker 2: I've got an announcement to make.
Speaker 1: He's soon commanding the attention of everyone in the caffetorium.
Speaker 2: We've conducted an initial investigation into claims of poison gas.
Speaker 1: He says, we.
Speaker 2: Haven't found any there's no evidence of any infectious disease either.
Speaker 1: By now the journalists are crowding round. Nitskin has cameras
Speaker 1: on him, microphones thrust in his face. What's happened here,
Speaker 1: he continues, is.
Speaker 2: An outbreak of math hysteria, and it needs to stop
Speaker 2: right now. We have to get this school back to normal.
Speaker 2: Get these kids out of the caffatorium so the kitchen
Speaker 2: staff can set up for lunch, Bring in all the
Speaker 2: other kids from under the trees outside, send them back
Speaker 2: to their classrooms.
Speaker 1: Now bright this minute, Nitskin scans the faces around him.
Speaker 1: Nobody says a word. The nurses look stunned, the teachers
Speaker 1: look thoughtful. He sees his colleague nodding and smiling, and
Speaker 1: the parents. The parents look appalled. Has Nitskin just said
Speaker 1: that their kids are crazy? But it's as if a
Speaker 1: spell has been broken. People start to talk to each other.
Speaker 1: The kids who had been feeling ill perk up. The
Speaker 1: teachers take them back to their classrooms and bring in
Speaker 1: the kids from under the trees outside. The first responders
Speaker 1: from the various emergency services begin to drift off. Dr
Speaker 1: Nitskin drives back to his office, thinking I hope I
Speaker 1: got that right. Cautionary tales will be back in a moment.
Speaker 1: When Joel Nitzkin spoke in that Miami school cafetorium, he
Speaker 1: described what was happening as mass hysteria. That was half
Speaker 1: a century ago. Language evolves, and hysteria is for good reason,
Speaker 1: no longer a medical diagnosis. It's an ancient Greek word
Speaker 1: from Hista, meaning uterus. Hysteria was thought to affect people
Speaker 1: with a uterus, and over the years it's often been
Speaker 1: used to describe any kind of behavior by women that
Speaker 1: men find annoying. Aristotle, for example, said women shouldn't have
Speaker 1: the vote because of their hysterical disposition. As for mass hysteria,
Speaker 1: that seems to have first become common in the Middle Ages,
Speaker 1: especially with outbreaks of the dancing plague. Here's one historical account.
Speaker 1: The streets were filled with men and women who joined hands,
Speaker 1: formed circles, and seemingly lost all control over their actions.
Speaker 1: They danced together ceaselessly for hours or days, and in
Speaker 1: wild delirium, the dance has collapsed and fell to the ground, exhausted,
Speaker 1: groaning and sighing, as if in the agonies of death.
Speaker 1: People believed that they were seeing God or being possessed
Speaker 1: by demons. Here's an especially striking case recounted by a
Speaker 1: German physician. I have read in a good medical work
Speaker 1: that a nun in a very large convent in France
Speaker 1: began to meou like a cat. Shortly afterwards, other nuns
Speaker 1: also meowed. At last, all the nuns meowed together every
Speaker 1: day at a certain time for several hours. The whole
Speaker 1: surrounding Christian neighborhood heard with equal chagrin and astonishment this
Speaker 1: daily cat concert, which did not cease until all the
Speaker 1: nuns were informed that a company of soldiers were placed
Speaker 1: by the police before the entrance of the convent, and
Speaker 1: that they were provided with rods and would continue whipping
Speaker 1: them until they promised not to meau anymore. When you
Speaker 1: hear stories like this, mass hysteria sounds like something from
Speaker 1: a long gone age of superstition. But it still happens.
Speaker 1: Only today we have a different name for it, mass
Speaker 1: psychogenic illness. Psychogenic means beginning in the mind. In contrast,
Speaker 1: an illness that begins in the body is called physiogenic.
Speaker 1: For example, if you've breathed in poison gas, we all
Speaker 1: find it easy to understand physiogenic illnesses. If a doctor
Speaker 1: tells you you're ill because a bacteria or a toxin
Speaker 1: has got into your body, you believe them. Psychogenic illnesses
Speaker 1: are much more mysterious. How does our own mind make
Speaker 1: us ill? And yet it does. It's lunchtime at a
Speaker 1: secondary school in the small Belgian town of Burnham. The
Speaker 1: year is nineteen ninety nine. As usual, the canteen has
Speaker 1: crates of coca cola that the children can buy to
Speaker 1: drink with their lunch. Today, something seems different, but quite right.
Speaker 1: A buzz of conversation goes round the canteen. Does this
Speaker 1: bottle of coke smell funny to you? Some of the
Speaker 1: children shrug and gulp down the coca cola regardless. Others
Speaker 1: start to drink theirs, but find that the taste is
Speaker 1: a bit off, so they leave their bottles unfinished. Still,
Speaker 1: others are concerned enough by the smell to take their
Speaker 1: bottle back to the canteen staff and ask to swap
Speaker 1: it for a new one. After this happens a few times,
Speaker 1: the canteen staff decide they'd better stop selling the coke.
Speaker 1: The children go back to their lessons, but Within half
Speaker 1: an hour, several are starting to feel ill. They have headaches, nausea, dizziness,
Speaker 1: abdominal pain. Some are having trouble with their breathing. The
Speaker 1: school phones their medical helpline for advice, better take all
Speaker 1: the kids to hospital. They're told to be on the
Speaker 1: safe side. The teachers don't yet know what they're dealing with.
Speaker 1: They decide to go round all the classrooms. Did any
Speaker 1: of you drink coca cola at lunchtime and you're now
Speaker 1: feeling ill? More children come forward, twenty two in all.
Speaker 1: The teachers drive them all to the hospital at home.
Speaker 1: That evening, still more children start to feel unwell. Another
Speaker 1: eleven turn up at the emergency room. Investigators later analyzed
Speaker 1: the coke the children had drunk. There was indeed a
Speaker 1: problem with it. The gas that makes fizzy drinks fizzy
Speaker 1: is carbon dioxide, but in bottles from this batch of drinks,
Speaker 1: it had been contaminated by two other gases, carbonyl sulfide
Speaker 1: and hydrogen sulfide. These are gases that smell like rotten eggs.
Speaker 1: They can make you ill in large quantities, although the
Speaker 1: investigators didn't find large quantities enough to cause a strange smell, yes,
Speaker 1: enough to harm someone, They didn't think so. Still the
Speaker 1: story is all over the Belgian news. Kids drank funny
Speaker 1: tasting Coca cola and now they're in hospital. And soon
Speaker 1: reports come in from different schools in different towns. Some
Speaker 1: children are feeling ill. They drank cans of Coca Cola
Speaker 1: light from a vending machine. We've seen the news and
Speaker 1: we're assuming that must have had something to do with it. Actually,
Speaker 1: some of the kids hadn't had Coca Cola Light. They'd
Speaker 1: had Fanta that's made by the Coca Cola company too.
Speaker 1: It soon turned out that these cans of Coca Cola
Speaker 1: Light and Fanta had been produced at a different facility
Speaker 1: from the coke bottles. The carbon dioxide in them is
Speaker 1: perfectly fine, so two different problems hit two different factories
Speaker 1: at the same time. Investigators looked into the cans too,
Speaker 1: and they did find another problem, although it didn't seem
Speaker 1: very serious. The wooden palettes used to transport the crates
Speaker 1: had apparently been treated with fungicide, and that fungicide might
Speaker 1: have reacted chemically with the chlorinated cleaning products used in
Speaker 1: the vending machines, and that reaction might have caused a
Speaker 1: smell on the outside of the can. Could it have
Speaker 1: poisoned people? Didn't look plausible. Meanwhile, the storm in the
Speaker 1: media grows. More and more reports come in, and not
Speaker 1: just from schools or from children. Adults too become convinced
Speaker 1: that Coca cola products are making them ill. Hundreds of
Speaker 1: members of the public call the twenty four hour hotline
Speaker 1: of Belgium's Poison Control Center, comporting symptoms and wondering if
Speaker 1: they should attribute those symptoms to the fizzy drink they've
Speaker 1: recently consumed. Most of the symptoms aren't too serious, like
Speaker 1: the wands originally reported in the media. Headaches, nausea, dizziness,
Speaker 1: abdominal pain, that kind of thing. But one doctor calls
Speaker 1: the Poison Control Center hotline to ask about a condition
Speaker 1: that's much more worrying, hemolysis, a disorder of the red
Speaker 1: blood cells. The doctor explains that he's treating a child
Speaker 1: with hemolysis and he's curious to know whether or not
Speaker 1: anyone has reported hemolysis as one of the conditions potentially
Speaker 1: linked to coca cola. Nobody has, but the doctor's inquiry
Speaker 1: goes into the database, and when Belgium's Minister of Health
Speaker 1: asks for a list of the possible effects of drinking
Speaker 1: Coca cola. That list contains hemolysis. The Minister mentions the
Speaker 1: term at a press conference. Soon after, the media finds
Speaker 1: a hospital that's treating people with hemolysis who have also
Speaker 1: recently drunk Coca cola. The Minister decides that urgent action
Speaker 1: is needed. Six days after the first school children fell ill,
Speaker 1: the Ministry of Health bans the sale of all Coca
Speaker 1: Cola products in Belgium. The Coca Cola company puts out
Speaker 1: a statement saying we deeply regret any problems encountered by
Speaker 1: our European consumers in the last few days, and they
Speaker 1: issue a mass product record for Coca Cola, Coca Cola Light, Fanta, Nesty, Aquarius, Bonaqua,
Speaker 1: Kinletnic and Lilt. They temporarily shut down three factories. They
Speaker 1: throw away stocks of soft drinks worth over one hundred
Speaker 1: million dollars. Gradually, the media reports die down and the
Speaker 1: calls to the poison hotline start to dry up. After
Speaker 1: a couple of weeks, the Minister lifts the ban and
Speaker 1: Coca Cola's CEO issues an abject apology. We let down
Speaker 1: the people of Belgium. But had the Coca Cola company
Speaker 1: let down the people of Belgium by making lots of
Speaker 1: the meal, or had they in fact let people down
Speaker 1: by not being more like no nonsense? Dr Nitskin cautionary
Speaker 1: tales will return in a moment. After Dr Nitskin told
Speaker 1: the children in Miami that there was no poison gas,
Speaker 1: when they should get back to their classrooms and carry
Speaker 1: on as normal, some parents were furious with him. One
Speaker 1: mother called his office, demanding that he apologize for insulting
Speaker 1: her daughter. How dare he imply that she's insane? Dr
Speaker 1: Nitskin tried to explain that he'd done no such thing.
Speaker 1: He had implied that she was suggestible. We all are,
Speaker 1: he explained, to some degree. It's not a sign of insanity,
Speaker 1: especially at the age of eleven. Here's how that suggestibility works.
Speaker 1: I see other people feeling ill. Someone tells me it's
Speaker 1: because of a mystery gas. I smell it too. I
Speaker 1: expect to start feeling ill, and I do, and it's
Speaker 1: not my imagination. I really do feel ill. Exactly how
Speaker 1: our beliefs and expectations translate into actual, real symptoms is
Speaker 1: still not well understood. It's one of the many mysteries
Speaker 1: of the human mind, but there's no room for doubt
Speaker 1: that it happens. Many people, though, seem to find that
Speaker 1: hard to get their heads around. When a doctor suggests
Speaker 1: that their illness might be psychogenic, the patient thinks they're
Speaker 1: being accused of something, of imagining their symptoms or faking them.
Speaker 1: A few weeks into the Coca Cola scare in Belgium,
Speaker 1: some scientists publicly raised the idea that mass psychogenic illness
Speaker 1: could have been the cause. The backlash from the general
Speaker 1: public was immediate. What do these scientists know. They haven't
Speaker 1: examined a single patient. Are they saying doctors were fooled
Speaker 1: or people simply imagined their symptoms? No, they weren't. They
Speaker 1: were saying people had real symptoms caused not by drinking
Speaker 1: poisonous soda, but by mistakenly believing their drunk poisonous soda.
Speaker 1: But if experts struggled to get that idea across to
Speaker 1: an irate public, imagine what would have happened to the
Speaker 1: Coca Cola company if they'd come out at the height
Speaker 1: of the media storm and said, our drinks seem fine
Speaker 1: to us, maybe it's psychogenic. It would have been a
Speaker 1: public relations disaster. No wonder they preferred to pour one
Speaker 1: hundred million dollars of soda needlessly down Belgian drains. From
Speaker 1: the backlash against doctor Nitskin and the scientists in Belgium,
Speaker 1: it seems clear that mass psychogenic illnesses are widely misunderstood.
Speaker 1: And that's a problem because when a mysterious new syndrome
Speaker 1: comes along, it can be hard to have a dispassionate
Speaker 1: discussion of the possible causes. I was inspired to write
Speaker 1: this cautionary tale about mass psychogenic illnesses by a book
Speaker 1: recently published by two distinguished academics, Robert Bartholomew and Robert Below.
Speaker 1: The book is well researched and it's convincingly argued, but
Speaker 1: it also has some terrible reviews from readers propagandistic garbage,
Speaker 1: unbribed ignorance, and pseudoscience, wild speculations, des information add its finest.
Speaker 1: The book is called Havana Syndrome. Remember the story. It
Speaker 1: started with an undercover officer at the US Embassy in Havana, Cuba,
Speaker 1: complaining that he fell ill after hearing a mysterious sound
Speaker 1: at his home. As news about the case got around,
Speaker 1: more and more people started reporting symptoms. After hearing similar sounds,
Speaker 1: officials became convinced that they were dealing with some kind
Speaker 1: of sonic weapon, a weapon that sounded sort of like
Speaker 1: a mass of crickets. The FBI took recordings of the
Speaker 1: sounds to an expert in crickets. He listened to them.
Speaker 1: That's crickets, he said, crickets, cicadas, or Katie did's one
Speaker 1: of them. Probably cicadas. Actually, Cuban cicadas can be pretty loud,
Speaker 1: he pointed out, ninety five decibels. That's about as loud
Speaker 1: as a motorcycle engine. But could a cicada damage your hearing, No,
Speaker 1: he said, not unless you shoved it into your ear canal.
Speaker 1: There might, of course, have been a sonic weapon that
Speaker 1: sounded a lot like cicadas. But think of it this way.
Speaker 1: You're about to be posted to Havana. You're quietly taken
Speaker 1: aside and played a recording that sounds very much like
Speaker 1: Cuba and cicadas. You're told, we think this may be
Speaker 1: a sonic weapon that's making people ill. You get to
Speaker 1: Havana and one night you predictably hear cicadas. As the
Speaker 1: authors below and Bartholomew put it, this is a classic
Speaker 1: setup for an outbreak of mass psychogenic illness. There's another
Speaker 1: reason to consider psychogenic explanations. Nobody seemed able to suggest
Speaker 1: how the mooted sonic attack device might actually work. Still,
Speaker 1: militaries don't tend to publicize their cutting edge technologies, and
Speaker 1: some experts say it can't all have been psychogenic because
Speaker 1: a few people's symptoms were too serious for that. Below
Speaker 1: and Bartholomew disagree. I don't feel qualified to judge, but
Speaker 1: I do think I can judge the quality of debate
Speaker 1: around the suggestion that Havana syndrome might have been a
Speaker 1: mass psychogenic illness. That debate was depressing, and not just
Speaker 1: in the reader reviews of Below and Bartholomew's book. Senator
Speaker 1: Marco Rubio, for example, sarcastically dismissed the idea that a
Speaker 1: bunch of people are just being hypochondriacs and making it up. Well, no,
Speaker 1: that's not how psychogenic illness works. Whether an illness begins
Speaker 1: in the body or the mind, the symptoms are real.
Speaker 1: But that leads to an other question, how do we
Speaker 1: treat them? In London in nineteen ninety, more than fifty
Speaker 1: school children were rushed to hospital when they started feeling
Speaker 1: sick after lunch. They had abdominal pain, nausea, and vomiting.
Speaker 1: They all recovered pretty quickly. You know the drill by Now,
Speaker 1: this looks like a mass psychogenic illness, right, Actually no.
Speaker 1: After careful investigation, it turned out that the cucumbers served
Speaker 1: at school lunch were probably contaminated with insecticide. Lots of
Speaker 1: things can make us ill, especially with the kind of
Speaker 1: symptoms I've been mentioning through this tale. Fatigue, nausea, dizziness, headaches.
Speaker 1: These are common ailments with all kinds of causes. It
Speaker 1: shouldn't surprise us if we happened to find a Belgian
Speaker 1: with some of these symptoms who just had a coke,
Speaker 1: or a US diplomat in Havana who recently heard cicadas.
Speaker 1: Diagnosis is hard and we need to keep an open mind,
Speaker 1: especially because cases of physiogenic and psychogenic illnesses often crop
Speaker 1: up together. The London investigators blamed the cucumbers, but they
Speaker 1: also reckoned that some of the later cases might have
Speaker 1: been psychogenic kids seeing their friends getting ill and thinking
Speaker 1: themselves into illness too. Some people think that might also
Speaker 1: have happened in Belgium. Those first few bottles of coke might,
Speaker 1: of course, children to feel sick, and from that starting
Speaker 1: point the problem ballooned through psychogenic contagion. Maybe that'll turn
Speaker 1: out to be the story with Havana syndrome II, a
Speaker 1: mix of physiogenic and psychogenic cases. We don't yet know
Speaker 1: all the answers. The trouble is that psychogenic and physiogenic
Speaker 1: illnesses need treating in completely different ways. If you're ill
Speaker 1: because something's got into your body a toxin or a
Speaker 1: virus or a bacteria, you need to figure out what
Speaker 1: that thing is and if it has an antidote. If
Speaker 1: the cause is psychogenic, then there isn't a cure as such,
Speaker 1: at least if we discount the medieval method of sending
Speaker 1: soldiers to whip the meowing nuns. But there is an
Speaker 1: approach that makes sense. If the power of expectation made
Speaker 1: someone ill, the power of expectation can also help them recover.
Speaker 1: When doctor Nitskin told the children in Miami that there
Speaker 1: was no toxic gas, they stopped worrying and their symptoms
Speaker 1: melted away. Of course, what's an inspired diagnosis, if you're right,
Speaker 1: looks like an arrogant rejection of your patient's experiences if
Speaker 1: you're wrong. For every Joel Nitskin who decisively cures a
Speaker 1: psychogenic outbreak, there's a doctor brusquely telling their patients to
Speaker 1: snap out of it, when in fact the illness has
Speaker 1: a physical cause that the doctor has overlooked. Joel Knitskin
Speaker 1: knew he had taken a risk he'd have to justify
Speaker 1: to his bosses. I'd made a bold move, he told
Speaker 1: The New Yorker, and bold moves are not encouraged in
Speaker 1: the bureaucratic world. The safe thing to do would have
Speaker 1: been to close the school for the day. When the
Speaker 1: report came back no poison gas. Sandy had a viral illness.
Speaker 1: All the other kids thought themselves into feeling ill too.
Speaker 1: Nobody would have blamed doctor Nitskin for airing on the
Speaker 1: side of caution. I'm not sure that makes sense. If
Speaker 1: a doctor tells us he thinks we've probably got a
Speaker 1: viral illness and it turns out to be bacterial, we're
Speaker 1: not going to get more or less upset than if
Speaker 1: it made the opposite mistake. But we don't feel the
Speaker 1: same symmetry about psychogenic illnesses. Nobody is happy when a
Speaker 1: doctor makes a mistake, but the mistake of declaring an
Speaker 1: illness to be psychogenic is the one we can't seem
Speaker 1: to forgive. And if we wrongly see the suggestion of
Speaker 1: psychogenic illness as a personal insult, we'll make doctors scared
Speaker 1: to mention it. John Nitskin took a risk because he
Speaker 1: understood how psychogenic illnesses work. He knew that if he
Speaker 1: allowed the idea of poison gas to linger, more kids
Speaker 1: would have felt ill, and he understood that their symptoms
Speaker 1: would have been genuine. Those forty kids in the caffetorium
Speaker 1: complaining of nausea or breathing problems weren't faking or imagining.
Speaker 1: They were suffering. With one calm and authoritative statement, doctor
Speaker 1: Nitskin cured them all. For a full list of our sources,
Speaker 1: please see the show notes at Timharford dot com. Cautionary
Speaker 1: Tales is written by me Tim Harford with Andrew Wright.
Speaker 1: It's produced by Alice Fines with support from Edith Russlow.
Speaker 1: The sound design and original music is the work of
Speaker 1: Pascal Wise. Julia Barton edited the scripts. It features the
Speaker 1: voice talents of Ben Crowe, Melanie Guttridge, Gemma Saunders and
Speaker 1: rufus Wright. The show wouldn't have been possible without the
Speaker 1: work of Jacob Weisberg, Ryan Dilly, Greta Cohne, let Al Millard,
Speaker 1: John Schnaz, Carlie mcgliori and Eric Sandler. Cautionary Tales is
Speaker 1: a production of Pushkin Industries. It was recorded in ward
Speaker 1: Or Studios in London by Tom Berry. If you like
Speaker 1: the show, please remember to share, rate and review go
Speaker 1: on you know it helps us And if you want
Speaker 1: to hear the show ad free, sign up for Pushkin
Speaker 1: Plus on the show page in Apple Podcasts or at
Speaker 1: pushkin dot Fm, slash plus