WEBVTT - Special Episode: Mary Roach & Replaceable You 0:00:44.320 --> 0:00:47.639 Hi, I'm Aaron Welsh and this is this Podcast will 0:00:47.680 --> 0:00:51.160 Kill You. You're listening to the latest episode in our tp 0:00:51.520 --> 0:00:54.480 w k Y book Club series, where I get to 0:00:54.560 --> 0:00:57.959 interview authors of popular science and medicine books about their 0:00:58.040 --> 0:01:01.920 latest work. We have featured some excellent books so far 0:01:02.000 --> 0:01:04.800 this season and have a great lineup for the rest 0:01:04.840 --> 0:01:07.280 of the year. If you'd like to sneak a peek 0:01:07.280 --> 0:01:09.319 at the books that we'll be reading later this season, 0:01:09.480 --> 0:01:11.720 as well as check out the ones we've already covered, 0:01:11.880 --> 0:01:14.400 head over to our website This Podcast will Kill You 0:01:14.480 --> 0:01:17.679 dot com. There under the extras tab you'll find a 0:01:17.720 --> 0:01:21.000 link to our bookshop dot Org affiliate page, which has 0:01:21.120 --> 0:01:24.600 a bunch of podcast related lists, including one for this 0:01:24.680 --> 0:01:28.200 book club series. I am always updating this list, so 0:01:28.440 --> 0:01:30.880 check back in regularly to see what's coming up later 0:01:30.959 --> 0:01:31.520 this season. 0:01:32.319 --> 0:01:33.920 As always, we love. 0:01:33.720 --> 0:01:36.399 Hearing from you all about these book club episodes as 0:01:36.400 --> 0:01:39.400 well as our regular episodes, so if you have anything 0:01:39.440 --> 0:01:42.039 you'd like to share, reach out through the contact us 0:01:42.120 --> 0:01:44.880 form on our website. Some of you have sent in 0:01:44.959 --> 0:01:49.200 some great book recommendations, which I always appreciate. Two last 0:01:49.240 --> 0:01:51.680 things before moving on to this week's book, and that 0:01:51.840 --> 0:01:55.200 is to please, rate, review, and subscribe if you haven't already. 0:01:55.400 --> 0:01:58.320 It really does help us out, and you can now 0:01:58.440 --> 0:02:01.559 find full video versions of most of our newer episodes 0:02:01.600 --> 0:02:04.720 on YouTube. Make sure you're subscribed to exactly Right Media's 0:02:04.720 --> 0:02:07.559 YouTube channel so you never miss a new episode drop. 0:02:08.480 --> 0:02:14.840 Our human bodies are astoundingly complex, intricate machines that allow 0:02:14.960 --> 0:02:20.119 us to interact with, exist within, and move about this world. 0:02:20.480 --> 0:02:23.560 Even at this moment, whether you're driving home from work, 0:02:23.800 --> 0:02:26.840 out for a walk, cross stitching on the couch, or 0:02:26.960 --> 0:02:31.239 just sitting meditatively, your body is performing a whole host 0:02:31.360 --> 0:02:34.040 of functions, some of which you might be aware of, 0:02:34.240 --> 0:02:37.160 like listening to what I'm saying, pumping the brakes, or 0:02:37.200 --> 0:02:40.040 picking up your dog's poop, and others that you don't 0:02:40.080 --> 0:02:44.760 even realize are happening, like digesting lunch, maintaining balance, or 0:02:44.840 --> 0:02:48.799 growing hair one micrometer at a time. When you think 0:02:48.840 --> 0:02:51.600 about all the things that have to go right every 0:02:51.720 --> 0:02:54.919 second of every day to keep us healthy and alive 0:02:55.400 --> 0:02:58.120 and doing what we want to be doing, it's hard 0:02:58.240 --> 0:03:01.520 not to be amazed at what our bodies are capable of. 0:03:02.400 --> 0:03:05.240 In general, they do such a good job of keeping 0:03:05.320 --> 0:03:09.040 as functional that When something happens that throws a figurative 0:03:09.040 --> 0:03:12.600 wrench in our figurative machine slash body, we are often 0:03:12.680 --> 0:03:16.880 left with only imperfect solutions. The human body is a 0:03:16.960 --> 0:03:20.600 difficult thing to replace, but that hasn't kept people from 0:03:20.600 --> 0:03:25.000 attempting to do so for centuries. From the earliest skin 0:03:25.120 --> 0:03:29.840 grafts to three D bioprinting, scientists have made incredible strides 0:03:29.880 --> 0:03:33.800 in developing suitable replacements for our various body parts, and 0:03:33.880 --> 0:03:37.080 Mary Roach is here to tell you all about it. 0:03:37.760 --> 0:03:41.120 The ever delightful Mary Roach joins me to discuss her 0:03:41.200 --> 0:03:45.840 latest book, Replaceable You, Adventures in Human Anatomy, which takes 0:03:45.880 --> 0:03:48.880 reader's body part by body part through the science of 0:03:48.960 --> 0:03:53.200 regenerative medicine. You'll learn what's so special about a pig's heart, 0:03:53.600 --> 0:03:56.760 why hair transplants work as well as they do, how 0:03:56.800 --> 0:04:00.360 to choose an OSTOMEI bag, what it feels like in side, 0:04:00.440 --> 0:04:04.680 in iron lung, and so much more. This journey is 0:04:04.840 --> 0:04:11.760 alternatively funny, bizarre, revelatory, passionate, and inspirational. In other words, 0:04:11.840 --> 0:04:14.560 it's a classic Mary Roach. By the end of the book, 0:04:14.640 --> 0:04:17.680 you're left in awe of the scientists who have accomplished 0:04:17.720 --> 0:04:21.200 so much to heal those in need, the brave patients 0:04:21.240 --> 0:04:23.680 who have dared to put their lives in their hands, 0:04:23.920 --> 0:04:28.279 and our bodies themselves, whose stubborn instinct to protect us 0:04:28.400 --> 0:04:31.080 is often the thing holding us back from creating a 0:04:31.080 --> 0:04:35.000 perfect replacement. I am beyond thrilled to get to chat 0:04:35.040 --> 0:04:37.200 with Mary again, so let's take a quick break and 0:04:37.240 --> 0:05:05.279 get started. Mary, it is so great to see you again. 0:05:05.480 --> 0:05:06.760 Thanks for joining me today. 0:05:07.320 --> 0:05:09.080 My pleasure lovely to be back. 0:05:09.480 --> 0:05:12.039 I am thrilled to get to chat with you about 0:05:12.080 --> 0:05:16.360 your newest book, Replaceable You, which takes readers on this 0:05:16.480 --> 0:05:20.760 frolicking tour through replacement body parts and the challenges in 0:05:20.839 --> 0:05:23.040 getting them to work the way we want them to. 0:05:23.640 --> 0:05:26.400 Could you tell me about the journey from the seed 0:05:26.440 --> 0:05:29.159 of an idea to how this book came to be, Like, 0:05:29.279 --> 0:05:32.560 was there a certain place or body part where you started? 0:05:33.720 --> 0:05:38.600 Yes, in fact, there is. When I'm looking for a 0:05:38.640 --> 0:05:42.080 book idea, I often call people from past books or 0:05:42.120 --> 0:05:45.520 people who have sort of generalized knowledge, and I called 0:05:45.520 --> 0:05:47.400 this one. I think partly because I was thinking about 0:05:47.600 --> 0:05:51.280 fat like as a book topic, oh, fat like fat 0:05:51.320 --> 0:05:54.279 as a substance. I didn't end up going there, but 0:05:54.400 --> 0:05:57.520 I spoke to this woman, Leah Bellis, who works with 0:05:57.760 --> 0:06:00.479 stem cells derived from fat, and we had this wide 0:06:00.560 --> 0:06:03.920 ranging conversation and one thing she told me had nothing 0:06:03.960 --> 0:06:07.919 to do with fat or stem cells. She mentioned this 0:06:08.120 --> 0:06:14.039 surgeon who had created he'd created a replacement penis for 0:06:14.080 --> 0:06:17.920 a man using his own metal finger, and I of 0:06:17.960 --> 0:06:23.240 course pictured the finger moved as is from the man's 0:06:23.279 --> 0:06:26.200 hand and just like stitched in place, able to move 0:06:26.320 --> 0:06:27.200 and like you. 0:06:27.200 --> 0:06:28.400 Know hencile penis. 0:06:28.560 --> 0:06:32.440 Yeah, exactly like you could beckon with it. And of 0:06:32.440 --> 0:06:34.760 course that's not the case. It was sort of used 0:06:34.800 --> 0:06:40.600 as a natural kind of prosthetic implant. Anyways, I was like, wow, 0:06:40.760 --> 0:06:44.240 I really need to see I need to visit this person. 0:06:44.279 --> 0:06:47.200 I need to write about that. And so I then 0:06:47.360 --> 0:06:53.360 started just thinking about replacement parts and prosthetics and ostomes 0:06:53.520 --> 0:06:57.400 and hair transplants and of course bioprinting and stem cells, 0:06:57.400 --> 0:07:01.240 and that's kind of where it's kind of how it happened. 0:07:01.240 --> 0:07:03.760 It just it tends my books tend to happen. There's 0:07:03.800 --> 0:07:07.640 one chapter and then there's another one, and then I think, well, 0:07:07.680 --> 0:07:10.600 what could be the kind of topic the umbrella that 0:07:10.720 --> 0:07:15.960 goes over all of this. So it's never me going yeah, 0:07:16.080 --> 0:07:19.360 I'd like to do a wide ranging book on regenerative 0:07:19.440 --> 0:07:22.960 medicine and prosthetics, which is not what the book really is, 0:07:23.000 --> 0:07:25.240 but that's how it goes with me. 0:07:25.920 --> 0:07:29.640 I love that the theme emerges, which as you just 0:07:29.680 --> 0:07:34.840 follow your curiosity from you know, prosthetic penises and beyond, like. 0:07:35.000 --> 0:07:37.200 Yeah, exactly, that could have been the title. 0:07:38.360 --> 0:07:40.040 Next time, the sequel. 0:07:40.160 --> 0:07:44.200 Yeah, you talked about how like you know, there's we 0:07:44.280 --> 0:07:47.360 start now with three D bioprinting, which sounds like this 0:07:47.480 --> 0:07:51.040 like sci fi thing, but in reality, the history of 0:07:51.080 --> 0:07:56.320 replacement body parts goes back centuries, millennia even and I 0:07:56.400 --> 0:07:58.960 know that you know, hindsight is twenty twenty, but it's 0:07:59.080 --> 0:08:02.160 hard to understand and some of the decisions that certain 0:08:02.200 --> 0:08:05.160 physicians have made throughout history when it comes to some 0:08:05.240 --> 0:08:06.720 of these replacement body parts. 0:08:07.160 --> 0:08:07.840 And one that. 0:08:07.760 --> 0:08:11.880 Springs to mind is trying to grow a skin flap 0:08:11.960 --> 0:08:15.320 through a human dog connection, which you talk about in 0:08:15.360 --> 0:08:19.040 your book. But without these attempts, we would not be 0:08:19.320 --> 0:08:22.000 quite where we are today. And I'm curious if you 0:08:22.040 --> 0:08:24.360 can take me through some of the either the early 0:08:24.440 --> 0:08:29.000 pioneers or some of the strangest, most outlandish stories of 0:08:29.520 --> 0:08:33.199 early skin grafting. Or any other prosthetics that you came 0:08:33.240 --> 0:08:34.320 across in your research. 0:08:34.640 --> 0:08:38.240 Sure, well, skin grafting is a good one. I mean 0:08:38.240 --> 0:08:42.760 that goes back seventeen hundred eighteen hundreds, and physicians or 0:08:42.840 --> 0:08:47.840 surgeons were initially there was a belief that when you 0:08:48.080 --> 0:08:52.800 took a graft from someone else, and back then it 0:08:52.880 --> 0:08:56.880 was animals mostly being used, that you needed to keep 0:08:56.920 --> 0:09:01.520 it attached to a blood supply. It's you know, getting 0:09:01.559 --> 0:09:04.960 settled in its new home. So there'd be it was 0:09:04.960 --> 0:09:08.400 called a pedical flap, and it was it was, you know, 0:09:08.440 --> 0:09:10.320 there'd be the piece that's going to be transferred and 0:09:10.360 --> 0:09:15.440 then sort of a peninsula connecting it to its original owner. 0:09:15.760 --> 0:09:18.880 And what that meant this going back to the eighteen 0:09:18.960 --> 0:09:22.200 hundred's Charles Setio I believe his name was, I had this. 0:09:22.520 --> 0:09:26.040 I remember reading about how he had used He described it. 0:09:26.120 --> 0:09:30.240 Of course, it's in French an chien denois, and I'm thinking, well, 0:09:30.280 --> 0:09:32.559 I don't know much about Danish dog breeds and I'm 0:09:32.600 --> 0:09:36.520 picturing something small, but no, you meant the great Dane. 0:09:36.920 --> 0:09:41.120 So this person had to lie with a great Dane 0:09:42.120 --> 0:09:45.400 for a number of weeks while the you know, the 0:09:45.600 --> 0:09:48.520 keeping the blood supply from the dog, but in fact 0:09:48.640 --> 0:09:52.000 he terminated the project early because of the continual and 0:09:52.080 --> 0:09:54.400 excessive movements of the dog. And I'm like, what did 0:09:54.440 --> 0:09:55.280 you expect. 0:09:57.559 --> 0:09:59.920 It's amazing that the project got as far as it did, 0:10:00.200 --> 0:10:02.640 like into actual execution and not just like in the 0:10:02.640 --> 0:10:04.280 early stages, like what are we doing here? 0:10:04.440 --> 0:10:05.040 What are we doing? 0:10:05.120 --> 0:10:08.559 There's one there was one description of a similar surgery 0:10:08.720 --> 0:10:11.640 using a pig, and a pig like a you know, livestock, 0:10:11.880 --> 0:10:15.600 horses cows have this ability to move the skin, you know, 0:10:15.679 --> 0:10:18.800 to discourage and make flies go away. They can kind 0:10:18.800 --> 0:10:22.000 of twitch the skin. So the pig kept doing that, 0:10:22.120 --> 0:10:24.120 you know, and instead of it being a fly that 0:10:24.160 --> 0:10:26.360 it was trying to dislodge, it was an actual human. 0:10:28.240 --> 0:10:30.600 So in the you know, there's a pig in the room, 0:10:30.640 --> 0:10:33.920 it meant there was manure. It was quite a sort 0:10:33.920 --> 0:10:37.840 of a circus. And at certain point surgeons realize it's 0:10:37.840 --> 0:10:40.400 going to work pretty well even if you just you 0:10:40.400 --> 0:10:43.280 don't keep it connected to it to the host. You 0:10:43.280 --> 0:10:46.280 can take a patch and put it. It's kind of 0:10:46.320 --> 0:10:49.200 a bio dressing. It isn't as though the person becomes 0:10:49.280 --> 0:10:52.280 part dog or port frog or par chicken, especially with 0:10:52.360 --> 0:10:57.079 a burn a big burn. The immune system is suppressed initially, 0:10:57.559 --> 0:11:03.440 and that allows foreign graft to sit there and to 0:11:03.520 --> 0:11:06.240 kind of take for a while, and eventually it'll slough off, 0:11:06.320 --> 0:11:08.840 or the surgeons will remove it and put on a 0:11:08.880 --> 0:11:13.560 graft from the from the patient themselves, which works. But 0:11:13.640 --> 0:11:15.760 as a kind of a band aid of bio dressing. 0:11:15.840 --> 0:11:19.920 They're called zoografts or zenographs. They do work. You know, 0:11:19.920 --> 0:11:22.400 it protects it, it keeps it from drawing out. It 0:11:22.480 --> 0:11:26.280 sounds really weird, but it did work fairly well. Chickens 0:11:26.320 --> 0:11:27.880 frogs were used often. 0:11:28.760 --> 0:11:30.800 Let's take a quick break, and when we get back, 0:11:30.880 --> 0:11:52.800 there's still so much to discuss. Welcome back everyone. I've 0:11:52.840 --> 0:11:55.880 been chatting with Mary Roach about her book Replaceable You 0:11:56.200 --> 0:12:01.440 Adventures in Human Anatomy. Let's get back into things. Chickens frogs, 0:12:01.480 --> 0:12:05.160 Why choose animals? I mean, I'm assuming access was one 0:12:05.160 --> 0:12:07.280 of the things. But you know, how did we go 0:12:07.360 --> 0:12:11.319 from chickens frogs to today where we're actually able to 0:12:11.400 --> 0:12:14.839 use you know, autograph someone's for someone's own tissue and 0:12:15.120 --> 0:12:17.800 will in the future people look back and go, I 0:12:17.800 --> 0:12:20.720 can't believe you used the own tissue like we now 0:12:20.800 --> 0:12:24.680 just print sheets of skin from someone's body. 0:12:24.760 --> 0:12:28.679 Yeah, yeah, yeah, And in fact, now you can do 0:12:28.760 --> 0:12:34.200 something called a cultured epithelial autographed where you take the 0:12:34.240 --> 0:12:37.240 person's cells and they're sent off site and they're grown 0:12:37.280 --> 0:12:41.880 into a very very very thin layer of their own cells. 0:12:41.960 --> 0:12:44.240 And that's nice because you're not taking a graph from 0:12:44.280 --> 0:12:47.000 another part of the body. You know. Frequently yeah, you know, 0:12:47.040 --> 0:12:49.080 you'll take a graph from the thigh or the back, 0:12:49.120 --> 0:12:51.160 you know, and and when it's somebody has a really 0:12:51.240 --> 0:12:54.080 serious burn that's covering you know, sixty percent of the 0:12:54.080 --> 0:12:57.199 body or something, you you don't have a lot of options, 0:12:57.200 --> 0:12:59.920 not a lot of real estate to be taking those 0:13:00.360 --> 0:13:03.560 grafts from so and you can wait for them to 0:13:03.679 --> 0:13:05.959 heal and then reuse that space. I mean, it's quite 0:13:05.960 --> 0:13:09.320 an undertaking. So some of these new newer developments like 0:13:09.360 --> 0:13:12.120 the spray on skin where you kind of you know, 0:13:12.160 --> 0:13:14.800 you take a graft and it's meshed and you kind 0:13:14.800 --> 0:13:18.000 of fill in the spaces and the mesh with some 0:13:18.120 --> 0:13:21.560 of the person's own cells sprayed on there. 0:13:22.160 --> 0:13:25.680 I love that, Like scaffolding build here, Yeah, this is 0:13:25.960 --> 0:13:27.880 this is the real estate that you want to be, yeah, 0:13:27.960 --> 0:13:31.640 taking it seems like the early days of replacement body 0:13:31.640 --> 0:13:35.000 parts is peppered with the use of animals of all 0:13:35.040 --> 0:13:39.360 different kinds and all different ways. And you talk in 0:13:39.400 --> 0:13:44.240 your book about milk and how in the hospital you 0:13:44.320 --> 0:13:47.000 might see like cows or goats or like, what tell 0:13:47.040 --> 0:13:49.280 me about the use of goat's milk in a hospital 0:13:49.280 --> 0:13:51.400 setting in the eighteen hundreds. 0:13:51.000 --> 0:13:55.640 Yeah, milk, goat's milk, cow's milk. There's some disagreement on 0:13:55.679 --> 0:13:59.599 whose milk was best. It was a blood substitute. Basically. 0:13:59.679 --> 0:14:03.720 It was because you know, early on before sodium citrate 0:14:03.960 --> 0:14:08.240 was found to be something that could prevent clotting, clotting 0:14:08.320 --> 0:14:12.439 was a real issue with transfusing blood from one person 0:14:12.800 --> 0:14:16.640 or one animal to another. So somebody had this idea 0:14:16.640 --> 0:14:21.800 of to try another miraculous bodily substance. So they tried milk. 0:14:22.040 --> 0:14:24.680 Goat's milk, cow's milk. I mean, it was just a 0:14:24.680 --> 0:14:29.160 lot of very excited journal articles going, this is going 0:14:29.240 --> 0:14:31.600 to be this is going to be huge milk transfusions. 0:14:31.600 --> 0:14:34.240 So we're going to apply to the hospital to get 0:14:34.360 --> 0:14:36.840 funding for a cow that you know, that will keep 0:14:36.880 --> 0:14:40.120 on the grounds. And very quickly medicine came to its 0:14:40.120 --> 0:14:43.000 senses and realizes it's just basically It's similar to giving 0:14:43.040 --> 0:14:45.600 someone saline to keep their blood volume up in the 0:14:45.640 --> 0:14:49.280 case of a hemorrhage. If somebody's lost a lot of blood, 0:14:49.480 --> 0:14:52.640 it prevents going at a shock, and so it's useful 0:14:52.680 --> 0:14:56.840 in that way. There wasn't something inherent in milk, you know, 0:14:57.520 --> 0:15:01.360 that made it this miraculous substance. But it wasn't an 0:15:01.520 --> 0:15:05.040 entertaining period, and it was like eighteen seventy eight, there 0:15:05.080 --> 0:15:08.600 was this flurry of milk transfusions. 0:15:08.040 --> 0:15:13.160 Milk transfusions, get them here. Did people not get sick 0:15:13.240 --> 0:15:13.680 from this? 0:15:13.920 --> 0:15:16.640 Not an ideal sterile scenario? 0:15:17.360 --> 0:15:22.040 No, No, We talked about frog skin and dog skin 0:15:22.160 --> 0:15:24.480 and chicken skin and all this, but then it goes 0:15:24.520 --> 0:15:30.960 beyond skin graphs and zographs into organs transplanted from animals 0:15:31.000 --> 0:15:34.560 as well, and sort of like with the frog skin graphs, 0:15:34.560 --> 0:15:37.840 these are temporary solutions. But I was wondering if you 0:15:37.840 --> 0:15:41.600 could tell me more about zeno transplantation or zo transplantation. 0:15:41.680 --> 0:15:44.960 I guess with pig hearts, when do we use that? 0:15:45.200 --> 0:15:48.320 How well does it work? How did we get the idea? 0:15:48.560 --> 0:15:49.800 Just the full story? 0:15:50.560 --> 0:15:53.840 Sure, zeno transplantation. I mean, this work has been going 0:15:53.880 --> 0:15:58.240 on about thirty years at least, and it is just 0:15:58.440 --> 0:16:01.720 now over the past year year and a half are 0:16:01.800 --> 0:16:06.040 actually being used in humans. So pig organs are the 0:16:06.040 --> 0:16:10.240 ones that are being used. I mean, pig's hearts are similar, 0:16:10.320 --> 0:16:14.440 especially a smaller, smaller size, kind of a good match 0:16:14.720 --> 0:16:18.760 for the human heart. And by now there are fewer 0:16:18.800 --> 0:16:24.400 than ten zeno transplantations into humans. There's one man, Tim Andrews, 0:16:24.440 --> 0:16:27.320 as far as I know, is still alive. The rest 0:16:27.360 --> 0:16:31.520 of them bought them about two months. This is a 0:16:31.560 --> 0:16:34.800 pig organ it's a genetic edit so that some of 0:16:34.800 --> 0:16:39.120 the surface proteins that tell the human immune system like 0:16:39.640 --> 0:16:43.440 this is really foreign, get it out of here. So 0:16:43.520 --> 0:16:48.120 there's these genetic edits to make this heart more like 0:16:48.160 --> 0:16:50.840 a human heart, to try to fool the immune system 0:16:51.120 --> 0:16:54.120 and to prevent hyperacute rejection, which is if you put 0:16:54.160 --> 0:16:56.600 in a pig heart, like right away, the body's going 0:16:56.640 --> 0:16:59.600 to attack it, it's going to start turning black. Is 0:16:59.640 --> 0:17:03.560 knock a work. So they've managed to get around the 0:17:03.640 --> 0:17:06.679 hyper acute rejection, but there are still rejection, you know, 0:17:06.760 --> 0:17:09.760 longer term rejection issues. So it's not thought of at 0:17:09.760 --> 0:17:13.399 this point. It's not a permanent like a human transplant 0:17:13.480 --> 0:17:17.639 human heart or kidney transplantation. You're buying time in the 0:17:17.640 --> 0:17:20.560 hope that you'll make your way up the list and 0:17:20.600 --> 0:17:23.520 be able to get a human kidney or heart whatever 0:17:23.600 --> 0:17:26.520 it is. So it's a stalling mechanism. It's a way 0:17:26.600 --> 0:17:29.200 just to buy time for the person you know, who's 0:17:29.680 --> 0:17:34.120 otherwise you know, could die. Unfortunately, that means the patients 0:17:34.160 --> 0:17:36.440 that are getting these hearts are are not in tip 0:17:36.480 --> 0:17:39.679 top shape and that may be contributing to to the 0:17:39.720 --> 0:17:43.280 short survival time. Tim Andrews was in better shape than 0:17:43.320 --> 0:17:47.240 some of the previous recipients. No one is quite sure, 0:17:47.280 --> 0:17:50.040 you know, why is it only lasting two months? What 0:17:50.119 --> 0:17:53.359 do we need to do next? How many more edits 0:17:53.480 --> 0:17:55.960 are we going to do? Or is it something else 0:17:56.240 --> 0:18:00.119 entirely that's going on. There's also concerns about zoom no 0:18:00.359 --> 0:18:03.679 ses diseases that could go back and forth between the 0:18:03.760 --> 0:18:08.400 animal and the person. I mean, it's amazing to think 0:18:08.440 --> 0:18:11.600 that we can even get two months using something that 0:18:11.720 --> 0:18:14.800 is that foreign. You know, it's a pig heart, so 0:18:15.240 --> 0:18:17.240 you know in pig valves have been used before, but 0:18:17.400 --> 0:18:20.960 that's that's not live cells, you know, that's a sort 0:18:20.960 --> 0:18:24.879 of extra cellular material, so not quite the same I 0:18:25.119 --> 0:18:28.920 visited a place in China where they're raising these pigs 0:18:28.960 --> 0:18:31.720 and so they're super cle It's a super clean pig sty, 0:18:31.840 --> 0:18:34.480 which to me was this lovely oxymoron. I'm like, what 0:18:34.520 --> 0:18:37.000 do you mean it's a clean pig sty, But it is. 0:18:37.080 --> 0:18:42.320 It's they're tested for forty bacteria, viruses, fungi. The whole 0:18:42.359 --> 0:18:45.119 place gets disinfected every few days. The staff are not 0:18:45.160 --> 0:18:48.240 allowed to leave. They work for three months in the facility, 0:18:48.280 --> 0:18:51.760 and then they're swapped out with someone else. So very 0:18:52.160 --> 0:18:57.760 very strict cleanliness and hygiene and sterile protocols for these pigs. 0:18:57.880 --> 0:18:59.480 You know what I saw. I wasn't allowed to go in. 0:18:59.520 --> 0:19:01.240 Of course. I I go all the way to China, 0:19:01.280 --> 0:19:03.200 thinking well, I'm going to get in to see the pigs. 0:19:03.200 --> 0:19:06.400 And they're like, of course you're not going in. You're 0:19:06.560 --> 0:19:10.080 full of germs, you know. And then they're like, you 0:19:10.119 --> 0:19:13.240 can see it from across the river. There there's the facility, 0:19:13.680 --> 0:19:16.000 you know. And then we went over to a kind 0:19:16.000 --> 0:19:19.119 of a control center where I could see them, the pigs, 0:19:19.160 --> 0:19:23.120 that is, on a video screen in real time. There 0:19:23.160 --> 0:19:26.040 they were the very clean pigs, still pooping on the floor. 0:19:26.119 --> 0:19:27.159 I mean, they're pigs. 0:19:27.600 --> 0:19:29.679 Right, there's no gene. 0:19:29.440 --> 0:19:31.560 At it to make a pig use a toilet. 0:19:32.119 --> 0:19:36.520 Not yet, not yet, moving away now from animals for now, 0:19:36.640 --> 0:19:39.680 I guess maybe we'll circle back at some point and 0:19:39.920 --> 0:19:44.080 going on to prosthetic devices. And you had such a 0:19:44.080 --> 0:19:46.520 great chapter about this where you kind of touched on 0:19:46.560 --> 0:19:49.280 these different misconceptions that I think a lot of the 0:19:49.280 --> 0:19:52.800 general public has, who maybe doesn't have experience with prosthetics 0:19:53.480 --> 0:19:56.880 has in mind about these devices, and also just the 0:19:56.960 --> 0:20:01.640 bias that there is for wholeness. And it's a really 0:20:01.640 --> 0:20:05.439 difficult decision to make for amputation, especially when it's not 0:20:05.520 --> 0:20:07.760 medically necessary, or when it's a parent that has to 0:20:07.800 --> 0:20:09.040 make this decision or. 0:20:08.960 --> 0:20:09.919 Not for their child. 0:20:10.040 --> 0:20:10.159 Right. 0:20:10.680 --> 0:20:13.879 I was wondering what your sort of did your perspective 0:20:14.040 --> 0:20:17.119 change or evolve as you worked on that chapter and 0:20:17.200 --> 0:20:20.200 visited people and talked with, you know, individuals who have 0:20:20.320 --> 0:20:22.719 different prosthetic or terminal devices. 0:20:23.200 --> 0:20:26.960 Yeah, that was a conversation. In fact, that was one 0:20:27.000 --> 0:20:31.359 of the early conversations I had that sort of cemented 0:20:31.400 --> 0:20:34.520 my decision to do this book. I heard from a 0:20:34.600 --> 0:20:38.439 reader of mine who believed that I should do a 0:20:38.480 --> 0:20:42.120 book on professional football referees. I don't know why she thought. 0:20:41.920 --> 0:20:45.520 It was a good fit for me in your real house. 0:20:46.000 --> 0:20:48.719 Yeah, so she's like, you should do this book. And anyway, 0:20:48.720 --> 0:20:52.240 we corresponded by email and come to find out she 0:20:52.440 --> 0:20:56.639 was an amputee below the knee amputee, but specifically she 0:20:56.720 --> 0:21:01.280 had an elective amputation. In other words, she chose to 0:21:01.359 --> 0:21:05.000 have a healthy foot amputated. It was a healthy foot 0:21:05.040 --> 0:21:08.440 in that the tissue was fine, there was no gangrene 0:21:08.520 --> 0:21:12.560 or anything, no reason, no obvious reason why a physician 0:21:12.640 --> 0:21:15.399 or surgeon would say you should remove this foot. But 0:21:15.480 --> 0:21:17.679 she had spina bifida and that she had like a 0:21:17.720 --> 0:21:20.760 tumor on her spine that it caused this foot to 0:21:21.040 --> 0:21:24.560 be twisted to not work well. She had had a 0:21:24.640 --> 0:21:28.560 half dozen operations, never getting to the point where she 0:21:28.640 --> 0:21:31.960 was improving, always getting worse. And she's described watching people 0:21:32.000 --> 0:21:36.200 out hiking and watching people who had prosthetic limbs in 0:21:36.359 --> 0:21:40.720 artificial foot who were able to walk or run or 0:21:40.800 --> 0:21:44.119 hike and do things that she couldn't do. And they've 0:21:44.119 --> 0:21:48.000 got a prosthesis and she has a natural foot, and 0:21:48.040 --> 0:21:51.320 she just decided, I don't want this foot. I want 0:21:51.320 --> 0:21:54.280 this gone. And it was very hard for her to 0:21:54.359 --> 0:21:57.000 find a surgeon willing to do that, because you're talking 0:21:57.000 --> 0:22:00.920 about removing healthy in quote, I mean it's healthy, it 0:22:01.000 --> 0:22:03.960 is just not functional. For her, it was very hard 0:22:03.960 --> 0:22:07.520 to find a surgeon willing to do that. She finally did, 0:22:07.720 --> 0:22:10.399 she was so much happier. She can do all of 0:22:10.400 --> 0:22:13.560 those things she would see other people doing. So there 0:22:13.640 --> 0:22:16.119 is a bias for wholeness, that's part of it. But 0:22:16.200 --> 0:22:18.359 it's also a surgeon. You know, no one's going to 0:22:18.400 --> 0:22:21.920 call a surgeon to task for Let's try another operation, 0:22:22.240 --> 0:22:24.720 Let's see if we can make this foot work, you know, 0:22:24.720 --> 0:22:29.240 because cutting a foot off feels extreme final, there's no 0:22:29.320 --> 0:22:32.760 going back. Also, the surgeon may or may not have 0:22:32.840 --> 0:22:36.199 experience and amputations and may be concerned about you know, 0:22:36.240 --> 0:22:38.480 what if there's phantom pain, what if I don't do 0:22:38.600 --> 0:22:41.199 it right? You know. You need also to convince the 0:22:41.240 --> 0:22:45.879 insurance people. That's another issue. So so it's it's a 0:22:45.920 --> 0:22:48.840 tricky thing to take off your foot and as you 0:22:48.960 --> 0:22:51.280 mentioned when when you ask the question, when it's a 0:22:51.400 --> 0:22:56.080 parent trying to make that decision for a child, that's 0:22:56.320 --> 0:22:57.280 really hard to do. 0:22:58.080 --> 0:23:00.199 Yeah, And I think that, like you said, the the 0:23:00.280 --> 0:23:04.840 technology being varied for different limbs is part of the 0:23:04.840 --> 0:23:05.600 equation too. 0:23:06.200 --> 0:23:12.119 Yes, absolutely, the feet and the legs are far better 0:23:12.160 --> 0:23:15.040 bet than those. You know, it's sort of in its 0:23:15.080 --> 0:23:18.320 infancy because a hand is that you get fingers and 0:23:18.359 --> 0:23:21.880 you're doing very fine tuned work. When you're trying to 0:23:22.200 --> 0:23:25.000 write or pick something up or whatever it is you're 0:23:25.040 --> 0:23:28.360 doing with your hand and your fingers, that's a big 0:23:28.480 --> 0:23:31.159 chore to get a prosthetic to do. Whereas walking is, 0:23:31.640 --> 0:23:35.679 you know, it's not simple. A gait is not just 0:23:35.960 --> 0:23:37.920 putting the foot on the floor. There's a lot going 0:23:37.960 --> 0:23:40.880 on there. But compared to a hand, it's a much 0:23:40.920 --> 0:23:42.800 more successful thing to replace. 0:23:43.880 --> 0:23:45.120 Let's take a quick break here. 0:23:45.400 --> 0:23:59.879 We'll be back before you know it. 0:24:02.560 --> 0:24:05.960 Welcome back everyone. I'm here chatting with the wonderful Mary 0:24:06.040 --> 0:24:09.040 Roach about her book Replaceable You. Let's get into some 0:24:09.080 --> 0:24:15.200 more questions. Speaking of difficult things to replace, breathing ventilators, 0:24:15.400 --> 0:24:20.400 it's something that we have various forms of technology, including EVA, 0:24:20.520 --> 0:24:24.240 which I want to ask you about because that was 0:24:24.280 --> 0:24:28.239 something new that I learned. But I also wanted to 0:24:28.800 --> 0:24:34.480