Speaker 1: Welcome to stuff you should know from how Stuff Works
Speaker 1: dot com. Hey, and welcome to the podcast. I'm Josh Clark,
Speaker 1: and there's Charles W. Chuck Bryant. It's just us. There's
Speaker 1: no producer, there's no guest producer, there's no nothing, just
Speaker 1: a ghost in the chair. Why is it whenever we're
Speaker 1: in this room, just the two of us, I go
Speaker 1: back to like elementary school or middle school and feel
Speaker 1: like we should just start drinking whiskey or something. Isn't
Speaker 1: that weird? Uh? Yeah, well, I guess Jerry kind of
Speaker 1: provides like a teacher like presence, and I guess Nol
Speaker 1: is kind of like a substitute teacher like presidents. So
Speaker 1: I didn't ever have the urge to drink whiskey in
Speaker 1: elementary school. But I can see where you're coming from.
Speaker 1: It was eighth grade before that started from me. I
Speaker 1: did drink to college. But I don't know. It's just
Speaker 1: and neither one of the Jerry. No one would care.
Speaker 1: Even it's just some weird thing about the teacher leaving
Speaker 1: the room. After all these years, I'm still like, all right,
Speaker 1: I need to act up right. My thing went more
Speaker 1: towards paper airplanes than breaking out the pint bottle whiskey
Speaker 1: I have in my sock. Again, I didn't even drink
Speaker 1: until college, so of course I wasn't doing that. I
Speaker 1: just probably started joking around. No, I know what you mean,
Speaker 1: but today's Chuck, but hit the bottle right. Actually, today's
Speaker 1: Chuck is all business. Because I hate to tell you this, buddy,
Speaker 1: but you're doing your job right now. That's true. We
Speaker 1: both are because this is our job to podcast. It's
Speaker 1: funny during the the Emily and Chuck pre Oscar's Mini
Speaker 1: Crush show, it was kind of dragging on. She's like,
Speaker 1: this starting to feel like a job, and I was like,
Speaker 1: this is my job. This is the job. The job
Speaker 1: we we say. We talked about it like cops talk
Speaker 1: about their jobs, good jobs. We're real, real podcasters that job.
Speaker 1: Remember that show The Wire. Have you ever heard of it?
Speaker 1: I'm just kidding. We've talked about it before. I remember
Speaker 1: they called that one uh cop, real police, Yeah, real police.
Speaker 1: I can't remember her name. Yeah, they said a lot
Speaker 1: on that show. Yeah, but they mostly talked about one
Speaker 1: officer in particular, police trying to think of Yeah, right,
Speaker 1: there you go, So let's start real podcasting is this
Speaker 1: one gonna be a stinker. No, it's not. Actually, it's
Speaker 1: actually really do you know why, because it has the
Speaker 1: hallmarks of a good episode, And I'm gonna I'm gonna
Speaker 1: peel the curtain back a little bit for everybody, Chuck.
Speaker 1: One of the hallmarks of a good episode, at least
Speaker 1: of stuff you should know, is that there is controversy
Speaker 1: associated with something even where there doesn't seem to be,
Speaker 1: and that there are people who are either getting drew
Speaker 1: it over, suffering, being neglected, being abused. There is some
Speaker 1: group of people who the rest of the world aren't
Speaker 1: really thinking of, um, who are who are suffering at
Speaker 1: the hands of other people. And this this actually, this
Speaker 1: episode has all that, all right, Surprisingly, I'll let you
Speaker 1: guys guess where that stuff comes in. Alright, So we're
Speaker 1: talking about false positives, and here's what that is. If
Speaker 1: you've ever been to the doctor, I've had a medical
Speaker 1: test done generally, well, not generally always, you will get
Speaker 1: one of four results. Yeah, good point. You can get
Speaker 1: a true positive. And remember, when you're getting a medical
Speaker 1: test back, positive is negative. Yeah, usually means bad news.
Speaker 1: Positive is not good. They don't say I have news,
Speaker 1: I have good news. For you. Your results are positive,
Speaker 1: it's a little bit of a mind trick that you
Speaker 1: need to reform. But positive is you have this condition. Right.
Speaker 1: It means that the the test that that searches for
Speaker 1: a condition found a result. It is confirmed as yes. Right,
Speaker 1: so that's it should say that's a true positive. Right. Yeah,
Speaker 1: then you've got a true negative, which means you don't
Speaker 1: have this. However, I feel like me or probably you
Speaker 1: and most people, you say that's good news, but I
Speaker 1: should like to get a confirmation on that. Yeah, how
Speaker 1: do you know? How do you know? Doc? Then you
Speaker 1: can get a false positive, which is what we're talking
Speaker 1: about here, which is they say you have this condition,
Speaker 1: like let's say you have cancer. I'm sorry to tell you,
Speaker 1: but you don't, as it turns out later on, which
Speaker 1: is great. False positives are kind of they should call
Speaker 1: it the new lease on life result, right, the Dabney
Speaker 1: Coleman out of time result. And then the worst of
Speaker 1: all probably is the negative. Agreed. Man, I'm glad you
Speaker 1: said that, because this this article just walks right past
Speaker 1: that fact. That means results say you're fine, but it
Speaker 1: turns out that you're not. Your your toast, so whatever
Speaker 1: the lead and not even good avocado toast. You're bad
Speaker 1: burnt toast right, exactly terrible stuff with that really cheap
Speaker 1: sliced cheese that nobody would want to eat. What's what's
Speaker 1: the opposite of a lease on life to result um
Speaker 1: early death? Sudden early death out of the blue, Although
Speaker 1: there is something to be said about that, about just
Speaker 1: not knowing right just out of nowhere, bay up, you
Speaker 1: just fall over dead. That's not necessarily the worst way
Speaker 1: to go. Yeah, I guess I was thinking more in
Speaker 1: the play on words of instead of a new lease
Speaker 1: on life, something to do with renting in your landlord,
Speaker 1: so an old and uh, we'll figure this one later
Speaker 1: and dub it in Wait, what's it called when you
Speaker 1: get kicked out of your apartment? An old eviction death? God,
Speaker 1: we did it, chuck man. So those are if you
Speaker 1: take a test at the doctor, those are the four
Speaker 1: possible results you can get. What's really interesting here, and
Speaker 1: this is something that you're going to want to remember.
Speaker 1: And after you hear the rest of what we have
Speaker 1: to say, you're really gonna want to remember this. But
Speaker 1: when you hear something like this test that I'm about
Speaker 1: to give you is accurate It doesn't mean that if
Speaker 1: it comes back with a positive result that says you
Speaker 1: have this thing. It doesn't mean there's a nine chance
Speaker 1: that you have that. It just means that when they
Speaker 1: say a test is accurate, that if if you do
Speaker 1: have that disease, there's a chance that this test will
Speaker 1: catch it. Okay, huge, huge difference between those two things. Okay,
Speaker 1: that's step one. So really what this is saying is
Speaker 1: that this test doesn't let very many false negatives get through.
Speaker 1: And if you look at the numbers, this is how
Speaker 1: that works out. If you have ten thousand people chuck,
Speaker 1: and they take a test that's accurate. Uh and and
Speaker 1: this is so ten thousand people and the them don't
Speaker 1: have this and it's a ninety nine percent accurate test,
Speaker 1: there's going to be one hundred that come back positive
Speaker 1: out of ten thousand. Okay, nine of those positive results
Speaker 1: are going to be true. One is going to be
Speaker 1: a false negative. Okay, Okay, are going to be negative.
Speaker 1: They're gonna come back negative. One are going to be
Speaker 1: true negatives, but are going to actually be false positives. Right.
Speaker 1: I know this is really mind bending, but if you
Speaker 1: if you take the numbers like this, that means that
Speaker 1: only one out of nine thousand, eight hundred and two
Speaker 1: people had a false negative. So that's a big deal.
Speaker 1: As you said, that's the big daddy, that's the one
Speaker 1: you've got to really watch out for. But nine out
Speaker 1: of a hundred are false positives, which means that this
Speaker 1: accurate test has a fifty percent chance of giving you
Speaker 1: a false positive if you come back positive. Should I
Speaker 1: just not even have said any of that stuff now?
Speaker 1: I think it's just funny that after ten years it's
Speaker 1: done on me that you have to true talents. One
Speaker 1: is explaining extremely complex things in a very easily digestible way,
Speaker 1: and the other is completely confusing me with words that
Speaker 1: come out. Well, this is very confusing stuff. I mean,
Speaker 1: it's not just me, this is BAYSI and statistics. Basically,
Speaker 1: the point of all of this is is that, first
Speaker 1: of all, if you're accurate test comes back that says
Speaker 1: you have something, it doesn't mean you have a ninety
Speaker 1: nine chance of that you have it. Very important number one.
Speaker 1: Number two, if it does say you have it, there's
Speaker 1: a fifty chance that a test is wrong even if
Speaker 1: it's accurate test. That's a big thing to remember that
Speaker 1: if your doctor doesn't explain that to you, you punch him,
Speaker 1: him or her in the arm and you say you're
Speaker 1: not doing your job fully because I'm scared, buddy. Yeah,
Speaker 1: I just got a positive test result and I'm scared
Speaker 1: out of my mind. So if your doctor is not
Speaker 1: going to come for you, hopefully Baysian statistics, well, and
Speaker 1: don't listen to me, go look it up yourself, because
Speaker 1: I'm sure someone else on the internet can explain it
Speaker 1: better than I can. Perhaps Mr Billy Bays in his
Speaker 1: whole statistical model. Was he a character of Melrose Place?
Speaker 1: I think so. He's a pool cleaner? Um. Alright, So
Speaker 1: with medical testing period, like you said, if your doctor
Speaker 1: is not telling me that, with with any test that
Speaker 1: you take, not all medical tests are created equally. Some
Speaker 1: are really accurate, some aren't as accurate as a well
Speaker 1: that's about say, so they could be. There's accurate as
Speaker 1: they can be, which is to say, maybe not as
Speaker 1: accurate as you would like it to be sure, but
Speaker 1: you really need to talk to your doctor and hopefully
Speaker 1: they're offering this up anyway, like, Hey, what's the deal
Speaker 1: with this test? How reliable is this? Do I need
Speaker 1: to get a second test? Because the whole thing with
Speaker 1: false positives and false negatives and even true positives and
Speaker 1: negatives is there's a bunch of different reasons why uh
Speaker 1: follow up testing is both good and bad. Like sometimes
Speaker 1: these procedures, like the follow up isn't like a pen prick.
Speaker 1: Sometimes it's an actual surgical procedure that you may not
Speaker 1: need a lot of times, and we'll get into these
Speaker 1: more specifically, but there's expense involved. Um, a lot of
Speaker 1: times you don't you didn't need to spend that money,
Speaker 1: but you know, it's hard to say, because you should
Speaker 1: be your own medical advocate and spend whatever money you
Speaker 1: can to ensure that uh, the testing is is reliable.
Speaker 1: And then there are things like the time that it
Speaker 1: takes between these things, like all right, we'll see you.
Speaker 1: We need to follow this up with another test, but
Speaker 1: it's gonna take three months to get you in. And
Speaker 1: in the meantime, in those three months, you're stressing out,
Speaker 1: you're up all night, you can't sleep, your sex drive
Speaker 1: is out the window. That sounds like a silly thing
Speaker 1: to talk about, but it's a real thing, especially when
Speaker 1: you're grown ups like us. Yeah, it's important, um, but
Speaker 1: it's it's a here's a study from two thousand nine said,
Speaker 1: granted this is a little old, but it's from the
Speaker 1: Annals of Family Medicine, and when it came to test
Speaker 1: for prostate long colorrectal and ovarian cancers, they found that
Speaker 1: positive false positives. Uh, after four tests they did tests,
Speaker 1: I think either four tests or fourteen test. After four tests,
Speaker 1: you had about a thirty seven percent chance for men
Speaker 1: in the chance for women for false positive. And then
Speaker 1: the more test you got, the more that went up,
Speaker 1: which is distressing. It is something like if you had
Speaker 1: fourteen tests, all fourteen to the tests that they studied, um,
Speaker 1: you had a sixty point four percent chance for men
Speaker 1: and forty eight point eight percent chance for women of
Speaker 1: coming back with a false positive. And again this isn't
Speaker 1: just like it's yes, you have that new lease on
Speaker 1: life on the other side, but studies have shown like these,
Speaker 1: getting a false positive result from a test, it it
Speaker 1: can be emotionally devastating and it can have an impact
Speaker 1: on your finances if you're a Scrooge McDuck type who's
Speaker 1: only moved by the idea of money, well and your
Speaker 1: physical health because of stress. Yeah, because it's not like
Speaker 1: you're not addicted demand which in the time just because
Speaker 1: you're stress eating the whole time. So that's not good
Speaker 1: for you. What was man? Which man? Which was a
Speaker 1: canned sloppy joe starter. Okay, I know it's a meal,
Speaker 1: and well it's more than a meal. A sandwich is
Speaker 1: a sandwich, but a man which is a meal? Oh
Speaker 1: that's right, I got it wrong. You're like, no, it's
Speaker 1: more than a meal. Even it's even greater than the
Speaker 1: ads per prophecies. Uh so the financial costs like you
Speaker 1: were talking about Scrooge McDuck um forty. They did another
Speaker 1: study of about a thousand people, and this was in
Speaker 1: December of two thousand four and the issue of Cancer
Speaker 1: Epidemiology bio Markers in Prevention that is a legit journal,
Speaker 1: just by the title oh for sure, oh eight, and
Speaker 1: then it says and and wakeboarding. More than participants had
Speaker 1: at least one false positive. Of these people went on
Speaker 1: to receive additional care at a cost of about a
Speaker 1: thousand dollars for women and about eleven for men. So
Speaker 1: that's not chump change. No, it's not um And a
Speaker 1: lot of people say, well, who cares, I got insuredce, Well,
Speaker 1: the health care spending is kind of a problem in
Speaker 1: this country. There's apparently in two thousand five, the National
Speaker 1: Academy of Sciences big shout out to them UM. They
Speaker 1: found that there was thirty of healthcare spending was wasteful
Speaker 1: in the United States in two thousand five, and the
Speaker 1: idea of that gave rise to something. There's a campaign
Speaker 1: called Choosing Wisely. Have you heard of that? Know? So
Speaker 1: it's a campaign called Choosing Wisely. They have a site
Speaker 1: called Choosing Wisely dot org. It's a joint effort between
Speaker 1: the American Board of Internal Medicine, so it's physician based
Speaker 1: and consumer reports, and they're basically saying, like, there are
Speaker 1: a lot of unnecessary tests being performed out there that
Speaker 1: are leading to these unnecessary surgeries, unnecessary expenses, unnecessary anxiety,
Speaker 1: and we want to figure out what they are, and
Speaker 1: we want to start advising people against them, or at
Speaker 1: least advising doctors to advise their patients against them because
Speaker 1: they might be unnecessary. And so this campaign UM has
Speaker 1: really kind of had a big impact is we'll talk
Speaker 1: about in a little bit. You know, the idea of
Speaker 1: breast cancer screening has changed. The recommendations have changed from
Speaker 1: what I understand from this Choosing Wisely campaign as UM
Speaker 1: really kind of just shifted things from well, this over
Speaker 1: abundance of caution can't be harmful to actually there are
Speaker 1: some harms involved in an over abundance of caution. Let's
Speaker 1: kind of UM streamline our caution and make it a
Speaker 1: little more UM laser focused. Should we take a break? Yeah,
Speaker 1: all right, we'll take a break, and I'll I'll hit
Speaker 1: you with a stat right out of the gate when
Speaker 1: we come back. All right, So before break, you were
Speaker 1: talking about UM breast cancer and mammograms in particular, And
Speaker 1: there was a study a few years ago in twenty
Speaker 1: two zero about false positive mammograms and breast cancer over
Speaker 1: diagnoses alone at four billion dollars a year billion. So
Speaker 1: it's it's just such a fine line of uh, striking
Speaker 1: the right note with preventative care and over diagnoses. Yeah,
Speaker 1: and here's here's the problem. Like the tests, it's not
Speaker 1: like they're not out there saving people's lives. Yeah, it's
Speaker 1: not like the people like Dr Papa Nicolau who came
Speaker 1: up with the pepsmere said, oh man, this is gonna
Speaker 1: be like a cash register for Western medicine. That's not
Speaker 1: what these tests were designed for. Unfortunately, they are used
Speaker 1: in some circumstances like that, and probably more circumstances than that.
Speaker 1: They're used again out of an over abundance of caution,
Speaker 1: because no doctor wants to be responsible for missing something
Speaker 1: and their patient um and and the leading to their
Speaker 1: patient dying, so they're using this over abundance of caution.
Speaker 1: The problem is that the tests aren't aren't infallible. They
Speaker 1: do have um they do have accuracy problems, and some
Speaker 1: tests are better than others, or another way to put it,
Speaker 1: some tests are worse than others as far as false
Speaker 1: positives go. And it takes the PEPs mirror in particular. UM.
Speaker 1: With the PEPs mirror, it looks for pre cancerous cervical cells. Right,
Speaker 1: three million, three million women in the United States get
Speaker 1: a positive PEPs mirror result UM. From what I understand,
Speaker 1: every year only three thousand of them have a deadly
Speaker 1: cervical cancer and that of women will get a false
Speaker 1: pepsmere in their lifetime. But is the thing. Four thousand
Speaker 1: women who die in the US every year from cervical cancer,
Speaker 1: most of them did not have a PEPs mirror or
Speaker 1: hadn't gotten a PEPs mirror in the last five years.
Speaker 1: So there's a really there's a there's a tough um
Speaker 1: relationship between using the tests and and and overusing the tests.
Speaker 1: And for every say, I think two thousand women who
Speaker 1: undergo a mammogram, one woman's life is saved. Well, those
Speaker 1: two thousand women, they didn't know whether it was gonna
Speaker 1: be whether they were going to be the one whose
Speaker 1: life was saved or not, so that to them or
Speaker 1: to their doctor, it was worth it. Unfortunately, two hundred
Speaker 1: of them will get false positives, and ten of them
Speaker 1: will undergo unnecessary surgeries, painful, unnecessary surgeries to remove non
Speaker 1: cancerous suspicious cells in their breasts. So there's this idea
Speaker 1: where yes, we need to use these tests, and then
Speaker 1: there's also this idea where we need to use these
Speaker 1: tests better or come up with more accurate tests. Yeah,
Speaker 1: I mean, in particular, mammograms UH and screening for colorectal
Speaker 1: cancer are two of the big ones that can show
Speaker 1: a lot of false positives, and they're sort of under
Speaker 1: the microscope as to how we can correct this UH
Speaker 1: moving forward. UM. For instance, mammograms UM correctly identifies breast
Speaker 1: cancer of the time However, uh, if you're younger, if
Speaker 1: you're a younger woman, or if you have very dense breast,
Speaker 1: you're more likely to have a false positive. And so
Speaker 1: because of this, over the past like even ten to
Speaker 1: fifteen years, they've changed the recommended recommended age a few
Speaker 1: times for who when when you should start getting these mammograms.
Speaker 1: It's gone from I think in two thousand nine they
Speaker 1: recommended between fifty and seventy four. Uh, then I think
Speaker 1: it went down, but mean, um, I think it went
Speaker 1: all the way down to forty. At one point, forty
Speaker 1: was where it started, I think where it started, then
Speaker 1: up to fifty and now I think this is the
Speaker 1: latest as of a few years ago, the A c
Speaker 1: American Cancer Society said if you are at average risk,
Speaker 1: and this is probably how they should do it and
Speaker 1: not just a sweeping age. But if you're an average risk,
Speaker 1: you should start at forty five annually, but you could
Speaker 1: begin as early as forty and I would guess that
Speaker 1: means if it if it runs in your family, and
Speaker 1: then after fifty five every other year, like Emily's mom
Speaker 1: and my mom both went through breast cancer, so Emily
Speaker 1: started getting mammograms. I think it maybe even at forty
Speaker 1: because she was in the higher risk group. Yeah, and
Speaker 1: they're no fun to go through, but she is. Uh.
Speaker 1: I think Emily has a good head on her shoulders
Speaker 1: as far as advocating for herself, but also um, not
Speaker 1: going off the deep end. Yeah, that's simily like through
Speaker 1: and through. Like she's not just gonna sit there and
Speaker 1: be like, oh, whatever you say, doctor, and she's like
Speaker 1: that actually doesn't sound quite right. She will stand up
Speaker 1: for herself. Yea. Yeah, advocating for herself it's important. Um.
Speaker 1: So with Mamma Graham's chuck, from what I've seen, nobody's saying, well,
Speaker 1: this is a kind of X ray, so you don't
Speaker 1: want to build up, you know, the radiation. That doesn't
Speaker 1: seem to be the problem with overuse of mammograms. What
Speaker 1: seems to be the problem is that they that well,
Speaker 1: a Mamma Graham is an X ray, and the X
Speaker 1: ray is handed off to a radiologist and they apparently
Speaker 1: are like eight eighty four some high eighty percent effective
Speaker 1: at finding cancerous tumors in breast. Just looking at an
Speaker 1: image of a breast. This trained human being can say, yep,
Speaker 1: there you go right there, circle it initially go follow
Speaker 1: this up. The follow up UM is it results in
Speaker 1: a a biopsy, usually a needle prick biopsy to remove
Speaker 1: some of the cells. Those are examined, and if those
Speaker 1: come back as suspicious, a doctor might say, we need
Speaker 1: to get those cells out. Most of the time those
Speaker 1: aren't actually cancer as cells, but they're still being removed surgically,
Speaker 1: which is painful, costly, and can be a problem emotionally
Speaker 1: to have to go through that surgical procedure to have
Speaker 1: cells removed that you didn't need to have removed. That's
Speaker 1: the that's the problem with with UM mammograms as far
Speaker 1: as getting them frequently, and supposedly, between ages forty and fifty,
Speaker 1: a woman has a fifty to sixty percent chance of
Speaker 1: getting a false positive result from a mammogram. Yeah, man,
Speaker 1: I mean a sixty chance. Yeah. And again, no one's saying, oh,
Speaker 1: don't get mammograms. They're gonna just totally screw you up.
Speaker 1: It's more like medical community, we need a better way
Speaker 1: to to find to keep an eye on breast cancer.
Speaker 1: I mean they're trying. I sure they are, of course
Speaker 1: they are. In Colorectal cancer is a perfect example. UM.
Speaker 1: It is the second leading cancer related death in the
Speaker 1: US right now? Um was it? Say here? A hundred
Speaker 1: thirty two thousand, seven hundred new diagnoses in two thousand fifteen.
Speaker 1: And one of the big problems with colorectal cancer is
Speaker 1: that not a lot of well, I'm saying a lot
Speaker 1: of people, but I think about fifty of people don't
Speaker 1: follow up on a recommendation to get a colonoscopy because
Speaker 1: they don't want to get a colonoscopy. Yeah, so that's
Speaker 1: a problem. Have you got one of those? Not yet?
Speaker 1: You know not. I haven't either. I'm really really not
Speaker 1: looking forward to it. And I was researching it today
Speaker 1: and just almost fainted like three or four times while
Speaker 1: I was reading the procedure. About the procedure, Yeah, it's hardcore, man.
Speaker 1: There's like a finger with tube that they stick in
Speaker 1: your anus, past your rectum up to your colon. The
Speaker 1: c seesme I think it is, which is the top
Speaker 1: of your colon, which is basically where the your rib
Speaker 1: cage ends on your left side, that's your sesome. They
Speaker 1: go all the way up there and it has like
Speaker 1: a camera and a light on the end, and basically
Speaker 1: what they're doing is visually inspecting the inside of your colon.
Speaker 1: If they see something that they find suspicious, they can
Speaker 1: put four steps through the tube and take a sample
Speaker 1: of it and then just you know, come on back out.
Speaker 1: Normally they'll they'll give you a sedative for this. UM.
Speaker 1: They also give you I can't remember the name of
Speaker 1: the drugs um, but it basically makes you forget that
Speaker 1: it ever happened. Like you can prevent you from forming
Speaker 1: memories during the procedure. But most people don't want to
Speaker 1: go through this, even though it's extremely effective. It finds
Speaker 1: like of um coal erectal cancer from what I understand, Yeah,
Speaker 1: it's amazing, what like all the advances of medical science,
Speaker 1: they're they're literally saying, like the best way is to
Speaker 1: really just get on up in there and take a look.
Speaker 1: Just jamming up there, you know, get up there. However,
Speaker 1: they do have some because like we said about people
Speaker 1: won't even get a colonoscopy when recommended. Uh, they have
Speaker 1: other tests. Now they aren't as accurate, but at least
Speaker 1: they're at least they're trying to get another test on
Speaker 1: the table for people that are reticent to have the
Speaker 1: two stuck up their butt, and some of them work.
Speaker 1: There's this one called colon Guard from Germany. Yeah. They
Speaker 1: they have accuracy rate of um no, no, no, this
Speaker 1: one is oh well yeah, yeah, yeah, colon Guard. That's high.
Speaker 1: Because I'm sorry, I'm miss spoke earlier. The the colonoscopy catches.
Speaker 1: So this stuff that you just poop into a cup
Speaker 1: and mail it in and some Porschemo tests it. Right,
Speaker 1: that's that's really great. Well it's not not quite. It
Speaker 1: showed of the cancers that a colonoscopy would uncover. Okay,
Speaker 1: so that's not overall. Oh okay, I got it. But
Speaker 1: it's still pretty good, right, But it has a high
Speaker 1: high false positive rate, of which I mean if you
Speaker 1: think a tube up your butt will make your rectum pucker,
Speaker 1: so will a false positive of colorectal cancer. Yeah, the
Speaker 1: German one, although that might be German two. But there's
Speaker 1: another German. Uh actually this is a German study about
Speaker 1: stool tests, and that's when you literally are just looking
Speaker 1: at it trace amounts of blood in the stool. Well,
Speaker 1: some do that had accuracy all over the place. That
Speaker 1: was from which I mean, that's such a wild swing,
Speaker 1: right that I don't know if I would opt for
Speaker 1: that one of them. So one of them. Some of them,
Speaker 1: I should say, probably most look for blood in the stool,
Speaker 1: some some look for DNA or genetic material of cancer
Speaker 1: in your stool, and another one looks for chemical changes
Speaker 1: of a certain gene that's that could be present in
Speaker 1: your stool. And by stool, of course, I mean poop
Speaker 1: by the way, everybody um and they analyze them for this,
Speaker 1: and again they're pretty good at catching the stuff, but
Speaker 1: they're also pretty good at giving false positives. So I mean,
Speaker 1: that's just a great the idea that we can catch
Speaker 1: like colorectal cancers with colonoscopy, But people who need one
Speaker 1: don't go get it because it's such an awful procedure that,
Speaker 1: like you were saying at the outset, like that begs
Speaker 1: for something new. You want to take another break, Yeah,
Speaker 1: let's go prepare the finger with tubes. We'll talk about
Speaker 1: drug testing right for this. Okay, all right, So we've
Speaker 1: honed in on mostly medical testing up into this point.
Speaker 1: But if anyone's ever taking a drug test, there is
Speaker 1: always the risk of a weird false positive. You can
Speaker 1: be a clean liver and still get a test that said, hey,
Speaker 1: it says here that you smoked marijuana and you can
Speaker 1: be like, dude, I don't and have never smoked marijuana,
Speaker 1: and then you have to plead. Like basically every athlete
Speaker 1: ever this test of positive for anything says I didn't
Speaker 1: do it, man, this false positive. They're like whatever, stoner,
Speaker 1: but it does. That's like the same thing with up
Speaker 1: my Twitter account was hacked alright, Like really every time
Speaker 1: some thing awful came out on your Twitter speed someone
Speaker 1: hacked it. Yeah, but Twitter hacking does happen, and true
Speaker 1: false positives and drug tests definitely happen. Yeah, it depends
Speaker 1: on on what you've been doing. Like if you are
Speaker 1: using a prescription medicine or even some over the counter medicines,
Speaker 1: you can come up with the false positive on a
Speaker 1: drug test. It says between seven and fifteen million people
Speaker 1: a year in the United States get a false positive
Speaker 1: drug test. That's a lot because think about it. When
Speaker 1: you know, if you're applying for a job and you
Speaker 1: go do the drug tests and you go home and
Speaker 1: you hear that you got passed over for the job,
Speaker 1: I don't know if they tell you that it was
Speaker 1: because you failed your drug tests. And even if they do,
Speaker 1: they're not going to be like, well, we want to
Speaker 1: hear your side of the story. Mr Candidate number nine
Speaker 1: twenty seven. You know they like you, just you just
Speaker 1: lost out on a job because of a false positive.
Speaker 1: You lost out on a sports scholarship, you lost out on,
Speaker 1: UM don't know, getting to deliver meals on wheels, who knows,
Speaker 1: But you're gonna miss out on something because of a
Speaker 1: failed drug test when you didn't do anything. You've been
Speaker 1: a straight air of your whole life. But again, you
Speaker 1: did you You made the mistake of um not keeping
Speaker 1: up with what prescription medicines can give you false positives. Yeah,
Speaker 1: and here's the thing parents, if you drug test your kids,
Speaker 1: I'm not weighing in on that one way or the other.
Speaker 1: But if you drug test your kids and they return
Speaker 1: a positive test from marijuana and they say, Mom, that's
Speaker 1: because I was in the car with some people who
Speaker 1: are getting stoned. That's how it showed up. Uh, it's
Speaker 1: not true. I hate to break it to you, but
Speaker 1: that is not You will not I don't think you
Speaker 1: can ever get a false positive for a marijuana from
Speaker 1: second hand smoke. Right. That's not your cue to burst
Speaker 1: into tears and grab Todd and go oh Todd, I
Speaker 1: knew you would never use drugs, And Todd's winking at
Speaker 1: the camera and breaks the fourth while and winks at
Speaker 1: the camera Ferris Bueller style. Yeah, stoked. It did kind
Speaker 1: of remind me though, because it said here that cocaine
Speaker 1: is one of the drugs that routinely do not come
Speaker 1: back with a false positive or a false negative. Yeah,
Speaker 1: it's kind of on the money. That means they have
Speaker 1: a good test for it. Well yeah, but I kind
Speaker 1: of that made me remember that old thing. I used
Speaker 1: to hear that like whatever percentage of dollar bills has
Speaker 1: cocaine on it, and I thought that's totally not true
Speaker 1: and one of those things that you just here in school.
Speaker 1: But I looked it up and apparently that is totally true. Uh.
Speaker 1: There was a study just a few years ago in
Speaker 1: New York City by n y U and they found
Speaker 1: of dollar bills had trace amounts of cocaine. Yes, some
Speaker 1: ridiculous amount of euros to too. Yeah, and not just cocaine,
Speaker 1: It's like there was some morphine, heroin and meth and
Speaker 1: lower quantities and then all manner of disgusting gross things
Speaker 1: on on paper money, right, which apparently people were using
Speaker 1: to roll into a tube and sticking into their nose
Speaker 1: to ingest draw ugs with not were but kind of
Speaker 1: always have. So so the idea that, um, you can
Speaker 1: find drugs on money? Have you heard that? They're They're
Speaker 1: like local laws around the country in the United States
Speaker 1: that say that police can confiscate money as drug money
Speaker 1: if they test it and it turns out that there's
Speaker 1: drug residue on it. But it sounds like it's of money.
Speaker 1: Yeah wow, yeah, not too cool. What are some of
Speaker 1: the other things that can give you a false positive
Speaker 1: aside from just jamming dollar bills in your nose? So
Speaker 1: remember that Seinfeld where I think Elaine was supposed to
Speaker 1: go on a j. Peterman trip but she got she
Speaker 1: got disinvited because she turned up positive for heroin. But
Speaker 1: it turns out that she was eating lemon poppy seed
Speaker 1: muffins every day. That apparently is true, although this article
Speaker 1: or how stuff Works article gets it wrong. So the
Speaker 1: poppy seeds don't actually contain opium, but when you're harvesting
Speaker 1: the seeds, opium can rub off onto the seeds and
Speaker 1: depending from people, they were doing opium no no, no
Speaker 1: from so like they're harvesting opium from the poppy and
Speaker 1: then they're harvesting seeds later, and the seeds can come
Speaker 1: in contact with opium residue from the poppy plant. And
Speaker 1: then however, well they're processed or not processed by the
Speaker 1: time you eat them, they they have they might have
Speaker 1: a substantial amount of opium on the outside of the shell,
Speaker 1: which will show up in a drug test. Seinfeld was
Speaker 1: correct because I felt was correct. Apparently, ibprofen um can
Speaker 1: come back with a positive from marijuana, barbiturates or Benny's
Speaker 1: m Benny's and that was Jack Carouac's drug of choice,
Speaker 1: one of several. Yeah, but he really, I mean I
Speaker 1: remember him writing about the Bennies a lot. That's how
Speaker 1: we wrote that book in like forty eight hours. He
Speaker 1: write on like one long scrolling piece of paper. That's
Speaker 1: what I've always heard. But last time I heard that,
Speaker 1: I was like twenty years old, so I know it
Speaker 1: looked into it since I think it's true, Well, I
Speaker 1: think I've seen it. Jack Caroway clad us no, uh uh.
Speaker 1: Some some OTC colden allergy medications apparently can result in
Speaker 1: result in positive tests for like emphetamines. It's crazy. Yeah,
Speaker 1: well you know that, like like if you're making bathtub crank.
Speaker 1: You can use suda fed as like a precursor or
Speaker 1: an ingredient in just crank. And that's why you're only
Speaker 1: allowed to buy like one box at a time with
Speaker 1: a driver's license. It such a seventies. Well yeah, if
Speaker 1: you're using over the counter suda fed to make your
Speaker 1: your meth, that's cranky. It's crank. Uh. And then tonic water. Surprisingly, um,
Speaker 1: apparently quinine contains a little bit of the real quinine,
Speaker 1: which is a drug. So here's the thing I looked
Speaker 1: into this. I could not figure out why quinine would
Speaker 1: result in the positive test for heroin. Here's why, Chuck,
Speaker 1: you ready for this. I'm ready because you know gin
Speaker 1: and tonics are my jam. Okay, well, just be careful
Speaker 1: because gin or tonic water does contain sometimes like eighty
Speaker 1: three milligrams of quinine in it, which was a malaria
Speaker 1: drug right well back in the thirties, Supposedly heroin dealers
Speaker 1: started adding quinnine to their heroin to combat malaria. That
Speaker 1: was the urban legend. It turns out that's not the
Speaker 1: case at all, but quinine actually interacts with heroin in
Speaker 1: a way that kind of boosts it and it also,
Speaker 1: more to the point, mimics heroin's bitter taste. So somebody
Speaker 1: would taste the heroin and what they were tasting was quinine,
Speaker 1: but they thought they had like some dynamite s gag
Speaker 1: on their hands. So it was really just kind of
Speaker 1: to take terrible junk and make it seem like it
Speaker 1: was much better by adding quinine. Apparently this has been
Speaker 1: going on for so many years that they that drug
Speaker 1: tests test for quinnine because they consider that an indicator
Speaker 1: of the presence of heroin. I think my big takeaway
Speaker 1: is here, is it quinnine and not quinine? I've heard both. Okay,
Speaker 1: that's your big takeaway. I was laying down gold. Well
Speaker 1: here's my deal. As lately, I don't have been buying um.
Speaker 1: I've been buying the real deal tonics. Yeah, like Feverit Tree.
Speaker 1: I hate to use the word artisan tonics. You should,
Speaker 1: but I've been buying the artisan tonics because they're delicious,
Speaker 1: and I've really embraced bitter as a as a taste
Speaker 1: that I can enjoy. Now Here in my late forties,
Speaker 1: I've never liked bitter at all, but I'm kind of
Speaker 1: have come around to it a little bit. Yeah. It
Speaker 1: is like the definition of an acquired taste, isn't it. Yeah?
Speaker 1: But now I really like it. And you know, these
Speaker 1: these tonics that they make her like they're made from
Speaker 1: the real Uh, what's the root the chincha? What is
Speaker 1: it chinchilla? It's not chinchilla, chin shona? Is it chinchona?
Speaker 1: I believe so. Yeah, And that's like the key ingredient, right, Yeah,
Speaker 1: from what I understand it is the key ingredient tonic.
Speaker 1: I'm not an artisan tonic making cinchona bark so as I. Yeah,
Speaker 1: I don't know if that's the key ingredient or if
Speaker 1: it's one of them. There's also like in white willow
Speaker 1: or something in that like an ingredient, and aspirin is
Speaker 1: also in to water. Yeah, I don't know. I enjoy
Speaker 1: it though, And it's it's the thing is, you don't
Speaker 1: use a ton of it. You just use like an
Speaker 1: ounce and then some club soda or whatever. If you
Speaker 1: have artisan soda water. Oh, I see what you're saying.
Speaker 1: So you're using artisan like tonic, not with any kind
Speaker 1: of fizz. You're using like the tonic tonic. Yes, oh wow, man,
Speaker 1: that is that's hardcore. It's you know, it's like dark brown.
Speaker 1: I got you, and then you pour that in. It's
Speaker 1: like a couple blounces a gin an ounce of that
Speaker 1: and then top it off with some soda water. Give
Speaker 1: it a good shake. Man, that sounds great. It's really
Speaker 1: good and it has a nice come over, come on over.
Speaker 1: I think I started gin and tonic season early this year.
Speaker 1: That's great, which is not good. No, it's great as well. Okay, yeah,
Speaker 1: it's not good. It's great artisan tonic made from doomed goats.
Speaker 1: They have some down They have a one kind downstairs
Speaker 1: at the eighteen. Yeah, the bitterest place. Yeah, And I like,
Speaker 1: there's okay. But then there's another one in Evandale, States
Speaker 1: that I think. I like there's a little more so
Speaker 1: is there like a specific tonic or just like the
Speaker 1: general tonic that they have? Well, the one uh in Evandale,
Speaker 1: States is one called dry Tonic and one called robust Tonic,
Speaker 1: And I think the robust just has a little more
Speaker 1: limp lime citrus. But they're they're both delicious this stuff, man,
Speaker 1: Nice work, Chuck trying, yes, deer clear of the drug tests.
Speaker 1: I'm pretty sure they're going to start instituting them at
Speaker 1: stuff media any day. Now. You know, the only drug
Speaker 1: test I ever had to take my entire life was
Speaker 1: when I went through, uh the adoption process. Oh yeah,
Speaker 1: I remember that. I never had to take one for
Speaker 1: for work or anything. Uh, nor have I now that
Speaker 1: you mentioned it. I think we're in the minority. You
Speaker 1: never had to drive a Bobcat for work. I did,
Speaker 1: but the guy I worked for couldn't have cared less.
Speaker 1: Who's insured to the teeth? Before we go, Chuck, you
Speaker 1: got anything else? You got nothing else? All right? So
Speaker 1: before we go? I found um one test that is
Speaker 1: just supposed to be. It just seems to me like
Speaker 1: it's the gold standard for test. It's an HIV screen
Speaker 1: and it's called the Enzyme linked immunos Orbit Essay or ELSA.
Speaker 1: I think we talked about it in our HIV two
Speaker 1: parter um. This is how this test is performed. So
Speaker 1: you you get this one screen, the ELISIA screen. If
Speaker 1: it comes back positive, a second ELISA screen is performed
Speaker 1: if that's positive, of a separate test that uses an
Speaker 1: entirely different technique is performed. All this is in the
Speaker 1: lab before you ever hear your results. And that means
Speaker 1: that one in the United States, one out of two
Speaker 1: hundred and fifty thousand tests show a false positive. That
Speaker 1: means that has a point zero zero zero zero zero
Speaker 1: four percent chance of returning a false positive. That is
Speaker 1: a bomb test. Yeah that's all I got. I got
Speaker 1: nothing else. Go check out choosing wisely dot org. It
Speaker 1: seems pretty interesting to me. Uh And in the meantime,
Speaker 1: how about some listener mail. Yeah, I'm gonna call this
Speaker 1: email from Mr Sweedman's class. All right, this is actually
Speaker 1: from Mr Sweedman and on his class, but we're gonna
Speaker 1: shout out his class and helps that he starts incorporating
Speaker 1: this into his class. Hey, guys, love the show on
Speaker 1: Walrus is wanted to chime in regarding reproductive isolation or
Speaker 1: reasons why different species don't mate. I have taught biology
Speaker 1: for several years and evolutionary biology is always my favorite unit.
Speaker 1: Remember when we talked about reproductive isolation and yeah, what
Speaker 1: other different types of like how that? How that would
Speaker 1: manifest itself? I remember? So he says there are several
Speaker 1: types of reproductive isolation, and geographic isolation is one of them.
Speaker 1: And here's a little breakdown geographic isolation when species live
Speaker 1: in different geographic reasons, sorry, regions, ecological like isolation, same region,
Speaker 1: different habitat, Okay, okay. So so they're in the same
Speaker 1: they're in the same big city, they just don't hang
Speaker 1: out the same clubs, different neighborhoods, different neighborhoods. Behavioral behavioral.
Speaker 1: I always have a trouble with that word isolation. One
Speaker 1: species mating behavior won't work on another. For instance, a
Speaker 1: peacock won't attract a chicken, right because the peacock can't
Speaker 1: do chaw cockaw? No, what is the peacock say? Help?
Speaker 1: That's right. Uh. Temporal isolation, same area, but breed at
Speaker 1: different times, and that could be everything from the season
Speaker 1: to literally the time of day. That's called two ships
Speaker 1: passing in the night reproductive isolation. And that's like I
Speaker 1: like morning sex and the other one's like, shut up,
Speaker 1: I only like depth sex at night when I'm drunk.
Speaker 1: Then there's gametic isolation. Mating can occur, but sperm and
Speaker 1: egg won't mix. No, not you again, And he says
Speaker 1: in this case it is usually the egg releases a
Speaker 1: toxin that kills the sperm. Quid. That's right. Uh, And
Speaker 1: finally has said, my student's favorite type of reproductive reproductive isolation,
Speaker 1: mechanical isolation. That's when the parts don't fit, like just wait,
Speaker 1: just hold, like, just give me a second. Wait, I
Speaker 1: can do this and then nothing, he says, think square, peg, round, whole. Sure,
Speaker 1: that's a really good way to put it, way better
Speaker 1: than what I was. So there you have a guy's
Speaker 1: all the types of reproductive isolation. Now you know, and
Speaker 1: knowing is half the battle. G I, Joe, nice job.
Speaker 1: Don't stop believing or whatever journey lyric guide your life.
Speaker 1: That is from Mr Baird Swedman. Thank you, Mr schwed Man.
Speaker 1: I's goot that you added at a h What is
Speaker 1: it Swedman? It's just Swedman, but I like Mr Mr Schwedman.
Speaker 1: I have to call him Schwedman. You know Mr Swedman
Speaker 1: from PS right exactly. That's how I'm doing well. Thank
Speaker 1: you very much, Mr Swedman. I'm sorry I got it
Speaker 1: wrong in the first time, but Chuck said behavioral wrong,
Speaker 1: so we're even. I could never say that right. If
Speaker 1: you want to get in touch with us, especially if
Speaker 1: you are one of the fine teachers instructing America's youth
Speaker 1: or any youth of any country around the world, because
Speaker 1: we think everybody's great. You can tweet to us where
Speaker 1: s y s K podcast I'm at Josh Ouam Clark
Speaker 1: Chuck's at Facebook dot com slash Charles W. Chuck Bryant.
Speaker 1: He's also on Twitter at movie Crush. You can send
Speaker 1: us all an email to Stuff Podcast at how stuff
Speaker 1: works dot com and it's always Join us at our
Speaker 1: home on the web stuffy sho dot com. For more
Speaker 1: on this and thousands of other topics, is it how
Speaker 1: stuff works dot com.