Fuld transskription af From the Vault: Replaceable You, with Mary Roach

quote-unquote healthy foot. And that frustrated her. And it was kind of interesting, just this sort of sense of this bias for wholeness and this sense of, are we a whole entity? Are we made up of parts? Can you just swap them in and out? And that kind of led me along that path. And of course, that There's lots of kind of interesting areas like iron lungs and nasal mutilation and skin grafting and the history of skin grafting. There's just a lot of kind of Mary Roach-y topics under that umbrella of replacing bits and pieces of the human body. 00:04:11 Speaker 1: Was there a particular chapter that kind of solidified first, or did they just sort of all sort of come together? Like, what's your process when it comes to writing a book? 00:04:22 Speaker 3: I knew right off the bat, there was something that there's one thing that I definitely wanted to include. And this is, again, it was a conversation. This was a woman who works in a stem cell lab, but it, it oddly had nothing to do with stem cells. She mentioned, I think I had contacted her because I'd been poking around on the idea about fat as a topic, a book topic, fat, the substance fat. And I backed off of that because I don't want to write about weight loss. So, uh, She mentioned, and I don't know how this came up, don't remember, but she mentioned that there was a surgeon who had reconstructed a man's penis using his own middle finger. And that, because of the way my brain works, I'm like, oh my God, they just cut the finger off and attached it down there and he could move his finger. And I had this very, as it turned out, inaccurate impression of what that surgery was. But I'm like, I'm going there. I'm going to see this surgeon. It turned out he's in former Soviet Georgia, and I did go there, and the story is in the book. But I think that was one of the first places that I went to report in one of the first chapters that I wrote. So that kind of cemented things, I think, for me. I have to have a book that includes this somehow. 00:05:41 Speaker 1: It reminds me a little bit of some of the topics you touched on in Grunt, which made me wonder, do you revisit what you wrote in previous books when you cover something like Adjacent? to it in a later book? And I ask in part because I know that the history broadly remains the same and the autobiographical and personal aspects of the book remains evergreen, but the science and the way we perceive where we are with the science can change so rapidly in just a few years. 00:06:09 Speaker 3: Yeah, I did go back to, in Grunt, as you know, I covered the Department of Defense was funding some work with penis transplants. In other words, taking a cadaver penis and hooking it up and replacing whatever remains of a man's penis. And this was during Afghanistan and Iraq when there were lots of IEDs going off and damaging not just legs, but all the way up to the pelvis. And I'd been in the lab when they were doing some of the early work for a penis transplant. So

I called that surgeon just to see where are things at, what's going on in the world of transplantation. I don't like to repeat things that I've covered before. I mean, I was definitely not going to include that project or kind of go back and follow up on that patient or anything like that. So I do make use of the people that I've met and sort of pick their brains and get ideas from them, and also referrals to people that they know. So I do that, but I don't really completely step back into the setting of a previous book. 00:07:35 Speaker 1: So the way that we perceive the current trajectory of science is one of the really fascinating subjects in the new book in numerous places. I was really floored by an early discussion in the book about how people viewed the promise of denture technology in the 40s, 50s, and 60s. This was just really mind-blowing for me. Can you explain this one for us? 00:07:55 Speaker 3: Sure. Yeah, the history of dentures, and we're talking here about not what goes on today, which is implants set into the bone and then a plate attached to those. I'm talking more about a whole set of teeth that's either glued or in some cases suspended. through piercings, that was unbelievable. A technology that at its best only gave you about 25% of your chewing capacity was never a good solution. But what amazed me was this trend in the period of time that you're talking about for having all of one's teeth pulled at once and getting fitted with dentures. And it was this sense of like, I'll have a marvelous, healthy, white smile And it was done as a gift for brides. It's called sort of matrimonial dentures, I think was the term. And I had thought of it as just this is something that's done in poor communities or people who don't have access to good dental care. But in fact, it was just kind of a trend. And I could only explain it to myself by thinking people were just assuming it's new and it's man-made and it's got to be better. I mean, Paul McCartney, his dad told him, when he turned 21, he should go get all his teeth removed and replaced with dentures. And there was this Reddit thread. It's no longer up for some reason, but this Reddit thread where someone mentioned it. And there were a thousand replies of people saying, my parent or grandparent, usually a grandparent, had this done and ended up regretting it, always had difficulty with the dentures. But it was a It was, to me, kind of a good way to open the book because it's interesting there's this tendency among humans, particularly in the 1900s and onward, to just assume if it's technical and new, it must be better. And to kind of rush headlong into that technology without really considering how will it stack up against what I've got going. My dad lost all of his back teeth. He had a few teeth in the front. left. He was much older. He was 65 when I was born. But anyway, he never got dentures. I don't know if he didn't trust dentists. He was British. I don't know if that had anything to do with it. But he managed just fine using his front teeth to chew. And I think probably that worked better than had he gotten a couple of those plates that are glued with polygrip and got stuff under them. It just sounded, it sounded, you know, like not a great technology. And he did fine. You know, it was a little weird to watch him chew his lamb chops, but it seemed to work. 00:10:57 Speaker 1: Yeah, it's just, it was so foreign to imagine this level of excitement and trust, and not only where the technology was going, but where it presently was. Because I can sort of put myself in the shoes of imagining someone saying, okay, well, I don't have to worry as much about uh, taking care of my teeth because the technology is coming along really well. And it'll, you know, and sort of like putting that off on your future self, but to go ahead and, and have it now to go ahead and get the dentures that, you know, at an early age, uh, it's hard to, like, I can't think of anything that I'm surely there's something in our world that's, that, that, that serves as an analogy for that. But I, I'm grasping at straws to think of it. 00:11:37 Speaker 2: Yeah. 00:11:37 Speaker 3: Well, we, what's going on now with, um, Interocular lenses, that's a technology that's for decades been used for cataract patients in particular, where there's this opacification of the lens and you just can't focus and you lose color. And the technology and the surgical procedure has come so far that there are now people who are in their 20s who just happen to be very, very nearsighted who want to have it done. And there's a term for that that I've forgotten. I think that's an example. And that's an example where if everything goes well, which it usually does, it's not analogous to the dentures in that I think folks who have that done, it can be kind of an amazing replacement. You don't have accommodation, which is the eye's amazing ability to go from far away to near focus just automatically, sort of an a built-in autofocus. So that's not something that exists yet. So you are accepting a compromise in that sense, but for somebody who's, who's very, very nearsighted or I suppose farsighted, uh, it's an appealing option, you know, to not have to think about glasses, contact lenses, et cetera. Um, and it, it's, I think, you know, even compared to LASIK, which can have after effects that are unappealing, but, um, Yeah. To have all one's teeth pulled at once. And I think also people had a sense of, people don't like to go to the dentist. They don't like dental procedures. So in areas where dental care was lacking or wasn't close by, they thought, let's just get it over with. And I'll never have to go back to a dentist. And I'll have this perfect straight smile. I don't have to get fillings. et cetera. But in fact, dentures, you know, the gums start to recede, so you would have to go back and get refitted. So it really wasn't, you didn't even deliver that. Right. 00:13:46 Speaker 1: Now,

later in the book, when you're discussing skin grafts and xenografts, the skin grafts based on the tissue from another species, you hit on something similar about how certain headlines about breakthroughs with xenografts might be considered an unnecessary distraction by some in the industry, certainly on the research end of things. But do you think these various headlines sometimes and advancements sometimes help implant the idea that the research is much further along than it actually is? 00:14:19 Speaker 3: Oh, yeah, absolutely. Press releases in particular. And a lot of times newspapers just take information from press releases without doing additional reporting. So in that sense, yeah, it makes its way into the news. Absolutely. I think that, you know, you see a headline like lab-grown penises are on the horizon, which was an actual press release headline from some years back. And I don't know, the penises seem to still be out on the distant horizon. You know, you follow up with these things a few years later and The company's gone out of business. The researcher has stopped researching that. And I think it's a disservice to the public because I have a friend who has Parkinson's and people are always sending him, look, I saw this. I saw this press release online. I heard about this technique. I heard about, same with the woman who, the elective amputee. She said, I cannot tell you the number of times my friends have sent me a link to a story that says, $ 20, you can bioprint a prosthetic foot, you'll never have to see a prosthetist again, and it's cheap. And she's like, that's never going to happen. And I want them to stop. They mean well, but stop sending me this stuff. Because there's so much of it out there. 00:15:43 Speaker 1: And I suppose that feeds into one of the central ideas of the book, right? That the human body isn't really replaceable, no matter how far the sciences come. 00:15:52 Speaker 3: Exactly. It's, it's, You're talking about 200 or so years of medical science competing with millions of years of evolutionary tinkering. And that's tough to compete with and it's tough to match. So it's not that the researchers and scientists aren't doing a good job. They're doing amazing things. It's just a really, the human body is just infinitely complex in ways that we don't even yet understand. So, um, of course it's going to take a long time. Yeah. Yeah. 00:16:30 Speaker 1: You cover when you're talking about various transplants, um, uh, this unforeseen consequences like the, I believe it was the pig's heart that, uh, wasn't supposed to grow, but then grew inside, um, the recipient's chest. Yeah. 00:16:45 Speaker 3: Yeah, exactly. Uh, and there's, and there's also, there's, there's just connections between, you know, we think of ourselves as made up of parts and the parts can, you know, you can replace parts. That's what you do on a car. But there are these kind of invisible links between, you know, the brain and the organs and the organs themselves. And there's just a lot going on that is difficult to anticipate when you talk about creating something to replace an individual piece, you know, trying to incorporate that piece into a whole system. I mean, we are a massively complex system. So it's quite a challenge, yeah. 00:17:34 Speaker 1: Now, the history of our attempts to replace lost limbs, organs, and tissues, this is as captivating and sometimes more nauseating, certainly, than the current and bleeding-edge research into such replacements. And you discuss a lot of this in the book. So I want to start with the history here. What was your favorite, I can't believe they were trying to do blank back in such and such year tidbit? 00:17:59 Speaker 3: I think the I can't believe reaction had to do with the crafting of a vagina from the intestine. And that is a technique that is sometimes done with trans women if there's been problems with them more standard procedure. You can, in fact, bring a section of the intestine down and use it, and it works surprisingly well. And it isn't new. In the 1800s, there were surgeons who were doing this, but it's for cancer patients. And there was a quote I wish I had it in front of me, but the surgeons were all conferring, like, should we do this? It's kind of risky. I don't know. It hasn't been done. But they said, if the home life and matrimonial harmony depends on it, it is mandatory. I'm like, hello, maybe you want to check with that woman before you do that. Yeah. But I spent some time with the surgeon who uh, who, who from time to time does that technique. And it is a kind of an incredible, I just, I just love the idea of like recruiting parts of the body that evolved for one thing and using them for something else. And the body is surprisingly adaptable, you know, agreeable. Like, yeah, I can be a vagina. I think I can do that. You know, moist tubular secretions. Yeah, I got it. 00:19:33 Speaker 1: And then, of course, early on in the book, you walk us through the history of just replacing the nose. And there's so many interesting details there with like the marching of the skin up from the forearm and so forth. Oh, yeah. 00:19:46 Speaker 3: Yeah. And this goes back to like 1500 BC. This is a. 00:19:50 Speaker 3: Is a technique because nasal mutilation was a pretty common, you know, globally and throughout history. To punish a group of people or an individual to cut off the nose was popular because not only is it humiliating and awful for the person, but it serves as a, kind of a deterrent. Like, look what will happen to you if you steal, if you're supporting the wrong leader, whatever it is. So there was this demand for rebuilding the nose. And over the course of time, some very ingenious techniques, you know, taking a piece of the forehead or a piece of the cheek, taking that skin, loosening it, leaving it attached so it still has a blood supply. and then turning it over and putting it in place on what's left of the nose and

building a nose that way. That's the dawn of plastic surgery right there. That's really where it began, with the nose. Of course, that leaves scarring. If you put a graft on the place where you took the skin, now you've got skin that doesn't match. It's not seamless, so they started using the underside of the arm, the 1500s in Italy. And then, of course, to have the underside of the arm close to the nose, you had to have the arm up over the head with a harness. I mean, it was quite an elaborate setup for a few weeks to keep that piece of the underside of the upper arm attached to the nose. He kind of looked like he was, you know, I've seen an etching of that, and the guy looks like he's checking for BO, kind of a, you know, head close to the underarm pose, but, uh, but just amazing the ingenuity that went into it. And then, then once, you know, you had more options with different materials and adhesives, there were noses made of celluloid noses made of brass or other metal composites. There were noses hanging off glasses, frames, uh, uh, kind of a Groucho Marx thing because they even had a little mustache to cover up the boundary below the lower boundary. So it was kind of a medical Groucho Marx glasses. 00:22:11 Speaker 1: The flammable celluloid nose that you mentioned, that was rather horrifying to imagine. 00:22:16 Speaker 3: Well, yes, it could only carry the Groucho Marx comparison so far. You would definitely not want the cigar. 00:22:26 Speaker 1: One example you brought up that really floored me too was the idea of polyester hair implants. I had no idea this was ever a thing. 00:22:35 Speaker 3: Oh, me neither. Me neither. Thank you for asking. Nobody has asked about that. But there was, in the 1970s, it was possible if you were losing hair, either a bald spot or just sort of all over, you could have essentially doll hair inserted with a kind of surgical crochet hook kind of hooked into the scalp and It's a terrible idea for a number of reasons. First of all, if you start to go gray, it's not going to go gray. You can't style it the same way you can style it. You can barely style it at all, not to mention infections and all these horrible kind of lumps that would appear. It's illegal now, but for a while, I think in Turkey, you could still get it done. And you had to space them out such that You kind of looked like a doll. You know how dolls have the plucks that are far apart. It didn't look natural. It looked like doll hair. But it was something, and it was not cheap. Wow. 00:23:45 Speaker 1: Now, I have to ask, which of the following did you find more horrifying? Goat milk transfusions or goat milk-based breast implants? I was surprised at how... how many different uses we had for goat and cow milk. 00:24:01 Speaker 3: Yeah. Goat milk in particular, I guess, because there's less of a market for drinking goat milk. They're like, what can we do with this? But goat milk, I think that the transfusions shocked me more partly, but it, They shocked me, but on the other hand, they often worked pretty well. If someone was hemorrhaging and losing a lot of blood and you needed to keep the volume up, obviously you don't have red blood cells to carry oxygen, but if what you're talking about is preventing somebody going into hypovolemic shock from just not enough blood, the blood vessels are going to collapse, and you want to get something in there. I mean, you could use saline. That's what is done now. So goat milk was kind of. 00:24:49 Speaker 3: Without knowing why, I think that the medical folks had stumbled on, and then we're talking 1878, I think it was, and there's kind of a flurry of journal articles about goat milk and cow milk transfusions. They assumed there was something in the milk that was a benefit, but in fact, it was just getting something in there to keep the blood pressure up. But they would talk about, you know, a cow was brought into the room because it was done, you know, it had to be fresh. It had to be fresh from the teat. They weren't storing the milk. So there was this wonderfully strange couple of years in medical history where cows and goats were being brought into the surgical facilities or the patient's home, and people were being transfused. And the articles were tremendously enthusiastic in the medical journals. And, you know, mainstream medical journal saying, I would be remiss if I did not predict great things for goat milk transfusions in the future. 00:25:48 Speaker 1: Yeah, I think there was an article in the New York Times that you cite that was hyping it up. 00:25:55 Speaker 3: Yeah, yeah, yeah. And in terms of breast implants, what wasn't tried was just anything kind of remotely injectable. Some surgeon tried putting it in there. So that's just one of many unwise decisions that were made for the goal of making tits bigger. 00:26:32 Speaker 1: Now, I want to come back around to the field work for this particular book. You mentioned a little bit about this already, but let's say you traveled to China and Mongolia. as well as some rather challenging domestic locations as well. 00:26:45 Speaker 3: I did. Whenever I have a chance to go somewhere interesting, I jump on it. My last book was about human-wildlife conflict, and I found a way to go to the Vatican for that one. There's no need to go to the Vatican for a book about human-wildlife conflict, but I always enjoy setting a chapter somewhere I know nothing about. So in this case, yeah, Mongolia. There's no need for a cataract chapter to go to Mongolia, but I chose to, and it was incredibly interesting. And I was in China. The China trip, in that case, both of the companies here that create pigs for xenotransplantation, in other words, pigs that are genetically edited such that their organs are don't create as intense a rejection in the human body. There are two companies here that have pig farms, and I wanted to visit one of the pig farms, pig facilities, I should say, the designated pathogen-free

facility, and they both very politely said no. So I contacted someone who's worked on xenotransplantation for 30 years and who happens to be in Sichuan, China, Chengdu, and they were very welcoming and they said, come on over. You're welcome to visit the facility. As it turned out, I couldn't go inside the facility. I could get close to it and watch it. And from the control room was of course, I'm, you know, um, a walking pile of bacteria and other horrible things that, uh, if you have a designated pathogen free facility, nobody comes in. I mean, the staff are quarantined and they stay there for three months. So, uh, I didn't actually get to go in, but I got close. But in that case, uh, the travel was, uh, warranted by my inability to get access here. And that is, uh, that was a challenge with this book. Biotech companies are notoriously wary of having outsiders, journalists, writers come in for various reasons. They, they have things that are secret that they don't want to risk somebody, um, getting access to. And they also just, I mean, there's a process that a lot of biotech firms, public relations firms adhere to, which is just to say, here is a press kit. Here's a video. This is what we're going to share with you. Take it or leave it. And that's not what I, you know, I as a reporter grew up with a lot more openness. Like, yes, you can come here and spend a couple days and we'll show you around. And it's not like that anymore. So if I have to go to China, I go to China. So sometimes that's what's at play. 00:29:50 Speaker 1: Because that's one of the great things about all your books is they're not just about the subject. They're about the places, and they're about the people. It's about you getting out in the field and visiting places and meeting people, and we get to know them through your writing. 00:30:04 Speaker 3: Right, exactly. I can't do what I do without going somewhere. If I can't get in anywhere, I just don't do that chapter. You know, there have been books where I should have included a topic because it was relevant and important. I'm thinking of packing for Mars. I don't have a specific chapter devoted to radiation. Cosmic radiation and solar radiation are two pretty significant physical challenges when you talk about living off planet. But I couldn't find a setting for it. I couldn't find there. Yeah, there was Brookhaven was doing something with irradiating some animals. I'm like, I don't want it. That's not the scene that I want. So I didn't do a chapter. But if you take that to its end point, I just can't do books. And I understand that. My agent said, kind of don't blame them, Mary, do you? What's in it for them? They're not being paid. They don't have any control over what I say, what I choose to represent, how I say it, how I portray them. So it's in some ways a big risk to say to me, Mary Roach, yeah, come on down for a couple days and do what you want to do. 00:31:18 Speaker 1: So, of course, if you do mention, you know, a particular topic or a particular company in your book, they could always put that on the product, say, as featured in Mary Roach's gulp or as Mary Roach's replaceable you. 00:31:29 Speaker 3: Yes, that is the small gift I give to them. And they, by and large, they take it well, given that they're not able to say it the way they want or highlight the things that they want. And I'm sure most of what they'd like to say doesn't end up in the chapter. But it certainly is exposure for a company. You know, I don't write exposés. I'm not out to get anybody. But by the same token, I'm not sugarcoating things or writing puff pieces. 00:32:10 Speaker 1: Broadly speaking, What do you feel like you learned about the human experience writing Replaceable You? And what do you hope that the reader takes away from the book? 00:32:20 Speaker 3: It's kind of an interesting mix. I want people to be impressed and kind of amazed at what has been done, is being done, might be done in the future, but at the same time to understand how difficult it is to make something that is a true replacement. And also, there's so many times where something is done in a lab, something is created, but then you have to figure out how do you get that into a body or even onto a body. I spent a couple of days with a biotech firm, Stemson Therapeutics, who no longer exist. They were trying to grow follicles. and then implant those from induced pluripotent stem cells, like a person's own cells regressed to pluripotency, encouraged, instructed to become follicle cells, and then incorporated into the person's head. And I thought, okay, the follicle, pretty simple. How hard could it be? But the challenges were so interesting and so immense. I kind of want people to understand why it's taking so long and not to be disappointed by science. I mean, but just to understand what a tremendous challenge it is when you get down to the cellular level to create something that you can incorporate into a complicated system and have it work in the way you want it to work. So it was just kind of a glimpse of how that's done, what's going on, what's taking so long, and what we could hopefully expect a couple decades down the line. But just Expect miracles, but don't expect them quickly. Well put. 00:34:08 Speaker 1: Let's see. Finally, you have some author appearances coming up, correct? I think you're going to do the Decatur Book Festival, which is right down the road from me. So where can folks see you and where can they check out all your dates? 00:34:22 Speaker 3: I have on Instagram, author Mary Roach, there is a visual of all of the book tours. appearances and the dates. So yes, I will be at the Decatur Book Festival. I'm looking forward to that. And I remember, yeah, I remember like one of the best fish tacos I ever had was in Decatur. 00:34:42 Speaker 1: Oh, nice. 00:34:44 Speaker 3: So yeah, and maryroach.net. There's, I think they're putting that up this week, the list of where I'm going, everywhere I'm going. 00:34:53 Speaker 1: Well, Mary, thanks once more for coming on the podcast. It's always a pleasure. 00:34:57 Speaker 3: Oh, thank you so much, Robert. I really had a great time. Thank you for such a smart and insightful interview. 00:35:07 Speaker 1: Thanks once more to Mary Roach for taking time out of her day to chat with me here. Again, that book is Replaceable You, Adventures in Human Anatomy. Go ahead and pre-order it now. I guarantee you, you're going to have a blast with it. As always, we'll remind you that Stuff to Blow Your Mind is primarily a science and culture podcast with core episodes on Tuesdays and Thursdays. But on Fridays, we set aside most serious concerns to just talk about a weird film on Weird House Cinema. Get excited because next week is Star Trek week. The whole week is going to be Star Trek themed. That means Star Trek core episodes, a Star Trek monster fact most likely. And yes, we will cover one of the Star Trek motion pictures for Weird House Cinema. You'll have to tune in to find out which one. Sometimes you can peek ahead by going to our account at Letterboxd. We are Weird House on Letterboxd, and we have a nice list of all the films we've covered over the years, and sometimes a peek ahead at what comes next. And as far as social media accounts elsewhere, we all, let's see, we're on Instagram, stbympodcast, and we are also on Facebook. We are on Twitter at We may be some other places, but those are the only ones that I really can immediately remember. So if you use any of those platforms, follow us, keep up with the show. Wherever you get the show, just make sure that you rate, review, and subscribe. It helps us out in the long run. Thanks, as always, to the excellent J.J. Possway for producing this show. And if you would like to get in touch with Joe and myself, email us at contact at StuffToBlowYourMind.com. 00:36:40 Speaker 2: Stuff to Blow Your Mind is a production of iHeartRadio. For more podcasts from iHeartRadio, visit the iHeartRadio app. Apple Podcasts are wherever you listen to your favorite shows.