SGU Episode 584

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SGU Episode 584
September 17th 2016
(brief caption for the episode icon)
SGU 583                      SGU 585
Skeptical Rogues
S: Steven Novella
B: Bob Novella
C: Cara Santa Maria
J: Jay Novella
E: Evan Bernstein
Guest
I: Ian Harris
Quote of the Week
"Common sense is the best distributed commodity in the world, for every man is convinced that he is well supplied with it."
Rene Descartes
Links
Download Podcast
Show Notes
SGU Forum

Introduction

You're listening to the Skeptics' Guide to the Universe, your escape to reality.

Special Report (0:49)

• https://www.youtube.com/watch?v=aRdgXc42IjM

News Items

GMO Brinjal (13:16)

• http://theness.com/neurologicablog/index.php/bt-brinjal-destroying-the-anti-gmo-narrative/

S: This actually segues nicely into the first news item I want to talk about, which is about GMO's, or genetically modified organisms. Two actual stories to do with this, but they both have in common this notion that people can invent their own reality. And it's amazing how they can do that, they can just manufacture their own reality to fit their ideology.

So, the first one – we've talked about GMO's a few times on the show. I've been writing about it a lot. It's really, I think, a big issue for the skeptical community to face because I think it's one where the disconnect – in fact, it is the issue where the disconnect between public understanding and opinion, and scientific knowledge is the greatest. At least, surveys shows that's the issue, even more so than things like global warming, and even evolution. So we have our job cut out for us.

So, one small aspect of this whole GMO story is happening in Bangladesh. The government, in cooperation with universities, have been researching how to make a BT version of various cultivars of brinjal. Brinjal is their word for eggplant. That's a staple.

J: What is BT? What's in BT?

S: The BT is a pesticide, right? So it occurs naturally in bacteria. It produces it. They were able to take the gene from the bacteria, put it in certain plants. So there's BT corn, there's BT cotton, and now there's BT brinjal.

J: So the plants are growing it themselves?

S: They're producing the pesticide themselves.

C: And plants, some plant varieties actually do produce their own BT. It's just in

S: Yes

C: such low quantities, it's not as, you know.

S: But all plants produce pesticides,

C: Yep

S: right? And in fact, 99.999% of the pesticides that will ever work their way into your body were produced naturally in plants, not added by people, not non-genetically modified. That's just the world, right? That's how plants survive.

C: Otherwise, they'd die.

S: They evolved to protect themselves against – it's literally a war going on between pests and plants. When we farm, it's like, here's acres and acres and acres of the same plant, so it's an invitation, you know, for pests to come in and adapt to that new food source, and pests and crops have sort of coevolved along with weeds, et cetera.

So, there's a root bore, is one particular pest that can wipe out forty percent, (pretty much, on average), about forty percent of the brinjal crop will be wiped out by root bore, and farmers have to spray a couple times a week, about a hundred and forty to a hundred and eighty times, they will have to spray pesticide on their brinjal crop, just to keep the damage down to forty percent.

J: What's brinjal?

S: Eggplant!

E: Eggplant.

(Cara laughs)

J: Why don't you say eggplant then?

S: Because that's what they call it.

E: That's what they call it.

J: See, this is a typical scientist, right? He knows that everybody in the god-damn room knows what the word eggplant means, but you have to u- (Imitates Steve) “The brinjal plant ...”

C: And also, Jay wasn't listening when he already defined what brinjal was!

J: Don't say that! It's very frigging late! (Audience and Cara laugh) I was sitting out there for like an hour!

S: As a good scientist, I said “brinjal,” with “eggplant.” I used a technical term, and then I explain it.

I: So how much are you getting paid by Big Brinjal?

(Laughter)

S: Monsanto, man! Right outside there.

B: Steve, if they use a pesticide, and lose forty percent, what would they lose without pesticide?

S: Oh, the whole crop.

B: The whole thing!

S: Yeah, that's how bad it is.

B: Wow.

S: So,

J: I love brinjal parmesan.

S: Yeah, brinjal paremsan.

J: Yeah

C: A Bangladeshi delicacy, right?

(Laughter)

S: So, you know, this is a big deal! Now they have a fore cultivar of brinjal, with - a cultivar, Jay, is one specific variety of a crop.

J: Yes

S: A cultivar, yeah, right.

J: Cult?

S: Yeah, cultivation? Cultivar, thing?

J: Yeah, right.

S: So, they're giving it to farmers, to test it out. It's already gone through field testing. It's actually approved for use. So they're just giving it to farmers for free, and the farmers love it! It's great! So they, first of all, it's reduced their pesticide applications by eighty percent.

I: Wow

C: Wow

S: More than eighty percent

B:Eighty!

S: reduction, and they have almost no loss of crop. Crop reduction is down to almost nothing. There are still other things that can happen to plants. If you water it too much, you can get some wilt, which is a bacteria. There's other pests that they have to spray for, but the main pest is taken care of. So it's fantastic. They love it. Their profits are up. Their spraying is way, way down. It's win-win all around.

J: And it's better for the environment, when they don't have to spray.

S: Of course! For their health, better for the environment.

C: For the ground water, yeah.

S: Again, this is their staple crop, right? This is not just something nice to have. This is what they're living off of. So this is a home run for genetic modification, right? For GM crops. There is no corporate profit involved. There's no ... decreased pesticide use. There's no Frankenfood here at all. This is pretty much a win-win scenario.

So of course, the anti-GMO crowd can't just sit by and let this happen, because this ruins their narrative, right? Their narrative is about farmers supposed to hate this. And it's supposed to be for corporate profit. And it's supposed to be bad for the environment, and bad for your health. And none of those things are happening. But that's not their reality, right? That's not their narrative.

So they have to now reinvent reality to fit their narrative. So when the story's how wonderful everything was going, we're starting to come back, and there were science programs and reporters reporting on how wonderful this is all working out; they actually, some dedicated anti-GMO activists went to Bangladesh, posing as reporters, to interview the farmers. And then they come back telling the story like, “Oh! They got it all wrong! The farmers hate it, their crops are failing, the BT doesn't work, they're still getting destroyed by bore.”

Meanwhile, they're also telling the farmers, “Oh yeah, don't eat the brinjal. It causes birth defects, and makes you sterile...”

J: So they're basically going in there, they're lying to the farmers, and then they're lying to everybody else on the outside.

S: Yeah, so the reporters who did the original story's like, “Wait, that's not what we found when we went there.” So they went back, and they interviewed the farmers on video, so you could watch the video of the farmers.

Of course, you could think that they're all being paid off, you know, it's all bullshit. But whatever. The farmers are like, “Um, no. Yeah, so this reporter showed up and was asking me about my plants. And they asked about the plants that were dying. And I explained to them, 'Those ones had already produced, and they were at the end of their life span, and that's what happens at the end,'”

(Cara laughs)

S: “'after they've already produced, they will die.'” You know. So, they interpreted the plants that were dying a natural death as failed crops, which is just not true. And then they were pointing out the plants that were the root bores were invading them, and destroying the crop, “Yeah, those were our control plants.” (Cara laughs) “Those were not BT

B: Oh my god!

S: plants,” but they interpreted that as a failure of the BT.

J: Yeah

S: So,

C: So not so good at science.

(Laughter)

S: But you wonder though, did they know that they were completely getting the story wrong, or they were just seeing what they wanted to see.

I: Yes and yes.

S: Yeah, so probably yes, some weird combination of those two things. Hard to really parse that apart. But they now have their story to tell, that fits their narrative, and so you know that if you're part of the anti-GMO crowd, and you look it up, “But this guy says that it's failing, and the farmers are unhappy, and it's not working anyway, and the plants are dying.”

E: It's gonna get legs!

S: Just, it feeds their – it's like, when you talk to an anti-vaxxer, they are full of misinformation. But that's the information that's going around their community. That's their narrative. It's just, they're building their alternate reality, and it doesn't matter what the facts on the ground are.

I: No

J: Yeah

S: It's amazing! All right, so the other story, actually, is it this morning, or yesterday morning? I got an email from one of our listeners. I thought they were actually advocating this story, but then it turns out, they were just, “Oh no, I don't believe that. I was just making sure you guys saw this.”

So it's another similar situation, where there are articles going around the anti-GMO websites, like Organics, and GM Watch, and RightToKnow, and all these websites, that the story is the GMO that almost ended the world. Okay,

E: Yep!

S: I haven't heard that one!

J: So this brindal crop ...

S: This is a different story entirely.

J: Oh, so it's different? Okay.

(Laughter)

J: We're off that. I'm just checking! Now if an eggplant was going to ruin the world, I would think I would have heard about that.

C: Yeah

S: Yeah. All right, so here's the story: And it didn't take me long to deconstruct this story, you know. I always like, when I reply, to say, “It took me five minutes to find that this was total BS.” But anyway, the story is that a European company was researching a soil bacteria, Clebsiella Planticola – Planticola.

I: Uh oh! Now we know what's behind it.

S: Clebsiella Planticola. It's a root bacteria, right? So it lives on the roots of plants, and it lives symbiotically with the plants. So they came up with a good idea, like, “Okay, so we're gonna insert a gene into this Clebsiella to convert some of the plant cellulose, or whatever, into ethanol, so we can then take the dying plants, and then turn them into biofuels,” right? Sounds good.

So, then another scientist did a small pilot study, where they put the bacteria in wheat (I think it was wheat), and a couple other plants. And the bacteria produced ethanol in the soil to toxic levels, and killed the plants.

C: Didn't work.

S: Well, that at least, that particular, the study actually wasn't designed to really test the effect of the bacteria, so much as how it should be studied.

C: Got it.

S: It was just creating a paradigm for studying the effects of the bacteria.

C: A pilot pilot study.

S: But then, somehow, an environmental group got a hold of this scientist, and then they gave testimony before, like, the New Zealand whatever, and their testimony was that this bacteria was about to be field tested. And if it had been field tested, it would have gone out into the world, and killed every plant on Earth.

(Laughter)

J: Jesus.

C: There are some plants that don't grow in soil!

S: Well, she did say terrestrial.

C: I see, okay. She's clear about that.

S: Every terrestrial – not gonna overstate the claim. Every terrestrial plant on Earth will be dead. Okay, so that seems to be going a little bit beyond the evidence a little bit.

E: A little hyperbole.

S: So what I found was, her apology for misinforming – giving bad testimony – before this New Zealand Council. Essentially, she cited a paper that hadn't been published. That's a no-no. She also incorrectly said that the bacteria was being field tested. And that was incorrect. It had not yet been approved for field testing. And she also said, “And, I really can't say from my study that it would have destroyed every terrestrial plant on the Earth.”

(Cara laughs)

E: Other than that, it was totally right.

C: Yeah

S: Yeah, other than that ...

J: So never mind everything I said.

S: Yeah, never mind, never mind.

C: Strike that from the record.

S: But it's too late!

E: Too late! The genie's out.

S: This is now, “The GMO That Almost Destroyed the World” is now out there, right?

C: That reminds me of when you are watching court proceedings, and a witness says something, and then there's an objection,

E: Strike it from the record.

C: and then, it's basically, “Jurors, you will not use any of that,” and it's like, you can unhear it.

S: Yeah

C: Like, how do you just not factor what you just heard into your

J: Yeah, the judge says, “Strike that.” I always think that's such bullshit!

C: I know!

J: Because the lawyers use that, they use it.

C: They intentionally make an objection,

J: Yeah

C: because they know it's a worm in your head now.

S: Or they say something they know is going to be objected to.

J: Yeah,

E: That's right, to get it on the record.

S: And I've been in court rooms where lawyers have said something like that, and then the other attorney says, “I object, and before the judge says, ah, strike it.” It's like, “I've already put that bug in the juror's ears

C: Yeah!

S: and now, Cara, I don't actually want it on the record.”

B: It's time delay. Like radio stations, time delay. You gotta buzz it before it gets to the jurors.

C: It's sort of like a big cage, right? And there's like a delay.

J: That's actually really interesting, Bob, like, a three minute time delay to the jurors, that they can un...

S: They only let through what's been ...

J: What's been approved by the judge, interesting, okay.

C: 'Cause we know enough about psychology, and we know enough about skepticism to know that there's just no way that they're not gonna use that information in their ...

S: So the thing is, in this

E: Don't think about an elephant.

C: Shit!

S: Yeah, and this means (Audience laughs), it's a GMO, even though it's a bacteria, right? Or a bacterium species. Okay, I totally get the idea that you shouldn't release a genetically modified virus or bacteria into the wild without studying the crap out of it, right? I mean, yeah, they're very rapidly self-replicating infectious types of things, and you have to think very carefully about

B: Sure

S: releasing, like, insects are another one. Like, before we release insects out into the world, the wild, I would want to really be sure that they're not gonna screw things up, right?

C: Yeah, like the Crisper mosquitoes.

S: Yeah

C: The Zika, yeah, yeah, all that.

S: We would never do it. All right, that's a high level of concern, in the research that we got, crops are really weak things, right? And it's also interesting because the anti-GMO world, in the anti-GMO world, if a rogue GMO crop gets out into the wild, it's gonna destroy nature!

C: Monsanto's already doing that. They're infecting every field with their GM wheat, and ...

S: I know, the wheat one ...

C: and then they're suing all of the farmers!

S: Do you realize how fragile crops are? They need to be babied by farmers ...

J: Except those weeds in my yard.

S: They're not crops!

J: I can't get rid of!

S: Right?

I: They're not crops!

J: Yeah

I: That's why.

J: They're weeds. They should just those crops, and whatever's keeping them alive, and fuse that with good crops, and ...

C: That's what they're doing.

J: Yeah

C: That's what genetic modification is!

(Laughter)

J: Oh, we've gone for it! Never mind. Thirty years too late.

S: Yeah, it's not like they're railing, “Oh, there's a few rogue GMO wheat plants that somehow, the seeds got out, and they're growing in a field. It's gonna destroy everything.” It's like, this shit's not kuzue, you know what I mean?

C: Yeah

S: It's not gonna – it's a crop! We've made them to be nutritious, and food, but not to grow in the wild. They're really fairly gimp as far as that's concerned, you know.

J: They're high maintenance.

S: Yeah, they're high maintenance.

C: Well, and this is an example of not a failure of the scientific method here, but it's an example of it working.

S: Yeah

C: Obviously, the pilot, as it were, you have this little test, you show that maybe there are some things that are not probably what we had hoped for,

S: Yeah

C: and then you move on

S: But here's the thing – yeah, yeah yeah

C: from there.

S: So, yeah, this is a totally – even if taken at face value, this story is not alarming at all. Science showed that there's a potential issue, we shouldn't be releasing this into the wild, because it could kill plants, fine. But actually, there was another study that they didn't cite in the scare-monger's stories, where other scientists looking at the same bacteria found that when you combined it with the wild type bacteria, the plants didn't die, which means the GMO bacteria wasn't competing against the wild-type bacteria. So it's not gonna take over the world! Even if it got released out there, the regular bacteria would have kicked its ass!

C: Yeah

S: Because again, the wild types, they're adapted to the environment. The stuff we're making in the lab is not super-anything! It's just different.

C: But there is that assumption, right, that somehow, it's

S: It's super!

C: yeah, like it's like, “We've made it radioactive!

S: Yeah

C: And it will kill anything in its path!” And it's like, no, it just has one gene modified to make it slightly sweeter.

S: Yeah, no, but that is the Frankenfood meme. That's the whole idea. It is basically exploiting the public programming from science fiction and superhero movies, the notion that you're a mutant, you're somehow super-something. And then, so these things are gonna take over the world, and destroy the ecosystems, and no, they're just plants. They're just plants, you know. “But they're resistant to glyphosate!” Yes, but so what? We're not throwing this stuff around.

C: All that natural glyphosphate!

S: Who cares!

I: The one I always hear is, “But they used a fish gene!”

C: Yeah

I: That's the one that always ...

E: That's right. Tomato!

C: Why do they say fish – why is that so scary? Why is that the fear mongering thing?

J: I think because it's fish, it's so foreign. It's not another plant, yeah, yeah. Like, fish are kinda ...

C: Gross, I don't eat fish.

S: So, first of all ...

B: How many genes with fish?

S: Yeah, we share sixty percent of our genes with bananas.

C: Yeah

S: Right? (Audience laughs) So, we share more than that, seventy, or something like that, with fish. It's not a fish gene, it's a gene! There's no difference! It's a gene. But the other thing's,

I: Same food.

S: we never made the fishmato. It was just an idea that somebody had, right? But it was ...

J: What was it supposed to do? It was supposed to have Omega-3 in it or something?

S: No, it was cold tolerance. They were putting cold tolerance from a fish into a tomato so it wouldn't freeze in the fall, or whatever, extend the growing season. It's actually a really good idea.

I: Yeah

S: And they should do it! But, whatever, the fishmato, that just became another meme within the anti-GMO community. No, it never existed, and it's not a bad idea anyway. And the whole idea that there are fish genes and tomato genes is bullshit.

C: Well, and even if they're – the only thing is, I remember reporting on some strawberries with Folta, with Kevin Folta, down at his lab in Florida, and reporting on some tomatoes, some strawberries, some peppers. And we were talking about the different kind of experimental genetic modification that they were doing, mostly to resist certain types of pests. And they were finding that within the public consciousness. If you put a pepper gene into a different kind of pepper. Like, this pepper has better resistance, so we're gonna insert it into this other species of pepper, which doesn't have as ...

And people are like, “I'm generally okay with that.” But you put a pepper gene in a strawberry, and they're like, “It's gonna make my strawberries spicy!”

S: Yeah

C: It's like they just can't have two totally different organisms cross

J: I think Steve is right though.

C: It's racist, yeah!

J: It's kind of like an artifact of our culture,

S: Yeah

J: like Steve was saying, because it really does seem like, there's a million movies out there, and books about ... I just think of the fly, right? The move the fly

C: Yeah

J: where the guy merges with the fly.

S: It's sci-fi. No, and when asked, most people thought that the fishmato would taste like fish.

C: Yeah

J: Of course.

S: No, they didn't put the flavor genes in it, they ...

(Laughter)

E: Right

C: Why would they do that? They wouldn't be able to sell it!

I: Now, isn't that though, all of this stuff, the fear mongering, all of the anti-science sort of stuff, it's always kind of a big straw man, where everything is, they are arguing with themselves.

C: Yeah, they make up the problem.

I: They make up this crazy idea. It's like when you talk to people with evolution. “Well, I didn't do this, and I didn't come from no monkey ...” And it's like, no one ever said any of that stuff! You're arguing with your own brain!

E: You did.

I: You made it up, and then this is gonna happen, and no! It's wrong! No one said that. And it's every single time, it's the same thing. They have no understanding of it, so they make it up, and then they break down what they made up.

C: Yeah, that's the definition of fighting that straw man.

J: A spontaneous straw man.

C: You know, Jay, follow up what you said, this is like a societal thing. It's like a function somehow, that's deep within us. I would urge all of you, when you go home, to do an image search. Like, doing journalism on GMO's is really interesting, 'cause you always have to tag your story with an image. And if you go to a stock photography website, like iStock Photo, or ShutterStock, and you just put in GMO, the images that come up!

J: They have a ton of 'em, yeah.

C: It's always like a tomato with a syringe.

S: Always a syringe.

C: Like a head of cabbage would have teeth. And you're like, “What is that?”

J: You know the photographer's like, “I wonder if that cabbage is real?” There's two f*cking things that we want to put together.

C: It's never just like, you know ...

J: Let's have a big dick growing out of this

C: Yeah

J: cabbage, and see if people freak out.

C: It's never a scientist with a beaker, 'cause that's really what it is.

S: Right.

C: I know, it's just ...

S: What's with the syringe though? I mean, it's not injecting stuff into tomatoes.

(Unintelligible cross talk)

J: Because it's provocative. That's why the dick should be comin' out of the cabbage, 'cause it would sell newspapers.

S: Why cabbage?

J: Just trust me, I know.

C: Dick cabbage?

J: Yes

I: I think dickmatoes is better.

B: Oh! Nice.

S: Dick cabbage sounds like Dick Cavage.

B: Yes, of course!

S: I don't know what that means, but ...

B: He could endorse it.

C: Oh!

E: Hey! We're all onto something here.

C: There was an SNL where John Ham was selling the John ham. It's like a roll of ham in the toilet.

B: Dick cabbage.

C: John Ham's John ham Yeah, I don't know.

S: All right.

I: Why is it that people cling to that sort of things? The emotional response, rather than pleading to more evidence-based things? Why do people get drawn into that so immediately?

C: So, why are people have an emotional response first, instead of thinking about the evi- because thinking is hard, right? And feeling is natural.

I: I don't think they're taught to.

C: Yeah

I: And I think it's not even thinking, 'cause I know some people that actually, they think they're thinkers, and they're smart, intelligent people, but they've never been taught where good evidence comes from, and how to acquire good evidence. So those people always end up being the crazy conspiracy theory people, where they're asking questions, and they've kind of got this logical process going on, but all of their information came from some crazy website, and they didn't fact check anything, 'cause no one ever taught them to fact check. And I think a lot of times, it's just that. This is the facts I have, and that's all I know.

S: We all know people (and I know Jay, Bob, and I know several people like this), who are armchair philosophers, right? It's hard to talk about this without coming off as elitist, but basically, these are people who don't have a lot of formal education, but they are curious, and they're interested in big ideas, and they want to participate in that. And they have their own ideas, but they don't have the, I think, perspective, or maybe the humility to realize that you can't just shoot from the hip, you know what I mean?

So, sometimes people just, we'll be around a dinner, and they will say, “Yeah, I always wondered about this.” And they would have some half-baked, crazy idea. And that's fine, we can talk about that. But then there are people who write a book. We know some guy who wrote a book, he had this wacky theory about how all of the Bible was actually influenced by aliens. And he had this really convoluted chain of evidence of how the Taj Mahal is a spaceship, and really weird stuff.

C: It's not like a comedy book then.

S: No! It was dead serious! Dead serious. So he took it to the next level, you know, where now he's not just armchair philosophizing at the dinner table, he actually thought this was publishable, and he published it.

I: But now he's an expert, like somebody else,

S: Now he's an expert.

I: to somebody else he's like, “Well, have you read so-and-so's book?”

E: A Marvel comic?

S: All right.

Membership Drive (36:37)

• Contains music and sound effects

Do Dogs Understand Language (37:52)

• http://www.cnn.com/2016/08/31/health/dogs-words-mri-study/

FDA Bans Antibacterial Soap (46:44)

• http://www.npr.org/sections/health-shots/2016/09/02/492394717/fda-bans-19-chemicals-used-in-antibacterial-soaps

Space X Explosion (53:12)

• http://www.slate.com/blogs/bad_astronomy/2016/09/01/spacex_falcon_9_rocket_explodes_while_being_fueled_for_test_firing.html

What's the Word (1:01:04)

• Comorbidity

S: All right, Cara, what's the word this week?

C: Ooh! The word this week is comorbidity.

S: It's a happy word.

C: Comorbidity.

S: What do you think that means, Jay?

J: It's when you and your spouse die at the same time.

C: Interesting. Do you guys feel, what do you think comorbidity means? Unless you know.

I: I don't know.

B: I think it goes along with death or something? Co-

C: I told you! Okay, so comorbidity is actually just existing simultaneously with, and often independent from another medical condition, meaning that you have two diagnoses. You have two conditions.

J: And they're gonna kill you.

E: No, no, they're not fatal.

C: They're just disease, yeah. So, when I first heard the word, it was in the context of patients that I work with when I was working for a clinical neuropsychologist back in Texas when I was doing my undergrad work. And many of them had blindness or visual impairment, and some sort of neuropsych issue; and so they had comorbid blindness, and whatever their diagnosis was there. And I couldn't get past the word when I first started, that it ...

B: Yeah, it didn't sound right.

C: It sounds like they have a dual death diagnosis. And so, to me, comorbidity meant death. But of course, the real word in medicine for that would be (even though there's no word) comortality, but that's not a real thing. So yeah, morbidity specifically refers to the state of disease.

S: Comortality is like, when you have a heart attack, and then you get in a car accident.

C: (Chuckles) Oh no! So like, on your cause of death, they have to, they're like, “both.”

S: No, they always have to say one. I'm just saying ...

C: And / or this.

S: There are sometimes, multiple things happen at once. The guy who jumps off a bridge and somebody shoots him on the way down.

E: Yes!

(Audience laughs)

C: Rare ...

S: Was that murder?

J: Did that happen?

S: When did that happen?

C: What killed him first? Wasn't that the famous with Ed Tubertée? What's the fatal stab wound?

S: Yeah.

C: No? Okay.

J: No, but you could go to the doctor and be like, “Okay, I've got incurable cancer and an aneurism.”

C: No, of course. It's comorbidity.

J: Yeah

C: Yeah. So, if you have a dual diagnosis, especially in psychiatry, this has become a very popular term in psychology, if you have a dual diagnosis of depression / anxiety, those are comorbid conditions. So the etymology of the word, which was first coined – this is very interesting to me – first coined by epidemiologist A.R. Fynstein, (I feel like you're not gonna believe me) here in the US. He first came up with the term in the '70's, and first published it, it first appeared in the literature, in 1985.

I: Wow

C: Yeah, very recent.

S: That was very recent, but the thing is, it was before I went to medical school,

C: There you go.

S: So it's

C: So it's always been in your training.

S: history, right? Before ...

(Evan laughs)

C: So, obviously, an amalgamation of “co,” meaning “going along with,” and “morbidity,” a word from the 1650's, meaning “diseased.” But the roots are the same for mortality and morbidity. “Mort,” right, when we think of mort, old French, Latin. Mort means death.

E: Death

C: And so, it was thought of in the 1650's of course, that these diseases caused death. Like, disease is a death sentence. So that's really where the word came from. But of course, we were talking about this earlier off camera ... (camera, off audio?) Doctors take part in these M and M sessions, right, which morbidity / mortality.

B: Yummy.

E: Oh.

C: Where, you

S: Morbidity / mortality. So things that went wrong.

C: Yeah, so all doctors are required – this is an important part of your training, right,

S: Yeah

C: is wherefore all of the residents all the way up to the attendings – how often do you ... once a month?

S: It depends.

C: It depends on your

S: Yeah

C: Yeah, where basically, the tough ones, right, the people that were lost, the people that had maybe something didn't happen the way that

S: Yeah

C: you might have wanted it, how you learn from your mistakes, and how you learn – not always from mistakes, but ...

S: Just bad outcomes.

C: bad outcomes.

S: But it is, in different contexts, different specialties, are more brutal. I mean, I

C: Surgery

S: Surgery M and M, if you lose a patient, and then you are a resident or something, and then you are grilled. They will destroy you.

C: Yeah

S: But the idea is that you're gonna learn how not to make that mistake again. But sometimes, it's also going over statistics, like, “Oh, we three aspirations on the wards this month,” meaning three patients choked and got a lung infection. Gotta get that number down,

C: Yeah

S: you know, how do we do that? What are we doing everything that we can to do that? It's very important. I do want to point out though, that the strict definition you gave, while true, is not how we typically use the word in practice.

C: Let me see, and what I had said specifically was, “existing simultaneously with, and often independent from another medical condition.”

S: Yeah, right. But there's no kind of point in saying you have two diseases, having a word for that. We use it when there's a relationship between the two diseases that we want to focus on. So, for example, I see patients with migranes, who have a sleep disorder. And we say those are comorbid. It's not just that you have both at the same time. Migraines worsen your sleep disorder, and your sleep disorder worsens the migraines. They're playing off of each other, so they're comorbid. So that's where we kind of use it that way, 'cause otherwise, it's kind of a point of concern.

C: It's like you have a cold and you have diabetes, like, who cares? And it's interesting that you said that, because

S: That sick guy

C: when I first heard of the word was when I came with a clinical neuropsychologist, like I said. He worked with these patients in the blind population, the visually impaired population, who also had neurological disorders. Very uncommon that they would have retinopathy of prematurity. And of course, the retina, everywhere from the retina back is central nervous system. Like, we don't often think about that, but it's the same kind of system, right? That are kind of flay, between the brain and the visual system.

S: The retina part is really an outgrowth of the nervous system.

C: Yeah, these are neurons in the retina. They kind of follow a lot of central nervous system rules, as it were. So it was not uncommon that you would have visual impairments that directly related to, you know, a premature baby who doesn't ever develop their retina appropriately also has some other things that are probably going wrong in the brain, so, it's interesting.

Science or Fiction (1:07:01)

Item #1: According to a recent study pornography use by married people has a greater negative impact on marriages of those considered more religious compared to less religious people. Item #2: Infamous con-man Victor Lustig, most noted for being a master counterfeiter in the early 20th century, traveled to Paris in 1925 and sold the Eiffel Tower to scrap metal dealers at a time when the tower was being seriously considered for demolition. Item #3: The subtitle of the Movie Star Trek II was called, The Vengence of Kahn. Because Star Wars’ Episode VI working subtitle was The Revenge of the Jedi, out of deference the Star Trek producers changed the title to The Wrath of Khan.

Skeptical Quote of the Week (1:23:30)

"Common sense is the best distributed commodity in the world, for every man is convinced that he is well supplied with it." Rene Descartes

S: The Skeptics' Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information on this and other episodes, please visit our website at theskepticsguide.org, where you will find the show notes as well as links to our blogs, videos, online forum, and other content. You can send us feedback or questions to info@theskepticsguide.org. Also, please consider supporting the SGU by visiting the store page on our website, where you will find merchandise, premium content, and subscription information. Our listeners are what make SGU possible.

References