SGU Episode 886

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SGU Episode 886
July 2nd 2022
A polymetallic nodule
SGU 885                      SGU 887
Skeptical Rogues
S: Steven Novella
B: Bob Novella
C: Cara Santa Maria
Quotes of the Week
-- Healthy skepticism is the basis of all accurate observation. -- We make our world significant by the courage of our questions and the depth of our answers.
first: Arthur Conan Doyle, British writer second: Carl Sagan, American astronomer
Links
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Show Notes
Forum Discussion

Introduction, Snake Rescue, Mice, Cats & Dogs

Voice-over: You're listening to the Skeptics' Guide to the Universe, your escape to reality.

S: Hello and welcome to the Skeptics' Guide to the Universe. Today is Wednesday, June 29^th 2022, and this is your host, Steven Novella. Joining me this week are Bob Novella...

B: Hey, everybody!

S: Cara Santa Maria...

C: Howdy.

S: And that's it. It's just the three of us.

B: What is happening now.

C: Weird.

S: Evan is on a scheduled break this week. Is doing something with his daughter I think. And Jay's traveling. So he's also. He was sick last week. Completely unrelated. He may or may not be here next week it depends on what his travel plans are. It's the summer. Summer's very disruptive. There's going to be a lot of swapping in over the next month or so. But first I want to tell you guys about a nature encounter I had recently. We like to tell about our nature encounters. And as Cara likes to say we live in the woods.

C: You do.

B: I guess.

S: There are woods near my house. Yeah. So anyway Sunday was like a beautiful day like. One of the first weekend days where we didn't have anything scheduled. So we're doing a lot of yard work. My wife says Autumn, it's our daughter, found a dead snake near the garden. Will you get rid of it for us. So I'm like hmm. I immediately knew what would happened. Because we have I have fencing around my garden and at one point I put up some like mesh fencing to keep little critters out. And then it didn't work out so I got rid of it but there was some left behind. I'm like I bet you that snake got caught in the mesh.

C: Oh no.

S: So I went. It was a rat snake which is was a black rat snake. Not that big probably a juvenile. It was absolutely completely entwined in the mesh. And it looked dead. And so I was getting ready to just cut it out and get rid of it and it starts to move. Like ooh this thing is not dead yet. Now my daughter is a budding herpetologist. She's the one who owns a Blue-tongued skink. Plus my wife is a softie. She's like oh she my wife is like deathly afraid of snakes but still she's like oh the poor thing. Free it.

C: Yeah. (laughs)

S: Free it? I mean it was so entangled in this mesh. This is like fine a very fine mesh of like plastic. It was also like grown into the ground and everything, you know I mean? It's been there for years. They talked me into like fine. The thing looks like it's still alive. I'll see what I could do. So I─

B: Yeah what's the strategy.

S: It took me like 20 minutes. I painstakingly cut that snake out of the mesh.

B: Do they bite? Do they bite?

S: So well it bit me. But I was wearing gloves.

C: Okay.

S: And they don't have fangs. They just have rows of tiny teeth. So it kind of like bit at my it snapped at my finger at one point which I didn't even feel it because I was wearing a glove. But it was like surgery. I had to get the scissor between the snake and the mesh. It was so tight in places it was constricting him, you know what I mean. I was digging into it and I wasn't sure like how healthy it was but then I had to have my daughter hold his head so he wouldn't keep snapping at me while I finished cutting it away.

B: Oh yeah that's a good strategy.

S: Yeah. So we did. We cut it away and as soon as it was totally free. After taking a picture. We released it and it slithered away really fast.

C: That's good.

S: So I think it was not moving mainly because it was probably painful for it to move. But we freed it quickly enough that it I don't think it was that harmed.

C: That's exciting.

B: Nice. Good job.

C: It's like a good deed for the weekend.

S: I know. It kind of felt good to freeing the creature. Plus it eats vermin. It eats mice and chipmunks which─

B: Oh god I wanna buy some.

S: ─we have a ton of in our property. And they of course are menace to my garden. So I'm like yeah black snake in the garden. Good. Eat all the mice. Get rid of them.

B: That's awesome.

S: Yeah they're just a menace.

B: Should have put them in my basement.

C: Oh no you have mice in your basement?

B: We did. It was bad. It was an infestation.

S: Yeah we did a couple of times. We've always been able to get rid of them but it's a constant thing. Like you have to constantly be on the lookout. And we've now we basically just have a service that just constantly keeps our house vermin free.

C: Interesting. We don't have basements here. And we didn't in Texas where I was growing up either. That's like not a concept I'm familiar with really.

B: That's sad.

C: Yeah. We have attics.

B: Nothing like a good basement.

S: Well they'll get into your house whether it's a basement or not. I mean again like if you if you live surrounded by wilderness mice will get into your stuff. That's just the way it is.

B: Basically nothing you could do.

S: There's nothing they're just constant fact of life. You just have to live with them or you got to be vigilant about keeping them out of your house. But part of it is covering all the entry points but they're very small and they're good at making entry points. So you can just minimize them but there's no way you could really keep them out.

B: Yeah they can know a way at most materials and they can get through so surprisingly small holes. So tiny you wouldn't believe that they could fit.

C: You should get a cat Bob.

B: Liz and I have a cat.

C: And she's not a good?

B: Oh yeah she's left a couple, not a lot, but she's left a couple of dead mice around which is kind of cool.

C: Interesting. I had a cat once. Here in California in my first apartment I lived in I had a cat and she was the sweetest thing ever and of course I didn't let my cat outside I live in an urban center and you shouldn't do that. But she really did like the outdoor. So she would hang out on my patio. Like on my balcony all the time. And one time I came home and she had gotten a bird. From my fourth floor balcony.

B: That's what they do.

C: And I was like wow okay we're gonna not do that anymore. It was amazing. I was like you are a hunter.

S: Oh yeah.

B: Yeah it's like a holocaust for the birds. The cats.

C: For sure. Especially the ones roaming the neighborhood. But I had no idea she was skilled enough to do it from like a six by six patio. Wow.

B: They're amazing. I have such love and respect for cats now. We never had cats growing up so there's always dogs. Always dogs. Always wanted a dog but now that I've gotten used to a cat the past four or five years. I got mad respect for their agility. Just astounds me all the time. It's so much. They're so much more three-dimensional than a dog.

C: Well they definitely more agile. I'll give you that. But they're also a lot easier. I loved having cats when I was in college because I could just leave for the weekend and they were fine. I could never do that to Killer. He would die.

B: That's huge. That's huge. That's huge. But so I will say of course coming home from whatever and having a dog run up to you and lick you all over to me that. I try to get my cat to do it and won't do it. Will not lick me.

S: The level of affection from a dog is like an order of magnitude than most cats.

B: Oh my god.

C: Oh yeah. But they're also an order of magnitude more needy.

S: Totally.

B: Absolutely. Yeah. Leaving for a day--no.

C: Oh leaving for three hours. My dog acts like I've been gone for a [inaudible].

B: Oh wow separation anxiety is a thing for sure.

S: All right so guys one other thing. Earlier this week I pre-recorded a talk that I'm giving for Skeptical 2022. This is virtual this year. It will be live July 16^th and 17^th but some of the bits are pre-recorded. Also Evan was on their skeptity this year with Bill Nye so Evan will be making an appearance as well. My talk was on when skeptics disagree. It was all the big issues over the last 30 years where there was significant disagreement within─

B: Oh wow.

S: ─the skeptical movement among skeptics.

B: Touchy.

S: And why I think caused them and how they what's the status of them were they resolved or not etc.

B: I wouldn't touch that with a 20-foot pole.

C: That's brave.

S: It was fun. So that'll be airing during the conference. Just like with NECSS which is also coming up. If you buy a ticket you'll be able to watch it whenever. You don't have to be watching it on the 16^th and 17^th. And then speaking of NECSS that's coming up as well. That is August 5^th and 6^th. Also a virtual conference. Also you'll have access to the whole conference for a long time once you purchase a ticket. So the full details are on necss.org just go there you'll see the updated list of all the speakers we're getting. That's gonna also be a lot of fun.

Special Segment: Cara's Upcoming Surgery (8:30)

C: And you know sorry to have to do this while we're missing Jay and Evan but I wanted to. I don't know. An announcement sounds odd. It's not really an announcement but I wanted to talk to you and to of course the listeners about some upcoming plans in my life. I had been grappling for a while with whether or not I wanted to be public about this because a nobody's f--ing business but I do think there are some real benefits to speaking out. So long story short I was recording an upcoming episode of Talk Nerdy a few weeks, maybe two weeks ago now with an incredible woman named Rachel Gross who wrote a book called Vagina Obscura and we were talking about women and women's health and reproduction. And I was like you know what I got to talk about my own thing that I've been dealing with and I just went there. So if you're a Talk Nerdy listener you're going to hear an in-depth very spontaneous conversation about this on my newest episode that comes out on July 4^th. And July 44^th of course is Independence Say here and it's also the day before I'm having a pretty major surgery. So anybody who has followed me on social media probably saw about six weeks to a month ago now when I had a more minor surgery. You saw a couple pictures that I posted and I got a lot of really wonderful love online. And that was--I didn't say what it was at the time but that was a very common surgery but I did do it under general anesthesia. It was my first time ever under general anesthesia so I was super scared. But I got through it. That was a common surgery called a LEEP which is a surgery that removes some cervical tissue to to study it for pathology. I also had something called an ECC which is an Endocervical Curettage so that's like a scraping of the endocervix. And then something called a D&C which is Dilation and Curetage of the uterus. That part's not usually included in the initialism. But D&C is actually a really interesting procedure that we're going to talk about a little later when we talk about abortion science. I was not having an abortion though. I was having a D&C for also pathology purposes. It's a scraping of the endometrial lining of your uterus to look and see if there's any abnormality. All of this came after an abnormal Pap. Women get paps regularly. Oftentimes when they come back abnormal the problem is squamous tissue which is a certain type of cell layer of the cervix. Mine came back abnormal in my glandular tissue which is more disconcerting because it happens farther up inside the cervix and it can and it enters into the uterus there's kind of no dividing line there. And it came back something called adenocarcinoma in situ which sounds really scary for good reason. That word carcinoma is scary. It's cancer. The operative words here are in situ or for some reason a lot of the doctors say in situ which I find interesting because researchers almost always say in situ. We use that term a lot in research too. Anyway that means in place. So what that really means is that the abnormal tissue the cancerous tissue is still in an outermost layer of cells. It has not yet invaded the basement membrane. So they often refer to AIS as cancer stage zero meaning it will progress. It's not a question of if but when. And yet it has not progressed yet which is a very good sing.

B: Sounds like a good number though to have.

S: Yeah you want stage zero if you're going to be staged for sure. And the so the good news is it's fully treatable. The bad news is the treatment is a total hysterectomy and so that is at the age of 38 something that I'm going to undergo here next week. Which means I'll be off the show for several weeks while I'm in recovery. And I thought it was important to talk about this because I think people listening right now either have gone through it or are gonna have to go through it. When I come back on the show I can report back what my experience was like. If anybody has questions of course you can reach out to me via social media as I'm preparing. I've been talking to a lot of younger women who have gone through this procedure for usually other reasons things like endometriosis or uterine fibroids. But also one person I talked to went through it because they were brachypositive and they did it preventively. So for cancer purposes. So that's my spiel.

S: Yeah.

C: I'd also love to answer any questions that you guys might have. I know we've talked about this offline so you might not have any but for the purposes of the listeners.

S: I think we should be clear: you're going to be fine. This is you're going to be totally fine when all this is done. But even still this is major surgery.

C: Yeah. Oh yeah. A hysterectomy is─

S: The removal of an organ.

C: ─and not just one I mean I think the reason that a lot of--I grapple with this because hysterectomy is the single most common surgery performed on women. Or I should say it's the single most common gynecologic surgery performed in the US. And so because it's so common and because there's a huge stigma around women talking about reproduction and because there's also a lot of misinformation disinformation and just lack of information that people generally have about our fundamental anatomy and physiology. I know women. Women who have given birth who when I tell them what the surgery entails they're like wait what now? I'm like yeah. So total hysterectomy for me it refers to the removal of the uterus, fallopian tubes and cervix. Radical hysterectomy also includes the ovaries. I get to keep my ovaries. I'm very lucky in that regard so I don't have to undergo any hormone replacement. But that said I will be having all of that structure removed which means you're also losing a lot of the structure in your pelvic floor. And so there's a lot of healing. It's laparoscopic which really helps with the heal time.

B: Oh sure.

C: But now pretty much the only thing between a woman or I should say or a trans man. Anybody who had a uterus. Who undergoes this surgery or somebody's non-binary. The only thing between where those organs used to be and the outside world now is the upper layer of your vagina that's sewn closed to form what's called a vaginal cuff. So basically it's tissue and then guts. Like your intestines. There's no cervix in between them anymore. So that's all of that structure has to be kind of sewn in artificially.

B: Wow.

C: So you've got a lot of healing to do.

S: Yeah.

B: That makes sense now. It's even more dramatic than I thought.

C: Yeah. But the good news is it is very common. I am in very capable hands and this for all intents and purposes and when you look at the literature by and large to like a very high degree. 99 point something will completely remove the cancer and there's really kind of no risk after that. I will still have to do some paps and things like that. And so they're a little bit different paps when you don't have a cervix. They're different but you still have to do them. But yeah. This should be a--this is a curative procedure. Or really a preventative procedure.

S: Yeah that's the good part.

B: Yeah. Right. So did they discuss? Are there any non-surgical alternatives or is that really your only option?

C: Yes. So the standard of care according to all of the different medical gynecologic groups who have done all of this research over the years is total hysterectomy. And the reason for that is that skip lesions are really common. So even though my LEEP came back positive for AIS but my ECC and my D&C were both negative there's a good chance we we actually removed all of the all of the AIS but the risk for skip lesions is so high. And a skip lesion is just a lesion that's non-continuous. So it could be somewhere else and we missed it.

S: So it looks like you got it all but you didn't.

C: Yeah it looks like you got it all but you didn't and the risk for that is so high that the standard of care is total hysterectomy. So if I had wanted children which I don't there are fertility sparing options but really all that entails is waiting. And you can wait a few years to plan your family and to give birth but during that time you have to have biopsies every six months. And to me what do I wait for? The longer you wait the riskier surgery is. The younger you are when you have a surgery and the more healthy you are the better outcomes. I don't have plans for fertility and I don't want to go through any more painful biopsies. I had already done multiple biopsies prior to this and one little thing that you might not know if you're not somebody who's had a colposcopy-they don't give you any anesthesia for those.

S: Yeah it's considered too brief a procedure.

C: Yeah they say it's so short that the shot itself would hurt too bad and then they have to follow it. But it's still multiple sites so I've probably had five colposcopies now in my life. Maybe more. And each time it's two biopsies and an ECC which is the curettage of the endocervix. So it's three brutally painful like almost pass out painful punches inside of you but yes it's fast. Doesn't mean it's not horrible. And that's partially why we did the LEEP and the and the ECC under general anesthesia this time. And we needed to do a D&C too. Which sometimes you don't do under general. But general definitely takes that kind of pain away. And so yeah this will be my second time under anesthesia. Boy oh boy propofol is weird.

B: Yeah because this is going to be more extensive. You're gnnna to be under longer, right? So you're a little worried about the reaction for such a lenghty time.

C: Yeah an hour and a half last time. This will be more like four to four and a half she said. But everyone reacts differently.

S: Yeah everyone reacts a little bit differently.

C: Some people don't have a reaction at all. And here's an interesting thing. Steve I'd be curious to hear your take on this. So the first surgery I did I didn't ha--I was under general but I didn't need pain meds because it's really not that pain. I mean it hurts but you take ibuprofen and use a heating pad and you're pretty much okay. This surgery they put you on dilaudid in the hospital which is a very strong opiate. So and then you go home with some like norco or something like that. Just for a few days and then you move on to NSAIDs. But I've spoken to a few people who told me that paradoxically my post-anesthesia yuckiness that I felt after the first surgery might actually be mitigated because I will be on pain meds this time. So I might not notice that horrible propofol hangover because I'm on heart like pain meds.

S: Yeah because you'll yeah because you'll be on narcotics at the same time.

C: Yeah because I'll be like effed up. So that's kind of my hope.

B: Good luck with that. Cara I've got a question. Considering how radical the surgery is. What I'm curious what's the impact on menopause?

C: None for--well I can't say completely but for the most part if the ovaries are in place none. If you remove your ovaries what that does is it forces menopause.

S: Yeah it's a surgically induced menopause.

C: Yeah. Which is why women, I keep saying women but anybody who goes through that procedure, which is why they often require hormone replacement therapy. Depending on their needs. But for me the hope is so the uterus and the fallopian tubes really don't have any endocrine bearing. Sometimes there are some things that can happen to the ovaries because the tissue near the ovaries has changed. But very often the ovaries continue to have a typical ovulation cycle. And before you ask I did ask my doctor I was like wait where does the egg go? And she was like it's just a cell Cara your body just absorbs it like it literally always does. And I was like right right. She was like very rarely does it actually make it down the fallopian tube and into the uterus and implant that's like, it's just a cell. Your body just gets rid of it. So I will still have a cycle. I just won't bleed because I won't have a uterus. I can no longer get pregnant but I will still go through menopause at whatever age my endocrine system indeuces menopause.

S: Well Cara we are absolutely gonna miss you over the next few weeks on the show.

C: I'll miss you guys too.

S: And I know you're going to keep us updated. You'll let us know what you want us to tell your audience while we're waiting for you to recover. But I'm sure everyone want to know that you're doing well.

C: Yeah yeah I'll definitely let you guys know as soon as I'm aware enough to send text messages.

B: That said if you feel like it and you're kind of really loopy on narcotics. (Cara laughs) You know come on the show for just a few minutes. It'd be kind of awesome.

C: It'd be hilarious. And also for the Talk Nerdy listeners a thank you and b I did pre-record a bunch of interviews so there won't be any interruptions in Talk Nerdy. I'm gonna record all of the ads and intros here over the next couple days and get them ready so that my assistant can manage posting during the weeks that I'm recovering. So no interruptions there but I will miss everybody on SGU but I'll be back soon enough.

B: Sure.

S: Yeah. It'll go fast.

Quickie with Bob: Gamma Ray Burst (21:34)

• Gamma Ray Burst [link_URL TITLE]

News Items

S:

B:

C:

J:

E:

(laughs) (laughter) (applause) [inaudible]

Mining the Sea (24:33)

• Mining the Sea

osmolarity

Science of Pregnancy and Abortion (46:04)

• After Roe v. Wade: US researchers warn of what’s to come

More Galaxies (1:11:35)

• There are more galaxies in the Universe than even Carl Sagan ever imagined

Questions/Emails/Corrections/Follow-ups (1:21:44)

Email #1: Can Dogs Talk? ()

Before I started listening to the show, I heard about this woman who has taught her dog to speak in sentences. It played into my environmentalist and vegetarian biases, and I was totally taken in. Reviewing it again though, I think it is possible that this is a combination of facilitated communication (she takes big liberties in her interpretation of the sentences), the Clever Hans effect, and cherry picking (she probably only shares the really compelling examples, when there may be many more failures). Would love it if you could comment on the current status of communication with animals, and whether you think the Clever Hans effect is at play here. Thanks for all you do, and this is just one example of how my thinking has started to improve thanks to your work.

Sincerely,
Bart T. Cubrich

Science or Fiction (1:31:39)

Theme: Snakes Item #1: Brazil has the most number of identified snake species of any nation, currently totaling 412. Item #2: There were an estimated 1.2 million snake bite deaths in India between 2000 and 2020. Item #3: Cobras have extreme accuracy when spitting venom, able to hit there targets consistently at up to 30 feet.

Answer	Item
Fiction	Cobras' 30-foot range
Science	Brazil is most snaked
Science	1.2m snake bite deaths

Host	Result
Steve	win

Rogue	Guess
Bob	1.2m snake bite deaths
Cara	Cobras' 30-foot range

Voice-over: It's time for Science or Fiction.

Skeptical Quotes of the Week (1:41:01)

Healthy skepticism is the basis of all accurate observation.
– Arthur Conan Doyle (1859-1930), British writer

We make our world significant by the courage of our questions and the depth of our answers.
– Carl Sagan (1934-1996), American astronomer, planetary scientist, cosmologist, astrophysicist, astrobiologist, author, and science communicator

Signoff/Announcements

S: —and until next week, this is your Skeptics' Guide to the Universe.

S: Skeptics' Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information, visit us at theskepticsguide.org. Send your questions to info@theskepticsguide.org. And, if you would like to support the show and all the work that we do, go to patreon.com/SkepticsGuide and consider becoming a patron and becoming part of the SGU community. Our listeners and supporters are what make SGU possible.

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