Rodents and Red Wine with Maria Konnikova - Transcripts
Author, psychologist and professional poker player Maria Konnikova joins the show as Revisionist History’s first ombudsman. Maria advocates for the audience, reading letters from listeners and challenging Malcolm on matters great and small. They discuss how iodized salt is changing lives, the ethics of the Minnesota starvation experiments, and the ever-changing guidance around drinking alcohol. If you’d like to keep up with the most recent news from this and other Pushkin podcasts, be sure to sign up for our email list at Pushkin.fm.
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statement credit. Terms apply. We once did an episode of Revisionist History on the importance of cooking French fries in beef tallow. And now I can't take my fries any other way. And why? Because I don't like to settle for second best. And that's also the reason I love T-Mobile. T-Mobile's award-winning 5G coverage is bigger than AT&T and Verizon's combined, and their plans are packed full of incredible extras. Customers can get a value of over $225 in benefits every single month on their Max family plans. With T-Mobile, you get a great network and a great value. Find out more at t-mobile.com-slash-cy. Qualifying service and capable device required $225 based on retail value of available monthly benefits with Max.
I love that you're wearing a t-shirt that says Canada just so that we have no ambiguity
Where? Where are you right now? Are you in Las Vegas? I'm in Vegas right now, yeah. Just got back here two days ago.
Nice. Very nice. Did I tell you, you know, that I was in Las Vegas and I had an afternoon and I sat in this coffee shop and there were three people next to me having the most interesting conversation. And one of the guys started talking and I realized he was talking about you. Really? Yeah. He was a lawyer of some kind who like was a writer, lawyer or something. I don't know what I couldn't figure it out. And I was eavesdropping on a conversation for like
forever and it was like the most interesting conversation.
I love that story. No, you did not tell me and I have no idea who you're talking about. Allow me to introduce a new voice to this podcast, Maria Konikova. In basketball, they call people like Maria Swiss Army Knives, people who do everything. Maria got a PhD at the famous Walter Michelle, the guy who invented the marshmallow test. She's written a bunch of brilliant New York Times bestsellers. She decided at one point that she was interested in poker, taught herself poker, became a poker champion, made some enormous sum of money. She's the kind of person that random strangers talk about in coffee shops, which is to say my kind of person. I'm Malcolm Gladwell. You're listening to Revisionist History, my podcast about things overlooked and misunderstood. And I have the pleasure in this episode to bring you the fabulous Maria Konikova, who has agreed to become the first ever Revisionist History ombudsman or rather ombudsman. She is joining the show to be the advocate for you, dear listener, to call me on my nonsense, to be a voice of reason, to participate in the kind of whimsical meandering flights of intellectual fancy that is our trademark here at Pushkin Headquarters.
So Maria, welcome to Revisionist History. I could think of no one better equipped to speak
truth to the power that is Revisionist History. Thanks so much for having me on the show, Malcolm. I'm very excited about this. Maybe you'll change my mind. Maybe I'll change yours. But I think that the conversation is going
to be very entertaining no matter what.
Wonderful. Let's have at it. I am putty in your hands. Is that correct?
Nice putty that's responsive and that talks back.
You're driving this train. All right. Perfect. So one of the fascinating episodes of this season of Revisionist History was about the lack of iodine in people's diets and how this was discovered and how it was actually then addressed. And I actually did not know the story at all. It's such a fascinating question. How do we think about these things in the present day? Would we be able to do something like this today? Especially after COVID, after all of these things, add iodine to their salt or their water and see what happens. What do you think the response to
something like that would be? Well, it's interesting that there is a line, there's a common line of either complaint or congratulation among scientists where they say that experiment could never be done today. The Stanford prison experiment could never be done today, then the Tuskegee syphilis experiment could never be done. There's a whole long list of things. They look at that and they say, and that's because we are much more mindful of people's autonomy, much better about obtaining consent. You totally today could not go to Akron and dose up a bunch of school girls with a ton of iodine. However, my reaction to that argument is always the same, which is, yeah, but we simultaneously conduct consentless experiments on human beings in the present day that are probably way more consequential, and we don't think twice about it. You know, think about the way we have disrupted the lives of, I don't know, children over the last 25 years with all of these new technologies. How is that not a massive experiment done without the consent of those who were experimented on? How is the Facebook algorithm which, you know, shows you only the things that are likely to evoke a deeply emotional response in you? How's it not an experiment? I mean, there's a part of me that just wants to throw up my hands and say, you know, however, let's not even bother making these distinctions.
Once we've conceded that all these experiments can go on, let's just declare them experiments and let people pick and choose
the one they want to be a part of. I think there's something to that, especially because, you know, at least with the iodine, right, there was scientific evidence for the test, right? There was a reason why they did it. There was a huge body of evidence behind this, and the study was run as a study, and so there were scientific controls in place. You know, they actually could gather data, whereas with a lot of these other things, you know, it becomes a natural experiment, which is obviously, Massey has a lot of unintended consequences, and I mean, there are a lot of different questions there. I'm actually curious about flipping it around, where you have something like fluoride, right, which is another additive that's put in our water, and last year, I don't know if you were following this, but in a town in Vermont, it turned out that a town official for over a decade had been lowering fluoride levels below the accepted minimums because he thought that it was a government conspiracy, you know, fluoride in your water, bad, and he resigned, and it was a big outrage, and everyone was outraged that their water wasn't being properly fluoridated, that they actually weren't getting the numbers that they needed for dental health, cavities, et cetera. I just did think that it was such an interesting counterpoint because normally, it's, oh, don't add anything, right? I don't want anything added that I don't know about. I want natural salt. I want natural water. I want, I don't want you adding anything, you know, big pharma, big government, big, big, et cetera. And here the town was actually horrified, which I think they should have been.
I'm biased. I think there's good evidence that adding Florida to water is a good thing, that adding iodine to salt is a good thing, and that when things are good for our health, and we're not going to get them in any other way, that this is a great way of doing it. But a lot
of people disagree. Well, I wonder if that... Are they responding to the Florida, they're responding to what they see as the official abusing his position. Maybe it's a bit of both, or you could see people who might ordinarily be indifferent to fluoride just getting pissed off over this issue. This guy's like, you're not allowed to do that, sir. Hold on, hold on. It's time for a short break. When we come back, we'll talk more about how salt and revisionist history are changing lives, and also the infamous Minnesota Starvation study. Whether you need it for work, school, or a special project, it's important to have the right printer. The Epson EcoTank is a new type of printer that doesn't use cartridges. Stop buying expensive ink cartridges and save yourself the frustration of replacing ink cartridges ever again. The Epson EcoTank printers have supersized, easy to fill ink tanks and come with a ridiculous amount of ink.
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exclusions apply. So let's read a letter about someone from someone who I actually I love this letter. I just saw it today. And it is a very positive take on additions to food. And someone who says that the salt episode actually really changed their life. So this is from Mary P. And she writes that it was a crazy awesome coincidence that I was listening to this episode around the same time my doctor felt a nodule on my thyroid. He told me to go get an ultrasound and my thyroid and nodule both were large enough and suspicious enough that it was recommended automatically that I get a biopsy. So she went for her first biopsy and the results came back and conclusive. And I'm going to continue reading her letter. They sent another slide for genetic testing. Meanwhile, I bought some iodized salt and started cooking with it.
I had switched to kosher salt and other fancy salts over the past few years. And I'm an avid at home cook. We also live in the Midwest. I used iodized salt in moderation, of course, and thought nothing more of it. Well, I went back for my biopsy and they took new ultrasound images of my thyroid. This was about two to three months after my original ultrasounds and biopsies. The ultrasound tech was asking me many questions and seemed confused but kept to himself. The doctor came in and told me to sit up. My nodules and thyroids had all shrunk. My once one centimeter nodule was now around five millimeters. He had no reason to biopsy because there was nothing of concern. In fact, he would not biopsy it.
No surgery, just a follow-up scan in a year. Hallelujah. I told him my theory about the iodine and he said that very well could have been what shrunk everything. I asked if the cancer could be in there just smaller. He scoffed at me and said no. What
a great letter. For all of those who doubt the healing power of revisionist history, I present you this letter. We don't just rile up our listeners. We save lives. This is
a resounding endorsement of eight years of revisionist history. Those types of coincidences are great that you hear something and it actually has such an impact. That would have been a life-changing thing for her to have no thyroid function, half her thyroid function for the rest
of her life. That's a huge thing. Yeah. It's a reminder. This is one of these weird things. A hundred years ago, what she's describing was commonplace. In fact, this is a little fact in that episode that I can never get over my head is if you went to parts of the world that were iodine deficient, some extraordinarily high percentage of the population had these massive goiters on their neck. That was just part of the experience of going to the Swiss Alps or part of the experience of going to somewhere around the Great Lakes, was you'd walk into a small town and whatever, a quarter of the people had big grapefruit-sized commonplace masses on their necks.
Hex. Hex. It's just so strange. It's crazy how little we still know about nutrition. Nutrition is complicated. I think that's one of the reasons why people still have so many questions, so many issues, why we go back and forth with nutritional advice because the body is a complex thing. It's a complex machine. It's very difficult oftentimes to know this is the
recommendation and it will always be the recommendation. Also, it's hard. This is sort of what brings us to the MESA starvation experiment, which I'm sure we're going to talk about, but one of the big impedances for that is that one of the reasons we know so little about nutrition is that it's impossible to test hypotheses about nutrition because how do you do it? If you think about something as simple as, does drinking alcohol harm or help your health? That's a question that's been irrelevant for as long as human beings have drunk alcohol, so thousands and thousands and thousands of years. We're still arguing about that, and the reason we're still arguing about it is it's virtually impossible to design a study which would satisfactorily answer that question. There have been studies which say people who drink wine in moderation seem to live long, healthy lives, but the problem is that people who drink wine in moderation are people who otherwise live moderate, healthy lives, right? They're like, they're villagers in the south of Italy who are getting an enormous amount of exercise and living in bucolic surroundings. So you just don't know, are they living long, happy lives in spite of their wine consumption or because of it, right? Someone's saying, you know, you see these, so you can read, it's just incredibly, I just read the other day, like there's a new line of thinking which says, you know, all alcohol is basically like really bad for you and should be avoided. I saw that. I have no idea what to make of that.
Like, I don't even know, how do they make that conclusion? It's just that, that idea that we could be in 2023 and still being capable of
answering these questions with any degree of accuracy is fascinating to me. I have no idea what to make of that. Yeah, it's totally crazy. It's so funny that you, that you mentioned red wine, which is, you know, or alcohol in general, the first one of the first studies I ever worked on as a journalist who kind of is interested in these questions forever ago was on resveratrol. When it first came out, like the data that, oh my God, resveratrol makes you live longer. And everyone was saying, great, drink red wine. It's amazing. Then a few years later, we find out that the quantity of resveratrol you need is just so much higher than you would ever get. And it goes back and forth. And I've seen that one question just go in circles for, you know,
almost 20 years now. And we, we just have no idea. Do you remember? Was it, was it, were they,
were they giving rats large doses of? Yes. Oh, that was the thing. Yes. Oh, that was the thing.
Exactly. That was exactly it. It was rodents. Rodents said red wine. So the only, the only thing we can say for certain is that within the rat population, those who enjoy a good bottle
of wine every night are going to live a little longer. So I think that this is a good, a good segue point. You know, people who were not drinking any wine were taking part in the starvation study that was part of this, this season of revisionist history. So, I mean, first of all, that study, let's just kind of recap it very quickly. I mean, we're talking actual starvation, like the number of calories that these men, so it was all men, right? It was all young, relatively healthy men who were, for one reason or another, not in the military, not serving abroad during World War II. And they were all, you know, brought to this place to try to control, because as we've just talked about, it's really difficult to control food intake, to try to control it as much as possible, to try to do their part for the war effort, to see how starvation affects the body. Is that a fair summary?
Yes. Yes. Yes. Yes, exactly. Because the only thing I want to add is the impetus was, this was in the middle of the war, and the feeling was that by the end of the war, one of the biggest problems the world was going to face was that millions of people around the world were, had suffered prolonged malnutrition throughout the conflict, and we didn't know how to help them. We honestly had no idea, if someone has been malnourished for a year and a half, what is the best way to nurse them back to health? And literally, people at the time didn't emphasize a clue, right? So they were trying to answer that question with some, or at least get some information about that. So the stakes here were huge. That's what gives
the study its kind of moral force. So that's an interesting question, right? Does the study have the necessary moral force to do something like this? Because back in the day, back when this study was done, World War II, we didn't have the sort of reviews on studies that we have today. So these days, you need to go through an IRB, which is an institutional review board, when you're doing any sort of human research, and you need to have every single subject give informed consent. And, and this is crucial, the benefits of this specific study have to outweigh any potential harm to the participants in the study. And so to me, when I listened to kind of the details of the starvation experiment, I knew that it existed, but I actually didn't, I'd never actually kind of gone deep into it. This was the most I'd learned about it was from you. And as I was listening, I was trying to think, you know, first of all, benefits versus harm, you know, how do we think about that? And I think that's actually changed over the years. The second part of it is, how do you actually give informed consent of all the potential downsides to something like this, when you're researching something where you don't
actually know what the potential downsides are? Well, it's like space flight. You're sending an astronaut to the moon. Presumably you pull the astronaut aside beforehand and you say, the benefit here is mankind will be able to say we went to the moon. But you know, in that situation, the first astronaut in space, we don't know what it's like to be out for a couple weeks in zero gravity. So I don't know, how did they do consent? I guess they said, you're taking a risk of unknown quantity. You might be damaged by what you're doing. Are you fine with that? And I think the answer they were fine with it is that many of those astronauts came out of the military. And so they were used to the idea that they were called to do something on behalf of their country, which carried with it a significant risk of illness and death.
I think that's an interesting example, but it's not a complete analogy because this was their profession, right? This was their career. This is what they had signed up for. They became astronauts with the knowledge that they would hopefully be able to go into space one day. Whereas these study participants were just ordinary men who were called upon by their patriotic feelings and said, do you want to do your patriotic duty? That's a lot of pressure and that's not your life. This is not something that's your career. You're being asked to do
something that's just totally out of the ordinary. Wait, are you a Minnesota starvation experiment
skeptic? Do you not think it should have been done? No, I'm someone who wants to push back though, and to question how it was done and whether they could potentially have ever given informed consent to something like this, especially given what we know now about the longitudinal long-term effects about starvation. Back then, the term epigenetic, I don't think even existed. People did not know kind of what the interaction of genes and environment is. Today, we actually know that starvation has lifelong consequences. They actually change the methylation patterns of your genes, of your genome, and that there's actually a lot of damage that is going to be done for your entire life. The funny thing is a lot of the data, the best data that we have on this didn't come from the starvation experiment, but actually happened from a natural experiment that came at the exact same time more or less contemporaneous, which was basically the Dutch hunger winter. This was also during World War II, and there was a huge famine in the Netherlands because there was a blockade by the Nazis, and thousands of people died. I think something like 20,000 people ended up dying. But at the same time, there were a bunch of women who were pregnant, and doctors were taking all of the measurements that you would normally take during pregnancy, but these women happened to be starving. Then they ended up following the women and the babies for their lives and actually got an amazing amount of data on what starvation does to the body.
In that instance, what does it do? Well, we're still finding out. There are lots of things that end up happening later in life. You're more prone to gain weight because your body is prepared for starvation and has been prepared for in utero. It also ends up affecting the way that your kids are going to develop. So if you were, I guess, a fetus during this time, then by the time that you're an adult, when you have your own kids, you're actually going to pass a lot of these epigenetic changes further on to them. There are also going to be effects on how you're going to just think and do in life. It turns out that there are labor market effects, hospitalization effects. So it actually puts you down a notch, but this is once again, we're talking about the people who were fetuses during this time, which is very different from the starvation study. But it ends up having a lot of downstream effects and those studies are still being done. So there's a new paper at least once every few years using this cohort, which shows that there are lots of things that you didn't know you were signing up for if you thought that this was just going to be an easy, I starve myself completely and then I'm all better. And this will never actually follow me throughout life.
And it's interesting to me that I think some of our best data comes from a natural experiment as opposed to something
where a bunch of men said, okay, starve me, and let's see what happens this time with me. So imagine that we were doing a version of the Dutch starvation thing involving pregnant women,
but it was an experiment, right? All right, magic wand.
This is definitely a magic wand. This is definitely a magic wand. And what we learned from that is that actually starving people when they're pregnant has incredible, unanticipated long-term consequences, not just for the mother, but for the child. And would even maybe for the child's children? Child's children. Yeah. Child's children. Yeah, absolutely. So in other words, and we had no idea of this before, so this is a earth-shattering, huge bit of understanding about human beings. Why wouldn't this be an argument, why wouldn't the magnitude of what we learned from that such an experiment be an argument for doing the experiment? It's so important that hundreds, thousands, millions more people could be helped from the knowledge gleaned from that experiment than those who were harmed by it. And if the people who signed up for that experiment had at least a kind of reasonable suspicion that what was learned from them putting themselves at risk might help many, many, many, many, many more people, then to my mind, that settles it.
It's fine. I mean, this is what I was trying to get to in the podcast is that we're so indifferent to people who have altruistic motives. Where is the altruistic motive data point in the consent algorithm? You should be able to say, I know it's going to harm me, but I think it's going to help
a lot more people, and I'm fine with that. Yeah. So like I said, when you asked me, am I a skeptic of this? I said, I'm not necessarily someone who said this shouldn't have happened. I just think that there are lots of issues to consider. So yeah, there is this. There's definitely an argument to be made that what we learned from Dutch famine shows that studies like this are incredibly important. But in this particular case, I think in the pregnancy case, you're also giving consent for your fetus. So it's one of these things where that's, even if you're an altruist, I think that that would be a very strange definition of altruism, because you're being altruistic for the world, but not for this one specific human who has no
say in this whatsoever. But I would say this, like, so for much of human history, continuing to the present day, a large percentage of the world's population suffers from prolonged malnutrition, right? Absolutely. So one really important historical question is, what can we do to convince the wealthier parts of the world that this is such an urgent problem that it needs to be addressed immediately, right? Wouldn't it make sense to try an extreme experiment of this sort to try and bring the world around?
Absolutely. Yeah. I mean, I think that's a very valid point. And you actually had a letter from a listener, Robert A., who asked a question that kind of circles around what we've been talking about. He asks, who is responsible for a system which both restricts voluntary breakthrough research like that conducted by Ansel Keys, and the conscientious objectors, and that which fails to take accountability when mistakes are made? So that's, I think, an interesting question, because you do have those two sides of it. So we do have a system that now does restrict that kind of breakthrough research quite often. I mean, when I was in grad school for psychology, and I needed to do an experiment that had deception, I just, I couldn't get it approved. I had to jump through so many hoops. And eventually, you know, with the support of all the senior faculty in the psychology department, it was just a silly thing. It wasn't even a major deception study, but we needed, we couldn't tell them that we were studying self-control, right? Because that would actually have defeated the purpose of the entire study, and how many studies are not done because of that.
So that's kind of the one side of it. But on the other hand, there's a reason for all of these safeguards, because you have things like the Stanford person experiment, right? You have things like Tuskegee, you have things that really cross the line without informed consent, with deception, with a lack of understanding of what was going to happen. I mean, one nutrition study that was done that was done, I don't know if you remember this one, but it was done in Washington on some young men who were working, you know, around DC at the time. And they were basically, they agreed to be poisoned. They went to the congressional cafeteria and their diet was very strictly controlled. And they were just trying to figure out how different food additives work. And some of them got incredibly sick, because it turns out that they were eating very toxic amounts of things they should not have been eating. So that was a study gone a bit off the rails when it comes to nutrition. But so you have those two extremes. And how do you weigh that? How do you balance that?
How do you, not in retrospect, where we can say, okay, you know, this is what we learned from this study, and it was really good. But before it happens, how do we think about that?
How do we kind of, how do we walk that line? Yeah. Yeah. I will say that there is, there is one area on this where I am, I'm the, you know, I've been talking so far about how I, I would, I tend to be pretty lazy, fair about giving researchers the freedom to do things that are a little bit risky or, um, um, there's another area though, where I'm on the exact opposite side of the fence. And what am I referring to? Patience Grasshopper. When we come back, more from my conversation with Maria Konikova. Whether you need it for work, school, or a special project, it's important to have the right printer. The Epson EcoTank is a new type of printer that doesn't use cartridges. Stop buying expensive ink cartridges and save yourself the frustration of replacing ink cartridges ever again. The Epson EcoTank printers have supersized easy to fill ink tanks and come with a ridiculous amount of ink. With the Epson EcoTank, you don't have to worry about running out of ink, so start printing in color.
Kiss expensive cartridges goodbye. Get yours today because EcoTank is changing the way people print. EcoTank makes it easy, so make the switch. Add EcoTank to your online shopping list so you can just fill and chill. Epson EcoTank printers, available at participating retailers and at epson.com. We all know the feeling of finding yourself stuck on the side of the road, struggling to get your vehicle running before work, or feeling a vehicle halt to a stop on a speeding highway. It's at this moment that your heart stops and the panic sets in, but now you can avoid all those pains by getting your vehicle the parts it needs before that breakdown oh no moment. With eBay guaranteed fit and over 122 million parts and accessories for your vehicle right at your fingertips, you can make sure your ride stays running smoothly. Air filters, brakes, batteries, taillights, alternators, shocks, struts, you name it, eBay Motors has it. And they'll make sure it's the right fit for your car. Whether you're cruising in a minivan, an SUV, a roadster, or a brand new shining sedan, stressing over what part to get, or which will be the one your vehicle actually needs, will never be part of your ride. Because eBay guaranteed fit helps you understand exactly what part you need for your vehicle the first time.
From which shock and strut assembly will keep your truck running smooth, to which air filter will keep your roadster breathing clean, or which battery is going to power that minivan for a morning drop off. You'll never be left in the dark. Speaking of dark, they even have headlights. So go forth, switch gears, enjoy that wind in your hair, crank the AC, put your favorite song on blast, and say goodbye to sweating if your ride needs a little fixing up. Because now you know you'll always be set up for success from the get-go. With eBay guaranteed fit, everything your vehicle is calling for is just a click away. For the parts and accessories that fit your vehicle, just look for the green check. Get the right parts, the right fit, and the right prices at ebaymotors.com. Let's ride. Eligible items only, exclusions apply. We're back, and I was telling Maria that I'm pretty laissez-faire about letting experiments go forward. Except in the case of what might be the most awful natural experiment we're living through right now.
I am incredulous at the idea that thousands of pages of text and hours of argumentation is spent on the ethics of one medical experiment or another. And at the same time, we are, you know, completely indifferent or cavalier about the levels of violence that are present in media every day. Now, there had been moments, every now and again periodically, there are moments where various interest groups get upset about depictions of violence on television. It was a big deal, I think, in the 70s, for example, and then it sort of went away. And then the people who were complained about this got painted as kind of buffoons or as naive sewer in the middle of nowhere. And, you know, I don't want to give it away, but I had in the course of, you know, there had been moments, an episode of I'm doing in this upcoming season where I have these long conversations with trauma surgeons who deal with gunshot wounds. And what they have to say on this very specific matter is incredibly interesting and disturbing. They're not like hotting their head in the sand about this. They're fully aware of it. The people who are, who have a, I believe, a morally objectionable position are the people in Hollywood, many of whom are self-described liberals who will go on and on and on about the, you know, the terrible need for gun control in America and how outrageous all the Second Amendment people is. And meanwhile, they're making movies where like 20 people are slaughtered in the first 15 minutes. Like, I'm sorry, this is just like completely incomprehensible behavior, right?
This drives me nuts. Behavior. Yeah. I know that there's a lot to be said for that. It's like we've never outlived the instinct for public executions, right? Where everyone would come to the town square. That instinct is still alive and well. It's an important tangent to go on. And it is kind of related to everything we've been talking about, about how do you study this? You know, what are the benefits? What are the harms? And there's, you know, so kind of coming full circle back to the starvation experiment, there is one thing that we haven't talked about, which was an important point that one of the listeners brought up.
And this is an important point about a lot of the research, not from that day, but that continues to be done to this day, which is how generalizable are the results to the segments of the population that might actually benefit most from it. So Mora, this listener wrote, how can we treat eating disorder patients, primarily young women, using data collected exclusively on white men? How can we use this to study the impact of dieting and weight loss when dieting is more prevalent and pressured upon among women? How can we use this to study obesity when non-Hispanic black adults and Hispanic adults have the highest prevalence of obesity in the United States? That's the end of her letter, but I would just go on and on when we're talking about malnourishment and we realize that most of the malnourished population of the world is not white men. So that is kind of an interesting side note. And this is actually still a huge problem. That's not something that we left behind in the forties. To this day, most medical data comes from men, not women. And it's a very kind of, that's an interesting way of looking at, you know, what are the actual benefits from this to the
people who need them and how generalizable is it? If you're trying to develop actionable policies and guidelines and approaches to effective populations, it absolutely does matter. And, you know, we went through this with, I think, with our understanding of heart attacks, right? Where we started off testing a lot of these hypotheses in men, white men, and that's how we got our baseline knowledge. But then we tried to use that information to kind of understand how to deal with women without realizing that the biology of a lot of these problems, physiology of a lot of these problems in women is very different. So I think it depends where you are in the kind of stage that you're at. And the mistake we make, I think, is we don't honor this distinction between kind of basic understanding and actionable research. If you talk to somebody who works for a pharmaceutical company and is involved in drug trials, you know, they will talk your ear off on this. And what they will say is, do you know how hard it is to put together a study population? It's insanely difficult to find someone. I actually thought of, I was going to volunteer for a trial about Lyme disease vaccine. And then I had that I, the first thing to do is you have a half an hour conversation with someone, and they detail that I would have to go drive to Albany an hour away, seven times, and have to set aside half a day on each of those occasions.
And I wasn't clear whether I'd be part of the treatment group or the placebo group, right? So I listened to that. I was like, I'm not, I can't do that. I'm not taking, you know, somewhat selfishly, I decided I don't have that much time to devote to this. So I'll let someone else carry the burden. So it's like, it's really hard to do these studies. So when you, if we say these studies have to be perfectly representative, you're just making it less likely that the study gets done in the first place at a certain point, right? So that's the trade-off. It's an impossible trade-off.
Yeah, sure. No, I think there's a lot of truth to that. That said, I do think that even baseline knowledge studies these days should at least include women because, you know, if you're omitting more than half the population and the basic biology is different, then-
But you couldn't have done the starvation experiment with women.
With women. So that's the other thing, right? What are we proposing in the starvation case? Do we want women there and Hispanic and Black, where it's much more difficult to actually obtain consent, because especially back then, but even to this day, you know, these are populations that have had a lot of negative research done without consent. And it's actually much more difficult, I would say, and the burden of proof is much higher to ask for consent from vulnerable population. Yeah. Yeah. Population.
But you can't do a starvation experiment like that in Minnesota on young women, because if it has consequences for their fertility, then you have- Yes. So what are you going to see? And it does. So are we going to use post-menopausal women only? But that brings up a whole different set of issues, because now you have an older population that's going to be less susceptible to whatever risks you're exposing them to. It's tricky. This reminds me, we talk in the season about magic wands, experiments we could do if we could wave a magic wand. This one doesn't actually require a magic wand, although it would be very hard to do in the real world. But- Yes, and it does. You mentioned that natural experiment in Holland, which gave us information that would have been almost impossible to get otherwise in a formal experiment. And it goes to the larger point that this is the great thing about natural experiments, is that when you can find a good one, they almost invariably tell you stuff that you could never find another one. They're incredibly productive kind of experiment.
So why can't we engineer natural experiments? So imagine this. Imagine if someone came to you and me, and a million other people, and said, we're at the stage now in technology where we can put little sensors on you, which can continuously monitor every one of your physiological signs and vital signs in real time. Would you agree to be basically monitored for the next, whatever, 10 years? 10 years. And you and 2 million or 10 million other people agree to be part of this. And we will simply wait and see what happens to you, and use that massive dataset to kind of improve our understanding of the kinds of things that lead to various sorts of diseases. I mean, if you had 10 million people, and they were giving you 10 years of their life, and every conceivable indicator and vital sign was being monitored on a moment to moment basis, you would be able to understand stuff that right now we have no clue about, right? And all it takes is for people just, they don't even take in a risk. They're just being willing to be monitored and donate their data. That's essentially engineering a natural experiment. I don't understand why that hasn't been done.
Privacy. I know, but who cares? Do you want to get me started on privacy? Privacy tries me just nuts. It's like, what an absurd thing in this day and age to be concerned about. Basically, as far as I can tell, every single fact about Malcolm Gladwell is known by some combination
of Facebook, Apple, Google, and someone else. I meant to ask Malcolm, what is your mother's
maiden name? I just have a few more questions before we wrap up. I know, it's like a ludicrous. And so it's fine for those guys to scour the internet and put together massive dossiers of every fact about me. But somehow if I want to allow someone to peek into my physiological, for the benefit of mankind, that's a problem. It just drives me crazy.
It is a problem, and I didn't know that I had hit a nerve with that one word privacy, but here we are. So that, I think, is a nice place to wrap up our starvation study, except for one final question. One listener was really fascinated by the cinnamon roll recipe from the episode of the starvation study. Tara A., she said, thank you for these episodes, Malcolm. So Malcolm, thank you for these episodes. Any chance you know how we could track down that cinnamon roll recipe? I was thinking it would be nice to make some and share in my community. And for a refresher for listeners who don't love cinnamon rolls as much as I do, so didn't immediately light up at this detail. So there was a character in the episode, Lester Glick, who was part of the study. And one of the things that mentally fortified him, although I think for me it would have probably had the opposite effect, is he carried around a picture of a cinnamon
roll, and he had it with him always, and it was something that kept him going. And then later he would, for the rest of his life, he would make them obsessively for family and friends by the
dozens. It was the defining, one of the defining acts of the rest of his life. Now, I love cinnamon
rolls, so I also wanted to track down that recipe. We will post it online and all those brave souls who want to recreate the famous cinnamon rolls can do that. That was fun. Thank you, Maria. That's really fun. Of course. Thank you. Bye-bye. Maria, Maria, Maria, thank you so much for going to take on the role of revisionist history's inaugural mambas person. Just so all of you know, we hope to make Maria a regular on this show in the future. You may have thought she went easy on me this time. Let me just say I have no expectation that will ever happen again.
Oh, if you're wondering why I said it takes bravery to make the cinnamon rolls, let's just say the recipe involves, among other things, mashed potatoes. Go to our website and see for yourself, and thank you to the Glick family for sharing that with us. Maria will be back soon, so send your questions, your challenges, your gripes, and your stories to all of us at revisionisthistory.com. Revisionist history is produced by Lee Mingestu, Amy Gaines, Kiara Powell, and Jacob Smith. Our showrunner is Peter Clowney, original scoring by Luis Guerra, mastering by Sarah Bruguire, and engineering by Nina Lawrence, fact checking by Kechel Williams. Special thanks to Julia Barton. Subscribe to Pushkin Plus to hear all our episodes of Revisionist History ad-free, and as of this year, get our shows two weeks earlier than the rest of the world. I'm Malcolm
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