The John P. McGovern Lecture: Learning from polio: A journey into publishing with Hannah Wunsch, MD, MSc

Transcript

• 00:00Okay. Alright. Good afternoon, everybody.
• 00:03I'm Anna Reisman,
• 00:04director of the program for
• 00:05medical humanities.
• 00:07And I am pleased to
• 00:08welcome you to the
• 00:10annual John p McGovern lecture.
• 00:14And this is this talk
• 00:15is supported by the McGovern
• 00:17Fund for the Humanities in
• 00:18Medicine.
• 00:19John McGovern was a Texas
• 00:21based medical humanist,
• 00:23allergist, investor, and philanthropist
• 00:25who established several lectures bearing
• 00:27his name at medical schools
• 00:28throughout the country.
• 00:29And this particular
• 00:31lectureship is given annually to
• 00:33a physician who demonstrates the
• 00:34true healing art,
• 00:36being a scientist and a
• 00:37humanist, a knowledgeable, humane, and
• 00:39caring physician.
• 00:42So we are happy to
• 00:43bestow this award upon doctor
• 00:45Hannah Wunsch, who is all
• 00:46of these things and who
• 00:47we are thrilled to welcome
• 00:48to Yale School of Medicine.
• 00:51Doctor Wunsch is a physician
• 00:52and writer and playwright in
• 00:53New York City. She's a
• 00:55distinguished professor
• 00:56and vice chair for research
• 00:57in the department of anesthesiology
• 00:59at Weill Cornell.
• 01:01She grew up in Cambridge,
• 01:02Mass, attended Harvard, received a
• 01:04master's degree in epidemiology
• 01:05from the London School of
• 01:06Hygiene and Tropical Medicine, and
• 01:08an MD from Washington University.
• 01:12She completed training in anesthesia
• 01:14and critical care at Columbia
• 01:15and holds a master's degree,
• 01:17as I already said, in
• 01:18epidemiology
• 01:20and was on the Columbia
• 01:21faculty for six years after
• 01:24residency and fellowship. Then she
• 01:25was at the University of
• 01:26Toronto,
• 01:27back to New York, and
• 01:28has been at Weill Cornell,
• 01:30for a few years.
• 01:32Her research focuses on the
• 01:33delivery and outcomes of critical
• 01:34care using large scale databases
• 01:37to examine the organization of
• 01:38intensive care units and the
• 01:40management of critically ill patients.
• 01:42Her writing has appeared in
• 01:44Time, The Globe and Mail,
• 01:46the literary review of Canada,
• 01:48and many other places.
• 01:50And she is the author
• 01:51of the book that you
• 01:52will hear a lot about
• 01:53today called The Autumn Ghost,
• 01:54How the Battle Against polio
• 01:56epidemic revolutionized
• 01:58modern medical care.
• 01:59Welcome.
• 02:06Thanks so much. Thanks for
• 02:08coming out at five o'clock
• 02:10on a cold day. Really
• 02:11appreciate it, and I'm really
• 02:13thrilled to have the opportunity
• 02:15to talk to you all.
• 02:16And
• 02:18I've entitled this talk learning
• 02:19from polio, a journey into
• 02:21publishing.
• 02:22And really what I wanna
• 02:23do with it is share
• 02:24with you very briefly a
• 02:26bit about the story of
• 02:27the book so you kind
• 02:28of have the gist of
• 02:28it,
• 02:30but also to kind of
• 02:31dive into
• 02:32some of the challenges and
• 02:34learning points that I had
• 02:36along the way
• 02:37of trying to dive in
• 02:38and write a book.
• 02:40And I can tell you
• 02:41I didn't have much of
• 02:42a background in writing when
• 02:43I did this and sort
• 02:44of took a leap of
• 02:45faith that I was gonna
• 02:47figure out how to tell
• 02:48the story I wanted to
• 02:49tell,
• 02:50and so gonna kind of
• 02:51share with you
• 02:54a bit of that. So
• 02:55I first learned about the
• 02:56story that I ended up
• 02:57writing about in this book,
• 02:58the rise and fall of
• 02:59modern medicine by James Le
• 03:00Fanu. And I read this
• 03:02book twenty five years ago
• 03:03when I was doing my
• 03:04master's degree, and each chapter
• 03:06is a different episode in
• 03:07medical history in the twentieth
• 03:09century.
• 03:09So Banting and Best in
• 03:10discovery of penicillin sorry. I've
• 03:12discovered insulin,
• 03:14Alexander Fleming, discovery of penicillin.
• 03:16And then there was this
• 03:18one short chapter
• 03:20about a polio epidemic in
• 03:21Copenhagen
• 03:22in nineteen fifty two and
• 03:23how important it was for
• 03:25the development
• 03:26of,
• 03:27ventilation intensive care, which became
• 03:29my specialty.
• 03:30And so this story stayed
• 03:32with me,
• 03:33and I felt like I
• 03:35just wanted to share this
• 03:36story more widely than was
• 03:38available in this short chapter.
• 03:40And I found that even
• 03:41people in my own specialty
• 03:42didn't know about this sort
• 03:44of origin story.
• 03:46And so one of the
• 03:47things that I did before
• 03:49starting to write was think,
• 03:50okay, what sort of book
• 03:52am I trying to write?
• 03:53I knew I wanted to
• 03:53write for the general public.
• 03:54I didn't want it to
• 03:55be an academic book just
• 03:56for
• 03:57people in my field. I
• 03:59wanted to reach a wider
• 04:00audience. And so, people often
• 04:02ask me sort of like
• 04:03what what are your influences?
• 04:04And so I just threw
• 04:05up here a bunch of
• 04:06the the books that did
• 04:07influence me. I spent a
• 04:08lot of time reading a
• 04:09lot of narrative nonfiction.
• 04:12You can see not all
• 04:13of them are in medicine
• 04:14or science, but really all
• 04:16of them are incredible writers
• 04:18who are able to just
• 04:20take, to to be honest,
• 04:21any topic and make it
• 04:23incredibly exciting and fun to
• 04:25read.
• 04:26And so I learned a
• 04:27lot from reading those books
• 04:28before I even started.
• 04:30Then I had to do
• 04:31the research for the book
• 04:32itself,
• 04:34and
• 04:35this is gonna sound maybe
• 04:37really, really obvious,
• 04:39but it actually was something
• 04:40that kind of took me
• 04:41back when I realized it
• 04:43kind of in detail, which
• 04:45was that anything I wrote
• 04:46had to be backed up
• 04:47by a reference. Now that's
• 04:49easy to do when you're
• 04:50writing, like, a medical paper
• 04:51because you kind of state
• 04:52a fact and then you
• 04:53reference the paper. Right? That
• 04:55kind of has that fact
• 04:56in it.
• 04:57But, of course, when you're
• 04:58trying to write something that's
• 05:00narrative and nonfiction,
• 05:02that means that you're trying
• 05:03to really make it a
• 05:04story. And to make it
• 05:04a story is to have
• 05:05a level of detail
• 05:07and sort of humanity in
• 05:08it
• 05:09that becomes a lot harder
• 05:11that you wanna kind of
• 05:12describe. Was someone happy or
• 05:14sad? Were they smiling? What
• 05:15do they even look like?
• 05:17And you realize that in
• 05:18order to do that, you
• 05:19can't make it up. Right?
• 05:20You can't say, oh, it
• 05:22was a stormy day out.
• 05:23You've actually got to go
• 05:24back to the archives
• 05:25and figure out what sort
• 05:26of day it was. And
• 05:28so the work to learn
• 05:30about this story really took
• 05:31me through a huge range
• 05:33of different
• 05:34types of research and starting
• 05:36with the kind of standard
• 05:37academic papers, articles, and books,
• 05:39but then very quickly moving
• 05:40on to things like newspapers,
• 05:41films, photos, other archival material,
• 05:44interviews, personal papers, personal photos.
• 05:47So the story, as I
• 05:48mentioned, is about polio, and
• 05:51first thing I had to
• 05:52do was learn about polio.
• 05:53I don't know about you.
• 05:54We didn't really get any
• 05:55teaching about it in medical
• 05:56school that may be changing
• 05:57now as people are worried
• 05:59about it coming back. But
• 06:00for me, my entire exposure
• 06:02to polio was really one
• 06:03family friend,
• 06:05of my parents growing up
• 06:06who was in a wheelchair.
• 06:07And it was explained to
• 06:08me this person had had
• 06:09polio.
• 06:10And I think for a
• 06:10lot of people it's learning
• 06:12about Roosevelt in school, that
• 06:14FDR
• 06:15probably most likely had polio.
• 06:17Some people think he had
• 06:18Guillain Barre syndrome,
• 06:19but, you know, it's taught
• 06:21that he had polio, was
• 06:22in a wheelchair.
• 06:23And then, actually, I read
• 06:24this book, which I recommend,
• 06:25whatever you think about Philip
• 06:27Roth. This is a great
• 06:28book about a polio epidemic
• 06:30in the nineteen forties. It's
• 06:31fiction,
• 06:32but it really captures the
• 06:34sort of the fear around
• 06:35this disease.
• 06:37And so just as a
• 06:37quick primer for anyone who's
• 06:39hasn't thought about polio at
• 06:40all, it is an enterovirus,
• 06:42meaning it's oral fecal transmission.
• 06:45And it's actually a lot
• 06:46like COVID in that most
• 06:47people who get exposed to
• 06:48it are asymptomatic and just
• 06:50pass it on.
• 06:51But for a small portion,
• 06:52they get a lot of
• 06:53those sort of nonspecific symptoms
• 06:55of illness there on the
• 06:56left. And for a tiny
• 06:57portion of less than five
• 06:59percent,
• 06:59they will develop paralysis where
• 07:01the virus goes from the
• 07:03gut into the bloodstream and
• 07:04then attacks the nerves that
• 07:06control
• 07:07generally the muscles for walking,
• 07:10for moving arms and such.
• 07:11And so you would see
• 07:12pictures of children with braces
• 07:14and wheelchairs, things like that.
• 07:16But there was also paralysis
• 07:18that could affect people's breathing,
• 07:20respiratory paralysis. And this came
• 07:22in two forms.
• 07:23One was spinal where it
• 07:25just attacked the muscles that
• 07:26control the ability for you
• 07:27to take a breath in,
• 07:28you know, in the chest
• 07:29wall.
• 07:30And then also it was
• 07:31called bulbar polio.
• 07:33And bulbar polio was when
• 07:34it attacked the brain stem.
• 07:35And so people couldn't swallow
• 07:37or cough and they would
• 07:38literally drown in their secretions.
• 07:40And early in the twentieth
• 07:42century, both forms of respiratory
• 07:44paralysis from polio were equally
• 07:46deadly, about ninety percent mortality.
• 07:48And I'm gonna kind of
• 07:49fast forward a little bit
• 07:51through this story so I
• 07:52can actually talk about the
• 07:53kind of the the research
• 07:54and writing more.
• 07:56But this changed in nineteen
• 07:57twenty eight when the iron
• 07:59lung got invented. And it's
• 08:00actually this really seminal moment
• 08:02in kind of humanity in
• 08:04that this is the very
• 08:05first time that humans become
• 08:08dependent
• 08:09on machines for life,
• 08:11nineteen twenty eight.
• 08:13And in case you've never
• 08:14thought about the iron lung,
• 08:15it's what's called negative pressure
• 08:17ventilation.
• 08:18It seals someone in, and
• 08:20then they suck the air
• 08:21out of that giant tube,
• 08:23which causes the chest wall
• 08:24to expand.
• 08:25The air rushes in,
• 08:27into the lungs to take
• 08:28up that space, and someone
• 08:30takes a breath and then
• 08:31they exhale.
• 08:33Incredibly
• 08:34useful for spinal paralysis.
• 08:36But as you might imagine,
• 08:37if you've got secretions pulled
• 08:39in the back of your
• 08:39throat with bulbar polio and
• 08:41you get put in an
• 08:42iron lung, what does that
• 08:43do? It sucks those secretions
• 08:44down into your lungs. So
• 08:45you end up with pneumonia,
• 08:47you end up with,
• 08:48you know, kind of,
• 08:50blockages of your airways and
• 08:51people still died. So there
• 08:52was still a ninety percent
• 08:54mortality
• 08:55from bulbar polio, but this
• 08:57was revolutionary
• 08:58for caring for patients who
• 08:59had spinal paralysis.
• 09:02So the story that I
• 09:03ended up telling took place
• 09:05at the Blyde Am Hospital
• 09:06in Copenhagen
• 09:07in nineteen fifty two, and
• 09:08this was the infectious disease
• 09:10hospital for the city.
• 09:11And there in the hospital,
• 09:13a man named Henry Kai
• 09:14Alexander Lawson was the head
• 09:15of the hospital,
• 09:17and he was a world
• 09:18expert on polio even though
• 09:19they'd never had a major
• 09:20epidemic.
• 09:21And they had one iron
• 09:23lung and a few other
• 09:24sort of,
• 09:26kind of minimal support, something
• 09:27called a cuirass respirators.
• 09:29But that was all they
• 09:30really needed until July and
• 09:32August of nineteen fifty two
• 09:34when this started to happen.
• 09:35They started seeing fifty cases
• 09:37a day coming in, ten
• 09:39to twelve per day with
• 09:40respiratory failure, and, crucially,
• 09:42those were vast majority of
• 09:44them had bulbar polio.
• 09:46So they only had one
• 09:47iron lung. They kind of
• 09:49knew that having more iron
• 09:51lungs wouldn't help. They didn't
• 09:52have access to more iron
• 09:53lungs, so it didn't matter.
• 09:54But they also, without really
• 09:56understanding why, recognized that this
• 09:57wasn't something that would be
• 09:59fixed by having more iron
• 10:01lungs. And the other thing
• 10:02to know about this epidemic
• 10:04was that in the United
• 10:04States, polio was the summer
• 10:06plague. It peaked in July
• 10:07and August.
• 10:08In the Scandinavian countries further
• 10:10north, we don't really know
• 10:11why, but
• 10:13it tended to peak in
• 10:14the autumn. Hence, the title
• 10:15of my book, the autumn
• 10:16ghost, that one writer described
• 10:18it as in the nineteen
• 10:19forties.
• 10:20So they were in mid
• 10:21August, and they knew they
• 10:22weren't even at the peak
• 10:23of their epidemic, and they
• 10:24were at their wits end
• 10:25as to what to do.
• 10:27And they ultimately
• 10:29invited in this man, Bjorn
• 10:32Ibsen, an anesthesiologist
• 10:34in Denmark,
• 10:35in Copenhagen,
• 10:36to come and see what
• 10:38he had to offer.
• 10:40Now there were five anesthesiologists
• 10:42in all of Copenhagen at
• 10:44that time. The specialty barely
• 10:46existed.
• 10:47And so he really,
• 10:49you know, he they didn't
• 10:50know what he would offer
• 10:51or what he might suggest.
• 10:52They just knew he was
• 10:53a very smart man. And
• 10:55what he suggested was what
• 10:56they used in the operating
• 10:57room to give patients ventilatory
• 11:00support, which was called the
• 11:01waters to and fro circuit,
• 11:03which was basically a bag
• 11:05to squeeze air into the
• 11:06lungs,
• 11:07a tracheostomy
• 11:09to have a place to
• 11:10get the air into the
• 11:11lungs, and then an oxygen
• 11:12tank and soda lime that
• 11:14would extract carbon dioxide.
• 11:16This doesn't sound too radical
• 11:18to us now because we
• 11:19give what's called positive pressure
• 11:21ventilation. Right? Squeezing air into
• 11:23the lungs all the time.
• 11:24But at the time, it
• 11:25was not used outside of
• 11:27the operating room pretty much
• 11:28anywhere in the world.
• 11:30So he described doing this
• 11:31to the doctors at the
• 11:32BlytheM, and that this was
• 11:34a way to keep their
• 11:35patients alive, and they were
• 11:36completely skeptical.
• 11:38But they said, okay.
• 11:40You can try this on
• 11:41one patient,
• 11:42and we'll choose that patient
• 11:43for you. And so the
• 11:44next day, which was August
• 11:46twenty six nineteen fifty two,
• 11:48a little girl by the
• 11:49name of Vivi Ebert was
• 11:50admitted to that hospital. And
• 11:51this is the house she
• 11:52grew up in Copenhagen.
• 11:54She's about nine in this
• 11:55photo and she was twelve
• 11:56at the time and she
• 11:58had Bolbar polio classic Bolbar
• 12:00polio,
• 12:01ninety percent mortality. Right? So
• 12:03they knew the doctors and
• 12:04nurses who admitted her to
• 12:05the hospital that day knew
• 12:06that she was going to
• 12:07die.
• 12:08The next morning, Henry Lawson
• 12:10and his team rounded on
• 12:12her, and she was already
• 12:13clearly at the end of
• 12:14her life. And so he
• 12:16pointed to her and said,
• 12:17her she's the one you
• 12:18can try this on.
• 12:20And so Ibsen was called
• 12:21in.
• 12:22They did a tracheostomy
• 12:23on her, and there's lots
• 12:25of details that I'm gonna
• 12:26skip over.
• 12:27But, basically, he demonstrated that
• 12:29he could rescue her from
• 12:31death
• 12:32and stabilize her and overnight
• 12:35hand ventilated her through that
• 12:37night to show everybody that
• 12:39he could keep her alive.
• 12:41Now Henry Lawson recognized a
• 12:42good thing when he saw
• 12:43it, and he said, right.
• 12:44We're gonna do this to
• 12:45everybody who's having respiratory failure.
• 12:47There's only one problem now.
• 12:49If you do a tracheostomy
• 12:50on someone and you want
• 12:51to give them ventilatory support,
• 12:52what do you do? You
• 12:53roll in a ventilator, you
• 12:54flick a switch, you hook
• 12:55them up, you walk away.
• 12:57There were no ventilators in
• 12:59the entire country of Denmark.
• 13:00Not a single one existed.
• 13:02So instead,
• 13:03they called on the medical
• 13:04students of Copenhagen to come
• 13:06sit at the bedside, and
• 13:07they hand ventilated
• 13:09all of these patients
• 13:11twenty four hours a day
• 13:12for weeks and months on
• 13:13end.
• 13:14Initially, it was a couple
• 13:15dozen medical students and then
• 13:17hundreds and ultimately twelve hundred
• 13:20medical and dental students took
• 13:21part in the care of
• 13:22these patients. And they did
• 13:23this for hundreds of patients.
• 13:25And this is in fact
• 13:26a picture of Vivi Ebert
• 13:27after she was stabilized with
• 13:29her mother reading to her.
• 13:30And remember, polio patients were
• 13:31awake. They didn't have anything
• 13:33wrong with their brain.
• 13:34And so once she was
• 13:35stabilized,
• 13:36she was awake and alert.
• 13:38So this, this is the
• 13:40origins of modern mechanical ventilation
• 13:42as we did in COVID
• 13:44nineteen, as we do every
• 13:45day in intensive care units.
• 13:46And this is really the
• 13:47origins of people beginning to
• 13:49create what we consider modern
• 13:51intensive care.
• 13:52So that's the story you
• 13:53can understand is very kind
• 13:55of dramatic, vivid imagery.
• 13:58And I wanna share share
• 13:59with you some of the
• 14:00interesting challenges along the way
• 14:01of doing the research to
• 14:03tell this story.
• 14:04And a big one that
• 14:06came up was around privacy
• 14:08and rights of,
• 14:10for, for kind of photos
• 14:11and things.
• 14:13So
• 14:14early on, I realized, well,
• 14:15I'm interested in positive pressure
• 14:17ventilation. That's the nineteen fifty
• 14:18two epidemic, and that's the
• 14:19kind of big,
• 14:21big thing that I'm excited
• 14:22about. But actually, I've gotta
• 14:23go back and learn about
• 14:24the iron lung first because
• 14:25that came before,
• 14:27positive pressure ventilation.
• 14:29And as I mentioned, that
• 14:30was nineteen twenty eight, professor
• 14:32Philip Drinker. He is here.
• 14:33He actually saw his colleague,
• 14:34Louis Agassiz Shaw, doing experiments
• 14:36with a cat,
• 14:38that had been sealed into
• 14:39this little box, and they
• 14:41were using this plunger to
• 14:42suck air out of the
• 14:43box.
• 14:44They were trying to actually
• 14:46determine whether or not cats
• 14:47could breathe through their skin.
• 14:49So they were sampling the
• 14:50air in that box after
• 14:52they sort of use this
• 14:53plunger to suck air out
• 14:54and push it back in
• 14:55a few times. And they
• 14:56published a paper in nineteen
• 14:57twenty eight that said, by
• 14:58the way, mammals do not
• 14:59breathe through their skin,
• 15:01in case you were wondering.
• 15:02But,
• 15:03you know, in his so
• 15:05he he he did this
• 15:06with this cat, and then
• 15:07he realized, okay, we can
• 15:09expand this to do this
• 15:10to humans, and he builds
• 15:12the first iron lung.
• 15:14And there's a case report
• 15:15that he publishes the next
• 15:16year
• 15:17about the first little girl
• 15:19they tried it on in
• 15:20Boston Children's Hospital, and it
• 15:21was BR, a girl aged
• 15:23eight years, was admitted to
• 15:23the Children's Hospital of Boston,
• 15:25October twelfth nineteen twenty eight.
• 15:28And I was looking through
• 15:28all the literature, reading all
• 15:30the the reports and accounts,
• 15:32and it was, you know,
• 15:33she was never named.
• 15:35And there was no other
• 15:36information about her beyond these
• 15:38descriptions sort of very clinical.
• 15:40And I thought, you know,
• 15:42it's nice to have a
• 15:43name and to know who
• 15:44somebody is. Right? You know,
• 15:46that that's important to us
• 15:47as people. We talk about
• 15:48that now in the hospital
• 15:50all the time of, you
• 15:50know, don't don't call people,
• 15:53by sort of patient x
• 15:54that they actually have a
• 15:56name. And so I emailed
• 15:57Boston Children's Hospital,
• 15:59filled out the request form.
• 16:00Would they be willing based
• 16:01on this information? Could they
• 16:03find who this was?
• 16:04And I had to wait
• 16:05a long time. It was
• 16:06COVID. People weren't in the
• 16:07office. And then finally got
• 16:08an email back. I have
• 16:09good news. I found the
• 16:10patient's admission record from the
• 16:12nineteen twenty eight logbook,
• 16:14and they shared it with
• 16:15me. And there it is,
• 16:16Bertha Richard. For the first
• 16:18time in almost a hundred
• 16:20years, she has a name.
• 16:22And it gave goes on
• 16:23to give me the name
• 16:24of her parents that she
• 16:25had acute pulomyelitis. And although
• 16:27they considered it a success
• 16:29treating her with the iron
• 16:30lung, in fact, she did
• 16:30die five days later on
• 16:32October nineteenth. And so based
• 16:34on this information,
• 16:35I was able to get
• 16:36a copy of her death
• 16:37certificate as well,
• 16:38and begin to kind of,
• 16:40you know, give her,
• 16:42give her a little bit
• 16:43of life in a sense.
• 16:45I wanted though to know
• 16:46more, right, as much as
• 16:47I could for this book.
• 16:49And so I wanted her
• 16:50full medical record if I
• 16:51could get it. And so
• 16:52I put in a request
• 16:53and, no, this is ninety
• 16:55two years after she's died.
• 16:57And I get a response,
• 16:58we are unable to fulfill
• 16:59your request for medical records.
• 17:01And it goes on to
• 17:01say, because I'm not a
• 17:03family member,
• 17:04they are denying my request
• 17:06for this. Now just so
• 17:07you know, HIPAA says
• 17:09fifty years after someone's died
• 17:12that that record can become
• 17:13public.
• 17:15Boston Children's Hospital said we
• 17:16don't care about HIPAA. We
• 17:17have our own rules, and,
• 17:19no, you can't have this
• 17:20medical record.
• 17:23I feel very mixed about
• 17:24that. Right? Because I understand
• 17:26certainly protecting people's privacy, but
• 17:28at a certain point,
• 17:29there's so much we can
• 17:30learn from knowing about the
• 17:32details of people like this
• 17:34who really contributed to medical
• 17:36history in ways that are
• 17:37meaningful.
• 17:38And I would argue that
• 17:39ninety two years later, nobody
• 17:41cares about the privacy issue.
• 17:43So perseverance,
• 17:45I happen to know Peter
• 17:46Lawson, who was the executive
• 17:47vice president for health affairs.
• 17:48He was an intensive care
• 17:49doctor up in Toronto for
• 17:51a while. I emailed him
• 17:52and said, hey, Peter, can
• 17:53you help me? He sent
• 17:54me to an anesthesiologist
• 17:56who happened to be also
• 17:57a medical historian at Boston
• 17:58Children's, and he's basically said,
• 18:00sorry. I can't help you.
• 18:02Back to Peter Lawson.
• 18:03Onto Michelle Garvin, the VP
• 18:06for general counsel,
• 18:08passed on to the lead
• 18:09general counsel for Boston Children's
• 18:11Hospital, passed on to the
• 18:12vice president and chief compliance
• 18:13officer who was sort of
• 18:14like, yeah, I don't know
• 18:15what the big deal is.
• 18:16Of course, you can see
• 18:17this record, and authorized me
• 18:19to have access.
• 18:21And unfortunately
• 18:22the trail went cold there
• 18:24because after I got access,
• 18:26I got an email that
• 18:27said, good morning. I wish
• 18:28that I had a more
• 18:29positive update.
• 18:30We have not quite given
• 18:31up yet, but at this
• 18:32point it seems the patient
• 18:33record no longer exists.
• 18:36Exists. So a lot of
• 18:37work for nothing in the
• 18:38end, but it was an
• 18:40important lesson for me about
• 18:42how difficult it is given
• 18:44current privacy laws and concern
• 18:46about protection of patients,
• 18:49that it really can make
• 18:50this type of research
• 18:52challenging. The other thing around
• 18:53that related to that is
• 18:55what sort of photos and
• 18:56what sort of permissions you
• 18:57need for what goes in
• 18:58a book and what can
• 18:59be published. So for instance,
• 19:01this image, which I love,
• 19:02is not in the book.
• 19:04I, to me, it's sort
• 19:05of the, the ultimate image
• 19:07of sort of the closeness
• 19:08of the medical students hand
• 19:10ventilating and reading a comic
• 19:11book at the same time.
• 19:12But I was told by
• 19:13the medical museum,
• 19:15you can only use this
• 19:16image if you get permission
• 19:17from the family,
• 19:19but I was not allowed
• 19:20to show people this image
• 19:23in order to figure out
• 19:24who this child was to
• 19:25get permission from the family.
• 19:27So I was stuck. And
• 19:29similarly, this image as well,
• 19:31also not in the book
• 19:32with this incredible imagery of
• 19:33this doll here.
• 19:35And so, you know, really,
• 19:37this is another area which
• 19:38is challenging, which is the
• 19:40the kind of rights and
• 19:40privacy issues around images,
• 19:43which is a a major
• 19:45issue in terms of being
• 19:46able to fully share stories.
• 19:50Yeah. Yeah. Say we're changing
• 19:51everything. Patients. Patients. Yeah. So,
• 19:54you know, nobody cared about
• 19:55the medical student.
• 19:56As you can see, I
• 19:57didn't have to block out
• 19:58her face.
• 19:59And and it's really interesting.
• 20:01Right? And and, of course,
• 20:02I understand the sort of
• 20:03privacy issues, but, you know,
• 20:05the reality is that this
• 20:06is seventy something years after
• 20:09these events. And so it's
• 20:10all it's interesting to me
• 20:11that people are still very,
• 20:13very concerned about the privacy
• 20:14and protection of these individuals.
• 20:16I can tell you for
• 20:17anyone I ever did approach
• 20:19for this sort of thing,
• 20:20nobody cares. Right? You know,
• 20:21they sort of said, like,
• 20:22sure. Go ahead if it
• 20:23was them.
• 20:24When for people where I'm,
• 20:25you know, Vivi Ebert's family
• 20:26was happy to have me
• 20:27use images of her as
• 20:29well.
• 20:31Issues of memory.
• 20:33This is a man that's
• 20:34named Ernst Trier Murch,
• 20:36and he
• 20:37was important in the book
• 20:39for many reasons. And just
• 20:41kinda give you a sense
• 20:42of who he was along
• 20:43the way, He was actually
• 20:44the first anesthesiologist
• 20:45in all of Denmark,
• 20:47in the nineteen forties.
• 20:49He's the person who actually
• 20:51told Ibsen that he should
• 20:52go train in the United
• 20:53States, which ended up being
• 20:54very important for sort of
• 20:55his education and and kind
• 20:57of the way he thought
• 20:58about medicine.
• 21:00He actually built an early
• 21:02positive pressure ventilator in Denmark
• 21:03in the nineteen forties
• 21:05that was not available for
• 21:06use because he'd moved to
• 21:07the United States by the
• 21:08time the epidemic occurred in
• 21:10the nineteen fifties.
• 21:11Turns out he was also
• 21:12a hero of the Danish
• 21:13resistance in World War two.
• 21:15And in fact, he'd beaten
• 21:16Ibsen to this entire concept
• 21:18of positive pressure ventilation for
• 21:20polio patients with a publication
• 21:21a year or two before
• 21:22him that apparently nobody read.
• 21:25And he was really a
• 21:26giant in the field of
• 21:27anesthesiology for the rest of
• 21:28his life. So, again, someone
• 21:30I wanted to sort of
• 21:31profile and give as much
• 21:33information about in the book
• 21:34as I could,
• 21:36and he was pretty colorful.
• 21:38Here is an obituary from
• 21:39the New York Times with
• 21:40amazing statements like, during World
• 21:42War two when they were
• 21:44trying to move the Jews
• 21:45out of Denmark, they took
• 21:47them by boat to Sweden
• 21:48in the middle of the
• 21:49night. And he said, among
• 21:49other things, according to his
• 21:51own account, at a time
• 21:52when the Gestapo was using
• 21:53bloodhounds to sniff out Jews
• 21:55hidden under the false bottoms
• 21:56of fishing boats, taking them
• 21:58to safety in Sweden, He
• 21:59and a friend who was
• 22:00a pharmacist experimented on a
• 22:02cocker spaniel until they perfected
• 22:03a mixture of dried rabbit's
• 22:05blood and cocaine
• 22:07that disabled the dog's ability
• 22:09to smell.
• 22:10Doesn't get more fun than
• 22:12that, right, to be able
• 22:13to write about that in
• 22:14a book.
• 22:15Trained as a geneticist
• 22:16producing research tracing dwarfism to
• 22:19a single mutant gene and
• 22:21establishing that the condition randomly
• 22:22occurred in one of every
• 22:23ten thousand births. The finding
• 22:25was later used as a
• 22:26baseline by scientists studying the
• 22:28genetic effects of the atomic
• 22:29bombing, and I think I
• 22:30should say Hiroshima there.
• 22:33He was definitely involved in
• 22:34something called the white buses,
• 22:36which was
• 22:38a
• 22:40transport
• 22:41that they took buses from
• 22:43Sweden and Denmark
• 22:44into Germany
• 22:46in nineteen forty five while
• 22:47World War two was still
• 22:49happening.
• 22:50They had negotiated
• 22:52to take home the prisoners
• 22:53from Ravensbruck concentration camp.
• 22:56And so he was one
• 22:57of the doctors who volunteered
• 22:58for this. And and, this
• 23:00is a picture of the
• 23:01white buses actually outside the
• 23:02Blythe Am Hospital in Copenhagen
• 23:04before going on to Germany
• 23:06in early nineteen forty five.
• 23:09And this is also from
• 23:10the Chicago Tribune nineteen eighty
• 23:11five. This was about, again,
• 23:13getting the Jews from Denmark
• 23:15into Sweden. If they should
• 23:16start crying in their dark,
• 23:17hot, wet quarters, everybody could
• 23:19get killed. So we gave
• 23:20the parents barbiturate suppositories,
• 23:23and they'd knock the kids
• 23:24out, actually put them in
• 23:25life threatening comas. Then when
• 23:27the Swedes took over, doctors
• 23:28would quickly revive them. And
• 23:30then about that white bus
• 23:31expedition, we were cheering on
• 23:33the allied bombers,
• 23:34but we had several hundred
• 23:35patients on buses who were
• 23:37dying from typhus, typhoid fever,
• 23:39tuberculosis,
• 23:40and other diseases. They had
• 23:41no time to wait. The
• 23:42German telephones were completely automatic.
• 23:45So I gave Bernadotte, the
• 23:46man in charge of the
• 23:47white buses, a dime and
• 23:49asked him to call his
• 23:50father who happened to be
• 23:51king of Sweden and asked
• 23:52him to call his cousin
• 23:52who happened to be king
• 23:53of England and asked him
• 23:54to call general Eisenhower Eisenhower
• 23:56who happened to be in
• 23:57charge of bombing Hamburg and
• 23:58asked him to hold things
• 23:59up for a few minutes.
• 24:02Great stories. Right?
• 24:04He was important enough in
• 24:06the resistance that even though
• 24:07he wasn't himself Jewish, the
• 24:09Shoah Foundation did an interview
• 24:10with him, and this was
• 24:12like gold. Right? I go
• 24:13listen to him talking about
• 24:14his life and and sharing
• 24:16this information.
• 24:18And then he was interviewed
• 24:19about the war, and this
• 24:21was the conversation.
• 24:22Oh, yeah. The German said
• 24:24that only the Jews had
• 24:25to wear a yellow band
• 24:26on the left arm with
• 24:27the Jewish star, as the
• 24:28interviewer,
• 24:29with the Jewish star. And
• 24:31then the next day, you
• 24:31saw maybe a hundred Danes
• 24:33with the same yellow star.
• 24:34On a few days later,
• 24:35you saw the king of
• 24:36Denmark riding on through the
• 24:37city with a big yellow
• 24:38band around the arm. So
• 24:39that became completely inefficient.
• 24:41They couldn't prove who was
• 24:42Jewish and who were just
• 24:44rebelling Danes. Did you take
• 24:45part in that activity? Did
• 24:47you wear a yellow armband?
• 24:48Oh, yeah.
• 24:50This is when I went,
• 24:51uh-oh,
• 24:53because this is a well
• 24:55known
• 24:56false story.
• 24:58This didn't happen.
• 25:00The Jews in Denmark were
• 25:01never made to wear yellow
• 25:02stars or yellow bands, and
• 25:04the king of Denmark never
• 25:05did that. And that's been
• 25:06written about and debunked.
• 25:08And all of a sudden,
• 25:09I said, oh my god.
• 25:11What of what this man
• 25:12is saying is actually true
• 25:14and what isn't? How do
• 25:15I trust it?
• 25:17And this is a quote
• 25:18actually from a fictional book
• 25:19by Kazuo Ishiguro.
• 25:21Memory, I realize, can be
• 25:22an unreliable
• 25:23thing. Often, it is heavily
• 25:25colored by the circumstances in
• 25:26which one remembers, and no
• 25:28doubt this applies to certain
• 25:29of the recollections I have
• 25:31gathered here.
• 25:33So this was my introduction
• 25:35into,
• 25:36you know, what every good
• 25:37historian will tell you, which
• 25:39is that oral histories are
• 25:40suspect.
• 25:42You know, that in medicine
• 25:43as well, right? That it
• 25:44can be challenging
• 25:45sometimes to really tease apart,
• 25:47you know, what is, a
• 25:48false versus true memory, that
• 25:50someone may have of their
• 25:51past.
• 25:52And so I recognize that
• 25:54I really had to triangulate
• 25:55everything that this man was
• 25:57saying
• 25:57and couldn't take it for
• 25:58granted. And that was really
• 25:59true of any of these
• 26:00interviews with people to try
• 26:03to make sure that I
• 26:04I could ground it in
• 26:05fact or else couch it
• 26:07very carefully in terms of
• 26:08the way I phrased it
• 26:09such as according to this
• 26:11individual. Right? So in the
• 26:13end, what did I find?
• 26:14Dwarves dwarfism research basis for
• 26:16the effects of the atomic
• 26:18bomb
• 26:19couldn't find a sign of
• 26:20this anywhere in literature.
• 26:23Rabbit's blood and cocaine to
• 26:25make dogs unable to smell
• 26:27the Jews underneath.
• 26:29Actually,
• 26:31I was in the resistance
• 26:32museum in Denmark going through
• 26:34their exhibitions.
• 26:36And there in one of
• 26:37the exhibitions was a little
• 26:38vial that was labeled
• 26:40rabbit's blood and cocaine with
• 26:42a description of this. Now
• 26:43I never could confirm that
• 26:44he was the one who
• 26:45had done this, but, and
• 26:47and if you read the
• 26:48book, you'll see how it's
• 26:49carefully worded, but that was
• 26:50a real thing. Our Britschwitz
• 26:52suppositories for babies on boats
• 26:54sounds a little for the
• 26:55hot preposterous to me. I
• 26:56could never verify it. Didn't
• 26:58put it in the book.
• 26:59Calls to the king of
• 27:00Sweden, king of England.
• 27:01They did try to relay
• 27:03to the allies to hold
• 27:04bombing,
• 27:05but it was definitely not
• 27:06up at that high level.
• 27:08Was he a hero of
• 27:09the resistance? Absolutely.
• 27:11Was he a hero of
• 27:12the specialty of anesthesiology?
• 27:13Absolutely.
• 27:14But it was a a
• 27:15fascinating journey trying to tease
• 27:17apart what was real and
• 27:18what wasn't. And here is
• 27:20is one of the very
• 27:20few pictures I could find
• 27:21of him, in his youth,
• 27:23and you can see with
• 27:23the medals he received from
• 27:25the King of Denmark, in
• 27:26fact, for his work in
• 27:28the resistance.
• 27:30So this is the city
• 27:31archives in Copenhagen where I
• 27:33spent a fair amount of
• 27:34time, and it's a it
• 27:35was a little bit of
• 27:36like a journey into Harry
• 27:37Potter land that, this was
• 27:39the entrance to the archives
• 27:41there.
• 27:42And one of the things
• 27:43that they had there, they
• 27:44have amazing I mean, the
• 27:45Danes are known for incredible
• 27:46sort of archival material and
• 27:48and,
• 27:49and records, and they plunked
• 27:51this giant black book in
• 27:52front of me. It's one
• 27:53of the things they pulled
• 27:54out when I said I
• 27:55was interested in in the
• 27:56hospital in nineteen fifty two.
• 27:58And when I opened it
• 27:59and finally figured out what
• 28:00it was, I realized it
• 28:01was their book of all
• 28:02the deaths in the hospital
• 28:04in nineteen fifty two. It
• 28:06was a log book. And
• 28:07as you flip through the
• 28:08pages, you could see they
• 28:10entered every death. And in
• 28:11January and February, it was
• 28:12sort of diphtheria and tetanus
• 28:14and a whole mix of
• 28:15different things. And then you
• 28:16got to July and August
• 28:17of nineteen fifty two and
• 28:18it was just polio, polio,
• 28:19polio.
• 28:20And it was I mean,
• 28:21it was very useful for
• 28:22me because I was able
• 28:22to go through and literally
• 28:22catalog the number of deaths
• 28:22and sort of quantify those
• 28:22things and
• 28:32but one thing you'll see,
• 28:33it's whited out here, right,
• 28:34are the names of the
• 28:35patients who died. And, again,
• 28:37I was told very clearly
• 28:38by the city archives
• 28:39that I could look at
• 28:40this,
• 28:41but I could not under
• 28:42any circumstances use the names
• 28:44that I found in this
• 28:46material
• 28:47to contact anyone for additional
• 28:49research.
• 28:51And so this was an
• 28:52amazingly frustrating
• 28:53because I really wanted to
• 28:55capture as many voices in
• 28:57the book as I could
• 28:57the different experiences of people
• 28:59in this epidemic. And I
• 29:00got a lot of them
• 29:01through different means.
• 29:03But one that is absolutely
• 29:04missing is the patients who
• 29:06died and the families, the
• 29:07patients who died. And I'm
• 29:09very aware that I don't
• 29:10have that perspective in the
• 29:12book because of this. Now
• 29:13in retrospect,
• 29:14I probably could have put,
• 29:15say, an ad in one
• 29:16of the newspapers and maybe
• 29:17found somebody that way. I
• 29:18didn't think to at the
• 29:19time.
• 29:20But I I was sort
• 29:21of stymied in figuring out
• 29:23how to reach these individuals.
• 29:25And so it was also
• 29:26just sort of reflecting on
• 29:28who are you capturing when
• 29:29you tell these stories and
• 29:31whose voices aren't there.
• 29:34Three of the strongest voices
• 29:35that I have in the
• 29:36book are the doctors, the
• 29:37medical students, and then surviving
• 29:39patients.
• 29:40And this is a map
• 29:42of Copenhagen from nineteen fifty
• 29:44two, and it was actually
• 29:45that picture I showed you
• 29:46of Henry Lawson. This was
• 29:47actually behind him when he's
• 29:49sitting at that desk. And
• 29:50he had it in his
• 29:51office, and he sent out
• 29:53six medical students
• 29:55to track every single case
• 29:56of polio that year in
• 29:58Copenhagen. And if you blow
• 29:59it up, you can see
• 30:00that there's a lot of
• 30:02pins in the city center.
• 30:03And the different colors are
• 30:04different months of the year.
• 30:06And,
• 30:07again, important, I think, to
• 30:09reflect on the fact that,
• 30:10of course, each of these
• 30:11pins is an individual,
• 30:13and I was able to
• 30:14track down a bunch of
• 30:15the survivors in the nineteen
• 30:16fifty two epidemic. And, I
• 30:18love hearing from people who've
• 30:19read the book because I
• 30:20hear what they found most
• 30:21compelling
• 30:22and gratified that for many
• 30:24people, they say it's the
• 30:25stories of the children
• 30:26in the book and their
• 30:27experiences.
• 30:28And the they all shared
• 30:30their experiences with me. Some
• 30:31of them actually found their
• 30:33pin for me on this
• 30:34map.
• 30:36And, and so I was
• 30:37really,
• 30:38found that that was incredibly
• 30:40important for humanizing the story.
• 30:42Right. That it wasn't just
• 30:44about
• 30:45the development of a technology.
• 30:46It was about the experiences
• 30:48of these individuals.
• 30:49One of the things I
• 30:50discovered though
• 30:52when talking to them
• 30:54was that I had to
• 30:55relearn how interview or change
• 30:57the way I interviewed. You
• 30:59learn in medicine how to
• 31:00do an interview. You know,
• 31:01how old were you when
• 31:02you got polio? What was
• 31:03the date? What were the
• 31:03symptoms? Was anyone else in
• 31:05your family affected? And and
• 31:06maybe I'm on the extreme
• 31:07of this having trained in
• 31:08anesthesia and critical care. Right.
• 31:09You know, I don't sit
• 31:10there and chitchat too much
• 31:12with my patients and their
• 31:13families.
• 31:15But, really, that's, you know,
• 31:16that's the kind of information
• 31:18we're taught to extract efficiently
• 31:19and effectively.
• 31:21And I started to write
• 31:22and realized that, of course,
• 31:24that doesn't make for a
• 31:25very interesting narrative.
• 31:26And in fact, there were
• 31:28all these other questions that
• 31:29I had to go back
• 31:30to these individuals and ask.
• 31:31Where were you living? What
• 31:32were the names and ages
• 31:33of your siblings? Were you
• 31:34close to them? Did you
• 31:35share a room? Did you
• 31:36live in a house or
• 31:37an apartment? Did you have
• 31:38stuffed animals or dolls? What
• 31:40were their names? What do
• 31:41you remember from the ambulance
• 31:42ride? Like, that's the color
• 31:44that creates the kind of
• 31:46connection with people.
• 31:48And so I literally had
• 31:49to go back and I
• 31:50thought I'd interviewed someone and
• 31:51I then had to kinda
• 31:52go back to them and
• 31:53say, can I talk to
• 31:54you again? I have more
• 31:55questions for you.
• 31:56And so that was really
• 31:57eye opening of what types
• 31:59of questions do you need
• 32:00to ask,
• 32:01and really how long an
• 32:02interview you need to do
• 32:04in order to get that
• 32:05information.
• 32:06In terms of the medical
• 32:08students, a few of them
• 32:09were still alive, and I
• 32:10was able to meet two
• 32:11of them.
• 32:12So this was Anne Holton
• 32:13Jensen. She was ninety in
• 32:14that picture when I got
• 32:16to meet her. And she
• 32:17had an extraordinary
• 32:19experience,
• 32:20in the epidemic. She became
• 32:21an anesthesiologist
• 32:22because of it. She named
• 32:24one of her children for
• 32:24one of the patients she
• 32:25cared for and was really
• 32:27able to give me a
• 32:28sense of both how terrifying
• 32:30it was, but also how,
• 32:32kind of informative it was
• 32:34for her. And just wanna
• 32:35share with you because we
• 32:36do have film footage
• 32:38of what it looked like
• 32:39when they were bat hand
• 32:41ventilating these patients as one
• 32:42of the students there. And
• 32:44one thing to note is
• 32:45those are true anesthesia bags.
• 32:46They're not ambu bags that,
• 32:47that spring back when you
• 32:48squeeze them. So if you
• 32:50lose the, the airflow through
• 32:52them from the, tank of
• 32:53oxygen or air,
• 32:55it stops working. And so
• 32:56the book is full of
• 32:57kind of descriptions from the
• 32:58medical students that both either
• 33:00I got from people or
• 33:01others had previously interviewed
• 33:03to, kind of understand all
• 33:05the things that went wrong.
• 33:06And, of course, they did
• 33:07have to allow them to
• 33:08eat and drink. A lot
• 33:09of them had feeding tubes,
• 33:10and they would literally just
• 33:11blend up what was the
• 33:12meal of the day and
• 33:13stick it down the tube.
• 33:16Now I also probably the
• 33:18biggest lesson I had comes
• 33:19from this man, Robert Caro.
• 33:22I don't know if people
• 33:23are familiar with this book
• 33:24called The Power Broker, but
• 33:25Robert Caro is a writer
• 33:27who's really known for his
• 33:29detailed deep dives
• 33:31into his research.
• 33:32And, there's a great documentary
• 33:34about him called turn every
• 33:36page. There he is on
• 33:37the left and his editor
• 33:39who recently died, Robert Gottlieb,
• 33:40is there on the right.
• 33:41And it's a great if
• 33:42you're interested in writing,
• 33:44and you're interested in nonfiction,
• 33:45I really recommend this documentary.
• 33:47And he tells his anecdote
• 33:48about being a young reporter
• 33:50just starting out
• 33:52and how his kind of
• 33:53grizzled old boss, to resume,
• 33:55says,
• 33:56Bob, make sure you turn
• 33:58every page.
• 33:59And he takes that to
• 34:00heart, and he really makes
• 34:01a career out of turning
• 34:03every page and doing these
• 34:05really deep dives.
• 34:07And I was in Copenhagen
• 34:09for about a month doing
• 34:10research, and,
• 34:11one of the patients who
• 34:13I'd been in contact with
• 34:14was Niels Franz, and he
• 34:15became a documentary filmmaker.
• 34:17And his documentary is called
• 34:18The Epidemic. It's got an
• 34:20amazing subtitle. I don't remember
• 34:22anything, but I'll never forget.
• 34:24He was one years old
• 34:25when he got polio. So
• 34:26he didn't remember the experience
• 34:28himself. He ends up interviewing
• 34:29his mother,
• 34:30about what it was like
• 34:31and and all of that.
• 34:33And so I'd seen the
• 34:34film and I'd emailed with
• 34:35him
• 34:36And I was in Copenhagen.
• 34:37I had this sort of
• 34:38fleeting thought of, may should
• 34:40I should I go talk
• 34:40to him? And then I
• 34:41thought,
• 34:42I know his story. I
• 34:43had seen his film. I've
• 34:45emailed with him. Like, what
• 34:46more could he possibly tell
• 34:47me?
• 34:49And then I heard Robert
• 34:50Caro's voice in my head
• 34:51saying, turn every page. And
• 34:53so with just a few
• 34:54days left, I emailed him,
• 34:56and he kindly invited me
• 34:57over. I went to his
• 34:58apartment.
• 34:59He fed me coffee and
• 35:00Danish buns, and he sat
• 35:02there and he said, so
• 35:03what are you interested about
• 35:04the epidemic? Is it the
• 35:06doctors or the nurses or
• 35:07the patients? You know, what
• 35:08what story are you telling?
• 35:09And I sort of said,
• 35:10well, I'm kind of all
• 35:11of it. I'd love to
• 35:12research anything and everything.
• 35:14And he said, well, you
• 35:16know, I ended up writing
• 35:17my or not just doing
• 35:18my film about the patient
• 35:20experience and my own experience.
• 35:21But, but while I was
• 35:22trying to figure out what
• 35:23I was going to make
• 35:24this film about
• 35:25back in the late 1990s,
• 35:27I actually interviewed a bunch
• 35:28of the doctors before they
• 35:30died. And I think I
• 35:31probably have those interviews on
• 35:32my hard drive somewhere. Would
• 35:34you be interested in that?
• 35:36And my jaw was on
• 35:37the floor because, you know,
• 35:39I could talk to the
• 35:40patients. They were still around.
• 35:41I could talk to the
• 35:42med students. They were still
• 35:43around, but the doctors had
• 35:44definitely all died. And although
• 35:46there was a lot, they
• 35:47wrote their voices in some
• 35:48ways were the strongest,
• 35:49Right? Because doctors write a
• 35:50lot and publish a lot,
• 35:52but it was all kind
• 35:52of that medical technical
• 35:55experience. Right? It didn't get
• 35:57into the the
• 35:59the true experience that they'd
• 36:00really had.
• 36:01And true to his word,
• 36:03he was incredibly generous. He
• 36:04uploaded
• 36:05hours
• 36:06of interview film footage for
• 36:08me,
• 36:09to share generously.
• 36:11And so here is you
• 36:13know? You're an Ipsen. Server.
• 36:14You know? Talking
• 36:16about the experience of
• 36:18Oh,
• 36:19epidemic. Now you will note
• 36:21for me If it's in
• 36:22Danish
• 36:24I do not speak Danish.
• 36:26Google Translate is amazing. Right?
• 36:29But
• 36:30it does not work when
• 36:31you try to take an
• 36:32old guy who mumbles slightly
• 36:34in Danish and put try
• 36:36to get Google Translate to
• 36:37do anything with it. So,
• 36:38I that was a a
• 36:39journey. I had to
• 36:41pay someone to transcribe it
• 36:43in Danish, use Google Translate
• 36:45into English, and then have
• 36:46somebody else go through and
• 36:47check the translation
• 36:48who's both both languages. And
• 36:50so it was months before
• 36:50I even knew what he'd
• 36:51said.
• 36:52But at the end of
• 36:53the day, it was the
• 36:54heart of the story because,
• 36:55you know, he described things
• 36:56like
• 36:57two days after this experience
• 36:59with Vivi Ebert
• 37:01sitting there in the hospital
• 37:02and starting to cry
• 37:04because he was so overwhelmed
• 37:07at how kind of scary
• 37:09and traumatic it had been
• 37:10trying to take care of
• 37:11her.
• 37:12You would never have gotten
• 37:13that from his publications.
• 37:15Right? That wasn't anywhere in
• 37:16it, that human experience.
• 37:19Also
• 37:20medical records,
• 37:21is bad enough when they're
• 37:22written in English. I don't
• 37:23know about you trying to
• 37:24decipher people's handwriting, but then
• 37:25you'd like take Danish handwriting,
• 37:28and it's almost impossible to
• 37:30do. And Google Translate can't
• 37:31do anything with this, I
• 37:32can tell you. So in
• 37:33the end, for dealing with
• 37:34Danish, just as an aside,
• 37:35I will tell you, don't
• 37:36write a book that takes
• 37:37place in a language that
• 37:39you don't know. But, Google
• 37:40translate actually is amazing. You
• 37:42can basically read an entire
• 37:43printed book with it and
• 37:44you will understand the book.
• 37:46Lisa Kaye was a surgeon
• 37:48who had had polio in
• 37:49that epidemic. And so of
• 37:50course she would, she sat
• 37:51at her kitchen table with
• 37:52me and understood the medical
• 37:54component of these old records
• 37:55and went through them with
• 37:56me. I paid Danish undergraduates
• 37:58who checked every quote in
• 37:59the book because, of course,
• 38:00I wasn't gonna trust Google
• 38:01Translate for that. And then
• 38:03for one piece, I turned
• 38:04to a professional translator.
• 38:06And that was because of
• 38:07this woman, Rosa Abramson, who
• 38:09was dubbed the the Blythem
• 38:10Rose.
• 38:11She was in her twenties
• 38:12when she got polio in
• 38:13this epidemic
• 38:15and was admitted to the
• 38:16Blythem, and she never fully
• 38:18recovered her,
• 38:20respiratory function. She remained ventilator
• 38:22dependent, And she lived in
• 38:23the hospital for years. She
• 38:25actually had two children who
• 38:27she was obviously
• 38:28take couldn't be with her.
• 38:30She did ultimately move to
• 38:31an apartment complex where they
• 38:32could support her care along
• 38:34with Vivi Ebert, who also
• 38:35never came off the ventilator.
• 38:37But Rosa became a poet,
• 38:39and she became a quite
• 38:40a well known poet in
• 38:41Denmark and had these two
• 38:42books of poetry that she
• 38:43published.
• 38:45And so, you know,
• 38:47in Danish, I wanted the
• 38:49English version. And as an
• 38:51aside, I couldn't reproduce the
• 38:53whole poem, which I wanted
• 38:54to do. This is one
• 38:55of her most famous poems.
• 38:56And that was because her
• 38:57daughter wouldn't speak to me
• 38:58and wouldn't give me permission
• 39:00to reproduce any of her
• 39:01work. I don't know what
• 39:02she'd been through. I think
• 39:03probably just a lot of
• 39:04trauma associated with her mother
• 39:06being taken away in that
• 39:07way.
• 39:08But because of that, I
• 39:09had to go with what's
• 39:10called fair use, which was
• 39:11basically to use, you know,
• 39:13snippets that sort of informed
• 39:15my story,
• 39:16but were not,
• 39:18the whole poem. And so
• 39:20I researched someone who could
• 39:21help me with this because,
• 39:22Cause of course, translating poetry
• 39:24from one language to another
• 39:25is really challenging.
• 39:27And what I discovered, I
• 39:28picked up one of the
• 39:29most famous recently translated books
• 39:32from Danish into English and
• 39:33this man, Michael Favella Goldman,
• 39:35had done the translation. So
• 39:36I emailed him and explained
• 39:38what I was looking for
• 39:39and, and he agreed to
• 39:40help me.
• 39:41And so, you know, kind
• 39:42of extraordinary translations, but I'm
• 39:44led on and on by
• 39:45invisible ships at night to
• 39:47where clouds disappear in tomorrow's
• 39:49beams of light. Could it
• 39:50be out there? A bit
• 39:51of joy awaits
• 39:53and Karen's old ferry boat
• 39:54can sail some other place.
• 39:56And I recognize that Rosa
• 39:58Abraham's words were so much
• 39:59more powerful than anything I
• 40:01could ever write in terms
• 40:02of
• 40:03giving people a sense of
• 40:04of the challenge,
• 40:06right, of dealing with having,
• 40:09come down with polio in
• 40:10this way.
• 40:11And that was really a
• 40:12huge insight that as much
• 40:14as possible
• 40:15using people's words and not
• 40:17mine,
• 40:18was way more powerful.
• 40:20And
• 40:21the, the, the par, the
• 40:23section in my book where
• 40:24I felt this most strongly
• 40:26was in the section where
• 40:27I was trying to get
• 40:28across the fact that, of
• 40:29course, many people survived, they
• 40:31reduced the mortality. These med
• 40:32students had this incredible experience,
• 40:34but it was also incredibly
• 40:36traumatic for these students. Right?
• 40:38And in understanding the toll
• 40:41of death,
• 40:43one of the medical students
• 40:44was interviewed not by me,
• 40:45but by another doctor earlier
• 40:47on before he died. And
• 40:48he described finishing taking care
• 40:50of patients after months in
• 40:51the hospital, going back to
• 40:52being a medical student,
• 40:54and sort of being in
• 40:55this fog
• 40:56and not really needing able
• 40:58to concentrate and taking a
• 41:00vacation
• 41:00to go skiing by himself
• 41:03and sitting at dinner.
• 41:05And this is what he
• 41:06told,
• 41:07Paul Warworker who who,
• 41:09recorded this. I said little
• 41:11during the meal, concentrating on
• 41:12eating. I would occasionally return
• 41:14conversation, but rarely took the
• 41:16lead.
• 41:17As the dessert was served,
• 41:18one of the other guests
• 41:19unexpectedly cracked a body joke.
• 41:21After a momentary embarrassed pause,
• 41:23all in the room roared
• 41:24with laughter,
• 41:25none more so than myself.
• 41:28It seemed that a safety
• 41:29valve had opened, and suddenly
• 41:30I felt able to cast
• 41:31off my reserve. But as
• 41:33I laughed, the tears started
• 41:34to flow, and the laugh
• 41:35slowly changed into cries,
• 41:37heart wrenching, soulful wails.
• 41:40At first, unnoticed, gradually, one
• 41:41by one, the diners stopped
• 41:43laughing until the whole table
• 41:44went silent and stared at
• 41:45me, their mouths open.
• 41:47I buried my head in
• 41:48my hands, and at last,
• 41:49the cries and mourning and
• 41:51tears for the children came.
• 41:54You know? And so I
• 41:55I'm as you can tell,
• 41:56I still have trouble
• 41:58reading that.
• 41:59I knew that I could
• 42:00never
• 42:01come close
• 42:03to this man's own words
• 42:04about what it was like
• 42:05to go through that. And
• 42:07that was an important lesson
• 42:08for me, which was that
• 42:09as much as possible
• 42:10to get their voices in
• 42:12the book.
• 42:14I just wanna end by
• 42:15kind of one note about
• 42:16the writing. I'm very happy
• 42:17to talk more about this,
• 42:19but a lot of people
• 42:20ask me just about the
• 42:21process and sort of how
• 42:22long this took.
• 42:23And so my little timeline
• 42:25is that it was many
• 42:26years of contemplation. You know,
• 42:27I read this story about
• 42:28this epidemic back in twenty
• 42:30twenty one, sorry, two thousand
• 42:31and one. And I started
• 42:33thinking about really writing probably
• 42:35in about twenty eighteen.
• 42:37I did about two years
• 42:38of research and writing before
• 42:40then taking a, a year
• 42:41long sabbatical. And for anybody,
• 42:43whoever has the opportunity to
• 42:44take a sabbatical, I say,
• 42:46go for it. It's the
• 42:47most wonderful experience to be
• 42:48able to step away and
• 42:49do something a little bit
• 42:50different.
• 42:51And then there was a
• 42:52year of editing,
• 42:53that came after that. And
• 42:55so just to give you
• 42:56a sense of the intensity
• 42:57of this process,
• 43:00once I'd finished the first
• 43:01draft, I sent it to
• 43:02two readers of my choosing,
• 43:04two friends who happened to
• 43:05both have been book editors
• 43:06in their past,
• 43:07and they gave me a
• 43:08lot of feedback. I then
• 43:10had six second readers, a
• 43:11whole range of people,
• 43:13historian,
• 43:14a writer, a scientist,
• 43:16you know, kind of really
• 43:17trying to get a broad
• 43:18swath of individuals with very
• 43:20different perspectives,
• 43:21polio survivor as well.
• 43:24Submitted the first draft, and
• 43:25then I got did first
• 43:26edits from the editor.
• 43:28I actually paid fact checkers
• 43:30to go through it. Thank
• 43:31god I did. They found
• 43:32all kinds of mistakes that
• 43:33had crept in.
• 43:35There was a second round
• 43:36of edits with my editor.
• 43:38There was a first copy
• 43:39edit. There was a second
• 43:40copy edit. There was a
• 43:42first proofread and a second
• 43:43proofread.
• 43:45And I put that up
• 43:45there because that is very
• 43:46different from the process of
• 43:48thing writing a medical paper
• 43:49where, you know, there might
• 43:50be kind of one round
• 43:51of edits, but not much
• 43:52more than that.
• 43:54And it was extraordinary experience.
• 43:56Highly recommend it. Not for
• 43:58everybody, but,
• 43:59but it was, it, it
• 44:00really
• 44:01was incredibly satisfying to go
• 44:03through this process.
• 44:05I wanna leave you with
• 44:06one last film.
• 44:08It's not about the writing
• 44:09experience, but it's, really some
• 44:11of the most amazing footage.
• 44:12This is from after the
• 44:13epidemic.
• 44:14As I mentioned, a few
• 44:15patients, exactly twenty five of
• 44:17them, never came off ventilators
• 44:19and remained in the hospital
• 44:21and ventilator dependent.
• 44:22But what's extraordinary is ventilators
• 44:24have barely been invented. And
• 44:26I find this amazing that
• 44:27they're getting them outside
• 44:29and into the sunshine and
• 44:31sort of haven't lost that
• 44:32sense of humanity,
• 44:34about the care. Now
• 44:36not recommending we do everything
• 44:37they did back then.
• 44:39I cringe every time I
• 44:40see that, although I do
• 44:41think that the probably this
• 44:42person is on air in
• 44:44that canister and not oxygen.
• 44:46But, you know, I think
• 44:47it's just an amazing imagery,
• 44:48and it sort of spurs
• 44:50should spur us on to
• 44:51really think about
• 44:53how we treat our patients,
• 44:55kind of every day. I
• 44:56mean, look at the like,
• 44:57how simple this old fashioned
• 44:59ventilator is.
• 45:00And then, the the tail
• 45:02end here is this little
• 45:03guy. And if you when
• 45:04he gets closer, you'll see
• 45:05he has a tracheostomy in
• 45:06place. So he's been on
• 45:07he's been ventilated,
• 45:09and you can see he's
• 45:09now breathing again on his
• 45:10own, but you can also
• 45:11see that his arms are
• 45:12still paralyzed, and he's in
• 45:14those slings.
• 45:15And it's this little guy
• 45:16who has always stayed with
• 45:18me,
• 45:19really
• 45:20just recognizing
• 45:21that
• 45:22they couldn't make that paralysis
• 45:23go away. Right? We don't
• 45:24have any way to reverse
• 45:25paralysis in these patients, but
• 45:27someone did take the time
• 45:28to pin those sheriff's badges
• 45:30on him to try to
• 45:31make him have maybe a
• 45:32slightly better day and feel
• 45:33a little better about things.
• 45:35And that's always what I
• 45:36would take to the bedside
• 45:37with me when I was
• 45:38seeing patients of sort of
• 45:39thinking, you know, in the
• 45:40ICU, there's all this machinery
• 45:42and ventilators and ECMO and
• 45:43dialysis machines, and there's not
• 45:45a lot I can do
• 45:46most of the time.
• 45:47And
• 45:48often it's like a cup
• 45:49of coffee for someone or
• 45:52an extra blanket
• 45:53and a squeeze of the
• 45:54hand. And at the end
• 45:56of the day, actually, that's
• 45:57what our patients and families
• 45:58remember about the care that's
• 46:00provided more than anything.
• 46:02And so I hope that
• 46:03you'll take this little guy
• 46:04with you on your journeys
• 46:06through patient care as well.
• 46:08So I'm gonna stop there.
• 46:10And, this is my book,
• 46:11The Autumn Ghost. It is
• 46:12written for the general public.
• 46:14It's written to not be
• 46:15annoying to people who are
• 46:16in medicine
• 46:17so that it should be,
• 46:19enjoyable by all.
• 46:20It's,
• 46:21mostly just a good story,
• 46:23but, I'm happy to answer
• 46:24any questions. And as you
• 46:25can see, my email's up
• 46:26there as well.
• 46:34Questions?
• 46:36I'll ask a question. Yeah.
• 46:41I appreciated that process slide
• 46:43and the timeline
• 46:45because
• 46:46I I can imagine I
• 46:47really like I loved hearing
• 46:49about
• 46:51your data gathering
• 46:52and all the different modalities.
• 46:54But I imagine you could
• 46:55have written a book that
• 46:56was a thousand pages long.
• 46:58And how did you make
• 46:59decisions about what to keep
• 47:00and what not to keep?
• 47:02Well, you know, it's interesting.
• 47:03I, was chatting when I
• 47:04was first starting to write
• 47:05this with someone who is
• 47:07a she's a professor of
• 47:08philosophy, but she, she actually
• 47:10was critically ill herself and
• 47:11and interacts a lot
• 47:13with the critical care community
• 47:14and has written papers with
• 47:16people in critical care. So
• 47:17she knows our world.
• 47:18And she had said to
• 47:19me, she said, I know
• 47:20what your problem is gonna
• 47:21be. Your problem is gonna
• 47:22be that you're used to
• 47:23writing twenty five hundred words,
• 47:25and now you have to
• 47:26write a lot more than
• 47:27that. And figuring out how
• 47:29to expand
• 47:31actually
• 47:32was
• 47:33a little bit more of
• 47:33a challenge.
• 47:35To your point, though, then
• 47:36you go to the other
• 47:37extreme where, you know, once
• 47:38you've kind of figured out
• 47:39how to expand and and,
• 47:40honestly, it is things like
• 47:41learning how to just put
• 47:42in the detail that you
• 47:44inherently take out in medical
• 47:46descriptions.
• 47:48There was some of that.
• 47:49And,
• 47:51I actually had a
• 47:52crisis moment where we had
• 47:54actually already gone to copy
• 47:55editing, and the publisher came
• 47:57back to me and said
• 47:58the book is too long.
• 48:00We've done the math. And
• 48:02if we publish it with
• 48:03this many pages, it'll be
• 48:04too expensive a book, and
• 48:05you've gotta cut nine thousand
• 48:07words in a week.
• 48:10And so that was a
• 48:11little bit of a meltdown
• 48:12moment. But to your point,
• 48:13I did I mean, I've
• 48:14certainly have chapters and pieces
• 48:16that didn't end up in
• 48:16the book, and a lot
• 48:17of that was just a
• 48:18good editor. And,
• 48:20you know, some of it
• 48:21I could do myself in
• 48:23trying to sort of find
• 48:24the rhythm of the story
• 48:25and recognizing
• 48:26you can't go too far
• 48:27down rabbit holes or you
• 48:28lose the reader.
• 48:29And some of it was
• 48:31my editor coming back to
• 48:32me saying, you know, this
• 48:33chapter on World War two
• 48:34is amazing
• 48:36and two thirds of it
• 48:37has to go because
• 48:38it's taking you too far
• 48:40outside the main story.
• 48:42And it broke my heart
• 48:43because there was tons of
• 48:44stuff I didn't make in
• 48:45a book and all these
• 48:46anecdotes and all these tidbits
• 48:47that I loved. And, you
• 48:48know, the co the classic
• 48:49phrase of killing your darlings.
• 48:52And but I do think
• 48:53that's where turning to others
• 48:54for help making those decisions
• 48:56really helps.
• 48:57And trying to figure that
• 48:59out for yourself is often
• 49:00you're you're just so blinded
• 49:02by the love of these
• 49:03people and these stories at
• 49:05a certain point.
• 49:06So so I always say,
• 49:08you know and even when
• 49:09writing medical papers, one of
• 49:10the things I'll tell students,
• 49:11I'll say, don't worry about,
• 49:13you know, the the three
• 49:14thousand or twenty five hundred
• 49:15word limit. Write what you
• 49:17need to write, and then
• 49:18we'll pair it down. Like
• 49:19like, that's actually the easy
• 49:20part in a way.
• 49:22Yeah.
• 49:25Lisa and then Lauren and
• 49:26then person in the
• 49:28What was the easiest
• 49:30thing?
• 49:35What was the hardest thing
• 49:36for you to cut?
• 49:38Which darling did you cry
• 49:40over?
• 49:42That's a great question.
• 49:44I think it was, you
• 49:45know, it was
• 49:47some of the descriptions
• 49:52II because
• 49:53I was just so I
• 49:54don't know. Well, I have
• 49:55a little bit of a
• 49:56World War II thing, obviously,
• 49:57that I find it just
• 49:58fascinating.
• 49:59But I would just like
• 50:00the respect I had for
• 50:03what they had done and
• 50:04the ways they'd risked their
• 50:06lives.
• 50:07And,
• 50:08you know, I could go
• 50:09on and on and on
• 50:10sharing that with people.
• 50:12And so I think I
• 50:13I definitely found that sort
• 50:15of most gut wrenching to
• 50:16have to take out some
• 50:18of that detail and not
• 50:20shove it all in there
• 50:21for people to admire and
• 50:23reflect on these individuals. Yeah.
• 50:29But thank you. Since we're
• 50:30talking about the process,
• 50:32how in in the timeline,
• 50:34how and when did you
• 50:35find a publisher?
• 50:36Like, did you have that
• 50:37in advance or somewhere along
• 50:38the way?
• 50:40So,
• 50:41so getting so if you'd
• 50:42yeah. So if you wanna
• 50:43write a book for the
• 50:43general public, you do generally
• 50:45need an agent
• 50:46to then pitch it to
• 50:48publishers, where if it's an
• 50:49academic press or academic book,
• 50:51you can generally go straight
• 50:52to the editor with your
• 50:53idea.
• 50:53And,
• 50:54you know, everyone's a little
• 50:55bit different in the way
• 50:56to do this, but, basically,
• 50:57what you need is a
• 50:58proposal. And you it's about
• 51:00a thirty page proposal. If
• 51:01you write fiction, often they'll
• 51:03want just to see, you
• 51:03know, your whole manuscript.
• 51:05And if you're a super
• 51:06high flying well known writer,
• 51:08you could probably just be
• 51:09like, hey. I wanna write
• 51:10about, you know,
• 51:11I don't know, gun runners
• 51:13in Brazil, and someone's gonna
• 51:15say that sounds great. Here's
• 51:16some money to do it.
• 51:17But if you're an unknown
• 51:18writer, you need to have
• 51:19a a proposal
• 51:20that actually is going to
• 51:22give them a sense of
• 51:23what you're trying to write
• 51:24and all of that. And
• 51:25so in order to actually
• 51:26write that detailed proposal, you
• 51:28in fact need to have
• 51:30done a fair amount of
• 51:30the research and some of
• 51:31the writing already because they're
• 51:33expecting a chapter by chapter
• 51:34outline. So you have to
• 51:36know the entire arc of
• 51:37your story. You have to
• 51:38be able to pitch, you
• 51:39know, what is this about
• 51:40and why should they care
• 51:41about it.
• 51:42And if you're an unknown
• 51:43writer, you also need a
• 51:44a sample chapter. So you
• 51:46have to have done enough
• 51:47of the detailed research to
• 51:48be able to put together,
• 51:49and it might not be
• 51:50the final version of it,
• 51:51but something that looks legitimately
• 51:53like what you imagine it
• 51:54will be. So I'd probably
• 51:55done about
• 51:57half the research
• 51:58and written about a quarter
• 51:59of the book
• 52:01when I first pitched to
• 52:02an agent who then pitched
• 52:04it to a publisher.
• 52:05The sequencing was a little
• 52:06faster than I think I
• 52:07would have liked only because
• 52:08it was COVID
• 52:09and
• 52:10probably unnecessarily.
• 52:12I had a you know,
• 52:12ventilators and ICUs were, like,
• 52:15front and center of every
• 52:16newspaper for months.
• 52:17I got a little bit
• 52:18of panic as people were
• 52:19starting to get interested in
• 52:20this story that someone else
• 52:22might, you know, decide to
• 52:23write this story.
• 52:25Turns out nobody else
• 52:26was
• 52:27that nerdy.
• 52:28But I sort of sped
• 52:30up the process a little
• 52:31bit,
• 52:32and and I think it
• 52:33helps to wait only because
• 52:35the more research you do
• 52:36and the more you learn
• 52:37about the story and the
• 52:38characters and and all of
• 52:40that, just the more nuanced
• 52:42understanding you have the story
• 52:43you're trying to tell and,
• 52:44therefore, the stronger proposal it
• 52:46is.
• 52:48So, yeah, so that was
• 52:49back in two twenty twenty.
• 52:51And, and then I had
• 52:52a a
• 52:54a contract that gave me
• 52:55eighteen months to finish the
• 52:56book, and I knew I
• 52:56was gonna have a sabbatical
• 52:57in there. So I also
• 52:59waited till I knew I
• 53:00was gonna have that sabbatical
• 53:01time coming up so that
• 53:02I could feel confident that
• 53:04I would get the the
• 53:05manuscript to them on time.
• 53:09I had a question. Thank
• 53:10you for this. This was
• 53:11wonderful.
• 53:13You mentioned yourself a few
• 53:14times that the type of
• 53:15writing in medical traditional medical
• 53:17journals differs a lot from
• 53:19what moves us as as
• 53:20humans and stories. So I'm
• 53:22just curious
• 53:24as after doing this and
• 53:25going back to reading, you
• 53:27know, traditional articles, what what
• 53:29you think about now or
• 53:30what you maybe would Yeah.
• 53:31It's a great question
• 53:33because
• 53:34turns out I now struggle
• 53:36to write traditional medical articles.
• 53:39I work very closely with
• 53:40one collaborator. Her name is
• 53:41Haley. And, you know, when
• 53:43we started out, I was
• 53:44the one who was sort
• 53:44of more experienced writing medical
• 53:46papers, and I was always
• 53:47kind of editing what she
• 53:48wrote and, you know, very
• 53:50and and trying to make
• 53:51it more concise and more
• 53:53consistent with sort of standard
• 53:54medical language.
• 53:56And now it's reversed. It
• 53:57turns out that I have
• 53:58a really hard time now
• 53:59sticking to, like, the the
• 54:01kind of really boring
• 54:04technical language that's expected. And
• 54:06she's always having to rewrite
• 54:07my lines that are getting
• 54:08a little too florid and
• 54:09a little too,
• 54:11to be honest, often a
• 54:12little too relaxed in tone.
• 54:14That's the thing that I
• 54:15struggle most with. And I
• 54:17really enjoyed
• 54:18doing this writing
• 54:20because it did feel freeing
• 54:21to not be bound by
• 54:23the need to use the
• 54:24same term for something every
• 54:26single time. In fact, it's
• 54:27the opposite. Right? You're trying
• 54:28to vary your language. You're
• 54:30trying not to sound repetitive.
• 54:32And so it has I
• 54:34think I might have become
• 54:35a worse medical writer because
• 54:36of it, but I'm okay
• 54:38with that.
• 54:39Just have to have good
• 54:40collaborators who will fix it
• 54:41for you.
• 54:43I was just wondering
• 54:45if you have, like, repurposed,
• 54:48like, some of these stories
• 54:49and anecdotes that you had,
• 54:50you know, so
• 54:51hard fought to find and
• 54:53to write out, like, you
• 54:55know, into, like, an essay
• 54:57or, like, an extended chapter
• 54:59or something like that. Have
• 55:00you done that? Yeah. I
• 55:01mean, I've done a few
• 55:02op eds,
• 55:04that have been in and
• 55:05unfortunately,
• 55:06you know, op eds on
• 55:07polio have felt important.
• 55:10And so I've been able
• 55:11to take some, for instance,
• 55:12some of the stories and
• 55:13interviews with patients
• 55:15and use their stories a
• 55:17little bit in some of
• 55:18those op eds.
• 55:19I was saying earlier I've
• 55:20I've experimented with all kinds
• 55:21of different forms of writing,
• 55:24and you discover I've discovered
• 55:26there's some I'm more comfortable
• 55:27with than others. And I
• 55:29would love to be able
• 55:30to write long form essays
• 55:32and maybe repurpose some of
• 55:33this. Turns out it just
• 55:35doesn't work for me in
• 55:36terms of that format.
• 55:38So it's been a little
• 55:39bit more limited in terms
• 55:40of what I've been able
• 55:41to do with it, but
• 55:41I have gotten a few
• 55:42of them out there in
• 55:43that way. Yeah.
• 55:45And, unfortunately,
• 55:46I really hope we don't
• 55:48see polio again.
• 55:50But if we do, I
• 55:51have a feeling I'll be
• 55:52writing a lot of op
• 55:52eds, so I will probably
• 55:54be repurposing it then.
• 55:57Time,
• 55:58and we'll hang out for
• 55:59a few minutes. Yeah. Absolutely.