Latest / The Short Coat (Audio): An Inside Look at Getting Into and Getting Through Medical School / President Garfield’s Doc had the Worst Take on Pus, ft. Ryan Nanni
Transcript
- 460 === Jeff Goddard: Matt Engelken: Hey, I just wanna Dave Etler: say that today is graduation day. Today's commencement day. And so, congratulations to all of our friends. in the M four slash senior stew. I'm trying not to leave out. people. Jeff Goddard: The M eights. Yeah. The m sixes, the m nines, the m sixes Riley Behan-Bush: to make us feel a little bit better about Yeah. Jeff Goddard: I was about say the never ending. Congratulations to those that have, already left several times before Riley gets to get out of here. Yeah. Dave Etler: I'm gonna go and see my boss, Kate de Cherry be the commencement speaker. She was,Shanghai slash nominated and voted yeah. to be the commencement speaker and, Jeff Goddard: try to sneak out the back door. She, I mean, couldn't do it. Dave Etler: I anticipate great things tonight, even though she would kill me for even acknowledging this, because she's terrified. Riley Behan-Bush: And congrats to all those. Graduating from other schools and coming Matt Engelken: to med school. Maybe that's where I was going. That's where Dave Etler: I was going for the first Matt Engelken: part. Riley Behan-Bush: Welcome to the road that is medical education. Yes. For some it will take a decade Jeff Goddard: Welcome Dave Etler: back to the Short Code Podcast. It's the show that gives you an inside look at medical school from the students. Drinking from that fire hose happens to be a production of the University of Iowa Carver College of Medicine. I'm Dave Etler with me today in the SAP Studio. She's been practicing all week for a blitz of insights. It's MD/PhD student Riley Bean Bush. Hello everyone. he's scoring TDS in every conversation. It's M one Jeff Goddard. I'm Jeff Goddard: not even sure what that means. He's Dave Etler: ready to block and clear the way for great ideas. It's M two Matt Engleton. Howdy. And he is a real good sport for joining us at the last minute. It's SeaComm Learning Communities Director Cody Pritchard. Hey, everybody. You know, and if you thought that was all shortcuts, I hate to disabuse you of this ridiculous notion that you have. We're also joined by our guest, Ryan Nani. Ryan is a sports writer. Ryan Nani is, no. Okay. You can do it. Ryan Nanni: I also don't know who I am. It's okay. Dave Etler: we're joined today by a special guest. Ryan Nani is a sports writer and podcast host, known for his witty and humorous takes on college football. He hosts the sh Shut, full cast podcast on ESP Nation. Is that right? Used to be. Not anymore. Not anymore. Okay. He's a beloved figure anyway, among college football fans, we still like him. and for some reason he's agreed to come on this show, which isn't usually about football at all, and may not be today. we're always excited to talk to people on the show that we've never met before. Thanks for coming, Ryan. Thank you for Ryan Nanni: having me. I Do you know why you're here, Ryan? You know, existentially? No. So why should this podcast be Matt Engelken: any different? I can, Dave Etler: we can. Very reasonable response. Yeah. I think we can all appreciate that response. but welcome, welcome to the show. Thank you. Matt. Matt Engelken: What are we doing today? so today I'm going to tell you some of my favorite medical stories from history. kinda like a drunk history format except I'm, completely sober, although I am drunk of the knowledge from taking a shelf today. So I apologize. I apologize. Yeah, I apologize. If I'm all over, I'll do a great self exams. Riley Behan-Bush: You're fine. Matt Engelken: I know which shelf surgery. Okay. Congratulations Ryan. Dave Etler: This is done just to keep you in the know. This is an exam that they take at the very end of their, so many of their clerkships, their standardized tests, universally loved. By, medical students everywhere. Completely relevant all the time. Clinically, Matt Engelken: they're really fun because you go in and like the doctors and the residents and everyone are like, oh, you're just a little child. You shouldn't know anything. Like, we expect you to be stupid. Right? Yeah. And then you go take a standardized test that's like, you don't know everything about being a doctor, you dumb person. it's a really great way to finish every class. Why, Ryan Nanni: is shelf an acronym or like where, what does that name come from? Dave Etler: Yeah, I think it's off the shelf. Matt Engelken: Oh, Riley Behan-Bush: what? That doesn't help me. Which mean Matt Engelken: off Dave Etler: the shelf, this exam sits on the shelf until like it's a standardized exam. Everybody takes it. We just put it back on the shelf and we take Matt Engelken: it off Jeff Goddard: and we need it. You know, that actually does kind of work for me. It's the idea that this is like, this is always going to be the same. We're just taking it off the shelf. Okay. We're not making something up every year. This is just a standard dusty tome that we're using that is not relevant to anything, but here we go. It's like all Riley Behan-Bush: shelves in my house, which are just like covered in dust no matter how much I dust them. It's like, how Matt Engelken: did that get there? I don't know. I mean like my first entire year of medical school and people are like, you have to take the shelf. I was like, what's that? I Dave Etler: mean, now you Matt Engelken: unfortunately know, I still don't Jeff Goddard: really know all the acronyms Riley Behan-Bush: around. I don't know what's going on. We don't even know if it's an acronym. I was gonna say, of all the acronyms in medicine, this one sucks the most, but it might not even be an acronym. Matt Engelken: No. Speaking of things that don't make any sense, what is the she or what is step like? I still don't really know why it's called Step. Because Jeff Goddard: there are three of them. You take three steps. Yes. You take step one, step two, step three. It's, you're just a simple, you're just taking steps toward becoming a physician. You see Dave Etler: what happens, baby steps. You see what happens. Ryan,you become used to a certain mindset in medicine. Sure. I e that everything has an acronym or a complicated bit of jargon, and then when something is like very standard and reasonable, that makes no sense. That throws Jeff Goddard: you Sure. Yeah. we can't handle it. Does Riley Behan-Bush: anyone want to know why they're actually called shelf exams? Matt Engelken: I really do. Riley Behan-Bush: Yes. Okay. So much. Google tells me that the exams are called shelf exams because they consist of shelved or expired us, m l e, step one and step two, questions from old exams, Matt Engelken: get the fuck out. Etler just thrown away. They weren't good enough. Riley Behan-Bush: Step one and step two, questions that have. Been shoved, which I already hate. Let's call 'em expired exams, like I'm expired because this sucks. And Jeff Goddard: I'm followed back. I mean, like, I have to take my general surgery. Expired exams. Expired Riley Behan-Bush: exams. Ryan Nanni: So you are taking the exam equivalent of We're making, we're having leftovers for dose. Riley Behan-Bush: Correct. Yes, exactly. Cool. This is like the sloppy seconds of, med school education, Matt Engelken: but not even, like, this is still good. It's not like a chili, which you can reheat and it's just like, delicious. It's like this wasn't good enough for step one and step. That's what I, it's like Riley Behan-Bush: it cost a question, like, why were they inspired? Jeff Goddard: It's probably moldy, but Matt Engelken: you know. It's because you may not even be relevant. We can feed it to the pigs. I don't know. Maybe Ryan Nanni: the way to think of this is very green practice. Like we never throw questions away. We just move them to the Matt Engelken: front. Yeah. Riley Behan-Bush: it's reduced, reused, recycle, it's lifecycle. Dave Etler: Actually electrons saved over Jeff Goddard: the years. Think Riley Behan-Bush: of them. The one electron hypothesis, Matt Engelken: Yeah. Now that I'm done teller, I have a couple stories to tell. So, basically just stories that I think are funny and I wanted to share with you all and the wonderful short coats out in the ether. This is not meant to be a contiguous story. So if you have anything to share, please do. Okay. Dave Etler: we welcome we, Ryan, for your knowledge, for your information. We welcome the tangent. So I Matt Engelken: would never Yeah, surely not. so the first story that I have to share is, are all of you guys familiar with James a Garfield? the cat something? Jeff Goddard: The cat? He loves lasagna. Lasagna Hates Mondays lasagna. Yeah. He's a famous presidential speech in which he decried Mondays. I remember this Matt Engelken: orange. Yeah. He had a two hour speech and then he said that he hated Mondays eight, some lasagna afterwards. and that's the person we'll be talking about today, specifically his death. starting off on a good note, so as I'm sure most of Elise, the American population knows James a Garfield was shot and killed. I think Jeff Goddard: you're giving too much credit to the American population, but I Riley Behan-Bush: appreciate, I appreciate that I, as a member of the American population, but like, do speak for Americans and say that I was not, I did not pay attention in history class that well. Yeah. I'm a STEM girl. Yeah, boy. Oh woman in stem. Actually. She's trying to build steps over here Matt Engelken: figuring out who got shot. Well, then I can go back a couple steps. thank you James. A Garfield, although a wonderful cat, was also a president of the United States for a little bit, about several months of 1881. early on in his presidency, he was shot and the story is not about how he got shot, but about what happened afterwards. The person who shot him during his trial, said the quote, I may have shot the president, but it was the doctors who killed him. So it's true. That really happened. So now we're gonna tell the story, and it sounds like you know the story already, Jess. I do know a little Jeff Goddard: bit of the story, but I'll let you take the front seat on this one. Okay. No, no backseat Matt Engelken: storytelling from me. Well, if you wanna chime in for anything I missed, feel free. So, although James a Garfield is the person that some of you may have heard of, others may not have heard of, he's looking at me. he's not the main character of the story. The main character of the story is a physician named Dr. Willard Bliss. And if you're me, you're like, wow, Willard, that's a pretty stupid first name. And for legal purposes. Wow. That's a joke. you have Dave Etler: nail, you have and alienated all of the Willards Matt Engelken: Well, Jeff Goddard: thousands of Willard out there who just turned off this episode. Matt Engelken: well, in defense to all Willards, that was actually not his first name. He was named after the doctor. Who was present when he was born. And so his first name was actually, doctor. You're kidding. No, that's so much better. so his full name, he went by DW Bliss, but his first name was Doctor. so he became a physician. It would've been way Riley Behan-Bush: funnier if he just didn't become a physician, was the same doctor. It really adds like a nuance to the like, conversation around who can be called doctor, who can't be called doctor. Like what if your name, I, Ryan Nanni: I assume this is the same way Dr. Jay's origin story. It was a basketball player. Yeah. Yes. Yeah. Oh, I just didn't want to do that. So I played basketball Jeff Goddard: and you know Dave Etler: what? Congratulations. Dr. J for casting off the chains of your Of Nominative. Jeff Goddard: Determinists. Yes, exactly. You could Riley Behan-Bush: have been, doc Martin could have had a line of shoes that last stood the T of time, Matt Engelken: but instead, Dr. Willard Bliss decided to be lame and is now known for, being the chief surgeon overseeing a president's death. so a little bit about how this happened, because the entire story from beginning to end is just wacky. First off, he wasn't the president's surgeon. He just kind of showed up and took over. I don't know how, but he was there. is this the, Dave Etler: the equivalent of. Like, you're in a plane and somebody says, is there a doctor in the Matt Engelken: house? Kind of, except the president's actual surgeon was also there. He just Jeff Goddard: like, bliss is like, no, I got Matt Engelken: this. Yeah. Do all presidents have surgeons? Yeah. Right after this? Jeff Goddard: Yeah. They have like an actual assigned to them physician. That's, do they Riley Behan-Bush: have all specialties? Ooh, Dave Etler: like I think they have the entire. Walter Reed Matt Engelken: Hospital. I'm the president's chief hematologist. A presidential dentist. Yeah, that's what I, Riley Behan-Bush: oh, there has to be. Right? And like, is there like a presidential nephrologist for when they end up with like a mild case Jeff Goddard: of I'm gonna go, yeah. I have to assume that Walter Reid Hospital is actually for the president and also they let other people use it sometimes. Okay, Matt Engelken: thank you. But do they get to pick their own doctors? Like, can they, you know, can they, it's like Jeff Goddard: a, yeah, this was like a thing. Can I fly on LinkedIn? Right. Trump, remember Trump's personal physician was a do and there was like a whole controversy around that. I do not remember that. Richard Nixon's personal physician was a do, there was a bit of controversy around that as well. Got it. Huh? So they do get to pick their, yeah. They have a personal physician that they get to choose. Yeah. Next show Riley Behan-Bush: road to becoming the president's Matt Engelken: doctor. Ooh. How do we get there? Give everyone the inside track. that's the job you want. Jeff Goddard: I'm Matt Engelken: sure it's low stress. Low stress. Let's see how bliss handled it. Yeah. Not well, spoilers. So he, it sounds like back in the, so this was the 1880s, it sounds like medicine was a bit of a turf war, and so he like just showed up and was like, no, this is my case. Like, get outta here to everyone else that wanted to help out. so it's up to this man, Dr. Willard Bliss to save the president. Jeff Goddard: As an aside, I'm very glad that particular aspect of medical culture hasn't survived into 2020. Yeah, he said, looking at the camera that seems go on. Matt Engelken: That seems real. so some fun things that happened is, he was shot kind of in the back. The doctor, Dr. Bliss thought it went into, the president's liver. So they tried to do what was the proper technique at the time, which was to stick an unter hand or any other objects into the tract of the wound to try to get the bullet out. Dave Etler: I don't, Matt Engelken: yeah. Okay. Once again, we don't do that anymore. But at the time, like aseptic technique was in its infancy. and honestly the doctors that were practicing as septic technique were horrible at it. They would like sometimes sanitize their instruments, but if they like fell onto the ground, they just pick 'em back up and keep using 'em. One, if they didn't have them, yeah. Dave Etler: Yeah. If they didn't have the right one, they went out to the yard and got a stick. Matt Engelken: Yeah. That was the other thing is most of the, tools they used actually had like wood handles, so like, couldn't be sanitized. Yeah. so just a lot of messy stuff. But this doctrine in particular didn't,didn't at all. in addition, he was a doctor who thought that by seeing puss in a wound said that was a good thing. Yeah. cuz it showed that the wound was healing. Okay. so anyways, they did this. I mean, he's not, Dave Etler: that's not quite wrong. I guess, Matt Engelken: right. It's also not quite right. The body Riley Behan-Bush: is Jeff Goddard: reacting. Yeah, I think there are trying, yeah, there are worse takes on pus, I suppose. Yeah. That's how I'm going to phrase this. Worst, worse, pus takes. Yeah. I think there are worse pus takes. If Ryan Nanni: you want, if you want this video to go super viral on YouTube, just make the thumbnail worst pu There are worst place, Riley Behan-Bush: not the worst Pus. Take go. Matt Engelken: There's your Cody Pritchard: episode title right there. Fun fact. The first Jeff Goddard: writing it down, the first person to look at, a case of, acute lymphoblastic leukemia under a microscope. Called it a Situation of the blood. Yeah. The blood was pussy. Matt Engelken: Okay. Yeah. Is what it's, Jeff Goddard: yeah, Matt Engelken: I guess. Fair. No, that's, Riley Behan-Bush: that's like a fair thing to think. You see a bunch of white blood cells, you're like, I guess it's gotta Matt Engelken: be puss. I don't, it's just, Jeff Goddard: it's just, he's, it's a situation. That's what it is. Blood just went bad. Who knows? Yeah. Let's move Matt Engelken: on. well moving on. Before we move on, I have to say one thing, which is that, as, so pus is the word that we like to use for. drainage with white blood cells. What we use in the chart is purulent because it turns out that when you say something has pussy drainage, people don't like it. When you Riley Behan-Bush: type it out, Jeff Goddard: when you type it out, meaning it is a little uncomfortable for a lot of people in the room. That's drain. Yeah. I mean it's also pus p Matt Engelken: it's also just confusing, you know? Yeah. But it's something I think about a lot of, just like every single time I see pure and drainage, I'm just like, ah, they had to make this work because the other one was uncomfortable. Bring it back. We could bring it back. Bring back. Yeah. Am I'll just tell every single patient I see to be like, you have some pussy drainage. And they're like, no, I don't like that. well anyways, for, James a Garfield's pussy drainage. Yeah, they created a huge mess. He became really sick, and so the next thing they did well, he's not eating, he's not healthy. So we're gonna give him some em enemas, which is everyone's favorite. Dave Etler: is there a rationale behind that in the 1880s? Are they just, they're Matt Engelken: just trying. They're just trying. They're just, they're doing their best. I mean, as he's like losing weight and everything, the doctor's reporting that. Yeah, he looks pretty good. He didn't, but they didn't care. so the enema, sorry, without the power Ryan Nanni: of positive thought. yeah, exactly. You have to manifest. Jeff Goddard: So, wait, can I just, like, as somebody who is not in medicine, Ryan, just, spitball with me here. You're sitting there in 1880s and you're thinking, yeah, this is how I'm gonna help this patient. The doctor says, I know enema logic, that one for me. How would you think that this could possibly help the patient? Ryan Nanni: You know, I guess I'm, I guess I'm looking at it more of like, what are the other options that might be, proposed and it's like, all right, trepanation and leeches. I don't like those options. So if enema is the best of the three. So from that perspective, I'm like, all right. Yeah, I feel good about that. Yeah, I mean it's, we're not drilling holes Riley Behan-Bush: in's head. Does it change your thoughts depending on what the enema is? Jeff Goddard: What do you mean? No, Ryan Nanni: I think this is a situation where I'd rather just not know. Yeah. Like Jeff Goddard: it could be more knowledge is doubt that it's just water. Yeah. Yeah. Probably for the best that it isn't just water at this time. Yeah. It's not, this is before water sanitation, so. Yeah. Yeah. But yeah. Do Matt Engelken: we know the animals is, there's nothing healthier than do I do know. Okay. The enema consisted primarily of ground beef. Jeff Goddard: Oh no. I was gonna Riley Behan-Bush: say stew, but Matt Engelken: describing, Jeff Goddard: are you sticking by This is probably better than the leeches because I'm less, I changed my mind. I'd like bleach. See? Exactly. Matt Engelken: It does change depending on enema. No milk and whiskey. Yeah. All things be in there. Of course. At least it sterilizes. Yeah. And a little bit of opium. Exactly. Oh, obviously. At least. At least that one was like, well, that's the only thing Jeff Goddard: that's helping. Matt Engelken: Yeah, exactly. Cuz medically opium will help prevent. We'll prevent like gastric mot or like GI motility, so it'll keep the enema in. So like opiums, the only thing that's even logical out of that, Riley Behan-Bush: all the pro carnivore people out here are hating us for not saying that the beef wasn't helping. Well, Jeff Goddard: look, I don't care where you stand on whether or not beef should be like your primary food source. It's not doing you any good in the colon. No, it doesn't get absorbed Matt Engelken: at all. It's just there, it's just hanging out. What's Dave Etler: the idea that the be because he was losing weight was, you know, the beef would, you know, beef him up, Jeff Goddard: help him. Yeah. Matt Engelken: That was exactly Cody Pritchard: the, and that's where that phrase came from. Yep. That one in 1881. Thank you Dr. Matt Engelken: Bis, the bliss. Absolutely. yeah, I mean the idea was like, well, if you can't eat food, then theoretically the other way to get into the digestive track is, the back way. Yeah. They both meet in the middle. Jeff Goddard: Of course. I think the point here is that even though they didn't follow what we would consider to be sound, Like scientific knowledge of today. There was logic to it. It was flawed, it was imperfect, but they're like, if we put beef up the pooper, Maybe it'll get into the body. Yeah. Okay. yeah. I can buy that. I also, Riley Behan-Bush: clearly it was sponsored by Big Cow because we got beef, we got milk. Like the, Jeff Goddard: he was literally, the next door neighbor was own bunch of cows. And he's like, you know what? You should try my products. This story should work for when I Riley Behan-Bush: got Ryan Nanni: this beef en Riley Behan-Bush: would be made better by the fact that like Garfield ran on like for the cattle farmers. Like, that was his like whole like, well, I mean that it's called Premise. And then he like had to go Matt Engelken: down with it. Well, I mean, think about it as, as he live, what is Garfield's favorite food? It's lasagna, which contains beef. It contains milk. Yep. It contains cheese, which is just kind of milk. so it contains whiskey apparently with Xop. You know, like why not? Mine does. But before the Jeff Goddard: FDA regulated our lasagna, that's a, Matt Engelken: this is a sad day. It's just a local anomaly. so to continue the story we have. so he's gone from 210 pounds to 130 pounds, not doing well. in what span of time is this? Right? This is like a couple months. Okay. Like very not, well, not idea. We are not Jeff Goddard: endorsing the beef in enema diet. It is not, no, Dave Etler: no. Thank you for, thank you for disclaiming that. I think, Jeff Goddard: I think it needed to be, I don't wanna get, it's too late. Ryan Nanni: There are people who listened to only the podcast to a certain point and we're like, alright, Jeff Goddard: like, I guess Matt Engelken: I'm gonna do it. Let's go. It's a good weight loss strategy. I mean, it's good enough Ryan Nanni: for a president, it's Matt Engelken: good enough for me. But if you don't have opium, then it'll just come right back out. So you need some kind of morphing too. so a little bit later we bring in another character in this story, which is Alexander Graham Bell. Ooh, this is the part that I know the best. This is the part that just shows how inept Dr. Willer Bliss was, yeah, we have Jeff Goddard: the telephone guy. Is that Yes. That's the guy. He Riley Behan-Bush: telephone guy. Yes, I did it. Yeah. Matt Engelken: Bell at t. That was, I was gonna say, yeah. Yeah. All right. So Mr. Bell is like, Hey, so you guys haven't found the bullet yet. As we know, the bullet is metal. And Alexander Graham was like, Hey guys, what if we use my new invention, the metal detector to find the bullet? Oh, okay. And so the doctor was like, genius. I think that the bullet's in the liver, someone used the metal detector at the liver, tries it once, gets a bunch of feedback from like everything metal in the room. So they move him, try a second time, go for the liver, can't find anything. And so like, all right, whatever. Third time they try it again. Like at this point, bell's like, I know this works. Like I've tried it on everything like this works. But he does it again because he is like, well, if the president's doctor can't find it, then like, who can. Does it again. Third time still doesn't work. And doctor is like, no, I'm, this is stupid. I'm done. Jeff Goddard: So, quick pause on the story. smart people in the room, why couldn't he find it in the liver? Because it wasn't Matt Engelken: there, because it wasn't in the liver. Where might it have been? Dave Etler: it could have been in any other part of the body. I mean, look, I think so far we've determined that doctor maybe wasn't the right person to be treating him, and may not have had the anatomy knowledge that even doctors in the 1880s had. That's fair. I think that's reasonable. I'm going to assume that it was in the forehead or the foot. Matt Engelken: It was not that bad, but it was, Riley Behan-Bush: I'm gonna guess it's a right versus left thing. Matt Engelken: Yeah. Oh, Jeff Goddard: you think it's over like in the splish area? Yeah. Riley Behan-Bush: I'm gonna go ahead and assume, cuz like, I feel like maybe they just like thought the liver could be like, on either side and then they were just like, I don't know, wacky guests, like didn't have all the knowledge. That's my Jeff Goddard: guess. Cody Cody Pritchard: thoughts. I'm gonna say it went up like chest cavity, like Jeff Goddard: traveled up somehow. That makes sense. Yeah. How about you, Ryan? Wow. Ryan Nanni: Fell out with the beef ema. Jeff Goddard: Reasonable. Fair thought. Wow. Yeah, there you go. I know there's some logic to it, right? Why not? It pierced the colon. It could have come right on out. Yeah. Yeah. yeah cuz turns out when you put a bullet inside of somebody, it moves around, it bounces around. it doesn't just like chill. Right? So all solid logic. Anyway, back to Bell and Bliss over here. Well it's like an Abbott and Costella show. Really? I Matt Engelken: know. well see the reason he couldn't find it in the liver is cuz. Wasn't in the liver, it was on the other side. Ah, good job Jeff Goddard: Riley. The rights Riley Behan-Bush: and lefts very difficult for anatomy. Well see that's in the 1880s. Cody Pritchard: In the 1880s. Old knows the difference from right, left, Matt Engelken: but the trajectory of the bullet was like right towards the spleen. It ended up lodging behind the splenic artery and the pancreas, which is on the left side. and he just thought it was on the right side. Okay. I have a question. Yeah. Jeff Goddard: Because he stuck his finger in there. That's why he thought it was on the right side. Well, Dave Etler: my question is, you know, bell, his first attempt to find it picked up everything in the room. But when they moved him out, I don't know, into the field where they got the beef, it didn't detect that bullet Matt Engelken: at all. Well, that's because Dr. Bliss was the only one that used the metal detector. Other people were like, why don't you use it in more than just the liver? And he is like, no, it's in the liver. Oh, okay. So they didn't find it. There's a lesson here Dave Etler: somewhere, but Matt Engelken: yeah. Okay. Yeah. The lesson is if you think you know what's happening, just keep doing it. Yeah. Keep it up. and part of the reason why I thought it was in the liver is because they made a different track with their fingers and instruments. That wasn't the track that the bullet went down. Oh, shit. So they made a different hole. Oh, Jeff Goddard: fascinating. Yeah. Yeah. So careful where you stick your finger in somebody's liver is really the Yeah. The Matt Engelken: takeaway from this toy. So altogether, just a disaster. president ended up dying ob obviously. cuz I think everyone that was alive in 1881 died eventually. except for the Jeff Goddard: defense. That was the assassinator defense. He's like, well, I mean, don't we all, everyone's Matt Engelken: gonna die one day. I'm just progressing the inevitable Dave Etler: as a comic once said, it would be a shame to die of nothing. So that's Matt Engelken: fair. Jeff Goddard: Yeah. Yeah. Better if Ryan Nanni: nothing else, this assassin proved that President Garfield was not Dracula. Jeff Goddard: Yeah. No, it's true. He did us a great service. I would like to, I would like to note for the crowd that Bliss was not brought up on charges and the assassin himself actually didn't get off even though he was right. It was bliss that killed Cody Pritchard: him. Are we sure that Bliss wasn't actually the assassin and for all the conspiracy out there, like Yes, exactly. Like 150 years later we can start this new conspiracy of, actually Bliss was the assassin. Had somebody like take Jeff Goddard: the fall. Yeah. And then he's just over here like poking his finger into his liver and be like, yep, it's over here. It's over here. Yeah. Cody Pritchard: Put him in the wrong direction. Yeah, exactly. I'm Riley Behan-Bush: glad this is historical, the last time up there that a doctor was ever stubborn enough to just not consider another possibility. Yeah, that's, that hasn't happened. Jeff Goddard: That's never happened. Unfortunately. This is, yeah, this was the turning Riley Behan-Bush: historical anomaly ever again. No doctor since has ever said, I know what's happening and I will not waiver only to find out later that, they should have wavered. Jeff Goddard: We call that Dave Etler: the courage of our convictions, and that is an admirable Jeff Goddard: trait. Yeah. Yeah. Matt Engelken: Right. yeah. You got anything else? not about that one. Okay. yeah. There was one, there Jeff Goddard: was Ryan Nanni: one thing that you left out of this story that I do like. At the time, I think that he was first examining the president. he didn't have any nurses present. So Dr. Dr asked several cabinet members' wives to serve as nurses even though they had no medical training whatsoever. what a terrible day that must have been for them to go. How was your day, sweetie? Well, I got to fumble around inside the president's abdomen Jeff Goddard: sucked. Dave Etler: But you know, on the bright side there was beef. It Matt Engelken: was, I am, Jeff Goddard: so it's what's for dinner? And Cody Pritchard: we'd go on upgraded Dr. Willard, was it Willard, right? Yeah. Willard Bliss to doctor. Doctor too. So are we actually Sure he. Was a doctor just by name. He was a, like, we know this physician, yet we haven't. It wasn't just created. Jeff Goddard: Look, I've never heard a stronger argument for the Flexner report than Dr. Bliss over here. Dave Etler: There you go. Call back to the last episode. Go listen to, all right. A more serious episode about the, about why we are, why medicine is the way it Matt Engelken: is. And that is the story of James a Garfield. Dave Etler: Thank you. You know, I, to any descendants of James Garfield that happened to be listening today, I'm sorry for your loss. I wish Jeff Goddard: a little belated, Dave Etler: but yeah, I wish, I wish things had been different. I really do. Matt Engelken: I appreciate the PSA to all of the Garfield. Hey, look, descendants, you Dave Etler: never know. You never know. Was he a, was he married? Ryan Nanni: I, the other thing I like about this story is, so this happened what, like 15 ish years after Lincoln was assassinated? Ballpark. Yeah. The US government, despite these two events, still did not institute what became the secret Service until an entirely third president got shot. And like, they're like, we, Jeff Goddard: we've, I'm seeing a pattern here. Yes, Ryan Nanni: yes. It's like, fool me once, fool me, even fool me twice. And it's still not my problem. But all right, if three presidents have been assassinated, maybe we should have somebody who can't ru present prevent you from rushing up to him and just Jeff Goddard: shooting him. Point blank to, to quote the, the philosopher poet president George W. Bush fool me twice. you can't fool me again. Matt Engelken: another fool me twice. Story is that one of Abraham Lincoln's sons, Robert Todd Lincoln, actually knew the doctor. part of the thing that I left out from the beginning is that one of the reasons why Dr. Willard Bliss was even in the stories, because, he was like, well, you helped my dad so. You should be able to help an next president. Little did he know that Dr. Bliss was actually forbidden from helping Abraham Lincoln. Oh. when he was,when he was, yeah. Forbidden. Yeah. He was not allowed to help out. so Robert Todd Lincoln, he's a reasonable decision Dave Etler: in Matt Engelken: hindsight. Yeah. He was present for, obviously portions of his, father's death. Yeah. he was present for James a Garfield shooting, and he was also,invited to William McKinley's second inauguration where he was shot. And so after that, for the rest of his life, Robert Toddling was like, I'm not accepting any more presidential offers. I will be living and hiding for the rest of my life. And so, huh. That's why no one, no. None of the presidents died after that. Fun fact. Okay. He was a, we're gonna ignore the ones that have died since then, but, Yeah, he was like, I'm a bad Oman, so I'm not gonna go to any more things. You Jeff Goddard: do. You guys know who,replaced McKinley after he died? His vp? No, Riley Behan-Bush: I have no Jeff Goddard: idea. Riley Behan-Bush: there was this, don't worry guys, I will speak for the American people. Gotten enough history nerds. Yeah. Jeff Goddard: All nerds know this stuff. Cody Pritchard: This is like, we were supposed to learn these things. We passed the exam and then we put it on the shelf. There you go. Just put on the shelf Riley Behan-Bush: some, my knowledge is on some shelf that is dusty all the way over in like some other Jeff Goddard: town. So, I it's somewhat relevant. So it was this, brash up and coming kind of annoying, politician from New York that they put into the office of VP specifically because it limited their power. It was considered to be the most, impa, impotent federal position You could give somebody to shut 'em up. Unfortunately, if you die, then they become president. And that was Teddy Roosevelt. Oh, who, the reason why this is relevant later got shot and then gave a two hour speech while he was bleeding to death. Fully expecting to die and was disappointed that he didn't die. He thought it would've been a fitting end to have bled out after giving this long and noble speech. And he was actually mad. He's like, that sounds very teddy rose. And doesn't that sound like the most teddy of Roosevelt's? The Matt Engelken: best part about this speech is he was campaigning for a third term and president under the Bull Moose Party, not like the Republican or Democrat. And during this, speech when he was shot, he said, I've just been shot, but it takes more than that to kill a bull moose. And he continued and he was right. And he was right. Absolute power move by our boy Teddy. Okay. Riley Behan-Bush: I like to believe that this is also how. The first menstruating person felt when they did something cool on their period. That's what I, they're like, I'm bleeding out, but don't worry guys. I got this. And they thought they were gonna die, and then they were like, wow. Crazy. I can keep on going. That's how I would like to, Jeff Goddard: who's this? I guess that's too personal a question. I was wondering if like, you as a teenager were like, look at all the things that Riley Behan-Bush: I can do. I think so, because like, I feel like there was the fear that like, I will not be able to do anything. And then I was like, wow, the world. Is that what you hear? Yeah. And then you hear the women mental assassination. Yeah. Just never talked about it. And then you hear about the people in the like 15 hundreds, I had to sit there on their little hay in their little house, with all the other like, people that were having periods and it's like, wow, I can do so much more now. Shout out to modern science. Yeah. and cotton. Shout out to cotton. Shout out cotton. Matt Engelken: It's fabric of my life. For the loo. Yeah. Matt Engelken: All right. would you guys like to hear the second story? Oh, there's a, another one. Let's, I very much would, well, the second story is one that, I'm not positive, but you might know a little bit about Ryan. It is the story of the 1904 St. Louis Marathon. I am Ryan Nanni: very familiar with this story. My, one of my friends and former colleagues, John Voyce, has done an entire video about this marathon. But please go Jeff Goddard: ahead. Which I want you to know that I could not have predicted that response from you. Oh, yes. I'm intimately familiar Marathon with this foot race from 120 years Matt Engelken: ago. Please go on. Yes, because the video that, I guess is this an a promotion? Whatever the video? No, I mean, Ryan Nanni: I don't work there anymore, Jeff Goddard: so I think it's just a reference Matt Engelken: for, it's just a reference. Well, the video by John Boyce is fantastic. It is about the events of the 1904 St. Louis Marathon. some things to know about this is. A few things before the race started, there was a few people that participated in, like the Boston Marathon were, you know, running. There were also two people that were there from, like they were Native South Africans there for the St. Louis World exhibition that year who just kind of decided to run the race. so they are accredited by some people as being the first, black Africans to ever participate in the Olympics. Okay. some other people that participated was a male carrier from Cuba who showed up. He lost all of his money gambling in New Orleans. Hitchhiked to, to St. Louis was just showed up wearing like regular clothes and one of the fellow competitors was like, you can't run wearing pants. So cut off the pants to make shorts slutty could run. And that's how short shorts started. Yeah, exactly. Of the short shorts. Of the shorts. The shorts, yeah. Shorts. Jorts. The jorts. This marathon took place in 90 degree weather on mainly unpaved roads that produced a lot of, dust. Notoriously Riley Behan-Bush: great running Matt Engelken: conditions, great running conditions. the Spartans can handle it. And the personal best part, which might be the only medical connection, is that, the person that created the race was trying to do a experiment of controlled dehydration and gave them two spots on the entire course to get water. Dave Etler: So, so was this the, I'm sorry. Was this the intent of the whole thing or he just like, we're Jeff Goddard: gonna put on this is for IRBs, so he just like set up, I'm gonna set up a marathon controlled experiment. Didn't tell any of the participants. Let's go. Riley Behan-Bush: This also seems like retroactive, where it's like, ah, crap. Forgot to put all the water out there, I guess. We'll, an explosion. Yeah, exactly. it's like me forgetting to put like a reagent in my cells and it's like, all right, well let's just see what happens. I guess we'll collect Matt Engelken: some data. Dave Etler: Cory, as, Cody is somebody who, helps to put on a yearly. run for charity here at the Carver College Medicine. We call it Dock dash. Go through a lot of water. I mean, I, well, I was thinking you could save money and retroactively decide that this is a study. Yeah. and have more money for the charity that you're, you know, Cody Pritchard: something tells me that our Office of Risk Management would not appreciate Matt Engelken: that one. Yeah. Well, the St. Louis Marathon did not have the first management apparently, but the race Cody Pritchard: could take place right along the river. Right. You got the Mississippi, you got the Missouri. There's plenty of water access. What Matt Engelken: are you talking about? That's fair. Yeah. They do take a little dime. Yeah, exactly. Jeff Goddard: Little giardia for the grass. You just hop off the Cody Pritchard: track, go down to the river. That's the point too. Matt Engelken: Part of the, it's really just a souvenir at that point. Let's go. That is great points. You told me Riley Behan-Bush: of two water stations in all of 26.2 miles. Yeah. Jeff Goddard: Well Matt Engelken: technically it was like 25 in change. They didn't, or 24 in change, I want to say. the marathon, they didn't measure it. They couldn't even get a sticker out of it. No. Back then's a rough guess. Back then, the marathon didn't have like a controlled distance. It was just like, no run for a while. Who cares? So they made it 40 kilometers. it was more about the Ryan Nanni: vibes. Jeff Goddard: Yeah. Yeah. Than it was about the distance. I mean, let's be honest though. And clearly the vibes break. Great. If you break 20 miles. The vibes. Yeah. The vibes of the vibes. Like it just is what it is at that point. Riley Behan-Bush: I like the idea of the vibes being like, what distance could we just like get enough people to hate their life about halfway through and like still have to complete a second Matt Engelken: half? Dude, that's like a mile for me. Yeah. Jeff Goddard: Right. to be honest, last time I ran a marathon, I remember so like a lot of marathons, hours. Had a half and a full. And so you basically, you run to the starting point of the half and then continue and do the half if you're doing the full. And I remember crossing through the arch of the 13.1 mile point and I was like, I'm done. Like, I'm so done. Matt Engelken: This is a mistake. 13, Jeff Goddard: 13.1 miles to go. Matt Engelken: Oh. What was the Dave Etler: name of the recent runner who like just took some cars, from a recent Matt Engelken: marathon? He just like stole a Dave Etler: car. No, she, within the past, year I think like hopped Cody Pritchard: in the car, kind Dave Etler: like she just took some cars. Yeah. She just maybe, I don't know, called an Uber. I'm not really sure. Jeff Goddard: I think sounds very for her, I guess. Yeah. I mean that's, Ryan Nanni: this was,an ultra-marathoner. Yeah. This was just in April, a Manchester to Liverpool race. Allegedly, like got in a car during the race and Riley Behan-Bush: wait and so then back out the car and tried to bamboozle everyone. Yeah. Jeff Goddard: See, the thing that I hate about the story the most is that like, The whole point of ultramarathons is that nobody thinks that you're cool for finishing it. We all think you're weird. Yeah. So like, you don't get cred for cheating. Like the whole point is you're weird. I don't know. I just, it bums me out. Matt Engelken: Well, I would like to say that was an amazing transition because the first person to finish this race also cheated by getting in a car. Wow. Riley Behan-Bush: And the car what went like 10 miles per hour, so they got like two minutes shaved off their time. So Matt Engelken: what happened was, like a little, it was, if I'm not mistaken, it was like a legitimate runner that ended up cramping because there's no water. So they cramp and they're like, I'm cutting outta the race. I'm done. They got in a car to drive back to just like the starting line. Car breaks down. So he is like, well, I guess I'm gonna run anyways. So he runs across the line and then like accepts everything and then immediately afterwards it's like, no, that was entirely a joke, but they banned him for like a year and then they're like, nah, I think it was pretty funny. So they reinstated him. Ryan Nanni: I appreciate the, do you know who he got his picture taken with when he Jeff Goddard: was the winner? I do not. I bet it wasn't James A Garfield. No. Riley Behan-Bush: What a twist Ryan Nanni: it was Teddy Roosevelt's daughter Alice. Oh wow. Matt Engelken: Still connect, connected. Wow. so yeah, that was the first finisher. good for him. He ran some of it, he ran more of it than I would've because I wasn't alive. Exactly. I'm Jeff Goddard: for no other reason. I just wasn't there otherwise I would've beat him. Yeah. Would've, I mean, it is Riley Behan-Bush: the equivalent now of the races where it's like there's always kind of the, like if they're a loop race, you could usually veer off and like if you're doing the marathon, you could be like, ah, I just don't feel it. And you do Jeff Goddard: the half like, yeah, I'm not vibing. It's just, Riley Behan-Bush: yeah, I'm not vibing. It's all about vibes and running. Yeah. It's honestly it is. No physical energy is needed. Just vibes. Just vibes. Matt Engelken: Yeah. And so for this race, like we determined, vibes are great. Okay. one thing that happened around the beginning is, obviously to track the marathon, there was a bunch of cars kicking up dirt. One person almost dies because they're like breathing in so much dirt. Oh yeah. so they almost had a fat, a fatality. Luckily they didn't. but yeah, there was a lot of instances of people, how much sucking up, chugging up dirt, how much dirt. Okay. Jeff Goddard: About as much as you would expect if you get mud in your lungs, turns out. I mean, that's a Matt Engelken: lot Dave Etler: of, that's what I'm saying. That's a lot of, I would assume that the body has some ability to get around some dirt in the lungs. yeah, it's called coughing. We're great at it. Right. But there must have been a lot of dirt being kicked up by all these cars and I Matt Engelken: mean, never to be fair, he's never been doing anything and was like, man, it's really dusty out here. I hope I don't die. Jeff Goddard: To be fair, like this is a serious thing. Like this wasn't the only marathon, like Olympic marathons have had enough runners that it's kicking up enough dust that people have had to fall out of the race because of Yeah. Okay. Yeah. Serious respiratory issues. So like, You can't take that as much dust as you would think, like throw up a little napkin or something. I don't know. Okay. A bandana fair, Matt Engelken: fair. So, yes. other than that, another thing that I think is fun to include is that, the, remember the Cuban, male carrier that I mentioned beforehand? Yeah. The Jor inventor. The Jor guy. Yep. Yep. well, he ran it. he was apparently pretty active, just like on an amateur level, but he was going out. He was like, man, I'm getting a little thirsty. so he veered off the course, stole some peaches from, stole some peaches from some, like just spectators or whatever. Got a Riley Behan-Bush: little bit from like a child. I Matt Engelken: takes a child, takes some peach. another one, no Ablo English Jeff Goddard: runs off. I love Matt Engelken: it. He goes a little further and then he, ends up veering off the course again. Goes over to an apple orchard to pick some apples off the tree. Well, one of them's bad. So he gets stomach aches and decides to take a nap during the marathon. Fives are good. My fives are good. Very Riley Behan-Bush: ultramarathon or S Matt Engelken: Exactly. Yeah. And even better, when he woke up from his nap, he kept running and finished fourth. Good for him. Jeff Goddard: Beat up a child Cody Pritchard: in the child. Was it a guy in the car or without the guy in the car? Right. Like fourth or fifth. Matt Engelken: Fourth. The guy straight, the guy with the car ended up getting disqualified. Yeah. Okay. Do we have times? we do. So do you guys know what a good marathon time is? I know Jeff Goddard: what one is today. I don't know what one was then. Riley Behan-Bush: I mean, under two hours is like the craziest that's ever been. Yeah. But I would say like under four for like an average person. I'm like impressed. Under three is like probably Boston Qualifying. Jeff Goddard: Yeah. It is for, well, for our age group. Matt Engelken: Yeah. Yeah. Well, it turns out though they didn't. I have it pulled up. They didn't have any times for anyone that didn't finish in the top three. but the winner of the race finished in three and a half hours. Good for Jeff Goddard: them. Yeah. Yeah. Would you like to hear? That makes sense. we've been improving over the last hundred and 19 years. Would you guys like to look Ryan Nanni: again? This wasn't a full marathon, right? Matt Engelken: It's really true. A couple miles in there, so Yeah. Yeah. Less, less dust today. Yeah. Yeah. It was almost to 25 miles. Little bit. You actually have water. It's like a, water. So speaking of the winner who, finished in just under three and a half hours, would you like to hear about his story? Yeah. Yes. did he take a nap? He did not take a nap afterwards, thankfully. Ryan Nanni: No, cuz I don't think he would've woken up from that. Matt Engelken: He. Was legitimately on the verge of death the entire time and just kept Jeff Goddard: going Soap. That sounds like a marathoner. Yeah. Matt Engelken: let's see, since you know this story, well, would you like to tell this part, Ryan? Ryan Nanni: I'll see how, well I can remember it. So the man who ends up winning it is named Thomas Hicks. Yes. And,he only gets about halfway through the race before he is basically like ready to stop, but his team is like, no, keep going. And so they decide to give him, a delightful little cocktail that includes brandy egg, I wanna say. Yep. Egg whites and most importantly, Strick nine, and they give him very low doses of Strick nine in this brandy egg cocktail throughout the race, just to keep him going. And by the time he gets to like the last mile, he's like fully hallucinating. He doesn't know where he is. I think he basically, I forget if it's him or another competitor for the last stretch. His, he's basically like floating on his trainer's shoulders, like draped around them and pretending to run. And they're this counts, right? It's 1904. Dave Etler: Why, it's pretty bad. Strict nine. any rationale behind the use of Strick nine? I guess for those of you who, I mean, I can get the, I can get the eggs in the brand. I thought ground beef, Cody Pritchard: beef could be in there. Maybe. Maybe Protein action. Matt Engelken: For those of you who don't know, do you guys know what strict nine is? it's a poison. It is rat poison. Yes. But isn't everything a poison? That's what I know. I mean, Jeff Goddard: pharmacon, we've had the hyn. Yes, let's call back everything. But Matt Engelken: in low doses, sufficient dose, it can be treated as a stimulant. Okay. which is also one of the first known records of somebody using peds during the Olympics. Ah, back before there were any rules, but Yep. He consisted out of a dose of rat poison, egg whites and brandy To try to get him through this race. They intentionally withheld water from this person. I can't remember the exact reasoning behind that, but they gave him like the little sponges that you give people that aren't allowed to drink anything in the hospital. They gave him those, but he is like, no, you can't drink any water. Wow. Jeff Goddard: I mean, I can't imagine his kidneys looked pretty good after this race. Like that must have been a rough one. Like little shriveled Dave Etler: raisins. Ryan Nanni: Wow. I just, you know, what the first person busted for peds at the Olympics, which wasn't until like the sixties or something. Do you know what the substance was that they used to enhance their Jeff Goddard: performance? Cocaine. Let's make it again. Ryan Nanni: I'll let you, I'll see if anybody can nail it. Cocaine is not right. Dave Etler: oh, what Jeff Goddard: year again? Sixties. 19, I think Matt Engelken: it was in the sixties, maybe year old. Sixties, seventies. Dave Etler: what was commonly, what was available in the Matt Engelken: M dm A out yet? I Riley Behan-Bush: feel like, no, just to like be in another world while it's happening, like just not worry about yourself, ego down. Know that Matt Engelken: would be my Dave Etler: performance enhancing drug of a choice would be someone was not M dm a. Okay. gosh, I, I, Jeff Goddard: just imagining a hurdle or am I like, am I jumping the hurdles or the hurdles jumping me? Dave Etler: I can't even, sometimes I'm not even sure I can Matt Engelken: Something for your brain to do. Dave Etler: Hazard a guess here. I know cocaine probably would've been my first go-to. Yeah. I mean, isn't it always cocaine? Matt Engelken: So the answer is beer. Yes. What, Jeff Goddard: this was a, I mean, that would make sense. Yeah. This is a Swedish Ryan Nanni: athlete who was competing in modern pentathlon. And one of the events, is pistol shooting and to calm his nerves. Before he entered the pistol shooting portion of the competition, he drank two beers. And when they test, you know, when they took his blood test afterwards, they were like, Nope, your ethanol levels are unacceptably high. And he was stripped of his bronze metal Jeff Goddard: as a result. I think, you know, it's the same argument with, cannabis use now, right? Is because there are like pain alleviating effects of cannabis. So it, it gives an unfair advantage. Riley Behan-Bush: Are you also not allowed to take like ibuprofen or Tylenol? No. Jeff Goddard: I feel like that's a lot less Matt Engelken: seriously. I yourself a medical student guys such a limited man. You Riley Behan-Bush: dunno. These rules, how, can you give me one fact, but not all the facts. Matt Engelken: so yes. Mentioned something about the today. Yeah, don't drink beer. Don't drink beer. but you can eat rat poison. but yes, he with a mile left. He thought he was hallucinating that he had another 20 miles to run. That's so I also would've quit. Yeah, that's fair. And so he was basically just like pulled across the finish line by all of his trainers and he won the gold medal. Dave Etler: I mean, this whole, honestly, this story just to me is. Relatable. I mean, this would be, this would be me. Jeff Goddard: Nothing says Dave's like life, quite like dust and no water and 24 miles for the vibes. It's some rat Matt Engelken: poison. Riley Behan-Bush: There is something that's always been like incredibly extreme about people who just like run really far for like no good reason. Pretty simple task, but I just feel like what Jeff Goddard: is it that you get out Dave Etler: of this other than being able to say that you ran this far? See, I mean there has to be more to, my Riley Behan-Bush: argument is that the people are chasing the endorphin high. I think people are seeking the mind, altering state. Therefore, it would make Jeff Goddard: sense why as somebody who's participated in ultramarathons, the community is the best thing that you get out of it. But it is just the vibes. Yeah. you're like 40 miles into a run and you're just like, I mean, I can do it. You know, like, it's just so liberating to be like, oh, look, I'm so unlimited. I'm, when you across the line and you can't walk for four days, and you're like, okay, maybe I am a little Cody Pritchard: limited. Well fun. So fun thing about, so Dr. Swanson flocks director,I haven't heard from him, but, he ran, but he ran him, he's trained for an ultra and, it was supposed to be this weekend. Oh yeah. I think he's up in Milwaukee, if I'm Jeff Goddard: not mistaken. Okay. I hope he's already, but I haven't heard from Cody Pritchard: him. Yeah. Hopefully he makes it back. Well, I did talk to him. He was taking some time off, so it makes Jeff Goddard: sense. But yeah, I'll send him a, send him Ryan Nanni: just a little strict line as like Jeff Goddard: a, Matt Engelken: give him some mdm a so he can get in that space before starting, Riley Behan-Bush: just tripping. It's called Runner High. Yeah, it's called Runners High. The short Cody Pritchard: span of my life where I like actually was running, I really did enjoy it. I, and then I just, believe it or Dave Etler: not, I also had a period in my life where I ran and, you know, I would not run now. Unless I was on fire. stop dropping. Matt Engelken: Don't even run. That's, this is the last Cody Pritchard: time you wanna run. I do remember that one from Dave Etler: school, but back then I did enjoy it, but I only, you know, max three K or Jeff Goddard: 5k. Yeah, I do think Riley Behan-Bush: running, that's about what I was, yeah. Just to bring it on back to the kind of point of the show, Redding is a lot like medical school and that like, you think it's gonna be awesome. Like, and somehow like the community keeps you there and it just sucks like a lot of the time that you're doing it, but then you like finish something and you're like, wow, I'm incredible. And then you just like keep doing that and then you're just like on the train. So you're like, I've been running for this long. I might as well not stop. The Jeff Goddard: high of the finish line makes you forget all of the miles before it, until you're in it again and you're like, Oh no, I remember this part. Yes, I hated this. Now 20 Cody Pritchard: more years to go. Yeah. Matt Engelken: And then you, yeah, you're like, oh, I just passed the first mile marker. That's fun. Ah, no, that means I have so much left. Riley Behan-Bush: The like mental games that you play with yourself. like I just ran a 10 K last weekend, and I was like, oh, like four miles in, only two to go easy. That is nothing. And that's how I feel right now about having done four years of school. I'm like, four more. Bring them on. That's nothing. Yeah. I am basically a freshman again. but running, I guess is the same thing. You get halfway through and you're like, ah, it's just one more half marathon. Jeff Goddard: I feel like Dave Etler: everything you said just then makes me go, you're out of your fucking Matt Engelken: mind. I Riley Behan-Bush: think what I am doing is actively like tricking my mind into like, Being Jeff Goddard: okay with things. Yeah. It's like they tell you that if you're like nervous, you can just convince your brain that you're actually excited. Yeah. Yes. Yeah. Yeah. And so I've done that quite a bit on runs. So the last marathon that I did was right before medical school and, I forgot to train for it, so I like showed up and I was like, that pesky thing. I was like, not supposed to, I have not actually. Done any preparation for this. In the first like eight miles, we were big chilling. But after that it was basically that I just had to keep convincing my brain that like 13 more miles, I just ran 13 miles. Obviously I can do 13 more. What's 13 more? You know, like it's funny, the math Riley Behan-Bush: you'll do where you'll be like, you'll like how much pain you're in will determine like how small of chunks you're gonna chunk it into. Like sometimes, I mean, I'll do like a minute and I'm like just 10 more of those. Like sometimes it's like 20 seconds where I'm like, wow, that's gonna be a lot of 22nd chunks. But I can do anything for 20 seconds. And you just to get smaller and smaller, the more pain you feel, you just are like one more. And that's how I feel right now about Matt Engelken: everything. This podcast. this podcast is brought to you by, Chunking your pain into small portions. Yes. So that way they're easier to consume. Small, Ryan Nanni: small doses of rat poison can fit all your life. Riley Behan-Bush: Small shelf exams, I mean, it's the same thing. Yeah. I mean, one more shelf exam. Yeah. One more Matt Engelken: step. At this point, you know, I've finished at the two shelf exams. I finished, I am in surgery, which means I'm almost halfway done, which means I, all I need to do is do it again, plus another one before I'm halfway done. And then I'm halfway done with being halfway done. And then I only have residency and, the rest of my life. But we're almost there. You're basically retired. Yeah. Yeah. At this point, when you think about it that way, Riley Behan-Bush: I'm telling myself I have half of two degrees now, which in some ways equals one full degree, but it doesn't. So now I'm gonna call myself a, an MPL because it's kind of like half of the letters that are in all of those degrees. I Matt Engelken: like that. That's very Jeff Goddard: reasonable. Thank you. Riley Behan-Bush: Cute. Is how I feel. Yeah, it's just, oh, that's cute. That's Matt Engelken: adorable. Was there Dave Etler: another anecdote Matt Engelken: that you had for us? Another story? those were the two I came up with. did you want me to share my Jeff Goddard: cowboy hat one? Yes, please. Absolutely. Okay. So, I was told that I'm bad at coming up with pop quizzes on the fly. That's fair. But I do have a quick pop quiz for the class and I will ask it hopefully better than last time. Which disease is, which disease caused, that's how we're gonna phrase this. Figure it out on your own. Which disease caused the existence of cowboy hats? Okay. Which by the existence of this disease, because this disease happened, now we have cowboy hats ready? We're gonna go down the list. Figure out how that you can make it work. I'm not very good at questions. I'm sorry. I made this up on my own. so the options were a chlamydia, B, depression, C gonorrhea, and D tuberculosis. Matt Engelken: None of the Jeff Goddard: above. Well, I mean, cowboy hats aren't made of any of these diseases, so that's what you're trying to say. Matt Engelken: just wearing a hat of depression. I Riley Behan-Bush: choose to believe it's depression and only for the reasoning that like somebody was like, you can't be depressed when you look so cute in that hat. That is my chosen so little logic, my chosen logic, and I will Jeff Goddard: beri having a bad day on a pink cowboy hat, and she's like, and it's gone. Riley Behan-Bush: And I'm like, retail therapy. Matt Engelken: This hypothesis, all you need is eight more cowboy hats, then you're done. Jeff Goddard: My Ryan Nanni: problem is with that is that at the time the cowboy hat was invented, I'm sure they were like, depression's not Matt Engelken: real. Yeah. Well, okay, so they might called it something Jeff Goddard: along the lines of melancholy, right? Sure. Right. Ryan Nanni: Romania. Right. I like tuberculosis Jeff Goddard: as the answer. Yeah. Good old tb. See, at the beginning of the episode, he mentioned TB in my name together. And I was like, that can't be what he means. Turns out he meant touchdowns. It was a td. Td. I'm just really bad at listening. I'm not a sports guy. I love sports as a concept. I guess. So the answer is in fact, tuberculosis. And so here is the short story. If you want the real story, you gotta go to John Green, who is a treasure. So, there was this guy who made hats. He was an A and he was an apprentice. Hatmaker, there's a specific name for that. I don't know what it is. A miler. Miler, okay. I knew cobblers for shoes, but a miler. Okay. In New Jersey, making these hats big, chilling contracts, tuberculosis in the 1850s. And do you know what the treatment for tuberculosis in the 1850s was? I'll give you a hint. It was the same treatment for the next hundred years. Put 'em else way. Go somewhere else. Yeah. Specifically, you were trying to give them different air. What The air was dependent on where you were coming from. If you were from New York, you needed high mountain air, but if you were from like a mountainous region, you need to get down on the ocean. You needed to like, so like there was no really consistency on what the air was, but it was different. You needed air that wasn't the same. it was, do you Dave Etler: think this is because physicians were like, I don't know what the fuck is wrong with you go someplace else. Jeff Goddard: I don't wanna be around you Ryan Nanni: else. Whatever this is. I think it's more insidious. I think this was the, newly formed travel industry warming their way of medicine. Jeff Goddard: Ooh. They were like, okay. Just pitching to doctors, like no matter what the sickness is, tell them again, send them the seaside. Yeah. Matt Engelken: And then it's like the selection bias of like, well I didn't hear from him again, so I'm gonna assume they're fine. Yeah. No news is good news, you know? Jeff Goddard: last Ryan Nanni: I, he was having an awesome time hiking in the mountains. Yeah. Jeff Goddard: So I mean, it really goes back to my asthma theory, right? This idea that air itself that is bad is what's causing you to be sick. So it was mostly about getting out of the city. yeah. So, but at the same time, something in the current air you're in, it was it just, I just think it's so funny that it was always, it doesn't really matter what the air is as long as it's not this air. Right. And so for him, he went out west, he went to Texas, had a great time breeding that yummy Texas air, right? And he was looking around at all these people and he was thinking to himself, wow, these are terrible hats. Um, Matt Engelken: and these are all Jeff Goddard: people on tv? No, Matt Engelken: just him. You have an infectious disease. Jeff Goddard: You're dying. And also your hat is stupid. Wow. no. So, so young Millar here, which is his trade and not his name, actually recovers, which, at the time is the unlikely that he would have, but he did right at this. It wasn't unheard of, but it was unlikely. So he ends up recovering from tv, not because the air was better in Texas. I want that to be clear. And he's still looking around thinking these hats are dumb. And so he makes a new hat, specifically designed for the rain. So he made a hat that was waterproof and a hat that actually kept the sun off of your skin and out of your eyes, which is incredibly important when you're riding across the prairie looking at cows. Right. And thus was born the cowboy hat because of tuberculosis. Wow. Yeah. If we didn't have tuberculosis, rain wouldn't Riley Behan-Bush: have cowboy the rain. That's like how I was like, just hold it up. Yeah. It just Jeff Goddard: like holds the rain. Well, cause before that they would rent boulder hats, which would catch the rain, you know? So like, that's true. Dave Etler: This, if you're a marathoner, is an important thing if you have a supply of Jeff Goddard: rainwater. Yeah. If you're in St. Louis, you want to catch that rains the original camelback Dave Etler: and there's only two. Matt Engelken: Just try to catch everything. Jeff Goddard: that's my fun historic disease. I've got a lot of weird historic diseases, but that one's one of my absolute favorites. big fan of tuberculosis and cowboy hats. Nice. Dave Etler: Nice. Well, it's been an hour and I have thoroughly enjoyed this, time with you all today. Thank you very much. Ryan, especially to you. Thanks for joining us on the show today. Where could listeners go and find out more about you? And your work. Ryan Nanni: you can find me on Twitter and Instagram at Celebrity Hot Tub. Very normal handle. or you can listen to the shutdown forecast, which is nominally a college football podcast, but most of the time. We don't even mention the sport. In recent episode, we mostly talked about, the various swords that are required to, coordinate the new King of England and the possible orgasm that somebody experienced at the La Phil Harmonic. we talked to a member of the La Phil to get his perspective on what was actually Jeff Goddard: going on there. So I heard about that. Yeah. Story. Yeah. yeah. We'll leave that. Go find that episode, guys. Yeah. Dave Etler: thank you so much, Matt for producing today's show. Thank you. And, Jeff Riley. Thank,and Cody, thanks for contributing your vocal. Guess it's fine. I'm not on his list. Matt Engelken: I mean, I Dave Etler: later, I guess we can think late arrival. yeah. Thanks for contributing your vocal tracks and your brokers and warnke areas to, to this discussion today. And what kind of personal foul would it be if I didn't? Thank you. Short cross making us part of your week. If you're new and you like what you heard today, Follow the show where fine podcasts are available, such as Spotify, apple Podcast, Google Podcast, YouTube, all those places. The show is made possible by a generous donation by Carver College of Medicine, student Government, an ongoing sport from the R and humanities program. Our music is by Dr. Vox and atmosphere. I'm Dave Etler saying Don't let the bastards get you down. Talk to you in one week.