Replaceable You, with Mary Roach

new book, Replaceable You Adventures in Human Anatomy. It's going to be released September sixteenth, twenty twenty five, and is currently available for pre order. So without further ado, let's jump right into the interview. Hi, Mary, welcome back to the show.

thousand and three Stiff and twenty sixteen's Grunt. Did it indeed spring in any way from topics you touched on in previous books or was there some other sort of out of the blue inspiration.

in talking to people. I'm often my way of finding a new book topic is sometimes just to reach out to people I've met in the past and kind of just bitball brainstorm and this but this one was a reader wrote to me and said for your next for your next book, you should write about professional football referees, which was, you know, no disrespect, just a terrible idea for me. I don't I don't watch football, I don't

know anything about football. And but we had a conversation on email and she mentioned that she's an elective vamputee and I had never heard this term, and I asked her what that means. And she's talking about how she has a kind of a dysfunctional foot. It's healthy, you know, it gets blood, it's funk, it's functional, but not in

the way she would like it to be. And she wanted it cut off and replaced with a prosthetic because she would see people walking around on prosthetic feet and they're running and they're hiking, and she couldn't do that stuff. And so she and it was very hard for her to find a surgeon willing to cut off a quote unquote healthy foot, and that frustrated her. And it was kind of interesting, does this sort of sense of whole, like this bias for wholeness and this sense of are

we a whole entity? Are we made up of parts? Can you just swap them in and out? And that kind of led me along that path. And of course, you know that there's lots of kind of interesting areas like iron lungs and nasal mutilation and skin grafting and the history of skin grafting. There's just a lot of kind of mary roachy topics under that umbrella of replacing bits and pieces of the human body.

So she mentioned, and I don't know how this came up, don't remember, but she mentioned that there was a surgeon who had reconstructed a man's penis using his own middle finger, and that because of the way my brain works, that just you know, I'm like, oh my god, they just cut the finger off and like attached it down there and he could move his finger. And I had this very, as it turned out, inaccurate impression of what that surgery was. But I'm like, I'm going there. I'm going to see

this surgeon. It turned out he's in former Soviet Georgia, and I did go there, and this story is in the book, But I think that was one of the first places that I went to report in one of the first chapter that I wrote, so that that kind of cemented things I think for me like that I have to have a book that includes this.

As you know, I covered the Department of Defense was funding some work with penis transplants, in other words, taking a cadaver penis and hooking it up and replacing whatever remains of a man's penis who And this was you know, during Afghanistan and Iraq, when there were lots of IEDs going off and damaging not just legs but all the way up to the pelvis so and I'd been in the lab when they were doing some of the early work for penis transplants, so I did I called that

surgeon just to see where where things at, what's going on in the world of transplantation. I don't like to repeat things that I've covered before. I mean, I was definitely not going to include that project or kind of go back and follow up on that patient or anything like that. So I do make use of the people that I've met and sort of pick their brains and get ideas from them, and also referrals to people that

they know. So I do that, but not I don't really completely step back into the setting of a previous book.

a good solution. But what amazed me was this trend in the period of time that you're talking about for having all of one's teeth pulled at once and getting fitted with dentures. And it was this sense of like, I'll have a marvelous, healthy, white smile, and it was

done as a gift for brides. It called sort of matrimonial dentures, I think was the term and the people and I had thought of it as just this is something that's done in poor communities or people who don't have access to good dental care, but in fact it was just kind of a trend. And I could only explain it to myself by thinking people were just assuming it's new and it's man made, and it's got to

be better. I mean, Paul McCartney, his dad told him you should when he turned twenty one, he should go get all his teeth removed and replaced with dentures and people and there was this reddit thread. It's no longer up for some reason, but this reddit thread where someone mentioned it, and there are a thousand replies people saying my grand my parent or grandparent, usually a grandparent had

this done and ended up regretting it. Always had difficulty with the dentures, but it was a It was to me kind of a good way to open the book because it was this interest. It's interesting there's this tendency among humans, particularly you know, starting in the nineteen hundreds and onward, to just assume if it's if it's technical and new, it must be better, and to kind of rush headlong into that technology without really considering how will

it stack up against what I've got going. My dad lost all of his back teeth he had he had a few front teeth in the front left and he was much older, sixty five when I was born. But anyway, he never got dentures. He never went. He didn't go. I don't know if he didn't trust dentists. He was British.

I don't know if that had anything to two in it, but he u but he managed just fine using his front teeth to chew, and I think, you know, probably that worked better than had he gotten a couple of those plates that are you know, glued with polygrip and got stuff under them. It just sounded it sounded, you know, like not a great technology, and he did find it. You know, it was a little weird to watch him chew his lamb chops, but it seemed to work.

putting that off on your future self. But to go ahead and have it now, to go ahead and get the dentures that you know at an early age, Yeah, it's hard to like, I can't think of anything, and surely there's something in our world that's that serves as an analogy for that, But I'm grasping at straws to think of it.

a term for that that I've forgotten. I think that's an example, and that's an example where if everything goes well, which it usually does, it's not analogous to the dentures in that I think folks would who have that done. It can be kind of an amazing replacement. You don't have accommodation, which is the eyes amazing ability to go from far away to near focus just automatically, you know, sort of an built in auto focus. So that's not something that exists yet, So you are accepting a compromise

in that sense. But for somebody who's who's very very near sighted or I suppose far sighted, it's an appealing option, you know, to not have to think about glasses, contact lenses, et cetera. And it's I think, you know, even compared to lasik, which can have after effects that are unappealing. But yeah, but to have all one's teeth pulled at once and there. And I think also people people had a sense of people don't like to go to the dentists.

They don't like dental procedures. So in areas where dental care was lacking or wasn't close by, they thought, let's just get it over with and I'll never have to go back to a dentist, and I'll have this, you know, perfect straight smile, I don't have to get fillings, etc. But in fact, the dentures, you know, the gums start to receid so that you would have to go back and get refitted. So it really wasn't you didn't even deliver that right now.

But do you think these various headlines sometimes and you know, advancements sometimes help implant the idea that the research is much further along than it actually is.

to still be out on the distant horizon. You know, you follow up with these things a few years later, and the company's gone out of business, the researcher has stopped researching that, and you know, and I think it's a disservice to the public because you know, I have a friend who have who has Parkinson's, and he people are always sending him. Look, I saw this, I saw this press release online. I heard about this technique. I heard about same with the woman who the elective amputee said.

I cannot tell you the number of times my friends have sent me a link to a story that says twenty dollars. You can buioprint and prosthetic foot. You'll never have to see prosthetists again. And it's cheap. And she's like, that's never going to happen, and I want them to stop, and they mean, well, but stop sending me this stuff because there's so much of it out there.

in ways that we don't even yet understand. So of course it's going to take a long time.

But there are these kind of invisible links between you know, the brain and the organs, and the organs themselves and the There's just a lot going on that is difficult to anticipate when you talk about creating something to replace an individual piece, you know, trying to incorporate that piece into a whole system. I mean, we are a massively complex system, so it's it's quite a challenge.

isn't it's it isn't new. In the eighteen hundreds, there were surgeons who were doing this, but it's it's for cancer patients and the set that there was a quote I wish I had it in front of me, but the surgeons were all conferring, like, should we do this? It's kind of risky. I don't know, it hasn't been done, but they said, if the home life and matrimonial harmony depends on it, it is mandatory. I'm like, hello, maybe

want to check with that woman before you do that. Yeah, But it's an it's a I spent some time with the surgeon who who from time to time does that technique, and it is a kind of an incredible I just I just love the idea of like recruiting parts of the body that evolved for one thing and using them for something else. And the body is surprisingly adaptable, you know, agreeable, like, yeah, I can be a vagina. I think I can do that, you know, moist tubular secretion. Yeah, I got it.

wrong leader, whatever whatever it is. So there was this demand for rebuilding the nose, and over the course of time some very ingenious techniques, you know, taking a piece of the forehead or a piece of the cheek, taking that skin, loosening it, leaving it attached so it still has a blood supply, and then turning it over and putting it in place on what's left of the nose and building a nose that way, and that and the fact that I mean plastic, that's the dawn of plastic

surgery right there. That's really where it began with the nose. And then of course that leaves scarring, or it can leave you know, if you put a graft on the place where you took the skin. Now you've got skin that doesn't match. You know, it's not seamless. So they started using the underside of the arm the fifteen hundreds in Italy, just having you know, and then then you of course to have the arm underside of the arm close to the nose, you had to have the arm

up over the head with a harness. I mean, it was quite an elaborate setup to for a few weeks to keep that piece of the underside of the upper arm attached to the nose. He kind of looked like he was you know, I've seen a etching of that and the guy looks like he's checking for bo kind of a you know, head close to the underarm pose. But just amazing the ingenuity that went into it. And then once you know, you had more options with different

materials and adhesives. There were noses made of celluloid, noses made of brass or other metal composits. There were noses hanging off glasses frames, kind of a grouseiow Marx thing because they even had a little mustache to cover up the boundary below the lower boundary, So it was kind of a medical Gaucho Marx glasses.

can style it. You can barely style it at all, not to mention infections and all these horrible kind of lumps that would appear, and it was it's illegal now, but for a while, I think in Turkey you could still get it done and you had to space them out such that you kind of looked like a doll, you know, how dolls have? You know?

to carry oxygen. But if what you're talking about is preventing somebody going into what is it hypovolemic like shock from just not enough blood, the blood vessels are going to collapse, and you want to get something in there. I mean, you could use saline. That's you know, what is done now. But so goat milk was kind of that. Without knowing why, I think that the medical folks had stumbled on and they were talking eighteen seventy eight, I think it was, and there's kind of a flurry of

journal articles about goat milk and cow milk transfusions. They assumed there was something in the milk that was a benefit, but in fact it was just getting something in there to keep the blood pressure up. But they were talking. They would talk about, you know, a cow was brought into the room because it was done. You know, they had to be fresh and had to be fresh from the teeth. They weren't storing the milk. It was so there.

You know, there was this wonderfully strange couple of years in medical history where cows and goats are being brought into the surgical facilities or the patient home, and people are being transfused, and and the the articles were tremendously enthusiastic in the medical journals, and you know, mainstream medical journals, saying I would be remiss if I did not predict great things for goat milk transfusions in the future.

I chose to and it was incredibly interesting. And I was in China the China trip. In that case, both of the companies here that create pigs for zeno transplantation, in other words, pigs that are genetically edited such that their organs don't create as intense a rejection in the

human body. There are two companies here that have pig farms that and I wanted to visit one of the pig farms pig facilities, I should say, the designated pathogen free facility, and they both very politely said no. So I contacted someone who's worked on zeno transplantation for thirty years and who happens to be in Sichuan, China, Chengdu, and they were very welcoming and they said, come on over, you're welcome to visit the facility. As it turned out,

I couldn't go inside a facility. I could get close to it and watch it from the control room, because of course I'm a walking pile of bacteria and other horrible things that if you have a designated pathoge and free facility, nobody comes in. I mean, the staff are quarantined and they stay there for three months. So I didn't actually get to go in, but I got close. But in that case, the travel was warranted by my inability to get access here, and that was a challenge

with this book. Biotech companies are notoriously wary of having outsiders, journalists, writers come in for various reasons. They have things that are secret that they don't want to risk somebody getting access to. And they also just I mean that there's a a process that a lot about tech tech firms, public relations firms adhere to, which is just to say, here's a press kit, here's a video, this is what we're going to share with you. Take it or leave it,

And that's not what you know. I as a reporter grew up with a lot more openness, like, yes, you can come here and spend a couple of days and we'll show you around and it's not like that anymore. So if I have to go to China, I go to China. So sometimes that's what's at play.

for it. I couldn't find there. You know, there was a Brookhaven was doing something with irradiating some animals. I'm like, I don't want it. That's not the scene that I want. So I didn't do a chapter. And and but if you take that to its endpoint, I just can't do books. If people because people, and I understand that, like my agent said, kind of don't blame them, Mary, do you

you know what's in it for them? They're not being paid, there's they don't have any control over what I say, what I choose to represent, how I say it, how I portray them. So it's a huge in some ways, a big risk to say to me, Mary Roach, Yeah, come on down for a couple of days and do what you want to do.

onto a body. I spend a couple of days with a biotech firm, Stems and Therapeutics, who no longer exist. They were trying to grow follicles and then implant those from induced pluripotent stem cells like a person's own cells regress to plury potency, encouraged, instructed to become follicle cells, and then incorporated into the person's head. And I thought, Okay, the follicle pretty simple, how hard could it be? But

the challenges were so interesting and so immense. I kind of want people to understand why it's taking so long, and not to be disappointed by science. I mean but just to understand what a tremendous challenge it is when you get down to the cellular level to create something that you can incorporate into a complicated system and have it work in the way you want it to work. So it's just a kind of a glimpse of how

that's done, what's going on, what's taking so long? And you know what, we could hopefully expect a couple decades down the line, but just expect miracles, but don't expect them quickly.

I did because next week is Star Trek Week. The whole week is going to be Star Trek themes. That means Star Trek core episodes, a Star Trek monster factor most likely, and yes we will cover one of the Star Trek motion pictures for Weird House Cinema. You'll have to tune in to find out which one. Sometimes you can peek ahead by going to our account at Letterbox.

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