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Okay. All

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right. Okay. All

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right. You're

0:32

listening to Radiolab. Radiolab

0:34

from WNYC. See?

0:43

This is Radiolab. I'm Lulu Miller. I'm Latif

0:45

Nasser. Oh, hello. Along

0:47

with reporter Jen Brandell. Hi.

0:50

Latif, Jen, have you guys met? Never

0:52

not. I don't think so. No. I'm

0:55

a radio reporter who I've known for a long

0:58

time. But these days, I'm

1:00

a little hard to explain. I have been a journalist.

1:03

I'm a CEO of a tech company right now. I

1:05

work between a few worlds between

1:07

entrepreneurship, democracy, media,

1:11

blah, blah, blah. Yeah.

1:13

Well, it's right. I'm an annoying person

1:15

to talk to at a cocktail party because I can't

1:17

really say it succinctly. I'm not like I'm

1:19

an astronaut. I'm a firefighter. Right. And

1:22

that'll maybe come back.

1:23

OK, so I don't know. Shall we just

1:26

shall we begin? Are you ready for? Yeah.

1:29

Are you ready for a journey? Yeah.

1:31

OK. So we're going to just kick

1:33

it off. Caffeinated, bagel, ready

1:35

to go. We are going to start inside

1:38

a hospital. We're on the fourth floor. Jed

1:43

and I are walking around its NYU hospital.

1:46

We're trailing some doctors and we're in this part

1:48

of the hospital I had never thought about that

1:50

exists, but it very much exists.

1:52

So this is Lulu. We

1:54

have permission to be here. We walk into

1:56

this room that looks a little bit like an

1:58

industrial kitchen. mention

2:00

any identifiers. There are big metal

2:03

counters and sinks. And anyway,

2:05

these doctors, they're pulling out

2:07

pepperwares

2:08

and kind of one by one they are lifting

2:10

the lids and pulling out

2:12

human organs.

2:15

So that's small intestine coming here. Organs

2:18

I've heard about but never seen before. And

2:20

this is the pancreas. They pulled out a

2:22

whole

2:23

stomach. Just like a big orangey

2:25

red chunk of meat. And they pulled

2:27

out. Here's the dome of the uterus. Wow.

2:29

A uterus. This is your ovary. Wow.

2:33

And they pulled out. Here's a large

2:35

fatty red tissue and that's the breast

2:37

tissue. Whole breast. They pulled

2:39

out a liver. Is

2:41

that brain? No, this is skin. Just organ

2:44

after organ. Are these organs for training

2:46

or? No, no, no, no. These are fresh. It looks

2:48

like we're seeing this is your stomach. Blood

2:51

and some of them were dripping blood. Yeah,

2:53

there's blood. The red stuff is blood. Some were dripping

2:55

bile.

2:55

These were organs that had come

2:57

out of people

2:59

that day. Oh,

3:01

so are you on pancreas today?

3:03

So what that room is, is it's a pathology

3:05

lab where they are looking at anything

3:07

that has been taken out of or off of

3:09

a patient in the hospital.

3:11

Coming down from the operating room

3:13

all day. Hundreds of specimens a day.

3:15

Because maybe that person's getting a transplant or

3:17

maybe they had. And what is that?

3:19

That's cancer. A tumor removed. Wow,

3:22

that's a big, that's like a tennis ball.

3:25

It's like

3:25

dizzying because it's these pieces of people but

3:27

they hold these full, you know someone like two

3:30

floors above you is going through a huge day.

3:31

Right. But

3:33

the reason why we were there that day

3:35

was to see a

3:38

body part. Should we just go now? Yep.

3:41

Oh, okay. A sort of organ.

3:46

It just tested the syringe a couple

3:48

drops came out. Here comes a big need

3:50

inside the human body. That

3:53

scientist had completely

3:56

missed. Is that it? Are we looking

3:58

at it right now?

3:59

Even though it had just been sitting there.

4:02

Oh my gosh. Wow. All

4:04

this time inside of all of us.

4:06

An Oregon? Yeah. Well,

4:10

a body part. A big deal body

4:12

part. A big deal body part.

4:13

A big deal body part that

4:15

we'd missed. Until like

4:18

five years ago. What? Yeah.

4:22

And yeah, and so today we are going to

4:24

bring you...

4:25

How could that be? Well, that's the story

4:27

we're going to tell you how we missed it. People

4:29

have been looking at the human body for like, since

4:32

the beginning. Yep, exactly. Which

4:34

is why it's so bizarre that we

4:36

missed it. I don't even know if I believe you. I'm

4:38

like in disbelief here. As were

4:41

many.

4:41

Yeah, so we're going to tell you the story of what this mysterious

4:43

body part is, what its name is, what it might be doing, why we

4:45

missed it, how knowing about it might change

4:48

our lives, our health, and maybe even

4:51

like society a little bit. Really?

4:53

I'm going to pipe down because

4:56

John's going to tell you the rest. All right. So,

4:59

I'm going to start right now. Just had a Google meeting pop up. Let me

5:01

just kill all these things. Stop it. Okay.

5:03

From your 17 other jobs that you were... Yeah,

5:06

exactly. Okay. All

5:08

right. Okay.

5:09

So, the story starts with this guy,

5:12

Neil

5:12

Cease. Hello. Hey, Neil. How

5:15

are you doing? Dr. Neil Cease. I'm

5:17

good.

5:17

Okay. So, Neil was actually one of

5:19

the doctors.

5:19

No, this is Lulu. This is Jen. Hi.

5:23

Hi. Who is showing us around the lab. Okay.

5:26

He's a kind of short, muscly fellow. He's got tattoos

5:28

on his arms, and he's kind of an unlikely

5:30

doctor because he studied computer science, and he

5:32

thought he

5:32

was going to be a rabbi for part of his life. So

5:35

I was sort of all over the map. The classic rabbi

5:37

programmer. No, exactly. Exactly. Yeah,

5:40

yeah, yeah.

5:40

What about... Sorry.

5:44

I know this could be a long story, but quickly,

5:46

like in summation.

5:47

I was freshman

5:50

in college. I

5:52

was gay and couldn't cope with

5:54

it. And I thought,

5:56

and I'm a child of Holocaust survivors too, so my

5:58

formula was... I'm going to get

6:01

old, I'll never get married, I'm never going to have

6:03

kids, and I'll be doing Hitler's job for

6:05

him because of that. And

6:10

I'm going to grow old and die alone.

6:13

So when he graduated with degrees in computer

6:15

science and Jewish studies, he was like,

6:17

what am I doing? What is my

6:19

role in the world? And then one day... My

6:21

mother called me up and said, oh, bad news.

6:24

The doctor

6:25

that she had worked for and who had delivered

6:27

him and his brother in his hometown in Connecticut...

6:29

Had died of a heart attack on the golf course

6:32

that morning. And the

6:34

funeral was going to be the next day. So she called me after

6:36

the funeral and I said, how was Dr. Robinson's

6:38

funeral? And she said, it was just amazing.

6:41

All of Hartford came out for his funeral.

6:43

And I thought, oh, if you're a doctor,

6:46

people come to your funeral. So

6:49

that's why I went to medical school.

6:52

Wait, so like

6:53

most people go into medicine because

6:56

they care about other people or they say that,

6:58

but you went because you wanted

6:59

more people to care about you. Yeah,

7:01

basically. I was terrified

7:04

of being alone and I thought I won't be alone.

7:07

I'll have meaningful relationships and I'll do good

7:09

things in the world and my

7:11

life won't be meaningless.

7:13

So he goes off to med school.

7:14

Discovered pathology in the middle of it and

7:16

was like, oh, I

7:18

like this. Which is funny because

7:20

in pathology... Opening up the small intestine...

7:23

You're mostly dealing with... I'm lifting up

7:25

the lining of the stomach. No parts of

7:28

patients, not the actual people themselves.

7:30

But I just really loved looking at beautiful puzzles.

7:33

Because a lot of what pathology is... So I've got

7:36

this big stack of slides here. Is taking

7:38

an organ and making a tiny... Cut

7:40

off a very, very thin slice. Little

7:42

sample of it, putting it on a slide,

7:44

adding some stains

7:45

to it to give it color. And then we'll look at it under

7:47

the microscope. Where he'll see... A pattern

7:50

of colors. Whoa! Shapes.

7:52

Oh my God. Relationships between the shapes.

7:54

Okay, wow. So, the cell as

7:56

a particular shape. The magenta stain

7:59

here is... is the blood vessel

8:01

lining cells, sort of like a stained glass. This

8:03

is an artery and this is a vein. The teal.

8:06

Or greenish called these white spaces

8:08

here and this is fat. And so see how

8:10

that looks blue? Yeah. Sit down at

8:12

my microscope and I look at the slides. I know

8:14

that's a bad size and I make diagnoses.

8:16

So he ends up becoming a liver pathologist

8:19

and like a world renowned one at that. But

8:21

he's also super accessible and like

8:23

friendly. And even though he's not working

8:25

directly with patients, he has a lot of meaningful

8:28

relationships with people and they go

8:30

to him for things. Like if they're seeing

8:32

something they've never seen before, which

8:35

is what happened in 2015.

8:37

When I was at Beth Israel Medical Center

8:39

in New York. So he had

8:42

this cush job at Beth Israel. It was very luxurious.

8:44

I had my own room with a multi-headed microscope.

8:47

Removed

8:47

from all the action so he could focus

8:50

on his microscope all day long.

8:51

And

8:52

a colleague walks in one day.

8:53

David Karloch.

8:55

Neil told us you are a

8:57

scope jockey. He

8:59

would say that. Do you

9:01

know what that means? Is that a term of art? No, no, it's

9:03

very, very derogatory. Is it like a dig

9:06

of someone who likes looking at microscope?

9:07

No, no, no, no. An endoscope.

9:10

Oh, endoscope. Oh, okay. They

9:12

like to put it up the places and look around.

9:14

Yeah, or down the places and look around.

9:16

Down and up, through all the ends. Yes, very

9:19

good. That's what I do. He's a gastroenterologist.

9:21

Thank you.

9:22

And so he comes into Neil's office and he's like,

9:24

hey man, no, it's probably

9:26

more like, excuse me, Dr. C. We've

9:28

got this new scope. Until now, gastroenterologists

9:32

were often in the dark. A very fancy

9:34

endoscope. Basically a miniature microscope. Enabling

9:37

you to see what you've been missing so far.

9:39

So you can see cells in a living

9:42

person. With real time microscopic information,

9:44

critical to their decision making process.

9:49

And it was showing us something that we didn't

9:51

understand. In

9:54

particular,

9:54

it was showing them something in. Bioduct

9:56

has arrived. The bioduct. The bioduct.

9:59

is this tiny, tiny organ. It

10:02

looks like just a tube. We looked at it

10:04

with neil. I don't know, three inches long,

10:06

two and a half, three inches long, and that's like

10:09

a piece of spaghetti? Oh, wow. Like

10:11

a little piece of spaghetti. Why is it called it more ziti?

10:14

A dried

10:14

ziti, a little mini ziti. Where

10:17

is the bile duct? Sort of if you go

10:19

about three

10:21

or four inches above your belly button, straight

10:23

in. And what does the bile duct do

10:26

again? So the bile duct takes bile

10:28

that your body produces and it sends

10:31

it to your small intestines to help

10:33

with things like digestion

10:34

and to fight off toxins. Okay.

10:37

So super important organ. It's purely

10:39

a passive tube, but it does a lot of important

10:41

things.

10:42

So when patients come in and have

10:44

something like abdominal pain or the whites of their

10:46

eyes are yellow or maybe their skin is itchy.

10:48

One of the causes of problems like that is

10:51

a narrowing in the bile duct, which could be

10:53

benign or it could be cancerous.

10:55

So the patient gets sent to David

10:57

Zowar.

10:58

And then we give the patient an injection of

11:00

something called the cisfluorescein. Fluorescein.

11:02

This

11:03

is actually what the microscope sees, this

11:05

fluorescent

11:06

liquid. It will distribute itself through

11:08

the blood system and fluid

11:10

spaces within seconds.

11:12

It basically lights up wherever

11:14

there is fluid in your body. And

11:16

then after the shot, David grabs his

11:19

fancy scope. So it kind of just looks like a big black

11:21

hose.

11:21

About as thick as your finger.

11:23

With a flashlight at the end. And then,

11:25

blah, blah,

11:26

blah, blah, blah, he threads the scope. Down

11:28

the esophagus, past the stomach. Into

11:31

the small intestine. And into the

11:33

bile duct.

11:34

So David and his colleague, Petros Benes,

11:36

they're looking through this new fancy

11:38

microscope and they're seeing something

11:41

they had never seen before. The

11:43

walls of the bile duct

11:45

were glowing. If you could imagine a sort

11:47

of honeycomb appearance.

11:48

Where they'd always seen just like a dark wall.

11:51

There were now these glowing holes where

11:53

the fluorescein was showing with these little dark

11:55

fibers around them. It's this nice regular honeycomb

11:58

shape. And this is in patients who have bile ducts. that

12:00

are diseased or? No, no, no.

12:03

In the normal bile duct. In a normal,

12:04

healthy bile duct he was seeing, again

12:07

and again, this honeycomb of lit up

12:09

holes in the wall. Well, why

12:11

haven't we seen this before?

12:14

And so David took some pictures of the honeycomb.

12:16

We went to Neil and they showed

12:18

me the pictures and said, look, what is this

12:20

thing? What does this correspond to that you've been

12:22

looking at for the last 30 years? And

12:24

I was like, I don't know what the hell I'm looking

12:27

at. I just don't know what I'm looking

12:29

at. I mean, Neil says, like, you know, I've looked at

12:31

the walls of a bile duct under the microscope

12:33

an uncountable number of times.

12:35

There's no spaces there. It's pretty much

12:37

solid. Like a dense wall.

12:39

So he's looking at all these lit up holes

12:41

thinking. This doesn't make any sense. Really

12:44

intense cognitive dissonance, which

12:46

is a lovely place to be scientifically.

12:48

For some people. Yeah, well, you

12:51

know, there's some really important

12:53

piece here that will make sense of it. Just

12:57

what is it and how do you find it

12:59

out? So Neil took these images

13:01

of the honeycomb.

13:01

I couldn't find them in any textbook. And he would

13:03

show them the colleagues on his lunch break. And

13:05

people were making fun of me. They were like, Neil,

13:08

he's just wild about bile. People

13:10

just didn't really care. Yeah, yeah. So

13:14

I don't know how long it took.

13:15

But eventually Neil was like, wait

13:17

a second.

13:19

When David uses his new

13:20

scope. What you've been missing so far. He's

13:23

looking at live tissue.

13:26

All the tissue I see is dead. So

13:29

a specimen comes down from the operating

13:31

room. So whenever an organ

13:33

lands on the lab desk of a pathologist.

13:36

You drop it in formaldehyde. You

13:38

do all this stuff to it. And you wash it. Dip it

13:40

in alcohol. Put it into wax.

13:42

Because you're mummifying it. You're dehydrating

13:45

it. You're turning it into a mummy of itself. Then

13:47

you shave off a super thin

13:49

slice of

13:50

it. And put it under the microscope. They'll

13:51

show us a slide of the bile

13:52

ductile. Now see

13:55

all these cracks?

13:55

You see all these faint little cracks

13:57

in the water? I always thought they were clean.

13:59

Now, in medical school, Neil and

14:02

everybody else was taught that those cracks were cursed

14:04

by the heating and drying process of just making

14:06

the slide. So for 30 years, he

14:09

had ignored these cracks, thinking they were just

14:11

an artifact of the process.

14:12

But they're

14:14

not. But after seeing David's pictures

14:16

of the live tissue and then studying different

14:18

samples that had been frozen rather

14:21

than dried out, he realized those

14:23

cracks.

14:23

They're the remnants of the living spaces.

14:25

They were what was left behind

14:28

when the holes of this honeycomb dried

14:30

out and would sort of collapse on itself.

14:33

It's sort of like, have you seen those tiny little

14:35

sponges that are dehydrated? And then you put

14:37

them in water and they go like, whoo. The ones that are shaped

14:39

like a dinosaur or something? The ones that are like a pellet

14:42

and then it's like, whoa, dinosaurs.

14:44

Right.

14:44

Yeah. You can think

14:46

about the way that slides have been being made for like 100 years,

14:49

like the pellet. That's what they've been

14:52

looking at. But with David's scope, they were seeing

14:54

the pellet expanded into the sponge

14:56

form full of holes, which

14:58

is how the walls around a real living bile

15:01

duct actually look.

15:02

And so we realized bile ducts

15:04

are not like anything we thought they were.

15:10

Huh. Which you know. Who cares about the bile

15:12

duct, right? Who actually cares that the

15:14

bile duct is encased in a spongy

15:17

honeycomb wall? Big deal. But

15:20

this is where it gets interesting.

15:23

So within days, Neil is

15:25

back to doing clinical work. And he started to look at

15:27

tissues that he sees every day, but now

15:29

with a new eye. So one day he

15:31

gets into breast. From a woman who had breast cancer

15:34

and had to have a breast taken off. And the breast

15:36

always comes with a portion of the

15:38

skin. So Neil did his thing. Formaldehyde,

15:40

alcohol, wax. Took

15:41

some of the healthy skin, put it under the microscope

15:44

and saw.

15:45

It had the same cracks. So

15:47

that was exciting. And it wasn't just the skin. He

15:50

was seeing those cracks in the collagen around

15:52

the stomach, around the colon. There

15:54

are cracks. Tiny little cracks in a dense

15:56

wall.

15:56

It's not just the bile duct. Okay,

15:59

now that's more interesting.

15:59

So I called the guys and I showed them and

16:02

it was like, oh, this is really cool.

16:04

And Neil, of course, being Neil... ...said, how

16:06

about we use the fancy endoscope... ...on him...

16:10

...to see if the places where you're

16:12

usually seeing cracks might also not dried

16:15

out, have this network of fluid-filled

16:17

holes.

16:19

Do it on me. Well, we

16:22

have scopes that can go lots of interesting

16:24

places.

16:24

David said that in order

16:26

to do the stomach and the colon, you'd have to knock Neil

16:29

out.

16:30

Well, why don't we look at the skin? So

16:33

we injected my vein with the dye, fluorescein...

16:36

And David just took the scope... ...just holding it... ...ran

16:38

it across Neil's skin... ...and his skin, and

16:40

sure enough... Is that it? Are we

16:43

looking at it right now? That's it, yeah, yeah, yeah, yeah. Wow. There

16:46

it was. The white spaces are fluorescein.

16:47

Like, like, bright orbs. We

16:49

actually went up to David's

16:50

OR at New York Presbyterian Hospital so

16:52

we could do this on Jen. Oh,

16:55

that's awesome. Really? They scoped

16:57

you? Yeah! It was like... It

17:00

was the coolest thing. And they saw the honeycomb

17:03

fluid thing?

17:03

Exactly. They could see it in

17:06

me. Like, right away. Wow. Anyway,

17:08

David and Neil had now seen these honeycomb

17:11

holes in the walls around the bile duct

17:13

and around the skin cells. And because they

17:15

knew that all these other places had the same cracks,

17:18

it seemed like this honeycomb was probably

17:20

surrounding all of our organs, which

17:22

raised a pretty simple question.

17:24

You know, it's just... what is it?

17:27

What is this structure they've never noticed before?

17:30

So... Okay, so they

17:32

phone a friend.

17:33

Becky Wells.

17:34

Professor of Medicine at the University of Pennsylvania.

17:37

So Becky does a lot of research into how organs,

17:39

like, hold their structure and their shape.

17:42

So the body is made up of cells, but there has to

17:45

be something in between cells and around

17:47

cells to keep it all together. For

17:49

example, if you think about an organ like

17:52

the bile duct, you know, you can't just have a little

17:54

layer of cells floating around

17:56

in the middle of the abdominal cavity. It

17:58

would, you know, things would leak out. it

18:00

would be very unstable, it would be very fragile.

18:03

So the bile duct actually has layers

18:06

of collagen to keep the

18:08

bile duct together. And

18:10

you'll find this throughout the body, not just around

18:13

the bile duct, but in the spaces around

18:15

and between most of our organs. This

18:17

is sort of thick woven mat of

18:19

collagen fibers. Exactly, a

18:21

very dense layer of collagen that

18:24

served as a barrier.

18:26

But now here, Neil had these pictures

18:28

of these holes in the barrier, and he was

18:30

so excited, he actually threw his slides into

18:32

a backpack and hopped on a train down to Philly

18:35

to Becky's lab. He came down, yes, exactly.

18:38

And Becky has some really cool instruments

18:40

in her lab, including a microscope that could

18:42

take a set of flat slides and turn

18:45

them into 3D image

18:47

of that specimen. And we sat at this

18:49

microscope in this completely dark room.

18:51

They turned it on. And what we could see

18:54

was, it was almost like waves

18:56

of hair, which was the collagen.

18:58

But now in 3D, they

19:01

could see it was actually like a network

19:03

of tubes.

19:04

And we just start yelling

19:07

and high-fiving each

19:08

other. Yeah, yeah.

19:09

And

19:11

why? Well, because

19:13

as far as Neil could tell.

19:14

That meant that every collagen

19:17

layer in the entire body, the

19:20

dermis, the wrappings of all your muscles

19:22

and your bones, the collagen

19:25

that wraps around every artery and

19:27

every vein, the collagen that

19:29

gives structure to every visceral

19:31

organ, your lungs, your heart, your liver,

19:34

your kidneys, your pancreas, your GI tract,

19:36

fibrous coverings inside your skull around

19:39

the brain, the fibrous coverings around the

19:41

nerves coming into the brain and going out of

19:43

the brain. All of these places throughout

19:45

the body that they'd always thought were just solid

19:48

structural

19:48

stuff were actually

19:50

shut through with little tubes and tunnels.

19:54

And inside of those tunnels, there

19:57

was this fluid.

19:59

they got a hold of some of the fluid. It's

20:02

clear but a little yellowy.

20:04

Sort of like egg whites. So

20:06

we have a colleague of Neil's analyze

20:08

it to see what's actually in it and they discover

20:10

this fluid has

20:11

water glucose insulin

20:13

hormones protein

20:14

and hyaluronic

20:18

acid. H-A or hyaluronic

20:20

acid.

20:20

Never heard of that. Well if you're a woman

20:22

you probably have because

20:23

the skincare ingredient that everyone

20:25

is searching for. You've been marketed on instagram

20:28

that you should buy it because it'll plump up your skin. And

20:30

reduces wrinkles for younger looking skin. So

20:32

when people get injections you know to

20:34

plump up their cheeks or whatever. Yeah. A lot

20:37

of times it's hyaluronic acid because

20:39

that you know sort of functions like a pillow under

20:41

the skin for example. But

20:44

we realize that hyaluronic acid

20:46

would be a fantastic marker to map out

20:48

where the fluid is going if if it's going

20:50

anywhere. So here's hyaluronic

20:52

acid. So they used a stain that that could

20:54

show them where the hyaluronic acid was

20:56

which could show them where the fluid was moving.

20:59

There are all these little brown

21:01

lines that have this sort of flow.

21:03

That's the hyaluronic acid. Like little

21:05

tiny tributaries from

21:07

tissue to tissue from organ to organ reaching

21:10

bigger streams that come together

21:13

in big rivers. It's

21:15

this vast fluid highway through

21:17

the body that travels

21:20

between organs from one organ to the

21:22

other. Connecting everything to

21:24

everything else throughout the body.

21:31

And they eventually figured out 25%

21:35

of the fluid going through our body is

21:37

this stuff. What?

21:38

25% of

21:41

the liquid in our body is flowing through this and

21:44

they had no idea what it was or that

21:46

it existed.

21:47

Wait and what percent is blood? So

21:48

we don't know the exact number but it's

21:51

less than that. So it's four times the amount of

21:53

blood. Four times

21:55

the amount of blood.

21:59

Oh, sorry. Yeah. As

22:02

you mentioned it like that, like, because

22:04

the circulatory system has a heart, which

22:06

is like pumping stuff through. Like what's

22:08

the mechanism of stuff getting... Right.

22:10

For, yeah, and like what's the directionality and what's

22:12

the... Yeah, and like why wouldn't it just all settle

22:15

in your feet or something, that kind of thing? Yeah.

22:18

What I think we're about to show, we're working on

22:20

this, is that the

22:22

spaces around the heart have fluid

22:25

in them. We know that.

22:26

So when the heart contracts

22:29

to push blood out the

22:31

left ventricle,

22:32

the spaces surrounding the heart

22:35

get relaxed

22:36

and fluid flows into them.

22:38

And then when the heart relaxes,

22:40

the spaces around the heart get a

22:42

little tighter and the fluid flows out. That

22:45

is the thinking and I think the same thing might

22:48

be going on with the lungs because the lungs also expand

22:50

and contract, expand and contract. Yeah.

22:52

Anyway, just a very quick recap. Yeah. This

22:55

tissue that everyone thought was dense

22:57

like a wall and totally passive

23:00

is almost like alive.

23:02

It has fluids, it has a bump in.

23:04

Crazy. The walls are juicy is what you're saying.

23:06

It's a juicy wall that's

23:08

pumping everywhere that they didn't even know. And

23:10

it seems to be a system,

23:13

like a unified body-wide

23:15

system similar to the nervous system

23:17

or the circulatory system that they had totally

23:20

missed. I started thinking that my

23:23

understanding of anatomy was extremely incomplete.

23:26

And so they're like, we got to publish. We

23:28

got to publish. Now the question

23:31

is, what do we call it?

23:32

And they call it the interstitium.

23:36

The interstitium. Who comes

23:39

to mind when you hear

23:40

that word? Well, I mean, if

23:42

I'm being honest, if I was making

23:44

up a fake organ, maybe that's the thing I

23:47

would call it. Okay.

23:48

Fair enough. But for

23:50

me, I don't know. I think it's actually

23:52

really evocative. Maybe because I'm

23:55

someone who lives my life professionally

23:57

between many different worlds and ways of thinking.

23:59

thinking like, I like how it

24:02

evokes spaces that are unseen

24:04

and

24:06

in between. But there's

24:09

still this overarching question.

24:12

What the f***

24:13

is it doing?

24:17

There's that noise. Sorry, in my background.

24:19

I

24:20

had a calendar update come up again. And we

24:23

will try to figure out what

24:25

the interstitium is doing after this

24:27

short break.

24:30

Hi,

24:33

Rebecca Murray here from Mount Vernon,

24:35

Washington. I'm a member of Radiolab's

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26:16

I just love the opera. Never

26:18

been? Then come with me, Henrianna

26:21

Giddens, host of Aria Code, the

26:23

podcast. Where together we explore

26:25

the magic of opera, one song at a time. For

26:28

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26:31

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26:34

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to Aria Code wherever you get podcasts.

26:48

Radio Lab, Lulu

26:50

here with Jen. Hello. Hello. I'm Latif. Hello.

26:53

Okay, when we left off, we had just

26:55

learned about this secret

26:58

inside the human body. This piece of

27:00

anatomy, a system, a human body

27:02

part that

27:03

nobody had noticed until like five years

27:05

ago. Well, not nobody.

27:08

It might not be nobody. Okay, well tell that

27:10

story. Explain that. So my

27:12

real job, this is the fun

27:14

stuff, is liver pathology and...

27:17

A group of scientists believes it's discovered

27:19

a fluid filled tissue that makes up a

27:21

previously unknown organ. Our interstitium

27:23

work broke. And shortly after Neil was

27:26

in China... Doing collaborative

27:28

stuff about liver disease. And some of

27:30

the scientists and doctors there were like, hey, can

27:32

you present on this interstitium

27:34

stuff?

27:34

And I said, sure. So

27:36

he gets to the stage, he gives

27:38

his presentation, and after he's done...

27:41

A very high level physician

27:43

in China. Trained

27:44

in Western medicine and traditional Chinese medicine.

27:46

He was given the first question. And his

27:48

first question was, what has been the

27:50

response to this work of yours? And

27:53

I said, well, blah, blah, blah.

27:56

Scientists have expressed skepticism that

27:58

the interstitium is...

27:59

own organ. Like the science world was arguing

28:02

about what to call this thing. Is it an organ? Is it a tissue?

28:04

Is it a system? But whatever it is, med school

28:06

anatomy books may soon include a

28:08

new chapter. People are talking about this

28:11

new exciting thing. And he said,

28:13

well, we've been talking about it for 4000

28:16

years.

28:17

Traditional Chinese medicine

28:19

has been working with fluid and channels

28:22

and energy and systems drop a whole body

28:24

for thousands of years.

28:26

Now,

28:30

we couldn't find that doctor at the conference,

28:32

but we did find another doctor in

28:34

China

28:37

who

28:39

also had a strong reaction to the interstitium.

28:42

Okay. Wow. His name is Q. Sheng Chen. So our

28:49

professor, Professor Chen,

28:52

is not a smart ass and

28:54

he didn't have the reaction.

28:57

He like, duh. So we

28:59

talked to Q. Sheng through the help of a translator.

29:01

Wow. I don't even understand

29:03

what it is happening

29:05

in Chinese. Like I'm mind blown.

29:08

So Q. Sheng is a professor at

29:10

a veterinary school in China. And he does a lot of research

29:13

on the kidneys of camels, animal tissue, the

29:20

uh,

29:22

yaks, lungs of yaks. Yes.

29:25

And apparently female turtles that can store

29:28

sperm in their tissue for up to one

29:30

year long and they

29:32

can still be fertilized.

29:34

Whoa. That's wild.

29:37

Yeah.

29:37

But anyway, in 2018,

29:40

he's on an airplane flying

29:42

somewhere for work and he comes across the interstitium

29:43

paper and

29:47

he suddenly had this

29:48

kind of memory of being

29:50

a little boy. He grew up in

29:52

a rural village in China. One day they,

29:54

he had something that give him food poison

29:57

and it was so bad

29:58

that he

29:59

he was having breathing problems. So

30:02

his parents took him to go see a doctor who

30:07

gave him acupuncture. And

30:10

he had been given a few needles

30:12

on his hands, on his legs, and

30:14

then he instantly

30:15

felt this relief. He

30:19

sort of flashed through. It was kind of like, oh, I

30:21

just farted, and then

30:23

I'm good. It's

30:24

like a fart in the sense of

30:26

instantaneous. The

30:30

discomfort just went away. It

30:32

wasn't actually a fart, but it was a

30:34

feeling of total relief.

30:35

So

30:39

he's on a plane reading about the interstitium,

30:41

and he was just

30:41

like, God. It

30:44

resurfaced that question he'd been carrying

30:46

in

30:46

his body since he was that little boy, which

30:48

was like, how

30:49

did that work?

30:57

So

31:00

he starts reading about meridians, which

31:03

are basically the network of

31:05

acupuncture, the pathways in the body

31:08

through which life energy, known as chi,

31:11

flows.

31:11

That's according to this book called

31:14

Wang Di Ni Jing from 2005 years ago. So

31:21

he picks this pathway, this meridian,

31:23

that is known to help with the gut. And

31:25

he can't actually do the experiment on people

31:28

because it wouldn't be ethical. So he

31:30

has to do it on animals. Wait, wait, wait.

31:33

Is animal acupuncture a thing?

31:34

Oh, good guy. Well, I didn't know

31:36

that until reading the paper. I had no

31:38

idea. My 14-year-old dog, we just took her

31:40

to the doctor, and they're like, you could take her to acupuncture.

31:43

No way. Really? Really? She got arthritis

31:45

in her hind legs. And the idea is like, it's

31:48

like the same networks and pathways. Yeah,

31:50

pretty much. Who knew?

31:53

OK. But so. Asuna,

31:55

Jin Ju Ju Hu. Q Sheng got some rabbits.

31:59

24 rabbits. Thank you.

31:59

the rabbit, colitis, yeah, yeah,

32:02

it's this disease that affects the lining of the colon.

32:07

So these rabbits, they're bleeding,

32:09

you know, they're having like little ulcers, they're

32:12

losing weight rapidly, they're not doing

32:14

well.

32:15

But then he takes

32:16

these little tiny needles

32:19

and puts them into like the

32:21

joint around the rabbit's like leg,

32:24

like its knee, and

32:25

the acupuncture, like the inflammation

32:28

gets better. The bleeding reduces, they

32:30

start getting weighed again, like they're better. And some

32:33

of them are just all good.

32:35

Totally cured, just returned to normal.

32:38

Yeah. Wow.

32:42

So then he uses the interstitium paper,

32:44

almost like a map, to see if he can find anything

32:47

in the

32:48

interstitium

32:51

that's happening that could explain this.

32:53

And he finds telesite.

32:58

These cells, oh, telesites,

33:01

yes, called

33:03

telesites,

33:06

which are a newly discovered cell. That

33:08

is just one of the residents that

33:11

lives in interstitium.

33:13

People aren't quite sure what it does,

33:15

it seems to have some role

33:17

in immune response regulation, some

33:19

role in like cell to cell communication

33:22

or signaling. But what he saw was

33:25

that in the rabbits who got acupuncture,

33:28

their telesites were like super

33:30

activated. They were like throwing off chemical

33:32

signals, talking to

33:33

each other. They

33:34

were just more active. So

33:36

the telesites are always there in the

33:39

interstitium, but at least

33:41

in these rabbits, when they got acupuncture,

33:44

they're on hyperdrive.

33:47

Yeah. Yeah.

33:49

So I was excited by it, like

33:51

there are people in China who are really excited by it. Does

33:53

he feel like he has

33:55

glimpsed

33:56

the meridians that were proposed

33:58

by Chinese medicine?

33:59

Because this feels big like it's

34:02

still

34:02

very big. Yeah

34:05

But his answer

34:07

was basically

34:08

All

34:11

I can say is that we found what we found So

34:18

I pushed again Asking

34:21

if he thinks this is you know, like it's

34:23

still a big thing No, we'll put

34:25

you down there. That's what you're talking

34:28

about. I cannot think that myself

34:33

Okay point taken so more to

34:35

learn he's excited by what he saw

34:38

and and he offers it

34:39

to the world to learn more Mm-hmm. Yeah,

34:41

cuz it's true. He hasn't found where they're going or

34:43

coming from or if they were exactly what

34:45

they do Yeah, but when it comes

34:47

to the body and modern

34:50

Approaches to health and healing

34:53

Neil says Western medicine has always

34:55

had a difficult time talking about or

34:58

understanding things like

34:59

acupuncture because there was no

35:01

western style anatomy to explain

35:04

those clinical impressions

35:07

those personal experiences

35:09

And you said even though we don't know how the

35:11

interstitium might be a part of acupuncture

35:14

at the very least it provides a Cultural

35:17

bridge to allow people to have these

35:19

discussions Which

35:23

is kind of exactly what happened with

35:25

to shame who said that to

35:28

him when Neil and the team found

35:30

the interstitium Can't I do shit? Check

35:32

up when Jen they found the body but they didn't

35:34

find the soul They didn't find

35:37

like the meaning the reason why

35:39

it's doing what it's doing what animates it What

35:41

is its purpose?

35:42

But they gave him a place to look and

35:44

a place to bring these different

35:46

ideas these

35:48

ancient time-tested Eastern

35:51

ideas together alongside modern

35:53

Western medicine

35:53

and my hope is bit by bit This

35:57

community will be talking to people in the Chinese

35:59

medicine community and the Tibetan medicine community

36:01

and Ayurvedic medicine, because we're all talking

36:04

about the same body.

36:08

Okay, okay, I get that. I

36:10

get that, but can I just say, I don't know, it

36:12

feels like we're just learning. And I don't know, it feels

36:15

like a jump to rope in

36:17

this whole other ancient

36:20

tradition of medicine. Maybe, it looks like

36:22

it has a resemblance, but

36:25

it seems like it's way too early to go there, no?

36:28

Would you like something that's less than

36:30

maybe? Yeah,

36:32

okay, I'm excited about this, go Lulu. Yeah.

36:35

Okay, so. How is everything? We

36:37

should be

36:39

ready to go. Great,

36:40

at the very last minute, Jen couldn't

36:42

make this interview, but I talked to this

36:44

guy. My name is Peter Friedel, I'm

36:46

a medical doctor by training.

36:49

His name is Peter Friedel, for a long time, he was a dermatologist.

36:52

But then discovered that maybe science

36:54

is what I am best at. Basically,

36:56

he had seen

36:57

so much skin cancer, melanoma, he'd

36:59

seen so many people dying. And so

37:02

he

37:03

became a scientist, he kind of left practicing

37:05

medicine behind, and he became

37:06

a cancer scientist.

37:08

Cancer scientist, yeah. And so he.

37:09

At the end of the day, I switched

37:12

from applying knowledge to generating

37:14

knowledge.

37:16

And he was curious about

37:18

basically one of the most fundamental

37:21

mysteries of cancer. Which is.

37:23

How does it metastasize? How

37:25

does it show up in the skin?

37:26

And then at some point, shows up

37:28

in lung or liver or the brain. Like

37:30

how does it spread?

37:32

Yes,

37:33

exactly. All throughout the body. Yeah,

37:35

so it was known. That

37:37

obviously once cancer gets into

37:39

the blood.

37:40

Or the lymphatic vessels. It spreads

37:42

all over the body, and then you have to resort to

37:44

chemo, and things can get really,

37:46

really bad. But what was not known was

37:48

how exactly cancer goes

37:51

from your skin tissue

37:54

to a blood vessel or a lymph vessel.

37:56

That's hard. It's harder than you would think.

37:58

Yeah,

37:58

because even though that might be a time.

37:59

A tiny little journey. A couple of microns,

38:02

maybe millimeters.

38:03

From the point of view of a cancer cell, like that journey

38:05

is huge. And

38:07

a very tough one.

38:08

Because to a cancer cell, your

38:10

body's tissue is like a thick, dense

38:13

jungle. Yeah, it's all right. So basically,

38:16

there was a hunch for a long time of how it worked.

38:18

It was thought that tumor cells... Tearing

38:21

through tissue with... He calls them bazookas.

38:24

Bazookas or... Bush knives. Like

38:27

machete. And scissors. Or...

38:30

Oxygens. To get through this tissue... In order

38:32

to

38:32

move. So that they can bushwag their way to

38:34

a vessel and then to

38:36

the rest of your body.

38:38

So this was the premise.

38:39

And why was that the premise? Well, we

38:41

saw that cancer cells

38:44

in the Petri dish, they cut everything

38:46

into pieces.

38:47

He says, like, you can throw cancer cells

38:49

and tissue cells into

38:50

a Petri dish... And come back after the

38:52

weekend. And the cancer will have ripped

38:55

up

38:55

that tissue. And so all the big

38:57

pharma were on it.

38:58

Peter says that's where millions

39:01

of dollars of clinical trials of cancer research

39:03

was focused in terms of like,

39:04

okay, that's how it moves through. So what do you need

39:06

to do? You need to disarm the cancer cell.

39:08

But... Turned out, even if you give medicine

39:11

to people that takes away the bazookas,

39:13

the bush knives... The tumor cells still invade

39:15

perfectly.

39:18

Which was totally puzzling

39:21

because they knew these cancer cells have

39:23

these weapons at their disposal but

39:26

it was like they didn't actually

39:28

need them to

39:28

spread. And discovering

39:31

that was like... Hundreds of million

39:33

dollars were burned. Devastating to

39:35

the cancer research field. I mean, it

39:38

was decades of drug development, of

39:40

clinical trials, of hope poured

39:43

into this type of treatment. And people took

39:45

a step back and wondered, okay, what did we get

39:47

wrong?

39:49

So early 2000s, Peter

39:51

makes this jump into science. And he figures

39:53

rather than studying what cancer

39:55

does in a Petri dish, what he really

39:58

wants to do... Figure out a way to...

39:59

watch in real time how

40:02

a cancer cell moves in the

40:04

body.

40:05

So what he does

40:07

is he gets all these mice and

40:09

then we take a mouse, cut a little

40:11

hole into it, into the skin on its side,

40:14

and build a frame out of plastic

40:16

into this hole. And then

40:17

into that, they put this little piece

40:20

of glass, a glass of an aquarium,

40:22

so you can look through this glass into

40:25

the living tissue. Wow. Yeah,

40:27

and then they take that mouse

40:30

and give it a skin tumor, melanoma, and a sleeping

40:33

pill. The mouse falls to sleep for

40:35

three or four hours. They put the mouse on its

40:38

back, underneath like a big, huge microscope.

40:40

A microscope so powerful it is the size

40:42

of a room.

40:42

And then,

40:45

they looked into the microscope, through the glass

40:47

portal, into the mouth. And it was spectacularly

40:50

colorful right from the beginning. So

40:52

imagine all the skin

40:55

tissue of the mouse was blue, like

40:57

a blue jungle of skin

41:00

tissue. And then the cancer cells,

41:03

there were like these green little dots. And the green

41:05

dots were moving. But what surprised

41:08

Peter was that the cancer cells weren't moving

41:10

like some wild hoard,

41:12

blowing up tissue wherever they

41:14

could. They were moving like a

41:16

fluid almost. Instead, they were lining

41:18

up. One after the other, or neighbors even

41:21

together holding hands. And streaming

41:23

through. And offensive, fruit-like fingers.

41:26

The mouse's skin. Basically,

41:28

the cancer cells were finding little channels in

41:30

the tissue where they could just zoom through

41:32

it and get to a

41:33

vessel. In

41:36

a way, it

41:37

seemed to be like a highway

41:40

type system.

41:41

But the cells were exploiting. And

41:43

what were you thinking in that moment? Oh,

41:46

this is interesting. Can

41:49

we observe it a little longer? So you're just like,

41:51

you're just like fascinated. Yeah, absolutely.

41:53

It's like a child in

41:55

a

41:56

reef with all the fish

41:58

and all the structure.

41:59

It's like fascination

42:02

pure. Because remember, he's seeing this

42:05

a few years before Neil and

42:07

Becky and David's paper come down.

42:09

So he still like doesn't this

42:11

idea of a unified system,

42:14

that isn't out in the world. But

42:16

he is seeing the interstitium,

42:19

like the channels of the interstitium.

42:21

So what did without that information, what did

42:23

he think it was? He thought that the cancer cells

42:25

were making

42:26

this channel? No, no, no. And he didn't tell

42:28

that the channels are in there, in

42:30

the skin. So after the kind

42:32

of transfixed awe wore off.

42:34

We thought, holy shit,

42:36

if every tissue has these channels. How

42:39

are we ever going to be able to stop

42:41

the spread of cancer? There are too many channels. It's

42:45

like it's endless. Like there's

42:47

just no way. It's clear we're not going to

42:49

stop them.

42:52

And so for years, Peter

42:54

just sat staring at

42:56

these cancer cells moving through these highways,

43:00

feeling hopeless. Until

43:04

one day, he was like, what

43:06

if we

43:07

forget about the highways, trying

43:09

to block them or stop them and instead

43:11

just go after the cancer

43:14

cell. And kill it.

43:17

So

43:18

what he does is he goes back to these

43:20

mice and he just

43:22

blasts the cancer cells with radiation.

43:25

And what he discovers is that the only cells

43:28

that survive the blast

43:29

are what we call the marathon runners,

43:31

are the cells that are running through the interstitium.

43:34

So Peter starts pulling these cancer cells out

43:36

of the mice

43:36

to find what makes the marathon runner

43:39

special, different from the rest.

43:41

And what he finds is that these marathon

43:43

runners, they are a smart opportunistic

43:45

creatures,

43:46

rather than deploying

43:49

these bazookas to rip through tissue,

43:51

they have these little claws that

43:54

they use to get into

43:56

the interstitium and move through it. And

43:58

they can also use the claws to

43:59

to like fuel up in a way that

44:02

makes them grow bigger and stronger and

44:05

harder to kill.

44:05

That's already bad news, but it also

44:07

is good news because if you now know what makes

44:10

them special you can take it away.

44:13

Fast forward, Peter develops these

44:16

antibodies that basically declaw

44:19

the cancer cells and he gives these antibodies

44:21

to the mice.

44:21

And you give radiation therapy at the same

44:24

time, the marathon runners

44:26

melt away and

44:27

they

44:28

die. And we can cure the mice

44:30

even in tumors that otherwise are not curable.

44:34

And we also followed those mice up for half

44:37

a year to check whether cells had made

44:39

it out into the lungs or the liver or

44:41

somewhere else. And nine out

44:43

of 10 mice were clean. So

44:45

that means we

44:48

didn't need to block the roads,

44:51

we bombarded the cars in a good way.

44:53

And he said the difference between that and

44:56

chemo

44:57

where you just flood the body

45:00

with everything

45:01

is like a huge

45:03

world of difference

45:04

obviously because you're not targeting

45:07

the sick

45:08

person's own immune system.

45:11

I'm like

45:15

finding myself getting emotional about

45:17

this. Why?

45:22

My mom passed away from cancer

45:26

from lymphatic leukemia and

45:28

lymphoma

45:29

which are system wide. That

45:32

means they've gone through the whole, they're

45:35

everywhere. And

45:37

she got chemo and she had

45:39

too many white blood cells and the

45:41

chemo they were too aggressive with it and

45:44

they knocked out so many white blood cells.

45:46

Like you said they just blast everything.

45:51

The white blood cell count couldn't get high enough

45:53

to fight it anymore. They overshot

45:55

it.

45:59

at what, because I know she lived with it for a long

46:02

time. She did. It was a chronic lymphatic

46:04

leukemia, which is better than

46:06

the acute, where people can pass very quickly.

46:09

It's really aggressive. But it

46:12

was really the chemo

46:13

that ultimately killed her. And

46:16

I think just hearing about

46:20

Peter's work and I don't

46:23

know, it gives me a little hope.

46:30

And I should say that Peter said this strategy

46:33

of using antibodies and radiation.

46:34

Whether then it is making

46:37

it, it's all the way into the clinics. As

46:40

we know, one out of 1,000 initially

46:44

proposed strategies will make

46:46

it to the patient. So we will

46:48

have to see. They'll have to go

46:50

through years of development of trials in humans.

46:52

But at least proof of concept we

46:54

made.

46:55

We delivered. And that's what feels big,

46:58

because what Peter was finding is

47:01

that the cells are now in mice.

47:03

So this is a slide of breast. Neil

47:06

and Becky are now seeing in humans. And

47:10

here are cancer cells walking along through the interstitium

47:14

like they've got a nice little path to follow

47:17

through the woods. Here they are just

47:19

marching from the interstitium to get to the

47:22

lymph nodes. Yeah. So Neil and Becky,

47:24

I kind of think of them as like these

47:26

trying to make these maps

47:27

of every single organ. Of

47:30

like where the interstitium is. Where would

47:32

it be in the womb? And where

47:34

it isn't? There's very little actually.

47:37

It's interesting. This is one of the areas where you don't

47:39

see a lot of interstitium. And it's like they

47:41

are publishing as fast as they can.

47:43

We've got six papers that are heading

47:45

their way towards publication.

47:47

And

47:47

they're not claiming to know what the interstitium

47:49

does or is doing throughout the body.

47:52

They're just like, here are the maps. Now all

47:54

these different fields, do with it what you will.

47:56

So obviously people are interested

47:59

in the acupuncture. pick this

48:00

up. But there's a lot of people who are focused

48:02

on primarily Alzheimer's research.

48:04

They've been interested in the interstitium in the

48:06

skull. Neil and I both participated in

48:08

a conference at the National Institutes of Health

48:11

in the spring on the interstitium

48:13

as

48:13

it relates to the kidney. There's

48:14

people looking at kidney function. There's people

48:16

who hope the interstitium might help. Understanding

48:18

metabolic diseases like diabetes,

48:21

understanding bacteria in the

48:23

body, how infections might spread in

48:25

places even like your mouth. I gave a talk

48:27

about this at the Pendanto School and

48:29

you know there's a lot of bacteria in the mouth,

48:31

right? But we

48:35

don't know. I mean it's uh it's

48:37

sort of wide open right now. Hmm.

48:40

It's just sort of amazing to think

48:43

like this little microscope

48:45

goes into the body and then opens

48:48

up this whole new realm that

48:50

we're just you know just

48:52

beginning to learn about. Like this is

48:54

my favorite kind of technology story where

48:57

it unlocks a

49:00

whole new part of our world and literally

49:03

a whole new part of ourselves that

49:05

we just could not have seen otherwise.

49:08

Well how

49:09

about that?

49:10

Turns out you didn't actually

49:12

need the microscope.

49:14

Wait it's not naked eye visible is it?

49:17

No.

49:18

It is? Really? So now

49:22

what I'm gonna show you we have cut as

49:24

I said we cut open the small

49:26

intestine and the wall of the stomach. Now

49:29

this is kind of like the wildest part

49:31

of the story for me. So when we were in the lab

49:33

with Neil

49:34

at one point he takes a cross-section

49:36

of the small intestine in his hand and you see

49:39

this and

49:39

he started pulling at this thin

49:41

it

49:42

looks kind of thready like layer of

49:44

almost like translucent threads

49:47

encasing the intestine. That that

49:49

is the interstitium? That's

49:50

the interstitium. What?

49:52

Yeah. But like that was

49:54

it. Like that is it.

49:55

Okay to get that this

49:57

close? Yeah.

49:58

See like here?

49:59

When I pull it, you see little threads

50:02

sort of getting tense inside there. Yeah. Yeah.

50:05

That's the interstition. Wow. Yeah.

50:08

Wow. I thought this was like a technology.

50:10

No, no, no, no. Sorry. No.

50:13

So, you got a fancy scope? Any new technology

50:16

that allows you to see things you didn't see

50:18

before or see them in a different way

50:20

is going to reveal things you hadn't noticed.

50:24

Some of them may not have been available to

50:26

your eye. In this case,

50:28

they were available to our eye. But

50:32

we had never put it together. And

50:35

what

50:35

Neil said was like, no one

50:37

had put it together because we've been

50:39

told to discount it. You

50:41

know, we all read the same textbooks and look at the same

50:43

drawings by the same people to

50:46

explain what is seen in the human body.

50:48

And all these people had decided that this thready

50:50

stuff

50:50

that we were seeing in the body, like,

50:53

it just didn't matter. It didn't do anything

50:55

important. Yeah. We

50:57

saw it,

50:59

but it had no meaning. Or even like Neil, who

51:01

had been seeing cracks in tissue

51:04

inside. He'd been told since

51:06

med school, this is nothing we even have to pay attention

51:08

to, that the cracks in the tissue, they

51:11

don't matter. Like, don't

51:12

worry about the cracks. And I taught people these

51:14

were just cracks for 30 years.

51:16

But so it's like when Jen brought

51:18

this story to us,

51:19

I originally understood it as like

51:22

a fancy new technology reveals this body

51:24

part we've missed forever.

51:26

But it sounds like you're like, no, like, is

51:28

this actually a story

51:29

just about belief getting in the way? Yeah.

51:32

Beliefs and training and dogma.

51:35

It comes back to the

51:38

Shinriyuu Suzuki Roshi, who was the founder

51:40

of San Francisco Zen Center, said that

51:42

in the mind of the beginner,

51:44

there are many possibilities in the mind of the expert.

51:47

There are

51:48

a few. I get, I get choked

51:50

up.

51:51

Why does that choke you up?

51:56

Because it's so profound.

51:59

What had I been told?

51:59

heart that got in the way.

52:05

What am I missing now?

52:28

This story was brought to us

52:30

and reported by Jennifer Brandell.

52:32

Before we go, we should say that

52:34

Jen has one more kind of brain

52:37

busting chapter about the

52:39

interstitium. She just published

52:41

an essay about it for Orion magazine.

52:44

Orion magazine. It's called Invisible

52:46

Landscapes. Go read it. But

52:49

Jen, can you just give like a cliff note? Sure.

52:51

Yeah. So I mean, truth be told,

52:53

I'm most interested in the interstitium's

52:56

metaphorical value. Like if

52:58

we've missed seeing this thing that connects so many

53:00

organs in our bodies, like might we be missing

53:02

analogous things in society?

53:05

Does

53:05

that make sense? Not

53:07

quite. Say one more piece. Say one more piece. What

53:09

does that mean? An interstitium in... Yeah.

53:13

Just briefly, like I mentioned at the top, I'm a

53:15

person who operates between different organs

53:17

in society, like we call them organizations,

53:21

you know, between journalism, tech, government, democracy.

53:24

And in learning about the interstitium,

53:27

it was kind of like the skeleton key for me

53:29

that made me realize that like there's

53:31

this whole invisible

53:33

thing that has been discounted.

53:36

The people, the

53:37

roles that do this connective work. And

53:40

like, like a kind of work. Yeah,

53:42

it's like a kind of work. It's been ignored.

53:44

It's like it doesn't have a job description. It's discounted.

53:47

And like, I think it's key

53:49

to the health of the whole body, like the whole economy.

53:52

And so in the essay, I give some examples

53:54

of what I mean. Yeah. And I guess I just

53:57

kind of want to hype you now. Like you talk about

53:59

work you did. connecting the city of

54:01

Chicago during COVID to

54:03

hospitals, churches, hotels to help

54:05

people in need. It's very concrete stuff. It's

54:07

really neat. Yeah, it's

54:09

really. Oh, well, thanks,

54:12

Lulu. I mean, basically, it's just making the

54:14

interstitium, like people, visible

54:16

in society and talking about how the

54:18

more we value it, the more we notice, invest in

54:21

it, it could have hopefully positive

54:23

ramifications for the health of the economy

54:25

and

54:27

stuff like that. Go check it. Again,

54:29

it is called Invisible Landscapes,

54:32

and you can read it at orionmagazine.org.

54:36

And if you are interested in geeking out in more

54:38

scientific ideas, Dr. Neil Thiesse

54:41

just published a book that

54:43

is called Notes on Complexity, a scientific

54:46

theory of connection, consciousness, and

54:48

being. It is really

54:51

profound and great. Go check that one out as well.

54:53

Notes on Complexity by Dr. Neil Thiesse.

54:56

This episode was produced by Matthew

54:58

Kilthy with production help from Akedi

55:01

Foster-Keys, mixing help from Ariane

55:03

Whack, fact checking by Natalie Middleton,

55:05

was edited by Alex Niesen. Big

55:08

special thanks to Jessica Clark,

55:10

Aaron Wickenden, Mada Zapata, Daryl

55:12

Holliday, Dr. Amy Chang, Kate

55:14

Fassoon, Guy Huntley, John Jacobson,

55:17

The Village Zendo, Scotty G, and

55:21

rest in peace to Mavis,

55:23

the 14-year-old. Oh,

55:27

and before we go, I guess we should just sign off

55:29

with what happened after Jen was injected with fluorescent

55:31

dye to get scoped. The doctors told her

55:33

that if she went to a dance club, she would glow under

55:35

the black light. But

55:38

instead, she just went home, drank some tea. Okay,

55:41

and I'm just getting back to the Airbnb

55:43

I'm staying at in Brooklyn, and

55:46

I have been told that the

55:48

dye that was injected is going

55:50

to make my pee green. We're

55:53

going to see. I have not urinated

55:56

since, well,

55:59

for a while.

55:59

since the dye was injected. So, all

56:02

right, let's see, here it goes.

56:22

Take a look, whoa. Oh, wow.

56:27

It's like highlighter yellow

56:30

green. It's really,

56:32

yeah, it's like neon greeny

56:34

yellow. It's wild. Okay,

56:36

I'm gonna take a photo. This

56:39

is what we get to do for work. What a privilege.

56:42

Radio Lab was created by

56:44

Jad Avumrad and is edited by

56:46

Sorin Wheeler. Lulu Miller and Bathef

56:48

Dasser are our co-hosts. Dylan Keefe

56:51

is our director of sound design. Our staff

56:53

includes Simon Adler, Jeremy

56:55

Bloom, Mecka Bresler, Kettie

56:57

Foster-Keys, W. Harry Fortuna,

57:00

David Gable, Maria Paz Gutierrez,

57:03

Sindhu Nyana Sambadam, Matt

57:05

Kilty, Annie McEwen, Alex

57:07

Neeson, Alyssa Jeong Perry,

57:10

Sara Kari, Sarah Sambach, Arianne

57:12

Wack, Pat Walters, and

57:14

Molly Webster. With help from Timmy Broderick.

57:17

Our fact checkers are Diane Kelly, Emily

57:19

Greger, and Natalie Middleton. Hi,

57:23

my name is Michael Smith. I'm calling from Pennington, New

57:25

Jersey. Leadership support for

57:27

Radio Lab's science programming is provided

57:29

by the Gordon and Betty Moore Foundation, Science

57:32

Sandbox, the Simons Foundation Initiative,

57:35

and the John Templeton Foundation.

57:38

Foundation of support for Radio Lab was provided

57:40

by the Alfred P. Sloan Foundation.