Episode Transcript
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Speaker 1 (00:01):
Welcome to stuff you should know, a production of iHeartRadio.
Speaker 2 (00:11):
Hey, and welcome to the podcast. I'm Josh, and there's
Chuck and Jerry's here too, and this is a good
old fashioned stuff you should know. Medical mystery episode.
Speaker 3 (00:21):
That's right.
Speaker 1 (00:22):
Look at Jerry were there. She's just sitting there. She's frozen.
And what you can do is, I don't know if
you know this, Josh, if you walk over to Jerry
and take her hand off the keyboard and raise it
above her head, she'll just keep it there until you
move it back down.
Speaker 2 (00:36):
Why, Chuck, sounds a lot to me like Jerry might
have chronic encephalitic lethargica.
Speaker 3 (00:44):
I think you might be right.
Speaker 2 (00:46):
I might be right. I might be partially right. I
think I would have been more right if I had
called it encephalitis lethargica. But that's probably what she has.
If those are her symptoms.
Speaker 3 (00:57):
That's right.
Speaker 1 (00:58):
File this under medical mysteries and also filing under a
Julia jam But we're basically going to call it el
or encephalitis lethargica here and there. I was also known
as the sleepy sickness, sometimes the sleeping sickness, although there's
a new sleeping sickness that is not to be confused
with the previous one.
Speaker 2 (01:19):
No, it's spread by the tetsifly and it's epidemic. I
don't think it's endemic yet in Africa, and it has
got a couple of similar symptoms, but they're in no
way related from what I understand.
Speaker 3 (01:31):
That's right.
Speaker 1 (01:31):
We're talking about an outbreak that happened in the early
twentieth century in Europe, starting in about nineteen sixteen, wherein
all of a sudden, people would kind of out of nowhere,
they would lose mobility, some people would fall into a
coma like state or a sleep like state. Many many
people would die within days, and it reached epidemic proportions
(01:54):
in at least four continents by nineteen nineteen, killed hundreds
of thousands of people.
Speaker 3 (01:59):
And it's a medical mystery because we still don't.
Speaker 1 (02:02):
Know exactly why it happened or why it just kind
of suddenly went away.
Speaker 2 (02:08):
Yeah, where it came from, what caused it? Nothing, We
don't know almost anything about it. They just kind of
know the symptoms enough that when you see the very
very very rare case come along these days, you can say,
I think this actually is encephalitis lethargica. And there was
something you said about people being struck into like a
(02:28):
coma or sleeplike state. The people who are struck with
in cephalites lethargica, they weren't like laying there like sleeping
beauty on their backs with like their hands crossed over
their chest like it was like you're saying, like they
might have their hand in the air and their mouth
open and like a silent scream and their eyes were open.
They just weren't moving at all and they were just
sitting like that. That's the kind of like horrible symptom
(02:51):
that you could suffer from for decades. Like once that started,
it might just keep going on for the rest of
your life, even though this happened to you and childhood.
Speaker 1 (03:01):
Yeah, exactly so. And there's a bit of a reveal
that we're going to hang on to here. But we're
gonna start off with not a reveal because that's not
how you do things in the.
Speaker 2 (03:10):
Three act structure, not in the podcast.
Speaker 3 (03:13):
Biz no, no, No.
Speaker 1 (03:14):
We're gonna start out nineteen sixteen with a doctor constantin Vaughan.
Is it economo or Economo? I? Like the first one
that's like saying is it economy or economy?
Speaker 2 (03:30):
This sounds to me like a Cosmo Kramer alias why.
Speaker 1 (03:35):
Don't you just tell me the name of the movie
you want to see.
Speaker 3 (03:40):
I'll never not laugh at that bit.
Speaker 2 (03:41):
No, it's a good one.
Speaker 3 (03:43):
Oh boy.
Speaker 1 (03:44):
So he was a doctor at the University of Vienna's
psychiatric neurological clinic and he started seeing some strange cases
come through his office in nineteen sixteen where the symptoms
were you know, they had diagnoses on the charts, like
meningitis or MS or delirium, but the symptoms weren't matching
these things or anything else that he could think of. Yeah,
(04:06):
and the first thing he did was ruled out neurological toxins,
infections and neurological disorders, and then was like, all right,
I'm open here. Let let's like, no one knows what
this is and we need to figure it out, so
let's sort of put our minds to this thing.
Speaker 2 (04:22):
Yeah, he dove in. He started describing it. He wasn't
actually the first one to describe it. I think he
was actually beaten by a couple of days, even though
some people say it was the opposite way around, by
a French physician named doctor Renee Cruschet. The difference was
doctor Crusette's take was that this was maybe a behavioral disorder,
(04:42):
and doctor Economo von Economo said, no, this is like
clearly some sort of infection or something like that. It's
an epidemic. It's transmissible. So that's why this is sometimes
called Economo encephalitis. It was essentially named after him because
he was the guy who said, this is what's going
going on. This is what I think is going on.
Check out these nutso symptoms.
Speaker 1 (05:04):
Right, not so nuts to at first, because when people
would come in at first, they had basically looked like
the flu, you know, fever, coughing, you know, kind of
what you would think of. Everyone said the flu, right, yeah,
I don't, I don't. Yeah, there you go.
Speaker 2 (05:20):
That's I watched Zuelander recently.
Speaker 1 (05:22):
You know, a picture is worth a thousand words. A
Josh impression of the flu was worth at least twenty
of my words.
Speaker 2 (05:28):
All right, thanks?
Speaker 3 (05:30):
Was that part of Zulander, did you?
Speaker 2 (05:32):
Yeah? He had the black clung when he went back
home to mine coal with his dad.
Speaker 3 (05:38):
Oh, I love that dumb movie.
Speaker 2 (05:40):
It is a really great dumb movie. I was like,
this is pretty great still.
Speaker 1 (05:45):
All right, So flu like symptoms at first, then just
a huge array of neurological symptoms that were really inconsistent
among the patients, the severity of which was pretty inconsistent.
Sometimes it varied widely from one to another. But one
of the most common threads of these neurological symptoms was
something called hyper somnolence, which is just really really sleepy,
(06:09):
like feeling really sleepy, and then eventually it could lead
to that coma like state where you're just sort of
locked in.
Speaker 2 (06:15):
So here's the thing. I so the sleep, the type
of sleep though that is common among people struck within
cephalitis lethargica, is not what you would consider sleep. They're
not getting rest. You can wake them very easily. They
are probably semi aware of what was going on around
(06:35):
them the whole time they were sleeping, but they couldn't
not fall asleep. Another thing that sometimes gets chalked up
under this hypersominolence is freezing mid action, like maybe they're
taking a bite of broccoli. That's a bad example because
they probably are like, I can't make myself eat this brocoli.
It's so disgusting. But let's say they're eating like a
(06:57):
delicious animal cracker, and they stopped mid bite. They might
not move again, or they might like hear a song
or something like that, and all of a sudden they
start eating the animal cracker again.
Speaker 3 (07:10):
Yeah, it's not.
Speaker 2 (07:11):
The point is it's called the sleeping sickness. It's not
sleep as you would understand it.
Speaker 3 (07:16):
Yeah. Yeah, that's good to clear that up.
Speaker 1 (07:18):
Thanks, because sleeping sickness sounds pretty good to me right
about now.
Speaker 2 (07:23):
It kind of does.
Speaker 1 (07:25):
Half of these cases, it was a pretty wide age range.
About half of them were in people aged ten to thirty.
Like I said, a lot of the patients died. Sometimes
they died within like a week or two after onset
of symptoms. There was one case of a girl who
was walking home from a concert suddenly experienced a paralysis,
fell asleep within about a half hour, and died less
(07:47):
than two weeks later.
Speaker 2 (07:49):
There was also some weird stuff, as we'll see, that
had to do a psychiatric system symptoms, where sometimes people
would be fine after you know, suffering from this for
a couple of weeks, but they will their personality would
have changed. There was one report of I guess a
study found four reports of people who developed kleptomania after
(08:11):
having suffered this and then ostensibly were cured from it.
So like, it could really mess with your head, essentially
in just about any way your head can be messed with.
Speaker 1 (08:21):
Uh did win Ona Writer claim that was her? Remember
when she was stealing stuff?
Speaker 2 (08:26):
Oh? Yeah, I remember.
Speaker 3 (08:27):
It was so weird.
Speaker 2 (08:29):
It was a big deal.
Speaker 3 (08:30):
She came back pretty strong, which I'm glad. I like
Winona Writer. She does a great job in Stranger Things.
Speaker 2 (08:36):
Oh, she's awesome and everything she's ever been in. Heather's Dude,
just one of the all time great movies. She was
great Mermaids, and then yeah, all the way through to Beetlejuice.
I'm not gonna say Beetlejuice Beetle Juice, but definitely Beetlejuice.
And then Stranger thinks.
Speaker 3 (08:49):
Sure, yeah, and a great crush of much of gen
X for sure. Both dudes and chicks.
Speaker 2 (08:58):
You got that straight. We're talking and dudes and chicks.
Jen X says that.
Speaker 3 (09:03):
Yeah, they do, all right.
Speaker 1 (09:05):
So Van Economo was studying all these people. He was
studying corpses of these people. He finally breaks it down
into its subgroups, the first of which is acute e
l That is the initial signals that you're going to get.
We talked about the fluey kind of stuff that you
get and all these neurological symptoms that are going to follow.
(09:27):
Then he broke those down into three forms, from most
common to least common, starting with the most common somnolent ophthalmologic.
How would you say that, ophthalmologic ophthalmoplegic, That's what I'm going.
Speaker 3 (09:44):
With, all right, that's the most deadly form.
Speaker 1 (09:47):
More than half the patients die when they have this form.
This is a really overwhelming sleepiness, but like you said,
you're aware, you're easy to wake up. The optimal part
is ocular paralysis, so you have you're not moving your eyes,
so if people come and they wave their hand in
front of your face, your eyes aren't moving or anything
like that. And also those neuro psychiatric symptoms that you
(10:09):
were talking about, like delirium sometimes confusion, catatonius, stupor stuff
like that.
Speaker 2 (10:15):
There was also the worst report that I saw, and like,
I didn't see anything like this, but I checked and
it does seem to have been a case report of
a girl from the thirties who basically had a psychotic
break because of it, and she pulled out all of
her own teeth and ouch out both of her eyes.
A little girl did because of this. And again it's
(10:35):
just some weird outlier symptom. But as you see, when
we get further and further into this, it's just the
brain getting eaten up somehow someway in some fairly predictable regions.
So it's creating this whole cascade or galaxy of different
symptoms that are just the worst things that can happen
to your brain happening.
Speaker 1 (10:56):
Yeah, the next subgroup of the next least or I
guess the next most common depending on which way you're
looking at it, is hyperkinetic. That is mania basically is
the big part of this one. You have a manic
phase in voluntary vocalizations and kind of herky jerky movements,
and then a hypomanic phase where there's a lot of fatigue,
(11:16):
a lot of weakness, you can hallucinate, you can have
nerve pain in your limbs and in your face. And
this is one of the odder symptoms is your sleep
pattern will flip from day to night or I guess
night to day.
Speaker 3 (11:31):
If you were a factory worker or something.
Speaker 2 (11:34):
And there's another thing with that sleeping sickness part, you know,
like your sleep is messed up. I also saw a
chuck that in at least one of these people might
also be super sleepy but not be able to fall
asleep no matter how hard they try, which sounds worse
to me than most of the other stuff.
Speaker 3 (11:52):
For sure.
Speaker 2 (11:53):
There's a third one that he said is the least common,
but it's also a way that it can present. It's
called hemiostatic akinetic, which is you can't move akinesis. And
this is kind of what the classic idea of what
encephalitis lethargica looks like, where you're just you're just sitting
there with like, yeah, your right arms in the air,
(12:16):
your left arms a little further down, your mouth's open.
You're basically a statue essentially, is how it's described. You're
frozen in place and you're not going to move until
somebody maybe put some slight pressure on your arm and
then maybe you'll move it down. But it's not that
they're just going to put pressure on your arm for
(12:37):
a second and then you move your arm down, like
they have to move your arm down. And this is
what's called waxy flexibility. You can pose somebody in this
state any way that you want them to, So you
have to be very kind when you're dealing with patients
like this.
Speaker 1 (12:55):
Yeah, I could not help but think that waxyf of
flexibility sounds like an album title for sure, like Guided
by Voices or somebody.
Speaker 2 (13:05):
Lips inc.
Speaker 3 (13:07):
Is that a real band?
Speaker 2 (13:09):
Yeah, they're a function town people.
Speaker 3 (13:11):
Oh oh okay, yeah, oh waxy flexibility. Sure nailed it. God,
why voice is? What was I thinking?
Speaker 2 (13:18):
This is the the biggest part to me, I guess
part of all of this because of the sleeping part.
The people suffering this, including the people who are or
wax figures frozen in place for years or decades potentially,
are there mentally. They're not like locked in as in
(13:39):
locked in syndrome, where they know every single thing that's
going on around them at all times, right, But they're
essentially in the same boat where they're aware of stuff.
They're aware of time passing. There were people coming and
going and interacting with them. They cannot respond, they can't speak,
they can't change their position of their eye, they can't
(14:00):
focus their attention, they can't do anything that would suggest
to anyone that they are there in any way to
er form. And it wasn't until a genuine medical miracle
took place that we understood, Oh my god, these people
have been there in their heads the whole time. They're
not just like comatose, like just completely out of consciousness.
(14:22):
They're conscious.
Speaker 1 (14:24):
Yeah, yeah, for sure. And you know, earlier I said
like they're locked in. I didn't mean the literal locked
in syndrome. I just meant sort of, you know, look
like they're locked in.
Speaker 2 (14:34):
Yeah. I didn't take it like that, Yeah, but I
think people might have. So, yeah, well, come on, guys.
Speaker 1 (14:41):
We don't know how many cases there were. It was
a legitimate pandemic, though it's one of the things that
was hard to diagnose.
Speaker 3 (14:48):
They think it was under diagnosed and.
Speaker 1 (14:50):
Reported estimates run from five hundred thousand to more than
a million, but they think that maybe half of the
cases weren't even reported to who knows how many it
could have been. About a third of them died, a
third survived and we're kind of okay, And then a
third survived and then got it again later on, and
that is acute eel. So maybe we should take a
(15:13):
break and talk about chronic el after.
Speaker 2 (15:14):
This let's all right, We'll be right back, okay, Chuck.
(15:44):
So a lot of the stuff I was talking about
about people being frozen in place as if they were statues,
they had waxy flexibility, mutism, catatonia, They weren't able to
respond or move or anything. When I said for like
years or decades, more accurately, I would have been referring
to the chronic form of encephalitis lethargica, because it was
(16:07):
essentially it seems to me kind of like ammeostatic akinetic,
but for years and years. The scariest part about all
this was that you had gone through the standard case
of encephalitis lethargica, one of those three that we just
talked about, and got better. You may have died, You
(16:28):
may have gotten better, but maybe you had like behavior changes,
like you turned into a kleptomaniac or something like that.
Or you got better and thought everything was fine, but
then you suddenly suffered from being just a ton of
bricks being dropped on you, and all of a sudden
you can't move for the rest of your life, even
though it's been ten years since you had that case
(16:50):
of encephalitis lethargica.
Speaker 1 (16:52):
Yeah, for sure. The chronic is much the same as
the earlier but with a few added symptoms, one of
which is very, very strange. You can have mood swings,
pretty normal feelings of euphoria, and maybe even an increased libido,
which is not the weirdest thing psychosis in about thirty
percent of patients, again not the most abnormal thing in
(17:15):
the world, but excessive silliness in the use of puns
was an actual symptom that they saw over and over
again in acute cases. Yeah, isn't that bizarre or not
acute in chronic cases, right?
Speaker 2 (17:28):
Yeah? Yeah, But again, the defining trait, the one that
people would point to and be like, oh, that person
has chronic encephalitis lethargica is that statue thing that I
was talking about, And that's more clinically called rather than
that statue thing, doctors tend to call it post encephalotic parkinsonism,
and parkinsonism is one of those difficult things to grasp
(17:50):
until you just stop trying to think too hard about it.
It's essentially a bunch of movement in neurological symptoms and dysfunctions,
and Parkinson's includes parkinsonism, but not all parkinsonism is Parkinson's disease.
That's right, Okay, it took me way longer than I
(18:11):
care to admit to finally just nail that down and
stop running in circles trying to figure it out.
Speaker 1 (18:16):
Yeah, I mean, I think they even had. One of
the reasons they call it post encephalitic PARKINSONI is parkinsonism parkinsonism, Gez,
that's a tough one, I know, or PEP is to
distinguish it from Parkinson's isn't exactly the same thing.
Speaker 2 (18:31):
Yeah, And one of the big things that distinguish it,
because a lot of that shares a lot of symptoms.
But one of the things that distinguishes post encephalatic parkinsonism
and Parkinson's disease is that Parkinson's disease progresses gradually in
a predictable pattern. Post Encephalatic parkinsonism, like I said, it
can come out of the blue. You could be again
(18:51):
sitting there eating an animal cracker, and all of a sudden,
you never finished eating that animal cracker for the rest
of your life. It just can suddenly come out of
no where and you're just living your normal life, and
then all of a sudden, you're in an institution and
you're bound never to move again unless you happen to
be in the right place at the right time in
the late nineteen sixties.
Speaker 1 (19:12):
That's right, And this is the big reveal. If you
were hearing these symptoms and you think, hey, that sounds
awfully familiar. I think I saw a movie about that,
then you're correct. This is the movie from the book Awakenings,
based on neurologist Oliver Sacks' book of the same name
about his work with EEL patients in the nineteen sixties.
I think there were eighty chronic el patients he worked
(19:34):
with at Beth Abraham Hospital in the Bronx, New York
in nineteen sixty six.
Speaker 3 (19:40):
When this came around and Oliver Sacks was in there,
e L had gone away.
Speaker 1 (19:45):
Basically, it was a medical footnote, and not a lot
of people in the nineteen sixties even knew much about
it because it was one of those things that they
never figured out what it was, or how it started,
or how to cure it or anything.
Speaker 3 (19:56):
It kind of just went away.
Speaker 1 (19:57):
So all the doctors were like, all right, God, I
guess we don't worry about that anymore, right exactly, And
they just moved.
Speaker 3 (20:03):
On to their other work.
Speaker 1 (20:05):
There was a nineteen eighty five NPR interview where he
was talking about this is a quote motionless figures who
were transfixed in strange postures, sometimes rather dramatic postures, sometimes not,
with an absolute absence of motion, without any hint of motion,
So everything looked frozen. And that was you know, Robert
de Niro's character in the movie Awakenings.
Speaker 2 (20:26):
Yeah, and all the others that he eventually grabbed together. Yeah,
in assemble. When's the last time he saw Awakenings.
Speaker 3 (20:34):
It's been a while. I think I remember thinking it
was a pretty good movie back then. Though.
Speaker 2 (20:37):
It's a great movie. Yeah, I watched it last night.
Speaker 3 (20:41):
Who directed that? Do you know?
Speaker 2 (20:42):
Laverne? Oh?
Speaker 3 (20:44):
Was that Penny Marshall?
Speaker 2 (20:45):
Yeah? She did. It was great. I mean, like, I
don't remember if Tonio got an oscar or not, but
if you didn't, that's one of the all time great snubs. Yeah,
she did amazing. I forgot how wonderful Robin Williams is
to just man, what a great guy that dude was.
Great dude, great movie too.
Speaker 1 (21:03):
Watching a thing with him this morning and very very
sad stuff.
Speaker 2 (21:06):
Where were you watching?
Speaker 1 (21:08):
It? Was an Instagram post of him with his mother
and his mother making him laugh, and I think the
whole point of the post was like, you rarely got
to hear Robin Williams like genuine laugh. And I heard
it and I was like, yeah, I don't know if
I really ever heard that. And his mom made him
laugh that hard.
Speaker 3 (21:23):
It was really sweet.
Speaker 2 (21:24):
Can you do an impression?
Speaker 3 (21:26):
It was kind of a haha ha thing.
Speaker 1 (21:28):
No, I mean, not like that, but it was exuberant,
but it was like ha ha ha ha, not.
Speaker 3 (21:34):
Like my goofy childish laugh.
Speaker 2 (21:35):
I got you. Yeah. So good movie, and it was
one hundred percent based on this so much so that
it's funny they went to the trouble of changing the
names of the change names that Oliver Sacks had in
the book.
Speaker 3 (21:51):
Wow.
Speaker 2 (21:51):
So yeah. So Wakenning's actually is pretty faithful in a
lot of ways. I mean there's a lot of like
movie stuff literary license in there, but yeah, the most part,
it's pretty faithful to Oliver Sax's book. And again it's nonfiction,
like Sex as a neurologist. Ory was a great neurologist
and a great writer too, so he didn't take a
lot of literary license as far as I understand. So
(22:12):
the movie. Being close to the book means the movie
was fairly close to real life. And one of the
tests that Oliver Sex conducted was he would demonstrate that
these people had demonstrated what's called paradoxical kinesia, where somebody
who seemingly can't move and hasn't moved for days, months,
(22:33):
however long it was since the last time somebody moved
them could suddenly move in a way that they just
should not be able to. And the way that he
demonstrates it in the movie, and I believe in the
book he did this too, was he would toss them
a ball, and all of a sudden, somebody who's just
sitting there with their hands in the air and their
face frozen in this mass, this expressionless mask, just suddenly
(22:55):
moves their hand without even moving their eyes and catches
the ball. And that was, I think, again, at least
in the movie, I haven't read the book, how he
identified people in this what they call the chronic hospital
that he worked at in the Bronx by by finding
somebody who kind of fit these symptoms and then tossing
(23:17):
a ball at them. And there's a very cute, funny
part where he does it to one person and she
gets hit in the face and is like, ah, why'd
you do that? She clearly didn't have encephalitis lethargic as
pretty cute.
Speaker 3 (23:29):
It sounded a couple of minutes ago, Like you said,
Oliver Sex.
Speaker 2 (23:32):
I know, I didn't correct myself. You're an all time
great conversation analyst though for noticing.
Speaker 1 (23:38):
That, well, I just I mean, that's a different movie altogether,
Oliver Sex.
Speaker 3 (23:42):
Yeah, also called Awakening.
Speaker 2 (23:44):
So yeah, God, was that a couple of minutes ago?
I've been Have I been talking that much? Oh?
Speaker 3 (23:48):
I have no sense of time. It might have been
ten seconds.
Speaker 2 (23:51):
That was amazing, Chuck, you've been killing it with the
jokes lately.
Speaker 3 (23:54):
Oh.
Speaker 2 (23:55):
Thanks.
Speaker 1 (23:56):
One of the things you mentioned there is like they
could catch a ball or something. Thing that would happen,
Like he said that if there was an emergency, like
another patient falls on the floor, all of a sudden,
somebody who like previously has not moved for days or
weeks or months might just leap up out of their
wheelchair and assist them and then sit back down and
go back to their statue pose. And that phenomenon that
(24:18):
you're talking about is that's the big key difference between
PEP and Parkinson's disease is called kinesia paradoxical, where you're switching,
you know, between mobility and immobility, and that is not
something that happens generally in Parkinson's.
Speaker 2 (24:34):
No, but I saw that it does some so yeah,
but I think for the most part it's more associated
with chronic encephalitis lethargica, right, Yeah, So the original things
where this disease, this mysterious disease, incephalitis lethargica, suddenly appeared
out of nowhere in nineteen fifteen sixteen, ravaged the world
for ten years, and then just vanished. And like you said,
(24:58):
let a whole generation of neurologists off the hook for
having to explain what it was like. They really tried,
like people like Economo really tried to figure this out.
I think nine thousand papers were written during this epidemic. Yeah,
and there were some things that they kind of were
able to pin down, but the big, big questions were
(25:22):
just left unanswered. We just don't know. Like one of
the big ones is how do you even catch this
terrible disease?
Speaker 1 (25:30):
Yeah, like is it contagious or not? They still didn't
have a definitive answer at the end of their study
on that evidence on transmission was really really mixed. There
were a couple of anecdotal cases that kind of illustrate that.
One of them that was among seven members of a
family in a small apartment, only one family member got sick.
Another case, there was a girl living at something called
(25:53):
the Derby and Derbyshire Rescue and Training Home, showed signs
of el and then very soon within two weeks, twelve
of the twenty one residents got sick. So, you know,
both cases, like one looks clearly contagious, the other one
doesn't look like it's at all contagious.
Speaker 3 (26:10):
So they didn't know.
Speaker 1 (26:11):
Maybe they thought some people might be immune, maybe they're
different strains that were contagious or had different levels of contagiousness,
or maybe it's just something that they never figured out.
Speaker 2 (26:21):
Yeah, and I was wondering too if the twelve of
the twenty one residents getting sick at that one home
was maybe just a case of mass hysteria or something interesting.
Speaker 3 (26:29):
Yeah.
Speaker 2 (26:30):
No, I think half of the people who got sick
died within ten days of falling ill, so they were
not Yeah, that was not mass hysteria, So that is
just a genuine mystery, right, Like, this just doesn't make
any kind of sense whatsoever. So they started trying to
rule out things they thought it wasn't right. One was
environmental causes, so that would make it toxic encephalitis. And
(26:51):
I don't even know if we said at the outset,
did you I think that encephalitis is swelling of the
brain and spinal cord.
Speaker 3 (26:58):
Oh no, Okay, So.
Speaker 2 (27:01):
I'm sure everybody got like a pretty good idea that
encephalitis is something bad that you don't want to have.
But what it is is a condition where your brain
and or your spinal cord swells and it can start
taking on water, and from doing that, all sorts of
terrible things can happen. The thing is, encephalitis is not
just specific to encephalitis lethargica. A lot of different things
(27:24):
can make your brain and central nervous system swell. A
disturbing amount of things can make that happen, actually if
you stop and think about it. And one of those
things is environmental toxins. So that's toxic encephalitis. And that
got ruled out very quickly because there just was no
pattern whatsoever where everybody was exposed to you know, like
(27:47):
a Tesseract made of kryptonite or something like that for
our nerd fans.
Speaker 3 (27:53):
Yeah, that's good.
Speaker 2 (27:54):
I tried to touch you as bone just screwed it
up royally, So I'm sorry. I think I may have
just conflated did DC and Marvel and.
Speaker 3 (28:03):
Uh yeah, yeah, distractice Marvel?
Speaker 2 (28:05):
Dude, No, I love it.
Speaker 3 (28:08):
I love it.
Speaker 1 (28:08):
Man.
Speaker 3 (28:10):
You should meld those Superman meets Thanos. Sure, I want
to see those dudes fight.
Speaker 2 (28:16):
Oh it'd be great. I'm sure that would be a
really interesting fight to watch.
Speaker 1 (28:20):
Somebody's going to write in and say, actually, guys, it
happened in nineteen eighty seven, when.
Speaker 3 (28:26):
You know, dude put out a comic.
Speaker 2 (28:28):
I suspect that those people aren't going to speak to
us any longer. I think you're right.
Speaker 1 (28:33):
Uh So, like you said, they rule that out, the
toxic exposure. Then they moved on to an infectious kind
of possibility, infectious encephalitis in fact, and that can be
you know, and infectious and cephalitis is a thing, So
it's not like we're we think it's that that was
(28:53):
already a thing. It can be secondary to bacterial or
fungal or viral or parasitic infection to use virus, it's
the most common type of encephalitis. It could be like
from the herpes virus, or maybe measles or West Nile,
even influenza. And considering how this went on during the
Spanish Flu initially, which happened in nineteen eighteen, and there
(29:17):
were flu like symptoms, they thought that, you know, this
probably early on at least was an influenza led infectious encephalitis.
Speaker 2 (29:27):
Yeah, and that was I think von Economo's leading theory,
which makes a lot of sense because they tracked with
one another, like you said, at least the start. So
was this just some horrible strain of Spanish flu that
managed to continue on for years after Spanish Flu? And
I think that was incontrovertibly proven incorrect, because actually, in
(29:50):
when I did The End of the World, I talked
about this guy who went up and dug up the
corpse of an Inuit woman who had died from Spanish
flu to get enough of the genome of it to
so bring the Spanish flu back to life to study it.
It's one of the most breathtakingly arrogant moments in all
of science for somebody to do that. But the reason
we know that encephalitis lethargica wasn't caused by the Spanish
(30:13):
flu is because we had the Spanish flu genome and
we couldn't find any Spanish flu RNA in like collections
of tissue samples of brains of people who definitely died
from encephalitis lethargica, Spanish flu wasn't there. Ergo, it wasn't
Spanish flu.
Speaker 1 (30:31):
And because Josh is always too humble to say so.
After an End of the World reference everyone if you
don't know, Josh had a great solo album, a eight
part or ten part.
Speaker 2 (30:42):
It was a ten part subtitled Waxy Flexibility.
Speaker 1 (30:47):
The End of the World with Josh Clark, where he
one episode at a time, examined ten I can't think
of the word existential risks that could humanity, some of
which are currently underway.
Speaker 2 (31:03):
Thanks a lot, Chuck, I appreciate that was really nice
to say.
Speaker 3 (31:05):
Yeah, yeh, very great.
Speaker 1 (31:06):
You got to be a smarty pants, But even if
you're not as smarty pants, you should still give it
a shot. I think because I gave it a shot
and I'm not as smarty pants.
Speaker 2 (31:13):
Hey, you are smarty pants, but yes, smarty pants are no.
I think everybody can be equally scared by this.
Speaker 1 (31:19):
Yeah, you did live shows too, So if you have
a time machine on your hands, go back and see
one of those while you're at.
Speaker 2 (31:23):
It, and come talk to us. If you have an
actual working time machine as well, it'd be pretty neat.
Speaker 1 (31:29):
Streptococcal infection was another possibility. At one point there was
some data that showed infection with streptococo bacteria was in
front of some of these cases of el and In
nineteen thirty one, our old pal, doctor von Ekonomo, did
an experiment and streptococcus vaccination actually led to el and
(31:53):
el like condition and dogs.
Speaker 2 (31:55):
Yeah it's just sad, but yeah, the thing is the
thing that makes it even more sad. It wasn't definitive.
They weren't like, oh, it's a strep infection. It was like,
I guess it could have been. There was another group
called the Mathieson Commission that studied encephalitis lethargica. Because a
guy was sensibly by the last name of Mathieson, I
(32:16):
couldn't find who it was. He was a wealthy businessman
from America who had been struck down by encephalitis lethargica.
Believe he had gotten better, but not fully, and so
he used some money to try to get to the
bottom of this and funded this commission for thirteen years.
They put out four different reports and basically at the
(32:36):
end said maybe herpes. We don't know, And he said,
your finding's cut off. I've gotten into Sherlock home societies.
That's who I'm finding now.
Speaker 1 (32:47):
At the end of all that dough for that many years,
you come back with maybe herpes?
Speaker 3 (32:51):
Are you kidding me?
Speaker 2 (32:52):
At give me herpes too? That reminds me when I
was a kid. I'll never forget one of the first
headlines that ever sunk in with me because I was
a Who's the Boss fan a little bit at the time. Okay,
it had to be The Inquire or something, but it
was Tony Danza gave me herpies. And I looked, like
just yesterday to see if Tony Dance I actually had
(33:15):
ever given anyone herpes, and it does not seem to
be the case. I don't believe Tony Dance it has herpes,
So that that headline was totally made up, and I
hope Tony Danza got some money from that for suing
the Inquirer.
Speaker 1 (33:27):
Yeah, oh, we should issue that correction too. But you
got that Tony Danza band name wrong?
Speaker 2 (33:33):
Oh I did?
Speaker 3 (33:33):
In the metal episodes.
Speaker 2 (33:35):
What do you know what the correct one was?
Speaker 3 (33:37):
Well, what do you what did you call it?
Speaker 2 (33:38):
I think I called it the Tony Danza tap dance Experience.
Is that not it?
Speaker 1 (33:42):
I think if that's what you said, I think it
was a tap dance extravaganza. Okay, or it's the other
way around. Whichever one you said was.
Speaker 2 (33:50):
Wrong, that's fine. I can live with that.
Speaker 3 (33:53):
Yeah. Yeah, we had a few metal people right in
about that.
Speaker 1 (33:55):
So can't you know, can't not correct the Tony dance
a tap dance extravagance.
Speaker 2 (33:58):
I bet they were nice though, Like to person, pretty
much all the metal fans that wrote in. Yeah, yeah,
I said, even the ones correcting us really cute. That
was great.
Speaker 3 (34:07):
Yeah, that's the metal way it is. All right. Shall
we take our other break?
Speaker 2 (34:18):
Yeah sure, all right, we'll be right back.
Speaker 1 (34:20):
Wait, all right, So we mentioned some people studying, you know,
(34:50):
different causes back in the day. They never could find
anything out, like we said, and for about thirty years
they just kind of left it there, and it was
in the late nineteen sixties when neurology researchers that we're
working on Parkinson's really hit on it when they developed
el dopa or levo dopa, which is a substitute for dopamine,
(35:11):
which is the missing neurotransmitter and Parkinson's disease. And it
was released in nineteen sixty seven and it brought akinetic
Parkinson's disease patients back to life. And if you've seen
the movie Awakenings, that's basically a big storyline. That's where
it picks up is when Oliver Sacks scores some el dopa.
Speaker 2 (35:30):
He did off a guy selling it on the corner
below Beth Abraham Hospital exactly. Yeah. So he finally starts
with Leonard Low, who's Robert de Niro, not the patient's
real name, obviously. But there's just this amazing transformation where
all of a sudden, these people again, who are these
frozen statue like people and have been for decades of
(35:52):
their lives, suddenly are like aware and talking and like
focusing their attention on you. And one guy's playing the
piano and they're like going out on field trips. Now
it's like they were just completely broad out of it,
and that's supposedly was very much the case with people
with actual Parkinson's disease, like they responded beautifully to el dopa.
(36:15):
But one of the reasons, one of the indicators that
post encephalatic parkinson ism and Parkinson's disease are different, is
that the people in Awakenings, the people with encephalitis lethargica,
they responded well for a little while and then they
started to show other symptoms that really kind of for
(36:36):
some of them, it basically meant you can't take al
dopa anymore, and incredibly sadly, like one of the most
sad things I can think of, they were left to
just go back to yeah, frozen statue state again. And
don't forget there is a great level of consciousness within
them when they're in the state. So they came out
(36:57):
of that state in which they were conscious, came to
full consciousness and full interactivity and maybe even left the
hospital on a field trip and then had to go
back to their frozen statue stay again conscious of this
whole experience.
Speaker 3 (37:10):
Yeah, very heartbreaking to see.
Speaker 1 (37:11):
In that movie, there was one case of a woman
who is this the rose of which you spoke of
to me?
Speaker 3 (37:19):
Privately.
Speaker 2 (37:20):
Yeah, that was Rose and then Lucy was her name
in the movie for some reason.
Speaker 1 (37:26):
Okay, well, this woman just one of the cases of
Oliver Sacks. She came out of it, and she basically
described like being aware of everything that was happening for
decades and understanding what was happening, but just not feeling
a connection to it, like there was this weird disconnect.
She knew about Pearl Harbor, she described knowing about the
(37:49):
assassination of Kennedy John f that is, and she said
that it just didn't seem real. She said, nothing has
seemed real since nineteen twenty six when I got the
encephalitis and came to a stop. I know him sixty
four now, and this is nineteen sixty nine, and that
I'm an elderly woman in a bizarre situation in a
chronic hospital. But I feel like I'm twenty one and
I feel like it's nineteen twenty six.
Speaker 3 (38:10):
Yeah, man, can you imagine?
Speaker 2 (38:12):
Yeah, And very sadly, she was one of the ones
who did not like have her symptoms with al dopo
or too extreme to continue on taking al dopa.
Speaker 1 (38:22):
Yeah, and some people you know, came out and were
just overjoyed and elated with this kind of thing, obviously,
and some people came out, and obviously you could also
see it had a very hard time with lost decades.
It could not have been an easy thing to accept
either way. The movie that there is good news. There
is a bit of a silver lining because the movie
(38:44):
does not cover the fact that after this a lot
of the patients finally regulated with the el dopa and
were able to leave at least lead compared to sort
of their previous life, a somewhat healthy life, like they
weren't in that statue s locked in state. They might
not have fully recovered, but they led an okay life.
Speaker 2 (39:05):
Right, Yeah, And they do mention that at the end,
and those I guess postcripts where they talk about how
they continued on experimenting and some people kind of worked
out with a little bit so, but they don't they
don't show it in the movie. The movie's all sad
at the end. It's so sad, and yeah, oh my god,
(39:26):
just go watch Awakenings again. I even watched it. I
accidentally watched Patch Adams first, and I wanted to watch
Awakenings so bad. I still watched it after Patch Adams
after Zoolander, and then I finally watched The Awakenings. I was
up till like four in the morning today last night.
Speaker 3 (39:42):
I never I never saw Patch Adams. It's that was
sex too there right, and then.
Speaker 2 (39:47):
No, it was just what it was Williams too. It
was Awakenings. I'll tell you that.
Speaker 3 (39:53):
Yeah, I need to check that out. It's funny.
Speaker 1 (39:55):
I met a guy named Leonard Lowe one time years ago,
and the only thing I could think in my head was,
my name is Leonard Lowe? Like I just remember Daniro
saying that you didn't say that to him, no, because
I figured, you know, like our listener Robert Paulson, he's
probably side of his jokes.
Speaker 2 (40:11):
I never stopped saying that to Robert Paulson. I can't
help myself.
Speaker 1 (40:16):
Uh so, what about these days? What do we think
about el of medically speaking?
Speaker 2 (40:20):
Well, so, one of the things that we did learn
that we still don't fully understand, but was something that
they recognized with el dopa and the study of the
patients before they were administered al dopa is that while
you're in a like this frozen state, like like I
said earlier, somebody like throws a ball at you, or
like you said, somebody sees an emergency, they can suddenly
(40:43):
move like normal and then they go back to that
frozen state afterward. They found that it's not just like
an emergency like a ball coming at you or your
friend laying on the floor because they fell down, but
things like music, human touch, even like obnoxious sounds like
a siren or something can basically prompt the person to
start moving again and like come back out of that
(41:04):
frozen catatonia mutism. And that was one of the things
that they found people could do on al dopa too,
Like even with the extreme like tremors or inability to
control the movement of your mouth or eyes, those could
be tamed by the same things by stimulating your brain
(41:26):
in some other way. And there is the story of
a guy who was a cobbler by trade before he
had gotten sick. Oh yeah, and the after el dopa
came along, he asked for like a cobbler's bench, and
the hospital staff got him one, and when he was
working at his cobblers bench, he was able to like
hold like nails in his teeth and like nail the
heel of the shoe with these little tiny nails and
(41:47):
just work and control the symptoms because there's something in
the brain that was overriding the symptoms. We have no
idea why. We just know that that was part of
this whole thing. There's some some way that the these
problematic symptoms can be overridden by some other region of
the brain taking importance or precedents over that, which is
(42:08):
just bizarre. Like from start to finish, this is one
of the most bizarre diseases in history.
Speaker 1 (42:15):
Yeah, yeah, for sure. Did you also watch Tremors by accident?
Speaker 2 (42:19):
Now? That would have been very pleasant. That's one of
my favorite movies.
Speaker 1 (42:23):
All of a sudden, the sun's coming up and you
still haven't seen awakenings. So getting back to the modern
perspectives and what we think medically these days. In the
last seventy five years, like I said, it completely in
a way, they kind of don't know. In the last
seventy five years, there has only been about eighty case
reports where it looks like it might be el They
(42:44):
call it like an eel like presentation, you know, the
hyper somnolence, maybe ocular paralysis, maybe some of those neuropsychiatric symptoms.
But they're really not sure because you know, the cases
are pretty varied, and the symptoms are pretty varied. And
again they you know, all they have is sort of
these case studies from before. They never landed on anything,
(43:05):
so it's hard to tell if this is still going
on at all or not. There's no like effective treatment.
You know, they still use al dopa I think, right, Yeah,
and that's still in the scene. Yeah, so for the
tremors and rigidity and stuff like that sometimes ect for
if you have like pretty extreme psychiatric symptoms. But for
(43:26):
Van Economo's work, he got he never won, but he
was nominated three times for a Nobel Prize.
Speaker 3 (43:33):
Pretty good, yeah, for sure.
Speaker 2 (43:35):
And remember he also originally suspected that it was some
sort of infection. Yeah, he thought Spanish flu wasn't Spanish flu.
But they do think that it's probable now that it
is the result of an autoimmune disorder triggered by an infection. Yeah.
So what that would amount to is that you are
infected by maybe it is tripped, maybe it is herpes,
(43:56):
maybe it is influenza. We don't know. But something that
resembles proteins found in different regions of your brain trains
your body to attack those proteins in your brain. So you,
it triggers an autoimmune disorder, and those proteins are only
found on specific regions of the brain that when you
step back and look at what those regions do, they
(44:19):
control the symptoms that you see in people with encephalitis lethargica.
I just sounded like Tim Curry and Rocky Horror Picture Show.
Speaker 3 (44:29):
Get on the slab.
Speaker 2 (44:33):
That's good. I forgot how good your impression is of
doctor Frankenfurter.
Speaker 3 (44:38):
Oh, well, you know I met the man. He held
my cat.
Speaker 2 (44:41):
That's right. He said your cat was naughty.
Speaker 3 (44:43):
Right, I said he had dramatic ears.
Speaker 2 (44:45):
Okay, yeah, but also naughty.
Speaker 3 (44:48):
Yeah, yeah, naughty. Get on the slab, laurn. I got
nothing else.
Speaker 2 (44:55):
Oh okay, let's see. I guess I got nothing else either.
That's it. We don't we I don't know they answer
to all of this, and I don't know when we
ever will. But it's just it's so fascinating that you
have to stop and remind yourself like this actually happened
to people, and that do you realize how terrifying the
whole thing really is? Yeah, well, Chuck said yeah twice
(45:17):
within seven seconds, which automatically means, oh well, no, he
derailed it. You have to say yeah one more time,
hurry yeah, Okay, now we're back on to listener, ma'am.
Speaker 1 (45:30):
Uh this is you're gonna like this one, Josh, I think, hey, guys,
it is about the A trax. I always learned something
from you sometimes unexpectedly, you guys and the A track
short stuff. You talked about kart being short for cartridge
and sparked a memory. I'm from Buffalo, you see, and
I used to listen to a radio announcer called Iron
Mike Benson. He famously had what he called and Jamie says,
(45:55):
sorry to you, specifically Josh about this, okay, where Mike
Iron Mike ben would say that he had the heinous
anus fart cart and he would use it to play
various part sounds and strategically place them over top of
the top of whatever song's happened to be getting played
on the air at the moment. Always imagine the word
kart at the time was referring to like a basket
(46:16):
on wheels that contained a bunch of separate tapes.
Speaker 2 (46:18):
Yeah, of fart.
Speaker 3 (46:19):
Sounds, now it all makes sense.
Speaker 1 (46:21):
It was a tape recording, but because it was a
looped tape with multiple tracks on it. He could cue
whatever selection he wanted much quicker than you could with
a linear cassette tape. So it was the analog way
to do that sort of thing before a digital soundboard
was used and invented. Thank you for all the useless interest,
grabbing information and uselessness in quotes, by the way, Okay,
(46:44):
that is only useless until you can relate it to
something else. Podcasts have come and gone, but your show
is the one I haven't gotten tired of.
Speaker 3 (46:52):
And my sister Ashley agrees. Keep it up, boys. That
is Jamie Lynn Bayer awesome.
Speaker 2 (46:57):
Thank you, Jamie Lynn, and thank you to your sister Ashley,
who sensibly listens as well. And the whole Bear clan.
How about that?
Speaker 1 (47:04):
Yeah, the clan at the Cave Bear.
Speaker 2 (47:06):
I thought that as well. Yeah, if you want to
be like the clan of the Cave Bear and write
in to let us know how much you like our
show and or we triggered some memory in you that
helped you put things together, and or whatever else you
want to say. We love that kind of thing. You
can send it to us via email at stuff podcast
at iHeartRadio dot com.
Speaker 3 (47:30):
Stuff You should Know is a production of iHeartRadio.
Speaker 1 (47:33):
For more podcasts my heart Radio, visit the iHeartRadio app,
Apple Podcasts, or wherever you listen to your favorite shows.