August 14, 2019 • 31 mins
We’re finishing out our two-parter on thalidomide. This episode covers the response, including criminal trials, changes to drug laws, and debates about the legality of abortion, and how this has continued to evolve for thalidomide survivors until today.
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Speaker 1 (00:01):
Welcome to Stuff You missed in History Class, the production
of I Heart Radios How Stuff Works. Hello, and welcome
to the podcast. I'm Tracy V. Wilson and I'm Holly Fry.
Today we are finishing out our two part are on
the direct the litamide, which caused serious health problems and
(00:22):
multiple disabilities and at least ten thousand people born in
the late nineteen fifties and early nineteen sixties, so folks
who are in their late fifties and early sixties. Today.
We're recording this in twenty nineteen. Last time we talked
about the direct itself and how it made it to
market and how a crisis unfolded after its release, and
today we're going to talk about the response to all
(00:42):
of this, including criminal trials, changes the drug laws, and
debates about the legality of abortion, and how this has
really continued to evolve for the litamide survivors until today.
This will probably not make much sense if you have
not heard part one. Yeah, you'll be a little in
the weeds. Uh. Again, we mentioned at the top of
the other one at part one that this is, you know,
(01:04):
a little bit more of a serious subject and not
always the most comfortable discussion, So keep that in mind.
There's still some appalling stuff in the realm of disability
rights in terms of how people have been treated that
kind of thing as well. So after thelidamide was withdrawn
from the market, authorities started reviewing the case histories of
people who were affected by the drug, including children born
(01:25):
with fetal pilidamide syndrome and their parents, and adults who
had developed permanent neuropathy and other nerve disorders. After six
years of review, the bill of indictment that was delivered
was nearly one thousand pages long. Ultimately, charges were brought
against nine men who worked at Shami grunenthalogy mb H,
which was the pharmaceutical company that had developed the litamide.
(01:48):
This included owner and founder Herman Vertz, senior chief scientist
Dr Heinrich Muchter, and seven other men. They were charged
with involuntary manslaughter and intent to commit bodily harm, and
their trial began on May seven, nineteen sixty eight. Criminal
proceedings went on until nineteen seventy, with a panel of
five judges hearing hundreds of hours of testimony from more
(02:11):
than three hundred fifty witnesses and receiving tens of thousands
of pages of evidence. Throughout it all, Grunenthal maintained that
it's safety testing on the litamide had met the requirements
of the time and that it could not have known
that the drug could disrupt fetal development. But then, after
nearly two and a half years, on December eighteenth, nineteen seventy,
the panel of judges dismissed the charges. They did this
(02:35):
with the approval of the prosecution, and Grunenthal was granted
immunity from further criminal prosecution in Germany. At the same time,
the company agreed to establish the Countergone Foundation, funded with
one hundred million Deutsche marks matched by the West German government.
More than two thousand, five hundred families who had pending
civil cases were pressured to drop their lawsuits and to
(02:58):
accept this settlement. Ins and the years since this happened,
there have been many allegations of wrongdoing relating to this trial.
In the UK's the Litamide Trust unearthed documents suggesting that
there had been a secret, behind the scenes negotiation between Grudenthal,
the German federal government and the state government of the
(03:19):
state of North Ryan West Failure without any the Litamide
survivors or their representatives present. Journalist Harold Evans reported on
this through The Guardian and Reuter's. According to these reports,
Hermandert Sr. Was at these meetings even though he had
been excused from attending the trial for reasons of his health.
The documents also suggested that State Minister of Justice Joseph Newbarger,
(03:43):
whose department was overseeing the prosecution, had previously been a
partner at Grunenthal's law firm. Yet that would be a
huge conflict of interest. Meanwhile, Grudenthal's website now today maintains
that quote Grunenthal is adamant that there was no secret
deal or other politic interference to halt the trial. We
are not aware of any evidence justifying these claims. The
(04:06):
company's statement goes on to say, quote, the allegedly new
documents were in part wrongly dated, and that the relationship
between them was wrongly described or distorted by the attorneys. Also,
in more recent years, some writers have looked into connections
between Grunenthal and members of the Nazi Party. There is
a whole conspiracy theory that solidimided was developed prior to
(04:27):
or during World War Two and tested in concentration camps
that does not appear to be true, but it is
true that various people working at Grunenthal did have ties
to the Nazi Party, which is frankly also true of
a lot of businesses that operated in Germany during and
after World War Two. Regardless of whether these claims about
the trials are accurate, the end result was the same.
(04:50):
The charges against eight Grunenthal employees and its founder owner
were dropped, the company was given immunity from prosecution, and
the Contragne Foundation was a ablished to provide financial support
to families who were affected by the litamide. The foundation's
operations are governed by German public law and today it's
paying monthly pensions, annual pensions, or one time payments to
(05:12):
people in thirty eight countries. Grunenthal has maintained that this
settlement was quote widely supported by the parents of the
affected children as well as the general public, but many
solidamide survivors have said the opposite, Without even getting into
the idea of compensation for the emotional pain and grief involved,
many pensions just have not been enough to support the
(05:34):
basic day to day needs of many people born with
fetal solidomide syndrome. Payments from the foundation have been increased
that a couple of points since it was first established,
and today the maximum is eight thousand, one seventeen euros
a month. Grnenthal also added an additional fifty million euros
to the fund into and two thousand nine, but today
(05:55):
the payments from the foundation are coming from the German
government rather than from Grunenthal. There's also a separate Grunenthal
Foundation that distributes non cash support, like modifying the litamide
survivors bathrooms and vehicles to make them accessible. That eight thousand,
seventeen euro number might sound like a lot, but living
(06:15):
with fetal the litamide syndrome can be incredibly expensive. Many
survivors require round the clock care or assistance, along with
multiple surgeries and medications, physical therapy, and devices like powered
wheelchairs with customized controls and lifts to move a person
to and from the wheelchair. My mom's powered wheelchair cost
more than my car. Yeah, that's an industry my husband
(06:39):
worked in for a while, and there were some models
that I was absolutely mind boggled when I saw the
prices on them. Yeah. So, Apart from whether the financial
settlement itself is enough money, many survivors have described the
process of getting benefits as unnecessarily bureaucratic and difficult. Applicants
(07:00):
have to document how they were exposed to the lidamide,
including sending their medical records. Applications have to be submitted
in German and there's a life certificate showing that the
applicant appeared in person. People who don't live in Germany
have to travel to a German embassy or consulate, although
in some countries there are alternate locations that are like
(07:20):
notaries or other other places. That includes in Brazil, Spain,
the Netherlands and Great Britain and Ireland. If an applicant
is physically unable to leave their home, or if the
location where they're supposed to appear in person isn't accessible
to people with disabilities, because that is still an issue
in a lot of the world, the applicant can submit
(07:41):
a certification from their physician. The Linamite survivors and their
families have really criticized Grunenthal's actions and responses to all
of this, including an apology that the company issued on
August thirty one. The apology was delivered at the dedication
to a memorial in Stolberg, Germany, and it depicts a
sculpture of a young girl with fulk amelia wearing prosthetic
(08:04):
legs as well as an empty chair. Yeah, a lot
of people felt like Grunenthal did not need to be
at that dedication at all, and then at it. Harold F. Stock,
the CEO at the time, delivered this apology translated into English.
It's said, in part, quote, Grunenthal has acted in accordance
with the state of scientific knowledge and all industry standards
for testing new drugs that were relevant and acknowledged in
(08:26):
the nineteen fifties and sixties. We regret that the tar
atogenic potential of the litamide could not be detected by
the tests that we and others carried out before it
was marketed. The statement later went on to say, quote,
we also apologized for the fact that we have not
found a way to you from person to person for
almost fifty years. Instead, we have been silent, and we
(08:46):
are very sorry for that. We asked that you regard
our long silence as a sign of the silent shock
that your fate has caused us. We have learned how
important it is that we engage in an open dialogue
with those affected and to talk and to listen to them.
We have begun to mutually develop and implement projects with
them to improve their living situation and assist in hardship
(09:07):
situations easily and efficiently. We will continue to pursue this
path in the future. Overwhelmingly, the lidamiters and their families
did not find this sufficient. Parts of it definitely read
as though they are saying, we're sorry, but it wasn't
our fault. Exactly. If you go and read their f
a Q and their website, there are a lot of
things on it that kind of make you go, you
(09:28):
didn't really answer that question, and also you're still saying
it wasn't your fault. The immunity that was granted to
Grunenthal when these charges were dismissed in nineteen seventy only
applies in Germany. So there have been other court cases
and civil suits in multiple other countries, both against the
pharmaceutical companies that distributed the litamide in those countries and
(09:52):
the governments that allowed them to do it, just as
examples the UK, the Litamide Trust was established as the
Litamide Children Trust in nine seventy three following a settlement
between the Stiller's Company Limited in four nine disabled children
who had been exposed to the litamide in Canada, A
lawsuit against the litamides distributor there led to cash settlements
(10:14):
and the establishment of a federal fund. The result of
all of this is kind of a patchwork of programs
and benefits that really vary from one country to another,
with some paying benefits only if the applicant isn't getting
support from somewhere else. Many programs also require documentation of
the litamite exposure, which in some cases is simply not possible.
(10:35):
One of the things we talked about is that sometimes
people would share their medications with someone else, probably not
any documentation there. Um. In the minds of many survivors,
it also shouldn't be necessary since outside of the context
of the litamite exposure, these patterns of disability are incredibly rare. Yeah,
It's like there's sort of a choice between possibly paying
(10:56):
benefit to somebody who has a similar disability that wasn't
caused by the litamide, which is incredibly rare, or requiring
all the litamide survivors to go through this huge rigmarole
and a lot of effort to get basic support for
day to day needs. Um. I didn't really write it
in this outline, But there have also been some countries
that have issued formal apologies or have talked about issuing
(11:19):
formal apologies for not regulating the companies that were distributing
the litamide more carefully before and during this whole crisis.
So all of this is really really still ongoing. A
financial support package known as the Canadian the Litomized Survivors
Support Program or ct SSP, was announced on January ninth,
(11:42):
twenty nineteen, so just this year, with an application period
running until June. That follows on to earlier programs from
and this is intended in part to allow survivors who
were previously turned down for a lack of documentation to reapply,
and it's ongoing in another sense as well. The solidamide
(12:04):
survivors who were born in the nineteen fifties and sixties
are in their late fifties and early sixties now. Numerous
surveys of survivors in various countries have reported that their
general health and quality of life are decreasing as they age.
To quote from the result of a survey conducted in
the UK, quote, as the litamide survivors reach their mid fifties,
they are experiencing a wide range of secondary health problems,
(12:28):
in particular muscular skeletal problems and depression and anxiety, with
multi morbidity a growing issue. These health problems are having
a negative impact on their employment. Two fifths are unable
to work and their physical health related quality of life,
which is significantly poorer than the general population. Some of
this is exacerbated by the fact that many the litamide
(12:50):
survivors have compensated for missing or shortened limbs by using
their other limbs instead, so for example, using their feet
in place of hands, and this means that they're particularly
susceptible to overuse injuries, joint issues, and other muscular skeletal problems.
This also means that many thalidomie survivors are needing additional
care and support while simultaneously reaching retirement age or being
(13:14):
unable to work because of their disabilities and health conditions.
And many of those who are receiving support from one
of the Solidamie survivor funds were evaluated when they were
much younger, so they need more now than they did
when they were initially approved, and the dollar amounts that
they've been granted have not necessarily been adjusted for inflation.
Plus some of these funds will only pay for specific
(13:36):
types of treatments and services, and not for things that
aren't regarded as a medical necessity. But a lot of
thelidamide survivors report that what they actually need the most
help with is day to day tasks like housekeeping and
personal hygiene, which some funds won't cover. Some funds also
won't cover things that weren't directly connected to the litamite exposure. So,
(13:58):
for example, of fund might pay for prosthetic arms because
a person's folk amelia was directly caused by the litamite exposure,
but not pay for physical therapy to address an injury
that resulted from using feet in place of missing hands.
We are going to take a short break before we
talk about some of the changes to disability rights, medicine,
(14:19):
and the law that followed the the litamide crisis. Back
in part one, we talked about how in many parts
of the world, the first response to newborns who had
been exposed to the litamide was a sense of hopelessness
(14:39):
and recommendations that be placed at institutions. Those attitudes started
to shift hospitals and other practices that had specialized in
fitting patients with prosthetic limbs, a lot of them had
initially been focused on veterans of wars turned their attention
to making limbs that were suitable for children. Soon specialists
(15:00):
were working on a range of limbs that were appropriate
for different stages of a child's development, and on new
types of press dcs that could work with different types
of folk amelia. There's obviously still a long way to
go in terms of accessibility and social attitudes about disability,
but it was a start. And also, I don't want
us to give the impression that every thalidomide survivor uses
(15:22):
press decies. It really depends on what an individual person
is comfortable with and wants to use and what works
for them. Attitudes about congenital conditions and disabilities also started
to shift in the wake of the thalidomide crisis. The
field of teratology, or the study of malformations during development,
was still very new. It's generally noted as being established
(15:43):
in the nineteen thirties, and before that point there had
not been much research into how a substance or condition
could affect development in uteroone. It had been established that
some things could negatively affect how a fetus developed, including
a lack of vitamin A or vitamin B, or the
rubella virus. The general public often thought congenital disabilities or
health conditions were brought on by natural forces or were
(16:06):
just random, and there were lots of superstitions and religious
and spiritual beliefs that were kind of baked into this
whole idea and muddied the waters a bit. The The
litamide crisis prompted a lot of research into teratology in general,
with the first medical journal dedicated to it established in
the nineteen sixties. I feel like at timelines of of
(16:28):
teratology as a field, a lot of times there's literally
a pre the litamide and post the litamide era in
the timeline. Researchers started studying which drugs can pass through
the placenta and what allows them to do that while
other drugs can't. And then there have also been hundreds
of studies into the litamides specifically over the decades. It's
(16:51):
only been in the last couple of decades that researchers
have started to figure out exactly what causes the litamides
teratogenic effects without getting too deep into chemistry, because there
are about ten different terms involved. That we would have
to define. This solidimide molecule exists into configurations which are
essentially mirror images of each other. The one known as
(17:12):
the R configuration acts as a sedative, the one known
as the S configuration is a tarata gym, and the
R configuration can be converted into the S configuration within
the human body. So even if drug manufacturers made a
very pure version that only included the R type of
the drug, it's still would not be safe during pregnancy.
(17:33):
Research is still ongoing into exactly how the S configuration
disrupts fetal development. I found five different headlines spanning more
than a decade that each claimed that researchers had finally
figured it out. This is a thing that's building and
discovering new elements of figuring it out. The most recent
of these came from Dana Farwork Cancer Institute in August
(17:56):
of eight teams, so just last year, according to the
press really ease quote. Building on years of previous research,
the researchers found that the litamide acts by promoting the
degradation of an unexpectedly wide range of transcription factors cell
proteins that helped switch teams on or off, including one
called SAL four. The result is the complete removal of
(18:19):
SAL four from cells. Aside from these shifts in public
awareness and attitudes and the huge growth of a huge
field of medical research, no single drug has had a
bigger impact on pharmaceutical regulations than the litamine. In much
of the world, the pharmaceutical industry was really growing without
a lot of regulations in place in the nineteen fifties
(18:40):
and nineteen sixties. In May of nineteen sixty three, British
Minister of Health Kenneth Robinson said, quote, the House and
the public suddenly woke up to the fact that any
drug manufacturer could mark any product, however inadequately tested, however dangerous,
without having to satisfy any independent body as to its
efficacy and safety. And the public was almost uniquely unprotected
(19:03):
in this respect. So these new laws, and I mean
they are really all over the world, set much more
specific standards into how drugs had to be tested, including
animal testing meant to confirm whether a drug is safe
during pregnancy before it's tested on or administered to humans.
In places where abortion was illegal, the palidomide crisis also
(19:25):
became part of debates about legalizing it or adding additional
exceptions to the existing law. In the US, for example,
abortion was a felony, and usually the only exception was
if the mother's life was at risk. Along with a
rubella epidemic that was happening at roughly the same time,
the palidomide crisis led to discussions about whether the law
should be expanded to include exceptions for pregnancies in which
(19:48):
the baby would not be able to survive after being born,
and there were also people who used the crisis to
support a eugenics argument in the context of abortion, either
to support the idea of allowing abortion for eugenic purposes
or to advocate for keeping abortion illegal because of its
potential use for eugenics. This became national news in nineteen
(20:11):
sixty two. Sherry Chessen was the host of Arizona's locally
syndicated version of the children's TV show Romper Room. Her
husband had brought some medication home with him from a
trip to London, and she had taken some of it
early in her pregnancy with their fifth child. Later, she
read an article about Dr Francis Oldham Kelsey's work to
prevent the litamite distribution in the United States, and she
(20:33):
realized that it was the same drug that her husband
had brought home with him. Chessen talked to her doctor,
who contacted doctors in Europe and then recommended that she
terminate her pregnancy. Chessen later described this decision as absolutely agonizing,
and she was also afraid that the same thing might
happen to other women, so she told her story to
(20:53):
the Arizona Republic under the understanding that her identity would
be kept confidential. Chessen's name became public after the hospital
ultimately turned down her request for an exception and her
attorney filed suit on her behalf. She lost her job,
she got hate mail and death threats, including threats to
her other children. Chested and her husband ultimately had to
(21:14):
travel to Sweden, where abortion was legal, to terminate the pregnancy.
Although it's no longer manufactured or distributed by Grudenthal, the
litamide has been reintroduced in several parts of the world
in the years since it was banned. That's something that
we're going to talk about in just a moment. And
as different regulatory agencies have tried to figure out how
to minimize the risk to developing fetuses, abortion has continued
(21:38):
to be part of this conversation, and that conversation has
also included the litamide survivors themselves. During advisory committee meetings
related to the reintroduction of the litamide, Randolph Warren, the
founder of the Lidamide Victims Association of Canada, stressed the
need to consider the possibility of abortion in this context, saying, quote,
(21:58):
people should not be forced to sign anything that would
force them to have an abortion should a the litami
be born, because we have some quality of life and
some right to be here. A lot of these questions
about the lidamide and abortion in general are still ongoing
in many parts of the world today, and we're going
to talk about the reintroduction of the lita mine after
we take another sponsor break. It wasn't long at all
(22:29):
after the litamides worldwide ban that doctors began discovering that
it could have medical use as an adult patients beyond
being a sedative. In nineteen sixty four, so just two
years later, doctors at a hospital in Jerusalem gave the
lidamide to a patient who had advanced Hanson's disease, which
is also known as leprosy. This patient was in very
(22:50):
severe pain and could not rest, so a doctor administered
some the litamide that he had on hand, basically as
a last resort. This doctor, j GB chess Can, realized
that that the litamide also treated some of the diseases
symptoms beyond just being a sedative. The World Health Organization
conducted a clinical trial of solidamide as a Hanson's disease
(23:12):
treatment in nineteen sixty seven. Today, it's used in some
places to treat your thema a dosum laprosum or e
n L, which is a complication that causes painful nodules,
high fever, and inflammation. The litamide is approved for treating
E n L in some parts of the world, but
the World Health Organization does not recommend it because of
its teratogenic effects and because there are other drugs that
(23:35):
can treat E n L. Yeah. Even though today hanson
disease can be treated with a very long course of
multiple antibiotics, this complication can happen during the process or
even afterwards. So even though Hanson's disease is more treatable
than it used to be, this particular complication still does
happen for people. Since then, the litamide has also been
(23:55):
discovered to be effective against a number of other serious
diseases and conditions and complications, including AIDS, wasting syndrome, and
multiple miloma. Because it can inhibit the growth of blood vessels,
it's also effective and cutting off the blood supply to
certain cancers. This has of course been an incredibly difficult
(24:16):
and sensitive topic amongst the litamide survivors in their families.
In the words of Randolph Warren from an article in
f DA Consumer in two thousand one, quote, we will
never accept a world with solidamide in it. However, we
are forced to prefer licensing of the drugs that disabled
us for compassionate reasons and to prevent uncontrolled access to
(24:36):
the drug. Yeah. I mean, no group of people is
a monolith. People all have their own opinions. But as
a group, the litamide survivors in general have been like,
we're not going to try to stop you from keeping
people who need this drug from having it, but we
have got to protect people. So, for example, when the
US was trying to set standards for prescribing the litamide
(24:57):
for multiple mileoma and hands and disease, Warren and the
the Linamide Victims Association of Canada were part of that process,
including attending advisory committee meetings with the Food and Drag
Administration in the National Institutes of Health. The result from
all these meetings was the system for the Lidomide Education
and Prescribing Safety Program known as STEPS, which is now
(25:18):
called Risk Evaluation and Mediation Strategy or REMS. REMS is
very involved, providers have to be certified, and distribution of
the drug is highly restricted. Patients who could become pregnant
are counseled on the risks of the drug. Along with
contraception and emergency contraception. The litamide can also be present
(25:39):
in siemens, so male patients whose partners could become pregnant
are required to use condoms even if they have had
a vasectomy or if their partners are using contraceptives, and
this is really just the beginning. Patients who could become
pregnant are required to have two negative pregnancy tests before
starting treatment. They must use two forms of birth control
(26:00):
while being treated, and also take regular pregnancy tests. The
pills are also dispensed in blister packs rather than pill bottles,
so that they can't be confused with other medication or
easily put into an unlabeled container. The pills themselves in
most cases literally have a picture of a pregnant silhouette
crossed out they're printed on the pill. No more than
(26:22):
four weeks of doses are dispensed at a time, and
there are no automatic refills. Unused doses are supposed to
be returned rather than discarded, and there's just a lot
of follow up and monitoring of patients regardless of their sex.
And this is the standard in the US. So in
order to be treated with solidamide, a person has to
give up a degree of bodily autonomy just to comply
(26:45):
with all these regulations. That has led to a whole
discussion of medical ethics and what it means for patients
to essentially just be reduced to being viewed in terms
of their capacity to have children and how to control
that capacity, as well as what it means for a
disabled person to be reframed as a problem that should
be prevented. Yeah, we've we've talked on the show at
various points about disability rights and about the evolving view
(27:10):
of not thinking of disability as like a bad thing
that needs to be fixed, but instead thinking of society
is something that needs to change to be accessible to everyone.
The the litamide survivors community has been pretty vocal about
the fact that in their view, this is something that
happened to them that should not have happened to them
(27:31):
and should not happen to anybody else. So it's a
little bit different nuance than some of the other disability
rights things that we have talked about. And then also,
like we said back in part one of this episode,
these steps don't necessarily prevent every exposure. Hanson's disease is
really prevalent in Brazil, and the litamide was re licensed
(27:52):
in Brazil for that reason. In n there have been
people born with feetle the litamide syndrome in Brazil than
including in very recent years. After examining the birth records
of seventeen point five million people born between two thousand
five and about one hundred were found to have health
conditions and disabilities that are consistent with fetal the litamide syndrome.
(28:16):
Brazil has similar regulations for dispensing the litamide compared to
what the US does, But the parts of Brazil where
hands and disease is the most prevalent are also the
parts where the medical system is the least robust, and
I mean it would not surprise me at all that
if there are other countries where the litamide has been
reintroduced that have a similar situation, but Brazil is where
(28:38):
the most research has been done. So that's the litamide
not a story that is confined to the past, as
folks may imagine it from seeing things like Call the Midwife,
which um that plot arc on Call the Midwife plays
out over a long time in terms of episodes, because
it has a very similar trajectory to what we talked
about in Part one, between somebody having morning sickness being
(29:01):
given this drug because it's been sort of a wonder
drug for treating morning sickness, to then eventually much later
making the connection between that drug and people being born
with this range of disabilities. Tracy d have a bit
of listener mail to wrap this one up. I do.
This is from Emily. Emily says, Hi, Holly and Tracy.
I'm excited to finally have something to contribute for listener mail.
(29:23):
I was born and raised in Conquered, California and have
driven through the Conquered Naval Weapons Station and on the
Port Chicago Highway for a long time, but I didn't
learn about the disaster until my twenties. For people that
would like to know more but can't visit the port itself,
there's another place to visit. There's an exhibit about the
disaster at the Rosie the Riveter World War Two home
Front National Historic Park Visitors Center in Richmond, California. This
(29:46):
is where I first learned about the event, along with
a lot of other amazing stories about the people who
fought the war from home and how wartime shaped the
Bay Area. The museum is at the site of the
Richmond Shipyards and Fort Assembly Plant. I highly recommend this
free museum to anyone who is interested in these topics
or as in the area. Thanks for keeping me company
through the more monotonous parts of my day, Best Emily.
(30:08):
Thank you so much, Emily for this note. If folks
have been sort of waiting for a reason to write us,
you can write us for any reason. Just say hi.
You can send pictures of your pets. We love to
hear random things about people's lives, as well as emails
like this that have a cool new information that we
didn't know about before. So thank you so much, Emily.
Uh If you would like to write to us, we're
(30:29):
a history podcast at how Stuff works dot com and
then we are all over social media at miss in History.
That's where you will find our Facebook, Interest, Instagram, and Twitter.
You can also come to our website, which is missing
history dot com, where you will find a searchable archive
of all the episodes that we have ever done and
show notes for the episodes that Holly and I have
done together. Uh and you can subscribe to the show
(30:52):
on Apple, podcast, the I heart Radio app, and wherever
else you get your podcasts. Stuff you Missed in History
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For more podcasts for my heart Radio, visit the heart
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Welcome to Stuff You missed in History Class, the production
of I Heart Radios How Stuff Works. Hello, and welcome
to the podcast. I'm Tracy V. Wilson and I'm Holly Fry.
Today we are finishing out our two part are on
the direct the litamide, which caused serious health problems and
(00:22):
multiple disabilities and at least ten thousand people born in
the late nineteen fifties and early nineteen sixties, so folks
who are in their late fifties and early sixties. Today.
We're recording this in twenty nineteen. Last time we talked
about the direct itself and how it made it to
market and how a crisis unfolded after its release, and
today we're going to talk about the response to all
(00:42):
of this, including criminal trials, changes the drug laws, and
debates about the legality of abortion, and how this has
really continued to evolve for the litamide survivors until today.
This will probably not make much sense if you have
not heard part one. Yeah, you'll be a little in
the weeds. Uh. Again, we mentioned at the top of
the other one at part one that this is, you know,
(01:04):
a little bit more of a serious subject and not
always the most comfortable discussion, So keep that in mind.
There's still some appalling stuff in the realm of disability
rights in terms of how people have been treated that
kind of thing as well. So after thelidamide was withdrawn
from the market, authorities started reviewing the case histories of
people who were affected by the drug, including children born
(01:25):
with fetal pilidamide syndrome and their parents, and adults who
had developed permanent neuropathy and other nerve disorders. After six
years of review, the bill of indictment that was delivered
was nearly one thousand pages long. Ultimately, charges were brought
against nine men who worked at Shami grunenthalogy mb H,
which was the pharmaceutical company that had developed the litamide.
(01:48):
This included owner and founder Herman Vertz, senior chief scientist
Dr Heinrich Muchter, and seven other men. They were charged
with involuntary manslaughter and intent to commit bodily harm, and
their trial began on May seven, nineteen sixty eight. Criminal
proceedings went on until nineteen seventy, with a panel of
five judges hearing hundreds of hours of testimony from more
(02:11):
than three hundred fifty witnesses and receiving tens of thousands
of pages of evidence. Throughout it all, Grunenthal maintained that
it's safety testing on the litamide had met the requirements
of the time and that it could not have known
that the drug could disrupt fetal development. But then, after
nearly two and a half years, on December eighteenth, nineteen seventy,
the panel of judges dismissed the charges. They did this
(02:35):
with the approval of the prosecution, and Grunenthal was granted
immunity from further criminal prosecution in Germany. At the same time,
the company agreed to establish the Countergone Foundation, funded with
one hundred million Deutsche marks matched by the West German government.
More than two thousand, five hundred families who had pending
civil cases were pressured to drop their lawsuits and to
(02:58):
accept this settlement. Ins and the years since this happened,
there have been many allegations of wrongdoing relating to this trial.
In the UK's the Litamide Trust unearthed documents suggesting that
there had been a secret, behind the scenes negotiation between Grudenthal,
the German federal government and the state government of the
(03:19):
state of North Ryan West Failure without any the Litamide
survivors or their representatives present. Journalist Harold Evans reported on
this through The Guardian and Reuter's. According to these reports,
Hermandert Sr. Was at these meetings even though he had
been excused from attending the trial for reasons of his health.
The documents also suggested that State Minister of Justice Joseph Newbarger,
(03:43):
whose department was overseeing the prosecution, had previously been a
partner at Grunenthal's law firm. Yet that would be a
huge conflict of interest. Meanwhile, Grudenthal's website now today maintains
that quote Grunenthal is adamant that there was no secret
deal or other politic interference to halt the trial. We
are not aware of any evidence justifying these claims. The
(04:06):
company's statement goes on to say, quote, the allegedly new
documents were in part wrongly dated, and that the relationship
between them was wrongly described or distorted by the attorneys. Also,
in more recent years, some writers have looked into connections
between Grunenthal and members of the Nazi Party. There is
a whole conspiracy theory that solidimided was developed prior to
(04:27):
or during World War Two and tested in concentration camps
that does not appear to be true, but it is
true that various people working at Grunenthal did have ties
to the Nazi Party, which is frankly also true of
a lot of businesses that operated in Germany during and
after World War Two. Regardless of whether these claims about
the trials are accurate, the end result was the same.
(04:50):
The charges against eight Grunenthal employees and its founder owner
were dropped, the company was given immunity from prosecution, and
the Contragne Foundation was a ablished to provide financial support
to families who were affected by the litamide. The foundation's
operations are governed by German public law and today it's
paying monthly pensions, annual pensions, or one time payments to
(05:12):
people in thirty eight countries. Grunenthal has maintained that this
settlement was quote widely supported by the parents of the
affected children as well as the general public, but many
solidamide survivors have said the opposite, Without even getting into
the idea of compensation for the emotional pain and grief involved,
many pensions just have not been enough to support the
(05:34):
basic day to day needs of many people born with
fetal solidomide syndrome. Payments from the foundation have been increased
that a couple of points since it was first established,
and today the maximum is eight thousand, one seventeen euros
a month. Grnenthal also added an additional fifty million euros
to the fund into and two thousand nine, but today
(05:55):
the payments from the foundation are coming from the German
government rather than from Grunenthal. There's also a separate Grunenthal
Foundation that distributes non cash support, like modifying the litamide
survivors bathrooms and vehicles to make them accessible. That eight thousand,
seventeen euro number might sound like a lot, but living
(06:15):
with fetal the litamide syndrome can be incredibly expensive. Many
survivors require round the clock care or assistance, along with
multiple surgeries and medications, physical therapy, and devices like powered
wheelchairs with customized controls and lifts to move a person
to and from the wheelchair. My mom's powered wheelchair cost
more than my car. Yeah, that's an industry my husband
(06:39):
worked in for a while, and there were some models
that I was absolutely mind boggled when I saw the
prices on them. Yeah. So, Apart from whether the financial
settlement itself is enough money, many survivors have described the
process of getting benefits as unnecessarily bureaucratic and difficult. Applicants
(07:00):
have to document how they were exposed to the lidamide,
including sending their medical records. Applications have to be submitted
in German and there's a life certificate showing that the
applicant appeared in person. People who don't live in Germany
have to travel to a German embassy or consulate, although
in some countries there are alternate locations that are like
(07:20):
notaries or other other places. That includes in Brazil, Spain,
the Netherlands and Great Britain and Ireland. If an applicant
is physically unable to leave their home, or if the
location where they're supposed to appear in person isn't accessible
to people with disabilities, because that is still an issue
in a lot of the world, the applicant can submit
(07:41):
a certification from their physician. The Linamite survivors and their
families have really criticized Grunenthal's actions and responses to all
of this, including an apology that the company issued on
August thirty one. The apology was delivered at the dedication
to a memorial in Stolberg, Germany, and it depicts a
sculpture of a young girl with fulk amelia wearing prosthetic
(08:04):
legs as well as an empty chair. Yeah, a lot
of people felt like Grunenthal did not need to be
at that dedication at all, and then at it. Harold F. Stock,
the CEO at the time, delivered this apology translated into English.
It's said, in part, quote, Grunenthal has acted in accordance
with the state of scientific knowledge and all industry standards
for testing new drugs that were relevant and acknowledged in
(08:26):
the nineteen fifties and sixties. We regret that the tar
atogenic potential of the litamide could not be detected by
the tests that we and others carried out before it
was marketed. The statement later went on to say, quote,
we also apologized for the fact that we have not
found a way to you from person to person for
almost fifty years. Instead, we have been silent, and we
(08:46):
are very sorry for that. We asked that you regard
our long silence as a sign of the silent shock
that your fate has caused us. We have learned how
important it is that we engage in an open dialogue
with those affected and to talk and to listen to them.
We have begun to mutually develop and implement projects with
them to improve their living situation and assist in hardship
(09:07):
situations easily and efficiently. We will continue to pursue this
path in the future. Overwhelmingly, the lidamiters and their families
did not find this sufficient. Parts of it definitely read
as though they are saying, we're sorry, but it wasn't
our fault. Exactly. If you go and read their f
a Q and their website, there are a lot of
things on it that kind of make you go, you
(09:28):
didn't really answer that question, and also you're still saying
it wasn't your fault. The immunity that was granted to
Grunenthal when these charges were dismissed in nineteen seventy only
applies in Germany. So there have been other court cases
and civil suits in multiple other countries, both against the
pharmaceutical companies that distributed the litamide in those countries and
(09:52):
the governments that allowed them to do it, just as
examples the UK, the Litamide Trust was established as the
Litamide Children Trust in nine seventy three following a settlement
between the Stiller's Company Limited in four nine disabled children
who had been exposed to the litamide in Canada, A
lawsuit against the litamides distributor there led to cash settlements
(10:14):
and the establishment of a federal fund. The result of
all of this is kind of a patchwork of programs
and benefits that really vary from one country to another,
with some paying benefits only if the applicant isn't getting
support from somewhere else. Many programs also require documentation of
the litamite exposure, which in some cases is simply not possible.
(10:35):
One of the things we talked about is that sometimes
people would share their medications with someone else, probably not
any documentation there. Um. In the minds of many survivors,
it also shouldn't be necessary since outside of the context
of the litamite exposure, these patterns of disability are incredibly rare. Yeah,
It's like there's sort of a choice between possibly paying
(10:56):
benefit to somebody who has a similar disability that wasn't
caused by the litamide, which is incredibly rare, or requiring
all the litamide survivors to go through this huge rigmarole
and a lot of effort to get basic support for
day to day needs. Um. I didn't really write it
in this outline, But there have also been some countries
that have issued formal apologies or have talked about issuing
(11:19):
formal apologies for not regulating the companies that were distributing
the litamide more carefully before and during this whole crisis.
So all of this is really really still ongoing. A
financial support package known as the Canadian the Litomized Survivors
Support Program or ct SSP, was announced on January ninth,
(11:42):
twenty nineteen, so just this year, with an application period
running until June. That follows on to earlier programs from
and this is intended in part to allow survivors who
were previously turned down for a lack of documentation to reapply,
and it's ongoing in another sense as well. The solidamide
(12:04):
survivors who were born in the nineteen fifties and sixties
are in their late fifties and early sixties now. Numerous
surveys of survivors in various countries have reported that their
general health and quality of life are decreasing as they age.
To quote from the result of a survey conducted in
the UK, quote, as the litamide survivors reach their mid fifties,
they are experiencing a wide range of secondary health problems,
(12:28):
in particular muscular skeletal problems and depression and anxiety, with
multi morbidity a growing issue. These health problems are having
a negative impact on their employment. Two fifths are unable
to work and their physical health related quality of life,
which is significantly poorer than the general population. Some of
this is exacerbated by the fact that many the litamide
(12:50):
survivors have compensated for missing or shortened limbs by using
their other limbs instead, so for example, using their feet
in place of hands, and this means that they're particularly
susceptible to overuse injuries, joint issues, and other muscular skeletal problems.
This also means that many thalidomie survivors are needing additional
care and support while simultaneously reaching retirement age or being
(13:14):
unable to work because of their disabilities and health conditions.
And many of those who are receiving support from one
of the Solidamie survivor funds were evaluated when they were
much younger, so they need more now than they did
when they were initially approved, and the dollar amounts that
they've been granted have not necessarily been adjusted for inflation.
Plus some of these funds will only pay for specific
(13:36):
types of treatments and services, and not for things that
aren't regarded as a medical necessity. But a lot of
thelidamide survivors report that what they actually need the most
help with is day to day tasks like housekeeping and
personal hygiene, which some funds won't cover. Some funds also
won't cover things that weren't directly connected to the litamite exposure. So,
(13:58):
for example, of fund might pay for prosthetic arms because
a person's folk amelia was directly caused by the litamite exposure,
but not pay for physical therapy to address an injury
that resulted from using feet in place of missing hands.
We are going to take a short break before we
talk about some of the changes to disability rights, medicine,
(14:19):
and the law that followed the the litamide crisis. Back
in part one, we talked about how in many parts
of the world, the first response to newborns who had
been exposed to the litamide was a sense of hopelessness
(14:39):
and recommendations that be placed at institutions. Those attitudes started
to shift hospitals and other practices that had specialized in
fitting patients with prosthetic limbs, a lot of them had
initially been focused on veterans of wars turned their attention
to making limbs that were suitable for children. Soon specialists
(15:00):
were working on a range of limbs that were appropriate
for different stages of a child's development, and on new
types of press dcs that could work with different types
of folk amelia. There's obviously still a long way to
go in terms of accessibility and social attitudes about disability,
but it was a start. And also, I don't want
us to give the impression that every thalidomide survivor uses
(15:22):
press decies. It really depends on what an individual person
is comfortable with and wants to use and what works
for them. Attitudes about congenital conditions and disabilities also started
to shift in the wake of the thalidomide crisis. The
field of teratology, or the study of malformations during development,
was still very new. It's generally noted as being established
(15:43):
in the nineteen thirties, and before that point there had
not been much research into how a substance or condition
could affect development in uteroone. It had been established that
some things could negatively affect how a fetus developed, including
a lack of vitamin A or vitamin B, or the
rubella virus. The general public often thought congenital disabilities or
health conditions were brought on by natural forces or were
(16:06):
just random, and there were lots of superstitions and religious
and spiritual beliefs that were kind of baked into this
whole idea and muddied the waters a bit. The The
litamide crisis prompted a lot of research into teratology in general,
with the first medical journal dedicated to it established in
the nineteen sixties. I feel like at timelines of of
(16:28):
teratology as a field, a lot of times there's literally
a pre the litamide and post the litamide era in
the timeline. Researchers started studying which drugs can pass through
the placenta and what allows them to do that while
other drugs can't. And then there have also been hundreds
of studies into the litamides specifically over the decades. It's
(16:51):
only been in the last couple of decades that researchers
have started to figure out exactly what causes the litamides
teratogenic effects without getting too deep into chemistry, because there
are about ten different terms involved. That we would have
to define. This solidimide molecule exists into configurations which are
essentially mirror images of each other. The one known as
(17:12):
the R configuration acts as a sedative, the one known
as the S configuration is a tarata gym, and the
R configuration can be converted into the S configuration within
the human body. So even if drug manufacturers made a
very pure version that only included the R type of
the drug, it's still would not be safe during pregnancy.
(17:33):
Research is still ongoing into exactly how the S configuration
disrupts fetal development. I found five different headlines spanning more
than a decade that each claimed that researchers had finally
figured it out. This is a thing that's building and
discovering new elements of figuring it out. The most recent
of these came from Dana Farwork Cancer Institute in August
(17:56):
of eight teams, so just last year, according to the
press really ease quote. Building on years of previous research,
the researchers found that the litamide acts by promoting the
degradation of an unexpectedly wide range of transcription factors cell
proteins that helped switch teams on or off, including one
called SAL four. The result is the complete removal of
(18:19):
SAL four from cells. Aside from these shifts in public
awareness and attitudes and the huge growth of a huge
field of medical research, no single drug has had a
bigger impact on pharmaceutical regulations than the litamine. In much
of the world, the pharmaceutical industry was really growing without
a lot of regulations in place in the nineteen fifties
(18:40):
and nineteen sixties. In May of nineteen sixty three, British
Minister of Health Kenneth Robinson said, quote, the House and
the public suddenly woke up to the fact that any
drug manufacturer could mark any product, however inadequately tested, however dangerous,
without having to satisfy any independent body as to its
efficacy and safety. And the public was almost uniquely unprotected
(19:03):
in this respect. So these new laws, and I mean
they are really all over the world, set much more
specific standards into how drugs had to be tested, including
animal testing meant to confirm whether a drug is safe
during pregnancy before it's tested on or administered to humans.
In places where abortion was illegal, the palidomide crisis also
(19:25):
became part of debates about legalizing it or adding additional
exceptions to the existing law. In the US, for example,
abortion was a felony, and usually the only exception was
if the mother's life was at risk. Along with a
rubella epidemic that was happening at roughly the same time,
the palidomide crisis led to discussions about whether the law
should be expanded to include exceptions for pregnancies in which
(19:48):
the baby would not be able to survive after being born,
and there were also people who used the crisis to
support a eugenics argument in the context of abortion, either
to support the idea of allowing abortion for eugenic purposes
or to advocate for keeping abortion illegal because of its
potential use for eugenics. This became national news in nineteen
(20:11):
sixty two. Sherry Chessen was the host of Arizona's locally
syndicated version of the children's TV show Romper Room. Her
husband had brought some medication home with him from a
trip to London, and she had taken some of it
early in her pregnancy with their fifth child. Later, she
read an article about Dr Francis Oldham Kelsey's work to
prevent the litamite distribution in the United States, and she
(20:33):
realized that it was the same drug that her husband
had brought home with him. Chessen talked to her doctor,
who contacted doctors in Europe and then recommended that she
terminate her pregnancy. Chessen later described this decision as absolutely agonizing,
and she was also afraid that the same thing might
happen to other women, so she told her story to
(20:53):
the Arizona Republic under the understanding that her identity would
be kept confidential. Chessen's name became public after the hospital
ultimately turned down her request for an exception and her
attorney filed suit on her behalf. She lost her job,
she got hate mail and death threats, including threats to
her other children. Chested and her husband ultimately had to
(21:14):
travel to Sweden, where abortion was legal, to terminate the pregnancy.
Although it's no longer manufactured or distributed by Grudenthal, the
litamide has been reintroduced in several parts of the world
in the years since it was banned. That's something that
we're going to talk about in just a moment. And
as different regulatory agencies have tried to figure out how
to minimize the risk to developing fetuses, abortion has continued
(21:38):
to be part of this conversation, and that conversation has
also included the litamide survivors themselves. During advisory committee meetings
related to the reintroduction of the litamide, Randolph Warren, the
founder of the Lidamide Victims Association of Canada, stressed the
need to consider the possibility of abortion in this context, saying, quote,
(21:58):
people should not be forced to sign anything that would
force them to have an abortion should a the litami
be born, because we have some quality of life and
some right to be here. A lot of these questions
about the lidamide and abortion in general are still ongoing
in many parts of the world today, and we're going
to talk about the reintroduction of the lita mine after
we take another sponsor break. It wasn't long at all
(22:29):
after the litamides worldwide ban that doctors began discovering that
it could have medical use as an adult patients beyond
being a sedative. In nineteen sixty four, so just two
years later, doctors at a hospital in Jerusalem gave the
lidamide to a patient who had advanced Hanson's disease, which
is also known as leprosy. This patient was in very
(22:50):
severe pain and could not rest, so a doctor administered
some the litamide that he had on hand, basically as
a last resort. This doctor, j GB chess Can, realized
that that the litamide also treated some of the diseases
symptoms beyond just being a sedative. The World Health Organization
conducted a clinical trial of solidamide as a Hanson's disease
(23:12):
treatment in nineteen sixty seven. Today, it's used in some
places to treat your thema a dosum laprosum or e
n L, which is a complication that causes painful nodules,
high fever, and inflammation. The litamide is approved for treating
E n L in some parts of the world, but
the World Health Organization does not recommend it because of
its teratogenic effects and because there are other drugs that
(23:35):
can treat E n L. Yeah. Even though today hanson
disease can be treated with a very long course of
multiple antibiotics, this complication can happen during the process or
even afterwards. So even though Hanson's disease is more treatable
than it used to be, this particular complication still does
happen for people. Since then, the litamide has also been
(23:55):
discovered to be effective against a number of other serious
diseases and conditions and complications, including AIDS, wasting syndrome, and
multiple miloma. Because it can inhibit the growth of blood vessels,
it's also effective and cutting off the blood supply to
certain cancers. This has of course been an incredibly difficult
(24:16):
and sensitive topic amongst the litamide survivors in their families.
In the words of Randolph Warren from an article in
f DA Consumer in two thousand one, quote, we will
never accept a world with solidamide in it. However, we
are forced to prefer licensing of the drugs that disabled
us for compassionate reasons and to prevent uncontrolled access to
(24:36):
the drug. Yeah. I mean, no group of people is
a monolith. People all have their own opinions. But as
a group, the litamide survivors in general have been like,
we're not going to try to stop you from keeping
people who need this drug from having it, but we
have got to protect people. So, for example, when the
US was trying to set standards for prescribing the litamide
(24:57):
for multiple mileoma and hands and disease, Warren and the
the Linamide Victims Association of Canada were part of that process,
including attending advisory committee meetings with the Food and Drag
Administration in the National Institutes of Health. The result from
all these meetings was the system for the Lidomide Education
and Prescribing Safety Program known as STEPS, which is now
(25:18):
called Risk Evaluation and Mediation Strategy or REMS. REMS is
very involved, providers have to be certified, and distribution of
the drug is highly restricted. Patients who could become pregnant
are counseled on the risks of the drug. Along with
contraception and emergency contraception. The litamide can also be present
(25:39):
in siemens, so male patients whose partners could become pregnant
are required to use condoms even if they have had
a vasectomy or if their partners are using contraceptives, and
this is really just the beginning. Patients who could become
pregnant are required to have two negative pregnancy tests before
starting treatment. They must use two forms of birth control
(26:00):
while being treated, and also take regular pregnancy tests. The
pills are also dispensed in blister packs rather than pill bottles,
so that they can't be confused with other medication or
easily put into an unlabeled container. The pills themselves in
most cases literally have a picture of a pregnant silhouette
crossed out they're printed on the pill. No more than
(26:22):
four weeks of doses are dispensed at a time, and
there are no automatic refills. Unused doses are supposed to
be returned rather than discarded, and there's just a lot
of follow up and monitoring of patients regardless of their sex.
And this is the standard in the US. So in
order to be treated with solidamide, a person has to
give up a degree of bodily autonomy just to comply
(26:45):
with all these regulations. That has led to a whole
discussion of medical ethics and what it means for patients
to essentially just be reduced to being viewed in terms
of their capacity to have children and how to control
that capacity, as well as what it means for a
disabled person to be reframed as a problem that should
be prevented. Yeah, we've we've talked on the show at
various points about disability rights and about the evolving view
(27:10):
of not thinking of disability as like a bad thing
that needs to be fixed, but instead thinking of society
is something that needs to change to be accessible to everyone.
The the litamide survivors community has been pretty vocal about
the fact that in their view, this is something that
happened to them that should not have happened to them
(27:31):
and should not happen to anybody else. So it's a
little bit different nuance than some of the other disability
rights things that we have talked about. And then also,
like we said back in part one of this episode,
these steps don't necessarily prevent every exposure. Hanson's disease is
really prevalent in Brazil, and the litamide was re licensed
(27:52):
in Brazil for that reason. In n there have been
people born with feetle the litamide syndrome in Brazil than
including in very recent years. After examining the birth records
of seventeen point five million people born between two thousand
five and about one hundred were found to have health
conditions and disabilities that are consistent with fetal the litamide syndrome.
(28:16):
Brazil has similar regulations for dispensing the litamide compared to
what the US does, But the parts of Brazil where
hands and disease is the most prevalent are also the
parts where the medical system is the least robust, and
I mean it would not surprise me at all that
if there are other countries where the litamide has been
reintroduced that have a similar situation, but Brazil is where
(28:38):
the most research has been done. So that's the litamide
not a story that is confined to the past, as
folks may imagine it from seeing things like Call the Midwife,
which um that plot arc on Call the Midwife plays
out over a long time in terms of episodes, because
it has a very similar trajectory to what we talked
about in Part one, between somebody having morning sickness being
(29:01):
given this drug because it's been sort of a wonder
drug for treating morning sickness, to then eventually much later
making the connection between that drug and people being born
with this range of disabilities. Tracy d have a bit
of listener mail to wrap this one up. I do.
This is from Emily. Emily says, Hi, Holly and Tracy.
I'm excited to finally have something to contribute for listener mail.
(29:23):
I was born and raised in Conquered, California and have
driven through the Conquered Naval Weapons Station and on the
Port Chicago Highway for a long time, but I didn't
learn about the disaster until my twenties. For people that
would like to know more but can't visit the port itself,
there's another place to visit. There's an exhibit about the
disaster at the Rosie the Riveter World War Two home
Front National Historic Park Visitors Center in Richmond, California. This
(29:46):
is where I first learned about the event, along with
a lot of other amazing stories about the people who
fought the war from home and how wartime shaped the
Bay Area. The museum is at the site of the
Richmond Shipyards and Fort Assembly Plant. I highly recommend this
free museum to anyone who is interested in these topics
or as in the area. Thanks for keeping me company
through the more monotonous parts of my day, Best Emily.
(30:08):
Thank you so much, Emily for this note. If folks
have been sort of waiting for a reason to write us,
you can write us for any reason. Just say hi.
You can send pictures of your pets. We love to
hear random things about people's lives, as well as emails
like this that have a cool new information that we
didn't know about before. So thank you so much, Emily.
Uh If you would like to write to us, we're
(30:29):
a history podcast at how Stuff works dot com and
then we are all over social media at miss in History.
That's where you will find our Facebook, Interest, Instagram, and Twitter.
You can also come to our website, which is missing
history dot com, where you will find a searchable archive
of all the episodes that we have ever done and
show notes for the episodes that Holly and I have
done together. Uh and you can subscribe to the show
(30:52):
on Apple, podcast, the I heart Radio app, and wherever
else you get your podcasts. Stuff you Missed in History
Class is a production of I Heart Radio's How Stuff Works.
For more podcasts for my heart Radio, visit the heart
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The official podcast of comedian Joe Rogan.
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