The Unseen Body - Dr. Jonathan Reisman - Grit Nation

Episode Transcript
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Joe Cadwell (00:08):
Welcome to Grit Nation. I'm Joe Cadwell, the
host of the show, and on today'sepisode, I have the pleasure of
speaking with physician,adventurer and author of the
newly published book titled Theunseen body. His name is Dr.
Jonathan Reisman. And on today'sshow, Jonathan and I will
discuss how his passion fortravel, prehistoric crafts, food
and practicing medicine allcoalesced when writing his book

(00:32):
will open our conversation asJonathan explains how cutting
into a cadaver in medical schooland literally pulling back the
curtain describing the hiddenmysteries of the human body was
so influential and to hisbecoming a doctor. Next we'll
discuss human anatomy, startingwith the throat, which Jonathan
believes is an overlycomplicated and anatomically
flawed design because of thehighly coordinated valley of

(00:53):
nerves and muscles needed tokeep us from dying every time we
eat or drink. Later, we'llunpack many of the body's organs
and tissues including the heart,lungs, and fat. And we'll dive
into why problems with ourbody's plumbing networks can
wreak havoc on our health andwell being will then discuss the
importance of sleep for optimumcognitive performance and why
the pineal gland located deep inour brain is responsible for the

(01:16):
production and regulation ofmelatonin, a hormone necessary
for a peaceful night's slumber.
And we'll wrap up ourconversation by focusing on the
kidneys. As Jonathan explainswhy his favorite bodily fluid
urine can be so beneficial ondiagnosing potential health
related issues. This episode isboth fascinating and at times
gross, and I hope you enjoy it.

(01:37):
Or at least learn somethingabout yourself that you didn't
know before. After the episode,be sure to check out the show
notes for more information aboutJonathan Reisman in his book,
The unseen body. And now on tothe show. Dr. Jonathan Reisman,
welcome to grit nation.

Jonathan Reisman (01:53):
Thank you so much for having me.

Yeah, thank you, Jonathan, for taking your time
to be on my show today, I reallyappreciate the opportunity. I've
just been fascinated readingyour book over the last week and
a half since I've had it andit's it's a great read. It's a
lot of fun. It's an insight intothe human body. It's an insight
into who you are and yourinterest as someone that likes

(02:15):
to travel and, and has a senseof curiosity in regards to
everything from how to skin ahide to how to cook a brain or
cook cook along. So for theaudience, can you tell us a
little bit more about who youare and how you got interested
in writing this book?

Well, I grew up in northern New Jersey, in
the unexciting suburbs in NewYork City. And I guess it was
around college time where I wentto New York University, I was
studying math and philosophythat's always sort of interested
in, you know, thinking moredeeply about the world and
history and human humanity andwhat we're doing here, why we're

(02:50):
here how to live best. And soafter college, I sort of set out
traveling, I got some greatopportunities to live and work
in Russia actually, for on andoff for about two years. That
was sort of my first bigimmersive trip where I learned
the language and history andtraveled all over the country
and went from knowing virtuallyzero about the place and its

(03:13):
people to knowing a lot and thatsort of probably got me addicted
for lack of a better term totraveling the world and learning
about all different cultures andnatural environments and how
people live in those unique andparticular natural environments,
how they use the plants andanimals for their own lives and
how culture intertwines with,with that connection between

(03:33):
humanity and nature. Eventually,I carried that interest with me
into my medical career. So Iended up going to medical
school. And ever since Ifinished my residency, which was
in Boston, I sort of continuedthat exploration of the world
and have sought out jobs workingin interesting geographic places

(03:54):
with interesting culturalcontexts. So that brought me to
Arctic Alaska. And I've workedon as ship doctor in Antarctica
and the Russian Arctic, and thehigh altitude in Nepal and rural
Appalachia. And so my career haskind of taken me all over. And
turns out being a doctor is agreat way to wander around the
country and the earth, becauseyour services are kind of needed

(04:17):
everywhere. So it turned out tobe a great ticket to exploring
the world and in a slightlydifferent but still really
invigorating and interestingway.

Yeah, for sure. And I really liked the way you
interwove some of your travelexploits into the book and how
you found common narratives forthe different body organs, and
that the name of the book is theunseen body and so we're so used
to I think, as a society toalways judge everything the book
by its cover what we see on theoutside, but you got interested

(04:48):
in what's actually going on inthe inside. And that started
with your dissection of acadaver, early on in the anatomy
class of your pursuit of adegree in medicine.

That's correct, right on the very first
day. as medical school, westarted the class called the
anatomy lab where we'redissecting a cadaver. And so it
was I found it fitting inretrospect, that they sort of
pushed us right into the deepend of the pool there, by
showing us kind of the end ofthe end of the story. You know,
every human body has a storybegins in the womb, and then

(05:18):
ends in death. And it was sortof here, you know, pushed into a
room, and here's a dead humanbody now start cutting it up and
learning the name and functionand structure of every single
little bit of flesh. And thatreally, really fascinated me. I
always, as you mentioned, thename of the books, the unseen
body. And I think there's thistheme about pulling back the

(05:40):
curtain and showing syrupshowing me what's what's behind
the scenes, I think, I thinkthat was a big part of why I
love traveling so much, it sortof pulls back the curtain on
these places that you maybenever heard of, or know nothing
about, showing you the innerworkings of a society, a
country, a culture, a language.
And so the human body felt verysimilar, pulling back, literally

(06:02):
pulling that plastic sheet offmy cadaver on that first day,
and then every subsequent day,over the next four months or so,
you really got to look behindthe scenes of life in a way we
all live our daily lives, kindof on the surface of our bodies,
you know, we see other people,we basically are looking at the
surface, we look at ourselves bylooking down at our bodies by

(06:22):
looking in the mirror, you know,unless there's some symptoms,
some pain or something that'sdrawing our attention to our
insides, we don't really thinkabout them much. And neither did
I until I started cutting openthat that cadaver. And so in a
way that was pulling back thecurtain on daily life on this
man's body, but also on everyother body in the world, all my
friends and family and my ownbody as well. So it was sort of

(06:44):
a sort of philosophicalreflection on myself while
looking at another body to andthen in my book, also, I tried
to pull back the curtain on, youknow, the healthcare industry
and what doctors go through intheir training and what it's
like to be on the doctor side orthe doctor patient equation. And
so sort of all kinds of pullingback the curtain and revealing
the unseen.

And that all started with that first scalpel
stroke, I understand that theperson you were working on it
was a man of deceased man, hewas prone face down, and that
first scalpel stroke, you cutinto his back, I think you were
investigating a lot ofhistoricize, something like
that, and, and beginning tounderstand the connectivity of
how the muscles and the bonesand the ligaments and tendons

(07:26):
all work and, and from there,you just continued on over the
course of what is it four monthsor so that you began to unravel
the mysteries of the, the unseenbody so that just fascinating
stuff I know a lot of peoplelistening right now are probably
going well, this can be really,really fascinating. But a lot of
people may be a little bitrepulsed by this as well. And

(07:47):
it's sort of that, you know, thefascinating versus gross and I
thought you know, another greatname for your book, as opposed
to the unseen body would befascinating versus gross. You
know, there are some componentsof your book that are cringe
worthy, there were also somegood humor in your book, I
appreciated that. But you youkind of have an insight again,
the philosophical look into intothe human body and you break it

(08:07):
down into sub parts and thefirst sub part, you jump us
right into the mix of of thethroat, you know, I just loved
the the mental image of thedevelopment of the, the the
Safa, geo passageway and in thetrachea, the airway, and that
the millimeters of, ofseparation between the two can

(08:28):
be millimeters between our lifeand death. And I was hoping you
could tell us why you startedwith the throat and what really
is going on, in what Iunderstand is a rather poorly
designed area of a human body.
So

the throat in particular, you know, when you
pull back the curtain on thehuman body, I got to learn about
every different body part, everybodily fluid, it became all
these all these, you know,supposedly gross parts of the
body sort of became my, my dailywork the bread and butter of my
job. And so, you know, it wasnever a squeamish person, which
probably helped. But becoming aprofessional in healthcare means

(09:05):
working with all these grossbody parts and bodily fluids all
day every day. So the throat forinstance, the reason I put it
first was actually because Iwanted to have the reader of my
book sort of pushed into thedeep end of what it means to be
in healthcare, just as I wassort of tossed in that first day
of medical school by dissectingmy cadaver. And so the the first

(09:27):
chapter about the throat doeshave a lot of talk about death
and the end of life inparticular. But as you
mentioned, the throat has kindof an interesting and complex
story. As I explained in thebook, each person each of us
everyone who's ever lived orwill ever live begins as
basically a microscopic tube inthe womb with an entrance on one
side and an exit on the other.
And then of course, as we growand develop and become more

(09:50):
complex, through the course ofgestation, the entrance to that
tube splits into multipledifferent entryways one
specifically for food, and onespecifically for air. And so for
instance, every day when weswallow food, every sip of
water, we take every bite offood that we swallow. One thing
I learned in medical school isthat I got a sort of a front

(10:13):
row, look at how close each ofthose bits of water and food
come to slipping into ourwindpipe, which could make us
choke or actually kill us. Soevery every single, you know,
the entrance to the esophagusand to the windpipe are right
next to each other, as youmentioned, just millimeters
separating them. And our throatgoes through this very complex

(10:33):
contortion that we callswallowing, to keep food and
drink out of that windpipe. Soto keep us alive. It's a very
basic function of the body tokeep those two things separate
so that only air goes into thewindpipe and everything else
that we swallow, whether it'sfood, drink, snot, coughed up
mucus, whatever it is, must godown the food pipe the

(10:54):
esophagus, and none of it shouldget into our airway, or else
we'll, we'll be in serioustrouble. So the throat did seem
sort of a stupid design,compared to most other body
parts would seem seembrilliantly designed to function
properly and efficiently and tokeep us alive. And then of
course, as I talked about in thebook, and throw it has, I gained
another perspective on thethroat by treating a lot of

(11:17):
elderly and infirm patients who,in fact, had trouble with that
most basic function of the bodyof keeping food and drink and
saliva out of the windpipe.

It really does seem like the muscles and the cranial
nerves kind of work in concertto, to allow people to just pass
fluid into the esophagus and notinto the trachea. And, as you
said, people with dementia,people that are getting older
stages in life, my father inlaw, close to the end of his his
life, we had to do somethinglike thickened water, in order

(11:49):
for him to be able to, for hisbody to be able to understand
that something was coming in andit needed to be directed towards
is his stomach and not towardshis lungs. And I've heard that
this can almost be sort ofwhat's referred to as old man's
friend or an escape hatch, that,you know, the body inherently
has this, this mechanism thatmay sort of hasten or, or

(12:13):
increase the likelihood thattowards the end of someone's
life that they do get, what isit called aspirational
pneumonia, can can be part ofthe cause of someone's death,
who's later on in yours?

Yeah, that's correct. So keeping food and
drink out of the out of theairway is one of our body's most
basic function. But as we getolder and more infirm, and
perhaps have, you know,degenerative neurological
conditions like dementia andParkinson's and strokes, we get
worse at that coordination thatit requires to keep things out

(12:44):
of our airway. So people dosuffer from aspiration. And I
think a lot you know, the thefirst things the basic
functions, people lose theability to do include taking
care of themselves, theiractivities of daily life cooking
for themselves, cleaningthemselves. Those are we think
of as the most basic functionsof the body. But actually, this

(13:06):
throat contortion, keepingthings out of their ways even
more fundamental. And so as weapproach the end of life, we
sometimes get even worse atthat. And aspiration pneumonia
can be the result when you doaspirate things into your
windpipe. And it's a very commoncause of death in people with
dementia and Alzheimer's andstrokes and other conditions.
And so I do paint it in my book,as that other perspective I got

(13:29):
on the throat, was that it'salmost serves as this exit from
life. You know, I don't I don'tbelieve it's designed that way.
But it's sort of a side effectof that very precarious
relationship between the airpipe and the food pipe is that
as we get old, weaker, perhapsour mental function declines,
perhaps our quality of life goesdown. There is this escape hatch

(13:51):
there, our body tends to slip upin this particular way that
causes pneumonia that is acommon cause of death. And it
was in the past called Old man'sfriend, could be old woman's
friend, too, but it was calledthe old man's friend, because
when people were suffering in aprolonged way and becoming more
debilitated, this pneumoniaoffered almost a way out of a
painful life, where the perhapsthe quality of life wasn't there

(14:14):
anymore.

So your book The the unseen body just thrust us
straight into the life deathconsequence, the ballet that
goes on in different body organsand starting off with the throat
and then taking it in order.
You've you've outlined the bodyand I'm gonna ask questions, and
maybe not not quite sequentiallyin your book. But I was
fascinated by the part of theheart. And again, getting back

(14:36):
into your travels. You talked alot about the flow of water over
mountain ranges, I think ineastern Russia and how the
streams are dumped into riverswould dump into seas and I
thought that was really poeticand helped my visualization of
the cardiovascular systems andwhat can you tell us more about
your travels in Russia and howyou came up with this thought of

(14:58):
this circulatory system.

Sure. So I think when I grew up, as I
mentioned in the New Jerseysuburbs, the land, the shape of
the land, the way water flowedover the land, the way that
streams branched and coalescedinto larger rivers was really
not a part of my life at all. Ithink most streams that road
flowed through my town, Iprobably interacted with them

(15:22):
when they went through drainageditches underneath the roads I
was driving on. And that wasabout all I thought about them.
But when I went to Russia, I gota really my first taste of what
it's like to live in wilderness,pretty much where there's no
roads through the mountains, andpeople traveled by horseback.
And I was really fascinated byhow they have to follow the

(15:43):
branching rivers and have toreally know the landscape so
intimately to travel through themountains. And so I joined a
family of native people thatfrom the event people who are
one of the groups that live inon the conjunct peninsula in the
Russian Far East, I try, Itraveled with them on a
horseback trip to their huntingcabin, which took several days
and learned a lot about how youtravel through roadless

(16:06):
mountains, something I knewnothing about. Were basically
you have to have a good mentalmap of the watershed of how the
streams coalesce and how theybranch in which ones to follow
to get over the mountain paths,you know, you make a wrong turn
at where tributary meets thelarger stream. If you take the
wrong tributary, you end up at amountain path with a sheer cliff

(16:27):
in front of you perhaps and youcan't get over that way into the
next valley. So you have to knowwhich way to go. And this family
I was traveling with new the neweach of those dreams like the
back of their hand, pretty much.
And then later, speaking of theback of the hand, you know how
veins on the back of our handsalso branch and come together
into larger and larger veins asthey sneak up our arm into the

(16:48):
form. That was something I waslearning about and had to
memorize these maps of branchingblood vessels in the human body,
it really had to learn the namesand courses and trajectories and
branch points of all thearteries in the body. But some
of the most important forinstance, was the arteries
feeding the heart. Because whenyou diagnose heart attacks, you

(17:10):
sort of have to know how theybranch and which part feeds
blood to which part of the heartand is that you're you're almost
when you're diagnosing a heartattack by looking at an EKG,
you're sort of traversing thosebranching arteries, through the
heart almost the same way thatme and that family, we're
traversing those branchingstreams to travel through the
mountains. And the same goes forstrokes in the brain, your way,

(17:32):
by examining the patient, andfiguring out what their
neurologic deficits are, you'resort of walking through the
branching art arteries that feedthe brain, and you're able to
pinpoint exactly where thestroke might be in their brain.
And so understanding branchingwaterways or understanding
branching blood vessels was avery similar mental exercise.

(17:52):
And so I when I was in medicalschool, learning about that, and
learning how to do that, since Ihad to learn so I can diagnose
and treat these conditions. Itreminded me of, of that trip I
had taken with that family andfrom jotka, following the
watersheds. And so I think a lotof those sort of unexpected
connections are was basically myexperience of medical school, I

(18:15):
had traveled a bunch and hadlearned a lot. And so I was,
like you mentioned tanning,animal hides, and things like
that. So I ended up connectingthe things I was learning about
the human body, to all theseother things I had experienced
or learned about. And so my bookis a collection basically of
those of those interestingconnections.

Yeah, for sure your book is full of again, travel,
it's full of human connection,it's full of organs. And, again,
getting back to the heart of thecirculatory system, the heart
muscle itself, it seems like forthe majority of listeners of the
grid nation podcast, we're, youknow, living in North America,
US and Canada were werecardiovascular diseases, one of

(19:00):
the biggest killers, if not thegreatest killer of people on a
year to year basis. And cardiovascular disease often manifests
itself in the blocking ofarteries. Is that how that
works?

Yep, that's correct. There's a kind of a
slower process where they the,the arteries can slowly narrow.
And then of course, there's avery sudden, and all at once
blocking that can happen in thearteries of the heart, and
that's a heart attack. And thosetwo processes are intertwined as
well.

And I loved how in the book and I teach CPR, I've
taught CPR for over 30 years forthe American Heart Association,
American Red Cross, and I'venever heard it expressed the way
you express it in your book. Andit works perfectly for myself
because I teach a lot ofcarpenters in the building
trades you you broke down thetwo main problems of the heart,
heart attack and cardiac arrestis being a plumbing disorder or

(19:52):
an electrical problem. Heartattack being a plumbing
disorder, and I was hoping youcould tell a little bit more
about that and then how it manit could manifest itself into an
electrical problem or a cardiacarrest?

Sure, I think there's a lot of confusion
understandably, about conditionslike heart attack, heart
failure, cardiac arrest, even inscience media, I find those
terms sometimes confused. And itis confusing, I admit. But yeah,
so plumbing is actually a hugepart of medicine. So many of the

(20:23):
diseases that we diagnose andtreat and try to prevent are
basically plumbing problems. So,blockages in the flow of fluid,
there's so many fluids in thehuman body, from blood to
saliva, to bile, to pancreaticjuices, and many others, and
each one must flow through itstubes and not be blocked up. And

(20:44):
a lot of the things that causeus pain and suffering and
disease are simply blockages ofthat flow. And so being a doctor
in many ways, is like being aplumber, because your job is to
locate the blockage and andrelieve it, whether that's with
a catheter threaded in therealmost like sneaking a drain to
get the plug out, or, you know,blood thinners to dissolve the

(21:05):
blood clot that is blocking theblood flow, let's say. And then
of course, there's also otherplumbing problems like leaks,
such as bleeding from trauma, ora lot of people bleed into their
intestines, especially whenthey're on blood thinners. So
leaks and clogs is a big part ofmedicine. So it's basically
plumbing. As you mentioned,heart disease is one of the
biggest killers of Americanadults these days. And that's

(21:27):
just a one particular kind ofplumbing, a heart attack is
where the blood flow to part ofthe heart is blocked by a blood
clot. And so the job of doctorsis again to find that locate
that clot, which involvesknowing the map of branching
arteries, and then getting thatclot taken out, which is usually
done by cardiologists,interventional cardiologists,

(21:49):
who do refer to themselves asthe plumbers in the cardiology
world. Now another anotherproblem that can arise in the
hardest cardiac arrest. And asthe name suggests, that's when
the heartbeat itself arrests orstops. And so in a cardiac
arrest, your heart's not gettingblood anywhere to your brain,
especially and so you're notconscious. And unlike a heart

(22:10):
attack, where you can be talkingto me as a doctor, and when I'm
asking you, where's the pain?
What does it feel like? When didit start? You can answer my
questions. Someone in cardiacarrest is unconscious, and is
not answering any morequestions. So cardiac arrest is
more of an electrical problem.
So the type of cardiologiststhat deals with that would be an
electrophysiologist. And theycall it consider themselves, the

(22:31):
electricians of thecardiovascular world, unlike the
plumbers who do the Cardiac Cathand get out the blockages when
you're having a heart attack.
But the two are, of courserelated. So when you're having a
heart attack, and blood flow isblocked a part of your heart,
the electrical system in theheart can get very irritated,
and can spiral out of controlinto an arrhythmia or an
abnormal rhythm, almost anelectrical storm in the heart,

(22:53):
because of that malfunctioningpart that's not getting blood.
And so that can lead to cardiacarrest two, so just to make it
even more confusing, a heartattack can lead to a cardiac
arrest or in other words, aplumbing problem can lead to an
electrical problem.

short out the fuse box and everything goes
sideways. Yeah, so that makes alot of sense. And some of the
contributing factors, obviouslyto cardiovascular disease,
smoking is huge. And I thinkwe're gonna get a little bit
into lung health as we find ourway further down the, into the
into the body, we'll talk aboutlungs, but dietary habits as

(23:30):
well can lead to cardiovasculardisease.

Sure, and I think that the story of
nutrition and cardiovascularhealth is a bit complicated, and
I think, to some extent ischanging as well as researchers
are doing larger multinationalstudies and, and finding out
that some of the advice thatdoctors have been giving for
some decades is not always borneout by the evidence sometimes

(23:55):
saw salt and cholesterol in yourdiet. And saturated fat may
actually not be as bad as wethought, believe it or not. But
But certainly, I mean,controlling risk factors for
cardio, coronary artery disease,narrowing of the arteries, heart
attacks is very important. Mostof those are, as we know,
smoking is a huge one. Ofcourse, there's genetic factors,

(24:16):
you can't change. But thenthere's things like high blood
pressure and cholesterol, anddiabetes that are being risk
factors for the narrowing of thearteries and having heart
attacks eventually, too. Andactually, it's the picture of
fat in the diet and fat on ourbodies in the form of obesity
and fat in our blood streams inthe form of cholesterol and

(24:37):
triglycerides is is actually notso well understood. And when I
left med school, I was confusedby it. And I'm still confused by
it. And the the studies don'tgive us a really clear picture.
I think it's certainly clearthat those risk factors are not
good for you. It's certainlyclear that that obesity can
contribute to some of thoseincluding diabetes type two and

(25:00):
high blood pressure, and themetabolic syndrome which comes
with all those things puttogether as well as chronic
kidney disease. Certainlyleading an active lifestyle,
eating fruits and vegetables,things like that is very good
for you. Even if the otherthings that doctors have been
telling you to avoid, I don'tthink those are actually as bad
as doctors have been saying. Butstill, the things that are good

(25:23):
for you are still still good foryou quitting smoking and getting
exercise and eating lots offruits and vegetables, even if
you also eat fat, or unhealthyfoods and fried foods etc. It's
still good to eat those things.
Because they outweigh any anynegatives you're getting from
your other foods. So if you needto fry your greens in pig lard,
God bless you eating the greensis still good for you.

There you go. And I thought it was really
interesting, the dichotomy offat you know, it's such a seems
like a taboo food, but then youfound yourself just outside of
Barrow, Alaska, living with someof the native population,
they're out on a whale hunt. Andwatching these people literally
just eat whale blubber, whalefat, and not only did this fuel

(26:10):
their bodies, but it also fueledtheir oil lamps and fueled heat
sources that allowed them tolive in this area. And I
thought, that's a really, reallyinteresting and you, you had to
kind of had your eyes open tothis dichotomy of fat, if you
will.

Exactly. I think when I left met, in my
medical education, in medicalschool, you come to think of fat
as the enemy in all ways,whether it's in your food on
your body and your bloodstream.
Fat is the enemy, we must fightagainst it forever and be at war
with fat. But then when I wentto the Arctic, I saw that human
life in the Arctic would neverhave even been remotely possible

(26:43):
without the huge amounts of fatthat people consume up there
from marine mammals, likewhales, wall verses and seals.
And as you mentioned, it's notonly about calories, although
that's a big part of it, forsure, if the animal fat can made
up about more than estimatedmore than half of all calories

(27:04):
that people consumed in theAlaskan Arctic, for instance, in
historic times was, did comefrom the fat. And so they had
basically no fruits andvegetables in their diet. They
ate all meat and fat prettymuch. And yet, their, for
instance, cholesterol was verylow, when they first started
doing studies on these peopleand their cardiovascular health

(27:25):
was actually great. And so Ithink it sort of threw a wrench
into the story of fat that I wastaught about in medical school
and showed me, at least that itperhaps should be questioned.
And I think that some of thesome of that dogma is, is
actually being questioned thesedays by bigger and larger
studies that are teaching usmore about the relationship
between what we eat and have andthe function of our bodies and

(27:47):
disease. It's a very complexpicture. doing studies on food
and nutrition are very hard for1,000,001 reasons, but it's very
hard to pinpoint what you put inyour mouth and how exactly it
impacts your body. Because thesesubstances are so complex with
1000s of chemicals. And ourbodies are complex to physiology
and metabolism differs betweendifferent cultures. For

(28:12):
instance, the natives of theArctic, in Alaska or elsewhere,
do have some genetic adaptationsto their environment and to
eating their high fat diets thatothers don't have. But even even
from one person to the next.
Even siblings who share parents,metabolism is can be very
different and vary widely. Andthe impact of whatever you put

(28:32):
in your mouth can can be verydifferent for even very closely
related people. So the pictureis super complex, but, but I do
credit, the Inupiat Eskimo ofnorthern Alaska for sort of
opening my eyes to the fact thatfat can be the hero, not just
the enemy.

And speaking of you know, opening your eyes, putting
things in your mouth that, youknow, may or may not seem
appropriate or the right thingto do. Tasty, but banned foods
is, you know, I thought would bea good title for your chapter on
the lungs. I also liked Ithought about lungs and juice.
You talked about having lungsand juice at one point, and that

(29:10):
the lungs, I mean, just anotherfascinating chapter, and are
basically our insides turnedout, if you will, the mouth goes
into the trachea, tracheabifurcates goes into the lungs.
We have two air sacs, bigsponges in our lungs that absorb
all kinds of stuff. And I thinkit was back in 1968 1969.

(29:30):
According to your book, they theFDA came in did a study and said
we can't let people eat lawnsthis is bad for them. Why? Why
do you have some sort ofdisagreement or find that study
to be a bit outdated?

So in 1969, the USDA started questioning
whether lungs should be eaten bypeople are if they can be safe
because of course, just animallung, inhale all the same things
we do which is dust in the airand smoke and pollution and
sport mold spores that arefloating through the air. And we
probably inhale with everybreath we've ever taken from the

(30:04):
first to the last. Andbasically, the law that was then
passed in 1971, that banned allsale of lungs for human
consumption, basically, it makesno sense that, that the lungs
that it would be dangerous toeat the lungs, and what they
found when they did that studyin the late 60s, early 70s, was
that these lung samples docontain some of those airborne

(30:27):
contaminants like fungal sporesand dust, and pollen, and they
get very deep into the lungs.
And so when someone examines thelungs in a post mortem
examination, and aslaughterhouse, they might not
see all that quote, unquote,contamination super deep in the
lungs, and it would be toolaborious to really cut all the
lungs open and look all the waydown into the tiny air tubes to

(30:48):
see if those quote unquotecontaminants are in there. So
they the USDA for justefficiency reasons felt it was
simple and it just banned themcompletely. So you cannot buy
lungs. In a butcher store. Thereare there are dog treats made
from animal lungs that are stillavailable, but humans cannot
consume them in a restaurant orand cannot buy them as human

(31:08):
food.

And just for clarification, Jonathan, you
know, we are talking aboutcatalogs, we are talking about
sheep lungs and Pig Lungs,obviously. And in you know that
we're investigating the humanbody. I just wanted to make sure
people knew we weren't talkingabout eating human lungs for for
general consumption. I thoughtit was interesting in your in
your, in the book, too, that oneof the biggest lobbyists,

(31:32):
they're one of the biggerlobbyists for turning over this
law come from Scotland becauseof Scotland's use of cow lung in
making haggis having justrecently come back from a trip
to Scotland two, three weeksago, I had my fair share of
haggis. I thought it tastedwonderful. But yeah, to just put
a point on it, we're talkingabout eating of lungs and and so

(31:54):
are do we stand alone? Jonathan,Are we one of the few countries
in the world that has bannedlung and car?

I understand Canada also has banned it. I
don't think there's too manyother countries. They're
certainly not the UK, as youmentioned, they have been
eating, especially in Scotland.
Haggis is traditionally madewith lungs. And that's made it
difficult to export haggis tothe US where of course there's a
lot of people of Scottishdescent who might want to buy
it. So the US government hastold the UK government they can

(32:21):
either submit a scientificdossier to showing studies
showing that eating lungs aresafe, or they can just develop a
lung free Hackett's recipe andso I've been in touch with some
representatives of the UKgovernment, they went with the
latter option and just havedeveloped lung free haggis,
which is exported to the US towork around, exactly work

(32:42):
around. And as you said, Yes,I'm not endorsing cannibalism at
all, of course, for both ethicaland legal reasons. But that was
another one of the, I would sayunusual perspectives that I
gained in medical school was aperspective of food on the human
body not not to eat the humanbody. But basically the
observation that we're made ofthe exact same stuff as the

(33:03):
animals that we eat. And so ifyou look at human muscle, under
the microscope, or cow musclebasically looks virtually the
same. We're made of the samemolecules, the same tissues,
they're structured verysimilarly, similarly. And so
when I was learning aboutmuscles in the human body, by
extension, I was learning aboutdifferent cuts of meat. And
there's that there's acorrespondence there, and many

(33:25):
of the muscles in us docorrespond to whether it's the
filet mignon, or the top andbottom, and I have round, or the
flat iron, steak, etc. And so I,as I was learning the human
muscles, I was always alsolearning how they correspond to
animals, and then got interestedin eating all sorts of other
unusual and less commonly eatenbody parts, including internal
organs, but also everything fromtongue to feet to tails, and

(33:49):
everything else in between aswell. And so that's something
that an interest I've continuedto this day, actually, I
currently travel around and teamup with local chefs to put on
what I call anatomy dinners,where we do serve some of those
internal organs and lesscommonly and body parts. And for
each dish, I explained theanatomy and physiology behind

(34:11):
the dish. Sometimes, I'll evendissect an animal's heart while
people are eating the heartcourse. And so I think I'm
trying to, again, pull back thecurtain on how the food that we
eat relates to our own bodies.
And, you know, a lot of peopleperhaps like to hide from the
fact that some of these foodsthat we eat, especially from

(34:33):
animals come from what was oncea living, breathing animal who
could see hear smell. And so forme, I think embracing that fact
and having learned everythingabout the human body, and
therefore by extension of a lotabout the animal bodies that we
eat, to me it you don't need tohide from the fact I think it's
really fascinating andinteresting, and it's also

(34:56):
totally delicious.

Yeah, I think for a lot of listeners, As of this
show, there's probably a lot ofhunters and fishermen that are
listening. But for the otherfolks who haven't, don't have
those type of pursuits, yeah,we're pretty disconnected from
our food sources nowadays,especially when it comes to
animal products. And I had donean interview a while back with
Al press who wrote a book calleddirty work and talking about

(35:19):
slaughterhouse workers and, andhow, you know, their job makes
it so it's it's fairly sanitary,and you don't associate it
directly with a cow or sheep orpig, something like that. So
getting back though, gettingback to the lungs, yeah, insides
turned out in human lungs, youknow, this is where a very
important interphase takesplace, the air that we breathe,

(35:40):
the oxygen in the air that webreathe is stripped out, it's
passed into the circulatorysystem way down in the bottom
passages, the lungs, I believethat the alveoli is where that
gas exchange takes place. Andand then that oxygen is
circulated around the body, andit's very important for cellular
metabolism and, and tying intothe circulatory system. So it
would seem it would seem to me,Jonathan, that taking care of

(36:03):
our lungs should be a highpriority for for everyone yet.
We know that a lot of peoplesmoke, we talked about some
changes in mindset about youknow, diet, and its effects on
the human body. But has anyonejust proven that smoking is bad
for you as a, as a livingbreathing human being?

No, that's, that's still not good for your
body. I think that's, I'm notsure that will ever change. But,
you know, the doctor's positionon that has has changed. We were
not at the forefront of, ofrecognizing the effect that
smoking has on the body. Infact, my uncle, who's a retired
pediatric nephrologist, which isa kidney specialist, he was

(36:43):
telling me about how early inhis career he would be smoking
cigarettes in the room withpatients who were children with
kidney disease. And that wastotally normal, and not seen as
anything unusual. And I grew upin a house full of cigarette
smoke too. And that was normalas well. And now it's, that's
changed a lot probably for thebetter. As we recognize that

(37:03):
smoking does have an effect onon the body. And it's not just
the lungs, that's the mostobvious effect, obviously,
because you're inhaling smokethat you know from vegetable
matter, basically, which haslots of toxins and other things
in it. But it's also justinhaling smoke in general, which
isn't good for your lungs. Butthe smoke, smoking has less less

(37:24):
obvious effects on the body aswell, especially on the arteries
so that we talked abouthardening of the arteries to the
heart narrowing of the arteriesto the heart or the brain, which
can predispose you to heartattacks and strokes. And there's
something about tobacco smoke, Idon't know that it's fully
understood. But there'ssomething about tobacco smoke
when you inhale it, it has aneffect on your arteries too. And

(37:45):
it causes that narrowing thathardening and you're so you're
at risk of those very commoncauses of death.

I seem to remember in your book, you've talked
about the cadaver that you wereworking on when you finally
extracted the heart from hisfrom his chest that the
vasculature of the heart wascrunchy and kind of crackled, as
you put pressed on it and, andso from that you deduce that he
was possibly a smoker,

his lung certainly looked like a smoker's
lungs, they were the color ofcigarette ash, and not the
normal pinkish beige of healthylungs. So his lungs definitely
told us he was a smoker, butthen the arteries running across
the surface of his heart, gavesort of more evidence or showed
more effects from that smokinghabit he had had. And that
crunchiness it almost felt likea caramel that you could crunch

(38:36):
between your fingers. And thatwas the hardening of the
arteries with it often getscalcified when you have plaques
like that in your arteries. Andso that makes the arteries hard
and crunchy, which you couldimagine is not ideal for blood
flowing through them freely andfeeding the tissues.

So moving on from the from the lungs, I found the
pineal gland, to be afascinating chapter and I'll be
honest with you, Jonathan, I didnot know what the pineal gland
was. I've always heard about thepituitary gland deep in our
brain, but the pineal gland Iguess, has a huge part of
regulat. regulating our sleep isin the production of melatonin
that the pineal gland isimportant.

That's correct. So the pituitary is
near the pineal gland. I'veheard people say it pineal and
pineal. It's actually namedafter pine trees because the
gland itself actually looks likea little pine nut and it's about
the size of a pine nut. And thepituitary is its nearby cousin,
but much more well known sort ofits celebrity cousin and the

(39:39):
pineal is less understood. Evenin scientific history, the
pineal gland which is one of theendocrine organs, it does
secrete the hormone melatonin.
It was really the last to bedeciphered. It was the last one
that people knew what it doeshow it functions partly because
it's so deep inside the brain.
It's almost in the center of thebrain. the very center when you

(40:00):
look at a patient's MRI or CATscan of their head, the
pituitary is kind of moretowards the front actually, but
the pineal is almost reallyright in the core of the brain.
And I think it's, it's in manyways, its function is still not
fully understood. But one of theone of its main functions is
secreting melatonin, which kindof prepares the body for sleep.

(40:23):
You know, when we wake up in themorning, our circadian rhythm,
our daily rhythm of our bodies,we our bodies secrete cortisol
that comes from a differentendocrine organ, which is our
adrenal glands, cortisol sort ofwakes us up in the morning
raises blood pressure, it givesus a little energy to get out of
bed and start the day. And thenthe pineal gland sort of the
counterpoint to that, as we nearthe end of the day, as the light

(40:47):
from the Sun fades, themelatonin sort of prepares the
body for the process of sleep.
And sometimes, if you evernoticed a few hours before
sleep, sometimes people startfeeling a little cold. That's
actually that chill is actuallya result of melatonin, which
sort of dilates blood vesselsand can can end does actually
lower the body's temperature. Sowhen we wake up in the morning,

(41:08):
our temperature sort of risesalmost just like the air and
earth around us as the sunstarts to shine on it. And then
as the sun sets, the light goesdown, our body temperature also
decreases partly due tomelatonin as we're preparing for
sleep and of course, stays lowerovernight before rising again in
the morning. So the pineal glandis essential for that daily
rhythm, which links our body tothe daily rhythm of the sun, and

(41:31):
the Earth's rotation. And likeevery, almost every other
organism on Earth, even plants,and even microscopic organisms,
like bacteria, do have a dailyrhythm that is set by the sun.
So we are very kinda dialed into the sun as Earthlings.

So our rhythms dialed in. But correct me if I'm
wrong, I think the science isstill out as to why we actually
need to sleep and theappropriate amount of sleep. Is
that correct?

Yeah, I think there's there's some theories,
but it's definitely I mean, it'sobvious to anyone who lives and
breathes that sleep isessential. And when you don't
get enough of it, there's somuch research on how it affects
almost every part of your body,even even some of the risk
factors we talked about forcardiovascular health. It's bad
for your blood pressure. It'sbad for your diabetes, it's bad

(42:23):
for healing from variousillnesses. And a lot of studies
show that not getting adequatesleep, reduces your ability to
recover your body's ability torecover from any of those
conditions, whether it'sinfections or anything else. And
obviously, your brain doesn'twork quite right. When you're
not sleeping as well. Even yourappetite is changed. And people

(42:46):
tend to eat more when they'rewhen they don't sleep as much,
it's sort of equivalent tohaving the munchies. Actually
being sleep deprived has beenshown to increase your appetite
almost like munchies if youconsume marijuana, so and that
actually, some people theorizethat might be a big part of the
obesity epidemic is is a sort ofhidden sleep epidemic, sleep

(43:07):
loss epidemic. So that might bea big part of it, too.
Everyone's eating more becauseno one's sleeping. Well, of
course, part of that is our ourlives, or you know, electric
light, which doesn't sort oftricks our eyes, and thereby our
pineal glands into thinkingperhaps it's still daytime and
not ready for sleep. And then,of course, our smartphones and
computer screens and TV screens,which shine light on our eyes,

(43:29):
and therefore, also trick thepineal gland and the thinking
perhaps it's still daytime, allthat's contributing to poor
sleep, which does really affectevery cell in our bodies in very
surprising ways. So though, youknow, it seems like sleep, maybe
cleans out some of the toxinsthat build up in our brains and
bodies through the course ofdaily life. So it could sort of

(43:50):
just be a sweeping clean of, ofthe byproducts of functioning
brain and other organs. I'm sureit's much more complicated than
that. But that's sort of some ofthe theories these days,

I liked. How in that chapter on the pineal
gland, that you turned around onyourself. And you were the case
study early on in your medicalcareer, when you were pulling as
an intern or practicing newphysician, you were, you were
working a lot of hours andreally burning the candle at
both ends, and in the middle,and you were finding yourself
sleep deprived. And you began torealize that, you know, your

(44:24):
cognitive abilities were, werepossibly being hampered by that.
And you looked around and yousaw other people you were
working with, possibly, and thesame thing. And then it all came
to point with with a terminallyill patient, and sort of the
procedures in the hospitalsystem that would wake these
people up in the middle of thenight and draw blood or
administer medications. And youkind of had an epiphany at that

(44:46):
point that maybe sleep was alittle more important than some
of these Brando tests that werebeing administered to him out of
that play out. Yeah, so

as you mentioned, when I started
medical school, specifically thepart where I was working in the
hospital, which began In thethird year of medical school, I
sort of considered my basictraining to be a morning person.
I was not a morning personbefore that, but started having
to wake up very early to go tosome of my rotations. So we're
going to hospital especiallywhen I was working as a in the

(45:15):
surgery department as waking upat 435, which was something my
body was not used to at all andI struggled with, but eventually
actually got used to and, andloved and sort of still do even
when I'm days when I'm notworking. But that that trouble
with sleep that I was having wassort of in parallel to the
trouble that my patients werehaving in the hospital. I

(45:38):
consider the hospital almostsleep annihilating institution,
it's almost impossible to getgood sleep in a hospital. And we
I mean, there's great research,as I mentioned, showing that not
sleeping well hampers recovery,the body's recovery from
illness, yet are asleepannihilating hospitals don't do
a good job at taking that intoaccount. But it is difficult,

(46:02):
you know, in hospitals, there'sthe light that can be on the
whole lights. And sometimes youknow, people share rooms and
perhaps their neighbor hassomething going on that needs
attention and the lights are onand there's noise and

Unknown (46:13):
people in the room monitors and buzzers monitor
things and everything else.
Right. Beeping

monitors is another huge factor. There's so
much noise pollution in thehospital. You know, workers me
and my fellow health careworkers often joke though, it's
not a joke that there's so manybuzzers and beeping going on all
the time. Now you have to foryour own sanity ignore a lot of
them, which sort of defeats thepurpose of the buzzers. I mean,
you know, we do have the moreurgent ones are louder and more

(46:40):
shrill, so they can't beignored. But still, the the
hospital has this cacophony ofbeeping and buzzing. And so it's
very hard to sleep for peopleeven though sleep should be one
of the most important medicinesyou know, if we thought it sleep
like that antibiotic you needfor your infection, perhaps we'd
be better at delivering it tothe patient and in the right
amount and not letting them bedeficient. But so I started I

(47:04):
did have a patient as you said,who was a young man in his 30s
he was about my age actually.
And he was suffering frommetastatic stomach cancer
gastric cancer and he wasclearly did not have long to
live he was totally wasting awayand hair falling out and had
barely strength even stand. AndI was in a admitted him to the

(47:24):
hospital with an oncologist acancer specialist sort of
overseeing the work, I was theresident doing the grunt work.
And every day I was drawing hisblood and checking his potassium
levels and magnesium and sodiumand all the other electrolytes
and they were never, they werealways low. And I was always
trying to repeat them. And theywere still low. And it was sort
of this, you know, fightingagainst the wind in a way where

(47:45):
the inevitability of his demisewas, was so obvious. And so and
I was also waking him up in themorning to assess him. And some
of those mornings, I reallydreaded that fact, because I
felt like I was waking him upback to the reality of his
terminal diagnosis. I had methis wife and his two young
children and the whole situationwas just so tragic. The poor man

(48:08):
or you know, just let him sleep.
I was thinking to myself withsome of these last days he has
on Earth. And yet I was thisbusy resident focused on my own
sleep and my own to do listwhich was always very long. And
rushing through my my day andwaking him and other patients up
along the way and depriving themof needed sleep. Not that I

(48:31):
thought sleep was going to curehis cancer, but at least he
couldn't, you know, get sleepand be rested for some of his
final days on earth in his finaldays with his his poor family.
And so that really gave me morevery important perspective on
sleep. And I sort of became anevangelist for letting my
patients sleep and giving themyour earplugs and putting Do Not

(48:53):
Disturb signs on their doors.
And I became really almostmilitant about protecting them
from all the noises and themidnight blood draws, as you
mentioned, you know, waking themup at the mill and then at an
inopportune time or medicaladministration times, which are
often convenient for doctors andnurses, but not convenient for
the patient. So that was areally, really important again,

(49:14):
drawing back the curtain on thepatient's perspective, in
hospital in the hospital, whichis not easy to get when you're a
busy resident running aroundstruggling to learn everything
you're supposed to and theresponsibility of all the sick
patients on your service.
Sometimes there's sleep as anafterthought, but I realized
that it really has to beimportant.

And a big part of that is just empathy for your
patients and something I thinkagain, we all get so busy and
sometimes people just turn intonumbers on a chart or a name on
a chart and in a way you goCorrect. Again. My guest today
is Dr. Jonathan Reisman, authorof the unseen body. Jonathan.
fascinating book. So manychapters. I hate to have to go

(50:00):
lumped together some of ourbodily fluids, but you had a
whole chapter on urine, which Iunderstand is your perfect
personal favorite, bodily fluid,feces, mucus, all things that
you know, a lot of people feel alittle bit uncomfortable talking
about. But you did such afantastic job in your book of
just breaking down theimportance of each one of these

(50:21):
bodily fluids, the mucuselevator that helps move debris
and, and bacteria out of ourlungs to fecal matter, and the
image I cannot and I'm gonnablame you for this a complicated
tube, how we started off as aflat desk, rolled into a tube
have an entry point and an exitpoint, I am going to live with
the rest of my life, thanks toyou. But it really does seem

(50:44):
like these bodily fluids oncethe complicated tube gets
established that what a hugerole they play in our health and
well being. And so with thatsaid, urine, feces, mucus, what
would you like to talk aboutright now?

Yes, so I think, you know, again, the
unseen body, although a lot ofthose body bodily fluids are
seen by each of us each day, youknow, we live with them, we use
the bathroom, it's part of ourdaily life as much as eating,
but it's sort of the more hiddenaspect of the body, the more
personal and private, notsomething we talk about in
polite company or dinnerparties. But again, when I

(51:23):
started learning about the humanbody started working in the
hospital, you end up dealingwith these bodily fluids that
you think are gross kind of allday, every day. They're the
medium of your craft when you'rea doctor and you learn to
interpret them and I'mconstantly asking patients about
their excretions and their mucusand their urine and is there
blood in it and what color andconsistency and amount and smell

(51:47):
and everything else? And so youalmost become a connoisseur of
these bodily fluids, you know,almost like a wine specialist
who can taste and smell allthese subtle things in the wine
you know, you become a you know,a gastroenterologist is a stool
connoisseur and a urologist is aurine connoisseur, etc. A
pulmonologist as a lung mucus orsputum connoisseur. I'm a

(52:10):
generalist, because I like allthe bodily fluids, I find them
all interesting and all the bodyparts as well that make those
bodily fluids. But urine is oneof the more interesting ones I
found, I found thatnephrologist, actually who are
kidney specialists who oftenlook at the urine under the
microscope and analyze it tofigure out what's going on with
the patient. They're really someof the smartest Doctors of any

(52:34):
and in fact, most doctors wouldagree if you ask them what
specialist is the smartest kindof doctor many will say
nephrologist. And I think that'sa reflection of how complicated
the kidneys are, which makeurine and also though how, how
complicated sometimes it can beto analyze urine and interpret
it. Most people have probablypeed in a cup for their doctor

(52:56):
to analyze, and then perhapsdidn't think much more about
what happens after that. But ofcourse, as a medical student, I
learned to how to kind of revealall the secrets from urine and
figuring out what urine can tellme about the human body that it
flowed out from. So urine, ithas a special place in the
practice of medicine, because itcan tell you so much. It's also

(53:18):
quite convenient. You don't haveto use a needle to get it you
just have someone pee in a cup,which is which is pretty nice.
And as I talked about in thebook, urine has other
interesting aspects that reallycaptured my fascination because
the kidneys are in charge ofmanaging all the salts in our
blood keeping sodium at theright level and chloride and
everything else potassium,magnesium, calcium, the kidneys

(53:40):
keep all those in the preciselycorrect range, not letting them
get too high or too low, whichcan cause a lot of problems for
us. And when I learned about theblood, which the kidneys titrate
in that way, I've found that thesalt levels in the blood are
very similar to seawater. And Ibelieve that's because we our
ancestors sort of first formedin the in the ocean before we

(54:03):
kind of crawled out onto land.
And so our blood is as salty asseawater. Though we seem to live
in a world of fresh waterbecause we only drink fresh
water without salt in it. Webathe in fresh water, we water
our crops with fresh water. Ofcourse you try to water your
crops with salt water, you'regonna be in big trouble. And so
even though we live in thisfreshwater world, it's actually

(54:23):
our bodies are actuallysaltwater. And that's why when I
give IV fluids to a patient, Igive them always saltwater. It's
always saline as we say which issaline solution.

Yeah. Which is awesome because freshwater
introduced into the circulatorysystem would just cause havoc on
the circulatory system andprobably death, wouldn't it?

Yes, if I were to infuse freshwater into a
patient's IV, their red bloodcells would explode, their brain
would swell they would haveseizures go into a coma and
probably died. So it sort ofonly saltwater can really be in
our hearts literally That's whatour body is made of saltwater
because we're from the ocean.
And kidneys are sort ofresponsible for that for keeping

(55:05):
the our blood salty for sort ofcarrying the ocean with us, even
though we no longer live in it.
And so as I say in the book,it's precisely because the
kidneys make urine and in keepthereby keep all the salts in
the right balance that we cancarry around. This is the ocean
inside of us.

Yeah, that's that was just fascinating to me,
Jonathan, this has been afantastic conversation. I really
appreciate you taking the timeto be on the show. Where can
people go to find out more aboutyour work?

You can go to my website, Jonathan
reisman.com. And that has allthe information about my book,
my other writings as well as myanatomy dinners.

All right. Well, thank you so much for taking
your time to be on my showtoday. This has been a real
pleasure.

Thanks so much, Joe.

I guess today has been Dr. Jonathan Reisman,
author of the Unseen Body. Findout more about Jonathan and his
work, be sure to check out theshow notes for this episode, or
visit the grid nation website atgrid nation podcast.com. And if
you really enjoyed today'sepisode, please consider sharing
it with a friend, family memberor anyone else you think may get
something out of it. As always,I appreciate your continued

(56:16):
support. And until next time,this is Joe Cadwell. Thank you
for wanting to know more todaythan you did yesterday. Do you
only do those dinners inPhiladelphia?

Well, I just started sort of traveling with
the show. So I weren't did mostin Philadelphia but I just did
some in Oxford, Mississippi. Ihave one in Washington DC later
this month.

We've got a great scene here in Portland. So if
you ever voted out this way, Iwould love to Dinner for one I
know my wife will not join mefor that.

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}The Unseen Body - Dr. Jonathan Reisman