Friday, Nov 19, 2021 • 51min
Listen Again: Jen Gunter: Body Talk
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Original broadcast date: May 28, 2021. What does it mean to be healthy and to care for our bodies? This hour, physician and writer Jen Gunter empowers us to cut through false medical claims and make informed decisions about our health.
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Jen Gunter
Manoush Zomorodi
Giulia Enders
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Verified
Break
Manoush Zomorodi
00:16
Hey, it's Manoush. We all know misinformation is a problem, but it's particularly worrying when it comes to making decisions about our health. My doctor always is telling me don't
Google
too much, but we should listen to people like Jen Gunter
. She's a physician, writer, and podcaster, and she has made it her mission to call out bad medical advice and false health claims. She's looking at you. Gwyneth Paltrow
.Share
00:44
I got to spend an hour talking to
Jen
about her list of top medical myths to debunk and the TED
talks that have shaped her gentle approach to treating people who struggle to believe the science. This episode first aired in May. Jen
is an absolute hoot. So enjoy it again or for the first time. See you soon.Share
01:07
This is the
TED
Radio Hour
. Each week, groundbreaking TED
talks.Share
01:14
Our job now is to dream big.
Share
Manoush Zomorodi
01:16
Delivered at
TED
conferences-Share
01:17
To bring about the future we want to see.
Share
Manoush Zomorodi
01:19
Around the world.
Share
01:20
To understand who we are.
Share
Manoush Zomorodi
01:22
From those talks, we bring you speakers and ideas that will surprise you.
Share
01:27
You just don't know what you're gonna find.
Share
Manoush Zomorodi
01:29
Challenge you.
Share
01:30
Have to ask ourselves why is it noteworthy?
Share
Manoush Zomorodi
01:33
And even change you.
Share
01:34
I literally feel like I'm a different person.
Share
01:36
Yes.
Share
01:37
Do you feel that way?
Share
Manoush Zomorodi
01:38
Ideas worth spreading, from
TED
and NPR
. I'm Manoush Zomorodi
. Today on the show: how we learn about our bodies, and tell fact from fiction.Share
Jen Gunter
01:58
Well, I think the issue is that medical internet is both amazing, and it's awful. And it shouldn't be that kind of crap shoot.
Share
Manoush Zomorodi
02:07
This is Dr.
Jen Gunter
.Share
Jen Gunter
02:09
I'm an OB/GYN, and a pain medicine physician, and an author, and podcaster.
Share
Manoush Zomorodi
02:15
Jen
is also internet famous for calling out celebrities who share misinformation about health and wellness.Share
Jen Gunter
02:24
I would say that my mission is to give people factual, accessible information about their health because I want people to be empowered about your health, but you can only be empowered with accurate information.
Share
Manoush Zomorodi
02:39
And for her, part of empowering people is to write guides to traditionally taboo women's health topics, including one called the Vagina Bible, and her latest: The Menopause Manifesto. She also recently started a podcast called Body Stuff.
Share
Jen Gunter
02:57
I'm Dr.
Jen Gunter
. I love science, and I hateShare
Manoush Zomorodi
03:03
In 2019,
Jen
gave a TED
talk called "Why can't we talk about periods?" And today she's brought us a selection of TED
talks, ones that have influenced her as she's become an outspoken critic on how society uses language and psychological tactics to shame and trick people about their basic bodily functions. Her story goes back 17 years ago, when Jen
herself was having a health crisis.Share
Jen Gunter
03:34
I initially got interested in how people access information online because I was in that position. And so that really started it when I had my pregnancy, and I had a triplet pregnancy. But it was incredibly complicated. And one of my sons died at birth and my other two boys were in the intensive care unit for a long time.
Share
Manoush Zomorodi
03:55
I'm so sorry.
Share
Jen Gunter
03:56
And they had all these other medical problems as well as prematurity. And when I didn't get answers from my own doctors, I went online, and I was horrified. This was sort of the earlier stages of the medical internet, if you will.
Share
04:11
And I just thought, "Wow, if it's so hard for me to get practical information, like, useful information that can help me today,"
Share
Manoush Zomorodi
04:20
As a physician.
Share
Jen Gunter
04:21
Right. As a physician caring for my babies, right?
Share
04:24
Like I wanted help, I wanted- There's gaps in medicine. You know, your doctors can tell you stuff, but they can't tell you like, what are the tips and tricks for taking your babies out in a stroller when you have two children on oxygen, right? Like those are things that other experienced parents can tell you. But then how do you know you're getting that right information?
Share
04:45
So I realized there was so many gaps that were important, but not covered by medicine. And how easy it was to fall down snake oil-filled rabbit holes, for lack of a better word. And I just thought, "If I was struggling like this, me, this person who's always been obsessed with evidence-based medicine, how was everyone else managing?"
Share
05:07
And so I decided that I was going to fix the medical internet.
Share
Manoush Zomorodi
05:15
Just a small goal, really
Jen
?Share
Jen Gunter
05:18
That's- I was very naive about it.
Share
Manoush Zomorodi
05:20
OK. So naive, but absolutely driven. And you're still doing that. And we're going to talk about some of the talks that have sort of propelled you as you try to fix the medical internet.
Share
05:32
But first, let's talk about your own talk. It's called "Why can't we talk about periods?" And
Jen
, from what I understand, you had absolutely terrible periods as a teenager. But you felt like you didn't have anyone to really talk to about your symptoms.Share
Jen Gunter
05:49
Right. I mean, as far as my mother was concerned, you didn't talk about anything from down there. And she suffered with periods, so suck it up, sister. And yeah, so there was just, there's no information. And so I spent two days each month curled up with a heating pad. I couldn't go to school. And you know, why was this happening? Why was I suffering so much? And it just felt to me like this big biological flaw.
Share
Manoush Zomorodi
06:15
And did you ask your doctor? Like, what is going on?
Share
Jen Gunter
06:19
I think I didn't actually get taken to one until maybe I was like 16. So I've been suffering for, you know, several years. And my mother took me to her doctor who basically said, "Yeah a period. Yeah, that's it."
Share
06:31
So basically, you know, it was just no practical information. And it's sad to me that, you know, that happened in the I guess, early 1980s, and that I still hear that same story from young women today.
Share
Manoush Zomorodi
06:44
And in your talk, you go back to kind of the historical roots of why you didn't have any access to information, and you felt ashamed of this bodily function.
Share
Jen Gunter
06:55
Why can't we talk about periods? And it's not about the blood. as Freud would have you say, because if it were, there'd be an ear, nose, and throat surgeon up here right now talking about the taboos of nosebleeds, right? And it's not even about periods, because otherwise, when we got rid of our toxic, shameful periods when we became menopausal, we'd be elevated to a higher social status.
Share
07:23
It's just patriarchal societies invested in oppressing women. And at different points in our lives, different things are used. And menstruation is used during what we, in medicine call the reproductive years. It's been around since pretty much the beginning of time.
Share
07:40
Many cultures thought that women could spoil crops or milk or wilt flowers. And then when religion came along, purity myths only made that worse. And medicine wasn't any help. In the 1920s and 30s, there was the idea that women elaborated something called a menotoxin. We could wilt flowers just by walking by.
Share
Manoush Zomorodi
08:04
OK, so how have things changed? Let's fast forward to when you were becoming a gynecologist? Are doctors taught- well, I guess there's two things. Were they taught, when you were in medical school, to speak more frankly about this stuff? And what about today, when you talk to medical students, you know, what's the status quo now?
Share
Jen Gunter
08:24
Well, certainly in the realm of gynecology, these words have always been used. But the public ability, this ability to talk outside of an office is, I think relatively new, right? You know, 50s, 60s, 70s, 80s, your uterus is trouble. We don't hear about it, you know? Really I think it's sort of taken social media and being online to sort of raise the noise level enough that the conversation is catching.
Share
Manoush Zomorodi
08:52
That's exactly what you do in your talk. You tell the audience what you tell your patients about how their periods work.
Share
Jen Gunter
08:60
Well, what if everybody knew about periods like a gynecologist? Wouldn't that be great? Then you would all know what I know — you know that menstruation is a pretty unique phenomenon among mammals. Most mammals have estrus. Humans, some primates, some bats. The elephant shrew in the spiny mouse menstruate.
Share
09:20
And with menstruation, what happens is the brain triggers the ovary to start producing an egg. Estrogen is released, and it starts to build up the lining of the uterus, cell upon cell like bricks. And what happens if you build a brick wall too high without mortar? Well, it's unstable. So what happens when you are ovulate, you release a hormone called progesterone which is progestational — it gets the uterus ready.
Share
09:44
It acts like a mortar and it holds those bricks together. It also causes some changes to make the lining more hospitable for implantation. If there's no pregnancy, lining comes out, there's bleeding for the blood vessels, and that's the period. I always find this point really interesting because with estrus, the final signaling to get the lining of the uterus ready actually comes from the embryo.
Share
10:09
But with menstruation, that choice comes from the ovary. It's as if choice is coded into our reproductive trap.
Share
Manoush Zomorodi
10:20
You got big cheers there. You get a little political there at the end,
Jen
, do you think politics and medicine, I mean clearly they have always been intertwined when it comes to women in reproduction. Have they always been intertwined for you?Share
Jen Gunter
10:35
I think so. You know, when I started in medical school, to get an abortion in
Manitoba
required approval of a three-person panel, and you didn't even get the privilege of pleading your own case in person. You told your family doctor, who then submitted a letter on your behalf. How wrong is that?Share
10:53
And throughout the history of humanity, how medicine has been accessed for women is different than how it has been accessed by the people in power — men. And so yeah, I think if you want to care for people and you want to help them medically, politics is simply part of it.
Share
Manoush Zomorodi
11:12
There are a lot of folks of course who, either because they can't or they won't, go see a doctor. They look for information online now. You know you go back in the day, you go to the library, nobody's there trying to sell you products at the same time, right? Whether that's to promote cleanliness or vagina health or like, I actually was at the doctor's office today and they were touting a three pack after you give birth.
Share
11:41
You know, "Come back, we'll slim down your tummy and tighten up your pores", and like, three procedures, plastic surgery procedures, for the low, low price of like I think it was $7500. I was like what? That there's this overlap between medicine and the commoditization of what women need to do to be healthy-slash-well-slash-look-good.
Share
Jen Gunter
12:06
Yeah. Every now and then I get messages from people who have been at the gynecologist and while they're sitting there waiting, wearing a robe naked in the office, they look on the wall and there's an advertisement for some kind of vaginal enhancement procedure. And -
Share
Manoush Zomorodi
12:21
I saw that.
Share
Jen Gunter
12:22
Yeah. And how, at your most vulnerable you're naked in a doctor's office and you see that, and you're supposed to be there to get factual, accurate information about your vagina, your vulva, your body, and to have this implication on the wall that there's something troublesome with your body. I have a problem with that. I think that cosmetic procedures need to not be folded in with annual exams and seeking care for medical problems.
Share
Manoush Zomorodi
12:54
So let's go back to your talk. Part of being able to look away from a lot of these advertisements or be like, "That's ridiculous", is knowing how your body works, right?
Share
Jen Gunter
13:07
Exactly. Information is power. Knowledge is power.
Share
13:14
It shouldn't be an act of feminism to know how your body works. It shouldn't be an active feminism to ask for help when you're suffering. The only curse here is the ability to convince half the population that the very biological machinery that perpetuates the species, that gives everything that we have, is somehow dirty or toxic. And I'm not gonna stand for it. And the way we break that curse is knowledge.
Share
Manoush Zomorodi
14:00
In a minute, we'll be back with physician and author
Jen Gunter,
and more facts about how our bodies work. I'm Manoush Zomorodi
and you're listening to the TED
Radio Hour
from NPR
. Stay with us.Share
Break
Manoush Zomorodi
15:30
It's the
TED
Radio Hour
from NPR
, I'm Manoush Zomorodi
and today our guest is Dr. Jen Gunter
, she's a practicing O B G Y N and physician but has also made a name for herself debunking celebrity wellness trends and helping us make informed decisions about our health.Share
Jen Gunter
15:49
Yeah, I mean, I think debunking is an extension of my quest to know. All sort of misinformation, you know, has this root in not being informed, and I just think that so much of medicine is not that difficult.
Share
16:03
It might be complex, and obviously you don't need to know all of the nuances of everything to have a good working knowledge, but the good working knowledge, a lot of it's not really that hard. It's just our ivory tower makes it seem like it is. And so I want that to be as accessible to everyone as it is to me.
Share
Manoush Zomorodi
16:23
That I think is the common theme of all the talks that you have chosen for us this hour. And so that brings me to the first talk that you've chosen, which is from
Lera Boroditsky
. Lera
is a cognitive scientist and she gave her talk in 2017. It's called "How language changes the way we think". OK, why was this? You were like, "Yes, I will pick talks for you, and we got to start with this one". Why?Share
Jen Gunter
16:48
Because this changed a lot of things for me. I remember reading about this talk like, when it came out, and I remember seeking it out and listening to it and then being like, "Whoa, whoa!"
Share
17:01
The idea that the words we use can shape our thoughts. I mean, it makes so much sense when you hear someone say it, but until someone actually studies it, how do you know? And then when you hear like, "Wow, whether I think something is weak or strong could be affected by the words I choose for that", It's pretty powerful.
Share
Lera Boroditsky
17:21
There are about 7000 languages spoken around the world. And all the languages differ from one another in all kinds of ways. Some languages have different sounds, they have different vocabularies, and they also have different structures. That begs the question, does the language we speak shape the way we think?
Share
17:39
Now this is an ancient question. People have been speculating about this question for forever.
Charlemagne,
Holy Roman Emperor said, "To have a second language is to have a second soul." Strong statement that language crafts reality.Share
17:52
But on the other hand,
Shakespeare
has Juliet say, "What's in a name? A rose by any other name would smell as sweet."Share
18:00
Well that suggests that maybe language doesn't craft reality. These arguments have gone back and forth for thousands of years, but until recently, there hasn't been any data to help us decide either way.
Share
Manoush Zomorodi
18:14
OK, so we should say
Lera
was one of the first linguists to question what most experts in the field believed to be true: that all languages have a common underlying structure. So even though we make different sounds with our mouths or use different words when we speak different languages, we're all pretty much thinking the same.Share
18:34
But she says that over the past 20 years, that has been debunked. And
Jen,
you told me that Lera
had a big influence on you and how you think about things medically. Can you tell me why?Share
Jen Gunter
18:48
Yeah. So I started thinking about how words affect how we might think about things if they can reversely craft our thoughts, if you will. I started to think about medical terms. Until relatively recently, you know, doctors learned
Latin
and Greek,
and they learned what all the roots meant. And I think some of that has been forgotten now, and I guess that's good.Share
19:10
But the word pudendum, which is used to describe the sort of external genitalia — mostly for women, so the vulva, and around the anal area — well, the
Latin
root for that, pudere, is to shame. And the clitoris, the root for that is to hide.Share
19:27
And the hymen is named after the
Greek
God of Marriage. Well, right. So we're actually when we're seeing those words, were imbuing those body parts with false information.Share
Manoush Zomorodi
19:44
That's such an interesting way to think about it. So I grew up speaking
German
to my mother, and German
has gendered articles, and in Lera's
talk her section about how gendered language can affect how we view things, like literal things, was something I wondered about for years, but she put a finer point on it.Share
Lera Boroditsky
20:06
Lots of languages have grammatical gender. So every noun gets assigned a gender, often masculine or feminine, and these genders differ across languages. So for example, the sun is feminine in
German
, but masculine in Spanish
. And the moon, the reverse.Share
20:22
Could this actually have any consequence for how people think? Do
German
speakers think of the sun as somehow more female-like? And the moon, somehow more male-like? Actually it turns out, that's the case. So if you ask German
and Spanish
speakers to say describe a bridge like the one here. Bridge happens to be grammatically feminine in German,
grammatically masculine in Spanish
. German
speakers are more likely to say bridges are beautiful, elegant, stereotypically-feminine words, whereas Spanish
speakers will be more likely to say they're strong or long. These masculine words.Share
Manoush Zomorodi
20:58
That's fascinating. So as someone who talks a lot about gender, how does what
Lera
says about gendered language strike you, Jen
?Share
Jen Gunter
21:10
Well, first of all, I have to point out that I'm fascinated that long is a masculine word. I think we all know why.
Share
Manoush Zomorodi
21:18
Little too on the nose, right?
Share
Jen Gunter
21:19
Yeah, exactly. I think it's fascinating because we assign physical qualities to gender, and we judge people by these physical qualities. And I don't think that's right. Any person can be beautiful, any person can be strong.
Share
21:38
But these are sort of these stereo- again, these stereotypical, patriarchal concepts that, you know, never really had any place in medicine or in language. But, you know, now that we know that gender is fluid, and people shouldn't be judged by their gender. Like, these are things that we should strive to move away from. These seem like a remnant of an older time that we should evolve from.
Share
Manoush Zomorodi
22:03
I can just imagine some people listening would think like, "Oh, come on. Like, so these gendered pronouns, these are languages that have evolved over centuries. What do you want us to do?"
Share
Jen Gunter
22:14
I guess what I would say is, we evolve, and we change, and as we learn things, we take that in. And I think what we don't realize is so much of what we think is true or what we think is convention, is actually something that's been forced upon us by those in power.
Share
22:32
And so why not evolve if it makes everything better for people? If we can change language to be more inclusive, to bring more people to the table, isn't that a good thing? I mean, I have a hard time finding downsides with that.
Share
Manoush Zomorodi
22:47
So how we are influenced to think certain things is also at the heart of the next talk that you chose to bring us. It's from a man named
James Randi
whom I had not heard of, but who was a very famous illusionist-turned-professional-debunker. I read with fascination, his obit in the Times
because he just died last year at the age of 92.Share
23:16
The talk he gave in 2007 is called "Homeopathy, quackery, and fraud". And you- again, you were like, "Oh we need to talk about this, about
James Randi
." Have you always been a James Randi
fan?Share
Jen Gunter
23:31
No, relatively recently. Ao yeah, I love how
James Randi
calls himself a conjurer.Share
James Randi
23:37
I have a very peculiar background, attitude, and approach to the real world because I am a conjurer. Now, I prefer that term over magician, because if I were a magician, that would mean that I use spells and incantations and weird gestures in order to accomplish real magic. No, I don't do that. I'm a conjurer who is someone who pretends to be a real magician.
Share
Jen Gunter
24:03
I didn't know really anything about the amazing
Randi
, or magic, or anything until his organization asked me to speak a few years ago. And I think it's fascinating because, you know, people who practice snake oil, people who push quackery, are essentially lying about being a conjurer. And magicians or conjurers are honest about it, right?Share
24:25
They're honest about it, and fun fact: I'm, you know, I'm now partnered with the love of my life who's actually a magician?
Share
Manoush Zomorodi
24:31
No, come on.
Share
Jen Gunter
24:33
Yes, perfect. Yeah.
Share
James Randi
24:36
Now how do we go about that sort of thing? We depend on the fact that audiences, such as yourselves, will make assumptions. For example, when I walked up here and I took the microphone from the stand, and switched it on, you assumed this was a microphone, which it is not. As a matter of fact, this is something that about half of you — more than half of you will not be familiar with — a beard trimmer, you see. And makes a very bad microphone. I've tried it many times.
Share
Manoush Zomorodi
25:07
OK, so
James
was holding a beard trimmer instead of a microphone. Jen
, why do you think his talk has stuck with you?Share
Jen Gunter
25:16
Well, I think that's how a lot of misinformation spreads, is based on assumptions. And if you look at the marketing for a lot of, you know, snake oil or medical misinformation, you know, they use a lot of terms and rhetoric. Terms like God words. Terms where we fill in the blank about what we assume to be true.
Share
25:38
So if I say something is natural or I say something is ancient, you automatically fill in the blank that that thing is probably a good thing for you, right? So when those marketing terms are used, they're being used because they know you will make an assumption about it.
Share
Manoush Zomorodi
25:54
His life was very interesting in that he was a follow up to a lot of
Houdini's
sort of, getting out of boxes that were sunk in hundreds of feet of water, all kinds of things.Share
26:08
But then sort of midway through his life, he stopped escaping and started really on this mission to try and help people who had sunk hundreds, thousands of dollars into things like séances, being contacted to the dead. Homeopathic medicine. He had a big career switch. I guess you would say though that those two things are related in some ways.
Share
Jen Gunter
26:35
Absolutely. Because all of these sort of fake medical things are using tricks, and they're preying on people. I mean, there's some, I don't know if you remember back in I think it might have been the 80s, when people were performing that so-called bloodless surgery.
Share
26:53
You know, they went to these other countries and there were these incredible videos where it looked like people were plunging their hands into abdomens and pulling out diseased body parts. Right?
Share
27:04
I think that's kind of how
Randi
maybe got sort of involved with it, or there was- there were these sort of tele-evangelist sort of preacher types who would have these auditoriums filled with people and you'd get healed, you know, and they'd call out the person, "Is Mary Smith here? Is Mary Smith here?"Share
27:21
And of course Mary Smith would come up and then they'd say, "Well, oh Mary Smith, you live here and you have this daughter here", and you know, the person was being fed all this information in an earpiece.
Share
27:31
So, you know, people are spending money. And if they have cancer, they're getting harmed. Or they have an illness because they might not be getting the treatment they need.
Share
Manoush Zomorodi
27:40
Yeah, so homeopathic medicine, he definitely takes aim at that. And
Jen
, what is your issue with homeopathic medicine?Share
Jen Gunter
27:49
So homeopathy means something that has been diluted to the point where there's essentially like, one molecule, you know? Like, diluted to the point where the water has memory of the original substance.
Share
Manoush Zomorodi
28:03
That's what it means?
Share
Jen Gunter
28:04
That's what homeopathy is, yeah. So you take something that's like the original thing, like a syphilitic ulcer, and you put it in water to make or alcohol or whatever to make a solution, and then you dilute it out, and dilute it out, and dilute it out, and dilute it out, you know, maybe 100 times or 60 times or 1000 times or whatever the dilution is. And then that product that you end up with is the homeopathic product.
Share
Manoush Zomorodi
28:31
So that's different than a midwife saying, "Make sure you drink some of this herbal tea which will stimulate your milk production", or chinese medicine and herbs. That's not considered homeopathy.
Share
Jen Gunter
28:43
No, those are completely different things. And each one of those interventions deserves to be studied, right? To see if they are effective or not. Because you have to remember if something is producing a biological effect, then there is something pharmaceutical about it, right?
Share
29:00
And so the assumption should not be that that is benign or safe, right? So I mean a tragic example is, you know, a lot of old time recipes for menstrual problems — which was often a euphemism for being pregnant but not always — involved a substance called
Pennyroyal
which is horribly toxic to the body, and often fatal when consumed.Share
29:27
It certainly can induce uterine contractions, but you know, death of the person taking it's kind of an undesired side effect. So yeah, so can this herbal thing produce the effect? If it's producing an effect, you should be able to prove it.
Share
Manoush Zomorodi
29:42
You mentioned this very briefly at the beginning of our conversation, but you have a lot of empathy. You've written that you have a lot of empathy for people who do want to believe all kinds of things because of a personal tragedy that you had. Can you just elaborate a little bit more about what you think the mindset is?
Share
Jen Gunter
30:00
Sure. I mean, you're desperate. You know, when my kids were in the intensive care unit and my son, you know, 1 pound, 11 ounces. And on top of that, he was diagnosed with an uncommon heart defect. Nothing to do with being premature. Right?
Share
30:19
So just one bad thing on top of another. And he needed to have surgery to fix this complex heart defect, but he was too small for the equipment, you know? And I had another son who vomited after every single feed because he is just, you know, his whole system wasn't developed yet. And so the first two years of his life, everything was a vomit.
Share
30:41
You know, I smelled- the back of my hair, smelled like vomit, I'm not kidding — for two years. And you know, he developed all kinds of- he couldn't eat solid food because of that. Because it's worse to vomit up solids than it is to vomit up liquids. He didn't have his first solid food till he was 3 and a half.
Share
30:56
So I got lost in all these food blogs and food allergy things. Because you're desperate. I mean, here I've got this, you know, my son is three, he hasn't eaten a bite of solid food. You can't even put it on his lip and he freaks out.
Share
31:12
And you've done everything medicine has given you. You've done everything. You've gone to 3 different occupational therapists. You've tried this, you've tried that. You've had these interventions and you're in this space where there is nothing to do but to wait. And it's a very vulnerable place to be. So I get it.
Share
Manoush Zomorodi
31:32
I mean, it goes back to what you said before about knowledge and accurate information being crucial and I mean, I guess it feels or seems strange to lump homeopathic medicine and belief in the supernatural with misinformation in general. But I think what I'm hearing you say is that especially for people who are in that vulnerable space, they can be gateways in some way.
Share
Jen Gunter
32:00
Yeah, I think that social media and the way we consume news in this 24/7 news cycle is this toxic combination that lets misinformation just metastasize. Because there's this concept called the illusory truth effect. We all mistake repetition for accuracy.
Share
32:23
And so if you see the same story on your Instagram feed, and maybe you see it two or three times because maybe several influencers that you follow posted. And then you see it on your
Facebook
feed, because what chases you on Facebook
? What you saw on Instagram, right?Share
32:38
And then you see some people and then maybe you decide, "Oh look, there's this
Facebook
community that was recommended for me and all these people seem nice", and then you get in there and then all of a sudden they're talking about conspiracy theories. And maybe you heard about that somewhere, but you don't quite remember where. It's really- we've created this echo chamber where the misinformation reverberates and you know what?Share
32:60
The misinformation is often fantastical and a bit like, whoa. And the truth is so stodgy and boring sometimes. And so how do you have- how does the stodgy truth about, you know, about the immune system, how does that compete with it?
Share
33:17
You know like, wah-wah, wah-wah, wah-wah. Like in the
Peanuts
comic.Share
33:24
And we have to learn to communicate in ways that people can hear.
Share
Manoush Zomorodi
33:33
In a minute, more from dr
Jen Gunter
and her mission to talk openly about basic bodily functions, like defecating. Today on the show: The truth about our bodies. I'm Manoush Zomorodi
and you're listening to the TED
Radio Hour
from NPR
. Stay with us.Share
Break
Manoush Zomorodi
35:29
It's the
TED
Radio Hour
from NPR,
I'm Manoush Zomorodi
. Today on the show: Debunking misinformation, stigma, and shame about our bodies. Our guide through a selection of TED
talks is physician, author, and podcaster, Jen Gunter
. And one topic in particular that Jen
wants to demystify for us is poop.Share
Jen Gunter
35:54
Everybody poops. This is one of those things people never talk about. Like, why is your poop any more shameful than your runny nose? That's what I want to know.
Share
Manoush Zomorodi
36:04
It doesn't smell the same, does it? OK, wait, we're going to get to that. Let's start with the talk that you have brought us, which is by Dr.
Giulia Enders,
called "The Surprisingly Charming Science of your Gut".Share
Giulia Enders
36:20
It took me three steps to love the gut. And the very first was just looking at it and asking questions like, how does it work? And why maybe does it have to look so weird for that sometimes?
Share
36:34
And it actually wasn't me asking the first kind of these questions, but my roommate. So after one heavy night of partying, he came into our shared room kitchen and he said
Giulia
, you study medicine, how does pooping work?Share
36:50
I did study medicine, but I had no idea. So I had to go up to my room and look it up in different books and I found something interesting, I thought, at that time. So it turns out we don't only have this outer sphincter, we also have an inner sphincter muscle. The outer sphincter we all know, we can control it, we know what's going on there. The inner one, we really don't.
Share
37:12
So what happens is when there are leftovers from digestion, they're being delivered to the inner one first. So this inner one will open in a reflex and let through a little bit for testing.
Share
37:24
So there are sensory cells that will analyze what has been delivered. Is it gaseous, or is it solid? And they will then send this information up to our brain. And this is the moment when our brain knows I have to go to the toilet.
Share
Manoush Zomorodi
37:39
I mean, she's the most charming doctor. She's just the best and it really- it reminds me of a friend of mine who I used to go on a lot of work trips with, and he used to go for pur-bur-bur-burr, and that was the trumpet noise — was when he had to excuse himself.
Share
37:57
But most people are not that comfortable — well, other than little kids — are not that comfortable about talking openly about the need to go, or pooping, right?
Share
Jen Gunter
38:09
Right, but they want to be.
Share
Manoush Zomorodi
38:11
That is true. Tell me more about that.
Share
Jen Gunter
38:14
You know, I talk a lot about poop in the office, how to have a bowel movement. I take care of a lot of people have pelvic pain, and a lot of times that's related to the same muscles that you use for defecation, to have a bowel movement. So there's a lot of crossover. And so chronic constipation can actually lead to public pain and vice versa.
Share
38:32
So I'm always talking to people like, "Do you mechanically know how to have a bowel movement?" and people are like, "There's a way?"
Share
38:40
I'm like "There is!" We talk about, you know, that why you really need to have fiber, why you really need to have these things. You know, people will say, "Oh you must have fiber, you must have fiber", but people want to know the Why. They want to know the why.
Share
Giulia Enders
38:52
Like those funny rumbling noises that happens when you're in a group of friends, or at the office conference table, going like, murrummurr. This is not because we're hungry, this is because our small intestine is actually a huge neat-freak, and it takes the time in-between digestion to clean everything up, residing in those 8 meters of gut, really 7 of them being very clean and hardly smell like anything. It will, to achieve this, create a strong muscular wave that moves everything forward. And that's been leftover after digestion.
Share
39:28
This can sometimes create a sound, but doesn't necessarily have to always. So what we're embarrassed of is really a sign of something keeping our insights fine and tidy.
Share
Manoush Zomorodi
39:39
Can we just clarify one thing? Well first of all, I need to know about the right way to poop. And second of all poop is basically just waste, right?
Share
Jen Gunter
39:47
Right. Absolutely. It's all the leftovers that you don't need, plus cells from the lining of the colon, and bacteria, and indigestible fiber, the sort of the non-soluble fiber. So yeah. So the leftovers, if you will, and some other stuff along for the ride. You know, there might be a bit gas that a lot of us might think smells a bit like sulfur. And it's because of the bacteria, right?
Share
40:07
So we depend on bacteria inside our bodies to help with digestion, to help with so many things. I mean, we have this important microbiome. And I think also too you know, a lot of our misconceptions about the colon come from before we knew about the microbiome actually, right?
Share
40:26
So it's sort of a different story to say, "Well you have gas because you normally have this bacteria that's helping you break down food and produce vitamins and it's really important part of your health."
Share
40:38
And so you should be proud of your sulfur because that means you've got a healthy microbiome right? As opposed to "You should be ashamed of it."
Share
Manoush Zomorodi
40:47
OK I'm going to try, but I should say, you know, earlier we mentioned that you are now doing a podcast, it's called Body Stuff. And this talk, the one that we've been discussing, particularly speaks to you because you have an entire episode dedicated to poop and you talk to a rather unusual expert who says we were not always so embarrassed to talk about it.
Share
Jen Gunter
41:13
So we talked to Dr.
Barbara Penner
who is an architectural historian. And she wrote a book called "Bathroom", about how toilet design and ideas about poop have, I guess, shaped each other.Share
41:26
And that's one of the great things about expanding your search for knowledge beyond just medicine. Like, medicine's part of society. Like, you have to look at all of society to understand where we are.
Share
Manoush Zomorodi
41:37
Right, which is exactly what you and Dr.
Barbara Penner
explain in your podcast.Share
Barbara Penner
41:43
If we look at pre-modern Times, let's say pre-18th century, there are loads of examples of 2 and 3 cedar out houses.
Share
Jen Gunter
41:57
Seats for people to poop side by side.
Share
Barbara Penner
41:60
And these really remind us that there just was not the same sense of shame around bodily functions. And we know that for many people, going to the toilet could even be a time for socializing.
Share
Jen Gunter
42:20
And that was totally normal until the 19th century, the
Victorian Era
in England
. That's when indoor plumbing became much more available in England
and the US
, and it's when we learned more about how diseases spread.Share
Manoush Zomorodi
42:37
OK. So let's time travel back to today and the goal with pooping. I mean, I think it's pretty fair to say is that everyone just wants their- sorry listeners to speak for you, but everyone just wants their poop to be regular and normal. Like once a day, fully-formed. Is that the right goal?
Share
Jen Gunter
42:58
Well, yes and no. Their poop should be regular for them. So what's regular and normal for me might not be regular and normal for you. You want the system to be working fine. So if once a day is what happens for you, that's great. If it's twice a day, that's fine. If it's every other day, that's OK. You know?
Share
43:16
So instead of thinking about like how often, you should think about more like, is there any discomfort am I feeling unwell otherwise? Is there blood in my stool? Which is certainly a very concerning sign and should always be reported to your doctor.
Share
43:28
You should just think about in terms of health. I always think your body is kind of working the best when you're not really thinking about it.
Share
Manoush Zomorodi
43:34
Yes.
Share
Jen Gunter
43:35
And also a change. People should be aware of changes. So if everything was going right and then all of a sudden there is a change for you, then that's something to think about.
Share
Manoush Zomorodi
43:44
What I like about you
Jen
though, is that you don't just talk about the negative stuff, you also talk about the positive stuff. And in this episode about poop, you have an expert with you and you introduce some terminology that I had never heard of called, poophoria, which is the lovely side of pooping.Share
Jen Gunter
44:03
Yes, our doctor of poo-ology, our gastroenterologist, is Dr. Anousheh. And he wrote the book, "What Your Poo is Telling You"
Share
44:14
So what's a monster poo?
Share
Anousheh Ghezel-Ayagh
44:16
Monster poo just means you're just having a large, huge bowel movement. When you have a monster poo, you can experience this sort of sense of joy and elation that we call poophoria, right? It comes from sort of distending the rectum, which we talked about as being a very sensitive area, and then having a decompressed, sort of in a single bullet, stool as it comes out and that sometimes just makes us like, feel great. Like, you want to high five the first person you see when you come out of the toilet.
Share
Manoush Zomorodi
44:50
Has making this episode changed the way that you approach your own bathroom time,
Jen
? is that too personal a question to ask you on public radio?Share
Jen Gunter
44:59
You can ask me anything. I seriously- I have like, no shame. I'm the person that when like, well, back in the before time — when you used to try on bras in the department store, I'd just like walk out of the change room going "Does this one fit?"
Share
45:09
So I mean, I would say I knew most of the medicine, but I've always been a fiber-evangelical but I've certainly even doubled down more. Like, fiber is the way.
Share
Manoush Zomorodi
45:24
Fibers the way.
Share
Jen Gunter
45:24
Fiber is the way.
Share
Manoush Zomorodi
45:26
But don't go too crazy, right?
Share
Jen Gunter
45:27
Well you can. Yeah, I mean, you can't. I have on occasion found out that sometimes you can overdo it and get a little gastric distress. But when your stool moves along as it should, when it's not a hard and scratchy, you lower your risk of getting hemorrhoids. And no one is ever happy with hemorrhoids.
Share
Manoush Zomorodi
45:44
OK. For those poor souls who don't know: Why? Why do we need fiber? Why is fiber so important? What does it do?
Share
Jen Gunter
45:53
Fiber. Ohh. People should talk about fiber like it's sexy, because it is. It's good for your body. One, it's really important because some fiber function is prebiotics. So for your colon, it helps you produce more good bacteria.
Share
46:06
Fiber draws water into the stool, making it softer, and then it's less scratchy when it comes out. Think of it like a sponge. A poo sponge. That's what fiber is. It's a poo sponge.
Share
Manoush Zomorodi
46:18
Do I have to?
Share
Jen Gunter
46:19
Yeah, it's a great way to think about it. We're giving it an upgrade. So fiber draws water into the stool and that increases the bulk. And the bulk of the stool helps stimulate the colon to move the stool along.
Share
Manoush Zomorodi
46:32
No. So you know, listening to you, I feel like we need to have like a call-in show or something. But what's your advice for making sure we ask our doctors the right questions? Because we need to be more fearless too, right? About bringing up issues that we might feel, "Oh it's nothing," or we feel squeamish about it, or you know, it's embarrassing. It's too- it's a human, right?
Share
Jen Gunter
46:55
Well I think, you know, I hate to put the onus on the patient. Because the doctor should be creating a welcoming environment for that. A lot of things in medicine occupy this in-between, this land of in-between where how to have a bowel movement isn't really like a medical problem, but if it's not done right, it can be. Right?
Share
47:14
So it's the same thing like with like how to wash your vulva. It's not- that's not really like medicine, but if it's done wrong, it is. So you know, these are areas I think medicine needs to step up. It's like practical information people need so they can live their lives. It really should be part of health maintenance and disease prevention.
Share
Manoush Zomorodi
47:33
So let's say someone is thinking, "Well it's not really a problem, at least not yet. So I'm not going to bother with going to the doctor's office", but then how can people find the right health information online?
Share
Jen Gunter
47:46
Yeah, I mean, I think it's natural for people to want to research what's going on with their bodies online. You know, write down what's bothering you or what's concerning you, and think about what organ system you might think that involves.
Share
47:58
So for example, if it's your poo, you're probably having a bowel movement. I would go to the American Gastrointestinal Association and then I would see what the experts have to say. Or the American
Academy of Family Physicians
, great place to start, you know. Or if it's an O-B-G-Y-N question, start with, you know, the American College of O-B-G-Y-N. I think people forget that medical professional societies actually have great information online. That's a good place to start.Share
48:24
And the
National Library Of Medicine
and the Centers for Disease Control
, they all have great information.Share
Manoush Zomorodi
48:30
Can I just ask — one thing that I've been wondering might be adding to this problem of lack of information about our bodies, is at least, in my experience, how specialized Western medicine has become.
Share
48:45
Like, if you go to see a podiatrist, they are definitely going to say like, "Yep, it's a foot problem", as opposed to "Maybe it's a problem with your back, or other ways that you carry yourself." Like we don't treat the body very holistically here in the
United States
. Is that part of the problem? And I don't know, do you see this changing at at all as we look forward into the future?Share
Jen Gunter
49:09
Yeah, so I think that one of the root causes of many problems is the lack of investment in primary care.
Share
49:17
You know, we have these amazing family physicians, these amazing pediatricians, you know, these amazing frontline doctors who are not subspecialized. Their specialty is all of you, right?
Share
49:27
And how can they look after all of you in 15 or 20 minutes?
Share
Manoush Zomorodi
49:32
No, right.
Share
Jen Gunter
49:32
So to me, one of the root causes of problems, certainly in
North America
, is this idea that we are fairly well-situated to manage acute problems.Share
49:47
You have a sore throat, you come in, you get checked for strep throat. You break your toe, you come in, you get your toe splinted. You know, you have this acute problem and you come in and get it fixed. But many of us also then get stuck in this idea that problems can be fixed.
Share
50:03
But a lot of medicine is chronic care, right? It's things that don't go away with a pill, or a surgery, or maybe those things can help, but they're part of the long-term management. And we need to invest in systems that account for that.
Share
Manoush Zomorodi
50:24
Going back to the debunking of health myths — your specialty. How how much do you worry that we're sort of entering a period that is ripe for more of this considering the sort of post- hopefully
post-covid
era where we're talking about long-haul symptoms. We don't know a lot about it. There are starting to be studies, but there aren't that many. It seems like there are going to be a lot of very vulnerable people looking for answers to feel better for a very long time to come.Share
Jen Gunter
50:59
Yeah, I think that is definitely ripe for charlatans to take advantage of it. I think also too, you know, many people who have unstudied medical conditions, and certainly something like long
covid
is something that is obviously unstudied, part because it's so new.Share
51:17
I think that a lot of times, doctors really just also need to say, "I don't know. I don't have an answer." Instead of brushing somebody off as "No, that can't be." Or "Let me doctor-splain that to you."
Share
51:31
When I'm honest, because I deal with chronic pain every day. I deal with a lot of conditions that that don't have easy fixes. And sometimes I sit down with people and I sort of say, "Yeah, that sucks. You are right. We don't have this information. You are right."
Share
51:48
And I think that sometimes people want to hear that. And I think when people have difficult illnesses, or illnesses that don't have answers, they get that you might not have an immediate cure. But when you say that, "I don't know, but let's work on this together." I think that's welcoming.
Share
52:05
And so I think medicine has to figure out how to be more welcoming, how to advocate for studying things, how to look at the way we allocate research funds to make sure that we're bringing everything to the table. One thing the pandemic has shown us is that if you throw a lot of money and a lot of smart minds at things, you can solve a difficult problem pretty quickly.
Share
52:26
That's kind of a hopeful thing.
Share
Manoush Zomorodi
52:29
Thank you again to Dr.
Jen Gunter
for spending the hour with us. You can find Body Stuff with Dr. Jen Gunter
wherever you listen to podcasts.Share
52:41
This episode was produced by Christina Kala and Matthew Cloutier, and it was edited by Sanaz Meshkinpour. Our
TED
radio production staff also includes Jeff Rogers
, Rachel Faulkner, Diba Motisham, James
Delahoussaye, JC Howard, Katie Monteleone, Janet Leigh, and Fiona Gearan. Our audio engineer is Daniel Shuqin.Share
53:03
Our theme music was written by Ramtin Arablouei. Our partners at
TED
are Chris Anderson, Colin Helms, Anna Phelan, and Michelle Quint, I'm Manoush Zomorodi
, and you've been listening to the TED
Radio Hour
from NPR
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Manoush Zomorodi
Jen Gunter
Lera Boroditsky
James Randi
Giulia Enders
Barbara Penner
Anousheh Ghezel-Ayagh