Sawbones: A Marital Tour of Misguided Medicine - Sawbones: ALS and the Many Diseases of Jean-Martin Charcot

Episode Date: March 25, 2018

This week, Dr. Sydnee and Justin mark the passing of Stephen Hawking by discussing the disease that shaped his life and the unusual, prolific physician that discovered it. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. I'm your co-host Justin McElroy. And I'm Sydney McElroy.

I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy.

I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy.

I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host Justin McElroy. I'm your co-host of Miss guy medicine. I'm your co-host Justin McElroy and I'm Sydney McElroy Sydney welcome them back to the program. Thank you. And welcome our third Third chair, which is technically Sydney's arms. Yes Cooper McElroy She we're gonna try to keep her mom not gonna keep her, I can't keep her quiet. That was a complete lie. I'm just gonna hope she sleeps. And doesn't take a huge dump again.

Yes. Like last time. She has three times in the last couple hours, so you have to assume she's empty. The numbers are on our side. But there really is no limit to how much a baby can poop. You're hurting your first ones from a doctor, baby's can poop infinitely. Anyone who has had children can attest to that. Is it just, sometimes they're just days

where they just do poop all day? We had a sad event last week. The celebrated physicist, Stephen Hawking passed away. That's right. Popular science guy and expert in all things space and physics. Time and physics and time and everything. The whole enchilada.

That whole area of science to me is, I mean, I know I am, I guess I'm a scientist, right? Like I'm a doctor, I'm a scientist. That area is just, I can't even begin to understand or try to understand. It's really, that's really hard for me. Cindy said to me before we started recording this episode, um, I understand the disease and the medicine of this, but I'm not an expert in sort of Stephen Hawking's discovery.

So I'm going to need you to sort of pick up the slack there. So I'm kind of like the Stephen Hawking. Right. You're the astrophysics. Astrophysics. Uh-huh. Right. Here's I know about Stephen Hawking. He made some discoveries that made it easier for us to study black holes. Yes. I knew that. And so much else.

Right. And that's sort of how it works. I wasn't very good in like regular physics. Right. Is the thing. And then you do physics in space, you take those physics out to space and let them do their thing. No, thank you.

I was, I was a biology person through and through with like the chemistry that was necessary and then the physics that you had to take to get into med school. And that was hard for me. But of course, we're not talking about physics sitting. We're talking about ALS, which everyone knows stands for Lou Gehrig's Zees. Okay, well, you're close. First of all, let me say thank you to, we had so many people recommend this topic. I can't thank you all because I think in light of Stephen Hawking's passing, a lot of

people were a little more interested in what exactly was this disorder, what was the nature of it. So thank you to everybody who tweeted and emailed and Facebook message and everything, because there were a lot of people. Amiatrophic lateral sclerosis, ALS, or what is popularly known in the US as Lou Gehrig's disease is a motor neuron disease. What does that mean?

I don't know. You don't know? Motor neuron disease. Okay. It is disease. I don't really expect you to know I'm relating to the neurons in the brain, which is the neuron is like a chemical connection in the brain and it really how it relates to our motor

functions. That was pretty good. You kind of neuron was a little off there. It's a nerve. So, so it's brain cell. Neuron. So anyway, that's okay. It's a cell. Yeah, it's a cell. So yes, I mean in the sense that it is a degenerative disease of the nerves that control our voluntary actions.

Our muscles and our ability to move and the things we do voluntarily. Does that make sense? Yes. And as these nerves degenerate over time, we lose the ability to control these muscles. And so, you know, the most obvious manifestation of that is you use the lose the ability to control your limb. It's over to walk or to stand. You become progressively weaker in that results. And I think what we were already aware of, the fact that Stephen Hawking was in a wheelchair through a good bit of his life because he was weaker.

He couldn't control those muscles. And those muscles over time, and this is true in general, for anything that would cause a muscle to become, to lose innervation, meaning no longer have a nerve to it, that muscle will start to atrophy. Okay. So over time, you lose the ability to walk, to, you know, voluntarily move those, whatever muscles are, have now become affected, whatever muscles have lost their nerves. Do things become actually because they're not integrated or because you don't move them? Or is that, I mean, that's kind of a causation in corrosion.

I was going to say that yes and yes. Okay. If I didn't move it though, it would become attribute in the same way. Yes. Yeah. Yeah. If it, yeah, you'd have to not move it though, it would become atrophied in the same way. Yes. Yeah. If you'd have to not move it for a long time to become atrophied as fast as it can if you lose innovation. You know what I mean? Yeah.

But yeah. I mean, if you lay in a bed, we say that for people who are sick in the hospital, you'll see people who come into the hospital with an illness and they'll spend a few days in bed and they will be incredibly weak at the end of that. And it really wasn't the illness as much as just being in bed for a few days. Yes, so that's fair. It also affects things like speaking and swallowing because obviously muscles are in charge of those things. And then eventually breathing can become affected because you use muscles to breathe. I don't know that we always think about that. We think about our lungs.

But we only think about our diaphragm and all of the other muscles of respiration that help us breathe. And that usually is what makes the disease fatal for the most part, generally speaking. Now what's interesting about Stephen Hawking is that as many people noted, he survived a lot longer than a lot of patients with ALS generally do. And that is largely because while the disease is always progressive, meaning it continues to affect more and more functions over time, it is variable in its course. You know, there are kind of different types, different subsets of ALS.

And in these different presentations, they can affect your muscles faster or more slowly. And the things that are critical for survival, like swallowing and breathing, those muscles could become affected much later in life. And some things can be overcome. You know, if you worry about like the muscles of swallowing, if you can't swallow, obviously

we worry about nutrition and hydration, but you can overcome those things with like we can put a, what's got a peg tube or a tube in like your stomach or you know, from the outside straight into your stomach and feed you that way and give you hydration that way. So we can overcome some things that are affected. Obviously breathing is the big, that's the big hangout. That's a big one. Yeah. And so for every patient who's diagnosed, the course is going to be a little different. There's some general categories you can put patients into that can help you kind of expect what you know predict what's going to happen next, but even within those categories

everybody is different. And it's a fairly rare disease. I'm sure that's more common with diseases that relate to the brain because it seems to be a pretty common connective tissue with like neurological diseases. Do you think of things like MS? Yeah. Yeah. I had a ready exam. I'm glad you had a superceptive sitting. Yes, I did have ready examples in my head, but thank you for choosing MS. Well, of that, or like if we want to get into more cognitive disorders like dementia, I think, you know, Alzheimer's and other types of dementia, I think you can make the same correlation. It's different. And now part of that might just be because we don't understand them as well yet.

You know, we're getting into a lot of areas where we know what happens, but why, and why it happens to the people it happens to, and how to stop it. Those are still obviously big questions. We don't have great answers to yet. And it wins something is very rare. It makes it harder to study. How rare is very rare? Yeah. How rare is it?

It is. There are about 6,000 new cases in the US each year. Wow. So fairly rare disease. And like I said, everyone can be a little bit different. There's some general categories you can put people into to predict things, but usually different. It is not often inherited.

We think about disease. I think that there's a lot of assumption that... How can something be not often inherited? Well, because it's different. Like I said, there are different types. And so there are, there is a small percentage of patients that we find they had a family history of it. But most of the time it's just random. That's so stricter. You can't predict it. That's very strange to me that they could be sometimes inherited. So those are probably different

what we would call like pathophysiologies. Kind of the the what is happening on a cellular level on a microscopic level is probably slightly different in some of these cases. But it's really hard because for one for one thing, if you want to talk about, you know, one thing we know about ALS and some of these other neurodegenerative diseases that we've talked about is they can have, you can accumulate these plaques, these materials that accumulate in the brain. That is really hard to study when someone's alive. Because if you get in there, brain surgery is the big deal. No, you should, well, I mean, we do, but we should try to stay out of there as much as possible. I mean, you probably shouldn't if you don't have to. Right.

And so they're harder to study when people are still alive and we don't necessarily get as much information after people on autopsy. And so it's still very complex and we don't know all the reasons why the people who get it do and why they progress the way that they do. There's still a lot of unanswered questions. As a result of this, we don't have a particularly effective treatment and we certainly do not have a cure at this point. There are things that we can do,

like experimental medications that can extend life a little bit, and then there are supportive treatments. So like I mentioned kind of with other ways to feed people, you know, or breathing support like ventilators, and then obviously all of the ways that we help people who are no longer able to walk or to stand or to communicate through speaking those kinds of things. But all that being said, it's really just supportive care. It's not necessarily disease treatment per se. Now, when did we figure this out? I don't know if I said, let's do some history.

Okay, let's do it. I felt like it was important to go over what ALS says, because I think it's one of those things that everybody's kind of aware of, but isn't quite sure what it is. The term ALS was first coined in 1874 by John Martin Sharko. There had been some descriptions of the disease a few decades earlier by another neurologist, Charles Bell. I couldn't find these descriptions.

I kept saying that like Charles Bell described it and then I couldn't find it and then he was writing. So I'm not. Bell's palsy. Exactly. Bell of Bell's palsy. Very good. All right. But he had, he had, I guess, written some, like, descriptions of patients that probably, if we look back,

probably did have ALS. But I didn't find those. So he gets the credit in a lot of articles, but I didn't find the proof of it. So there you go. I'm going to give it largely to Sharko. He was a French neurologist, the father of neurology in many ways. He discovered a lot of different neurological diseases. He was also a very prominent figure in developing

the neuro-exam, the way we figure out sensory nerves, first motor nerves, and what does what, and how we figure out if different nerves are working or not You know what tests we do and things so a big figure in the history of neurology huge for the ASMR community He's done a lot of because the neurological exam is like really one of the bed rocks of ASMR videos right a huge contribution to them too. That's what he's mainly known for anymore Yeah, that's true a huge contribution to them too. That's what he's mainly known for anymore. Yeah, that's true. That's the biggest thing. ALS was actually initially called Sharko's disease

and my understanding is that in a lot of the world it's still called Sharko's disease. I can't attest to that because I live here. Now you're saying Sharko, I'm gonna go ahead and say Sharko because that sounds like a fun shark mascot of some sort of But did you see the spelling? Yeah, but like shark. It's not it's like It's like French. Yeah, but like

Not like sharko not like shark with an like dash. Oh Yeah, but it would be funny if his name was sharko Okay, sharko sharko sounds like a bad clown a sea world Yeah, but it would be funny if his name was Sharko. So let's go with Sharko. Okay. Sharko. Sharko sounds like a bad clown at SeaWorld. Sharko has a lot of stuff. What are you Sharko? That kid just want me to make a balloon dolphin? If you've, it was possible to make clowns a little scarier, you've, you've done it.

Yeah. I'm not sure. I won't tell you which half. Is that the name of the clown on it? No, that clown's name is Pennywise. Okay. I don't know. Pennywise. I, oh, it's the last name is Sharko.

That's right. I forgot. I watched the old one and it was really scary up until a giant spider. So I didn't watch the new one. Spoiler. Sheesh. That's the old one. I don't know. The new one might not have one. I have a bigger spider for a smaller one. Sharka has a bunch of stuff named for him.

I don't know if this is interesting to everybody. I'm looking at this list that you've put in your notes here. It is wild. I won't go into all of them because I understand that it gets boring. It's just, okay, list a few of them. And then I'll make a pithy and a fascinating insight. There's an artery name for Sharko,

cleverly named Sharko's artery. There's a condition that can happen to joints called Sharko's joint. There, obviously, Sharko's disease we talked about. There's Sharko Marie Tooth disease, which has nothing to do with teeth. By the way, it's another neurodegenerative disease. The reason I like it, though, is he published accounts of this disorder, this neurodegenerative disorder, at the exact same time as Pierre Marie, who was one of his students, and Howard

Henry Tooth. And so it got named for all of them. Um, not, and it has nothing to do with teeth. And he has so many others. You think he would be like, no, no, no. That can be Marie Tooth. It's cool. It's Marie Tooth. People already hear my name and associate it with so much wax stuff,

but I've got to get my name on a Sharko Marie Tooth disease. For sure. There's other stuff like Sharko's intermittent hepatic fever and Sharko's triad that have nothing, those have nothing to do with like neurodegenerative disorders. He's not, like he's, he was practicing the wrongs, right? Yeah.

You gotta see, but he got into other stuff. Yeah, but this cat would be like, how many times did this cat have will be like, how many times did this cat have to be like, I actually do know what this is. You have me, you have a backcase of me, Ida's and what, what kind is it? Is it the series kind of you, Ida's?

Or the like not a series kind of you, Ida's like, I don't know, there's a lot of things that I cause. He actually had two triads. Okay, great. In that wild, two separate triads. What's a triad? It's a constellation of three symptoms that are pathonomonic, meaning that they usually indicate a certain disease process. If you see these three symptoms, it's probably this. So, sharko's triad of acute colonitis means that you have pain in like the area where your liver is, your right, right,

upper quadrant of your stomach, that you have jaundice. We've turned yellow and you have a fever. So those three symptoms together usually indicate acute colinitis. I won't go into all that, but that's a triad in medicine or other things, you know, we didn't corner, we didn't corner the market on the word triad, I don't think. Anyway, a bunch of stuff is named for him. I always think that's impressive because so far nobody's named any diseases for me. Not yet, Sid, but maybe...

Sure, Cove, you connect with him. Would like, peel you off one or two of his. I will say that on my iPhone, if anybody ever tries to type Sid to me, call me Sid instead of by Sidney, it changes it to STD. I've experienced that. Yeah. So is that sort of like having something named for me? That's a little bit like it.

So he was a really brilliant neurologist. He also described MS, by the way, multiple sclerosis. He was the one who trained Tourette. That's a ret syndrome. Yes. Who described Tourette syndrome. He actually gave, he like bequeathed upon him the ability to name that. He was like, you get to name this one, buddy. What's the sort of peer Marie discovering the same thing is the same time as Charco? I would be a little suspicious if I was him. I mean, tooth is in Henry Howard. he was over in England and these guys were in France.

So like he did it on his own, but it's actually a primary. An almanaba, like people discovering things, it's weird. It's like right about in a book about where ideas come from and like about how ideas come from. And like, about how ideas are often discovered at the same time because there's so much like cultural and society has to be at a certain point for these ideas to take shape. But like once it's there, they're just like, it's not uncommon for several people at the same time to push it into the end zone.

Well, and there are a lot of sports metaphors and so well known. Well, and you're right. And there are a lot of times in medicine where that results in like, you know, bitter, you know, adversaries who hate each other forever because they both published, but one got the name or whatever, one gets the credit. I did not read that in this case. As far as I know, Sharko, Marie, and Tooth were all still fine with each other. They just shared the name. Where good ideas come from, it's any of that, but Stephen Johnson.

It's good. He also was a huge influence on Freud. So while he was a neurologist, he and we'll get into this more extensively. He dabbled in psychiatry. And so Freud says. We dabbled in psychiatry. Sure. And so Freud says, We just have a few disorders over there. Just to lay his name some more stuff. His hospital worry practice,

Saul, not on, this is French. Do you want to say it for me? It's right there. Sure. Saul Petriere. I love yours. Saul Petriere. Saul Petriere. There you yours. Salpetry year. Salpetry year.

There you go. Salpetry year. Yeah, like that. It was... It was... He had a lot of patients there that he could study, especially when it came in, came to the field of psychiatry because it became sort of a refuge for anyone who was destitute. So for anyone who was homeless.

So a lot of people who by today's standards would have been suffering from psychiatric disorders that were undiagnosed and unrecognized and nobody knew they existed and completely untreated. They found refuge in the hospital. There was a lot of people with very select prostitutes, often stayed there homeless people beggars. And so he saw many, many patients and was able to study many disorders and

describe them. He actually referred to his hospital as a grand asylum of human misery, which I would not put on a billboard. Were it me? No. No. But that is the only way I refer to dollar general. When I have to go there. So they call our hospital, they say that we're your partners for life. And the other one in town is the hands of experience.

I don't think Grand Asylum of Human Resources. That's the St. Mary's jingle. With these hands, it's stuck in your head. So I don't think he was in PR. But, and this interaction with a lot of psychiatric He's hands. He's stuck in his head. So I don't think he was in PR, but... And this interaction with a lot of psychiatric illness that was, again, very poorly understood at this point in history, led him down some very strange paths, which I would like us to take a quick diversion into.

All right, let's do it. After... Oh! We visit the Billy department. Z right, let's do it. After. Oh, we visited the Billy department. Z9. Let's go. The medicines, the medicines that ask you let my cards for the mouth. Sydney, you lured me into some strange paths that Sharko went down in the treatment of

ALS. And I'm ready. Well, he wasn't, and let me clarify, this was not in any way related to ALS. I just, we're talking about Sharko and this is a show about wacky medical history. So here we are. So we got to mention it. And again, can I just say he was obviously a very smart guy who figured out a lot of stuff.

So I don't want to take that from him. But like every medical figure from the time, he got some stuff wrong. Of course, right. That's natural. It's a learning environment. And especially if you started digging into the history of a lot of psychiatric disease, there was so much misunderstanding for so many years and so much stigma and magical thinking. And I, you know, there was no, a lot of people got stuff wrong.

So a patient was transferred to his hospital that changed the course of his studies for a while. And I would say if anything kind of, I don't want to say, damages his legacy, but, you know, if there was a black spot, this is probably where it is. So there was a flower delivery man who was out in the street pushing in a wheelbarrow, delivering his flowers when he was struck by a carriage. He was knocked unconscious and sent to one hospital when he awoke. He had memory issues.

He was actually paralyzed from the waist down. He'd developed this trimmer in the corner of his mouth. No one really understood what had happened at the time. They knew something had happened, but there was no visible injury. Okay. So something happened. Right.

Now, he was there at this hospital, he was initially at for six months, and then what probably happened is over time, nobody knew what to do with him, nobody knew how to fix them, he wasn't really getting better and he probably couldn't pay, I would assume eventually. And as I already mentioned, the hospital where Sharko worked was kind of a refuge for people like that. So he was transferred there and also they had this neurological expert working there.

And Sharko saw him and interviewed him and got read the history and everything and came up with a diagnosis of hysteria. Not a real thing. Right. Now as we have discussed before on this program, hysteria was a diagnosis, usually historically applied to women who were acting any way that men didn't like. And sometimes that was because there was an actual underlying medical or perhaps it was a psychiatric disorder. Other times, hysteria was used to describe women who, I don't know, didn't want to like stay at home necessarily or get married or raise kids. Maybe they wanted to have jobs. Maybe they wanted to wear pants. Who knows? Maybe they just didn't want to cook their husband

dinner that night. But for whatever reason, hysteria was often applied to just women who, you know. Try to have a line. Yeah, you could say. I wouldn't say, I'm just saying that I would say. I could not say. In this case, obviously something had occurred. This man probably suffered from a close head injury. And there was probably some... Maybe like some sort of like sub-dural hematoma or something like that. It could easily have been some sort of intracranial hemorrhage.

There were parts of his brain that were obviously he had suffered some sort of damage to a spinal cord possibly. He was paralyzed from the waist down, but you couldn't see any of that. He wasn't cut or bleeding. There was no obvious source of injury. So these sort of injuries, you wouldn't be able to see at the time,

so it'd be very hard to say what exactly happened. He also started having seizures at one point, which again would point to maybe some sort of hemorrhage in the brain, but nobody knew that at the time. So he called it hysteria. Now his understanding of hysteria was a little different. Again, from ancient times, the word hysteria referenced the uterus and it was thought that hysteria was something only women or people with uterus could have because it was the result of the uterus moving around in the body and making you act strangely. This was a departure from that view obviously. He believed that

hysteria was the result of kind of a weak neurological system. Your nerves were just kind of weak. Just kind of. Yeah. Which is like the idea of your nerves being frayed or weak is actually a pretty old, like people who have anxiety, I think, get that, like that was sort of the line of thinking for a while that your nerves would just get sort of like Weren't worn down

And I to this day I a lot of people will refer to it as I have a problem with my nerves I have an issue with my nerves. Well what what when you think about the term nervous breakdown? That's where this kind of Misunderstanding comes the nervous breakdown, actually, we still use that term, but that's actually not very specific, isn't it? Or accurate. Accurate, but it's the word I've meant to use. Yeah.

But this persists. The nerves in and of itself is kind of a culture bound syndrome that people will use to describe somewhat anxiety, but they don't even but it's not even necessarily anxiety. It's also just stress, but nerves is its own thing which isn't actually a diagnosis. Anyway, so he began to develop this theory that you could get hysteria as a result of some sort of trauma. It could be a physical trauma, it could be a psychological trauma, but some sort of trauma occurs and then your neurological system is weakened and you can develop, he broke it all down. There was major hysteria and minor hysteria. Some

of it could be just like a change in behavior, someone who is, whose behavior had changed somewhat bizarrely, may be described as having hysteria, and that may well have been an underlying psychiatric illness, who knows. And then someone like this who has a clear neurological problem would also be described as having a different kind of hysteria when there probably was underlying nerve damage that was done that would have explained it. There were also, he studied a lot of women with what he called hystereoepilepsy.

Okay, what's that? So some of these patients may have had seizures. And we've talked about epilepsy before. Epilepsy was poorly understood for a long time and thought to be, well, after we stopped thinking it was either possession or a some sort of spell, we misunderstood it as a psychiatric illness for a long time as well. So some of these women may have actually had seizures, have had epilepsy. For others, it may again have been a psychiatric illness that would cause some sort of like maybe

a catatonic state, something, something like that could have been described as hystereoepilepsy as well. So he is very famous for many reports he did on specific patients, there were two women in particular that he did a lot of, he spent a lot of time with to understand their hysteria. So his name is closely linked with a study of hysteria and also with hypnosis.

Now at this point in history we've talked about mesmer before. Sure. Mesmer was very popular. He had popularized hypnosis, mesmerizing people hypnosis. And hypnosis was being used to try to treat a lot of things. And so he would actually, Sharko would use hypnosis to induce the hysterical symptoms in front of his colleagues.

Yeah. At least that was what he was intending to do. So he would, in front of like students and colleagues, people who were studying to become doctors or just wanted to know what he knew would come and he would put one of his patients in front of them all and he would hypnotize them and then suggest to them to do all of these things that he'd witnessed

and they would do them all. Now, in retrospect, what was probably happening is that the power of suggestion, he was telling the patients to do the thing and the patients were doing the thing. A lot of hypnotists work. Exactly. And not actual hypnosis. And it wasn't even necessarily, like, a lot of hypnosis work. Exactly. And not actual hypnosis

And it wasn't even necessarily like some a lot of people would write it was to treat the patient It didn't necessarily treat the patient if they were suffering from something that made them Dangerous Then it certainly would make them more docile for the moment, right? But it didn't necessarily treat anything Certainly wouldn't have treated the patient we discussed. He actually, for a while, was called the Napoleon of Narosses. So, yeah, I don't think that nickname stuck with all of his other medical epitoms.

So like I said, he spent a lot of time and energy describing hysteria and using hypnosis and refining these techniques. And this was a huge influence on Freud. Oh, okay. So now, eventually, Freud would start to depart from some of these ideas. And eventually, even Sharko would say, you know what, I think maybe there's, I got some things wrong. He would start to divide the neurological and psychiatric illness and start to see them as different things. That's a refreshing level of awareness for this time period.

But it really, and when you do these kinds of studies and you are respected the way he was and you have so many students and doctors come in and learn from you, it has a huge impact on medicine and psychiatry. Right, because you're a leader in the field. So like the things that you're sort of focusing on are going to be a lot of things, a lot of people are bad. And so as a result, a lot of stuff got thrown into this basket of hysteria, which was nothing.

And those specific disorders, it took longer to figure out what they were and probably set psychiatry back somewhat. He did believe that men could get hysteria, which was a new idea for the time. For the time? That was the worst. For the time.

I don't think that that's actually accurate in this case. It was less sexist, but still wrong. Right. So I don't know if you get points for that. So his neurological legacy is amazing. His psychiatric legacy, not so great. A lot of people will know. That's a lot of people say, well, but he wasn't a psychiatrist, so that would be my advice.

So stick with what you know. Just don't run your mouth about a bunch of stuff, man. You're not 15 diseases. I just don't know. Stick with what you know, because he did accurately describe ALS. Now I would love to give you this history of all the things we learn and have improved in the treatment of ALS since then,

but there isn't a lot of history with that. Obviously, it came largely into public awareness as a result of Lou Gehrig, and then which is why we refer to it as Lou Gehrig's disease. At least in the States, probably, I can't imagine that's. It's like, yeah, it's usually just in the United States. Um, and it has been closely associated with him. And then since that Stephen Hawking, I think to some extent, I feel like I've heard it since Stephen Hawking has come to prominence, referred to more as ALS and the Lou Gehrig disease.

Like, because it sounds weird to say like Stephen Hawking has Lou Gehrig disease. Like, well, I mean, Stephen Hawking is pretty good. He's a really good girl. Exactly. It's kind of weird to say like, he's got baseball player syndrome. Like, yeah, I mean, like, no doubt Lou Gehrig was a very big deal, but like, Stephen Hawking is Stephen Hawking. Maybe we just name it. Maybe just don't even name it after somebody who had it.

No, we're a lot of, what about Sharko's disease? I mean, it was named for the guy who discovered it. Yeah, that's fine Yeah, he has a lot of other things going on Sydney He's got to make up some stuff about psychiatry any other Disorder-named after him like he doesn't need this Are there many I can't say can you think of any other instances of diseases that are named after people who had them? You know what as you said that I was thinking I thinking, I don't think that's really nice.

I don't know. I'd have to read about it. But no, I mean, that doesn't seem, which I think attests to the fact that we didn't know a lot about it. It was very unique. And so when, I mean, it's very rare to see disease. And so when Lou Gehrig announced he had it,

I think a lot of people were like, what does he have? I don't know. It's that. And then people would say, it's that thing Lou Gehrig announced he had it, I think a lot of people are like, what does he have? I don't know. It's, it's that. And then people would say it's that thing Lou Gehrig had. That Lou Gehrig disease. Right. And so I think, I think that's why. And also, ALS is easy to remember. But Amitrophic Laterals Chlerosis is not. So it's not even easy to say. No, it's not. Stephen Hawking was diagnosed in 1963.

We still did not know much about What was going on? I mean, we knew what the we knew the generation of the nerves happened And we knew what the results were but as far as what could be happening that we could target with drugs to fix We did we didn't understand well. And at the time, I think he was given like a prognosis of two-year survival. Obviously, that was wrong. You think it is? Which, again, is not because the doctor, that's not even because the doctors didn't know

much, it's just, it's hard to predict the course. And what is interesting is that in some cases of ALS, it can affect cognitive function. Obviously, that was not true, right, was Stephen Hawking, because despite the fact that he had, you know, some physical, many physical manifestations of the disease. It didn't stop him from changing the way we look at the universe. Mm hmm. Um, and then he, you know, he survived till he was 76, which is a really long time. That's the right thing. I mean, like, yeah, it's a sounding. Yeah, which I mean, that's like 76,

a good long life. Generally, yeah. Um, and a lot of people have asked like, what was different about him? Probably just luck that that was the form of ALS he got. You know, some people have asked like, because he was so famous and well known and probably had the means to support himself.

Did he get better? Did he get better treatment? I wouldn't say necessarily. No, I mean, yes, he was able to afford the supportive treatments that are available, but it probably just has more to do with the kind of the way his ALS manifested as opposed to any special care he received. Not to say he didn't. I'm sure he got excellent care, but I doubt that that is why he lived so long. It's just the nerves that affected his diaphragm,

his ability to breathe. Clearly we're unaffected for a very long time. And so he was able to stay with us longer and change our understanding of the universe, which is pretty amazing. Pretty darn good. Mm-hmm. I think it's a very inspirational.

There is nothing, nothing has to hold you back. I think it's very, it's very inspirational story. Me too. Um, so, say- And that's also, it's a good reminder, diseases like ALS sometimes, I mean, there was the ice bucket challenge on YouTube, right, where everybody was attempting, you know, working to raise money for ALS by dumping buckets of ice water on their head. And so obviously it has gotten some attention, but a lot of times where your diseases like

this don't necessarily get all of the research attention and money and funding that they could, but we need to. Clearly, because this is still an area where we don't have a great treatment other than just to support people as long as we can. So, thank you so much to listening to this episode. Hey, if you're a fan of solbons or any of the other great max fun shows, I have big news. The max fun drive is kicking off April, second running for just two weeks. great gifts for new and upgrading members. And it's the best time to support these shows that you enjoy. We hope so much.

So don't miss that. That is kicking off April 2nd, the day after April Fools Day, which falls on Easter this year, which is unfortunate. I think it's gonna be a weird day. For Jesus. It's a bad timing for him, I think.

He'd prefer that to not occur. Cause it's like, he's like, I'm back. And they're like, how we get it. And he's like, no serious. Hey, Justin. I'm back. No, I wouldn't, you know. And he's like, no, it's not a joke.

I know what you're thinking. This isn't, no, I'm back. I feel like this is not the kind of, let's just stop there. He is risen, someone will say it. And someone else will say, Ha, good one. And then someone else would be like, the, let's just stop there. He is risen, someone will say, and someone else will say, Ha, good one. Mm-hmm. And then someone else will be like, no, really,

I saw the stone rolled away. I think, I think religious humor is not really where the stop bones are. Agreed. That's not where we live. Say Jesus. You know people are going to get on your case about it. You can take this stuff to your other podcast.

Folks. Uh, Sydney's right. Thank you to the taxpayer's relentless user song medicines is the intro and outro program. I think you're for listening. We will return to you next week with another episode. But until then, my name is Justin McRoy. I'm Sydney McRoy. And as always, don't throw a hole in your head. Maximumfund.org Comedy and Culture, Artistone Listener Supported