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Diagnosis

By Lulu Miller

December 30, 2008

In this hour on Diagnosis, we’ll walk into one situation after another and discover that something is not right here. Something’s not right with my pancreas, what do I do? Something’s not right with my son, what do I do? Something’s not right with the phrase “something’s not right.” What? You’ll see.

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Comments

Comment from Peet
Date: December 30, 2008, 5:39 am

Another gem from the Radiolab team. I could not find this episode in the podcast feed … shouldn’t it be?

Comment from Ellen
Date: December 30, 2008, 12:25 pm

Thanks, Peet – We’ll look into that! Until we get it fixed — you can always download it here, manually.

Comment from howie zelaznik
Date: December 30, 2008, 6:56 pm

I have been on Science Friday, but your series is the best.

You might want to have a show in which the two of you and the two quirks and quarks guys interview each other about asking questions about science.

Comment from Jason Kucsma
Date: December 31, 2008, 2:49 pm

Although the story seemed to bore Robert, I was excited to hear more about the Resurrectionists. Check out the digital collection put together by the New York Academy of Medicine for more background: http://tinyurl.com/8f8wwy

Comment from Jason Kucsma
Date: December 31, 2008, 2:51 pm

by the way, Radiolab is hands-down some of the best audio programming I’ve heard in a LONG time. Keep up the great work. Your show prompted me to finally make good on my promise to contribute to my local station — WNYC.

Comment from jeff
Date: December 31, 2008, 5:41 pm

Fascinating as usual. This episode has some really interesting music ‘bumpers and scoring’ trough-out. Is there somewhere on the website that lists some of the pieces used? I realize certain elements are specifically designed by a composer as ’score’ to the stories (such as the cello and vibes behind the beginning of the SIDS segment), other music seems to come from other recordings that have been layered in… such as the romantic classical piece during the ‘break’ 23 minutes into the show, or the haunting piano piece that closes the program.
Where do I find info about the music used for Radio Lab?

Comment from elo
Date: December 31, 2008, 10:35 pm

Elma isn’t in Eastern WA – it’s in Western!

Comment from Burk Braun
Date: January 2, 2009, 3:32 pm

I was puzzled by the ending of this show. Has the concept of controls not occurred to the presenters? The thymus/SIDs story bears little relation to the current fMRI/depression story because the algorithm that discriminates depression from normal in the latter used controls. It was fed known normal (control) and depressed patients for learning and testing. The thymus/SIDs story makes quite evident that no one looked at the population at large at the time to check on normal vs non-normal status in children of that age. matched for “age, and intelligence quotient … and no history of … neurological disorder or head injury”, etc., as did Cynthia Fu’s group. They did not do the proper controls, and this is one way that scientific critique has advanced over the years. The Nobel prize really does mean something!

Fu CHY, Mourao-Miranda J, Costafreda SG, Khanna A, Marquand A, Williams SCR, Brammer MJ. Pattern classification of sad facial processing: toward the development of neurobiological markers in depression. Biological Psychiatry 2008;63:656-662.

Comment from Arthur Finn
Date: January 2, 2009, 8:23 pm

From Wikipeida: The thymus is in the chest. The thyroid is in the neck. Was it in fact the thyroid that was at the center of that story?

Comment from Ryan
Date: January 4, 2009, 9:56 pm

Burk, they thought they HAD proper controls. They just didn’t know the variables they had to control. They didn’t know that poor people had smaller thymus glands. The only way to know how big thymus glands were was through dissection, and the only people they were dissecting were poor. It’s entirely possible that there’s some factor consistent in the type of people who volunteer for fMRIs for research purposes that makes them have more/less activity in the facial recognition region of the brain. Nobody knows, that’s the point.

Arthur, it’s technically in the chest, but it is against the esophagus, and is pretty high in the chest. Bit lower than they described it, but is close enough to the thyroid to cause cancer if you irradiate it.

Great episode as usual, but I gotta say, I didn’t really enjoy the first story, about pancreatic cancer. It really didn’t follow that much of a story (Guy’s family has high rate of pancreatic cancer, two scientists go to the guy’s town and test all his family’s blood, find genetic cause of rare form of pancreatic cancer, end of story), and the research is… well… irrelevant for most of us. It’s a rare form of cancer, and there’s still not a cure for it, and from the sounds of it, anyone who is at risk for is probably already knows from their family history. It really sounded vaguely of a This American Life story. Just not one of the ones that was particularly interesting, but with the excellent Radio Lab flair for polish.

Instead, you should have just replaced it with just talking to V.S Ramachandran or Neil DeGrasse-Tyson. About anything. I don’t care what. They’re just awesome.

Comment from perri
Date: January 5, 2009, 11:28 am

Loved it! I was especially moved by the story of Emmanuel and his dad. I was on the brink of tears throughout, and I don’t cry easily–at all.

Comment from Gavin
Date: January 5, 2009, 10:00 pm

I was surprised by the ending of the pancreatic cancer story–unless I’m sorely mistaken, we never found out what happened to Patient X! Did he dodge the cancer? Was he dead by the time all this research was finished? I understand the focus shifted to the researchers, who I found interesting, but I wanted at least a sentence on the fate of Patient X, who instigated everything.

Comment from mark
Date: January 6, 2009, 1:10 pm

a nitpick: marie curie died of “from aplastic anemia, almost certainly contracted from exposure to radiation” and not cancer… the whole characterization of her “like dipping her arm into vats of uranium and dying soon afterward of cancer” seems to exaggerate the facts, per wikipedia, but sure sounded cool!

thanks for a great show!

Comment from Ellen
Date: January 6, 2009, 7:42 pm

for Gavin:

What happened to Patient X

He had to have his entire pancreas removed. It means that he’s now a diabetic – since his pancreas isn’t there to help manage his digestion. And he’s got enzymes he’s supposed to sprinkle over every meal to help break it down. He’s alive today, though, because they did confirm that he was developing cancer and they were able to remove it before it spread rapidly in his body.

Comment from GP(MPK)
Date: January 8, 2009, 7:41 pm

Anyone else having trouble downloading the episode?

Comment from Jessica
Date: January 10, 2009, 12:21 am

OK, I listened to your last two episodes on a long road trip and I’m getting annoyed. Three things: First, it seems to be a habit to leave the middle story in it’s ‘unresolved’ state. This is fair, as many questions remain open in our current understanding. That doesn’t mean you shouldn’t “wrap up” the tale. I’m often left confused about the direction of current study, or really what is currently understood, simply because you leave the strings to dangle. Second, what’s with the dramatic pauses? At the moment of anticipation, you often put in a few extra seconds before you answer the big question. Why? There is enough drama inherent in the stories themselves. My third issue is related, and I think was brought in comments in the very first episode of the season: think you are going overboard with the sound effects? Particularly that extra loud WOOOSH noise when you are trying to say that everything came together. It hurts.

Otherwise I love you. But keep it simple. The subjects are enough.

Comment from Ryan
Date: January 11, 2009, 1:33 pm

I’m just gonna throw my support behind fun sound effects. I notice in almost every episode someone complains about the sound effects, and I really really like them.

Comment from Christine
Date: January 12, 2009, 7:53 pm

Love the show. Been listening since 2007.
Though it seems some listeners haven’t been enjoying the direction of the recent episodes, I haven’t been bothered much by the change as the stories still engaged me (and I just love hearing Jad and Robert’s voices).

On the flip side, specific to this episode, I cringed just a bit in hearing the hosts argue with each other. My ears felt the tension.

Comment from Brandon Sussman
Date: January 16, 2009, 2:18 pm

The accompanying flowchart is not the way I learned to chart ‘if-then-else’ constructs.
It is not invalid but it is harder to read quickly.
Where did it come from? Did you make it up?

Comment from thomas
Date: January 20, 2009, 4:08 pm

I hope some of your banter back and forth is scripted and either Robert or Jad is supposed to play devil’s advocate at times. Especially since Jad took issue with computer diagnosis of depression. As stated in the piece, it was only 85-86% right. The machine is only a tool that doctors use to corroborate their analysis of a patient. It’s, I’m sure, only one of many tools doctors will use to do so. Jad’s loathing of this method is very strange given that during the Race episode he was in bed with the scientist who told him Jad’s ‘inner self’ was more European than he originally thought. And as far as invasive, genetic testing/profiling is way more so. Are you against that too, Jad?

Comment from Sioen
Date: January 24, 2009, 7:52 pm

Thanks for another great show. It was nice to hear someone reiterate that we might not know what “normal” is in relation to mental illness, even though with our fancy “modern” science, we think we do right now.

Back when the SIDs diagnosis occurred, they thought their science was giving them the right answers, too.

Eventually, people will realize that “normal” isn’t so easily come to when you’re talking about the brain’s chemical balance.

Comment from kms
Date: February 8, 2009, 1:46 am

I love listening to NPR, and yet had never heard of Radiolab until today (which I found via a link on another Web site). What a gem! I look forward to listening to all the shows made available online.

I guess I wanted to say Thank You for this show, specifically the portion about familial pancreatic cancer. My mother passed away from pancreatic cancer 3-1/2 years ago, and listening to Drs. Brentnall and Bronner was very moving.

Pingback from that which rolls » Blog Archive » For Your Ears
Date: March 24, 2009, 8:19 am

[...] commentary and other sounds. It’s a very arty science show. The first one I listened to was Diagnosis. It’s a good place to start if you want to get [...]

Comment from Ian
Date: July 28, 2009, 2:21 am

Anyone know the name of the piano piece at the end?

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