Bedside Rounds is a storytelling podcast about medical history and medicine’s intersections with society and culture. Host Adam Rodman seeks to tell a few of these weird, wonderful, and intensely human stories that have made modern medicine.
Does smoking cause lung cancer? How could you ever know? The second in a three-part series on causality, I’m joined by Dr. Shoshana Herzig to discuss how Austin Bradford Hill and Richard Doll set out to try and answer this question -- and along the way revolutionized the way we think about what causes disease. In this episode, we’ll talk about the first double-blinded randomized controlled trial, the long shadow of tuberculosis, and why epidemiology is beautiful.
In 1495, a mysterious and deadly plague struck the city of Naples. Over the next 500 years, the medical attempts to understand and treat this new disease -- syphilis -- would mold and shape medicine in surprising ways. In this episode, Tony Breu and I will perform an historical and physiological biography of syphilis, covering the development of germ theory, epic poetry, mercury saunas, intentionally infecting patients with malaria, magic bullets, and lots and lots of experiments on poor rabbits.
What was behind the mysterious increase in lung cancer deaths at the turn of the 20th century? This episode looks at that early debate about environmental pollution. Along the way, we’re going to talk about toxic vapors -- and not Miasma theory, but the actual literal Great Smog of London in 1952 that killed over 10,000 people -- as well as the birth of the case-control study, Nazi attempts at tobacco control programs, and the rather prosaic beginnings of a debate that rages to this day.
What killed Charles II of Spain, the inbred monarch whose autopsy famously showed a heart the size of a peppercorn, a head full of water, and a bloodless body? This episode addresses that medical mystery by not only delving deep into Charles’ unfortunate past, but by exploring some of the fundamental assumptions physicians have made about the nature of disease. Along the way we’ll walk about inbreeding coefficients, postmodern philosophy, and two thousand years of anatomy and autopsy.
Florence Nightingale stands as one of the most important reformers of 19th century medicine -- a woman whose belief in the power of reason and statistical thinking would critically shape the both the fields of epidemiology and nursing. This episode discusses how modern nursing was born out of the horrors of war, medical theories about poisonous air, the outsize influence of the average man, the first graph in history, and how Nightingale's legacy continues to influence the 21st century.
Mesmerism has had an outsize influence on medicine, despite the rapid rise and fall of its inventor Dr. Franz Mesmer and hostility from the medical establishment. This curious story covers the healing powers of magnets, secret societies in pre-Revolutionary France, fundamental questions about what makes someone alive, and one of the most fascinating medical investigations in history led by a dream team of Benjamin Franklin, Lavoisier, and Guillotine on behalf of King Louis XVI.
Bacteriophages -- viruses that target and kill bacteria -- were one of the most promising medical treatments of the early 20th century, and were used to treat all sorts of infections, from cholera to staph, and everything in between. But by the 1950s, they had all but died out in the West. This episode tells the story of the humble phage, from its discovery in the waters of the Ganges, love trysts ending in a KGB execution, and to its 21st century resurgence to fight antibiotic resistance.
Tuberculosis has been humanity’s oldest and greatest killer. Starting at the turn of the nineteenth century, the White Plague was decimating entire generations in the crowded and unclean cities of Europe, North America, and across the globe. But as medical science learned more about the disease, doctors and reformers developed new ways to combat it, most notably specialized tuberculosis hospitals that sought to heal their patients with fresh air, rest, and a nutritious diet.
The first population study in history was born out of a dramatic debate involving leeches, “medical vampires,” professional rivalries, murder accusations, and, of course, bloodletting, all in the backdrop of the French Revolution. The second of a multipart series on the development of population medicine, this episode contextualizes Pierre Louis’ “numerical method,” his famous trial on bloodletting, and the birth of a new way for doctors to “know”.
Many podcasts start with an “Episode 0”, basically a mission statement for the podcast. Well, better late than never! This episode explores why I make Bedside Rounds, my philosophy about medical history, and a little bit about who I am and my research methods. Hopefully listeners new and old alike will find it interesting!
For thousands of years, bloodletting was the standard of care for any number of medical conditions, but at the turn of the nineteenth century, often acrimonious debates about the practice would lead to a new method of medical knowledge. This episode visits the controversies surrounding the death of George Washington and Benjamin Rush’s bleeding of Philadelphia during the 1793 yellow fever epidemic and asks the big question -- how do doctors truly “know” what actually helps their patients?
The southern United States was hit by a dramatic epidemic of a mysterious disease called pellagra in the early twentieth century. This episode discusses the cultural and scientific sources of the outbreak -- from the cotton fields of the south, to the cow pastures of rural Germany, to the river basins of Uganda -- and the incredible lengths a young doctor named Joseph Goldberger went through to try and put an end to this plague. Plus, a new #AdamAnswers about the source of the name “internal medicine.”
The Adventure of the Speckled Band by Sir Arthur Conan Doyle
Sir Arthur Conan Doyle considered The Adventure of the Speckled Band to be his best Holmes story, and Adam does too. Meant to be a companion to Episode 35 (Sherlock), this is the story in its entirety. THIS IS NOT AN EPISODE! It's Adam reading for almost 50 minutes. Consider yourself forewarned!
Why do doctors love Sherlock Holmes so much? In this episode, we’ll explore this endearing, nerdy obsession with the good detective, from Holmes’ medical origins and influences, the parallels with medical reasoning, and how the Holmes stories still influence medicine to this day. Plus a new #AdamAnswers about the origin of the white coat.
The physical exam has become a ritual of the modern doctor’s appointment, with pokes, prods, and strange tools. How did this become a normal thing to do? In this episode, I’ll discuss how the physical exam went from the medieval examination of a flask of urine to basically what we have today in just a few decades in early 19th century France, and how the exam is still developing in the 21st century.
Alexis St. Martin and William Beaumont have one of the strangest relationships in the history of medicine -- a young French-Canadian fur trapper with a hole in his stomach from an errant shotgun blast and the American army physician who cared for him, and then made his own career by turning Alexis into a human guinea pig. They’d revolutionize our understanding of the physiology of the stomach, put American medicine on the map, and start a conversation about human experimentation that goes on to this day.
The Four Humors are probably the longest-lasting idea in the history of medicine, even though they’ve been more or less completely abandoned for the past century or so. In this episode, we’ll explore how the ancient Greek idea of disease coming from imbalances in body fluids touched every aspect of medicine for two millennia, well into the modern era. And we’ll discuss how humoral explanations likely hampered adoption of the first clinical trial in history, James Lind’s famous scurvy study.
Malariotherapy -- infecting comatose syphilis patients with malaria to cure them of the disease -- was once the cutting edge of medicine, and earned its inventor Julius Wagner-Jauregg the Nobel Prize in Medicine or Physiology in 1927. In this episode, we’re going to talk about the fascinating story behind this remarkable treatment, from the murky beginnings of syphilis through its sordid sexual connotations, to the birth of modern psychiatry and Nazi experiments.
Two hundred years ago, a few doctors, a matron, and 22 orphans set sail in a gutsy attempt to spread the new invention of vaccination across three continents in the world’s first attempt to eliminate smallpox. Learn about their epic journey, the Balmis-Salvany Expedition, as well as the medical context surrounding the invention of vaccination in “The Orphan Vaccine”.
Did the famous composer Gustav Mahler work his fatal heart murmur into his final ninth symphony? To try and answer this question, I’m joined by Dr. Kevin Nordstrom of the Great Composers Podcast. We’ll delve into Mahler’s diseases, a history of heart sounds, musical theory, his obsession with mortality, and the unfortunate circumstances of his own death. Classical music and medicine, in one podcast! What more could you want?
The story of smallpox blankets offered as gifts to indigenous peoples as a weapon of war is ubiquitous -- but is it based in truth? And did our increased medical understanding of smallpox lead to its use as a biological weapon? In this episode, we confront these questions and explore the history of biological warfare, smallpox, and medicine. Listen to all this, a new #AdamAnswers, and more in this episode of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine.
The United States is in the midst of an epidemic of addiction and overdose deaths due to opiate painkillers. Its causes are varied, but there’s no question that physicians share a large part of the blame. Little discussed is that this is actually the second time this has happened. Almost a century ago, a remarkably similar epidemic struck the country. In this episode, called “The First Opiate Epidemic,” I discuss what happened, the parallels to today, and the lessons we can learn from our forebearers.
In 2005, a mysterious plague called Corrupted Blood hit the online denizens of World of Warcraft, ripping through cities and decimating player characters. After the smoke cleared, it became clear that this virtual plague shared many characteristics with real-world diseases and almost immediately attracted the attention of researchers. In this Summer Short, I go over the details of the in-game Corrupted Blood incident, and the very real-world epidemiological research that followed.
The invention of dialysis -- essentially artificial kidneys for people with kidney failure -- revolutionized medicine. It also started a debate about medical rationing and ethics that rages to this day. Producer Cam Steele brings us a story about the God Squad, the group of lay people and doctors tasked with deciding who lived and who died in the early days of dialysis, and how it has informed every debate about medical rationing since.
The eclipse is coming! Get out your eclipse glasses (or your camera obscura, if you didn't prepare like me), and enjoy a review of the medical literature on eclipses with our guest Dr. Avi O'Glasser in our first summer short. Beyond solar retinopathy (a very good reason to not look into the sun), are there health effects on humans? Is there anything to the widespread belief of an eclipse being a bad omen? Find out all this and more in our first Bedside Rounds Summer Short.
Intravenous or IV fluids are a ubiquitous treatment in medicine, and one of the most cost-effective treatments that we have, costing less than a cup of coffee in the developing world. But it wasn’t always this way. In this episode, called Salt Water, we go back to the second great cholera epidemic, where a young doctor developed IV fluids to help fight this mysterious disease, only to see his invention abandoned for over half a century. We also have a new #AdamAnswers about bloodletting.
#TipsforNewInterns and Introducing Summer Shorts (NOT AN EPISODE)
In this month's #AdamAnswers, he discusses his #TipsforNewInterns (seriously, it's trending on Twitter). And we introduce the Summer Shorts for this summer -- and discuss how you can contribute and be on the show! (#spoileralert -- Tweet me @AdamRodmanMD). This is NOT an episode! Make sure you listen to Episode 24.
What makes a disease? And who gets to decide? Producer Cam Steele brings us a story that spans migrating uteruses in ancient Egypt, a disease that makes slaves want to run away in the antebellum south, and the accidental discovery of an erection pill while trying to treat heart disease. Join us in our journey to disassemble the concept of disease in Episode 24 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine! Sources: Bynum B. Discarded Diagnoses. The Lancet. Volume 356, No. 9241, p1615, 4 November 2000. Conrad P. The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders. Drescher J. Out of DSM: Depathologizing Homosexuality. Behav Sci (Basel). 2015 Dec; 5(4): 565–575. Robison J. Look Me in the Eye: A Brief History of Nosology. Retrieved from: http://jerobison.blogspot.com/p/a-brief-history-of-nosology.html Shorter E. The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders. Dialogues Clin Neurosci. 2015 Mar; 17(1): 59–67. Tasca C, et al. Women And Hysteria In The History Of Mental Health. Clin Pract Epidemiol Ment Health. 2012; 8: 110–119. Music credits: Sad Marimba Planet by Lee Rosevere Pookatori and Friends by Kevin MacLeod
A darkened laboratory with an eerie green glow; a photograph of the bones of a woman’s hand published on the front pages of newspapers throughout the globe; mysterious rays that promise to change medicine forever but also cause horrific disease in their champions and pioneers. In this episode, called Bone Portraits, I tell the story of two men -- Wilhelm Roentgen, the discoverer of x-rays who would later win a Nobel Prize, and Clarence Dally, the first victim of x-ray radiation. Listen to the thrilling conclusion of our to part series on the dawn of diagnostic imaging! We’ve got all this, plus a double-header #AdamAnswers, in Episode 23 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine. Sources: Mahroo, et al. 'Dilatation' and 'dilation': trends in use on both sides of the Atlantic. Br J Ophthalmol. 2014 Jun;98(6):845-6. doi: 10.1136/bjophthalmol-2014-304986. Epub 2014 Feb 25. King, Gilbert. “Clarence Dally — The Man Who Gave Thomas Edison X-Ray Vision.” Smithsonian.com, March 14, 2012. Goodman, et al. Medical Writing: A Prescription for Clarity. P37. Gagliardi, Raymond A. “Clarence Dally: An American Pioneer,” American Journal of Roentgenology, November, 1991, vol. 157, no. 5, p. 922 Dunlop, Orrin. Deleterious effects of X-rays on the human body. Electrical Review 1896;29:95 Cheng, Tsung. Dilation vs. Dilatation. American Journal of Cardiology. February 15, 1994. Volume 73, Issue 5, Page 421 Brown, Percy. American martyrs to radiology. Clarence Madison Dally (1865-1904). 1936. Obrien, Frederick. In Memoriam: Percy Brown, MD. Radiology. December 1950Volume 55, Issue 6 Sansare K, et al. Early victims of X-rays: a tribute and current perception. Dentomaxillofac Radiol. 2011 Feb;40(2):123-5.
A mortally wounded American president and the quest to find his assassin’s bullet unexpectedly opened up a potentially new era of medical diagnostics in the late nineteenth century. In this episode, learn about the assassination of James Garfield and how the controversy surrounding his medical care led Alexander Graham Bell to develop an “induction balance” that could locate a piece of metal inside a human body. This is the first part of a two part series called “Sound and Light.” Also included -- a new #AdamAnswers about … hiccups! All this and more in Episode 22 of Bedside Rounds! Sources: Bell AG. Upon the electrical experiments to determine the location of the bullet in the body of the late President Garfield; and upon a successful form of induction balance for the painless detection of metallic masses in the human body, Retrieved from: https://archive.org/details/uponelectricalex00bell Paulson G. Death of a president and his assassin--errors in their diagnosis and autopsies. J Hist Neurosci. 2006 Jun;15(2):77-91. Trunkey D, et al. Medical and surgical care of our four assassinated presidents. J Am Coll Surg. 2005 Dec;201(6):976-89. Epub 2005 Jun 16. Reyburn R. Clinical history of the case of James Abram Garfield. JAMA. 1894;XXII(13):460-464. Steger M et al. Systemic review: the pathogenesis and pharmacological treatment of hiccups. Aliment Pharmacol Ther. 2015 Nov;42(9):1037-50
Does medicine have a place for renegades who play by their own rules? Producer Cam Steele brings us a story about medical mavericks drinking toxic cocktails of their own creation, threading rubber tubes through their veins, and trying to disrupt entire industries, all in the attempt to change the world. Learn about all this and more, plus a new #AdamAnswers, in Episode 21 of Bedside Rounds!
The nineteenth century was struck by a collective panic about being buried alive, leading to a bevy of new laws, regulations, and inventions like the safety coffin. In this episode, we explore how medical science created and fueled this fear by blurring the line between life and death with the invention of new tests for death, developing life-saving technologies like rescue breathing, and even re-animating corpses. And just in case you thought the fear of premature interment was something of the past, we explore how issues raised in this panic still inform medicine today. Learn about all this, a brand new #AdamAnswers, and more in Episode 20 of Bedside Rounds, Buried Alive!
Can the moon make you crazy? The superstition is rampant in medicine, but the idea that a full moon awakens psychiatric pathologies traces back thousands of years. In Episode 19 of Bedside Rounds, producer Cam Steele looks at evidence behind the belief and traces the origins of this cultural fossil that has managed to last until the 21st century. Learn about all this and more in Of Madness and Moons!
By the time that David Livingstone died on the banks of Lake Bangweulu, his name was already legend -- first, as a great explorer, becoming the first European to lay eyes on Victoria Falls and Lake Malawi, and second as a fierce advocate against the slave trade. But we often forget that he was a medical doctor, and made significant contributions to the nascent field of tropical medicine. In Episode 18 of Bedside Rounds, I recount his innovations in fighting malaria and discuss all the fun (by which I mean quite gross, and very deadly) tropical diseases that he described in his journals. Even though the phrase was almost certainly made up, you should still listen to "Dr. Livingstone, I presume?"
In 1991, two hikers near the Austrian-Italian border discovered the 5,000 year-old mummified body of Otzi the Iceman buried in a glacier. What have we learned about medicine from the Iceman? From a fungus-based first aid kit, ancient acupuncture , analysis of paleofeces, hints about his violent demise -- and of course the good old fashioned physical exam -- the answer is more surprising than you might think. Learn more with Episode 17 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!
Everyone knows the story of Phineas Gage, the young man who had a tamping iron shot through his brain in a freak accident and miraculously survived, only to have extreme personality changes. But the true story is far more complex -- and more interesting. In Episode 16 of Bedside Rounds, I revisit the primary sources on Gage's injury, delve into modern research into what actually happened, and take a field trip to visit the man himself.
Understanding statistics has never been more important for the practice of medicine. Unfortunately, innumeracy plagues the medical field. Listen to Episode 15 of Bedside Rounds to learn more, and maybe find a way out of this statistical morass with this one weird trick...
The Randomized Controlled Trial (RCT) is the gold standard for how we know something works in the world of medicine. But how did we get to this point? The answer involves vegetarians and orange juice, spans two thousand years, and stretches from ancient Babylon to the high seas of the British Empire and back to America. Find all these answers (and more!) in Episode 14 of Bedside Rounds -- the First Trial!
Doctors recite an oath, often the Hippocratic Oath, when they graduate medical school, swearing to serve their patients and to do no harm. The common perception is that physicians have sworn an oath for thousands of years, leading back to Hippocrates. But the origins are far more modern and buried in the greatest atrocity of the twentieth century. Learn more in Episode 13 of Bedside Rounds!
Pimping ain't easy, especially when it happens on rounds. Where did the peculiar medical tradition of "pimping" come from? How did it get its name? Is it even effective? And does it still have a place in modern medical education? Find out in Episode 12!
Celebrate ten episodes of Bedside Rounds with a rerecording (with new material) of the first episode, Frank's Sign! The most powerful man in the world, the Roman Emperor Hadrian, dies of a mysterious illness. Learn how the case was (sort of) cracked 2000 years later using the physical exam and just a little bit of math. If that can't get you to listen to this podcast, I don't know what will ...
On episode 10, I discuss one of the best public radio shows of all time, Car Talk, and how it's an awesome example of clinical reasoning. I also talk a little bit about how doctors learn to think like doctors. Dedicated to Tom Magliozzi, who recently died.
In the beginning of a string of podcasts about sound in medicine, Bedside Rounds goes back to the beginning, with the invention of the stethoscope by Rene Laennec. How was the stethoscope invented? What are doctors listening for when they listen to their lungs? Who was Rene Laennec? Well, learn all the answers to these questions in Episode 9 of Bedside Rounds, Laennec's Cylinder!
In Episode 7, we take you to a galaxy far, far away to explore the medicine of the best Star Wars film, the Empire Strikes Back. How close are we to replicating their medical interventions? And what can Star Wars tell us about medicine back here on Earth? This is the first in (hopefully) a series of "Medicine in Science Fiction" podcasts.
In this episode of Bedside Rounds, we discuss how risks and benefits are communicated by scientists and physicians, and why those numbers you see in advertisements and newspapers might not be the clearest way to express risk.
In Episode 4, I wish a hearty 202nd birthday to the New England Journal of Medicine, and look at how much things have changed over the centuries by looking at the 1912 and 1812 editions. #spoileralert: the answer is a LOT
In episode 3 of Bedside Rounds, I talk about the human triumph of small pox vaccination, and discuss the government exercise called Dark Winter which simulated a bioterrorism attack on the United States.
In episode 2 of Bedside Rounds (though still technically untitled), I talk some about the myths and realities of cardiopulmonary resuscitation (CPR) in the hospital, and how the media influences how doctors and patients approach these important conversations.
A re-recording of the very first episode of Bedside Rounds! Learn how we can use the physical exam to help solve the mysterious, 2000 year-old death of the Roman Emperor Hadrian! Learn about how biostatistics are used in every day clinical medicine! Start at the very beginning -- with Frank's Sign!