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Transcript of Malpractice Podcast #3.13: "Medical History, with Tegan Kehoe"

This is the transcript of Malpractice Podcast #3.13: Medical History, with Tegan Kehoe. You can find the audio version here.

A note from Tegan: I used the digital transcription service to create this transcript, and edited it myself. Otter makes guesses as to who is speaking, but they were wildly off in this one and thought I was Jess a lot of the time, so I had to go in and hand-assign the names. With an episode that's nearly an hour long, I was convinced that I was going to mess up and switch the names of the two hosts, Syd and Jess, multiple times. Their voices sound different, but they definitely talk like they've known each other a long time! So, please forgive the segments in which my assigned speaker names make it look like the podcast is talking to itself. This is a great reminder that while digital transcription (and similiar things like captions) are fantastic tools, they don't replace humans when it comes to accessibility.

Malpractice Podcast Welcome to malpractice podcast. Beep, boop, bop, go. So are you ready to get started? Hi, I'm very ready to get started. We're here we're in this it's malpractice at night time. Malpractice at midnight. Malpractice Podcast Oh my god, can you imagine? No. We both feel like whatever this is it. I don't care anymore. I could never. Midnight is not our time. I'm an early bird. I'm not a night owl. Malpractice Podcast Except if you give Sydney a couple drinks, she will force you to stay awake. Malpractice Podcast Well, that's correct. I am straight up a pusher. Malpractice Podcast You're like, aw, stay awake with me. Malpractice Podcast I was watching the show the other day. It's called Psych the show. Have you ever seen it? Malpractice Podcast Yes. I've seen some episodes. Malpractice Podcast Okay. There's this one where they're at a bachelorette party. And the chief of police is there and the woman was like, take a shot. And the chief goes, Excuse me, I'm the chief of police. And the other woman goes, and I'm the Chief of making bitches do shots. And Eric looked at me and he was like, that's you. Malpractice Podcast Yeah. And Eric is the chief of police. Malpractice Podcast Literally, he's the chief of picking us up off the floor. Period. Have you guys put up your Christmas decorations? Malpractice Podcast Oh, Cwistmas tree? Yes. Malpractice Podcast Is your Christmas tree good? Malpractice Podcast Yes. I like it. Malpractice Podcast Do you guys do like all one type of decoration? Or do you have like a theme or do you just do random stuff? Malpractice Podcast Yeah, we do. Ours is like gold and silver. Malpractice Podcast That's cool. Malpractice Podcast Yeah. That's what we do. I like coordination. Malpractice Podcast Same. Malpractice Podcast You know, when I was growing up my parents had, we always had like, go out and to the farm and cut down your own tree. Malpractice Podcast Yeah, right. Yeah. Malpractice Podcast But then we had it was like a chaotic Christmas experience where there was like, multicolored lights, which I should have appreciated because gay, but I didn't, because chaos. And then every ornament is totally different. There's no system and it was like, macaroni strings that I had made when I was in preschool. And I'm like, I don't care about this anymore. Malpractice Podcast My parents straight up still have a three wisemen ornament that -- I must have made it out of popsicle sticks. So I must have made it in... elementary school for sure. Couldn't couldn't have been any later than like fourth grade. Malpractice Podcast I was about to say, separation of church and state? But you went to private school. Malpractice Podcast Yeah. Malpractice Podcast So yeah, that makes sense. Malpractice Podcast That's correct. They did not separate that shit. Um, like when I see my mom's tree. I'm like, it looks so homey, because she has so many decorations. They're random and chaotic. But it's homey because there's so many of them. Yeah, whereas our tree is basically like gold, gold and silver, kinda like yours. Malpractice Podcast Love it. Malpractice Podcast And we had to buy plastic ornaments because we have cats. Malpractice Podcast Right? Malpractice Podcast And if there's one thing that everyone in the world should know about a cat, it's that as soon as you put the Christmas tree up, those bitches are up in that tree, trying to knock stuff down. Malpractice Podcast What do you want from them? Malpractice Podcast The first thing they do you get the tree out of the box. They start chewing on it. I'm not exaggerating. And then the ornaments, we have to hang the all of the ornaments at least like three feet off the ground so the cats can't swing at them. Malpractice Podcast Oh my god. Malpractice Podcast They've literally climbed up the tree and knocked it over before, it's in their DNA. Malpractice Podcast Is it both cats? Malpractice Podcast It's both cats. Yeah. So you can imagine the fat girl cat climbing up a target Christmas tree? Yeah, Malpractice Podcast She's like, this is my time. Malpractice Podcast I'm in the jungle, bitch. Malpractice Podcast This is my workout. Malpractice Podcast When in fact she is not. And it's a mess. What else is new? Malpractice Podcast I didn't realize how have you ever had this moment where you're like, I had a great day I'm exhausted like it literally right after you're like I love today. I'm -- will go to sleep right now. Malpractice Podcast Every single day. Malpractice Podcast That's how I am. Malpractice Podcast I spent about 45 minutes on the phone with my cousin when I got off work today. I was like, you know we were both going home. We were both on our little commutes or whatever. And we were just talking about the fact that begrudging. The fact that we're not independently wealthy -- Malpractice Podcast Me every day, Malpractice Podcast We still have to continue going to work and it's so rude. Malpractice Podcast No, it is rude. I find it disgusting. Malpractice Podcast I'm just thankful sometimes I have a job. Malpractice Podcast Same I should feel that way but I don't. You know how sometimes people ask you like if you won the lottery, would you quit your job? And people are like no, I would just live exactly the same. I'm like, absolutely not. No, I'd quit my job. Malpractice Podcast How much is the lottery? Malpractice Podcast You know, they're always like $800 million. Malpractice Podcast Oh, yeah, I'm quitting. Malpractice Podcast I wouldn't think twice people like, oh, you wouldn't want to finish your PhD? And I'm like, No, I don't need to be a doctor if I have $800 million. Malpractice Podcast I'll be able to buy it. Malpractice Podcast I'll buy a doctorate. Malpractice Podcast Literally. Honorary Doctorate University of Me that I started with my $800 million. Malpractice Podcast I bet you'd make a big enough donation to a university, they'd give you an honorary doctorate. They do that all the time. Malpractice Podcast They probably would. They did it to Shaq. He's a doctor. Malpractice Podcast There you go. Dr. Shaq. Malpractice Podcast Just saying. Malpractice Podcast That's a bop. That's a good idea. Actually. If I had money, I'd do that. Malpractice Podcast What, win the lottery? Malpractice Podcast Winning the lottery is a great idea. Malpractice Podcast I mean, you got to play to win. And I don't. Malpractice Podcast You don't? Malpractice Podcast My dad does. Malpractice Podcast I don't either. Malpractice Podcast My dad plays the lottery and he calls me and he's like, hey, check these lotto numbers and see if we have to go to work on Monday. That's what he tells me every time. Malpractice Podcast Aww. And does he ever win any? Malpractice Podcast Yeah, he won, um... he won like 50 bucks or something like that, which is you know. Malpractice Podcast That's a lunch, dinner. Malpractice Podcast Lunch, dinner, yeah. Pays for your lottery tickets next week. Malpractice Podcast Period. Malpractice Podcast You know, what I would say is like, nobody should rely on the lottery. Like don't make that your plan A. But it's like a fun thing to. Malpractice Podcast Are there people who it's their whole plan? Malpractice Podcast Dude, I literally think that people like, spend their paychecks on lottery tickets thinking like, I'm going to win if I play all these. Absolutely not my friend. You are not. Malpractice Podcast Are you okay? Malpractice Podcast I also they have an episode of criminal podcast, where this guy worked for the lottery in one state, like the state lottery. And he rigged the numbers so that he won twice. And I was like, Dude, you probably could have gotten away with it. Why? Malpractice Podcast Why did you say anything? People get greedy man, people get so greedy, greedy. Malpractice Podcast How much do you need two lotto winnings? Absolutely not. Malpractice Podcast Two? Malpractice Podcast No. Malpractice Podcast And you don't think they're gonna check up on that? Malpractice Podcast No, you work there. Malpractice Podcast You're the number one suspect my guy. Malpractice Podcast They should have checked the first time. Malpractice Podcast I would be very suspicious. Malpractice Podcast Same. Malpractice Podcast It's also like anytime you ever ran for anything in school, you couldn't count the ballots? Malpractice Podcast You can't trust them. Malpractice Podcast Can't trust me I would definitely give d-- owuld give myself what I wanted move on with my life. Malpractice Podcast Two for me one for you. Two for me one for you. Malpractice Podcast Just because you don't understand my math doesn't mean the math is not here. Malpractice Podcast Also, if you won a student body position, the joke is on you because you have to organize the class reunion. Malpractice Podcast Joke is so on me. I wish I had counted and made myself lose. Malpractice Podcast To popular for your own good. Malpractice Podcast Was I? I don't think I was very popular. Malpractice Podcast Popular with me. I was there. Malpractice Podcast I was... I was involved. I was very involved in high school, I will say that. Malpractice Podcast I would say you were cool. I think you were cool. Whatever. I'm hanging out with you. 10 years later. Malpractice Podcast I'm still glowing up right now. I was not cool in high school. But I did sign up for everthing. That is something I did. Malpractice Podcast I feel like we were we were cool in our own circle. We, whatever. I don't give a fuck. Malpractice Podcast I don't give a fuck either, but I was not cool. Malpractice Podcast I got home and I drank a glass of wine and I honestly was gonna finish that sentence and I just couldn't make myself do it. I don't give a f- Malpractice Podcast Sometimes it be like that. Well, let me introduce our guest today then. Malpractice Podcast Get into it! This is a great episode and I really like this interview. Malpractice Podcast Sa-ame. Malpractice Podcast Okay, today we're bringing you an interview with Tegan Kehoe. Tegan is a public historian, a museum curator and a writer specializing in the history of healthcare and of science and society with a social history angle. So she's like, pretty much one of the coolest people ever, which. Malpractice Podcast Yeah, she's so cool. Malpractice Podcast First of all, I didn't know this job existed. Malpractice Podcast No, same. Malpractice Podcast Second of all, to integrate the very two things that we also like to integrate, which is history, and medicine. It's a bop. She is currently an Exhibit and Education Specialist at the Paul S Russell, MD Museum of Medical History and Innovation in Boston, which shout out to Boston. Boston doesn't get enough credit for being Boston. Malpractice Podcast Totally agree. Malpractice Podcast And she has a book coming out soon. So she's an author. It is called Exploring American Healthcare through 50 Historic Treasures. It's coming out in January of 2022. And we are going to you can preorder it on Amazon. So we'll link that in the notes. Malpractice Podcast The other thing I'll say about her book is that she sent us some chapters so that we could do the interview and talk to her about the book a little bit. And I will say it is so fascinating because she bases the ... each single chapter is based on a piece of like medical history that's like a physical object. And she talks about kind of the history of that object, how it was integrated into medicine, some of the problematic things that went along with that, because as you know, like medical history has some, has some shit to atone for. Malpractice Podcast Yeah, it is really, it's an interesting way to understand history. So, especially people who are like, I want to know some more stuff about, like, the topics we really like, but who don't want to spend an entire book on one topic. It's a really good like, short, sweet, but also extremely descriptive way to get a lot of information about tons of different stuff. Malpractice Podcast Totally. And she has such an interesting and unique perspective. Like the way that she words things and the topics that she chooses to spend time on are so cool and informative, Malpractice Podcast and relevant! Malpractice Podcast Definitely go preorder her book. I think it's really really cool. Yeah. Malpractice Podcast Yeah. So we're super hyped for her, obs. We're super excited to bring her to your earholes. Malpractice Podcast So with that, here's the interview. Malpractice Podcast Welcome. Tegan. Malpractice Podcast Welcome. Tegan. Thanks so much for being here. Tegan Kehoe Hello, everyone, my name is Tegan Kehoe. I use she her and hers pronouns. And I am a public historian and museum professional and writer. My day job -- although day job is a little derogatory, and I do love it -- is exhibit and education specialist at the Russell Museum of Medical History and Innovation at Mass General Hospital in Boston. And I recently wrote a book, Exploring American Healthcare through 50 Historic Treasures. Malpractice Podcast And we will absolutely link that book in our show notes, please go buy Tegan's book. It's really, really cool. We've definitely read some chapters of it. And I'm so excited to read the rest. Tegan Kehoe Yeah. Malpractice Podcast So could you tell us how you got into this field of work? Tegan Kehoe Sure. So I got into history museums very intentionally, and got into medical museums a little bit unintentionally. So I was interested in a career in history museums, started volunteering in some in college, started browsing course catalogs for what grad school in this field would look like. So I have a master's in history and museum studies. And I always knew that I wanted to do things that involved both the curatorial and the education side, and jobs like that are a little bit hard to come by. And I also, among my many interests within history, had sort of a hobby interest in medical history. And after grad school, this position that I have now opened up, that was both the exhibit side and the education side, and a medical history museum. And so I've been there about six years now. And I've just been going deeper and deeper, you know, wrote a book and continuing research on medical history topics. Malpractice Podcast That's so cool. Malpractice Podcast And your book, which is so cool, like the amount of people that I know that can say they've written a book, it's like two, and you're one of them. Can you tell us why you chose to do that? Tegan Kehoe Sure. So I've known that I wanted to write actually longer than I knew that I wanted to work in museums. And so I had been, you know, looking for an opportunity that, that I was actually qualified to write, because there are lots of books I would love to write where I wouldn't necessarily be a good person to be the one to write them. Malpractice Podcast Yeah. Tegan Kehoe And then I, you know, had a couple of false starts and that sort of thing. But I saw this call for proposals from a professional organization in my field, the American Association for State and Local History. And they normally do books that are specifically aimed at people within the profession, and volunteers, so people within the field, but this series is really for both people inside the museum world, and people who just like museums, so it was a new thing for them. And they put out this call for book proposals on this theme of exploring a topic in 50 "historic treasures" as they call them. So, museum artifacts, historic sites, around the country. And I thought about whether that would be a good fit for what's now my expertise, medical history, and I thought, very much a good fit, especially because medical history is inherently visceral, it's tangible, it's stuff you can touch. It's stuff that even when you can't touch it, it can touch you when it's something like a microbe. Uou you know, viruses and bacteria can touch us, even if there isn't something tangible to put in a museum exhibit. That's just a really good fit for talking about that history, through the lens of material things. And so, I wrote the proposal and they were interested. And you know, from beginning to end, it was a couple year process, there was a lot of research. And if I write another book, which I definitely plan to, it will definitely not be on 50 different subjects. That was a lot. Malpractice Podcast Yeah! Tegan Kehoe But it was a fantastic experience. Malpractice Podcast No, it's so cool. And the -- for our listeners -- in the book, Tegan has images of all of the different medical instruments and illustrations from from the time period like they're so cool and so interesting. And as kind of a history buff myself, I was, you know, obsessed with it. When you think about historical writing, what kind of keeps you interested and engaged? And what about specifically, like, medical history kind of drew you to -- maybe you've already answered this -- what kind of drew you to that topic? Tegan Kehoe Sure. I think that, for me, and for a lot of people, history is about stories, they're true stories, but they're stories about what motivates someone or what problem they're trying to solve. what question they're trying to answer, kind of, sometimes who they are as a person, what drives them. And sometimes you don't really know the stories, you don't really know the personal stories, when you look at historical things. But you can get at some collective stories, even if you don't know, you know, oh, these two people who were research partners didn't get along personally. You might not know that kind of backstory. But you know, solving this problem had a big societal effect, or was supposed to, but didn't. Yeah, one of my favorite chapters to research was the one on alternative medicine in the 19th century, where much of what was being done doesn't hold up to the scientific standards of today. Much of it didn't hold up to the scientific standards at the time. Malpractice Podcast Yeah. Tegan Kehoe Yeah. Tegan Kehoe The artifact itself is a bottle of Hostetter's Celebrated Stomach Bitters. that was the name, with "celebrated" in the name. And it was supposed to cure all kinds of GI distress. And it was basically an alcohol with some herbal tincture. It didn't really do anything. Malpractice Podcast Cool. Tegan Kehoe But they were marketed as an alternative when Malpractice Podcast Yeah, Tegan Kehoe a lot of scientific medicine wasn't really scientific yet, either. It was a lot of mercury pills. a lot of bloodletting. Malpractice Podcast A lot of cocaine. Malpractice Podcast Yeah. Tegan Kehoe Yes. Actually, Hostetter's predates cocaine. But but there is a chapter on cocaine as well. Malpractice Podcast Oh, cool. Tegan Kehoe And yeah, and you get that sort of thing when you're looking at medical history of oh, that predates cocaine, and let's talk about the beginnings of cocaine, and... Malpractice Podcast Yeah. Tegan Kehoe Which was actually the first successful local anesthetic in addition to being you know, a very dangerous drug. And so that has its own story. Malpractice Podcast Yeah. Tegan Kehoe And so yeah, I think that the personal stories, but also there are fascinating stories, even when they're not personal. And that's one of the things I really like about it. Malpractice Podcast Yeah, that's so cool. And are some of my favorite topics that we've covered have included things like this era, when, you know, we didn't we did an episode, and there's a chapter in your book, I think about opioids, right? And kind of learning that in the early 1900s, they were just like, oh, yeah, your, you know, your liver hurts. Did you try heroin? Tegan Kehoe Right. Malpractice Podcast It's like, now we think about that, and you're like, why would anyone do such a thing? But at the time, it's kind of all they had? Tegan Kehoe Yeah. Malpractice Podcast Right. And they just did what they could, right? Tegan Kehoe Right. And a pain medication that's extremely potent, that was seen as wildly successful. Malpractice Podcast Yeah. Tegan Kehoe Because they didn't have anything that potent before. And so not knowing enough about the side effects, not knowing enough about the addictive properties. It was, based on what they knew at the time, it was excellent. Malpractice Podcast 100%. Yeah, yeah. Tegan Kehoe And the course of the 20th century is really when we start to see changes in requirements, well, the existence of requirements, and then changes of requirements, of medical testing, and testing medications, and making sure that your studies are scientifically rigorous. Some of that had been going on before the 20th century, but it wasn't mandated until the 20th century. Malpractice Podcast Yeah. Tegan Kehoe And so while there are still absolutely things that go wrong in medicine, either through lack of knowledge or through malfeasance on often on the part of the big corporations that are involved. I'm not saying that drugs don't hurt anyone anymore. But we don't have nearly as many of those, "Oh, we just didn't know about that problem for decades, while millions of people were using this." Malpractice Podcast Right. Tegan Kehoe Because of those regulations, we don't have nearly as much of that anymore. Malpractice Podcast Yeah. Well, love your mention of, like, telling the stories. When I first started teaching Texas history, I would start every class like, "Okay, let me tell you a story." I'm pretty sure they thought the entire class was fiction. I literally was like, "let me just tell you a story." And they would take tests about the story. But we want to give you the space to really talk through maybe your top three topics in your book. And you know, I think you have so much to share, information-wise. So we'll let you kind of start roaming free in your educational space here. We're just captive listeners. So go crazy. We're okay with it, that's welcome here. Tegan Kehoe All right, well, thank you. So I cannot choose my top three, because I probably have twenty favorite stories from this book of 50 stories. Malpractice Podcast We love that. Tegan Kehoe But I do -- Malpractice Podcast We'll make it a series, we'll just keep interviewing you. Tegan Kehoe But I did pick three that I can relate to one another. And so they they kind of tell a bigger story, in addition to their own stories. And that bigger story is really about the medical establishment, and people, influential people within the medical establishment, making decisions on who's worthy of receiving care and what type of care. So one of the artifacts in my book is a craniometer, meaning a measurement tool, kind of a set of calipers for measuring a human skull. These are still in use today. Things like when you determine whether a newborn's head is in the, you know, 50th percentile of newborns or the 90th percentile, that sort of thing. You're taking human measurements, the field of anthropometry, which is where this craniometer fits into, Malpractice Podcast Yeah, Tegan Kehoe you know, has some useful and benign applications, including up through today. But you can tell by the fact that I'm saying this is still used, and there are benign applications, that what I'm about to say is not a benign application, because so the craniometer was invented as a way of measuring heads in order to tell things about people. And those things, well, it wasn't accurate, but it gets worse from there. Malpractice Podcast Yeah. Tegan Kehoe So phrenology you may have heard of, or you may have seen those those busts, they're kind of popular as reproductions. It was the study of "determining," and that's in quotes, things about people's personality and their character by examining the bumps on their head. This sort of hit its peak at about the 1810s to 1840s. And it was a pseudoscience, but it was practiced by a wide range of people from people that would be kind of easily recognized as engaging in pseudoscientific endeavors, you know, people who are basically traveling showmen. And also it was embraced by some people who had been kind of legitimized through the medical school system, and were official doctors. It actually did have influence on early psychology and neurology and the concept that different areas of the brain have, Malpractice Podcast right, yeah, Tegan Kehoe different functions, that was kind of inspired by phrenology. But phrenology itself was never... there was no accuracy in it. Malpractice Podcast Right. If you're a medical doctor practicing something that you also can see at a carnival, reevaluate. Tegan Kehoe Yes, definitely. Although actually, we'll come back to that, because there's a point in one of the other stories -- Malpractice Podcast Oh, no. Is there a good thing? Tegan Kehoe Yes. Malpractice Podcast Okay. Tegan Kehoe But I think that that's, it was a pretty unique circumstance. And I think that overall, your rule definitely stands. I think that, you know, people should never take medical advice from podcasts or from historians, but yeah, but that one, "if it's at a carnival," it's probably a good rule. Malpractice Podcast Yeah, thank you. We like to make wild accusations here. Yeah. Yeah. Tegan Kehoe So, so that was one thing you could do with a craniometer was measure someone's head for this. Phrenlogy sometimes played into stereotypes, you know, the particular practitioner might say that a man's intelligence head bump was greater than a woman's intelligence head bump, um there's, you know, racism and stuff in there too. But it wasn't a system codifying or promulgating racism. But what overlapped with it and came afterwards absolutely was. So the the field of scientific racism was a school of thought within medicine and within anthropology and kind of any field that's studying the human body or studying humans as a group and dividing people into races. Normally today we don't talk about medicine as a field that divides people into races, but it was a big, big thing in the 19th century. So a scientist named Anders Retzius created what he called the cephalic index, which was a way of quantifying how round or how tall your head is. So whether it's wider than it is tall or taller than it is wide, and where it is in kind of the gradation between that, and he assigned those to racial categories. Those assignments were messy, but at least they had some grounding in fact. But you can kind of see where this is going. The reason that he wanted to do that was so he had a quantifiable way of how civilized a person or a race was. Malpractice Podcast Yeah. Tegan Kehoe How advanced they were, that sort of thing. So that was one of the first quantifiable changes in scientific racism, where it was really, alright, we're scientists, and we believe that white people are the best. And so we're going to figure out a way to put that on paper. Malpractice Podcast Yeah. Tegan Kehoe And so throughout the 19th century, into the 20th century, this was a really big part of both medical research and anthropological research. You saw a number of medical museums being formed some part of the US government that were collecting specimens of human beings, pretty much entirely against those human beings' will. And when I say specimens, I mostly mean human remains. I don't mean living people. There were touring exhibits that included living people, usually either without their consent or in an extremely exploitative situation. But these collections that were created for scientific study, were really used again and again to reinforce these same racist ideas. Malpractice Podcast Right. Tegan Kehoe A lot of the collecting practices were grave robbing. But grave robbing is mild compared to "oh, well, we're also engaged in wars against a number of different Native American nations right now. Why don't we have soldiers bring back the bodies when they're done killing people," Malpractice Podcast Ugh. Tegan Kehoe "Or robbing graves that are being protected by armed guards? And if you kill the guard, oops." So these really brutal and dehumanizing practices. Malpractice Podcast Yeah. Tegan Kehoe Where dehumanizing was really kind of the point. The point was separating people out. And especially when it came to Native peoples, right, US government and scientific authorities at the time, were really invested in this quote-unquote, "vanishing Indian" narrative, in which the idea was, "we're not committing genocide, this group of people is just vanishing. They're constitutionally weaker. Native American groups," Malpractice Podcast Right. Malpractice Podcast Yeah. Tegan Kehoe were more susceptible to certain diseases, epidemic diseases in the 19th century. Largely, because those diseases were attacking people with insecure housing, poor access to health care, trauma. If they are being moved across the country forcibly, if they are under literal attack, if there's warfare going on. Malpractice Podcast Mm hmm. Tegan Kehoe You know, today, we call those social determinants of health. Malpractice Podcast Right. Tegan Kehoe So yes, Native Americans were dying of tuberculosis faster than other people were dying of tuberculosis but it didn't mean that they deserved to die faster than others. Malpractice Podcast The idea of like a population vanishing is so passive, when you're actively perpetrating these things. Malpractice Podcast Right? Tegan Kehoe If you're forcing a group of people to live in poverty, to to live under really horrible conditions, that are going to be more susceptible to things. So I want to switch gears, but at first, it's not going to sound like I'm switching gears. Because one of the other topics in the book is eugenics, which was the -- well, is -- the system of belief within science and social science, first of all, that what characteristics in people are inheritable is very important. And second of all, that you can improve society by choosing what genes future generations get. Malpractice Podcast Yeah. Tegan Kehoe And by extension, it's also choosing who deserves to live longer, who deserves to have access to medical care and so on. So some people say that something cannot be considered eugenics unless it's talking about the gene pool and further generations, but eugenic thought really exists within how people are treated within their own lifetimes as well.

Malpractice Podcast Yeah. No, 100%. Tegan Kehoe One of the sort of predecessors to this was this 18th century theory that it would be just impossible -- it would be against natural law -- for food supply to ever outpace population growth, just the population is always going to grow faster than we can feed people. And therefore there will always be poor people, and therefore, it's not helping anyone if you help poor people, because apparently poor people aren't anyone. Malpractice Podcast Gross. Tegan Kehoe Yeah, very gross. Malpractice Podcast We hate to see it. Tegan Kehoe And so this theory stuck around, even though it's been disproven many times because there have been many times when food supply outpaces population growth, but also this, quote unquote, logical progression from there will always be poor people to and thus poor people don't deserve help. That's not provable. But it's also just... Malpractice Podcast Yeah. Tegan Kehoe Wrong. I mean, there's an ethical issue with it, a really big one. Malpractice Podcast Yeah. Tegan Kehoe But eugenics combined this passion for the science of genetics that was going on in the late 19th century, with this idea of that it's important to help society. But the way you do that is by lifting up the people who are already successful, because if they're successful, they must be doing something right. They must be constitutionally, genetically doing something right. Malpractice Podcast Yeah. Tegan Kehoe So the artifact in my book that's related to this is a medal from a Fitter Families pavilion at a state or county fair. And Fitter Families contests were like livestock contests, except they were for humans. And they were for human families. And people were judged on whether they had normal or superior genetic qualities. A side note to this, one of the other common things in sort of heyday of eugenics from the late 19th century up to about the 1930s is this obsession with the idea of heritable traits. Malpractice Podcast Right. Tegan Kehoe And so lots and lots of things that today, we know cannot be inherited -- or we know, maybe there's a genetic component, but it's really complicated -- they were considered absolutely black and white heritable traits. Malpractice Podcast Yeah. Tegan Kehoe So intelligence, kindness, patriotism, criminality, all of these different things good and bad, were considered genetic. And these, in addition to having these contests where the winners were told that they were of good stock, and that they should breed a lot. And the losers were told that they should not breed and not marry if they hadn't already, because marriage leads to breeding. Malpractice Podcast That's so stressful. Malpractice Podcast Why would you enter that competition? I would never want that kind of feedback in my life. Malpractice Podcast Also, how as a family, do you decide to do that like, "Okay, kids, everybody pee in your cups? We're gonna go take this to the state fair." Malpractice Podcast Yeah, right. No, thank you. Tegan Kehoe But it was it was very normalized. At the time I read some newspaper coverage of these fairs. Yeah. And it was it was like the newspaper was reporting on a high school football game. And I think I even made that observation in the chapter about it was just. Malpractice Podcast Oh, my God, Tegan Kehoe very, very normalized. People were excited about this idea. And so, you know, today at a county fair, you might swing the comically large hammer at the thing that tells you whether you're a strong man and, and people do it, because it's fun to think that they might be good at it. Malpractice Podcast Yeah. Tegan Kehoe And I think that that was part of it. People who already knew that they were going to get at least average points in this kind of thing, because eugenics was not some brand new idea that had completely different sets of prejudices from the rest of society. No, it was healthy, able bodied white people who were doing well in these competitions. Malpractice Podcast Right. Tegan Kehoe So people who already thought that they might do okay were inspired. Malpractice Podcast Which is gross. Malpractice Podcast Yeah. Which is super gross. Tegan Kehoe Yeah, no, absolutely. And I think a lot of them didn't think they were hurting people. Didn't think that eugenics was hurting people but definitely didn't think that they were hurting people by participating in this. Malpractice Podcast Right. Tegan Kehoe And they weren't necessarily directly, but the indirect effect of letting this continue to be this big phenomenon, absolutely hurt people. Malpractice Podcast Right. Tegan Kehoe It's really hard to talk about this part because it sounds like hyperbole. But the Nazis got a lot of their ideas from American eugenicists. Yeah, they moved faster on them, than American eugenicists did, they sterilized a lot more people a lot quicker. But American eugenics societies were influencing the sterilization of prisoners and inmates in mental health institutions, up through the 1970s at least. That's when there's a lot of documentation. I don't know that it necessarily ended then. And, you know, the Nazis used race-based justifications for murder that were never implemented on a government scale here. But you know, eugenics absolutely harms people. Malpractice Podcast No, 100%. Tegan Kehoe Yeah. There were instances of doctors promoting infanticide for disabled or mixed race babies in the United States. And some of them got some pretty positive press coverage about that. And so that's why I want to say that the US never murdered people out of eugenics on a government scale. But on an individual scale, there was some of it that went on, and I don't even know if the extent of it is documented. Malpractice Podcast Yeah. Malpractice Podcast I mean, if anything that you did heavily influenced Nazis... Malpractice Podcast You messed up. You messed up. Malpractice Podcast You probably want to consider that an error. Tegan Kehoe Right, right. Yeah. And after World War Two, a lot of Americans started to distance --distance themselves from eugenics. But a lot of them put that distance in what I would consider to be the wrong place, just from an ethical standpoint. They would say, "Oh, we practice positive eugenics, we try to encourage healthy, normal, good people to breed rather than discouraging abnormal, tainted (their words) people from breeding, we're not sterilizing people, we're incentivizing people." Malpractice Podcast Okay. Tegan Kehoe And that kind of language of like, positive versus negative eugenics had existed before the war, before the Nazis. But that was one of the ways that they justified it to themselves and to each other. Malpractice Podcast Yeah. Malpractice Podcast Lots of times in scientific history, in my experience, and what I've heard because I'm a, so I'm in a neuroscience Ph. D program. And with that, a lot of what I do is behavioral biology. A lot of neurobehavioral biologists don't necessarily have the best backgrounds with eugenics. It's not really a secret. It's something that I think the field is coming to terms with and atoning for now for the first time, maybe ever, with the new generation of scientists coming in. But it's like, one of the members of my committee was not trained by but was trained by someone who was outright a eugenicist. James Watson of the famous Watson and Crick duo is a eugenicist and has been stripped of titles for being a eugenicist like unabashedly. And I think it's really interesting to hear your take on the medical history of like where they're, they're placing the the distance in the wrong part, right? They're like, "Oh, well, we'll, we're just encouraging, like positive breeding." Anytime you're saying like, the breeding of humans, you're probably dabbling in eugenics. Malpractice Podcast Yeah. Yeah. Or at least your eugenic eugenics adjacent. At the minimum. You're right there, you're on the cusp, you should stop. Tegan Kehoe And if you're, if you're breeding for selected characteristics, which is, you know, when you start calling it breeding, rather than just having kids, Malpractice Podcast Correct. Tegan Kehoe then you're you're making some kind of value judgment about those characteristics. And I think that that's the other thing that makes makes eugenics eugenics is that, you know, in the heyday of eugenics, it was, people were really excited about the ways that science could contribute to society. This was kind of the tail end of the progressive era, there were a lot of new scientific innovations. Germ theory was pretty new. You know, there were a lot of great things happening. And people were saying, yes, science can make the world better, science can make society better. Malpractice Podcast Right. Tegan Kehoe And so it really it took off. But it also took off because it kept confirming things that people already thought they knew and believed in. Malpractice Podcast Yeah. Tegan Kehoe Because the people who wrote these textbooks also believed those things. So it was wildly racist, wildly ableist. Often classist and various other, a lot of things that we now know are absolutely based on people's circumstances were believed to be something inherent. Malpractice Podcast Yep. Tegan Kehoe People had long said that these things like criminality were inherent to someone's character. Now, they were saying they're inherent to their physical makeup. Malpractice Podcast Right? Society's like how can science contribute to society? And science is like twirling its goatee, like how can I further my own agenda? Tegan Kehoe Absolutely. Malpractice Podcast And that's exactly what happened, right? Tegan Kehoe Mm-hmm. And eugenics was really mainstream within American medical schools and European medical schools in the early part of the 20th century. So the fact that, you know, you know people who studied under people who studied under eugenicists is probably the norm and not the aberration. Except, I think one of the things that's changing in society is that we're starting to acknowledge and look at -- Malpractice Podcast Yeah. Malpractice Podcast Right. Tegan Kehoe All right, just how eugenicist was this particular person. Malpractice Podcast There has to be a cut off on the scale here, that we just -- chop them, right, all these people got to go. Tegan Kehoe And let's not make that cut off negative versus positive eugenicists. Malpractice Podcast Right, just just a general... Malpractice Podcast Please no, that's not the cutoff line. Tegan Kehoe And I absolutely as a historian am passionate about looking at people in their historical context, because someone who is in medical school when all of their instructors are teaching eugenics, they're in a very different position from someone who stumbles across it today and gets really excited about the idea. Malpractice Podcast Yeah. Tegan Kehoe And not that there aren't people who are being exposed to this by their teachers today. But I do want to make sure that we look at people in their historical context, but also want to look at all people in the historical context. You know, people with congenital disabilities did not feel the same way as able bodied people. But they were typically not able to attend to those medical schools because of the structural ableism in place. Malpractice Podcast Yeah. Tegan Kehoe So they were not in the room talking about whether or not they should be alive. Malpractice Podcast Yeah. Right. Malpractice Podcast It's also though, like, if you're, let's say, you know, James Watson's age, and you're 100 million years old, and you haven't changed those opinions, right? I feel like you've, you've had the opportunity to reevaluate how you were taught. And sometimes it's time to just, you know, be like, "Well, it's time to change." But I do appreciate what you're saying totally, that it's very different from like a modern, like a modern eugenicist. That's a hard problem. So how do you kind of as a historian, how do you kind of, you know, finagle, your distaste for some of these things with like, what it was at the time? Tegan Kehoe That's a yeah, that's a great question. And I think that, in talking about topics like these, I find it important to state where my own moral values lie, even when I'm talking about the facts of history. Because they continue to do harm. These ideas continue to do harm. Malpractice Podcast Yeah. Tegan Kehoe But when looking at, you know, writing about historical figures, who are doing incredible amounts of harm, I try to focus on the harm they caused, rather than who they were as people. Malpractice Podcast Yeah. Tegan Kehoe And look at what motivates them. And what motivates them might be racism. But it also might be a passion for their scientific career, that sort of thing. And I try not to get into the "was this person good or bad?" It was, this person did a lot of really wonderful things, and a lot of really awful things. And if we're going to look at them, we need to look at both. Malpractice Podcast Yeah. Tegan Kehoe And also look at their victims, or the people fighting back against them, or look at all of the different people in the equation. So the people who are attending that fair saying, "Alright, kids, we're going to go and go for the gold." And the people saying, "All right, well, that fair is physically not safe for me, because people like me get lynched there." Systems of power and oppression that privilege some racial groups over others that are happening in the literal, same era. There's obviously an indirect connection there. Malpractice Podcast Correct. Malpractice Podcast Yeah. Yeah, that's a really good point. Tegan Kehoe Just looking at all of the people involved, and their different relationships to the power structures is kind of the perspective that I try to take. Malpractice Podcast Yeah, I think you did a great job of that in the book, it comes across really well. Malpractice Podcast Yeah. Tegan Kehoe Thank you. Tegan Kehoe I do want to tell one more story, if we have time. Malpractice Podcast We do, yeah. Malpractice Podcast Absolutely. Tegan Kehoe And this one is -- excellent. And this one is actually from the same era as the Fitter Families metal. But it's it's a much happier story. And this is why I wanted to put a pin in that idea of "if this medicine is happening at a carnival, it's probably bad." Fitter Families is another example of public health that's happening at a carnival that's bad. Although state fairs and things did also have information booths about not spreading tuberculosis. They had a lot of good things going on in the Progressive Era. Again, this idea of science can make society better. Malpractice Podcast Yeah. Jess But also in the early 20th century, late 19th to early 20th century, there were a couple of people in the United States, who really wanted to get baby incubators to catch on. Some of those were doctors. The field of obstetrics was kind of new because specializing that much was only a few generations old in that era. So there were a couple of obstetricians who were trying to get baby incubators to catch on for preterm babies, you know, babies who couldn't make it if they didn't have any medical help, because they were born too early. And these doctors were theorizing that we have the technology to help them, we just need to apply it. Malpractice Podcast Right. Tegan Kehoe There was also a man named Dr. Martin Couney, who -- the doctor was a part of his name that he added himself it was not was not because of a medical degree. Malpractice Podcast Okay. Tegan Kehoe Who was also passionate about ensuring that preterm babies had a chance to develop into, you know, healthy kids and adults. And he made a business of displaying baby incubators at carnivals, at World's Fairs, at Coney Island. He recruited families to actually display their live preterm babies in these incubators, because those incubators weren't available anywhere else yet. Malpractice Podcast Yeah. Tegan Kehoe You couldn't go to the hospital and have your baby cared for an incubator there. Because your local hospital did not have a baby incubator. Malpractice Podcast Mm hmm. Tegan Kehoe And so they would let this I don't know if sideshow was really the right word. But you know, carnival act, take care of these babies. Malpractice Podcast Yeah. Tegan Kehoe He was not a doctor. He almost never had a doctor in his employ. He did have nurses, which I think is how the babies did so well. Yeah. And this is actually around the era when nurses started getting really good professional training, whereas before it had been largely something that you learned on the job, Malpractice Podcast Which is crazy to me. Malpractice Podcast Yes. Tegan Kehoe Yeah. Malpractice Podcast Can you imagine? Couldn't be me. Tegan Kehoe Yeah. And it's I think the root of a lot of the negative stereotypes about nursing being just a caretaking role. I mean, caretaking is very important, but it's not a healthcare role. But a lot of the things that persist today, were true ... in the 1840s. And then, about the 1870s, 1880s, that stopped being true. And nursing became this really important, trained medical health care role. Malpractice Podcast Right. Tegan Kehoe And so some of those trained nurses were taking care of these babies. And it was the start of an ideological shift, because many doctors at the time, didn't believe that these babies could be saved. And so they weren't going to waste energy on something that they felt was just doomed. And especially, I think there's likely to be an emotional component there, that you don't want to get invested in a three pound infant, only to have them die on you three days later. If you think that that's inevitable that you're never going to save them... Malpractice Podcast Right. Tegan Kehoe It's not going to happen. But between the doctors who are involved and Dr. Couney, it did catch on. More and more doctors started to realize, no, this is possible. We actually can save preterm babies' lives. And they can grow up to be completely healthy, indistinguishable from a full term baby. And so that was a huge, huge shift. I think 1930s or so was when it was pretty mainstream. But the shift kind of continued, yeah. And then connecting it back to eugenics and scientific racism. I think the shift is still in progress towards, "if you can save a baby's life, but they're not going to grow up to be healthy, they're still worth saving." Malpractice Podcast Yeah. Tegan Kehoe Because their life is still worth living. Malpractice Podcast Right. Tegan Kehoe And so that's a shift that I think for some people is very much still in progress. And if you, you know, listen to disability activists, there are a lot of people who have faced a lot of abuse because people believe their lives aren't worth living. But sorry, I wanted to end on a happy note. And that happy note is baby incubators. And the incubator in my book is from the 1930s. It's from Nebraska. Couney started in the US in Nebraska, although this is from later. So it's kind of two different snapshots. And I found a newspaper article, not about a baby who had been in the particular incubator in the book, the years are just a little bit wrong for it to be that incubator. So I found a couple of newspaper articles about this one girl, and one of them said that you know, with luck, she'll grow up to be the next Greta Garbo of Cass County. I just thought that was such a charming, extremely period way of putting it. I later was able to look up her information. This is the wonderful thing about living in a time when so much has been digitized. And I found that that that girl lived to age 63. Malpractice Podcast Wow. Cool story. Malpractice Podcast Yeah. As you've studied all of these time periods, if you had a time machine, what would you go back and see, first? Malpractice Podcast Oh, good question. Tegan Kehoe Very good question. Um, so I have this really love hate relationship with the Progressive Era. Because so much of it was so idealistic, and they were ideals that I largely agree with. And there was a lot that went wrong in that period. And the Progressive Era is sort of the era following a lot of industrialization in the US when a lot of both private groups and social movements and also public policy were aimed at fixing or making stopgaps in some of the societal ills of industrialization. So, hey, maybe child labor isn't so great, that sort of thing. Malpractice Podcast Yeah. Tegan Kehoe But there was a movement of public lectures, where that was just a form of entertainment that people would go to, not limited to the progressive era, but that's some of the stories I've heard that I'm most interested in are from that era. Where it was this idea of, oh, let's improve society with knowledge, not necessarily science, but just knowledge. And it's not that we don't have that now. I mean, we have educational podcasts, we have TED talks, we have all these sorts of things. But there's just something about the way I see described people getting swept up in that, yes, let's go to a lecture as our form of entertainment. Malpractice Podcast Yeah! Tegan Kehoe That's something that I would want to experience, even though I mean, I do go to lectures at libraries, museums and things. So it's a ... it's just the cultural phenomenon part I think I'd want to see. And that could be medical history, or a medical topic at one of those lectures or not, you know, if I had a time machine, maybe my first impulse wouldn't be research, but just fun. Malpractice Podcast Fair. Malpractice Podcast Yeah. We ask all of our guests on the podcast this last question. And it is, how do you take your coffee? Tegan Kehoe Very occasionally. I'm a tea drinker. Malpractice Podcast Oh, really? Tegan Kehoe I do love coffee, but I love tea more. So typically, black tea, as strong as I can find it. Typically kind of boring, like English or Irish breakfast, but very strong. When I do take my coffee I prefer it black, but I often have it with a little milk, because that's a little gentler on my stomach. Malpractice Podcast Yeah. Tegan Kehoe And the first time I said that out loud was kind of a wow, I've hit adulthood. I prefer black coffee but makes my stomach a little ooky. So that was like three different answers to your one question. Malpractice Podcast But we love it. Malpractice Podcast Perfect. Yeah. It's definitely a coming of age moment when you're like, oh, I have a specific way that I take my coffee. And if I change that up, I'm gonna feel bad. Malpractice Podcast Yeah. Malpractice Podcast Yeah. Yeah. Well, you've been so generous with your time, especially with the re-recording of this episode. Your stories are incredible. Your book is amazing. We're so honored to have you as a guest on the show. Thank you for being here. Yeah. Tegan Kehoe No, it was my pleasure. It was it was a delight to have this interview. And yeah, thank you both so much. Malpractice Podcast Thanks so much. Malpractice Podcast Hey malpals. Thanks for listening. The sources and links for this episode can be found in our show notes. If you haven't already, go follow us on social media. You can find us on Instagram, Facebook, and Twitter at malpractice podcast. You can also send topic suggestions, questions or concerns to our email. And just as a reminder, if you like what you're hearing, you should definitely subscribe, rate and review us on Apple podcasts, Spotify, Stitcher, or wherever you like to listen. Don't forget, malpractice makes perfect Malpractice Podcast Heyoh, negative for co-v. Still negative. What's up? Malpractice Podcast That's cuz you got that boost. Malpractice Podcast I don't have the cove. Malpractice Podcast You know how they used to be like, "Oh, you have cooties." They're gonna be like when we're older. They're like you have COVID you get your booster shot. You're disgusting. Malpractice Podcast It's all our generations' children who like having the cooties and Malpractice Podcast It'll say circle circle dot dot now I have my covid shot, circle square square boostie boostie everywhere. Malpractice Podcast Oh my god, I'm putting that in this episode. You can't stop me. Malpractice Podcast I don't care. Malpractice Podcast Okay, perfect.