Transcript: The Small Business Radio Show with Barry Moltz, #666 segment 3: Interview with Tegan Kehoe
Transcript: The Small Business Radio Show with Barry Molz, #666 Segment 3: Interview with Tegan Kehoe
Stick around to get your small business unstuck. More of Small Business Radio with Barry Moltz now on WCPT 820, Chicago's progressive talk.Barry Moltz Well when we think of inventions and innovations, rarely do we think in terms of medical advancements in history, although we are living through a significant one right now with a COVID vaccine, but like business, it has its share fair share of twists and turns and false starts. My next guest is Tegan Kehoe, who is a public historian specializing in healthcare and science. Her book is exploring American Healthcare through 50 Historic Treasures. Tegan is the Exhibits and Education Specialist at the Russell Museum of Medical History and Innovation at Mass General Hospital in Boston. She has an unintentional pattern of writing about 19th century medical ideas and experiments, having written adaptations of Edgar Allan Poe's The Premature Burial and Stephenson's Jekyll and Hyde. Tegan, welcome to the show. Tegan Kehoe Thank you very much for having me. Barry Moltz I got to ask you about these unintentional patterns of writing. How did you get started with those things? Tegan Kehoe Sure. Well, I think in my nonfiction, I very deliberately write about medical history, but it has seeped into my hobby life. So the adaptations that you mentioned are of novels and novellas into radio plays for a local radio play group. And I think that just the more I research medical history, the more I realize how fascinating it is, and so it, it infiltrates other things I do as well. Barry Moltz You know, when we think of medical history, and I think this has to do with a lot of even business innovations, we think it as a steady march and things are always, you know, they're always linear, but that's not really the case is it? Tegan Kehoe It really isn't I think that the history of science sometimes gets oversimplified. And that march narrative can be useful sometimes, but really, there are a lot of ups and downs and twists and turns. Barry Moltz And so is that because actually making true innovations just like any place else does take time? Tegan Kehoe Yeah, I think that's a lot of it. It can take time, it can take resources that aren't necessarily readily available to the first person who first makes the discovery. A great example of this is the discovery of penicillin, probably one of the most famous eureka moments in medical history. It was actually, the discovery was unusable for almost 15 years, until further innovation and cross-discipline collaboration made it into a viable treatment. Barry Moltz When you say it was unusable, give us a little more background on discovery of penicillin, because I think most of us think, "Oh, someone discovered penicillin, and then we use it to combat all these diseases." Tegan Kehoe Yeah, absolutely. So that eureka moment was in 1928, when biologist Alexander Fleming returned from a vacation to find that some of his petri dishes had gotten moldy. And Penicillium mold seemed to be killing the bacteria colonies in the dish. So if you've heard the story, that's probably the part that you have heard. But at the time, bacteriologists and chemists rarely worked together and rarely worked on medicine. And this kind of collaboration was going to be necessary in order to make something of the discovery. And so the big problem didn't end up being whether penicillin worked, but how to grow enough of the mold to produce enough penicillin to make a difference in the human body. Is it alright if I elaborate more on this story a bit? Barry Moltz No, please go ahead, it's fascinating. Tegan Kehoe Yeah. So 10 years after Fleming's discovery, pathologist Howard Florey read Fleming's paper on the subject, and he decided to tackle the problem, along with biochemist Ernst Chain and others. So in those intervening 10 years, these cross-discipline collaborations had become more common. And so that was one of the sort of missing pieces. And so to grow enough mold, a colleague of theirs realized that a particular type of bedpan that had actually recently been discontinued, was perfect for growing penicillin, because Penicillium mold only grows on the surface of the culture you're growing it in, and this shape of bedpan maximized the surface area. So they custom ordered them from a ceramics manufacturer to have these bedpans that they were using for mold culture. An example of that mold bedpan is in my book. Barry Moltz It's amazing. It's amazing. Tegan Kehoe So it was in 1942, after a number of problems, like the surface area problem, that the team finally saved a patient's life with penicillin for the first time, and the rest is history. Barry Moltz So is this fairly a traditional way that these medicines get developed? And is it -- I mean, I think it's fairly amazing the way that the COVID vaccine has been developed, where, I mean, they've been doing the research for a while, but they were able to develop the vaccine within a year. Is that unusual? Tegan Kehoe It is, and it isn't. I think that one of the things that's fairly common about the penicillin story is that it was absolutely a team effort. And that's true of almost every medical discovery, especially by the time it gets to the point where it's being put in the human body. The COVID vaccine was both typical and atypical in that a lot of the research had already been done. But it hadn't been applied to something that had gone through all the way to getting to people, for a variety of reasons. You know, one thing that looked like it was going to be a pandemic petered out, or another thing just didn't have funding, and so on. And so that essential idea of lots of research and a team effort from many, many collaborators was a big part of the COVID vaccine. And then the thing that made it extraordinary was just how many people and how much funding and how it was being prioritized over nearly everything else in medicine, because it was such an important thing that it happen quickly. And so that prioritization and allocation of resources, is what made something that was otherwise, following really established practices in medicine, be able to happen that quickly. Barry Moltz We're talking with Tegan Kehoe who's the author of a book called Exploring American Healthcare through 50 Historic Treasures. Keegan, why did you decide to tell the story through actually physical objects? Why was that important? Tegan Kehoe That's a great question. So, the short answer is because that's what the publisher wanted. Barry Moltz [Laughter] Tegan Kehoe This is part of a series. It's part of a series written by different historians and museum professionals with different topics, all through the lens of artifacts. And I'm also a museum professional. So artifacts are my expertise. But I also think that they're particularly suited to telling the stories of healthcare and medicine, because it's such a visceral subject, and having those physical things, even if in this case, they're just two dimensional photographs in a book, those physical things become touchstones for really understanding. We're not just talking about premiee care, we're talking about an incubator made of wood heated with a light bulb, the size of a large shoe box, or we're talking about a device used to measure people's heads, when 19th century racists are trying to create a scientific justification for their racism, which they were very successful at popularizing. Not so successful at actually doing any real science about it. But those things make it visceral, make it tangible. And that's just such a great fit for the subject. Barry Moltz And we look back, we look back on some of these artifacts, sometimes we think they're rudimentary or barbaric. I remember looking back on the, I guess, the iron lung, you know, for polio. Is that an unfair lens to look back through that these things were really rudimentary and barbaric? Tegan Kehoe I think it's a really natural lens for people to use, because we are comparing it to the present day and to our own experiences. And some of these things did cause a lot of pain or suffering, or didn't alleviate pain and suffering the way our modern equipment does. But I think this goes back to whether progress is a steady march forward. A lot of what's in the book, people are really doing the best they can with the information they have at the time. Sometimes that meant huge scientific breakthroughs. The iron lung, which helped a number of patients, many thousands of patients, survive polio, was really state-of-the-art at the time. I also have some things in the book that were never scientifically state-of-the-art, but people chose to use them. And in the book, I tried to dig into those reasons, whether they're cultural, whether they have to do with people's understanding of what the science is, and so on. Barry Moltz Well, we've seen that in our own lifetime that people use things that don't have any kind of scientific verification, especially to combat COVID. What were some of the things you include in the book that weren't necessarily state-of-the-art? Tegan Kehoe Well, one example it kind of straddles the line between state of the art and not. So a historic site in my book, The Saranac Lake Laboratory and its environs was the site where many patients took the, quote, "rest cure" for tuberculosis, which really never had any medical backing. But there was a period when it was as close as state-of-the-art as you can say about something that didn't have any scientific art in it. The rest cure was spending time, usually in a recliner chair on a porch outdoors in a bucolic setting, like in the mountains and try to get as much fresh air as possible for your lung disease. Barry Moltz And why'd they think this was gonna work, or is this just someone -- it sounds today like it was a spa, right? Tegan Kehoe Absolutely. And actually, health spas were a big business in the late 19th century. I think that people thought it would work because one of the few things that was really certain about tuberculosis is that it typically affected the lungs. And so this idea of fresh air was, in a sense, it was palliative care. It could ease people's symptoms a little bit, but not enough to help them actually fight off the bacteria. Barry Moltz So one artifact in your book that you talk about is this carbolic acid sprayer that was invented by Joseph Lister, tell us about that. Tegan Kehoe Sure. So Joseph Lister was one of the people who developed germ theory, which is the scientific understanding that germs like viruses and bacteria cause infectious disease. He examined pus from infected wounds under a microscope and correctly hypothesized that the microorganisms he saw were the source of the problem. So in 1865, he began to try to kill microorganisms in wounds by soaking bandages in carbolic acid, and he had great successes reducing the rates of infection in his patients. But this sprayer he invented in 1871. And he was trying to kill germs in the air in operating rooms. So it squirted this fine mist of carbolic acid into the air. While a doctor's assistant pumped the handle. It was a great idea, but it just wasn't effective. And so he ended up abandoning the sprayer within a decade. But that's not the end of Lister's story. He really did make huge contributions to surgery and to sterile surgery, both before the sprayer and afterwards. Barry Moltz And so did someone else pick it up afterwards for to become more effective? Tegan Kehoe The sprayer really was a dead end. But Lister kept campaigning for making operating rooms as sterile as possible. And others absolutely picked that up as he and some of his peers were really demonstrating the efficacy of this. And he also as a surgeon pioneered some operations that had never been done successfully before, because the risk of deadly infections had been so high. For example, he performed a type of reconstruction on a broken kneecap. It required making the problem worse before wiring it together, which is something that happens in orthop-- orthopedic surgery, sometimes now, you have to break something apart to make it whole. And that makes a much more thorough recovery. But before Lister, it hadn't been possible because a compound fracture was often a death sentence, whether it was in the kneecap or somewhere else. And so because he was able to reduce the risk of infection -- this was after his sprayer, this was using the bandages and his other techniques -- he was able to do this successfully and have a healthy patient afterwards. Yeah, I think we have to understand that these surgeons really were inventors. It's not like today where stuff has to be approved by the government before the surgeons use things. They were they were trying to, they had a problem, they were trying to fix it, we whatever they had, Yes, although the addition of needing to approve things by the government has been itself a huge step forward, or actually several huge step forwards, steps forward in medicine. And really all of that didn't start happening until the 20th century. So it's quite recent, relatively speaking. Barry Moltz So Tegan, if we fast forward 100 years, have you thought about is there any things that we use today that might be artifacts 100 years from now that someone might feature in a volume two of this book? Tegan Kehoe That's an excellent question; I am positive that there are. And as part of the nature of, you know, what learning looks like and what discovery looks like, I'm not sure that I can predict which things those are. I think that some people who are experts in their own fields within medicine might have predictions about what's going to be replaced based on what they know, is in development. And I think that, you know, if we're lucky, and if society is going to continue functioning for another 100 years, many of the conversations that are happening around diversity and equity and access to health care, and those sorts of things. Some of our practices today will look like barbaric by standards from 100 years from now. Barry Moltz Yeah, man, I know I keep thinking about bloodletting, about what that was all about. Tegan Kehoe Right. Right. Barry Moltz Seems today I actually keep thinking, Tegan, that, that our current, the current way that we treat cancer someday will be seen as barbaric chemotherapy and radiation. Tegan Kehoe Mm-hmm. Yeah, I think a lot of people feel that way. And I, you know, I, as a historian, I can't predict the future, but I think that that's certainly a big candidate for areas of improvement, because so much of what we have right now is really damaging to the patient, but it's going to save their life, or in many cases, it saves their lives. And what we had for cancer 100 years ago, was really damaging to the patient and probably wouldn't save their life. So the hopeful natural evolution of this is then something that isn't really damaging to the patient. So you get both sides of the positive coin there. Barry Moltz Well, my vote for the artifact of the future since I have diabetes would be the disposable insulin syringe or insulin pen, because that is that to me that has revolutionized take -- for a diabetic to take care of themselves, because it doesn't be refrigerated for a week. It's portable, it's synthetic. There's the same amount of you know, concentration of insulin not previously, when you have to get it from animals. That device is, is amazing. Tegan Kehoe Yeah, absolutely. And I think diabetes is an excellent example of what medical progress means in people's lives. Because just over 100 years ago, diabetes was still a very fast death sentence after diagnosis. There's a chapter in the book about this. And it's, it was one of the hardest chapters to research because the stories were just so grim, especially for type one diabetes. And it became a chronic disease because of health care, you know, it became something that people live with for, you know, many, many decades. And so changing something from fatal to chronic is one of the examples of, of what healthcare can, can do for people. Barry Moltz Yeah, I feel really fortunate, now I've got a little device attached to my arm, I put my smartphone up to it and tells me when my blood sugar is, so that's pretty darn good. No pricking of, of fingers or anything like that. Tegan Kehoe Right? Absolutely. Barry Moltz Well, Tegan I appreciate your joining the show the title the of book is called Exploring American Healthcare through 50 Historic Treasures. Tegan where can people get in touch with you or get a copy of the book? Tegan Kehoe My website is www.tegankehoe.com. So if you can spell my name, you can find me on the internet. And the book will be available in many, you know bricks and mortar stores wherever you like to find your books. And I also have a bookshop.org page, which is bookshop.org/shop/tegankehoe. Barry Moltz Tegan, thank you so much was a fascinating interview. And I want to thank everyone for joining this week's radio show. I got to thank our sponsors. Nice job the amazing tool that can make it easy to build reviews to grow your business go to get started, go to www.nicejob.com and use the code barry for $50 off. Plus, I want to thank plastiq, a smarter payment platform for your small business go to plastiq.com/barry for a special offer and plastic is spelled p l a s t i q.com. Thanks to our incredible staff our booking producer Sarah Shafran. Our in studio producer Lady B, our marketing manager Courtney Gilchrist. If you're serious about being successful in this COVID economy, give me a call of separate private line 773-837-8250 Or email me at firstname.lastname@example.org Remember love everyone. Trust the few paddle your own canoe and go out there and get vaccinated have a profitable and passionate week. Speaker 1 You can find Barry Moltz on the web at barrymoltz.com Or more episodes of Small Business Radio at SmallBizradioshow.com.