The Unseen Body - Dr. Jonathan Reisman

Welcome to Grit Nation, I’m Joe Cadwell the host of the show and on today’s episode I have the pleasure of speaking with physician, adventurer and author of the newly published book titled, The Unseen Body.

His name is Dr. Jonathan Reisman, and on today’s show Jonathan and I will discuss how his passion for, travel, prehistoric crafts, food, and practicing medicine all coalesced when writing his book.

We’ll open our conversation as Jonathan explains how cutting into a cadaver in medical school, and literally pulling back the curtains shrouding the hidden mysteries of the human body, was so influential to his becoming a doctor.

Next, we discuss human anatomy, starting with the throat, which Jonathan believes is an overly complicated and anatomically flawed design, because of the highly coordinated ballet of nerves and muscles needed to keep us from dying every time we eat or drink.

Later, we’ll unpack many of the bodies organs and tissues including the heart, lungs and fat, and we'll dive into why problems with our bodies plumbing networks can reak havoc on our health and well being. 

We’ll then discuss the importance of sleep for optimum cognitive performance, and why the pineal gland, located deep in our brain is responsible for the production and regulation of melatonin, a hormone necessary for a peaceful night’s slumber.

And we’ll wrap up our conversation by focusing on the kidneys, as Jonathan explains why his favorite bodily fluid, urine, can be so beneficial in diagnosing potential health related issues.

This episode is both fascinating and at times gross, and I hope you enjoy it, or at least learn something about your self that you didn’t know before.

The Show Notes
http://www.jonathanreisman.com/

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Transcript

Joe Cadwell: 0:08

Welcome to Grit Nation. I'm Joe Cadwell, the host of the show, and on today's episode, I have the pleasure of speaking with physician, adventurer and author of the newly published book titled The unseen body. His name is Dr. Jonathan Reisman. And on today's show, Jonathan and I will discuss how his passion for travel, prehistoric crafts, food and practicing medicine all coalesced when writing his book will open our conversation as Jonathan explains how cutting into a cadaver in medical school and literally pulling back the curtain describing the hidden mysteries of the human body was so influential and to his becoming a doctor. Next we'll discuss human anatomy, starting with the throat, which Jonathan believes is an overly complicated and anatomically flawed design because of the highly coordinated valley of nerves and muscles needed to keep us from dying every time we eat or drink. Later, we'll unpack many of the body's organs and tissues including the heart, lungs, and fat. And we'll dive into why problems with our body's plumbing networks can wreak havoc on our health and well being will then discuss the importance of sleep for optimum cognitive performance and why the pineal gland located deep in our brain is responsible for the production and regulation of melatonin, a hormone necessary for a peaceful night's slumber. And we'll wrap up our conversation by focusing on the kidneys. As Jonathan explains why his favorite bodily fluid urine can be so beneficial on diagnosing potential health related issues. This episode is both fascinating and at times gross, and I hope you enjoy it. Or at least learn something about yourself that you didn't know before. After the episode, be sure to check out the show notes for more information about Jonathan Reisman in his book, The unseen body. And now on to the show. Dr. Jonathan Reisman, welcome to grit nation.

Jonathan Reisman: 1:53

Thank you so much for having me.

Joe Cadwell: 1:54

Yeah, thank you, Jonathan, for taking your time to be on my show today, I really appreciate the opportunity. I've just been fascinated reading your book over the last week and a half since I've had it and it's it's a great read. It's a lot of fun. It's an insight into the human body. It's an insight into who you are and your interest as someone that likes to travel and, and has a sense of curiosity in regards to everything from how to skin a hide to how to cook a brain or cook cook along. So for the audience, can you tell us a little bit more about who you are and how you got interested in writing this book?

Jonathan Reisman: 2:30

Well, I grew up in northern New Jersey, in the unexciting suburbs in New York City. And I guess it was around college time where I went to New York University, I was studying math and philosophy that's always sort of interested in, you know, thinking more deeply about the world and history and human humanity and what we're doing here, why we're here how to live best. And so after college, I sort of set out traveling, I got some great opportunities to live and work in Russia actually, for on and off for about two years. That was sort of my first big immersive trip where I learned the language and history and traveled all over the country and went from knowing virtually zero about the place and its people to knowing a lot and that sort of probably got me addicted for lack of a better term to traveling the world and learning about all different cultures and natural environments and how people live in those unique and particular natural environments, how they use the plants and animals for their own lives and how culture intertwines with, with that connection between humanity and nature. Eventually, I carried that interest with me into my medical career. So I ended up going to medical school. And ever since I finished my residency, which was in Boston, I sort of continued that exploration of the world and have sought out jobs working in interesting geographic places with interesting cultural contexts. So that brought me to Arctic Alaska. And I've worked on as ship doctor in Antarctica and the Russian Arctic, and the high altitude in Nepal and rural Appalachia. And so my career has kind of taken me all over. And turns out being a doctor is a great way to wander around the country and the earth, because your services are kind of needed everywhere. So it turned out to be a great ticket to exploring the world and in a slightly different but still really invigorating and interesting way.

Joe Cadwell: 4:25

Yeah, for sure. And I really liked the way you interwove some of your travel exploits into the book and how you found common narratives for the different body organs, and that the name of the book is the unseen body and so we're so used to I think, as a society to always judge everything the book by its cover what we see on the outside, but you got interested in what's actually going on in the inside. And that started with your dissection of a cadaver, early on in the anatomy class of your pursuit of a degree in medicine.

Jonathan Reisman: 4:58

That's correct, right on the very first day. as medical school, we started the class called the anatomy lab where we're dissecting a cadaver. And so it was I found it fitting in retrospect, that they sort of pushed us right into the deep end of the pool there, by showing us kind of the end of the end of the story. You know, every human body has a story begins in the womb, and then ends in death. And it was sort of here, you know, pushed into a room, and here's a dead human body now start cutting it up and learning the name and function and structure of every single little bit of flesh. And that really, really fascinated me. I always, as you mentioned, the name of the books, the unseen body. And I think there's this theme about pulling back the curtain and showing syrup showing me what's what's behind the scenes, I think, I think that was a big part of why I love traveling so much, it sort of pulls back the curtain on these places that you maybe never heard of, or know nothing about, showing you the inner workings of a society, a country, a culture, a language. And so the human body felt very similar, pulling back, literally pulling that plastic sheet off my cadaver on that first day, and then every subsequent day, over the next four months or so, you really got to look behind the scenes of life in a way we all live our daily lives, kind of on the surface of our bodies, you know, we see other people, we basically are looking at the surface, we look at ourselves by looking down at our bodies by looking in the mirror, you know, unless there's some symptoms, some pain or something that's drawing our attention to our insides, we don't really think about them much. And neither did I until I started cutting open that that cadaver. And so in a way that was pulling back the curtain on daily life on this man's body, but also on every other body in the world, all my friends and family and my own body as well. So it was sort of a sort of philosophical reflection on myself while looking at another body to and then in my book, also, I tried to pull back the curtain on, you know, the healthcare industry and what doctors go through in their training and what it's like to be on the doctor side or the doctor patient equation. And so sort of all kinds of pulling back the curtain and revealing the unseen.

Joe Cadwell: 7:06

And that all started with that first scalpel stroke, I understand that the person you were working on it was a man of deceased man, he was prone face down, and that first scalpel stroke, you cut into his back, I think you were investigating a lot of historicize, something like that, and, and beginning to understand the connectivity of how the muscles and the bones and the ligaments and tendons all work and, and from there, you just continued on over the course of what is it four months or so that you began to unravel the mysteries of the, the unseen body so that just fascinating stuff I know a lot of people listening right now are probably going well, this can be really, really fascinating. But a lot of people may be a little bit repulsed by this as well. And it's sort of that, you know, the fascinating versus gross and I thought you know, another great name for your book, as opposed to the unseen body would be fascinating versus gross. You know, there are some components of your book that are cringe worthy, there were also some good humor in your book, I appreciated that. But you you kind of have an insight again, the philosophical look into into the human body and you break it down into sub parts and the first sub part, you jump us right into the mix of of the throat, you know, I just loved the the mental image of the development of the, the the Safa, geo passageway and in the trachea, the airway, and that the millimeters of, of separation between the two can be millimeters between our life and death. And I was hoping you could tell us why you started with the throat and what really is going on, in what I understand is a rather poorly designed area of a human body. So

Jonathan Reisman: 8:41

the throat in particular, you know, when you pull back the curtain on the human body, I got to learn about every different body part, every bodily fluid, it became all these all these, you know, supposedly gross parts of the body sort of became my, my daily work the bread and butter of my job. And so, you know, it was never a squeamish person, which probably helped. But becoming a professional in healthcare means working with all these gross body parts and bodily fluids all day every day. So the throat for instance, the reason I put it first was actually because I wanted to have the reader of my book sort of pushed into the deep end of what it means to be in healthcare, just as I was sort of tossed in that first day of medical school by dissecting my cadaver. And so the the first chapter about the throat does have a lot of talk about death and the end of life in particular. But as you mentioned, the throat has kind of an interesting and complex story. As I explained in the book, each person each of us everyone who's ever lived or will ever live begins as basically a microscopic tube in the womb with an entrance on one side and an exit on the other. And then of course, as we grow and develop and become more complex, through the course of gestation, the entrance to that tube splits into multiple different entryways one specifically for food, and one specifically for air. And so for instance, every day when we swallow food, every sip of water, we take every bite of food that we swallow. One thing I learned in medical school is that I got a sort of a front row, look at how close each of those bits of water and food come to slipping into our windpipe, which could make us choke or actually kill us. So every every single, you know, the entrance to the esophagus and to the windpipe are right next to each other, as you mentioned, just millimeters separating them. And our throat goes through this very complex contortion that we call swallowing, to keep food and drink out of that windpipe. So to keep us alive. It's a very basic function of the body to keep those two things separate so that only air goes into the windpipe and everything else that we swallow, whether it's food, drink, snot, coughed up mucus, whatever it is, must go down the food pipe the esophagus, and none of it should get into our airway, or else we'll, we'll be in serious trouble. So the throat did seem sort of a stupid design, compared to most other body parts would seem seem brilliantly designed to function properly and efficiently and to keep us alive. And then of course, as I talked about in the book, and throw it has, I gained another perspective on the throat by treating a lot of elderly and infirm patients who, in fact, had trouble with that most basic function of the body of keeping food and drink and saliva out of the windpipe.

Joe Cadwell: 11:27

It really does seem like the muscles and the cranial nerves kind of work in concert to, to allow people to just pass fluid into the esophagus and not into the trachea. And, as you said, people with dementia, people that are getting older stages in life, my father in law, close to the end of his his life, we had to do something like thickened water, in order for him to be able to, for his body to be able to understand that something was coming in and it needed to be directed towards is his stomach and not towards his lungs. And I've heard that this can almost be sort of what's referred to as old man's friend or an escape hatch, that, you know, the body inherently has this, this mechanism that may sort of hasten or, or increase the likelihood that towards the end of someone's life that they do get, what is it called aspirational pneumonia, can can be part of the cause of someone's death, who's later on in yours?

Jonathan Reisman: 12:24

Yeah, that's correct. So keeping food and drink out of the out of the airway is one of our body's most basic function. But as we get older and more infirm, and perhaps have, you know, degenerative neurological conditions like dementia and Parkinson's and strokes, we get worse at that coordination that it requires to keep things out of our airway. So people do suffer from aspiration. And I think a lot you know, the the first things the basic functions, people lose the ability to do include taking care of themselves, their activities of daily life cooking for themselves, cleaning themselves. Those are we think of as the most basic functions of the body. But actually, this throat contortion, keeping things out of their ways even more fundamental. And so as we approach the end of life, we sometimes get even worse at that. And aspiration pneumonia can be the result when you do aspirate things into your windpipe. And it's a very common cause of death in people with dementia and Alzheimer's and strokes and other conditions. And so I do paint it in my book, as that other perspective I got on the throat, was that it's almost serves as this exit from life. You know, I don't I don't believe it's designed that way. But it's sort of a side effect of that very precarious relationship between the air pipe and the food pipe is that as we get old, weaker, perhaps our mental function declines, perhaps our quality of life goes down. There is this escape hatch there, our body tends to slip up in this particular way that causes pneumonia that is a common cause of death. And it was in the past called Old man's friend, could be old woman's friend, too, but it was called the old man's friend, because when people were suffering in a prolonged way and becoming more debilitated, this pneumonia offered almost a way out of a painful life, where the perhaps the quality of life wasn't there anymore.

Joe Cadwell: 14:15

So your book The the unseen body just thrust us straight into the life death consequence, the ballet that goes on in different body organs and starting off with the throat and then taking it in order. You've you've outlined the body and I'm gonna ask questions, and maybe not not quite sequentially in your book. But I was fascinated by the part of the heart. And again, getting back into your travels. You talked a lot about the flow of water over mountain ranges, I think in eastern Russia and how the streams are dumped into rivers would dump into seas and I thought that was really poetic and helped my visualization of the cardiovascular systems and what can you tell us more about your travels in Russia and how you came up with this thought of this circulatory system.

Jonathan Reisman: 15:01

Sure. So I think when I grew up, as I mentioned in the New Jersey suburbs, the land, the shape of the land, the way water flowed over the land, the way that streams branched and coalesced into larger rivers was really not a part of my life at all. I think most streams that road flowed through my town, I probably interacted with them when they went through drainage ditches underneath the roads I was driving on. And that was about all I thought about them. But when I went to Russia, I got a really my first taste of what it's like to live in wilderness, pretty much where there's no roads through the mountains, and people traveled by horseback. And I was really fascinated by how they have to follow the branching rivers and have to really know the landscape so intimately to travel through the mountains. And so I joined a family of native people that from the event people who are one of the groups that live in on the conjunct peninsula in the Russian Far East, I try, I traveled with them on a horseback trip to their hunting cabin, which took several days and learned a lot about how you travel through roadless mountains, something I knew nothing about. Were basically you have to have a good mental map of the watershed of how the streams coalesce and how they branch in which ones to follow to get over the mountain paths, you know, you make a wrong turn at where tributary meets the larger stream. If you take the wrong tributary, you end up at a mountain path with a sheer cliff in front of you perhaps and you can't get over that way into the next valley. So you have to know which way to go. And this family I was traveling with new the new each of those dreams like the back of their hand, pretty much. And then later, speaking of the back of the hand, you know how veins on the back of our hands also branch and come together into larger and larger veins as they sneak up our arm into the form. That was something I was learning about and had to memorize these maps of branching blood vessels in the human body, it really had to learn the names and courses and trajectories and branch points of all the arteries in the body. But some of the most important for instance, was the arteries feeding the heart. Because when you diagnose heart attacks, you sort of have to know how they branch and which part feeds blood to which part of the heart and is that you're you're almost when you're diagnosing a heart attack by looking at an EKG, you're sort of traversing those branching arteries, through the heart almost the same way that me and that family, we're traversing those branching streams to travel through the mountains. And the same goes for strokes in the brain, your way, by examining the patient, and figuring out what their neurologic deficits are, you're sort of walking through the branching art arteries that feed the brain, and you're able to pinpoint exactly where the stroke might be in their brain. And so understanding branching waterways or understanding branching blood vessels was a very similar mental exercise. And so I when I was in medical school, learning about that, and learning how to do that, since I had to learn so I can diagnose and treat these conditions. It reminded me of, of that trip I had taken with that family and from jotka, following the watersheds. And so I think a lot of those sort of unexpected connections are was basically my experience of medical school, I had traveled a bunch and had learned a lot. And so I was, like you mentioned tanning, animal hides, and things like that. So I ended up connecting the things I was learning about the human body, to all these other things I had experienced or learned about. And so my book is a collection basically of those of those interesting connections.

Joe Cadwell: 18:38

Yeah, for sure your book is full of again, travel, it's full of human connection, it's full of organs. And, again, getting back to the heart of the circulatory system, the heart muscle itself, it seems like for the majority of listeners of the grid nation podcast, we're, you know, living in North America, US and Canada were were cardiovascular diseases, one of the biggest killers, if not the greatest killer of people on a year to year basis. And cardio vascular disease often manifests itself in the blocking of arteries. Is that how that works?

Jonathan Reisman: 19:11

Yep, that's correct. There's a kind of a slower process where they the, the arteries can slowly narrow. And then of course, there's a very sudden, and all at once blocking that can happen in the arteries of the heart, and that's a heart attack. And those two processes are intertwined as well.

Joe Cadwell: 19:29

And I loved how in the book and I teach CPR, I've taught CPR for over 30 years for the American Heart Association, American Red Cross, and I've never heard it expressed the way you express it in your book. And it works perfectly for myself because I teach a lot of carpenters in the building trades you you broke down the two main problems of the heart, heart attack and cardiac arrest is being a plumbing disorder or an electrical problem. Heart attack being a plumbing disorder, and I was hoping you could tell a little bit more about that and then how it man it could manifest itself into an electrical problem or a cardiac arrest?

Jonathan Reisman: 20:02

Sure, I think there's a lot of confusion understandably, about conditions like heart attack, heart failure, cardiac arrest, even in science media, I find those terms sometimes confused. And it is confusing, I admit. But yeah, so plumbing is actually a huge part of medicine. So many of the diseases that we diagnose and treat and try to prevent are basically plumbing problems. So, blockages in the flow of fluid, there's so many fluids in the human body, from blood to saliva, to bile, to pancreatic juices, and many others, and each one must flow through its tubes and not be blocked up. And a lot of the things that cause us pain and suffering and disease are simply blockages of that flow. And so being a doctor in many ways, is like being a plumber, because your job is to locate the blockage and and relieve it, whether that's with a catheter threaded in there almost like sneaking a drain to get the plug out, or, you know, blood thinners to dissolve the blood clot that is blocking the blood flow, let's say. And then of course, there's also other plumbing problems like leaks, such as bleeding from trauma, or a lot of people bleed into their intestines, especially when they're on blood thinners. So leaks and clogs is a big part of medicine. So it's basically plumbing. As you mentioned, heart disease is one of the biggest killers of American adults these days. And that's just a one particular kind of plumbing, a heart attack is where the blood flow to part of the heart is blocked by a blood clot. And so the job of doctors is again to find that locate that clot, which involves knowing the map of branching arteries, and then getting that clot taken out, which is usually done by cardiologists, interventional cardiologists, who do refer to themselves as the plumbers in the cardiology world. Now another another problem that can arise in the hardest cardiac arrest. And as the name suggests, that's when the heartbeat itself arrests or stops. And so in a cardiac arrest, your heart's not getting blood anywhere to your brain, especially and so you're not conscious. And unlike a heart attack, where you can be talking to me as a doctor, and when I'm asking you, where's the pain? What does it feel like? When did it start? You can answer my questions. Someone in cardiac arrest is unconscious, and is not answering any more questions. So cardiac arrest is more of an electrical problem. So the type of cardiologists that deals with that would be an electrophysiologist. And they call it consider themselves, the electricians of the cardiovascular world, unlike the plumbers who do the Cardiac Cath and get out the blockages when you're having a heart attack. But the two are, of course related. So when you're having a heart attack, and blood flow is blocked a part of your heart, the electrical system in the heart can get very irritated, and can spiral out of control into an arrhythmia or an abnormal rhythm, almost an electrical storm in the heart, because of that malfunctioning part that's not getting blood. And so that can lead to cardiac arrest two, so just to make it even more confusing, a heart attack can lead to a cardiac arrest or in other words, a plumbing problem can lead to an electrical problem.

Joe Cadwell: 23:09

short out the fuse box and everything goes sideways. Yeah, so that makes a lot of sense. And some of the contributing factors, obviously to cardiovascular disease, smoking is huge. And I think we're gonna get a little bit into lung health as we find our way further down the, into the into the body, we'll talk about lungs, but dietary habits as well can lead to cardiovascular disease.

Jonathan Reisman: 23:33

Sure, and I think that the story of nutrition and cardiovascular health is a bit complicated, and I think, to some extent is changing as well as researchers are doing larger multinational studies and, and finding out that some of the advice that doctors have been giving for some decades is not always borne out by the evidence sometimes saw salt and cholesterol in your diet. And saturated fat may actually not be as bad as we thought, believe it or not. But But certainly, I mean, controlling risk factors for cardio, coronary artery disease, narrowing of the arteries, heart attacks is very important. Most of those are, as we know, smoking is a huge one. Of course, there's genetic factors, you can't change. But then there's things like high blood pressure and cholesterol, and diabetes that are being risk factors for the narrowing of the arteries and having heart attacks eventually, too. And actually, it's the picture of fat in the diet and fat on our bodies in the form of obesity and fat in our blood streams in the form of cholesterol and triglycerides is is actually not so well understood. And when I left med school, I was confused by it. And I'm still confused by it. And the the studies don't give us a really clear picture. I think it's certainly clear that those risk factors are not good for you. It's certainly clear that that obesity can contribute to some of those including diabetes type two and high blood pressure, and the metabolic syndrome which comes with all those things put together as well as chronic kidney disease. Certainly leading an active lifestyle, eating fruits and vegetables, things like that is very good for you. Even if the other things that doctors have been telling you to avoid, I don't think those are actually as bad as doctors have been saying. But still, the things that are good for you are still still good for you quitting smoking and getting exercise and eating lots of fruits and vegetables, even if you also eat fat, or unhealthy foods and fried foods etc. It's still good to eat those things. Because they outweigh any any negatives you're getting from your other foods. So if you need to fry your greens in pig lard, God bless you eating the greens is still good for you.

Joe Cadwell: 25:48

There you go. And I thought it was really interesting, the dichotomy of fat you know, it's such a seems like a taboo food, but then you found yourself just outside of Barrow, Alaska, living with some of the native population, they're out on a whale hunt. And watching these people literally just eat whale blubber, whale fat, and not only did this fuel their bodies, but it also fueled their oil lamps and fueled heat sources that allowed them to live in this area. And I thought, that's a really, really interesting and you, you had to kind of had your eyes open to this dichotomy of fat, if you will.

Jonathan Reisman: 26:22

Exactly. I think when I left met, in my medical education, in medical school, you come to think of fat as the enemy in all ways, whether it's in your food on your body and your bloodstream. Fat is the enemy, we must fight against it forever and be at war with fat. But then when I went to the Arctic, I saw that human life in the Arctic would never have even been remotely possible without the huge amounts of fat that people consume up there from marine mammals, like whales, wall verses and seals. And as you mentioned, it's not only about calories, although that's a big part of it, for sure, if the animal fat can made up about more than estimated more than half of all calories that people consumed in the Alaskan Arctic, for instance, in historic times was, did come from the fat. And so they had basically no fruits and vegetables in their diet. They ate all meat and fat pretty much. And yet, their, for instance, cholesterol was very low, when they first started doing studies on these people and their cardiovascular health was actually great. And so I think it sort of threw a wrench into the story of fat that I was taught about in medical school and showed me, at least that it perhaps should be questioned. And I think that some of the some of that dogma is, is actually being questioned these days by bigger and larger studies that are teaching us more about the relationship between what we eat and have and the function of our bodies and disease. It's a very complex picture. doing studies on food and nutrition are very hard for 1,000,001 reasons, but it's very hard to pinpoint what you put in your mouth and how exactly it impacts your body. Because these substances are so complex with 1000s of chemicals. And our bodies are complex to physiology and metabolism differs between different cultures. For instance, the natives of the Arctic, in Alaska or elsewhere, do have some genetic adaptations to their environment and to eating their high fat diets that others don't have. But even even from one person to the next. Even siblings who share parents, metabolism is can be very different and vary widely. And the impact of whatever you put in your mouth can can be very different for even very closely related people. So the picture is super complex, but, but I do credit, the Inupiat Eskimo of northern Alaska for sort of opening my eyes to the fact that fat can be the hero, not just the enemy.

Joe Cadwell: 28:48

And speaking of you know, opening your eyes, putting things in your mouth that, you know, may or may not seem appropriate or the right thing to do. Tasty, but banned foods is, you know, I thought would be a good title for your chapter on the lungs. I also liked I thought about lungs and juice. You talked about having lungs and juice at one point, and that the lungs, I mean, just another fascinating chapter, and are basically our insides turned out, if you will, the mouth goes into the trachea, trachea bifurcates goes into the lungs. We have two air sacs, big sponges in our lungs that absorb all kinds of stuff. And I think it was back in 1968 1969. According to your book, they the FDA came in did a study and said we can't let people eat lawns this is bad for them. Why? Why do you have some sort of disagreement or find that study to be a bit outdated?

Jonathan Reisman: 29:42

So in 1969, the USDA started questioning whether lungs should be eaten by people are if they can be safe because of course, just animal lung, inhale all the same things we do which is dust in the air and smoke and pollution and sport mold spores that are floating through the air. And we probably inhale with every breath we've ever taken from the first to the last. And basically, the law that was then passed in 1971, that banned all sale of lungs for human consumption, basically, it makes no sense that, that the lungs that it would be dangerous to eat the lungs, and what they found when they did that study in the late 60s, early 70s, was that these lung samples do contain some of those airborne contaminants like fungal spores and dust, and pollen, and they get very deep into the lungs. And so when someone examines the lungs in a post mortem examination, and a slaughterhouse, they might not see all that quote, unquote, contamination super deep in the lungs, and it would be too laborious to really cut all the lungs open and look all the way down into the tiny air tubes to see if those quote unquote contaminants are in there. So they the USDA for just efficiency reasons felt it was simple and it just banned them completely. So you cannot buy lungs. In a butcher store. There are there are dog treats made from animal lungs that are still available, but humans cannot consume them in a restaurant or and cannot buy them as human food.

Joe Cadwell: 31:10

And just for clarification, Jonathan, you know, we are talking about catalogs, we are talking about sheep lungs and Pig Lungs, obviously. And in you know that we're investigating the human body. I just wanted to make sure people knew we weren't talking about eating human lungs for for general consumption. I thought it was interesting in your in your, in the book, too, that one of the biggest lobbyists, they're one of the bigger lobbyists for turning over this law come from Scotland because of Scotland's use of cow lung in making haggis having just recently come back from a trip to Scotland two, three weeks ago, I had my fair share of haggis. I thought it tasted wonderful. But yeah, to just put a point on it, we're talking about eating of lungs and and so are do we stand alone? Jonathan, Are we one of the few countries in the world that has banned lung and car?

Jonathan Reisman: 31:59

I understand Canada also has banned it. I don't think there's too many other countries. They're certainly not the UK, as you mentioned, they have been eating, especially in Scotland. Haggis is traditionally made with lungs. And that's made it difficult to export haggis to the US where of course there's a lot of people of Scottish descent who might want to buy it. So the US government has told the UK government they can either submit a scientific dossier to showing studies showing that eating lungs are safe, or they can just develop a lung free Hackett's recipe and so I've been in touch with some representatives of the UK government, they went with the latter option and just have developed lung free haggis, which is exported to the US to work around, exactly work around. And as you said, Yes, I'm not endorsing cannibalism at all, of course, for both ethical and legal reasons. But that was another one of the, I would say unusual perspectives that I gained in medical school was a perspective of food on the human body not not to eat the human body. But basically the observation that we're made of the exact same stuff as the animals that we eat. And so if you look at human muscle, under the microscope, or cow muscle basically looks virtually the same. We're made of the same molecules, the same tissues, they're structured very similarly, similarly. And so when I was learning about muscles in the human body, by extension, I was learning about different cuts of meat. And there's that there's a correspondence there, and many of the muscles in us do correspond to whether it's the filet mignon, or the top and bottom, and I have round, or the flat iron, steak, etc. And so I, as I was learning the human muscles, I was always also learning how they correspond to animals, and then got interested in eating all sorts of other unusual and less commonly eaten body parts, including internal organs, but also everything from tongue to feet to tails, and everything else in between as well. And so that's something that an interest I've continued to this day, actually, I currently travel around and team up with local chefs to put on what I call anatomy dinners, where we do serve some of those internal organs and less commonly and body parts. And for each dish, I explained the anatomy and physiology behind the dish. Sometimes, I'll even dissect an animal's heart while people are eating the heart course. And so I think I'm trying to, again, pull back the curtain on how the food that we eat relates to our own bodies. And, you know, a lot of people perhaps like to hide from the fact that some of these foods that we eat, especially from animals come from what was once a living, breathing animal who could see hear smell. And so for me, I think embracing that fact and having learned everything about the human body, and therefore by extension of a lot about the animal bodies that we eat, to me it you don't need to hide from the fact I think it's really fascinating and interesting, and it's also totally delicious.

Joe Cadwell: 34:58

Yeah, I think for a lot of listeners, As of this show, there's probably a lot of hunters and fishermen that are listening. But for the other folks who haven't, don't have those type of pursuits, yeah, we're pretty disconnected from our food sources nowadays, especially when it comes to animal products. And I had done an interview a while back with Al press who wrote a book called dirty work and talking about slaughterhouse workers and, and how, you know, their job makes it so it's it's fairly sanitary, and you don't associate it directly with a cow or sheep or pig, something like that. So getting back though, getting back to the lungs, yeah, insides turned out in human lungs, you know, this is where a very important interphase takes place, the air that we breathe, the oxygen in the air that we breathe is stripped out, it's passed into the circulatory system way down in the bottom passages, the lungs, I believe that the alveoli is where that gas exchange takes place. And and then that oxygen is circulated around the body, and it's very important for cellular metabolism and, and tying into the circulatory system. So it would seem it would seem to me, Jonathan, that taking care of our lungs should be a high priority for for everyone yet. We know that a lot of people smoke, we talked about some changes in mindset about you know, diet, and its effects on the human body. But has anyone just proven that smoking is bad for you as a, as a living breathing human being?

Jonathan Reisman: 36:21

No, that's, that's still not good for your body. I think that's, I'm not sure that will ever change. But, you know, the doctor's position on that has has changed. We were not at the forefront of, of recognizing the effect that smoking has on the body. In fact, my uncle, who's a retired pediatric nephrologist, which is a kidney specialist, he was telling me about how early in his career he would be smoking cigarettes in the room with patients who were children with kidney disease. And that was totally normal, and not seen as anything unusual. And I grew up in a house full of cigarette smoke too. And that was normal as well. And now it's, that's changed a lot probably for the better. As we recognize that smoking does have an effect on on the body. And it's not just the lungs, that's the most obvious effect, obviously, because you're inhaling smoke that you know from vegetable matter, basically, which has lots of toxins and other things in it. But it's also just inhaling smoke in general, which isn't good for your lungs. But the smoke, smoking has less less obvious effects on the body as well, especially on the arteries so that we talked about hardening of the arteries to the heart narrowing of the arteries to the heart or the brain, which can predispose you to heart attacks and strokes. And there's something about tobacco smoke, I don't know that it's fully understood. But there's something about tobacco smoke when you inhale it, it has an effect on your arteries too. And it causes that narrowing that hardening and you're so you're at risk of those very common causes of death.

Joe Cadwell: 37:52

I seem to remember in your book, you've talked about the cadaver that you were working on when you finally extracted the heart from his from his chest that the vasculature of the heart was crunchy and kind of crackled, as you put pressed on it and, and so from that you deduce that he was possibly a smoker,

Jonathan Reisman: 38:12

his lung certainly looked like a smoker's lungs, they were the color of cigarette ash, and not the normal pinkish beige of healthy lungs. So his lungs definitely told us he was a smoker, but then the arteries running across the surface of his heart, gave sort of more evidence or showed more effects from that smoking habit he had had. And that crunchiness it almost felt like a caramel that you could crunch between your fingers. And that was the hardening of the arteries with it often gets calcified when you have plaques like that in your arteries. And so that makes the arteries hard and crunchy, which you could imagine is not ideal for blood flowing through them freely and feeding the tissues.

Joe Cadwell: 38:56

So moving on from the from the lungs, I found the pineal gland, to be a fascinating chapter and I'll be honest with you, Jonathan, I did not know what the pineal gland was. I've always heard about the pituitary gland deep in our brain, but the pineal gland I guess, has a huge part of regulat. regulating our sleep is in the production of melatonin that the pineal gland is important.

Jonathan Reisman: 39:18

That's correct. So the pituitary is near the pineal gland. I've heard people say it pineal and pineal. It's actually named after pine trees because the gland itself actually looks like a little pine nut and it's about the size of a pine nut. And the pituitary is its nearby cousin, but much more well known sort of its celebrity cousin and the pineal is less understood. Even in scientific history, the pineal gland which is one of the endocrine organs, it does secrete the hormone melatonin. It was really the last to be deciphered. It was the last one that people knew what it does how it functions partly because it's so deep inside the brain. It's almost in the center of the brain. the very center when you look at a patient's MRI or CAT scan of their head, the pituitary is kind of more towards the front actually, but the pineal is almost really right in the core of the brain. And I think it's, it's in many ways, its function is still not fully understood. But one of the one of its main functions is secreting melatonin, which kind of prepares the body for sleep. You know, when we wake up in the morning, our circadian rhythm, our daily rhythm of our bodies, we our bodies secrete cortisol that comes from a different endocrine organ, which is our adrenal glands, cortisol sort of wakes us up in the morning raises blood pressure, it gives us a little energy to get out of bed and start the day. And then the pineal gland sort of the counterpoint to that, as we near the end of the day, as the light from the Sun fades, the melatonin sort of prepares the body for the process of sleep. And sometimes, if you ever noticed a few hours before sleep, sometimes people start feeling a little cold. That's actually that chill is actually a result of melatonin, which sort of dilates blood vessels and can can end does actually lower the body's temperature. So when we wake up in the morning, our temperature sort of rises almost just like the air and earth around us as the sun starts to shine on it. And then as the sun sets, the light goes down, our body temperature also decreases partly due to melatonin as we're preparing for sleep and of course, stays lower overnight before rising again in the morning. So the pineal gland is essential for that daily rhythm, which links our body to the daily rhythm of the sun, and the Earth's rotation. And like every, almost every other organism on Earth, even plants, and even microscopic organisms, like bacteria, do have a daily rhythm that is set by the sun. So we are very kinda dialed in to the sun as Earthlings.

Joe Cadwell: 41:50

So our rhythms dialed in. But correct me if I'm wrong, I think the science is still out as to why we actually need to sleep and the appropriate amount of sleep. Is that correct?

Jonathan Reisman: 42:00

Yeah, I think there's there's some theories, but it's definitely I mean, it's obvious to anyone who lives and breathes that sleep is essential. And when you don't get enough of it, there's so much research on how it affects almost every part of your body, even even some of the risk factors we talked about for cardiovascular health. It's bad for your blood pressure. It's bad for your diabetes, it's bad for healing from various illnesses. And a lot of studies show that not getting adequate sleep, reduces your ability to recover your body's ability to recover from any of those conditions, whether it's infections or anything else. And obviously, your brain doesn't work quite right. When you're not sleeping as well. Even your appetite is changed. And people tend to eat more when they're when they don't sleep as much, it's sort of equivalent to having the munchies. Actually being sleep deprived has been shown to increase your appetite almost like munchies if you consume marijuana, so and that actually, some people theorize that might be a big part of the obesity epidemic is is a sort of hidden sleep epidemic, sleep loss epidemic. So that might be a big part of it, too. Everyone's eating more because no one's sleeping. Well, of course, part of that is our our lives, or you know, electric light, which doesn't sort of tricks our eyes, and thereby our pineal glands into thinking perhaps it's still daytime and not ready for sleep. And then, of course, our smartphones and computer screens and TV screens, which shine light on our eyes, and therefore, also trick the pineal gland and the thinking perhaps it's still daytime, all that's contributing to poor sleep, which does really affect every cell in our bodies in very surprising ways. So though, you know, it seems like sleep, maybe cleans out some of the toxins that build up in our brains and bodies through the course of daily life. So it could sort of just be a sweeping clean of, of the byproducts of functioning brain and other organs. I'm sure it's much more complicated than that. But that's sort of some of the theories these days,

Joe Cadwell: 44:02

I liked. How in that chapter on the pineal gland, that you turned around on yourself. And you were the case study early on in your medical career, when you were pulling as an intern or practicing new physician, you were, you were working a lot of hours and really burning the candle at both ends, and in the middle, and you were finding yourself sleep deprived. And you began to realize that, you know, your cognitive abilities were, were possibly being hampered by that. And you looked around and you saw other people you were working with, possibly, and the same thing. And then it all came to point with with a terminally ill patient, and sort of the procedures in the hospital system that would wake these people up in the middle of the night and draw blood or administer medications. And you kind of had an epiphany at that point that maybe sleep was a little more important than some of these Brando tests that were being administered to him out of that play out. Yeah, so

Jonathan Reisman: 44:55

as you mentioned, when I started medical school, specifically the part where I was working in the hospital, which began In the third year of medical school, I sort of considered my basic training to be a morning person. I was not a morning person before that, but started having to wake up very early to go to some of my rotations. So we're going to hospital especially when I was working as a in the surgery department as waking up at 435, which was something my body was not used to at all and I struggled with, but eventually actually got used to and, and loved and sort of still do even when I'm days when I'm not working. But that that trouble with sleep that I was having was sort of in parallel to the trouble that my patients were having in the hospital. I consider the hospital almost sleep annihilating institution, it's almost impossible to get good sleep in a hospital. And we I mean, there's great research, as I mentioned, showing that not sleeping well hampers recovery, the body's recovery from illness, yet are asleep annihilating hospitals don't do a good job at taking that into account. But it is difficult, you know, in hospitals, there's the light that can be on the whole lights. And sometimes you know, people share rooms and perhaps their neighbor has something going on that needs attention and the lights are on and there's noise and

Unknown: 46:13

people in the room monitors and buzzers monitor things and everything else. Right. Beeping

Jonathan Reisman: 46:18

monitors is another huge factor. There's so much noise pollution in the hospital. You know, workers me and my fellow health care workers often joke though, it's not a joke that there's so many buzzers and beeping going on all the time. Now you have to for your own sanity ignore a lot of them, which sort of defeats the purpose of the buzzers. I mean, you know, we do have the more urgent ones are louder and more shrill, so they can't be ignored. But still, the the hospital has this cacophony of beeping and buzzing. And so it's very hard to sleep for people even though sleep should be one of the most important medicines you know, if we thought it sleep like that antibiotic you need for your infection, perhaps we'd be better at delivering it to the patient and in the right amount and not letting them be deficient. But so I started I did have a patient as you said, who was a young man in his 30s he was about my age actually. And he was suffering from metastatic stomach cancer gastric cancer and he was clearly did not have long to live he was totally wasting away and hair falling out and had barely strength even stand. And I was in a admitted him to the hospital with an oncologist a cancer specialist sort of overseeing the work, I was the resident doing the grunt work. And every day I was drawing his blood and checking his potassium levels and magnesium and sodium and all the other electrolytes and they were never, they were always low. And I was always trying to repeat them. And they were still low. And it was sort of this, you know, fighting against the wind in a way where the inevitability of his demise was, was so obvious. And so and I was also waking him up in the morning to assess him. And some of those mornings, I really dreaded that fact, because I felt like I was waking him up back to the reality of his terminal diagnosis. I had met his wife and his two young children and the whole situation was just so tragic. The poor man or you know, just let him sleep. I was thinking to myself with some of these last days he has on Earth. And yet I was this busy resident focused on my own sleep and my own to do list which was always very long. And rushing through my my day and waking him and other patients up along the way and depriving them of needed sleep. Not that I thought sleep was going to cure his cancer, but at least he couldn't, you know, get sleep and be rested for some of his final days on earth in his final days with his his poor family. And so that really gave me more very important perspective on sleep. And I sort of became an evangelist for letting my patients sleep and giving them your earplugs and putting Do Not Disturb signs on their doors. And I became really almost militant about protecting them from all the noises and the midnight blood draws, as you mentioned, you know, waking them up at the mill and then at an inopportune time or medical administration times, which are often convenient for doctors and nurses, but not convenient for the patient. So that was a really, really important again, drawing back the curtain on the patient's perspective, in hospital in the hospital, which is not easy to get when you're a busy resident running around struggling to learn everything you're supposed to and the responsibility of all the sick patients on your service. Sometimes there's sleep as an afterthought, but I realized that it really has to be important.

Joe Cadwell: 49:36

And a big part of that is just empathy for your patients and something I think again, we all get so busy and sometimes people just turn into numbers on a chart or a name on a chart and in a way you go Correct. Again. My guest today is Dr. Jonathan Reisman, author of the unseen body. Jonathan. fascinating book. So many chapters. I hate to have to go lumped together some of our bodily fluids, but you had a whole chapter on urine, which I understand is your perfect personal favorite, bodily fluid, feces, mucus, all things that you know, a lot of people feel a little bit uncomfortable talking about. But you did such a fantastic job in your book of just breaking down the importance of each one of these bodily fluids, the mucus elevator that helps move debris and, and bacteria out of our lungs to fecal matter, and the image I cannot and I'm gonna blame you for this a complicated tube, how we started off as a flat desk, rolled into a tube have an entry point and an exit point, I am going to live with the rest of my life, thanks to you. But it really does seem like these bodily fluids once the complicated tube gets established that what a huge role they play in our health and well being. And so with that said, urine, feces, mucus, what would you like to talk about right now?

Jonathan Reisman: 51:00

Yes, so I think, you know, again, the unseen body, although a lot of those body bodily fluids are seen by each of us each day, you know, we live with them, we use the bathroom, it's part of our daily life as much as eating, but it's sort of the more hidden aspect of the body, the more personal and private, not something we talk about in polite company or dinner parties. But again, when I started learning about the human body started working in the hospital, you end up dealing with these bodily fluids that you think are gross kind of all day, every day. They're the medium of your craft when you're a doctor and you learn to interpret them and I'm constantly asking patients about their excretions and their mucus and their urine and is there blood in it and what color and consistency and amount and smell and everything else? And so you almost become a connoisseur of these bodily fluids, you know, almost like a wine specialist who can taste and smell all these subtle things in the wine you know, you become a you know, a gastroenterologist is a stool connoisseur and a urologist is a urine connoisseur, etc. A pulmonologist as a lung mucus or sputum connoisseur. I'm a generalist, because I like all the bodily fluids, I find them all interesting and all the body parts as well that make those bodily fluids. But urine is one of the more interesting ones I found, I found that nephrologist, actually who are kidney specialists who often look at the urine under the microscope and analyze it to figure out what's going on with the patient. They're really some of the smartest Doctors of any and in fact, most doctors would agree if you ask them what specialist is the smartest kind of doctor many will say nephrologist. And I think that's a reflection of how complicated the kidneys are, which make urine and also though how, how complicated sometimes it can be to analyze urine and interpret it. Most people have probably peed in a cup for their doctor to analyze, and then perhaps didn't think much more about what happens after that. But of course, as a medical student, I learned to how to kind of reveal all the secrets from urine and figuring out what urine can tell me about the human body that it flowed out from. So urine, it has a special place in the practice of medicine, because it can tell you so much. It's also quite convenient. You don't have to use a needle to get it you just have someone pee in a cup, which is which is pretty nice. And as I talked about in the book, urine has other interesting aspects that really captured my fascination because the kidneys are in charge of managing all the salts in our blood keeping sodium at the right level and chloride and everything else potassium, magnesium, calcium, the kidneys keep all those in the precisely correct range, not letting them get too high or too low, which can cause a lot of problems for us. And when I learned about the blood, which the kidneys titrate in that way, I've found that the salt levels in the blood are very similar to seawater. And I believe that's because we our ancestors sort of first formed in the in the ocean before we kind of crawled out onto land. And so our blood is as salty as seawater. Though we seem to live in a world of fresh water because we only drink fresh water without salt in it. We bathe in fresh water, we water our crops with fresh water. Of course you try to water your crops with salt water, you're gonna be in big trouble. And so even though we live in this freshwater world, it's actually our bodies are actually saltwater. And that's why when I give IV fluids to a patient, I give them always saltwater. It's always saline as we say which is saline solution.

Joe Cadwell: 54:35

Yeah. Which is awesome because freshwater introduced into the circulatory system would just cause havoc on the circulatory system and probably death, wouldn't it?

Jonathan Reisman: 54:43

Yes, if I were to infuse freshwater into a patient's IV, their red blood cells would explode, their brain would swell they would have seizures go into a coma and probably died. So it sort of only saltwater can really be in our hearts literally That's what our body is made of saltwater because we're from the ocean. And kidneys are sort of responsible for that for keeping the our blood salty for sort of carrying the ocean with us, even though we no longer live in it. And so as I say in the book, it's precisely because the kidneys make urine and in keep thereby keep all the salts in the right balance that we can carry around. This is the ocean inside of us.

Joe Cadwell: 55:25

Yeah, that's that was just fascinating to me, Jonathan, this has been a fantastic conversation. I really appreciate you taking the time to be on the show. Where can people go to find out more about your work?

Jonathan Reisman: 55:36

You can go to my website, Jonathan reisman.com. And that has all the information about my book, my other writings as well as my anatomy dinners.

Joe Cadwell: 55:45

All right. Well, thank you so much for taking your time to be on my show today. This has been a real pleasure.

Jonathan Reisman: 55:49

Thanks so much, Joe.

Joe Cadwell: 55:52

I guess today has been Dr. Jonathan Reisman, author of the Unseen Body. Find out more about Jonathan and his work, be sure to check out the show notes for this episode, or visit the grid nation website at grid nation podcast.com. And if you really enjoyed today's episode, please consider sharing it with a friend, family member or anyone else you think may get something out of it. As always, I appreciate your continued support. And until next time, this is Joe Cadwell. Thank you for wanting to know more today than you did yesterday. Do you only do those dinners in Philadelphia?

Jonathan Reisman: 56:24

Well, I just started sort of traveling with the show. So I weren't did most in Philadelphia but I just did some in Oxford, Mississippi. I have one in Washington DC later this month.

Joe Cadwell: 56:34

We've got a great scene here in Portland. So if you ever voted out this way, I would love to Dinner for one I know my wife will not join me for that.